The tricuspid valve in pulmonary atresia and intact ventricular septum: a morphological study of 60 cases. A morphologic study of the tricuspid valve was performed in 70 patients with pulmonary atresia and intact ventricular septum who had died and subsequently undergone autopsy. The right ventricular cavity was enlarged in 8 patients, normal in 4 patients, mildly underdeveloped in 18 patients, and markedly underdeveloped in 24 patients. In the patients with dilated and enlarged right ventricle, the tricuspid valve exhibited features of dysplasia or Ebstein's malformation (downward displacement), or both, with a dilated anulus. The majority of patients had restriction of the tricuspid valve apparatus and an underdeveloped anulus, usually of a severe degree. The right ventricle appeared to have normal dimensions in four patients, but the tricuspid valve and tensor apparatus, even in these patients, exhibited departures from the normal. This study suggests that in many of these patients adequate right ventricular growth will not be achieved because of inadequate right ventricular filling. This seems directly related to moderate or severe underdevelopment of the tricuspid valve.


Fetal death secondary to constriction and torsion of the umbilical cord. Constriction and torsion of the umbilical cord is a cause of fetal death that is seldom noted. A stillborn fetus with these changes is described. The literature is reviewed. A localized absence of Wharton's jelly in the involved area of the cord is believed to be the etiologic factor in the constriction and subsequent torsion.


Tuberous sclerosis initially seen as hydrops fetalis: report of a case and review of the literature. Hydrops fetalis is a manifestation of tuberous sclerosis that previously has not been reported, to our knowledge. The multiple-organ involvement in this disorder is stressed. Support is given to the hypothesis that tuberous sclerosis represents a widespread tissue dysplasia involving all germ layers.


Hemorrhagic cerebral white matter: infarction with cerebral deep venous thrombosis and hypoxia. Postmortem examination of the brain of a 5-week-old boy disclosed extensive thrombosis of the deep venous system and widespread necrosis of the cerebral parenchyma. As is characteristic of this uncommon form of cerebrovascular disease, malacia was present in the central gray matter but was only focal and incospicuous in contrast to a diffuse hemorrhagic softening of the centrum semiovale. This association of deep venous thrombosis and predominant white matter necrosis suggests that impairment of venous drainage should be considered in the pathogenesis of certain disorders of the cerebral white matter.


A morphologic study of intracerebral hemorrhage in a case of acute leukemia. Morphologic studies have thus far failed to demonstrate the nature of the vessel involved in the brain hemorrhages of patients with acute leukemia. A detailed study of such hemorrhages was carried out in a patient with leukemic phase of mycosis fungoides. Plastic-embedded lesions showed that blast cells blocked the lumen of the capillary, leading to severe dilation and rupture of the vessel. The rheologic properties of blast cells in vessels of critical diameters seem to be an important factor in the pathogenesis of intracerebral hemorrhages.


Lymphoid hypophysitis in a patient with hypoglycemic episodes. Destructive inflammatory processes of the anterior pituitary gland are unusual and are rarely recognized either during life or at autopsy. A woman with recurrent episodes of hypoglycemia was found on autopsy to have a destructive lymphoid infiltrate in her adenohypophysis that appeared to result in only partial hypopituitarism. This lesion is thought to be an autoimmune disorder and has been reproduced experimentally. Four other cases have been reported previously in the world literature and are reviewed in this paper.


Ultrastructural observations on Kupffer cells in intrahepatic cholestatic jaundice. A liver biopsy specimen from a patient with intrahepatic cholestatic jaundice had marked dilation of the bile capillaries, disappearance of the microvilli, and thickened ectoplasm. The unusual finding was a great increase in the number of Kupffer cells that contained masses of electron-dense material, most probably bile. A second examination of the liver, performed one month later when the liver test results had returned to normal, showed only remnants of the Kupffer cells. We report the possible role of the Kupffer cells in the clearance of the blood from the bile pigments.


Fatty acid biosynthesis by a particulate preparation from germinating pea. 1. Fatty acid synthesis was studied in microsomal preparations from germinating pea (Pisum sativum). 2. The preparations synthesized a mixture of saturated fatty acids up to a chain length of C(24) from [(14)C]malonyl-CoA. 3. Whereas hexadecanoic acid was made de novo, octadecanoic acid and icosanoic acid were synthesized by elongation. 4. The products formed during [(14)C]malonyl-CoA incubation were analysed, and unesterified fatty acids and polar lipids were found to be major products. [(14)C]Palmitic acid represented a high percentage of the acyl-carrier protein esters, whereas (14)C-labelled very-long-chain fatty acids were mainly present as unesterified fatty acids. CoA esters were minor products. 5. The addition of exogenous lipids to the incubation system usually resulted in stimulation of [(14)C]malonyl-CoA incorporation into fatty acids. The greatest stimulation was obtained with dipalmitoyl phosphatidylcholine. Both exogenous palmitic acid and dipalmitoyl phosphatidylcholine increased the amount of [(14)C]-stearic acid synthesized, relative to [(14)C]palmitic acid. Addition of stearic acid increased the amount of [(14)C]icosanoic acid formed. 6. [(14)C]Stearic acid was elongated more effectively to icosanoic acid than [(14)C]stearoyl-CoA, and its conversion was not decreased by addition of unlabelled stearoyl-CoA. 7. Incorporation of [(14)C]malonyl-CoA into fatty acids was markedly decreased by iodoacetamide and 5,5'-dithiobis-(2-nitrobenzoic acid). Palmitate elongation was sensitive to arsenite addition, and stearate elongation to the presence of Triton X-100 or fluoride. The action of fluoride was not, apparently, due to chelation. 8. The microsomal preparations differed from soluble fractions from germinating pea in (a) synthesizing very-long-chain fatty acids, (b) not utilizing exogenous palmitate-acyl-carrier protein as a substrate for palmitate elongation and (c) having fatty acid synthesis stimulated by the addition of certain complex lipids.


[Participation of pulmonary macrophages in regulating the quantity of surfactant on the alveolar surface]. The fixation of the rat lung by perfusion through the pulmonary artery permits to prevent the "washing out" of macrophages into the alveolar lumen and to preserve their natural disposition in the hypophase of the alveolar lining layer beneath the surfactant film. The surfactant synthesis was enhanced in the granular alveolar cells (type II) of the remaining lung 5 to 7 days after the leftside pneumonectomy; the amount of the tubular myelin in the hypophase of the hypertrophic alveoli increased, and the surface tension of the lung washings diminished. At that period the alveolar macrophage count more than doubled. The alveolar macrophages utilized the excess of surfactant (the tubular myelin) in the hypertrophic lungs, thereby taking part in the regulation of the alveolar surface tension.


Symposium on peptic ulcer disease. 1. Medical treatment of peptic ulcer. The conventional treatment of peptic ulcer disease with special dietary regimens, antacids or anticholinergics has been found wanting. Recently introduced agents show considerable promise in the benefit they can render. Carbenoxolone accelerates the healing of gastric ulcers by increasing gastric mucosal resistance. Cimetidine, a histamine HI-receptor antagonist, is an effective suppressant of acid secretion and therefore promotes healing of duodenal ulcers. Metoclopramide hastens gastric emptying and increases the tone of the gastroesophageal sphincter, and is valuable in cases of reflux esophagitis and gastric ulcer.


Oxygen-dependent chemical tumorigenesis in a Nicotiana hybrid: inhibition by ascorbic acid and dinitrophenol. Aqueous solutions of molecular oxygen, per se, or in combination with either pyrogallol or 6-azauracil increased tumorigenesis in Nicotiana suaveolens X Nicotiana langsdorffii seedlings relative to control seedlings. The biological activities of the organic chemicals were O2-dependent, because the substitution of N2 or O2 or the degassing of 0.1-1 mM solutions of the compounds eliminated or greatly reduced their tumorigenic effects. Rates of tumorigenesis exceeded 95% for 0.5 mM solutions of either pyrogallol or 6-azauracil solutions in the presence of l mM O2. Although tumors developed in 20% of seedlings in the presence of 1 mM O2, alone, 4-5 times more tumors were induced by the organic chemical--O2-H2O systems. Dinitrophenol and ascorbic acid, compounds which affect cellular respiration or redox systems, strongly inhibited the chemically-mediated tumorigenesis. Dinitrophenol was equally effective at one-tenth of the molar concentrations of ascorbic acid that were required for the suppressions of oncogenesis. Dehydroascorbic acid was much less inhibitory than ascorbic acid.


[Skin ulcer caused by Mycobacterium ulcerans in Cameroon. II. Bacteriological study]. Nine stains of Mycobacterium ulcerans isolated in Kamerun, in Congo and in France, were compared with six reference strains found in Zaïre, Australia and Mexico and M. intracellulare, M. simiae, M. paratuberculosis. These fiveteen strains constitutets an species whose typical features were: the difficult and slow growth at the optimum temperature of 30 degrees C, the biochemical tests and the sensitivity to rifampin, streptomycin, kanamycin, viomycin, cycloserin and probably capreomycin. In mice inoculated by the intravenous route, M. ulcerans gives ulcerations of external teguments and sometimes, internal lesions.


[Sero-epidemiological survey of arbovirus diseases in the Bi-Aka pygmies of Lobaye, Central African Republic]. Sero-epidemiological survey for Arboviruses among Bi-Aka Pigmies of the Lobaye, Central African Empire. A sero-epidemiological survey has been conducted, in 1975-1976, among 349 nomadic Pygmies of the Lobaye area in the Central African Empire, to investigate the prevalence of arbovirus infections. The percentages of individuals with detectable antibodies were 9,5 % for Chikungunya, 13,5 % for Semliki Forest, 5,2 % for Sindbis; 11,7 % for Bunyamwera; 2,3 % for West Nile, 6,3 % for Uganda S, and 8,9 % for Yellow Fever. These results are similar to those found in 1964 by CHIPPAUX in a comparable group of Pigmies of the same area and confirm that the prevalence of arbovirus infections is lower in the nomadic pygmies of the same area and confirm that the prevalence of arbovirus infections is lower in the nomadic Pygmies than in the sedentary Pygmies as well as in the settled bantus of the Lobaye valley villages. Yellow fever specific antibodies detected in this non vaccinated population indicate that latent infections occur in human beings living in the depth of the tropical forest, from the natural sylvatic focus of yellow fever, which remains active as recently proven in the Central African Empire by virus isolations obtained from wild caught mosquitoes.


[Importance and distribution of serological findings of ornithosis-psittacosis in semi-domestic pigeons]. Ornithosis-psittacosis is a widely distributed disease in birds throughout the world. A serological study by the complement-fixation test and a few isolation of Chlamyqia were performed on feral pigeon population of Antwerpen city. The incidence of positive cases in Antwerpen averages 58.51 %. For each serum, a serological index (S. I.) was calculated with regard to the intensity of immunological response in different dilutions: S. I. seems to suggest an endemic status of the disease in Antwerpen. Evolution in time of the prevalence and the serological response shows the presence of two peaks: the first one in spring and the last one in summer. This might be explained by some factors influencing the transmission of the infection: between them, one must emphasize the pigeons habits and the ectoparasites.