A field study of persistence of antibodies in California horses vaccinated against western, eastern, and Venezuelan equine encephalomyelitis.

As a result of the continuing threat of Venezuelan equine encephalomyelitis (VEE), a study was made to determine if revaccination against VEE (TC-83 vaccine) was feasible and if revaccination could be incorporated into other routine vaccination practices. Of the horses given annual vaccination with bivalent western equine encephalomyelitis (WEE) and eastern equine encephalomyelitis (EEE) vaccine, 57% retained detectable serum-neutralizing (SN) antiboyd titers for VEE 18 months after the initial VEE vaccination was given. Of horses with no record of WEE-EEE vacinnation, 100% retained detectable VEE SN antibody titers over the same period. The VEE geometric mean titer was 25 times greater for horses not previously vaccinated against WEE-EEE than for horses given annual WEE-EEE vaccination at the time of VEE vaccination. In horses vaccinated against VEE 18 months previously, the geometric mean titer increased from 4 to 70 at 48 days after the intitial WEE-EEE vaccination. This increase indicated that similar antigenic factors for VEE are possibly present in bivalent WEE-EEE vaccine. In horses previously vaccinated against WEE-EEE and VEE, the best SN antibody response to VEE revaccination occurred when VEE vaccine was given simultaneously with the bivalent WEE-EEE vaccine. Of 150 serum samples tested by both the SN and the hemagglutination-inhibiton tests, agreement between positive reactions at greater than or equal to 1:10 was 70% for VEE, 81% for EEE, and 87% for WEE.


In vivo measurement of bone strain in the horse.

Strain gauges were successfully bonded in vivo to the cranial, caudal, medial, and lateral aspects of the equine radium and tibia and to the dorsal, palmar, or plantar, medial, the lateral aspects of the metacarpus and metatarsus--all in the mid-diaphyseal region. Various activities were investigated, including walking, trotting or pacing, and standing up from anesthesia. The strain patterns showed that each stride produced a characteristic deformation cycle. The strains were measured and the axial loads were calculated as the horse performed certain activities. The tension band side of each bone was predicted from the results. The tension band sides of the metacarpus and metatarsus were the dorsomedial and dorsolateral aspects; for the radius and tibia, the tension band sides were the cranial and craniolateral aspects, respectively.


Occurrence of second and third instars of Gasterophilus intestinalis and Gasterophilus nasalis in stomachs of horses in Kentucky.

The occurrence of 2nd and 3rd instars of Gasterophilus intestinalis and Gasterophilus nasalis was determined in 476 horses during the 22-year period from 1951 to 1973. Overall, G intestinalis infected 98.7% of the horses and averaged 168/horse; whereas G nasalis infected 80.7% of the horses and averaged 52/horse. Aggregate average total numbers for G intestinalis ranged from a low of 50 in September to a high of 229 in March, and for G nasalis, from a low of 14 in September to a high of 82 in February. Horses were infected by 2nd or 3rd instars of both species on a year-round basis. Differentiation between the instars provided insight into the dynamics of the infections. For G intestinalis, the data indicated (1) 2nd instars from the previous year's generation of flies continue to arrive in the stomach until April; (2) arrival of the current year's crop of 2nd instars starts in July; and (3) 3rd instars from the previous year's generation of flies are not voided in appreciable numbers until August, when numbers of the current year's crop of 3rd instars appear in the stomach. For G nasalis, the data indicated (1) arrival in the stomach of the current year's generation of 2nd instars starts in July and terminates in January and (2) 3rd instars from the previous year's generation of flies are voided over a period beginning in March and extending into August, when the current year's crop of 3rd instars begin to appear. Acquisition of infections of horses with G intestinalis is nearly a year-round process, except for April, because of the persistence of viable larvae in eggs for a prolonged period after development and fly activity has ceased in the fall. In contrast, infection with G nasalis is interrupted between December and May, because eggs hatch naturally after a short period of development, and fly activity ceases in the fall.


Efficacy studies with three formulations of cambendazole in horses.

Treatment with 3 formulations of cambendazole (paste, pellets, and suspension) was compared with thiabendazole treatment in 181 Quarter Horses (females and intact and altered males) of different ages in 2 experiments. The mean output of strongyle eggs, as measured by eggs per gram of feces (epg), was reduced by at least 95% by the 3 formulations of cambendazole compared with pretreatment epg and epg in simultaneously nonmedicated horses. Eggs of Parascaris equorum were seen in 19 of the younger horses in experiment I. Parascaris eggs were not seen in postmedication fecal samples from 14 horses treated wtih cambendazole. Of the 5 horses treated with thiabendazole, 2 had postmedication Parascaris egg counts.


Suppression of in vitro lymphocyte transformation by serum from dogs with generalized demodicosis.

Serum from dogs with generalized demodicosis suppressed the in vitro reactivity of peripheral lymphocytes to phytohemagglutinin. Suppression occurred with peripheral lymphocytes from normal dogs or from dogs with generalized demodicosis. Serums from dogs in remission were no longer suppressive. The data indicate that peripheral lymphoid cells obtained from dogs with generalized demodicosis do not respond differently in vitro to phytohemagglutinin than do lymphoid cells from normal dogs when either is cultured in the presence of serum from normal dogs.


Hypervitaminosis A in the dog.

Toxic effects of excessive vitamin A and of excessive vitamin ADE were studied in 9 mixed Labrador Retriever pups. Clinical signs were loss of body weight, dullness, emaciation, roughened coat, evident pain in limb joints, and retarded growth. Radiologic changes were decreases in overall length and thickness of long bones, development of osteophytes, periosteal reaction, and premature closure of epiphyses. Pathologic changes were degenerative epiphyseal plate, hemorrhage and exostotic proliferation of periosteum, fatty liver, and microcalculi in kidney. Toxic effects of excessive vitamin A did not appear to be so great when it was administered as vitamin ADE.


Experimental hexachlorophene intoxication in young swine.

Hexachlorophene (HCP) intoxication in swine was studied as a possible model of HCP poisoning in human beings. Swine were topically or orally given HCP each day, and observations were made on central nervous system function, hematologic measurements, serum chemical analyses, necropsy, microscopic examination of tissues, and concentrations of HCP residues in blood and tissue. Intoxication was observed in orally exposed swine, but the syndrome was not consistently produced in topically exposed swine. Signs and microscopic lesions were all related to dysfunction of the central nervous system, e.g., incoordination, paresis, and status spongiosus. Occurrence of signs and lesions, mortality rates, and concentrations of HCP residue were positively correlated with the dosage of HCP given.


Comparative electrophysiology and pharmacology of mammalian (including one marsupial) intercostal muscle biopsy preparations.

Characteristics of minature end-plate potentials (MEPP) of isolated external intercostal muscle preparations of 7 mammalian species (dog, cat, pig, horse, cow, and goat) including 1 marsupial (opossum, Didelphis marsupialis) were determined with intracellular microelectrodes. Mean amplitude (+/- standard error of MEPP for all species was 0.60 +/- 0.06 mV, and the range was 0.28 mV (opossum) to 1.07 mV (pig). Amplitude was inversely correlated (P less than 0.01) with muscle fiber diameter which ranged from 93 mum (opossum) to 51 mum (pig). Mean values for rise time, half-decay time, and frequency of MEPP for all species were 0.88 +/- 0.07 msec, 1.89 +/- 0.16 msec, and 0.44 +/- 0.12 MEPP/second, respectively. Species differences among these measurements were not statistically significant. Resting potentials ranged from 64 mV (pig) to 75 mV (cow and opossum). Amplitude of MEPP was reduced significantly by d-turbocurarine (0.06 muM) only in preparations from the dog (P less than 0.01), pig (P less than 0.05), cow (P less than 0.01), and goat (P less than 0.01), suggesting species variations in sensitivity to this neuromuscular blocking agent. Frequency of MEPP decreased in the prescence of d-tubocurarine, but the change was not significant. The techniques utilized in this study and the results obtained will have application in evaluation of intercostal muscle biopsy preparations from these species when affected by myasthenic diseases.


Interrelationships between athyroetic and copper-deficient states in rats.

Possible interrelationships of copper-deficient (copper-deficient ration) and hypothyroid (thiouracil treatment) states in rats were examined. Clinical signs, necropsy changes, and thyroxine concentrations were determined in 6 groups of rats treated as follows: group A--nontreated control; group B--thiouracil treated; group C--fed copper-deficient ration; group D--thiouracil treated and fed copper-deficient ration; group E--thyroid-stimulating hormone (TSH) treated; and group F--TSH treated and fed copper-deficient ration. Clinical signs occurred first and were most severe in the thiouracil-treated rats fed copper-deficient ration and included conformational changes and slower maturation, weakening of ear cartilage, middle ear changes (reflected by tilting of heads), and alopecia. Fatty infiltration of hepatic tissue was found in all rats fed copper-deficient rations, and considerable fluid retention occurred in rats fed copper-deficient ration and subjected to daily TSH treatment. Adrenal gland weights were 81% of control values (adjusted for body weight) in thiouracil-treated rats fed copper-deficient ration, and hypophysis weights were 114 and 154% of control values in thiouracil-treated rats and thiouracil-treated rats fed copper-deficient ration, respectively. Thyroid gland weights were 281% of control values in both thiouracil-treated rats and thiouracil-treated rats fed copper-deficient ration. Plasma thyroxine concentrations were markedly reduced (9% of control value) in thiouracil-treated rats fed copper-deficient ration. Thus, copper-deficient and hypothyroid states were considerably enhanced when the 2 existed concurrently, giving added meaning and necessity to close surveillance of trace mineral concentrations and thyroid gland status.


Attachment of Corynebacterium renale to tissue culture cells by the pili.

One or more cells of Corynebacterium renale strains (serologic types, I, II and III), which possessed numerous pili, frequently were attached to BHK-21 cells, primary dog kidney cells, and primary rabbit kidney cells. The percentage of the cultured cells to which C renal cells were attached was about 70%. The percentage was less with cells of C renale possessing fewer pili, around 30%. After C renale was treated with the homologous anti-pili serum, the percentage of BHK-21 cells to which bacterial cells were attached was even less (22%). In electron micrographs, the pili of C renale were observed to attach themselves to the membranes of BHK-21 cells. The adhesive property of the pili of C renale to tissue culture cells was thus demonstrated.


Cardiopulmonary measurements in nonanesthetized, resting normal ponies.

Cardiopulmonary measurements were determined in 19 nonanesthetized, normal ponies. Mean values for arterial pressure, pulmonary arterial pressure, cardiac output, heart rate, packed cell volume, and hemoglobin are reported, as well as acid-base determinations of arterial blood and cerebrospinal fluid. Respiratory function test data include total ventilation, respiratory rate, alveolar ventilation, oxygen uptake, and carbon dioxide output. The data compare favorably with the available data from previous reports on ponies. Because of large day-to-day variations in total ventilation, alveolar ventilation should be measured if ponies are used in the study of pulmonary function.


Internal parasites of Washington cattle.

The occurrence of internal parasites in Washinton cattle was estimated. During the survey period in 1972 and 1973, more than 3,700 fecal samples from 29 herds and 4 feedlots, and viscera from 55 cattle were examined. The percentage of fecal samples with parasite eggs or oocysts from herds was as follows: oocysts, 77%; "strongyline" eggs, 44%; Nematodirus eggs, 3%; Moniezia eggs, 3%; Fasciola eggs, 2%; Trichuris eggs, 2%; and Dictyocaulus larvae, 1%. The fecal samples from feedlots contained principally strongyline eggs which varied markedly in numbers among groups of cattle in the lots. The predominant parasite in viscera was Ostertagia spp, which was recovered from all of the cattle examined. Other parasites identified in the survey were found less frequently in these examinations. Cattle in dairy and beef operations utilizing irrigated pastures were particularly prone to Fasciola infections, and more strongyline eggs were observed there than in fecal samples from other management systems. Seasonal fluctuations in numbers of strongyline and Fasciola eggs were pronounced.


Respiratory complications of overdose with sedative drugs.

The records of 195 patients admitted to an intensive care unit with a diagnosis of sedative drug overdose were reviewed with special reference to respiratory complications. Endotracheal intubation with mechanical ventilation was required in 150 patients (77 per cent). Complications associated with mortality included difficult or traumatic intubation (P less than 0.001), initial hypotension (P less than 0.001), alveolar hypoventilation (P less than 0.02), and the presence of chest roentgenographic infiltrates (P less than 0.01). Infiltrates appeared on the chest roentgenograms of 72 patients (37 per cent) and were related to hypotension (P less than 0.05) and evidence of gastric aspiration (P less than 0.001). Eight of 9 deaths were due to progressive respiratory insufficiency, and bacterial pneumonia was documented at autopsy in 4 of 7 cases. High serum drug concentrations and the presence of shock or gastric aspiration on admission characterized the 9 patients (4.6 per cent) who died.


The role of the parasympathetic nervous system in the maintenance of chronic airway obstruction in asthmatic children.

To evaluate the role of the parasympathetic nervous system in the mediation and maintenance of reversible airway obstruction in perennially asthmatic children, we measured pulmonary function in 18 patients before and after the administration of atropine sulfate aerosol. The bronchodilatory effects of atropine were compared with those of isoproterenol hydrochloride and placebo aerosols. Placebo aerosol did not change any of the pulmonary functions tested. Atropine and isoproterenol aerosols improved forced expiratory flows, airway resistance, and specific airway conductance significantly and to the same degree. Hyperinflation was significantly lessened by atropine, but not by isoproterenol. Because atropine is not a direct smooth muscle relaxant, but rather a selective blocker of cholinergically induced smooth muscle tone, any significant improvement in the lung function of chronically asthmatic children by atropine suggests that at least some of their reversible airway obstruction is induced and maintained by parasympathetically mediated bronchial smooth muscle constriction.


Blood studies in untreated patients with acute asthma.

Arterial and venous blood samples were obtained from 23 patients with acute asthma before they received systemic or intermittent positive-pressure breathing therapy. Serum lactate, electrolyte, and enzyme concentrations, arterial pH, arterial PCO2, arterial PO2, peak expiratory flows, and 2,3-diphosphoglycerate concentrations were measured. The serum glutamic oxaloacetic transaminase, lactic dehydrogenase, and creatine phosphokinase activities were increased in 90, 81, and 38 per cent of the patients, respectively, and the individual values correlated poorly with the arterial PO2. In addition, there was a close correlation between the 2,3-diphosphoglycerate concentration and arterial PO2 (r = -0.75), indicating an active intraerythrocytic compensatory mechanism for enhancing O2 delivery operative in acute asthma.


Gas exchange in the pulmonary collateral circulation of dogs. Effects of alveolar hypoxia and systemic hypoxemia.

The left main pulmonary artery was ligated in 7 fully grown dogs. This resulted in an enlarged pulmonary collateral (systemic) flow to the left lung. By collecting gas from each lung separately, gas exchange in the pulmonary collateral circulation was studied and compared to that in the normal contralateral side. Studies were done repeatedly during a period of 3 years. Compared to that in the preoperative period, the ligated (left) side showed a decrease in ventilation (42.5 to 34.5 per cent of total), a marked increase in wasted ventilation (0.30 to 0.55), and a marked decrease in O2 uptake (45 to 11.2 per cent of total) and CO2 production (27.5 to 15.3 per cent of the total). There were no changes in arterial blood gases or pH. A significant, sustained, systemic hypertension was noted in all dogs in which the left main pulmonary artery was ligated (190/120). The mean blood flow through the pulmonary collateral circulation of the left lung with the dogs breathing room air was estimated to be 94 ml per min. When the dogs were made hypoxemic by breathing 12 per cent O2 through the normal right lung, there was a marked increase in pulmonary collateral (systemic) flow to the contralateral side (194 ml per min). This resulted in an increase in O2 consumption (29.4 per cent of total) and CO2 production (23.1 per cent of total) of the left lung. When the dogs were given 12 per cent O2 to breathe through the ligated left lung, there was no change in arterial PO2. There was a significant increase in blood flow through the pulmonary collateral circulation to 136 ml per min. Because of the gradient of O2 between the blood flowing into the left lung and that present in the alveoli, there was a net production of O2 from the left lung of 4.5 ml per min. When the pulmonary systemic circulation participates in gas exchange, it appears to increase during hypoxemia as well as during alveolar hypoxia.


Appraisal of a new test: Between-technician variation in the measurement of closing volume.

To determine the between-technician variation in the measurement of closing volume, 24 subjects were divided into 3 blocks of 8 subjects each. Each block was then tested by a pair of technicians. Each of the 3 technicians involved in the study tested 16 subjects. It was later necessary to reject the tracings of 2 subjects in one of the 3 blocks, leaving 22 for analysis. The N2 method of determining closing volume was used. The statistical analysis was performed separately on the following measures derived from the tracings: expired vital capacity, planimetry of the area under the curve, total lung capacity, closing volume as a per cent of expired vital capacity, and closing capacity as a per cent of total lung capacity. All tracings were assessed by each technician. Two separate analyses of variance were then carried out to determine, respectively, the components of variance in the administration of the test and in the interpretation of the tracings. Because different persons were able to administer the test the same way, it seems that closing volume poses no problem in administration, provided that instructions as to how to perform the test are closely followed. In the interpretation of the tracings, significant differences were found for all measures, except planimetry; however, not all of these have the same practical implications. Some tracings were found "difficult" to interpret and contributed more to the over-all variation than did others. When making use of a new test in a population study, the between-technician variation should be determined before the study is begun.


Human granulocyte lysosomal elastase activity using t-butyloxycarbonyl-L-alanine p-nitrophenyl ester and elastin-rhodamine as substrates.

Polymorphonuclear leukocyte lysosomal esterolytic activity on the synthetic substrate, t-butyloxycarbonyl-L-alanine p-nitrophenyl ester was observed to correlate well with polymorphonuclear leukocyte granule elastase activity measured on the natural substrate, elastin, bound to rhodamine. In addition, the effect of highly specific, irreversible chloromethyl ketone elastase inhibitors on leukocyte lysosomal elastase activity was similar, using t-butyloxycarbonyl-L-alanine p-nitrophenyl ester or elastin-rhodamine as substrate. Whether polymorphonuclear leukocyte lysosomal granules contain two different enzymes, a true elastase with esterase activity and a similar esterase without elastase activity, as found in the human pancreas, is, as yet, unknown. Both enzyme activities have been identified in isoenzymes of purified human polymorphonuclear leukocyte lysosomal elastase. The correlations observed between the two enzymes, if present in polymorphonuclear leukocytes, are sufficiently strong to use the esterase assay for clinical purposes.


The effects of dehydration on the radiologic and pathologic appearance of experimental canine segmental pneumonia.

In an attempt to determine whether dehydration (intravascular fluid depletion) alters the radiologic or histologic picture of segmental Streptococcus pneumoniae pneumonia, we induced pneumonia in 2 groups of dogs, group 1 (normally hydrated) and group 2 (dehydrated). Five hours after the intrabronchial instillation of a brain-heart-Streptococcus pneumoniae mixture, all chest radiographs of dogs in group 1 and 2 were compatible with segmental alveolar pneumonia. Histologic lung sections obtained as early as 2.5 hours after infusion of the brain-heart-Streptococcus pneumoniae mixture revealed intra-alveolar edema with a minimum of leukocytes. By 24 hours after infusion, both groups showed marked intra-alveolar collections of edema fluid, fibrin, and leukocytes. We conclude that in a canine model, moderate dehydration has no effect on the radiologic or histologic features of Streptococcus pneumoniae pneumonia.


Bronchial obstruction by incorporation of aspirated vegetable material in the bronchial wall.

The bronchoscpie, cytologic, and histologic features of a foreign body of vegetable origin embedded in the wall of a bronchus are described. The utility of bronchial biopsy in the diagnosis of this obscure cause of bronchial obstruction is emphasized, and the mode of treatment described.


Sporotrichoid Nocardia brasiliensis infection. Response to potassium iodide.

A lymphocutaneous infection due to Nocardia brasiliensis occurred in a Maryland gardener. This infection responded rapidly and completely to potassium iodide therapy.


Coccidioides immitis. A rare cause of pulmonary mycetoma.

Coccidioides immitis occurring as a fungus ball within a chronic pulmonary cavity has previously been reported twice and must be rare. We report a mycetoma composed of both spherule and mycelial forms of Coccidioides immitis, proved by culture and histologic sections. Fungus ball due to Coccidioides immitis is a logical progression from mycelia seen in the cavity wall in the active pulmonary coccidioidal lung cavity.


Lack of effect of rifampin on the antibody response to a viral antigen in patients with tuberculosis.

Twenty-three volunteer patients with pulmonary tuberculosis were studied for the effect of rifampin on humoral immunity. The patients were matched for age and body weight with other patients not on rifampin treatment. Antibodies to influenza virus were measured 18 days after immunization. At the clinical doses used and for the periods of treatment between 3 and 8 months no difference in humoral immune response was observed between patients treated with rifampin and the control subjects. All but one treated patient showed an increase of antibody titers after vaccination.


Pulmonary calcification in chronic dialysis patients. Clinical and pathologic studies.

A prospective study of 31 chronically hemodialyzed patients was made to investigate the incidence and pathology of pulmonary calcification and the relation of the latter to ventilatory function. Fifteen of the patients have died thus far; 9 had evidence of lung calcification. The lesions occurred predominately in alveolar septa and were associated with varying degrees of fibrosis and alveolar septal thickening. Only one patient had X-ray evidence of calcification. An X-ray diffraction analysis showed a predominant pattern of whitlockite (CaMg)3(Po4)2 in deposits. Patients with the severest pulmonary calcification had abnormalities of vital capacity, carbon monoxide diffusion, and Po2. Serum calcium levels were slightly higher in patients with calcification, but there was no measurable association with the duration of dialysis, serum phosphorus, calcium X phosphorus product, magnesium, bicarbonate, or arterial pH. These data show that pulmonary calcification occurs with high frequency in patients undergoing long-term hemodialysis and that such lesions are associated with restrictive and diffusion ventilatory defects.


Adult thyroid cancer after head and neck irradiation in infancy and childhood.

We report the surgical-pathologic findings in 15 adults who had a history of irradiation of the head and neck in childhood. These patients we selected for thyroid surgery because of a "cold" area or areas detected on 99mTc thyroid scan, with or without palpable thyroid abnormalities. Eight of the fifteen patients had thyroid cancer, and 3 had atypical adenomas. We found multiple lesions in 12 patients. Macroscopic and microscopic malignancy in a location different from the cold area or areas occurred in 5 of the 8 cancer patients. In vitro of these findings, we recommend that adults who received irradiation to the head and neck in childhood and who have been found to have an abnormal thyroid scan or thyroid examination, or both, have a total thyroidectomy...


Management of anaerobic infections.

Anaerobic infections are reviewed with emphasis on management. Most anaerobic pulmonary infections respond to penicillin G, even when Bacteroides fragilis (penicillin-resistant) is present. Clindamycin is suitable in penicillin-sensitive patients. Intraabdominal infections have a complex flora usually involving anaerobes, especially B. fragilis. It is desirable to use antimicrobial therapy to cover potential pathogens of all types. Surgical drainage and debridement are extremely important considerations. Anaerobic bacteria were found in 72% of 200 patients with female genital tract infections and were the exclusive isolates in 30%. Surgical therapy is primary, but antimicrobial and anticoagulant therapy are also important. A variety of soft-tissue infections involve anaerobes. Surgery is the major therapeutic approach. Anaerobic endocarditis is uncommon but may be difficult to manage. Chloramphenicol is ordinarily the drug of choice for brain abscess. New antimicrobial agents, which are under investigation and are promising, include new penicillins, new cephalosporins, new tetracyclines, and metronidazole.


Study of nitrogenase activity in the mycorrhizal rhizosphere of pine and oak.

No nitrogenase activity was observed in the rhizosphere of pine and oak having mycorrhizal associations. It is concluded that mycorrhiza did not play any role in stimulating the nitrogen fixing system. More work with pine and oak mycorrhiza by isotopic method is suggested.


[Interest of some additional biochemical tests for the classification of "Bacillus" (author's transl)].

In addition to previous taxonomic work, eight biochemical tests have been applied to the study of 580 Bacillus strains belonging to 22 species. The attack of chitin, melibiose and amygdalin can be used for the differentiation of some species. It is the same with most of the enzymes studied here, although Tween-esterase and DNase are often present in the majority of the isolates. RNase is still more frequent, being found in nearly all the strains. On the other hand, arginin-dihydrolase appears to be very rare and ornithin-decarboxylase seems always absent.


[Nutrition and taxonomy of "Enterobacteriaceae" and related bacteria. I. Technical procedure for auxanograms (author's transl)].

Study of nutritional capacities of 186 strains of Enterobacteriaceae or related bacteria has been undertaken for a taxonomic purpose. In this paper, the auxanographic method is described and discussed. Unlike other techniques in which the medium is supplemented by each substrate, at fixed concentration, the method described here consists in achieving diffusion of the 146 substrates tested as sole source of carbon and energy, in a medium without other energetic substrate. The results of these tests will be described in a further paper.


[The enzymatic hydrolysis of cell wall applied to yeasts classification (author's transl)].

The rigid structure of yeast cell wall may be a taxonomic criterion. Using the Helix pomatia juice (with mercaptoethylamine hydrochloride) as a polyenzymatic system, we have always obtained protoplasts from ascomycetous yeasts and never from basidiomycetous yeasts tested. Then, we have applied this enzymatic analysis to the Fungi imperfecti yeasts and, according to this test, separated genus looking like basidiomycetous behaviour: Trichosporon, Pityrosporum, Rhodotorula, Cryptococcus and non fermentative Candida (group II). Oppositely, we have put together the Fungi imperfecti yeasts looking like ascomycetous behaviour: Kloeckera, Trigonopsis, Brettanomyces and fermentative Candida (group I). With the second lytic system made of mercaptoethylamine-HCl and beta-(1-3)-D-glucanase, we have selected ascomycetous yeasts giving protoplasts: Saccharomycoidea with genus Saccharomyces, Kluyveromyces, Pichia, Hansenula, Citeromyces, Debaryomyces; we have joined Saccharomycodes and Hanseniaspora to this second group. The other ascomycetous yeasts studied did not give protoplasts with the definite lytic system made of purified beta-(1-3)-D-glucanase and thiol. These results seem to demonstrate that the structure of cell wall can act as an important taxonomic criterion.


[An intracellular polysaccharide involved in sporulation of "Clostridium butyricum" I. Cytology, production and preliminary enzymic analysis (author's transl)].

Free glucose concentration and polysaccharide production in Clostridium butyricum cells have been studied with an enzymatic method. Results indicated a substantial decrease in intracellular glucose content simultaneously with a production of polysaccharide prior to the end of exponential growth. Then the polysaccharide accumulated rapidly to reach a maximum just before the first refractile spores appeared, and it decreased by 50% during the last stages (V and VI) of sproulation. Electron micrographs of ultrathin sections have demonstrated that most of the polysaccharide is located inside the mother cell cytoplasm as large granules when the remaining is dispersed within the spore cytoplasm beginning during stage III of the sporulation. Overall results showed that production and use of C. butyricum polysaccharide were closely related to sporulation. The isolated polysaccharide exhibited poor water solubility, iodine spectrum with a lambda max at 545 nm and 72% beta-amylolysis. Total hydrolysis occurred with amyloglucosidase indicating an alpha-glucan containing alpha(1 leads to 4) and alpha(1 leads to 6) glucose linkages. The debranching from its beta-dextrin limit by pullulanase revealed the presence of a glycogen like-type structure with some external chains which are longer than those of a normal glycogen. This glycogen arrangement appeared to be of clusters linked by linear chains at least as long as the longest external chains.


[Isolation of water vibrios in Greece (author's transl)].

"Water vibrios" were isolated from 3 superficial wells in the province of Attika, from 3 rivers situated at about 300, 180 and 100 km North-West of Athens, and from 4 samples of sea water from the seashore South of Athens.


[On the taxonomy and physiology of bacteria utilizing hydrocarbons in the sea (author's transl)].

Using mineral media with gas oil as sole carbon source, 191 bacterial strains were isolated from the costal area of Marseille. These strains were attributed to Achromobacter, Alcaligenes, Pseudomonas, Acinetobacter and Arthrobacter genera. Amongst isolated strains there was a predominance of the Alcaligenes-Achromobacter group over others genera. Growth and respiratory activity of 5 strains were studied on hexadecane and acetate. Respiratory activity on hexadecane of 32 strains cultured on acetate has been measured. These strains could be placed in two groups. The group 1 shows an immediate respiratory activity which is not abolished by chloramphenicol. The group 2 presents either an immediate or a delayed respiratory activity which is always abolished by chloramphenicol. Maintenance or suppression of respiration by chloramphenicol is a character which is homogenously distributed amongst the species.


[Energy metabolism in the liver of rats fed a diet contaminated with dithiocarbamates].

Young male rats, Wistar CF strain, weighing about 100 g, were fed during 14 days with a well-balanced diet, but containing either 275 p.p.m. nabame, either 600 p.p.m. thirame or 3 600 p.p.m. zinebe. The animals given the non-contaminated diet were the controls. On the evening before the experiment, they were all fasted and some of them, forced to walk during 18 hours in a restraint wheel. On the morning of the experiment, some of the rats which have not been working were placed in a cold room at + 4 degrees C, and some others were given an i.p. injection of 2,6 g glucose per kg body weight. The animals were then killed, those that received the glucose treatment 30 mn after the injection, the cold-exposed rats 90 mn after the beginning of their exposure. The redox and energy potentials of the liver tissue were determined after the enzymatic assay of the following liver metabolites : lactate, pyruvate, beta-hydroxybutyrate, acetoacetate, ATP, ADP, AMP, inorganic phosphate. The thirame group rats had the smallest body weight and the lowest food intake. All the pesticides-exposed animals has a higher liver weight than predicted by their body weight. The pesticides-containing diets decreased liver lactate concentration and the lac/pyr ratio. Thirame was the more efficient and it partly impaired the glucose induced increase of the cytoplasmic redox potential, as estimated from the variation of the lac/pyr ratio. The pesticide-containing diets also lowered the liver concentrations of beta-hydroxybutyrate, acetoacetate, and their ratio. Last the pesticides, which but slightly modified the liver contents in adenine nucleotides and inorganic phosphate in the fasting state, increased the ATP fall following cold exposure and decreased the net ATP synthesis produced by glucose administration. The thirame diet was the more efficient in our experimental conditions, the zinebe diet the least one. It was concluded in our discussion that dietary dithiocarbamates either induced a hyperthyroidic status in the animal, or acted themselves as thyroxin-like compounds, because the liver metabolism was more directed towards heat production than towards that of chemical energy available for syntheses.


[Metabolism of L-ascorbic, L-dehydroascorbic and 2,3-diketo-L-gulonic acids during a short duration fast in guinea pigs].

Tricolor variety of guinea-pigs, two or three months old, received, without sex distinction L(+)-ascorbic or L(+)-dehydroascorbic acids intraperitoneally injections as 20 mg p. 100 by weight, three or twenty-four hours after starting a forty-eight hours fast. Ascorbic, dehydroascorbic and 2,3 diceto-L-gulonic acids are estimated by the Roe, Mills, Oesterling and Damron differential 2,4-dinitrophenylhydrazin method in whole blood, urines, kidneys and liver. Food absorption during twenty-four hours after the end of the forty-eight hours fast is not suffisant for guinea-pigs regain first state, during this time, especially in their kidneys and liver. Three hours after the beginning of the fast, urinary excretion of the injected acid increases during the first twenty-four hours of fast; at the end of the forty-eight hours fast their kidneys are deficient in ascorbic acid. Twenty-four hours after the beginning of fast, urinary excretion of ascorbic, dehydroascorbic and 2,3-diceto-L-gulonic acids rises importantly, especially when L-ascorbic acid is injected; it is only the quantity of ascorbic acid which increases in their kidneys and liver, its level being higher in their liver. L-dehydroascorbic acid is utilized immediately. L-ascorbic acid is distributed slowly, stored in a reduced form and it prepares the animals to face a prolonged fast. When the animals are injected three hours after the fast begins, it will be protected for forty-eight hours; if it is injected twenty-four hours after the beginning of fast, the animal will be better prepared to face a prolonged state of stress or a fast lasting more than forty-eight hours.


[Immunosuppressive effect of ethionine in rats. Resistance of this effect to methionine, tryptophan, ATP, adenosine and uridine].

One hundred eleven male adult rats of a pathogen-free Sherman or Charles River strain were divided into 3 series. Each of them contained non-treated controls and rats treated with intraperitoneal (i.p.) injections of DL-ethionine (E) [75 mg/d p. 100 g] for 6 weeks (series 1) or for only 2 weeks (series 2 and 3). Series 1 and 2 included also rats injected simultaneously with E and DL-methionine (68.4 mg/d p. 100 g). In the series 2 there were also groups receiving at the same time E, ME and tryptophan (5 mg/d p. 100 g) or E, Me and ATP (1.65 mg/d), and in the series 3, groups were injected with E + adenosine (31.2 mg/d p. 100 g) and (or) uridine (284 mg/d p. 100 g). All animals were immunized i.p. 1 week before killing with sheep red blood cells (SRBC): either 2.4 X 10(9) SRBC p. 100 g without adjuvant (series 1 and 2) or 1 X 10(9) SRBC with Freund's adjuvant added (series 3). Rosette-and plaque-forming cells (RFC and PFC) were counted in the spleen, and titers of serum hemagglutinins and hemolysins were determined with separation of 2-mercaptoethanol-resistant IgG from non-resistant immunoglobulins. E provoked within 2 weeks a drastic inhibition of the immune responses: drop in the RFC and PFC levels p. 10(6) (approximately 2900 leads to approximately 320 and approximately 415 leads to 40 respectively, in the study 3), and significant decrease in the serum antibody titer, especially IgG. Addition of Me still amplified the immunosuppression. Supplementation with tryptophan, ATP, adenosine and (or) uridine was also ineffective. Though not displaying any immunoprotective potency, Me partly neutralized the non-immunological effects of E: arrest of the body growth and involution of lymphoid organs and male genital organs, particularly apparent after 6 weeks of treatment. In conclusion, the ethionine-induced immunosuppression does not result from a metabolic exclusion of labile methyl groups or from an acute ATP deficiency due to an excess trapping of adenine as S-adenosyl-ethionine. Lack of pyrimidines or tryptophan must also be discarded. On the other hand, the possibility of maintaining the immunosuppressive activity of E, while reducing the toxicity of this compound, by addition of Me deserves to be emphasized.


[Maillard reaction. 10. Effects of premelanoidins on reproduction in rats].

The early soluble premelanoidins are obtained by a wet heat treatment (1 hour at 90 degrees C) of isomolecular quantities of glycine and glucose. It is know that these products decrease the nitrogen digestibility and the biological value of the diet. These premelanoidins are used as a well-balanced ration for the female rats at the rate of 2.15 g of degraded nitrogen by kg of diet. They disturb the reproduction phenomena: -- the fertility of the female is of 56 p. 100 instead of 76 p. 100 in the control females; -- the still-born youngs are twice more numerous and the intrauterine resorptions five time more numerous with the premelanoidin diet than with the control diet; -- the living youngs of experimental litters are 30 p. 100 less important than control litters. Yet, they have an lower weight at the birth and also at the end of the lactation phase. The damages induced by early premelanoidins can be imputed to an antinutritional character. of these substances, or -- more accurately -- to a nitrogen inefficacy that they could provoke. The premelanoidins have not a significant effet on the liver weight, but hypertrophy the kidneys and principally the caecum. The premelanoidin metabolism seems difficult and is similar to the lactose one.


Effects of diet and cold acclimation on lipid composition of rat interscapular brown adipose tissue.

The effects of diet and of cold acclimation on lipid composition of interscapular brown adipose tissue (BAT) were studied in rats. Three groups of animals were acclimated for 20 weeks to 28 degrees C (controls), 5 degrees C (CA) or to a daily fluctuating temperature (Cy). They received either normal fat (5 p. 100 lipids) [NF] or high fat (26 p. 100) [HF] diets. Cold acclimation increased the tissue weight and its protein, phospholipid, free fatty acid and cholesterol content. It decreased the total lipid proportion in the tissue. HF diet led to an increase in lipid content and to a decrease in the protein content only in control and Cy groups. The mean chain length of triglyceride or phospholipid fatty acids was increased by HF diet and cold acclimation. The proportion of unsaturated acids was not changed in cold acclimated rats, but the amount of arachidonic acid bound to phospholipid was significantly increased. It is concluded that the total amount of lipid in the diet acts on the synthesis of BAT lipids. The cold dependant changes in lipid composition which are similar but less important in cyclic cold acclimation than in constant cold adaptation seem to be proportional to the increase in the tissue energy metabolism.


[Lipid metabolism in rats fed a diet rich in various carbohydrates. I. Results after I.P. injection of lipogenic precursors].

Male rats, Wistar CF strain, weighing 120 g at the beginning of the experiment, were fed during 7 months with one of the following diets, containing 72 p. 100 (w/w) carbohydrate: starch, fructose, glucose and sucrose. These diets were about 18% (w/w) in protein content and were conveniently balanced with respect to vitamins and mineral nutrients. After an overnight fast, the animals received by the i.p. way, 30 mn before their killing, one of the following lipogenic precursors: glucose (considered as the control treatment), fructose ethanol or acetate, thus forming 16 experimental groups. In their liver, heart and blood were determined the concentrations of 6 lipid compounds: triglycerides, non-esterified fatty acids, free, esterified and total cholesterol, phospholipide. a. The sucrose diet gave the heaviest animals, with a liver and heart which were the richest in triglyceride content. They had also the highest liver and blood cholesterol, but their blood phospholipid was the lowest. The starch diet also increased, compared to the glucose diet, liver and heart triglycerides and liver cholesterol. As regards the fructose diet, it had the same effects than the sucrose one in elevating liver weight, blood triglycerides and cholesterol; conversely, it lowered liver and chiefly heart triglycerides and increased blood phospholipide. The glucose diet was for almost all parameters the one which displayed the lowest values. b. Relative to the glucose injection, other ones increased liver triglycerides, cholesterol and phospholipids and non-esterified fatty acids of the 3 assayed tissues. We observed that some differences between the effects of two given injections varied according to the previous diet, e.g. the sucrose-fed rats had more liver triglycerides and cholesterol, more heart and blood cholesterol after i.p. fructose than after i.p. glucose, which was not the case for the starch-fed animals. The importance of liver esterification reactions, which are increased with a long-term administration of a fructose-containing diet, is emphasized in the discussion. However dietary fructose could not be able to display its lipogenic effets in the absence of dietary glucose and that is why sucrose is more efficient than glucose in promoting a net lipid synthesis.


Cryotherapy of proliferative sickle retinopathy. Part I. Single freeze-thaw cycle.

Transconjunctival cryocoagulation was used to treat proliferative sickle retinopathy in 6 patients. Ten eyes were treated with a single freeze-thaw cycle and were observed for 3 to 18 months. Nine of 13 (70%) neovascular lesions were completely closed without occluding major vascular trunks, while the remaining 4 (30%) showed marked attenuation.


Macular hole following topical pilocarpine.

A unique case of macular hole following the instillation of pilocarpine is presented. Miotically induced vitreoretinal traction was postulated as the mechanism for hole formation.


Toxic maculopathy. Part I. A result of quinine usage.

A group of 16 heroin-dependent patients undergoing voluntary detoxification were studied to detect "toxic" quinine amblyopia." No true "amblyopia" was found but 8 of 16 (50%) patients had positive Amsler grid tests. This was called "toxic maculopathy." A control group of US Army reservists showed 1 of 25 (4%) to have positive Amsler chart tests. The difference between the two groups is significant and probably represents a chronic, low dose quinine macular toxicity. The strongly suggested relationship between chronic low doses of quinine and subtle macular changes led us to create a second study to document objective abnormalities. This study is presented in Part II.


Cysteine in corneal ulcer: part I. An experimental study.

This study was undertaken to see the healing effect of cysteine in corneal ulcer of traumatic origin (nonalkali burn). In both eyes of 11 albino rabbits, central corneal ulcers in a 5 mm diameter area were produced. Cysteine drops of 0.1 M were instilled in one eye while placibo (normal saline) drops were used in the other eye. This work was carried out as a blind study. The result of present work showed that the average rate of healing was enhanced with cysteine--it was 74 hours with cysteine while with placibo (normal saline) 98.7 hours. The statistical analysis of the present observation, ie, p and t value was highly significant.


The effect of light deprivation on the B-wave input-output function.

Adult cats were subjected to monocular light deprivation for periods ranging from 12 to 20 days. Deprivation resulted in a significant decrease in the slope of the dark-adapted b-wave amplitude-luminance (input-output) function, as well as what appears to be a truncatee amplitude-luminance function, it is exaggerated in the light-deprived eye.


Some clinical aspects concerning microtropia.

The present study is concerned with the specific nature and the multiformity of microtropia, which is characterized by unilateral convergent small angle (under 10delta) strabismus with amblyopia and abnormal retinal correspondence. Three types of microtropia may be distinguished: Type I: Showing a positive cover test, amblyopia and abnormal retinal correspondence. Type II: Showing in addition to the above, heterophoria. Type III: Showing a negative cover test, a positive 4delta base-out prism test, amblyopia due to anisometropia, eccentric fixation and harmonious abnormal retinal correspondence, where the angle of anomaly is equal to the angle to eccentricity. For the prevention of microtropia all children aged under 4 and irrespective of the presence of any symptoms should undergo an eye examination. At a more advanced age the diagnosis of this clinical entity is of importance chiefly from a prognostic point of view, because it permits us to avoid futile efforts at correcting visual acuity by means of covering up to sound eye.


Present surgical approaches to vitrectomy.

The present techniques of vitrectomy employ the open sky method (anterior approach) which is usually performed using cellulose sponges and blunt scissors, or the pars plana approach (transcleral approach) which uses a vitreous nibbler. The indications for each technique and the techniques themselves are briefly discussed. In addition, mechanical vitreous nibblers used for the open sky approach are reviewed.  The results of present techniques of anterior vitrectomy are better than the results obtained when no vitrectomy was performed for vitreous loss. The results of pars plana vitrectomy for certain pathologic entities compare favorably to results obtained in vitrectomies performed during keratoplasties. Newer surgical approaches to the vitreous and other technical advances promise to greatly improve the results of vitreous surgery.


Difficulties in the phaco-emulsification of soft senile cataracts.

Several difficulties arise when a surgeon embarks upon the Kelman-Phaco-Emulsification method of cataract extraction. The most common but yet the least expected are technical difficulties with a soft cataract. A step by step, illustrated method of avoiding the disasterous pitfalls is outlined in order to aid the novice or occasional surgeon using phaco-emulsification on the "ideal" candidates for this operation.


Limbal trepanation: fourteen years' experience.

Limbal trepanations on 264 eyes were observed postoperatively for 6 months to 14 years. Excellent results were obtained in patients over 35, particularly those in the 50 to 70 age group, with chronic open angle and chronic angle closure glaucoma. Results were poor in younger age groups, and in those with secondary glaucoma, especially where it was associated with inflammatory disease.


The absorbable sutures in cataract surgery.

An unusual case of cataract extraction is presented in which 6-0 chronic catgut sutures persisted over 2 years and 8 months and caused repeated attacks of conjunctival inflammation and iritis. This along with the discussion in this paper shows that despite is other advantages the chronic catgut is not a suitable suture for routine use in cataract surgery. However, because of the distinct advantages it is suggested that its use be limited to the selected cases, eg, in nervous persons where difficulty in removal of sutures is a problem.


Physiology and pathophysiology of the lower esophageal sphincter.

The physiologic factors controlling lower esophageal sphincter (LES) function are interrelated in a complex fashion and include the autonomic nerve supply, gastrointestinal hormones, and specific characteristics of the circular smooth muscle at the esophagogastric junction. It might be expected that a defect in any of these three controlling mechanisms would result in a clinically recognizable symptom complex. Abnormalities with either high or low LES pressure have been shown to relate to these specific aspects. Studies of the effects of various foods and other agents which decrease or increase LES pressure are of therapeutic interest in relating to patients with reflux symptoms. Decreases in LES pressure occurring after fat ingestion may explain a mechanism for many cases of fatty food intolerance. Pressure decreases after chocolate ingestion, after smoking, and after alcohol all have strong therapeutic implications in patients with chronic heartburn. Gastric alkalinization will increase pressure for up to one hour in patients with basal sphincter hypotension and reflux symptoms. Recent studies with drugs that work through the cholinergic mechanism have important therapeutic considerations. Anticholinergic agents produce definite decreases in LES pressure and are to provided in treatment of patients with reflux symptoms. On the other hand cholinergic drugs such as bethanechol have been shown to increase LES pressure in normal subjects and in patients with chronic sphincter incompetence. Recently, a double-blind therapeutic trial with bethanechol in patients with chronic heartburn has indicated that this drug, when given on regular basis, is an effective adjunct to therapy in these patients.


Early lung cancer detection and localization.

The Mayo Lung Project was established to develop and evaluate a screening program for early lung cancer in high-risk subjects. Men who are more than 45 years of age and who smoke one package of cigarettes or more daily are screened by the use of thoracic roentgenograms, three-day pooled sputum cytology, and lung health questionnaires at four-month intervals. These data are compared with data from similar subjects screened only on entry into the project. During the past three years, 34 patients who had no roentgenoraphic evidence of lung cancer were identified and examined because of carcinoma cells in sputum. Of these 34 patients, 27 have had bronchoscopic localization of their tumors and definitive treatment and 3 had upper respiratory tract neoplasms and also have been treated. Of the remaining four, one patient died suddenly after myocardial infarction and three patients have not had localization or treatment because of other severe complicating medical problems. Localization of roentgenographically occult lung cancer is reliable by the use of bronchofiberoscopy and meticulous, thorough sampling from the tracheobronchial tree. A search must be made for upper airway cancers in the same high-risk population, and the possibility of second primary bronchogenic tumors also must be considered. Although follow-up is short, 22 of the 27 treated lung cancer patients were found with stage I disease. The outlook for 19 of these 27 is encouraging an average of 16 months after surgical resection.


Clinical experience with pleuroscopy utilizing the bronchofiberscope.

The gas sterilized bronchofiberscope has been utilized as a pleuroscope for visual exploration of the pleural space and forceps biopsy of abnormal lesions in 16 patients with undiagnosed pleural disease. The instrument was inserted through a small (1-2 cm) incision. Aspiration of pleural fluid and instillation or aspiration of air to produce a controlled pneumothorax are easily accomplished through the instrument's suction channel. In eight patients with undiagnosed pleural effusion, biopsy of visualized nodules established the diagnosis of carcinoma. Three patients with bronchogenic carcinoma and pleural effusion had no pleural metastases at pleuroscopy which was confirmed in two patients who had thoracotomy and lung resection. Parenchymal subpleural nodules of metastatic carcinoma were confirmed by pleuroscopic biopsy in one patient. Biopsy via the pleuroscope was unsuccessful in two patients, one with pleural fibrosis, probably related to asbestosis, and one with mesothelioma. Both required open surgical biopsy of the pleura. There has been minimal patient discomfort and no serious complications.


Unexpected radiographic findings related to foreign bodies.

In two asymptomatic patients, routine preoperative radiographs revealed three pennies in the esophagus in one patient and a spring from a toy in another patient. In contrast two symptomatic patients, one with a flip-top cap from a beer can in the esophagus and the other with a piece of photographic film in the larynx, had negative findings on their radiographs. Salient points of the cases are that diagnosis can be delayed by inadequate history, misinterpretation of signs and symptoms, and unexpected radiographic findings. Special attention should be focused on the flip-top cap ingestion case. Sixty-five percent of 677 people polled have placed flip-top caps into full cans. Fifty-two people almost swallowed a flip-top cap. Otolaryngologists should be alerted about the radiolucency of this metallic foreign body, and the general population should be discouraged from this dangerous practice.


Special new low resistance to flow tube and endotracheal tube adapter for use during fiberoptic bronchoscopy.

This paper describes endotracheal tubes and adapters which are designed specially for fiberoptic bronchoscopy; the tubes are designed in such a way that they are wide at the upper part but are narrow and thin walled in the part of the tube which goes through and below the cords. By designing tubes in this manner, the resistance to flow of gas through the tube when the fiberoptic bronchoscope is in place is very much reduced and the safety of the whole precedure is enhanced. A special adapter for use under these circumstances is also described which utilizes a commercially available swivel tracheostomy adapter with a special silicone diaphragm fitted onto the top to enable the fiberoptic bronchoscope to be placed through the diaphragm and keep a sealed system. A plug is available for the hole in the diaphragm when the fiberoptic bronchoscope is not being  used. Clinical and laboratory data show that these pieces of equipment perform the function for which they were designed.


Evaluation of major airway lesions using the flow-volume loop.

The flow-volume (FV) loop is another way of representing spirometric data from combinations of forced expiratory and forced inspiratory vital capacity breaths. The FV loop is of use in identifying, and often localizing, lesions of the larynx and the trachea (down to the carina). Three general patterns have been recognized. When the lesion behaves in a fixed fashion (as might occur with an artificial orifice), maximal expiratory and inspiratory flows are almost equally compromised. This results in a rectangular FV loop, irrespective of whether the lesion is located intrathoracically or extrathoracically. When the lesion behaves in a variable fashion, two distinct patterns are seen, depending on the location of the lesion (intrathoracic or extrathoracic). The variable lesion acts as a fixed lesion during one phase of forced respiration only. The extrathoracic variable lesion results in a predominant reduction in forced inspiratory flow, with little effect on expiratory flow, whereas the intrathoracic variable lesion produces a characteristic reduction in expiratory flow. These patterns reflect the transmural forces existing at the site of the lesion.


Hyoid autograft repair of chronic subglottic stenosis.

A previously unreported surgical technique has been evaluated for the correction of chronic subglottic (cricoid) stenosis. The principle of skeletal support as the primary means of repair was examined. Severe stenoses were created in sixteen adult, mongrel dogs. One to three months later a hyoid bone autograft on a sternohyoid muscle pedicle was employed for repair. The dogs were sacrificed at regular intervals from two weeks to six months. The majority of the animals maintained a widely patent lumen after repair. Vocal cord mobility remained normal in every case. The results are illustrated by photographs and histologic sections. This study convincingly demonstrates a successful surgical technique for correcting a most difficult laryngeal lesion.


Postgraduate surgical training in Makerere. The crystallization of ideas.

The need for the postgraduate training of medical practitioners in the environment in which they will eventually work is well recognized, and in 1967 it was felt that the University of East Africa had reached sufficient maturity to undertake postgraduate instruction and certification in medicine. This paper describes the evolution and the present structure of the MMed (Surgery) degree at Makerere.


An antibiotic policy for surgical patients.

This paper offers guidance on antibiotic usage in surgical patients. A policy is outlined rather than the comprehensive coverage of every surgical situation. The principles of antibiotic prescribing are given. The antibiotics available and their routes of administration are reviewed. Indications for the prophylactic and therapeutic use of antibiotics are discussed. Factors causing the failure of antibiotic therapy are considered in brief.


A method of removing starch powder from surgeons' gloves.

A method of washing the outside of surgeons' gloves with cetrimide is described. Experiments on animals showed that the method resulted in a considerable reduction in the amount of intraperitoneal contamination by starch powder.


Perforated appendicitis--lavage or drainage?

A comparison was made regarding the observed frequency of intraperitoneal complications between two groups of patients operated upon for perforated appendicitis during a 5-year period (1968-73). The two groups, corresponding to two different general surgical departments at the same hospital, were given different forms of adjuvant treatment. The first group (78 patients) received postoperative intraperitoneal lavage, with antibiotics added to the lavage solution. In the other department (77 patients), the peritoneal cavity was drained postoperatively. No lavage was performed in this group, but antibiotics were given systemically. Sixteen patients in the drainage group developed intraperitoneal complications, as compared with 5 in the lavage group.


Fat embolism in severely injured patients.

Forty-five patients with severe blunt injuries were examined during eight posttraumatic days. At random, 14 patients were given three doses of methylprednisolone intravenously; 10 mg/kg at 8-hour intervals. Fat embolism syndrome was diagnosed in 13/45 patients, only one of whom had received corticosteroid (p = 0.03). Shock, acidosis and elevated plasma catecholamines showed no correlation with the occurrence of fat embolism syndrome. Platelet counts immediately after trauma were significantly lower in the fat embolism patients than in the other trauma patients, indicative of early platelet aggregation. Prophylactically administered methylprednisolone in pharmacological doses appeared to inhibit the emergence of fat embolism syndrome.


Hypogeusia, dysgeusia, hyposmia, and dysosmia following influenza-like infection.

Hypogeusia, with or without dysgenusia, and hyposmia, with or without dysosmia, followed an influenzal-like infection in 87 of 143 consecutive patients who presented at the Taste and Smell Clinic at the NIH with taste and smell abnormalities. Findings in this disease included pale nasal mucous membranes with marked patency of the nasal airway, a postive Rudolph sign, elevated detection and recognition thresholds for several tastants and odorants, disruption of the pore region of the tast dub observed on electron microscopy and infiltration of the upper lamina propria of the nasal mucous membrane wih chronic inflammatory cells observed on light microscopy. These findings, taken together, are relatively specific for the diagnosis of this surprisingly common disorder.


Cavernotomy in renal tuberculosis. Seven cases. Review of the literature.

During the period 1957--1973 the author treated 7 cases of renal tuberculosis where cavernotomy was performed. Some views presented in the literature concerning the development and the detrimental effects of renal cavities are discussed. The diagnosis is purely radiological. Because of impaired renal function, drip infusion urography is recommended for such cases. The indication for operation is an isolated focus near the renal surface containing active tuberculosis with presence of tubercle bacilli. Vascular circulation is impaired locally and renal function diminished. This consitutes a latent danger for the host. The present findings are discussed and compared with results from the literature.


Radiology and fine needle aspiration biopsy in the diagnosis of tumours of the kidney.

The value of angiography and fine needle aspiration biopsy in detecting, grading and staging of renal tumours was studied in 55 patients with renal tumours suspected clinically or on urography. 42 patients had malignant tumours. A correct angiographic diagnosis was made in 94% of the renal adenocarcinomas, the corresponding percentage for the aspiration biopsies was 71%. A combination of angiography and cytologic examination gave the correct diagnosis in 97%. In 4 cases of renal pelvic carcinoma the angiography showed extensive hydronephrosis only, the final diagnosis in these was cases achieved by fine needle aspiration biopsy. Angiographic staging of 30 renal adenocarcinomas was made according to the TNM system. The radiological staging was correct in 30% of T3 tumours, but in only 50% of T1 tumours and in one out of five T2 tumours. The difficulties seemed to be in determining the relation of tumours situated marginally near the renal capsule. Angiographic grading of the tumour was made according to the vascular pattern and the time of venous filling. Sparse vascularity and venous filling time of over 5 seconds was found in highly differentiated carcinomas and abundant vascularity and fast venous filling in neoplasms of moderate or low differentiation. The cytologic grading correlated fairly well with the histological grading. This study shows that angiography combine with fine needle aspiration biopsy provides good facilities for obtaining a correct diagnosis in renal tumours and preoperative information of the extent and degree of differentiation of renal malignant tumours.


Effective drainage of the bladder after transvesical prostatectomy.

The series presented consisted of 94 patients who underwent transvesical prostatectomy and whose bladders were drained by using a cystostomy tube (silastic) with an 8 mm lumen, in addition to a urethral catheter. Retention by blood clot was avoided. The wounds healed well, and no infection of the urinary tract occurred. The mean period of postoperative hospitalization was 9.5 days.


Vesico-ureteral reflux following transurethral slitting of the ureteral orifice.

A series of 14 patients treated with transurethral slitting of the ureteral orifice is presented. In 6 cases there was a stone at the distal end of the ureter and in 8 cases a ureterocele. Half the patients developed vesico-ureteral reflux. Other complications, such as urinary infection or renal scarring, have not been observed during the mean follow-up period of 47 months from the time of operation.


Effect of irrigation of vas deferens on sperm analyses after vasectomy.

70 men were operated for voluntary sterilisation by vasectomy alone and 20 men by vasectomy and irrigation of distal vasa with acid Kystosol solution. Postoperative semen analyses 2 weeks later showed azoospermia in only 2% of cases after vasectomy alone and in 25% of cases following vasectomy and irrigation, and 2 months postoperatively in 44% and 90%, respectively. Non-motile sperm cells in seminal analyses was the most common finding in both series 2 weeks after vasectomy. The problem whether the non motile sperm cells are viable or not is discussed. However, two azoospermic semen analyses must be obtained before sterility after vasectomy can be ascertained.


Non-traumatic chylous effusion in the thorax and abdomen.

A female of 31 with chyloascites and bilateral chylothorax is presented. The thoracic duct was obstructed below the diaphragm. The lymph vessels in the left iliac and para-aortic areas were enlarged and there were lymphocysts. When the lymph loss was greatest the patient was in a state of grave malnutrition with marked hypoalbuminaemia and an absolute and relative lymphocytopenia in the blood. "Malignant" cells were demonstrated in the chylous fluid, but no malignancy could be found at laparotomy. It is possible that the cells were confused with immature lymphocytes. The lymphatic cysts were excised and the lymph vessels ligated. Decortication of the right lung was performed. The patient recovered. The follow up time has been over four years.


Broncholithic casts. A case report.

A case of multiple broncholithic casts is reported. The diagnosis was made on clinical and radiological findings without histological verification. Tuberculosis was regarded as the probable cause.


Headache as a symptom of endometriosis externa.

Prior to an abdominal operation, 125 patients were asked if they regularly had headache during the menstrual period together with or without pain in the lower pelvic region. Pelvic pain patients with endometriosis externa reported headache significantly more often than those without endometriosis. Headache proved to be almost as common a symptom as lower pelvic pain in patients with endometriosis.


Multiple repeat caesarean sections on one patient.

A case history is presented of a patient with 8 consecutive caesarean sections over 1965--1973. Total hysterectomy was performed during the last section because of thinned uterine wall, marginal placenta praevia and heavy bleeding. The aspects of repeated caesarean sections are discussed in the light of the present case.


Luteectomy in early pregnancy. A report of three cases.

The exact day in early pregnancy when the corpus luteum could be dispensed with without deleterious effects on the pregnancy has been a matter of some dispute. It seems that there is a difference regarding the prognosis of the pregnancy if luteectomy or oophorectomy is performed where the corpus luteum alone could be dispensed with somewhat earlier. Three cases are presented. In case one luteectomy was performed at the end of week six or day 42 according to Naegele's rule. Plasma progesterone values decreased initially but increased steadily thereafter. No abortion occurred. Patient No. two was oophorectomized unilaterally at day 53 on the side where the corpus luteum was situated. She aborted three days later. Patient No. three was oophorectomized in the same was as patient No. two at day 49 and treated with Progesterone substitution thereafter. No signs of threatening abortion could be seen.


Blood lipid changes in musculoskeletal trauma of the rabbit.

After multiple long bone fractures, signs of excessive fat transport were observed in rabbits. Staining of albumen in the lipoprotein electrophoresis suggests an increased free fatty acid mobilisation. During the five day experimental period the beta lipoproteins increased while the alpha1 lipoproteins decreased. On the second post-traumatic day, the proportion of pre- beta lipoproteins increased simultaneously with a four-fold increase in plasma triglycerides. Some increase in cholesterol was also observed. An augmented de novo synthesis of fat is proposed as an explanation for part of the increased post-traumatic lipid transport. The changes were compared with a simultaneous occurrence of fat in the lung and kidney.


HL-A27 and arthritis.

In patients with recent inflammatory arthritis HL-A27 was seen in 6 out of 7 patients with ankylosing spondylitis, in 15 out of 18 patients with Reiter's disease, in 9 out of 12 patients with reactive postinfectious arthritis, in 22 out of 45 patients with rheumatoid arthritis, and in 2 out of 14 patients with other types of inflammatory arthritis. In two control series HL-A27 occurred in 46 out of 326 persons and in 3 out of 34 persons. The high frequency of HL-A27 in RA patients is in disagreement with previous results by other investigators. The explanation for this may be either that the diagnostic criteria do not apply at the early stage of the disease, or that there is a high prevalence of HL-A27 associated RA in Finland.


A population study of rheumatoid factor in Iceland. A 5-year follow-up of 50 women with rheumatoid factor (RF).

The subject of this paper is a 5-year follow-up of 50 women found with Rose-Waaler Titre greater than or equal 1 : 10 or with a Acryl Fixation Titre greater than or equal 1 : 10 in a general health survey conducted in the Reykjavik area in 1968-1969. The average annual incidence of RA was 2.3 percent. Of four women who died during the follow-up period, three were amongst those with the highest titres. Two of the decreased had cancer mammae and one had lung cancer. Changes in RF-titres and New York Criteria are also discussed. It is suggested that RF-positives could be divided in three different riskgroups.


Osmic acid treatment for rheumatoid synovitis.

47 patients with rheumatoid arthritis and synovitis were treated with intra-articular injection of hydrocortisone and 52 patients with both hydrocortisone acetate and osmic acid. In another series of 24 patients with synovitis in both knees were injected with osmic acid to the more seriously affected knee and with methylprednisoloneacetate to the other knee. Osmic acid gave better improvement than corticosteroid alone, although the difference between th groups of the latter series was not statistically significant. On the basis of previous investigations and this study osmic acid is one alternative to radiation or surgical synovectomy in rheumatoid synovitis. The therapeutic result is not always satisfactory but facility of treatment and minor side effects are the advantages of osmic acid therapy.


Radiation synovectomy of the rheumatoid knee with yttrium 90.

The use of radioactive yttrium (90Y) in the treatment of rheumatoid knee joints is described. Clinical results in 48 knees after a mean observation period of more than 3 years are reported: 60 percent excellent or good at one year, 46 percent at two years, 33 percent at three years and 17 percent at four years. The number of failures or relapses exceeded 50 percent between 30 and 36 months. The average rate of relapse in successful cases was 12.8 percent per year. The most important factors associated with unsatisfactory result were advanced articular destruction and progression of the systemic disease.


The pathogenesis of ankylosing spondylitis.

Various factors of possible pathogenetic significance in ankylosing spondylitis are surveyed, with the conclusion that ankylosing spondylitis may be due to more than one cause and have varying symptomatology: It is not a disease but a syndrome. Terms such as spondylarthritis ankylopoietica or ankylosing spondylitis, which have such direct reference to symptoms, are not necessarily applicable. It is difficult to find an adequate name, but Bechterew's sydrome is suggested.


Rheumatic fever in adult patients.

A study of rheumatic fever in adult patients (diagnosed according to the Jones revised criteria; Circulation 36: 664, 1965) was performed by examining 26 patients during the acute phase of the disease, and by re-examining 22 of them from 6 months to 64 months later (mean 33 months). Polyarthritis and carditis were the most common major manifestations. 23 patients had polyarthritis and 3 monoarthritis. 18 patients had signs of acute cardiac involvement. Carditis appeared to be rather benign: at the acute stage no patient developed congestive heart failure or any other serious complication. Five patients had erythema marginatum, but we saw no chorea or subcutaneous nodules. Of the 22 patients examined in the follow-up study, 4 had persistent signs of cardiac involvement and 15 showed chronic joint manifestations. Yersinia enterocolitica infection was by far the most difficult differential diagnostic problem, since polyarthritis and carditis associated with this enteric infection were very similar to those in patients with rheumatic fever. Current literature on rheumatic fever and the results of this series suggest that the diagnostic criteria of rheumatic fever (Jones) should be re-evaluated, at least in industrial countries.


[Androgens and regression of the Mullerian ducts in the male mammalian embryo(author's transl)].

1. The capacity of androgen biosynthesis by the mouse embryo testis was studied in vitro. Testosterone and androstenedione were obtained from 14C-sodium acetate by testes undergoing sexual differentiation (12-12 1/2 days). 2. the question was examined whether testosterone or any other androgen could be regarded as the causative factor in the regression of the Mullerian ducts. Mullerian ducts from 13-14 - day - old mouse embryos were cultivated in vitro in the presence of a crystal of either testosterone, dihydrotestosterone or androsterone, but in none case could any regression be observed. Our conclusion tends to support the earlier view expressed by Jost (1970) and Josso (1970 beta) which holds that the regression of the Mullerian ducts in the male mammalian embryo is brought about by a factor different from androgens.


[Ultrastructural study of the interrenal tissue in the Pekin duck(author's transl)].

The fine structure of the interrenal tissue in the Pekin duck has been studied utilizing intravascular perfusion method of fixation. The adrenocortical cells were found to contain considerable amounts of lipid droplets, mitochondria, ergastoplasm, endoplasmic reticulum and a well-developed Golgi apparatus. The subcapsular and central regions of the adrenal cortex can be distinguished mainly by the abundance of liposomes and mitochondrial size and shape.


Age-dependent rapid antiinsulin effect of hydrocortisone hemisuccinate during insulin induced hypoglycemia in white rat.

The effect of hydrocortisone hemisuccinate upon the intravenous insulin-induced hypoglycemia in various age-groups of white rats was studied. Insulin was injected intravenously in a dose of 10-(2) units per 100 g b.w. in the same age-groups of animals in a basal state, and 2 days later, 15 minutes after the i.p. administration of hydrocortisone hemisuccinate (0.5 mg/100 g b.w.). It has been estabished, that hydrocortisone hemisuccinate had a rapid anti-insulin effect, which is quantitatively different in dependence on the age of animals.


[Proceeding: Production rate, metabolic clearance rate and mean plasma concentration of cortisol in hyperthyroidism (author's transl)].

The adrenocortical function was studied in 23 patients with hyperthyroidism and compared with a group of 15 normal subjects. Parameters of adrenal function were determined with 1,2(3)H-cortisol. The half-life of cortisol is significantly shortened in hyperthyroidism, as compared to normal subjects (49,5 +/- 6,6 min vs 68,3 +/- 10,5 min) and metabolic clearance rate is increased (418,5 +/- 89,5 L/24 h vs 237,5 +/- 48,5 L/24 h, for normal subjects). The production rate of cortisol, calculated from specific and cumulate activities of THE and THF is increased in hyperthyroidism expressed as mg/24 h or mg/m2/24 h (respectively : 26,7 +/- 7,8 mg/24 h vs 15,7 +/- 3 mg/24 h and 16,9 +/- 4,6 mg/m2/24 h vs 9,5 +/- 1,8 mg/m2/24 h). The mean plasma concentration, calculated as the radio (see article) is not statiscally different in hyperthyroid and normal subjects (6,8 +/- 2,1 microg/100 ml vs 7,3 +/- 1,9 microg/100 ml). 7 patients were reinvestigated after treatment of thyrotoxicosis when they were clinically and biologically in euthyroid state. All the values were normalized, without statistically significant difference from control (T 1/2 = 65,4 +/- 18 min, Metb Cl. Rate : 255 +/- 64,5 L/24 h, production rate : 15,6 +/- 1,8 mg/24 h and 9 +/- 1,4 mg/m2/24 h. mean plasma concentration : 6,8 +/- 2,8 microg/100 ml). Shortened cortisol half life, increased metabolic clearance rate and production rate, and normal mean plasma concentration have been reported in hyperthyroidism (Peterson, Copinschi, Gallagher). These changes, secondary to thyroid hormone excess, are the consequences of increased hepatic catabolism of cortisol. The activity of 11 OH steroid deshydrogenase is increased, as demonstrated by increased ratio (see article) in normal subjects (0,001 less than p less than 0,005). There is a high proportion of 17 kéto metabolites (E, DHE, THE) whose feed-back effect is weak as compared to 17 OH metabolites (F, DHF, THF). The hypothalamo-hypophyso-adrenal system is stimulated to maintain a normal plasma concentration. The fact that the mean plasma concentration is normal despite the increased production rate suggest that changes are rather due to increased catabolism than to central effect of thyroid hormones.


[Proceedings: Cortisol-dependent glycogen storage and responses to insulin and glucagon in rat fetal cultured hepatocytes (author's transl)].

It has been shown that in primary cultures of rat fetal hepatocytes cortisol induces the development of glycogen storage ability. Cortisol has also a permissive effect in insulin action on the development of the glycogen synthetic pathway. However the regulation of glycogenolytic pathway by glucagon, which is present before any significant amount of glycogen storage, is not cortisol dependent.


[Annual and circadian rhythms in plasma testosterone of five healthy young male Parisians (author's transl)].

Every other month, during the course of 14 months, the circadian rhythm in plasma testosterone (among others variables) of 5 healthy males (26 to 32 years) was documented. Subjects' synchronization : light-on at 07 +/-  1 hr; light-off at 23hr +/- 1.5 hr all the year long. Blood sampling 4-hourly, at fixed clock hours during 28 hrs, for radioimmunologic testosterone determinations. The cosinor method was used for statistical analyses. An annual rhythm in the testosterone 24-hr mean is detected (p less than 0.025) with a peak in October (from 16 July to 26 December, with 95% confidence limits). Annual mean (+/- 1 SE) - 759 (+/- 26)ng/100 ml. Peak-through difference = 107 ng/100 ml (from 106 to 290 with 95% confidence limits). The timing of the testosterone circadian peak, in the 24 hr-scale varies also in the course of the year. The peak is found around 08(00) in May and around 14(00) in November, this phase-shift being statistically significant (p less than 0.05). The sexual activity (daily self-recording) also has an annual rhythm with a peak in October.


[Proceedings: Sulpiride effects on plasmatic gonadotropins in women (author's transl)].

The study of longitudinal evolution of plasmatic gonadotropins in women receiving sulpirid, a psychotropic drug with a strong anti-ovulatory effect, shows the coexistence of anovulation and the peristance of a physiological pattern of gonadotropins during the first cycle of treatment. It also shows the persistance of LH peaks comparable to preovulatory levels more than one year after the initiation of therapy. However, the basal line became very unsteady. This study suggests the presence of two types of perturbations with sulpirid. A hypothalamic-hypophyseal mild action and, an ovarian resistance to gonadotropins resulting from the hyperprolactinism induced by sulpirid.


[Proceedings: Interrelations between cholinergic and monoaminergic mechanisms in the determinism of spontaneous electrical activity in the central nervous system of scorpion (author's transl)].

Spontaneous electrical activity of the cerebral nervous system of Scorpion is characterized by potentials of 30 muV, and of average frequency varying between 200 et 400 impulses/min. This activity is enhanced by acetylcholine, and inhibited by adrenaline, nor-adrenaline, and serotonine, from a pharmacological study, it is assumed that spontaneous electrical activity of cerebral nervous system is due to cholinergic neurons, and antagonized by a serotoninergic system.


[Proceedings: Plasma renin activity in management of Addison's disease (author's transl)].

13 patients with Addison's disease, 7 men and 6 women, 19 to 61 years old, were investigated. Plasma Renin Activity (P.R.A.) is measured by radioimmunoassay of Angiotensin I (ng/ml/h) in the supine (S) and the upright (U) position. These patients are studied before treatment and under normal sodium diet in 11 cases: the P.R.A. value is constantly increased [5 men: MS = 10,09 (range: 6,2-12,5) and MU = 23,22 (range : 17,1-31,09), 6 women : MS = 24,48 (range : 3,46-45,04) and MU = 42,23 (range : 42,23 (range 17,37-69,34), to be compared with our normal values (M +/- S.D.) : MS = 1,02 +/- 0,39 and MU = 2,56 +/- 0,99 for men - MS = 0,82 +/- 0,14 and MU = 2,32 +/- 0,93 for women in follicular phase - MS = 1,45 +/- 0,56 and MU = 4,59 +/- 1,63 for women in luteinic phase. After dietary sodium restriction (10 mEq/24 h) in 2 cases, the P.R.A. is significantly increased with respect to the basal value]. Under Hydrocortisone alone (25 to 30 mg/24 h) and normal sodium diet, 4 patients kept significantly increased P.R.A. values. Under Hydrocortisone (20 to 40 mg/24 h) and 9-alpha-fluorohydrocortisone (50 to 100 microgrammes/24 h) for 6 days to 14 months, the P.R.A. value decrease into the normal range [men : MS = 1,02 (range : 0,54-1,92) and MU = 1,68 (RNAGE : 0,81-2,57) - 2 Menopausal women : MS = 1,55 and MU - 1,16. The P.R.A. measurement seems useful in the adaptation of Addision's disease treatment.


[Proceedings: Prolactin adenoma revealed by gemellary? pregnancy after clomiphen therapy. Hypophysectomy during 5 th month of pregnancy (author's transl)].

A 25 year old woman had galactorrhea and secondary amenorrhea since her first pregnancy at 20 years. After several treatments with Clomiphene, menses reappeared for 2 months and she became pregnant. At admission, she was in her 4th pregnancy month and had headaches and bitemporal hemianopsia. Hypophysectomy was performed during 5th pregnancy month. Prolactin adenoma with hemorragic lesions was found. Parturition of normal twins occurred 8th month. Partial hypophyseal recovery took place for the following 2 years, but hyperprolactinemia reappeared too.


[The limits and boundaries of De Morsier's syndrome (based on 33 personal cases) (author's transl)].

If De Morsier's syndrome represents the priviledged anatomo-clinical pattern of olfacto-genital correlations, the deteriorations of the sense of smell are not exclusively due to it. After having studied olfaction very precisely in 101 cases of hypogonadism, the authors report 17 cases of olfacto-genital displasia and bring out a clear hyposmia in other affections: Klinefelter's syndrome (25,7%), congenital anorchidism, puberty delay. A part from th: physio-pathological interpretation of these facts, there arises the problem of the precise nosological limits of De Morsier's syndrome.


[Proceedings: Effect of oestrogens and diet on lipids in the plasma of castrated rats of both sexes (author's transl)].

The hypertriglyceridemia after treatment with oestrogens by the castrated rats is of the same amplitude in both sexes with regimes enriched with saccharose or with beaf fat or with both. The gonosomes not influenced the hypertriglyceridemia after treatment with oestrogens.


[Progesterone administered by percutaneous route: an antiandrogen locally useful (author's transl)].

A skin specimen has been obtained from 5 volunteered men submited to a percutaneous administration of progesterone. Plasma progesterone, testosterone and dihydrotestosterone were evaluated before and after this treatment. Progesterone percutaneously administered does not change plasma testosterone and dihydrotestosterone and only slightly increases plasma progesterone. On the contrary, in the skin samples obtained from subjects percutaneously treated by progesterone, radioactive testosterone was not converted to dihydrotestosterone by skin homogenates. In conclusion, progesterone when percutaneously administered inhibits testosterone 5alpha-reduction and may be considered as an antiandrogen locally useful.


[Proceedings: Study of a new steroid: the 3beta,5alpha-tetrahydro-deoxycorticosterone (3alpha,5beta-tetrahydro-DOC). Its significance during pregnancy (author's transl)].

The physiological significance of a new steroid: the 3beta, 21-dihydroxy-5alpha-pregnan-20-one (3beta,5alpha-tetrahydro-DOC) was studied during human pregnancy. The urinary excretion values in the first and second trimester of pregnancy are 100-400 mug/24 h and in the third trimester the values increase to 240-1080 mug/24 h. This compound is not found in men nor in non-pregnant women but is found in the urine of newborns (2-12 DAYS): 25-80 mug/24 h. After perfusion of the fetus with H-deoxycorticosterone, 3H-3beta, 5alpha-tetrahydro-DOC was found in the fetal liver. These data suggest that this steroid could originate in the fetus: parallel studies of the urinary excretion of the other isomer : 3alpha821 dihydroxy-5beta-pregnan-20-one (3alpha,5beta-tetrahydro-DOC) shows that this compound increases at the end of pregnancy but its excretion rate is 2-3 times less than that of 3beta, 5alpha-tetrahydro-DOC.


[Proceedings: Iodine metabolism in isolated human thyroid cells (hyperplastic goitre and toxic adenoma) (author's transl)].

We present here data on hormone synthesis and thyroxine secretion by isolated human thyroid cells. Thyroid cells were dispersed by trypsinization. Thyroid tissue was surgically obtained from two euthyroid patients with hyperplastic goitre and from two thyrotoxic patients with toxic adenoma. In 6 hr incubation experiments, we observed that isolated human thyroid cells, i) concentrated iodide, ii) synthetized iodothyronines, iii) released thyroxine in the incubation medium. Each parameters was TSH dependant. That thyroxine release was due to a secretion process is suggested by similar and further documented data obtained with isolated hog thyroid cells. This technique may provide further help for thyroid physiopathology investigation in humans.


Data on the HL-A linkage group.

Lod scores from a study in 229 families of the linkage relations of HL-A-PGM3 to 19 marker loci and cystic fibrosis are reported. The data exclude that ADA belongs to this linkage group while they give weak support for the inclusion of P. There is weak evidence for linkage of cystic fibrosis to PGM3, but none for linkage to HL-A. No new suggestive linkages appeared.


[Radioautographic study of the action of androgens on the synthesis of nucleic acids in the male genital tract of the white mouse (author's transl)].

A comparison was made, by autoradiographic studies, of the nucleic acids synthesis in the target organs of the male hormone, in normal mice, castrate and castrated mice with an implantation of a testosterone pellet. The results show that the response of each of these organs, to a physiological supply of hormone or to a supraphysiological supply is quite different, both in intensity and in evolution. The differences are still apparent in castrated animals. The transfer of RNA from the nucleus to the cytoplasm seems to be affected by the castration. The signification of these results is discussed.


[Proceedings: Peroxydase activity in benign thyroid diseases and in experimental rat goiters (author's transl)].

Peroxydase activity in various benign thyroid diseases has been investigated. In hyperthyroid patients treated with antithyroid drugs, the observed increase in iodide-peroxydase activity (7 times that of normal tissue) is double than that of the DNA content. In goiter, the activity is 3 times that of normal tissue while the DNA content is unchanged. These results are in agreement with those obtained in rats maintained on a low iodine diet suggesting that high cellular enzymatic activity is due to specific enzyme induction in excess of cell proliferation and protein synthesis.


Genetically determined polymorphism of a form of hexokinase, HK III, found in human leucocytes.

1. A form of hexokinase which appears to correspond to HK III, seen in liver, spleen and lung, has been identified in human polymorphonuclear leucocytes. HK III activity has not been demonstrated in lymphocytes, permanent lymphoblastoid cell lines or in cultured fibroblasts. 2. In fresh leucocyte preparations HK III usually appeared as a single band, but in extracts of post-mortem tissues multibanded patterns were seen. Leucocyte preparations also give multi-banded patterns after storage for more than a few hours. 3. In certain individuals the HK III showed a two-banded pattern even in fresh preparations. Repeat samples and family studies suggested that this pattern was genetically determined and represented a heterozygote for a common allele HK1III and a less common variant HK2III. Out of a total of 330 English people successfully tested 10 probable heterozygotes were found. 4. It is suggested that HK III may be a monomeric enzyme whose genetic determination is independent of that of the other main forms of hexokinase.


[Proceedings: In vitro thyroid hormone formation (author's transl)].

Iodination of a non halogenated goiter thyroglobulin and the resulting thyroxinogenesis was studied in vitro with purified thyroid peroxidase, H2O2 generating system and various concentrations of iodide. The rate of iodination was linear during the first minutes of incubation but thyroxine synthesis only began after a lag period whatever the iodide concentration in the incubation medium was. With high iodide concentrations a highly iodinated thyroglobulin (40-50 iodine atoms) containing no thyroxine was obtained after 3 minutes of incubation. If this highly iodinated goiter thyroglobulin was purified and reincubated with peroxidase and H2O2, thyroxine synthesis was again observed only after a lag period (2-3 min). In the absence of iodide the enzyme to elicit thyroxine synthesis. Depending of its concentration free diiodotyrosine exerts two opposite effects on the reaction catalyzed by thyroid peroxidase : at high concentration (10(-4) M) in inhibition of thyroglobulin iodination, and at low concentration (10(-7), 10(-8) M) a stimulating effect on thyroid hormones biosynthesis.


Premature centromere division: a mechanism of non-disjunction causing X chromosome aneuploidy in somatic cells of man.

Apparent acentric fragments which replaced a C-group chromosome in cultured blood lymphocytes from a woman patient were shown by autoradiography, G-banding and C-banding to be complete X chromosomes in which the centromere had divided prematurely in relation to the centromeres of other chromosomes in the same metaphase. Metaphases with multiple 'fragments' suggested that non-disjunction of the 'fragments' had occurred. This anomaly of the X chromosome was associated with increased aneuploidy of a C-group chromosome, presumed to be X. Premature centromere division of the X chromosome (PCD, X) appeared to be a mechanism of non-disjunction which caused significant monosomy and trisomy of the X chromosome in blood cells and skin fibroblasts. The frequency of cells with multiple fragments and the extent of the aneuploidy in 48 hr. blood cultures indicated that this mechanism of non-disjunction operated during mitosis both in vivo and in vitro. Premature centromere division occurred at a lower frequency in normal women donors, and was age-related, being four times more frequent in women 60 years and older than in women under 40. Associated with the higher frequency of PCD, the older women also showed evidence of increased X chromosome aneuploidy. Premature centromere division of the X chromosome is considered to be the mechanism of non-disjunction, causing the well-documented increased number of 45, -C metaphases in ageing women. Premature centromere division was rare in men, but an age effect was again suggested.


Quantitative linkage: a statistical procedure for its detection and estimation.

A new approach for detecting and estimating quantitative linkage which uses sibship data is presented. Using a nested analysis of variance design (with marker genotype nested within sibship), it is shown that under the null hypothesis of no linkage, the expected between marker genotype within sibship mean square (EMSbeta) is equal to the expected within marker genotype within sibship mean square (EMSe), while under the alternative hypothesis of linkage, the first is greater than the second. Thus the regular F-ratio, MSbeta/MSe, can be used to test for quantitative linkage. This is true for both backcross and intercross matings and whether or not there is dominance at the marker locus. A second test involving the comparison of the within marker genotype within sibship variances is available for intercross matings. A maximum likelihood procedure for the estimation for the recombination frequency is also presented.


[Proceedings: Kinetics and disposal rate of triiodothyronine in patients with atuonomous hot nodular goiter, with or without thyrotoxicosis (author's transl)].

Eight female patients are studied, four of them without hyperthyroidism. The following were measured before and after surgery = hormonal iodine by column, serum concentrations of T T3, AF T3, TSH, total T3 distribution space, T3 pool size T3 fractional turnover rate. T T3 is measured in the serum of peripheral venous blood, nodular venous blood and of jugular venous blood of the opposite side of the adenoma. Before surgery, the mean of T T3 in patients with hyperthyroidism is increased in serum obtained from brachial and not nodule venous blood. Are also increased AF T3 and T3 production rate. In patients without hyperthyroidism, T T3, AF T3 are increased in two subjects only, but T3 production rate is rised among three of them. After surgery the previous values are not different with normal values. These data are in good agreement with the hypothesis that, in patients without thyrotoxicosis, there is an increase in T3 production from not nodular goiter. There phenomena may explain unresponsiveness to TRH test and inactivity of normal thyroid. Absence of hyperthyroidism may be due to a lack of sensitivity of peripheral tissues to the increase of T3.


A non-parametric test for linkage with a quantitative character.

A non-parametric test for the detection of linkage between a quantitative and a mendelian character is described. It can be applied to families of three, two or one generations. The limitations, advantages and disadvantages of this test are discussed.


Phenylketonuria as a balanced polymorphism: the nature of the heterozygote advantage.

Mothers of children with phenylketonuria have a significantly lower miscarriage rate than a matched control population in Ireland and west Scotland. This protective effect of the gene against some factor causing foetal death would seem to constitute a heterozygote advantage which might account for the previously observed polymorphism for phenylketonuria. It is suggested that the decrease in foetal mortality is mediated by the higher concentration of phenylalanine in the heterozygous mother's blood, but that this is not a simple nutritional effect of an increased supply of an essential amino acid leading to increased protein deposition.


Linkage data on red cell acid phosphatase from family studies.

An analysis of the linkage relationships of red cell acid phosphatase (ACP1) with 36 other loci is presented. Close linkage is excluded for many loci. The hint of loose linkage with MNSs is not statistically significant, nor is it apparently consistent with the assignment of ACP1 and and MNSs to different arms of chromosome 2.