Assessment of pituitary function in patients with serum prolactin levels greater than 100 ng/ml. Twelve women with galactorrhea-amenorrhea and prolactin levels greater than 100 ng/ml were evaluated with dynamic pituitary challenge testing. Forty-two per cent of the patients had positive findings on polytomography and subsequent surgical confirmation of a pituitary tumor. Patients with tumors had a delayed elevation of growth hormone (GH) and cortisol following induction of insulin hypoglycemia. Patients had increased thyroid-stimulating hormone levels after injection of thyrotropin-releasing factor, but showed blunting of prolactin secretion. Patients with tumors had decreased basal levels of GH and showed a blunted response to luteinizing hormone-releasing hormone (LRF) stimulation. These patients had normal elevations of follicle-stimulating hormone after LRF challenge. Patients with tumors showed a delay in elevation of GH levels following l-dopa treatment. They also failed to show prolactin suppression following this treatment. There are consistently predictive changes that occur in pituitary functions in the presence of a pituitary tumor. However, absolute prolactin levels and sellar polytomography are more reliable in diagnosing the presence of a pituitary tumor in the patient with galactorrhea-amenorrhea.


The effect of transection of the accessory ligaments on reproduction in the rabbit. The mesotubarium superius (MTS) and uterovarian ligament (UOL) contain smooth muscle, are mechanically active, and have been implicated in ovum transport in a number of species. To assess the reproductive importance of these ligaments, they were unilaterally transected in 27 rabbits and the effects on reproduction determined. Reproductive function was characterized in terms of the numbers of corpora lutea, uterine implants, and normal conceptuses resulting from breeding with fertile bucks. Fertility was defined by the proportion of ovulating follicles resulting in implantation and normal conceptuses. Grouped and paired sample analyses of these data showed no differences between the experimental and control sides of the reproductive tracts of animals in which the UOL, MTS, or both were transected. The structural integrity of these ligaments is thus not necessary for normal conception and fertility in the rabbit.


Age of measles immunization in tropics.

Age of measles immunization in tropics. Maternal immunity to measles was studied in a group of 500 newborn children and another group of 500 children aged one to 12 months, before vaccination. The geometric mean titer of detectable hemagglutination-inhibition antibody was 16 for newborn children. This titer was absent in most children aged 3 to 5 months. Our previous studies indicate that from 1970 to 1972, children from the lower socio-economic classes aged 5 to 9 months were the main target of measles complications and deaths. Based on the present data, we suggest that children in developing countries should be vaccinated as young as 6 months and should be revaccinated 3 to 4 months later to assure full protection.


[Controlled tests of anti-meningococcal polysaccharide A vaccine in the African Sahel area (Upper Volta and Mali) ]. After the first tests of this vaccine in Egypt (1972) and in the Sudan (1973), two controlled tests in the field were performed in two high-risk areas for meningitis: --firstly, in the region of Koudougou (Upper-Volta), in November-December 1973 (17,300 vaccines). Its major aim was to solve operational and logistical problems; --secondly, in the Koutiala (Mali) area, according to a very strict schedule, in November-December 1975 and December 1975 (37,979 vaccines). The complete innocuousness of the vaccine was proven and excellent seroconversion was observed after its administration. On the individual level, it was confirmed that the vaccine ensures excellent protection for a period of at least three years. This new prophylactic weapon inspires the authors to suggest a new strategy in the fight against meningitis epidemics caused by meningococcus in the African Sahel area, taking into account the current increase there in serogroup C, against which there is also a vaccine whose efficacy has already been demonstrated.


Serum requirement for growth and immunoglobulin synthesis by cultured human lymphocyte lines. Swine serum is an inexpensive substitute for foetal calf serum for lymphocyte culture. It gives an increased yield of Ig from 1788 cells and permits the large scale production of cells for Ig mRNA isolation.


In vitro capacitation of ejaculated rabbit spermatozoa. Prior to fertilization mammalian spermatozoa undergo physiological changes in the female reproductive tract. These changes are collectively known as capacitation. In essence capacitation is a further differentiation that the sperm cell must acquire beyond the maturational changes that it undergoes in the epididymis. Although capacitation in vitro has been easily achieved in rodents, its accomplishment in the rabbit is inconsistent and difficult. We report here successful in vitro capacitation of ejaculated rabbit sperm, assessed by in vitro and in vivo fertilization of rabbit ova. Sperm were used from pooled ejaculates collected from bucks of proven fertility since sperm collected from individual bucks resulted in significant differences in fertilization levels. Conditions favoring in vitro capacitation were: (1) extended incubation time of 12 h, (2) addition of 20% heated rabbit serum to incubation medium, and (3) an atmosphere of 5% CO2, 8% O2, and 87% N2 during incubation. In vitro capacitation of sperm under these conditions resulted in 67% fertilization compared to 89% for control sperm capacitated for 13 h in the uterus.


[A study of the natural evolution of hypertrophic obstructive cardiomyopathy. Analysis of 100 cases (authors' transl)]. The authors present a study of the course of hypertrophic obstructive cardiomyopathy (C.I.O.), diagnosed both through noninvasive (52) and invasive (48 cases) techniques, in 100 patients. The average period of observation (prospective and retrospective) was 8.2 years; in 68 cases prospective inquiries were carried out over an average period of 4.6 years. In 80% of the cases the first symptoms occurred when the patient was under 40, while the first diagnosis and period of observation usually took place between the ages of 20 and 50. The results of this study confirm that CIO is an illness with a slow evolution; the following facts emerge: a) considerable stability of the symptoms; b) low yearly mortality rate (1.8%); c) high rate of survival 10 years after the first onset of the symptoms. The most frequent cause of death is usually sudden, which leads to the supposition that one of the most important elements for prognosis is the identification and treatment of arrhythmias.


[The carotidogram in the diagnosis of the juxtavalvular fibrotic aortic stenosis. Report of 47 cases (author's transl)]. The morphological aspect of the carotid pulse has been under study in 47 cases of juxtavalvular aortic stenosis previously confirmed through hemodynamic and surgical examinations. The study included 39 cases of subvalvular fibrous stenosis (subaortic fibrous stenosis) (SAsV) and 8 cases of supravalvular annular aortic stenosis (S AsV). In 75% of both SAsV and SAsV cases the carotid pulse showed a rapid ascent and a finely notched apex, while in 25% of the cases it followed the pattern of a typical valvular stenosis. This is more obvious for the left carotid artery. The morphology of the carotid pulse resulted as independent from the aortic ventricular gradient, but, on the other hand, connected with the simultaneous stenotic involvement of the valvular cusps. The sign possesses not only high sensitivity but also high specificity with regard to juxtavalvular aortic stenoses because it has only been met with in 2 cases of valvular aortic stenosis. The pathophysiological explanation remains as yet obscure.


[Specificity of systolic anterior motion of the mitral valve in the echocardiographic diagnosis of hypertrophic cardiomyopathy (author's transl)]. In order to determine the prevalence of sistolic anterior motion (SAM) of the mitral valve, we evaluated the echocardiographic records of 229 consecutive patients with a variety of cardiovascular conditions. SAM was present in all the 9 patients of this series with hypetrophic cardiomyopathy and in additional 4 patients with other conditions. Their diagnosis were: arterio-venous fistula of the forearm, tetralogy of Fallot, Prinzmetal angina and idiopatic hypercynetic cardio-circulatory state. Thus SAM without hypertrophic cardiomyopathy is not a rare event in patients undergoing echocardiography. The wide variability of conditions associated with SAM suggests that it represents a functional and aspecific abnormality and does not involve peculiar anatomic factors.


Antitumor activity of norditerpenoid dilactones in Podocarpus plants: structure-activity relationship on in vitro cytotoxicity against Yoshida sarcoma. The in vitro cytotoxicity of norditerpenoid dilactones isolated from Podocarpus plants was determined against cultured Yoshida sarcoma cells. The dilactones involved 15 natural lactones as well as their derivatives, which include appropriate modifications necessary to the estimation of the structure-activity relationship. The unsaturated system on the B/C ring portion, the dienolide or the epoxyenolide moiety, is essential for the activity, but the gamma-lactone group on the A/B ring portion is not. Other oxygenated substituents on the skeletal carbons, such as hydroxyl, acyloxyl, or epoxide group, also show some significant effect.


Neodymium-yag laser treatment of experimental canine gastric bleeding. Acute and chronic studies of photocoagulation, penetration, and perforation. Determination of the efficacy and safety of endoscopic laser photocoagulation to control upper gastrointestinal bleeding is prerequisite to the general application of this treatment in humans. We studied photocoagulation hemostasis, penetration, and perforation produced by a 55-W neodymium-yag (Nd:YAG) laser to control standardized experimental gastric bleeding lesions in a heparinized canine model. Photocoagulation of bleeding lesions was 100% successful with an application time of 3.56 +/- 1.65 sec (mean +/- SD). Histologic examintion of the gastric wall revealed a depth of injury to the muscularis externa of 40-100% with greater than 2 sec photocoagulation. Continuous photocoagulation exceeding 4 sec produced an 80-100% depth of muscle injury. Perforation of the gastric wall occurred after 9.6 +/- 1.5 sec, and all dogs studied after perforation survived. These studies indicate that Nd:YAG photocoagulation is an effective method to control experimental gastric bleeding lesions with a ratio between mean photocoagulation hemostasis and perforation times of approximatley 1:3. Further studies are required to define the implications of photocoagulation injury to muscle and the role of the gastric serosa in laser applications.


Mechanisms responsible for antibody-dependent, cell-mediated cytotoxicity to isolated hepatocytes in chronic active hepatitis. Lymphocytes from patients with chronic active hepatitis have been found to be cytotoxic for isolated rabbit hepatocytes. Although this reaction has been shown to be of the antibody-dependent type, no autologous serum was added to the assay system and in the present experiments the source of the antibody has been sought. The failure of puromycin to block the reaction argued against a role for antibody synthesised during the culture period, and the demonstration that normal mononuclear cells could become cytotoxic when preincubated in chronic active hepatitis sera was more in favour of the passive acquisition of an antibody from the circulation. Evidence for the existence of free antibody in the sera reacting with hepatocyte surface antigens came from an additional series of experiments in which it was shown that preincubation of hepatocytes in chronic active hepatitis sera rendered them susceptible to damage by normal mononuclear cells. This effect was almost completely abolished by adding a membrane lipoportein fraction of human liver (LSP) to the sera during the preincubation step, suggesting that the LSP contained those antigens on the hepatocyte surface against which the majority of the antibodies were directed.


Small intestinal intraepithelial lymphocyte levels in cow's milk protein intolerance. The mean small intestinal intraepithelial lymphocyte count in seven children with untreated cow's milk protein intolerance (CMPI) on a milk-containing diet was significantly higher than 22 control children also having a milk-containing diet. Ten milk-intolerant children on a milk-free diet had a mean intraepithelial lymphocyte count which was significantly lower than the level in the 22 control children on a milk-containing diet. When these 10 children were challenged with cow's milk they relapsed clinically, and in every case the intraepithelial lymphocyte count rose, although it remained within normal limits. Nineteen children on milk-free diets who had recovered from CMPI had a mean lymphocyte count which was also significantly lower than controls on normal diets, suggesting that when milk is remo-ed from the diet the lymphocyte count is low regardless of whether the child is milk sensitive or not. The reaction of intraepithelial lymphocytes to milk in CMPI is markedly different from their response to gluten in coeliac disease.


[Synthesis of the bis(S-methoxycarbonylthio)-B-chain of beef insulin (author's transl)]. The bis(S-methoxycarbonylthio)-B-chain of beef insulin was synthesized from B-chain bis(S-sulfonate) and methoxycarbonyl-sulfenylchloride and reacted with thioglycolic acid as well as with cysteine in acidic solution to the corresponding unsymmetrical disulfides in 80% yield.


The IRS strikes out in court!

The IRS strikes out in court! Three organizations that recently took the IRS to court to obtain tax-exempt status under section 501(c)(3) of the code have won their cases--an HMO and a PSRO on the basis of their benefit to the community, and a cooperative hospital laundry because of its connection with tax-exempt institutions and its nonprofit operation.


Heteromorphic X chromosomes in 46,XX males: evidence for the involvement of X-Y interchange. G- and R-banded chromosome preparations from eight of twelve 46,XX males, with no evidence of mosaicism or a free Y chromosome, were distinguished in blind trials from preparations from normal 46,XX females by virtue of heteromorphism of the short arm of one X chromosome. Photographic measurements on X chromosomes and on chromosome pair 7 in cells from twelve 46,XX males, eight 46,XX females, and four 46,XY males revealed a significant increase in the size of the p arm of one X chromosome in the group of XX males, independently characterised as being heteromorphic for Xp. No such differences were observed between X chromosomes of normal males and females or between homologues of chromosome pair 7 in all groups. The heteromorphism in XX males is a consequence of an alteration in shape (banding profile) and length of the tip of the short arm of one X chromosome, and the difference in size of the two Xp arms in these 46,XXp+ males ranged from 0.4% to 22.9%. From various considerations, including the demonstration of a Y-specific DNA fragment in DNA digests from nuclei of one of three XX males tested, it is concluded that the Xp+ chromosome is a product of Xp-Yp exchange. These exchanges are assumed to originate at meiosis in the male parent and may involve an exchange of different amounts of material. The consequences of such unequal exchange are considered in terms of the inheritance of genes located on Yp and distal Xp. No obvious phenotypic difference was associated with the presence or absence of Xp+. Thus, some males diagnosed as 46,XX are mosaic for a cryptic Y-containing cell line, and there is now excellent evidence that maleness in others may be a consequence of an autosomal recessive gene. The present data imply that in around 70% of 46,XX males, maleness is a consequence of the inheritance of a paternal X-Y interchange product.


Do the partners of dizygotic schizophrenic twins run a greater risk of schizophrenia than ordinary siblings? An exceptionally high incidence in dizygotic co-twins of schizophrenic index cases, together with normal incidence in siblings, was reported by M. Fischer in 1973. Apart from chance fluctuation, a methodological explanation for the difference is suggested.


Antibody-containing cell response in lymph of sheep after intra-intestinal infusion of ovalbumin with and without DEAE-dextran. The output of antibody-containing cells (ACC) was monitored in efferent ileal lymph after continuous infusion of ovalbumin into the ileum of sheep with and without the adjuvant DEAE-dextran. When ovalbumin was infused at the slow rate of 5 ml/h, maximum outputs of 2.9 x 10(5) and 2.4 x 10(5 ACC/h were observed on days 9 and 16 respectively. When infused at the faster rate of 15 ml/h, peak levels of 6.9 x 10(5) and 11.7 x 10(5) ACC/h were recorded on days 10 and 16 respectively. The maximum response was substantially enhanced when ovalbumin was infused simultaneously with DEAE-dextran when a mean output of 51.7 x 10(5) ACC/h occurred on day 10. With all treatments the distribution of ACC amongst various immunoglobulin classes was similar. During the first few days of the response IgM-specific ACC predominated and later IgG1-specific ACC were most abundant. Throughout the response a substantial proportion (10-81%) of ACC in efferent ileal lymph were IgA-specific.


Intestinal response of sheep to intraperitoneal immunization. The aim of the present study was to develop an immunization procedure which centrally stimulated the IgA system of sheep with the release of antibody-containing cells (ACC) of the IgA class into intestinal lymph. It was found that intraperitoneal injection of ovalbumin resulted in a substantial output of ACC in intestinal lymph. ACC of the IgA class reached a peak 8--9 days after intraperitoneal injection when they comprised 1.4% of cells in lymph. ACC of the IgM and IgG1 classes comprised 3.5 and 2.9% of cells in lymph at this time. The output of ACC of the IgA, IgM and IgG1 classes in lymph at the peak of the response was respectively, 3.7 X 10(6), 9.8 X 10(6) and 8 X 10(6) cells/h. In marked contrast to rats, virtually no ACC appeared in intestinal lymph of sheep following intraduodenal infusion of ovalbumin in animals primed 2 weeks earlier by intraperitoneal injection of antigen in Freund's complete adjuvant (CFA).


Histological investigation on the so-called urethral syndrome. The urethral syndrome is generally not associated clinically with urethral changes, however, histology often reveals inflammatory or degenerative alterations. The conventionally diagnosed urethral syndrome can certainly be considered to be a synonym of chronic urethritis in adult females. The remarkable histological lesions were rupture of elastic fibers in the submucosa and the vascular wall, and a decrease of acid mucopolysaccharides in each layer of the urethra, accompanied by lymphocytic infiltration.


Urethral pressure changes in reflex micturition. The mechanism and pattern of urethral pressure changes during bladder filling and voiding were investigated in anesthetized female dogs. A series of experiments was performed involving simultaneous recording of intraurethral and intravesical pressures before and after surgical separation of the bladder from the urethra. Similar experiments were done after pharmacologic blockade of the striated muscles, alpha-adrenergic receptors, and autonomic ganglia. The urethral pressure rise during the collection phase and its drop simultaneous with bladder contraction were observed both before and after vesicourethral interruption. Tubocurarine did not block pressure changes recorded in the proximal urethra. Phentolamine did not prevent a urethral pressure drop simultaneous with detrusor contraction. After effective blockade of autonomic ganglia by pentolinium, reflex micturition could not be induced by bladder filling. However subsequent administration of bethanechol chloride induced a bladder pressure rise together with a simultaneous drop of urethral pressure. We conclude that both vesicourethral muscle continuity and autonomic reflexes contribute to the urethral pressure changes during the two phases of bladder activity, passive collection and active expulsion.


Muscle and liver glycogen content: diurnal variation and endurance. The purpose of this study was to determine the influence of diurnal variations of muscle and liver glycogen stores on exercise endurance in male albino rats. Animals were swum to exhaustion at either 0700 or 1900 h, after which samples of soleus, white vastus lateralis, and red vastus lateralis muscles as well as liver were excised and subsequently analyzed for glycogen content. Glycogen content of all tissues from nonexercising control animals was higher in the morning than in the evening. Consequently, animals at 0700 h swam 60% longer than those at 1900 h (209 +/- 20 min vs. 130 +/- 23 min, respectively). However, because the skeletal tissues of the exhausted animals were not totally depleted of glycogen, it was concluded that fatigue under the swim protocol was the result of hypoglycemia secondary to hepatic glycogen depletion. The results of this study demonstrate the physiological consequences of diurnal glycogen fluctuation and establish experimental support for the importance of controlling this variable in rodent exercise investigations.


The fine structure of macrophage granules in experimental granulomas in rodents. Macrophages in granulomas in four rodent species contain cytoplasmic granules with an ordered substructure similar to those previously described in human granuloma macrophages. These appearances, as well as other ultrastructural features of the cells, are compatible with the view that those macrophages have a secretory function.


The mode of action of a new antitumor antibiotic, sporamycin. Sporamycin, an antitumor antibiotic, primarily inhibited DNA synthesis, while RNA and protein synthesis were not significantly affected in HeLa S3 cells. The antibiotic also caused strand scission of cellular DNA. However, the effects were not observed when the cells were incubated at 0 degrees C before washing and subsequently incubated at 37 degrees C. The Tm of calf thymus DNA decreased when incubated with sporamycin in vitro. Sporamycin did not affect DNA synthesis in vitro catalyzed by partially purified DNA polymerase alpha, beta, and gamma derived from EHRLICH ascites cells.


Evidence for a fatty acid reductase catalyzing the synthesis of aldehydes for the bacterial bioluminescent reaction. Resolution from luciferase and dependence on fatty acids. The enzyme responsible for the stimulation by ATP AND NADPH of light emission catalyzed by bacterial luciferase has been partially purified from extracts of the luminescent bacterium, Photobacterium phosphoreum. The stimulatory activity was found to be stabilized by high concentrations of mercaptoethanol, permitting it to be separated from luciferase into an active and stable form and enabling further characterization of its functional properties. The activity of the enzyme was shown to be dependent not only on ATP and NADPH but also on the presence of a long chain fatty acid, and was inhibited by the addition of NADH and horse liver alcohol dehydrogenase. The specificity for fatty acids, as measured by the stimulation of luciferase activity, had a very limited range, with maximal luminescence being obtained with myristic acid and lower responses being observed only with tridecanoic and pentadecanoic acid. These results provide evidence in vitro for an enzyme in bioluminescent bacteria that functions as a fatty acid reductase converting fatty acids to aldehydes which in turn can be utilized by luciferase in the light-emitting reaction.


Cloned pigmented retinal epiehtlium. The role of microfilaments in the differentiation of cell shape. 3-wk-old clones of pigmented epithelial cells from chick retina can be divided into four zones on the basis of cellular morphology and pigmentation. These zones appear to represent different stages in the re-expression of differentiation: those cells with essentially no differentiated characteristics are at the outer edge and those with the greatest number are at the center. Cells of the colony exhibit three different types of movement when analyzed by time-lapse cinephotomicrography: focal contractions, extension and retraction of apical protrusions, and undulations of the lateral membranes. All the cells of the colony contain microfilaments, 4--7 nm in Diam, which are primarily arranged as apical and basal webs. In addition, less well defined filamentous networks are found in the apical protrusions and lateral interdigitations. When colonies are treated with 10 micrograms/ml of the drug cytochalasin B (CCB), the apical microfilament arrays are disrupted and movement stops. Both phenomena are reversible upon removal of the drug. During the process of redifferentiation, the cells change their shape from squamous to cuboidal, and the greatest change is found where the colony exhibits the greatest number of focal contractions. The evidence suggests that the apical microfilament arrays are directly responsible for the observed movements, particularly the focal contractions, and that focal contractions contribute to the development of the differentiated cellular shape. Possible roles for the other movements are discussed.


Involvement of glutathione in the inhibition of sea urchin egg mitosis by phenyl glyoxal. Cell division in fertilized sea urchin eggs was reversibly inhibited when the ketoaldehyde phenyl glyoxal (PG) at a concentration of 0.1 mM was added to eggs for ten minutes prior to the formation of the mitotic spindle. We investigated whether inhibition of mitosis was due to PG binding to the cell surface (as previously suggested by Stein and Berestecky, '74) or to some intracellular effect. When 14C-PG was added to eggs, label was readily taken up into the egg cytoplasm; very little label was associated with the egg surface. In the cytoplasm PG combined with equimolar amounts of reduced glutathione (GSH), decreasing the levels of cellular GSH to less than 15% of normal and accounting for at least 50% of the PG taken up by eggs. The concentrations of oxidized and protein-bound glutathione were unaffected by PG treatment. We showed that glyoxalase enzymes were present in sea urchin eggs and were capable of metabolizing the PG-GSH complex, thereby restoring GSH to normal levels after PG was removed from the sea water. Though some other effect of PG cannot be ruled out, the major fate of PG in eggs was to combine with GSH, and the transient decrease in GSH which resulted could lead to inhibition of mitosis. While other reports (Nath and Rebhun, '76; Oliver et al., '76) have shown that reagents which oxidize GSH disrupt microtubule-related events, our results showed that such inhibition could be caused by decreased GSH levels alone.


Measurement of formaldehyde concentrations in a subatmospheric steam-formaldehyde autoclave. A method has been developed for measuring formaldehyde concentrations in a subatmospheric steam-formaldehyde autoclave. Data obtained using this method indicate that the concentration of formaldehyde in the chamber atmosphere is not homogeneous and that it decreases rapidly with time. The penetration of formaldehyde vapour into narrow tubes has also been investigated and was shown to be dependent on the length-to-bore ratio of the tubes. The formaldehyde concentration within the tubes could be increased by using a lower vacuum in the air removal stage at the beginning of the cycle.


Primary sarcoma of the heart: a light and electron microscopic study of two cases. Two cases of primary malignant cardiac neoplasms are presented. The first, an angiosarcoma of the right atrium, developed in a 44-year-old housewife, who survived 23 days from the time of presentation; diagnosis was made at necropsy. The second, an embryonal rhabdomyosarcoma of the right ventricle, developed in a 17-year-old student; diagnosis was made by angiocardiography. He underwent surgery and cytotoxic and irradiation therapy and died 14 months later.


Utilization of milk proteins as starting materials for other foodstuffs. The modern food-processing industry is placing more and more emphasis upon the utilization of protein ingredients to provide specific functional properties to a wide range of formulated foods. Isolated milk protein products represent an important and valuable source of protein ingredients due to their recognized superior nutritional, organoleptic and functional properties. This paper provides up-to-date information on the quantities, production processes, composition, general properties, and specific functional properties of the major milk protein products, e.g. caseinates, co-precipitates, lactalbumin, whey protein concentrates and milk blends. The subject of chemical and enzymic modification to improve certain functional properties of milk proteins is considered briefly.


Eosinophilia in maintenance hemodialysis patients. Peripheral blood eosinophilia was noted in 38% of a group of maintenance hemodialysis patients, and documented by bone marrow examination. The prevalence of eosinophilia rose with increasing time on hemodialysis. In 3 subjects the phenomenon appeared to be related to dialysis equipment, but the relationship was less clear in the group as a whole. Severe hypersensitivity reactions during dialysis occurred in 2 patients with marked eosinophilia. Possible causes of sensitization in maintenance hemodialysis patients are discussed.


Health in old age: how do physicians' ratings and self-ratings compare? The present study was designed to provide information on the relationship between self-reports of health and physicians' ratings in an aged sample, and to determine how both of these measures of health relate to longevity. Subjects were 69 survivors (median age = 84.25 years) of a sample of aged twins who had been followed longitudinally since 1947 to 1949. Self-reports of health were found to be significantly correlated with ratings assigned by a physician on the basis of medical records. Both types of measures were predictive of differences in survival time among the younger subjects in the sample, but neither was significantly related to longevity for older subjects. The results suggest that self-reports could provide a valid, cost-effective means of health assessment in studies in which other forms of health information are lacking.


A study of the hygienic aspects of the pedagogic process. A knowledge of the laws governing changes in the functional state of the organism of pupils during lessons at school is one of the principal bases for solving the hygienic problems of organizing the teaching. The main concern is the dynamics of changes in the actual functional state of the CNS as a result of a whole complex of endogenous and exogenous factors as well as the school work of the pupil itself. Changes in the functional state of the optic and acoustic analysors deserve special attention in this respect because of their great exposure in pedagogical work. The existing interindividual differences in performance and in the work rate of pupils should be solved by an adequate pedagogical approach. Correct use of the principle of differentiated tuition can be a positive contribution to solving some of the topical problems of hygiene of the pedagogical process.


Biochemical investigation of the functional state of various subcellular structures as a criterion for the assessment of unfavourable effects of environmental factors. Theoretical basis and results of biochemical studies of the enzymic systems of different localization in the cell--both bound with subcellular structures lysosomes--and dissolved in the cytosol--during experimental exposure to some environmental factors (carbon tetrachloride, carbon disulphide and others) are presented. It has been suggested to employ the assessment of the functional state of biomembranes of cellular organelles (e. g. lysosomes) and especially the effect of solubilization of membrane-bound enzymes and labilization of lysosomal membranes as one of the biochemical criteria of hygienic assessment of toxic effects and of some forms of delayed effects of environmental contaminants. Simultaneous biochemical investigation of enzyme-markers of subcellular organelles in the tissues of various organs and in biological fluids (blood, urine, seminal and amniotic fluids) permits us to elaborate and recommend for use in hygienic practice new biochemical criteria of unfavourable biological effects of chemical factors of the environment.


Bacteriocin typing of some Lactobacillus species of the subgenus betabacterium. One hundred and forty cultures of L. fermenti, L. brevis, and L. buchneri were tested by the method of delayed antagonism for sensitivity to 39 bacteriocins produced by lactobacillus strains of different species. According to their bacteriocin sensitivity patterns, 84 L. fermenti, 43 L. brevis and 13 L. buchneri cultures were differentiated into 26, 18 and 10 bacteriocin types, respectively. Bacteriocin typing allows not only intraspecific differentiation of L. fermenti, L. brevis and L. buchneri cultures but also a subdivision of their biochemical-physiological variants.


A comparative study of changes in immunological reactivity during prolonged introduction of radioactive and chemical substances into the organism with drinking water. A comparative study of the factors of non-specific protection and specific immunity, allergic and autoallergic reactivity during prolonged introduction into the organism of experimental animals of 6 different radioactive and 7 harmful chemical substances was carried out. Qualitative and quantitative peculiarities were found in the changes in immunological reactivity during exposure of the organism to radionuclides and stable chemical compounds. Impairment of immunity plays a substantial role in the course and outcome of affections provoked by chronic effect of the substances examined.


Attempt to isolate antierythrocyte antibodies by the method of affinity chromatography. I. IgM--complete antibodies. It follows from the results of the present study that erythrocyte stromata can serve as a suitable insoluble immunosorbent of complete antibodies. When using optimum conditions, such as laboratory incubation timperature, suitable buffers for both washing the column prior to absorption and for elution, it is possible to obtain, by means of the chromatographic column with 0.5 ml of erythrocyte stromata suspended in 40 g of silica glass beads (ballotini), fractions devoid of complete antibodies and subsequently to obtain the latter in purified form by elution. In complete anti antibodies, the elution yield amounted to an average of 35% of the initial amount of antibodies. Although the elution yield is not high and non-specific absorption has been demonstrated, the method can be recommended for the isolation of complete antibodies and thus for the production of monospecific sera because it is easy, rapid and inexpensive due to the regeneration ability of the mentioned columns and the relatively long duration of the immunoabsorption capacity of the incorporated erythrocyte stromata.


Prevalence of HBsAg and anti HBs in hospital personnel. Of the 473 employees of a Prague hospital, examined for the presence of hepatitis B surface antigen (HBsAg) and the antibody to it (anti HBs), 23 (4.9%) were shown to have the antigen and 88 (18.6%) to have the antibody. No differences were found in the prevalence of HBsAg and anti HB according to sex and age, but the percentage of persons with antibodies increased with increasing length of occupation. Significantly higher levels of antibodies were found in persons having direct contact with the patients or their excretions (nurses, laboratory assistants). Positive serological findings were more frequent in employees with a history of falling ill with hepatitis after entering employment in the health services than in persons without this history. In the serological evidence of hepatitis B according to work place, those working in biochemical and haematological laboratories and in the blood transfusion department took first place, followed by persons employed in medical and surgical departments.


Laboratory epidemic of toxoplasmosis.

Laboratory epidemic of toxoplasmosis. Mass occurrence ot toxoplasmosis in laboratory employees of a department of genetics was described. Biological material collected for genetic examinations and cultures as cell cultures in media which, if not directly enhancing proliferation of possibly present toxoplasmata during cultivation, at least do not essentially unfavourably influence their viability, is considered to be a potential source of infection.


Incidence of antibodies to antibiotics in subjects with chronic staphylococcal diseases. Antibody response to antibiotics in patients with chronic staphylococcal diseases was studied and the results were compared with the production of specific antibodies. Increased titres of antibodies to antibiotics were found in cases with inadequate antibody response. The possibility of an immunosuppressive effect of antibiotics on the formation of specific antistaphylococcal antibodies is discussed.


Evaluation of intercellular adhesion with a very simple technique. Rosetting techniques are widely used to quantify or purify various lymphocytic subpopulations; however, these techniques cannot discriminate between different receptors of similar specificities and different binding strengths, further, they do not provide any information concerning the molecular mechanisms involved in cell-cell adhesion. This paper describes a very simple technique of assaying rosette stability: cell suspensions are driven with known pressure through a calibrated needle with a syringe. Adhesion is quantified before and after this treatment. This procedure did not damage rat peritoneal cells used in a model system. Further, this method yielded fairly reproducible results and allowed a crude estimate of the force involved in the binding of glutaraldehyde-treated sheep red cells (GSRC) or immunoglobulin-coated sheep red cells (IGSRC) by rat macrophages (an average force of 0.8 x 10(-7) Newton was needed to separate 50% of bound IGSRC from macrophages). Binding and binding strength were found to be independent parameters. Last, this method possibly provided a way of separating two distinct subpopulations of rat macrophages. It is suggested that this technique might be routinely used to refine rosette studies.


on the extracellular sheath of dermal melanocytes in nevus fusco-ceruleus acromiodeltoideus (Ito) and Mongolian spot. An ultrastructural study. The dermal melanocytes in the lesions of nevus of Ito and Mongolian spot were shown to possess the extracellular sheath composed of both fine filaments and granules (2-5 nm in diameter). In the case of nevus of Ito, the granular component appeared to predominate in the shealth, which measured up to 3 micrometers in width and was estimated to cover about 97% of the total surface of dermal melanocytes. No ultrastructural changes were appreciable on the melanocyte shealth in nevus of Ito according to the difference in the age of patients (39 and 64 years), or in the lasting period of the dermal melanocytosis. By contrast, the melanocyte sheath in the case of Mongolian spot was much less developed than in nevus of Ito, predominantly filamentous in texture, and showed a marked decline with advance of the age of infants (from 2 mo to 6 yr). Many of the dermal melanocytes in Mongolian spot showed a partial disruption of their cytolemma, resulting in discharges of melanosomes free into the connective tissue matrix. Significance of these findings was discussed in relation to the differtial fate of melanocytes within the human dermis.


Human reticulocyte maturation and its relevance to erythropoietic stress. A comparative study of circulating human reticulocytes by phase-contrast microscopic observation and NMB staining revealed two different forms of reticulocytes which could be clearly distinguished by their distinctive morphologic appearance. These were (1) a multilobular motile form and (2) a cup-shaped nonmotile form. Sequential studies of different populations in the circulation of newborns showed that the multilobular form was the youngest and the cup-shaped form the more mature reticulocyte. The multilobular form was found in the circulation only under conditions of erythropoietic stress and could not be detected in the circulation of hematologically normal individuals. The presence of these characteristic forms in peripheral blood can be used as a reliable indicator of transient or persistent erythropoietic stress.


Clinical records.

Clinical records. By facilitating the early detection of an intracranial lesion, electronystagmography contributed to a successful outcome in a thirty-eight-year-old patient who initially presented only with occasional dizzy spells associated with nausea and vomiting, but with no other central nervous system, cardiovascular or otological signs.


Dynamic characteristics of F-actin and thin filaments in vivo and in vitro. Measurements of birefringence, ultraviolet dichorism and quasielastic light scattering were carried out on F-actin in solution and on the thin filaments of glycerinated myofibrils. The birefringence of the I-bands of myofibrils was of the same order of magnitude as that of F-actin or the F-actin-tropomyosin-troponin complex oriented in vitro at the same concentration. The ultraviolet dichroism spectrum of the I-bands was very similar to that of F-actin or the F-actin complex in vitro, which is due to orientation of bound ADP and tryptophan residues in F-actin. Quasielastic light scattering measurements, electronmicroscopic observations and the analyses of the electro-optic effect of the I-bands suggested approximately the same flexibility for F-actin in vitro and for the thin filaments in vivo. These optical measurements which were made under various conditions provide evidence for a conformational change induced by calcium ions in F-actin both in vivo and in vitro. This conformational change was found to be amplified by the interaction of F-actin with myosin. This is a brief review of our investigation on the dynamics of F-actin and the thin filament in vivo and in vitro by optical methods.


Dielectric dispersion of actin.

Dielectric dispersion of actin. The dielectric dispersion of G-actin was 7 X 10(6) Hz, and the low frequency reduced dielectric increment 0.99 +/- 0.15 ml/mg. The dielectric increment of F-actin in the range 10(5) to 10(8) Hz was very low, about 0.3.


Plasma concentrations of ovarian hormones during the oestrous cycle of the sheep and cow. Measurements were made of the plasma concentrations of testosterone, progesterone and oestradiol-17 beta during the oestrous cycle of the ewe, and of the plasma concentrations of testosterone and progesterone during the oestrous cycle of the heifer. The maximum concentration of progesterone in the heifer was nearly twice that in the ewe. The maximum concentration of testosterone was similar in both species and occurred at the onset of luteolysis; in the ewe the peak concentration of 19.5 ng/ml plasma was significantly greater (P less than 0.05) than the concentrations of testosterone measured during the remainder of the oestrous cycle.


Electrochemical deposition of iron onto rat oxytocinergic neurones does not result in milk-ejection. Exposure of the preoptic-tuberoinfundibular system to iron ions causes ovulation in the pro-oestrous rat. This electrochemical treatment has been used frequently to study the way that the hypothalamus triggers secretion of gonadotrophic hormone and most investigators have assumed that the effect is mediated by the direct excitation of those neurones exposed to the cation. The present paper reports experiments designed to confirm that iron directly excites hypothalamic neurones to the firing frequencies essential for ovulation. Because of the difficulty of measuring input-output relationships in the diffuse preoptic-tuberoinfundibular system the experiments were performed on the anatomically distinct oxytocinergic neurones of the paraventricular-hypophysial tract in lactating rats. These neurones were simulated electrically (from 10 to 50 Hz for between 1 and 300 s) and subjected to the electrochemical treatment by depositing iron ions from the tip of the stimulating electrode (up to 250 muA anodal current for between 60 and 180 s). Changes in intramammary pressure were used to indicate oxytocin release and mammary glands were calibrated for sensitivity by intravenous injection of oxytocin. Electrical stimulation in excess of about 15 Hz invariably caused release of sufficient oxytocin to cause a rise in intramammary pressure. In contrast, no changes in pressure were observed during or after the electrochemical deposition of iron. The results suggest that the response of hypothalamic neurones to electrochemical treatment is not the same as their response to electrical stimulation.


Plasma concentrations of luteinizing hormone, follicle-stimulating hormone and progesterone during the breeding season in ewes immunized against androstenedione or testosterone. Levels of plasma LH, FSH and progesterone during the breeding season were measured by radioimmunoassay in control ewes and ewes actively immunized against androstenedione-11 alpha-hemisuccinyl--bovine serum albumin or testosterone-3(O-carboxymethyl)oxime--bovine serum albumin. Immunization against androstenedione resulted in normal oestrous cycles with raised plasma LH and progesterone levels and a reduction in the concentration of FSH during the luteal phase. It is tentatively suggested that androstenedione, or its metabolites, could modify the oestrogenic control of LH secretion and facilitate the release of FSH in the ewe. Immunization against testosterone prevented oestrus and resulted in markedly increased levels of LH without alteration of the FSH concentration. Since evidence of increased binding of oestradiol-17 beta was found in the ewes immunized against testosterone, these results cannot be attributed solely to a reduction in the biologically active faction of testosterone.


Plasma concentrations of luteinizing hormone and follicle-stimulating hormone during anoestrus in ewes actively immunized against oestradiol-17 beta, oestrone or testosterone. The concentrations of LH and FSH in jugular venous plasma were measured during anoestrus in control ewes and ewes actively immunized against 17 beta-oestradiol-6-(O-carboxymethyl)oxime--bovine serum albumin, oestrone-6-(O-carboxymethyl)oxime--bovine serum albumin or testosterone-3-(O-carboxymethyl)oxime--bovine serum albumin. During a 12 h sampling period, the basal level of LH and the frequency of LH pulses were significantly increased in all the immunized animals. The plasma FSH concentration was increased in two out of five oestradiol-immunized ewes and two out of three oestrone-immunized animals. The plasma FSH concentration in the testosterone-immunized animals was similar to the control values. Significant titres of antibodies to oestradiol-17 beta were found in all the immunized animals. It is suggested that binding of oestradiol-17 beta in the circulation by antibodies reduced the negative feedback action normally eserted by this steroid on LH secretion and, to a lesser extent, on FSH escretion. However, since the oestradiol antibody titres in the testosterone-immunized and oestrone-immunized ewes were considerably lower than those found in the oestradiol-immunized animals, it is possible that testosterone and oestrone, perhaps by acting as prehormones, could influence the negative feedback control by oestradiol-17 beta of gonadotrophin secretion in the anoestrous ewe.


Glucocorticosteroid receptors in the liver of normal and decapitated rabbit foetuses. The affinity and the number of receptor sites for the synthetic steroid triamcinolone acetonide were studied in the livers of foetal rabbits. Twenty-two-, 24- and 29-day-old control and 29-day-old foetuses decapitated on day 22 were used to determine whether a change in steroid receptors occurs in the liver when it accumulates glycogen, and whether decapitation impairs such a change. Steroid receptors were found as early as day 22, when they were as numerous (0.091 pmol/mg protein) as on days 24 (0.098 pmol/mg) and 29 (0.104 pmol/mg). The binding affinity was found to be slightly higher on day 24 than on day 22 and it remained the same on days 24 and 29. The binding affinity of the receptors was the same in decapitated foetuses as in 29-day-old controls but the number of sites was slightly lower. The labelled steroid was transferred to the nucleus of the liver cells in vivo. It seems unlikely that steroid receptors are the limiting factor preventing the accumulation of glycogen in the liver of the rabbit foetus before day 26 or after decapitation.


Rat defensive behavior: burying noxious food. In Experiment 1, rats living in chambers containing bedding material were injected with a toxicosis-producing dose of lithium chloride shortly after their initial taste of sweetened condensed milk. They consumed no additional milk and used the bedding to bury the spout through which the milk had been delivered, although they did not bury a concurrently available water spout. In another control condition, rats did not bury a spout containing a novel solution (saccharin) not paired with toxicosis. In Experiment 2, rats did not bury a milk spout until milk consumption was followed by toxicosis. In Experiment 3, rats buried a spout containing Tabasco pepper sauce but not a concurrently available water spout. Thus, burying the food source appears to be an integral component of the rat's defensive reaction to noxious food.


Age-related changes in ovarian responsiveness to gonadotropins in normal and neonatally estrogenized mice. Young ovariectomized mice were transplanted with ovaries obtained from either neonatally estrogenized or normal mice at different ages. Cyclic estrus ensued in 71% of the mice receiving ovarian grafts from 3-month-old normal donors. If donors were 12, 15 and 20 months old, cyclic estrus took place in 15, 10 and 0% of the recipients, respectively. By contrast, after transplantation of ovaries from neonatally estrogenized mice, and 3, 12 or 15 months, cyclic estrus occurred in about 42-48% of the recipients regardless of the age of donors. Three of 17 recipients receiving ovarian grafts from 20-month-old neonatally estrogenized donors still showed cyclic estrus. Therefore, in neonatally estrogenized mice, decline of ovarian responsiveness to circulating gonadotropins appears to be inhibited or delayed until at least 15 months of age.


In vitro fertilization of two species of deer mouse eggs by homologous or heterologous sperm and penetration of laboratory mouse eggs by deer mouse sperm. Newly ovulated eggs from immature deer mice (Peromyscus maniculatus and P. polionotus) and mature laboratory mice (Mus musculus) treated with PMSG and HCG were inseminated in vitro with spermatozoa recovered from the cauda epididymidis of mature males. The time required for capacitation of deer mouse sperm in culture was estimated to be about two to five hours based on the dispersal of sperm agglutination and increase of sperm motility. The rate of sperm penetration through the zona pellucida of deer mouse eggs by homologous or heterologous sperm was relatively high (72-91%) but that of laboratory mouse eggs by deer mouse sperm was low (20-21%). After penetration through the zona pellucida, a high proportion of deer mouse eggs (79-93%) were fertilized by homologous or heterologous deer mouse sperm but no laboratory mouse eggs were fertilized by sperm of two species of deer mice. The zona pellucida was dissolved in a higher proportion of laboratory mouse eggs cultured with P. maniculatus (45%) than with P. polionotus sperm (3.4%), but this did not happen by incubation of deer mouse eggs with homologous or heterologous sperm. It seems that there is little difference in sperm penetration and fertilization between these two closely related species of deer mice but the reactions between the mouse eggs and deer mouse sperm are quite different.


Diurnal variation in large granulated vesicles in sympathetic nerve fibers of the mouse pineal--quantitative electron micrsocopic observations. Quantitative electron microscopic studies of the sympathetic nerve fibers of the mouse pineal demonstrated a marked diurnal rhythm in the number of the large granulated vesicles of 80 to 150 nm diameter. The number of these vesicles showed its minimum at the middle and the end of the dark period and its maximum at the end of the light period, respectively. The large non-granulated spherical and elliptical vesicles were almost constant in number throughout the day.


Histopathological types of cardiac fibrosis in myocardial disease. Myocardial fibrosis is a frequently observed pathologic finding. It is a common practice to differentiate macroscopic scarring and microscopic scarring, but there has been little attempt to distinguish the various types of interstitial fibrosis, and to determine their prevalence in different cardiac disorders. In this study, we have semiquantitatively assessed microscopic scarring, interfibre and perivascular fibrosis and a distinctive type of plexiform fibrosis. We examined ten hearts with congestive cardiomyopathy, ten with hypertrophic cardiomyopathy, ten with severe valvular aortic stenosis and ten normal hearts. Perivascular and interfibre fibrosis were quantitatively closely linked and most marked in the congestive cardiomyopathy and the valvular aortic stenosis groups. Plexiform fibrosis occurred maximally in the hypertrophic obstructive cardiomyopathy group, closely associated with myocardium exhibiting muscle fibre disarray. Our study demonstrates that although different types of interstitial fibrosis have particular associations with certain disease entities, the associations are not specific. The recognition of the prevalence of one or more types of interstitial fibrosis may, however, assist in the histopathologic diagnosis of certain myocardial disorders.


Acquired carbohydrate intolerance and cow milk protein-sensitive enteropathy in young infants. Sixty infants with acquired carbohydrate intolerance, 19 with protracted diarrhea, and 41 with features indistinguishable from acute infectious enteritis, were maintained on a lactose-free and cow milk protein-free formula for about eight weeks, after which jejunal biopsies were performed before and after oral provocation with cow milk protein. Following provocation, 43 infants showed mucocal abnormalities associated with marked reduction in the levels of all three disaccharidases. In one infant, mucosal change was unaccompanied by enzyme depletion. Six infants had enzyme depletion without visible mucosal changes. In ten infants the intestinal mucosa remained normal and there was no consistent pattern of change in the enzyme levels. The findings suggest that cow milk protein has a deleterious effect on the small bowel mucosa of young infants recovering from enteritis and may be an important contributing cause of acquired carbohydrate intolerance in these infants. In the management of young infants with acquired carbohydrate intolerance both the offending sugar and protein should be excluded.


Inhibition of the baroreceptor reflex on stimulation in the brain stem defence centre. 1. In anaesthetized cats, the pattern of cardiovascular response characteristic of the defence reaction has been elicited by localized electrical stimulation within the appropriate region of the hypothalamus. The baroreceptor reflex response has been elicited by raising the pressure in a blind sac preparation of the carotid sinus or by electrical stimulation of the sinus nerve.2. In addition to arterial blood pressure, heart rate and regional blood flows, activity was recorded in cardiac and renal sympathetic nerves, to assess more precisely the cardiomotor and vasomotor changes during interactions between brain stem stimulation and baroreceptor activation.3. The sympatho-inhibitory and depressor effects of carotid sinus stimulation or electrical stimulation of the sinus nerve could be completely suppressed by stimulation within the hypothalamic defence area, as could the reflex bradycardia. It is concluded that this suppression is effected through the central nervous system.4. Stimulation at points in the hypothalamus close to, but outside, the defence area, and which elicited increases in arterial pressure and sympathetic activity of similar magnitude to those from the defence area itself, did not abolish the sympatho-inhibitory or depressor effects of baroreceptor activation, though the reflex bradycardia was usually inhibited. It is suggested that this less localized change results from augmentation of the central inspiratory drive which inhibits the vagal outflow to the heart.


Maintenance of functional corpora lutea in androgenized female rats treated with OMSG. Rats were androgenized by injection of 50 micrograms testosterone propionate on the 5th day after birth and when adult were treated with 5 i.u. PMSG; some of the animals were mated. Serum was obtained daily and the concentrations of progesterone, 20 alpha-dihydroprogesterone and prolactin, estimated by radioimmunoassays, were compared to values found for mated, but not ovulating, androgenized females and those for normal pregnant females. Ovulation and luteinization of follicles occurred. The concentration of progesterone increased after the injection  of PMSG and remained elevated for at least 10 days; mating did not alter the progesterone levels. The concentration of 20 alpha-dihydroprogesterone was also elevated but the ratio of the level of progesterone to this steroid was generally greater than unity. Prolatin levels were elevated in the rats which ovulated. It is concluded that the corpora lutea induced in androgenized females by PMSG are functional and maintained.


Female reproductive patterns in nonhibernating bats. The major reproductive events in the oestrous cycles of nonhibernating mega- and microchiropteran species are reviewed. However, special attention is given to the reproductive biology of the temperate North American species, Tadarida brasiliensis mexicana (Molossidae), the Mexican free-tailed bat, which expresses dextral uterine and ovarian dominance. Only the larger right ovary is capable of producing an ovulatory follicle and the left has long been considered atrophic. In order to elucidate the normal oestrous cycle and define the structural and functional characteristics of the ovaries of this nonhibernating bat several analytical technique were utilized. These included light microscopic analysis, histochemical localization of delta 5-3 beta-hydroxysteroid dehydrogenase (HSD) activity, and radioimmunoassay of seasonal plasma progesterone levels. Interstitial tissue was found in both ovaries, but the left was almost entirely an interstitial organ. Histochemical analysis demonstrated that the gonads have seasonally varying amounts of delta 5-2 beta-HSD localized either in the thecal cells of the Graafian follicle or in the interstitium. The corpus luteum persisted throughout gestation, reaching maximum development just prior to parturition. Circulating progesterone levels correlated directly with luteal gland size and peaked at 106 ng/ml when the corpus luteum was largest.


Surgical complications of gynecologic surgery. Complications of gynecological surgery are considerable and when reviewed in detail are almost frightening. There is no substitute for experience and intimate knowledge of the intricate pelvic structures in health and disease.Anyone who is active in the field is sooner or later going to experience some difficulty whether it be due to his miscalculation or to innate conditions in the patient which are beyond his/her control.It is the responsibility of the pelvic surgeon to recognize the complication and apply proper corrective measures. The patient should not be given false hopes of sure success nor should she be deprived of whatever hope for success does exist.


Cystathionine synthase in rat brain: regional and time-of-day differences and their metabolic implications. In relation to concern for probable interrelations of cystathionine synthase (CS, EC 4.2.1.21) and methionine, one-carbon, and 5-hydroxytryptamine metabolism, we have investigated tissue and time-of-day differences in CS activity in the laboratory rat under standardized conditions. Liver, kidney, and pancreas had highest CS activities; nine regions of the CNS had mean activities ranging from 4.5% (lumbosacral cord) to 24.5% (hypothalamus) of mean hepatic activity; pituitary and adrenal glands lacked detectable CS activity. Although significantly lower CS activity occurred in liver (9%, P less than 0.050) and kidney (13%, P less than 0.025) during the interval two hours before to two hours after the daily onset of darkness, no significant changes were found in hypothalamus, cerebellum, or medulla oblongata. Regional CNS differences in CS activity appeared to be without correlation in relation to published data on relative contents of 5-hydroxytryptamine, tryptophan 5-hydroxylase (EC 1.14.16.4), 5,10-Methylene reductase (N5-methyltetrahydrofolate-NAD-oxidoreductase, (EC 1.1.1.78), or 5-methyltetrahydrofolate. Therefore, among CNS regions examined, a critical deficiency in ability to metabolize a homocysteine load is considered to be unlikely under normal conditions.


Dissociated effects of inhibition of catecholamine synthesis on motor activity, "emotionality," and aggression in mice. The inhibitor of catecholamine synthesis at the tyrosine hydroxylase level, alpha-methyltyrosine, administered in daily doses of 250 mg/kg IP, altered motor activity and aggressive behavior of isolated male mice in ten-minute paired encounter tests conducted on nine successive days. Motor activity was determined by an electromagnetic activity meter which measures fine and coarse movements separately. Coarse motor activity correlated significantly with aggressive behavior. Nonaggressive fine motor activity was significantly increased, while all the parameters of aggressive behavior showed a significant decrease in aggression. Increased escape behavior, heterogrooming, squeaking, and two cases of stupor were observed, suggesting possible equivalents of anxiousness. The defecation rate did not differ from that of the control group, victors having had a higher rate than losers. Results are discussed in connection with the "construct of emotionality" and the hypothesis of there being several categories of aggression with corresponding biochemical correlations.


Tuberculosis of the male urethra.

Tuberculosis of the male urethra. Tuberculosis of the male urethra is a rare lesion, with only 21 cases reported in the literature. Two patients with tuberculosis of the urethra, who presented with multiple periurethral fistulas and a periurethral abscess, are described. In both patients there was associated genitourinary tuberculosis. Mycobacterium tuberculosis could be isolated from the urine and the exudate of the perineal ulcers. Biopsy from the perineal ulcers demonstrated tuberculous granulation tissue with tuberculous bacilli. Treatment consisted of suprapubic cystostomy and a 2-year course of antituberculous drugs, consisting of streptomycin, para-aminosalicylic acid and isoniazid. The urethral fistulas healed with this treatment. The urethral strictures were treated with repeated urethral dilations.


Sequential bilateral germ cell tumors of the testis despite interval chemotherapy. We report on 3 patients who had a second primary germ cell tumor of the testis despite prior or ongoing systemic chemotherapy for the original tumor. Evidence favoring the designation of the tumors as separate primary lesions is presented. The clinical and theoretical implications of this phenomenon are discussed.


HLA in hypertrophic cardiomyopathy and rheumatic heart disease. 1. HLA antigens were determined in 30 Japanese patients with hypertrophic cardiomyopathy. Several antigens were more common in patients compared with controls, but statistically significant differences were not evidenced. In families one and two, six of seven kindred who inherited HLA-A9 and B7 had the disease. None of five kindred lacking HLA-B7 showed evidence of the disease. In families three and four, affecting family members had HLA-A2 and BW-35. Our finding suggest that the HLA system may play some role in the pathogenesis of hypertrophic cardiomyopathy with familial occurrence. 2. Twenty patients with rheumatic valvular heart disease were also studied. There was no significant difference in frequencies of HLA antigens between patients and controls.


Hepatocarcinogenesis by hydrazine mycotoxins of edible mushrooms. Two edible mushrooms are known to contain hydrazine analogs. The wild false morel Gyromitra esculenta contains up to 0.3% acetaldehyde methylformylhydrazone and N-methyl-N-formylhydrazine (MFH). The latter chemical, under certain conditions, also yields methylhydrazine. The commonly eaten, cultivated mushroom Agaricus bisporus contains up to 0.04% beta-N-[gamma-L(+)-glutamyl]-4-hydroxymethylphenylhydrazine and 4-hydroxymethylphenylhydrazine. MFH was administered in drinking water continuously for life to Swiss mice and Syrian (golden) hamsters. In both species the compound induced high incidences of benign and malignant hepatocellular neoplasms. Also, methylhydrazine given orally induced a significant incidence of malignant histiocytomas in the livers of hamsters. The N'-acetyl derivative of 4-hydroxymethylphenylhydrazine administered orally to mice gave rise to lung tumors and blood vessel tumors, mainly in the liver. Furthermore, these three compounds produced tumors in various other tissues. Histopathologically, the tumors were classified as benign hepatomas, liver cell carcinomas, angiomas and angiosarcomas of blood vessels, and adenomas and adenocarcinomas of lungs. From representative samples of these neoplasms detailed transmission electron microscopic investigations were also carried out. Since these hydrazine analogs induce tumors in animals and these mushrooms are consumed on a large scale by humans in various parts of the world, their hazardous nature should be considered.


[Organization and performance of a selective screening programm for organic acidurias (author's transl)]. After definition and a short description of organic acidurias, the benefits of a selective screening for this group of diseases are demonstrated. In all children, being suspected to suffer from an inborn error of metabolism and giving rise to investigate the serum amino acids, the urinary organic acids should be analyzed additionally. A more detailled list of indications is given. Some specialized laboratories performed the necessary investigations routinely are announced.


[Mucocutaneous lymph node syndrome in Austria -- Report of four cases; one with cardiac arrest. First of two parts: clinical observations (author's transl)]. Since October 1978, four cases of mucocutaneous lymph node syndrome, a disease previously not yet described in our country were observed in our childrens hospital. This particular disease has been described quite frequently in Japan since 1967. It has a characteristic manifestation being mostly benign and self limited. In a few cases however acute cardiac arrest has been described. The first case we observed expired as a result of acute coronary infarction on the twentyfifth day of illness although clinical improvement had been previously noted. At post mortem examination the coronary arteries showed changes consistent with arteriitis. The following three cases presented the more typical benign course of this disease one of them with deformities of the coronary arteries. The clinical synopsis describes the above mentioned cases.


[Study of the glucose concentration in five vascular regions -- aorta, arteria pulmonalis, vena cava inferior, vena cava superior, vena hepatica -- in childhood (author's transl)]. Using the Beckman glucose analyzer, glucose concentration was determined in the serum of the fasting blood in five vascular regions -- aorta, arteria pulmonalis, vena cava inferior, vena cava superior, vena hepatica -- of 52 children (ages 2,5 months up to 14 years and 3 months, x = 6 years and 3 months, male = 28, female = 24) with a healthy metabolism. The comparison of the average values of the glucose concentrations determined in five vascular regions in childhood showed that the glucose concentration in the vena hepatica was statistically significant higher than in the other vascular regions. Moreover the comparison of the glucose concentrations revealed that the values in the vena cava inferior were statistically significant higher as compared to the values in the vena cava superior. The glucose concentrations in the arteria pulmonalis, the vena cava superior and the aorta were nearly equal. Compared with the older children, the younger children had in all the investigated vascular regions lower glucose concentrations.


[A contribution to the understanding of Infantile self-mutilation based on communication theory (author's transl)]. Autoaggressive behaviour in childhood often poses diagnostic and even more so, therapeutic problems to the physician. One of the causes on which these problems are based, is that hitherto there was no possibility to look into the "conditional structure" of autoaggressive behaviour in a large population of children using sound statistical methods. The results as reported in this study are based on an "automutilationquestionnaire" as developed by the authors. They support the hypothesis that the different kings of self-mutilation, although phenomenologically quite variable, represent a deficiency of communication. This communication deficiency is manifested in that the child, by being autoaggressive, seeks to satisfy for the insufficiently compensated asymmetric communication with his environment. This result emphasizes in particular the necessity to include the family in the therapeutic regimen of the treatment of the autoaggressive child.


[Long-acting traumas following hospitalisation (author's transl)]. The article reports on 50 children with hospital (operation) traumas presented many years later to the doctor or educational consultant because of disturbed behaviour basing on an anxiety neurosis combined with a symbiotic mother fixation. In these cases, there was a clear connection between the triggering traumatising event the the existing symptom pattern. Most of the children had been admitted during infancy once or several times to special wards without sufficient psychological care and with restricted visiting hours. Tonsillectomy and strabotomy, as well as equilibrating operations, have proved to the particularly traumatising, especially in infants. This is evident even after several years and shows up during psychodiagnostic examination. Children who have suffered an accident and are admitted to hospital in a state of shock, are particularly susceptible to the hospital separation trauma. Preventive and curative psychohygienic measures are described. The mother's presence in the hospital has always remained the most reliable protection, from the infant's aspect, in all danger situations, including hospitalisation.


[Intracranial pressure increase following treatment nalidixic acid in a child aged 3 1/2 years (author's transl)]. Neurological symptoms developed in a girl aged three-and-a-half years during treatment with nalidixic acid. The symptoms progressed even after the preparation had been discontinued, and culminated in the development of a transient intracranial pressure increase.


[Congenital atrial flutter with hydrops fetalis caused by tocolytic therapy (author's transl)]. A 31-year-old healthy woman received Ritodrine (Pre-Par) from the 26th week of gestation because of twin pregnancy. Three weeks before birth continous intravenous medication with the same drug was commenced because of premature uterine contractions. Five days later a heart rate of over 200/minute was noted in one of the twins. This tachycardia persisted until birth while the heart rate of the other twin remained normal. At 33 weeks monozygotic female twins were delivered after artifical rupture of membranes. One twin was normal, birth weight 1.6 kg. The other baby showed persistent atrial flutter, was hydropic (weight 2.75 kg) and suffered from gross cardiac failure. Atrial flutter was converted to sinus rhythm one hour after birth by DC-countershock. Digoxin was commenced, the child rapidly improved and now still remains in sinus rhythm six month later.


The child with chromosome ring 15.

The child with chromosome ring 15. A case of ring chromosome was reported. By application of different techniques it was identified as 15 r. The boy 19 months old was of a short stature, small skull and slight psychomotoric retardation.


[Triglandular insufficiency in a 14-year old boy (diabetes mellitus, adrenal cortex insufficiency, hypothyrosis) (author's transl)]. The article reports on a 14-year old boy who developed diabetes mellitus juvenilis when he was twelve years old. In his fourteenth year of life, an insufficiency of the adrenal cortex appeared as an additional symptom, followed half a year later by hypothyrosis. The article discusses the aetiological aspects. References are added regarding the combination of Addison's disease and diabetes mellitus in children and juveniles.


Insulin influences on fetal growth.

Insulin influences on fetal growth. Insulin appears to function as a "growth hormone" during late fetal development in man and other species. Infants of diabetic mothers exhibit generalized somatic hypertrophy except for the brain. Effects of insulin on fetal growth may be direct influences on cell proliferation or insulin may indirectly affect growth through stimulation of glucose and amino acid uptake into fetal tissues. While hyperinsulinism results in fetal macrosomy there is a delay in pulmonary functional maturity in infants of diabetic mothers that may reflect insulin induced alterations in lung growth and substrate flow in phospholipids.


[Experiments for the development of a hepatitis B vaccine: immunogenicity of HBsAg in guinea pigs (author's transl)]. Hepatitis B surface antigen (HBsAg) was purified from human plasma by gel chromatography, isopyknic centrifugation, and zonal centrifugation. The final product had about 60% of the original activity and was essentially free from hepatitis B virus particles (HBV) and plasma proteins. Treatment with formaldehyde concentrations up to 0.1% for inactivation of residual infectivity did not significantly reduce antigenicity in vitro and immunogenicity in guinea pigs. Adsorption to aluminum hydroxide resulted in 16-fold higher concentrations of antibody against HBsAg (anti-HBs) than did injection of soluble HBsAg. After two injections of 0.2 microgram HBsAg, which was treated with 0.1% formaldehyde and absorbed to aluminum hydroxide, the median titer of anti-HBs in guinea pigs was 4 IU/ml (normal value in human hepatitis B convalescents: about 0.1) for 1 year without further injections. When guinea pigs received 12 equivalents of homologous anti-HBs serum before the first injection of adsorbed HBsAg, the same anti-HBs titers were found after the booster injection as in animals which had not been passively immunized. A simultaneous application of an experimental HBsAg vaccine and hepatitis B immunoglobulin would probably decrease the potential risk of HBV infections caused by the vaccine itself and also produce rapid protection. To establish absence of HBV as completely as possible, the vaccine should be produced from anti-HBe-positive plasma by efficient purification procedures and it should be inactivated by formalin.


[Effect of methanosarcina on the growth of primary anaerobes]. The effect of Methanosarcina vacuolata on the mixed celluloytic population and on pure cultures of anaerobic bacteria was studied. In the pasteurized enrichment culture decomposing cellulose but producing no methane, the biomass of primary anaerobes increased at a higher rate when Methanosarcina was introduced; the rate of cellulose hydrolysis did not change. Methanosarcina stimulated also the growth of Escherichia intermedia and Ruminococcus albus on a medium containing glucose and cellobiose. The growth of combined cultures with the production of methane was possible only on a medium with a low content of carbohydrates since an increase in the concentration of glucose inhibited the growth of Methanosarcina.


[Preliminary and postradiation effect of long-wave ultraviolet rays on cells of different species of Candida irradiated with short-wave ultraviolet rays]. Certain characteristics of photoprotection induced by near-UV were studied in Candida guilliermondii. Candida tropicalis was also capable of photoprotection from the lethal effect of far-UV. The spectrum of action of photoprotection was recorded. The photoprotective effect was not found in Candida utilis. The postradiation effect of near-UV was studied. The lethal action of far-UV was intensified in C. guilliermondii and C. tropicalis incapable of photoreactivation in contrast to C. utilis capable of photoreactivation.


[Alcohol dehydrogenase activity of Torulopsis candida during growth on intermediate products of glucose and hexadecane oxidation]. The activity and substrate specificity of alcohol dehydrogenases (ADH) toward normal primary alcohols with different length of the carbon chain (C2--C16) was studied in the cells of the yeast Torulopsis candida. The yeast was grown in a mineral medium with various carbon substrates: glucose, pyruvate, acetate, hexadecane, cetol and palmite acid. Soluble ADHs in the cytosol fraction and ADHs bound to the fraction of membrane particles (mitochondria and microsomes, etc.) were found in the cells. Dehydration of higher alcohols (C8--C16) by the membrane fraction of cells was shown to have a relatively high rate (considerably higher than in cytosol) when the yeast was grown on hexadecane, cetol, palmitic acid and pyruvate. The membrane fraction of yeast cells prepared upon the growth on all carbon sources tested did not oxidize lower alcohols, ethanol and propanol. In contrast, upon the growth on glucose, ethanol and acetate the activity of ADH was mainly due to soluble ADHs and concentrated mainly in the cytosol fraction. Numerous molecular forms of ADH differing in their affinity for lower and higher alcohols and dependent on the growth substrate were revealed by electrophoresis in polyacrylamide gel.


Changes in free nucleotides, nucleosides and bases during thermal processing of goat and sheep meats. Part I. Effect of temperature. Effect of processing temperature on the changes in free nucleotides, nucleosides and bases in goat and sheep meats was investigated. The major changes in nucleotides and related compounds took place during first 30 min of heating and the rates of changes were maximum at 60 degrees C and minimum at 100 degrees C. At 120 degrees C, thermal degradation of inosinic acid proceeds at significant rates but below 100 degrees C major changes are brought about by phosphomonoesterases (5'-mononucleotidases) during initial stages of heating.


Pyrimidine dimer excision in human cells and skin cancer. We compared three methods for estimating the induction and removal of UV-induced pyrimidine dimers from the DNA of human fibroblasts. Results indicate that after UV doses of 5-20 J/m2, 50% of the dimers are removed by 24 hours. Almost complete excision can be observed if the cells are incubated for periods not less than 72 hours after a dose of 5 J/m2. After higher doses, it probably takes even longer for such complete removal to doses, it probably takes even longer for such complete removal to be seen.


Role of the pineal gland in diurnal endocrine secretion and rhythm regulation. The effects of the pineal gland on diurnal endocrine function were studied in male rats. Pineal stimulation by exposure to short daily photoperiods (1L:23D) did not alter plasma levels of testosterone, thyroid-stimulating hormone (TSH) or growth hormone (GH) as compared with those of controls maintained under normal (12L:12D) lighting. Pinealectomy lowered diurnal testosterone levels and increased TSH levels in animals maintained under 1L:23D lighting. Pinealectomy also altered the TSH rhythm and shifted the peak in testosterone levels but did not abolish hormonal rhythms. Active immunization against melatonin and its precursor, N-acetylserotonin (NAS), significantly reduced diurnal androgen levels and elevated TSH levels in animals exposed to short photoperiods, but the 24-hour rhythms persisted. Plasma GH exhibited a diurnal rhythm in animals kept under short photoperiods but GH levels were not affected by any of the above treatments. These data suggest that melatonin and/or NAS may be involved in the maintenance of basal testosterone and TSH levels. The pineal may not be involved in generating hormonal rhythms; however, it may have a role in entraining TSH and testosterone rhythms to environmental lighting.


Clinical correlations of partial deficiency of lipoamide dehydrogenase. Reduced activities of lipoamide dehydrogenase (LAD) relative to cytochrome oxidase have been found in 12 or 26 patients with inherited ataxias. One of the 12 patients had adult-onset ataxia plus ragged-red muscle fibers. The other 11 had Friedreich syndrome or early-onset variants of this, as did 6 patients with normal enzyme activity. However, the 11 patients with reduced enzyme activity were clinically more homogeneous than the 6 with normal activity.


Epileptogenic paroxysms: modern approaches and clinical correlations. Epileptogenic paroxysms were studied in patients whose attacks were verified during prolonged recordings on the closed-circuit television-electroencephalogram (CCTV-EEG). Three types of complex partial seizures and four subvarieties of absence seizures were observed. All patients with complex partial seizures showed interictal spikes. Focal, low-voltage 8- to 30 Hz rhythms were most common during the onset of partial seizures in 64 patients, whereas diffuse spike-wave complexes appeared most often during generalized seizures in 26 patients. Relating the exact onset of clinical attacks on the videotape to depth electrographic events defined the local or diffuse origin of seizures in candidates for anterior temporal lobectomy.


[Activation of bioelectric activity of the brain by sleep deprivation after closed craniocerebral injuries]. The study was undertaken for establishing the practical usefulness of 24- or 48-hour sleep deprivation test for activation of bioelectric changes in electroencephalographic investigations of patients after craniocerebral injury with loss of consciusness. For clinical and EEG investigations 84 patients were qualified. The age range was mostly 20--26 years with a low standard deviation. Positive activation was obtained in 33 cases (39.3%). A correlation was found between the frequency of positive activation was obtained in 33 cases (39.3%). A correlation was found between the frequency of positive activation and the severity of past trauma. Focal temporal-lobe changes prevailed among these bioelectric changes.


Results of the national surveillance for Guillain-Barré syndrome. The preliminary results of the national surveillance for Guillain-Barré syndrome(GBS) are reported. In the first 6 months of 1978, 327 cases of GBS were reported to the Center for Disease Control (CDC). A statistically significant difference was observed between sex-specific attack rates, and a direct correlation also was observed between advancing age and increasing risk of GBS.


Landry-Guillain-Barré syndrome with abnormal pupils and normal eye movements: a case report. A 66-year-old woman with acute idiopathic polyneuritis (Landry-Guillain-Barré [LGB] syndrome) had normal extraocular movements, but her pupils did not react to light or accommodation. This is the first such case to be reported. Pharmacologic testing pointed to postganglionic involvement of parasympathetic and sympathetic nerves.


Investigation of the role of prolonged emotional stress in the genesis of hypercholesteremia and hypertension. In experiments on freely moving rabbits, exposed to prolonged (for 2 h) interrupted stimulation of negative emotiogenic zones of the hypothalamus through implanted electrodes daily for 4 months, the development of a lasting endogenous hypercholesteremia and of a mild but lasting hypertension was observed. Changes in the cholesterol concentration were greater if stimulation continued in conjunction with daily feeding of the rabbits with small doses of methylthiouracil.


Sign language aphasia in a non-deaf-mute. A 19-year-old left-handed man, who was raised by deaf-mute parents and learned sign language concurrently with normal speech, sustained a traumatic cerebral contusion. He subsequently had no evidence of apraxic, visual-spatial, or sensorimotor deficits of the left limbs with which he was accustomed to use signs. Globally aphasic with a dense right hemiparesis, he initially recovered sign language to a greater degree than spoken language with a reversal on follow-up observations. Receptive skills improved to a greater degree than expressive skills with no marked difference between verbal and sign language, but with natural signs better preserved than finger spelling.


Chorea: a late complication of a subdural hematoma. Subdural hematoma has rarely been implicated as a cause of chorea. We describe a case of chorea occurring several months after evacuation of a traumatic subdural hematoma. No other causes of chorea were found. In this case and one previously reported case, signs of tentorial herniation were present prior to surgery. Herniation may damage the basal ganglia, with resultant chorea.


Fusiform basilar artery aneurysm in a child. A giant fisuform basilar artery aneurysm ruptured, causing the death of an 11-year-old girl who had presented with a 5-month history of headaches and a 1-month history of progressive brainstem features with choreiform movements. This case, unlike other reported cases, demonstrated no evidence of a generalized arteriopathy, and draws attention to the occurrence of this rare cause in the differential diagnosis of progressive brainstem syndrome in children.


Jaw reflex in Friedreich ataxia.

Jaw reflex in Friedreich ataxia. Twenty-one patients with Friedreich ataxia were examined and found to have a brisk jaw reflex. This previously unreported clinical finding contrasts with the impairment of tendon reflexes in the limbs and should not rule out the diagnosis of Friedreich ataxia.


Audioalgesic and audiovisuoalgesic synesthesias: epileptic manifestation. A patient with partial seizures with complex symptomatology of left frontotemporal origin experienced audioalgesic and audiovisuoalgesic synesthesias.


Amphetamine-induced hypersensitivity in guinea pigs. Chronic administration of d-amphetamine to young guinea pigs results in an increased behavioral response to this drug. After 6 months of daily amphetamine exposure, animals demonstrated behavioral hypersensitivity and developed full amphetamine-induced stereotyped behavior with decreased latency. The data suggest that chronic agonism with amphetamine can produce dopaminergic hypersensitivity, a behavior that contrasts with the development of drug tolerance to other pharmacologic agents. The mechanism of this induced hypersensitivity was studied by comparing brain amphetamine levels after acute and chronic amphetamine treatment. The two groups of guinea pigs showed no significant difference in amphetamine levels or drug distribution. These results suggest that altered amphetamine metabolism cannot account for the hypersensitivity seen after amphetamine exposure. Guinea pigs chronically pretreated with d-amphetamine were hypersensitive to another dopaminergic agonist whose metabolic pathway is distinct from that of amphetamine. These results have therapeutic implications in the management of clinical conditions related to chronic agonist-induced hypersensitivity.


Antibody to acetylcholine receptor in canine and human myasthenia gravis: differential cross-reactivity with human and rabbit receptor. Anti-acetylcholine receptor (AChR) antibody (ab) was found in the serum of a dog with acute myasthenia gravis (MG) by the use of Cowan 1 strain Staphylococcus aureus to bind radiolabeled anti-AChR ab-AChR immune complexes. Fifteen months later, when the dog was in remission, there was only a very low level of the anti-AChR ab. These observations strengthen the contention that anti-AChR ab is important in the pathophysiology of myasthenia gravis. Higher titers of the canine ab were measured with rabbit than with human AChR, whereas 17 human MG sera, selected to represent a wide range of anti-AChR ab titers, were all more reactive with human AChR. The degree of cross-reactivity of human anti-AChR ab with rabbit AChR varied widely, indicating a heterogeneous population of anti-AChR ab molecules in human myasthenia gravis sera.


Benign acute childhood myositis.

Benign acute childhood myositis. Four school children, aged 6 to 9 years, had acute postinfectious myositis. The prodromal illness usually involved the upper respiratory tract, but gastrointestinal symptoms were also seen. Fever and nonspecific malaise were characteristic. After cessation of the illness, myalgia involved the calves and thighs. Arm and neck muscles were less frequently affected. Weakness was less marked than muscle pain. Serum creatine phosphokinase (CPK) was markedly increased in all cases. Myalgia and CPK levels subsided in less than a week, although one child was not back to normal for 4 weeks. Two children had electromyography, and patchy myopathic changes were found. Viral studies were not helpful in any of the cases.


Sinemet and thyroid function in Parkinson disease. Patients on chronic carbidopa-levodopa (Sinemet) therapy underwent thyroid function testing that included measurement of serum thyroxine (T4), triiodothyronine (t3), thyrotropin (TSH), T3 uptake (T3U), free T4 index (FT4I), and free T3 index (FT3I). The subjects were studied both in a random sampling and in a controlled manner, fasting and 2 hours after receiving the drug. All subjects were euthyroid by testing, and there was no significant difference in thyroid hormone levels of patients and controls or in fasting values and values 2 hours after the drug. However, there was a small but significant reduction in serum TSH levels after Sinemet. Therapeutic doses of Sinemet have no significant effect on thyroid function in euthyroid patients with Parkinson disease.


Joseph disease: protein patterns in fibroblasts and brain. The separation of brain and fibroblast proteins was analyzed on two-dimensional acrylamide gels. Proteins were examined from skin fibroblast cultures and brain homogenates from the frontal cerebral cortex, putamen, and cerebellum. Protein species from skin fibroblast cultures of controls and patients with Joseph disease or Huntington disease were not significantly different. The proteins from homogenates of the cerebral cortex, putamen, and cerebellum from controls differed from those of one Joseph disease patient. Two major classes of proteins were increased in the patient's putamen and cerebellum. Proteins of 40,000 and 50,000 daltons--including the glial filamentous acidic protein complex (molecular weight 50,000), and two proteins which migrated near actin--were increased in the cerebellum. The glial filamentous acidic protein complex increased 3.7-fold in the putamen of the patient. These protein changes probably represent gliosis, but may also be an expression of the primary genetic mutation.


Language after bilateral cerebral infarctions: role of the minor hemisphere in speech. Language was studied in four patients with bilateral cerebral infarctions. Bilateral destruction of the third frontal gyri did not necessarily produce the severely limited language output characteristic of global or severe Broca aphasia; for Broca aphasia to occur, there must be extensive frontoparietal damage in the dominant cerebral hemisphere. Thus, the marked recovery of language after lesions limited to the dominant third frontal gyrus is mediated by adjacent areas of the dominant hemisphere, and not by the nondominant third frontal gyrus. The nondominant hemisphere nevertheless has a limited capacity to produce oral speech after extensive damage to the dominant hemisphere and may play an appreciable, although still subsidiary, role in normal articulation. The central gyri and rolandic operculum may be more essential than the third frontal gyri for well-articulated speech.


Experimental autoimmune myasthenia gravis and cholinergic ionophore: an electrophysiologic study. Rabbits were immunized with purified acetylcholine receptor from Narke electroplax japonica. A defect of neuromuscular transmission, physiologically identical to human myasthenia gravis, developed when antibodies against the receptor were found in serum. To clarify the mode of action of these antibodies, changes in the endplate current of frog muscle fibers were recorded after exposure to immune rabbit sera. The rabbit sera depressed the amplitude of the endplate current, but caused no change in the time course or the dependence of amplitude and half-decay time on membrane potential. Antibodies may affect acetylcholine binding without impairing ionophore function.


The effect of symptom duration on cognitive and motor performance in parkinsonism. Neuropsychologic test performance was examined in a normal control group and in three groups of Parkinson disease patients, with symptoms for 2 years or less, for 3 to 5 years, or for 6 to 15 years. On a test battery sampling a wide variety of cognitive and motor abilities, significant intergroup differences occurred primarily on tasks with a primary motor component, although mild intergroup cognitive impairment was also demonstrated. The results suggested that maximal deterioration occurred during the first 5 years of symptoms, with few significant additional changes after that.


Differential diagnosis of limb-girdle muscular dystrophy and spinal muscular atrophy. Neuromuscular biopsies from 18 patients with proximal muscle weakness were classified electromyographically as myopathy (11 cases), denervation (3 cases), or inconclusive (4 cases). Myopathic changes of muscle fibers occurred in all biopsies. Small angular dark fibers were observed in nine biopsies, and small-group atrophy in four biopsies from the three above-mentioned groups. Two biopsies classified as denervation showed large-group atrophy. Terminal innervation ratio (TIR) was increased only in the three cases classified as denervation and in one inconclusive case. TIR, which is more closely correlated with electromyographic (EMG) results than are muscle fiber changes, may help differentiate spinal muscular atrophy from limb-girdle muscular dystrophy.


Gyrate atrophy of the choroid and retina with hyperornithinemia: tubular aggregates and type 2 fiber atrophy in muscle. We studied 21 patients with gyrate atrophy of the choroid and retina and hyperornithinemia. Although the patients were not weak, type 2 muscle fibers were almost universally atrophic and had tubular aggregates. Gyrate atrophy is the first disease in which females are shown to have tubular aggregates; the sexes were affected equally. In gyrate atrophy the number of type 2 fibers decreases with age. The muscle and eye changes are probably related to abnormal creatine synthesis, caused, in gyrate atrophy, by the increased body pool of ornithine; muscle abnormalities may also be present in other tapetoretinal dystrophies.


Parasites of domestic and wild animals in South Africa. X. Helminths in impala. Two to four impala in the Nylsvley Nature Reserve were culled each month from February 1975-February 1976. Two trematode species, 1 cestode species and 13 species of nematodes were recovered from these antelope. Of these, Fasciola gigantica, Gongylonema pulchrum, Haemonchus placei and Trichostrongylus falculatus are new records for impala. In general, H. placei, Longistrongylus sabie and Impalaia tuberculata exhibited a similar pattern of seasonal occurrence. Adult worms were present during November-February, while marked inhibition in the development of large numbers of 4th stage larvae occurred from April-September or October. Cooperia hungi, Cooperioides hamiltoni and Cooperloides hepaticae followed a similar pattern, but inhibition in the 4th larval stage was not as marked and lasted from June-September. No seasonal pattern of prevalence could be determined for Trichostrongylus spp. The worm burdens of young impala increased with the age of the animals and reached a peak when the impala were 1 year old.


Production of a chicken meat infusion broth suitable for the mass production of a Haemophilus gallinarum bacterin. A chicken meat infusion broth was prepared by various formulations and tested in 200 l volumes for their suitability to support the growth of Haemophilus gallinarum. The best yield (0,1% packed cells, or 10(9) colony-forming units/ml) was obtained with a medium prepared from whole flayed carcasses with a ratio of 1 kg of meat to 1,2 l of water.


Tympanometry in 2-year-old children. Seasonal influence on frequency of secretory otitis and tubal function. Repetitive screening tympanometry performed in 240 healthy 2-year-old children showed that tympanometric conditions are significantly better in the summer season than in the spring or winter. A very large tendency to spontaneous normalization of the tympanogram type B was demonstrated. Only 16% of the ears that had type B at the first investigation in November had the same type in August. Simultaneous with the normalization of some ears others deteriorated, thus in November type B tympanogram was found in 12%, in February 14.6%, in May 11.3%, and in August 7.2% of all ears investigated. Due to the large variability in the tympanometric conditions which are predominantly caused by catarrhalia, 28.6% of the ears have had type B tympanogram at least once during the period from November to August, while only 1.6% have had type B at all four investigations. The large spontaneous recovery of secretory otitis, demonstrated in the present study, indicates that the child should be observed for a period before implementation of surgical treatment.