Diagnosis and successful management of septal myocardial abscess: a complication of bacterial endocarditis. A case of acute enterococcal aortic valve endocarditis is presented in which the complication of a septal myocardial abscess was diagnosed clinically and successfully treated surgically. This represents the first instant, to our knowledge, in which the preoperative diagnosis of a myocardial abscess served as the indication for emergency cardiac surgical intervention in active endocarditis with successful outcome. The diagnostic parameters permitting clinical recognition of a myocardial abscess include the development of advancing degrees of atrioventricular and bundle branch block, and the finding of pericarditis or pericardial effusion in aortic valvular infections. Two additional findings were noted in the present case: echocardiographic evidence of septal thickening, and loss of septal Q waves on the electrocardiogram. Since myocardial abscesses do not respond to medical therapy, continuous electrocardiographic monitoring and frequent echocardiographic determinations are recommended in cases of active aortic valve endocarditis to permit early diagnosis and surgical management of this complication.


Renal cell carcinoma: analysis of 31 cases with assessment of endocrine therapy. Thirty-one patients with locally extensive and metastatic renal cell carcinoma were observed over an eight year period. At onset of the disease, symptoms due to metastatic deposits were the most frequent mode of presentation, followed by manifestation of local tumor growth (hematuria, flank pain or palpable mass) and paraneoplastic syndromes. Hormonal therapy with testosterone propionate, a progestational agent or both was assessed in 21 cases. Five instances of tumor regression, two involving recalcification of lytic osseous metastases, were documented. Endocrine studies to elucidate possible mechanisms of hormonal effectiveness were carried out in seven cases. Median survival from diagnosis was ten months. Following the rapid early mortality, a very gradual decrease in survival occurred, with 25% alive at ten years. Factors influencing survival include the duration of the interval between diagnosis of the primary tumor and appearance of metastases and the association of certain paraneoplastic syndromes.


Isolated acid neuraminidase deficiency: a distinct lysosomal storage disease. An 8-month-old female presented with coarse facies and hepatosplenomegaly at birth. Growth proceeded at an accelerated rate and mental development was normal. A pattern of dysostosis multiplex developed radiographically. Cytoplasmic inclusions consistent with lysosomal storage disease were demonstrated by electron microscopy in bone marrow, liver, and cartilage cells and in cultured skin fibroblasts. Assays of the fibroblasts revealed a specific deficiency of acid neuraminidase and 6-fold increase in intracellular bound sialic acid. An unidentified macromolecular compound rich in sialic acid was excreted in excessive amounts in the urine. The phenotype suggests defective degradation primarily of glycoproteins and possibly to a lesser extent of keratan sulfate and gangliosides.


A case of 17alpha-hydroxylase deficiency with symptoms mimicking testicular feminization. A case of 17alpha-hydroxylase deficiency mimicking testicular feminization is reported. Different from the complete form of testicular feminization in which androgens are normal or elevated and end-organ insensitivity to androgens is supposed, this case had a negligible amount of androgens and responded to the injection of testosterone propionate with a positive nitrogen and phosphate balance.


Familial occurrence of the Wiedemann-Beckwith syndrome and persistent fontanel. We describe a family in which 3 sisters gave birth to 8 infants with the Wiedemann-Beckwith syndrome. The clinical manifestations in all the affected individuals included macroglossia, macrosomia and omphalocele, while their mothers all were entirely normal. Pedigree analysis suggests that familial occurrence of the Wiedemann-Beckwith syndrome may be due to delayed mutation.


Acromesomelic dwarfism: manifestations in childhood. Acromesomelic dwarfism is a distinct condition characterized by short stature of the short limb type, with the hands and feet showing the most obvious deviations from normal. The forearm bones are usually disproportionately shorter than the other long tubular bones of the limbs. The intelligence is normal. Available data suggest autosomal recessive transmission. Characteristic clinical and radiographic features permit establishment of a confident diagnosis in the first year of life.


Pleural effusion: a rare manifestation of acute pulmonary blastomycosis. A 47-year-old woman presented with cough, pleuritic chest pain and fever of three weeks duration. Although the patient lived in an area where blastomycosis is endemic, this diagnosis was not initially considered owing to the presence of consolidation and a large pleural effusion on the initial chest roentgenogram. Cultures of sputa, bronchial washings and pleural fluid documented the presence of pleuropulmonary infection with Blastomyces dermatitidis. Therapy with amphotericin B was associated with rapid clinical, roentgenographic and bacteriologic resolution of both pleural and parenchymal lung disease.


Anatomical analysis of the developmental effects of aneuploidy in man--the 18-trisomy syndrome: I. Anomalies of the head and neck. This paper describes the anatomical variations observed in the head and neck in eight infants with the 18-trisomy syndrome that were dissected and studied in detail. Of the usual muscles of facial expression, occipitofrontalis and the auricular and nasal muscles were hypolastic in all eight bodies and each subject showed extensive fusion of the muscles around the corner of the mouth. In each body there was a supernumerary muscle band that extended from the region near the corner of the mouth to the occipital attachment of trapezius. The otomandibular region in each body showed a variable spectrum of muscular, skeletal, arterial, and salivary gland variations bilaterally. Three of the bodies had infrahyoid muscle variations. The sum of these observations provides a more complete delineation of the variations that occur in the 18-trisomy syndrome. Tentative pathogenetic hypotheses for several of the defects are discussed, based on observations from human descriptive embryology. Poswillo's teratological model [1973] implicating hemorrhaging as a causal mechanism in human first and second branchial arch malformations is suggested as a possible mechanism to explain the bilateral otomandibular defects.


Metastatic myocardial abscess due to group F streptococci. Remote myocardial infarction in a 60-year-old, blind diabetic man, was complicated by suppuration within the old fibrotic area by a group F streptococcus. Osteomyelitis of the fifth (right) metatarsal bone served as the primary focus. A review of the literature uncovered no findings which could help to predict the onset of abscess formation within a myocardial infarction. Although this complication occurs rarely, the entity should be kept in mind in patients with infarcts and a remote source of infection.


Pericentric inversion of chromosome 14 and the risk of partial duplication of 14q (14q31 leads to 14qter). Cytogenetic analysis after conventional staining and Q-banding demonstrated a pericentric inversion of chromosome 14 in the mother of a child with a mental retardation/multiple congenital abnormality syndrome and an abnormal chromosome 14. The proposita's partial duplication for the distal segment of 14q is apprently the result of crossing over within the inverted segment during meiosis. An attempt is made at assessing the risk that a carrier of the described pericentric inversion faces of having an abnormal child. The estimate of the risk depends on two factors: 1) the probability of a crossover occurring within the inverted segment during meiosis, and 2) the probability of a child with either of the two possible unbalanced recombinant chromosomes being born alive. An explanation is offered as to why some pericentric inversions confer a signifcant risk while others are so benign and occur with such a high frequency that they can be considered normal chromosomal variants, rather than chromosome aberrations.


Prenatal diagnosis of renal anomalies.

Prenatal diagnosis of renal anomalies. Within the past 24 months, we have performed prenatal diagnostic studies in 4 pregnancies known to be at risk for well-described genetic syndrome involving renal abnormalities, ie, Meckel syndrome, Roberts syndrome, and bilateral renal agenesis. The diagnostic techniques utilized were ultrasonographic scanning (B-mode and grey scale), biochemical assays, and radiographic evaluation. The ultrasound finding common to the 3 affected cases was extreme oligohydramnios, which we considered indirect evidence that renal anomalies were present. The ultrasound scans of the fetuses affected with Meckel and Roberts syndrome demonstrated anechoic cystic spaces in the abdomen, representing the enlarged dysplastic cystic kidneys. An encephalocele was well demonstrated by B-mode scan in the fetus with Meckel syndrome. The absence of normal limbs in the Roberts syndrome was evident on serial grey scale scans of the fetus. Biochemical and radiographic studies provided results consistent with the suspected diagnoses. The importance of providing genetic counseling and prenatal diagnosis to families at risk is emphasized.


A national optometric-student attitudinal survey. This paper contains the results of a survey of 1549 optometry students who responded to a questionnaire that was sent to all optometry schools and colleges in the United States. The results reflect student attitudes and opinions about such issues as commercial optometry, malpractice suits, price advertising of glasses and professional services, and the cost of professional education. In addition, the survey results disclose the reasons students enter the profession, their anticipated modes of practice and their expected incomes. We believe that the issues encompassed in this survey will affect the future practice of optometry.


A field expander for patients with retinitis pigmentosa: a clinical study. An inexpensive, commercially available optical device was tested on 10 patients with retinitis pigmentosa to determine its value as a field expander for scanning and as an aid to mobility. Visual acuity and visual fields were measured with and without the expander, and the patients' subjective responses were monitored by a questionnaire that was administered at regular intervals during a 2- to 4-week period between test sessions. Six of the 10 subjects considered the device helpful in at least 1 important visual task and planned to continue using it.


Reliability of visual acuity measures of amblyopic eyes. Ten amblyopes had their visual acuity measured once a week for 6 weeks using a Snellen chart (whole chart and single line) and a newly developed E chart was designed specifically for testing the acuity of amblyopes. For each test at each trial, the subject's acuity responses were graphically plotted and were fitted by a least-squares straight line to the central-most data. The reliability (repeatability) of the 50% threshold acuity was compared for the 3 acuity tests. The new E chart was the most reliable and the Snellen single-line test was the least reliable. These results have complications for quantifying acuity improvement during and following amblyopia therapy. The slope of the fitted acuity line may have value in assessing the prognosis for treatment.


Prevalence of glaucoma in optometric patients under 40 years of age. A survey of 3,494 patients under 40, who were examined in an urban optometric center, showed that 0.4% of the sample had glaucoma and an additional 0.2% had suspected glaucoma. The clinical implications of glaucoma in persons under 40 are discussed.


Simplified analysis of meridional refraction data. An eye may be refracted by making independent measurements of spectacle correction in 3 or more preselected meridians. This paper presents a method for calculating sphere power, cylinder power, and axis, from meridional data taken in evenly spaced axes (such as 45, 90, 135, and 180 deg). The formulas given are equivalent in accuracy to a method previously published and are simpler to apply. Meridional techniques can simplify the patient's task in a subjective refraction and are therefore more suitable for automation than the traditional subjective techniques using crossed cylinders. Methods that might usefully be coupled with this technique include laser and stenopaic slit refraction and streak retinoscopy.


Asymmetry of central and peripheral corneal astigmatism measured by photokeratoscopy. 1976 Neumeller Award Paper. The radii of curvature of 10 astigmatic corneas (1.125 to 3.625 D) were measured by photokeratoscopy in 4 semimeridians: 2 axis semimeridians and 2 power semimeridians. Most of the angular separations between adjacent semimeridians differed from 90 deg by more than 2.5 deg; the separations ranged from 55 to 120 deg. Corneal astigmatism, as specified by the difference in curvature between adjacent axis and power semimeridians at corresponding distances from the corneal apex, was also highly asymmetric with decreasing astigmatism in the corneal periphery. An interesting revelation was the interchange of the axis and power semimeridians in the periphery of 3 subjects' corneas.


Standardization of the Bausch & Lomb Autoplot tangent screen. A method is described of modifying the Bausch & Lomb Autoplot to obtain background and test target luminances of 10.02 cd/m2 and 32.8 cd/m2, respectively. Together with the use of a 2-mm target, these test conditions closely correspond to those of the Goldmann perimeter. These conditions can be maintained to provide more standardized perimetry than is currently available with the Autoplot.


Astigmatism after contact lens wear.

Astigmatism after contact lens wear. With-the-rule astigmatism increased by more than 3 D in 2 habitual long-term wearers of contact lenses after they abruptly stopped wearing their lenses. Reducing wearing time gradually over a 2- to 3-month period caused less than 1 D increase in with-the-rule astigmatism in 2 other long-term wearers. All 4 persons had worn polymethylmethacrylate contact lenses for 12 or more years.


Use of "black light" in assesing pupillary responses. A modification of the conventional technique of pupillary analysis that maximizes the ability of the clinician to interpret papillary abnormalities, especially in aging patients, is presented. The technique, which utilizes the principle of lenticular fluorescence from "black-light" (ultraviolet) stimulation, employs equipment that is readily available to clinicians.


The visual world behind the head.

The visual world behind the head. After a 5-minute inspection of 7 objects laid out on a shelf, subjects were seated with the objects behind them and answered questions about the locations and orientations of objects by throwing a switch left or right. The "visual image" subjects were told to imagine that the objects were still in front of them and to respond accordingly. The "real space" (RS) subjects were told to respond in terms of the positions of the objects in real space behind them. Thus correct responses (left vs. right) were completely opposite for the 2 groups. A control group responded while facing a curtain concealing the objects. The task was harder, by time and error criteria, for group RS than for the other 2 groups, but not dramatically so. All RS subjects denied using a response-reversal strategy. Some reported translating the objects from back to front and thus responding as to a mirror-image of the array. When this evasion was discouraged, RS subjects typically reported responding in terms of visual images located behind them and viewed as if by "eyes in the back of the head." The paradox of a visual image that corresponds to no possible visual input is discussed.


Contextual effects in duration experience. The role of contextual factors on duration estimates was investigated, employing 6 time intervals ranging from 15 to 35 sec (demarcated by the onset and termination of a display panel of lights). When compared with earlier research, the results suggest that duration estimates are affected by the context of the stimulus intervals with regard to other stimuli in the series. Specifically, those stimuli that were overestimated when they were the shortest members of the series were underestimated when they were the longest intervals of the stimulus series. In addition, a lengthening effect was observed: duration estimates increased over blocks of trials for all stimulus intervals.


The case for misapplied constancy scaling: depth associations elicited by illusion configurations. It has been suggested that many visual-geometric illusions arise from inappropriate evocation of size-constancy by depth cues implicit in illusion configurations. Observers gave free association responses while viewing illusion figures. Analysis of these responses provides weak but consistent evidence for the elicitation of depth in the Sander parallelogram, Mueller-Lyer, Zoellner, and Ehrenfels variant of the Ponzo illusion. No evidence for depth is found in the normal form of the Ponzo, Poggendorff, and horizontal-vertical illusions, and the evidence is ambiguous in the Orbison configurations. These results indicate that depth processing may be evoked by some, but not all, classical illusion forms.


An illusion of auditory saltation similar to the cutaneous "rabbit". Trains of brief clicks produced successively at 3 points in a horizontal array were not localized accurately. Observers reported clicks occurring in succession across the spaces between sources as well as at the sources themselves. The illusion is functionally related to interstimulus interval, number of clicks per speaker, and regularity of pulsing. It appears similar to Geldard and Sherrick's cutaneous "rabbit" illusion.


Competition between memory and perceptual tasks involving physically similar stimuli. Performance on a perceptual recognition task and a concurrently performed short-term memory (STM) task was studied. The stimuli used in the STM task were either visually similar, acoustically similar, or dissimilar to the stimuli in the perceptual task. The results demonstrated that any type of concurrent list memorization has a detrimental effect upon perceptual performance, but this effect is magnified if the stimuli used in the 2 tasks are visually similar. Acoustic similarity had no effect. The results document the fact that distinct tasks interfere, when the tasks compete for a limited total processing capacity, or when the tasks demand the same visual coding program.


[Injury from the deceleration and acceleration of human skulls (author's transl)]. Diametral injuries of the skull accidental force may be accepted as an effect of summation of osseous and cerebral oscillations which cause a gradient of pressure inside the skull. The cavitations of liquor between cerebrum and skull are of no influence neither in a positive nor a negative direction in transmission of the vibration. Situated in an area which is not effected by the oscillation the hypophysis is protected against trauma. The causes for the contre-coup is to be seen in the anatomical and morphological specificity of the skull following Newton's axioms. Several concepts of the contra-coup are discussed.


Density of goblet cells on normal adult nasal turbinates. On the basis of 10 middle and 10 inferior turbinates from autopsies on normal adults, a quantitative study of the goblet cells was performed, using the whole-mount method. There was quite some increase in density into the posterior direction, with a generally higher density on the inferior than on the middle turbinate. The results are related to the current of air in the nose.


Morphological and histochemical studies of the mandibular salivary glands of the one-humped camel (Camelus dromedarius). The morphology, and nerve and blood supply of the mandibular salivary glands of the one-humped camel were studied in detail. The intraglandular portion of the duct system was also examined. The micromorphological and histochemical studies showed that the mandibular glands are of the tubuloacinar type. The secretory cells are of two types; (1) Mucous cells grouped into secretory tubules and acini, and (2) seromucoid cells grouped into acini and demilunes. These demilunes are associated with the mucous acini. The interlobular excretory ducts and the mandibular duct contain globlet cells between their lining epithelium.


[Interruption of the vegetative innervation of the teeth of dogs and its effect on the organs of chewing (author's transl)]. The results of our investigations, therefore, demonstrate that after a resection of part of N. vagosympathicus peripheral to the ganglion nodosum on the right side two of the test dogs showed changes in the bite and in the position of teeth, a fan-shaped position of the incisors and canines, prognathism of the jaw including protrusion and changes in the parodont with some incisors becoming loose. All test animals showed distinctly marked dystrophic changes and weak signs of regeneration of Truncus vagosympathicus and the branches of N. trigeminus. The changes in the branches of N. trigeminus can be explained by the intrusion of sympathicus cells in the reflex arcs of the cerebral nerves and in their paths in the central nervous system. In this way the sensory nerves are joined to the afferent fibres of the vegetative nervous system, which affect the organic supply through the vasomotor nerves.


[Eruption and shedding of the teeth in the beaver, Castor fiber albicus (author's transl)]. 46 skulls of Castor fiber albicus aged from 0 to 2 years were studied morphologically and radiographically with regard to eruption and shedding of the teeth. According to the characteristics of the dentition the age of immature beavers until to 1 1/2 years can be determined with an error of about 4 weeks. Later the development of the roots and the apposition of cementum are to consider additionally.


Hypothalamo-hypophysial neurosecretory and vascular system of the teleost Labeo rohita (Ham.). The paired nucleus preopticus (NPO) lying on either side of the III ventricle gives rise to the left and right main neurosecretory tracts which proceed posteroventrally towards the pituitary and give rise to several finer axons which ramify the infundibular floor adjacent to the pituitary. The bulk of the neurosecretory tracts enter the pars intermedia and few finer ones are seen among the pars distalis. The ventromedian component of the nucleus lateralis tuberis (NLT) is aldehyde fuchsin (AF) positive whereas the anterolateral neurons are AF negative. The internal carotid artery gives rise to the hypophysial and ventral hypothalamic arteries. The ventral hypothalamic artery gives rise to the primary capillary plexus at the infundibular floor region adjacent to the pituitary stalk. Portal vessels formed from this plexus largely irrigate the adenohypophysis. The hypophysial artery enters the neurohypophysis and gives rise to typical teleostean type neuradenointerface vasculature. Morphological contact between the neurosecretory axons and primary capillary plexus at the floor of the infundibulum suggests the possibility of at least some active principles entering the blood vessels. Structurally L. rohita exhibited both tetrapodean and teleostean type of hypothalamo-hypophysial vasculature. Morphological evidences suggest a direct neuroglandular and an indirect neurovasculoglandular pathways of hypothalamic control of hypophysis in L. rohita.


[Semantics of psychopathological statements. I. Tetraglossia and affective function of the language]. The semantics of clinical statements in psychopathology will be studied in two parts. Here, the affective function and the vernacular element are analysed in the light of their relationship to the other aspects of the language, i.e. the vehicular, referential and mythical aspects. This tetraglossy is in the context of two neuroses whose outbreak involves linguistic phenomena. The symptoms and utterances form semiotic statements linked up by the perlocutory acts of the utterance which in the psychopathological process closely associate vehicular function and affects in a field of belief consistent with their clinical expression.


[Sociability of the need of human interactions]. In the following article, the originates, forms, abnormalities, pathology, variations of social inter-relations, variations in different social situations, are examined. It emphasizes in general the relationship between patient and doctor, and in particular that of the psychiatrist and his patient.


[For a clinical approach to impulsion phobias]. Having first recalled the problems involved in classifying impulsion phobias, (problems which have been experienced in the course of all the work done on this subject), the authors report, from a strictly clinical viewpoint, on a series of studies of patients whose problems are very different but who all show the symptoms of impulsion phobia. They next setout a phenomenological approach to the problem, with emphasis on the products of the patient's imagination, his passive fascination with the image of a terrifying act constituting the object of the phobia, the external world in relation to the subject, and the ambiguity of dependance on others which is mirrored by aggressiveness. Lastly, the subject's entire existence is put symbolically at stake, and the phobia is seen to spring from his narcissistic relationship with the external world at a deeper level than that of any oedipian relationships. The first stage in the treatment is, indeed, to build up this narcissistic relationship, and later treatment will be varied according to the patient's fundamental needs.


[Severe mental disorders after prolonged post-traumatic coma]. Using observation in a number of patients with severe closed head injuries followed by prolonged coma and of which three are reported in detail, the authors present an analysis of the resulting psychiatric problems. After a brief review of the literature they suggest a central psychopathological "core" common to such head injuries beneath their seemingly diverse symptomatology. This "core" seems to be built up around the following disturbances: 1) Memory disorders; 2) Perceptual problems and difficulties with the association of ideas; 3) Excessive tiredness and concomitant reduction in the powers of concentration.


Physical studies of a Staphylococcus aureus plasmid mediating resistance to streptogramins, lincosamins and aminoglycosides. Previous studies have demonstrated that resistance to three groups of drugs (streptogramins, lincosamins and aminoglycosides) was plasmid borne in a clinical isolate of Staphylococcus aureus. This plasmid, referred to as pIP524, was transferred in mixed culture or transduced into a plasmid-free host and analyzed for size, molecular weight and replication control. Plasmid pIP524 is a new member of the class of "large" plasmids (8.5 micrometer) isolated from S. aureus and represents up to 7% of total DNA. Some evidence indicates that the number of copies of pIP524 and of plasmids of the same size--penicillinase plasmids--are similar (up to 10 per cell).


[Serological analysis of coagulase-negative staphylococci: study of characteristic agglutinogens in type strains of the nine species individualized by Schleifer and Kloos (author's transl)]. The occurrence of characteristic agglutinogens has been searched for in the type strains of the following species: Staphylococcus xylosus, S. cohnii, S. epidermidis, S. capitis, S. saprophyticus, S. warneri, S. haemolyticus, S. hominis and S. simulans. Serotyping of these nine strains and study of their antisera have been carried out with formalin-treated and autoclaved bacteria. It has been shown that the characteristic agglutinogens of S. epidermidis and S. haemolyticus were respectively identical to the agglutinogens previously described in the coagulase-negative type strain 52.186 and in the S. aureus type strain 18. Characteristic agglutinogens have been found in each of the other seven type strains. Agglutinogens found in S. xylosus and S. saprophyticus are thermolabile, the corresponding absorbed sera reacting only with the formalin-treated homologous strain. Concerning S. cohnii, S. capitis, S. hominis and S. simulans, their absorbed sera reacting both with formalin-treated and autoclaved homologous strains, the observed reactions can be accounted either by one thermostable agglutinogen or by two characteristic agglutinogens, one thermostable, the other thermolabile. In S. warneri, only one thermostable agglutinogen has been characterized, the specificity of the reaction observed between the absorbed S. warneri antiserum and the homologous formalin-treated strain having to be confirmed. The use for serotyping of absorbed sera prepared against the type strains of the species S. xylosus, S. cohnii, S. capitis, S. saprophyticus, S. warneri, S. hominis and S. simulans should permit to improve the individualization of coagulase-negative staphylococci.


[Solid-phase enzyme immunoassay for specific immunoglobulin G and immunoglobulin M antibodies of rubella virus (author's transl)]. A sensitive solid-phase enzyme-immunoassay for the detection of rubella virus specific IgG and IgM antibodies has been developed. Wells of polystyrene trays were sensitized with purified rubella antigen. A substrate employed in enzyme-histochemistry, which gives a stable staining, was used to allow direct determination of titre values. One hundred and thirty-five human sera were tested. Antibodies titres, detected using this glucose oxidase immunoassay, correlated well with those obtained using a virus haemagglutination inhibition test. With this procedure sera can be tested without any pretreatment and evaluated within one day. Moreover, TIE is more sensitive and specific antibodies are detected earlier.


[A simple lesion-free drop of the chorio-allantoic membrane of the chick embryo (author's transl)]. In the embryonated 4-5 days old chicken egg incubated in the normal vertical position, only the blunt top end, a small part of the egg surface, is covered by the embryo. Soon after rotation of the egg to the reverted vertical position with the blunt end down, the egg shell is pierced and the artificial air space is formed on the pointed end which is far from the region occupied by the embryo. Thus any possibility of lesion is avoided.


[Haemagglutinin from rabies viruses (author's transl)]. Rabies virus haemagglutinin has not hitherto been obtained to our knowledge, from brain material of infected animals. A slight modification of the arbovirus technique and the use of trypsin treatment can reveal a good haemagglutinin from fixed and street strain from infected brains.


[Acquired fibro-keratoma. Report of 8 cases]. The acquired fibro-keratoma is a benign fibro-epithelial tumor of acquired nature. I was set apart as a distinct entity in 1968 by Bart et al. who named it "acquired digital fibro-keratoma". It is predominantly, although not exclusively, located on the fingers and toes, near the phalangeal joints. The authors report 8 personal cases and make a short general review of the disease. The lesion is slightly prominent, well defined and surrounded by a hyperkeratotic collar. It protrudes on the surface of the skin much like a hernia. Histologically, it is a dermo-epidermal tumor. There is a proliferation of connective tissue under the papillomatous, hyperacanthotic and orthokeratotic epidermis. The mature collagen bundles, voluminous fibroblasts and numerous enlarged capillaries are parallel to the vertical axis of the tumor. The acquired fibrokeratoma must be differentiated from other cutaneous tumors, particularly fibromas and Koënen's tumors. The etiology is unknown. However, it was found in some cases that a trauma had contributed to the development of the tumor. The only possible treatment is surgical excision.


[Shulman's syndrome: fasciitis with eosinophilia, pseudoscleroderma with eosinophilia]. The authors report two cases of the Shulman's syndrome. Twenty one cases of this new entity are found in the literature. The main signs are the acute painful onset after an unusual physical exertion, the development of fasciitis, and (or) myositis, and (or) scleroderma of limbs, the absence of Raynaud's phenomenon, visceral involvement, constant eosinophilia and hypergammaglobulinemia; the prognosis is good with an improvement sometimes spontaneous or coincident with prednisone therapy. One of the observations is interesting by the association with Gougerot-Sjogren's syndrome, and a familial case of morphea. The prognosis in this case is mediocre: failure of corticotherapy, and incomplete remission with cyclophosphamide.


[Multiple kerato-acanthomas and visceral carcinomas: Torre's syndrome]. Women 63-between 1949 and 1970 has shown 11 K. A., 1 Bowen's diseas of the vulva, a carcinoma of the rectum (together with a carcinoma of the anus). This last association allows to integrate this observation to Torre's syndrome. No return of the K. A. since the removal of the carcinomas (1970) which have not actually come out again.


[Onychopathy of mushroom-growers].

[Onychopathy of mushroom-growers]. Particular nail damage appeared in patients working on mushroom beds. In five cases, all similar, the recent use of plastic bags containing the growing medium, seems to be the origin of this onychopathy. Onycholysis with latero-distal "usure des ongles", koilonychia, longitudinal splitting with sometimes splinter haemorrhages are the most specific changes. Chemical damage by phytosanitary products or fungi infection have no significant part in these abnormalities; their cause is traumatic, representing occupational stigmata mark, and results from repeated rubbing of the nails in workers lifting up heavy plastic bags.


[Pyoderma gangrenosum: Clofazimine therapy]. Two patients with pyoderma gangrenosum have responded remarkably well to treatment with Clofazimine (Lamprène). The first patient, a 68-year old women suffered from pyoderma gangrenosum of the buttock and left leg and on the incision scar for cancer of the breast. Laboratory findings showed monoclonal dysglobulinemia (alpha 2-kappa 2). A daily dose of 300 mg of Clofazimine resulted in complete healing with ten days. The second patient was a 24-year old women suffering from ulcerative colitis and a rapidly progressing pyoderma gangrenosum of the left leg. The lesions was completely healed after two weeks of Clofazimine therapy. The dosage was 200 mg daily and was increased to 400 mg daily. Our cases showed decreased cellular immunity and their phagocytic activity was variable.


[Arterial damage and the renin-angiotensin system in essential hypertension. Study of 63 cases]. Brunner, Laragh et al. have suggested that essential hypertensives with low plasma renin activity (PRA) are at lower risk of myocardial infarction or cerebrovascular accidents than those with high or normal PRA levels. In this paper we report on 63 patients with essential hypertension in whom the relation between PRA and the ocurrence of cardiovascular events was studied. The patients were categorized in high (11%), normal (70%) or low (19%) PRA subgroups, according to their 24-hour sodium excretion. Coronary angiogram was performed in 24 subjects. The three subgroups showed no significant differences in diastolic blood pressure, serum cholesterol levels, smoking habits or obesity. The incidence of cardiovascular complications was similar in patients with high or low PRA levels (28.5% and 33.3% respectively). In those hypertensives in whom coronary angiogram was done, coronary lesions were observed in 80% of the low renin subjects and in 37.5% of those patients with normal PRA. Therefore, no relation between PRA levels and vascular complications was observed in this series of patients. It is conclude that patients with essential hypertension must be treated as soon and effectively as possible regardless of their PRA value.


The acute effects of cigarette smoking on left ventricular function. Cigarette smoking is a major risk factor of coronary artery disease. Frequent repetition of an acute effect on the heart caused by cigarette smoking has been suggested as the etiology because of the increased incidence of myocardial infarction in cigarette smokers which drops to the incidence in non-smokers after cessation of smoking. This study of cardiac patients during cardiac catheterization evaluates the acute effect of the ordinary cigarette, smoked in the individuals own manner, on parameters of cardiac pump and muscle performance. The accuracy of measurements was enhanced by employing high-fidelity pressure signals, signal averaging, and computer analysis of the data. The results of the present study suggest that when cardiac patients smoke 1 cigarette of their own brand in their accustomed manner, no deleterious effects on pump performance, ventricular contraction or relaxation and blood pressure are evident.


[Electrophysiological studies in permanent atrial paralysis]. Permanent atrial paralysis is a very rare entity characterized by absence of electrical and mechanical activity of the atria which persists for months or years. We present a patient with congestive cardiomyopathy and chronic atrial paralysis. The phonomechanocardiographic study confirmed the absence of mechanical contraction of the atrium and did not show atrial electrical activity in the superficial electrocardiogram nor in the intracavitary tracing. In the electrophysiological study of the biopsy of the atrial myocardium an unexcitable tissue was found with an important diastolic despolarization of 30 mv. The histologic and ultrastructural studies showed nonspecific changes, with the replacement of the myocardial cells by fibrous tissue.


[The normal pulmonary angiogram].

[The normal pulmonary angiogram]. The experience obtained from the study of 151 normal pulmonary angiograms is presented. It was found, that is possible to identify most if not all the segmental arteries in the anteroposterior view, but the lateral view let identify the segmental arteries that arise perpendicular to the frontalplane. The role of the byplane pulmonary angiography in order to identify the segmental pulmonary arteries is emphasized. Must of the normal variation patterns of the segmental pulmonary arteries were found and only two differents patterns were seen, type IV in the right upper lobe and probably type II for the left lower lobe. It was also found that the arterial patterns of the middle lobe and right lower lobe were observed in different percentages that would be expected.


[Experimental study of a new circular semiprosthesis for mitral and tricuspid valve replacement]. The experimental behaviour of a new semiprosthesis for mitral and tricuspid ring plasty is studied. The tolerance of the materials of which the ring is composed was realized by inserting it into the right atrium with hypothermia and occlusion of the cavas, in dogs which were permitted to live 6 months. It was shown that the ring was covered by a very thin, white membrane, with uniform characteristics and strongly attached. The histologic and the ultrastructural study with the electronic microscope, showed proliferation of conjunctive tissue with abundant collaginous fibers. The free border of this covering presented endotheliazation with flat endothelial cells. The prosthetic material behaves as an inert body when there is no evidence of lymphocytes or polymorfonuclears.


[Beneficial effect of morphine on the threshold of electrical fibrillation of the ventricle. Experimental study]. The action of 2-3 mg/kg of morphine on the threshold of electrical fibrillation of the ventricle (TVF) in anesthetized dogs has been studied. The basal TVF was 10.5 +/- 4.9 mA, increased to 20.2 +/- 7.7 mA (P 0.005) with the administration of this drug. Comparatively, the effect of morphine on the TVF is similar to that of propranolol and bretilium and more effective than procainamide. The mechanism by which it acts is not well known. Perhaps it is due to a homogenization of refractory periods in the ventricle as well as a possible morphine-catacholamine interaction. Morphine in dosis of 2-3 mg/kg could occupy a place among the antiarrhythmic drugs of choice with antifibrillatory action, with important usefulness in the field of anestesiology of cardiopaths.


[Cerebral abscess due to abnormal caval return]. A case of abnormal venous return is reported. It was discovered during investigation of a cerebral abscess. There was a persisting and unique left superior vena cava, draining in the left atrium. No other cardiac malformation was present. This abnormality is rare as only 2 other cases have been reported. It should be suspected in children presenting with cyanosis, clubbing of the fingers and left ventricular hypertrophy on electrocardiography.


[Hypoplasia of the left side of the heart in two brothers]. Amongst the malformations which constitute the hypoplastic left heart syndrome, the coexistence of mitral and aortic valve atresia should be considered a separate entity. The analysis of cases reported in the literature does not reveal a male preponderance nor is the family picture characteristic of a genetic autosomal recessive disorder.


[Pediatric home care services in Belgium]. In 1970 a home care service for children was started by the committee for public assistance in Brussells with medical supervision from the department of paediatrics of the University. The main features are as follows: - It is exclusively paediatric and its aims are to shorten or avoid hospital admissions, or to provide medico-social support especially for the underpriveledged. - The medical supervision is undertaken by the family doctor (15% of cases) or by the physician in charge of the home care service with the help of specialists in the department of paediatrics in necessary. - Social workers, nurses and physiotherapists look after social problems, give nursing care and appropriate treatment. - The service has its own secretaries.


[Prognosis for infants treated in pediatric intensive care units]. The first part of the inquiry reported herein is dealing with the diagnostic distribution and the death-rate of a population of 1,607 newborns, admitted for vital distress and treated in an intensive care unit for children from 1969 to 1972. Global death-rate reached 30%. 49% of the patients were admitted for different neonatal respiratory diseases: they were responsible for 31% of the deaths. Perinatal cerebral suffering was the principal cause for admission for 15% of the newborns: with a 40% death-rate, it was responsible for 20% of deaths. However, from 1969 to 1972, global death-rate was constantly decreasing, from 36 to 24%. This improvement concerns especially the respiratory diseases and the perinatal cerebral suffering.


[Study of the classification of chondrodysplasias with mesomelic predominance]. Chondrodysplasiae with mesomelic predominance, that is with an elective defect of the middle segment of the limbs, constitute a complex group. The authors pronose to divide it into two types according to the presence or the absence of lesions in bones of the hand. The chondrodysplasiae without impairment of hands and feet include dyschondrosteosis, the type with cubitus and fibula hypoplasia described by Langer, Reinhardt and Pfeiffer's type with dominant transmissions, as well as the types with a relative elongation of fibula. The group of dysplasias in which hands and feet are concerned includes the dyschondrosteosis with shortness of hand, the acromesomelic dwarfism with impairment of phalanxes, described by Campailla and Martinelli, Nivegelt's syndrome, and the dwarfism with disorder in the vertebral segmentation, described by Robinow.


[Weights and heights of newborn infants with hypothyroidism]. Among 166 congenitally hypothyroid children, 30% had a birth weight over the 90 degrees percentile of normal newborns, and 17% of those born after a full-term gestation weight 4000 g or more. The birth length was known in 84 cases and was not different from normal standards. An excess of birth weight relatively to birth length must suggest, among other factors, the possibility of congenital hypothyroidism.


[Treatment of ADP responsive diabetes insipidus in children with DDAVP (1-desamino-8-D-arginine-vasopressin)]. Twenty children with diabetes inspidus, 19 children and adolescents and one baby of 2 months, were treated with DDAVP. The drug was very effective, the average urine volume being 1.7 L/24 hours. The control of the diuresis in the baby was very satisfactory. There were no secondary effects and the only episode of water intoxication occurred in a girl with corticosteroid deficiency which was not well controlled. The effects of this drug are discussed in the light of the biochemistry and pharmacology and the activity compared with that of Lysine vasopressin (LVP). Plasma levels of DDAVP and LVP showed that DDAVP persists for longer which may explain its greater potency and duration of action.


[Clouston's ectodermal dysplasia. A case report with biochemical study of keratin]. One familial case of ectodermal dysplasia of the Clouston's type is reported. The clinical picture consisted of hypotrichosis and dysonychia with normal sweating. The disease follows dominant autosomal transmission. Histologically, keratin was slightly abnormal. The biochemical study of keratin of hair and nails showed diminished cysteine.


[Tomodensitometry of hydatid brain cysts in a child]. A case of an eleven year old boy with an intracranial hydadid cyst is reported. The characteristics of computerised tomography of the skull are described, and differential diagnosis of other cystic space occupying lesions of the brain as seen on computerised tomography is discussed.


[beta-glucuronidase activity in human tumors of the lung and of the mammary gland (author's transl)]. The intratumoral activity of beta-Glucuronidase (total and free) was determined in surgical specimens of malignant tumors of the lung (N equal to 20) and of the breast (N equal to 15) from patients. A free beta-Glucuronidase-activity from about 90 mU per g tissue was found but there was no difference between both tumor types, and the beta-Glucuronidase-activity, as it seems, is not dependent on histological characteristics of the tumors. The findings are discussed under the view of the key function of the lysosomal enzymes in the concept of the "Cancer-Multistep-Therapy" by M. von Ardenne.


[Cancer risk in different types of gallstones (author's transl)]. Among 22,868 autopsied adults were 7,411 cases with cholelithiasis or cholecystectomy. In the cancerous gallbladders pigment-stones, pure crystalline cholesterol stones and lobulates stones were seldom found but multiple faceted stones and solitary combined stones are more frequent. If the partial volume of gallstones increased, there were more cases with cholecystitis or later carcinoma. Nevertheless in males with all forms of gallstones, carcinoma of the lung, the stomach, the colon and rectum and the prostatic gland were more frequent then carcinoma of the gallbladder. Only in female with multiple faceted stones and solitary combined stones, carcinoma of the gallbladder was the most frequent cancer. The "Störfeld" of the gallbladder with stones is more important for the localisation of a later carcinoma in female then for men. If the gallbladder with stones should be resected in good time, the patient is protected of the risk of cancer of gallbladder, but the percentage of all cancers among inoperated cases with gallstones is not higher than among cases with previons cholecystectomy. Instead of carcinoma of the gallbladder other cancers develop after cholecystectomy.


[Significance of cytology in diagnostics of non-malignant lesions of gastric mucosa (author's transl)]. The cytology of the stomach aims at detecting the carcinoma. For the obtaining of cell material today mainly endoscopically well-aimed techniques are applied. In other words: The diagnostic results decisively depend on the abilities of the endoscopist who has to discover a suspect region in the stomach and to take off the material in a well-aimed way. Under these aspects and prerequisites, in fact, any type of stomach cancer can be cytologically diagnosed. For the differentiation between tumourous cells and non-tumorous cells the changes of the gastric mucosa with non-malignant diseases are important (chronic gastritis, ulcer, erosion) for the cytologist. Often, with stomach cancer the stomach cell findings resemble those arrived at with non-malignant stomach diseases. Characteristic cytological findings with gastritis, ulcer and erosions are demonstrated. The clinical diagnostics of these diseases is the task of endoscopy and biopsy. The problem of the so-called false positive cell findings is discussed. Ways towards a quantitative diagnostics are being opened by cytophotometric methods. The author states first experience of his own gathered by applying the DNA-determination in individual cells and in the flow-through method.


[Circadian changes in serum prolactin in a group of apparently healthy subjects]. Serum immunoreactive prolactin was evaluated in 16 female and 5 male apparently healthy subjects aged 21-76 yr. After a period of synchronisation, with sleep from 22 to 5 and standardized meals at 8-8.30, 12-12.30, 17.30-18, venous blood samples were taken at 4, 8, 12, 16, 20 and 24. The radioimmunological data were processed using an ordinary chronogram technique and quantified by mean cosinor method. A significant (p less than 0.05) circadian rhythm was noted, with an acrophase at 1.45, amplitude of 2.17 and Mesor 6.89. Chronobiological studies are thus needed to determine the best normal temporal values of prolactin when setting control standards in pathological situations.


[Theories concerning viruses and neoplasms]. The causes of neoplasia are discussed with particular reference to viruses. Stress is laid on some differences between the mainly cytolytic action of viruses in man and their possible cancerigenic power. It is felt that neoplasia arises from a variety of aetiologies, mostly of an irritative nature, coupled with a single, final pathogenetic mechanism linked to chromosome changes that do not result in the death of the cell.


[Stimulating action of hematoporphyrin on motor coordination and resistance to fatigue in rats]. The pharmacological activity of hematoporphyrin has been studied on two experimental models which are able to monitor the motor coordination in the rat, namely the natatory exhaustion and the Rota-Rod tests. A dose related effect of hematoporphyrin in increasing resistane to motor fatigue has been observed in the Rota-Rod between 2-8 mg/kg i.p. Higher doses of hematoporphyrin seem to be less effective (difasic effect). In both tests hematoporphyrin was able to potentiate the stimulating effect of d-amphetamine (6 mg/kg s.c.). The potentiation appeared to be dose related between 2 and 8 mg/kg in the Rota Rod and between 2 and 16 mg/kg in the natatory test.


[Psoriatic polyarthritis in childhood. Clinico-nosological study]. The nosological independence of psoriatic arthritis is discussed in the light of the literature. The clinical and laboratory pictures of infantile psoriasis and PCP are described. Three cases of infantile psoriatic polyarthritis are presented and attention is drawn to the difficulty of diagnosing this condition in children. Longitudinal assessment of the possibility of early onset on the part of forms becoming evident during adulthood is envisaged.


[Epidemiology of the most widespread bacterial infections and current trends in use of antibiotics]. The last decade has seen a greater use of broad spectrum antibiotics at the expense of those with limited spectrum. With this in mind, the trends in the commonest bacterial, respiratory, gastroenteric and urinary infections from 1963 to 1974 have been analysed with a view to identify correlations between epidemiology and trends in antibotic consumption. The epidemiological investigation was carried out on the INAM health institution assisted population, i.e. on a sample of more than thirty million subjects throughout the country. Diseases with prevalently Gram-positive aetiology (acute and chronic infections of the respiratory tract) and those with prevalently Gram-negative aetiology (infections of the urinary tract) were examined and the data obtained processed statistically. It is personally considered that study of this pathology over the last decade is not enough to explain the tendency to make use almost exclusively of broad spectrum antibiotics and the serious clinical, epidemiological and social implications deriving from the dissemination of multiresistant bacterial strains.


Proteins of the hard keratins of echidna, hedgehog, rabbit, ox and man. In the accompanying paper it has been shown that two major groups of proteins (low-sulphur and high-sulphur) of ovine wool, horn, and hoof contain similar components although the overall proportions of the groups of proteins and the relative proportions of components within the groups may show significant differences. In the present paper it has been shown for five other species (echidna, hedgehog, rabbit, ox and man) that the hard keratins produced by one animal contain the same groups of protein components but in different relative proportions. The wide apparent differences in the type and relative proportions of the the low-sulphur components which comprise the major constituent proteins of the microfibrils suggest that microfibrils can tolerate a considerable variation in the constituent proteins and still produce functional structures. The low-sulphur protein components are sufficiently well resolved by sodium dodecyl sulphate-polyacrylamide gel electrophoresis to make this procedure potentially useful for animal identification and classification.


A chymotrypsin inhibitor from the parastitic nematode, Oesophagostomum radiatum. An inhibitor of alpha-chymotrypsin was isolated from O. radiatum by affinity chromatography, as well as by ion-exchange and molecular sieve chromatography. The inhibitor was associated with the cuticle or musculature of the parasite. It completely inhibited the esterolytic activity of chymotrypsin. Molecular sieve chromatography gave an apparent molecular weight of 9700 for the inhibitor alone and 32000 for the complex with chymotrypsin. This suggests reaction in a 1:1 molar ratio. The inhibitor reacted with diisopropyl phosphoryl-chymotrypsin weakly, if at all. Measurement of the dissociation constants for the enzyme-inhibitor complexes gave values of 2.2x10(-9) M for the product of affinity chromatography but less than 2x10(-10) M for all other preparations. Possible explanations of this are discussed.


[Topical treatment of some dystrophic and inflammatory lesions of the skin and soft tissues]. An investigation has been carried out on lysozyme cleasing antiphlogistic granulogenic activity when topically applied to various lesions such as varicous ulcers, bed sores, herpetic infections or actinic ulcerative processes. 38 patients who had undergone surgery and were affected with these lesions, were treated with lysozyme ointment applied twice daily for 15 days. Parameters for evaluating the therapeutic effect of the drug were, besides the typical subjective symptomatology, planimetry of the lesions, hyperemia and perilesional erythema. At the end of the investigation it was observed that lysozyme applications had favourable restorative effects and, in the case of herpetic lesions, complete resolution was achieved. Tolerance was satisfactory, although in 2 cases treatment had to be precautionarily discontinued having the subject complained of reacutization of pruritus.


[Use of salbutamol in cough sedation in pediatrics]. Salbutamol (in syrup form) has been used as a cough sedative in a paediatric series (children from 1 1/2 months to 12 yr) of bronchial and bronchopulmonary forms of varying gravity. The hypothesis is put forward that the sedation achieved is connected to the drug's action on the spastic component.


[Bipedal lymphography in mediastino-pulmonary sarcoidosis. Report concerning 9 cases]. The relevant literature is briefly reviewed and lymphographic data obtained from 9 patients admitted to the S. L. Gonzaga Hospital are examined. In all cases, the diagnosis of sarcoidosis had been given prior to lymphography and confirmed histologically. This small series helps to show the extent of lymph node lesions in sarcoidosis and the more commonly observed adenographic features.


[Tetanus prevention in burn patients].

[Tetanus prevention in burn patients]. The pathogenesis of tetanus as a complication of burn wounds is discussed briefly. The two most important moments in local tetanus prophylaxis are careful cleaning and the removal of necrotic tissue. Passive prophylaxis with hyperimmune human globulin is useful but the aim is to extend active immunoprophylaxis to the entire population, since tetanus can present with only slight wounds or shollow burns.


Studies on the tubular ferritin-uptake in the kidneys of Goldblatt-hypertensive rats. Ferritin deposition in the tubular epithelial cells developing after intravenous ferritin injection was investigated in the kidneys of 25 Goldblatt hypertensive rats and of 10 normotensive controls. The phenomenon was detected only in the hypertensive animals. Light microscopic and planimetric data indicate an increased permeability of the glomerular filter and contradict a degenerative damage of the tubular epithelial cells as a primary cause. Ferritin after having crossed the glomerular filter is partly reabsorbed by the tubular epithelium and partly excreted by the urine. The high iron content of the urine and the ferritin detected electrophoretically in it also proves this explanation.


On the lysosomal function of juxtaglomerular granules. The presence of acid phosphatase, beta-glucuronidase and aryl sulfatase in juxtaglomerular cell granules (JGG) as well as the uptake and concentration of certain low molecular weight dyes by these granules have repeatedly suggested that they are akin to lysosomes. In the present experiments, rats were injected with three substances of widely different molecular weight and physicochemical properties--sucrose, iron sorbitol-citric acid complex (Jectofer) and horseradish peroxidase--that are well known to selectively concentrate in renal tubular cell lysosomes. None of these substances was found to enter the JGG to any significant degree, although both sucrose and Jectofer were evident in juxtaglomerular cells. Contrary to previous reports, thorium dioxide (Thorotrast) particles were not detected in the JGG after parenteral injection. These results indicate that JGG do not possess any significant lysosomal function and raise the question of the role of hydrolytic enzymes in the physiology of these granules.


Effect of hemoglobin loads on the function and morphology of ischemic kidneys in the rat. Male Wistar rats were used to investigate the effects of stromafree hemoglobin (200 mg Hb/100 g body weights, i.v. as a 16.4% solution) on kidney function and morphology. Ischemia of the kidney was induced by bilateral clamping of the renal pedicle. The most severe disturbances of kidney function occurred in kidneys damaged by ischemia during the peak of Hb excretion; endogenous creatinine clearance decreased to 5% of control values, serum creatinine concentration rose 6 times as high as control values, and Hb excretion in the urine was reduced. Kidney damage after Hb loading and ischemia was more severe than damage caused by ischemia alone. These results demonstrate that the vulnerability of kidneys to damage by ischemia is increased by Hb loading.


The technique of death masks making.

The technique of death masks making. In taking death-masks two different techniques are used. In the technique using a plaster matrix the plaster mash is brought on the face. When the plaster-cast has dried it is filled with plaster mash. Later the matrix is removed in order to lay open the mask. In the technique using a plastic matrix the plastic powder Palgat is brought on the face after mixing it rapidly with icewater until it appears pappy. After that a layer of several centimeters of plaster mash follows in order to stabilize the delicate plastic matrix. Likewise the matrix is filled with plaster mash. The mask can be furnished with a collar and a fixation and the surface can be prepared. The skin relief of the face is reproduced finer using the cast of a plastic matrix.


[Metameters for the statistical treatment of data expressed in percentage values]. Medical or biochemical data are often expressed as percentages or proportions. Since the sampling error of percentage values does not usually follow a normal (Laplace-Gauss) model, statistical significance tests may give unsatisfactory results, when applied to the original data; however, the fitting to a normal distribution can be improved by choosing suitable metameters. The Author proposes the transformation of percentages to a hyperbolic function zp, based on Fisher's z, which is almost normally distributed. The performances of this transformation are checked, with special reference to medical laboratory problems.


[Fractionated low dose radiotherapy].

[Fractionated low dose radiotherapy]. 20 cases of head and neck cancer underwent radiotherapy at low dose rate (2 rad/min) in a clinical trial. Final results were unsatisfactory in terms of both survival and complications. A radiobiological analysis of the high rate of complications is made.


[Valvular insufficiency after venous thrombosis. Experimental study]. Venous thrombosis can produce lesions of valvular cusps which are generally ascribe to the phase of thrombus organization. Valvular lesions hold a very important role in the genesis of the post phlebitic chronic venous insufficiency. Experimental thrombosis had been induced in dogs with electrical stimulation of femoral veins to study morphological aspects of valvular cusps in various evolutive phases of thrombosis. Results emphasize too early onset and quick evolution of valvular damage. It can contribute to explain frequent failures of attempted therapy about prevention of post phlebitic syndromes.


[Prenatal biophysical monitoring: stress tests]. Intrapartum fetal monitoring has provided a method by which the clinician can more accurately determine the status of the fetus during labor. More recently, investigations have been directed toward antepartum FHR monitoring studies to determine fetal well-being prior to the onset of labor. In this study, the results of "stress" monitoring are presented. The Authors have used three types of stress-tests: 1) oxytocin stress test 2) step-test 3) Oxygen stress test. The positive tests appears to correlate meaningfully with intrauterine compromise and neonatal status.


[Aldosterone-Na-K interactions after operations with extracorporeal circulation]. The Authors, valuing the interrelationships with aldosterone and idrosalin retention and potassium depletion after E.C.C., study all the factors affecting the loss of potassium particularly the secondary iperaldosteronism. The preoperatory heart failure, duration of the E.C.C. and low cardiac output increase the secundary iperaldosteronism. They also say that the plasmatic potassium concentration is not a good index of body potassium depletion, and there is a good ratio between urinary log. Na/k and aldosteronic activity; at the end the Authors say that there needs several potassium administration.


[Preliminary experiences with the use of cimetidine in the treatment of acute hemorrhages in the upper gastrointestinal tract]. On the basis of favorable results recently reported in literature with cimetidine in the prevention and therapy of upper gastrointestinal haemorrhages, the Authors have treated a patient with severe haemorrhage from acute gastric ulcer arised after jejunum-ileal massive resection for mesenteric infarction. Result was very good, with stop of haemorrhage and quickly healing of the lesion. This clinical report is of interest particularly in view of high mortality of postoperative haemorrhagic acute gastropaties with therapeutic means, medical or surgical, just now available. At last the particular physiopathological aspects of the case suggested some considerations about mechanisms of action of the Cimetidine.


[Clinico-statistical data on 1,478 cases of burns admitted to the Burn Center of the Plastic Surgery Institute of the University of Parma in the 10-year period of 1967-76]. After having shortly illustrated the work's purpose, the Authors start to examine the statistics obtained in a research developed on 1,478 burned patients admitted at the burn center of the Institute of Plastic Surgery of Parma's University from 1967 to 1976. By and by are taken into consideration the statistics concerning age, sex, work, the percentage of burned body surface, the burn's causes, the mortality due to burns and the time spent in hospital. The most important data are those that come out from the comparison of the data that the N.B.I.E. considers optimal for a burn center, and those of the Burn Center of Parma, that have resulted practically the same. At the end of the work are related some considerations concerning the necessity of a bigger prevention of the illness and of collaboration with the other italian Burn Centers.


Postnatal changes in plasma and renal renin of the rat. Plasma renin activity (PRA) of infant rats is high until some time between the 3rd and 4th week after birth. Mothers, however, return PRA to normal by 2 weeks post partum. The rate of disappearance endogenous PRA of nephrectomized rats is slower in those animals having gigh PRA than in mature rats. Disappearance curves of endogenous PRA of mothers post partum is also the same as that of normal mature females. Part of the high PRA of the neonate can thereby be the related to the lower rate of destruction. Total kidney renin content increases with age. Renal renin activity (RRA) is low only during the 1st postnatal week when expressed in terms of whole kidney weight and compared to later postnatal times. Although there are some slight differences in the means in older animals, none are statistically significant.


Ontogeny of human lysozyme. Distribution in fetal tissues. Using the immunoperoxidase method, major changes in the distribution of lysozyme (LZM) were found to occur during fetal development. At 10 weeks of gestation LZM was detected for the first time in the proximal tubules of the kidney. This generally coincides with the reported appearance of LZM in fetal blood and amniotic fluid. The enzyme was observed in lung macrophages and in mononuclear cells of the lamina propria of the small intestine in fetuses 12 and 16 weeks old, respectively. At about 18--20 weeks, LZM-positive mononuclear cells were detected in other tissues tested, such as liver, spleen and thymus. Paneth cells were found to be specifically stained at about 20 weeks of gestation. The timing of the appearance of LZM in the various tissues is discussed in relation to the functional maturation of each organ and the ontogeny of this enzyme in other species.


Variations of the intraesophageal pressure with maturation in the postnatal piglet. Variations in intraesophageal pressure (Pes) to 5-min exposures of 100% O2, 10% O2, and 6% CO2 were studied in successive days during the first 2 months of 8 piglets. Pressure measurements were integrated over time to obtain mean pressure changes for each minute. Initial exposure to 100% O2 decreased the mean pressure in all piglets followed by an increase over the next 4 test minutes. 5 of 8 piglets demonstrated maximum increases (25--55% above control) at 5 days and between 15 and 22 days; 3 piglets only at 5 days. Initial exposure to 10% O2 increased the pressure in all piglets followed by a decrease pressure (-10%) in the next 4 min when the piglets were less than 22 days, and an increase (15--70%) when above this age. Exposure to 6% CO2 increased the pressure throughout the 5-min test period with the maximum increase (140--160%) at the earliest ages tested of 5 days.


Transport of uric acid and hypoxanthine across the isolated guinea pig placenta. Transport of uric acid and hypoxanthine across the isolated guinea pig placenta is investigated quantitatively. The clearances measured are independent of concentration. It is shown that the uric acid transport is not greatly influenced by variations in flow, so it is concluded that the uric acid transport is membrane limited. The clearance of hypoxanthine is even less than the uric acid clearance, so hypoxanthine transport is also membrane limited. Xanthine oxidase is shown to be present in the uterine tissues, and an apparent Km and a maximum velocity have been determined.


Effect of premature weaning to different diets on the subsequent response to a dietary change. Rats were weaned prematurely (day 18 postnatally) to a high-fat, high-carbohydrate or Purina Chow diet until aged 30 days. They were then fed the Purina Chow diet until aged 43 or 68 days. For a further 2 days they then received a high-fat diet. They were compared with rats weaned on day 30 to the Purina Chow diet. Adipose tissue of rats weaned prematurely to the high-carbohydrate diet or Purina Chow showed higher activities of phosphoenolpyruvate carboxykinase, malic enzyme and fatty acid synthetase than the same tissue from normally weaned rats or rats fed the high-fat diet from 18 to day 30. Prematurely weaned rats also have a higher level of blood cholesterol on day 45 after 2 days on the high-fat diet.


Distribution of label in maternal plasma, placenta, fetal plasma and tissues after injection of 14C-palmitate into the circulation of 21- and 28-day-pregnant rabbits. Tissue and plasma samples were obtained from fetuses removed 1--20 min after injection of 14C-palmitate into the doe at day 21 or day 28 of gestation. Specific activity of maternal plasma free fatty acids (FFA) was higher, but that of fetal plasma FFA lower in 21- than 28-day-pregnant rabbits. In 21-day fetuses, total radioactivity in the liver never exceeded that in the placenta; in 28-day fetuses, the liver radioactivity exceeded that in the placenta after 3 min. Total radioactivity in the fetal brown adipose tissue (BAT) never exceeded that in the placental. Most of the placental radioactivity was initially in the FFA, but at later time intervals the majority of the label was in the phospholipids. The fetal liver and BAT rapidly esterified label into triglycerides. It is concluded that transport of FFA across the placenta is greater at 28 days than at 21 days gestation. The evidence suggests that a pool of placental FFA,  which equilibrates rapidly with the maternal plasma FFA, is a possible source of fetal plasma FFA. The rapidity and quantity of label appearing in the fetal liver suggest that fatty acids may first be processed by the liver before transport to extrahepatic tissues.


Effects of maternal dodecanoic or lauric acid (C12:0) feeding on milk fatty acid secretion and lipogenesis in the suckling rat. Lauric acid feeding induced large alterations in mammary gland fatty acid secretion. It was highly incorported in milk triglycerides, suggesting that mammary gland was not able to efficiently regulate the qualitative aspects of medium-chain fatty acid secretion. These modifications in milk fatty acid secretion did not alter pup growth, lipogenesis balance or the classic parameters of the pup liver during the suckling period. Nevertheless, maternal lauric acid feeding induced important alterations in the qualitative aspects of pup lipogenesis before weaning.


Effect of postnatal age and clinical status of newborn infants on bilirubin-binding capacity. Serial determinations of bilirubin-binding capacity were performed in 61 newborn infants during the first 10 days of life. 27 infants were classified as term (gestational age greater than or equal to 36 weeks) and 34 as preterm (gestational age less than or equal to 33 weeks); 34 were classified as 'sick' and 27 as 'well'. Bilirubin-binding capacity was measured by Sephadex gel filtration. In relation to postnatal age, total bilirubin-binding capacity (TBBC) remained stable in well term and preterm infants, decreased slightly in sick preterm infants, and decreased significantly in sick term infants. TBBC, serum albumin, and molr binding ratio (B/A) were significantly higher in well than in sick infants in both term and preterm groups; there were no significant differences between sick term and sick preterm infants. Clinical recovery in 16 infants was associated with a significant rise in TBBC and in B/A. The data suggest that in healthy infants, the serum bilirubin-binding capacity remains relatively unchanged during the first 10 days of life. Clinically ill infants show wide patient-to-patient variability in TBBC. Because of the tendency of TBBC to decrease with postnatal age in sick infants, repeated determinations of TBBC may be indicated for the management of sick jaudiced newborns.


Effects of testosterone and estradiol on ratios of adult to fetal hemoglobin in cell cultures of human fetal liver. The effects of testosterone and 17beta-estradiol on the synthesis of fetal and adult hemoglobins have been studied using a short-term primary cell culture system of human fetal liver at midgestation. There was a significant 23% increase in incorporation of 59Fe into adult hemoglobin relative to the total after the addition of 5 X 10(-8)M testosterone. 17beta-Estradiol (10(-6)M) lowered the incorporation of 59Fe by 21%. beta-Globin chain synthesis, measured as 3H- or 14C-leucine incorporation into globin chains, was identical in control and testosterone-treated cells and only slightly lower when 17beta-estradiol was added. For this reason the observed changes in adult hemoglobin resulting from the action of testosterone and 17beta-estradiol are caused by an indirect effect either in the final hemoglobin assembly or by small changes in the gamma/alpha-chain ratio which may be undetected by the methodology used.


F2alpha prostaglandin levels in mothers and infants of different gestational periods. 53 mother-neonate couples, of different gestational ages, were studied for PGF2alpha levels in the mother's blood at the beginning of the first stage of labor and in the umbilical cord blood. PGF2alpha levels were found to be increased in all neonates compared to their mothers and in the blood of the mothers of prematures compared to the mothers of the post-mature babies. No correlation could be found between the gestational age of the neonate and the umbilical cord levels of PGF2alpha.


Optimum temperature requirements for cutaneous oxygen measuremtns (cpO2); a comparative study of 44 and 43 degrees C. Simultaneous measurements of cutaneous pO2 with oxygen skin sensors heated to 44 and 43 degrees C have been performed in 9 newborns in respiratory distress. 25 simultaneous measurements of paO2, cpO2 (44 degrees C) and cpO2 (43 degrees C) and 150 h of simultaneous recordings at these two different temperatures were compared. The agreement with arterial pO2 values was found to be superior at the higher sensor temperature. At 43 degrees C, the cpO2 is much lower than at 44 degrees C and lower than the arterial values. Although the risk of thermally induced lesions during prolonged use is higher at 44 degrees C, it is advisable to use this temperature for monitoring critically ill infants. Burns can be avoided by frequently changing the measuring site.


Skin sensors for continuous oxygen monitoring of newborns. Since the introduction of the technique of cutaneous1 pO2 measurement by directly heated oxygen sensors in 1972, the clinical applications and limitations of this new method have been extensively investigated. The method has proven to be of particular value in monitoring of high risk newborns as it affords the possibility of continuously monitoring clinically significant changes in the oxygenation state of the newborn. In this paper, methodological criteria for the assessment of the reliability of cutaneous pO2 monitoring are discussed. Particular consideration is given to the oxygen and temperature profiles in the vicinity of the skin sensor and to the response time of the sensor. In view of the fact that the cutaneous pO2 reflects the oxygen partial pressure at the level of arterialized cutaneous tissue, the method has limitations if it is used as an indirect determinant of arterial pO2.


Relation of transcutaneous to arterial pO2 in hypoxaemia, normoxaemia and hyperoxaemia. Investigations in adults with normal circulation and in patients with circulatory insufficiency. The transcutaneous oxygen tension was monitored continuously by a heated cutaneous polarographic electrode in 7 adult intensive care patients, 12 patients without circulatory insufficiency, and 5 healthy volunteers, Arterial pO2 values were varied from hypoxaemia to normoxaemia and hyperoxaemia by variations of the inspired oxygen concentration. In normal volunteers and in patients without circulatory failure, transcutaneous pO2 indicated on an average about 81-92% of the arterial pO2 in normoxaemia and hyperoxaemia with a correlation coefficient of 0.97. In hypoxaemia there was an over-proportional decrease of the transcutaneous pO2 to a mean value of 44% fo the arterial pO2. In one case the transcutaneous pO2 reproducibly dropped to zero at paO2 values of 41 respectively 38 mm Hg (5.5 respectively 5.1 kPa). In intensive care patients the transcutaneous pO2 values were considerably lower than the paO2 values. There was no constant transcutaneous to arterial pO2 ration in most of the intensive care patients at different pO2 levels. In adults without disturbance of peripheral perfusion paO2 can be predicted with satisfactory accuracy from transcutaneous pO2 values in normoxaemia and in hyperoxaemia. In hypoxaemia and in circulatory insufficiency, the transcutaneous pO2 is only an indicator of the trend of the arterial pO2. Under these conditions it does not allow a quantitative estimate of paO2 changes.


Transcutaneous pO2 of volunteers during hyperbaric oxygenation. Continuous transcutaneous pO2 measurements (tcPO2 measurements) were performed in healthy volunteers who were breathing air and oxygen under hyperbaric conditions (max. 4 ata). The results show a close correlation of PO2 values measured by the noninvasive method, in blood from discret arterial punctures, chamber PO2, respectively, the PO2 of the inspiratory gas mixture which was checked up to maximal values of 2,200 mm Hg. The PO2 in the arterial blood samples was measured immediately after the puncture insight the hyperbaric chamber using a specially designed through electrode.


The adult Chiari malformation.

The adult Chiari malformation. The adult or type 1 Chiari malformation is a hindbrain anomaly in which the cerebellar tonsils, but not the vermis, are chronically dispalced into the foramen magnum (1). Syringomyelia or syringobulbia are frequently associated with the anomaly (2-4). Seventeen cases of surgically verified adult Chiari malformations with or without a syrinx were recently diagnosed at the Neuropsychiatric Institute. University of California at Los Angeles. A review of these patients confirmed this anomaly has protean manifestations. Recognition of paroxysmal complaints induced by a variation of the Valslava maneuver, especially in the presence of nystagmus, might lead to early neurodiagnostic procedures and surgical intervention, with reduced morbidity.


Genetic analysis of the nephrogenic diabetes insipidus defect in SWV mice. Females of the SWV mouse strain had an age-dependent nephrogenic diabetes insipidus. The distribution of water intakes in the F1, F2 and backcross to each parental strain indicated that at least the polydipsia was determined by a few major dominant genes; rather than by a polygenic system. The Smirnof and chi square analyses revealed more than one major gene was involved. A hypothesis was presented that there are two dominant genes (one fully dominant and one codominant) which may be linked. The expression of these major genes was influenced multiplicatively by environmental factors and the water intakes approached a continuous distribution. The defect was sex influenced: SWV males had only a very mild urine concentrating defect but the reciprocal crosses showed no X-linkage. The kidney weight of the SWV females correlated significantly (P less than 0.05) with the polydipsia in the F1, BC SWV and F2 progeny and the use of both traits provided a qualitative measure for classification. The polydipsia and enlarged kidneys probably represent pleiotropy.


Relationship between cell proliferation, chromatin template activity and accumulation of nuclear proteins. Trypsinization of confluent monolayers of WI-38 cells causes an extensive loss of nuclear proteins. The loss of nuclear proteins is restored only several hours after the cells have been replated at a lower density in 10% serum. When trypsinized fibroblasts are replated at a lower density in 10% serum, there is also a sustained progressive leading to DNA synthesis and cell division. If 0.3% serum is used instead of 10%, there is a modest increase in nuclear template activity, but not accumulation of nuclear proteins and no DNA synthesis or cell division.


Temperature sensitivity of the erythrocyte membrane potential as determined by cyanine dye fluorescence. We have used the cyanine dye fluorescence technique to measure the membrane potential of human erythrocytes as a function of temperature. With erythrocytes starved of glucose, there is an abrupt decrease in membrane potential centered at 38 degrees which is reversible up to 41 degrees, and irreversible at higher temperatures. With erythrocytes supplemented with glucose, the thermally induced transition is centered at 41 degrees and is reversible up to the highest temperature measured, 45 degrees. These results extend previous spectroscopic studies with erythrocyte membranes which demonstrated a thermally induced transition in protein tertiary or quaternary structure that is irreversible above 42 degrees.


Dibucaine-induced synchronous mucocyst secretion in Tetrahymena. Synchronous secretion of all available mature mucocysts was induced in late log phase cultures of Tetrahymena thermophilia (B III) by the local anaesthetic dibucaine. No assembled fusion rosettes were seen within the plasma membrane after release until 2-3 hrs of regrowth, thus proving that the rosettes are not permanent sites within the plasma membrane but have to be reassembled each time for a new fusion event to occur. Concomitant with the reappearance of assembled fusion rosettes, the cell cytoplasm fills up with precursors of new mucocysts thus linking the two events together.


Alkaline phosphatase in mitochondria.

Alkaline phosphatase in mitochondria. In electron microscope cytochemical studies alkaline phosphatase activity was present in the mitochondria of all liver cells and associated with the plasma membrane of the cells of bile canaliculi. The mitochondrial activity was partially inhibited by L-phenylalanine and Levamisole but the plasma membrane associated activity was completely inhibited by Levamisole. Biochemical assays have shown that a significant amount of the total mouse liver alkaline phosphatase activity was present in the mitochondria fraction. Starch gel electrophoresis showed that this mitochondrial alkaline phosphatase had a characteristic isoenzyme pattern, consisting of 3 distinct bands which were not retarded by neuraminidase treatment. The enzyme in the mitochondria-free supernatant showed one wide band which was retarded by neuraminidase.


Binding of alpha-bungarotoxin and cholinergic ligands to acetylcholine receptors in the membrane of skeletal muscle. A membrane fraction enriched in acetylcholine receptors was prepared from denervated cat leg muscles. 97% of the alpha-bungarotoxin-binding sites in the dispersed membranes are sensitive to nicotinic cholinergic ligands. In intact msucle, 90% are. A filtration assay of the binding to the membranes of tritiated alpha-bungarotoxin, as retarded by these ligands, provides a convenient system for the determination of affinities of ligands for the muscle receptor in its membrane-bound state. Affinities were found thus for 6 nicotinic ligands. An allosteric system, rather than desensitisation, may explain the high affinities observed for certain ligands.


Isolation of single stranded transcription sites from human nuclear DNA. Single stranded DNA (ss-DNA) isolated from nuclear DNA of human rhabdomyosarcoma (RD line) cells amounts to 2% of total DNA. As compared with native double-stranded DNA (ds-DNA), ss-DNA has a lower mean sedimentation coefficient, higher buoyant density, contains fewer repeated DNA sequences and a greater proportion of it can be hybridized to human RNAs (up to 35% and less than 8% for ds-DNA). The hybridization kinetics determined by S1 nuclease digestion and verified by other methods (hydroxylapatite chromatography, density gradient centrifugation and thermal melting) indicate that ss-DNA corresponds to a great number and variety of transcripts. These data are discussed as evidence for DNA strand dissociation in the course of gene activity.


DNA distribution and intrachromosomal organization of moderately repetitive sequences. The DNA content of individual subregions along the 4th chromosome of Drosophila hydei has been measured. 51% of the subregions have a DNA content averaging 0.7-0.8 pg; 31% a mean DNA content of 0.25-0.35 pg and 18% a mean DNA content of 1.7 pg. Moreover the structural chromosomal distribution of moderately repetitive DNA is not random since the specific activity of the chromosomal segments in terms of those sequences is not the same. 9% of the subregions are very poor in repetitive sequences and 18% rich in repetitive DNA while being very poor in DNA.


The effect of temperature during trypsin treatment on viability and multiplication potential of single normal human and chicken fibroblasts. Both the number of colonies formed from single cells and their average size are affected by the temperature at which nontransformed human and chicken fibroblasts are harvested from monolayer cultures. At constant levels of trypsin activity, treatment of cells at temperatures less than 15 degrees C during all steps from monolayer to subsequent culture markedly improves viability and multiplication potential of single cells.


Cytoplasmic annulate lamellae and intranuclear membranes in human spermatids and sperm. In human spermatide cytoplasmic annulate lamellae and intranuclear lamellae were found. In the cytoplasm, the annulate lamellae may vary from 3 to 11 layers of cisternal structures. There is evidence that the annulate lamellae are formed from the outer nuclear envelope. The intranuclear membranes are often seen directly connected to the inner nuclear membrane. These morphologic findings suggest that annulate lamellae may be involved in the transfer of genetic material from the nucleus to the cytoplasm.


The effect of dimethyl sulphoxide on electron transport in chloroplasts. The effect of DMSO (dimethyl sulphoxide) on electron transport in chloroplast membranes has been studied. It has been found that concentrations of DMSO up to 20% (v/v) do not inhibit electron transport in freshly isolated chloroplasts, but that higher concentrations start to cause inhibition. However, in chloroplasts that have been aged for 8 to 24 hours by storage at 4 degrees C, the addition of DMSO at concentrations up to 20% causes stimulation of electron transport. Possible mechanisms for this effect are discussed.


Glucose consumption and lactate production in normal and fluoride adapted LS cells. The established cell line LS (mouse fibroblasts) has been adapted to grow at otherwise toxic concentrations of fluoride. Different substrains of adapted LS cells consumed less glucose and converted less of the glucose to lactate than the unadapted cells. Differences were also found in the two parameters dependent on the number of generations grown in the presence of fluoride. The more generations with fluoride, the less lactate was produced and the less glucose consumed.


Nuclear actin: an apparent association with condensed chromatin. In Amoeba proteus the concentration of actin is the same in the nucleus and cytoplasm. Certain characteristics, e.g., the ready loss of actin from isolated nuclei, suggest that the association with nuclei is normally not a tight one. Here we report, however, that when nuclei are isolated several hours after mitotic amebas are placed in actinomycin D (which allows normal progression of mitosis), the nuclei retain substantial amounts of actin. Since this finding correlates with other observations that the chromatin of such cells is extensively condensed, we suggest that a relationship may exist between actin and chromatin condensation.


Electron microscopic localization of DNA-dependent RNA polymerase binding sites on DNA using enzyme immobilized on colloidal gold. DNA dependent RNA polymerase has been coupled to gold granules of 60 A. The gold-polymerase complex (Au-P) has been demonstrated to bind to chick oviduct DNA and be capable of transcription as monitored by both biochemical activity and electron microscopy. Binding of Au-P to DNA is competable with free polymerase.


Ram sperm mitochondrial DNA.

Ram sperm mitochondrial DNA. Circular DNA was isolated from mitochondrial fractions of ram spermatozoa by SDS treatment followed by convex sucrose gradient centrifugation. The DNA had a contour length of 5.0 micron. Its buoyant density was 1.6983 g cm-3, which was smaller than two nuclear DNA components with buoyant densities of 1.6999 and 1.7156 g cm-3, found in ram spermatozoa. The Tm of the mitochondrial DNA was 69.7 degrees C. The mole fraction G+C calculated from the buoyant density and melting temperature was 39.1% and 38.6%, respectively.


Protein biosynthesis by rat gastric mucosal cells in suspension. Suspensions of cells freshly isolated from rat gastric mucosa by the pronase technique did not synthesize protein unless washed. Synthetic activity proceeded for at least 3h in washed cells, but unless three or four washing cycles were given the synthesized protein was subsequently degraded. Supplementation of the incubation medium with 3% w/v bovine serum albumin markedly increased synthetic activity. Special consideration was given to the control of artifacts caused by bacterial activity, oxygen deficiency and adsorption of radioleucine.


A method for the isolation of Chinese hamster cell variants with an altered ability to utilise carbohydrates. Chinese hamster ovary cells (CHO-K1) are able to utilise only a few carbohydrates for growth such as glucose, mannose, fructose and galactose. They do not grow on ribose, lactose, sucrose, glycerol, lactate, pyruvate, citrate, succinate, fumarate or malate nor on glycogenic or ketogenic amino acids. After mutagenesis and selection in glucose free medium supplemented with various, individual, growth substrates, we have isolated single-cell derived clones which are now able to grow on one of the following energy source: ribose, lactose, sucrose or lactate.


Properties of carbohydrate utilising variants of Chinese hamster cells. Variants of Chinese hamster ovary cells (CHO-K1) have been isolated which can grow on one of the following carbohydrates: lactose, sucrose, ribose or lactate. The ribose+ clones grow at the same rate on glucose as the parental cells whereas the others grow more slowly. With the exception of one ribose+ clone all excrete lactic acid while growing on glucose; none excrete significant amounts of lactic acid while growing on the alternative energy source. Wild-type cells and the variants accumulate radioactively labelled glucose and the corresponding radio-actively labelled alternative energy source to the same extent. The ribose+ variant that does not accumulate lactate while growing on glucose is also exceptional in its inability to utilise mannose.


The histidine analogue L-histidinol arrests the growth of BALB/3T3 cells in G0. The histidine analogue L-histidinol inhibits the growth of Balb/3T3 cells in a dose-dependent manner and concentrations of 1 or 2 mM cause a total but completely reversible growth arrest. Growth resumption which follows removal of the analogue shows kinetics and requirements indistinguishable from those of quiescent cells stimulated to proliferate by fresh serum. Cells which have progressed beyond the G1/S boundary appear to complete the cell cycle in the presence of L-histidinol and become arrested in the subsequent G1 or G0.


[Our experience in esophago-colonic plastic surgery for esophageal stenosis caused by caustics]. The Authors report their experience (16 cases) in esophago-colon plastic surgery for esophageal stenosis from caustics and emphasize the advantages presented by the colon as a substitute for the esophagus, as compared with the stomach and jejunum. Although the results were equally satisfactory irrespective of the selected segment of colon, the Authors indicate their present preference for the left colon because of some technical aspects making the operation easier and more reliable.


[13 cases of double neoplastic localizations, 1 involving the esophagus]. During the course of nine years 494 patients suffering from oesophageal cancer have come under our observation, including 13 cases characterised by the phenomenon of double neoplastic localisation. In some cases, in view of the histological identity of the two neoplasias, remote endocanicular colonisation may be presumed, while in other cases the rise of the tumour "disease" may be correlated with the action of carcinogenetic agents on sites of lesser resistance in organisms whose immunitary defences have been decreased in relation to neoblastogenesis. This is supported by the increase in the incidence of malignant neoplasias in patients subjected to immuno-suppressive treatment.


[Early diagnostic laparotomy in patients with multiple injuries (apropos of 125 cases)]. Hundred twenty five patients with multiple areas of injury requiring surgical repair outside of the abdomen too were subjected to laparotomy. In patients with multiple areas of trauma the abdomen is almost always suspect. The proliferation of diagnostic tools to detect intraperitoneal damage have, in some ways, helped phisicians decide as to laparotomy. However, when multiple injuries are present, particularly of the central nervous system, classical findings of peritoneal damage are difficult to elicit. A diagnostic laparotomy does not add significantly to the overall morbidity or mortality, for that we think is still a place for diagnostic laparotomy in patients with multiple trauma.


[Diagnostic peritoneal lavage in pediatric surgery]. Diagnostic peritoneal lavage has been evaluated in 44 pediatric cases, suspected of intraperitoneal hemorrhage. This test was proved to be a useful, safe, and highly accurate procedure for early diagnosis of intraperitoneal hemmorhage also in pediatric surgery.


[The prognosis in patients with esophageal cancer: statistical study in relation to age, histotype, tumor stage, and immunological reactivity]. This paper analyses the prognostic factors in cancer of the oesophagus in relation to site, histological type, age, and the patient's immunitary reactivity evaluated histologically in the lymphonodes and the tumoral tissue itself, and the invasion or otherwise of the loco-regional lymphonodes. The survival curves are calculated by the actuarial method. In particular, it was seen that patients with absence of peritumoral lymphocytic infiltrate and depletion of the loco-regional lymphonodes present a survival curve stopping at the second year after the operation, whereas reactive patients survive beyond that date in 29% of cases. It may therefore be asserted that the presence of lymphocytic infiltrate in the tumour and of lymphonodal reactivity are a pointer to an attitude of defence of the organism, and the importance of the study of these factors as prognostic criterion in patients subjected to resection of the oesophageal tumour clearly emerges.


Fast detoxification of heroin addicts by acupuncture and electrical stimulation (AES) in combination with naloxone. Detoxification can be accomplished more rapidly by first "flushing" the opiates from the receptor sites. Naloxone, a short acting antagonist displaces opiates from the receptor sites and such displacement precipitates an abstinence syndrome. Recently, a method of using acupuncture and electrical stimulation (AES) in combination with naloxone for fast detoxification was reported. This technique was applied to 50 cases of heroin addicts. Forty-one were detoxified. There were nine failures. Of the 41 cases, 18 patients were sent to rehabilitation centres and did not experience abstinence symptoms. Six were sent out of Hong Kong where heroin is not available, and two others did not go to a rehabilitation centre but still abstained. The other 15 were presumed to be on the drug. It is advocated that AES increases endorphin and relieves abstinence syndrome, but also at the same time inhibits the autonomic nervous system, mainly the parasympathetic nervous system. The technique does not stop the craving, therefore after detoxification, the patients should be sent for psycho-social rehabilitation, or alternatively be put on long acting antagonist.


Acupuncture in bronchial asthma: bodyplethysmographic measurements of acute bronchospasmolytic effects. In 12 patients with bronchial asthma the effects of acupuncture (45 tests altogether) on airway resistance have been investigated. In 9 patients there was a significant decrease of airway resistance 10 minutes, 1 hour and 2 hours after the end of acupuncture. The lowest level for airway resistance (70.1% of control value) was reached during the first hour after acupuncture. The possibility of a merely suggestive effect could be excluded, because "placebo-acupunctures" did not change airway resistance significantly. The comparison with a parasympatholytic acting drug as a metered aerosol (Atrovent) demonstrated that acupuncture had a somewhat weaker bronchospasmolytic effect. Three patients did not show any reaction after repeated acupunctures.