Allograft cytotoxicity: differences between lytic and non-lytic interactions as revealed by ultrastructural histochemistry. Alloimmune and normal mouse (C57Bl/10) spleen cells and tumour cells (P815Y) were cultured together in flat-bottomed microtitre plates. Cytolytic activity was assessed by the 51Cr release assay in combination with histological analyses. Cells were fixed and embedded in situ and substrates to reveal ATPase or, alternatively, endogenous peroxidase activities, were applied. Both lymphocytes and monocytes formed junctions with the target cells and estimates of their relative frequencies were produced. Junctions between lymphocytes and tumour cells were completely ablated by treatment with anti-brain-associated theta and complement. Junctions involving immune lymphocytes were typically associated with locally increased ATPase activity in the target cell membrane. Neither monocytes nor normal lymphocytes increased local ATPase activity or 51Cr release to any significant extent.


Inhibition of mixed-lymphocyte reaction by quinine and lack of effect on plaque-forming cells and lymphoid-derived tumor cells. Using Balb/c cells as responder cells and mitomycin-treated C57B1 cells as stimulator cells, it was found that quinine was inhibitory in a one-way mixed-lymphocyte reaction. Incorporation of [3H]-TdR was brought down to base levels in the presence of quinine. Quinine was not toxic for antibody-forming cells, and had no effect on plaque-forming cells formed by antibody-committed cells. The degree of [3H]-TdR incorporation of MOPC-315 tumor cells and Burkitt's lymphoma cells was not affected by the presence of quinine in the medium. The cytotoxicity of quinine for mitogen-stimulated cells was demonstrated in soft-agar cultures.


Measuring attitudes toward the physically disabled: testing the 'Attitude Towards Disabled Persons' scale (A.T.D.P. Form O) on social work and non-social work students. The aim of the study was to test the U.S.A. Validated 'Attitude Towards Disabled Persons' Inventory (A.T.D.P. Form O) on a British student population to establish norms. The objectives were to test specific hypotheses related to the sex of the respondent, contact with physically disabled people and whether social work students had different attitude scores than non social work students. In addition, a comparison was made between the British and U.S.A. 'norms'. The student population of four specific British Universities comprised the sampling frame. The sample was a non probability accidental sample of social work and non social work students. Standardised A.T.D.P. Form Os were administered in group situations. Each form was accompanied by a letter explaining the study, together with a short questionnaire eliciting the sex of respondent and type and extent of any contact with disabled people. The findings demonstrated that there are probably differences between U.S.A. and British norms but that there are general similarities between the two countries. In both countries females, scored higher than males, which by interpretation indicates possibly a more favourable attitude. Contact with the disabled is also a contributing factor in higher scores. Social work students also tended to score more highly than non social work students. The implications of these findings are discussed with regard to the possible development of professional attitudes for those who work with the disabled. It is postulated that 'idealisation' may be reflected in attitudes of students who intend to work with the disabled which, after general and professional life experience gives way to less favourable attitudes. Closeness of contact of respondents to disabled people is a factor which needs further exploration in connection with changing attitude scores.


[Paraneoplastic acrokeratosis].

[Paraneoplastic acrokeratosis]. Paraneoplastic acrokeratosis is a distinctive dermatosis observed only in patients with either carcinoma of the upper respiratory and digestive tract or with metastatic lymphnodes in the cervical or mediastinal region. The characteristics of this dermatosis are: acral beginning, erythematous, squamous and hyperkeratotic plaques with centripedal spreading and healing only after successful treatment of the carcinoma. An allergic or toxic skin reaction to a substance formed by the tumor cells is discussed as causative agent. The author gives a review of the symptoms, the course of the disease, of histological and biochemical data and of the differential diagnosis as reported in the literature.


[Trichophyton mentagrophytes var. erinacei infection contracted from a hedgehog]. Occasionally the hedgehog (Erinaceus europaeus) is infected by Trichophyton mentagrophytes (Robin) Blanchard var. erinacei. This zoophilic dermatophyte may cause a difficult human phlegmatic trichophytia infection. The thread-fungus grows on the usual culture-medium with a clear-white surface without radius-folding. The lower surface of the culture shows a typical brillant-yellow colour. Microscopically the fungus presents abundant microconidia formation and a few distinct macroconidia. Cross-breeding with the tester strain Arthroderma simii "+" was negative, with "-" showed an increased growth and a formation of cleistothecium-primordia in the combination zone.


The structure of the Harderian and lacrimal gland ducts of the turkey, fowl and duck. A light microscope study. The secretory ducts of the Harderian and lacrimal glands of the turkey, fowl and duck are similar in both structure and function. The single duct of each gland is lined by mucus-secreting epithelium. The epithelial cells vary from cuboidal to columnar, and goblet cells of three types are found. Type A, the most numerous, contain neutral mucopolysaccharides, type B have mixed acid and sulphated mucosubstances and type C, the least numerous, contain acid mucins. In both ducts glycogen is present in the lumen, but it occurs intracellularly only in the fowl up to seven days after hatching. Lymphocytes, either as diffuse tissue or as germinal centres, are found scattered along the length of the ducts. Some plasma cells and plasmablasts are also present.


Interaction of aminoglycosides and other antibiotics with actin. Skeletal muscle actin was found by centrifugation, turbidity, and viscosity measurements to form polymers upon addition of aminoglycosides, viomycin, polymyxin B, and tetracycline. A linear relationship was observed between the amount of actin polymerization and the number of primary amino groups on the aminoglycoside antibiotics except kanamycin. Of the antibiotics studied, neomycin was most efficient in actin polymerization. Polymerization of actin was not significantly induced by kasugamycin, chloramphenicol, erythromycin, benzylpenicillin, angustmycin A, formycin, actinomycin D, and mitomycin C. Aminoglycosides and viomycin were demonstrated to inhibit the acto-HMM Mg(2+)-ATPase reaction but did not significantly affect HMM Mg(2+)-ATPase activity. It was found by equilibrium dialysis that [(3)H]dihydrostreptomycin bound to actin.


Radiofrequency facet rhizotomy in the treatment of chronic neck and low back pain. The value of radiofrequency facet rhizotomy in the treatment of patients with chronic neck and low back pain problems is assessed on the basis of experience with 117 consecutive patients. Only patients with positive responses to facet blocking with local anesthetic were selected. Overall results in 50 neck procedures were: excellent, 16%; good, 34%; fair, 18%; poor, 28%; and lost to follow-up, 4%. In the 71 lumbar rhizotomies results were: excellent, 15%; good, 20%; fair, 27%; poor, 31%; and lost to follow-up, 7%. Average follow-up time was 13.7 months. We conclude that radiofrequency rhizotomy is a valuable tool in the treatment of chronic neck and low back pain.


Effect of primycin on the inner membrane permeability of rat liver mitochondria. The effects of primycin on mitochondrial respiration, volume changes, ATPase activity and the acidification following ATP hydrolysis were studied. Primycin in concentrations below 2--3 nmoles/mg mitochondrial protein reacts only with energized mitochondria rendering their inner membrane permeable to K+, Na+, Tris+ but not to TEA+. Above this concentration primycin interacts both with energized and deenergized mitochondria and the inner membrane also becomes permeable for H+, Cl- but not for ATP. In this case mitochondria very probably lose Mg2+. It is concluded that primycin up to concentrations of 2--3 nmoles/mg mitochondrial protein acts like an ionophore, while at higher concentrations it changes the permeability properties of the mitochondrial inner membrane without a drastic alteration of the membrane itself.


Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification. The prevalence, in children aged under 15, of severe impairments of social interaction, language abnormalities, and repetitive stereotyped behaviors was investigated in an area of London. A "socially impaired" group (more than half of whom were severely retarded) and a comparison group of "sociable severely mentally retarded" children were identified. Mutism or echolalia, and repetitive stereotyped behaviors were found in almost all the socially impaired children, but to a less marked extent in a minority of the sociable severely retarded. Certain organic conditions were found more often in the socially impaired group. A subgroup with a history of Kanner's early childhood autism could be identified reliably but shared many abnormalities with other socially impaired children. The relationships between mental retardation, typical autism, and other conditions involving social impairment were discussed, and a system of classification based on quality of social interaction was considered.


A case of infantile autism associated with Down's syndrome. There is increasing recognition that autism is a syndrome, not a disease entity. But it is not yet clear why some children develop autistic behavior more easily than others. It has been noted that autistic symptoms occur more frequently in children with mental retardation, blindness, congenital rubella, phenylketonuria, etc., and that there are very few cases of classical infantile autism in the general population. Very rarely has autism been associated with Down's syndrome. This is a report of a case of Down's syndrome and infantile autism.


Characterization of the carbohydrate component of fraction I in the Neurospora crassa cell wall. The carbohydrate portion of fraction I of the Neurospora crassa cell wall has been analyzed for sugar composition by gas-liquid chromatography and colorimetric methods. The analysis was performed comparatively in a wild-type strain (RL 3-8A) and three morphological mutants: scumbo (FGSC 49), peak-2a (a mutant known to be allelic to biscuit), and ragged (FGSC 296). Fraction I of all strains studied contains glucose, mannose, and galactose as the main sugars. Uronic acids and amino sugars are also present in small amounts. The glycosidic linkages binding the neutral sugars were analyzed by Lindberg's combined gas chromatography-mass spectrometry techniques for identification of the partially methylated alditol acitate sugar derivatives. The main polymeric portion of fraction I seems to be a linear glucan with the glucose residues linked by 1 leads to 3 and 1 leads to 4 bonds. A mannan portion with a branched configuration is also present, with galactose as the sugar residue which serves as branches in the molecule(s). The branched mannan portion appears to increase in amount in correlation with more drastic morphological changes of the mycelia. In this respect, the mutant ragged has the lowest mycelial growth rate and the largest amount of mannan. The importance of the polysaccharide structure of fraction I on the colonial morphology of the mycelia is discussed.


Nitrogen metabolite repression of nitrate reductase in Neurospora crassa. The effect of different nitrogen compounds on the induction of reduced nicotinamide adenine dinucleotide phosphate-nitrate reductase was examined in Neurospora crassa. Whereas in the wild-type strain several amino acids and ammonia inhibit the formation of nitrate reductase, only glutamine, cysteine, and histidine are shown to inhibit the synthesis of nitrate reductase in a glutamine-requiring auxotroph. None of the amino acids inhibited nitrate reductase activity in vitro. The effects of cysteine and histidine are nonspecific, these amino acids being inhibitory of the growth of the organism. The effect of glutamine on the induction of nitrate reductase is not due to an inhibition of the uptake of the inducer nitrate. By the use of histidine-, pyrimidine-, and arginine-requiring auxotrophs, it was shown that glutamine appears to act per se and does not seem to be converted to another product in order to be effective in repression. The repression of nitrate reductase by ammonia appears, from the results described herein, to be indirect; ammonia has to be converted first to glutamine in order to be effective in repression.


Arrangement of the genes coding for ribosomal ribonucleic acids in Neurospora crassa. We have cloned and characterized Neurospora crassa ribosomal deoxyribonucleic acid (rDNA). The rDNA is found as a tandemly repeated 6.0-megadalton sequence. We have mapped a portion of the rDNA repeat unit with respect to its sites for 13 restriction endonucleases and defined those regions coding for the 5. 8S, 17S, and 26S ribosomal ribonucleic acids (rRNA's). We have also isolated several clones containing 5S rRNA sequences. The 5S rRNA coding sequences are not found within the rDNA repeat unit. We found that the sequences surrounding the 5S rRNA coding regions are highly heterogeneous.


Transmission of mitochondrial deoxyribonucleic acid in Neurospora crassa sexual crosses. Neurospora crassa mitochondrial deoxyribonucleic acid shows strict uniparental inheritance in sexual crosses, with a notable absence of mixtures and recombinant types that appear frequently in heteroplasmons.


Spectinomycin dependence in Bacillus subtilis. Spectinomycin dependence in Bacillus subtilis involves two mutations, one conferring drug resistance and the other producing a requirement for spectinomycin for growth.


Solubilization of adenosine triphosphatase from membranes of Escherichia coli: effect of p-aminobenzamidine. The five subunits of the membrane-bound adenosine triphosphatase (F1) from Escherichia coli were identified on electrophoretograms of membranes which had been washed with a low-ionic-strength buffer containing the protease inhibitor p-aminobenzamidine. All of the subunits of the membrane-bound F1 appeared to have the same molecular weights and isoelectric points as those of the soluble F1, as judged by two-dimensional electrophoresis. p-Aminobenzamidine inhibited the solubilization of F1 rebound to F1-depleted membranes, and was found to inhibit the membrane-bound adenosine triphosphatase activity to a much greater extent than the solubilized activity. It is therefore unlikely that p-aminobenzamidine inhibits the solubilization of F1 by inhibiting a protease, as suggested previously by Cox et al. (G.B. Cox, J.A. Downie, D.R.H. Fayle, F. Gibson, and J. Radik, J. Bacteriol. 133:287--292, 1978).


Inactivation of Neurospora crassa conidia by singlet molecular oxygen generated by a photosensitized reaction. Photodynamic damage of Neurospora crassa conidia was studied in the presence of the photosensitizing dye, toluidine blue O. Conidia which germinated to form colonies decreased in number as irradiation time became longer. The photoinactivation of conidia was suppressed by azide, bovine serum albumin, and histidine, and was stimulated in deuterium oxide. Wild-type conidia were less sensitive to the irradiation than albino conidia. In the wild-type, carotenoid-enriched conidia were more resistant against the lethal damage than the conidia which contained small amounts of carotenoids. These results suggest that singlet molecular oxygen causes photodynamic lethal damage to N. crassa conidia and that singlet molecular oxygen is quenched by endogenous carotenoids.


Synthesis and biological activity of an icosapeptide analog of the actomyosin ATPase inhibitory region of troponin I. A 20-residue peptide analog of the actomyosin ATPase inhibitory region of rabbit skeletal troponin I (Tn-I) has been synthesized by the solid phase method. The analog exhibited biological activity similar to both Tn-I and a 21-residue cyanogen bromide fragment of Tn-I. At ionic strengths where the inhibition of the actomyosin ATPase due to tropomyosin alone is low, the synthetic peptide in the presence of tropomyosin inhibits 90% of the original ATPase activity. In the absence of tropomyosin, the inhibition due to the peptide is much reduced. In contrast, salmine, a basic protein also known to inhibit the actomyosin ATPase, shows less inhibition in the presence of tropomyosin than it does in its absence. Gel electrophoresis data showed that the enhancement of the analog's inhibition by tropomyosin may be related to the analog's promotion of tropomyosin binding to F-actin similar to that reported for Tn-I and that the reduction of salmine inhibition by tropomyosin may be due to the binding of salmine by tropomyosin. At ionic strengths where binding and inhibition of tropomyosin is significant, the analog enhanced inhibition in a manner similar to that reported for whole Tn-I.


Assembly of the mitochondrial membrane system. The DNA sequence of a mitochondrial ATPase gene in Saccharomyces cerevisiae. The mitochondrial DNA of a cytoplasmic "petite" mutant (DS400/A3) of Saccharomyces cerevisiae has been characterized by restriction endonuclease analysis and by DNA sequencing. The DNA has a repeat length of 1,800 base pairs and contains the oli 1 and pho 2 loci, two known markers of the ATPase proteolipid subunit. The nucleotide sequence has helped to establish the presence in the DS400/A3 DNA of the proteolipid gene flanked by two long stretches of DNA rich in A + T. The sequence of the structural gene is in excellent agreement with the previously reported primary structure of the proteolipid. The DNA sequence also indicates that the mitochondrial codons of yeast are highly nondegenerate. The proteolipid gene has been precisely localized on the restriction map of the wild type genome. In addition, it has been possible to orient the gene with respect to other genetic markers and to determine the direction of its transcription.


On the mechanism of Ca2+-dependent adenosine triphosphatase of sarcoplasmic reticulum. Occurrence of two types of phosphoenzyme intermediates in the presence of KCl. The steady state kinetics of ATP hydrolysis by partially purified adenosine triphosphatase preparations of sarcoplasmic reticulum was investigated at 0 degrees C and pH 7.0 in 2.0 mM MgCl2, 20 microM [gamma-32P]ATP, 20 microM CaCl2, and various concentrations of KCl in the presence and absence of 12% dimethyl sulfoxide. The steady state phosphoenzyme formed under these conditions could be resolved kinetically into ADP-sensitive and ADP-insensitive forms. These steady state kinetic data were analyzed according to a scheme in which the ADP-sensitive and ADP-insensitive phosphoenzymes occur sequentially, and Pi is derived from the latter. The KCl-dependent turnover rate of the ADP-insensitive phosphoenzyme that was estimated according to this scheme was in good agreement with the directly measured hydrolysis rate constant of the ADP-insensitive phosphoenzyme. In addition, the time course of the decomposition of the total amount of phosphoenzyme, measured after a steady state level was reached in 20 mM KCl and further phosphorylation was prevented by addition of excess ethylene glycol bis(beta-aminoethyl ether)N,N,N',N'-tetraacetic acid, was also in agreement with that calculated according to this scheme using values of the rate constants estimated from the amounts of the ADP-sensitive and ADP-insensitive phosphoenzymes and the rate of ATP hydrolysis. These results, together with our previous findings, support the view that this scheme describes the mechanism of ATP hydrolysis in the presence of KCl.


Binding phenomena of isolated unique plasmic degradation products of human cross-linked fibrin. Proteolysis of human cross-linked fibrin by plasmin results in the formation of a DD . E complex, and Fragments DD and E as the major degradation products. Three species of Fragment E, which differ both in molecular weights (E1, Mr = 60,000; E2, Mr = 55,000; E3, Mr = 50,000) and in charge, have been isolated from a digest of cross-linked fibrin. Each Fragment E species reacts with monospecific anti-E antiserum. Fragments E1 and E2 bind with Fragment DD to form a DD . E complex but Fragment E3 is inactive. This binding is specific since these Fragments E do not bind to fibrinogen or to degradation products of fibrinogen or of noncross-linked fibrin. Fragments E1 and E2 incubated with plasmin are degraded to Fragment E3, suggesting that the three species represent sequential degradation products. Plasmin-treated Fragments E1 and E2 no longer bind with Fragment DD; therefore, it appears that the peptides cleaved from Fragment E2 by plasmin contain or modify the sites responsible for complex formation. On the other hand, Fragment DD binds not only to Fragments E1 and E2, but also to fibrinogen, Fragments X (Stage 1), X (Stage 2), Y, and NH2-terminal disulfide knot, but only after thrombin treatment, suggesting that Fragment DD binds to complementary sites on the NH2-terminal region of fibrinogen which are exposed after thrombin treatment.


A comparative study of poly(glycolic acid) and catgut as suture materials. Histomorphology and mechanical properties. The "quality" of poly(glycolic acid) as an absorbable suture material was investigated in comparison with catgut. Tissue reactions to poly(glycolic acid) and plain catgut were examined histomorphologically at different time intervals after implantation in rats, and compared. Four mechanical properties were also examined as relevant quality factors: elastic stiffness, tensile strength, toughness, and percent elongation at rupture of the suture material per se (unknotted). The variation of these properties in poly(glycolic acid) implants was followed since their insertion in the tissues. Histological behavior and mechanical properties appear to be more closely correlated in the case of poly(glycolic acid) than in the case of catgut, as a consequence of a greater regularity of tissue reaction towards the synthetic material. Both tissue reaction and tensile properties variation are independent of size in the case of the braided poly(glycolic acid) sutures examined. Elastic stiffness and tensile strength decrease steadily in time; toughness and ultimate elongation display an increase up to a maximum within one day since implantation, and then decrease.


Real time observation of left atrial myxoma with high speed B mode echocardiography. Four patients with left atrial myxoma were studied using high speed B mode echocardiography with a mechanical sector scanning system. In all four patients, a mass of echoes was recognized in the left atrial chamber during systole. Its lower portion protruded into the left ventricle through the mitral orifice in diastole. The degree of protrusion of the tumor echo varied. An analysis of three cross sections, long axis of left ventricle, sagittal and horizontal axes, showed that the tumor moved anterosuperiorly to posteroinferiorly in the left-sided heart chambers. Its movement was clearly observed in real time. The echo pattern from the tumor had an appearance of mottling, not layering. The myxomas were successfully removed from the left atrial chambers by surgical intervention in all cases.


Gray scale ultrasound in adnexal thickening: correlation with laparoscopy. A retrospective comparison between ultrasound and subsequent laparoscopy was made in 70 female patients to evaluate the sonographic features of minimal pelvic disease (in particular, adnexal thickening). The overall accuracy of sonography as compared with laparoscopy was 75 percent (53 of 70), with a true positive rate of 72 percent (40 of 51) and a true negative rate of 68 percent (13 of 19). In this study the concept of clinical or sonographic adnexal thickening did not correlate with observations at laparoscopy. Of the 7 patients diagnosed by ultrasound as having adnexal thickening, only 1 had pelvic inflammatory disease, whereas the other 6 showed no abnormalities at laparoscopy.


Standardization of parameters in follow-up study after mitral commissurotomy. Two-hundred and fifty-five patients were followed up to maximum 19 years (1879 patient-years) after mitral commissurotomy by means of either the finger fracture, transventricular dilator or open method. During this period of time, patients were asked to answer a questionnaire and to be examined at 2 to 3 years intervals. Twenty-two late deaths and 17 reoperations were encountered, and significant differences according to operative methods were observed in the survival and reoperation-free curves. Values from CTR, Rv1 + Sv5/Rv5 + Sv1 ratio, LAMP and DDR were standardized, and each standard value showed a tendency of significant improvement followed by gradual deterioration after commissurotomy even in patients with normal social activities. Parameters from patients reoperated on were compared with standard values, and statistically significant differences were noted. It would be concluded that standardization of parameters is of a great importance in follow-up study after mitral commissurotomy especially to establish indications to reoperation most adequately.


Inclusion of a program of instruction in care of the disabled in a dental school curriculum. Lack of practitioner training is considered a major reason for dental neglect of disabled persons. The feasibility of instruction in the care of the disabled for dental and dental hygiene students at the undergraduate level was demonstrated in a prototype program encompassing a continuum of didactic courses, clinical experiences in extramural and intramural settings, inservice training and continuing education, interdisciplinary activities, and evaluative research. Successful implementation of such a program required developing and using appropriate support systems, such as instructional materials, social services, public relations, and monitoring of care delivery. A format combining specific courses with inclusion of disability subject matter in existing courses appeared to be advantageous in intergrating the program into the dental curriculum. Evaluation data indicated the value of undergraduate training in improving access to dental care for the disabled patient.


Assessment of student attitude and confidence in a program of dental education in care of the disabled. An analysis is presented of the effect of a four-year dental school program in care of the disabled on expressed student attitude and confidence towards treating the handicapped patient. The longitudinal study, involving 503 students in six dental classes, revealed a willingness by the majority of students (greater than or equal to 60 percent) to treat pateints with whom they feel capable. This attitude remained essentially unaffected by the program. In contrast, levels of students' perceived confidence in treating handicapped persons increased significantly as the result of specific instruction in disability management; heightened confidence levels were sustained for one academic year. Expressed ability to treat the disabled appeared to increase for successive classes. The result support the premise that dental graduates who have received instruction in disability care will fell more confident and hence will be more likely to treat patients with special needs.


The effect of supplemental lecture, evaluation method and instructional type on student performance in a preclinical technique project. This study examined two types of instruction, two methods of evaluation, and the effects of a supplemental lecture in teaching a laboratory technique exercise. Students were randomly assigned to one of four groups: (1) self-instruction, self-evaluation; (2) self-instruction, teacher-evaluation; (3) teacher-aided instruction, self evaluation; and (4) teacher-aided instruction, teacher-evaluation. In addition, half of the students in each of the four groups received a supplemental lecture. Ratings of technical performance, a didactic posttest, and project completion time, were used as outcome measures. Of 27 main treatment effects tested, 25 demonstrated no significant differences. This study fails to demonstrate any major advantage of using self versus traditional forms of instruction and evaluation when student performance is the primary consideration.


Assessment of allergy to local anesthetics. Regional analgesia is much too important to be denied to patients on the basis of questionable allergic histories. Often, adverse reactions can be traced directly to the pharmacologic properties of the agents involved. The dentist must adequately distinguish these reactions from those directly related to allergic phenomena. For the comprehensive management of patients with allergic histories, the significance as well as the limitations of intracutaneous skin testing must be appreciated. The practitioner should recognize the need, make proper referrals, and interpret the results of skin tests appropriately. Hopefully, this report has served to disperse the confusion surrounding local anesthetic hypersensitivity and will enable more dentists to proceed with confidence in the assessment and management of their allergic patients.


Primary inoculation tuberculosis.

Primary inoculation tuberculosis. A case of primary inoculation tuberculosis of the finger is described, in which Mantoux test conversion reverted after prompt surgical and medical treatment. The pathology of primary inoculation tuberculosis is reviewed briefly, and the rationale for excision of the early tuberculous lesion is discussed.


False positive 51Cr release tests during post-transplant immunological monitoring due to recipient serum radioactive contamination. The occurrence of false positive 51Cr release test results in post-transplant immunological monitoring of human kidney graft recipients due to 131I carryover from renograms is described. False positivity was detected in 7 instances in 4 recipients, and suspected in 12 instances in 7 recipients, in a series of 46 consecutive transplant recipients. Technical methods and controls to detect and prevent such false positivity are described.


The value of plasmid studies in the epidemiology of infections due to drug-resistant Salmonella wien. Since 1969 strains of Salmonella wien that are resistant to multiple antibacterial drugs have caused widespread epidemics of enteritis in Europe and North Africa. Of 113 British strains examined between January 1970 and January 1977, 67 were multi-resistant. These strains and 22 strains from six other countries were examined to determine their plasmid content. Two plasmids were found in the vast majority of strains: an FIme factor, conferring resistance to ampicillin, chloramphenicol, kanamycin, streptomycin, spectinomycin, sulfonamides, and tetracyclines (ACKSSpSuT), and a nonautotransferring plasmid of resistance type ASSu. The FIme plasmids have dual incompatibility: they are incompatible with group FI factors and with the MP10 plasmid of Salmonella typhimurium, which belongs to a separate group. Other plasmids found in S. wien included principally a ColIa factor and an autotransferring plasmid that codes for ampicillin resistance and belongs to compatibility group I2. The similarity in plasmid content of strains isolated in widely separated areas suggests that they have a clonal origin.


Acute effects of streptozotocin diabetes on rat renal function. Renal clearance studies were performed on rats both during the administration of streptozotocin and sequentially during the following 8 days as hyperglycemia progressed. Although GFR was depressed 30 min after the drug administration, GFR steadily rose during the following days to become 52% greater than control levels. Renal size did not change during this short period, and it is suggested that glomerular hemodynamic changes are responsible. A maximal tubular reabsorptive capacity for glucose (TmG) could not be satisfactorily demonstrated in normal rats, although glucose reabsorption was significantly depressed at high-filtered loads. At comparable filtered loads, glucose reabsorption in diabetic rats was almost complete in contrast to normal rats, and the increases in GFR and renal tubular sodium reabsorption are presumed to be the major factors. The administration of insulin to normal and diabetic rats was followed by a significant diuresis as well as an increase of 1% to 4% in the fraction of filtered sodium excreted although GFR was unaltered. This shows that even a 35% to 60% reduction in the filtered load of glucose can significantly depress renal sodium reabsorption. It is concluded that this is a good animal model in which to study the effects of diabetes on renal function as well as the in vivo interrelationships of sodium and glucose reabsorption.


Sulphur and phosphorus content in relation to fibre composition and atrophy of skeletal muscle in patients with Parkinson's disease. Seventeen patients with Parkinson's disease have been compared with 8 normal individuals by biopsy of either the biceps brachii or quadriceps femoris muscles. All biopsies were investigated by enzyme histochemistry. With 13 patients, as well as all controls, scanning electron microscopy with X-ray microanalysis was employed on cryo-sections adjacent to those prepared for light microscopy. Thus, the elemental composition of single muscle fibres was obtained and could be related to histochemical fibre types. Fibre type analysis on the diseased material, based on differential stainability for alkali- and acid-stable ATPase, showed a normal type I and type IIA fibre frequency. A mild type IIB dominance at the expense of type IIA fibres was regarded as a significant deviation from normal. A slight to moderate muscle atrophy affected type IIB fibres almost exclusively. Normal content of sulphur and phosphorus was detected in type I and type IIA Fibres but a lowered sulphur content was obvious in type IIB fibres, especially in the atrophic ones, which also exhibited an increase in phosphorus content. The shift in fibre composition from IIA to IIB, the type IIB fibre atrophy and the change in sulphur and phosphorus content of type IIB fibres are interpreted as signs of a disuse which preferentially affects fast twitch type IIB motor units. These presumably have the highest threshold for activation under pathological conditions characterized by increased muscular tone and difficulties in the performance of rapid and strong voluntary movements.


An ultrastructural study of nerve terminal degeneration in muscle spindles of the tenuissimus muscle of the cat. Muscle spindles in the tenuissimus muscle of the cat were studied between 12 and 168 h after cutting or freezing the nerve to this muscle. Degenerative changes in sensory and motor nerve terminals on intrafusal muscle fibres were observed using the electron microscope. Comparisons were made with spindles from unoperated or sham-operated cats. The earliest degenerative changes were seen in sensory and motor terminals at 20-24 h after the lesion. No nerve endings were seen by 114 h after denervation. The most consistent initial signs of degeneration were: (1) the presence of abnormal mitochondria and dense bodies in sensory terminals, and (2) a decrease in the number and clumping of synaptic vesicles combined with an increase in glycogen and neurofilaments in motor endings. Intrafusal fibres participate in the removal of degenerating sensory endings. Schwann cells phagocytose degenerating motor terminals. The disappearance of nerve terminals precedes the complete degeneration of preterminal myelinated fibres within the muscle spindle.


Stereochemical preferences for curarimimetic neuromuscular junction blockade IV: Monoquaternary ammonium probes possessing carbon and nitrogen asymmetry. Two enantiomeric pairs of neuromuscular junction blocking agents were prepared in which an asymmetric carbon atom is adjacent to an asymmetric quaternized nitrogen moiety. The blocking agents were obtained from the enantiomers of laudanosine by stereoselective quaternization with benzyl and ethyl iodides. Curarimimetic potencies were measured with an in vivo cat hypoglossal nerve-tongue muscle preparation. The studies suggest that the asymmetry present in these structures does not lead to significant differences in blocking potency between enantiomers.


Transport of organic ions in renal cortical luminal and antiluminal membrane vesicles. Based upon saturability, kinetic analysis and specific inhibition, specific transport for the organic anion, p-aminohippurate was found in isolated luminal and antiluminal membrane vesicles from dog kidney cortex. The transport for organic anions in the two membranes differed from one another on the basis of kinetic parameters ((Km, Vmax and Ki for probenecid) and counterflow phenomenon (only the antiluminal membrane displayed the capacity to accelerate the exchange of p-aminohippurate). Also described is specific transport for the organic cation N1 methylnicotinamide in each membrane. The luminal and antiluminal transport of N1-methylnicotinamide are distinguished from one another by kinetic parameters (Km, Vmax and Ki for Darstine) and counterflow data (counterflow of N1-methylnicotinamide was observed only in the luminal membrane). The results are discussed in view of a proposed model to explain transepithelial transport of these organic ions.


Renal impairment in urate excretion in patients with Down's syndrome. Uric acid and creatinine clearance studies were performed in nine subjects with Down's syndrome and in eight mentally retarded controls. The urate clearance was significantly decreased in subjects with Down's syndrome compared with controls. Their mean creatinine clearances were also significantly lower than the controls. No significant differences were shown in erythrocyte lactate dehydrogenase activity, in blood lactate and in blood beta-hydroxybutyrate levels between 20 subjects with Down's syndrome and 16 controls. Glomerular dysfunction would seem to contribute to hyperuricemia in Down's syndrome.


Evidence for multiple sites of regulation of heme synthesis in murine erythroleukemia cells. Friend murine erythroleukemia (MEL) cells can be induced to differentiate along the erythroid pathway by such dissimilar agents as dimethyl sulfoxide (DMSO), butyrate, inhibitors of DNA synthesis, and certain highly polar agents. This study showed differential biochemical effects of the potent inducers DMSO and butyrate on the heme biosynthetic pathway in three clones of Friend MEL cells. When the cells were incubated with combinations of DMSO and butyrate, hemoglobin production was less than that amount produced when each inducer was incubated singly with the cells. Procaine, a local anesthetic that competes with Ca2+ and thus affects membrane permeability, slightly inhibited DMSO-mediated hemoglobin production but almost tripled the level stimulated by butyrate alone. Similarly, EDTA, which also can bind Ca2+ and which can modify the activity of heme biosynthetic enzymes, also inhibited hemoglobin production mediated by DMSO, whereas it stimulated hemoglobin production in cells exposed to butyrate. Total porphyrin accumulation was greater in DMSO-treated cells than in butyrate-treated cells, which suggests that butyrate induces the enzymes of the heme pathway more efficiently than does DMSO. DMSO and butyrate may affect the heme biosynthetic pathway by multiple mechanisms or, alternatively, they may affect the multistep pathway at various points, producing partial blocks or incomplete enzyme induction.


Technique for preclinical evaluation of continuous infusion chemotherapy with the use of WF rat acute myelogenous leukemia. A technique was developed for continuous iv infusion chemotherapy in an inbred rat model of acute myelogenous leukemia. Polyethylene tubing was inserted surgically into the internal jugular vein of adult WF rats, burrowed sc to the base of the tail, and connected to an infusion pump. A flexible spring was sutured at the base of the tail and fastened to the cage wall; it protected the infusion catheter and allowed movement of the rat within the cage. This technique was used to compare bolus with continuous infusion therapy with adriamycin, cytosine arabinoside, and neocarzinostatin. Only small differences were noted in host toxicity and in antitumor effect against tumor grown as a subcutaneous myeloblastoma. Nearly three times more neocarzinostatin was required by continuous infusion for an effect equivalent to that of bolus injection. In contrast, continuous infusion of methotrexate with concurrent thymidine infusion prevented toxicity, enhanced the antitumor effect, and prolonged survival. This infusion system should facilitate rapid preclinical evaluation of drugs considered for constant iv infusion therapy.


Inhibition of tritiated thymidine incorporation in cultured cells by rat kidney extract. KCl extract from rat kidney, rat liver, and Morris hepatomas inhibited [3H]thymidine incorporation into cultured cells. Tissues came from male inbred BUF rats. The most pronounced inhibition was achieved with the kidney extract. Protein synthesis was not inhibited during a 24-hour exposure of the cells to the inhibitor. Incorporation of [3H]deoxycytidine was inhibited, as was cell growth, when the kidney KCl extract was present for several days. [3H]thymidine incorporation was inhibited almost immediately after the addition of the extract. The inhibition was reversible. Regular [3H]thymidine incorporation was restored 24 hours after removal of the inhibitor, which was neither arginase nor a thymidine-degrading enzyme. The inhibitor was stable to heat (80 degrees C for 10 min) and resistant to trypsin, pronase, DNase, and RNase. Exposure of the extract to proteolytic enzymes, hyaluronidase, and neuraminidase resulted in a loss of inhibitory activity only after extensive dialysis of the treated extract. The inhibitor appeared to be a mucoprotein in which the carbohydrate moiety may be responsible for the inhibition. The KCl extract also inhibited RNA synthesis and DNA synthesis by the de novo pathway. The inhibition of phosphorylation of thymidine, however, appeared to be the primary action of the inhibitor.


[Ophthalmological opinions for liability affairs material damage (Part I) (author's transl)]. German law abides anyone reponsible for the damage he or she has caused to another person's property or corporal integrity. This includes all medical costs directed towards the restitution of health as well as economical damage in direct consequence of the corporal damage. An ophthalmological expert is to state his opinion therefore in accordance with the specific conditions of every individual case and not just according to general charts. Financial compensation is only granted for the actual results of damage inquestion. Prior damage and disability have to be remarked but not to justify a financial compensation. The question of smart-money is dealt with in Part II.


Bacteriological examination of a modern animal house containing small laboratory animals. Floors and other areas totalling 1800 m2, comprising conventional and specified-pathogen-free (SPF) units, were screened bacteriologically 6 times in a year. The contamination indices observed were lower within than outside the units, and lower in the SPF than in the conventional unit. Bacterial counts in rooms containing animals in the conventional and SPF units were very similar. In all of the areas investigated within the units, most of the samples revealed less than 2 colony forming units per cm2. In contrast, high degrees of bacteriological contamination were detected in the changing rooms after showering or washing before entry. Staphylococcus epidermidis was the dominant bacterial species isolated. The bacteriological spectrum did not vary between the areas surveyed.


A review of allergic respiratory disease in laboratory animal workers. There is increased recognition of hypersensitivity lung disease among workers with laboratory animals as an occupational disease. Symptoms of asthma in 44 of 78 workers with laboratory animal dander allergy reflected the serious consequences of this occupational ailment. Affected employee profiles induced family history of atopy; immediate (Type I) allergic reaction; symptoms of rhinitis, asthma, and cough; hypersensitivity to one or more species, most often rats, mice, and rabbits. Diagnosis depends on history and physical, radiologic, and laboratory examinations, including skin tests with relevant antigens. Control and treatment depend on environmental change (reemployment or reduction of antigen contact); mechanical devices (masks and filters); chemotherapy (bronchodilators, steroids), prophylaxis and immunotherapy (hyposensitization). Standardization of medico-legal criteria covering occupational asthma is needed.


Chronic systemic Dacron and Teflon embolization of a Beall model 103 mitral valve prosthesis. A case is presented of chronic systemic Dacron and Teflon embolism arising from a Beall Model 103 mitral valve prosthesis installed 11 years earlier. The emboli induced intense foreign body reaction resulting in numerous microgranulomas throughout the body. Multiple microinfarctions in the brain accounted for repeated episodes of transient ischemic attacks. Wearing of the prosthesis with consequent embolic complications seems to be the inevitable terminal fate of such early models of the Beall valve. Regular assessment of the functional status of such prostheses, particularly those in place for more than 5 years, is strongly recommended.


[Desmoid in a laparatomy scar].

[Desmoid in a laparatomy scar]. A patient, aged 55, three years after having undergone abdominal histerectomy and adnexectomy for a myoma, developed a hard swelling near the surgical cut in the abdominal wall. A similar swelling appeared also in another patient, aged 33, as early as three months following salpingectomy for tubal pregnancy. In both cases these hard tumours radially permeating the facia and muscles were surgically removed and histologically verified as desmoids.


T-cell division and aging.

T-cell division and aging. The age-dependent drop in mixed lymphocyte reactivity and responsiveness to concanavalin A of lymph node and spleen cells of C57Bl/6J female mice were studied. The relative decrease in mixed lymphocyte reactivity was shown to be the same whether mounted against H-2 or Mls incompatibile stimulator cells. The time of peak response in vitro as well as the sensitivity to stimulator cell concentration are not altered with age. Cell cycle studies demonstrate that those cells which respond in vitro to alloantigens or to concanavalin A do so with a cell cycle which does not change with the age of the lymphocyte donor. In addition, regardless of the age of the donor, those cells which divide in vitro demonstrate identical capacities to redivide. These experiments suggest that the decline in observed T-cell proliferation in mixed lymphocyte and mitogen reactivity of senescent mice is not to a decreased cell generation time or to a reduced capacity to divide and redivide but rather to a smaller population of reactive cells.


An overview of immune aging.

An overview of immune aging. A brief overview of the effect of age on the function of cells of the immune system is presented. Normal immune functions can begin to decline shortly after an individual reaches sexual maturity. Foremost among the cellular changes are those in the stem cells as reflected in their growth properties and the availability of precursor T cells, and in the T cell where a shift in subpopulations may be occurring. Present evidence indicates that thymic involution precedes and therefore may be responsible for the age dependent decline in the ability of the immune system to generate functional T cells. It now appears that the primary effect of thymic involution is on a T cell differentiation pathway affecting the more mature T cells first and only later the less mature T cells. Thus, the thymus may be the aging clock for the immune system. Future studies should be centered around processes regulating growth and atrophy of the thymus.


Autoimmunity, histocompatibility, and aging. The immunologic theory of aging proposes that the normal process of aging in man and all animals is pathogenetically related to faulty immunological processes and may be analogous to a type of autoimmune phenomena ultimately involving all body tissues. It may be said that the sharply increased incidence in elderly humans of the autoimmune and immunodeficiency "diseases of age" are thought to be greatly potentiated by the age-related decline in immune surveillance mechanisms particularly involving self/non-self discriminatory abilities. The major histocompatibility complex has emerged as a complex of "supergenes" coding for antigens whose ultimate biological function may be to serve as recognition units allowing lymphocytes to recognize self from non-self on an immunological basis. Also, recent data are consistent with our supposition that differences in age-specific peaks of various immune functional parameters in genetically homozygous mice may be influenced by genes linked to the major histocompatibility complex. These differences may account, at least in part, for the highly strain-dependent, age-specific incidence of certain diseases, including autoimmune and malignant diseases in the mouse. Heightened susceptibility to develop a particular disease in a susceptible animal occurs when a certain balance is reached between the interplay of immune functional parameters which mature, differentiate, or decline at different rates in the same animal. The age-specificity of this balance may be under partial control of H-2 or HLA-linked genes.


Human mutations affecting aging--a review. A review of human genetic mutations that affect aging and their potential contribution to help understand normal aging processes is presented. The lifespans of most animal species, including man, have a genetically determined maximum. The lifespan of man appears to have evolved exceedingly rapidly, which suggests that relatively few genes may determine longevity. Analysis of biochemical evolution suggests that the regulation of enzyme levels may underlie most evolutionary changes. There is a wide spectrum of human genetic mutations. Some, such as progeria and Werner's syndrome, produce a phenotype resembling premature aging and may involve genes related to the aging process. Certain human chromosomal abnormalities, such as Down's syndrome, produce an appearance of premature aging and may be due to abnormal gene regulatory mechanisms. Progress in understanding the genetic mechanisms underlying aging is likely to come from elucidation of the molecular defects that result in the premature aging syndromes and from insights gained regarding the regulatory mechanisms governing eukaryotic genetic expression.


Reversible translocation of antibiotic resistance determinants in Salmonella ordonez. Salmonella ordonez (BM 2000) codes for kanamycin (Km, aphA), ampicillin (Ap), streptomycin (SmSp:aadA and Sm:aphC), chloramphenicol (Cm), tetracycline (Tc) and sulfonamide (Su) resistances and for production of colicin Ib (Cib). Genetical analysis by incompatibility testing, conjugation, transformation and physical studies using electron microscopy, agarose gel electrophoresis, led us to associate the Km and Cib characters to a 98.7 kilobase (kb) IncI1 plasmid (pIP565), and the Sm (aphC) and Su determinants to a 8.3 kb plasmid (pIP605). The ApCmSmSp(aadA)SuTc determinants were not associated in BM2000 S. ordonez with a plasmid structure. Following conjugation of S. ordonez to E. coli, the ApCmSmSpSuTc determinants were found stably associated with a single plasmid structure (pIP173, 127.5 kb) belonging to IncI1 group. Agarose gel electrophoresis of plasmid DNA restriction endonuclease digests and electron microscopy heteroduplex analysis showed that the acquisition of the ApCmSmSpSuTc determinants resulted from the insertion into pIP565 of a 28.8 kb DNA sequence. This sequence coding for ApCmSmSpSuTu resistances in S. ordonez could be translocated either to pIP565 plasmid or to several IncI1 plasmids but never to plasmids belonging to IncW, IncP or IncFII, suggesting the existence of specific sequences on the IncI1 receptor plasmids. Moreover, R-determinants were translocated back "en bloc" from pIP173 to the chromosome of a susceptible S. ordanez. The results were consistent with the presence in BM2000 S. ordonez chromosomal DNA of an integrated translocatable sequence encoding ApCmSmSpSuTc resistances. Such a structural association could account for the stability of these resistances in the Salmonella ordonez serotype.


Isolation and genetic analysis of nuclease halo (nuh) mutants of Neurospora crassa. Nuclease halo (nuh) mutants of the ascomycete Neurospora crassa have been isolated which are characterized reduced release of deoxyribonuclease (DNase) activities from colonies grown on sorbose-containing agar media. To identify nuh mutants, mutagenized isolates were transferred to commercial DNase test agar, or grown on minimal medium and then overlayed with agar that contained heat-denatured DNA. DNase activity was visualized by acid precipitation which produced clear rings of digestion (haloes) around the colonies. To identify the number of genes in which mutations lead to reduced release of nuclease activity, eleven nuh mutants were checked for close linkage and linked pairs were tested for complementation. These mutants were assigned to eight genes, and all except one were mapped in six small regions of the Neurospora linkage maps. In addition, among a large number of existing mutants which were tested for nuclease haloes, two mutants were found that showed the Nuh phenotype, namely uvs-3 and uvs-6. One of the isolated nuh mutants was also found to be sensitive to UV and was mapped close to uvs-3; it may represent a new allele of this gene. As a first step towards identification of genuine nuclease mutants, extensively backcrossed strains of mutants from different genes have been assayed for nuclease activity with denatured DNA in extracts. A pronounced reduction, compared to wild type at the same stage of growth, was found in uvs-3 and also in nuh-3, a mutant that is not UV-sensitive.


Bioenergetic aspects of aerobic glucose metabolism of Escherichia coli K-12 under varying specific growth rates and glucose concentrations. An attempt was made to find a bioenergetical explanation for the differential effect of specific growth rate and glucose concentration on glucose metabolism of Escherichia coli K-12 with the help of 2,4-dinitrophenol (DNP). The effect of DNP on biomass occurred only at high glucose concentrations. The presence of this uncoupler strongly stimulated glucose uptake rates and oxygen uptake rates, but repressed severly Yg values. Increase in glucose concentration, however, sharply decreased QO2. The amount of oxygen required for maintenance was not affected by DNP, but Yomax values were much lower in the presence of DNP. The results are discussed and it is suggested that aerobic fermentation is caused by a severe reduction of site 1 of the respiratory chain region, whereas biomass formation is affected by repression of the terminal cytochrome a2. In comparing the effect of glucose on biomass formation at similar Qglucose levels aerobic and anaerobic fermentation, repression occurred in both cases at glucose concentrations of 0.3% and above. Although the analyses of 15 enzymes established the metabolic differences, the repression of growth was common to both fermentation types.


[Tubal sterilization with the tupla-clip per laparoscopiam (author's transl)]. This study refers about a newly developed plastic clip which has been used with good results for the past three years in tubal sterilization. By applying this method, heat or thermal injuries are avoided and a greater possibility of refertilization is indicated. This clinical evaluation consists of experimental data of 243 women who underwent sterilization in the local OB/GYN clinics at Fulda and at Bremerhaven. 59 women were sterilized during puerperium, and 184 were sterilized irrespective of pregnancy. As complications, 2 pregnancies were observed, further 3 hematomae within the broad ligament; 11 clips dropped into the free adbominal cavity while 5 clips broke during application. After the initial difficulties, the authors of this study recommend a sterilization with this tubal clip as an alternative to the usual methods of sterilization.


Maternal speech to normal and Down's syndrome children matched for mean length of utterance. The study was designed to provide data on the maternal linguistic environments of normal and Down's syndrome children at three levels of language development, as assessed by children's mean length of utterances (MLU). The three MLU levels were 1.00--1.50, 1.75--2.25, and 2.50--3.00, respectively. The subjects were 21 Down's syndrome children and their natural mothers and 21 normal children and their natural mothers. Normal children ranged in chronological age from 20 to 32 months and Down's syndrome children from 3 to 12 years. A one-hour verbal interaction between mother and child was tape recorded at home in a free-play situation. Maternal speech was analyzed using 20 measures related to its output-numerical, lexical, syntactical, semantic-structural, semantic-pragmatic, and language-teaching aspects. Additionally, eight measures of children's speech related to the output-numerical, lexical, syntactical semantic-structural aspects, and to imitativeness of maternal speech were computed as a means of testing the validity of the MLU-matching that forms a basis for this study. Except for the Type-token ratio, which favored Down's syndrome children, normal and Down's syndrome children were not found to differ. In contrast, there were numerous differences between the children in the different aspects of speech considered according to language level. None of the comparisons made of mother's speech to normal and to Down's syndrome children led to differences for any of the three children's language levels studied. It appeared that the maternal linguistic environments of language-learning Down's syndrome and normal children of corresponding MLU were similar in most respects. In contrast, there were numerous differences in mother's speech according to the language level of the children addressed. This confirmed that the expressive language level of the children is a far more powerful factor in influencing maternal speech than whether they are normal or Down's syndrome children. The implications of these findings were related to the delay-difference question in the language development of Down's syndrome children and to various interpretations of the effects of maternal linguistic input for language development and for intervention programs of language enhancement in the Down's syndrome child.


[Isolation of an autotrophic variant of Nocardia opaca]. A hydrogen-oxidizing autotrophic actinomycete, strain Z-766, was isolated from the neuston of a marsh near Moscow. The organism was identified as Nocardia opaca Z-766 according to its morphologo-physiological properties. The spectrum of organic compounds used by the strain, its cultural characteristics and growth are similar to those of the monotypical autotrophic microorganism N. opaca 1b described earlier. Repeated isolation of the autotrophic variant of N. opaca Z-766 suggests that the ability of this species for autotrophic growth is not a unique phenomenon. It would be expedient to construct a taxon of the subspecial range, N. opaca var. autotrophica, for autotrophic variants of N. opaca.


Growth hormone hyperresponsiveness to dopaminergic stimulation in Huntington's chorea. The effect of 3 dopamine (DA) mimetic drugs, i.e. bromocriptine (Bro), apomorphine (Apo) and L-3,4-Dihydroxpenylalanine (L-dopa), was evaluated on plasma growth hormone (GH) levels in 18 patients with Huntington's chorea (HC). 27 Nonobese hospitalized patients were used as controls. Mean baseline GH levels were not altered in patients with HC. Oral administration of Bro (2.5 mg po) or L-dopa (500 mg), or subcutaneous administration of Apo (1.0 mg) resulted in a significantly greater and more prompt (Bro, L-dopa) increase in plasma GH in patients than in controls. These results suggest that presence of an altered dopaminergic regulation of GH secretion in HC.


Immune complex vasculitis, polymyositis, and hyperglobulinemic purpura. This is the first description of a patient with both polymyositis and Waldenström hyperglobulinemic purpura. There was evidence of circulating immune complexes, and immune deposits were found in dermal and muscular vessels. Similar electron-dense deposits were seen ultrastructurally in the basement membrane of both normal and abnormal microvasculature. The findings suggest that the muscle and skin lesions may be associated with deposition of circulating immune complexes in and around blood vessels, followed by complement activation and subsequent inflammation.


Motor innervation and fiber type pattern in amyotrophic lateral sclerosis and in Charcot-Marie-Tooth disease. A quantitive study of the terminal innervation ratio (TIR) was conducted using 18 amyotrophic lateral sclerosis (ALS) and 12 Charcot-Marie-Tooth disease (CMT) muscle biopsies. Morphometric and histochemical analyses of muscle fibers were performed in 9 ALS and 6 CMT biopsies. The results revealed that TIR and type grouping were significantly greater in CMT than in ALS. The proportion of type 3 fibers was higher in ALS, though the proportion of intermediate and type 0 fibers was significantly higher in CMT. The atrophy factor was significantly greater in type 3 than in types 1 and 2 fibers, but it was not significantly different in type 0 and intermediate fibers as compared to types 1 and 2, It appears, therefore, that CMT has a better capacity for collateral reinnervation than ALS. Type 0 and intermediate fibers may represent altered endproducts of successful collateral reinnervation.


Bromocriptine and dopaminergic function in Huntington disease. The cerebrospinal fluid (CSF) content of homovanillic acid (HVA) was assayed in 10 patients with Huntington disease. On doses of less than 40 mg of bromocriptine daily, there was clinical improvement and the CSF HVA concentration increased. On higher doses of bromocriptine, chorea worsened and the CSF HVA concentration decreased. Bromocriptine at low dosage seems to act as a partial dopamine antagonist, with phenothiazine-like effects, and at higher doses it acts as a direct dopamine-receptor stimulating agent.


Silicone band technique for laparoscopic tubal sterilization in the gravid and nongravid patient. Laparoscopic tubal sterilization by the Falope ring technique was performed on 196 patients. Sixty-four patients underwent laparoscopic tubal sterilization at the time of gestation termination. One hundred thirty-two patients underwent interval laparoscopic sterilization. The complication and failure rates in the group that had both laparoscopic tubal sterilization and gestation termination was lower than in the group that had laparoscopic tubal sterilization alone. The Falope ring sterilization technique is a safe method when combined with gestation termination, and spares the patient the inconvenience and increased hazard of 2 separate procedures.


Benign adenoma of the ciliary epithelium with tumour seeding. Report on a benign epithelioma of the ciliar body which caused cataract and dislocation of the lens in a 44-year-old woman. Tumour seeding was a remarkable finding, and is a result of disruption of the epithelial lining due to active production of mucopolysaccharides by tumour cells.


Thymic deficiency in Down's syndrome.

Thymic deficiency in Down's syndrome. Children with Down's syndrome (DS) often have small and abnormal thymuses, with lymphocyte depletion, diminution of the cortex, and loss of corticomedullary demarcation--a picture resembling thymic involution. Besides this, they have markedly enlarged Hassall's corpuscles, some surrounded by a sheath of lymphocytes. Patients with DS are known to have increased numbers of respiratory infections; they also have a higher incidence of lymphatic leukemia than do individuals who do not have DS. Studies of cell-mediated (thymic-dependent) immunity demonstrate that children with DS have both diminished numbers of T cells as well as functional deficiency of these cells.


Fungus cultures in a pediatric outpatient clinic. Comparison of culture results with clinical impressions showed that pediatric house officers made frequent errors in diagnosing superficial fungus infections. Results of cultures on dermatophyte test medium (DTM), read by nonmycologists in the clinic, were comparably accurate with those on standard media processed in a laboratory. DTM is a useful aid in diagnosing dermatophytoses and teaching clinical mycology to pediatric residents.


The heart in acute glomerulonephritis: an echocardiographic study. Patients with acute glomerulonephritis often are seen with signs suggesting heart failure. Whether these signs are due to fluid overload secondary to kidney damage only, or whether there is associated myocardial damage has not been elucidated. Fourteen children with acute glomerulonephritis were studied by echocardiography during the edematous phase of the disease and five months later to evaluate cardiac function in this disease. Left ventricular size and function remained normal in all children throughout the study. The most consistent finding was enlargement of the left atrium during the edematous phase with a return toward normal values five months later. There was no correlation between blood pressure and the echocardiographic findings. This study suggests that signs of heart failure in acute glomerulonephritis are not due to myocardial damage but probably reflect fluid overload.


Fluctuations in superhelical DNA.

Fluctuations in superhelical DNA. The effect of superhelicity on the base-pair opening probability and on the probability of occurrence of cruciform states in palindromic regions is theoretically treated. The calculations show that below the superhelix density value of -sigma=0.05 superhelicity does not appreciably affect the characteristics of DNA secondary structure fluctuations. In the range of physiological superhelix densities sigma (-sigma=0.05-0.09) the base-pair opening probability markedly increases. However, within this range of sigma the base-pairs are opened only transiently and permanently open regions are not formed. Permanently opened regions appear at higher negative superhelix densities (-sigma greater than 0.10). At the values of -sigma higher than 0.06 a cruciform structure in the palindromic region centred in position 3965 proves to be the most probable fluctuational disturbance in the 0x174 duplex DNA. Different experimental approaches used for probing the fluctuations in superhelical DNA have been analysed. The results suggest that most direct quantitative information can be derived from data on the nicking of closed DNA by single strand-specific endonucleases. Such data (Wang, 1974) accord with the results of theoretical calculations. Calculations show that, due to base-pair opening, the total free energy of superhelical DNA should depend parabolically on sigma only up to some critical value of sigma=sigmac. If negative superhelicity exceeds this critical value, which under physiological conditions proves to be -sigma=0.085, the free energy should increase linearly with -sigma. The biological role of supercoiling is discussed in the light of obtained results.


A novel method for purification of prephenic acid. Prephenic acid accumulated in culture filtrates of Neuro-spora crassa has been purified in 66% yield utilizing adsorption chromatography on Sephadex G-10 in the major purification steps.


A new method for the preparation of beta-amylase from sweet potato. A simple method for the preparation of sweet potato beta-amylase by thymol amylose adsorption is described. The method is far more efficient and gives higher recovery of the enzyme. The crystalline enzyme thus obtained is found to be homogeneous by gel chromatography, polyacrylamide gel electrophoresis.


Specialized transducing phage lambda carrying the genes for coupling factor of oxidative phosphorylation of Escherichia coli: increased synthesis of coupling factor on induction of prophage lambda asn. Studies were made of the synthesis of the coupling factor complex (F1--F0) of oxidative phosphorylation after prophage induction of a set of Escherichia coli strains lysogenic for defective transducing phage lambda asn, lambda uncA, or lambda bglC. The transducing phages had been isolated from a strain of E. coli carrying prophage lambda cI857 S7 within the bglB gene located near the unc gene cluster [Miki, T., Hiraga, S., Nagata, T. & Yura, T. (1978) Proc. Natl. Acad. Sci. USA 75, 5099--5103]. When lysogenic cells carrying lambda asn and lambda cI857 S7 were induced at high temperature, synthesis of the F1-ATPase portion of the complex increased to severalfold that of the noninduced cells. In contrast, no increase was observed upon thermoinduction of cells carrying lambda uncA or lambda bglC. The number of membrane sites that could bind purified F1-ATPase also increased significantly upon induction by lambda asn but not by lambda uncA or lambda bglC. In addition, F1-depleted membranes prepared from lambda asn-induced bacteria required more dicyclohexylcarbodiimide to seal the proton pathway than did those from noninduced bacteria. These results strongly suggest that lambda asn carries a set of bacterial genes coding for all the F1 polypeptides (the alpha, beta, gamma, delta, and probably the epsilon subunits) and at least some of the genes involved in formation of F0 polypeptides. Although lambda uncA carries the structural gene (uncA) for the alpha subunit of F1-ATPase, it apparently does not carry the whole set of F1--F0 genes.


In vitro synthesis of the Ca2+ transport ATPase by ribosomes bound to sarcoplasmic reticulum membranes. The calcium transport ATPase (M(r) 100,000) from sarcoplasmic reticulum membranes was synthesized in a cell-free translation system containing rough microsomes or detergent-treated bound polysomes from 14- to 16-day old chicken embryo muscles. Immunoprecipitates obtained from total translation mixtures treated with anti-ATPase antiserum contained 1.5% of the total radioactivity incorporated in vitro. A polypeptide with the electrophoretic mobility, isoelectric point, and [(35)S]methionine-labeled tryptic peptide pattern of the mature ATPase was a major component of these immunoprecipitates. By contrast, free polysomes from the same source, which were capable of high levels of in vitro protein synthesis, did not yield immunoprecipitable ATPase. ATPase synthesized in rough microsomes was not released by treatment with 10 mM EDTA in a high-salt medium (0.5 M KCl) which removes ribosomes and peripheral membrane proteins. Furthermore, labeled ATPase remained associated with the microsomes after these were treated with low concentrations of deoxycholate (0.1 mg/mg of protein in 0.3 ml) which release the luminal content of the vesicles. Only with higher deoxycholate concentrations (0.5 mg/mg of protein in 0.3 ml), which cause membrane dissolution, was the labeled ATPase found on the detergent extracts. These observations indicate that newly synthesized ATPase discharged from bound ribosomes is transferred directly to the sarcoplasmic reticulum membranes where it is incorporated as an integral membrane protein.


Presence of heparan sulfate in the glomerular basement membrane. The glomerular basement membrane was subjected to digestion with specific enzymes to determine the chemical nature (sialoglycoproteins, collagenous peptides, or glycosaminoglycans) of the anionic sites previously demonstrated in the laminae rarae. Enzyme digestion was carried out both in situ and in vitro. Kidneys were perfused in situ with enzyme solutions followed by perfusion with fixative containing the cationic dye, ruthenium red, to detect the anionic sites. Glomerular basement membranes were isolated by detergent treatment of glomeruli and incubated with enzyme solutions, followed by incubation with cationized ferritin (pI 7.3-7.5) to label the anionic sites. Only highly purified enzymes free of proteolytic activity were used. The findings were the same both in situ and in vitro. The anionic sites were unaffected by treatment with neuraminidase, chondroitinase ABC, and testicular or leech hyaluronidase. However, they could no longer be demonstrated after digestion with crude heparinase, purified heparitinase, or Pronase or after nitrous acid oxidation. The results demonstrate that the sites contain heparan sulfate since they are removed by treatment with heparitinase and by nitrous acid oxidation-procedures specific for heparan sulfate; and that sialoglycoproteins or other glycosaminoglycans do not represent major components of these sites since the latter are not affected by digestion with neuraminidase and other glycosaminoglycan-specific enzymes. Identical findings were obtained on basement membranes in other locations (Bowman's capsule, tubule epithelium, and endothelium of peritubular capillaries). The presence of heparan sulfate in the glomerular basement membrane is discussed in relation to the charge-selective properties of the glomerular filter and in relation to its potential involvement in various types of glomerular injury.


Possible involvement of serotonin in extinction. In  Experiment 1, rats were trained to leverpress for continuous reinforcement with food; half were then intubated with the serotonin synthesis inhibitor parachlorophenylalanine (PCPA: 400 mg/kg) and half with water. In extinction the PCPA-treated rats responded at a higher rate. In Experiment 2, rats were trained on a random interval schedule and then assigned to two groups, treated as in Experiment 1, and tested in extinction. There was no significant difference in the resistance to extinction of the two groups. In Experiment 3, the responding of rats trained in a punished stepdown response paradigm and then given an intragastric injection of PCPA took longer to recover than the responding of water-injected controls. These observations suggest that serotonergic neurons might play a role in extinction processes.


Reticulospinal neurones with axons in the dorsal part of the lateral funiculus of the lumbar segments. The presence of reticulospinal axons in the dorsal part of the lateral funiculus (DLF) of the lumbar spinal cord segments was tested in chloralose-anaesthetized cats. In the medial part of the reticular formation, 59 units which gave antidromic responses to stimulation of the isolated DLF of segment L1--L3 were observed. The rate of their axonal conduction was 20--120 m/s. 62% of the units generated discharge activity in response to electrical stimulation of the skin of the trunk and/or the limbs. The activating intraspinal pathways were localized in the DLF and the ventral part of the cord. The most effective natural stimulus was tapping. Monosynaptic control from cerebellar pathways was confirmed in 37% of reticulospinal neurones with axones in the DLF. The results showed that reticulospinal axones form part of the dorsal reticulospinal system in the lumbar cord region.


Study of electrical activity in the area of the hypothalamic ventromedial nucleus and the lateral hypothalamus of rats fed on a high protein and high fat diet. The authors studied bioelectric potentials in the area of the hypothalamic ventromedial nucleus and the lateral hypothalamus of rats fed on a standard, a high protein and a high fat diet. On the first 3--6 days after changing from the standard to the high fat and high protein diets, a decrease in the amplitude of electrical activity was recorded in both the areas in question. It was also found that the frequency of electrical activity in the hypothalamic ventromedial nucleus or the lateral hypothalamus rose, after 3 days administration of the high fat or the high protein diet, in correlation to the type of diet, and that, in the frequency spectrum, a change occurred in the proportion of basic frequency in relation to superimposed frequencies distorting it. It was further found that there was a permanent difference between the amplitude of electrical activity in the lateral hypothalamus and the hypothalamic ventromedial nucleus.


Theta (RSA) activity in the brain of the turtle. The existence of a synchronizing system generating theta (RSA) activity of an average frequency of 4 Hz has been demonstrated in the brain of the turtle Testudo Graeca. Three brain structures probably participate in the activity--the septum, amygdala and hippocampus. The septal region seems to play a leading role in this complex--lesions in this region abolished the generation of theta activity in 71% of experiments. This synchronizing system is functionally coupled with the olfactory generator of electrographic respiratory response (ERR), which is brought into activity by nasal air flow. This coupling can play a role in genesis of epileptic electrographic activities not only in the turtle, but also in phylogenetically higher species.


In vivo kinetics of blood cholinesterase inhibition by 9-amino-1, 2, 3, 4-tetrahydroacridine, its 7-methoxy derivative and physostigmine in rats. In vivo inhibition of blood acetylcholinesterase activity by 9-amino-1, 2, 3, 4-tetrahydroacridine, its 7-methoxy derivative and physostigmine was studied in rats. Changes of enzyme activity in the blood were continually registered using an automatic colorimeter Auto Analyzer system. The dependence of % enzyme inhibition upon time in semilogarithmic transformation was characterized by a two phase curve. The first phase reflected the increase in the concentration of inhibitors in the blood during their resorption; this was followed by a slow second phase of inhibition. The inhibitory effect decreased in the order: physostigmine greater than tacrine greater than 7-methoxytacrine. The relationship between the anticholinesterase and antipsychotomimetic action of the examined substances is discussed.


Physical fitness of Czechoslovak population between the ages of 12 and 55 years. Pulse rate and blood pressure. In loading test of a representative sample of the Czechoslovak population aged 12--55 years, the authors, examined the reaction of the pulse rate and blood pressure (in watts--W) to loading on a bicycle ergometer. On increasing the submaximal load, the pulse rate rose linearly with age--more gradually in the phase of growth and along an approximately the same trend from the age of 18. The course in adult women corresponded to the course in boys aged about 13. The maximum pulse rate fell linearly in correlation to age, by about 4--5 beats for every 10 years, from 195/min in 12-year-old boys and 198/min in girls. The working capacity at pulse rate 170 (W 170) attained the maximum at 25 years (men 198, women 112 W). The systolic pressure rose non-linearly with loading. It increased more rapidly at lower loads. Children had the smallest pressure reaction and the oldest subjects the greatest. Diastolic pressure fell gradually and non-linearly with loading. The maximum blood pressure values, according to age, rose from 138/56 torr in the oldest males and from 139/57 to 182/84 torr in females.


Physical fitness of the Czechoslovak population between the ages of 12 and 55 years. Pulmonary ventilation. Examination of ventilation function in an average population showed that maximum minute ventilation in adults fell with advancing age. Males had higher values than females, the highest values being attained, in both sexes, at 18 (117 and 83 1/min respectively). Tidal volume during loading, expressed as a percentage of vital capacity, rose with advancing age in all groups of males and females (from 53% at 18 to 64% at 55 in males and from 51% to 59% in females). The ventilation equivalents for O2 and CO2 attained optimum values at a load of 100 W in males and at 50 W in females. On increasing the load they rose in both sexes--in females more than in males. Percentual utilization of O2 from the inspired air was greatest in males at a load of about 100 W (4.8--5%) and in females at about 50 W (4.3--4.8%). At higher loads it fell faster in females than in males. In males, the respiratory quocient attained the value 1 at a load of about 2 W/kg body weight and in females at 1.5 W/kg. At maximum loading it was over 1 in all the age categories. No differences between males and females were observed, but males, in maximum loading, gave the greatest absolute and the greatest relative performance.


Physical fitness of the Czechoslovak population between the ages of 12 and 55 years. Oxygen consumption and pulse oxygen. The authors measured oxygen consumption in a Czechoslovak population aged from 12 to 55 years. An abrupt increase was found between 12 and 18 years, when the maximum was reached (males 3.28, females 2.17 l/min), followed by a slower decrease to 55 years. Relative O2 consumption (per kg body weight) showed a continuous decrease from 12 years, when maximum values were recorded (49 ml/min . kg for boys, 46 ml/min . kg for girls), to 55 (33 ml/min . kg for males, 27 ml/min . kg for females). In the adult population (18--55 years), no differences were observed in the values at the various levels of submaximal loading. The pulse oxygen attained the maximum at 18 (males 16.8, females 11 ml).


Cultivation of frozen mouse bone marrow cells in agar. The authors attempted to cultivate frozen mouse bone marrow cells in a semisolid medium. They demonstrated that the stem haematopoietic cells of frozen mouse bone marrow were capable of proliferation and of colony formation on agar. The much smaller number of colonies from frozen mouse bone marrow (about 80% fewer) compared with fresh marrow is evidence that part of the stem haematopoietic cell population retains proliferative capacity even after freezing.


Experiences with the tensor fascia lata flap. Our experience with 60 TFL flaps is reviewed. The anatomy and the arcs of rotation of this flap are described. Our clinical experience--particularly in reconstruction of the groin and abdominal wall, and in free flap transfers--has been detailed, including the use of a free osteomyocutaneous sensory TFL flap for reconstruction of the heel.


The effect of dopamine and noradrenaline blockade on amphetamine-induced behaviour in the marmoset. Acute administration of 4 mg/kg d-amphetamine in the marmoset results in a large increase in small head movements (checking), an almost total suppression of purposeful activities and social interaction, but little change in the amount of locomotion. Checking behaviour is blocked in a dose dependent manner by 0.03--0.18 mg/kg haloperidol but not by propranolol, aceperone or diazepam, suggesting dopaminergic mediation of this behaviour. The loss of activities and social interaction after amphetamine is not antagonized by any of the drugs used in this study. Locomotion is decreased by haloperidol, propranolol and diazepam in amphetamine treated animals and by haloperidol and aceperone in normal animals.


[The patello-femoral joint in osteoarthritis of the knee with gene varum (author's transl)]. The authors have treated 63 knees with osteoarthritis associated with varus deformity by valgus osteotomies. The clinical and radiological state of the patello-femoral joints has been studied before and after correction of varus deformity. No correlation was found between the severity of tibio-femoral osteoarthritis and patello-femoral osteoarthritis. Medical patello-femoral discordance was found in 12 p. 100 of the cases. Clinical evidence of pain arising from the patello-femoral joint was more often found than evidence of radiological abnormality. It is concluded that pain arising from the medial compartment may be confused with patello-femoral pain. A five-year follow-up showed that the patello-femoral joint was not influenced radiologically by the valgus osteotomy but patellar pain was improved in most of the cases. Procedures to re-align the patella should not normally be associated with valgus osteotomy in cases in which patellar pain exists in association with osteoarthritis of the knee with varus deformity.


[Ununited fractures of the femoral neck treated by cervicocephalic impaction. A report of two cases (author's transl)]. Two cases of ununited fracture of the femoral neck, treated by a technique described by Brackett (1927) and modified by Merle d'Aubigné (1968) are reported. The femoral head was partly evacuated, care being taken to preserve its blood supply and then impacted onto the femoral neck. The results were found to be satisfactory.


Characterization of the decreased ATPase activity of rat cardiac actomyosin in isoproterenol-induced cardiac hypertrophy. Daily administration of d,l isoproterenol-HCl (5 mg/kg) in rats for periods of 14-21 days results in marked cardiac hypertrophy and a decrease in cardiac actomyosin ATPase activity. Actomyosin suspensions (ionic strength 0.08) from right and left ventricles showed average decreases in ATPase activity of 37.1% (p less than 0.005) and 35.7% (p less than 0.05), respectively, for animals treated with isoproterenol for 14 days. Isolated myofibrils from combined ventricular muscle of another group of animals that received the same isoproterenol treatment showed an average decrease in ATPase of 36.4% (p less than 0.0025). The later experiments also demonstrated that the decrease in ATPase activity was not Ca++ sensitive suggesting the lack of involvement of a change in the calcium regulatory factors (tropomyosin-troponin complex). In contrast to these findings, purified myosin from treated animals and actomyosin assayed under conditions which essentially reflect myosin ATPase activity uninfluenced by actin interaction (actomyosin in solution, ionic strength 0.6), did not demonstrate a change in ATPase from controls. It was concluded that the decrease in cardiac actomyosin ATPase in isoproterenol treated rats involved primarily a defect in actin or the interaction of actin with other components of the contractile protein complex.


[Atypical findings in lumbar discography (author's transl)]. Lumbar discography is a good supplement to myelography in the evaluation of low back pain and sciatica. Knowledge of both typical and atypical findings helps to avoid false positive and negative diagnoses. On the other hand atypical findings may show up pathological processes, elsewhere only seen by pathological anatomy. In some cases a relation between these phenomena and clinical symptoms is found.


Intrahepatic pressures measured during laparoscopy. Intrahepatic pressure measured during laparoscopy were all correlated to occluded hepatic vein pressures and thereby to the portal vein pressures. Assessment of the intrahepatic pressures increases the diagnostic yield of laparoscopy, and should be used whenever it is important to quantitate the pressure in the portal circulation.


Functional characterization in vitro of two human T-cell subpopulations with different affinities to sheep erythrocytes. On the basis of their different abilities to form resettes with unsensitized sheep erythrocytes (SRBC), two subpopulations of human T lymphocytes were separated by the rosette sedimentation technique. In a series of in vitro experiments the T cells carrying high-avidity receptors for SRBC ('active' T cells) were shown to respond significantly better when stimulated with purified protein derivative (PPD) and allogeneic cells than the subpopulation carrying low-avidity receptors ('non-active' T cells). On the other hand, the latter responded better to phytohaemagglutinin, concanavalin A and pokeweed mitogen; it was likewise demonstrated that these cells were better stimulators in a mixed lymphocyte reaction. The role of monocytes in mitogen and PPD responses was investigated by adding such cells to Fe-treated suspensions. These were found to be crucial for an optimal response of both subpopulations. Furthermore, different patterns of activation were observed for the active and non-active cells. Especially interesting was the observation that the Con A response of the active fraction was more monocyte-dependent than that of the non-active one.


Cytotoxic effects of activated human monocytes and lymphocytes to anti-D-treated human erythrocytes in vitro. Incubation of human monocytes, derived from peripheral blood, with cell-free supernatants from mixed lymphocyte cultures resulted in morphological and functional changes in the mature macrophages. Activation of monocyte-derived macrophages by these factors resulted in a significant increase in their capacity to lyse anti-D-treated human erythrocytes. The lytic activity of both normal and activated macrophages appeared to be independent of erythrophagocytosis. T lymphocytes activated by either allogeneic cells or the mitogen phytohaemagglutinin were not cytolytic to treated erythrocytes even at high effector to target cell ratios.


[Diminished peritoneal pain perception in patients with liver cirrhosis and ascites]. Complete loss of parietal peritoneal sensitivity observed in a patient with long-standing ascites secondary to cirrhosis of the liver prompted an investigation of peritoneal sensitivity in 22 patients with the same condition. In all of them a decrease of the peritoneal sensitivity to needle perforation was found. All perceived peritoneal perforation as less painful than perforation of the abdominal skin by the same needle. In 8 control patients perforation of the peritoneum caused more discomfort than the perforation of the skin. In 7 cirrhotic patients where a histologic examination of the parietal peritoneum was available a chronic fibrotic peritonitis was present. Peritoneal insensitivity may partly account for mild abdominal symptoms in cirrhotics developing bacterial peritonitis.


Potential halogenated industrial carcinogenic and mutagenic chemicals. III. Alkane halides, alkanols and ethers. A variety of alkane halides, alkanols and ethers, analogous to the previously considered halogenated unsaturated (Part I) and saturated hydrocarbons (Part II) possess significant utility in a broad spectrum of applications including: solvents, fumigants, propellants and intermediates in the production of other chemicals, textiles, plastics and ion-exchange resins. Ethylene dichloride and dibromide, propylene dichloride; dibromochloropropane; 2-chloroethanol; 1-chloro-2-propanol; 2,3-dibromo-1-propanol; bis(chloromethyl)-, chloromethyl methyl-, bis(2-chloroisopropyl)-, and bis(2-chloroethyl-ethers were reviewed principally in terms of their synthesis, areas of utility, stability, distribution, reactivity, levels of exposure, population at risk, metabolism, carcinogenicity and mutagenicity.


Prolongation of the Q-T interval in a victim of sudden infant death syndrome: cause or effect? A 3-week-old infant died of sudden infant death syndrome (crib death, cot death). Although prolongation of the Q-T interval was found on an electrocardiogram taken at birth, this child appeared to have died of terminal respiratory failure as judged by a postmortem arterial oxygen tension of 4 mm Hg. The heart showed right ventricular hypertrophy, a finding consistent with chronic hypoxemia. The prolongation of the Q-T interval may have contributed to the death of this child with hypoxia predisposing to a fatal episode of ventricular fibrillation.


Radiology as an aid in the diagnosis and management of cardiac diseases. Conventional radiology is a routine examination in the diagnosis and management of cardiac diseases. A brief review of its value and limitations is given. A number of technical and/or physiological factors which may influence the cardiopulmonary configuration are mentioned. An approach is suggested for analysis of radiographs of the heart.


Immunological monitoring as a guide to the management of transplant recipients. Immunological monitoring assays are of current value in the management of transplant recipients. These assays allow the pre-transplant quantitation of both donor-recipient histocompatibility and recipient "responder status." In addition, these assays allow the individualization of immunosuppression, permitting a more uniform and effective immunosuppression in the difficult early post-transplant period. Individualized modulation of recipient immune reactivity avoids the documented pitfalls of conventional stereotyped suppression and permits better abrogation of acute rejection responses and lesser rates of serious infections consequent to excessive immune suppression. Immunological monitoring of long-surviving recipients permits early detection of immune reactivity which often culminates in clinical chronic rejection, as well as permits the quantitation of immune facilitory mechanisms (reduced capability to generate anti-donor cytotoxic T cells and/or cellular suppressor mechanisms) that indicate an immune milieu conductive to long-term graft survival. The primary limitations to the more widespread use of immunological monitoring assays at present are the need for more consensual validations of the utility of these assays in different laboratories, more standardization and better controls of techniques, and improvement in the technology of the assays to permit rapid, reproducible, and accurate results with a lesser expenditure of laboratory time and money and greater economy in demands for recipient blood and donor tissue. Finally, immunological monitoring assays are notable for the great promise they offer in terms of immunobiological probes to dissect mechanisms of rejection, mechanisms of graft facilitation, mechanisms of action of immunosuppressive agents, and mechanisms by which empirical technology of recipient pre-treatment may condition the host to better acceptance of an incompatible graft.


Bronchodilatation and the site of airway resistance in severe chronic bronchitis. Twenty-one patients with severe chronic bronchitis and emphysema (FEV1 less than 1 1) inhaled 80 microgram of the atropine-like agent ipratropium or placebo in a double-blind study and three hours later inhaled 200 microgram salbutamol. After 80 microgram ipratropium, mean FEV1 was significantly greater than after 200 microgram salbutamol (P less than 0.025), but the difference was only 40 ml and the clinical significance of this difference is unproved. There was no correlation between the patient's response to ipratropium and the response to salbutamol. When salbutamol was administered three hours after ipratropium, the FEV1 rose to higher levels than after either agent alone (P less than 0.01). Studies breathing 80% helium/20% oxygen suggest that ipratropium dilates both large and small airways. There was no correlation between the response to helium/oxygen and the response to either bronchodilator. The results suggest that in severe chronic bronchitis and emphysema ipratropium is at least as effective as salbutamol, and that such patients should have reversibility studies with salbutamol alone, ipratropium alone, and after both agents together. The combination of ipratropium and salbutamol may be clinically useful.


An evaluation of the mini-Wright peak flow meter. The mini-Wright peak flow meter (MPFM) has been evaluated, and the results obtained from it show a strong positive correlation (r=0.970) with the Wright's peak flow meter (PFM). MPFM measurements, however, were biased to be about 38 1/min higher than PFM measurements (95% confidence limits 31.01/min to 45.01/min). Between instrument variation was found (F--ratio 3.67 with 9 and 81 degrees of freedom: P less than 0.001). In practice this did not appreciably affect individual measurements greatly as 95% confidence limits on any individual measurements were increased from +/-24 1/min to +/-27 1/min. There was no significant day-to-day variability in measurements obtained with individual instruments. The MPFM is a pocket-sized, simple, cheap, and robust instrument for following changes in ventilatory function. In clinical trails and surveys, however, both the bias in favour of the MPFM compared to the PFM and inter-machine variation must be taken into account. As the manufacturers have altered the scale to remove the bias since this study was performed, it will be important to know whether the original or the modified meter is being used in future studies.


Coexistence of asymmetric septal hypertrophy and aortic valve disease in adults. Echocardiography detected asymmetric septal hypertrophy (ASH) in five of 200 adults being assessed for aortic valve surgery. Four of these were among 119 patients with dominant aortic stenosis, which was severe in three. ASH was confirmed at the time of aortic valve replacement in two of these patients; the third declined operation. The finding of ASH in only one of 81 patients with free aortic reflux is consistent with chance association. While the same explanation could apply to the higher prevalence in those with aortic stenosis, it may be that a long-standing pressure overload can trigger inappropriate septal hypertrophy in predisposed individuals.


Standardization of the human in vitro cell-mediated lympholysis technique. Cytotoxic lymphocytes (CTL) can be generated in mixed lymphocyte culture and cryopreserved after a 6-day sensitization phase. CTL tested after storage in liquid nitrogen do not show lysis of autologous target cells and can mediate strong cytotoxicity against other target cells. This lysis shows the same specificity as that of the corresponding fresh CTL. The ability to cryopreserve CTL enables performance of sequential CML testing. Data from separate CML experiments can be pooled using a percent relative cytotoxic response (%RCR) to normalize values within individual experiments. Together, these methods provide a standardized cell-mediated lympholysis technique.