Effect of protein/energy nutrition on rat plasma corticosteroids and liver microsomal hydroxylase activity.

Three groups of 24-day-old male Wistar rats were fed (a) a control diet containing 210 g/kg protein ad libitum (control) (b) a low protein diet consisting of the stock diet diluted with starch to contain 70 g/kg protein ad libitum (protein deficient) or (c) an amount of stock diet containing the same amount of protein as eaten by (b) but without starch (energy deficient). The low protein diet did not affect the ability of the animals to metabolize biphenyl and excrete it as 4-hydroxybiphenyl, or reduce the total activity of 4-hydroxylase per liver, whereas this was reduced by restricted amounts of the high protein diet. The low protein diet resulted in raised levels of corticosteroids in the plasma. It is concluded that the raised specific activity, and unchanged total amount of biphenyl 4-hydroxylase per liver of the low protein animals is an adaptation to the diet mediated by corticosteroids as exogenous corticosteroids were also found to increase the activity of this enzyme in normal animals.


Effects of orciprenaline on uterine contractility and maternal heart rate. A quantitative study.

Amniotic pressure and maternal heart rate were recorded continuously and simultaneously in 15 women in labor or prelabor. Orciprenaline (Alupent) was administered through an intravenous infusion pump at the rate of 10 and 20 mug/min. Uterine contractility and maternal and fetal heart rate were measured before its onset and during the infusion. The development and stabilization of the effects were studied. Continuous intravenous infusions of orciprenaline at rates of 10 and 20 mug/min are recommended. They proved to be very useful in obtaining uterine inhibition with a minimum of undesirable side effects.


Risks of fetomaternal hemorrhage resulting from amniocentesis with and without ultrasound placental localization.

The incidence of multiple abdominal punctures, blood-stained aspirates, and fetomaternal transfusion was compared in patients undergoin amniocentesis at various stages of pregnancy with and without prior placental localization by ultrasound. A lower incidence of complications was found in those on whom ultrasound examination had been performed.


Ovarian tumors in pregnancy. An ovarian tumor registry review.

Among the 2300 cases accumulated in the Emil Novak Tumor Registry between the years 1942 and 1972, there were 100 examples of ovarian neoplasia associated with gestation. Lutein cysts or luteomas were excluded since such lesions usually represent physiologic responses of the gonad to increased levels of chorionic gonadotropin. Only 10 cases of dermoids (benign cystic teratomas) were reviewed. We believe this to be the largest series reported in conjunction with pregnancy. There was a total 5-year salvage rate of 76%, which is obviously much greater than with ovarian tumors in general, although there are certain patients alive with a late recurrence. This excellent survival rate seemingly reflects the low-grade malignant potential of many of the neoplasms encountered during pregnancy. However, certain cases of extremely aggressive and advanced ovarian tumors as noted at operation seemed to do surprisingly well following termination of pregnancy, and one must speculate whether gestation impairs antibody response with an apparent immunologic rebound postpartum.


Congenital absence of the vagina. Clinical and psychologic aspects.

Seventeen patients with congenital absence of the the vagina are presented. The clinical results of conservative and surgical treatment are briefly described. Psychologic problems produced in the patients by knowledge of the anomaly and following the operative procedure were studied by a retrospective interview technique and are discussed. It is concluded that the gynecologist and psychologist must together undertake psychologic preparation of the patient for the operation--and its mental aftermath--as early as possible if the best clinical and psychologic results are to be obtained.


Urologic and genital anomalies in patients with congenital absence of the vagina.

Forty-three patients with primary amenorrhea secondary to congenital absence of the vagina have been seen at this institution over the past 25 years. Associated urologic anomalies were present in 47% of patients in whom evaluation of the urinary tract was performed. Two patients recently presented with the rare combination of vaginal agenesis and solitary pelvic kidney, and one other such patient was found in a retrospective study of these records. A review of the literature concerning the associations of these conditions is presented with reference to frequency, embryology, pathophysiology, diagnostic methods, and various surgical procedures for correction of vaginal agenesis. The results of surgical correction using simple techniques in this institution have been comparable to those of other authors. The need for thorough preoperative evaluation of patients with genital malformations to include complete urologic studies is stressed.


Olfactory, auditory, and gustatory function in patients with bonadal dysgenesis.

The olfactory, auditory, and gustatory functions of 20 women with gonadal dysgenesis were studied. Various abnormalities of these functions were found, and they occurred principally in patients with mosaicism of the sex chromosomes. This is further evidence of the increased likelihood of various somatic abnormalities among women with gonadal dysgenesis, and particularly among those who carry more than one line of sex chromosomes.


Scanning electron microscopy of cervical mucus crystallization.

The crystallization phenomenon of human cervical mucus was studied with the scanning electron microscope. Changes in the conformation of the crystals, crystal conglomerates, and ferning patterns occurred almost daily. During the very early and late stages of the cycle two types of crystals could be found, one columnar and the other flat. At the other times, the columnar crystals were absent and the flat crystals changed their shape to cuboidal. During the follicular phase, these cuboidal crystals were initially located in small groups, then in parallel rows, and finally in three types of ferning patterns, one seemingly typical for the time of ovulation. These patterns reversed during the luteal phase of the cycle. The scanning electron microscope appears to be an extremely useful instrument for the evaluation of these phenomena.


Unilateral tubo-ovarian abscess and intrauterine contraceptive devices.

The association of unilateral tubo-ovarian abscess and the presence or use of an intrauterine contraceptive device (IUD) appears to be a definite clinical entity. Four cases of unilateral tubo-ovarian abscess in patients using the IUD are presented. Three patients had a Dalkon Shield IUD and one had a Lippes Loop. Two patients had unilateral salpingo-oophorectomy while the other 2 had total abdominal hysterectomy and bilateral salpingo-oophorectomy. The differential diagnosis, possible etiology, route and mode of infection, and management are discussed.


Therapy of advanced epidermoid carcinoma of vulva. Report of 13 patients, with review of recent literature.

Exenteration for Stage IV cancer of the vulva is feasible and desirable, with expected 5-year survival rates of 34-57%. A team of gynecologic oncologists operating simultaneously has the cohesion to reduce operating time, surgical fatigue, and perhaps morbidity and mortality. Data indicate that ultraradical surgery in the 71-year and over age group is nonproductive of salvage and should be individualized critically. Patient selection, attention to detail, and use of the proper surgical procedure are all important in improving results.


Factors affecting survival in stage I and state II carcinoma of the cervix.

Eighty-eight cases of Stage I and Stage II carcinoma of the cervix treated with radiotherapy at the University of North Carolina Memorial Hospital between April 1969 and July 1971 are reviewed. The question of whether the radiation time-dose-fraction relationship can be applied to the combination of external beam and intracavitary therapy used in the treatment of cervical carcinoma is studied. Formulas are outlined which enable one to calculate a total Rad Equivalent Therapy (RET) value, including the contribution from both the fractionated external beam and intracavitary therapy. Both the calculated RET value and the rad dose to Point A show good correlation with control of local disease in this retrospective analysis; however, the RET value may be more applicable when deviations from the standard time-dose-fraction relationship have occurred.


Progesterone and estradiol patterns in women using an intrauterine contraceptive device.

Levels of progesterone, estradiol, LH, and FSH were measured in daily serum samples obtained from 4 subjects during a control cycle and during the first and fourth menstrual cycles after insertion of an intrauterine device (IUD). In addition, progesterone and estradiol were measured in serum samples obtained from 6 women 3, 4, or 5 months after IUD insertion, and from 6 women more than 1 year after IUD insertion. These measurements were compared to the data obtained from study of a large group of normal cycles. The results indicated that the IUD does not influence follicular maturation, time of ovulation, or corpus luteum function. The IUD did exert a local effect on the endometrium, causing the onset of menses to take place when steroid levels were higher than in control cycles.


Liver tumors and oral contraceptives.

Benign hepatocellular neoplasia has been found in 23 patients receiving oral contraceptives of various types. Because primary liver tumors are rare, this marked increase in incidence within 5 years suggests a cause-and-effect relationship. Since progestogens are enzyme inducers it is possible that they accelerate oncogenesis by increasing toxic metabolites which cannot be excreted due to the cholestatic effect of estrogens. Vascular changes and the hypercoagulation state of pill users may act synergistically to produce hemorrhagic necrosis and tumor rupture. Liver scans, celiac arteriography, and standard liver function tests are impractical and ineffective in the identification of the patient at risk. Management of the suspect patient with an intact liver should consist of biopsy at laparotomy so that the entire liver can be inspected. Observation, discontinuance of oral contraceptives, avoidance of similar steroids, and pregnancy should provide adequate prophylaxis against liver rupture. However, if a large blood-filled sinus lake or an area of coagulation necrosis is encountered, resection is imperative to prevent later rupture.


Intramuscular (15S)-15-methyl prostaglandin F2alpha for midtrimester and missed abortions.

The efficacy of intramuscular 15-me-PGF2alpha as an abortifacient was evaluated in 40 women between 14 and 20 weeks of gestation and 6 patients with missed abortions. Pregnancy was successfully terminated in all the cases. The injection-abortion interval was significantly lower in 20 patients (Group II) who had intracervical laminaria insertion prior to treatment with 15-me-PGF2alpha than in 10 women (Group I) without laminaria insertion (t = 7.2; P less than .001). Abortion was also accomplished in 10 women with ruptured membranes and 6 patients with missed abortions. Gastrointestinal side effects were minimal and acceptable when premedication with antiemetics and an antidiarrheal was used. This study demonstrates the availability of the intramuscular route--a simple, safe, reliable means of terminating pregnancy, especially during the early midtrimester period.


Oral contraceptives, ABO blood groups, and in vitro fibrin formation.

The relation between oral contraceptive (OC) use, ABO blood groups, and in vitro fibrin formation, as measured by thromboelastography, was investigated in 4315 women. The thromboelastogram (TEG) measures the speed of fibrin formation (R, K) and clot firmness (Ma). More rapid fibrin formation and increased clot firmness were associated with current OC use, but not to the extent seen in pathologic states. This relation was not related to dose, estrogen-progestin type, or duration of exposure. Past and "never" OC users had similar TEG values, suggesting reversibility, and noncontraceptive estrogens had a minimal effect on the TEG. ABO blood groups were found to have only a slight association with TEG values. Subjects with blood group O showed a somewhat prolonged speed of fibrin formation as compared to all other subjects. A decreased clot firmness was found in AB subjects, but this did not persist among OC users.


Cancer of the colon during pregnancy. A review of the literature and report of a case associated with ulcerative colitis.

The first case of adenocarcinoma of the transverse colon and splenic flexture during pregnancy associated with ulcerative colitis is reported. The patient presented with perforation and widespread metastatic disease. After 10 years' duration of symptoms of ulcerative colitis, the risk of coexisting cancer of the colon is 3 to 5% each year. As ulcerative colitis frequently coexists with pregnancy, the obstetrician needs to be alert to the potential for malignant changes in these patients. With the addition of this patient, there are now 18 reported cases of cancer of the colon during pregnancy. These 18 cases are reviewed especially as to management, outcome of the pregnancy, and prognosis.


Pregnancy and delivery in a woman with hemophilia B.

Hemophilia B (Factor IX deficiency, Christmas disease) may cause excessive bleeding in women. The obstetric and hematologic management of the pregnancy and delivery of a woman with a Factor IX level of 4% is presented and discussed.


Improved epidural needle.

The standard Weiss epidural needls is well known to many obstetricians. Its principal advantage is easy manipulation, especially with the "hanging drop" sign. Among its disadvantages are the sharp Huber point, the difficulty of keeping the point in the midline using the conventional technic, and the possibility of dural puncture when the needle must be rotated. The modified needle overcomes these objections because the point is blunt and the elliptical flange soldered to the hub is rotated 90 degrees about the shaft. The resulting instrument is easier to use and is associated with a very low incidence of accidental dural puncture.


Immunization activities of private-practice physicians: a record audit.

A record audit of the office immunization records of 13 private-practice Idaho physicians included 813 2-year-old children. Thirty-six percent had completed all the Public Health Service recommended immunizations for a 2-year-old child. Forty-four percent of the "active" patients (those seen by the physician within the previous 12 months) were complete as opposed to 8% of the "inactive" patients. In general, the children who received immunizations exclusively from their private physician were better immunized (38% complete) than those who received immunizations from both their private physicians and the health department clinics (22% complete). Despite the low percentage of overall completeness, the vaccine-specific immunization levels were at least as high as the levels computed from the National Immunization Survey. While the limitations of the study prevent application of the results to physicians in general, the data suggest that the inability to complete an immunization schedule, once begun, is a major weakness in the immunization activities of private-practice physicians.


Effect of food supplementation during pregnancy on birthweight.

The high prevalence of low-birthweight (less than or equal to 2,500 gm) babies in many poor communities is a major public health problem. Studies in humans in situations of acute starvation suggest an effect of maternal nutrition on birthweight, but less clear results appear under situations of moderate maternal malnutrition. We studied the effects of food supplementation during pregnancy on birthweight in four rural villages of Guatemala, in which two types of supplements were distributed: protein-caloric and caloric. The caloric supplementation increased the total caloric intake during pregnancy. In both supplements, the amount of calories supplemented during pregnancy showed a consistent association with birthweight. In the combined sample the proportion of low-birthweight babies in the high-supplement group (G greater than or equal to 20,000 supplemented calories during pregnancy) was 9% compared with 19% in the low-supplement group (less than 20,000 supplemented calories during pregnancy). The relationship between caloric supplementation and birthweight (29 gm of birthweight per 10,000 supplemented calories) was basically unchanged after controlling for the maternal home diet, height, head circumference, parity, gestational age, duration of disease during pregnancy, socioeconomic status, and different rates of missing data. Moreover, a similar association was found in consecutive pregnancies of the same mother. We concluded that caloric supplementation during pregnancy produced the observed increase in birthweight.


Obesity and leanness at birth and their relationship to body habitus in later childhood.

Prospectively collected data concerning a large group of children were analyzed to determine whether extremes of body habitus at birth were predictive of obesity and leanness at 4 and 7 years of age. A ratio of weight to height (ratio index) was used to determine relative fatness. Neonates who were extremely lean (0 to 5th percentile) or extremely obese (95th to 100th percentile) showed a tendency to persist, albeit at a decreasing rate, in their original habitus at 4 and 7 years of age. This tendency was slightly more marked in the extremely lean than it was in the extremely obese children at 4 and 7 years of age. Children who were extremely lean or obese at 4 years of age seldom abandon that status by 7 years of age. Similarly, most children at the extremes of body habitus at 7 years of age had already attained that status by 4 years of age. In addition to these postnatal trends, a positive correlation was found between the maternal ratio index and pregnancy weight gain, on the one hand, and the ratio index of the children in the extreme categories at each age, on the other.


Visual following and pattern discrimination of face-like stimuli by newborn infants.

Forty newborn infants, median age 9 minutes, turned their eyes and heads to follow a series of moving stimuli. Responsiveness was significantly greater to a proper face pattern than to either of two scrambled versions of the same stimulus or to a blank. The demonstration of such consistent response differences suggests that visual discriminations are being made at this early age. These results imply that organized visual perception is an unlearned capacity of the human organism. The preference for the proper face stimulus by infants who had not seen a real face prior to testing suggests that an unlearned or "evolved" responsiveness to faces may be present in human neonates.


Association between gestational and environmental events and central nervous system function in 7-year-old children.

The prevalence of variables frequently associated with low birthweight was compared in samples of low-birthweight (LBW) infants and normal-birthweight infants (single births of the white race) drawn from the Boston component of the Collaborative Perinatal Research Project. Then the association between these exposure variables and central nervous system function at 7 years was examined in the LBW infants. Finally the interrelationships of the five variables having the strongest association with abnormal or suspect CNS function were examined with regard to their joint predictive utility. A high-risk subgroup (10%) of the total LBW group having a greater than 50:50 chance of falling into an adverse category at age 7 was identified by various combinations of the factors: gestational age of 33 weeks or less, premature rupture of membranes, low Apgar score, and respiratory distress. Small subgroups thus defined should receive special attention in follow-up, particularly in relation to the new regional perinatal care centers. They might also be selected for special study of the mechanisms of interference with central nervous system development. In a population of 7-year-old children with abnormal or suspect CNS function as defined by the protocol of this study, 80% will have a history of normal birthweight.


Comparison of the effectiveness of single-direction and double-direction phototherapy for neonatal jaundice.

Two matched groups of Chinese infants with "idiopathic" jaundice were subjected to phototherapy, one group to "single-direction" phototherapy and the other to "double-direction" phototherapy. The total energy output on the skin of the infants was similar in both groups. The 24-hour fall in bilirubin levels was almost identical in the two groups; the number of infants in each group achieving bilirubin levels less than 11 mg/100 ml at 24, 48, and 72 hours was statistically very similar too. Where the energy output can be adjusted to supply a constant dose on the infant (by varying the energy output in inverse proportion to the skin area exposed), the effect of varying the skin area under phototherapy is minimal. However, the total area of skin exposed to phototherapy under uniform lighting conditions is important because it determines the dose of energy output acting on it, and hence the effectiveness of the procedure.


Postnatal development of obstruction in coarctation of the aorta: role of the ductus arteriosus.

The sequence of events leading to the development of acute obstruction in two infants with coarctation has been defined by clinical, hemodynamic, and angiographic studies. One infant had normally related great arteries and an isolated coarctation, while the other infant had transposition with a hypoplastic right ventricle, a ventricular septal deffect, narrowing of the aortic isthmus, and a localized site of coarctation. In each instance, a posterior aortic shelf--the basic pathologic lesion in coarctation--could be observed angiographically. Signs of aortic obstruction were absent, however, as long as the ductus arteriosus was widely patent. Following ductal obliteration, femoral pulsations diminished, a peak systolic pressure difference was recorded between the ascending and descending aorta, and a discrete area of juxtaductal coarctation was seen. The basic malformation (posterior aortic curtain) would appear to exist in utero, possibly as an aortic branch point. This lesion is nonobstructive as long as blood can traverse the aortic isthmus through the aortic end of the ductus into the descending aorta. Postnatally, as the ductus arteriosus undergoes constriction at its aortic insertion, signs of acute aortic obstruction may b  =ecome apparent. Normal femoral arterial pulsations during the newborn examination do not definitively exclude coarctation. Pediatricians should recheck at 2 weeks of age if the infant is asymptomatic or sooner if there are signs of cardiac failure to establish the presence or absence of this defect.


"Streaking leukocyte factor," arthritis, and pyoderma gangrenosum.

A 14-year-old boy with a 12-year history of episodes of sterile pyarthrosis and cutaneous inflammation and ulceration was found to possess a serum factor which enhanced the random migration of leukocytes in vitro. The serum factor was isolated by Sephadex G-200 gel filtration and found to have a molecular weight of approximately 160,000. This partially purified principle enhanced the random migration of purified normal human neutrophils or mononuclear leukocytes by up to 200% without influencing chemotaxis. Trauma or other stimuli may lead to an accumulation of this serum factor in some tissues of the patient with resultant excessive leukocyte influx and heightened local activity of the leukocytes in the inflammatory exudate.


Adaptation and affect: toward a synthesis of Piagetian and psychoanalytic psychologies.

In this model, we have assumed that Type I processes (assimilation) and Type II processes (accommodation) are theoretically independent, although of course no real system would ever demonstrate one without some of the other. This assumption permits a final elaboration: since there are eight states in Type I and eight in Type II, and if we assume these to be independent, the model predicts a minimum of 64 theoretically possible states of the organism. (While we have used three separate components of the feedback loop, this is not a maximum, since the feedback loop can be further subdivided. A further division would of course yield a larger number of states.) If these 64 states can be identified, and if rules of transformation can be found determining the transitions between these states, a theoretical basis for a general description of human behavior will have been achieved.


[Scandinavian world record in physician manpower].

If Denmark, Finland, and Sweden continue to train new doctors at the same rate as they do now, these countries will stand a good chance of holding the world record in the doctor-patient ratio before the year 2000. Then, around 1980, 1990, and 2000, respectively, they will pass the milestones of 20, 30, and 40 doctors per 10,000 population. This means a two-fold increase in the number of doctors in 20 years, the number of doctors in the three countries increasing by between 50 and 100 per cent in the 1970s. In Scandinavia as a whole, there would in the year 2000 be about 95,000 doctors serving a population of just under 24,000,000. What does the situation look like in the global perspective? Calculating optimistically with "only" a twofold increase in the world population over the 30-year period 1970-2000, there would be a need of: 2,000,000 more doctors just to maintain the doctor/patient ratio of 1970, i.e. 7.9 doctors per 10,000 population, a ratio that Finland exceeded in the early sixties; 4,200,000 more doctors so as to keep up the same increase as in the 1960s. End result: 12 doctors per 10,000 population in the year 2000, a level that Iceland, Norway, and Sweden reached in the mid sixties -- in Denmark the doctor-patient ratio was then 14 per 10,000 population. It is most realistic, however, to count on an increase of 3,300,000 doctors in 30 years, which will mean a total number of 10.5 doctors per 10,000 population in the year 2000.


[Medical education at the university of Trondheim].

In January 1975, medical education was started at the University of Trondheim, the fourth medical school in Norway. The educational planning committee for medicine has presented a complete curriculum comprising a two-year pre-clinical and a four-year clinical course. Working in co-operation with the Norwegian Institute for Hospital Research and the school of Social Work and Public Administration as well as with the faculties of social science, biology, and technology at the University of Trondheim, the medical faculty will have unique possibilities of development. This holds true for, e.g., occupational medicine, industrial hygiene, health administration, environmental protection, toxicology, biophysics, and medical technology.


[Education and research in industrial medicine in Scandinavia].

A review is given of the requirements for training of occupational-health doctors and factory doctors in the Nordic countries and of the present prognosis for the future organisation, extent, and functions of the industrial-health service.


Pharmacology of new ethylenediamine derivatives (ROM-126, ROM-131, MK-142) with antiarrhythmic action. Part II. Antiarrhythmic properties, the influence on heart and some hemodynamic parameters.

ROM-126, ROM-131, MK-142 prevent arrhythmias: in digoxin-induced arrhythmia MK-142 in a lower dose and ROM-126 in a higher dose are most effective; MK-142 antagonizes most powerfully the aconitine arrhythmia. MK-142, contrary to ROM-126 and ROM-131 weakens also the toxic action of CaCl2 on heart. All tested drugs, however, antagonize adrenaline-induced arrhythmia to a similar degree. MK-142 did not influence the coronary blood flow in guinea pig or rabbit isolated hearts while ROM-126 and ROM-131 increased it. In the experiments performed on dogs "in situ" the decrease in sinus outflow was stated after all the three drugs. Arterio-coronary-oxygen difference did not undergo any significant changes. The calculated values of cardiac muscle oxygen usage showed tendency to decrease. All the three drugs induced transient hypotension, decrease in heart rate and cardiac muscle contractility, increase in outflow index and also, after MK-142, in minute volume.


Acute toxicity and the influence of some undecane, cyclopentylpentane and pyridine alpha- and beta-carboxylic acid derivatives on the increased hyperlipemia in rats.

Acute toxicity and hypolipaemic properties of 17 new compounds were studied in the tyloxapol test. Out of these, sodium salts of 1-chloro-2,6,10-trimethylundecane-1-carboxylic acid (I-2) and of 2-hydroxy-2-methyl-5 (2(2),2(2),3(2)-trimethylcyclopenten-3(2)yl)-pent-3-en-1-carboxylic acid (V) have hypolipemic activity.


Effects of oxotremorine after nigrostriatal lesions in rats.

Bilateral injection of 6-hydroxy-dopamine (6-OH-DA) (8mug/4mul) into the substantia nigra causes a significant decrease of the dopamine content in the nucleus caudatus. The intraventricular application of 6-OH-DA (250 mug/10 mul) induces a considerable decrease of dopamine in the caudate nucleus as well as in the globus pallidus and in the medial septal region. Simultaneous changes in norepinephrine content are less spezific. It has to be assumed that there are dopaminergic nerve endings in the glubus pallidus not originating in the substantia nigra. Only after intraventricular applications of 6-OH-DA s short-term and reversible reduction of oxotremorin-induced tremor has been observed. Lesions of the nigrostriatal pathway cause an impairment of motility, probably elicited by rigidity and akinesia. These symptoms correlate better than the tremor to biochemical changes following nigro-striatal pathway lesions.


The influence of carathane and toxaphene on the activity of some enzymes in rat's tissues in the studies in vivo.

Administration of pesticides to the experimental animals bring changes in the activity of enzymes: 3.1.3.1. alkaline phosphatase (AP), 3.1.3.2. acid phosphatase (AcP), 1.4.1.2. glutamin dehydrogenase (GDH), 1.1.1.27. lactate dehydrogenase (LDH), 2.6.1.1. glutamic oxalacetic transaminase (GOT), and 2.6.1.2. glutamic pyruvic transaminase (GPT), determined in blood serum, liver, and kidneys. In the majority of cases these changes are statistically significant.


Central effects of certain drugs and allergic encephalomyelitis in the circumstances of increased or decreased histamine in CNS.

The significance of the effect of histamine (Hi) in CNS has been demonstrated. By way of the inhibition of imidazol-N-methyltranspherase the amount of Hi in the brain can be increased, whereas by means of decaborane or thiazolil-metoxamine it can be lowered. It has been shown that Hi sensitizes the effect of acetylcholine (ACh) in CNS and, consequently, intensifies or weakens certain pharmacological reactions associated with ACh. It has been noted, as the most important result of the decreased Hi in CNS, that certain symptoms of motion sickness (such as vomiting, nistagmus etc.) disappear. Similarly, the increase of Hi in CNS prevents the development of the allergic encephalomyelitis in rats.


A search for radioprotective agents. Part XXXIX. Synthesis of some sulfenamides.

4-(2'-, 4'-nitro- and 2',4'-dinitrobenzenesulfenamido)-quinaldines (I--III) as well as 2-(2'-,3'-nitro and 2',4'-dinitrobenzensulfenamido)-46-oimethylpyrimidines (IV--VI) were obtained. These compounds show a very weak radioprotective activity.


Cardenolides of Trachomitum sarmatiense Woodson.

From the roots of Trachomitum sarmatiense Woodson (Apocynaceae) 5 cardial glycosides were isolated. Among them 4 substances were identified: cymarin and k-strophanthin-beta, and two derivatives of cannogen: apocannosid and apobiosid. In the overground part of the plant, the cardenolides were not found.


Phytochemical investigations of Vernonia flexuosa Sims. Part II. Vernoflexuoside and vernoflexin--new sesquiterpene lactones.

The isolation and structural elucidation of two new sesquiterpene lactones from the roots of Vernonia fexuosa Sims. were described. Vernoflexuoside and vernoflexin have been identified as guianolides with the structure I and V respectively.


The central action of intraventricularly (ivc) administered propranolol and phentolamine in rat.

Propranolol (100mug) ivc together with phentolamine (60 mug) decreased spontaneous locomotor activity and weakened post-nialamide locomotor activity in rat. When applied separately in the above doses, neither of the two compounds had this action. Depression of amphetamine-induced locomotor activity was observed after propranolol (250 mug) together with phetolamine (60 mug). Phentolamine alone, had hypothermic action but when applied together with propranolol, it increased after 4 hrs body temperature. The tested compounds prolonged hexobarbital-induced sleeping time but did not affect noradrenaline or dopamine levels in rat's brain.


The management of cervical lymph nodes in head and neck cencer.

It is suggested that the last major improvement in the surgical treatment of head and neck cancer was Crile's description of radical neck dissection in 1906, and that modifications of this procedure, including extended surgery, have made little or no difference to survival rates. It is hoped that some means may soon be found of identifying those patients with head and neck cancer who do badly--the majority. As a start, it is proposed that patients with an antral carcinoma and a gland in the neck, and patients with hypopharyngeal carcinoma and bilateral neck glands should not be treated by surgery. A retrospective analysis is made of matched pairs drawn from a personal series, one patient in each pair having had a prophylactic neck dissection, and one having been submitted to a policy of 'wait and see'. The survival rate for patients undergoing prophylactic neck dissection was worse than that of the wait and see group; this difference was statistically significant.


A strategy for the control of endometrial cancer.

Epidemiologic studies can provide us with etiological clues and help us recognize high risk factors. The definition of high risk factors, especially in the perimenopausal years can lead to prophylactic measures that may aid in the control of endometrial cancer. Recognition of the high risk patient in the perimenopausal years by aspiration curettage of ambulatory women may offer a significant strategy of surveillance. The advent of modern steroid metabolic technology promises to help us clarify the problems of hormone sensitivity of this tumor so that we may properly translate these data into therapeutic action. Virulence scales can help the choice of treatment for invasive carcinoma so that patients with tumors of low virulence do not suffer from an excess of complications nor those with tumors of high virulence an excess of failure to control. In this manner we can define the role of radiotherapy and surgery, elect combined treatment when indicated and select radical surgery as indicated. There is evidence to suggest that the developmental concept of this tumor may lead to its control in a manner similar to that occurring with cervix cancer.


The effect of bile and of sodium taurocholate on the epithelial cell dynamics of the rat small intestine.

The absence of bile from the intestinal lumen of rats for a period of 48 hr led to: a decreased proliferative cell pool, reduced cell shedding, and a 50% decrease of the labeling index in the ileum. The constant duodenal perfusion of Na taurocholate for periods of 48, 60, 72, and 96 hr in animals with a biliary diversion was associated with: deepening of crypts and decreased crypt/villus ratios as well as with acceleration of the epithelial cell migration rate on the crypt-villus units. The data suggest that bile and bile acids constitute important regulatory factors influencing enterocyte proliferation, migration and loss.


The influence of exogenous PMS and HCG on the arachidonic acid content of the immature rat ovary.

The influence of exogenous PMS and/or HCG, on the arachidonic acid (C 20:4omega6) content of the immature rat ovary was examined. Changes in ovarian arachidonate content associated with hormone administration were assessed in total lipid extracts, and in several neutral and phospholipid fractions. Both relative percentage and absolute amounts of arachidonic acid in several lipids were measured as well as uptake of radioactivity into total lipid resulting from the administration of 3H-labeled arachidonic acid in vivo. On the basis of these studies, we conclude (1) PMS, with or without HCG promotes increased uptake of exogenous arachidonic acid into ovarian total lipids; (2) Arachidonic acid is a mojor fatty acid constituent from noncholine containing phosphatides at the onset of normal estrous (ca. 38 days) even in the animals which received no PMS or HCG; (3) Changes in ovarian arachidonic acid levels following gonadotropin administration are more striking in the two phospholipid fractions than in the two neutral lips examined; (4) PMS is associated with a rapid outpouring of ovarian lipid, accompanied by a high turnover of arachidonic acid which is enhanced or modified temporally by added HCG in vivo. These results provide the first quantitative evidence that gonadotropins may regulate prostaglandin biosynthesis in the ovary by their effects on the uptake, storage, or release of arachidonic acid, a major PG precursor, from specific ovarian lipids. While the data strongly suggest that the regulation of one or more ovarian esterases (cholesterol esterase, lipase, phospholipase) is the mechanism by which gonadotropins regulate PG biosynthesis, a direct action on PG synthetase is not ruled out.


Effect of coitus on serum levels of testosterone and LH in male and female rabbits.

Levels of testosterone (T) and LH in the peripheral serum of male and female rabbits were measured and compared following coitus. Blood was collected by heart puncture from restrained, unanesthetized animals of both sexes. In male rabbits, basal serum T levels were highly variable, ranging from 131 to 12,149 pg/ml, and if low preceding coitus they tended to rise; whereas, if high, they usually dropped as they did in nonmated males subjected to repeated heart punctures. In contrast, basal serum LH levels in males were quite constant (mean +/- SE, 1993 +/- 152 pg/ml) and were not significantly altered after coitus unless blood T levels had been drastically lowered by two priming doses of estradiol benzoate. In intact does, on the other hand, copulation which resulted in ovulation induced an approximately 20-fold increase in serum LH concentration which was sustained for about 4 hr. Postcoital elevations in serum LH also occurred in estrogen-primed intact and estrogen-primed ovariectomized does. Under the conditions of our experiments, the parallel elevations in serum LH and T observed postcoitally in the female rabbit could not be demonstrated in the male.


Aminoisobutyric acid transport in primary cultures of normal adult rat hepatocytes.

In contrast to suspensions of freshly isolated hepatic parenchymal cells (HPC), short-term monolayer cultures of HPC displayed properties of active transport for the amino acid analog aminoisobutyric acid (AIB). The uptake of AIB was inhibited by KCN and iodoacetate, failed to occur at 4 degrees, and was stimulated by glucagon. The apparent Km for AIB uptake by cultured HPC was approximately 19 mM. Glucagon did not alter the apparent Km but did increase V.


Heat denaturation of bovine liver glutamate dehydrogenase.

Heat denaturation of bovine liver glutamate dehydrogenase occurred at 47 degrees with loss of enzyme activity and formation of inactive, insoluble protein. Fractional loss of catalytic activity coincided with alteration in protein fluorescence and solubility for a corresponding percentage of protein molecules. Operationally, at 50% denaturation, one-half of the total population of enzyme molecules is fully active catalytically and soluble and the other half of the protein molecule population is completely inactive catalytically and insoluble.


Suppression of lymphocyte transformation by 16, (16) dimethyl prostaglandin E2 and unsaturated fatty acids.

A new synthetic prostaglandin (16, 16-PGE2) and unsaturated fatty acids have been shown to inhibit the incorporation of [3H]thymidine in the lymphocyte transformation reaction in response to phytohemagglutinin (PHA). This inhibition was not due to toxicity of these substances, for the lymphocytes remained intact and capable of excluding trypan blue.


Changes in plasma levels of lysosomal and non lysosomal enzymes during hemorrhagic hypotension.

In a study of 4-hr hemorrhagic hypotension in dogs, the plasma levels of the lysosomal enzymes, cathepsin (CATH) and acid phosphatase (AP) showed early and progressive increases in activity. The plasma levels of the intestinal fraction of alkaline phosphatase (IAkP) and aspartate aminotransferase (AAT) were increased after 2 hr of hypotension and the liver specific enzyme, ornithine carbamyltransferase (OCT), and creatine phosphokinase (CPK), after 3 hr. All of the enzymes showed large increases after 4 hr of hypotension. The plasma levels of CATH showed the earliest and largest relative increase indicating that with the shock model used, this enzyme was the most sensitive indicator of shock severity. The increase in plasma enzyme levels was probably the result of tissue damage in the splanchnic region but the elevation of plasma CPK, a muscle specific enzyme, indicates some muscle cell damage as well. While the increase in the plasma enzyme activity is probably due, in large part, to cellular damage, it is likely that a decreased enzyme removal rate--resulting from a hypofunctional RES--also contributes to the elevated plasma enzyme levels during hemorrhagic hypotension.


The role of the adrenal in relapses of experimental allergic encephalomyelitis.

Adrenalectomy shortly after onset of clinical signs of experimental allergic encephalomyelitis (EAE) was uniformly lethal to rats within 2 days. If adrenalectomy was postponed until the third to fifth day of signs, most of the rats survived and experienced a complete or incomplete remission followed by a relapse. The success of adrenalectomy in inducing relapses suggests that spontaneous relapses in EAE are related to adrenal homeostatic mechanisms whereby paralysis, nonspecific stress, increased corticosteroids, immunosuppression, recovery from paralysis, decreased stress, corticosteroids and reimmunization follow each other in logical order. However, the failure of adrenalectomy to induce relapses in EAE produced with aqueous inoculum or by passive transfer with lymphoid cells suggests that relapses are related to the persistent antigenic depot from water-in-oil inocula, rather than being an inherent part of the immunopathologic process.


Hemoglobin levels in persons of tibetan ancestry living at high altitude.

The mean hemoglobin level of persons of Tibetan ancestry living at 4000 m in the Nepal Himalayas was found similar to that expected at an altitude of 2300 m and an arterial O2 saturation of 92%. Plasma volumes were normal, and deficiency states and hemoglobinopathies were not significant. Possible reasons for this finding are discussed.


A comparison of recovery times from exercise and ischemic dilations at constant pressure and flow.

Recovery times from exercise and ischemic dilation in gracilis muscle were compared during constant pressure (natural flow) and constant flow perfusion. Recovery times were longer at constant flow. This finding provides additional support for the metabolic hypothesis for the regulation of blood flow in skeletal muscle.


Hydroxyurea-induced erythroid differentiation.

Hydroxyurea, a cytotoxic agent which destroys cells in DNA synthesis, has been shown to evoke the differentiation of a small number of hemopoietic precursor cells in the erythroid series of erythropoietically suppressed hypertransfused mice. This effect does not appear to be mediated by erythropoietin (EP) since the simultaneous injection of anti-EP did not alter this response.


Ethacrynic acid induced inotropism.

Ethacrynic acid (ECA), a sulfhydryl group inhibiting diuretic was examined for positive inotropic effects. These were found to be present in isolated guinea pig left atria studied in 0.9 and 1.8 mM Ca bathing solutions and were partially dependent upon adrenergic mechanisms (presumably secondary to norepinephrine release from sympathetic nerve endings) and partly independent of such mechanisms as demonstrated by propranolol induced beta-blockade and reserpine-induced catecholamine depletion. The mechanism of the non-beta adrenergic inotropism is unclear but may relate to the ability of ECA to inhibit the sarcolemmal Na-K-Mg-dependent ATPase. ECA-induced premature contractile failure occurred in all atria as well as a late increase in diastolic tension, the latter being comparable to that described for toxic doses of cardiac glycosides in similar preparations.


The uptake of 14C-labeled hydroxyanthranilic acid and enantiomers of tryptophan, kynurenine, and hydroxykynurenine in human blood.

Labeled enantiomers of tryptophan, kynurenine, and hydroxykynurenine were given to five patients with scleroderma. Blood samples were drawn periodically over a 24-hr period. When the D-isomers were given, peak blood levels of radioactivity did not appear until 8 hr, whereas with the natural L-isomers peak levels were reached in 2 hr Considerable radioactivity was found firmly bound to the precipitated plasma proteins from both the L- and D-isomers. Incubation studies confirmed the binding of the D-isomers to the serum proteins. These experiments show that the use of pure labeled L-isomers is required, when studying the metabolism of amino acids in man, and that compounds other than L-tryptophan are bound to serum proteins in significant quantities.


Effect of the interferon inducer, dextran phosphate, on influenza virus infection in mice.

Intraperitoneal administration of dextran phosphate (MW 40,000) or DP 40, an interferon inducer, was shown to increase the survival rate of mice infected with 10 LD50 dose of influenza A2 virus (H2N2). In the treated mice, a 1-day delay was evident in the virus growth in lung, and production of HAI antibody, when compared to the nontreated or dextran-treated controls. More significant was the 2-day delay in the development of lung consolidation, which leads to 40% survival of the treated mice. Mediation of the protection by the interferon induced by DP 40 was indicated.


Demonstration of lag phase in the sol-gel transformation of deoxygenated S hemoglobin without temperature alteration.

1). During the sol to gel transformation of deoxygenated sickle hemoglobin, a time-dependent process preceding gel formation (lag phase) was demonstrated that was inversely proportional to a function of the hemoglobin concentration and that occurred without alteration in temperature, pH, or oxygen tension. 2). As determined by the Schachman modification of the capillary viscometer, preparations of oxyhemoglobin S and A and deoxyhemoglobin A were indistinguishable when compared over a wide range of concentrations. Up to the concentration at which gelling occurred, deoxyhemoglobin S exhibited the same viscosity behavior. The viscosity of deoxygenated hemoglobin S within the lower gelling concentration range was normal during the lag phase and became abnormally high only at the time of gelation.


Amelioration by copper supplementation of mutant gene effects in the crinkled mouse.

The possibility of a relationship between the autosomal recessive mutant gene crinkled in mice and copper metabolism was investigated by examining the effect of copper supplementation during pregnancy and lactation on the expression of the gene in homozygous mutant young. Survival of mutant mice to 30 days of age was doubled by feeding their mothers a high copper diet (500 ppm copper) during pregnancy and lactation, as compared with controls (6-11 ppm dietary copper). High dietary copper also prevented the lag in pigment development characteristic of the mutants. Furthermore, skin and epidermal thickness and hair bulb development were nearly normal in the high copper group, in contrast to thin skin and paucity of hairs in controls. Supplementation with manganese did not have these effects. Scanning electron micrographs showed the presence of three types of hair abnormalities in crinkled mutants, monilethrix, pili torti, and possibly trichorrhexis nodosa. The results show that increased availability of copper favorably altered the expression of the mutant gene, and demonstrate the interaction of a gene and a trace metal in development.


Control of cell division in the cornea of rats. III. Mitogenic effect of isoproterenol and theophylline.

The effects of isoproterenol, theophylline and the combination of the two drugs were studied on the circadian mitotic rhythm in rat corneal epithelium. The drugs induced profound alterations in the normal circadian mitotic pattern. The alterations included an initial suppression of cell division, followed by two distinct rises above control; the first immediately following suppression, the second 12-16 hr following drug administration. The second peak of cell division occurred at the circadian trough in controls. The simultaneous administration of isoproterenol and theophylline greatly magnified the effects seen with either drug alone.


Relationship of blood concentrations of calcium, phosphate, gastrin and calcitonin to the onset of feeding in the rat.

Daily fluctuations in plasma calcium concentrations in rats trained to a closely regulated feeding pattern have been compared to corresponding plasma gastrin and calcitonin concentrations. The time period studied was that extending from 4 hr prior to the start of the feeding. Both plasma calcium and phosphate levels fedd prior to the start of the feeding period and remained low at least for the first 2 hr of feeding. This pattern was also observed in rats in which food was withheld for 2 hr past the regular feeding time. Plasma 45Ca and 32P concentrations (radionuclide injected at least one week prior to sampling) did not follow the pattern of their stable counterparts. Instead, these values rose or remained constant until after feeding had commenced, after which they fell precipitously. Both plasma calcitonin and gastrin levels rose rapidly after the start of the feeding period. The primary point of emphasis is that calcitonin secretion was produced in these rats by an intestinal related stimulus and not by a rise in plasma calcium concentration.


Effects of diet, age, strain and anatomical site on fat depot triglyceride and fatty acid content in rats.

OM rats fed a high fat ration were heavier, fatter and had fat depots which weighed at least three times as much as those fed a low fat (grain) ration. S rats fed a high fat ration showed slight increase in fat depot weights and no increase in body weight or fat when compared to rats of the same strain fed grain. For both strains of rats fed either diet for 4, 10 or 20 wk following weaning, there was a lower percentage of TG in the inguinal depot than in the epididymal or perirenal-retroperitoneal fat depots. There was a tendency for rats fed a high fat ration to have a higher percentage of TG in adipose tissues than rats fed grain, but the differences were not significant as long as age, anatomical site and strain were constant. Strain and age had no significant effect on the percentage of TG in fat depots. The fatty acid composition of the fat depots was effected by ration, but not by age, strain or anatomical site of the fat depot.


Effects of indomethacin on local blood flow regulation in canine heart and kidney.

In two series of experiments we studied the effects of indomethacin on (a) coronary reactive hyperemia and, (b) renal blood flow, autoregulation, and reactive dilation. Coronary blood flow was measured in closed-chest dogs. Reactive hyperemia was induced by coronary occlusion for 5 and 15 sec. Indomethacin, an inhibitor of prostaglandin synthesis, was infused intra-arterially in doses of 90-200 mg over periods ranging from 30-120 min. Coronary reactive hyperemia was not affected by indomethacin. The canine renal vascular bed was studied under conditions of natural flow, controlled flow, and controlled pressure. Intra-arterial infusion of 90 mg of indomethacin over a 30- to 60- min period caused increased renal vascular resistance and an attenuation of reactive dilation (induced by stopping renal blood flow for 90 sec). Indomethacin slightly attenuated the autoregulatory response to decreasing perfusion pressures, but did not affect the respone to increasing pressures. Thus the study fails to provide evidence for participation of the prostaglandins in regulation of coronary blood flow and suggests only minimal participation of prostaglandings in renal blood flow regulation.


Comparison of radioimmunoassay and gas-liquid chromatography analyses of progesterone concentrations in cow's milk.

Progesterone concentrations in milk were not significantly different when quantitated by different methods (RIA vs. GLC). There was a significant day effect (P less than 0.05) on milk progesterone level due apparently to gradually decreasing values as pregnancy advanced over days 30, 120 and 210. The means for the percent fat content were different (P less than 0.05) for all comparisons among four times of collection (immediately premilking, milking pool, immediately postmilking, and 3 hr postmilking). For progesterone concentration, the main effect of time and the three-way interaction (time times antiserum times purification method) were significant (P less than 0.005); all other main effects and interactions were not significant. Within each of 4 assay groups (2 antisera times 2 purifications), the concentration of progesterone was greater (P less than 0.05) for the samples which were collected immediately postmilking than for any of the other times of collection. The three-way interaction seemed due primarily to difference in progesterone determinations among the four assay groups in the samples which were taken immediately postmilking. Over all milk samples within each assay group, the percent fat content and the concentration of progesterone were positively correlated (r = 0.71, P less than 0.01).


Coxsackie B4 virus crystal formation in mouse pancreas.

For the first time, Coxsackie B4 virus crystals are demonstrated in tissues of animals inoculated with the virus. Until this report, Coxsackie B4 virus had never been found to form crystalline aggregates in tissues of any kind. The viral crystals which were located in the pancreas of newborn mice were associated with ultrastructural damage to the pancreas not observed in control animals, thereby indicating that viruses directly invade and damage these tissues. Thus, this virus must be considered among etiologic factors in pancreatic disease.


Induced adrenal and ovarian enlargement in nursing mothers by a single mug injection to their pups of a 3beta-hydroxy-delta5-steroid oxidoreductase inhibitor.

Isoxazole-14C, a potent inhibitor of 3beta-hydroxy-delta5-steroid oxidoreductase, injected into nursing pups is naturally transferred to their mother where it is retained, for at least a month, in ng quantities in the adrenals and ovaries and results in adrenal, ovarian, preputial and pituitary enlargement.


Potentiation of the hepatotoxic responses to chemicals in alloxan-diabetic rats.

Alloxan diabetes enhances the hepatotoxic response of male rats to chloroform and 1, 1, 2-trichloroethane, but not to trichloroethylene nor 1, 1, 1-trichloroethane. Insulin treatment partially protects the animals against the alloxan-induced enhancement of chloroform hepatotoxicity. Alloxan diabetes also enhances the hepatotoxic response to galactosamine but not to beryllium nor alpha-naphthylisothiocyanate.


NaCl intake and preference threshold of spontaneously hypertensive rats.

Both male and female spontaneously hypertensive (SH) rats have an appetite for NaCl solution. The appetite is present when a choice is offered between distilled water and either isotonic or hypertonic (0.25 M) NaCl solution to drink. Total fluid intake (water plus NaCl solution) was greater for SH rats than for controls while food intakes (g/100 g body wt/day) of SH rats were not different from controls. Mean body weight of SH rats was always less than that of controls. The appetite for NaCl solution was accompanied by a significant reduction in preference (detection) threshold. SH rats could detect the difference between distilled water and NaCl solution when the concentration of the latter was 12 mEq/liter compared to a control threshold of 30 mEq/liter. The NaCl appetite and reduced NaCl preference threshold induced by spontaneous hypertension is in marked contrast to the NaCl aversion induced by other types of experimentally induced hypertension in rats. The mechanism or mechanisms responsible for these differences remain for further study.


Circulatory turnover of pancreatic amylase.

Radiolabeled amylase and unlabeled pancreatic amylase were infused into pigs in order to determine the plasma half-life of the enzyme. Regardless of the parameter measured (radioactivity, enzyme activity or concentration), the plasma removal curves could be resolved into three components when subjected to tracer analysis. The plasma half-life was estimated to be approximately 3 hr. Through the use of a recently developed radioimmunoassay specific for porcine pancreatic amylase, the plasma concentration of amylase was calculated at 2.4 mug/ml. Knowing the plasma concentration and half-life of amylase we determined the circulatory turnover of the enzyme. Over a 2.4-hr period, 9.6 mug of pancreatic amylase/ml of plasma must re-enter the circulation to maintain the enzyme at constant levels.


The anemia of chronic renal failure: in vitro response of bone marrow to erythropoietin.

Bone marrow cells of patients with chronic renal failure were studied in short-term in vitro cultures to determine erythropietin responsiveness. Seven normals and fourtheen patients on hemodialysis were studied. Bone marrow cells of normal subjects and of patients with chronic renal failure responded similarly to erythropoietin. Total heme synthesis was significantly lower in cultures prepared with uremic serum than normal serum. We conclude that there is a substance in the serum of uremic patients which suppresses general heme synthesis and that this "uremic toxin" may be responsible, in part, for the clinically severe anemia seen in these patients.


Rapid assessment of ventricular fibrillation thresholds during experimental infarction in the canine heart.

Sophisticated instrumentation is described which allows the rapid estimation of vulnerability of the ventricle to multiple responses and fibrillation with the classical technique described by Wiggers and Wegria. It seems particularly pertinent to the assessment of the significance of "R on T" type of ventricular extrasystoles in myocardial infarction. The thresholds to tachyarrhythmia were decreased by about 64% within 10 min of coronary occlusion and persisted at that level for 60-90 min, suggesting the usefulness of this model in assessing anti-fibrillatory drug regimes during the early evolutionary stage of myocardial infarction.


Effect of papain-induced emphysema on permeability of rat lung to drugs.

To investigate the effect of a papain-induced emphysema-like condition on pulmonary absorption of drugs, rats were exposed to either papain aerosol or distilled water aerosol (control) intermittently for 2 wk, and rates of drug absorption from damaged and control lungs were compared. To measure absorption rates, 0.1 ml of drug solution (0.1-10 mM) was administered through a tracheal cannula to anesthetized animals, and after various times lungs were assayed for unabsorbed compound. In absorption experiments with the lipoid-insoluble compounds, mannitol, p-aminohippuric acid, and procaine amide ethobromide, all three drugs were absorbed from the lungs about twice as rapidly in papain-treated rats as in control. In contrast, procaine amide, a relatively lipoid-soluble drug, was absorbed at the same rate in both control and papain-treated animals. The results suggest that papain-induced lung damage increases the porosity of the pulmonary epithelium.


Urinary kallikrein excretion in a spontaneously hypertensive strain of rats.

Concentration and 24-hr excretion of urinary kallikrein in spontaneous hypertensive Wistar strain rats of both sexes obtained by selected inbreeding (25th generation) are significantly decreased as compared with the excretion in normotensive inbred rats (24th generation) descending from common ancestors. Apparently in these hypertensive rats there is an abnormal capacity of the kidneys to produce or release kallikrein, but more studies will be necessary to correlate this findings with blood pressure increase.


Effect of 3,4-toluenediamine on output from in situ rat Brunner's glands pouches.

Duodenal and gastric glandular mucosal damage have been observed 24 hr following single subcutaneous doses of 3,4-TDA in fed, unrestrained rats. 3,4-TDA significantly reduced secretion from in situ Brunner's glands pouches in pentobarbital anesthetized rats. The reduction in volume output with a definitely duodenal ulcerogenic dose of this compound was more than twice that observed with a minimally ulcerogenic dose, suggesting a correlation between the duodenal ulcerogenic and duodenal anti-secretory activities of this compound. The animal model described in this communication should facilitate experimentation to establish the inhibitory effect of compounds on the output of protective fluids from the proximal duodenum.


The evolutionary origin of feathers.

Previous theories relating the origin of feathers to flight or to heat conservation are considered to be inadequate. There is need for a model of feather evolution that gives attention to the function and adaptive advantage of intermediate structures. The present model attempts to reveal and to deal with, the spectrum of complex questions that must be considered. In several genera of modern lizards, scales are elongated in warm climates. It is argued that these scales act as small shields to solar radiation. Experiments are reported that tend to confirm this. Using lizards as a conceptual model, it is argued that feathers likewise arose as adaptations to intense solar radiation. Elongated scales are assumed to have subdivided into finely branched structures that produced a heat-shield, flexible as well as long and broad. Associated muscles had the function of allowing the organism fine control over rates of heat gain and loss: the specialized scales or early feathers could be moved to allow basking in cool weather or protection in hot weather. Subdivision of the scales also allowed a close fit between the elements of the insulative integument. There would have been mechanical and thermal advantages to having branches that interlocked into a pennaceous structure early in evolution, so the first feathers may have been pennaceous. A versatile insulation of movable, branched scales would have been a preadaptation for endothermy. As birds took to the air they faced cooling problems despite their insulative covering because of high convective heat loss. Short glides may have initially been advantageous in cooling an animal under heat stress, but at some point the problem may have shifted from one of heat exclusion to one of heat retention. Endothermy probably evolved in conjunction with flight. If so, it is an unnecessary assumption to postulate that the climate cooled and made endothermy advantageous. The development of feathers is complex and a model is proposed that gives attention to the fundamental problems of deriving a branched structure with a cylindrical base from an elongated scale.


Studies in atypical Streptococcus equi.

An atypical variety of Streptococcus equi is described. It was shown to be deficient in capsular material, to be very virulent for mice and to possess a cell-wall protein similar to the M-like protein of classical Str equi. Antiserum prepared against classical Str equi effectively opsonised the atypical strains, and induced the formation of long chains by these atypical strains. It is possible that this variant of Str equi can be used to overcome many of the current problems associated with the manufacture and use of strangles vaccines.


Isoenzymes of alkaline phosphatase in serum of lambs and ewes.

Electrophoresis in polyacrylamide gels was used to identify isoenzymes of serum alkaline phosphatase in sheep. Skeletal isoenzyme predominated in the serum of lambs and liver, skeletal and intestinal isoenzymes were found in the serum of adult ewes. In r ewes (R-r-i blood group system) intestinal isoenzyme activity was 67 per cent of total serum activity; in R ewes intestinal activity was only 36 per cent of total activity. Relative activities of the three isoenzymes differed greatly within individual ewes and between individual ewes during pregnancy and lactation.


Isoenzymes of alkaline phosphatase in serum of newly born lambs.

In the serum of lambs at birth most of the circulating alkaline phosphatase, identified by electrophoretic analysis, was of skeletal origin. Suckling was associated with a rapid increase in activity of intestinal alkaline phosphatase isoenzymes in serum. There was a coincidental increase in level of circulating gamma globulin. Activity of the intestinal isoenzymes in serum began to fall between 15 and 21 h after birth and this fall preceded a fall in serum gamma globulin concentration. The electrophoretic characteristics of the intestinal isoenzymes in serum changed as activity of these isoenzymes increased and then decreased.


A quantitative histological study of changes in the bovine testis and epididymis associated with age.

Quantitative histological studies were performed on the testis and epididymis of 80 normal bulls from beef herds in tropical Australia. Four age groups, ranging from nine months to over 10 years were established. Volumetric proportions of parenchymal and collagenous tissues, and tubular or duct surface to tissue volume ratios were determined at the dorsal, middle and ventral testicular regions and at the head, body and tail of the epididymis for each group. Detailed volumetric analyses of the relative volumes of particular parenchymal and stromal elements were made a the middle testicular region. Lymphoid and plasma cell populations were compared in all regions, including the efferent ducts. Differences in the distribution of testicular parenchyma and collagen were found; the dorsal region had more parenchyma and less collagen than the middle and ventral areas. Progressive intertubular fibrosis attributed to age was quantified; it was most marked ventrally. Reductions in the relative volumes of germinal cells, Sertoli cells, tubular cytoplasm and parenchyma, and in tubular surface to testis volume ratios with advancing age, indicated a decrease in the capacity per unit volume of testis to produce sperm. Increased immunocyte populations in the efferent duct region in young bulls were attributed to initial antigenic exposure. Increased antigenic exposure, in association with senile degenerative changes of the genitalia, might have caused the increased immunocyte populations seen in very old bulls.


The effect of intramuscular and intramammary vaccination of cows on antibody levels and resistance to intramammary infection by Staphylococcus aureus.

Cows were vaccinated simultaneously by the intramuscular and intramammary route with formolised Staphylococcus aureus cells of strains BB, Mexi and 3528. Vaccination resulted in slight increases in serum agglutinin titres, but the levels of the agglutinins in milk and colostrum were not higher in vaccinated cows than in the unvaccinated controls. Vaccination did not result in higher levels of IgM, IgG1, IgG2 or IgA immunoglobulins in serum, colostrum or milk as compared with controls. Vaccinated cows, particularly those in which strain 3528 was used, showed some resistance to infection following challenge with low numbers of viable S aureus Mexi, but there was no resistance to infection when similar numbers of the virulent BB strain were used for challenge. It is concluded that vaccination is unlikely to prevent infection of the bovine udder by S aureus.


Immunisation of cattle against the herpesvirus of malignant catarrhal fever: failure of inactivated culture vaccines with adjuvant.

Attempts were made to immunise cattle against the herpesvirus of malignant catarrhal fever by inoculating living or formalinised preparations of the agent, propagated in cell cultures and combined with Freund's incomplete adjuvant. High and persistent levels of virus-neutralising antibody were regularly demonstrable, especially following two intramuscular inoculations at an interval of six to eight weeks. In spite of this no protection was demonstrable against parenteral challenge with virulent virus, whether in cell-free or cell-associated form. In a controlled field trial vaccinated cattle showed no evidence of protection against natural challenge by exposure to wildebeest herds. It was concluded that humoral mechanisms are probably not important in determining resistance to infection with virulent MCFV.


Morphological studies of the canine intervertebral disc. The assignment of the beagle to the achondroplastic classification.

The morphological development of the epiphyseal growth plate and intervertebral discs of newborn and nine-month-old beagles, greyhounds and dachshunds have been studied. On the basis of the cellular and matrix development of these canine tissues together with the known characteristics associated with achondroplasia it is concluded that the beagle should be assigned to the chondrodystroid breed classification.


The histopathology of fatty liver and kidney syndrome in chicks.

Studies of the general histopathology of the fatty liver and kidney syndrome in chickens have shown abnormal accumulations of the lipid in a variety of organs but no degenerative or inflammatory reactions. Lipid was found in some skeletal muscles, alimentary tract, autonomic ganglia, central nervous system and pineal gland as well as in the liver, kidney and heart. Small amounts of lipid were sometimes seen in the exocrine pancreas, adrenal medulla and epithelium of the thyroid follicles. Lipid deposits in the liver were primarily associated with the hepatic structural unit. The glycogen content of the hepatic cell was reduced. The lipid-metabolising gastrocnemius muscle contained abnormal amounts of lipid but this did not apply to the carbohydrate-metabolising pectoralis major muscle. The thymus did not contain excessive lipid but was significantly smaller in affected than in control birds of similar ages. There was loss of tinctorial distinction between the cortex and medulla of the adrenal gland associated with decreased basophilia of the latter region. Many of these morphological changes can be correlated with previously reported biochemical findings and they are discussed in relation to the hyperlipaemia and hypoglycaemia which characterise the disease.


Immunoglobulin concentrations in ovine body fluids.

Ovine IgG, IgM and IgA and antisera specific for these immunoglobulins were prepared. The specific antisera were used to estimate the immunoglobulin concentrations in certain sheep body fluids. IgA was shown to be the major immunoglobulin in saliva, lung and lachrymal fluid, tracheobronchial and nasal secretions while IgG was the predominant immunoglobulin in colostrum, milk, bile and serum.


In vitro response of lymphocytes to Micropolyspora faeni extract in cattle.

The in vitro stimulation of small lymphocytes to blast formation, measured by the rate of 3H-thymidine incorporation, was used to study the occurrence of cells sensitive to antigens of Micropolyspora faeni in cattle. M faeni extract induced a significant stimulation index in lymphocytes from the peripheral blood cells of cattle from an endemic area in autumn but rarely in spring. Blood lymphocytes from animals from a non-endemic area tested during the winter period rarely showed a positive reaction or only a relatively weak one. On the other hand, lymph node cells, particularly from bronchial lymph nodes, showed positive results in all investigated animals and even in those from non-endemic areas. In three-months-old calves, positive results were obtained mainly with cells from bronchial lymph nodes. It seems therfore that sensitisation to M faeni antigen is a widespread phenomenon but additional circumstances seem to be required for the clinical manifestation of farmer's lung disease in cattle. The most important factor is probably strong and repeated exposure to the M faeni organism. Whether or not existing reactive lymphocytes against M faeni antigen are directly involved in the pathogenesis of farmer's lung disease in cattle by producing a delayed type reaction remains to be clarified.


Experimental reproduction of turkey syndrome 65 with Mycoplasma meleagridis and M gallisepticum and associated changes in serum protein characteristics.

Groups of one-day-old turkeys were infected with two isolates of Mycoplasma meleagridis and one of M gallisepticum. The experiment was terminated at three weeks of age when the incidence of TS65 in the three groups were 32, 24 and 82 per cent respectively. The development of TS65 in the M meleagridis-infected groups was not accompanied by dramatic falls of serum albumin levels thus invalidating the hypothesis that low serum albumin concentration is a primary factor in the development of TS65.


The development of the lesions caused by second generation schizonts of Eimeria necatrix.

First generation merozoites of Eimeria necatrix were found in epithelial cells of the crypts of Lieberkühn of chicks cells appeared to migrate into the lamina propria, forming nests of second generation schizonts that extended from the external muscularis to the lamina propria of the mid-villus. On the fourth and fifth days the mature schizonts, usually still within the infected cells were dishcarged into adjacent crypts. The muscularis mucosa appeared to be repaired by the formation of new, smooth muscle cells that spliced the broken ends of the ruptured muscle. 'Ghosts' of schizonts were found in the lamina propria on the sixth day after infection.


Diminished antibody response to rinderpest vaccination in cattle undergoing experimental East Coast fever.

The immunocompetence of cattle undergoing East Coast Fever (ECF) reactions of varying degrees of intensity was evaluated using the neutralising antibody response of these cattle to the vaccine response was found in animals undergoing severe ECF reactions. The results suggest that the massive lymphoid cell involvement of such severe ECF reactions diminishes the immune responsiveness of cattle to rinderpest vaccine.


Fragility of the skin in a cat.

Skin that showed abnormal fragility was investigated by histochemical and other methods. There was a reduction in the amount of acid glycosaminoglycan but collagen cross-linkage and electron microscopic appearance of the fibres was normal. This differs from the condition of dermatosparaxis noted in other species.


The effect of fospirate on Echinococcus granulosus and Taenia hydatigena infections in dogs.

Trials with fospirate carried out with 170 dogs infected with either Echinococcus granulosus or Taenia hydatigena indicated that a dose rate of 40 mg/kg given on three occasions and 10 mg/kg given on one occasion eliminated each species, respectively. Increasing the dose rat substantially above 40 mg/kg did not reduce the number of treatments required to eliminate all hydatid organisms. Vomiting was observed in some dogs.


Preliminary characterisation of paramyxovirus isolated from a parrot.

A virus, designated 0121, which was isolated from a parrot, was shown to be a paramyxovirus, which was serologically related to the paramyxoviruses Bangor/flinch/N. Ireland/73 (Bangor) and Yucaipa/chicken/California/60(PMY). However, the 0121 virus differed in several properties from both the PMY and the Bangor viruses. The virus was not pathogenic for chickens. I was designated Paramyxovirus: Parrot/England/0121/74.


The role of colostrum in glomerulonephritis of Finnish Landrace lambs: effect of cross-fostering newly born Finnish Landrace and Cheviot lambs.

Newly-born Finnish Landrace and Cheviot lambs were cross-fostered to determine the role of colostrum in the development of mesangiocapillary glomerulonephritis of the Finnish Landrace breed. Severe glomerulonephritis occurred in four Finnish Landrace lambs reared by their own dams. One of six siblings of affected lambs, all reared by Cheviot foster mothers, developed a milder focal form of the disease. No glomerulonephritis occurred in three Cheviot lambs reared by Finnish Landrace foster mothers whose own naturally reared lambs died of the disease. An artificially reared colostrum-free Finnish Landrace lamb became severely affected, though its naturally reared sibling had no renal disease in sequential biopsies. It is concluded that colostrum has no primary role in the development of the disease.


Functional recovery from spinal cord trauma following normothermic irrigation in dogs.

The spinal cords of 16 normal dogs were exposed via dorsal laminectomies and damaged with a known impact force. In eight dogs the injured portions of the spinal cords were irrigated, without durotomy, for 2 h with normothermic saline. The remaining eight dogs were used as controls and were not irrigated. The results showed that normothemic irrigation of damaged spinal cords, immediately after impact trauma, had a significant beneficial effect on the functional recovery of the spinal cords.


Pasture levels of tryptophan in relation to outbreaks of fog fever.

Oral administration of tryptophan induces in cattle clinical signs and lung lesions similar to those of fog fever. Tryptophan assays were performed by a microbiological method on various herbage samples. There was no significant difference in tryptophan content between herbage from two normal pastures and from three pastures in which outbreaks of fog fever occurred.


The effect of mebendazole on Echinococcus granulosus and Taenia hydatigena infections in dogs.

The effect of micronised mebendazole on Echinococcus granulosus and Taenia hydratigena has been investigated in a trial involving 175 dogs. The hydatid organism was eliminated from the dogs at dose rates of either 160 mg/kg given on one occasion or 20 mg/kg given on two occasions. A single dose of 20 mg/kg eliminated T hydratigena. The drug was readily accepted when given in food and there were no untoward sequelae.


The composition of the liver lipids of the ewe during pregnancy and lactation.

During late pregnancy and early lactation there were significant increases in the concentrations of triglycerides and cholesteryl esters in the liver lipids of the ewe. These changes were accompanied by higher concentrations of oleic acid and lower concentrations of stearic acid in both fractions, and may be related to an increased mobilisation of fatty acids from adipose tissue.


The use of disophenol in studies of the pathogenicity of the arrested fourth-stage larvae of Haemonchus contortus in the sheep.

Disphenol was administered to sheep infected with Haemonchus contortus in order to prevent the development of populations of adult worms, and studies were made of the pathogenicity of the arrested fourth-stage larvae which remained. The treated sheep showed elevated plasma pepsinogen and abomasal pH, predominantly negative dry-matter balance, and evidence of greater fluid loss, including plasma, into the gastro-intestinal tract. It was concluded that arrested larvae may cause damage to the abomasal mucosa.


Clinical significance of the measurement of membrane diffusing capacity and pulmonary cappillary blood volume.

The results of 64 membranes diffusing capacity (Dm) and pulmonary capillary blood volume (Vc) estimations were analysed to assess the clinical significance of these measurements. These estimations were performed on 18 healthy subjects, 19 patients with mitral valvular involvement of rheumatic aetiology, 15 patients with chronic bronchitis and emphysema, 8 patients with chronic bronchitis alone, and 4 patients with pulmonary embolism. It was observed that Dm correlated very well with the pulmonary diffusing capacity (DLCO) measured during the inhalation of room air in all the groups of subjects. In patients with rheumatic heart disease, the DLCO was affected little by even large changes in Vc, whereas it ran closely parallel to the Dm in these subjects. In the past Dm has been considered to be an unreliable estimation, varying greatly as a result of small errors in the measurement of DLCO. This appears to be relatively true only in normal subjects having low Vc/Dm ratio. In a majority of diverse clinical conditions where the Vc/Dm ratio is increased, the Dm becomes a more reliable estimation. In these patients the DLCO itself is a good index of the membrane diffusing capacity.


Static recoil of the lungs and static compliance in healthy children.

The static lung compliance was studied in 57 healthy children, 6 to 14 years old. A new method called ' end-expiratory-compliane' (C1 EE) has been developed and the results were compared to the data obtained from ZAPLETAL et al. with the 'static pressure-volume' curves technique. The advantages of the method are discussed. The static lung compliance of children increases with height. Static lung compliance value is greater than dynamic lung compliance. This difference is discussed. Static recoil pressure of the lung was measured by the oesophageal baloon technique at so-called 'zero volume' of air in the balloon. At functional residual capacity (FRC), i.e. 41-44% total lung capacity (TLC), static recoil pressure is negative in all children, according to this technique. The taller the child, the more negative is the intrathoracic pressure at the same lung volume in percent of TLC, the slopes of the P/V curve being significantly different in younger and in older children. These data are compared to those observed in adults. The elastic properties of the lungs in younger children seem to be similar to those in older adults as a result of lung growth and aging, which successively influence the elastic behaviour of the lung tissue. The influence of the experimental conditions (intra-oesophageal ballon) on the data collected in children is emphasized.


Pulmonary function in metastatic carcinoma to the lung.

Pulmonary function tests, at rest and during exercise, were performed in nine patients with metastatic carcinoma to the lung. The results are compared to the usual characteristics of diffuse interstitial fibrosis. Differences also occur between the pure multiple metastases pattern and the lymphangitic one. Literature on this topic is reviewed.


Effect of isosorbide dinitrate on hemodynamics and respiration of patients with coronary artery disease and of patients with chronic cor pulmonale.

The influence of isosorbide dinitrate on hemodynamics and gas exchange was studied in 10 patients with coronary artery disease and 10 patients with chronic cor pulmonale. A significant decrease in total pulmonary vascular resistance was found in both groups. This effect seemed mainly to be due to improved conditions for the left ventricle in the patients with coronary heart disease, while it could be explained by vasodilatation of the precapillary pulmonary resistive vessels in the patients with cor pulmonale. In the latter group, there was also a significant increase in the alveolo-arterial PO-2 gradient.


On the theory of base excess curve in the Siggaard-Andersen nomogram.

Two definitions of the base excess (BE) curve are known. The first definition is a geometrical one. We call the second definition the physicochemical one. These definitions are only valid if the water shift between red blood cells and plasma caused by pH alteration is neglected. We show that under this condition the BE curve cannot be calculated according to the mentioned definition. On the contrary we get a well-defined BE curve by calculation only if water shift is taken into account. In that case we must modify the physicochemical definition. The modified equations redefining the BE curve are derived. Furthermore the equivalence of both the geometrical definition and the modified physicochemical definition is shown. Using the modified definition the BE curve is calculated and compared to the curve measured by SIGGARD-ANDERSEN.


Two new pulmonary functional indexes suggested by a simple mathematical model.

We propose a new experiment consisting of several 'single-breath' tests made during different stages of nitrogen (or other inert gas) washouts and then measuring the slope of the alveolar plateau divided by the mean expiratory nitrogen concentration (normalized slope). A simple mathematical analysis predicts that: (a) The normalized slope should grow in function of the breath number n (after the beginning of the washout) chosen to perform the single breath test. It should reach an asymptotic value which is an index of the asynchroism of the expiratory movement (sequential ventilation): Isv. (b) The index of the distribution of the ventilation (IDV) is not the slope of the alveolar plateau as usually considered, but the slope of the normalized slope of the alveolar plateau plotted in function of n and divided by ISV.


[Stenosis of the cervical spinal canal: acquired? congenital].

The authors show that it is impossible to describe congenital stenosis of the cervical rachidian canal with a particular morphology that would make it possible to recognize the condition before the appearance of neurological signs. They do not deny its existence, but at the moment there is no proof, and hope of a prophylaxis for the neuropathy is not justified. On the other hand, there is clearly a possibility of an acquired stenosis. The term arthrosis is so generalized that it has lost nearly all its meaning. The rheumatologist knows the complex lesions comprise osteophytes and thickening of the soft parts next to the bone, and can be accompanied by hypertrophy of the neighbouring bone tissue; projection of the disc, proceeding from a soft hernia to diffuse protrusion and to ossification, is one aspect among others. It is useful to analyse these factors and those concerning the vessels and nerve tissues both in the study of individual cases and in general studies.


[Necrosis and ischemia of the femoral head during arteritis of the lower extremities. Survey of 138 patients with arteritis and 159 aortographies].

Among 138 subjects suffering form arteritis of the lower limbs, the authors found clinical signs of lesions in one or both hips in 47.6 percent of cases and radiological signs in one or both hips in 42.8 percent of cases. Five patients presented a distinct flattening of the femoral head indicating necrosis at stage III, 19 showed voluminous or multiple dense islets in the femoral collar or head indicating necrotic lesions at stage II, and 26 showed narrowing of the superior joint space mostly on the internal side. The authors think ihat the latter sign indicates ischaemic chondropathy. Eleven of the 138 patients had undergone pertrochanteric phlebography : this was abnormal in all 11 cases. At the same time the authors studied the coxofemorals on 159 aortograms and found, among other anomalies, 2 cases of advanced necrosis at the stage of rupture (stage III). This study tends to confirm the occurrence of necrotic lesions of the femur that are secondary to arteriopathies.


[Lymphoblast transformation test in osteoarticular tuberculosis].

Bacteriological proof of an osteoarticular tuberculous lesion is difficult to obtain, notably in Pott's disease. The authors, on the basis of earlier work in the field of pulmonary pathology, wished to assess the value of the lymphocyte transformation test in the diagnosis of this disease. Old tuberculin from the Pasteur Institute and LP48 tuberoulin were used at different concentrations. Out of 10 tuberculous patients (8 with Pott's disease and 2 with white tumours), 9 had positive tests, of which 7 were strongly positive ; the average transformation value was 13 percent. This positiveness was a function of the condition of the patient, of the extent of the lesions, and of the treatment. Of the 25 control patients affected by an infectious, nonmicrobial or other osteoarticular process, 17 gave negative results in the test, and 8 were positive, two of whom had high values. The average transformation value was 4 percent. From this study it seems that a negative result in the LTT is a valuable argument against the diagnosis of osteoarticular tuberculois ; a weak positive result indicates tuberculin hypersensitivity without absolutely defining evolution of tuberculois ; a strongly positive test may be encountered in hyperergic states connected with prolonged infectious conditions in bones or joints.


Intra-articular triamcinolone hexacetonide and osmic acid in persistent synovitis of the knee.

43 rheumatoid knees with persistent effusion were treated by intra-articular injections of triamcinolone hexacetonide (40 mg) or combined triamcinolone - osmic acid. Both treatments produced long-lasting improvements in the treated knees. Osmic acid seemed to potentiate the effect of the steroid. This demonstrated by measurement of joint circumference and local 99mTc uptake. In the general clinical evaluation the difference between the treatments was not noticeable. The percentage of 'excellent' and 'good' improvements was 36 at 12 months in the steroid-group and 44 in the steroid-osmic acid group.


Response of synovial immunocytes to intra-articular agents in experimental arthritis.

In rabbits with immune arthritis the numbers of lymphoid aggregates and pyroninophilic and non-pyroninophilic cells per unit area of synovium were calculated from sections taken at various intervals after intra-articular drug injections. A model of immune arthritis based on the results is presented. In the active phase of the arthritis, plasma cells, plasmablasts and lymphoid aggregates proliferate, while the number of lymphocytes decreases. In the inactive phase after treatment, the cell pattern is the reverse. The ratio of pyroninophilic to non-pyroninophilic cells proved to be a good measure of the activity of the arthritis. A favourable therapeutic effect was achieved with triamcinolone hexacetonide and combined steroid-osmic acid, but not with osmic acid alone.


Thermographic evaluation of intra-articular treatment with radioactive yttrium (90Y) in 62 rheumatoid knee joints.

A total of 62 rheumatoid knee joints were treated with intra-articular 90Y. Results were assessed by clinical, roentgenologic and thermographic examination after a six-month follow-up. The majority of the joints had moderate roentgenologic manifestations of RA before treatment. The roentgenologic stage of the disease did not change during the follow-up period. The thermographic heat emission pattern was pathologic in all cases prior to treatment. The clinical cure and improvement in the thermographic pattern were in agreement in 44 of 50 completely examined cases (88%). The thermographic pattern was unchanged or worse in six knees with a clinically satisfactory anti-inflammatory response. This is probably due to remaining deeper inflammatory activity or to the relatively short observation period of six months, during which time only the clinical symptoms disappeared, while hyperthermy based on increased vascularity remained. The thermographic pattern remained pathologic in all knees without a clinical response to 90Y. Thermography is a safe and reliable complementary method for recording the anti-inflammatory effect of irradiation synovectomy on rheumatoid knees.


The influence of social factors in expectations of pain associated with osteoarthritis.

A survey was conducted on a sample of 113 individuals who might not be under medical care at the time of the study. A stratified random sample was drawn from two lists; one from a population of college teaching faculty who for purposes of the study were defined as upper class, and a second from individuals interviewed in various lower class neighbourhoods in a large metropolitan area. Among other questions the respondents were asked about the amount of pain they would expect to have with arthritis. Lower class, Blacks, and women respondents expect greater amounts of pain than do upper class, Whites, and men. Age, religion, and whether or not a person is married and living with a spouse do not appear to be important factors in an individual's expectations of the amount of pain associated with arthritis.


Rheumatic fever and Yersinia arthritis. Criteria and diagnostic problems in a changing disease pattern.

A study of rheumatic fever (RF) in Finland and Sweden was carried out by examining (a) the patients with RF in two hospitals in Helsinki, Finland during the years 1969-72, (b) the case reports of RF patients in Uppsals hospital region (UHR) in Sweden during the years 1968-69. In Helsinki there were 22 and 2n UHR 16 patients with an acceptably certain diagnosis of RF. Of the five "major manifestations" according to Jones' revised criteria (Circulation, 32: 664, 1965), carditis and polyarthritis were the most valuable diagnostic criteria, whereas only 8 cases of the whole material had erythema marginatum. The two remaining criteria, chorea and subcutaneous nodules, have lost their diagnostic value, since they are extremely rare nowadays. The diagnosis of RF was substantially influenced by arthritis associated with Yersinia enterocolitica infection. Some of the patients with YA met completely the Jones revised criteria for the diagnosis of RF. The symptomatology of Yersinia arthritis (YA) and that of RF are similar in some cases it is impossible to separate then even on the basis of serological tests. Diagnostic criteria should therefore be viewed against the geographical distribution of the disease. In addition to the required Jones' criteria, we concluded that at least in Sweden and Finland, in order to be categorized under RF, a patient must demonstrate clinical and serological evidence of acute streptococcal infection and, furthermore, Yersinia infection must be excluded.


Mycoplasma antibodies in rheumatoid arthritis.

Sera of 100 patients under examination at the Outpatient Department of the Rheumatism Foundation Hospital were studied by the indirect hemagglutination technique, using both mycoplasma reference strains, and isolates from RA and SLE as antigens. The series consisted of five groups: I, definite RA (49 patients); II, probable RA (11); III, possible RA or nonspecific inflammatory arthritis (34); IV, osteoarthrosis (2); V, Reiter's disease (4). Mycoplasma antibodies in titres of 16 or higher were encountered in groups I-IV in 26, 8, 19, and one case respectively. Twenty-one out of 106 blood donors had antibodies against an isolate from RA and/or M. arthritidis strain PG 6. The titres found were 16 or 32, except in two cases, 128. In the definite RA group, 21 out of 26 patients possessing mycoplasma antibodies, showed titres of 16 or higher against isolates from RA and/or SLE, 12 against M. arthritidis strain PG 6 and/or Campo, 8 against M. fermentans, and 6 against a T-strain from NGU. Antibodies against M. arthritidis strain Campo were found more often than against strain PG 6. The longer the duration of the arthritic symptoms was, the more frequent seemed also to be the occurrence of mycoplasma antibodies.


Effect of an intravenously administered bile acid (chenodeoxycholic acid) on rheumatoid arthritis.

On the basis of the earlier observations of an ameliorating effect of jaundice on rheumatoid arthritis, the purpose of the present study was to confirm the influence of bile acids on rheumatoid arthritis. Ten patients were treated with intravenous infusions of chenodeoxycholic acid in single doses of 1-2 g, given over 5-8 hours on 1-4 consecutive days. The concentration of serum bile acids during the infusions were determined. The effect of the treatment was evaluated by means of the subjective experience of the patients, together with the ESR and Lansbury's clinical index. In 6 of the patients, pain relief was obtained for periods of up to 14 days after the last infusion, whereas the symptoms in the remaining 4 patients were unchanged. Where the ESR and the clinical index were concerned, it was characteristic that the course rose and fell, most often with an increase in initial values followed by a cecrease to below the pre-treatment level. In relation to the bile acid infusions, a brief rise, in most cases marked, was observed in the rheuma factors (Waaler-Rose). The serum bile acid concentrations registered during the infusions varied widely. However, no relation was observed between the concentrations and the effect. In all patients, phlebitis occurred in conjunction with each of the infusions. Transient, slight signs of liver injury were recorded in 3 patients, and, in 1 further patient, these signs were more pronounced and accompanied by fever together with deterioration of the joint condition. In all cases, the symptoms had disappeared within 1 week. It is concluded that a certain effect of the bile acid infusions on the clinical condition of rheumatoid arthritis and its related parameters was established. However, the effect was both temporary and inadequate, and especially because of the inevitable occurrence of phlebitis treatment cannot be recommended in tis present form.