Growth, development and chemical composition of the pig. III. Bone, ash and moisture.

Growth and development of bone and the ash and moisture contents in the body of the growing pig were studied in a group of 90 animals, representing 12 weight groups and a live weight range of 10-132 kg. The average daily increase in body moisture was more rapid in the 10-34 kg animals than in subsequent weight groups. Beyond 34 kg the increase in moisture was more gradual and linear. The average daily gain of ash was almost linear over the weight range of 10 to 90 kg, but showed a decline from 90 to 132 kg. Length and width of the femur showed a similar growth pattern. From cross-sectional areas it appears that bone tissue develops somewhat faster in the shoulder and back than in the ham and loin. It is apparent from comparisons with growth curves reported in the literature that the animals used in the present study were much later maturing than those reported on during the thirties and forties. This could be the result of continued selection for leaner animals.


The growing conceptus of the domestic cat.

The feline conceptus is similar to larger mammals rather than to rodents in the amounts of fetal fluids and the contribution of the fetus to the total volume of the conceptus. When growth rates of several mammals are compared as Gompertzian functions, the feline fetus is more similar to that of the guinea pig or beagle than that of the mouse, rat, man, sheep or cow. The feline Gompertzian growth starts at about the 6th day of gestation. The weight of the fetus, +/- 10%, as a function of gestational age starting on day 28 is: Weight in grams = 2.6477 X 10(-10) exp (see article) when t = gestational age of 28 days or more. The feline weight to crown-rump relationship can most easily be expressed as a power function where: Crown-rump length in cm = 2.69 (weight in grams) 0.3508; with an error term of +/- 5%. The relationship of three variables gestational age, fetal weight, and fetal crown-rump length can also be expressed mathematically: Gestational age in days = 15.335 + 3.9805 (crown-rump length in cm) -0.0675 (weight in grams) Equations for crown-rump length or weight were calculated, but the inaccuracy of these expressions is too great to allow practical use.


Hemoglobin values and organ weights in fast and slow growing rats at the time of weaning.

Three experimental groups of newborn rats were formed according to the number of animals suckled by one dam: fast growing animals (4 per litter), normally growing animals (8 per litter) and slow growing animals (16 per litter). All the animals were killed on the 21st day of life and the following data were collected: hemoglobin and hematocrit values, body weight and the weights of heart, kidney, liver and spleen. The results were statistically analyzed according to experimental group and also in relation to body weight with all rats treated as a single group. Hemoglobin concentration was highest in the smallest animals, gradually declining towards the lowest values around the normal body weight with a subsequent increase in the heaviest animals. The relationship between the organ weights and body weight followed an allometric formula. The slopes of the lines alpha were close to 1 in case of the heart, kidney and liver, indicating the growth of these organs proportional to the growth of the total body. The spleen grows faster than the total body in this experimental situation (alpha = 1.6).


Comparison of ontogenetic brain growth in marine and coastal dolphins.

In young postnatal individuals, brain growth proceeds at a much faster rate in the high seas dolphin Stenella than in the coastal waters form Pontoporia, and the encephalization is much higher in the former than in the latter. In prenatal Stenella, brain growth is also very rapid. These results agree with indices of brain progression estimated for several families (Platinistidae, Delphinidae, Delphinapteridae, Phocoenidae). The possibility that the difference is related to more demanding conditions of life in marine than in coastal or inland environments is discussed.


Protein synthesis, development, growth and life span.

To test the hypothesis that reduced protein synthesis may increase life span by retarding genetic informational transfer during early life and reducing the use of the genetic code and thereby minimizing genetic imperfections as they may occur during late life, two approaches were used. In the first protein synthesis was depressed by the administration of cycloheximide, in the second by reducing the dietary protein level. One-day-old chick embryos were injected with either 0.8 gamma or 1.0 gamma of cycloheximide. On the second and third day of incubation both stage of development and heart rate were lower in the treated embryos. Growth was retarded throughout the 17 days of incubation as measured by size and DNA contents. As estimated by the activities of various enzymes per unit DNA, cells of the treated embryos were the same as normal ones of the same age. Sixteen-month-old female Wistar rats which had been previously maintained on a commercial diet (23.4% protein) were fed diets which contained either 24, 12, 8 or 4% casein throughout their remaining life span. Except for a lowering of the body weights of the animals fed the 4% casein diet, the body weights of the remaining animals were unchanged. Reducing the dietary protein level from 24% to 12% increased the life span (25%) of the animals.


High power polynomial regression for the study of distance, velocity and acceleration of growth.

A technique is given to use high power polynomials of logarithms of age, up to order 18, to describe, as exactly as possible with the given data, the growth as such, the growth velocity and acceleration of any desired parameter in function of age. E.g., this can be done for height or weight in children and for blood pressure or serum cholesterol or serum uric acid a.s.o. in children and adults. The growth velocity and acceleration are given at any age between the observation limits, in a dimensionless and in a linear form. Although the linear velocity id clinically more easy to understand, the dimensionless growth velocity has many advantages. Among them, it makes it possible to compare, e.g., the growth of weight and height or of blood pressure and serum cholesterol in the same individual or in the same population at a given age or it permits the comparison between individuals, between different populations or within the same population, but at different ages, of the same parameter (e.g., height, serum cholesterol a.s.o.). The comparison of growth velocity between different species is also preferably done with the dimensionless growth velocity.


The role of the antrum in determining the acid secretory response to meals to different consistency.

Three dogs with denervated pouches of stomach were tested with two test meals, one of homogenized and the other of minced meat, before and after antral denervation. The results show that the preparation of food plays an important part in the acid response and that homogenization augments acid stimulatory potential, probably by virtue of increased buffer capacity.


Gastrin response to meals of different composition in normal subjects.

The serum gastrin responses and the integrated gastrin responses to eating three meals of very different composition were studied in the same normal subjects on different days. Two meals, a milk meal of 500 ml, and a breakfast of eggs, toast, butter, marmalade, fruit juice and coffee, were eaten at breakfast time. The serum gastrin responses to these meals were compared and contrasted with the concentrations observed when the subjects fasted over the same time of day. A steak meal was eaten at lunch time. There were no significant differences between the mean serum gastrin concentrations to the three meals but each meal produced a significant increase in serum gastrin above fasting levels. When the prefeeding gastrin concentration was subtracted from the gastrin responses then the integrated responses to the steak meal were greater than those to either of the breakfast meals. Considerable variability in response to any one meal was observed within the group of subjects, but those subjects who produced high serum gastrin concentrations to one meal did so to the others. Conversely, at low response to one meal was reflected in low responses to the other two meals. Fasting serum gastrin concentration was correlated with the age of the subject. Repeatability of the response to one meal was tested in two subjects who ate the same meal on four separate occasions showing their responses to be repeatable.


The gastric response to a transpyloric duodenal tube.

The quantification of gastric, pancreatic, biliary, and small bowel functions in man often requires the use of intestinal tubes. In this study, the presence of a transpyloric tube did not alter gastric emptying, acid secretion, or serum gastrin levels in response to an ordinary solid meal.


Is there an antral-body portal system in the stomach?

The direction of blood flow from the gastric mucosa of the antrum of the rat stomach has been studied using the isotope Rb86Cl. In a series of five experiments radioactivity has been shown to be transported via the blood stream from the antrum to the parietal cell mass without passing through the general circulation first. It is suggested that a 'portal' or direct transport system from antral mucosa to the body of the stomach exists.


Comparison of bowel function after ileorectal anastomosis for ulcerative colitis and colonic polyposis.

Bowel habit has been studied in a group of 92 outpatients with ileorectal anastomosis for ulcerative colitis and compared with that in a group of 45 outpatients with ileorectal anastomosis for colonic polyposis. Bowel frequency ranged from 1-7 to 8-7 stools per 24 hours with a mean of 4-5 in the colitic group compared with a range of 1-3 to 8-1 stools per 24 hours and a mean of 3-5 in the polyposis group. Eighty-two per cent of the colitic group and 95% of the polyposis group had six or fewer bowel actions per 24 hours. Colitic patients in poor general condition at the time of colectomy seemed more likely to have over six bowel actions per 24 hours than those less severely ill. Urgency of defaecation was rare. Bowel actions every night and occasional faecal incontinence occurred in small but similar percentages of patients in both groups. Fifty-one per cent of patients in the colitic group, as compared with 9% in the polyposis group, were taking regular treatment to improve bowel function. Dietary difficulty was rare after ileorectal anastomosis in both colitic and polyposis groups.


Polyposis in ulcerative colitis.

One hundred and fifty cases of ulcerative colitis were assessed by total colonoscopy with multiple biopsies. Inflammatory polyposis was found in 25 (17%) cases and six of these had a large (greater than 1-5 cm) solitary polyp which radiologically resembled carcinoma in four cases. Adenomatous polyps were discovered in four cases. Three carcinomas were found at endoscopy, of which two were entirely unsuspected. In all cases endoscopic polypectomy or surgical intervention was performed to establish the exact histological diagnosis.


Serum transaminase levels after experimental paracetamol-induced hepatic necrosis.

The relationship between serum transaminase levels and the extent of paracetamol-induced liver necrosis has been investigated in the rat. Three methods of histological quantitation were used to assess of necrosis--arbitrary grading, point counting, and the image-analysis computer. Highly significant correlations were obtained between the three methods and all were found to be reproducible. A close correlation was found between the extent of hepatic necrosis and the serum ASAT and ALAT 24 hours after a large dose (4 g/kg) of paracetamol. Likewise, the mean grade of necrosis correlated reasonably well with the serum enzyme levels in the recovery phase at 36 and 72 hours, although the transaminase level for a given degree of necrosis was considerably lower at 72 hours than at 24 hours. These findings suggest that serum transaminase levels gives a reliable indication of the severity of hepatic necrosis if the time of ingestion of the paracetamol is known and taken into account.


Large bowel myoelectrical activity in man.

The myoelectrical activity of human colon and rectum has been studied by three types of electrode in man--intraluminal (suction), serosal and cutaneous. The patterns obtained indicate a high degree of consistency between the methods and the value of surface electrodes is emphasized. Gradient along the large bowel of both frequency and percentage electrical activity have been observed and possible physiological roles are postulated for them. By correlating the features of regular electrical and corresponding regular motor waves an alteration in the myoelectrical pattern is observed in the region of the rectosigmoid junction.


Photometric assay of antithrombin III with a chromogenic substrate.

A simple assay procedure for antithrombin III is described. The synthetic product benzoyl-Phe-Val-Arg-p-nitroanilide (S-2160) is used as substrate. By thrombin p-nitroaniline is split from the tripeptide molecule. The yellowish color of this split product can be measured in a photometer. Inactivation of thrombin by antithrombin III results in inhibition of this reaction. The percentage of thrombin inhibited is in direct relation to the activity of antithrombin III. Various modifications were tested to optimate the method. Comparable results were obtained between the coagulation method of HENSEN and LOELIGER and the photometric method.


Changes in coagulation factors and platelet function in response to progestational agents.

Levels of coagulation factors I, II, V, VII-X, VIII, IX, X, plasminogen and antithrombin III, were determined at midcycle in 17 test subjects using oral contraceptive agents, and in 10 control subjects. Immunoassay of factor II and antithrombin III was also carried out, and platelet aggregation quantitatively assessed. Significant increases were found in the activity of factors II, V, VII-X, X and plasminogen, but factor II antigen levels did not change. Platelet aggregation with collagen was significantly enhanced. No change occurred in antithrombin III activity or antigen levels.


Cyclical changes in coagulation factors associated with the use of progestational agents.

The activity of factors II, VII, VIII, IX, X and fibrinogen and factor VIII antigen levels were followed during a single menstrual cycle in three females using oral contraceptive agents, and in two controls. Marked cyclical variation occurred in the activity of factor VII and VIII, but not in factor VIII antigen levels. Less marked changes occurred in factor II and fibrinogen.


Serotonin uptake and glycolytic activity of human platelets after prolonged incubation with glucose-poor plasma.

It is confirmed that metabolic energy is a prerequisite for the uptake of serotonin by human blood platelets. Starvation (i.e. incubation at 25 degrees C of platelets resuspended in glucose-poor autologous plasma) generally stops glucose consumption, lactate formation as well as serotonin uptake within 2 h. The addition of glucose restores lactate formation immediately and, independent of total starvation time, to normal or even higher levels. The active uptake of serotonin, however, can be restored only partly after prolonged incubation with glucose, to an extent which seems to be dependent of the preceding starvation time. The results are compatible with the hypothesis that besides an active carbohydrate metabolism another factor, presumably the integrity of the platelet membrane, is obligatory for the active transport of serotonin.


Controlled trial of platelet anti-aggregating agents and subcutaneous heparin in prevention of postoperative deep vein thrombosis in high risk patients.

In a prospective randomised trial, three groups of 20 patients each were compared. A first group served as a control, a second group received dipyridamole and acetylsalicylic acid and a third group received low doses of heparin. The incidence of deep vein thrombosis determined by the 125I-fibrinogen test was 40% in the first group, 50% in the second group, and 5% in the third group. The differences between the heparin group and the two other groups are statistically significant. No wound complication and no haematoma at the injection site occurred.


The influence of phentolamine on the fluorescence of catecholaminergic structures in selected areas of rat brain.

Wistar rats were given phentolamine into the ventriculus lateralis. The D1 group of rats received a larger dose than the D2 group. The animals were decapitated within 2 hours after phentolamine injection. The FALCK fluorescence technique was applied to demonstrate the fluorescence of catecholaminergic structures. The results in rat brain areas selected according to KONIG and KLIPPEL are shown in figs 10-46. Whereas earlier biochemical experiments did not show any phentolamine-induced changes in the NA level of the whole brain, the present histochemical experiments carried out with the fluorescence technique revealed the influence of phentolamine on individual structures and areas of the NA system. In comparison with the control material in 5 out of 11 areas the fluorescence was much weaker, in 3 it was similar to the control group, and in 3 (1 with a larger dose and 2 with a smaller dose of phentolamine) it was slightly stronger. The simultaneous increase of fluorescence in 6 out of 7 areas of the DA system may indicate a compensatory interaction of these areas as a response to the neuromediator decrease in the NA system. The paper discusses the increase in the intensity of fluorescence induced by a small dose of phentolamine in some brain areas, or by a large dose in others, both these alternatives depending on the neuromediator turnover.


Histochemical and electron microscopical studies of skeletal muscle affected by gas gangrene.

Ultrastructural and histochemical changes of skeletal muscle were studied in three patients affected with gas gangrene. There was complete lack of the phosphorylase, succinate dehydrogenase and adenosine triphosphatase activities in the affected muscles of all the patients. In unaffected muscles these enzymes showed weaker activities than in norm. The lactate dehydrogenase activity, especially the heart type isozyme (LDH-1 or H4) proved less sensitive to the effect of clostridial toxin. A general increase in the acid phosphatase activity was found both in affected and in unaffected muscles. On electron microscopic examination damage to sarcolemmal membrane and disintegration of myofilaments was seen. The mitochondria were swollen and their cristae distorted and fragmented.


Effect of hydroxyurea on the protein content and synthesis in normal and tumorous tobacco tissues cultured in vitro.

An over 9 per cent increase was found in the protein content of callus and tumorous tissues of Nicotiana tabacum cultured for 39 days in a medium with an addition of hydroxyurea at a concentration of 100 mg/l. The inhibitory effect of this compound on incorporation of [14C]leucine was demonstrated, differences in the intensity of labelling between the nucleus and cytoplasm being present only in the tumorous tissue. These differences may indicate either disturbances in the migration of proteins from cytoplasm to nuclei or a specific blockade of histone synthesis. Hydroxyurea inhibits incorporation of [3H]arginine in callus tissues, whereas in tumorous tissues, apart from inhibition (at 75 and 100 mg HU/1), the stimulation of incorporation of this amino acid was observed (at 10 and 50 mg HU/1). The inhibitory effect of hydroxyurea on incorporation of [3H] lysine was demonstrated in both tissues examined, but it was stronger in the callus tissue. On the basis of the results concerning the influence of hydroxyurea on the content and synthesis of nucleic acids [4, 5] and the results of the present study it may be supposed that this compound induces unbalanced growth of cells of both tissues (inhibition of DNA and RNA synthesis and simultaneous accumulation of proteins), thus leading to their death.


Karyometric observations of WISH cell cultures irradiated with 3 GHz microwaves.

WISH cell cultures 24 hours after passage were irradiated with 3 GHz microwaves (10 cm) at far field conditions in free space (anechoic chamber) for 30 minutes, at field power density 5 or 20 mW/cm2. Within 1,24 and 48 hours of the exposure to microwave fields the volumes of nuclei and nucleoli were measured with the use of a micrometer, and logvolumes and nucleo-nucleolar ratios were calculated. Under the applied irradiation conditions the culture medium temperature did not exceed 37 degrees C. In cultures irradiated at field power density 20 mW/cm2 increased number of cells with small nuclei and enlarged nucleoli was noted within 1 hour of the exposure. Within 24 and 48 hours after irradiation the nucleolar volume showed a slight decrease, whereas the nuclear volume increased. In cultures irradiated at field power density 5 mW/cm2 increased numbers of cells with enlarged nuclei and nucleoli were found. Analysis of the distribution curves of nuclear and nucleolar volumes suggests that non-thermal power densities of microwaves stimulate the metabolism of cell cultures. However, at higher power densities (20 mW/cm2) the stimulation phase is preceded by a period of reduced viability of cell cultures.


The effect of a long-term CCl4 action on the DNA content of rat liver cell nuclei. A cytophotometric study.

Inbred CFY male and female rats were given subcutaneous injections of carbon tetrachloride solution in sunflower oil for 12 weeks. Cytophotometric DNA determination was made on liver cell nuclei. Cell nuclei from normal liver showed modal peak of DNA in the diploid range. In the treated animals there were modal peaks of DNA in diploid and tetraploid regions as well as remarkable numbers of over-tetraploid nuclei. The hepatic lesions classified histologically were more severe in males than in females. The ploidy distributions were not related to the histopathological features and sex.


[Rectal neoplasms: the current state of surgical treatment].

The number of patients with rectal cancer ist increasing steadily in the BRD. Even if diagnosis of early stages of rectal cancer is not too difficult, the fatal diagnostic delay is 7-8 months on the average. After operative methods have been subtilized and radicalized only preventive medical examinations and early public instruction may improve the prognosis of the patients concerned. Additional treatment with cytostatical agents seems to be promising. If preventive medical care makes it possible to detect rectal cancer in its early stages, the same operative results can be obtained by the meanwhile developed continence-preserving methods as by the hitherto carried out widespread and continence-sacrificing rectal resection as our own experiences prove.


[Emergency endoscopy].

We prefer emergency-endoscopy in case of acute hemorrhage of the upper gastro-intestinal-tract, in case of perforation no endoscopy. Within the last two years 122 patients were treated by endoscopy and more than half of them must be treated by operation.


[The Mallory-Weiss syndrome (MWS)].

Mallory and Weiss (1929) described the syndrome which is characterized by hemorrhages from mucous membrane gaps of the cardia ner the esophagus. There are many causes responsible: sudden intraluminal pressure, obliteration of the mucous membrane, alcohol excess, voluminous meals, myocard infarction. In 3-5% hyperemesis is accompanied by Mallory-Weiss-Syndrome. For diagnosis endoscopy is the method of choice; if conservative therapy is without result, surgical measures are necessary. Lately endoscopic electrocoagulation gains more and more importance. 2 cases are reported.


[Problems of the so-called geriatric gastrointestinal diseases].

The significant increase in the number of people older than seventy forces the physician to be acquainted with both psychological and physical alterations induced by aging and to devote an ever increasing proportion of time for recognition and treatment os such alterations. In the medical sense, the biological and physiological age is more important than the chronological age. With increasing age there is--especially concerning the digestive tract and its accessory organs--a rise in the incidence of organic affections and a decline in the frequency of functional disorders. Besides it is wise to know, that the increasing age there is often a coexistence of multiple degenerative disorders and disease states, involving many body systems and organs. On the background of this recognition it is also important to know, that prognosis too varies with age because of the coexistence of individually prognosticated disease states and moreover to realize, that elderly patients do not tolerate invasive and prolonged surgical procedures. Structural or functional disturbances of the digestive organs by aging processes do not cause death per se, but can become one important factor; degenerative sclerotic vascular alterations bear relationship to the poorly contractile vasculature that brings up difficulties in the control of hemorrhagic gastroduodenal ulcers. Many gastrointestinal disorders in elderly patients occur with an equal frequency in younger patients, some are more common in the geriatric population; these include hiatal hernia, carcinoma of esophagus, stomach, pancreas, bile ducts and colon, intestinal obstruction (ileus) by neoplastic growth, gallstone ileus, external hernia and operative adhesions and especially diverticular diseases of the colon and its complications and ischemic colitis by mesenteric vascular occlusion. Cirrhosis of the liver is often diagnosed for the first time in the older age groups while acute viral hepatitis uses to run a cholestatic course and is therefore often misdiagnosed as mechanical obstruction. In general history is difficult to obtain, the response of the organism with temperature and white blood count to stress is often delayed and rigidity associated with an underlying inflammatory disease involving the peritoneum is often delayed and rigidity associated with an underlying inflammatory disease involving the peritoneum is often atypical. Because of this limited reaction to severe stress, early surgical intervention is imperative in the elderly patients.


[Aims and realities in geriatric psychiatry].

The psychiatric care of the elderly in the Federal Republic of Germany must presently be considered to be inadequate. At the present the main point of emphasis in treatment is placed almost exclusively on the stationary sector, having a predominantly keeping character. What is necessary, however, is psychogeriatric activity which unfolds itself very substantially in the field of out-patient diagnostics, therapy and health education in order to cope better with the handcaps of the the elderly. Apart from the urgently needed establishment of new institutions, the overcoming of the wide-spread therapeutic pessimism in the care of the older people is to be seen as a substantial aim, particularly of those active in geriatric health care.


[Ketone bodies in the blood during sorbitol infusion].

The concentration of hydroxybutyrate and pyruvate during infusion of sorbitol was significantly depressed in 12 healthy subjects. The dosage ranged between 0.25 and 0.50 g/kg BW/h. Considering the blood parameter the hunger ketosis was depressed by the infusion rate of 0.25 g/kg/h. Cholesterol concentration, too, was significantly lowered by sorbitol.


Purification and characterization of a hemagglutinin from Arachis hypogeae.

A. hypogaea hemagglutinin was purified by ammonium sulfate fractionation and Sepharose 6 B column chromatography. The homogeneity of the purified hemagglutinin was ascertained by ultracentrifugal analysis and polyacrylamide gel electrophoresis. It has a molecular weight of 106.500 and is a tetramer of a subunit with a molecular weight of 27.000. The purified hemagglutinin agglutinated neuraminidase-treated human erythrocytes regardless of their ABO group type, but did not agglutinate intact erythrocytes. In hapten inhibition assays with simple sugars, the so-called Mäkelä's group 2 sugars, which bear the same configuration of hydroxy groups at C-3 and C-4 as D-galactopyranose, were inhibitors for this hemagglutinin. It does not contain any carbohydrate, in contrast to most phytohemagglutinins except concanavalin A and wheat germ agglutinin.


Formation, circular dichroism and x-ray photoelectron spectroscopy of hepatic Zn-thionein.

The formation of the powerful Zn binding protein called Zn-thionein was examined using male albino rats and [14C]cysteine, as cystein is known to be the most abundant constituent of this metal protein. 65% of the hepatic [14C]cysteine was incorporated into the protein portion of freshly prepared Zn-thionein. The protein was isolated by a combination of ethanol/chloroform treatment and various chromatographic steps, including ion exchange and gel filtration. 4.7 mol of Zn, 0.02 mol of Cd and less than 0.001 mol of either Cu or Hg were found per 12 000 g of portein. It was presumed that considerable amounts of Zn were lost during these isolation procedures, with the consequence of disulphide gridge formation. Indeed, the presence of R-S-S-R was deduced from circular dichroism and X-ray photoelectron spectroscopy. Due to the clearly detectable disulphide chromophore in the circular dichroism spectrum, it was possible to assign the shoulder at S 2p1/2,3/2 =  162.7 eV of the X-ray photoelectron spectrum of native Zn-thionein to R-S-S-R and not to strongly polarized sulphur. Upon reducing R-S-S-R-containing native Zn-thionein with dithiothreitol, all oxidised thiolate moieties of the thionein molecule could be restored. The addition of ZnCl2 with the subsequent desalting of extraneously bound Zn2 yielded a homogeneous Zn-thionein with 9.6 mol Zn2 per mol protein. A stoichiometry of ZnRS 1:3 was seen, which confirmed earlier reports of the existence of the mixed Cd,Zn-thionein. The conversion of mixed Cd,Zn-thionein into homogeneous Zn-, Cd-, Hg- and Cu-thionein by the gel filtration technique proved successful. From chiroptical measurements, the extraordinary contribution of the metal chromophores to the circular dichroism was seen. Due to the differences in the geometry of complexes formed by the respective metal ions, dramatic changes in the protein portion were expected. Polyacrylamide disc electrophoresis of purified native untreated Zn-thionein resulted in the appearance of two or more bands. This phenomenon was attributed to the different migration rates of cystine-thionein and thiolate-rich Zn-thionein, and was consistent with the spectral properties of the above Zn-protein species. By contrast, only one single band was monitored when a homogeneous metal-thionein was electrophoresed.


On the carbohydrate composition of bovine colostrum trypsin inhibitor.

The trypsin inhibitor from bovine colostrum has been separated into several forms by CM-Sephadex and DEAE-cellulose chromatography. These forms differ in the amount and composition of the carbohydrate they contain, which has been quantitated for four components by gas-liquid chromatography and standrad colorimetric procedures. The monosaccharides fucose, mannose, galactose, galactosamine, glucosamine and sialic acids have been determined. A microheterogeneity was establish ed in the carbohydrate moiety, which amounts to about 40% of the total molecular weight (Mr 11 000 - 14 000) of bovine colostrum inhibitor.


The isolation of the urogastrones - inhibitors of gastric acid secretion - from human urine.

It has been known for over thirty years that extracts of human urine could cause inhibition of gastric acid secretion. The active principle was called urogastrone and this has now been isolated using a series of twelve simple stages of partition, gel and ion-exchange chromatography. In fact two products were obtained, each in a yeild of less than 1 mg per 1 000 l urine, which represented an overall recovery of 3 - 5%. These materials were biologically indistinguishable, causing inhibition of gastric acid secretion in a variety of circumstances at doses of less than 1 mug/kg. The purified urogastrones were found to be acidic polypeptides composed of 53 and 52 amino acid residues with three internal disulphide bonds, and they differed by only one arginine residue. Neither threonine nor phenylalanine residues were present in the urogastrones.


The relationship between systems theory and community psychiatry.

General systems theory, when applied to human personality and behavior, considers the human system to be an active, open one in which personality develops through interaction with other systems; problems within one system can produce ripple effects in others. Community psychiatry sees the roots of most mental disorders as being in disturbances within the network of interacting systems. The author believes that community mental health centers, with their multifaceted approach to treatment and prevention, reflect the health profession's efforts to deal with the mental health problems of a community in a systems-oriented way. Although the CMHC movement has weaknesses, he feels they do not stem from the basic concepts behind the centers, but from the inadequate implementation of those concepts. He considers four major interfacing variables that are relevant in determining a center's capacity to survive and to function.


Medically oriented psychiatry: an approach to improving the quality of mental health care.

To assure the consumer of the highest quality cost-effective mental health care, the author argues for the use of a proper "medical model" when care is delivered. He also argues that psychiatrists must deal with the whole person-both his psyche and his soma. The author discusses the role of the medically oriented psychiatrist, and presents a case study that demonstrates the interplay between a patient's psyche and soma. In addition, he introduces a four-step principle, to be incorporated into all health insurance plans, that will ensure that a patient's physical and psychological problems will be dealt with together and that he will receive quality health care.


A survey of rural community mental health needs and resources.

The authors conducted a survey of 215 rural community mental health centers across the country to determine their unique problems, needs, and resources. From the 92 responses they received, they formulated a composite description of the rural mental health scene. Their description focuses on services offered, skills required to operate effective rural programs, and problems in the delivery of care and of evaluation. From the responses they also analyzed the extent of inservice training available to rural practitioners, the support systems needed, and the functions a proposed national task force on rural mental health could perform.


The first year of a child advocacy project.

In a child advocacy project funded through a community mental health center, five area residents were trained as advocates and assigned to two elementary schools. The advocates spent much of their first year in training, and in trying to establish themselves as resource persons for children and families, in setting up parent-school councils, and in developing recreational programs. They found it easier to be activists and caregivers than corrdinators of services, and they met some resistance from the schools and the community. But by the end of the first year the advocates had made significant progress in helping children and families obtain community services and in increasing contact between parents and the schools.


Measuring staff attitudes toward computerization.

The authors developed and tested an 88-item scale designed to measure staff attitudes toward and knowledge about computers. A questionnaire was completed by 42 staff members at a psychiatric unit of a hospital where a health information system was being implemented; 28 of the staff members had attended a two-and-one-half day course on computer systems. Those who had completed the course had more favorable attitudes toward computerization than the 14 who did not. The authors described the findings and discuss their implications.


Organizing a staff development department: the Fort Logan Model.

The staff development department at the Fort Logan Mental Health Center in Denver was created to increase interdisciplinary coordination and participation in student- and continuing-education programs. A great deal of interdisciplinary competition was evident at the beginning. Eventually, continued interaction and expanding needs for members' skills eliminated most competition, and staff were able to learn from one another. Most of the staff now have multiple capabilities and are effective not only in teaching but also in systems intervention. The department's services include a preservice program, which is responsible for student and professional training programs; inservice- and continuing-education programs; and a consultation program.


An evaluation of alcoholism treatment services for Alaskan natives.

Using chart-review procedures, the authors examined the management of patients with a recognized alcohol problem in 12 medical facilities and 20 alcoholism programs throughout Alaska. The evaluation, which covered a one-year period, focused on the service delivery system rather than on treatment outcome, and sought to determine if problems of alcohol abuse were being solved. The authors found that a treatment plan was developed, followed up, and evaluated for 8 per cent of the problem drinkers treated in medical facilities and for 16.7 per cent of those in alcohol programs.


[Mitochondrial antibodies induced by drug administration in patients with and without pseudo LE syndrome (author's transl)].

The pseudo LE syndrome was first described in 1972. It is a severe, sometimes fatal condition, in which high titres of mitochondrial antibodies are a constant feature. In the vast majority of cases detected, Venopyronum in dragée form (containing phenopyrazone, horse-chestnut extract, and cardiac glycosides from various plants), had been taken prior to onset of the clinical symptoms. It is probably commoner, that following intake of the drug mitochondrial antibodies appear without clinical manifestations. In both situations, disposition, dose and duration of treatment are important factors. There is reasonable ground to believe that not just a single component, but rather the combination of various substances in the preparation is responsible for the induction of an autoimmune process. At the present time it appears that an idiopathic form, without drug contact, also exists.


[The role of rubella specific IgM within the serological diagnosis of rubella (German measles) (authors transl)].

The sera of 327 patients were investigated for rubella specific IgA after separation of the IgM fraction by sucrose density gradient centrifugation. 1. In 96 out of 137 cases suspicious of clinical rubella, where the time for demonstration of a significant rise of the antibody titer had been missed, the demonstration of rubella specific IgM confirmed the diagnosis of German measles. This demonstration was still possible in 9 out of 10 cases 5 to 7 weeks after the onset of the disease, but in only 2 out 7 cases 8 to 15 weeks after the onset of the disease. 2. In 48 patients who had contact with patients with German measles but did not develop any symptoms, a primary infection could not be excluded by the examination of the whole serum. In 5 out of them rubella specific IgM indicted a recent rubella infection. 3. Rubella specific IgM could not be demonstrated in 47 patients who had high antibody titers but no other hints for a recent rubella infection. 4. In 89 newborns, the investigation was prompted, when elevated IgM levels were found in umbilical cord blood, or when the newborn was sick, or when a rubella infection of the mother was suspected or proven. Rubella infection of the newborn was confirmed by rubella specific IgM only if the mother had contracted German measles during the first trimester of the pregnancy (6 out of 7 cases). The diagnosis of primary rubella infection during pregnancy is proven only if 2 out the fose in antibody titer, demonstration of rubella specific IgM.


[Pertussis and it complications-analysis of hospitalized patients in Hamburg 1950-1970 (author's transl)].

From 1950 to 1970 in Hamburg, 9240 patients under 15 years of age were treated as inpatients for pertussis. 1674 patients had pneumonia due to pertussis, 114 had pertussis encephalopathies, and 41 seizures. The fatality from pneumonia went from 2,26% (1950-1960) to 0,4% (1961-1970). Fatality from encephalopathy was less influenced (24% respectively, 17,9%). The mild clinical course of pertussis is also reflected in the reduced number of hospitalizations due to pertussis (1956, 3,7%; 1970, 0,8%). Permanent damage from complications due to pertussis was seen in 0,7% of survivors from pertussis pneumonia and in 3,4% after pertussis encephalopathy.


Inhibition of mitogen mediated lymphocyte blastogenesis by adenosine.

The effect of adenosine on the proliferative response of human peripheral circulating lymphocytes to stimulation by concanavalin A, phytohemagglutinin and pokeweed mitogen was evaluated. Increasing concentrations of adenosine substantially inhibited mitogen mediated lymphocyte blastogenesis. Erythro-9(2-hydroxyl-3-nonyl) adenine. HCl enhanced the inhibitory effect of adenosine. Inosine, the deamination product of adenosine, had an inhibitory effect which was less than that of adenosine. Inhibition by adenosine may be relevant to the normal regulation of immune function and may account in part for the pathophysiological relationship between severe combined immunodeficiency disease and adenosine deaminase deficiency.


Spontaneous release of soluble HL-A antigens from platelets during conservation.

Experiments with the aim of studying the solubilisation of HL-A antigens from blood platelets by methods which do not involve any biologically active processes (moderate, discontinuous agitation of a low concentration of platelets suspended in a saline medium, in the presence of an antiseptic; supernatants collected at frequent intervals) have shown that platelets release membrane proteins, including HL-A antigens, spontaneously. Optimal conditions for the treatment of membrane proteins have been perfected. The great stability of HL-A antigens under these conditions permits prolonged treatment. The products extracted are soluble and extremely complex. The molecular weight of the HL-A antigens is between 40,000 and 70,000.


Carbohydrate metabolism in PHA stimulated human peripheral blood lymphocytes.

Human peripheral blood lymphocytes (PBL) stimulated in vitro by phytohemoagglutinin (PHA) manifest augmented glycolysis and oxidation of glucose-1-14C, indicating an increased utilization of the pentose pathway. Lactic acid production, as index of increased glycolysis, follows the same kinetic of thymidine incorporation and can be easily quantitated by an enzymatic assay.


Central nervous control of venous tone. III. Responses of capacitance and resistance vessels of skin to bulbar and hypothalamic stimulation.

Electrical stimulation of 350 points in the bulbar formation of 35 dogs under chloralose anaesthesia demonstrated the presence of sites producing increase or decrease of systemic arterial pressure (SAP) in the same general morphological limits of bulbar pressor and depressor regions as described by earlier authors. Simultaneous recording of pressure changes in the cutaneous vessels however demonstrated that pressure changes in these vessels did not correspond to the pressor or depressor effects of the SAP. Instead, responses were obtained in which pressures in cutaneous capacitance and resistance vessels followed a trend which was opposite in direction and magnitude to that of SAP. Thus there were 30 depressor sites which produce increase in cutaneous vessel pressure and 23 pressor sites which produced a fall in cutaneous vessel pressure. For a marked rise in the SAP, only 62 sites elicited equally marked increase in both capacitance and resistance vessel pressure, while another 52 elicited only a small increase of equivalent magnitude in the capacitance and resistance vessels. Stimulation of 84 points produced dissimilar effects on capacitance and resistance vessels out of which 38 elicited moderate increase in resistance vessel tone with minimal changes in the capacitance vessel tone, while 46 points elicited moderate increase in capacitance vessel tone with only a small increase in the resistance vessel tone. These points were diffusely admixed in the bulbar reticular formation. Effects which were exclusive to the capacitance and resistance vessels of skin, singly or in combination, without affecting the SAP were elicited from 12 points while another 28 points produced marked rise or fall of systemic arterial pressure without affecting the cutaneous vessels. These observations suggest that the neuronal organisation regulating cardiovascular activities at the bulbar level is quite complex having the capacity to generate varying activities in different components of the vascular circuits by differentially altering the discharge of the efferent sympathetic fibres on the one hand, and marked selectivity of action on any particular vascular bed or circulatory component on the other hand. Stimulation of 93 points in the hypothalamus produced similar patterns of response as obtained from medulla oblongata. In addition, stimulation of 6 points in the anterior hypothalamus produced a distinctive response accompanied by dilatation of cutaneous resistance and capacitance vessels with marked increase in respiratory rate and minimal changes in the SAP. This type of response which resembled the physiological response employed for heat loss was not obtained from any stimulation site in the medulla oblongata.


Effects of heat--stress in rats: Critical period and reduced survival of post-implantation heat-stress inducted in early gestation.

High ambient temperature (34.4 C degrees and 60-65% relative humidity (RH) did not affect foetal survival when bred female rats were exposed between day-8 and -18 (Day-0=day of breeding). Heat-stress at this intensity given on day-0 was critical for embryonic and/or foetal survival rate and more so, if the ambient temperature was increased to 36.6 C degrees and 70-75% RH than on day-1. Postimplantation foetal survival was reduced due to heat-stress given only during early gestation period.


Effect of Krebs cycle metabolites on frog heart.

All the Krebs metabolites except pyruvate, lactate, acetate and succinate reduced the force and rate of myocardial contractions and also decreased cardiac output in frog. Succinate on the contrary was found to augment the rate and force of heart. The cardiac stimulation produced by epinephrine was reduced by fumarate, malate, oxaloacetate and alpha-oxoglutarate, whereas transaconitate and citrate produced only a slight inhibition. Pyruvate, lactate, acetate and succinate did not alter cardiac response to epinephrine.


Effects of heat--stress in rats. II. Factor(s) responsible for reduced embroynic and/or foetal survival percentage.

High ambient temperature (34.4 C degrees and 60-65% relative humidity (RH failed to maintain optimum embryonic and/or foetal survival rate in ovariectomized pregnant rats given exogenous progesterone and oestrone injections. A still higher ambient environment (36.6 C degrees and 70-75% RH) did not affect the decidual cell response (DCR) in psuedo-pregnant rats. Heat stress did not result either in insufficiency or lack of progesterone and hence the latter two are not factors for the heat stress causing embryonic and/or foetal loss. The possibility of the failure of oestrone being converted to oestradiol or an intrinsic interference of RNA synthesis to be the factors responsible for embryonic and/or foetal loss caused by heat stress has been examined.


Central nervous system pharmacology of propranolol.

In rats, propranolol potentiated alcohol and pentobarbitone hypnosis, but not barbital sleeping time, indicating enzyme inhibition as a possible mechanism of potentiation. Propranolol showed anticonvulsant effect on normal and reserpine treated rats by MES test, but showed dose related lowering of MET. Probable mechanisms are discussed.


Isolated innervated, rat and guinea-pig hemi-urinary bladder preparations.

Isolated innervated hemi-urinary bladder preparations of the rat and the guinea-pig have been described. In durability and behaviour to different frequencies of stimulation, the guinea-pig hemi-bladder is shown to give comparable results to those reported for the whole nerve-bladder. The rat hemi-bladder gave less durable contractions on prolonged stimulation. It is shown that the isolated guinea-pig hemi-bladder can be substituted for the isolated whole bladder preparation.


[Basics on the application technics of infusions].

For the application of infusion solutions the subclavian catheter is best suited. The sometimes serious complications resulting from it can only be avoided by exact insertion technique and observation of the contraindications. In rare cases the vena-cava-inferior catheter serves as an alternative access. For short-term infusions and in the case of non-occurring circulation centralisation arm and leg venipuncture can be applied. Due to frequent complications and difficulties arising during insertion the brachial vein catheter is contraindicated.


[Infusion therapy in disorders of the sodium and water balance].

Water depletion, water in excess and sodium depletion are the most important disturbance of sodium-water balance. Water, electrolytes and acid-base balance have always to be considered in their complex correlation because of their various interrdependency. The restoration of balance concerning imput and output is considered as a basic principle of any intravenous therapy.


[Diagnosis and treatment of disorders of the potassium balance with special reference to infusion therapy].

Following a short review of the physiological regulation of body potassium diagnostic procedures to detect disturbances in potassium balance are cited. The limited value of serum potassium concentration is emphasized. Possible caused of potassium deficiency and prophylactic measures to prevent negative potassium balance are summarized including oral and parenteral potassium administration. A synopsis of the causes of hyperkalemia is followed by a description of therapeutical measures. Chronic hyperkalemia may be treated by oral or rectal administration of ion-exchange resins, while acute lifethreatening hyperkalemia is corrected by infusion of isotonic saline, glucose and insulin, and calcium gluconate as well as by correction of metabolic acidosis with sodium bicarbonate. In patients with intact renal function these measures will generally result in rapid correction of increased serum potassium levels.


Traumatic rupture of the thoracic aorta-a radiological pitfall.

A previously undescribed feature of a traumatic thoracic aneurysm is presented. The pateint was a young motor cyclist who sustained multiple injuries and died 10 days after admission from delayed rupture of the thoracic aorta which had dissected along oesophageal planes into the stomach. Although the radiological features of traumatic mediastinal haematoma were evident shortly after injury, these features had disappeared in later radiographs creating a false sense of security.


Long-term follow-up of a series of infected fractures of the tibia.

The management of chronic infection in fractures by a method I described in 1965 which was shown to give a better than 9 out of 10 chance of wound healing, is now shown to offer at least a 6 out of 10 chance of wounds remaining healed for 10 years. Amputation is almost never necessary.


Traumatic arteriovenous fistulae.

Twenty-two cases of arteriovenous fistulae are reviewed retrospectively, with particular emphasis on their clinical presentation, physical signs, investigations and management. This review allows us to make certain conclusions for the future diagnosis and management of this condition.


Subclavian artery rupture (an unusual seat-belt injury).

A case of blunt injury to the subclavian artery in the absence of bony injury or dislocation sustained while wearing a seat belt is described. Its rarity and diagnostic pitfalls are discussed. The mechanism of the injury is analysed. The value of angiography is emphazided. It is suggested that, even in the presence of collateral circulation, exploration and repair should be undertaken.


Olecranon fractures in children.

A series of 40 cases of fractures of the olecranon in children under the age of 11 years is presented. These fractures are commonest at 5 years of age and are almost twice as common in boys as in girls. The fracture is usually undisplaced and incomplete; fractures in the long axis of the ulna (the 'longitudinal split' fracture) are not uncommon in children. Associated injury of the proximal end of the radius is recognized. Only 2 cases were sufficiently displaced to require open reduction. Although immobilization in plaster with the elbow at 90 degree for a month is usually recommended, the results indicate that in the usual undisplaced and incomplete fracture, a period of 3 weeks in a sling may be all the treatment necessary.


Fracture recurrence in children.

A group of 20 children are described who presented with refracture (predominently affecting the forearm). The most likely causes were a combination of premature cessation of splintage combined with excessively reckless physical activity, the latter factor being of major importance. The problem is not a major one except where a significant increase of deformity occurs in refractures of the forearm.


Riot injuries to policemen. An analysis of 808 policemen injured in roiting between 1969 and 1972 in Northern Ireland.

Injuries to 808 policemen injured in rioting in Northern Ireland are analysed. The causes and effect of the injuries are discussed especially in relation to the protective clothing worn, and modification are suggested.


A case of traumatic bilateral superficial dislocation of the testis.

A rare case of traumatic bilateral dislocation of the testis is described. Aetiology, management, factors which influence treatment and prognosis, and the differential diagnosis are discussed.


The results of operative and non-operative management of tibial fractures.

A series of 160 fractures of the tibia in 155 patients is analysed. Eighty patients were operated on' intramedullary nails were used in 33, AO plates in 29 and screws in 18 cases. In the final evaluation the result was classified as good in 39, fair in 27, and poor in 14 cases in the non-operative group, and 40, 25 and 15 in the operative group. Fracture comminution had a significant effect on foot and ankle motion.


External fixation of the pelvic girdle with a trapezoid compression frame.

The compression obtained with external anchorage in the anterior and posterior part of the pelvic girdle has been studied with a measuring device in the sacroiliac joint and and the symphysis of a specimen pelvis. Two models of external frames were tested, in both of which anchorage to the pelvic bone was brought about with 3 pins inserted in the iliac crests. The results were best with a trapezoid frame and bar exerting a compressive force on the pelvic girdle. When mounted with an inclination of 70 degrees to the long axis of the body, the frame exerted considerable compression on the posterior part of the pelvic girdle. This mounting afforded good stability of the detached hemipelvis. The trapezoid compression frame is recommended as an alternative to conventional methods of treating unstable fractures and dislocations of the pelvic girdle.


Penetrating injuries of the neck.

In view of the close arrangement of a large number of vital structures in the neck, penetrating wounds in this region should be considered as potentially lethal. Nineteen cases of injury to great vessels and food and air passages which required repair are analysed. There were 4 deaths, giving an overall mortality of 21 per cent. Two of these were injuries of the subclavian and innominate veins when prolonged delay for resuscitation was probably the main reason for the deaths. The third was in a patient with tracheal injury in whom a coexistent oesophageal lesion was missed and the fourth a case of spinal cord injury. When adequate exposure cannot be obtained by exploration of the neck, median sternotomy or anterior thoracotomy is advisable.


Traumatic intercostal pulmonary hernia.

A case of intercostal pulmonary hernia following blunt trauma to the chest wall is reported. This type of hernia is a benign disorder. Although most lung herniae need operative treatment, it is reasonable to wait for spontaneous regression.


Jaundice as a sign of delayed gall-bladder perforation following blunt abdominal trauma.

A case of delayed rupture of the gall-bladder following blund abdominal trauma is presented. A discussion of the aetiology, clinical and biochemical manifestations, and prognosis of this condition follows.


Burns to infants using walking aids.

Thirty-one burns and scalds to infants using walking aids are recorded. The mechanism of injury and resulting morbidity are described. The need for more rigerous precautions is discussed.


Fractures of the clavicle.

Three hundred and forty-two patients with fractures of the clavicle attended the Fractrure Clinic at Bridgend General Hospital between 1957 and 1972. The history of injury was recorded in the notes at the first visit but in only 215 cases was the exact mechanism of the injury clearly stated. Of these, 91 per cent were caused by a fall or a blow on the point of the shoulder. All patients were treated symptomatically. A triangular sling was applied to support the weight of the arm and early use of the limb was encouraged. One hundred unselected patients were followed up, the longest period being 15 years and the shortest, 1 year. None had any loss of function of muscle power at the shoulder. Only 15 per cent were left with any noteworthy deformity at the site of fracture.


Fractures of the neck of the femur in childhood and adolescence.

Twenty cases of fracture of the neck of the femur in children and adolescents below the age of 20 were reviewed. The most important single prognostic factor was the degree of displacement of the fracture at the time of injury. Undisplaced fractures, whether treated conservatively or by internal fixation, did well. Displaced fractures, however, always required internal fixation with thin pins after accurate correction of displacement. The various complications of this fracture in children are discussed. Acute necrosis of articular cartilage following this fracture in children is recorded for the first time in 2 cases.


Fractures of the radius and ulna in children.

A consecutive series of 375 fractures of the radius and ulna in children of up to 15 years is described. At discharge from the fracture clinic, 65 failed to achieve a satisfactory result. After 4 years, however, only 9 children did not have normal function and only 1 was aware of any disability. The natural history of this injury is towards a complete functional recovery in the vast majority of cases.


Tibial shaft fractures treated by rigid internal fixation: the early results in a 4-year series.

Ninety-nine fractures of the shaft of the tibia in 98 patients were treated by rigid internal fixation over 4 years. One patient died after operation from myocardial infarction; and one patient went abroad. The healing course of the remaining 97 fractures is described, classified according to the type of fracture and the accuracy of operative reduction. Seventy-five fractures had a normal time to union, defined as the lasting achievement of full weight-bearing within 4 months. In 7 fractures the healing period was moderately delayed (full weight-bearing being achieved in 4-6 months) and in 5 it was seriously delayed, requiring 6-11 months after injury. Nonunion occurred in 4 cases and refracture in 6 cases. Osteitis developed in 2 cases and was successfully treated with antibiotics within 6 weeks. A second internal fixation was necessary in 12 patients. In 5 patients a plaster cast was applied to treat delayed union. Amputation was necessary in a 75-year-old man with senile dementia who developed infection after a second operation for refracture. One patient still has a pseudarthrosis after 2 years and 2 further operations. In the other 95 fractures union was the end-result. Of the 21 comminuted and open fractures only 13 healed within 4 months. We recommend a different approach in the treatment of badly comminuted and open 'high-energy' fractures. With this reservation, we find that the method of rigid internal fixation which we employ has given satisfactory early results. The frequency of both delayed healing and infection is reasonably low compared to the results in similar series.


Dislocation of the hip associated with fracture of the femoral head.

With increasing numbers of road traffic accidents, dislocation of the hip associated with fracture of the femoral head is becoming more common. Seven cases are presented. Treatment of this injury is difficult but it is suggested that conservative methods should be considered initially. Long-term follow-up is necessary as many of these patients develop late complications.


Fracture-dislocations of the elbow.

This paper presents a series of 105 cases of fracture-dislocation of the elbow joint. All these fractures differ in mechanism, age of patient and method of treatment, so problems arise in classification. Causes can be grouped together more easily than in principles of treatment. The cases are classified into 2 major groups and 10 subgroups. Single fracture types are analysed and the optimal type of treatment is studied. As with all joint fractures, adequate reconstruction is obilgatory to remove all steps in the articular cartilage, and rigid fixation is mandatory except for the radial head, where excision is indicated. The different fracture types and their relevant operations are illustrated with examples.


Trauma to the urethra.

Little is known of the exact aetiology of traumatic stricture of the urethra, but the first clinical presentation can be delayed many years after the trauma. Diagnosis can be made on clinical grounds alone and the passage of a catheter is condemned as clinically misleading and surgically dangerous. Partial rupture is relatively common and every effort should be made to preseve the remaining bridge of tissue which may still be viable. Initial treatment should ensure that no additional damage is done to the urethra by converting a partial rupture into a complete transection.


An analysis of the post-mortem findings in the 21 victims of the Birmingham pub bombings.

On the evening of 21 November, 1974 explosions occurred almost simultaneously in two crowded public houses in the centre of Birmingham. Of the 21 people who died, 18 were killed outright and 3 died later in hospital. All 21 cases showed the terrible multiple injuries associated with close proximity to a powerful explosion within a confined space. Although all the victims suffered one or more injuries which alone would have been fatal, certain patterns of injury were noted which, if appreciated early in any future similar incident, may help to save the lives of those who are futher removed from the centre of the explosion or exposed to one of lesser force.


Antigenic variation of Streptococcus mutans colonizing gnotobiotic rats.

Strains of Streptococcus mutans representative of serotypes b and d exhibited antigenic variation in both the oral cavity and in the intestinal canal of gnotobiotic rats. Laboratory-maintained cultures did not vary. The antigenic alterations observed were: (i) loss of detectable levels of both weakly reacting "strain" antigens and the type antigen; (ii) decreased production of the type antigen; (ii) production of altered type antigen; and (iv) production of an antigen not possessed by the parent strain. Immunization of animals before monoinfection with S. mutans strain Bob-1 (serotype d) appeared to increase the rate of emergence of antigenically altered mutants in the intestinal canal, and more diversely altered isolates were obtained. Antigenic variation may account in part for the variation noted by several investigators in attempting to immunize animals against S. mutans-induced dental caries.


Mycoplasma-mediated hyporeactivity to various interferon inducers.

Three strains of Mycoplasma arthritidis were shown to induce marked hyporeactivity in mice to interferon induction by both Newcastle disease virus and poly(I:C). In contrast, the interferon response of mice to tilorone was only partially suppressed by pretreatment of the animals with mycoplasms. Hyporeactivity to Newcastle disease virus was maximal 1 and 3 days after mycoplasms treatment, but the interferon response was maximal 1 day after injection of the mycoplasmas and was no longer apparent by 5 days. No relationship was found between the ability of the mycoplasms themselves to induce interferon and the degree of hyporeactivity produced. These results suggest that mycoplasmas may alter virus-host relationships in vivo.


Multiple sclerosis-associated agent: transmission to animals and some properties of the agent.

In confirmation and extension of observations by Carp and his associates, brain tissue and sera from patients with multiple sclerosis (MS) were found to harbor an agent which induces a transitory depression in polymorphonuclear leukocytes (PMN) in mice as well as in rats, hamsters, and guinea pigs. All of eight MD brains contained this agent at titers as high as 10(-9)/g of brain tissue. The agent was found in MS sera at titers up to 10(-3)/ml of serum, but its presence depended to some extent on the clinical status of the patients; it was observed more frequently in sera of patients with active disease (73%) thatn in sera of patients with quiescent disease (31%). Control brain tissues or sera failed to induce PMN depression. The apparently MS-associated agent (MSAA) passed through 50-nm but not 25-nm membrane filters (Millipore Corp.) and was largely sedimented at 105,000 X g but not at 50,000 X g for 1 h. It multiplied to high titers in the central nervous tissue of the inoculated animals and could be serially transmitted from animal to animal by passage of brain homeganates. Various observations and considerations appear to preclude that MS-associated agent represents an indigenous animal virus. Although its role in MS remains to be determined, it should be considered a candidate for the etiology of this disease.


Multiple sclerosis-associated agent: neutralization of the agent by human sera.

A total of 172 sera from patients with multiple sclerosis (MS), theri relatives and nursing personnel, patients with other neurological and nonneurological diseases, and healthy donors living in the United State or East Africa under vastly divergent hygienic conditions were examined for their capacity to neutralize the MS-associated agent (MSAA), which induces in experimental animals a transitory depression of circulating polymorphonuclear leukocytes (PMN). A considerable proportion of sera from MS patients and their relatives or nursing personnel and East African donors revealed neutralizing activity, but only one of 59 sera from American donors without known contacts with MS patients revealed neutralizing activity. Some of the sera could be diluted 100- or 1,000- fold and still prevent, or substantially reduce, PMN depressions in mice. The neutralizing activity was shown to be associated with the immunoglobulin fractions of sera and therefore appears to be due to an antibody. Cerebrospinal fluids from MS, but not other, patients also strongly neutralized MSAA. Evidence has been presented that sera from MS patients may contain both MSAA and MSAA neutralizing antibodies. Antigen-antibody complexes were separated from such sera by high-speed centrifugation, and neutralizing antibodies were dissociated from them at a low pH. Whereas the data are as yet limited due to the vagaries and complexities of the test procedures, they provide further evidence that MSAA is not an indigenous virus of experimental animals, causes infections in man, and is indeed closely associated with MS. If it were the cause of MS, which remains to be ascertained, the data imply that not all infections by MSAA lead to the development of MS.


In vitro radiolabeling procedure which labels the proteins of Newcastle disease virions with carbon-14.

A convenient and gentle procedure was used for in vitro radioisotopic labeling the proteins of Newcastle disease virus. This method, which utilizes [14C]formaldehyde and sodium borohydride, labels all the proteins of purified Newcastle disease virus. Virions labeled in this manner retained biological and biopysical integrity


Effect of dextranase on the extracellular polysaccharide synthesis of Streptococcus mutans; chemical and scanning electron microscopy studies.

A dextranase preparation (AD17) partially purified from a culture liquor of Spicaria violacea strain IFO 6120 significantly inhibited the formation of artifcial dental plaque on a steel wire or on an extracted tooth surface. Changes in the surface morphology of Streptococcus mutans cells due to AD17 action were studied using scanning electron microscopy. S. mutans cells grown in 5% sucrose-containing broth were coated with sticky amorphous capsule-like material, whereas cells grown in sucrose in the presence of AD17 or in glucose instead of sucrose did not synthesize such capsular material. AK17 degraded commercially available dextrans of molecular weight 7 X 1(04) and 2 X 10(6) to liberate glucose and various oligosaccharides, including isomaltose. On the other hand, AD17 hydrolyzed the extracellular polysaccharides (mainly glucan in nature) of some strains of S. mutans to a limited degree. Only 15 to 36% of the total polysaccharides were hydrolyzed by AD1M with little release of isomaltose. Prolonged incubation of the polysaccharides from S. mutans with AD17 did not release additional reducing sugars, which indicates that AD17 did not contain alpha-1,3-glucanase activity. These results suggest that glucosidic linkages which are susceptible to AD17 may play an important role in the adherence of S. mutans cells to smooth surfaces.


Comparative toxic effect of the surface lipid of Corynebacterium ovis on peritoneal macrophages.

The postphagocytic effect on mouse, rabbit, and guinea pig peritoneal macrophages of a petrol-ether lipid extract from Corynebacterium ovis (C. pseudotuberculosis) representing the surface coat of the organism external to the cell wall was investigated by examing three parameters of cytotoxicity, viability assayed by dye exclusion, glycolytic activity, and ultrastructural morphology. The viability test demonstrated a lethal effect on normal and immune mouse macrophages but not on those of the rabbit or guinea  pig. Measurement of glycolsis indicated a significant degree of cytotoxicity in normal mouse macrophages ingesting lipid, a nonsignificant depression of activity in cells from immune mice, and no alteration in the activities of rabbit and guinea pig macrophages. Electron microscopy demonstrated that C. ovis surface lipid caused acute lethal injury in normal and immune mouse macrophages. The early stages of degeneration were typified by dilatation of the cisternae of rough endoplasmic reticulum, Golgi lamellae, and nuclear envelope, proceeding to focal disruption of various cell membranes, particularly those of the lipidcontaining phagolysosomes and nucleus. In contrast, over the 3-h period of study, no cytotoxic change was evident in rabbit or guinea pig macrophages. The results add further support to previous observations that the surface lipid of C. ovis plays a major role in the pathogenesis of the organism in mice, but they do not explain the guinea pig's marked susceptibility to infection.


Comparison of the rate of absorption and proteolysis of [14C]choleragen and [14C]bovine serum albumin in the rat jejunum.

[14C]choleragen was used to study the rate of disappearance of choleragen enterotoxin from the jejunum of rats. [14C]bovine serum albumin (BSA) was studied in a similar manner. Almost one-third of the labeled toxin had disappeared from the intestine after 6 h. Its rate of disappearance was the same in germfree rats as in conventional rats. The rate of proteolysis of [14C]choleragen and [14C]BSA by intestinal mucodal lysosomal enzymes was also studied. Neither was significantly degraded by neutral proteases; however, heat-inactivated toxin was. They were all degraded by acid proteases; however, the rate of BSA proteolysis was only one-third of that of toxin. Soybean trypsin inhibitor had no effect on the in vivo disappearance of toxin nor on the acid proteases. It did inhibit the neutral protease digestion of heat-treated toxin. Aprotinin and protamine inhibited disappearance in loops of gut but had no effect to inhibit degradation rates. Gangliosides inhibited both rates of disappearance and proolysis of toxin. These agents had some different effects on disappearance rates and proteolysis of BSA. The data indicate that cholera enterotoxin is absorbed by intestinal mucosal cells and is degraded by acid proteases in the cells.


Effect of neonatal thymectomy on experimental subacute sclerosing panencephalitis in adult hamsters.

Syrian golden hamsters were thymectomized in the first 48 h of life, raised, and then inoculated intracerebrally with the HBS strain of hamster-adapted subacute sclerosing panencephalitis virus when over 12 weeks old. Two groups soon become apparent; one group showed progressive neurological susmptoms and the other group remained healthy. The sick hamsters became moribund between days 8 and 17 postinoculation, and they had large amounts of complete virus in their brains, no antibodies to measles virus in their sera, and a demonstrated lack of thymus tissue. Pathological changes in the central nervous system included marked focal necrosis, numerous giant and inclusion-bearing cells, and slight inflammation. The healthy animals, killed at day 22 or 35 postinoculation, contained no central nervous system virus, moderate amounts of measles antibody in their sera, minimal or absent central nervous system pathology, and histologically identifiable remnants of thymus tissue. These studeis indicate that, in the hamster, the immune system is essential in recovering from central nervous system measles infection and that the antibody response to measles probably requires helper T lymphocytes to develop. Im the absence of antibody to measles, the virus did not undergo modification to a cell-associated state, as noted in previous hamster studies and in human subacute aclerosing panencephalitis. This model system may be useful for passive transfer studies to further clarify the effect of the n vivo immune response to acute and persistent central nervous system measles virus infections9


Thymus dependence of tapeworm (Hymenolepis diminuta) elimination from mice.

Although normal mice eliminated the lumen-dwelling intestinal cestode Hymenolepis diminuta by day 21 post-cysticercoid inoculation, congenitally thymus-deficient (nude) mice maintained their work burdens. Nude mice grafted with thymus glands or injected with thymus cells eliminated their worms.


[Fetal vaccinia (author's transl)].

The problems of vaccination in pregnancy are discussed with regard to the specific immunological circumstances of pregnancy and the immunological relationship between the mother and the fetus. In the whole medical literature only 18 cases of fetal vaccinia are described. The author emphasizes that fetal vaccinia is a complication of primovaccination of a pregnant woman. Experiments on rabbits disclosed that the suppression of cellular immunity in the mother may cause prolanged virusemia and thus favour intrauterine infection. Pregnancy is an absolute contraindication for primovaccination against smallpox.


[Further pharmacokinetical observations on gentamicin (author's transl)].

Applying a single i.m. dose of 80 mg (41 patients) and 120 mg (23 patients) of gentamicin, respectively, investigations in females have shown that, although the bulk of the antibiotic is excreted with the urine within the first 24 hours after injection, slow excretion is maintained at a very low level. According to the dose administered gentamicin remains detectable in the urine for many days. Thus, after injection of 120 mg in two patients gentamicin was detectable in the urine for a period of up to 20 days. Peak serum levels one hour after i.m. injection of 120 mg did not exceed 8.2 mug/ml, the mean concentration was 5.76 mug/ml. Serum half life was 2 hours. Studies of distribution in animal and human tissues have shown that gentamicin is accumulated almost exclusively in the kidneys, mainly in the cortex.


[Central european tick-borne encephalitis from 1969 to 1972 in central bohemia (author's transl)].

From 1969 to 1972 1,080 patients admitted with a diagnosis of viral meningoencephalitis were treated at the Hospital for Infectious Diseases in Prague-Bulovka. In 633 of these patients tick-borne encephalitis could be detected serologically. The epidemiological conditions and the clinical course of the disease are described. Paresis of the extremities and the cranial nerves occurred in 12.8% of the patients; the outcome was fatal in 0.8%. Treatment in hospital usually lasted 3 to 4 weeks and patients were unfit for work for a further 6 to 10 weeks after dismissal.


Rapidly reversible depression of delayed hypersensitivity in two children with visceral leishmaniasis.

Two cases of visceral leishmaniasis in children are described. In both "in vitro" lymphocyte response to mitogens and allogeneic cells was initially markedly depressed, but returned to normal within a few days after six days of treatment with N-methylglucamine antimonate; in one the candidin skin test reverted from negative to positive after treatment and in the other a circulating serum factor was found which strongly inhibited phytohemagglutinin--and mixed--responsiveness of normal lymphocytes, but disappeared after therapy.


Economic class and differential access to care: comparisons among health care systems.

This paper presents a new technique for describing inequality of access to medical care. Access is described by the empirical relationship between need and the probability of entering the health care system for treatment. The need-entry probability relationship for one population group is compared with that for another population group to determine the extent of access differentials (differences in entry probabilities) at varying levels of need. As an illustrative application, the technique is employed to describe access differentials by economic class in six different geographic areas located in five different countries (Canada, England, Finland, Poland, United States) with differently structured health care systems. Although the findings for adults varied considerably from area to area, the access differentials among children were surprisingly consistent and unrelated to health care system structure. In particular, it appears that higher family income is associated with greater access to medical care among children at all levels of need. The paper concludes with suggestions for further applications of the proposed technique to problems of monitoring and evaluating the effectiveness of policies aimed at reducing the extent of access inequality.


Women and health care: a comparison of theories.

There are three distinct approaches to the analysis of women's position in society, and thus of women's relation to the health care system. Liberal feminists seek equal opportunity "within the system," deman equal opportunity and employment for women in health care, and are critical of the patronizing attitudes of physicians. Radical feminists reject "the system" as one based on the oppression of women and seek to build alternative structures to better fill their needs. They see the division between man and woman as the primary contradiction in society and patriarchy as its fundamental institution. They have initiated self-help groups and women's clinics to extend the base of health care controlled by women in their own interests. Marxist-feminists see the particular oppression of women as generated by contradications within the development of capitalism. Women's unpaid labor at home and underpaid labor in the work force both serve the interests of the owners of capital. The health care system serves these same interests; it maintains and perpetuates the social class structure while becoming increasingly alienated from the health needs of the majority of the population.


Health service planning in a British new town.

The initial postwar development of new towns in Britain took place at a time when the present British National Health Service was in its infancy, and few attempts were made to integrate health service planning into the overall planning process. The more recent new towns have been the object of better social planning and, at the same time, the National Health Service has been substantially unified, at first functionally and, in 1974, administratively. In consequence, attempts have been made to use the opportunities which such towns present for planning health services in a comprehensive and integrated manner. The evolution of a planning and implementation structure for health services in Milton Keynes, a new town with a target population of 250,000, is described, together with some of the implications for the administratively unified National Health Service which came into being in 1974.


National health planning in the United States: prospects and portents.

The National Health Planning and Resources Development Act of 1974 in the United States demonstrates a growing determination in Congress to motivate the system of health services toward greater efficiency in utilization of resources. The Act was designed to overcome some of the weaknesses in earlier planning  legislation. More complete coverage and more functional local jurisdictions for planning should result. The Act provides better financial support, and more effective incentives and inducements to assure adherence to plans. Concern is expressed about aspects of the legislation which the authors feel may deserve consideration. The principle of delegating responsibility to voluntary agencies for disbursement of public funds is questioned, and the authors suggest that local public health authorities apply for designation as planning agencies. Reservation is expressed about the adequacy of regional organization as provided by the Act to accomplish its purposes, and the authors recommend demonstrations of regional administrative agencies to implement plans developed by Health Systems Agencies. Failure to incorporate the provision of the House planning bill to set up a national health policy council in the Act is considered unfortunate. Persistence in pursuing the course outlined in the Act is urged.


Challenge to international agencies.

International health agencies face major changes requiring basic adjustments in approaches and values. The ethical issues include moral criteria for allocating scarce resources, relation of health to population growth and development, iatrogenic social consequences of health measures, and inappropriate transfer of technology. A proposed new style of international health work is summarized in five principles and ten guidelines. The principles are: development from below; a role shift from adviser collaborator; sequential research, demonstration, and implementation; concentration on problems of motivation; and parternship in approaches to mutually shared complex problems.


Path analysis of socioeconomic correlates of county infant mortality rates.

Relationships between selected socioeconomic characteristics of counties and infant mortality rates are examined. There are two research objectives: to determine the extent to which low family income, low education, sound housing, and the percentage of blacks "directly" and "jointly" relate to neonatal and postneonatal mortality rates; and to determine the degree to which a zero-order correlation between a given socioeconomic measure and general infant mortality is transmitted by neonatal and postneonatal mortality rates, respectively. Data corresponding to 2237 counties in the United States are analyzed by path analysis. Results show that the percentage of blacks and low education are two variables which have appreciable direct effects on both components of infant mortality. These two factors are also responsible in large measure for gross associations between low family income, sound housing, and rates of infant loss. On the basis of this study it is estimated that approximately two-thirds of the zero-order correlation between a given county measure of socioeconomic status and infant mortality occurs through the postneonatal component. Implications of these findings are discussed.


Increasing threat to man as a result of frequently uncontrolled and widespread use of various drugs.

Consumption of drugs is steadily increasing. The reasons for this could be the diminished threshold level of acceptable sufferings, increased expectations about health, the psychological effects of a medical prescription, publicity, consumer society attitude in respect to drugs and polipharmacy. Overexposure to drugs increases the risk of precipitating drug adverse reactions. This could be avoided in many cases by non-administration of an unnecessary drug. The frequency and consequences of drug adverse reactions are considerable, and WHO plays an import role in collecting data and facilitating the exchange of informations in that area.


Interaction of heart glycosides and phenobarbital.

One week's administration of phenobarbital does not affect the disappearance of a single dose of digitalis glycosides from the serum of man. The increase of bile flow and of liver weight produced by phenobarbital in the rat is not further enhanced by glycosides. In case of acute digitalization, the enzyme inducing effect of barbiturates has probably no clinical significance.


[The effect of allopurinol on hemodynamic, respiratory and biochemical functional values in health persons following oral administration].

Starting from results of experimentation on animals, the influence of allopurinol on hemodynamic, respiratory and biochemical parameters after oral application by 10 probands in quiescence and after load had been studied. With mecanocardiographic, spiroergometric and circulation analytic function tests, no significative decrease of heart frequence, systolic blood pressure, pulse volume, heart minute volume, work of the heart, power of the heart and consumption of oxygen appears. The time of ejection diminished. Besides a pronounced sinking of the concentration of uric acid serum, it came to a suspension of the increase caused through load of the total free fatty acids and the beta-lipoproteide in the serum. The results indicate a circulation economized effect of allopurinol.


Plasma concentrations of diazepam and its metabolites after peroral, intramuscular, and rectal administration. Correlation between plasma concentration and sedatory effect of diazepam.

Plasma levels of diazepam, N-demethyldiazepam and free oxazepam were measured gaschromatographically in ten healthy volunteers after 5 mg of diazepam perorally, intramuscularly and rectally (with three different kinds of suppositories). The best absorption of diazepam was found after peroral administration. After an intramuscular injection a delayed absorption with low plasma concentrations of diazepam was found. The basal component of a diazepam suppository seems to have a great effect on the rectal absorption of diazepam. Two of the three different kinds of diazepam suppositories caused higher plasma diazepam concentrations than the intramuscular injection of the drug. There were no great differences in the amount of the metabolites of diazepam after different kinds of administration. The subjective sedatory effect of diazepam lasted approximately as long as the fast distribution of diazepam from plasma took place. A very highly significant correlation between plasma concentration and subjective sedatory effect of diazepam after a single dose was found.


Studies on absorption and elimination of drugs. Part VI: Fitting of a double exponential curve to the observed drug concentration after single extravascular administration.

A simple program was written in Algol 1204 for the Polish digital computer ODRA 1204. It permits the fitting of the Bateman equation C equals const [e-KEt -- e-KAt] or the equation C equals Be-KEt -- Ae-KAt to the observed plasma or serum concentration data after single extravascular administration of a drug. The results obtained with this M-31 program, compared with the calculations of the pharmacokinetic parameters for tetracycline HCl obtained with the Wagner's Nonline or Lag Time program, show a good conformity.


[The reciprocal actions of phenprocoumon (Marcumar) with human serum albumin, erythrocytes and blood].

The binding properties of phenprocoumon (PhC) to human serum albumin (HSA) and to red blood cells (RBC) were determined by using the equilibrium dialysis. Analysis of PhC-binding data to HSA at pH 7.4 and temperatures of 10 degrees C and 27 degrees C resulted in binding constants (k) of 11.8 - 10(4) and 7.0 - 10(4), in free standard enthalpy changes deltaG0 of -6.658 and -6.651 kcal/mol, and in standard enthalpy change TdeltaS0 of 1.386 and 1.469 kcal/mole, respectively. The standard enthalpy change deltaH0 was -5.182 kcal/mole for both temperatures. These results indicate that the binding between PhC and HSA is predominantly effected by hydrophobic interactions. At pH 7.4 the binding to HSA is essentially characeterized by two straight lines of binding, whereas at pH 9 and 10 there are three. With increasing pH more binding sites become free and the affinity of PhC to HSA grows. Studies of binding properties to RBC indicate a strong binding of PhC to hemoglobin (k 7.9 - 10(5)), but only a weak one to red cell membranes (binding ratio hemoglobin to ghosts 66 : 1). In a combined system of HSA and RBC, competition occurs between both components and therefore the strength of binding decreases. At therapeutic PhC-concentrations, 91.7% of the PhC are bound to the whole blood, 20.8% to RBC, and 70.9% to HSA. With increasing concentrations of PhC the binding to RBC declines to 10.5% accompanied by an approximately unchanged binding to whole blood of 92.1%; whereas binding to HSA increases to 81.6%. The affinity of PhC to HSA grows larger than its affinity to RBC. The total binding to blood remains unchanged within a 21-fold range and it is predominantly determined by the affinity of HSA to PhC.


Human leptospirosis in Brazil.

Serological data on the prevalence of human leptospiroses in certain regions of Brazil are presented. Out of 467 diseased and clinically healthy persons, 40 were positive in the Amazonia. The most frequent serotypes were grippotyphosa (27.5%), panama (25%), icterohaemorrhagiae (10%) and woffi (10%). In 1966 and 1970, 279 cases were identified in Recife (northeastern Brazil) during outbreaks subsequent to floods. Among these 92.5% belonged to the icterohaemorrhagiae serotype. From 1947 to 1972, in São Paulo City (southeastern Brazil), of 18,233 patients with clinical signs of leptospirosis, 2,237 were positive with 86.5% belonging to icterohaemorrhagiae. In all Brazil, 32 strains of leptospires were isolated, 27 of which belonged to the icterohaemorrhagiae serotype and one strain for each wolffi, canicola, grippotyphosa, andamana and alexi serotypes.


An investigation of canine antileptospiral antibodies in Japan.

From 1970 through 1973, blood samples of 7113 attended dogs and 1615 stray dogs in 50 cities of Japan were examined for leptospiral antibodies by RMAT on filter paper specimens. Results were as follows: 1. Prevalences of antibodies against L. icterohaemorrhagiae and L. canicola in attended dogs in 50 cities ranged from 22.5% to 0% with an average of 9.8%. Those of stray dogs in 8 cities ranged from 52.5% to 0% with an average of 21.7%. 2. 64 and 37 of 7113 attended dog sera reached positively only against either L. icterohaemorrhagiae and L. canicola, respectively. 595 of 7113 attended dog sera reacted positively against both antigens. 3. In 820 attended dog sera tested against 8 leptospiral serotypes, 57 had antibodies against L. icterohaemorrhagiae, 52 against L. canicola, 2 against L. australis A, 10 against L. pyrogenes and 2 against L. grippotyphosa. 4. The prevalence of antibodies was twice as much in male dogs as in females. The prevalence in a healthy group was only half that of a sick group. Attended dogs below 4 years old had a higher antibody prevalence than any other age. The prevalence of antibodies in summer was lower than for any other season.


Histopathological correlates of presumed ocular histoplasmosis.

There are very few eyes with the ocular histoplasmosis syndrome that have been studied as such by the ophthalmic pathologist. Hoefnagels and Pijpers [6] were the first to demonstrate H. capsulatum in the human eye. However, this was a case of endophthalmitis and not the clinically observe syndrome. Klintworth et. al. [7] demonstrated the organism histologically in granulomatous choroiditis occurring in dissemiated histoplasmosis. The hot was compromised immunologically, and this again is somewhat different from the typical clinical situation. The histopathological material available for study was derived from the eyes of patients enucleated after the diagnosis of malanoma at the AFIP, nd from autopsy material from the Wilmer Institute. These five cases have a number of findings in common. The atrophic scars and punched-out sponts in the periphery and elsewhere correlate with an absence of the pigment epithelium. The degree of inflammation, usually lymphocyte infiltration, can be variable...


Koch's stulates and experimental ocular histoplasmosis.

The present study shows clearly that focal choroiditis is produced in rabbits by infecting the animals with a mycelial form of H. capsulatum. Identification of this organism as the pathogenic agent was made by histopathological and mycological observations. This fungus was recovered from infected ocular lesions in those eyes enucleated within four weeks following the appearance of uveitus-a time period consistent with the clinical and pathological appearance of multiple granulomas in the choroid. The absence of organisms in the contralateral eyes of these same animals at eight weeks suggests perhaps that recovery was associated with the emergence of immunity by two months following the appearance of uveitus. This is supported in part by our previous study, which supplied evidence that animals were protected from further uveitis on subsequent reinfections (after they had recovered from their initial infection) by a mycelial or yeast form of the fungus. Similar protection was also seen in animals that had prior exposures to heat-killed organisms. Moreover, onset of the ocular changes occurred usually two weeks after infection. This evidence strongly suggests that the experimental choroiditis may be immunologically induced. H. capsulatum recovered from infected eyes (Groups I and II) produced identical ocular lesions clinically and histopathologically when injected into normal animals (Groups IA and IIA). Fulfillment of Koch's postulates in experimental ocular histoplasmosis was achieved within only one month following the appearance of uveitis. This may be of fundamental importance in that efforts to demonstrate a causal relationship between the ocular picture and benign systemic histoplasmosis have been unsuccessful in man. Because of the striking similarity between the experimental choroiditis in rabbits and the changes observed in presumed ocular histoplasmosis in man, studies in primates are necessary. Since the ocular anatomy is similar in monkeys and in man, there remains the necessity to reproduce the hemorrhagic disciform lesion of the macula, which represents the gravest aspect of presumed ocular histoplasmosis.