[Results of long-term treatment of primary osteoporosis with sodium fluoride (author's transl)]. Twenty-three patients with primary osteoporosis were treated with sodium fluoride over 25 months. Mean total dose was 21 g fluoride. Symptoms, body size, biochemical results, radiological changes and skeletal mineral content as well as bone histomorphometry were evaluated in assessing results of treatment. Accordingly, no advance in the disease process was demonstrable in 13 patients, while there was definite improvement in six, but in four there was further progression.


[Blood viscosity during long-term intravenous infusion of low-molecular dextran (author's transl)]. The effect on whole-blood viscosity and haematocrit was investigated in 54 persons during intravenous infusion of 500 ml Rheomacrodex 10% or 500 ml 0.9% sodium chloride solution for two, four and six hours. Rheomacrodex 10% led to a significant decrease in whole-blood viscosity after all infusion periods and up to two hours afterwards. The decrease in viscosity was definitely more marked at lower degrees of shear than at higher ones and with long-term infusion (four and six hours) than short-term infusion (two hours). Physiological saline caused significant decrease in viscosity compared with initial values at the end of four and six-hour infusions and only at shear of 230 s-1. During all infusion periods and for all degrees of shear the decrease in viscosity was significantly greater with Rheomacrodex 10% than physiological saline.


[Incidence of spontaneous rhythm after pacemaker implantation for total A-V block (author's transl)]. Follow-up investigation over 12--84 months (mean 30 months) of 86 patients with the primary diagnosis of permanent total atrioventricular block revealed that spontaneous rhythm could be demonstrated in all but 17 patients. A-V conduction was re-established in 13, but in most of them it was on the basis of ventricular ectopic beats. These findings prove that in the described type of patient spontaneous rhythm after pacemaker implantation is common. Therefore, fixed-rate pacemakers are not indicated in these patients.


[Immunodiagnostic aspects of breast cancer (author's transl)]. In 39 patients with breast cancer and in 38 female controls the leucocyte adherence was tested in glass tubes in the presence of a series of extracts of breast cancer and control tissues. It was shown that the adherence of leucocytes of patients with operable carcinoma of the breast (stage I/II) is selectively inhibited by extracts from breast cancer tissues. Leucocyte adherence inhibition tests could thus become important for immunodiagnostics.


Active-site titration of pig-plasma benzylamine oxidase. 1. Titration of benzylamine oxidase with benzylamine under anaerobic conditions shows that full reduction of the enzymic 470-nm chromophore is obtained on the addition of one mole of substrate per mole of enzyme. Concomitantly, one mole of benzaldehyde per mole of enzyme is produced. 2. A single prosthetic group interacting with carbonyl reagents can be detected on titration of benzylamine oxidase with phenylhydrazine. Titration data reported to indicate a higher content of prosthetic groups were obtained under conditions where equilibration between enzyme and phenylhydrazine is insufficiently complete. 3. It is concluded that pig-plasma benzylamine oxidase contains a single catalytically active site. This means that the two copper atoms present in the enzyme may be structurally or functionally different.


Quantitative determination of ferredoxin, ferredoxin-NADP+ reductase and plastocyanin in spinach chloroplasts. Ferredoxin, ferredoxin-NADP+ reductase and plastocyanin extracted from spinach chloroplasts were determined by quantitative immunoelectrophoresis in an antiserum-containing gel. The advantage of the method is its high sensitivity and specificity so that crude extracts can be directly analysed. It requires, however, purified electron carriers and the corresponding monospecific antibodies. The ratios of ferredoxin to reductase to plastocyanin approximated 5:3:4, respectively, per cytochrome f or P700 in spinach chloroplasts.


Evidence for the inhibition of trypsin by thiols. The mechanism of enzyme-inhibitor complex formation. Ehrlich ascites tumour cells contain a neutral protease, capable of solubilising fluorescein-labelled telopeptides from fluorescein-labelled polymeric collagen fibrils. The cells also contain an inhibitor for this enzyme and for trypsin. The enzymically inactive enzyme-inhibitor complex can be dissociated with the mercurial thiol agent, mersalyl, with the consequent regain of enzymic activity. The reactivated neutral protease and also trypsin can be inhibited by addition of thiols such as cysteine, mercaptoethanol and dithiothreitol. Trypsin can be protected from inactivation by the tumor inhibitor by addition of cystine or L-1-tosylamido-2-phenylethyl chloromethyl ketone(TosPheCH2Cl)-inactivated chymotrypsin. The evidence suggests that the inhibitor contains a reactive thiol group which exchanges with one or more significant disulphide bridges in trypsin and the neutral protease, resulting in enzyme-inhibitor complex formation and loss of activity. Similarly, thiols interact with these enzymes resulting in a corresponding loss of enzymic activity. The evidence obtained with Tos-PheCH2Cl-inactivated chymotrypsin, which reactivated previously inhibited trypsin and neutral protease, demonstrates that the active site of the enzyme is not involved in the interaction with the thiol of the inhibitor but that the significant disulphide bond in the enzyme is required for the maintenance of the active site conformation. This disulphide exchange mechanism is therefore a form of reversible allosteric control of proteolytic activity and has been shown to be distinct from the mechanism by which soya bean trypsin inhibitor interacts with trypsin.


Isolation and chemical characterization of a highly purified phytomitogen from Phaseolus coccineus seeds. An effective lymphocyte mitogen with a low erythroagglutinating ability was isolated from the seeds of Phaseolus coccineus L. by ammonium sulphate precipitation and repeated ion-exchange chromatography on modified Sephadex. The mitogen stimulated lymphocytes at concentrations as low as 0.25 microgram/ml, the optimum concentration being in the range of 2.5-5.0 microgram/ml. This stimulating effect was completely inhibited by 5 mg/ml methyl alpha-D-mannopyranoside. Column gel filtration, disc electrophoresis on polyaceylamide gel in an alkaline medium and in the presence of sodium dodecylsulphate and the finding of a single N-terminal amino acid (alanine) showed the phytomitogen to be homogenous. Disc electrophoresis in an acid medium revealed the presence of two or three bands which are assumed to be due to aggregates of the mitogen. The minimum molecular weight, as derived from sodium dodecylsulphate electrophoresis on polyacrylamide, was 35000. The mitogen is a glycoprotein containing 10% neutral sugars and 1.3% amino sugars (glucosamine). The amino acid composition of the isolated phytomitogen is presented.


Free and membrane-bound polysomes from rat liver. 2. Recovery of large free and membrane-bound polysomes. Techniques allowing the recovery of large free and membrane-bound polysomes in high yield are reported. Subcellular fractions were prepared from rat liver homogenates as described in the preceding paper. Purified microsomal membranes (obtained from the post-lysosomal supernatant) were adjusted to 50 mM Mg(CH3COO)2 and treated with 2% Triton X-100 and 0.3% sodium deoxycholate in the presence of yeast RNA and cell sap, and polysomes were purified by overnight centrifugation through low-ionic-strength discontinuous sucrose gradients containing 2 mg/ml of cell sap proteins. Polysomes were isolated from the mitochondria/endoplasmic reticulum complex (fraction C) by treatment with 2% Triton X-100 and 0.5% sodium deoxycholate in the presence of 50 mM Tris-HCl, pH 7.6, 0.1 M KCl, 0.15 M NH4Cl and 50 mM Mg(CH3COO)2 and purified through sucrose layers of decreasing ionic strength containing 2 mg/ml of cell sap proteins. Analyses of polysomes in isokinetic sucrose gradients showed that the free polysome fraction and both membrane-bound polysome fractions had 14-15 ribosomes per mRNA at the maximum of absorbance. Experiments from which these methods were derived are described.


Purification and characterization of aldehyde dehydrogenase from bovine liver. Aldehyde dehydrogenase from bovine liver has been purified to homogeneity. Amino acid composition showed a high content of cysteine of 32 mol/mol enzyme. The enzyme is composed of four identical subunits as judged by sodium dodecyl sulfate gel electrophoresis and end-group analysis. The molecular weight was determined to be 220 000 +/- 10 000 by sedimentation equilibrium analysis in an analytical ultracentrifuge. The Michaelis constants for NAD+, glyceraldehyde and acetaldehyde were found to be 47 micron, 170 micron and 130 micron, respectively.


Quantitative analysis of the protein composition of yeast ribosomes. The molecular weights of the individual yeast ribosomal proteins were determined. The ribosomal proteins from the 40-S subunit have molecular weights ranging from 11 800 to 31 000 (average molecular weight = 21 300). The molecular weights of the 60-S subunit proteins range from 10 000 to 48 400 (average molecular weight = 21 800). Stoichiometric measurements, performed by densitometric scanning on ribosomal proteins extracted from high-salt dissociated subunits revealed that isolated ribosomal subunits contain, besides some protein species occurring in submolar amounts, a number of protein species which are present in multiple copies: S13, S27, L22, L31, L33, L34 and L39. The mass fractions of the ribosomal proteins which were found to be present on isolated ribosomes in non-unimolar amounts, were re-examined by using an isotope dilution technique. Applying this method to proteins extracted from mildely isolated 80-S ribosomes, we found that some protein species such as S32, S34 and L43 still are present in submolar amounts. On the other hand, however, we conclude that some other ribosomal proteins, in particular the strongly acidic proteins L44 and L45 get partially lost during ribosome dissociation. Proteins L44/L45 appears to be present on 80-S ribosomes in three copies.


Association of binding sites for guanine nucleotides with adenylate cyclase activation in rat pancreatic plasma membranes. Interaction of gastrointestinal hormones. 1. The activation of rat pancreatic adenylate cyclase by guanosine 5'-(beta-gamma-imido)triphosphate (p[NH]ppG) and GTP, and by the two gastrointestinal hormones pancreozymin (as C-terminal octapeptide) and secretin was correlated with the binding of [8-3H]guanosine 5'-(beta-gamma-imido)triphosphate to rat pancreatic plasma membranes. 2. The low basal adenylate cyclase activity was stimulated 17-fold by p[NH]ppG (after a 2 min lag period), 3,5-fold only by GTP, 21-fold by C-terminal octapeptide of pancreozymin, and 8-fold by secretin. GTP inhibited competitively the activation of adenylate cyclase by p[NH]ppG with a Ki,app almost identical with the Ka,app (0.3 micron). p[NH]ppG and GTP enhanced the stimulation by secretin more markedly than that by the C-terminal octapeptide of pancreozymin, leading to the same maximal activity. Both hormones suppressed the lag period of activation by p[NH]ppG. 3. The binding of [8-3H]p[NH]ppG was dependent on time, temperature and Mg2+ and it was also a saturable and reversible process. Scatchard plots with a concavity upward were linearized after co-addition of ATP, Mg2+ and an ATP-regenerating system that abolished low-affinity sites for p[NH]ppG without saturating higher affinity sites, GTP, ITP and UTP inhibited [8-3H]p[NH]ppG binding to the high-affinity sites in concentration ranges identical with those found for adenylate cyclase activation. Considerable binding of [8-3H]p[NH]ppG was still evident at 20 degrees C, but enzyme activation was not observed any more, except in the presence of hormones.


Free and membrane-bound polysomes from rat liver. 1. Improvements of subcellular fractionation. Substantial improvements of cellular fractionation in ionic conditions allowing preservation of polysome structure and polysome-membrane interactions are reported. They consist primarily in minimizing the lysosomal content of fractions containing endoplasmic reticulum by isolating a lysosome-rich fraction with little loss (6%) of RNA. Endoplasmic reticulum membranes were recovered in high yield, mainly in association with mitochondria, the remainder being found in the post-lysosomal supernatant. The latter also contained practically all the free polysomes, as judged by metrizamide gradient analyses. The distributions of various constituents (RNA, DNA, protein and marker enzymes) among cell fractions is presented.


Transport of phosphate analogues in rat-liver mitochondria. The swelling of rat liver mitochondria has been studied in isotonic ammonium salts of phosphate, thiophosphate, monofluorphosphate, difluorphosphate or in isotonic ammonium malate induced by low concentrations of the mentioned anions. The data lead to the following conclusions. 1. Phosphate, thiophosphate, and monofluorphosphate are taken up by the mitochondria, whereas difluorphosphate is not, indicating that the substrate of the transporter represents the divalent anion HPO24- and not H2PO4-. 2. Thiophosphate, monofluorphosphate and phosphate, but not difluorphosphate induce the swelling of mitochondria in isotonic ammonium malate, only after a lag phase. The length of the lag phase depends on the concentration of inducing anion and pH. This phenomena cannot be explained by the current concept of two independent phosphate-transporting systems in mitochondria.


Characterisation of cathepsin B and collagenolytic cathepsin from human placenta. 1. Human placental cathepsin B and collagenolytic cathepsin were separated by chromatography on columns of Amberlite CG-50. Collagenolytic cathepsin was partially purified by chromatography on DEAE-Sephadex (A-50) and Sephadex G-100. Cathepsin B was purified by chromatography on CM-cellulose and Sephadex G-100. 2. Both enzymes required activation by thiol compounds and were bound to organomercurial-Sepharose-4B. Sulphydryl-blocking reagents were inhibitory, which confirmed an essential thiol group to be present. 3. The enzymes degraded soluble calf skin collagen and insoluble bovine tendon collagen in the telopeptide region at pH 3.5 and 28 degrees C to yield mainly alpha-chain components. 4. In contrast to cathepsin B, collagenolytic cathepsin was found not to hydrolyse any of the low-molecular-weight synthetic substrates that were tested. 5. Leupeptin, a structural analogue of arginine-containing synthetic substrates, and antipain, an inhibitor of papain, were strongly inhibitory to both enzymes. 6. The isoelectric points of the enzymes were similar, being 5.4 for cathepsin B and 5.1 for collagenolytic cathepsin. 7. From chromatography on Sephadex G-100 the molecular weight of cathepsin B was calculated to be 24 500 and that of collagenolytic cathepsin to be 34 600.


A simple screening method for detecting gastrointestinal protein loss in intestinal lymphangiectasia. A ten month old female Turkish child with chylous ascites, diarrhea, steatorrhea, peripheral edema and hypoproteinemia was investigated for protein losing enteropathy which probably dated from the first weeks of life. Gastrointestinal protein loss appeared to be due to abnormalities of the intestinal lymphatics. In order to detect a localized lymphoenteric fistula, lymphangiography was tried but failed due to hypoplasia of peripheral lymphatics. However, three hours after intradermal injection of Patent Blue, the dye appeared in the stools of the patient, suggesting intestinal protein loss via a lympho-enteric fistula. This observation may provide the basis for a diagnostic test for gastro-intestinal protein loss in patients with intestinal lymphangiectasia.


Hemolytic pattern of erythrocytes in the newborn measured by the coil planet centrifuge system and its relationship to neonatal jaundice. Dynamic osmotic fragility of erythrocytes in cord blood and its changes during the neonatal period were studied by means of a coil planet centrifuge system. The starting-point for hemolysis in the newborn become similar to that of adult blood after approximately a week, while the shift of the end-point to the adult range required one month or more. The percentage of fragile cord blood cells with a hemolysis starting-point above 110 m osmol and the maximum bilirubin level during neonatal period were examined. A high percentage of fragile cells was associated with high bilirubin levels, and when fragile cells comprised more than 7.0% of the total cord blood erythrocytes, the bilirubin level tended to rise above 15 mg/dl.


Diagnostic and therapeutic problems in Cushing's syndrome. Series of 7 cases. A series of 7 patients (all females) with Cushing's syndrome are presented. The syndrome was due to an adenoma of the cortex in 4 cases, to a carcinoma in 1 and to bilateral adrenal hyperplasia in another. In the 7th patient the cortical hyperplasia was due to a bronchogenic carcinoma (ectopic production of ACTH). Surgery was performed in all patients except 1. In 5 patients (adenoma, carcinoma) the diseased adrenal was removed. In 1 patient a left total and a right subtotal adrenalectomy were performed. Out of those 7 patients 4 survived and 3 died. 1 died a few hours after surgery, another 3 months after operation and the last one was never operated on.


On the etiology of testicular tumors. An experimental study. This paper demonstrates experimentally that autofertilization induces malignant  metastatic or recurrent testicular tumors in the rat. The role of fertilization, i.e. of nuclear fusion, in the process of carcinogenesis is discussed.


A retrovesical echinococcal cyst: unusual cause of acute urinary retention. In a middle-aged man a rare case of echinococcal cyst of the retrovesical space is reported as a very unusual cause of acute urinary retention. The discussion points out the difference between primary and secondary hydatid cyst of the retroperitoneum, the diagnostic problems and a suggested treatment is given.


Lymphovenous shunting in a case of retroperitoneal seminoma. Lymphovenous shunting in a patient presenting with a metastatic retroperitoneal seminoma is reported. Its aetiology as well as the prognostic value are discussed. A search of the literature has been made and the various theories offered to explain such a phenomonen have been evaluated, in an attempt to corelate them with the findings in our case.


Necrotising ureteritis after cystoplasty for leukoplakia of the bladder--an unusual complication. Ileocaecocystoplasty was performed after subtotal cystectomy in a man with extensive leukoplakia of the bladder as a prophylaxis against carcinoma. 2 years later the ureter (contralateral  nephrectomy had previously been performed) became blocked by an unusual interstitial inflammation complicated by necrosis and calcification. This was excised, and the tail of the ileum anastomosed to the renal pelvis with a good result at 20 months.


Urethro-balanitis xerotica obliterans.

Urethro-balanitis xerotica obliterans. A clinical report of 5 cases of balanitis xerotica obliterans (BXO) with urethral involvement is presented. Involvement of the urethra in the BXO is emphasized and the fact that this process is often unnoticed, is stressed. The clinical and histological characteristics of this disease are described in its different localizations. Investigations are suggested to diagnose urethral involvement and the suitable therapy is outlined.


Serum inhibitors to granulopoiesis in thalassemia major. Peripheral blood (pb) and bone marrow CFU-C were evaluated in patients with thalassemia major. A decrease in both pb and marrow CFU-C was noted when compared to normal donors and individuals with hemolytic anemia requiring transfusion therapy. Experiments suggested that a nondialyzable serum factor was resonsible for the depressed pb CFU-C in 6 and of 6 children with thalassemia. Serum lipoprotein electrophoresis revealed type IV pattern in 9 out of 18 children with elevation of the pre-beta fraction. These experiments suggest (1) decreased stem cell CFU-C, (2) decreased pb CFU-C, and (3) a serum inhibitor that may be contributing to the depressed pb CFU-C.


Megakaryocytic responses to thrombocytopenia and thrombocytosis in Sl/Sld mice. Sl/Sld mice maintain normal platelet counts in spite of a reduced number of megakaryocytes, but their megakaryocytes are macrocytic. The present studied were done to analyze platelet turnover in the steady state and thrombocytopoietic responses to perturbations of the platelet count. Platelet production, estimated with 35S incorporation in the steady state, blood volume, and total complement of peripheral platelets were normal. Sl/Sld mice responded to thrombocytopenia with normal degrees of macromegakaryocytosis and production of macrocytic platelets, but rebound thrombocytosis did not occur. Their megakaryocytes were unusually responsive to transfusion-induced thrombocytosis, showing a prompt and substantial reduction in size. Platelet turnover was normal in undisturbed Sl/Sld mice, and feedback regulation occurred. However, increased numbers of platelets were not produced in response to stimulation. The findings are consistent with the possibility that their megakaryocytes are large because of stimulation rather than a direct local effect of the abnormal microenvironment.


Marrow stem cell release in the autorepopulation assay. The early migration of stem cells from a shielded marrow to an irradiated spleen has been re-evaluated, and the findings have been compared with the results of earlier studies. The composite data reveal a constant rate during the first 24 h after irradiation, with a slope of 1.6 cells per h and an intercept of 2.4. The positive intercept is interpreted to signify an immediate brief perturbation of CFU's release. The low concentration of CFUs in the bloodstream, despite their continuous migration from the shielded marrow, is indicative of a rapid, and probably greatly increased, blood turnover. Despite the constancy of stem cell seeding, it is not yet possible to determine whether the rate of stem cell release is different in shielded marrow than in normal marrow. The resolution of this question requires more precise information about spleen seeding efficiency in the autorepopulation assay and about the normal turnover rate of stem cells in the bloodstream.


Characterization of mouse fetal liver granulocyte-macrophage colony-forming cells using velocity sedimentation. Fetal liver cells from CBA mice were separated by velocity sedimentation to determine the distribution and properties of granulocyte-macrophage colony-forming cells (GM-CFC). Twelve-day fetal liver GM-CFC separated into two peaks (s=7.7 mm/h, s=9.4 mm/h) in cultures stimulated by mouse lung conditioned medium (GM-CSF MLCM) or human urine (GM-CSFHU). Because fetal liver GM-CFC are of relatively light bouyant density, this finding indicates that fetal liver GM-CFC are much larger than corresponding cell in adult bone marrow (s=4.5 mm/h). By 18 days gestation more slowly sedimenting colony-forming cells were present (s=4.7 mm/h, s=6.0 mm/h). At all gestational ages, the most rapidly sedimenting (larger) colony-forming cells were more responsive to stimulation by GM-CSF MLCM than the smaller (slowly sedimenting) cells. Unlike the situation with adult marrow cells, velocity sedimentation achieved no segregation of GM-CFC according to the morphological type of colony produced.


Failure of diphenhydramine hydrochloride to prevent thrombosis at sites of endarterectomy in dogs. Our previous work has shown that the addition of diphenhydramine hydrochloride to platelet-rich plasma is capable of causing disaggregation of platelet aggregates already induced by adenosine diphosphate as well as of inhibiting platelet aggregation when added prior to the aggregating agent. This led us to attempt to prevent arterial thrombosis in a canine experimental model. Ten dogs received an injection of diphenhydramine (approximately 3 mg/kg of body-weight) into the right common femoral artery 1 cm proximal to the proximal end of a 2 cm endarterectomy immediately after closure of the endarterectomy site and prior to performing an endarterectomy of the other common femoral and both common carotid arteries. The dogs which received diphenhydramine were compared with ten control dogs and found to have no protection against thrombosis at the sites of endarterectomy after 4 and 24 hours.


A comparative study of floctafenine (Idarac) and ibuprofen in the treatment of osteoarthrosis. A two-by-two-week crossover trial was conducted in patients with osteoarthrosis, using a double-dummy technique of drug administration. The drugs used were floctafenine (Idarac) and ibuprofen both given in a dose of 200 mg four times daily. Both drugs provided comparable relief of pain. Side-effects were few and generally mild. The results indicate that in the treatment of osteoarthrosis, floctafenine is comparable to ibuprofen (in the dose used in the study) in terms of efficacy and toxicity.


An open assessment of a new low dose oestrogen combined oral contraceptive. This was a multicentre general practitioner study using a new low dose oral contraceptive, Ovamin 30 (ethinyloestradiol 30 microgram, ethynodiol diacetate 2 mg). Results showed a pregnancy rate calculated as a Pearl Index of 0.4. An analysis of bleeding patterns showed consistently acceptable cycle control. From these results it would appear that Ovamin 30 is an effective and well tolerated low dose oral contraceptive preparation.


Single-dose oral treatment of vaginal trichomoniasis with tinidazole and metronidazole. Sixty cases of trichomonal vaginitis were randomly allocated to treatment with tinidazole or metronidazole, both administered as a 2 g single dose. One patient on tinidazole did not complete her follow-up. Parasitological cure was obtained in all patients in both the treatment groups. A satisfactory clinical response was obtained in all 29 patients on tinidazole, and in 27 out of 30 (90%) on metronidazole. Complete relief of sumptoms was obtained in 62% (18/29) and 13% (4/30) of patients ontinidazole and metronidazole, respectively (p less than 0.01). Ten patients on tinidazole and 24 on metronidazole manifested side-effects. The frequency and severity of side-effects were much more in the metronidazole group (p less than 0.01). Tinidazole has distinct advantages over metronidazole in the one-dose treatment of trichomonal vaginitis.


A comparative evaluation of oral decongestants in the treatment of vasomotor rhinitis. In a seven-week double-blind crossover study, Disofrol (dexbrompheniramine maleate +d-isoephedrine sulphate) was compared with Lunerin (brompheniramine + 2-amino-1-phenyl-propanol-(1)-hydrochloride) and with placebo in the treatment of vasomotor rhinitis in thirty-one patients. From the patients' evaluations on diary cards Disofrol reduced the symptom running nose to a higher degree than Lunerin, an effect possibly ascribable to a greater anticholinergic activity. Both preparations had equal ability to relieve nasal blockage and both combinations were found to be more effective than placebo.


Further experience with 2100 consecutive ketamine administrations: newer indications and restrictions. Two thousand one hundred consecutive administrations of ketamine as an anaesthetic agent are reviewed. On the basis of the experience described, the authors assess that this agent could be used with safety in the average patient presenting for surgery and that it would be likely to suffice as the sole anaesthetic agent in 40% of such cases but would require supplementation by other anaesthetic agents in the remaining 60% of cases. They recommend it as being particularly useful in children submitting to dental surgery as it can be used without sedative premedication and permits of rapid recovery.


Calcium and secretin as provocative stimuli in the Zollinger-Ellison syndrome. The effects of calcium and secretin were studied in 8 patients with the Zollinger-Ellison syndrome and 18 patients with duodenal ulcer disease. Intravenous infusion of calcium gluconate produced marked increases in serum gastrin levels in the patients with Zollinger-Ellison syndrome (4,350 +/- 1,625 pg/mg) and very slight increases in the patients with duodenal ulcer disease (140 +/- 49 pg/ml). Secretin given as a single intravenous injection also induced marked elevations in serum gastrin in the group with the Zollinger-Ellison syndrome (4,063 +/- 1,990 pg/ml). By contrast, intravenous secretin resulted in a progressive fall in serum gastrin levels in the duodenal ulcer group (from 119 to 97 pg/mg). These results suggest that both stimuli are very useful dagnostic tools in discriminating between Zollinger-Ellison and non-Zollinger-Ellison patients. The secretin challenge test is felt to be superior to the calcium infusions because it is simpler, safer and very rarely produces false-negative or-positive results.


Glucagon inhibition of secretin and combined secretin and cholecystokinin stimulated pancreatic exocrine secretion in health and disease. The effect of glucagon infusion on secretin and combined secretin and cholecystokinin stimulated exocrine pancreatic secretion was studied in normal subjects and in patients after acute and with chronic pancreatic disease. Glucagon inhibited pancreatic protein secretion and had no inhibitory effect on volume or bicarbonate secretion.


Morphology of the gastric mucosa, gastric secretion and serum gastrin concentration following a test meal. In 32 subjects, the HCl secretion, the histological state of the antral and fundic mucosa and the gastrin response to a liquid meal extract were studied. Atrophy of the antrum was associated with normal gastrin concentration in the fasting state and after the test meal, in the presence of normal fundic mucosa and HCl secretion. In achlorhydria and atrophic gastritis, fasting gastrinemia was significantly elevated in subjects with a normal antrum, and only moderately increased in subjects with an atrophic antrum. The gastrin response to feeding was correlated to the fasting gastrin concentration in achlorhydric subjects with normal antral mucosa, in contrast to a uniformly reduced output in achlorhydric subjects with atrophic lesions of the antral mucosa.


Hemorrhagic necrosis of the intestinal mucosa associated with disseminated intravascular coagulation. Disseminated intravascular coagulation (DIC), experimentally induced by endotoxin, caused severe hemorrhagic necrosis of the intestinal mucosa in dogs. Microscopic observation showed tortuous thrombus formation in the microcirculation of the villi. Ligation of the pancreatic and bile ducts, or administration of heparin protected the mucosa from hemorrhagic necrosis, while systemic administration of tranexamic acid increased the intestinal mucosal lesion. Local pretreatment of the intestinal mucosa by Trasylol or tranexamic acid reduced the degree of hemorrhagic necrosis. It is concluded that intravascular coagulation in the microcirculation of the intestinal mucosa, as well as pancreatic proteases, play a role in the pathogenesis of hemorrhagic necrosis in the intestine associated with DIC.


Fasting and postprandial serum bile acid concentrations in normal persons using an improved GLC method. An improved GLC method was employed to study individual serum bile acids in 14 control subjects after a 12-hour fast followed by a standard fatty meal. Peripheral venous blood samples were obtained at 15-min intervals for up to 2 h in 7 subjects, and 4 h in 2 subjects. The fasting total bile acids, and cholic:chenodeozycholic acid ratio fell within a narrow range. The total bile acids and chenodeoxycholic acid increased significantly within 30 min of the meal, to reach peak values within 75-120 min. The extent of the increase was variable, and the range of values increased progressively after the meal.


Calcium transport by the normal rat colon in vivo and in vitro. We studied calcium transport in vivo and in vitro in large bowel of normally fed young male rats. Solutions containing zero, 1.7, 3.4 and 5.0 mM calcium and isotopic 45Ca as tracer were perfused in vivo through the lumen of cecum and descending colon. In vitro flux studies were also carried out in cecum with 2.0 and 0.2 mM calcium solutions utilizing the technique of Ussing and Zerahn whereby both chemical and electrical gradients across planar sheets of cecal tissues were nulled. The combined findings demonstrated that (i) cecum was more permeable to calcium than descending colon indicating a proximal to distal absorption gradient in large bowel; (ii) the transport of calcium in both segments increased with increasing luminal calcium concentration, and (iii) calcium transport in both cecum and descending colon was passive only. Thus the large bowel appears to play only a minor role in calcium homeostasis in the normally fed rat.


Fat necrosis - a cause of pancreatic parenchymal necrosis? Acute pancreatic necrosis resulted when oleic acid or olive oil was injected into the pancreatic duct or rats. After injection of droplets of both lipids into the pancreatic interstitial tissue, coagulation-type necrosis of acinar tissue developed adjacent to these droplets. Mono-olein or paraffin oil caused no histological alterations of acinar cells. It is concluded that (1) the deleterious effect of olive oil on the pancreas is mediated through fatty acids released by pancreatic lipase, and (2) fatty acids split off in fat necrosis of acute pancreatitis may damage adjacent pancreatic acinar tissue.


Effect of highly selective vagotomy on gastric motor activity of duodenal ulcer patients. The effect of highly selective vagotomy on the gastric emptying time of a food-barium meal and antral myoelectrical and manometrical activities was studied in two groups of duodenal ulcer patients: one with and another without delay in gastric emptying. Controls performed 1 and 3 months after operation showed that the group of patients with non-delayed preoperative gastric emptying kept a good emptying, only with sporadic, slight and transient disturbances of the gastric myoelectric activity. Conversely, the group of patients with delayed preoperative gastric emptying showed an increase in emptying time together with marked alterations in myoelectric and manometric activities.


Diet and cholesterol gallstones. A multicenter study. In France, changes in the incidence of gallstones during the 20 years following World War II paralleled the changes in total calories, protein and lipid of the diet. The incidence of gallstones in autopsy statistics has been compared to the diets in different countries: France, India, Japan, Portugal, South Africa, Sweden and Uganda. Low calorie, low protein, low lipid intake and vegetable diet are associated with a low incidence of gallstones. A positive correlation between calorie intake and gallstones incidence was found at necropsy for calorie intakes lower than 3,000 kcal. In countries with high calorie, high protein and high lipid intakes, such a correlation was not found. These results suggest that a hypocaloric diet associated with a low intake of fat and protein mostly of vegetable origin, is protective against cholelithiasis.


Diet and cholesterol gallstones. A further study. In a first study, a population of 1,045 women from 20 to 61 years old has been studies. 24 (2.3%) were known to have gallstones. After excluding these 24 cases, 214 were drawn from the same population and accepted an oral cholecystography. 11 cases of stones (5.1%) were discovered. The diet of these 11 patients and of the 202 women without gallstones was not significantly different. In a second study, the diet of 50 patients with known gallstones and the diet of 50 matched controls have been compared. No significant difference between the two groups can be demonstrated for calories, protein, fat or carbohydrates intake. These results are compared to previous results which showed overconsumption of food in gallstone patients. The method for all studies being similiar, it seems that the dietetic factors are now less important in cholesterol stones pathogenesis than during the period which followed the second world war starvation in southeast France. The assumption that undernutrition diminishes the chance for a women to develop gallstones is proposed.


Experimental production of diffuse colitis in rats. Diffuse, topical application of dilute acetic acid to the serosal surface of rat colon, or standardized intraluminal (per rectum) instillation induced a reproducible, diffuse colitis in a dose-response manner. These lesions were reproduced with 100% reliability and were evaluated up to 60 days when healing occurred. Histopathological features of this chemically induced colitis were diffuse ulceration of the distal colon, occurrence of pseudopolyp-like structures, alterations in crypt depth and mucus secretion, and a transmural, nonspecific inflammatory response.


The interrelations of gastrin release, antral gastrin concentration and acid secretion rate. The interrelations of meal stimulated gastrin release, antral gastrin concentration (AGC) and acid secretion rate were examined in a heterogenous group of 72 patients, Gastrin release calculated as the integrated gastrin output was directly related to AGC, r = 0.50 (p less than 0.001) and inversely related to maximum acid output (MAO), r = -0.31 (p less than 0.01). The relation between integrated gastrin output and AGC was significant in 21 patients with low acid secretion rates (MAO: less than 10 mEq/h), r = 0.66 (p less than 0.01) and in 27 patients with normal acid secretion rates (MAO: 10-25 mEq/h), r = 0.56 (p less than 0.05), but not in 24 patients with high acid secretion rates (MAO: greater than 25 mEq/h), r= 0.35 (p greater than 0.05). A weak inverse relation between AGC and MAO may exist in patients with low acid secretion  rates, r = -0.40 (p less than 0.10). Considered together using multiple regression procedures AGC and MAO explained less than one-half of the variability in meal stimulated gastrin release.


Disaccharidase deficiency in infants with cow's milk protein intolerance. Response to treatment. 7 infants, aged 5 weeks to 11 months, with clinically documented intolerance to cow's milk protein, chronic diarrhea, and failure to thrive, underwent small intestinal (peroal, suction) biopsy before and after withdrawal of milk proteins. Mucosal specimens were examined by light microscopy and assayed for disaccharidase activities. In all patients, moderate to severe mucosal changes were presented, associated with marked inflammation of lamina propria and damages to the brushborder. Disaccharidase activities (lactase, sucrase, maltase and palatinase) were markedly depressed in all. Follow-up biopsies were obtained in 6 infants, after 3-5 months on a milk-protein-free diet. At the time of the second biopsy, the disaccharidase activities had risen significantly and histologic improvement had occurred in each instance. In infancy, intestinal mucosal lesions due to intolerance to cow's milk protein are histologically indistinguishable from those seen in gluten-sensitive enteropathy and are associated with marked secondary disaccharidase deficiencies. Following therapy, the activity of the disaccharidases become normal or near normal prior to the complete morphologic recovery of the small intestinal mucosa.


Detection of IgE insulin antibody with radioallergosorbent test. An in vitro method for detecting IgE insulin antibody using the principle of the radioallergosorbent test (RAST) is described. In six patients with insulin allergy, the RAST values were higher than in normal persons or insulin-treated diabetics without insulin-allergy. No differences were observed between normal persons and insulin-treated diabetics without insulin-allergy. Moreover, it was observed that in one patient treated with highly-purified insulin, there was a gradual decrease of RAST value parallel to the radioinsulin binding activity and clinical allergic symptoms. The RAST value of insulin is slightly inhibited by non-IgE antibodies and is, therefore, a semiquantitative value. However, the RAST is simple to perform and reproducible; It therefore is very useful in the detection of IgE insulin antibodies.


Oxidation of an exogenous glucose load using naturally labelled 13C-glucose. Effect of butylbiguanide therapy in obese mildly diabetic subjects. The effect of a 14 day-administration of butylbiguanide was investigated in a group of 10 obese patients with mild-to-moderate glucose intolerance. Glucose tolerance was significantly improved, while fasting blood glucose and plasma levels of free fatty acids, insulin and glucagon remained unchanged. The estimation of the amount of the oral glucose load oxidized into CO2 was performed by means of a recently described procedure using "naturally labelled 13C-glucose" as tracer. The curves depicting the oxidation of the exogenous glucose load were similar in shape and magnitude before and after administration of the biguanide; in the latter case, however, slightly higher rates of oxidation of exogenous glucose were recorded during the 2nd, 3rd and 4th hours of the test. These data do not provide evidence that the biguanide-induced improvement in glucose tolerance in patients with mild-to-moderate glucose intolerance is associated with any inhibiting or delaying effect of this type of drug on intestinal absorption (and subsequent oxidation) of the exogenous glucose load. On the contrary, a slight, but statistically significant, increase in the oxidation of exogenous glucose has been observed after butylbiguanide.


Effect of insulin in vitro on the isolated, perfused alloxan-diabetic rat liver. Withdrawal of exogenous insulin and a subsequent fast (24 h) of alloxan diabetic rats stimulated rates of gluconeogenesis, urogenesis, ketogenesis, and amino acid release by in situ perfused livers when compared to those from normal, fasted rats. The contribution of liver glycogen to the high rates of gluconeogenesis observed with the diabetic liver could be excluded. Perfusate lactate concentrations remained constant during the period when the elevated rate of gluconeogenesis was observed with diabetic liver. Addition of insulin as a bolus (750 mU) and continuous infusion (12.5 mU/min) to the perfusion medium of diabetic livers resulted in constant perfusate levels of glucose, urea and alpha-amino nitrogen indicating a suppression of the catabolic processes present in the fasted, diabetic liver. The rate of ketogenesis was also slowed by insulin to about half the rate prior to addition of the hormone. These data indicate that insulin has an immediate anti-catabolic effect in the perfused, diabetic liver.


The serum glucose response to glucagon suppression with somatostatin, insulin or antiglucagon serum in depancreatized rats. Total immunoreactive glucagon (IRG) and immunoreactive glucagon of A cell origin (IRGa) were measured in the serum of normal, sham-operated and depancreatized rats, after the administration of three glucagon antagonists: insulin (5--200 mU/rat/h), somatostatin (SRIF; 100 microgram/kg/h) and antiglucagon serum (AGS, enough to bind three times the calculated total amount of circulating IRG). Since no differences were noted between the responses of normal and sham-operated animals, the values were pooled and used as controls. Pancreatectomy caused a significant increase in serum glucose, IRGa and total IRG and a significant decrease in serum insulin. AGS and SRIF significantly decreased serum glucose in control, but not in depancreatized rats, even though SRIF caused a significant decrease of IRGa in all animals. SRIF significantly decreased plasma insulin in control rats, but did not modify total IRG secretion in either groups. In control rats the minimum effective hypoglycaemic dose of insulin (5 mU/rat/h) may have decreased serum IRGa, but not total IRG. At higher doses (20 mU/rat/h) insulin stimulated glucagon secretion. In depancreatized animals, higher doses of insulin (200 mU/rat/h) were needed to lower serum glucose. On the other hand, a dose of 100 muU/rat/h was sufficient to lower the serum IRG. We conclude that although hyperglucagonaemia may contribute to the hyperglycaemia of the untreated depancreatized rats, the excessive secretion of glucagon is secondary to insulin insufficiency and that, at least in this animal model, the hypoglycaemic action of insulin is only minimally dependent upon its ability to suppress glucagon secretion.


[The preventive treatment of general risks prior to gynaecological operations (author's transl)]. The operative treatment of high risk patients is of increasing importance in gynaecology. The preoperative preventive treatment of latent general problems is an important tool in the prevention of intraoperative and postoperative complications. The experience of the department for gynaecology in Hanover, Germany, during 1976 is reported. Among 1583 major operations 158 were carried out on patients in the risk class III. Guidelines are described for the preventive treatment of cardiac, bronchopulmonary, hypertensive and diabetic risks. The importance of obesity and advanced age is discussed in our cases.


Glucose metabolism in the newborn rat: the role of insulin. The effect of the administration of anti-insulin serum to newborn rats, surgically delivered under ether anaesthesia at term, was examined with respect to liver glycogen concentration and plasma concentrations of glucose, lactate and free fatty acids. Newborn rats thus treated showed decreased liver glycogen concentrations and elevated plasma concentrations of glucose, lactate and free fatty acids compared to untreated control animals one hour later. These effects were dose-dependent with respect to the amount of anti-insulin serum administered. The simultaneous administration of glucagon with anti-insulin serum at birth was no more effective in mobilising glycogen stores than anti-insulin serum alone, although plasma glucose concentrations in these animals were higher and plasma lactate concentrations were lower. Either anti-insulin serum or glucagon abolished the postnatal hypoglycaemia observed in untreated neonatal rats. The rate of fall in plasma lactate concentrations after birth was stimulated in glucagon-treated rats but was retarded in rats treated with anti-insulin serum. Hormonal control over the initiation of glycogenolysis and gluconeogenesis in the newborn rat appears to be different, a fall in plasma insulin being the prime factor involved in triggering glycogen mobilization and a rise in plasma glucagon the prime event that initiates gluconeogenesis.


[Chromosome Anomalies in cases of habitual Abortions (author's transl)]. Chromosome examinations in the case of 78 married couples with recurrent abortions are discussed. The analyses were based on 141 caryogrammes--78 women, 63 men. Inheritied chromosome anomalies as cause of the recurrent abortions could be ascertained with 7 patients (5%): 4 autosomal anomalies in the form of balanced translocations; 1 gonosomal anomaly occurring as X-trisomy with deletion of the short arms of an X-chromosome; 2 cases of striking fragility of the chromosome no. 2. The significance of such chromosome anomalies in women and recurrent miscarriages is discussed. Cytogenetic and histological examinations of the aborted product of conception can give valuable indications for the detection of a chromosome anomaly in the parents. The prognosis and consequences of parental chromosome anomaly and the necessity of prenatal chromosome analyses are discussed.


[Symptomatic therapy of primary dysmonorrhea by inhibition of prostaglandin synthesis with indomethacin (author's transl)]. In a controlled trial the effect of indomethacin was studied in 54 patients with primary dysmenorrhea. 34 patients were treated with 3 X 25 mg indomethacin per day orally for 5 days starting 2 days before onset of menstruation. Treatment was continued for 4 months, 20 patients received a placebo preparation. Symptoms of dysmenorrhea were reduced by 66-73% over the control group during all 4 treatment periods. 18 patients of the treated group reported complete relief from symptoms, 10 a marked improvement. Only 3 patients reported no effect of the drug, while in 3 other patients the treatment had to be discontinued due to the well-known untoward effects of indomethacin (nausea, vertigo). The therapeutic efficacy of indomethacin supports the concept of an essential role of prostaglandins in primary dysmenorrhea. The use of prostaglandin-synthetase inhibitors (aspirin-like drugs) is discussed for patient with primary dysmenorrhea who cannot be treated by contraceptive steroids.


[Cervical polyps and diagnostic curettages (author's transl)]. The early detection of carcinoma of the cervix is successful due to the systematic cytologic and colposcopic examination of the largest number of women possible. In cases with endocervical polyps a diagnostic curettage is customarily done along with removal of the polyp. The curettage which requires admission to hospital and carrie a risk of operative complications is an extensive procedure for the diagnosis of a cervical polyp. Because of the high accuracy of cytologic and colposcopic diagnosis it is suggested to omit the curettage in the management of non-bleeding polyps in the premenopausal woman. The asymptomatic polyp should be followed by cytology or office removal with obligatory histologic examination. Follow-up cytology of the cervical canal is necessary.


[Investigation on the mycoplasma population of the lochia (author's transl)]. 105 puerperae were examined for mycoplasma population one day and seven days post partum, after pregnancy and childbirth had remained without any complications. Whereas mycoplasmas could be identified in the lochia of 10 women in the seventh day post partum, all mycoplasma investigations remained negative on the day following childbirth.


[Investigations on mycoplasma infestation of the human placenta post partum (author's transl)]. In 95 healthy delivered women the placenta (externally and internally) and the amniotic sac were examined for mycoplasma population. Mycoplasmas could not be identified in any of the cases under investigation. In healthy pregnant women, mycoplasmas are not identifiable as "harmless commensals" either in the amniotic sac or in the placenta. In cases where mycoplasmas are found, they may act as pathogens.


[Contritution of correction to genetic recombination in T4 phage measured by the effect of map contraction]. Marker-dependence of the fine structure map contraction in T4 phage is studied in two-factor crosses between rIIB mutants separated by indicator distances. The genetic intervals, which were short as compared with mean length of the  heteroduplex region in hybrid DNA molecules but which exceeded the length of the DNA strand involved in a single correction event, were selected as indicator ones. On the basis of a deviation of measured frequencies from additivity (map contraction) the marker-specific frequencies of wild type recombinants arising as a result of correction to the wild type (kappa (- leads to +)) were calculated. For the most of the marker studied both of the base substitution and frame shift type the frequencies kappa (- leads to +) have the values below 2.10(-4). In the case of three most highly corrected frame shift markers with kappa (- leads to +) being 14.10(-4)--17.10(-4), about ten percent of all mismatched regions are corrected to the wild type.


[Mutagenic action of dimethyl sulfate and N-nitrosoethylurea on the mulberry silkworm]. Mutagenic effect of chemical mutagens, dimethalsulphate (DMS) and N-nitrosoethyl urea (NEU), on silkworm is studied. The effect of these mutagens have never been studied on silkworm before. DMS is found to be completely insufficient as mutagen for the silkworm, because its low mutability is accompanied with strong cytotoxic effect. NEU appeared to be of "milder" effect. Injection of male-moth proved to be very efficient. The majority of exuded mutants showed mosaic colouring of the graine.


[Cytogenetics of albinism in polecats of the genus Putorius (Carnivora, Mustelidae)]. Karyotypes of two ferret species, Putorius eversmanni (2n = 38) and P. putorius (2n = 40), differ in a single Robertsonian rearrangement, resulting in decreased chromosome number in P. eversmanni. Interspecific hybrids from crosses between P. eversmanni and domesticated albino ferret P. putorius furo are fertile. Hybrid individuals have a chromosome set 2 = 39. Analysis of offspring from crosses of these hybrids showed that albinism is a recessive character. Offspring obtained from crosses between interspecific hybrid ferrets and between these hybrids and parental species was subjected to chromosome analysis. A statistically significant correlation was observed between the chromosome number and albinism. As a rule, albino hybrids have a chromosome number 2n = 40. This suggests that the locus, controlling albinism, is located at one of the two pairs of acrocentric chromsomes involved in Robertsonian rearrangement. The rare occurrence of albino hybrids with 2n = 39 may be attributed to recombination. According to our data, recombination probability is less than 0.5 which indicates that the albinism locus located near the centromere. Possible extrapolation of the data obtained for ferrets to other Mustelidae is discussed.


[Genetic determination of the immune response of mice to cells of various histological types]. The intensity of the immune response of cells in mice to strong transplantation antigens of the H-2 complex can depend on the histological type of cells taken for immunization. Splenic cells of C3H mice immunized the cells of BALB/c line better that cells of the non-lymphoid origin taken from the same donor. A reverse situation was observed in case of immunization by the same cells of the lines C57Bl/6 and A/He. It was shown by the analysis of the lines of the first generation derived from the crosses between the 3 lines studied and also by the analysis of these characters in mice born from the backcross, that these characters do not exhibit a simple Mendelian segregation.


[Reduction of perinatal mortality of twins by means of preventive tocolysis]. Twins of mothers who were treated with 10 mg Ritodrin q.i.d. beginning from the 26th week of gestation reached higher birth weights and better maturity than twins of an untreated control group. Although the average time of gestation could not be prolonged 20% more children were born between the 36th and 40th week of gestation as compared to the untreated group. These findings seem to be the result of the haemodynamic influence of betamimetic drugs on metabolism of mother and child. The mortality rate (7.5%) was clearly lower than that of the untreated group (12,8%).


[Localization of the placenta by means of nuclear medical methods]. Accurate localization of the placenta in the cavity of the uterus is indicated prior to transabdominal amniocentesis and in cases where hemorrhages occur during pregnancy. Several nucleo-medical techniques are available for this purpose. Earlier a so-called placentography was performed, a method later replaced by placental scintigraphy. Today the gamma scintillation camera is ideal for localizing the seat of the placenta. In case of a normally embedded placenta, the profile view makes it possible to determine whether the placenta is attached to the anterior or posterior wall. In case of an anterior wall placenta it is possible with a radioactively labelled marker to draw the outline of the placenta on the abdomen of the patient so that the examiner is certain to puncture in an area that does not contain the placenta. Diagnosis of placenta praevia is assured in all cases by use of the gamma scintillation camera. Short-term introduction of an emitter into the posterior fornix vaginae makes it possible to determine the position of the internal orifice of the cervix uteri. If the caudal part of the placenta extends up to this mark, a placenta praevia is likely and all obstetrical precautions indicated have to be taken.


[Oral contraceptives, hypertension and nephrosclerosis]. Oral contraceptives are of pathogenetic importance in hypertension of women aged 26 to 35 years. The hypertensive reaction occurs predominantly in those women who have hereditary predisposition to hypertension or diabetes mellitus, who suffer themselves from diabetes or who showed toxemia in previous pregnancies. Our findings are not in agreement with the suggestion that oral contraceptive hypertension in women is always reversible. Simultaneous administration of estrogen and progestogen accelerates Goldblatt-type hypertension in rats. Neither estrogen nor progestogen alone alters arterial blood pressure. In the hormonal combination the hypertensive effect of estrogen can be replaced by epsilon-aminocapronic acid. Estrogen is the only substance increasing plasma renin activity. There is no correlation between the increase of blood pressure and the plasma renin activity in the various groups of experimental animals receiving the different pharmacological substances. Estrogen and the synthetic progestogen cause sodium retention. Because of this, oral contraceptive hypertension may be supposed not to result from a stimulation of the renin-angiotensin-system. Oral contraceptive hypertension may result from a combination of endothelial lesions due to the estrogen's effect on blood coagulation leading to nephrosclerosis, and sodium retention produced predominantly by the synthetic progestogen.


[The value of the postcoital test (Sims-Huhner test) in the treatment of sterility]. The analysis of 751 postcoital tests performed in patients consulting the infertility clinic of the Department of Obstetrics and Gynecology, University of Cologne, allows the following diagnostic and prognostic conclusions: 1. In case motile spermatozoa are present in the cervical mucus, the assumption can be made that adaequate insemination takes place. 2. The postcoital test and the simultaneous examination of the cervix factors offer themselves for the assessment of the estrogenic status during the normal cycle or after stimulation with clomiphene, HMG-HCG or estrogen. 3. The timing of the postcoital test itself results in a remarkable increase in pregnancy rates. 4. The pregnancy rates are higher when higher numbers of motile sperms are found in the cervical mucus. 5. Negative or doubtful postcoital tests do not rule out the possibility of pregnancy. 6. The postcoital test provides some information about the number of spermatozoa, their progressive motility, their morphology and about the interaction of spermatozoa with the cervical mucus. However, the postcoital test cannot replace a complete semen analysis.


[Solitary plasmacytoma of the scapula and clavicle]. A 59 year old female patient with a large solitary medullary plasmocytoma of two years duration of the right scapula and clavicle is presented. The patient refused operation and received telecobalt radiation therapy. The palpable swelling and pain disappeared. Bone marrow puncture, blood and urine analyses were quite normal. An individualized therapeutic procedure is recommended for such cases.


[Resection in the treatment of gastro-duodenal ulcer]. The differing results after gastric resection and vagotomy are extensively discussed in regard to mortality, recurrence, dumping syndrome, post-alimentary problems, nutritional deficiencies, and gastric stump carcinoma. The resection is given preference, except in younger ulcer patients.


[A case of Poland syndrome].

[A case of Poland syndrome]. A typical case of Poland syndrome is reported; brachiothoracic hemi-aplasia with absence of major pectoralis muscle, shortening of the arm and symbrachydactylia. Additionally, there was some evidence of debility. There were no malformations in the family history.


[Modern endoscopy in surgery].

[Modern endoscopy in surgery]. Our own endoscopic experience in surgical gastroenterology is based on 5000 esophago-gastro-duodenoscopies, 650 coloscopies and 1200 endoscopic retrograde cholangio-pancreaticographies. Endoscopic diagnosis and therapy is pre-, intra-, and postoperatively well established today. Improvements of preoperative diagnosis in certain surgical diseases let hope for further successes in this field. Endoscopic procedures and operations reduce the patient's risks to a minimum. Well established endoscopic technique may substitute and support certain surgical procedures.


[The potentiation of stimulated gastric juice secretion by prednisolone]. In 5 series of dogs the acute effect of a high dose of prednisolone (40 mg/kg i.v.) on Histalog stimulated gastric secretion (5 mg/kg s.c.) was tested. There was no effect of prednisolone alone. The combination of Histalog and prednisolone showed a potentiation of Histalog stimulation in high range. The effect was not seen when truncal vagotomy was performed before stimulation. It is possible that there is a cholinergic reaction or an interaction in the metabolism of histamine.


[Changes in the antigenicity of influenza virus neuraminidases due to various methods of preparation]. The influenza virus strains A/Sing/1/57 (H2N2), A/Bel/42 (HoN1) and A/Bel/42 (Ho)-A/Sing/1/57 (N2) were treated with bromelain under reducing conditions and with reducing agent alone, and the antigenicity of the neuraminidase (NA) of intact virus and of the split products was tested comparatively. It was found that the antigenicity of NA was influenced quantitatively and qualitatively by the preparation procedure. Antineuraminidase (AN) antibodies obtained after vaccination of guinea pigs with intact virus and with split products differed in their cross-reactivity with heterologous neuraminidases. AN antibodies directed against N2 NA on the recombinant differed qualitatively from those directed against N2 NA of parent virus. The results warrant the conclusion that the antigenicity of isolated NA or of NA on recombinant virus can differ from that of the NA on intact homologous virus and that such alterations could influence the determination of antigenic relationship between neuraminidases.


Synthesis of collagen by chick calvaria in the presence of 2,2'-bipyridyl. Lack of the aminoterminal extension peptides. A precursor of type I collagen was accumulated when cranial bones from embryonic chicken were cultured in vitro in the presence of 2,2'-bipyridyl. While biochemical studies demonstrate that the precursor was present as a covalently linked trimer, evaluation of electron micrographs of segment-long-spacing aggregates show that the molecules of this precursor have an extension at the carboxy terminus only. These data provide further evidence that the inter-chain disulfide bonds in procollagen are located at the carboxy-terminal extension, and secondly, that 2,2'-bipyridyl does not interfere with a normal cleavage of procollagen peptides at the amino terminus, but inhibits the cleavage of the carboxy-terminal procollagen peptides.


Properties of two Clostridia strains acting as catalysts for the preparative stereospecific hydrogenation of 2-enoic acids and 2-alken-1-ols with hydrogen gas. A Clostridium strain growing on crotonate/hydrogencarbonate, which is able to hydrogenate stereospecifically 2-enoates as well as other unsaturated compounds with hydrogen gas, has been isolated and methods for its propagation elucidated. For this strain and for Clostridium kluyveri DSM 555 grown on ethanol/acetate/hydrogencarbonate, samples of 200-l batches were assayed to determine the hydrogenation activity for (E)-2-methyl-2-butenoate and (E)-2-buten-1-ol as a function of time during the exponential and stationary growth phases. For the strain growing on crotonate/hydrogencarbonate, the hydrogenation rate as a function of substrate concentration, pH and temperature has been measured. Storage conditions for both strains are given.


Lysosomal phospholipids from rat liver after treatment with different drugs. Rats were treated with 5 different drugs p-ethoxyacetanilide (I), indometacin (II) and nor-amidopyrine-methanesulfonate (III), O,O'-bis(diethylaminoethyl)hexestrol(IV) and choloroquine (V) for 3 - 4 weeks. Liver cell fractions were isolated by discontinuous gradient centrifugation and the specific activity of acid phosphatase was determined in each. Lysosomal fractions contained widely varying amounts of this marker enzyme, indicating that the concentration of lysosomes within these fractions differed. The amounts and patterns of phospholipids reflected this fact. Since we assumed bis(monoacylglycero)phosphate [(MAG)2-P; synonym:lysobisphosphatidic acid] is a marker lipid for secondary lysosomes, we expected and found significant quantities of this acidic phospholipid only in those lysosomal fractions which were also rich in acid phosphatase activity. 12% of the lysosomal phospholipids from animals receiving the hexestrol derivative (IV), and 19% of those from the chloroquine (V) experiment were present as (MAG)2P. The fatty acid compositions of this lysosomal phospholipid were not the same in all lysosome fractions. The more (MAG)2P present in the lysosomes, the more unsaturated are the fatty acids. Thus, after treatment with chloroquine, more than 90% of the fatty acids from (MAG)2P are unsaturated; C22:6 represents about 70% of the total.


Lysosomal bis (monoacylglycero)phosphate of rat liver, its induction by chloroquine and its structure. Since chloroquine is able to induce phospholipidosis, and in particular formation of bis(monoacylglycero)phosphate [(MAG)2P] in rat liver lysosomes, we tested the influence of the drug on this acidic phospholipid 1) after application of the drug for different periods, 3, 7, 14, 21 and 28 days, and 2) after application of different doses of the drug for 7 days. In both cases, the amounts of the total phospholipids and of (MAG)2P within the lysosomal lipids showed a direct relationship to the quantity of the drug. Lysosomal fractions were identified by acid phosphatase activity and by electron microscopy. After 14 days of treatment, the lysosomal fractions showed an increase in the marker enzyme to more than 30 times the level in the homogenate, and consisted of almost pure "lamellar bodies". (MAG)2P was isolated from those lysosomal lipid fractions by column chromatography. We also isolated this phospholipid from "tritosomal" lipids and tested the two preparations in different ways. They both showed glycerophosphoglycerol as the only P-containing product after mild alkaline hydrolysis, and molar ratios for phosphorus: fatty acid: glycerol close to 1:2:2; and yielded diacetylacyl glycerol after acetolysis. Thus, there is no doubt that (MAG)2P occurs in these secondary lysosomes--as we described in others--and that its production is a consequence of accumulation of lysosomes. There is some indication for the occurrence of an acylated (MAG)2P (which is the same as acylphosphatidylglycerol) within the same cell organelles.


[2alpha-Hydroxylation of testosterone and dihydrotestosterone in rats in vivo and in vitro (author's transl)]. The hydroxylation of testosterone and 5alpha-dihydrotestosterone at C-2 was measured quantitatively in vivo and in vitro in rats by using "metabolically labile" tritium labelled substrates. The enzyme activity was dependent on the sex and age of the animals. There was a good correlation between in vivo and in vitro experiments. Whereas testosterone was hydroxylated only in liver, 5alpha-dihydrotestosterone was hydroxylated in adrenals, kidney, lung and prostate as well. Hydroxylation was not sex-dependent in adrenals and lungs.


[Antibody formation following immunization with mono- and bivalent mumps-(measles-)vaccine (author's transl)]. The authors studied the seroconversion of 307 children, 1-11 years old, induced by Mumpsvax (136 children) and a bivalent mumps-measles vaccine (strain Jeryl Lynn/strain Moraten; 171 vaccines) by the HI-test. The seroconversion induced by the measles component of the bivalent vaccine covered 96.3% of the seronegatives prior to immunization. The comparable values for mumps antibodies were lower (Mumpsvax:80.6%; bivlant vaccine: 82.2%). An increase in titer in seropositive children was obtained in 57.1% after immunization with Mumpsvax and in 50.8% with the bivalent vaccine. Comparative studies to investigate the sensitivity of the HI-test versus the neutralisation test (NT) showed the greater accuracy of the latter. Before the vaccination with Mumpsvax, only 26.6% of 60 sera studied were found to be seronegative, whilst the NT gave a more reliable figure (55%). Similar data were found in 62 sera before immunization with the bivalent vaccine (HI-test: 33.8%; NT:66.1% seronegative). The seroconversion rates were slightly higher when the NT had been used: 75.6% (bivalent) and 81.8% (monovalent vaccine) versus 75.6% and 75%, respectively, by the HI-test.


Binding of activated properdin to untreated erythrocytes: a new function of activated properdin. Activated human properdin was found to be capable of binding to rabbit and sheep erythrocytes to form new intermediate cells of the alternative pathway of the complement system. The intermediate cells, termed EP, can react with B, D and C3 to form other intermediate cells, tentatively termed EPB(D)C3, which can be lysed by the subsequent action of six late-acting complement components, C3 to C9. The possibility of participation of C3, B, D or immunoglobulin in the formation of EP cells was neglected by the experiments in which the inhibition of the reactivities of P or EP by antisera to P, C3, B, D or immunoglobulins were investigated. The reduction in reactivities of P to E, or of EP to B, D and C3 was observed only when pretreated with antiserum to P. Furthermore, EP cells were agglutinated only by anti-P, not by antisera to C3 or IgG. The other possibility of participation of the classical complement components such as antibody, C1, C4 and C2 in the formation of EPB(D)C3 was excluded by the non-reactivities of EP with C4 and C2 and of EAC1 with B, D and C3. Thus, activated properdin is likely to function not only as modulator of preformed enzyme such as C3bBb but also as one of early-acting components of the alternative pathway.


Inhibition by isoptin (a calcium antagonist) of the mitogenic stimulation of lymphocytes prior to the S-phase. Isoptin (alpha-isopropyl-alpha-(N-methyl-N-homoveratryl)-gamma-amino-propyl-3,4-dimethoxyphenylacetonitril-hydrochloride)--a calcium antagonist--inhibits mitogenic stimulation of lymphocytes. Isoptin acts prior to the S-phase of the cehl cycle but does not prevent the early events involved in triggering of cell mitosis. The drug seems to be a good tool for studying the relevance of the 'early events' assumed to be involved in lymphocyte stimulation.


Shedding and reappearance of Fc, C3 and SRBC receptors on peripheral lymphocytes from normal donors and chronic lymphatic leukaemia (CLL) patients. The shedding and resynthesis of Fc, C3 receptors, and receptors binding SRBC has been studied in normal peripheral lymphocytes, in lymphocytes from CLL patients and in a Raji cell line during 4 h incubation at 37 degrees. During the first part of the incubation, an increased release of receptors was observed. The shed, functionally active, receptors were detectable in the incubating medium on the basis of their ability to inhibit rosette formation specifically. After 4 h incubation the original ratios of the different rosette forming cells were observed, showing that the cells were capable of resynthesizing their shed receptors. This later phenomenon may be the result of an active metabolic process. The shedding was not detectable on Raji cells. Different patterns of receptor shedding and resynthesis were demonstrated by the lymphocytes of CLL patients. The correlations between the reappearance of the receptors on the cells, and the metabolism of the lymphocytes, is discussed.


The uptake of IgG and IgM coated sheep erythrocytes in perfused rabbit liver. Erythrocytes sensitized with IgM and IgG (EA) are entrapped during perfusion of isolated rabbit liver. The binding of EIgG is of high affinity while that of EIgM is weak and partly reversible. Moreover, the binding of EIgM is dependent on the presence of Ca++ ions in the perfusion medium whilst the binding of EIgG is independent of divalent cations. No uptake of sensitized erythrocytes during perfusion of the inferior extremities of rabbits is found.


Life table analysis of the effectiveness of contraceptive methods using an APL computer program. An APL computer program has been developed to perform life table analysis without the tedium and error associated with manual computation. Life table analysis is proposed as the standard method of reporting and analysing the effectiveness of contraceptive methods of all types.


An epidemiological database system.

An epidemiological database system. An epidemiological database system is presented. It is a system built around the concepts of record structure and location, and of processing of the data item values so stored. It is designed to operate in many situations with a minimum of programming, and to be easily expanded to more complex situations by adding new program modules to those already existing and functioning.


An interpretation of asynchronism in non-sequential ventilation (apical and basal regions of the lung). Non-sequential asynchronous ventilation is interpreted by a variation of velocity of fluid at a given level of bronchial tree based on a physical model already published (Chauvet and Tuchais, 1976). The possible different causes of this variation of velocity are examined. A complete study of apical and basal regions of the lung is made and it shows the influence of some factors (phase difference, amplitude, respiratory frequency) on the regional variations of alveolar pressure.


The assessment of patient prognosis using an interactive computer program. The use of chronic disease probabilistic models to calculate patient prognosis is presented. The method relies on the calculation of transition probabilities between discrete disease states from a patient data bank. Maximum likelihood estimates are used for each age and unwanted fluctuations are removed by a moving average. An interactive computer program was written and the method applied to the calculation of the probability of stroke and myocardial infarction for male patients on antihypertensive therapy. A clinician could obtain the prognostic information for a patient in less than one minute. Applications in medical student education are also discussed.


[Study of statistical test connections in non-orthogonal analysis of variance]. In the Analysis of Variance, we quite often split up the model to test different hypotheses about the model. However, when we analyse the results, we must not forget that the statistics used for the tests are not stochastically independent, either for an orthogonal design, because the test statistics have the same denominator, or for non-orthogonal design. In the latter case, test statistics have not only the same denominator but also not-independent numerators. The links between test statistics have been studied for orthogonal designs (Dall'Aglio, 1962) and for symmetrical Incomplete Block Design (Ballas and Webster, 1966). We shall give here results for the general case of the Analysis of Variance, treat more particularly the case of the Incomplete Block Design and show the joint distribution of two test statistics and, more simply, their correlation coefficient.


Chromosome findings in effusions from patients with Hodgkin's disease. Effusion cells from six patients with advanced Hodgkin's disease were studied. Even though no Hodgkin or Reed-Sternberg cells could be identified cytologically in five of the six cases, striking chromosome anomalies of a clonal nature, including a number of recurrent marker chromosomes, were demonstrated in all effusions. It is concluded that the effusion cells with abnormal karyotypes were intimately related to the pathogenesis of Hodgkin's disease.


Natural cell-mediated cytotoxicity in rats. I. Tissue and strain distribution, and demonstration of a membrance receptor for the Fc portion of IgG. Studies in mice and in humans have provided most of the available information concerning natural cell-mediated cytotoxicity. Rats represent a second experimental species which is well suited for the study of natural cytotoxicity. Our studies indicate that the distribution of natural killer (NK)3 cells in rat lymphoid tissues is similar to their tissue distribution in man, with high levels in the blood and spleen and low or undetectable levels in lymph node, thymus, thoracic duct or peritoneal exudate cells. The levels of NK activity varied considerably among various inbred strains of rats. However, the genetic control of levels of NK activity did not appear to be linked to the rat major histocompatibility complex. As recently demonstrated in mice by depletion experiments on antibody-erythrocyte monolayers, many or most rat natural killer cells were found to have surface receptors for the Fc portion of IgG.


Natural cell-mediated cytotoxicity in rats. II. In vivo augmentation of NK-cell activity. Natural cell-mediated cytotoxicity in rats as well as in mice has been shown to vary consistently with age, with peak levels detectable at 5-10 weeks. The levels of cell-mediated cytotoxicity against tumor cells could be augmented in strains of inbred rats with either high or low levels of natural reactivity, by IP injection of a variety of agents, including C. parvum, LCMV, KRV, and poly I:C. The specificity of the augmented cytotoxicity appeared to be the same as the specificity of natural killer cells which are found in normal rat spleen cells. Similarly, the cells mediating the augmented cellular cytotoxicity were small, non-adherent, esterase-negative lymphocytes with Fc receptors, as are rat NK cells. The kinetics and organ distribution of the augmentation of NK activity by poly I:C and C. parvum were compared and the kinetics were found to differ, with a shorter time course of augmented activity seen after inoculation with poly I:C. These data indicate that interferon may play a central role in the augmentation of NK activity in vivo.


Traumatic sternoclavicular dislocation.

Traumatic sternoclavicular dislocation. Traumatic dislocations of the sternoclavicular joint may be anterosternal or retrosternal. Anterior dislocation is due to forces which retract and depress the clavicle. Posterior dislocation is due to either direct force on the medial end of the clavicle or to a force acting on the posterolateral aspect of the shoulder. From 1950 to 1974 we treated 16 patients with traumatic complete sternoclavicular dislocations. Twelve patients were followed and their cases are discussed. Treatment may be closed or open. In some cases we did not attempt reduction because it may be very difficult to maintain and dislocation may recur. Open reduction is extremely difficult and not recommended unless a serious intrathoracic problem also exists. Based on our cases, we conclude that stability of the sternoclavicular joint is not necessary to ensure normal function of the involved limb. The residual prominence of the medial portion of the clavicle does not cause pain and does not interfere with chest or shoulder function.


Pattern of bone injury in Ibadan.

Pattern of bone injury in Ibadan. A series of 1,329 patients with 1,327 fractures and 100 dislocations has been studied. Boys under 10 years of age predominated. The majority of the injuries resulted from falls or road traffic accidents. Upper limb fractures occurred more commonly than those of the lower limbs or axial skeleton. Femoral shaft fractures were 2-1/2 to 5 times more common while femoral neck fractures were three to five times less common than in Americans. Dislocations were most common at the elbow, followed by the shoulder. Only 11.5% of the patients had open operations; the others were treated conservatively. The prognosis as regards survival and functional results was very good, but malunion was the most common complication.


Paget's disease of bone in Iran.

Paget's disease of bone in Iran. Paget's disease of the bone is extremely rare in this country of 34 million inhabitants. The three cases discussed are probably the only documented cases of this disease seen in natives of Iran (Persia).


Hyphal production by  Pityrosporum ovale. Pityrosporum ovale with abundant hyphae was found in 8 patients with lesions of the scalp and glabrous skin. It is thought that P. ovale in its mycelial form can produce lesions on seborrheic areas of the skin that probably represent a clinical form of tinea versicolor.


Regional lymph gland biopsy in tubercular synovitis of the knee. One hundred patients with proved tubercular synovitis of the knee were studied and 50 patients underwent inguinal lymph node biopsy. Results for and experience with lymph node biopsy in tubercular synovitis of the knee are presented.


Extension contracture of the hip due to idiopathic fibrosis of the gluteus maximus. Extension contracture of the hip in our case was produced by a thick fibrous band in the substance of the gluteus maximus. The patient had never received an injection around this hip. Z-plasty of the fibrous band led to immediate and full flexion of the hip and the patient was relieved of her symptoms.


Lymphedema of the hand following a fracture of the distal radius. A case of chronic lymphedema of the hand and forearm following a fracture of the distal radius is reported. None of the classic causes of secondary lymphedema appeared to be the cause. A strong psychogenic component appeared to be the underlying mechanism. This rare phenomenon was thought to be self-induced and not genetic in nature.


A modified method of Achilles tendon lengthening. A modified technique of tendo achillis lengthening which takes advantage of the tendon sheath is described. Lengthening of the tendon is achieved by feel under direct vision.


True macrodactyly of the hand.

True macrodactyly of the hand. A case of true progressive macrodactyly was treated by cosmetic amputation of the middle and ring fingers with defatting of the palm and dorsum of the hand. Three months later the result was satisfactory.


Odontogenic adenomatoid tumor of the mandible (adenoameloblastoma). Adenoameloblastoma may recur when treated incompletely by curettage. In the rare case of recurrence, an extensive and mutilating resection may become necessary. A correct diagnosis must be made in cases of atypical ameloblastomas in order to avoid unnecessary radical surgery. In doubtful cases, biopsy with histopathologic examination is indicated. Acknowledgment: We thank Mrs. Frieda Werebe for organizing this manuscript.


Partial characterization of human collagen and procollagen secreted by human corneal stromal fibroblasts in cell culture. Human corneal stromal fibroblasts were established into cell culture. Fractions highly enriched for collagen and procollagen were purified from the medium and cell layer. Analysis using polyacrylamide gel electrophoresis and DEAE cellulose chromatography indicated the presence of a heterogeneous population of procollagen molecules ranging in molecular weights from 200,000 to 120,000 daltons along with alpha1 and alpha2 collagen chains. Cyanogen bromide peptides of a corneal peptide fraction migrated concomitantly with type I standard cyanogen bromide peptides.


Obstruction of aqueous outflow by lens particles and by heavy-molecular-weight soluble lens proteins. Enucleated human eyes were perfused via the anterior chamber at 25 mm Hg pressure with lens particles (whole lens homogenates) in one series of experiments and with soluble lens proteins from human cataractous lenses in another series. Adding 1% of a homogenate of a single cataractous lens to the anterior chamber induced a 68% decrease in outflow. Perfusion with HMW soluble lens proteins (1 mg/ml; MW more than 150 million) caused a 60% decrease in outflow in 1 hr. In neither series was the obstruction to outflow relieved by subsequent irrigation of the anterior chamber with balanced salt solution or alpha-chymotrypsin. The results show that both lens particles and soluble lens proteins can directly obstruct the aqueous outflow pathways of human eyes. Such obstruction may be a significant factor in certain lens-induced glaucomas.


Localization of lysosomal enzymes in retinal pigment epithelium of rats with inherited retinal dystrophy. Four acid hydrolase activities are demonstrable by light microscopy in pigment epithelial cell lysosomes of rats (Royal College of Surgeons--RCS) with inherited retinal dystrophy and in control (Fischer) rats. The enzymes include acid phosphatase, aryl sulfatase, N-acetyl-beta-glucosaminidase, and esterase activities. No marked differences are observed in distribution or staining intensity of lysosomes in the two strains of rat. Acid hydrolase activities are not localized in sites other than lysosomes. Acid phosphatase and aryl sulfatase activities are also demonstrable by electron microscopy. In both strains, acid phosphatase reaction product is localized to various forms of lysosomes in pigment epithelial cells. A diffuse precipitate, considered to be nonspecific in origin, is seen in the cytoplasm, apical processes, outer segments (control), and outer segment debris (RCS). The precipitate is probably due to adsorption of lead from the incubation medium or of lead phosphate that diffuses from heavy accumulations in nearby lysosomes. Aryl sulfatase reaction product, in contrast to acid phosphatase, is localized to far fewer lysosomes and there is virtually no nonspecific precipitate. The findings indicate that lysosomes of RCS pigment epithelial cells possess several cytochemically demonstrable acid hydrolase activities. There is no evidence for the localization of acid phosphatase (or aryl sulfatase) activities in sites other than lysosomes.


Ultrastructure of cataract in myotonic dystrophy. Four cataractous lenses from patients with myotonic dystrophy were studied by transmission electron microscopy. All lenses showed whorls of what appeared to be plasma membranes.


Effect of timolol therapy on outflow facility. A 14-week course of timolol therapy in 38 eyes with open-angle glaucoma produced a statistically significant drop (6 mm Hg) in their mean intraocular pressure but had no effect on the mean coefficient of aqueous outflow. These data are compatible with those of Zimmerman et al. obtained after a single drop of treatment and suggest that timolol reduces intraocular pressure by inhibiting aqueous production.


Trace elements in kidney stones from three areas in the United States. A large number of trace elements has been found in calcium stones (whewellite, weddellite, and apatite) and in struvite. Significantly fewer elements, with lower abundances, are found in uric acid and cystine. With the exception of four trace elements (lead, silicon, strontium, and zine), the trace element assemblages are identical in the oxalates (whewellite and weddellite); struvite is also similar but with notable exceptions. In general, apatite contains approximately twice the level of trace element abundances as do the oxalates. This study is based on the distribution of 20 elements in 186 mimeralogically identified urinary calculi from three generalized areas of the United States (northeast, southeast, and midwest). In general, there is no statistical difference in the trace element assemblages of mineralogically identical stones from the three areas.


An evaluation of the role of the Doppler stethoscope and the testicular scan in the diagnosis of torsion of the spermatic cord. The spermatic cord of five dogs were twisted 720 degrees. The animals then underwent both Doppler and isotope evaluations of their scrotums. Both modalities proved highly accurate in diagnosing acute testicular ischemia.


The effects of topical instillation of adriamycin in bladder tumors of rats fed with FANFT. Topical bladder instillation of adriamycin was evaluated in FANET produced rat tumors produced by diets containing (N-[4-(5-Nitro-2-Furyl)-2-Thiazolyl] Formamide). The drug was ineffective in either preventing or eradicating tumors. The failure of response in this animal model may be related to drug schedule, biological potential of this tumor, or ineffectiveness of Adriamycin in this tumor.


Minimal medullary droplets in DOCA-induced potassium depletion of rats. When potassium depletion is induced in rats administering desoxycorticosterone acetate instead of restricting potassium in the diet, the droplet accumulation in medullary cells is reduced, despite the similar degree and duration of potassium depletion. This finding indicates that the accumulation of droplets is more dependent on the inducing agent than on the severity or duration of potassium depletion.


The male genitourinary sphincter mechanism in the dog. In an effort to locate and characerize a genital sphincter in the male posterior urethra, the intraluminal changes in urethral pressure under both sympathetic and parasympathetic stimulation were studied. It appears that the urethra has a specific genital sphincteric length corresponding to the supramontanal portion. The urethral length is seemingly under sympathetic control, so that backflow of semen does not occur during ejaculation. The urinary sphincter apparently involves the entire posterior urethra and is primarily under parasympathetic influence.


Neurologic control of prostatic secretion in the dog. A model to record the volume of prostatic secretion was developed. The influence of both divisions of the autonomic nervous system on the prostate by pharmacologic stimulation and blockade, and by direct electrical nerve stimulation was observed. The prostate responded to parasympathetic stimulus by increasing secretion. Under sympathetic stimulation, the secretion collected in the acini and ducts was expulsed into the urethra by contraction of the smooth muscle fibers surrounding these structures. A correlation between these findings and the normal sexual function may be made: Early in the excitation phase there is parasympathetic activity with increased secretion. With onset of orgasm and emission, sympathetic activity initiates the contractile activity of the genital duct system and the prostatic muscular element. As a result, the secretion is transported to the prostatic urethra (emission) to be later ejaculated by the genital skeletal musculature of the perineum, mainly the ischiocavernosus and bulbospongiosus.


Organ culture of canine prostate.

Organ culture of canine prostate. The simple life support system of organ culture contrasts sharply with the life support system in vivo. Organ culture, a technique for characterizing the effect of various substances on an organ, has potential clinical usefulness in many areas. In the present case explants of canine prostate are minimally maintained when cultivated in a medium enriched with testosterone and insulin. Pretreatment of the dog with methylprednisolone or the addition of vitamin A markedly improves the maintenance of normal structure. Methylprednisolone pretreatment and the addition of vitamin A had a significant synergistic effect. The clinical significance and implications of the findings are presented. We believe these preliminary experiments with organ culture can serve as a basis for deciphering some of the complex functions or an organ.


The effect of indomethacin on renal blood flow and uretral pressure in unilateral ureteral obstruction in a awake dogs. In the conscious dog, the effect of administering indomethacin before and throughout an 8-hr period of unilateral ureteral occlusion was determined. Before ureteral occlusion, indomethacin infusion caused a 35 to 40 per cent decrease in bilateral renal blood flow. After ureteral occulsion, the characteristic ipsilateral renal vasodilation did not occur and the ureteral pressure rose only to a maximum of 18 mm Hg and remained significantly lower (P less than 0.05) than pressures in control animals during the entire study period. Hence, pathways for renal synthesis of prostalglandins must be intact for renal vasodilation to occur in response to ureteral occlusion.


A comparison of the healing processes in uremic and parallel-fed rats. The effect of nutrition on the healing capacity of uremic rats was investigated. Wound tensile strenth and the amount of collagen formation in polyvinyl sponges implanted subcutaneously were compared in a group of uremic rats and a group of nonuremic rats parallel-fed an identical diet and caloric intake. Wound tensile strength in the parafed rats closely and significantly approximated that in the uremic snimals conpared to the stronger wounds in the controls. A correlation was also noted for collagen accumulation in the uremic and parafed groups. This experiment lends further evidence to support the theory that the mechanism of action for the shown poor healing associated with uremia is based on the poor state of nutrition in the uremic animal.


Effect of obstruction of renal metabolism. Renal tissue metabolite concentration after alpha-ketoglutarate infusion. beta-Hydroxybutyrate and/or alpha-ketoglutarate were infused into awake, resing dogs after varying periods of unilateral ureteral obstruction. The animals were then anesthetized, and the kidneys rapidly excised and frozen in liquid nitrogen. While maintained at temperatures below -60 C, the frozen kidneys were separated into cortical and medullary fractions. The concentrations of alpha-ketoglutarate, glutamate, lactate, pyruvate, citrate, and malate were determined in both cortical and medullary renal tissue. The induction of reversible renal damage by 2 weeks of obstruction was associated with decreased ability to accumulate alpha-ketoglutarate after alpha-ketoglutarate and/or beta-hydroxybutyrate infusion. The induction of irreversible renal damage by 6 weeks of obstruction was associated with the inability to produce or accumulate (i) alpha-ketoglutarate, (ii) lactate, (iii) citrate, or (iv) malate after infusion of alpha-ketoglutarate and/or beta-hydroxybutyrate. The metabolic changes induced by unilateral ureteral obstruction indicatr that aerobic metabolism is inhibited with the virtual elimination of many aerobic reacions in the irreversibly damaged kidney. The reversibly damaged kidney is capable carrying on certain aerobic reactions but usually at a diminished rate. Differences in the extent and character of the metabolic changes induced by ureteral obstruction may make it possible to predict the degree of renal damage and, therefore, recoverability.


The radiographic demonstration of the dynamic transfer of radio-opaque material from the differential vein to the prostate in the dog. Radio-opaque contrast medium was injected into the deferential vein of the dog in vivo and was seen to pass, in two of five animals, into the intrinsic veins of the prostate and the cavernous tissue of the prostatic urethra. In other cases an increase in abdominal venous pressure was required to bring about the retrograde flow. The observations support the previously cited evidence that the prostate receives hormonal stimuli via the deferential vein.


Intrarenal hemodynamics and renal function in postobstructive uropathy. Impairment of renal function was noted after release of 24 hr of unilateral (UUO) and bilateral (BUO) ureteral obstruction. After release of obstruction fractional sodium excretion was identical in both obstructed and intact kidney of UUO rats, whereas massive natriuresis occurred in BUO rats. Renal blood flow in BUO rats, determined by the microsphere method after released of 24 h of obstruction, was approximately 60 per cent of control values. Mean renal blood flow of the obstructed kidney of UUO rats after release of obstruction was 78 per cent of the mean renal blood flow of the contralateral unobstructed kidney. No redistribution of intrarenal blood flow was noted in UUO and BUO rats. Filtration fractions of obstructed kidneys from BUO and UUO rats after release of obstruction were lower than those of controls, suggesting that preglomerular vasoconstriction is primarily involved in the reduction of glomerular filtration rate.


[Tropic-subtropic fungus infections in Germany]. Observations by the author and other workers on exotic mycoses in Germany are used in order to establish several groups of patients. The following mycoses from tropical and subtropical areas and their causative agents are mentioned: Tinea nigra (Cladosporium werneckii), south American blastomycosis (Paracoccidioides brasiliensis), coccidioidomycosis (Coccidioides immitis), histoplasmosis (Histoplasma capsulatum), mycetoma (Madurella mycetomi), dermatophytosis/tinea capitis (Trichophyton soudanense, Trichophyton violaceum, Microsporum ferrugineum), sporotrichosis (Sporothrix schenckii), chromomycosis (Fonsecaea pedrosoi).


[Reflections on dermatophytes].

[Reflections on dermatophytes]. In light of his experiences especially in tropical regions, the author makes some remarks about dermatophytes and dermatophytia, which they cause. The following main items are: 1. The dermatophytes lead a saprophytic life. 2. Exceptionally, they can invade nonkeratinized tissue and cause "dermatophytic disease", perhaps mycetomas. 3. 45 percent of the ringworm of the scalp heal before puberty. 4. In the tropical regions, trichophytosis caused by endothrix-species are often of inflammatory nature, the favus appears often without scutula formation (afavic). 5. One can heal a substantial percentage of the ringworm of the scalp with a single dosis of 12 tablets (125 mg each) of fine particle griseofulvin. 6. Athlete's foot has also other causes than only dermatophytes.


[How should mycoses by most effectively treated in dermatological practice?]. An appropriate antimycetic therapy in the office is based on the following prerequisites: 1. demonstration and identification or at least determination of species of the causative germ, 2. selection of an adequate antimycetic medicament with a) least possible rate of sensitisation, b) greatest possible effectiveness and c) a spectrum as restricted as possible, d) galenic preparation and e) duration of therapy depending on the clinical and histological type of the mycosis, 3. detection and, if possible, elimination of other predisposing factors. The success of therapy actually obtained is rather unsatisfactory mainly because the factors listed under 2 d), e) and 3) are not or cannot be observed sufficiently.