The effect of natural and surgically constructed aortopulmonary shunts on hemodynamic function in tetralogy of Fallot.

A hemodynamic model has been developed for the patient with tetralogy of Fallot. Equations representing the circulatory flow pattern and oxygen balance in this disease were incorporated into a computer program. With the computer model it is possible to simulate the effect of natural and surgically constructed aortopulmonary shunt flow on hemodynamic function in tetralogy of Fallot. Graphic representations of the computer output are presented which show how aortopulmonary shunt flow influences the physiology of exercise and hypoxic episodes. An explanation is advanced for the lack of correlation between resting arterial oxygen saturation and the incidence of hypoxic episodes. The model demonstrates the effect of surgical aortopulmonary shunts in eliminating hypoxic spells.


Pulmonary edema following pulmonary valvulotomy.

A previously unreported combination of critical pulmonary valve stenosis and mitral stenosis is described. The initial clinical presentation was one of right ventricular failure that obscured the evidence of pulmonary venous hypertension. Following pulmonary valvulotomy, pulmonary edema ensued because of the increased pulmonary blood flow. The importance of urgent cardiac catheterization postoperatively following an operation that increases pulmonary blood flow is discussed.


[Results of the use of the counter-pulsation balloon in experimental post coronary oclussion cardiogenic shock in closed thorax].

An experimental study of the production of cardiogenic shock together with the results of its treatment by means of the intraaortic balloon was carried out. Cardiogenic shock was produced in dogs with closed thorax and spontaneous respiration. In 13 of the 21 dogs studied, the production of acute myocardial infarction by means of selective embolism of the left circumflex artery permitted the reproduction of a model of cardiogenic shock. Embolism was produced by injecting metalic mercury through a double catheter. Six of the 8 remaining dogs died due to accidental introduction of mercury in the anterior descending coronary artery which produced irreversible ventricular fibrillation. The other 2 died due to rupture of the ascending aorta during the maneuveres to place the coronarygraphy catheter. The 13 dogs with cardiogenic shock were treated with intraaortic balloon pumping during 3-4 hours. The left ventricular systolic pressure fell from 128 +/- 12.07 to 124 +/- 4.65 mm. Hg. The cardiac index increased by 42%. These findings confirm the fact that intraaortic balloon pumping lessens the after load. The fall of the telediastolic pressure by 20% was an index of the lessening or the preload. The aortic telediastolic pressure rose by a mean value of 32.21 mm. Hg. This raises the coronary perfusion pressure thus limiting the extension or reducing the size of the infarction. A frank reduction of the electrographic subepicardiac lesion was observed after using intraaortic balloon pumping. The mean aortic pressure only rose by 8%, the central venous pressure remained unchanged and the increase in diuresis was not estimable. The maximum dP/dt was unaltered and the Vmax. rose 17%. Two dogs were left alive after the experiment and lived for 3 and 12 days respectively. To conclude the results obtained permit us to indicate that intraaortic balloon pumping when used in dogs with this standard type of cardiogenic shock produces an important reduction of the after load, a discrete reduction of the preload and a significative increase in coronary blood flow. There were no changes in cardiac frequency and although the results of myocardial contractility were not definite, they seem to indicate a moderate improvement.


[Tricuspid atresia: A therapeutic problem].

1. The authors present 80 cases of tricuspid atresia of the Children's Cardiology Service of the Instituto Nacional de Cardiología de México. They propose their own classification based on the position of the visceral suits and of the great arteries and the possible existance of a persistent truncus arteriosus. 2. The requirements that should be fulfiled to establish an anatomic and hemodynamic diagnosis are determined; and the need to know in detail the anatomy of the right ventricle; of its exit chamber, of the pulmonary valve and of the pulmonary truncus is emphasized; as well as the measures in the auricles and the left ventricle. 3. They insist upon the need, when the pulmonar arterial pressure cannot be measured directly, to introduce a catheter in a pulmonar vein, because the pressures obtained are quite similar to the pressure in the pulmonar arterial territory. 4. The fundamental data of the anatomic and hemodynamic study are discussed and illustrated. They confirm the close relation that exists between the diameter of the exit chamber of the right ventricle and of the valvular ring, the pulmonary truncus and its branches. 5. In all cases of tricuspid atresia with AQRS deviated to the right and downwards in the frontal plane; transposition of the great arteries should be thought of when it deviates to the left and upwards, in patients with crossed great arteries. 6. In the cases operated with sistemic-pulmonary fistula, there was an intrahospital mortality range of 25%, similar to that obtained by most authors. 7. The paliative surgical procedures are analyzed, and those that at present could be considered as "corrective" such as Fontan and Kreutzer's operations. The need, to gather several diagnostic parameters. To establish the surgical indication in the sistemicpulmonary and venus shunts, is emphasized.


[Aneurysm of the pulmonary artery. Analysis of 7 cases].

Aneurysms of the pulmonary artery are very rare, very few have been reported in medical literature. It is the purpose of this paper to present and discuss 7 cases. The etiology was congenital in 2, syphilitic in 2, cystic medionecrosis in 1, and mycotic in 2. The diagnosis was confirmed by necropsis in 3, and by angiography in 4. The basic clinical aspects are hemoptysis, pulmonary ejective murmur, and the radiological findings. The evolution depends on the etiology. The mycotic aneurysms ruptured and the patient with cystic medionecrosis died in heart failure. One of the syphilitic aneurysms died from an unrelated cause, and the others are alive and asymptomatic. The medical treatment is determined by the etiology.


[Phonomechanocardiography in the evaluation of the functional status of valvular prosthesis].

The FMCG in 22 patients with valvular prosthesis is analyzed and its clinical, hemodynamic and surgical correlation are established (11 from the I.N.C. and 11 from the Hospital Infantil I.M.A.N.). The average age of the patients was 15 years old, 18 had a mitral and six aortic valvulopathy, and they all required a valvular replacement. Of the mitral prosthesis, 14 were Starr-Edwards (13 of ball valve and one of disc), three Lillehei-Kaster and one Börck-Shiley. In 5 patients, the FMCG suspected disfunction that was later corroborated by catheterism in three patients and by surgery in all of them. The important differences of the FMCG between the group with good and the one with bad function were: the aparition of a rumble, a decrease in the amplitud of the closing snap, index of closing snap opering snap of less than one, lenghtening of fases PFVP and IVCP, and shortening of IVDRP. In the patients with auricular fibrilation, after long dyastoles; that would represent an adequate atrial emptying; the closing snap was more intense, the PFVP was lennthened the IVDRP was shortened when the prosthesis was not properly functioning. All the aortic prosthesis were ball valve Starr-Edwards type; in one the FMCG suspected disfunction and the patient had a sudden death outside of the Hospital. The significant differences of the FMCG were the decrease in the intensity of the opening snap, with a Hylen index of less than one, lengthening of the PFVP, IVCP and of the expulsive period (EP). The authors conclude that the FMCG is a good method for an early detection of the disfunctions of valvular prosthesis.


[Phonomechanocardiographic analysis in patients with artifical pacemaker].

Eighteen patients with artificial pacemakers have been studied by phonomecanocardiographic means. All had complete atrio-ventricular block. Ten had an endocardial electrode in the right ventricle and 10 an epicardial in the free wall of the left ventricle. Two patients were studied, first with a temporal endocardial pacemaker and then with a permanent one. The studies were divided in 3 groups: Group I. In six cases comparison was made between the systolic tunes of the normally conducted cycles, and the ones produced by direct ventricular stimulations. The beats produced by direct ventricular stimulation showed a statistically significant diminution of the function of the left ventricle. This was reflected by a shorter relative ejection period. This diminution can possibly be explained by one of two mechanisms: absence of the "atrial kick", or alteration in the sequence of depolarization and ventricular contraction, producing an asynchrony in the contraction. This would lead us to suppose that the best site for contact of the electrode would be the middle third of the left aspect of the ventricular septum, where the activation starts normally. Group II. Ventricular function was compared in 20 cases, depending on the site of electrical stimulation: endocardium of right ventricle or epicardium of the left ventricle: there were no statistically significant differences. Group III. On 14 cases we studied cycles in which an effective contribution of the atrial kick could be expected, because the interval between the P wave and the electrical artifact was less than 300 msec. These were compared with others with a larger, statistically significant, improvement of the left ventricular function it was observed as a longer ejection period in the cases with a P wave-electrical artifact pause shorter than 300 msec.


[Value of the electrocardiogram to predict the pattern of left ventricular contraction in ischemic cardiopathy].

A correlative electrocardiographic and ventriculographic study was performed in a series of 100 patients with clinical and electrocardiographic diagnosis of ischemic heart disease. The analysis was focused on the possibility of predicting ventricular contraction pattern (VCP) disturbances, through electrocardiographic signs of coronary insufficiency. Two main groups were separated on the basis of the presence of necrosis. There were 66 cases with necrosis, and 34 without it. The type of VCP was calssified in accordance with the criterion of Herman et al. in: asyneresis, akinesis and dyskininesis. The degree of coronary narrowing was arbitrarily evalued as less than 50%, between 50 and 75%, and over 75% of the lumen.


[The effects of imolamine on auriculo-ventricular conduction by recoil of His potential].

The electropharmacological action of imolamine was studied using Hiss bundle electrography.  In dogs with spontaneous sinusal rhythm, imolamine decreases Hiss-Purkinje and total intraventricular conduction, without affecting auriculoventricular conduction time. In dogs with paced sinusal rhythm (180/min), imolamine increases atrial and ventricular thresholds and atrial refractory period, and decreases intra-atrial and intraventricular conduction; no significant modification of auriculoventricular conduction was noted at therapeutic dosages. In ouabaïn-intoxicated dogs, imolamine suppresses digitalis rhythm disorders and antagonizes the action of the glycoside on A-V node, as does diphenylhydantoïne, but, in contrast to this drug, it increases slightly intraventricular conductivity.


[QRS in mitral stenosis: Electrohemodynamic correlation].

The electrocardiograms of 50 patients with mitral stenosis in sinus rhythm were reviewed (axis of QRS and T in the frontal and horizontal planes, with each one of their modules, Lewis index and right Sokolow-Lyon, quotient R/R + S in V1, time of beginning of the intrinsecoide deflection of QRS), they were related with the hemodynamic data; and the existence of clear relations between both methods of exploration were confirmed. 1. The QRS axis in the frontal plane kept a good relation with the hemodynamic data (mainly thzontal axis there proved to be a closer relation than in this one. 2. The quotient R/R + S in V1 was the parameter that best correlated with the mean pressure of the pulmonary artery and with the pulmonar capillary pressure. 3. Although the right Sokolow-Lyon index is not a definite criterion for recognizing a right ventricular hypertrophy; it is very useful in correlating the total pulmonary resistances with the mean pulmonary arterial pressure, even if it did not reach pathologic values. The same can be said the Lewis index, although the dependence is less important. 4. The horizontalization of the frontal axis of T becomes more important with the increase in the hemodynamic repercution. 5. As an expression of the systemic hemodynamic alteration, the decrease in time of inscription of the intrinsecoid deflection, of the left ventricle in V6 became evident when the mitral area diminished or by increase of mean pressure of the pulmonary artery. 6. The electrocardiographic characteristics that allow to recognize the existence of a mitral area smaller than 0.8 cm2, with a possibility of error of less than 5% (false positives), are: -- a horizontal axis of QRS less or equal to + 9 degrees -- a right Sokolow-Lyon index of more than 21.56. 7. The existence of a mean pressure of more than 25 mm. Hg in the pulmonary artery can be acknowledged, with a possibility of false positives of less than 5%, by the apparition of one or more of the following data: -- a frontal axis of QRS more or equal to + 87 degrees -- a Lewis index of less than -7.44. 8. The diagnosis of mean pressures of the pulmonary artery of more than 35 mm. Hg can be established, with the same degree of possibility, by: -- a T frontal axis of less or equal to + 10 degrees -- a horizontal axis of QRS of less or equal to + 13 degrees -- a right Sokolow-Lyon index of more than 19.71 -- a quotient R/R + S in V1 more or equal to 0.88. 9. The only finding that permits to establish of a pulmonary capillary pressure higher of 25 mm. Hg, with false positives possibility of less of 5% is: -- quotient R/R + S in higher or equal to 0.07 in V1.


[Electro-ventorcardiographic manifestations of ventricular inversion with transposition of great arteries].

Electrocardiograms obtained in two groups of patients with inversion of the ventricles and transposition of the great arteries, were analyzed: group I corresponding in situs solitus and group II to situs inversus. This series comprises 36 cases (29 of group I and 7 of Group II), in which the diagnosis of the main congenital heart disease --ventricular inversion-- and of the associated defects was established by angiocardiography. In 7 cases of group I and in one of group II, the angiocardiographic diagnosis was proved at least in part during open heart surgery. Direct anatomic study was possible in 5 more cases of group I and in 2 more of group II. Each group comprises two subgroups: A, without RBBB, and B, with RBBB of different degrees. Group I consists of 11 cases of subgroup A and 18 of subgroup B. In group II there were 2 cases of subgroup A and 5 of subgroup B. Vectorcardiograms were obtained following Grishman's method in 17 cases of group I (8 of subgroup A and 9 of subgroup B) and in 3 cases of group II (1 of subgroup A and 2 of subgroup B). In 7 cases of group I (5 of subgroup A and 2 of subgroup B), it was possible to record also the vectorcardiographic curves following Frank's method. Electro and vectorcardiographic findings were correlated with hemodynamic data and, in some cases, also with anatomic ones.


[Comparison of the antiarrhythmic effects of PGA1, PGA2, PGE1, PGE2 and PGF2 alpha on a barium chloride arrhythmia model in unanesthetized rabbits].

Experimental studies on BaCl2 induced arrhythmias in unanaesthetized rabbits showed an antiarrhythmic effect of prostaglandins A1, A2, E1, E2 and F2a by infusions of 0,1 to 6,0 mug/kg/min over 3 min. There was a maximum antiarrhythmic effect between 50% and 80%. Ajmaline was similarly effective when given in doses 100-1000 times higher. PGA1 and PGE2 were most effective in this model; the ED50-values of the other PGs were 2-3 times higher. The mode of action of PGs is unknown; the following factors are discussed: the influence on the ionic movements, the negative feedback mechanism on the release of adrenergic transmitter and central nervous effects.


Comparison between the effects of ST 600 and clonidine.

The effects of the antihypertensive imidazoline compounds 2-(5 fluor-0-toluidine)-2-imidazoline hydrochloride (ST 600) and 2-(2, 6 dichlorophenylamine)-2-imidazoline hydrochloride (ST 155, clonidine, Catapres) on intra-arterial pressure, cardiac output, stroke volume, heart rate, total peripheral resistance, renal blood flow, glomerular filtration rate, renal vascular resistance, plasma volume, plasma renin and aldosterone concentration were studied in five patients with essential hypertension. The antihypertensive action of both compounds was similar and was accompanied by a reduction in heart rate and in cardiac output, total peripheral resistance being unchanged. There was no significant decrease in renal blood flow and glomerular filtration rate. Plasma volume and plasma concentrations of renin and aldosterone also did not change significantly. In the face of similar reductions in blood pressure, no differences were observed between cardio-renal haemodynamic responses after ST 600 and clonidine. However ST 600 had a longer lasting effect (8-12 hours).


[Value of interacardiac recordings in the evaluation of positive QRS in V1 provoked by stimulation of the right ventricle].

The analysis of the common bundle and of the ventrical filtered electrograms has incrased our knowledge of the intraventricular conduction following the simulation of the PVS as well as the different types or reciprocating that can be produced by premature beats. 2. The positive QRS complexes in V1 produced from PVD by St2 can be explained as a greater degree of incomplete recuperation of the right ventricular wall than in the interventricular septum. In contrast with what happened in the basal beats, where the front took longer to reach the TSVD than the VI. 3. The refractarines of the transitional tissues that serve as the phisiological banier was longer than the banal myocardium. The intraventricular propagation, and therefore the morphology and direction of QRS, depended of this one; while the moment of arrival of activation retrogradly to the common bundle was conditioned by the transitional tissues. 4. Episodes of ventricular taquicardies with QRS positive complexes in V1 can be due to a re-entry throught the bundle branches or in (or around) an area that has been recently injured.


[Acut aortic insufficiency caused by rupture of a normal valve during labor].

We are presenting a case of a young woman with sudden onset of heart failure and several episodes of syncope, after a prolonged labor. The findings at physical examination suggested the diagnosis of acute aortic insufficiency, that was confirmed by cardiac catheterization. At surgery, the aortic valve showed a round perforation in the non coronary cusp. Pathological examination of the valve showed no significant abnormality. We conclude that the stress of labor was the cause of the rupture of a previously normal aortic valve.


[Agenesis of the right branch of the pulmonary artery, diagnosis by lung scan].

The white thrombus is formed due to the platelet adhesiveness to the vascular wall, and to their agglutination mediated by the liberation of ADP, the adenosine inactivation and the deposit of calcium and accelerating factors of coagulation as well. The red thrombus is formed by the thromboplastic activity, combined with the action of several coagulation factors, fibrin, erythrocytes and leucocytes. For the above mentioned facts, we may try to avoid the white thrombus formation by means of antiadhesive platelets drug, and the red thrombus production with the use of anticoagulants. If the thrombus is already formed, the drugs of choice are the fibrinolytics, to intend the dissolution of the clot. In the present paper, the mean characteristics as well as the actual concepts on the use of these three groups of drugs, are described.


Loperamide antagonism of castor oil-induced diarrhea in rats: a quantitative study.

The time-course of castor oil-induced diarrhea in fasted rats was quantified by weighing stools every 15 minutes for 8 hours after the challenge and then after 24 hours. Diarrhea began within 1 hour as a series of rapidly occurring evacuations over 20 to 40 minutes. The mean weight of these stools was 5.7 g; later irregular evacuations increased the weight to 9.4 g at 8 hours. The area of individual time-weight diagrams had a median value of 432 units. Pretreatment with 0.16 mg/kg of loperamide, a new antidiarrheal drug, significantly decreased the area of similarly obtained diagrams; 0.31 mg/kg caused a 50% reduction. This antagonism by loperamide of castor oil-induced diarrhea may involve reduction in the severity of inflammatory changes in the intestinal wall.


Direct renal hemodynamic effects of two vasodilators: diazoxide and acetylcholine.

The direct renal hemodynamic effect of two different vasodilators, diazoxide and acetylcholine, in the anesthetized dog, were studied. In 12 dogs (Group 1), diazoxide was given first directly into the renal artery and was followed by the addition of acetylcholine. In 6 dogs (Group 2) the order of drug administration was reversed. The glomerular filtration rate (GFR), the effective renal plasma flow (ERDF), and the excretion of sodium, potassium, chloride, and urine output were determined for both control and experimental (infused) kidneys. Both drugs when given alone resulted in a significant increase of all parameters tested on the experimental kidney, except the ERPF which was spuriously decreased by diazoxide. The addition of either drug upon the first given did not produce and further effect. It was, therefore, concluded that the hemodynamic changes, as well as the handling of electrolytes and water by the kidney, were solely due to the vasodilating properties of both compounds. A local renal tubular effect by diazoxide concerning sodium excretion could not be substantiated by our studies.


Effects of suprofen, an inhibitor of prostaglandin biosynthesis, on platelet function, plasma coagulation and fibrinolysis II. In vivo experiments.

Suprofen, an inhibitor of prostaglandin biosynthesis, was found to affect certain aspects of platelet function after in vivo administration in various species. In guinea-pigs, platelet aggregation induced by collagen and Thrombofax, and secondary A.D.P. aggregation were reduced in a dose-dependent way by suprofen (single oral administration) from 0.08 mg/kg on. In dogs, the effect of a single oral dose of 2.5 mg/kg of suprofen on collagen-induced aggregation started 30 min after administration, lasted for at least 8 h and had disappeared after 24 h. Plasma coagulation parameters were not affected by the compound in this species. In rats, suprofen prolonged tail bleeding times, but did not modify fibrinolysis, platelet adhesion to glass beads or plasma coagulation. Sub-chronic administration of comparatively high doses of the compound resulted in potentiation of the anti-coagulant effect of warfarin in this species.


In vitro influence of steroidal hormones on protein and glucose metabolism of isolated granulomatous tissue cells.

A standard method of preparing isolated cells from granulomatous tissue capsules was developed. Results of morphological and chemical studies indicated that the cells were intact and functional. An inhibitory effect of glucocorticoids added in vitro was demonstrated for the first time, and this effect was consonant with the influence of glucocorticoids on granulomas in vivo. The isolated cells were predominantly monocytes, macrophages and lymphocytes with smaller numbers of polymorphonuclear leucocytes, mast cells and fibroblasts. Dimethyl sulfoxide, used to aid steroid solubilization (0.0016 ml/ml), had no influence on protein synthesis or on glucose oxidation. Cholesterol, a nonhormonally active sterol (1 x 10(-4) M, 3 x 10(-4) M), had no effect on labeled glycine incorporation. Methylprednisolone (1 x 10(-4) M, 3 x 10(-4) M) decreased protein synthesis after 30 min of incubation indicating that this might be one important early mechanism of action. Methylprednisolone (1 x 10(-4) M) had no influence on glucose oxidation. Deoxycorticosterone (1 x 10(-4) M, 3 X 10(-4) M) inhibited both protein synthesis and glucose oxidation after 30 min of incubation.


Contractor effect of barbiturates on smooth muscle.

Four different convulsant barbiturates and also thiopental, methohexital and pentobarbital were tested for in vitro contractor effects on rabbit jejunal segments, aortic strips and tracheal chains. The two convulsants that elicited lethal, tonic seizures in vivo contracted all three types of isolated preparation; however, two other convulsants that elicited intense but nonlethal, clonic seizures lacked contractor effect. Methohexital and pentobarbital also lacked contractor effect. In aortic strips, contractions induced by the two convulsants were not impaired by concentrations of phenoxybenzamine (10(-5) M) that blocked all contractor response to 10(-4) M norepinephrine, acetylcholine or histamine. Thiopental also contracted aortic strips but the effect differed from that of the convulsants in that it was much less intense, was partially antagonized by pretreatment with phenoxybenzamine, and was greatly potentiated by the presence of norepinephrine. Intense contractor effects, independent of adrenergic mechanisms, seem characteristic of a particular group of convulsant barbiturates; there are also similar with respect to structure, stimulant potency, and seizure pattern.


Comparison of animal models for predicting bronchodilator efficacy in man.

In vitro and in vivo models of bronchodilation were compared to assess their relative usefulness for  predicting clinical efficacy. Drugs studied were isoproterenol, isoetharine, salbutamol, hexoprenaline, terbutaline, ephedrine and aminophylline. In vitro preparations were guinea pig perfused lung, tracheal strip and spontaneously beating right atria. In vivo, drugs were compared by three routes in conscious guinea pigs and anesthetized dogs and relative  potency estimates and separations of bronchodilator and heart rate effects of these agents were determined. The  Spearman rank correlation coefficient was statistically significant when the effects of the drugs were compared for guinea pig perfused lung and tracheal responses, in vivo guinea pig and dog intravenous and oral (or intraduodenal) responses. Aerosol results did not correlate, most likely due to differences in experimental techniques. Relative potency estimates were in general agreement with human data in the literature and support the use of these tests for the study of bronchodilator agents.


Effects of atropine and neostigmine on receptor interaction at the neuromuscular junction.

Rats treated chronically with atropine or atropine and neostigmine showed marked alterations in the responsiveness of receptors at the neuromuscular junction. Receptors in the phrenic nerve-hemidiaphragm interacting with d-tubocurarine were unaffected by atropine but exhibited a supersensitivity after neostigmine administration. Succinylcholine-sensitive sites developed a subsensitivity with both atropine and neostigmine treatment. Acetylcholine-induced contractures in the denervated hemidiaphragm showed a hypersensitivity after both drug administrations, but responses to carbamylcholine were unaffected. It is suggested that there exists a heterogeneous population of receptors at the mammalian neuromuscular junction who can be identified by their responses to the effects of chronic drug application.


Cardiovascular and antiarrhythmic effects of carnitine.

Thresholds for electrically induced atrial fibrillation were measured in response to IV carnitine. Mean arterial pressure, heart rate, and mean aortic flow rate were also monitored. Carnitine 100 mg/kg resulted in an increase in mean aortic blood flow. The antiarrhythmic effect was much less than with 5 mg/kg quinidine, but after atropinization, 100 mg/kg carnitine was similar in antiarrhythmic effect to quinidine and did not result in the blood pressure depression seen with quinidine.


Effects of L-dopa on myocardial contractile force: a reappraisal.

The apparent decrease in myocardial force of contraction observed after L-dopa, 10 mg/kg i.v., is artifactual since the maximum rate of left venticular isovolumic pressure rise (dP/dt) remains elevated. The apparent decrease is due to shrinkage in heart size secondary to venous "pooling". The decrease in contractile force parallels a decrease in cardiac output. A peripheral decarboxylase inhibitor and L-dopa produce a decrease in both contractile force and dP/dt. Strain gauge arch recordings may produce false-positive data during marked venous pooling.


The effect of ethylurethane on hematocrit, blood pressure and plasma-glucose.

Intraperitoneal (i.p.) injection of 25% ethylurethane (i.e. 2.8 M) in a dose of 1 g/kg causes a rise in hematocrit (Hct) accompanied by an identical rise in erythrocyte count but by a fall in plasma protein. This effect is absent after intra-arterial (i.a.) and oral administration and much reduced after subcutaneous (s.c.) injection. The hemoconcentration is not caused by osmotic attraction of fluid but by leakage of blood plasma into the peritoneal cavity. The higly concentrated urethane solution causes superificial damage of intra-abdominal organs. Extensive local damage is also observed after s.c. and intramuscular injection of 25% urethane. The fall in blood pressure which is found after i.p. injection, but is absent after i.a. injection, can be explained by the loss of blood plasma. Plasma-glucose rises after i.p. injection but not after i.a. injection. This hyperglycemia may be initiated by stimuli arising in the damaged tissues.


Effect of amantadine on blood pressure responses induced by vagal and sympathetic stimulation.

Amantadine antagonizes the blood pressure responses evoked by electrical stimulation of the central and peripheral end of the vagus. Blood pressure responses on sympathetic stimulation are also attenuated. These results could be explained on the basis of a possible effect on autonomic ganglia.


The effects of dexetimide on pimozide-, haloperidol- and pipamperone-induced inhibition of brain self-stimulation in rats.

Pimozide (0.04, 0.16, 0.63 and 2.50 mg/kg), haloperidol (0.01, 0.04, 0.16 and 0.63 mg/kg) and pipamperone (2.50, 10.0, 40.0 and 160 mg/kg) were given subcutaneously to rats, pressing a lever for brain-stimulation through electrodes implanted in the lateral hypothalamic region of the medial forebrain bundle. The lowest dose of each neuroleptic did not affect self-stimulation; the second dose inhibited the response rate by approximately 50%, whereas the two highest doses completely suppressed self-stimulation behaviour. The centrally acting anticholinergic dexetimide (0.63 mg/kg, s.c.) completly antagonized the pimozide-induced inhibition; the haloperidol-induced inhibition was also completely antagonized except at its highest doses, whereas the effects of the sedative neuroleptic pipamperone were not antagonized. These data are consistent with a presumed dopaminergic cholinergic striatal interaction and show brain self-stimulation to be an effective measure of neuroleptic-anticholinergic interaction.


Dichlorvos and the cholinergic system: effects on cholinesterase and acetylcholine and choline contents of rat tissues.

The inhibition of cholinesterase by 50 mg/kg/5 ml, p.o., dichlorvos and subsequent recovery of enzyme activity was uniform in all brain regions studied. This uniformity was not observed in liver, erythrocytes and plasma. Acetylcholine levels were elevated in brain areas from 48 to 171% at 15 minutes after treatment. However, a biphasic effect was seen on choline metabolism in the brain. The cortex was found to be more cholinergic than the striatum in terms of per cent increase in acetylcholine and choline.


The effect  of 1-sarcosine, 8-leucyl angiotensin II on glycerol-induced acute renal failure.

Several studies have suggested that increased activity of the renin-angiotensin system plays an important role in the pathogenesis of acute renal failure. An analog of angiotensin II, 1-sarcosine, 8-leucyl angiotensin II (AIIA), a potent antagonist of the pressor response of angiotensin II (AII), was injected (16 mug/200 gm) or infused (1.5 mug/200 gm/min) intravenously into glycerol treated (8 ml/kg) rats to evaluate the involvement of the renin-angiotensin system as a mediator in the pathogenesis of acute renal failure. Dehydrated animals, whether untreated, given AIIA, or saline became progressively azotemic and died with 72 hours after glycerol administration. Plasma renin activity, as measured by radioimmunoassay, decreased below dehydrated control levels at one hour after glycerol administration (7.45 ng/ml/hr +/- 1.29 (SE) to 3.24 +/- 0.64), and progressively increased to a maximum 9.9 +/- 0.98) at 17 hours; there was no difference between dehydrated control levels and those obtained 24 and 48 hours after glycerol. Nondehydrated glycerol treated rats were studied as above. These animals developed a non-lethal form of acute renal failure, the severity of which was also unaffected by AIIA administration. These observations indicate that AIIA neither prevents nor alters the development of glycerol induced acute renal failure.


[The influence of treatment with cocaine on the synthesis and liberation of cerebral noradrenaline].

The influence of cocaine (10 mg/kg, i.m.) on the synthesis and the release of noradrenaline (NA) has been studied in rat brain. Cocaine pretreatment reduced significantly the amount of NA-3H synthetized from tyrosine-3H (TY-3H) in the whole brain and various cerebral structures. The synthesis rates of NA (estimated by calculation of the ratio: amount of NA-3H/tissular specific activity of TY-3H) were reduced by 40% in the whole brain, 30 and 60 min after administration of TY-3H. The rise of the NA endogenous level 10 min after administration of a monamine  oxidase inhibitor (ranylcypromine) was inhibited after cocaine treatment. The release of NA has been studied after inhibition of its synthesis by alpha-methyl-paratyrosine. Cocaine pretreatment significantly delayed the disappearance rate of cerebral NA. The possible mechanisms by which cocaine reduced NA turnover are discussed.


[Accumulation of ephedrine, norephedrine, amphetamine and tyramine labeled with carbon 14 in pigmented and non-pigmented eyes in two races of rats].

The pigmented eyes of non albino rats (PVG) accumulated ephedrine, norephedrine and amphetamine. After 15 min accumulation of ephedrine and amphetamine was larger than of norephedrine. Autoradiographic studies showed that accumulation occurred in melanin containing iris and choroid and also in lacrymal glands which lack melanin. Accumulation of tyramine did not occur in eyes containing melanin. The non pigmented eyes of albino rats did not accumulate ephedrine, amphetamine, norephedrine and tyramine. It appeared that in pigmented eyes melanin was a site of loss of ephedrine,  amphetamine and norephedrine; hence a smaller amount of drug will be available for interaction with adrenergic neurons and a smaller mydriatic effect will occur. Accumulation is possible only when metabolism is low, as observed with alpha-methylated amines. The four sympathomimetic amines used did not accumulate in the pigmented skin of black and white rats.


Preventive effect of estrogen on postmenopausal bone loss.

Follow-up studies of bone mineral content in the radius were done in 82 postmenopausal women 4 to 10 years after the first examination. These patients were subdivided into four groups depending on the type of menopause (artificial or natural) and estrogen administration (treated or untreated). Bone mineral mass and combined cortical thickness decreased significantly in both groups of untreated women. Both mineral loss per year for the untreated women was -9.1 mg/sq cm for castrates and -6.9 mg/sq cm for those with a natural menopause. In neither group was the rate of loss correlated with age. The change in bone mineral mass per year in the estrogen-treated subjects (mean +3.25 mg/sq cm) differed significantly from that of untreated subjects (mean -7.99 mg/sq cm). The findings suggest that postmenopausal osteoporosis could be prevented by estrogen treatment.


A reappraisal of staging and therapy for patients with cancer of the rectum. I. Development of two new systems of staging.

Existing systems of staging for patients with rectal cancer depend almost exclusively on anatomic evidence. Consequently, the stages cannot be determined in advance of therapeutic decisions and cannot be used for patients treated without surgery. Furthermore, the stages contain no provision for important prognostic distinctions, that cannot be discerned from anatomic data. After preparing a taxonomy for hiterto unclassified medical data, we developed and tested two new systems of staging in a cohort if 318 patients. The first system which can be applied before treatment, is divided into four composite stages that contain elements of symptomatic, chronometric, co-morbid, and para-morbid data, as well as information obtained from physical examination, sigmoidoscopy, and roentgenography. The second system, applicable to patients with resected tumors, is based on a combination of pre-therapeutic clinical information and post-surgical anatomic evidence. The two systems produce prognostic gradients that are clinically distinctive and statistically efficacious.


A reappraisal of staging and therapy for patients with cancer of the rectum. II. Patterns of presentation and outcome of treatment.

Two new biologically composite systems of staging were used to analyze the patterns of presentation, therapy, and outcome for 318 patients with rectal cancer. Selectional bias was evident in therapeutic decisions. The patients chosen for surgical exploration and possible resection came mainly from prognostically favorable stages and had higher survival rates than the "inoperable" patients wven when the tumor was not resected. In patients with tumors located 8 cm or higher above the anus, survival rates in each composite symptom-anatomic (S-A) stage were essentially similar with radical and simple resections. Radical surgery gave better survival rates than simple surgery for tumors at 5 to 7 cm and was an anatomic necessity to remove tumors at 0 to 4 cm. Regardless of the extensiveness of surgery, the S-A stages were directly related to rates of postoperative infection, postoperative death, subsequent quality of life, and deaths due either to cancer or to noncancer causes.


Physiologic and biochemical abnormalities in self-induced drug overdosage.

The following abnormalities were observed during the first 24 hours of admission for 162 drug overdosage (OD) episodes in 152 patients: abnormal chest x-ray films; increased A-aO2 gradient; elevated white blood cell (WBC) counts; elevated serum enzyme levels; gross myoglobinuria; skin lesions suggestive of pressure necrosis; and abnormal electrocardiograms. Many sputum cultures were positive for single or multiple potentially pathogenic organisms. These correlations existed: all patients with OD duration of less than 12 hours were hyperthermic; as temperatures increased so did WBC counts; hyperthermic patients had higher creatine phosphokinase (CPK) values than those with hypothermia or normothermia; patients with skin lesions had higher temperatures and CPK values and longer OD duration; serum enzme levels increased with increasing OD duration; patients with CPK levels greater than 10,000 mU/ml had myoglobinuria; and patients with the most abnormal chest x-ray films had higher temperatures and larger A-aO2 gradients. Incidence of pneumonitis is low, even with abnormal chest radiograms, leukocytosis, hyperthermia, and positive sputum cultures. Abnormal temperatures and leukocytosis are probably secondary to stress, hypoxemia, acidosis, and specific drug ingestion rather than infection.


Long-term observations of glucose tolerance in thyrotoxic patients.

In an attemp- to clarify the clinical importance of glucose intolerance associated with acute thyrotoxicosis, 22 patients had evaluations performed for glucose tolerance while thyrotoxic and at mean follow-up times of 8.8 months and 11.6 years after adequate antithyroid treatment. High incidences of glucose intolerance at long-term follow-up (32%) and of histories suggestive of diabetic diathesis (43%) support the hypothesis that there is an inherited relationship between diabetes mellitus and thyrotoxicosis and suggest that initial testing of all thyrotoxic patients for glucose intolerance is advisable. In addition, all thyrotoxic patients displaying diabetic glucose intolerance after a return to the euthyroid state should be considered to have permanent diabetes mellitus until proved otherwise.


Evidence for mild reversible hyperparathyroidism in distal renal tubular acidosis.

Circulating levels of immunoreactive parathyroid hormone were measured in six patients with distal renal tubular acidosis before and during two years of long-term alkali therapy. Parathyroid hormone level was elevated modestly in five patients before treatment and fell, gradually during treatment to normal or near normal levels. Urine calcium level fell, serum calcium level rose, and renal phosphorus reabsorption rose during treatment. Stopping treatment briefly caused reversion of serum parathyroid hormone and calcium levels and renal phosphorus reabsorption to pretreatment values within eight weeks. Mild hyperparathyroidism is present in renal tubular acidosis and reverses with alkali treatment.


Misplacement of central venous pressure catheters and unilateral pulmonary edema.

Two instances of misplacement of a central venous pressure monitoring catheter into a pulmonary artery are presented. In one case, reported in detail, unilateral pulmonary edema developed during administration of 0.5N saline for the treatment of diabetic acidosis via the misplaced catheter, and it reverted following repositioning of the catheter in the superior  vena caca. Experiments were carried out in dogs to explore possible causes of this phenomenon. The results of these experiments suggest that the release of vasoactive substances, stimulation of neural reflexes, or both are the pathophysiological mechanisms responsible for the development of the pulmonary edema.


Tetany, malabsorption, and mastocytosis.

Mastocytosis is characterized by increased proliferation of mast cells. Two patients had systemic mastocytosis involving the skin and gastrointestinal tract, complicated by malabsorption and tetany. Absorption studies in these patients suggested that the entire small bowel was involved and that the defect was mild in the absence of diarrhea. Small bowel biopsies disclosed infiltration of the lamina propria and submucosa by mast cells, and gastrointestinal tract x-ray films showed nodular densities, edema, and thickening of the bowel wall. Tetany was due in part to combined hypocalcemia, hypomagnesemia, and hypokalemia. Diarrhea and malabsorption were due to mast cell infiltration of the bowel rather than to histamine. patients with signs of systemic mastocytosis should have careful evaluations and be followed up to prevent development of malabsorption and tetany.


Empty sella syndrome. Sequela of the spontaneous remission of acromegaly.

Untreated acromegaly is usually a progressive disorder resulting in early death from cardiovascular or pulmonary complications. Although spontaneous remission of the metabolic features of acromegaly is not uncommon, its correlation with return to truly normal serum growth hormone concentrations is not routinely documented. This study reports a patient with the empty sella syndrome occurring as a sequel to the spontaneous remission of acromegaly. This association, as well as the preservation of normal anterior-pituitary function, suggests that selective tumor infarction resulted in the "empty sella" and cessation of active acromegaly.


[Quantitative analysis of the electroencephalographic activity during human sleep].

Correlation of hormonal changes and EEG activity requires objective measurements to define the behavior of the different frequency bands during sleep. With this purpose, EEG activity of six healthy male volunteers (19-22 years) was recorded throughout all night during spontaneous sleep. The C4-left mastoid EEG combination was channeled to a frequency analyzer with four band pass filters (beta, alpha, theta, and delta) using a one minute averaging interval. Analyzer data were fed to an IBM-1130 computer, programmed with RC filter recursive algorithm. Sleep stages were characterized in the polygraphic record (Rechtshaffen criteria), and identified in the smoothed profile. The latter was computed for mean voltage value of each band during the sleep stages. Differences in the behavior of each band throughout sleep stages were statistically tested. Delta activity showed the highest discriminatory capacity characterized by a statistically different mean voltage value in all sleep stages, with the exception of R-I. The method is proposed for quantitative correlation of the EEG sleep phenomena with another physiological parameters.


Halobacterium volcanii spec. nov., a Dead Sea halobacterium with a moderate salt requirement.

A halophilic bacterium was isolated from bottom sediment from the Dead Sea. The organism possessed the properties of the halobacteria, but differed from the known species in two important respects, 1) the cells were disc shaped and often cupped when grown under optimum conditions, 2) the optimum requirements for sodium chloride was in the range 1.7--2.5 molar which is about half of that generally reported for the halobacteria. The organism was assigned to the genus Halobacterium and described as Halobacterium volcanni spec. rov. The optimum sodium chloride concentration for growth was close to that found in the Dead Sea. The tolerance for magnesium chloride was very high; the organism grew well in media containing magnesium chloride in the concentrations found in the Dead Sea. Halobacterium volcanii is therefore remarkably well fitted for life in the Dead Sea.


[Electron microscopy of ageing cells of Pseudomonas rhodos: fine structure of native and isolated tubular membranes (author's transl)].

During a 10 day-incubation on agar surfaces at 30 degrees C, cells of the gram-negative soil bacterium Pseudomonas rhodos pass through three phases distinguishable by physiological and morphological criteria. When viewed by electron microscopy, typically "rolled" mesosomes could frequently be observed in young cells. In aged cells instead, loosely rolled or stretched-out, flattened tubules could be discerned, presumed to be degenerate mesosomes. Tubular flattened structures have been isolated from these cells by lysozyme treatment or sonication and were concentrated by differential centrifugation. Electron micrographs of these preparations showed long, straight tubules which sometimes appeared sealed at one end. Their width was 34 +/- 5 nm. They contained a lining of material, which could be digested by trypsin leaving behind an electron-transparent matrix. In rare cases, isolated tubules showed a periodic fine structure composed of ellipsoidal subunits. Optical diffraction analysis yielded a lattice consisting of subunits arranged in helices of pitch-angle 27 degrees; the unit cell dimensions were shown to be 112 X 56 A. Owing to their sensitivity to trypsin, components of the regular lattice are supposed to consist of protein. It is postulated that these protein components are layered onto a tubular membrane. These tubules are clearly distinguishable by their shape and fine structure from the periodic structure of a P. rhodos cell wall layer, which exhibits a tetragonal pattern, and also from polyheads and polysheaths of defective bacteriophages. Their possible origin from intact mesosomes in discussed.


The active species of "CO2" utilized in ferredoxin-linked carboxylation reactions.

The active species of "CO2", i.e. CO2 or HCO-3(H2CO3) utilized by enzymes catalyzing ferredoxin-linked carboxylation reactions was determined. The enzyme investigated was pyruvate synthase from Clostridium pasteurianum (EC 1.2.7.1; Pyruvate: ferredoxin oxidoreductase). Data were obtained which were compatible with those expected if CO2 is the active species. The dissociation constant (Ks) of the enzyme-CO2 complex was measured. At pH 7.2 Ks for CO2 of pyruvate synthase was found to be approximately 5 mM.


[Deoxyribonucleic acid hybridizations among some vibrio-like marine bacteria (author's transl)].

The genotypic relationships established by DNA/DNA hybridization in vitro confirm the results obtained by earlier phenotypic analyses of certain vibrio-like marine bacteria. These strains are closely related to the species Photobacterium fischeri, and do not belong to the genus Vibrio. The group of marine, vibrio-like bacteria that require Na+ for growth is genotypically very heterogeneous.


Variations in the carotenoid content of Chlamydomonas reinhardii throughout the cell cycle.

Synchronous cultures of Chlamydomonas reinhardii have been examined for the total amounts of carotenoid and chlorophyll present throughout a 12 hrs light -- 4 hrs dark life cycle. Variations in the carotenoid distribution at different points within the cell cycle have been found. During the greater part of the light period all major carotenoids increased at a proportionally similar rate. However, the increases in lutein and violaxanthin preceded those in beta-carotene and neoxanthin by some 2 hrs and that in loroxanthin, and algal xanthophyll, by abour 3 hrs. A marked drop in total carotenoid accumulation, corresponding to similar temporary falling away in the accumulation of beta-carotene, lutein and violaxanthin occurred at 9 hrs. The correspondence of this with the established drop in RNA accumulation and the break-up of the nucleolus was pointed out. Considerable redistribution among the carotenoids occurred during the dark period, notably the amount of beta-carotene increased relative to the total xanthophylls. The full significance of these results can not be estimated in the absence of comparative data on related organisms.


B-Phycoerythrin from Rhodella violacea: characterization of two isoproteins.

Two isoproteins of the "native" B-phycoerythrin of the red alga, Rhodella violacea, were purified from crude extracts by preparative polyacrylamide gel electrophoresis and subsequently characterized. The slower moving pigment in gel electrophoresis was designated B-PE I, the faster as B-PE II. Both were found to occur in about equal amounts. B-PE I has a molecular weight of about 280000 and an IEP at 4.39, B-PE II a molecular weight of nearly 265000 and an IEP at 4.23. B-PE I and II are characterized by absorption maxima at 568 and 542 nm and a shoulder at 500 nm in the visible part of the absorption spectra. Their absorption coefficients at 542 nm differ with values of 5.54 and 5.63, respectively. The fluorescence emission spectra show a single maximum at 575 for B-PE I and at 578 nm for B-PE II. Both spectra have a shoulder at 630 nm. The fluorescence yield of B-PE II is lower by 25%. In calibrated SDS gel electrophoresis of the purified pigments B-PE I and II show two subunits of molecular weights of 18900 and 29200 and 18500 and 29900, respectively. Quantitative amino acid analyses indicated, that the isoproteins are very similar. B-PE II, however, has a significantly higher content of acidic amino acids and a lower percentage of basic residues, which is in keeping with its lower isoelectric point. Functional aspects of the occurrence of two isoproteins of B-phycoerythrin are discussed.


Conjugation in the yeast Saccharomycopsis capsularis Schiönning.

Cells of the yeast Saccharomycopsis capsularis fused in pairs after disolving of part of the cross wall between them near the lateral wall. After nuclear migrations through the opening, the cross wall was closed again and the cells at both sides became asci. The wall of the ascospores developed from a prospore wall. Between the two unit membranes a very thin dark layer broadened to the dark layer of the wall and after that, the light inner layer developed. Immature spores in the strain studied had a ledge which disappeared during maturation.


Competitive ability of amylolytic bacteria in activated sludge.

Shifts were induced into the microbial community of activated sludge by the pulse addition of soluble starch. The subsequent changes of amylolytic and proteolytic microbial populations were recorded. Four amylolytic strains were isolated and characterized with regard to carrying capacity, specific surface and growth kinetics. The competitive ability of these strains was studied by means of two-member competition experiments. These experiments were analysed according to the Lotka-Volterra model and the de Wit method. The different results obtained suggest that the dominance of the amylolytic Pseudomonas sp. (code 01) is based on a combined occurrence of high amylolytic activity, large relative cell surface, high maximum specific growth rate and reduced sensitivity towards associated proteolytic populations.


Morphology and physiology of Spirochaeta aurantia strains isolated from aquatic habitats.

1. Seven strains of Spirochaeta aurantia were isolated from pond and swamp water by means of a selective technique which utilized the ability of these organisms to move through bacterial filters and to diffuse through agar media. Although most of the isolations were accomplished when enrichment media low in carbohydrates were used, all seven strains were found to be exclusively saccharolytic. 2. The isolates could be divided into two groups on the basis of cell morphology: a loosely coiled group, and a tightly coiled group with markedly smaller wave length and wave apmlitude. Spirochetes of the latter group possessed a slightly lower GC content in their DNA. The isolates were facultative anaerobes, synthesized carotenoid pigments which conferred an orange color to aerobic colonies, and utilized a variety of carbohydrates--but not amino acids--as energy sources. Exogenous thiamine was required by six isolates tested, riboflavin by four, and biotin by one. The major products of glucose fermentation were acetate, ethanol, CO2 and H2. Growth of the isolates was inhibited by a variety of antibiotics. Determinations of GC contents of DNA showed that strains of S. aurantia are phylogenetically distant from spirochetes classified in the genera Treponema and Leptospira. 3. S. aurantia populations inoculated in the center of agar medium plates migrated in the form of growth rings toward the periphery of the plates. The rate of migration of glucose-utilizing rings was greatest at low glucose concentrations (e.g., 0.02 g/100 ml). It was concluded that migration of cells present in these rings was mainly due to a chemotactic response to glucose which served both as the attractant and the substrate. Chemotaxis of S. aurantia toward glucose may be used as a selective factor in isolating this bacterium from natural environments. 4. The subspecific epithet stricta is proposed to recognize, taxonomically, the tightly coiled strains of S. aurantia.


Photochemical reaction centers from Rhodopseudomonas capsulata.

A photochemically active bacteriochlorophyll-protein complex (reaction center) has been isolated from the carotenoidless mutant A1a+ of Rhodopseudomonas capsulata by treatment of membranes with lauryl dimethyl amine oxide. Three proteins with molecular weights of 20,500, 24,000 and 28,000 (molar ratio 1:1:1) were detected in the reaction center preparations. After mild treatment of intracytoplasmic membranes with Na-dodecyl sulfate (0.5%, 30 degrees C, 1 min) succeeded by polyacrylamide gel electrophoresis two pigmented bands were obtained. Material of one fraction could be bleached reversibly by actinic light and contained two proteins with molecular weights of 20,500 and 24000. The second band is photochemically inactive.


[Pichia lindnerii sp. n., a new methanol assimilating yeast from soil (author's transl)].

A new undescribed species of yeast could be detected in forest soils in the area of Berlin, Germany. A description of the new homothallic species including latin diagnosis is given.


Effect of vanadium on growth, chlorophyll formation and iron metabolism in unicellular green algae.

In the presence of vanadium, growth of Scenedesmus obliquus and Chlorella pyrenoidosa was increased five to sixfold as determined by dry weight, when cultured under autotrophic conditions for 7 days. The stimulation by vanadium decreased with increasing stability towards hydrolysis of the iron(III)-compounds added. Pentavalent vanadium (20 mug V/1 as NH4VO3) was able to overcome completely a limited iron-deficiency in the algae following growth in presence of 1.8 - 10(-5) m ferric chloride. Vanadium did not alter the iron uptake into the algal cells. 90% of offered 48V was taken up by Scenedesmus obliquus during 5 days of growth, and 21% thereof were found in the chloroplast fraction. In presence of vanadium, the chlorophyll formation was stimulated in Scenedesmus obliquus. This stimulation by vanadium was found to be light-dependent but occurred to a certain extent in the dark also. The main porphyrin of the yellow mutant 211-11h/20 of Chlorella vulgaris was identified as protoporphyrin-IX. The formation of this compound was stimulated by vanadium within 10 days up to 83%. The role of vanadium in the biosynthesis of chlorophylls is discussed.


Gene transfer agents, bacteriophages, and bacteriocins of Rhodopseudomonas capsulata.

Thirty-three wild type strains of Rhodopseudomonas capsulata were examined for ability to engage in genetic recombination through mediation by "gene transfer agent" (GTA) particles. The genetic exchange assays were based on capacity of strains to produce or receive GTA required for restoration of photosynthetic growth competence to a non-photosynthetic "white" mutant or for acquisition of resistance to  rifampicin. A majority of the strains could either produce or receive GTA, and it was demonstrated that the agent is species specific. Possible relations between GTA and bacteriophages or bacteriocins were investigated. Sixteen types of virulent phages active on Rps. capsulata were isolated and their host ranges determined. Tests for transduction by the phages gave uniformly negative results. The viruses showed strict species specificity, but there was no apparent correlation between capacity of the Rps. capsulata strains to donate or receive GTA and susceptibility to the phages. A comparable survey disclosed that most of the bacterial strains were sensitive to or capable of producing bacteriocins; the latter also appear to be unrelated to GTA activity. The collection of bacterial strains was also screened for detection of lysogenic properties. None of the isolates is a "true" lysogen, but phages were detected in cultures of two strains, which may be "phage carriers" or pseudolysogens.


Chemical and structural differences in mycelial and regeneration walls of trichoderma viride.

When incubated in Winge medium, protoplasts from Trichoderma viride obtained by treatment with Micromonospora chalcea or Streptomyces venezuelae RA lytic systems first synthesized an aberrant wall, different from the normal one; it was aseptate, larger and irregular in size and length. They then regenerated a new wall, similar to the original one from which they were liberated. Analysis showed that the wall polymers were mainly beta-(1-3) glucan, beta-(1-6) glucan and chitin in the normal walls, whereas chitin was absent in aberrant tubes. These results are discussed below together with electron micrographs of aberrant and normal walls.


Sulphate uptake and metabolism in the chrysomonad, monochrysis lutheri.

The intracellular concentration of inorganic 35SO4 in Monochrysis lutheri cells exposed to 0.513 mM Na235SO4 for up to 6-hr remained constant at about 0.038 mM. The exchange rate of this 35SO4 with the external unlabelled sulphate was negligible compared to the rate of influx across the plasmalemma (0.032 mu moles/g cells/hr). The flux of free 35SO4 to organic 35S was 0.029 mu moles/g cells/hr. Assuming an internal electrical potential in the cells of -70 mV, this intracellular concentration of inorganic 35SO4 was well in excess of that obtainable by passive diffusion as calculated from the Nernst equation. These results indicate that sulphate is accumulated by an active mechanism rather than by facilitated diffusion. Sulphate uptake appears to occur via a carrier-mediated membrane transport system which conforms to Michaelis-Menten type saturation kinetics with a Km of 3.2 X 10(-5) M and Vmax of 7.9 X 10(-5) mu moles sulphate/hr/10(5) cells. Uptake was dependent on a source of energy since the metabolic inhibitor CCCP almost completely inhibited uptake under both light and dark conditions and DCMU caused a 50% decrease in uptake under light conditions. Under dark conditions, uptake remained at about 80% of that observed under light conditions and was little affected by DCMU, indicating that the energy for uptake could be supplied by either photosynthesis or respiration. A charge and size recognition site in the cell is implied by the finding that sulphate uptake was inhibited by chromate and selenate but not by tungstate, molybdate, nitrate or phosphate. Chromate did not inhibit photosynthesis. Cysteine and methionine added to the culture medium were apparently capable of exerting inhibition of sulphate uptake in both unstarved and sulphate-starved cells. Cycloheximide slightly inhibited sulphate uptake over an 8-hr period indicating, either a slow rate of entry of the inhibitor into the cells or a slow turnover of the protein(s) associated with sulphate transport.


Ultrastructure of the sporangiospore of Piptocephalis unispora (Mucorales).

Sporangiospore structure in Piptocephalis unispora Benjamin was studied using light microscopy, freeze-etching, scanning and transmission electron microscopy, and compared with that of other members of the Mucorales. A merosporangial wall, plasmalemmal invaginations, and wall protuberances were demonstrated in sections and their possible significance discussed.


Synthesis of beta-glucanase and other extracellular proteins by cells and protoplasts of the yeast Pichia polymorpha: effect of 2-deoxy-D-glucose.

The synthesis of beta-glucanase either by cells or by protoplasts of the yeast Pichia polymorpha has been found to occur in the presence of 2-deoxy-D-glucose in the growth medium. On the other hand, the synthesis of typical extracellular proteins such as invertase and acid phosphatase is strongly affected by the presence of the drug. The degree of inhibition is, however, directly related to the 2-deoxy-D-glucose concentration.


Sulfur metabolism in Thiobacillus denitrificans evidence for the presence of a sulfite reducatase activity.

The relatively high specific sulfite reductase activity of 25 mU/mg protein was found in extracts from Thiobacillus dentrificans. The absorption spectrum of the partially pruified enzyme was similar to the siroheme containing sulfite reductases from other sources. It is suggested that the T. denitrificans sulfite reductase may function during the oxidation of reduced sulfur compounds.


[In-vitro studies on the break-down of chlormequat (chlorcholinchloride) in the rumen].

Under anaerobic conditions chlormequat did not undergo microbial breakdown in samples of rumen contents or rumen juice. Comparison with other forms of microbial breakdown of chlormequat, such as in soil, showed that oxidative processes were responsible.


[Consistometric studies on meat and meat products. V. Determination of consistency of raw and smoked bacon at various temperatures of bacon].

Penetration values for the superficial (cutaneous) part of bacon in the raw state were smaller than the deeper (subcutaneous) part, because of the high connective tissue content of the superficial part. The course of the curve of penetration in relation to temperature varied within the range of 1 to 60 units in cutaneous bacon, and up to 90 units in subcutaneous bacon; penetration values increased with increasing temperature. Penetration values for the superficial and deep parts of smoked bacaon were similar to those of unsmoked bacon.


[Tolerance of condenser impulses in cattle].

Extensive testing of electric fence equipment on cattle confirmed the effectiveness of the current intensities laid down by Koeppen and Osypka. Condenser discharges within the grade I of current intensity were tested for safety and effectiveness using standard equipment ("Cerberus" type). These condenser discharges were much more effective than induction current impulses. The risk of accidents to human beings and animals, and veterinary and zootechnical applications of condenser impulses were discussed.


[Effects of Turisynchron and Suisynchron on the thyroid gland in rats during simultaneous administration of TSH].

Thyrotrophin was injected i/p at 2 I.U. daily simultaneously with oral administration of Turisynchron at 100 mg/kg or Suisynchron at 125 mg/kg daily for five days to Wistar rats. The uptake of radio-iodine by the thyroid was reduced, and there were slight changes in thyroid structure. Suisynchron produced a milder inhibition of thyroid regulatory mechanisms than Turisynchron.


[Calcium, magnesium, phosphorus, chloride and glucose in the blood of cattle following intravenous infusion of solutions with various calcium and magnesium concentration aimed at improving the treatment of hypomagnesemia].

Recent findings on changes in the mineral content of tissues in bovine hypocalcaemia and hypomagnesaemia show the necessity of using different mineral solutions for the treatment and prevention of these conditions. Infusion of 2% CaCl2-6H2O with 10% MgCl2-6H2O and 5% glucose one after the other or in combination produced severe functional changes in cardiac activity and respiration. Recommended concentrations for treatment or prophylaxis of hypomagnesaemia were 10 g magnesium chloride and 2 g calcium chloride, or alternatively 12 g magnesium adipate and 5 g calcium gluconate, in 100 ml of distilled water (total dose 500 ml). This was well tolerated and it overcame the mineral deficiency in tissues.


[Experimental bedsonia infections in calf. 2. Pathomorphologic studies].

Tracheal inoculation of bovine strains of Bedsonia was often followed by inflammatory processes in lung, trachea, nasal mucosa and also spleen, lymph nodes and brain. Lesions in the duct system and alveoli of the lung consisted of exudates containing neutrophilic granulocytes and proliferation of epithelial and mesenchymal cells. The initial changes were evidently located in the bronchioli. Elementary bodies were present in variable numbers. The formation of lesions seemed to be influenced by route of infection and concentration of the causal organisms in the inoculum.


[A method for the rapid pick-up of bioelectric potentials from the unprepared body surface of animals, with special reference to cardiac action potentials].

Established methods of obtaining cardiac action potentials indirectly are laborious and require much time and apparatus. A rapid method of picking up bioelectrical potentials from the intact body surface was developed by using rapid-contact proximity electrodes and a simplified conduction technique. Useful cardiograms were obtained without changing the normal posture of the animal.


[Prevention of tetanus in man and animal following injury].

The effect of heterologous and homologous antitoxin is the same if an equal amount of antitoxin is present in the organism. In man there are no circulating antibodies in the blood after the first injection of the toxoid because there is no natural immunity against the tetanus antigen. After the second injection, man develops the same immunity as animals. Large antitoxin doses protect people for a longer period than small doses. Normally 3,000 I. U. of the heterologous antitoxin protects people for 2 to 3 weeks. In man and sheep 2 ml of the adsorbed vaccine produces an earlier and longer-lasting immunity than 0.5 ml. Simultaneous active and passive prophylaxis is superior to passive prophylaxis alone. To achieve a long-lasting active immunity, 2 ml of the vaccine should first be injected and a booster dose 7 to 10 days later, and again 6 to 12 weeks after the first dose. Immediate vaccination against tetanus following an injury will not protect a person who has not been vaccinated previously, as the active immunity will start too late.


[Phosphoric acid ester preparations used in cattle, swine and sheep with special reference to cholinesterase activity. 3. Use of phosphoric acid ester preparations and their effect on acetylcholinesterase activity in swine].

The use of organophosphorus preparations in the treatment of ectoparasites and endoparasites of pigs is discussed. Treatment of 43 store pigs with preparations produced in the German Democratic Republic by washing and by the pour-on method resulted in considerable inactivation of acetylcholinesterase, which implies good systemic action. Overdosage increased this effect, but without producing signs of toxicity. The oral dosages for pigs cited in the literature were confirmed. Repeated treatment was recommended for the best results, as pigs rapidly break down the preparations. It is necessary to take into account adverse effects of oral administration on palatability of the ration and on weight gain. Addition of a preparation to a batch of food for a group of pigs is likely to be less successful than individual dosing, which is the best method for sows.


[Phosphoric acid ester preparations used in cattle, swine and sheep with special reference to cholinesterase activity. 4. Use of phosphoric acid esters and their effect on acetylcholinesterase activity in sheep].

The use of organophosphorus preparations for the control of ectoparasites and endoparasites of sheep, particularly systemic application, is discussed. Experiments on 13 groups of sheep with five preparations produced in the German Democratic Republic in various formulations and concentrations showed that external application had good contact activity, but little was absorbed. Acetylcholinesterase activity was not inhibited, except by pour-on application of doses several times the normal dose. The preparations were arranged in order of cholinesterase inhibition. In contrast to cattle, diminished cholinesterase activity was unreliable as in indicator of systemic toxicity of organophosphorus preparations in sheep.


[Histochemical studies of acid phosphomonoesterase activity in experimental inflammation of the rat's paw caused by carrageenin].

During the primary phase of inflammation of connective tissue of the paw there was an increase in enzyme activity among the resident connective tissue cells, probably as a result of catabolic processes (lytic processes, phagocytosis). As early as two days after the start of inflammation it was possible to recognize a close relationship between regeneration of the altered tissue (anabolic processes) and the increase of phosphomonoesterase activity in resident cells of the inflamed tissue. The role of the enzyme during inflammation was discussed.


Modification of some hematologic and biochemical indices in mice consecutive mecadox administration.

Mecadox addition to the diet of laboratory mice in doses of 25 mg/kg/day for 30 days resulted in some hematologic and biochemical modifications: 1. Red cell count declined moderately, leucocyte and neutrophile count was higher and reached their normal values 15 days following treatment. 2. Modifications of liver transaminases expressed by a diminution of GOT and GPT activities were observed together with a reduction of free nitrogen. Values returned to normal within 15 days after treatment. 3. Mecadox stimulated weight gain in treated animals during the first 15 days of treatment. No significant differences were observed in weight gain between the two groups during the period which followed treatment.


[Effect of anemia on various reactions of the domestic swine due to physical exertion. I. Initial values and characteristics of anemia].

In six anaemic and six healthy pigs at rest the following values were determined:--rectal temperature, heart rate, respiratory rate, haemoglobin (Hb), haematocrit (Hk), total haemoglobin (THb), plasma volume, blood volume, plasma osmolarity, lactic acid and glucose content of plasma, blood pH, carbon dioxide tension and base excess. There were significant differences between anaemic and normal pigs in Hb, THb, relative THb, Hk, mean cell haemoglobin concentration, lactic acid content; in the ECG there were differences in QT and ST intervals and the ratio of diastole to systole.


[Effect of anemia on various reactions of the domestic swine due to physical exertion. 2. Components of cardiovascular function and body temperature].

The following measurements were made in six anaemic and six healthy pigs during and after physical exertion on a belt moving at 70 m/min for 10 minutes at environmental temperature of 22-24 degrees C and relative humidity of 55-65%:--rectal temperature (RT), heart rate, total haemoglobin, plasma volume (PV), blood volume (BV) and plasma osmolarity (PO). The increase: in RT and PO, heart rate during exercise, respiratory rate after exercise, and the fall in PV and BV during exercise as well as changes in erythrocytes were all more pronounced in anaemic pigs than in healthy pigs.


[Effect of anemia on various reactions of the domestic swine due to physical exertion. 3. Changes in plasma glucose and lactic acid concentrations].

Six anaemic and six healthy pigs were exercised for ten minutes on a belt moving at 78 m/min. Initial blood glucose values in healthy pigs averaged 71.2 mg/100 ml, and they changed very little during and after exercise. Initial values were similar in anaemic pigs (70.7 mg/100 ml), but they increased continuously, during exercise, reaching a peak of 157.4 mg/100 ml one minute after the end of exercise. Blood lactic acid increased from 1152 to 2463 mmol/litre in healthy pigs during the first minute of exercise, and then fell gradually. In anaemic pigs it increased from 1652 to 8478 mmol/l during the ten minutes of exercise, and then fell gradually. Correlations between lactic acid and haemoglobin content, between rectal temperature and Hb, and between lactic acid and changes in rectal temperature were discussed.


[Effect of anemia on various reactions of domestic swine due to physical exertion. 4. Changes of serum acid-base equilibrium].

Carbon dioxide tension, pH and the excess of base were determined in blood samples obtained from the posterior vena cava of six healthy and six anaemic pigs subjected to ten minutes of exercise on a belt moving at 78 m/min at 22-24 degrees C and relative humidity of 55-65%. The fall in these values during physical exertion was greater in anaemic than in healthy pigs. The roles of buffering capacity and rise in body temperature, and the relationship between blood lactic acid and base excess were discussed.


[LD 50 and selenium concentration in organs following intravenous administration of sodium selenite in the rabbit].

In experiments on 72 rabbits, the LD50 of sodium selenite by intravenous injection was found to be 2.24 mg/kg body weight. The clinical picture and pathological changes associated with acute selenium poisoning are described. The increase in selenium concentration was up to nine times the normal in liver and up to six times in kidney and muscle. There was no sign of a return to normal values 24 hours after administration.


[Relationships between chemical constitution and germicidial effect. 28. Preparation, antimicrobial and anthelminthic effect of diiosothiocyanates].

In comparison with monoisothiocyanates, diisothiocyanates were either less active or of the same activity against bacteria and fungi. None of the compounds tested possessed antimicrobial activity worth investigating further. However, compound No. 2 (2,4-diisothiocyanatomethyl ethoxybenzol) and compound No. 5 (1,3-dimethyl-4,6-diisothiocyanatomethylbenzol) were more active as anthelmintics against Enchytraeus than the p-phenylene diisothiocyanates.


[Evaluation of blood glucose concentration during exertion. 6. Effect of anemia on the glucose regulation capacity of domestic swine in standardized running exercise].

Individual mean blood glucose values and the scatter of individual values were determined in six healthy and six anaemic pigs before, during and after ten minutes of exercise on a belt moving at 78 m/min (environmental temperature 22-24 degrees C, relative humidity 55-65%). The glucose regulatory capacity of anaemic pigs was inferior to that of healthy pigs. Blood glucose regulation was related to haemoglobin content and to the increase in rectal temperature during exercise.


Cardiac evaluation of a physical rehabilitation program for patients with ischemic heart disease.

A reconditioning exercise program that was applied to group of 12 coronary patients resulted in an increase of their tolerance to physical work and of their maximal working capacity. In some instances the improvement in physical condition was accompanied by changes in indicators of cardiac function which suggest that an improvement in myocardial performance also occurred. Although some evidence of this has been presented, more studies are needed for substantiation. It is believed, on the other hand, that to explain the improvement of the patient, it is not necessary to invoke an improvement of myocardial performance. An improvement of patient's tolerance to physical work may also be explained by extracardiac mechanisms that produce changes in arterial peripheral resistance, regional blood flow distribution, overall mechanical efficiency, muscle capillarization, fiber size and mitochondrial enzymatic activity, patterns of sweating, adaptation between pulmonary ventilation and circulation, work of breathing efficiency, autonomic nervous system balance and in the adaptive responses of the neuroendocrine system which mediate between psychic and physiological behavior. All of these changes have been observed in healthy individuals submitted to physical training. It is plausible to assume that they may also occur in the patient with ischemic heart disease. What is to be shown is which one or which ones of these mechanisms prevail in a given individual.


The neurological examination: advancements in its quantification.

For the past decade, our group of neurologists, biomedical engineers and statisticians has developed objective tests to quantify apropos neurological functions (cognition, strength, steadiness, reactions, speed, coordination, sensations, fatigue, gait, station and selected skills of daily living). Instrumented tests have been extensively evaluated and used in several randomized double-blind trials in multiple sclerosis and Parkinson's disease. Our long-term goal is to bring to clinical neurology a type of quantification of the nervous system which does not exist. In this report, a brief overview of test development, personnel training, test administration and selected situations for using the clinical quantitative neurological examination (CQNE) are discussed. In addition, 57 tests are illustrated and described.


Quantitative examination of neurological function: reliability and learning effects.

During the last five years, a battery of tests measuring neurological function called the Quantitative Examination of Neurological Function (QENF) has been greatly expanded. To evaluate more effectively the efficacy of clinical trials, the results of a study on reliability of test measures and on long- and short-term effects of learning are reported. Of the 113 test measures that were evaluated using 18 young adult normal subjects, only the fatigue and error measures, the vibration sense and two simulated activities of daily living tests were found unreliable. With respect to learning, the largest improvements in performance were found for arm-shoulder pursuit tracking, followed by many of the tests of coordination, particularly those requiring manual and/or finger dexterity. Only slight changes were found for tests of vision, strength, and speed of hand and foot. There were no important differences between short- and long-term learning. Considering this and other studies, patients are not likely to improve their performance appreciably by learning in a clinical trial.


Heating patterns produced in humans by 433.92 MHz round field applicator and 915MHz contact applicator.

Temperature distributions produced by a round field applicator operating at a frequency of 433.92 megahertz (MHz) are comparable to those produced by a 915 MHz cooled contact applicator in human volunteers with less than or equal to 1 cm or greater than or equal to 2 cm of subcutaneous fat. The major difference between the two applicators is the temperatures produced on the skin surface and in the subcutaneous fat in humans. The circulating coolant of the 915 MHz contact applicator keeps skin surface temperatures much lower than those produced by the round field applicator in thick and thin subjects. It also tends to cool the superficial subcutaneous fat layer in thin subjects but doesn't affect the deeper subcutaneous fat layer in subjects with greater than or equal to 2 cm of subcutaneous fat. The 915 MHz contact applicator gives the ability to control by cooling the temperatures produced in the superifical tissues. By regulating the temperature of coolant and time of cooling, temperature gradients can be modified so the highest temperatures may be found in the muscle. However, the superficial tissue temperature cannot be regulated with the present application of the 433.92 MHz applicator. When the two applicators were compared, it was shown that the 433.92 MHz round field applicator did not surpass the heating ability of the 915 MHz contact applicator. Therefore, at this time, there is no reason to legalize the frequency of 433.92 MHz for diathermy use in the United States.


Training procedures and biofeedback methods to achieve controlled partial weight bearing: an assessment.

Limiting weight bearing to a prescribed level is clinically desirable when patients use crutches or canes or wear prostheses. Several training methods currently being used in clinical settings were tested. These included the use of bathroom scales, and several more sophisticated feedback systems, to train normal subjects to limit weight bearing on a protected limb to a target load. It was found that such training was of limited value since subjects, during training and after, often exceeded target loads by 50% or more. Any retained learning was found to diminish rapidly on the first and second days after training. Even when using continuous auditory feedback, overshoot of the target load seemed inevitable due to the time lag between auditory perception and motor response, and the rapid rate of loading of the extremity.


The frequency of sexual intercourse during pregnancy.

Reports of day-by-day sexual activity for the previous week were collected from a total community sample of over 900 pregnant and nonpregnant Thai women of childbearing age during a fertility survey in 1967-1968. About 13% of the women were pregnant. Examination of the women's intercourse frequencies at various stages of pregnancy revealed a downward trend as pregnancy progressed. However, a difference between the mean frequency for age-matched, nonmenstruating, nonpregnant women and that during any stage of pregnancy was not statistically significant at the p = 0.05 level (t test, two-tailed) until the seventh month. Much individual variation existed among the women. Complete abstinence from intercourse during the previous week reached a peak of 72.7% in the ninth month. The increase in abstinence with the progression of pregnancy appeared linear. The importance of these data lies in two methodological facts: they were collected from a total population sample and are therefore unbiased by sample selection; the women were not asked to report their "average" frequencies for some time period in the past. Reports of behavior on each day of only the preceding week were the basis for the conclusion. Although the women are from a different culture, lay and professional advice concerning intercourse during pregnancy is similar to that in the United States. Because intercourse may be discouraged, particularly in the third trimester, it is difficult to attribute the observation of the gradual decline in frequency to a "physiological" reason. This tempting hypothesis, however, is worthy of further study.


Heterosexual interest in homosexual males.

Androphilic, ephebophilic, and homosexual pedophilic males were compared on heterosexual interest and arousal potential. The former was measured by the subjects' retrospective reports and the latter by penile responses to pictures of females. The penile responses of the ephebophilic and homosexual pedophilic groups to pictures of physically mature females were not different from those of androphilic males. In the present study as well as in an earlier one, the ephebophilic males responded significantly more to physically mature males than to physically mature females. Homosexual pedophilic males showed little difference in responses to physically mature males and females. In retrospective reports of heterosexual interest and experience and of development of homosexual interest and activities, there were only two differences among the groups: as opposed to androphilic males, a relatively greater number of ephebophilic and homosexual pedophilic males indicated that up to age 15 or later they had felt attracted exclusively to females and that they had been seduced in childhood or early adolescence by a male. These results will have to be replicated before being accepted as reliable. As in some earlier studies, there was a weak but significant correlation of degree of "feminine gender identity" with age at onset of homosexual interest and with heterosexual interest or experience. A higher degree of feminine gender identity went together with less heterosexual interest and experience and with an earlier onset of homosexual interest and experience.


Dhat syndrome: a culture-bound sex neurosis of the orient.

The Indian Dhat syndrome is a culture-bound symptom complex. The clinical picture includes severe anxiety and hypochondriasis. The patient is preoccupied with the excessive loss of semen by nocturnal emissions. There is a fear that semen is being lost, and mixed in urine. A study was carried out to investigate the cultural basis of the Dhat syndrome. One hundred and seven respondents from the general public were interviewed. A vignette describing an individual having nocturnal emissions was read aloud to the respondents. Attitudes toward nocturnal emission, its causes, and its management were investigated. A large segment of the general public from all socioeconomic classes believed that semen loss is harmful. Seminal fluid is considered an elixir of life both in the physical and in the mystical sense. Its preservation guarantees health, longevity, and supernatural powers. This belief is more frequent in lower socioeconomic classes. The susceptible individual reacts to the prevalent belief system and to the fears of semen loss. The symptoms usually disappear if the misconceptions about semen loss are effectively dealt with. It is expected that with increasing literacy and progress in sex knowledge the syndrome will become less common.


Plasma testosterone in male patients with sexual dysfunction.

Plasma testosterone values were established by the protein-binding method in 45 married patients who at the age of 36-55 were examined for sexual disinterest and/or disturbances of penile erection. The control group consisted of 108 men whose ejaculate was normospermic and who reported adequate coital activity. The average values of male sex hormone in all age subgroups of patients with functional sexual disorders were lower than those of the control group. However, in patients with a pathological somatosexual finding (chromatin-positive men, patients with a varicocele), where the plasma testosterone level was approximately the same as in patients with functional sexual disorders, similar coital activity was found as in the control group of normospermic men.


The rechargeable cardiac pacemaker. A clinical evaluation in 25 patients.

After five years of laboratory development and in vivo testing, a rechargeable cardiac pacemaker with R-wave inhibited demand circuitry was introduced into clinical use in February 1973. We have used the rechargeable pacemaker in 25 patients in the past 1 1/2 years. The series includes 14 women and 11 men, with an age range of 38 to 80 years. Eleven of the patients had the rechargeable system implanted as a replacement for a failing or a failed conventional pacemaker. These 11 patients accounted for 26 previous pacemakers. The rechargeable pacemaker is smaller than conventional pacemakers, and it promises to obviate the need for periodic pulse generator replacement. Our initial experience with the rechargeable pacemaker has been favorable, and patient acceptance has been good.


Renal arteriovenous fistula treated by endofistulorrhaphy.

A renal arteriovenous fistula responsible for diastolic hypertension was repaired without sacrificing renal parenchyma by endofistulorrhaphy, a unique surgical technique. The fistula site was localized preoperatively by selective renal arteriography. The renal artery was incised and the ostium of the efferent venous channel suture-ligated from within the depths of the artery. The fistula was successfully interrupted, and the patient has remained normotensive. Postoperative arteriography confirmed the absence of the fistula. Vascular surgical procedures sparing renal parenchyma are relatively new, as the most common treatment for this condition had been nephrectomy.


Definitive diagnosis of pulmonary lesions in leukemia and lymphoma. The supportive role of thoracic surgery.

As therapy for leukemia and lymphoma has improved, secondary pulmonary disease has become a major cause of death. In this review of 225 patients with leukemia or lymphoma, six possibly preventable deaths resulted because progressive pulmonary infiltrates were treated without tissue diagnosis. Four other patients died of undiagnosed second primary lung tumors. When pulmonary infiltrates were diagnosed by open lung biopsy examination, appropriate therapy in nine patients resulted in seven survivals from potentially lethal infections. Of six patient with either primary lung tumor, leukemic infiltrate, or lymphomatous nodule, bronchoscopy and brush biopsy examination revealed bronchogenic tumors, leading to appropriate surgical therapy and survival in three. In three others, bronchoscopy and mediastinoscopy suggested exacerbation of the primary disease, which was treated satisfactorily by radiotherapy. Thus, when pulmonary disease develops in patients with leukemia or lymphoma, aggressive therapy based on tissue diagnosis may avert untimely death.


Serious complications after umbilical artery catheterization for neonatal monitoring.

Umbilical artery catheterization in critically ill neonates caused major complications, including five deaths, in 15 of 165 infants with respiratory distress syndrome who underwent autopsy at the UCLA Hospital during the past eight years. Arterial occlusion leading to visceral infarction occurred in 12 patients, and vascular perforation caused hemoperitoneum in three patients. Repeated catheter manipulation and protracted catheter use were common factors identified in patients in whom complications developed. Restricted indications for catheter use, routine roentgenographic confirmation of catheter tip location below the kidneys, low-dosage heparin sodium infusion, use of cannulas with decreased thrombogenicity, avoidance of catheter manipulation, and vigilance to remove catheters when no longer required should reduce the incidence of this iatrogenic neonatal complication while still permitting arterial pressure and blood gas monitoring when clinically indicated.


Phytohemagglutinin-stimulated immune response. Assay in colorectal carcinoma patients.

Tritiated thymidine incorporation by peripheral human lymphocytes stimulated with phytohemagglutinin (PHA) was investigated in 18 colorectal carcinoma patients (seven with localized tumor and 11 with metastatic tumors). The effect of sera obtained from these patients on lymphocytes from control patients was also studied. The mean mitotic index of PHA-stimulated versus nonstimulated lymphocytes from all tumor patients was 29.2; from patients with localized tumors, 23.0; from patients with metastatic tumors, 26.0; and from controls, 29.4. In the presence of sera from tumor patients, the mitotic index in all tumor lymphocytes was 47.1; from localized tumor patients, 53.7; from metastatic tumor patients, 43.8; and from control lymphocytes, 47.4. No substantial difference in mitotic index was detected in normal compared to tumor patient lymphocytes with or without normal or tumor serum.


Serum calcium responses to exogenous secretin.

Increasing attention is being focused on the relationship between gastrointestinal hormones and calcium metabolism. While it is apparent that some relationship does exist, the exact nature and significance is as yet undefined. Information regarding the effect of secretin on serum calcium has been both sparse and contradictory. Boot's secretin, 3 units/kg, was given to a group of 44 patients consisting of normal controls and patients with duodenal, gastric, and marginal ulcers; primary hyperparathyroidism; and pernicious anemia. Six serial serum specimens were obtained from each patient at ten-minute intervals for calcium determination by atomic absorption spectrophotometry. Using two-way analysis of variance, no significant changes in postsecretin serum calcium values were observed. It is unlikely that physiologic levels of secretin exert any effect on serum calcium.


Breast cancer genetics and cancer control. Tumor association.

Verified breast cancer was present in a father, his mother, and his daughter. His sone had a brain tumor (by history) and his grandson, (ehs sone of the affected daughter), had a histologically verified rhabdomyosarcoma. This familial aggregation of cancers (except for leukemia, which is absent) is consistent with a newly described familial breast cancer syndrome. A single pleiotropic, dominantly transmitted gene, possibly interacting with carcinogenic factors, such as an oncogenic virus, may be the cause. A cancer-control potential exists for tumor associations such as those exhibited in this kindred, as well as for other cancer genetic syndromes where careful consideration is given to all histologic varieties of cancer.


Subcutaneous angiolymphoid hyperplasia (Kimura disease). Report of a case.

A subcutaneous mass removed from the cheek showed histologic features of subcutaneous angiolymphoid hyperplasia (Kimura disease) at its early stage. The condition shows a wide spectrum of pathologic changes. At its early stage, the main findings consist of active vascular proliferation with plump endothelial cells and varying degrees of lymphocytic, histiocytic, and eosinophilic infiltration. The lesion at its later stage features hyperplastic blood vessels with inconspicuous endothelial cells, well-formed lymphoid follicles, and varying degrees of lymphocytic and eosinophilic infilitration. Blood eosinophilia is frequently seen. Review of the literature and study of our own case strongly suggest that this disease is a distinct clinical and pathologic entity.


Experience with infected aneurysms of the abdominal aorta.

Seventeen consecutive patients with abdominal aortic aneurysms were treated during a 14-year period. Fever was the most common symptom first to appear (12 patients), either as fever of unknown origin or in association with other symptoms. Several factors raise the suspicion of an infected aneurysm: positive blood cultures, erosion of lumbar vertebrae, lack of aortic calcification, aneurysms found in female patients or after a prolonged illness of bacteremia. Staphylococci (41%) and Salmonella (18%) were the most common organisms. Aneurysms with Gram negative organisms exhibited a greater tendency toward early rupture than those with Gram-positive organisms (84% vs 10%), and were associated with a higher mortality. Delay in making the diagnosis adversely affected the death rate. "Infected aneurysm" is suggested as a better term than "mycotic aneurysm," since fungi are rarely involved.


Prognostic indicators in femoropopliteal reconstructions.

The incidence of early failure in 115 vein femoropopliteal grafts has been analyzed for the presence of reliable prognostic indicators of such failures. One hundred twelve patients had preoperative Doppler ultrasound assessment; 98 had intraoperative graft flow measured. Early graft failure was more prevalent in patients with rest pain and gangrene and in patients with poor runoff. Neither of these two findings had predictive value. Ninety-one percent of patients with a pressure index (ankle systolic pressure/brachial systolic pressure) less than 0.20 had early graft thrombosis. This suggests that arterial reconstruction is futile in this group. Measurement of vein graft flows intraoperatively was of value. Grafts with basal flows less than 70 ml/min uniformly thrombosed. There was significant correlation between ankle pressure index and intraoperative vein graft flow (r=.52). Both ankle pressure index and intraoperative vein graft flow provide prognostic indications of graft failure and should be of value in selecting patients for femoropopliteal reconstructions.