Rubella haemagglutination inhibiting antibodies in females of child-bearing age in western Nigeria. Hitherto, epidemiological surveys of viral disease in Nigeria had been concentrated mostly on arboviral infections. This could be due to prevalence of the arthropod vectors responsible for the arboviral infections in this country. Recently, however, the Departments of Paediatrics and Ophthalmology of the University College Hospital, Ibadan, reported an alarming number of cases of congenital heart defects and cataracts in some infants in the wards. The clinical histories of these cases seemed to incriminate congenital rubella infection. A serological survey of females of child-bearing age was carried out the detection of antibodies to rubella virus using the haemagglutination-inhibition (HI) test. The results showed that over 70% of the sera tested were positive for rubella HI antibody.


[Biological properties of the mumps virus--behavior in the rct marker]. 12 different mumps virus strains or their variations were studied in the rct-marker in dog kidney cell cultures at 32 degree and 39 degree C. The results obtained were compared with those of the T50 marker ascertained earlier revealing considerably coincident data. Changes in culture conditions became clearly evident in both markers. Relations between their behaviour in vitro in vivo are discussed.


Evaluation of the indirect haemagglutination test in the diagnosis of amoebiasis. The IHA test was evaluated in the diagnosis of amoebiasis. Axenically-grown E. histolytica was used as an antigen. A total of 427 sera from symptomatic (intestinal and extra-intestinal) amoebiasis patients. asymptomatic carriers, patients with parasitic intestinal infections other than E. histolytica, and healthy controls were tested. From 288 symptomatic cases of amoebiasis, 232 (80.6 per cent) gave positive reactions. In 93 asymptomatic cases of amoebiasis, 55 (59.1 percent) were seropositive. In testing of sera from 16 subjects with parasitic intestinal infections other than E. histolytica, a low-level positive IHA titres occurred in 2 (12.5 per cent). The test was also positive with a low titre in 3 (10.0 per cent) of the 30 subjects of the healthy control group. The results indicate that the IHA test is of value in the confirmation of intestinal and extra-intestinal amoebic infections especially in cases where the parasite is difficult to demonstrate.


A new trend in non-infectious immunology-investigation of the biological role of natural anti-tissue antibodies in humans and animals. The author analysis a number of studies of Soviet and foreign investigators demonstrating the presence of natural anti-tissue antibodies in healthy human and animals. A large number of these antibodies appear during and they occur more frequently and in larger amounts in females than in males. The physiological function of these antibodies which influence the permeability of tissues, their metabolism and their role in the removal and neutralization of the products of cell disintegration and metabolism, are discussed. Emphasis is laid on the participation of normal autoantibodies in the resistance of the organism of tumours and to radiation, discovered in the last few years. The studies dealing with the detection of activators--inductors of normal autoantibodies and with the role of their effect in specific immune response are mentioned. Thus the review elucidates the theoretical and practical perspectives of exploring this new trend in immunology.


Intra-ovarian formation of steroid sulphates: measurement and influence of gonadotrophins. The steroid sulphokinase activity in 105 000 g supernatant fractions from rat and bovine ovarian tissue has been determined by measuring the radioactivity incorporated into conjugated steroids after incubation with 14C-labelled androgens and oestrogens. The enzyme from bovine ovaries was partially characterized, changes in its activity with pH were measured and Km values of 30, 10 and 4 mumol/1 were obtained for testosterone, oestradiol and oestrone respectively. The rate of formation of sulphates from oestrogens by preparations of bovine luteal tissue was 10--20 times higher than the rate of formation by follicular tissue (P less than 0.001), but both tissues exhibited similar rate of sulphate formation with testosterone. Sulphation of dehydroepiandrosterone by the ovaries of gonadotrophin-treated rats did not differ from that observed in the control group, whereas sulphation of oestrone was nearly three times greater in ovaries obtained from rats treated with gonadotrophins (P less than 0.005). Furthermore, a comparison of steriod sulphation in the ovaries of pseudopregnant and normal cyclic rats showed that the sulphation of oestrone was about six times greater during pseudopregnancy. These observations suggest that the formation of oestrogen, but not androgen, sulphates by ovarian aryl sulphokinase differs in follicular and luteal tissue and may be gonadotrophin dependent. The greater capacity of luteal, compared with follicular, tissue for the sulphation of oestrogens may be a control mechanism for steroidogenesis within the ovarian tissue.


Cytological effects of hormones and plasma on bovine mammary tissue in vitro. Mammary explants from two heifers pretreated with oestradiol and progesterone were cultured for 96 h with various combinations of hormones and calf plasma to identify the complement causing mammary tissue development in vitro in the cow. Initial tissue histology, determined by quantitative morphological analysis, was maintained by incubation with insulin, cortisol, oestrogen and progesterone; enlarged lumina were observed after treatment with insulin and cortisol. Lactogenesis was induced in vitro by insulin, cortisol and prolactin, enhanced by adding oestrogen and progesterone at the doses used here and further stimulated by the addition of plasma. The most highly developed mammary alveoli were characterized by an increased luminal area with lipid and stainable secretion, epithelia with large lipid droplets in the apical cytoplasm and a limited stromal area. In a second experiment, samples of plasma were collected from two cows, successfully induced to lactate, on days 6, 15, 17, 19 and 21 after treatment with oestradiol and progesterone. Mammary gland explants from five heifers pretreated with oestradiol and progesterone in vivo were cultured with insulin and cortisol plus these plasma samples (30%, v/v) to test for changes in lactogenic activity. All plasma samples were found equally beneficial in promoting tissue differentiation. These experiments show that low concentrations of ovarian steroids synergize with prolactin at the level of the mammary epitherlium and suggest that other plasma components aid the development of bovine mammary epithelium in vitro.


Fluctuations of adenylate cyclase activity during anterior regeneration in Owenia fusiformis (Polychaete Annelid). Biochemical assays of adenylate cyclase activity were performed during the early phases of regeneration in Owenia fusiformis (Polychaete Annelid). The results indicate the existence of a strong stimulation in an early phase following trauma. This stimulation is then followed by periodic fluctuations exhibiting a diurnal rhythm correlated with the cell cycle. Adenylate cyclase activity is also shown to be neurotransmitter-dependent. In this paper it is proposed that neurotransmitters might participate in the regulation of cyclic AMP formation, by means of adenylate cyclase acting on target blastema cells, undergoing the cell cycle.


Voltage-modulated membrane resistance in coupled leech neurons. 1. Resistive interactions have been studied between two pairs of large identifiable neurons in ganglion 6 of the leech CNS, called the lateral and rostral cells. Both are motor neurons causing penile eversion. 2. Lateral and rostral neurons have different membrane resistance properties. Input resistances of lateral neurons are virtually constant. By contrast, membrane resistances of rostral neurons are highly voltage dependent. When depolarized from resting potential to firing level, a rostral neuron's input resistance can increase 10-fold, from 30 to 300 Momega. 3. Voltage-dependent membrane characteristics of rostral neurons cause resistive interactions with lateral neurons to be nonlinear. DC potentials evoked in lateral cells are transmitted to rostral cells with an efficiency varying over a 10-fold range. Hyperpolarizing coupling is weak, with coupling factors of about 0.03. Depolarizing coupling factors increase progressively with increasing lateral neuron depolarization, reaching values of up to 0.3. 4. Membrane resistance changes in rostral neurons accompany lateral to rostral cell interactions. Input resistances increase during depolarizing and decrease during hyperpolarizing coupling potentials. The lateral to rostral cell junctional resistance is high and invariant, as evidenced by uniformly weak coupling in the reverse direction, from rostral to lateral neurons. 5. In conclusion, asymmetries in lateral to rostral cell interaction are based on postsynaptic rather than junctional resistance changes. The impact of the lateral onto the rostral cell's excitability contains a nonlinear component besides the usual linear additive one. As in conventional resistive coupling, depolarizing coupling potentials raise the rostral neuron closer to its voltage threshold. But more significantly, depolarizing coupling potentials lower the rostral neuron's current threshold because increases in resistance proportionately reduce the amount of excitatory current needed to reach firing level. Thus, the resistance change acts to amplify the input signal efficiency. In addition to the static changes in current threshold, the reostral neuron also changes dynamically. Membrane resistance increases lead to increases in space constant shrinking the neuron's electrical lenght. 6. Other properties of the network have been analyzed. The pair of lateral neurons is strongly coupled, whereas the pair of rostral neurons is weakly coupled, the coupling factors are 0.3 and 0.05, respectively. Hyperpolarizing membrane time constants for the lateral and rostral neurons are estimated to be between 100 and 200 ms. Time constants of depolarized rostral neurons are significantly larger.


[Evolution of plasma corticosterone concentration in basal conditions or after psychic aggression during growth in the Rat. Influence of neonatal gonadectomy (author's transl)]. Evolution, during growth, of basal plasma concentration of corticosterone and the adrenocortical response to psychic aggression was studied in animals of both sexes, normal or gonadectomized on the day of birth. 1. In the control animals : (a) The fluctuations of the basal plasma concentration of corticosterone took a similar course in the male and female; no significant difference was observed between males and females except on the 55th day. (b) The intensity of the response to aggression took the same course in all the test animals between the 15th and 60th day with an increase between the 15th and 45th day and a decrease between the 45th and 60th day. 2. In the animals whose gonads were removed at birth, the basal plasma concentration of corticosterone and the response to psychic aggression developed in a similar manner in the two sexes, during the period studied. 3. These results suggest the existence of an autonomous maturation of the adrenocortical function which is independent of genetic sex and gonadal secretions. These latter, however, play a determinant role in the amplitude of the response which is increased by estrogens and decreased by androgens. The existence of a mechanism whose maturation is accomplished, in part, independently of the gonadal secretions and is responsible for the response to aggression is discussed.


Periovulatory gonadotrophin and ovarian steroid patterns in sheep of breeds with differing fecundity. Plasma hormone concentrations before and during luteolysis (induced by injection of a prostaglandin analogue on Day 10 or 11 of the cycle), during the period of preovulatory follicle growth and ovulation were examined in sheep with known differences in ovulation rate (Romanov, Préalpes, Romanov x Préalpes cross, Ile de France). The number of CL at the time of treatment and the ovulation rate in the ensuing cycle were established by endoscopy. Plasma concentrations of FSH, LH, progesterone and total oestrogen were measured by radioimmunoassays in the 3 days before PG injection, then hourly for the 24 h after PG injection and 2-hourly for a further period up to about 100 h after PG injection. The onset and duration of oestrus were also recorded. Although breed differences were observed for many of the features studied, only the intervals between oestrus and the LH peak and between PG injection and the LH peak were significantly correlated with ovulation rate.


Luteolytic effect of oestrone sulphate on cyclic beef heifers. The action of oestrone sulphate on luteal function was tested in cyclic beef heifers. Once daily injection of 28 or 56 mg oestrone sulphate in corn oil beginning on Day 10 of the cycle had a significant luteolytic effect as compared to corn oil-treated controls.


Plasma progesterone levels throughout the oestrous cycle and release of LH at oestrus in sheep with different ovulation rates. The concentrations of progesterone in the peripheral plasma throughout the oestrous cycle and the preovulatory LH discharge were examined in Finnish Landrace, Galway and Fingalway (Finnish Landrace X Galway) ewes. Progesterone levels were significantly higher in Finnish Landrace ewes during the luteal phase of the cycle (Days 10--13) than in Galways of Fingalways in which the concentrations were similar. Luteal-phase progesterone levels were almost 50% higher during December than during October in all three breeds. The relationship between the number of CL and plasma progesterone was not a simple linear function. All aspects of the preovulatory LH discharge were similar in the three breeds with the exception of the timing of the LH release in relation to the onset of oestrus. This occurred earliest in the Galway and latest in the Finnish Landrace while the Fingalway was intermediate.


Multiple marking of cell surface receptors by gold granules: simultaneous localization of three lectin receptors on human erythrocytes. A method is described for transmission electron microscopy which allows high resolution mapping of three lectin receptors on the same cell. As a model, receptors for Concanavalin A, soya bean and wheat germ agglutinins have been simultaneously localized on human erythrocytes using lectin-labelled gold markers of different sizes (5, 17 and 26 nm, respectively). Quantitative binding data and examination of stereoscopic micrographs of thin sections of marked erythrocytes indicated that the greatest part of these lectin markers was bound by receptors spatially separated. As gold granules are electron dense and uniform in size, they are well suited for multiple marking of cell surface components. The method is simple and leads to a better understanding of the topography of cell membranes.


Prenatal diagnosis of a de novo Y/22 translocation. Prenatal chromosomal analysis was performed at 17 weeks' gestation because of the previous birth of a girl with trisomy 13. A seemingly balanced de novo Y/22 translocation was diagnosed. Translocations involving the Y chromosome are rare and no similar translocation, detected pre- or postnatally, could be found in published reports. The counselling problems are discussed. The pregnancy ended at term with the birth of a phenotypically normal boy. After birth, the prenatal diagnosis was confirmed and the H-Y antigen expression was determined.


A new method for electromyography of the female urethra. A newly developed catheter enables the introduction of fine wire electrodes into the urethral striated sphincter muscle at predetermined locations and depths. Because of FET-probes electrode wires can be short, thus the signals show minimal artifacts owing to cable movement. The technique 1) facilitates registration of signals during coughing, walking, micturition and other activities, 2) is simple to perform and painless to the patient, 3) can be done by inexperienced personnel and 4) provides assurance that the electrodes are in the urethral sphincter muscle.


[Congenital valves and diaphragms of the urethra in adult men. A series of 16 observations (author's transl)]. The authors studied 16 adult men with congenital valves and diaphragms in the urethra, and stress that: --their frequency is greater than is commonly stated; --they have serious effects on the upper urinary tract; --they are often difficult to diagnose radiologically; --they are responsible for some cases of difficulty in ejaculation which are wrongly considered to be cases of lack of ejaculation;  --endoscopy play a fundamental role in their diagnosis and treatment, --excellent results are obtained with endoscopic treatment.


Radiation therapy of the nasopharynx: a 30 year view. A 15 to 30 year follow-up study has been made of radium therapy to the nasopharynx for Eustachian tube obstruction and serous otitis, with a review of the relevant literature. No malignancies or other complications have been seen or recorded. Objective evaluation leads to the conclusion that this is a safe, effective treatment modality. In spite of this it has been discontinued because of public fear and pressure. A judgement reached for this reason, ignoring scientific medical facts, contains the seeds of decline of quality and effectiveness of medical care.


[Genetic means for control of insect vectors of human diseases (author's transl)]. We divide genetical control methods in two major groups:--mechanisms operating between different species and an example is the attempt of control of A. gambiae in West Africa,--mechanisms operating in a single species with: gamma rays and chemical treatment for sterilisation, cytoplasmic incompatibility (ex.: C. pipiens). Genetical control also suppose the knowledge of biology and ecology of the target insect. This paper does not want to be an exhaustive review of this problem. Its only ambition is to try and expose the possible applications of genetics in the control of vectors.


Chemoimmunotherapy of sarcomatoid renal cell carcinoma. Sarcomatoid renal adenocarcinomas are rare, invariably fatal tumors. There is only one report of treatment of this tumor with chemotherapy. We report a case of an advanced sarcomatoid renal adenocarcinoma treated with chemoimmunotherapy consisting of cyclophosphamide, vincristine, Adriamycin (doxorubicin), DTIC, BCG, and sarcoma viral oncolysate. The patient had an objective response with a marked reduction in the size of the tumor mass. The residual tumor was removed surgically, and the patient remains in complete remission two years after the diagnosis was made.


Loss of rRNA genes during a phenotypic, masculinizing mutation in Allomyces arbuscla. Saturation hybridization of 3H rRNA from Allomyces arbuscula Bali wild-type to homologous DNA and to DNA preparations from Allomyces arbuscula Bali X-ray induced male mutant and an interspecific male hybrid (Allomyces arbuscula X Allomyces macrogynus Emerson and Wilson) has shown approximately 50--60% reduction in the cistrons coding for rRNA in the masculinized strains.


[Intestinal schistosomiasis in People's Republic of Congo. Epidemiological features derived from statistics (author's transl)]. From 1952 to 1976, 910 cases of intestinal schistosomiasis have been registered in People's Republic of Congo. The distribution is not homogeneous. The higher rate has been registered in Brazzaville. The country annual rate is increasing and this constitutes a potential danger.


[Formation and degradation of peroxisomes in yeasts]. The formation, development and degradation of peroxisomes were studied directly in growing yeast-methylotrophs under the microscope using anoptral and phase contrast. The degradation of peroxisomes was caused by their degeneration and dislocation to the central vacuole of the yeast cell. A fluorescent-microscopic technique was elaborated for detecting selectively the crystals of catalase in the cells. As was shown by intravitam studies, electron microscopy and cytochemistry, peroxisomes are directly connected with the central vacuole of the cell, enzymes being transferred from the former into the latter. Experiments conducted with different cultures have demonstrated that the high activity of exocatalase is typical of methylotrophic yeast organisms. The highest activity that was exhibited for a long period of time was found in Torulopsis molischiana.


Chromosome breakage and neoplastic transformation of Syrian golden hamster embryonic cells in tissue culture by transplacental application of 2-(2-furyl)-3-(5-nitro-2-furyl)acrylamide (AF-2). Hamster embryos were treated with 2-(2-furyl)-3-(5-nitro-2-furyl)acrylamide (AF-2) in vivo (in the mother) by transplacental application. The fetuses were isolated 24 h after administration of the AF-2 and cultured. Within the first 24h of primary culture, some parts of the cells were treated with colcemide for 3 h so that mitotic cells could be observed in the first cell cycle in vitro. Cultured embryonic fibroblasts in metaphase plates showed a marked dose-dependence in chromosomal aberrations. Transplacental application of AF-2 also caused slightly dose-dependent morphological transformation. When some transformed colonies were cloned and transferred to the hamster cheek pouch, these cells produced tumors in the host animals. This new in vivo--in vitro combination assay system is considered  to be useful for detection of environmental potential carcinogens.


H-Y antigen mosaicism in the gonad of a 46,XX true hermaphrodite. To clarify the mechanism for the coexistence of ovarian and testicular tissue in the 46,XX true hermaphrodite, we studied a 20-year-old phenotypic male with gynecomastia and elevated serum concentrations of estradiol in whom an ovotestis was discovered upon scrotal exploration. Y chromosomal material could not be detected by fluorescent Y-body analysis or Giemsa-banding technics in cells cultured from peripheral blood, breast or forearm skin or the ovarian or testicular portions of the ovotestis. However, serologic testing, using the sperm cytotoxicity assay, revealed that cells cultured from the testicular portion of the ovotestis were H-Y antigen positive whereas cells cultured from the ovarian portion were H-Y antigen negative. These observations indicate that the ovotestis arises from an H-Y+/H-Y- mosaic primordium.


[The action of products of the formaldehyde reaction with different amines on nucleic acids and their components]. The kinetics and equilibrium of the reaction between nucleic acids components and the products of formaldehyde interaction with ethanolamine and different amino acids has been studied. These parameters were found to be similar for all the products used. The destabilization of the N-glycosidic bond in deoxyadenosine caused by formaldehyde derivatives of different amines was studied. The rate of the cleavage of the N-glycosidic bond under the action of formaldehyde derivatives of glycine and ethanolamine was found to be 10 times greater than that under the action of formaldehyde derivatives of other amines. It is shown that DNA preparations with different content of adenine can be obtained by adding the product of formaldehyde reaction with glycine to DNA.


Taxonomy of Exophiala jeanselmei (Langeron) McGinnis and Padhye. The black yeast-like fungus Exophiala jeanselmei (Langeron) McGinnis et Padhye was originally described as Torula jeanselmei by Langeron. Since its original description in 1928, this dematiaceous hyphomycete has been placed in the genera Phialophora, Pullularia and Rhinocladiella by various authors. Study of the type culture of E. jeanselmei has confirmed that the principle conidiogenous cells of this fungus are annellides, thus supporting its current generic disposition. After reviewing the neotype culture of Phialophora gougerotii (Matruchot) Borelli sensu Borelli, the type culture of Torula bergeri Langeron, authentic cultures of Margarinomyces heteromorpha (Nannfeldt) Mangenot sensu Mangenot, the type culture of Trichosporium heteromorphum Nannfeldt and the neotype culture of Exophiala mansonii (Castellani) de Hoog sensu de Hoog, as well as additional cultures, it was concluded that P. gougerotti sensu Borelli, T. bergeri and M. heteromorphis sensu Mangenot pro parte are conspecific with E. jeanselmei. Trichosporium heteromorphum and E. jeanselmei are not conspecific as suggested by some workers. Tr. heteromorphum is a distinct species and should be referred to as Phialophora heteromorpha (Nannfeldt) Wang. Sporotrichum gougerotti Matruchot is considered to be a later synonym of Sporothrix schenckii Hektoen et Perkins and E. mansonii sensu de Hoog as a later synonym of Microsporum mansonii Castellani. M. mansonii is held to be a later synonym of Malassezia furfur (Robin) Baillon. The neotype culture of E. mansonii produces phialides without collarettes.


Lactate dehydrogenase isoenzymes of the hypothalamus, limbic structures, and the anterior pituitary during the estrous cycle. Lactate dehydrogenase (LDH) and its isoenzyme (ISO) pattern were measured in the hypothalamus (HYP), amygdala (AMYG), hippocampus (HIP), cerebral cortex and anterior pituitary (PIT) of adult female rats sacrificed at different estrous cycle phases. The HYP, the AMYG and the PIT showed their maximal LDH values at proestrus and the lowest at diestrus. Those of the HIP showed the opposite pattern. The study of the ISO distribution pattern indicated that the cyclic variations of pituitary LDH activity were mainly due to changes of the ISO rich in A subunits, while in the B type they remained constant. By contrast, the cyclic changes of total LDH activity of all the brain structures studied were due to well balanced variations of both A and B subunits.


Contribution to the study of the arterial nutrition of the cervical spinal cord. The feeding of the anterior spinal artery of the cervical cord is very poor. Angiographic studies have shown that only two to three radiculomedullar arteries assure the feeding of this arterial axis. Since it is possible that smaller feeding arteries exist, which are not visible on a conventional X-ray study, we have reviewed cases with arteriovenous aneurysms or vascularized tumors in the cervical region, and obstructions of the vertebral arteries. In these cases, the feeding arteries may be hypertrophic. In spite of being hypertrophic, their number is not increased, and the statistical proportion is the same as in the studies carried out in normal cases.


The borderline pituitary fossa in patients with amenorrhoea and/or galactorrhoea. A retrospective clinicoradiological study of 80 patients with amenorrhoea and/or galactorrhoea showed: 1. Of 60 patients, in whom prolactin levels were estimated, 28 (47%) had hyperprolactinaemia (serum prolactin levels greater than 20 ng/ml). 2. Hyperprolactinaemia was present in 85% of patients with amenorrhoea and galactorrhoea, 35% of those with galactorrhoea only, and 12.5% of those with only amenorrhoea. 3. Pituitary adenomas were surgically removed from six patients; all but one had prolactin levels over 100 ng/ml. The level was 53 ng/ml in the sixth patient. 4. There is a considerable degree of observer variation in the interpretation of borderline sellar changes. 5. Minor abnormalities of the pituitary fossa were noted in 64% of patients with hyperprolactinaemia and 36% of those with normal prolactin levels. 6. The highest incidence of perfectly normal sellae was among patients with either amenorrhoea or galactorrhoea and normal serum prolactin.


Clinical and extraneural histologic diagnosis of neuronal ceroidlipofuscinosis. Neuronal ceroid-lipofuscinosis is manifested by visual and intellectual deterioration and seizures. Autofluorescent lipopigments are found in neural and many nonneural tissues, with characteristic staining and ultrastructural properties. Presumptive diagnosis can usually be made on the basis of history, physical examination, and electrodiagnostic tests, but in the absence of a specific biochemical defect, histologic confirmation is essential. A 6-year-old boy with the clinical appearance of the juvenile form of the disease had sea-blue histiocytes in the bone marrow, and curvilinear profiles in ultrastructural inclusions in skin biopsy tissue, cultured skin fibroblasts, and bone marrow cells.


Congenital central hypoventilation syndrome: a pathologic study of the neuromuscular system. An infant with congenital central hypoventilation was managed by bilateral phrenic nerve pacing for 3 months. He died at 8 months of age, following 19 days of continuous bilateral pacing necessitated by the eventual loss of voluntary as well as autonomic ventilatory control. The phrenic nerves showed axonal dystrophy at the site of electrode implantation and more severe distal degeneration. Focal neurogenic atrophy was seen in the diaphragmatic muscle. These changes were attributed to electrical injury resulting from the period of continuous pacing. The most significant neuropathologic finding was a mild generalized decrease in the density of neurons and myelinated nerve fibers in the respiratory centers of the medulla. These morphologic abnormalities were attributed to a sublethal intrauterine lesion that would be the first example of a morphologic correlation with the functional abnormality in congenital central hypoventilation.


Movement-activated central fast rhythms: an EEG finding in action myoclonus. Five patients with relatively mild but disabling action myoclonus displayed a subtle and heretofore unemphasized electroencephalographic manifestation of action myoclonus consisting of low-voltage, central fast activity somatotopically related to the extremity being used. The importance of recognizing this rhythm lies in its association with milder forms of action myoclonus which resemble other types of movement disorders, the difficulty in recognizing this rhythm unless special tests are carried out, and the beneficial response of anticonvulsant therapy if the nature of the movement is realized.


Methylphenidate-induced chorea: case report and pharmacologic implications. In a child with minimal brain dysfunction, we found that chorea was related to the major central effect of methylphenidate and probably to the effect of the drug on central catecholaminergic systems. Also, after 3 weeks of treatment with methylphenidate, guinea pigs showed a hypersensitive response to apomorphine, suggesting that chronic administration of methylphenidate leads to hypersensitivity of receptor sites. Chorea beginning shortly after initiation of methylphenidate therapy probably is related to the central dopaminergic effect of the drug; when choreic movements appear after chronic methylphenidate administration, altered responsiveness of striatal dopamine receptor sites may be responsible.


Reproduction in Duchenne dystrophy.

Reproduction in Duchenne dystrophy. A man with Duchenne muscular dystrophy fathered two living children. He was 1 of 10 affected males in 5 generations. Clinical and genetic patterns, muscle biopsies, autopsy results, and serum enzymes were all compatible with the diagnosis of Duchenne muscular dystrophy. History, blood typing, and karyotypes indicated that he was the biologic father. This report gives confirmatory evidence that Duchenne dystrophy is transmitted as an X-linked defect.


Serum creatine phosphokinase and pyruvate kinase in neuromuscular disorders and Duchenne dystrophy carriers. Serum levels of creatine phosphokinase (CPK) and pyruvic kinase (PK) were determined in 42 controls, 57 patients with various neuromuscular disorders, and 23 female relatives of Duchenne dystrophy patients. CPK and PK enzyme activities were increased in comparable numbers of muscle disease patients and female carriers; there was no advantage in the combined use of the two tests. We did not confirm earlier reports suggesting that determination of PK is more valuable than CPK in carrier detection.


Morphometric study of motoneurons in congenital nemaline myopathy and Werdnig-Hoffmann disease. To test whether congenital nemaline myopathy (NM) might have a neurogenic basis, we evaluated the number and frequency distribution of L5 motoneuron cell bodies and their myelinated ventral root (VSR) axons in a typical case. Results were compared to those from three age-matched controls and those from a child with Werdnig-Hoffmann disease (WHD). Diameter histograms of cell bodies of L5 motoneurons from controls contained three peaks which were identified as large, intermediate, and small cytons (LC, IC, and SC). In previous work from our laboratory, the numbers of LC and IC of the L5 segment was found to correspond closely enough to the numbers of LA and IA (large and intermediate diameter myelinated axons) of L5 ventral spinal root to indicate that the majority of LC are alpha and the majority of IC are gamma motoneurons. The number of LC of L5 reference cords varied from 3508 to 4916, and of IC from 967 to 2204. The diameter histogram of cytons from the NM case differed from controls; the LC and IC peaks were displaced to smaller diameter categories, but their number was normal (4520 and 2023, respectively). In WHD, the numbers of LC and IC were 211 and 946, respectively. Axons were similarly affected. The severe decrease from normal in the number of large motoneurons in WHD, and the reduction in size without loss of motoneurons in NM, indicates a different morphologic basis for NM and WHD. In NM the reduction in size without decrease in number of motoneurons is probably secondary to congenital myopathy and does not provide evidence for a neurogenic etiology.


Total blindness after trivial frontal head trauma: bilateral indirect optic nerve injury. A 10-year-old girl developed bilateral blindness and partial third nerve paresis immediately following a closed head injury. Bilateral optic atrophy developed subsequently. This is the first report of an association between second and third nerve injuries after minor head trauma in the absence of a preexisting lesion. The pathophysiology of indirect injury to the optic nerve under these circumstances is uncertain, but the lesions in this patient seemed to be due to ischemia.


Increased CSF IgM in multiple sclerosis. CSF IgM levels have been measured by radioimmunoassay in 56 patients with MS, 62 patients with other neurologic diseases, and 31 normal controls. Forty-eight percent of the patients with MS had a raised CSF IgM level compared with 5 percent of the patients with other diseases. The IgM level did not correlate with the IgG level. Forty percent of the MS patients with normal IgG levels had high IgM levels. No relationship was found between the CSF IgM level and length or severity of the MS, relapses, or steroid therapy. Attempts to identify the IgM as being anti-measles were unsuccessful.


Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: the Framingham study. Chronic atrial fibrillation (AF) as a precursor of stroke was assessed over 24 years of follow-up of the general population sample at Framingham, Massachusetts. Persons with chronic established AF, with or without rheumatic heart disease (RHD), are at greatly increased risk of stroke, and the stroke is probably due to embolism. Chronic AF in the absence of RHD is associated with more than a fivefold increase in stroke indicence, while AF with RHD has a 17-fold increase. Stroke occurrence increased as duration of AF increased, with no evidence of a particularly vulnerable period. Chronic idiopathic AF is an important precursor of cerebral embolism. Controlled trials of anticoagulants or antiarrhythmic agents in persons with chronic AF may demonstrate if strokes can be prevented in this highly susceptible group.


Twin study of multiple sclerosis: an epidemiologic inquiry. The National Research Council Twin Registry comprises 16,000 pairs of white male twins, both members of which had been in military service, mainly in World War II. All their available military and Veterans Administration records and their responses to a 1965 to 1970 NRC questionnaire have been coded as to disease. Upon review we found 16 cases of multiple sclerosis (MS) among 15 pairs of twins, for an age-specific prevalence rate of 51 per 100,000 veterans aged 43 to 53--about half the expected frequency. Of the 15 sets, three sets refused cooperation and three were unavailable for study. Nine sets were examined and interviewed together with the mother. One of five monozygotic twin pairs was concordant for MS and in another the co-twin of an MS case had had a solitary episode of retrobulbar neuritis; all others were discordant. There were more definable environmental events (as noted below) among the affected twins than among the unaffected co-twins. The greatest excess was within the 20 years before onset. Summing events across the four 5-year periods before onset, among the 10 MS versus the eight not-MS individuals, there were 5:1 instances of trauma, 8:2 or operation, 7:1 of ether anesthesia, 7:1 of allergy, 10:5 of infection, and 9:0 of animal exposure. Summing these same events within each 5-year period, the MS:control ratios were 9:1, 10:2, 12:3, and 15:4, respectively, for 0 to 4, 5 to 9, 10 to 14, and 15 to 19 years before onset.


Cerebrospinal fluid IgG, IgA, IgM, IgD, and IgE levels in central nervous system disorders. Using a radioimmunoassay, we evaluated the cerebrospinal fluid content of IgG, IgA, IgM, IgD, and IgE in multiple sclerosis, viral meningitis, and tumors. Abnormal immunoglobulin levels occurred in all conditions, reaching 13 times the norm for IgM in multiple sclerosis and 5 times the norm in aseptic meningitis. Striking increases also occurred with IgA, IgM, and IgE in benign and malignant (both primary and metastatic) tumors of the CNS. Furthermore, the immunoglobulin-protein ratio was calculated. In aseptic meningitis and multiple sclerosis, the ratio was significant as compared to the norms.


Binocular fundus reflectometry and ophthalmodynamometry in carotid occlusion. Continuous bilateral simultaneous measurement of the circulation time between arm and ocular fundus and arm and earlobe was performed by fundus reflectometry (FRM). Differences in dye appearance time between the two ocular fundi were larger in cases of angiographically proved stenosis or occlusion of the common or the internal carotid artery. Prolonged dye appearance times in the earlobe were observed in occlusive disease of the common or external carotid artery. The harmless method of FRM seems to be useful in the detection of carotid occlusive disease and helpful in deciding whether carotid angiography should be performed.


Spontaneous spinal epidural hematoma in the young. There have been few descriptions of spontaneous epidural hematoma of the spinal cord in children. Duration of symptoms in previous cases has varied from hours to days. We recently evaluated a 6-year-old girl with cord compression from an extradural clot, who complained of thoracic back pain for 3 months before becoming paraplegic. Our experience suggests that spontaneous epidural bleeding may be responsible for episodic back pain and cord compression in children.


Myosin light chains in Duchenne dystrophy and paraplegic muscle. Myosin light chains were isolated from cat gastrocnemius and soleus muscles rendered paraplegic for 1 year and from the vastus lateralis of six patients with Duchenne muscular dystrophy. Despite the altered pattern of function of these muscles, no alterations were noted in the type or relative proportion of these myosin light chains when compared to control muscles.


Regional cerebral blood flow comparison of right and left hand movement. Regional cerebral blood flow measurements were made in normal right-handed subjects by the 133 xenon inhalation method at rest and during movement of either hand. Left hand movement evoked a prominent focal flow increase in the right hemisphere in the Rolandic region. During right hand movement, there was a smaller and not statistically significant increase in left hemisphere Rolandic region. This suggests that more effort is required of right-handed subjects to move the left hand than the right, or that motor organization differs for left and right hand movements. Of several flow indices tested, there was little difference among gray matter flow rate, the product of gray matter flow and relative weight, the mean regional flow, and the initial slope index, all reflecting the flow changes with nearly equal sensitivity. The gray matter weight and fractional flow did not change consistently during hand movement.


Eye movement fatigue in myasthenia gravis. An 18-year-old woman presented with dissociated nystagmus that was first attributed to multiple sclerosis. When she attempted to maintain 30-degree horizontal gaze deviation in either direction, there was progressive weakness of the adducting eye and increasing amplitude of nystagmus in the abducting eye. The amplitude and maximum velocity of repetitive one-per-second 30-degree saccades progressively decreased over a 3-minute period. Intravenous edrophonium completely abolished the dissociated nystagmus and adducting muscle weakness, and returned the saccade maximum velocity to normal. Her subsequent response to pyridostigmine and thymectomy confirmed the diagnosis of myasthenia gravis.


Supraorbital Doppler studies, carotid bruits, and arteriography in unilateral ocular or cerebral ischemic disorders. In 122 patients with unilateral brain or ocular ischemia, supraorbital Doppler studies revealed evidence of obstruction in 44 of 51 common or internal carotid arteries having greater than 70 percent stenosis, and in only 4 of 23 arteries with 50 to 70 percent stenosis. Ipsilateral bruits were present in 52 of 74 carotid arteries with greater than 50 percent stenosis, and in 19 of 37 arteries with less than 50 percent stenosis. Only one false-positive Doppler result occurred, and only 15 false-positive midcervical bruits were present in 129 normal carotid arteries. Unfortunately, these studies do not decrease the need for radiopaque arteriography, since in 11 of 53 patients, a potentially operable, symptomatic, nonobstructive common or internal carotid artery lesion would not have been suspected by supraorbital Doppler testing and auscultation alone.


Age-related changes in peripheral and central nerve conduction in man. Somatosensory evoked potential (SEP) latencies, motor and sensory nerve conduction velocities (CVs), and F-wave latenies were measured in 15 elderly normal subjects (mean age 74.1 years), and the results were used to derive indirect estimates of spinal cord CVs. These measurements were compared to those from 15 younger normal adults (mean age 31.6 years), and the nerve conduction characteristics of all 30 subjects were analyzed with respect to age. Peripheral motor and sensory CVs slowed progressively, and the onset latencies of F-waves and SEPs increased gradually with advancing age. Spinal cord CVs showed little change until approximately age 60, and declined sharply thereafter. In addition, the latencies of F-waves and SEPs were positively associated with height. Human clinical and experimental studies utilizing SEP and F-wave measurements must allow for morphologic differences between individuals, and for the systematic changes which accompany normal aging.


Cerebral complications of angiography for transient ischemia and stroke: prediction of risk. We examined the records of 147  consecutive patients studied by femoral catheterization to identify factors contributing to angiographic risk in cerebrovascular disease. Cerebral complications occurred in 12.2 percent and were permanent in 5.2 percent. Computer-assisted multivariate analysis of 21 possible risk factors was done. Two of these risk factors correlated strongly with increased risk: number of previous transient ischemic attacks (TIAs) (p less than 0.001), and the presence of arterial stenosis of greater than 90 percent (p less than 0.03). Risk factors of marginal significance were: diabetes, female sex, and number of selective injections. A discriminant function for estimation of risk was derived: D = [8 X number of TIAs] + [6 x number of arteries catheterized] + [14 if diabetic, 0 if not] + [11 if female, 0 if male]. When D was greater than 55, 77 percent of patients had a complication. When D was less than 55, 98 percent of patients had no complication. Unfortunately, patients in whom the study is most indicated tend to be those at greatest risk.


Assessing segmental excitability after acute rostral lesions: II. The blink reflex. Blink reflexes were obtained in a total of 34 different patients with cerebrovascular lesions; 28 were studied within 1 week of the ictus and 11 were eventually restudied. In 13, the latency of the first component of the reflex on the clinically involved side was significantly delayed (greater than 1.5 msec). This was an acute phenomenon that usually resolved within the first week after the ictus, correlated clinically with the severity of the hemiparesis and decrease in tone, and may be seen with lesions restricted to the pyramidal tract. The second component was absent in 17 of 34 patients during the early phase after stroke, and was associated with a decreased corneal response. These changes, which reflect decreased excitability of certain brainstem structures (rather than a lesion within those structures), are therefore potentially important for documenting CNS pathophysiology.


Differential aphasia in tow bilingual individuals. Moderate nonfluent aphasia following a left parietotemporal lesion was found in the native language of one bilingual patient, in contrast to less severe, fluent aphasia in the patient's secondary language. Conversely, mild anomia was found in the native language of a second patient, while global aphasia was found in the secondary language. His lesion was located in the left posterior frontal area. These examples of differential aphasia were assessed by standard aphasia tests and by language inventory translated into the appropriate languages. We propose that differential aphasia resulting from a single hemispheric lesion is related to the disruption of different basic cognitive functions, which participate to varying degrees in the performance of the languages affected. In terms of neurolinguistic theory, the findings in these patients support the observation that most frequently used language is the first to recover. They refute the notion that the native language recovers first.


Quality of survival after out-of-hospital cardiac arrest: predictive value of early neurologic evaluation. One hundred and seventeen patients were admitted following out-of-hospital cardiac arrest. After initial neurologic evaluation, they were followed prospectively until discharge or death. Seventeen patients were alert when admitted. Of these, four died and 10 of 13 survivors were neurologically normal. One hundred of the patients were unresponsive; of these, 60 died. Of 40 survivors, 15 were neurologically normal, at discharge; 15 could perform some self-care but were confused, and 10 required total care. Absence of pupillary light reaction, oculocephalic reflexes, purposeful response to pain, and spontaneous respirations were associated with high mortality and more severe neurologic deficits. However, some patients with usually unfavorable signs recovered good neurologic function.


Functional paralysis of horizontal gaze. A 52-year-old steelworker displayed a consistent defect in leftward voluntary gaze across the midline. Both fast (saccadic) and slow (pursuit) eye movements were affected. Neuro-ophthalmologic evaluation revealed no additional neurologic or ophthalmologic deficit. Pupilary miosis occurred during leftward gaze attempt, indicating that the gaze palsy was due to spasm of the near reflex. Special maneuvers during clinical eye movement testing disclosed full ability to make normal horizontal fast and slow eye movements despite the apparent defect in "voluntary" leftward gaze.


Pyramidal infarction in the medulla: a cause of pure motor hemiplegia sparing the face. We present a case with an infarct limited to the right pyramidal tract in the medulla. The lesion lay approximately 1 cm below the pontomedullary junction. On the basis of this case and three previously reported cases of medullary pyramidal infarction, there is defined a syndrome of severe hemiplegia with relative sparing of the face, tongue and articulation, minimal sensory loss, and good recovery. The hemiplegia is initially flaccid and later spastic. Transient symptoms, referable to the tegmentum of the medulla, occur at the onset, and reflect ischemia in the deeper territory of a paramedian penetrating vessel.


Effect of animal proteins on the absorption of food iron in man. The way in which meat and fish act to promote the absorption of nonheme iron in food is not known. The present paper is a report of the results of a series of studies aimed at obtaining some insight into the mechanism of action of meat and other animal proteins on the absorption of food iron. Beef, fish, chicken and calf thymus all increased the iron absorption to about the same extent. Neither egg albumin, cysteine or a water extract of beef did, however, affect the absorption of food iron. Beef increased the absorption of a solution of inorganic iron given without food only when the iron salt was trivalent or when sodium phytate was added to the solution. It was concluded that meat acts by counteracting luminal factors that inhibit iron absorption. The most probable mechanism for this action is formation of a luminal carrier which transports the iron to the mucosal cell membrane.


The Sertoli cell in mixed gonadal dysgenesis. Since 1937, over 100 cases of mixed gonadal dysgenesis have been described. Thus far, no correlation has been made between the light and electron microscopic morphology of the gonad and the appearance of the ipsilateral internal genitalia. In the case presented in this paper the presence or absence of the Sertoli cell in the ipsilateral gonad correlates with the morphology of the internal genitalia on that side.


Extramembranous pregnancy in twin gestation. An ususual case of extramembranous development of 1 infant in a twin pregnancy is described. The pregnancy was associated with the intermittent loss of liquor and a bloody discharge starting at the 26th week of gestation. Spontaneous delivery occurred at the 32nd week of gestation; the first infant was delivered by vertex and the second by breech presentation. The first infant was normal, but the second infant, who died shortly after delivery, had most of the external features of dysplasia renofacialis. (Potter facies). The gestation was diamniotic, dichorionic, and with a single placenta, but the side of the affected twin was markedly circumvallate, with short, thick membranes that covered no more than 10% of the infant.


Pregnancy in a true hermaphrodite.

Pregnancy in a true hermaphrodite. True hermaphroditism is a rare form of intersexuality, and fertility in such an anomaly has been reported only once before in literature. A 19-year-old true hermaphrodite reared as a female with normal secondary sex characteristics and a karyotype of 46,XX was treated by removal of the left ovotestis. The right ovary and other pelvic organs were of a normal female. Ten months after the treatment she became pregnant. The pregnancy was complicated by a premature delivery of a 1500-g male infant that showed no congenital anomalies. Histologic findings of the ovotestis and clinical findings of a true hermaphrodite with pregnancy are presented.


The ultrastructure of the round window membrane of the cat. The ultrastructure of the round window membrane of the cat was investigated. Three distinct layers were recognised and described. It was established that the outer epithelial layer is non-ciliated, but often contains microvilli. The middle layer, under the basement membrane, contains a large amount of collagen and elastic fibres in addition to fibrocytes. The inner layer is a continuation of the epithelial layer of the perilymphatic space. The thickness of the membrane has been measured as being 15--20 micrometer. The latest human audiological and clinical observations concerning the function and rupture of the round window membrane emhasise the importance of the electron microscopic study of this membrane.


Bilateral synchronous trabecular adenocarcinoma of the parotid gland. This report deals with a rare case of bilateral cancer of the parotid gland, with lymph node metastases. Histologically, the tumor was a trabecular adenocarcinoma. The first neoplasm was located in the right parotid gland and developed into a pleomorphic adenoma. Both cancers were treated with parotidectomy and bilateral neck dissection. From a comprehensive review of the literature, it appears that the present case is the sixth on record of bilateral parotid tumors. Pathogenetically, it is suggested that a common carcinogenic factor might have acted simultaneously and bilaterally on the parotid gland.


Cochlear blood circulation studied with microspheres. The cochlear blood flow was studied with the microsphere method in guinea pigs, rats and cats. Results from experiments using different sizes of microspheres were compared and the effect of middle ear infection or perforation of the otic capsule on the cochlear microcirculation was investigated. Neither the opening of the cochlear bony wall nor the middle ear infection influenced the blood flow in the cochlea. 9- and 15-micrometer spheres were given simultaneously and the results were equivalent, indicating no more shunting of the smaller ones than of the bigger ones. Thus, the smaller spheres are to be preferred, since the smaller ones can be used in a larger number without negative effects on the general circulation. In cats, the cochlear blood circulation was determined before and during cervical sympathetic stimulation. Sympathetic stimulation caused a reduction of 25% of the cochlear blood flow.


Tympanometry in 2-year-old children.

Tympanometry in 2-year-old children. Screening tympanometry was performed in 278 healthy 2-year-old children (556 ears) born the first 10 days of every month in 1976 in two municipalities from Copenhagen County. A middle ear pressure between 0 and -99 mm H2O was found in 49.6%, between -100 and -199 in 19.4%, between -200 and -300 in 20.1%, and flat curves in 10.8%. The latter group also otoscopically gave evidence of middle ear effusion. The results reveal the highest incidence of tubal dysfunction and middle ear effusion for this age group in contrast to any other age group. However, a large spontaneous recovery from secretory otitis was also noted. No differences were found between sexes, right ear/left ear, the socio-economic factors, or whether the children lived in houses or apartments. Children who were nursed in public nurseries had a significantly higher incidence of secretory otitis than those nursed in private nurseries or at home.


Positional nystagmus of the persistent type. In a 6-year period (1970-1975), a total number of 10,730 patients were examined oto-neurologically by the same physician, all of the patients being referred from the neuromedical and neurosurgical departments. Persistent positional nystagmus is in this material the same as central positional nystagmus, because the lesion in all cases was of central origin. Central positional nystagmus was found to be a rare symptom, since it was only demonstrated in 124 patients (1%). Central positional nystagmus was defined as being with no latency, low and irregular frequency, nonfatiguable with no accompanying dizziness, and the patients examined in the following positions: right and left side, supine and with hanging head. In 52 cases (42%) the nystagmus was only demonstrated with hanging head. The diagnoses were dominated by intracranial tumors (34 infra-tentorial, 19 supratentorial). Among other diagnoses encountered were intracranial vascular disease, encephalopathia, epilepsy and multiple sclerosis. 21 patients were children under 15 years of age, and in this group the intracranial tumors, especially the infratentorial, were even more dominant.


Use of lyophilized dura in aural surgery. Lyophilized dura was utilized in chronic ear surgery to cover raw promontory surfaces, to stabilize the reconstructed ossicles, to raise the posterior insertion point of the grafted drum after canal wall removal, and to fortify the soft posterior canal wall. In 3 guinea pigs, lyodura was also placed in the bulla and studied 6, 12 and 16 months later. In 6 months of time, lyodura had become covered with normal epithelium and in 12 months of time, the greatest part of the lyodura was resorbed from the middle ear, normal epithelium having developed. In the canal wall area, resorption is slower and collagenic dural network is clearly recognizable even after a period of 24 months. Lyophilized dura contains no irritating material and is considered to be a versatile and useful material in chronic ear surgery.


Menière's disease. II. A neuropsychological study. 23 Menière patients were examined with a extensive battery of neuro-psychological tests. In a previous investigation, the authors had demonstrated that patients with long-duration Menière's disease had psychological disturbances, presumably localized in the nondominant hemisphere. In the present investigation, the patients had short-duration Menière's disease, and we were unable to replicate the results of the former investigation. It is concluded that the central changes in nondominant hemisphere function develop over a long period of time. It is hoped for that further neuropsychological investigations of Menière patients will give more information on what is primary in Menière's disease: peripheral, sensory or central neurological changes.


Quantitative histology of the normal ethmoidal sinus. In 16 patients the mucosa from 32 normal ethmoidal sinuses was removed post mortem and studied by whole-mount methods. In the anterior ethmoidal cells, there was a median density of 0.5 gland/mm2, in the posterior cells 0.13 gland/mm2. The distribution of the glands was irregular, with the highest density around the ostia. Individual variations of density were wide, ranging from 0.07 to 0.81 gland/mm2. The median density of goblet cells was the same in the anterior and posterior ethmoidal cells, about 6,900 cells/mm2. The greater part of the mucous secretion in the ethmoid is produced by the goblet cells.


Treatment of long, rigid tracheal stenoses. An experimental study on animals. Using both PVC models and animal experiments, new surgical methods of expanding long, rigid tracheal stenoses were investigated. After making a longitudinal incision laterally, oval-shaped composite grafts from the auricle were sutured on either side of the trachea. The stenoses were successfully stretched from about 35 to about 80% of the original lumina. In this way, and together with a sleeve resection, stenoses up to 7 or 8 cm are operable. It is the first time in experiments that a stenosis was carried out beforehand, and later expanded. This method allows a better judgement of the final result to be reached. Modifications of the basic technique are described and results are discussed in some detail.


[Organic impotence. Diagnostic and therapeutic aspects (author's transl)]. Organic impotence is far more frequent than usually thought. Diagnosed frequently on clinical grounds, organic impotence is confirmed by more sophisticated and invasive techniques (Multi Modal Psychologic interview: MMPI, Nocturnal penile tumescence detection, pelvic angiography). Apart from local and neurogenic factors, vasculogenic impotence seems very frequent although its treatment has not met with the anticipated success. Intracavernous prosthesis remains the best form of palliative treatment in cases of organic impotence.


Reactivity of antibodies to guanosine modified by the carcinogen N-acetoxy-N-2-acetylaminofluorene. N-(guanosin-8-yl) acetylaminofluorene (Guo-AAF) was prepared by the reaction of N-acetoxy-N-2-acetylaminofluorene (AAAF) and guanosine. Antibodies to Guo-AAF were elicited in rabbits by immunization with bovine serum albumin-Guo-AAF conjugate. The antibodies were purified by affinity chromatography on a Sepharose-Guo-AAF column. The reactivity of these antibodies towards several ligands was studied by radioimmunoassay. The antibodies have the same affinity for double stranded DNA-AAF and single stranded DNA-AAF. Thus the geometry of the regions of DNA substituted by AAF residues is the same in native and denatured DNA. The affinity of the antibodies is smaller for DNA-AAF than for Guo-AAF. This can be due in part to the stacking of AAF residues with the adjacent bases as shown by the study of the interactions between the antibodies and AAF-oligonucleotides. The circular dichroism spectra of AAF-oligonucleotides bound to the antibodies are reported.


[A new method of comparing intravital and postmortal coronary angiography (author's transl)]. A cardanically suspended plexiglass cylinder, filled with water and containing a specific supporter, enables postmortal hearts to be x-rayed in every possible projection. After filling the coronary vessel system with x-ray contrast medium, intravital angiograms can be repeated postmortally with equitable projection. The diastolic and systolic change of ventricle size in intravital hearts as well as postmortal rigor mortis or relaxation, result in only insignificant differences between postmortem and intravital x-rays of the coronary vessels taken from the same projection. Combined with histological studies, such examinations promise further knowledge about the development of degenerative changes of the coronary vessels. The described apparatus is also suitable for comparative intravital and postmortal x-ray examinations of other organs. With its aid, stereoscopic x-ray pictures can also easily be made.


Post-circumcision epidermoid inclusion cysts of the clitoris. We describe our experiences during the last 5 years with 19 cases of epidermoid inclusion cysts of the clitoris resulting from circumcision. There were 14 children and 5 adults. The management consisted of complete excision of the cyst, and reconstruction of the clitoris, wherever possible.


Gastrointestinal perforation by chicken bones. Four cases of gastrointestinal perforation by chicken bones are presented. Variability in the clinical manifestations generally precludes a correct preoperative diagnosis of intraabdominal chicken bone abscess. However, in 2 patients, a diagnosis was possible with plain abdominal radiographs. Although the abnormalities seen were nonspecific, the identification of a chicken bone with an associated mass or extraluminal gas collection in a patient with signs of peritonitis, mechanical bowel obstruction, or pneumoperitoneum strongly suggests the diagnosis. A history of alcoholism or wearing dentures strengthens it.


Combined urethrocystometry and cinefluorography in continent and incontinent women. Intravesical and intra-urethral pressures were recorded in 5 continent women and 10 women with urinary stress incontinence using combined urethrocystometry and cinefluorography. At rest, two types of stress incontinence could be recognized; one involved widening of the proximal urethra and the other did not. Under stress, the proximal urethra was rather mobile in the incontinent women. Artifacts caused by axial movement of the urethral microtransducer were eliminated by fixation of the catheter against the external meatus.


[Etiological study of low fertility in eastern Gaboon. III. Filarial endemicity (Loa loa, D. perstans). Prevalence of microfilariae in hydroceles (author's transl)]. During an inquiry performed in Gaboon the prevalence of hydroceles had led to puncture systematically every vaginal flow. 68 fluids were so collected at the end of the inquiry. Subsequently the statistical analysis of the results in men seems to suggest a correlation between microfilaremia (Loa loa and D. perstans) and the prevalence of hydroceles. Microfilariae were found in 77% according to the following distribution: Loa loa seldom diagnosed in this kind of flow were detected in 10%; D. perstans although never reported so far in hydrocele fluids appeared to be present in 62%. O. volvulus more currently referred to in hydrocele liquids were scarcely traced.


Pancreatic exocrine secretion in the rat after chronic alcohol ingestion: nonparallel secretion of proteins and pancreatic secretory trypsin inhibitor. Pancreatic secretion was studied in rats given 20% (v/v) ethanol or water ad libitum for 7--8 months. Basal secretion samples were collected for 30 min, after which secretion was stimulated with secretin (1.1 U/h) and cholecystokinin-pancreozymin (2.8 U/h). Then, four  successive 30-min samples were collected. The flow rate, protein concentration and output, pancreatic secretory trypsin inhibitor (PSTI) concentration and output, and chymotrypsinogen concentration increased significantly from basal levels during the first stimulation period in both groups, with no significant differences between the groups. During the second, third, and fourth stimulation periods gradual decreases of these parameters were observed in both groups, and the decrease of volume, protein output, and PSTI output were significantly greater in the alcohol group than in the control group. No significant differences were observed in the concentrations of chymotrypsinogen, protein, and PSTI, but the PSTI/protein ratio was significantly lower in the alcohol group at the end of the experiment. The concentrations of bicarbonate did not decrease during stimulation and were elevated in the alcohol group compared with the control group during the fourth period. It is suggested that the decreased PSTI/enzyme ratio caused by long-term alcohol ingestion might favour premature activation of the proenzymes in the pancreatic ducts.


[New insulins in diabetes therapy].

[New insulins in diabetes therapy]. The new MC or RI insulins are critically reviewed and the indications for switching to MC or RI pork insulin are discussed. A new means of determining the insulin requirement of brittle diabetics is short-time use of an insulin infusion apparatus.


Enduring changes in dopamine receptor cells of pups from drug administration to pregnant and nursing rats. A decrease in specific [3H]spiroperidol binding to rat caudate tissue and a parallel decrease in sensitivity to apomorphine in eliciting stereotyped behavior was observed in the offspring of rat mothers treated with either haloperidol or alpha-methyl-p-tyrosine-methyl ester during pregnancy. In contrast, evidence of increased dopamine-receptor sensitivity was observed in the pups if haloperidol was administered to their mothers postpartum during nursing rather than during pregnancy.


Modified bases characterized in intact DNA by mass-analyzed ion kinetic energy spectrometry. Pyrolysis of DNA into a chemical ionization source yields protonated bases and other base-containing ions. Kinetic energy spectra allow the characterization of the bases 5-methylcytosine and 1-methyladenine from underivatized salmon sperm DNA. Isomeric bases are distinguishable with this technique.


Idiopathic scoliosis in identical (monozygotic) twins. The exact nature of the primary predisposing cause of idiopathic scoliosis is unknown. Hereditary and/or environmental factors may be responsible. Two sets of identical twins presenting in adolescence with concordant scoliotic curves were studied and lend support for a hereditary predisposition favoring a multifactorial inheritance.


Haemangiosarcoma of the pulmonary valve presenting as a pulmonary stenosis. A case report. Intractable congestive cardiac failure, unexplained arrhythmias, changes in the cardiac silhouette and murmurs which change with position are all features which should arouse suspicion of a cardiac tumour. A case of intracardiac haemangiosarcoma of endothelial origin is discussed. The tumour presented as a pulmonary stenosis and extended into the right ventricular myocardium, causing a right bundle-branch block. At first the tumour seemed to be restricted to the endothelium of the pulmonary vascular bed, but it later infiltrated the interstitium and bronchi, cuasing dyspnoea and haemoptysis. After surgical removal of the tumour and reconstruction of the pulmonary outflow tract, the patient was free of symptoms for 14 months. However, rapid tumour growth in the pulmonary arterial system, lung interstitium and right ventricle subsequently recurred. Deep radiotherapy did not cause the tumour to regress.


Histoplasmosis in the Cape Province. A report of the second known outbreak. Histoplasmosis is a rare disease in the Cape Province. The diagnosis of acute disseminated histoplasmosis in a patient who presented at Groote Schuur Hospital 3 weeks after a caving expedition, led to the identification of acute benign pulmonary histoplasmosis in 9 other people who had explored the same cave. Possible explanations for this outbreak are discussed.


Unusual presentation of choriocarcinoma. A case report. We report the management of a case of malignant trophoblastic disease which presented initially as a haematemesis and melaena from a gastric metastasis. The patient had had a tubal sterilization 4 years previously. The management of trophoblastic disease in general is also discussed, and the importance of chemotherapy is stressed.


Severe intravascular hemolysis after triple valve replacement: cure by replacement of aortic and mitral valves with porcine xenografts. A case report of a patient with a triple cardiac valve replacement complicated by severe postoperative intravascular hemolysis is presented. The patient had neither prosthetic valvular dysfunction nor paravalvular leak and had an excellent hemodynamic response to the operation. Despite intensive medical management, the patient required transfusions of 500 ml of blood every 3 weeks. Replacement of the aortic and mitral prostheses with porcine xenografts alleviated the problem. When a patient requires triple valve replacement, the use of homograft or heterograft valves should be seriously considered as a means of minimizing this potential complication.


Microtubules and actin in giant nerve fibers of the spiny lobster, Panulirus argus. Giant axons of the spiny lobster, Panulirus argus, are filled with microtubules that are decorated with fine, irregular filaments. Mitochondria and membrane-limited clear vesicles are the only other distinguishable elements in the axoplasm and are located around the periphery of the axon near the axolemma. Neither 100 A neurofilaments nor 70 A microfilaments are evident in fixed, intact axons or in negatively stained axoplasm. Actin-like microfilaments are a prominent constituent of the glial cells that closely ensheathe the axons, and gel electrophoresis studies suggest that most of the actin in the nerve fibers is located in the glia rather than in the axons. Studies of isolated axoplasm indicate that microtubules are the primary elements stabilizing the axoplasm. The microtubules in the isolated axoplasm are disrupted by Ca2+ in the medium in the presence of protease inhibitors.


Spreading of vascular endothelial cells in culture: spatial reorganization of cytoplasmic fibers and organelles. The three-dimensional organization and fine structure of cytoplasmic components within whole non-embedded bovine aortic endothelial cells were examined during their attachment and spreading in tissue culture. Cells were cultured directly on Formvar-coated gold grids, fixed in glutaraldehyde and osmium tetroxide, critical point dried and examined by transmission electron microscopy (TEM) using stereoscopic methods, and by scanning electron microscopy (SEM). Reorganization of cytoplasmic structures during cell spreading occurred in four sequential stages: (1) spreading of the plasma membrane and unstructured cytoplasmic matrix; (2) spreading of cytoplasmic fiber systems (microtubules, microfilament bundles and microtrabecular system); (3) alignment of microfilament bundles and formation of radial tracts of microtubules; and (4) centripetal movement of organelles along radial tracts. These stages observed by TEM correlated with progressive degrees of cell flattening as visualized by SEM. These studies demonstrate that a characteristic reorganization of intracellular fiber systems and organelles accompanies the spreading of endothelial cells in culture.


Formaldehyde-induced appearance of septate junctions between digestive vacuoles. Tissue biopsies from (1) some chronic inflammatory diseases, (2) a necrotic tumoral process, (3) normal human lymphatic ganglia, and (4) two congenital diseases of the adrenal cortex were selected for study. A block from each biopsy was fixed in glutaraldehyde-paraformaldehyde; a second block was fixed in 10% formaldehyde. In all cases septate junctions between digestive vacuoles did occur in phagocytic cells and some adrenal cortex cells fixed in formaldehyde. These junctions were similar to those reported recently for malakoplakia phagocytes. Consistently, they were not found to attach organelles other than lysosomes derivatives. Both phagocytes and adrenal cortex cells in the material fixed in glutaraldehyde-paraformaldehyde did not display adhesive specializations between digestive vacuoles. This suggests that the septate junctions described herein are artifactuous structures induced by formaldehyde. There is, however, a certain degree of specificity of cells having the capability of developing these septate junctions. It is assumed that the coating material of digestive organelles in phogocytes and some other cells would be responsible for both cell specificity and organelle specificity of the formaldehyde-induced septate junctions.


Urethrocystometric findings in urgency.

Urethrocystometric findings in urgency. 15 women with chronic urgency have been examined with simultaneous urethrocystometry during an exacerbation of their disease. A thin microtip transducer catheter was used for pressure registrations. Both the bladder pressure and the maximal urethral pressure in the erect position were recorded during slow filling of the bladder. Although the patients had severe symptoms of frequency and in some cases urge incontinence in daily life, bladder capacity was almost normal. The desire to void appeared early but was not accompanied by a rise in bladder pressure. Even when the patients felt violent tenesmi, the bladder pressure curve remained completely calm. Only the urethral pressure reacted, with rapid rises and falls of 20--40 mm Hg, as the patients desperately tried to hold urine. Thus, no detrusor activity, but only a certain instability of the urethral pressure accompanied the subjectively imperious desire to void in urgency.


[Cellular reactions of immunocytes against prostate carcinoma and their clinical relevance (author's transl)]. The body's intrinsic defence against cancer depends mainly on cells of the lymphatic and reticulo-endothelial system, recognisable by an infiltration of mononuclear round cells into tumour tissue. In contrast to bladder carcinoma, cellular immune defence reactions to prostate carcinoma are only regularly observed when the tumour has broken through the capsule, or when distant metastases are present. This observation may be explained by the absence of an intrinsic lymphatic vascular system in the prostate. In contrast to bladder carcinoma, cellular immune defence reactions have no clinical significance in the later stages of prostate carcinoma.


Cultures from different parts of the urethra in female urethral syndrome. It is a common belief that the female urethral syndrome is an infectious disease, caused by ascending vestibular microorganisms or bacteria harboured in the paraurethral glands. To study the flora of different parts of the urethra in patients with urgency, cultures were obtained in 36 cases from the proximal urethra, the external urethral opening, the distal urethra after paraurethral massage and from the upper vagina for comparison. All locations were dominated by lactobacillae. Enterobacteria and anaerobic bacteria occurred in approximately one third of the cases at all sites, although only in small amounts in the urethra, especially in the proximal part. The urethral and the vaginal flora resembled each other very closely. Only in a few cases did a possible pathogen reside solely in the urethra, i.e. it could not be found in the vagina or in the vestibular flora. On the whole, no appreciable amount of any microorganism was present in the urethra or in secretion from the paraurethral glands. The clinical significance which a very small amount of enterobacteria or anaerobes may have in these locations remains to be established.


[On the treatment of the osteodystrophia deformans (Paget's disease) with synthetic salmon calcitonin (author's transl)]. Sixteen patients with Paget's disease of bone aged from 51 to 80 years was treated daily with 20 micrograms (equivalent to 80 MRCU) synthetic salmon calcitonin. Fourteen patients was observed on a long time. In all cases was observed significant reductions in increased serum alkaline phosphatase. The urinary hydroxyproline excretion was also decreased. Other laboratory dates as serum calcium, serum phosphorus, serum acide phosphatase, urinary calcium and phosphorus excretion was not significantly influenced by the therapy. The treatment produced a clear remission of pain. After treatment of 6 months the dose was reduced (2 or 3 injections subcutaneously of 20 micrograms salmon calcitonin weekly). There was observed a recurrence of pain and an increase of serum alkaline phosphatase, but not until the pretreatment values. These results confirm the effectiveness of calcitonin treatment in Paget's disease of bone.


[Activity and isoenzyme composition of lactate dehydrogenase and malate dehydrogenase in the blood and erythrocytes of newborn children with hemolytic disease]. Activities of lactate dehydrogenase (LDH) and NAD-dependent malate dehydrogenase (MDH) were considerably increased in blood serum of healthy children within the first 10 hrs after their birth. Content of LDH4 and LDH5 isoenzymes was increased, along with a decrease in LDH1 content, in blood serum. Differences in LDH isozyme spectra between blood serum and hemolysate in healthy newborns became more distinct within the perinatal period. In blood serum of newborns with hemolytic disease high activity of LDH and MDH was found immediately after birth. As distinct from healthy children, high content of LDH1 and very low concentrations of LDH4 and LDH5 were observed in blood serum of the impaired children within the perinatal period. The dissimilarity in LDH spectra became less distinct in blood serum and hemolysate of children with hemolytic disease. The composition of MDH isoenzymes was not distinctly altered in blood serum and hemolysate of both healthy and impaired newborn children within the perinatal period.


[Gynecomastia--an indication of a malignant chorionepithelioma in the male]. The course of the disease in a 26-year-old patient showed that also an endocrinological clinical picture may be the basis of a gynaecomastia. Here the symptom gynaecomastia was bilaterally conditioned by a malignant chorion epithelioma. By this tumour a feminisation with gynaecomastia, atrophy of the testicles and positive HCG-test developes. The ascertainment of the diagnosis is possible with the help of the HCG-test. In the early diagnosis of a malignant chorion epithelioma new therapeutic consequences arise by cytostatic drugs.


[Paradoxical intervention technics in psychotherapy--can the brief therapy model of the Palo-Alto--group serve as a contribution to the broadening of psychotherapeutic treatment methods, especially in behavior therapy]. This article examines the question, if - in spite of the theoretical inadequacies and insufficient reproducibility of the therapy-model and its treatment methods that Watzlawick et al. described in Lösungen - an analysis of concrete treatment examples could yield suitable therapeutic techniques to broaden the interventional spectrum of psychotherapy, especially of behavioral oriented forms. The result of the analysis is negative.


[Echocardiographic and hemodynamic studies on the influence of verapamil in hypertrophic obstructive cardiomyopathy (author's transl)]. 15 patients with obstructive hypertrophic cardiomyopathy were studied by m-mode echocardiography and 9 of them also by left heart catheterism before and after 10 mg Verpamil. The following results were obtained: 1. The systolic anterior movement (SAM) of the mitral valve was reduced (p less than 0.005), 2. the enddiastolic and endsystolic diameter were increased (p less than 0.02 and 0.05 respectively), 3. the EF-slope remained unchanged. 4. The left ventricular systolic pressure was reduced (p less than 0.025) and the gradient diminished from an average value of 58 to 34 mmHg (p less than 0.02), 5. heart rate and left ventricular enddiastolic pressure remained constant. The results of this acute study suggest a beneficial effect of Verpamil in patients with hypertrophic obstructive cardiomyopathy.


[Psychosomatic symptoms and functional disorders in migrant workers--Japanese and Greeks in Germany and Germans abroad]. An epidemiologic pilot-study of Greek, Japanese and German workers in foreign countries investigates genesis, frequency and characteristic symptomatology of psychosomatic and functional disorders. Social change as pathogenic stressor as well as psychopathologic consequences on behavior were demonstrated in the context of the life-change-unit research. The increase of psychosomatic disorders corresponds with intense homesickness reactions which can change in hypochondriacal depression. Psychopathology of intense homesickness, prejudices and other factors which prevent from adequate integration in a new environmental setting were delineated as well as prophylactic-psychosocial and therapeutic procedures.


Strategies of emigration and transfer by primates, with particular reference to gorillas. In many primate species, more males than females leave their natal group and transfer to another. In man, chimpanzee and the gorilla, however, the reverse is the case. This paper presents detailed data for the gorilla on individuals' movements into and out of breeding units. Comparisons are made with other primates, and with data on two non-primate species in which females rather than males move between breeding units. Proximate causes and functions of emigration and transfer are considered, and the reasons (proximate and evolutionary) for the observed sex differences in frequency of movement are discussed.


[Treatment of female stress incontinence. Direct vaginal urethrocystopexy using D. Alessandrescu's method]. In cases of urinary stress incontinence the urethrocystopexy in the vaginal route by the technique of Dan Alessandrescu is described. After 2-10 years 98% out of 489 patients were cured.


[Treatment of hyperprolactinemic conditions with bromoergocryptine]. Ten hyperprolactinemic patients were treated by a daily dose of 5 mg bromergocryptine (Parlodel, Sandoz). The prolactine concentration in the peripherial blood showed a fast declind and after two months the patients were relieved from the symptoms (galactorrhea, amenorrhea). As side-effects of the compound headache and nausea were noted.


[Cardiorespirography in physiologic and pathologic premature infants]. The cardiorespirography investigation, carried out in 42 premature newborn has led to the following results: 1. The narrowed undulatory zone was stated more frequently in cases of prematurely born infants, than in those of mature ones.--2. A silent zone was a typical phenomen with pathological prematurely born infants. The silent zone of type b together with tachypnoe and apnoic attacks and decelerations, prevailed within the group of infants suffering from IRDS. A typical silent zone of type a together with bradycardia, bradypnoe and apnoic attacks without decelerations was found in infants with the symptoms of intracranial haemorrhage. There were observed the silent zone of type a and of type b in cases of severe neonatal infections. But apnoic attacks with decelerations proved to be more frequent than in cases suffering from IRDS and intracranial haemorrhage. The respiratory curves showed an accentuated respiratory periodicity.--3. Whereas in cases of infants with IRDS the correction of the acid base balance brought about the correction of CRG--a gradual passage from the silent zone of type b to the undulatory one, the correction of the acid base balance did not bring about any change in the type of the silent zone within the group of cases of infants suffering from intracranial haemorrhage.--4. The cardiorespirography would therefore be suitable to be used, in relation to acid base balance values, as an additional method of establishing differential diagnosis in neonatal pathological cases.


[Effect of homogenates of the substania grisea and alba from a syngeneic brain on the immune response in intact and thymectomized mice]. Experiments on mice CBA demonstrated homogenate of the grey (cortex) substance of syngenous brain to contain components restoring the T-cells population of the spleen in thymectomized animals and producing a stimulating effect on the immune response to SRBC. Homogenate of the white matter possessed a much lesser activity; it is not excluded that it was connected with the admixture of grey matter in the preparation. Homogenate of syngenous muscle tissue possessed no biological activity.


Critical polytraumatization of a patient by a low-velocity gunshot. Case report. A case report of a 15-year-old boy hit by a single low-velocity gun shot is presented. He sustained injuries to the small bowel, colon, appendix, iliac vessels, femoral nerve and ureter. The injury mechanism and the treatment are discussed, and the importance of exploring a retroperitoneal hematoma is emphasized.


Diurnal variations of prolactin in the plasma of maturing female rats bearing hypothalamic lesions. Previous evidence from our laboratory suggested a possible involvement of prolactin (PRL) in the induction of precocious puberty due to hypothalamic lesions in maturing female rats. In the present report the concentrations of PRL in plasma of lesioned and control rats were determined three times a day at three different periods of puberty. Lesions were produced in 20 day-old rats by a radiofrequency current in the anterior hypothalamic area (AHA). Intact littermates were used as control. Respectively 23, 25 and 28 day-old lesioned and control rats were bled at 08.00, 12.00 or 16.00 h. PRL levels, measured by RIA were determined from plasma aliquots. In control rats, elevated plasma PRL levels were found in the afternoon. Hypothalamic lesion induced a tendency to elevate tonically the PRL plasma concentrations which was evident at 16.00 h in 23 and 25 day-old rats and at 08.00 and 12.00 h in 28 day-old rats. The present results give additional support to our previous suggestion that PRL secretion is modified by the effect of lesions in the AHA.


The effect of food intake on insulin receptor in man. Insulin binding to circulating monocytes was studied in 22 normal volunteers before and 1, 3 and 5 h after a 1400 Kcal meal. Results indicate that 3 h after food intake there is an increase in the specific cell binding fraction (P less than 0.001) with a change in receptor affinity. Data emerging from the present study demonstrate that there are rapid changes in insulin receptor properties during the day. These changes probably play a role in the regulation of the hormonal and metabolic pattern in normal subjects.


Partial purification and characterization of a binding protein for insulin-like activity (ILAs) in human amniotic fluid: a possible inhibitor of insulin-like activity. An insulin radioreceptor assay (INS-RRA) and an insulin-like activity radioreceptor assay (ILAs-RRA) have been utilized to partially purify and characterize a protein from human amniotic fluid with ILAs-RRA reactivity. An acid-ethanol soluble protein with an apparent molecular weight of 34,500 daltons by calibrated Sephadex chromatography and an isoelectric point (pI) of 4.7 accounts for all of the ILA'S-RRA reactivity present in human amniotic fluid. Since this protein has been found to be a binding protein for ILAs, but not insulin, it has been termed amniotic fluid binding protein or AFBP. AFBP is reactive in a non-parallel manner in the ILAs-RRA and totally inactive in the INS-RRA. The activity of AFBP in the ILAs-RRA is thus to the competition of AFBP with the placental membrane receptor for the [125I]ILAs tracer employed in the ILA'S-RRA. AFBP inhibits the activity of employed insulin, in the INS-RRA, presumably by binding ILAs, while being inactive itself. In two biological assays studied to date, the rat epididymal fat pad assay and the rabbit chondrocyte sulphation assay, AFBP also inhibits the activity of added ILAs. These observations raise the possibility that binding protein(s) for insulin-like peptides may function as inhibitors of their bioactivity in different physiologic and pathologic states. The relation of AFBP to binding protein(s) in human plasma remains to be clarified.


Secretion of proteins, androgen binding protein and oestradiol by Sertoli cells in culture: effects of serum. Effects of chicken- and foetal calf serum on secretion products of Sertoli cells have been investigated. At day 5 or 6 of culture, Sertoli cells incubated with 1% chicken serum secreted significantly more androgen binding protein (ABP) than cells cultured in media without chicken serum. This effect of chicken serum was smaller than that of chicken serum together with FSH and testosterone. Addition of 1% chicken serum or foetal calf serum stimulated the incorporation of [3H]leucine in secreted proteins by Sertoli cells. Secretion of oestradiol-17 beta (Oe2) was stimulated by addition of foetal calf serum. However, chicken serum did not stimulate the secretion of Oe2 even in the presence of extra added testosterone. The nature of the compounds in the sera responsible for these effects is unknown, but the effects cannot simply be explained by the presence of FSH or androgens. The results indicate that compounds other than FSH and androgens may influence Sertoli cell function. Evidence has been obtained that a serum component with a molecular weight of less than 5000 may be involved in the stimulation of Oe2 production.


Locomotor stereotypy in visually deprived kittens. Thirty-two kittens from nine litters were observed in home-cages during the first 8 months of life. Eighteen kittens were visually deprived from birth by means of double linen hoods, while 14 served as controls. In 6 of the deprived kittens locomotor stereotypy was observed. The kittens usually shuttled along the front of the cage. The episodes of stereotypy developed fully in the fourth month of life and occupied on the average from 19 to 40 percent of observation time in different kittens. The stereotypy was not observed in any of the control kittens. It is proposed that reduction of sensory stimulation by visual deprivation evokes in some kittens a compensatory mechanism of stereotyped walking which supplies some kinesthetic and tactile stimulation.


The effect of raphe nuclei lesions on the rat ovarian cycle. The effects of lesions of the median raphe or dorsal raphe nuclei on ovarian cycle were studied in rats. Lesions involving raphe nuclei decreased forebrain 5-HT and 5-hydroxyindole acid (5-HIAA) concentrations. Rats with lesions of the raphe showed prolonged estrous phase as well as an increase in both the eosinophilic index and karyopycnotic index of the vaginal smears. Histological examinations revealed that lesions of both the dorsal and median raphe produced marked increase in the number of maturing and mature follicles as well as an increase in corpora lutea. The increase in uterine weight was also observed. Present results indicate that lesions of the ascending 5-HT neurons stimulate ovulation and cause an increase in the estrogenic activity. Thus, the 5-HT neurons of the raphe nuclei seem to inhibit ovulation probably due to inhibiting of the hypothalamic releasing hormones.


Antiplatelet antibodies in childhood idiopathic thrombocytopenic purpura. The serotonin release test using platelets from a panel of donors and autologous platelets after recovery was used to detect platelet antibodies in 42 children with idiopathic thrombocytopenic purpura. The test was done with sera obtained in the thrombocytopenic phase, in partial recovery, and after recovery. The test results for sera from 23 (55%) of 42 patients with thrombocytopenia were positive against platelets from the donors; 14 (61%) of 23 were positive against autologous platelets; and 28 (88%) of 32 were positive against either donor or autologous platelets. Complete recovery occurred in 17 (52%) of 33 patients whose sera had positive tests against the donor platelets at the time of diagnosis. Postrecovery sera from all patients had negative tests against donor platelets, and two (12%) had positive tests against autologous platelets. These results indicate that childhood idiopathic thrombocytopenic purpura is an autoimmune disease caused by platelet antibody that usually disappears with recovery from the thrombocytopenia.


Y-autosome translocation, gonadal dysgenesis, and gonadoblastoma. A 5-year-old girl was discovered to have an abnormal karyotype with a translocation involving the Y chromosome. The primary complaint was slight physical growth retardation. Cytogenetic and endocrinologic evaluations were performed. The chromosomal complement exhibited a mosaicism: 45,X,t(Y;18)(q11;p11)/45,X0. The gonads of this patient were typical streaks containing no ova or follicles. A gonadoblastoma was present bilaterally.


Postsynaptic supersensitivity and kindling: further evidence of similarities. Fourteen Sprague-Dawley rats of 150 to 200 g of initial weight were given either d-amphetamine or cocaine intermittently following both a drug-abuse model previously described by the author and an intermittent model for pharmacological "kindling." The psychotogenic effects of the drugs were measured as stereotyped behavior utilizing standardized scales. A retest with the same drug and same protocol as the pretest stage was executed after an off-drug period of 12 weeks, demonstrating dopamine receptors hypersensitivity as measured by stereotyped behavior for both d-amphetamine and cocaine. The importance of demonstrating dopamine receptor hypersensitivity with an intermittent (kindling) drug-abuse-type model is discussed.


Mosaic autosomal trisomy in cultures from spontaneous abortions. In a consecutive series of 592 karyotyped spontaneous abortions, ten of 103 autosomal trisomies were mosaic, with a normal cell line also present. The frequency of mosaicism (10%) is much higher than that reported in Down syndrome, but similar to that reported in amniotic fluid cultures and in induced abortions. The most likely explanations for this discrepancy are (1) previous underestimation of mosaicism in live births or (2) mosaicism which is often restricted to extraembryonic fetal tissue.


Perinatal difficulties, head and face trauma, and child abuse in the medical histories of seriously delinquent children. The authors compared the medical histories of incarcerated and nonincarcerated delinquent children. Incarcerated delinquent children were significantly more likely than nonincarcerated delinquents to have sustained severe head and face injury. Differences were evident by age 2. Perinatal difficulties and psychiatric impairment were also significantly more prevalent in the histories of incarcerated delinquents. Especially violent incarcerated children had more perinatal difficulties, accidents, injuries, and ward admissions than did their less violent incarcerated peers. The authors suggest that the combination of early CNS trauma, parental psychopathology, and social deprivation is responsible for the serious, often violent, delinquency that is now prevalent.


Case report: Thymectomy-induced remission of acquired autoimmune hemolytic anemia in an adult with myasthenia gravis. A 57-year-old woman with diabetes mellitus, hypothyroidism, idiopathic thrombocytopenic purpura, myasthenia gravis, systemic lupus erythematosus, atopy, and basal cell cancer of the skin developed a severe Coombs'-positive autoimmune hemolytic anemia which was resistant to treatment with large doses of azathioprine, cytoxan, and prednisone. One year after transcervical thymectomy the hemolytic anemia disappeared and the patient has maintained a normal hemoglobin and negative Coombs' test without immunosuppressants even since. We believe this case report to be the first recorded instance of thymectomy-induced remission of autoimmune hemolytic anemia in an adult.


Splenectomy and antiplatelet agents in thrombotic thrombocytopenic purpura. Ten patients with thrombotic thrombocytopenic purpura (TTP) were studied retrospectively. The male:female ratio was 2:3 and the median age was 27 years. Six patients were alive one-half to 18 years after the onset of the disease. Four of these patients underwent emergency splenectomy and received antiplatelet drugs. Of the remaining two, one responded to splenectomy and the other had received a short course of aspirin therapy. The study supports the usefulness of splenectomy and/or antiplatelet agents in the treatment of TTP.


Nonlethal mushroom poisoning.

Nonlethal mushroom poisoning. The harvesting and consumption of wild mushrooms has become a popular pastime in many areas of the United States. Reports of mushroom poisonings and fatalities have been increasing since 1964. Between May 1973 and April 1978, 16 cases of mushroom poisoning were treated at our institution, including 13 within a 12-month period ending April 1978. All patients exhibited either gastrointestinal or neurologic symptoms, which responded to supportive therapy. There were no fatalities. In most cases, the clinical course can be predicted and appropriate therapy instituted if the mushroom is identified or if the interval between the ingestion and the onset of symptoms can be ascertained and certain characteristic symptoms are observed.