Plain film findings of anatomically corrected malposition: its association with juxtaposition of the atrial appendages and right aortic arch. Three cases of anatomically corrected malposition of the great arteries (ACM) are presented. The association of ACM with juxtaposition of the atrial appendages and right aortic arch is emphasized. The unique plain film findings of anatomically corrected malposition include: (a) 1-position of the ascending aorta; (b) discrete convexity of the mid-left heart border in association with findings of an abnormal right atrial border (left juxtaposition of the atrial appendages); and (c) right aortic arch. This unusual combination of findings on the postero-anterior chest should lead to a high degree of suspicion in regard to the diagnosis of anatomically corrected malposition.


Superficial esophageal carcinoma. Radiological findings in double-contrast studies. Most cases of superficial esophageal cancer have been reported in Japan and China. Radiological findings in 11 patients (13 lesions) are described. Superficial spreading cancer is difficult to detect despite widespread mucosal involvement. Double-contrast technique is essential, both to detect lesions and to demonstrate their extent. An irregular, rigid wall, mucosal abnormalities such as barium pooling and coating, and protrusions of various sizes and shapes are diagnostic features.


Small-bowel malabsorption and gastrointestinal malignancy. In addition to lymphoma, there is an increased incidence of gastrointestinal carcinoma in patients with malabsorption due to celiac disease. This is frequently manifested by a loss of response to gluten withdrawal. Four such cases are described: one patient had lymphoma and the other three had cancer of the esophagus, jejunum, and pancreas, respectively. The literature indicates that carcinoma of the esophagus and small bowel is particularly common in patients with celiac disease. These findings suggest that celiac disease should be considered a premalignant condition and that such patients should undergo a regular radiographic survey to detect early cancer.


The protean gastrointestinal manifestations of metastatic breast carcinoma. Metastatic breast carcinoma commonly remains silent for many years following initial diagnosis and mastectomy, and then appears as metastases at various locations. Gastrointestinal involvement is not uncommon and includes any site along the whole length of the gut, the liver, and the biliary tree; it occasionally simulates other diseases and causes difficulty in diagnosis. The radiographic features and differential diagnoses are discussed.


Strongyloides stercoralis colitis: findings in four cases. The 4 cases of Strongyloides stercoralis colitis presented show various radiological manifestations of colonic reaction. Mild involvement may be associated with minimal radiographic changes. Invasion of the bowel wall by the larvae results in ulceration and edema with loss of haustral markings; stricture may develop. Barium-enema examinations can help in evaluating the nature and clinical progress of the disease.


Neoplastic pseudoaneurysm of the superior mesenteric artery. The authors describe a case of pseudoaneurysm of the superior mesenteric artery caused by arterial invasion by a liposarcoma. Neoplastic pseudoaneurysms are rare; most are due to sarcomas and usually involve veins.


The origin of the left gastric artery.

The origin of the left gastric artery. Five hundred celiac angiograms were reviewed to evaluate the frequency of clinically significant variations in the origin of the left gastric artery. In 13 of 500 cases, the left gastric artery arose anomalously most often as a direct branch of the aorta; in 14 of 500 cases, the left gastric artery primarily supplied the liver with only minor contributions to the stomach. An aberrant origin of the left gastric artery necessarily influences the angiographic diagnosis and therapy of gastrointestinal hemorrhage.


The angiographic diagnosis of acute hemorrhagic renal cortical necrosis. The authors report a case of acute renal failure resulting from acute cortical necrosis. A selective renal angiogram defined a very unusual, abrupt termination of vascularity at the interlobular and arcuate levels. Nephro-angiography is an important tool in the diagnosis of acute cortical necrosis in the initial phase of acute renal failure.


Urethrographic manifestations of venereal warts (condyloma acuminata). Intraurethral spread of venereal warts is a serious complication. Urethral involvement may be extensive and is associated with severe irritative symptoms. Spread to the bladder is possible. Recurrence are frequent and eradication difficult. We describe the urethrographic appearance of intraurethral verrucae and believe it to be strongly suggestive of the diagnosis. Voiding cystourethrography is recommended, and satisfactory visualization may be obtained with either voiding or retrograde urethrography. Voiding urethrography following intravenously administered contrast (excretory voiding cystourethrography) is particularly advantageous since it avoids the need for urethral instrumentation and, therefore, cannot contribute to retrograde spread of these contagious growths.


Retroperitoneal iliac fossa pyogenic abscess. Five cases of retroperitoneal iliac fossa abscess are presented. Abnormal excretory urogram and plain films, coupled with a history of either hip pain, limp, or pelvic mass should suggest the diagnosis. The excretory urogram is the most sensitive means of detecting iliopsoas abscess; all patients had medial displacement on the distal ureter. The upper urinary tract was normal in all cases. Study of the gastrointestinal tract may be of additional help in localizing the abscess and ruling out other pathology. A retroperitoneal muscle splitting approach is the preferred surgical procedure. Drainage of the abscess cavity and systemic antibiotic coverage are curative.


Angiographic manifestations of soft-tissue and osseous hemangiopericytomas. Hemangiopericytomas are rare vascular tumors and may originate wherever there are capillaries. So far, the author has found 341 cases of soft-tissue and 10 cases of osseous hemangiopericytomas. Only a few of these vascular tumors have been investigated angiographically. A review of 20 previously reported cases and 5 cases of his own, including a case of periosteal hemangiopericytoma, reveals that these are the only vascular tumors which present some characteristic angiographic features, regardless of their location or site of origin. Typically, a few feeder arteries enter the mass with radially arranged branching around and inside the tumor and a longstanding, well-demarcated tumor stain is seen.


Double contrast arthrographic evaluation of the anterior cruciate ligament. A review of 100 surgically confirmed cases indicates that double contrast arthrography, performed and interpreted with the described criteria, can accurately demonstrate the status of the anterior cruciate ligament. Visualization of the posterior cruciate ligament, which is less commonly injured, assures that proper radiologic positioning has been attained. Joint distraction is used to increase the visualized length of the anterior cruciate ligament coated by contrast agent. Various types of anterior cruciate ligament abnormalities as well as the high incidence of anterior cruciate ligament in young athletes are emphasized.


Arthrography in the evaluation of the temporomandibular joint. Temporomandibular joint arthrography has been helpful in selecting patients for reconstructive surgery who have severe temporomandibular joint dysfunction. Structural abnormalities of the soft tissues can be demonstrated where only minimal osseous changes are seen on tomography. The normal arthrographic anatomy of the joint is reviewed and normal and pathological joints are illustrated.


Superior marginal rib defects in traumatic quadriplegia. The interpretation of the chest films of hospitalized quadriplegic and paraplegic patients over a one-year period revealed three quadriplegic patients with superior marginal rib defects. The resorptive defect involved the posterior portion of the third through seventh ribs. The etiology is probably intercostal muscle atrophy with resulting loss of muscle stress causing bone resorption.


Influence of age at first pregnancy on breast parenchymal pattern: a preliminary report. Two groups of women, aged 50 and 60, were randomly selected from a mammographic screening project. The parenchymal pattern was classified according to Wolfe. A correlation was found between a known risk factor, age at first pregnancy, and parenchymal pattern. The results support the hypothesis of a relationship between breast parenchymal pattern and risk of cancer development.


Army technologists: 29-year follow up for cause of death. A previous 18-year follow-up study revealed no significant excess of cancer among men who served in the Army during World War II as radiological technologists (n = 6,560) as compared with men who served as medical, laboratory, or pharmacy technologists (n = 6,826). Extension of the follow up by 11 years (1946-1974) revealed that 145 former radiological technologists had died of cancer, as compared with 158 controls. No statistically significant differences were found between these groups for individual sites of cancer or for deaths from other causes.


A protocol for the use of contrast enhancement in cranial computed tomography. There is some confusion regarding the indications for and methodology of the use of contrast material in cranial computed tomography. Some authors recommend a nonenhanced scan in all cases, followed by an enhanced scan if indicated by the symptoms or the appearance of the unenhanced scan. Others have questioned the value of the nonenhanced scan in patients with tumor. The authors offer a protocol for the use of contrast material. Possible tumor patients are scanned with contrast material alone; other patients are scanned either (a) without contrast material or (b) both with and without contrast material, depending upon the most likely clinical diagnosis.


Non-contrast CT scanning: limited value in suspected brain tumor. Most patients who have computed tomography because of a suspected brain tumor are subjected to a noncontrast scan followed by a contrast study. Analysis of the scans of all such patients over a two-year period indicates that in most cases a single contrast scan affords the same degree of diagnostic accuracy as a combined pre- and postcontrast study.


Computed tomography and radionuclide imaging in the evaluation of ischemic stroke. One hundred forty-one patients with cerebral or cerebellar infarction were examined by computed tomography (CT) as soon after the ictus as possible. The examination was repeated in 7 days, and a radionuclide brain scan was performed. The overall detection rate for ischemic infarction was approximately equal for both techniques, ranging from 58% for radionuclide scanning to 66% for the delayed CT. Almost half of the supratentorial infarcts examined by CT on the day of the ictus were demonstrated. Mass effect was observed as early as the first day and as late as the 25th day.


Adrenoleukodystrophy. A correlative analysis of computed tomography and radionuclide studies. A discrepancy in location of abnormality has been noted between computed tomography (CT) and radionuclide studies in patients with adrenoleukodystrophy (ALD). Radionuclide concentration occurs only in the periphery of the lesion or area of acute demyelinating process and no concentration is seen in the area af gliosis whereas gliosis appears as a low-density lesion in the CT scan. Forward migration of radionuclide uptake in the follow-up study is another characteristic feature of this disease.


The effect of gastrografin and glucagon on CT scanning of the pancreas: a blind clinical trial. The effect of Gastrografin and glucagon on pancreatic CT scanning was studied in a blind clinical trial. Twenty-five patients had a pancreatic CT scan performed on an 18-second scanner and a repeat pancreatic CT scan following administration of Gastrografin and glucagon. The results were statistically significant: decreased streak artifacts; improved pancreatic head, body and tail delineation; and improved overall pancreatic visualization. Gastrografin-glucagon administration is recommended prior to pancreatic CT scanning if the scanning cycle is 18 seconds or longer.


Computed tomography in the diagnosis of renal masses. CT diagnosis of renal lesions proved to be highly efficient and reliable. This modality was most accurate in diagnosing renal cysts and the great majority of solid lesions. There was an indeterminate group (5% of cases studied) that included cysts, tumors and abscesses. This group requires additional investigation, but angiography is often not conclusive because of the avascular nature of these tumors. Other problem areas included cysts with apparently irregular margins and artifacts produced by the presence of contrast agent in the collecting systems.


The ultrasonic and computed tomographic appearance of splenic lobulations: a consideration in the ultrasonic differential of masses adjacent to the left kidney. A splenic lobulation interposed between the tail of the pancreas and the left kidney is not uncommon. On prone ultrasonic scans, this variant of splenic configuration must be considered in the differentiation of anterior masses adjacent to the left kidney and masses originating in the tail of the pancreas. Computed tomography is the most sensitive method to use in making this distinction.


Characteristics of calcification in tumors of the pineal gland. Thirty-two cases of proved pineal tumor were analyzed. Calcification was seen in 75%. The size, character, and position of the calcification were useful indicators of abnormality on plain-film evaluation. Fray's cranioangle method was more sensitive than Oon's method in determining abnormal position of the calcified pineal tumor on the lateral skull film. Most calcifications were displaced postero-inferiorly or inferiorly, which can be explained by obstructive hydrocephalus or direct tumor expansion.


Decreased 99mTc sulfur colloid activity in healed rib fractures. This report describes 2 patients in whom focal areas of decreased 99mTc sulfur colloid marrow activity were associated with callus formation and healing rib fractures in one case and rib fractures with bony bridging in the second. Since bone marrow scans are occasionally used to select appropriate sites for marrow biopsy in patients with suspected metastatic disease, radiographic correlation of "cold" lesions on marrow scans is recommended prior to biopsy to exclude fracture with callus formation as a benign cause of the abnormality.


Congenital cystic adenomatoid malformation. A report of three unusual cases. Most children with congenital cystic adenomatoid malformation present in the first six months of life. Three cases are described with unusually late presentation. One child was completely asymptomatic and another became symptomatic only after secondary infection of a congenital cystic adenomatoid malformation. In two cases the correct diagnosis was not made preoperatively. The value of preoperative lung scanning was demonstrated in one case in which a lung scan showed a larger perfused area than indicated on the radiograph. At operation, a lobulated cystic structure was seen attached by a thin pedicle to the interior surface of the left upper lobe.


Empyema as a complication of retropharyngeal and neck abscesses in children. Empyema developing from retropharyngeal abscess is a rare complication. Two infants with clinical symptomatology and inital chest radiographic findings of pleural fluid which suggested the possibility of retrophoryngeal abscess are described. A child with submandibular and cervical abscesses is also reported; pleural fluid and mediastinal abscess developed less than 24 hours after admission. Pathological processes in the neck can spread into the chest or conversely, either by direct continuity or by dissection through the fascial planes enveloping the cervical compartments. The middle or visceral space which is in direct continuity with the mediastinum is generally the area in which cervicothoracic disease inter-relates.


"Vascular" benign liver cyst in children: report of two cases. Cyst wall vascularity not evident on abdominal aortography was demonstrated by selective magnification angiography in two children with complicated solitary, nonparasitic liver cysts. In one, its character and degree led to a false diagnosis of tumor. The observed mural vascularity probably reflected secondary changes of inflammation and necrosis in one case and prior surgery in the other case. Histologic findings in previously reported cases, however, indicate that, contrary to accepted angiographic beliefs, mural vascularity also occurs in many noncomplicated, simple liver cysts. Angiographers should be aware of this, and that the possibility exists of visualizing this mural vascularity by selective magnification angiography.


Renovascular hypertension as a complication of umbilical arterial catheterization. Renovascular hypertension (RVH) in the neonatal period is frequently associated with thromboembolic complications of umbilical artery catheterization. Seven newborn infants with RVH were studied by angiography and/or radionuclide examination. Aortography and, in one case, selective angiography showed variable degrees of renal artery occlusion or attenuation. Thromboembolic defects were frequently present in other vessels. Radionuclide flow studies, renograms, and computer analysis of data (ADAC) demonstrated defects in renal function, indicative of renal ischemia. There was a high degree of correlation between angiographic and radionuclide studies. Successful medical management suggests a more conservative alternative to nephrectomy in the hypertensive newborn.


Gray scale ultrasound in the evaluation of rheumatoid arthritis of the knee. Gray scale ultrasound at a frequency of 5.0 MHz was used as part of a study to evaluate the results of yttrium-90 injection as therapy for rheumatoid arthritis of the knee. Popliteal cysts, suprapatellar effusions and synovial thickening in the suprapatellar pouch were demonstrated and ultrasound studies were correlated with the clinical and arthrographic findings. Gray scale ultrasound can be a useful adjunct in the evaluation and follow-up of rheumatoid arthritis of the knee.


Antepartum ultrasonic diagnosis of congenital hydrocele. Ultrasound scans are presented in 2 cases of bilateral congenital hydroceles. In both cases, large scrotal sacs were identified and seen to contain prominent fluid collections. In one case, the testes were identified within the fluid. No testes were seen in the other patient, who subsequently proved to have bilateral undescended testicles.


Generation of iso-TDF maps: considerations for radiation therapy planning. The NSD (nominal standard dose) concept has been useful in therapy for comparing various radiation treatment schedules. More recently, TDF (time, dose, and fractionation) factors were introduced. By incorporating treatment schedules (time and fractionation) with isodose summations, TDFs can be determined throughout the patient contour, including tissue in and outside the tumor volume. For this purpose an isodose summation program was modified to generate iso-TDF maps based on the treatment schedule. For schedules in which all fields are not treated every day, recovery is not inhibited throughout the total treatment volume. It was necessary to reevaluate the concept of "recovery time" for tissues outside the tumor volume and to introduce a "threshold to inhibit recovery" model. Clinical examples assuming this recovery model are presented.


Apparent reformation of the base of the skull following radiotherapy for nasopharyngeal carcinoma. Skull radiographs of 11 selected patients with carcinoma of the nasopharynx were reviewed before and after radiotherapy. Apparent bone reformation was seen at the initial sites of osteolytic destruction within four to six months after delivery of cancericidal radiation dosages.


Experimental observations on short and long-term effects of arterial occlusion with Ivalon. Ivalon sponge has proved to be a useful embolic material, particularly when long-term or permanent occlusions are desirable. It has been stated that Ivalon is well tolerated and that it produces little if any damage to the wall or periadventitial tissues of the embolized artery. Our study demonstrates definite evidence of inflammatory reaction in the wall of the embolized arteries; these changes were seen only in the acute phase and seem to be secondary to damage of the vessel wall by the plastic material. Permanent occlusion results with disappearance of the inflammatory changes at nine months postembolization.


A method for rapid determination of the energy of electron beams from medical linear accelerators. A method has been developed using a Varian Clinac-18 LINAC for the rapid determination of electron beam energy for clinically used linear accelerators. The method involves measuring the ionization values in a water or polystyrene phantom with an ion chamber at two predetermined depths. Then with predetermined Bremsstrahlung "tail" values which are presented here or which can be developed by the user, the practical range, Rp can be measured. With the Rp, the effective surface energy Eo of the electron beam can be determined by the Markus range-energy formula. Thus, by measuring just two depth ionization values, one is quickly able to determine the Eo of an electron beam without plotting a full depth ionization curve.


Orthogonal fields: variations in dose vs. gap size for treatment of the central nervous system. Variations in dose at the junction at the lower end of two lateral skull portals and the upper end of a posterior spinal portal used for irradiation of the central nervous system (CNS) were studied using 60Co and 6 MV linear accelerator radiation. The relationship between dose and gap size was measured via film dosimetry. Small variations in gap size resulted in large variations in dose (+/- 40%) at the junction. These variations in dose were more pronounced for the 6 MV accelerator than for the 60Co, but the volume of high and low dose tended to be smaller with the 6 MV linear accelerator.


Effects of negative pi mesons on immune responses in mice. Spleen cells from normal or preimmunized mice were exposed to graded doses of peak pions or 300-kVp x rays in vitro and then cultured in heavily irradiated mice to determine antibody production against sheep erythrocytes. The RBE for the primary antibody response was 1.46. Equal suppression of secondary responses was seen with both pions and x rays. When spleen cells were irradiated 1, 3, or 5 days after antigen injection, developing immune responses became less sensitive to pions than to x rays. Because T-cell activity (needed for the antibody response) is also implicated in tumor immunity, antitumor immune responses might not be more sensitive to pions than the response used; also, pions might not impair ongoing autochthonous immune responses more than conventional radiation modalities do.


Computed tomographic angiography of the body. Large and medium-sized blood vessels can be identified on extracranial computed tomographic (CT) scans when a combination of infusion and bolus injection of conventional contrast material is administered. The cases illustrated in this report show that CT angiography can sometimes offer clinically useful information not present on CT scans obtained without contrast injection.


Experimental investigations of the possible cause of liver appearance during bone scanning. Rats were injected with 99mTc-Sn-diphosphonate preparation containing various concentrations of Al+3, ranging from 0 microgram/ml to 60 microgram/ml, and whole-body rat images were obtained at two hours postinjection to assess soft-tissue uptake. Uptake (kidney and liver) occurred at approximately 20 microgram/ml Al+3. [This is the maximum allowed in pertechnetate eluate by the Nuclear Regulatory Commission (NRC). ] Increased soft-tissue uptake and progressive degradation of bone scan images occurred with higher Al+3 concentrations. Chromatographic analysis confirmed the breakdown of the radiopharmaceutical preparation containing 20 microgram/ml or more Al+3. Millipore filtration showed no evidence of large colloid particles (greater than 0.2 micrometer).


An easy method to demonstrate the cruciate ligaments by double contrast arthrography. A reproducible technique which does not require special equipment for demonstrating the cruciate ligaments by double contrast arthrography is described. The positive contrast medium coats the synovial surfaces of the ligaments, i.e., the anterior aspect of the anterior cruciate ligament and the posterior aspect of the posterior cruciate ligaments. The ligaments appear lucent by this technique because they are delineated by a sharp positive contrast medium/lucent interface. The study is performed prior to the meniscal exam before medium absorption occurs.


An efficient patient data entry system for a busy computer. The authors describe an independent minicomputer consisting of a CRT and a cassette unit which was designed to store patient data and interact with the main computer at a convenient time. This system permits the computer to handle data entry and treatment planning functions simultaneously. The layout of the overall system, the function of the program and a time analysis of the system are discussed.


Distinguishing ischemic from fibrotic myocardium during ventriculograpy by means of physiological potentiation. Physiological potentiation during ventriculography is more helpful than the routine ventriculogram in predicting postoperative ventricular function. The authors describe a control device which allows the operator to flexibly program a pacing stimulus, thus making it possible to obtain both a resting beat and an optimum potentiated beat during a single ventriculographic study.


A cyclotron target for the production of radioxenons. A liquid cesium target has been developed which allows the production and separate identification of the neutron deficient isotopes of xenon. The present report describes irradiations utilizing 34--41 MeV protons to produce millicurie quantities of 127Xe and 129Xem. At higher energies, however, the target could be used without modification to produce xenon isotopes as light as 119.


A catalytic generator for the production of H2 14O and H2 15O. A technique is described for the continuous production of water labelled with 14O or 15O. Total activities are achieved which are virtually independent of the distance separating the accelerator from the user site, limited only by beam current and energy. The specific activity is determined by the user's needs, since the entire 100-mCi inventory can be collected in liquid volumes on the order of microliters. The studies triggered by this resource range from basic investigations in physics and biochemistry to practical nuclear medical procedures.


[Physical training and sports exercises within the framework of an early rehabilitation programme at a health resort (author's transl)]. The article reports on early rehabilitation measures carried out at a health resort on nearly 4000 patients with signs of "wear and tear", degenerative and other changes of the musculo-skeletal system as well as insufficiencies of cardiovascular system. Provided the preliminary diagnostic examinations are carried out and medical supervision ensured physical training and sports become increasingly important as integral parts of an active treatment plan including natural healing methods. Sport-physiological experiences have, however, shown that a real and measurable positive training effect can only be achieved if these components are administered in the correct dosages. This holds particularly true if a wide spectrum of gymnastic and sports exercises is offered - primarily in groups and under professional supervision - which are not only intended to increase physical capacity, but also respond to individual inclinations. Thus, in addition to its therapeutic value, early rehabilitation at a health resort can provide the feeling of achievement appropriate to give the rehabilitees new impulses at home. As a consequence, these programmes make a positive contribution to the well-being of the general public.


Renal osmol clearance during prolonged heavy exercise. Serum and urine osmolality and creatinine were measured in fifty-eight well-trained men, aged 21-57 years, in connection with three 70 km cross-country ski races taking place under essentially the same external circumstances, leading to slight dehydration. Although the race urine flow was low, 0.51 (0.05-1.10) ml/min, the urine osmolality and the urine to serum osmolality ratio were relatively low, averaging 860 (399-1220) mosm/kg H2O and 2.84 (1.32-4.10), respectively. Decreasing urine flow and endogenou- creatinine clearance were associated with decreasing urine to serum osmolality ratio, indicating declining urine concentrating ability. Thus, the data confirm the author's recent suggestion, based on the measurement of a limited number of urine solutes, that during prolonged heavy exercise a decrease in urine flow and glomerular filtration rate is accompanied by a decline in the urine concentrating ability.


The glomerular filtration rate determined with 99mTc-DTPA and a portable cadmium telluride detector. In twenty-two patients with 51Cr-EDTA renal clearance (glomerular filtration rate) values of 36-141 ml/min, the final plasma disappearance rate constant of i.v. injected 99mTc-DTPA (Sn) was found to be very close to that of 51Cr-EDTA determined from 180 to 300 min after injection. The disappearance of i.v. injected 99mTc-DTPA (Sn) was also recorded from the body surface by means of a low weight cadmium telluride detector (CRN, Strasbourg, France) and commercially available stationary or portable tape recorders. The disappearance rate constant of 99mTc-DTPA as determined externally from 30 min was comparable to that in plasma determined from 180-300 min. The external rate constant could be converted to plasma clearance by means of one plasma 99mTc-activity determination 180 min after injection. The calculated values agreed with the conventionally determined 51Cr-EDTA clearance values. The portability of the detector system allows it to be used to estimate alterations in GFR during the measurement due to changes in physical conditions such as posture, exercise, etc.


Plasma citrate during submaximal and intermittent supramaximal exercise. Plasma citrate was determined in seven subjects working 45 min at 50-60% of their maximal aerobic power and in six subjects who were exercised intermittently for five periods of 1 min at supramaximal work loads. Determinations of plasma lactate, glucose, free fatty acids and insulin were carried out simultaneously. During submaximal work the mean plasma citrate concentration decreased from 116 +/- 4 mumol/1 at rest to 108 +/- 5 mumol/1 after 10 min exercise (P less than 0.05) and increased above resting level to 136 +/- 5 mumol/1 40 min after cessation of work (P less than 0.05). During intermittent supramaximal exercise, mean plasma citrate concentration rose after the third work period and during recovery from 117 +/- 6 mumol/1 at rest to 181 +/- 9 mumol/1 40 min after last work period (P less than 0.05). Plasma citrate varied similarly to variations in plasma free fatty acids and inversely to changes of lactate concentrations during submaximal exercise. Opposite interrelationships were demonstrated during intermittent supramaximal exercise. Plasma citrate concentration varied in the same way as might be expected for changes in cytosolic citrate levels of muscle from in vitro knowledge of the regulatory role of citrate on glucose oxidation.


The relation between carbohydrate extraction by the forearm and arterial free fatty acid concentration in man. I. Forearm work with nicotinic acid infusion. To see if the magnitude of carbohydrate extraction by working skeletal muscle in man is inversely correlated with the arterial free fatty acid (FFA) concentration as in the heart, eighteen healthy men were studied during dynamic forearm work with and without nicotinic acid. The extraction or release of glucose, lactate and pyruvate was determined by the simultaneous sampling of blood from the brachial artery (a) and a deep vein (dv) of the active forearm. Nicotinic acid decreased the arterial FFA concentration from 498 +/- 53 to 134 +/- 12 mumol per litre plasma and this caused a decrease in calculated extraction of FFA. However, it did not affect the extraction of glucose, which was of a magnitude similar to one third of the oxidative metabolism in both situations. One of the possible reasons of this difference compared to the human heart muscle is that the exercising skeletal muscle may utilize stored substrate to a greater extent, which makes possible shifts in substrate utilized for oxidation without changes in substrate extraction. Another reason may be that FFA utilization covers a far smaller proportion of oxidative metabolism in skeletal than in heart muscle already before nicotinic acid.


Uromucoid in normal urine.

Uromucoid in normal urine. Uromucoid was determined in urine from persons or various ages with normal kidney function by a radial immunodiffusion technique. Uromucoid concentration was inversely correlated to diuresis. Excretion rates showed a weak correlation to body surface area in young adults of both sexes. Children had a greater excretion of uromucoid per m2 than young adults, and even newborn had a considerable excretion. Elderly subjects had similar excretion rates to young adults. Excretion rates were uninfluenced by sex, salt load or diuresis, and no difference between day and night excretion rates was observed. Intraindividual fluctuations were small, and determination of uromucoid in one single night's urine therefore gives an adequate expression of the uromucoid excretion rate.


Release of newly synthesized squalene, methyl sterols and cholesterol from human adipocytes in the presence of lipoproteins. Upon incubation of free fat cells for 3 h with labelled mevalonate, more than 90% of the radioactivity of the non-saponifiable material was found in the squalene fraction and less than 10% in the methyl sterol and cholesterol fractions. About 25, 30 and 65% of the cholesterol counts were found respectively in VLDL, LDL, or HDL added to the medium while none of the newly synthesized squalene was released into the lipoproteins. The results indicate that adipose tissue squalene can originate from local synthesis. It is not released from the cells into the medium, but can contribute to local cholesterol synthesis in both rapidly and slowly exchangeable cholesterol pools of adipose tissue.


Bone phosphorus/hydroxyproline ratio and bone histomorphometry in normals. Bone phosphorus/hydroxyproline ratio (P/Hypro) was compared to bone histomorphometry in thirty-four normal individuals. Bone P/Hypro ratio correlated significantly to both the relative mineralized bone volume (r = 0.38, P less than 0.05), the relative osteoid volume (r = -0.38, P less than 0.05) and the percentage of osteoid covered surfaces in trabecular bone (r = -0.38, P less than 0.05).


[Problems in prolonged artificial respiration. A review]. For about twenty years, the method for prolonged artificial respiration was an imitation of spontaneous breathing pattern. New pathophysiological informations about acute respiratory failure showed that a technique which is widely different in frequency, cycle, and tidal volume is more suitable for the fast and safe restauration of spontaneous breathing. Especially the determination of pulmonary shunt flow (QS/Qt), and of the ratio of dead space to tidal volume (VD/VT) have completed our knowledge. In the management of patients with prolonged artificial ventilation, the calculation of shunt flow allows an evaluation of therapeutic procedures. This was the reason to present a nomogram, which simplifies the determination of pulmonary shunt and to discuss an easy, non-invasive method to at least estimate its amount.


[Glomerulonephritis in sarcoidosis].

[Glomerulonephritis in sarcoidosis]. A case of lung sarcoidosis and proliferative glomerulonephritis is reported. The medical literature includes several descriptions of coincidence of sarcoidosis and glomerulonephritis, but only three times is complete documentation by standard microscopy, immunofluorescence and electronic microscopy available. In view of the augmented humoral immunity in sarcoidosis, the authors believe that the association of sarcoidosis and glomerulonephritis is more than a fortuitous coincidence.


[Selective proximal vagotomy with or without pyloroplasty. Results of a prospective randomized study]. The authors report on the one-to-five year results of a prospective randomized trial of proximal gastric vagotomy (PGV) with and without pyloroplasty in 64 men operated upon electively for chronic duodenal ulcer. The effects of the operation on gastric secretion tested at six months with pentagastrin and insulin were identical in both groups. There were fewer long-term side effects in the group without pyloroplasty. The differences between the groups do not reach statistical significance. So far no recurrent ulcers have been found in this series. It is concluded that a drainage procedure is unnecessary with PGV and that the long-term results of the operation are probably better when not combined with a pyloroplasty.


[Doxycycline hyclate in the treatment of non-gonococcal urethritis]. 91 men with non-gonococcal urethritis (including urethritis due to Chlamydia trachomatis and non-specific urethritis) were treated by a 14-day course of doxycycline hyclate; 75% were considered cured at follow-up on the 10th day and 3-4 months post-treatment. The results show a bettter cure rate (83%) in urethritis due to Chlamydia trachomatis than in non-specific urethritis (64%). A 5-day course of doxycycline hyclate was disappointing and was followed by a very high recurrence rate in both groups. Simultaneous treatment of sex patners is advisable as this appears to lower the recurrence rate in the group of men with chlamydial urethritis.


[Once-weekly intravenous L-thyroxine replacement in hypothyroidism]. A 58-year-old female patient with gastrointestinal complications also had primary hypothyroidism which proved therapy-resistant against high-dosage oral replacement with L-thyroxine or an L-thyroxine/L-triiodothyronine combination. Administration of four intravenous injections each of 2 mg L-thyroxine given at weekly intervals brought about a clinical and chemical euthyroid state. Thereafter it was possible to adopt an oral L-thyroxine replacement procedure without complications. Intravenous replacement of L-thyroxine and later transfer to oral medication appears a superior and safer method than the daily subcutaneous or intramuscular administration described hitherto.


Rabies viruses increase in virulence when propagated in neuroblastoma cell culture. Several strains of attenuated rabies virus lacking the capacity to kill adult mice acquired a high lethal potential for mice after one to five serial passages in murine or human neuroblastoma cells. The virulence acquired after passage in neuroblastoma cells is a stable genetic trait retained during subsequent passage of viruses in nonneuroblastoma cell systems.


Eye movements of African chameleons: spontaneous saccade timing. Despite asynchrony, saccades of left and right eyes of African chameleons had similar timing statistics. Prominent qualitative aspects of these statistics did not change if one or both eyes were masked. Evidently, an internal stochastic process regulated chameleon saccade generation.


Discrimination of intermediate sounds in a synthetic call continuum by female green tree frogs. Male Hyla cinerea produce two distinctive calls. Acoustically intermediate calls are rare. Females discriminate between synthetic intermediates that differ by one cycle of amplitude modulation (50 per second). Processing appears to be continuous. The tree frog's auditory system thus provides a wide margin for the discrimination of its two principal signals.


An ultrastructural correlate of the membrane mutant "paranoiac" in Paramecium. The highly organized array of intramembranous particles, the ciliary plaque, varies from the wild type in size and organization in two stocks of the Paramecium behavioral mutant, paranoiac. In one of these stocks, the alteration is dramatic.


Pyrazole-induced thyroid necrosis: a distinct organ lesion. One oral dose of pyrazole caused necrosis of rat thyroid follicular epithelial cells but spared the parafollicular (C) cells and the parathyroid glands. Serum thyroxine (T4) and triiodothyronine (T3) were significantly decreased on day 3 after pyrazole administration and were immeasurable on day 5. At day 5 the thyroid was enlarged and the concentration of thyroid-stimulating hormone in the serum was increased, indicating an appropriate pituitary response to a primary lesion in the thyroid. Doses of pyrazole which produced no morphologic change in the thyroids also significantly depressed the concentrations of T4 and T3 in the serum.


Postprandial changes in the exhalation rate of radon produced in vivo. The rate of exhalation of radon by persons with long-standing radium burdens increases about twofold shortly after a meal. The increase is short-lived and "normal" values are regained in 1.5 to 2 hours. The effect may account in part for the poor reproducibility in estimates of the freely emanating part of the radium content.


Pupillometric signs of brain activation vary with level of cognitive processing. The idea that hierarchically higher brain processes require greater amounts of central nervous system vigilance or activation for their execution was tested in two experiments measuring pupillary dilation during the decision interval of a hierarchically structured letter-matching task. Larger dilations indicative of increased activation were observed for letter pairs requiring higher levels of processing.


Cat color vision: the effect of stimulus size. Adult cats were trained to discriminate blue from green and gray. Although the cats could discriminate the intensity of stimuli whose areas ranged from 33 to 0.36 square centimeters they could not discriminate color when the stimulus was 0.36 square centimeter (less than 20 degrees visual angle). This influence of stimulus size may account for both positive and negative results of previous studies.


Merging of modalities in the optic tectum: infrared and visual integration in rattlesnakes. The optic tectum of pit vipers (Crotalinae) contains a layer of infrared-sensitive neurons subjacent to the visual layer; these indirectly receive input from the facial pit organs. They respond transiently to the appearance or motion of warm objects within their 25 degrees to 70 degrees excitatory receptive fields (some have inhibitory regions) and presumably allow the snake to orient or strike toward prey. The infrared and visual spatiotopic tectal maps have similar but not identical axes; the infrared magnification is greater than that for vision. Bimodal neurons have receptive fields for each modality that reflect the disparity of the two maps. This finding suggests that (i) during development the infrared and visual fibers spread out independently to fill available tectal sites and (ii) bimodal neurons form local connections without regard to establishing spatial correspondence between the two modalities.


Effect of prolonged illumination (phototherapy) on concentrations of luteinizing hormone in human infants. Concentrations of luteinizing hormone in the serums of human neonates were altered when the neonates were exposed to prolonged, intense illumination (phototherapy) with their eyes covered. Concentrations decreased after 48 to 72 hours of exposure, increased 6 to 9 days after phototherapy, and subsequently returned to levels similar to those of controls. These data suggest that light may affect pituitary-gonadal function in the human neonate.


Increased resistance to Staphylococcus aureus infection and enhancement in serum lysozyme activity by glucan. Glucan is a potent reticuloendothelial stimulant whose immunobiological activity is mediated, in part, by an increase in the number and function of macrophages. In studying the role of glucan as a mediator of antibacterial activity, we attempted to ascertain the ability of glucan to modify the mortality of mice with experimentally induced Gram-positive bacteremia, and to enhance antibacterial defenses in rats as denoted by serum lysozyme and phagocytic activity. After intravenous administration of glucan, serum lysozyme concentrations were increased approximately sevenfold over control concentrations. The increase in serum lysozyme appeared to parallel the glucan-induced increase in phagocytosis and induced hyperplasia of macrophages. Prior treatment of mice with glucan significantly enhanced their survival when they were challenged systemically with Staphylococcus aureus. These studies indicate that glucan confers an enhanced state of host defense against bacterial infections.


Nonhistone proteins HMG1 and HMG2 change the DNA helical structure. Two chromatin nonhistone proteins (from calf thymus) of the high mobility group, HMG1 and HMG2, reduce the linking number (topological winding number) of a circular DNA if the covalent closure of the DNA is carried out in their presence. This indicates that these proteins can either unwind the double helix, or induce a supercoiling of the DNA.


Isolation of St. Louis encephalitis virus from overwintering Culex pipiens mosquitoes. Two strains of St. Louis encephalitis virus were isolated from overwintering mosquitoes collected in Maryland and Pennsylvania during January and February 1977. There isolations from Culex pipiens constitute evidence that a mosquito-borne flavivirus can persist in a vector mosquito in temperate climates during the winter season.


Erythroid progenitors circulating in the blood of adult individuals produce fetal hemoglobin in culture. Erythroid colonies, raised from erythroid stem cells circulating in the peripheral blood of normal adult individuals, synthesize considerable amounts of fetal hemoglobin. In cultures from persons with sickling disorders, amounts of hemoglobin F that are known to inhibit sickling in vivo are produced. The results provide evidence that primitive erythroid progenitors are able to express the hemoglobin F production program and that cultures of mononuclear cells of the adult blood can be used to investigate the mechanisms involved in regulation of gamma-globin gene switching.


Optokinetic eye movements in albino rabbits: inversion in anterior visual field. When visual contrasts are restricted to the anterior sector (90 degrees to 180 degrees) of the albino rabbit's visual field, eye position is dramatically unstable, and when such contrasts are moved, horizontal optokinetic eye movements are inverted: the direction of pursuit is opposite to that of the stimulus. In the posterior visual field stability and optokinetic reactions are normal, as in all parts of the pigmented rabbit's visual field. This phenomenon may be one more of the complex of visual system defects linked to albinism.


Frequency discrimination following the selective destruction of cochlear inner and outer hair cells. Frequency discrimination was measured behaviorally before and after drug-induced lesions of cochlear hair cells in the cat. Discrimination was unaffected by complete loss of outer hair cells provided that at least 50% of inner hair cells were intact. Thus, inner hair cells are important for frequency discrimination, and they can function normally in this regard without the influence of outer hair cells.


Moyamoya disease in children.

Moyamoya disease in children. A review of the recent Mayo Clinic experience with stroke in children having cerebral angiography revealed five patients with moyamoya disease. The disease commonly presents as recurrent strokes and only rarely as a seizure disorder. The angiographic pattern suggests that the telangiectasia characteristic of this condition represents normally present dilated vessels.


Radiographic evaluation of treatment of advanced carcinoma of the prostate. Radiographic evaluation of 65 patients with disseminated carcinoma of the prostate shows that 8% demonstrated resolution of metastatic deposits after palliative transurethral resection and/or estrogen or castration therapy. The increased effectiveness of therapy and the improved management of patients are reflected in longer survival. Roentgenographic evidence of increasing sclerosis of osteoblastic metastases of carcinoma of the prostate indicates that the rate of bone repair exceeds the rate of bone destruction, and is not necessarily an indication of progression of the disease. Increasing prominence of blastic bony lesions is not a poor prognostic sign; several patients showing it were symptom-free and survived for long periods. Sclerotization of lytic deposits is definitely a good prognostic sign of treatment and represents "healing change" within involved bone.


Diagnostic compound B-mode ultrasound scanning in gynecology. Diagnostic compound B-mode ultrasound scans done on gynecologic patients during the past three years were reviewed and compared with surgical findings or clinical follow-up. The 190 scans were analyzed and categorized as diagnostic, compatible (or confirmatory), equivocal, misleading, or negative. Although only 6.4% were diagnostic, the majority (66.3%) were compatible with the clinical and pathologic findings. Criteria for interpreting B-mode scans are discussed.


Otolaryngologic manifestations of acute leukemia and lymphoma. This paper reviews the otolaryngologic manifestations of acute leukemia and lymphoma. Our experience includes 50 patients with acute leukemia and 61 patients with lymphoma of the head and neck. Acute leukemia was manifested by infection, bleeding, tissue infiltration, and complications of chemotherapy. Lymphoma manifestations were usually head and neck masses. The otolaryngologist must be familiar with the manifestations of these disease entities.


Functional status evaluation form: development and implications. A medical audit revealed marked deficiency in the quality of functional evaluations in a rehabilitation hospital. Routine staff educational programs and an optional, simple functional evaluation form failed to correct this deficiency. The functional evaluations of the patients never reached 100% completion and the quality of the evaluations varied widely. As a result, a mandatory functional status form was devised for incorporation into the patients' charts. This form included past, present, and future goals in a problem-oriented design. Review of charts after six months of use showed that the form led to improved rates of functional status reporting, with all functional areas now documented in over 90% of charts. It is hoped that a comprehensive program including use of functional status form will be successful in improving patient care and physician education, and in facilitating a comprehensive medical audit.


Massive airway hemorrhage after transtracheal aspiration. An instance of massive hemorrhage following transtracheal aspiration with successful resuscitation is reported. Indications for the procedure are pneumonia with poor ability to produce sputum, fever, or pulmonary infiltrate in a stuporous patient, and facial injuries which would complicate nasotracheal suction. The cricothyroid membrane is recommended as the site of entry. If airway hemorrhage does occur, immediate maintenance of the airway and tamponade of the bleeding can aid in successful resuscitation of the patient.


Traumatic avulsion of the lumbar nerve roots. Lumbar nerve root avulsion is rare but may follow severe traction injury of the pelvis. Diagnosis is based on neurologic deficit and myelographic demonstration of traumatic meningocele. Nerve root avulsion should be differentiated from peripheral nerve injury because surgical treatment of nerve root avulsion has uniformly proved futile.


Treatment of Raynaud's disease with temperature biofeedback. A 40-year-old white woman who for 15 years had had Raynaud's disease--a vascular disorder characterized by poor blood circulation and coldness in the extremities--was treated with temperature biofeedback. In treatment sessions over a 13-month period she was provided with continuous, moment-to-moment information about the rise and fall of fingertip temperature. Gradually she was able to learn to raise her peripheral temperature and to gain some volitional control over a highly complex physiologic response.


Middiastolic click in mitral valve prolapse. The interesting and unusual occurrence of a middiastolic click is documented in an asymptomatic young woman with typical mitral valve prolapse. This click is shown to occur later in diastole than previously reported diastolic clicks in this syndrome.


Acute abdominal pain precipitated by phenformin-associated lactic acidosis. Phenformin-associated lactic acidosis is an important though unusual cause of acute abdominal pain. Its clinical picture suggests other catastrophic abdominal entities. A representative case is presented. Aids to arriving at this diagnosis are presented and the specific therapy is outlined. The pathophysiology of this condition is discussed.


Infectious mononucleosis associated with rhabdomyolysis and renal failure. Acute rhabdomyolysis and renal failure occurred in a 16-year-old boy with infectious mononucleosis; recovery was complete. Renal failure is a rare complication of infectious mononucleosis. Rhabdomyolysis has been reported only once in association with the Epstein-Barr virus, but has frequently been associated with influenza virus infections. Prospective studies measuring creatine phosphokinase enzymes should establish the frequency of rhabdomyolysis in viral infections.


Staphylococcus aureus sternal osteomyelitis complicating bone marrow aspiration. This case of S aureus sternal osteomyelitis occurring at the site of bone marrow aspiration in a 24 year-old man illustrates the potential for infection that complicates any clinical procedure, even those considered to have a very minimal risk of infection. The patient recovered uneventfully after antibiotic therapy with nafcillin administered intravenously, followed by dicloxacillin taken orally.


Reminiscences on the antireflux mechanism. A common view is that the lower esophageal sphincter is the sole component of the antireflux mechanism. Other methods of investigation especially radiology, and the effects of surgery suggest that the position of the sphincter and the size and shape of the hiatus are at least as important as the sphincter in the control of reflux and recent appropriate manometric studies support this view. The development of some of the ideas about what is and what is not a significant component is reviewed. A unifying hypothesis is offered which proposes that the sphincter is of primary importance in resisting the challenge of intragastric pressure developed by contraction of the stomach wall which may lead to physiologic reflux; whereas the position of the sphincter and the size of the hiatus are concerned with resisting the challenge of intra-abdominal pressure. The physiologic component has a limited capability of resisting intra-abdominal pressure so that when the anatomic component fails, pathologic reflux occurs.


Hypertensive lower esophageal sphincter: a reappraisal. The hypertensive lower esophageal sphincter (LES) is defined as one with normal relaxation and an average LES-intragastric pressure gradient greater than or equal to 40 mm Hg. Case histories of two patients with hypertensive LES and normal peristalsis in the body of the esophagus are contrasted to that of a patient with a hypertensive LES and diffuse esophageal spasm. In one patient, the postdeglutitive contractions were excessively prolonged due primarily to a slower return to baseline pressure. It is suggested that the hypertensive LES may be a separate disease entitly, and that it should be separated from diffuse esophageal spasm so that its pathophysiology and natural history can be elucidated.


Medical management of patients with reflux esophagitis. Medical management of reflux esophagitis includes physical manipulations, antacids, and antireflux medications (bethanechol and alginic acid). Their combined usage in the continuous dyspeptic and the problem case help "break the cycle," providing relief for long periods of time. Identification of possible inciting factors in cases of recurrence should be pointed out to the patient so that he will develop an instinctive antireflux behavior. The effect of this combined therapy on the pathophysiology and natural history of the disease remains to be determined.


Association of aspirin ingestion with symptomatic esophageal hiatus hernia. The observed association of aspirin ingestion and symptomatic esophageal hiatus hernia is ascribed by me to injury of the esophageal mucosa during delayed passage of ingested aspirin from mouth to stomach. Physiologic alterations attributable to esophageal hiatus hernia act to prolong contact between swallowed material and the esophageal mucosa. This prolongation of contact between swallowed aspirin and the esophageal mucosa predisposes patients with esophageal hiatus hernia, and who are aspirin-users, to develop symptomatic esophagitis. Clinical data obtained from human subjects are presented which show that swallowed material may become trapped for extended periods in the esophagi of patients with esophageal hiatus hernia. Also, the capability of aspirin to injure alkaline mucosa by direct contact, in the absence of acid, is demonstrated.


Endoscopic evaluation of gastroesophageal sphincter dysfunction. The introduction of modern endoscopes, light sources, and cameras has greatly improved the endoscopist's ability to diagnose and document the presence of reflux esophagitis. A reliable objective diagnosis of reflux esophagitis can be made in the presence of active erosion, friability, and ulceration. Reflux can be suspected in the presence of a patulous cardia. Gross reflux is uncommonly seen in the relaxed patient during endoscopy, but its presence is pathologic. The x-ray and endoscopic diagnosis of hiatal hernia correlate well. Endoscopists must be aware of those rare cases where an infectious cause for esophageal inflammation may be present. Although endoscopic biopsy and brush cytology are of limited value in the diagnosis of esophagitis, they permit an accurate differentiation between benign and malignant lesions in the esophagus and their use is encouraged in chronic cases of esophagitis where an increased risk of malignancy is present.


Conservative management of esophageal stricture using dilatation and antireflux therapy. Ninety patients with benign esophageal stricture were treated conservatively with bougienage, antireflux, and antacid therapy. There was improvement in 79% of these patients, only 14% were unchanged, and 7% became worse. Only three patients eventually were operated upon. Bougienage was accomplished in many cases using the fiberscope as a bougie, followed by progressive dilatations with soft mercury-filled dilators. Many patients had initial dilatation with a guidewire placed through the stricture into the stomach under direct vision through the fiberscope. All patients were treated with antireflux measures and antacid subsequent to their dilatations. These measures were found to be both safe and effective in most cases. Surgery was believed to be indicated only in patients who failed to respond to these measures.


Control of argininosuccinate synthetase by arginine in human lymphoblasts. Human lymphoblasts in long-term culture have the enzyme activities necessary to convert citrulline to arginine: argininosuccinate synthetase and argininosuccinate lyase. Upon transfer from arginine-supplemented to citrulline-supplemented medium, lymphoblasts exhibit a lag period before resuming exponential growth. During this lag the specific activity of argininosuccinate synthetase increases an average of 60-fold. Argininosuccinate lyase activity remains unchanged. If normal lymphoblasts are starved in arginine-deficient medium without citrulline or if argininosuccinate lyase--deficient lymphoblasts are transferred to citrulline-containing medium, argininosuccinate synthetase activity increases linearly for several days and reaches even higher levels. Cycloheximide blocks the increase in enzyme activity. Cells grown in citrulline medium and pulse labeled with 35S-methionine incorporate more 35S-methionine into argininosuccinate synthetase protein than cells grown in arginine; the rate of disappearance of radioactively labeled enzyme is the same in citrulline- and arginine-grown cells. Arginine or a closely related metabolite thus appears to repress the synthesis of argininosuccinate synthetase of human lymphoblasts in culture.


A recurring temperature-sensitive mutant class of BHK-21 cells. A particular technique designed to select for temperature-sensitive DNA-synthesis mutants of BHK cells has yielded primarily a class of mutants which do not show complementation in cell hybrids.


Heterogeneity of alkaline phosphatases in different HeLa lines. Alkaline phosphatase (ALP) components in 8 cell lines of HeLa were examined. Line to line heterogeneity in ALP expression was observed using the criteria of electrophoretic mobility before and after neuraminidase treatment, heat stability, L-phenylanine inhibition, and reactivity against antiplacental ALP antiserum. Six lines contained a placentallike ALP isozyme and varying amounts of a liverlike ALP isozyme. One line contained a liverlike ALP isozyme only. One line contained a new ALP form which was clearly distinguished from the placental, liver, bone, and intestinal ALPs. Thus, derepression of the placental ALP structural locus appeared to have occurred in 6 of the 8 lines. However, where expressed, the placentallike ALP varied electrophoretically from line to line, and in only one case was the mobility identical to that of a common placental ALP phenotype. This phenotypic heterogeneity of the ""derepressed'' placentallike ALP contrasts markedly with the phenotypic stability of other enzymes expressed in HeLa cells.


Six complementation classes of conditionally lethal protein synthesis mutants of CHO cells selected by 3H-amino acid. Using a tritiated amino acid suicide procedure designed specifically to select conditional protein synthesis mutants, we have isolated and characterized a large number of such mutants of Chinese hamster ovary cells. All of the mutants are genetically stable and behave as recessives in somatic cell hybrids. Most of the new mutants are phenotypically dependent on the concentration of a specific amino acid as well as on temperature. In addition to identifying many additional leucyl- and asparagyl-tRNA synthetase mutants, complementation analysis has distinguished four new genetic classes representing methionine-, glutamine-, histidine-, and arginine-dependent mutants. Biochemical characterization of representative mutants from each of these six classes has identified the primary lesions as being defective aminoacyl-tRNA synthetases. Our selection results further demonstrate the high specificity of the 3H-amino acid procedure for isolating protein synthesis mutants. Reconstruction experiments performed with two representative mutants indicated a selection efficiency of approximately 10% under standard conditions.


Assignment of the gene locus for human alpha-L-fucosidase to chromosome 1 by analysis of somatic cell hybrids. The alpha-L-fucosidases (EC 3.2.1.51) from human and mouse cells could be separated by isoelectric focusing of neuraminidase-treated cell extracts in acrylamide slab gels. Fourteen hybrid clones derived from the fusion of mouse and human cultured fibroblasts and 37 hybrid clones derived from the fusion of human long-term lymphoid lines with mouse RAG cells were tested for expression of human alpha-L-fucosidase. A strong correlation between the expression of the human enzyme and the presence or absence of human chromosome 1 was found. The presence of human alpha-L-fucosidase in clones scored as positive by isoelectric focusing was confirmed by Ouchterlony double immunodiffusion against IgG from rabbits immunized with purified human alpha-L-fucosidase. It is concluded that the structural gene locus for human alpha-L-fucosidase is located on chromosome 1.


Uptake and early fate of metaphase chromosomes ingested by the Wi-L2 human lymphoid cell line. Aspects of the ingestion and early intracellular fate of homologous. [3H]-thymidine-labeled chromosomes (donor) were studied in recipient Wi-L2 cells in the absence of reutilized radioactivity. As much as 67% of the cell-associated radioactivity was resistant to hydrolysis by DNase I after 4 h of incubation. Cell fractionation and electron microscope autoradiography indicated that chromosome uptake was rapid, into both cytoplasmic and nuclear fractions and was facilitator and dose dependent. Sedimentation analysis demonstrated that at 4 h donor DNA of approximate single-strand mol wt of 1--6 X 10(6), as compared to 6--12 X 10(6) for chromosomal DNA, was recoverable in cell fractions. By 6 h, a significant portion of the nucleus-associated donor DNA was converted into material of higher mol wt, although no evidence was found for integration into recipient DNA. Cytoplasmic donor DNA continued to be degraded. An average number of chromosome equivalents of nucleus-associated donor DNA to recipient cell nuclei of 1--4 was obtained and its relationship to the lower frequency of chromosome-mediated gene transfer is discussed.


Mutants of CHO cells resistant to the protein synthesis inhibitor emetine: genetic and biochemical characterization of second-step mutants. Second-step mutants highly resistant to the protein synthesis inhibitor emetine (Emt(RII) have been selected from emetine resistant (Emt(RI)) Chinese hamster ovary cells described earlier. The frequency of the Emt(RII) mutants was increased 50- to 75-fold after mutagenesis, and none of these highly resistant mutants could be selected in one step using wild-type cells. Like the Emt(RI) mutants, the increased resistance of Emt(RII) mutants results from another lesion in the polyribosomal fraction, as measured by the effects of emetine in fractionated extracts. As with the first-step mutants, the Emt(RII) isolates behave recessively in somatic cell hybrids. Segregation studies have shown that the Emt(R) lesions are not on the X chromosome, and in at least one isolate there is evidence that the Emt(RI) and Emt(RII) mutations may occur at different sites.


Distal profunda femoris to popliteal artery bypass for patients with a short length of long saphenous vein. A technique of distal profunda femoris to popliteal artery bypass is described in two patients in whom the length of long saphenous vein available for grafting was too short for a conventional femoropopliteal bypass. Because each patient has a large profunda system which was free from proximal disease, a bypass was constructed betweeen the distal profunda femoris and the upper popliteal arteries, utilizing the short length of long saphenous vein available. Both patients had complete relief of their symptoms and objective evidence of improvement.


The continent reservoir ileostomy: review of a collective series of thirty-six patients from three surgical departments. A reservoir ileostomy was created in 36 patients. Three patients died from septic complications in the postoperative period, and one patient died from rectal carcinoma during the observation period. In six patients the reservoirs were removed during the observation period because of nipple-valve extrusion, nonspecific ileitis of the reservoir, or recurrence of Crohn's disease. Complications from the reservoir and its outlet were quite frequent and included fistula formation in eight patients, nipple-valve extrusion in 12 patients, nonspecific ileitis of the reservoir in five patients, and stenosis of the nipple in one patient. Malabsorption of vitamin B12 and fat due to a stagnant loop syndrome was found in four of seven patients examined for this. Fifteen patients underwent 25 reoperations for complications from the reservoir and its outlet. Twenty-six patients still have their reservoirs. Twenty-five of them are continent. They do not wear external appliances and they empty their reservoirs with a tube two to five times daily. One patient is incontinent due to an unrepaired nipple-valve extrusion.


Prevention of stroke by carotid endarterectomy. Cerebral stroke can occur in patients having visual symptoms only. Fundoscopy is valuable in identifying those patients with visual symptoms who are likely to have carotid disease; and carotid endarterectomy can prevent a stroke in a significant percentage of patients at risk. Meticulous operative technique is essential. In a series of 187 carotid endarterectomies performed on 154 patients over a 7-year period, the operative mortality rate was zero. Operative morbidity was 1.3% in 139 patients who had no prior permanent neurological deficits, and 13% in 15 patients who had suffered previous strokes. Data compiled on follow-up for an average of 20 months indicated that six patients (4.7%) suffered postoperative strokes, nine patients (7%) experienced persistence of symptoms, and 113 patients (88.3%) remained neurologically well.


Cardiac arrhythmias associated with treadmill claudication testing. Eighty-one consecutive patients of an average age of 58 years with suspected lower limb arterial disease underwent standard 5-minute treadmill claudication testing. Prior to, during, and after testing the patients were monitored electrocardiographically. The number of electrocardiographic abnormalities seen in 81 patients undergoing study increased from 33 (40.6%) at rest to 49 (60.5%) with exercise. The commonest abnormalities encountered with exercise were the development and increased incidence of paroxysmal beats and ST-T wave changes which, in some instances, became life-threatening, aborting the test. Since the principal hazard for patients with claudication appears to derive from an increase propensity to cardiac mortality and morbidity, rather than from the consequences of impaired circulation to the limb, electrocardiographic monitoring during treadmill claudication testing, though little practiced, is strongly advised.


Spontaneous perforation of bile ducts in neonates. Three neonates with spontaneous perforation of the common bile duct have been described. All were treated by laparotomy in the seventh week, with attempted closure of the perforation and a simple biliary diversion by cholecyst-jejunostomy with jejunojejunostomy below it. They have done well and represent 100% salvage of our cases to date. One is now 12 years of age. As far as we are aware, this method of dealing with the condition has not been described before.


An objective assessment of common femoral endarterectomy and profundaplasty in patients with superficial femoral occlusion. Common femoral endarterectomy with profundaplasty has become accepted as a useful operation in the treatment of ischemic arterial disease which is the result of superficial femoral occlusion. However, objective assessment of its long-term postoperative hemodynamic effects has not been reported. This study determines the effect of this operation on the resting pressure index, the walking distance on the treadmill, the fall in postexercise ankle pressure, and the recovery time. Measurements were made just before operation and 1 month later in 20 patients with severe claudication and superficial femoral occlusion. Sixteen patients were available for follow-up at 1 year. These patients were matched according to the resting pressure index to another group of 20 patients with superficial femoral occlusion followed up conservatively. The results indicate that common femoral endarterectomy with profundaplasty improves the distal perfusion pressure and, by inference, flow, which provides strong objective confirmation of the clinical impression that this operation is of value and help in determining its place in the management of severe lower limb ischemia.


Prevention of deep vein thrombosis in neurosurgical patients: a controlled, randomized trial of external pneumatic compression boots. A prospective, randomized clinical trial in 95 patients undergoing neurosurgical operative procedures was performed to investigate the efficacy of external pneumatic compression (EPC) of the calves as compared with results in a control group that received no specific form of prophylaxis for prevention of deep vein thrombosis (DVT). The diagnosis of DVT was established by the I125 fibrinogen scan and radiographic contrast phlebography. The data indicate that EPC provides significant protection against the development of DVT in comparison with results in the control group (p less than 0.005). There were no known pulmonary emboli in any of the EPC-treated patients. There were no complications of EPC.


The influence of the incubation period and the amount of antigen on the haemagglutination inhibition titres to Newcastle disease virus. An investigation was made into the significance of incubation period and amount of antigen used in the haemagglutination inhibition (HI) test for Newcastle disease virus in chicken serum. Also the results of a manually performed macrotest were compared with those of an automated microtest. Both incubation period and amount of antigen greatly influenced the HI titres. In incubating sera the titres increased up to 75 or 120 minutes when respectively 2 or 4 haemagglutinating units per volume were used. By contrast they became stable after 45 minutes' incubation with 8 units per volume. It was concluded that the latter combination gave optimum results. There were no significant differences between the results obtained with the macro and the micro technique.


Quantitation of P metabolism in the rabbit by means of 32P. Cr2O3 was found to be very effective in correcting the daily variations in the excretion of dry matter, Ca, Mg, and P in rabbit faeces. It can shorten the length of a balance experiment by 50%. We have an idea that a considerable part (about 50%) of the total P retained is incorporated in the organism so quickly that it cannot be observed with the intravenous radioactive tracer method. The excretion of the endogenous faecal P amounted to 20 mg per day. No significant difference was found between the apparent and the actual absorption coefficient of P. The exchangeable P pool of the organism amounted to 690 mg. The experiment results should be subjected to detailed biometric evaluation.


An infection with the lungworm Filaroides milksi Whitlock, 1956 (Nematoda: Metastrongyloidea) in a dog from Belgium. A one-year-old male boxer coming from Belgium was presented at the Small Animal Clinic with signs of respiratory distress which had been present for three weeks. A radiograph of the thorax showed features of peribronchitis and infiltration in both lungs. In spite of antibiotic and supportive therapy the dog died. Postmortem examination of the lungs revealed a large number of nematodes in most of the bronchioles and alveoli. These nematodes were identified as filaroides milksi, Whitlock, 1956, a lungworm of dogs which has not been reported in Europe previously.


Fertility control in cattle by use of the "milk progesterone test". The development and validation of a radioimmunoassay for progesterone in cow's milk is described. Control of the temperature during storage of the milk and also during the sample incubation procedure appeared to be a critical requirement with respect to reduction of nonspecific binding of tritiated progesterone. Ranges of milk progesterone levels were established during pregnancy as well as during the luteal and the follicular phase of the oestrus and of pregnancy in three trials on two experimental farms. The mean accuracy with respect to the diagnosis "pregnant", "non-pregnant" or "not in oestrus" were 84.0, 97.6, and 100%, respectively. By leaving out of account all animals with high progesterone values (greater than 10 ng. ml(-1)) on day 1 (= day of insemination) the accuracy of the diagnosis "pregnant" was improved to 87.1%.


[Value of different systems of mammography records with regard to their exposure to radiation and their information content (author's transl)]. We learned from our examinations that, if there were optimum conditions, the combination Medichrome MR50 as a form of low dose method offers the same information content as the film without intensifying screens PE 4006. We found out that the discernibleness of details of 70 non selected mammographies which had each been taken by both systems was absolutely identical. By xeroradiography, however, a more precise representation of details, especially if there are microcalcifications, is possible because of its effect which renders the edges more visible. If the Medichrome low dose method was applied, the exposure to radiation of the breast was, depending on the density and width or the organ, only 1/12 to 1/14 of the dose measured if the film without intensifying screens was used. The exposure to radiation connected with xeroradiography is between these two values. We came to the following conclusion: the low dose method is recommended for routine mammographies, and only if there are special problems or if suspicious findings are to be clarified, xeroradiography is applied as supplementary examination method. Before using the film without intensifying screens, one should consider the high radiation exposure which, however, does not involve a greater information content.


[Measurement of post-irradiation population kinetics using single-cell cytophotometry combined with double-labeling autoradiography: model investigations into a diploid Ehrlich ascites tumor after 475 rd X-irradiation (author's transl)]. A technique for in vivo determination of the population kinetics in tumors following irradiation is reported in this paper. Using the model of a diploid Ehrlich ascites tumor (EAT-dipl), the migration of cells from different subpopulations was followed up through the generation cycle. The measurability of post-irradiation growth kinetics in different subpopulations is emphasized with regard to its importance for practical application with combination treatments or possibility for the problem of dose-time relations. The individual results obtained after 475 rd are presented in detail.


Estimation of cell cycle parameters by the cumulative method. Cell cycle parameters exhibit one of the characters of tumor cells. The cumulative method for the estimation of the parameters was analysed and evaluated, considering variations of the phase duration. The following procedure was proposed for the accurate estimation: The cell cycle time and the duration of G2 phase are estimated from the accumulation of mitotic cells and labeled mitotic cells, respectively, by the simultaneous administration of an inhibitor of cell division and a labeled DNA precursor. The duration of S phase is calculated with the labeling index using an equation. The duration of G1 phase is obtained by subtraction from the cell cycle time.


Alterations in tissue lipids of rats subjected to whole-body X-irradiation. Whole-body irradiation of rats at sublethal doses leads to hepatic lipid accumulation which reaches a maximum by the sixth day; this effect on lipid metabolism does not appear to be due to accompanying inanition but due to irradiation per se. The female rats show a greater and more consistent increase in liver lipids than males and this better response of the females is not abolished by prolonged administration of testosterone to these animals. An accumulation of triglycerides accounts for almost all the increases in total liver lipids, although smaller elevations in the levels of free fatty acids and cholesterol are also seen. Free fatty acids of liver show a marked decrease on the second day following irradiation. Serum lipids do not show any appreciable changes while adipose lipids progressively decrease reaching a minimum by the sixth day. Although an insufficiency of ATP may be responsible for lipid accumulation in the irradiated rat as is the case in rats treated with ethionine or orotic acid, adenine administration, which prevents fatty infiltration due to these chemical agents, does not protect against the radiation-induced increase in liver triglycerides.


Total and local X-radiation effects on 18F uptake of bones. Flourine uptake in rat bones under local and total-body X-irradiation was studied. Data were obtained by measurements with a scintillation crystal counter and in the case of limbs by means of macro and microautoradiographies. The autoradiographic studies showed a higher concentration of the isotope in the metaphyseal area of the endochondral plate. Irradiation produced a depression of 18F uptake in both cases. An alteration in the mineralization mechanism due to irradiation is presumed.


[The place of radiation therapy in the treatment of giant cell tumors of bone (osteoclastomas): results from 32 cases (author's transl)]. Radiotherapeutic results of giant-cell tumors of the bone in 32 own cases are presented. The frequency of local recurrency was 30%, the 10-year survival rate was somewhat about 70% and in nearly 12% of primary benign giant-cell tumors there appeared malignant transformations (inclusive two fibrosarcomas in irradiated tissue). In other radiotherapeutic series, the frequency of malignant transformation is between 14 and 19%, in series with primary surgical therapy the rate of secundary malignant transformation is between 3 and 10%. Despite of the limited comparability of the surgical and radiotherapeutic material, we recommend in accordance with most authors in operable lesions surgical treatment. In inoperable lesions or when the lesion is not radically operable, radiation therapy has a definite place in the treatment of giant-cell tumors of the bone with a curative rate of about 80%.


[Results of radiation therapy in chordoma: data from seven patients and a review of the literature (author's transl)]. Seven patients with chordoma who were treated in the Universitätsklinik für Nuklearmedizin und Radiotherapie, Zürich, since 1950 are presented. In all the cases, high-dose irradiation resulted in symptom-free survival of many years duration. Five years after the first treatment, all the patients are alive, after ten years about 50% of the patients are alive. Our own experiences as well as the already published cases show that radiotherapy has an important role in the management of chordoma.


[The electroresection as therapy of the vulva carcinoma. Method and results (author's transl)]. At the Ist Gynecologic University-Clinic of Vienna 292 patients with vulvar carcinoma were admitted and treated in the years 1952--1970. The therapy was an electroresection and -coagulation of the primary tumor, followed, if necessary, by a surgical dissection of the inguinal groin. An electrocoagulation is indicated for the more extended cases, too--a local healing in 97% of the cases is obtained in this way. The inguinal dissection was progressively replaced by telecobalt-irradiation (6000 rd). Of the 292 cases 139 of 47.6% presented palpable nodes and only 56 patients were operated. 79.3% were aged between 61 and 90 years. Of the 292 cases 167 or 57.4% were cured for five years or more. The primary mortality was 1% (three cases). 40 patients (13.3%) died of intercurrent diseases.


[Light-chain plasmacytoma with reversible renal insufficiency after intravascular application of thorotrast (author's transl)]. Thirty-three years after intravascular injection of Thorotrast, a light-chain plasmacytoma with hypercalcemia and renal insufficiency was diagnosed in a 60-year-old man. The question of causal relation between Thorotrast deposit and plasmacytoma is discussed. The accumulated radiation load to the bone-marrow as caused by thorium dioxide deposition amounts to circa 3000 rem. According to casuistic and epidemiological communications, induction of plasmacytomas by external X-irradiation may be regarded as possible. A distinct increase in myeloproliferative diseases but only small numbers of plasmacytomas are reported in extensive epidemiological Thorotrast studies. From combination of results of the three most comprehensive epidemiological Thorotrast studies is obtained a numerical ratio of 1:5 for the spontaneous rate against the number of plasmacytomas observed. Identical correlations are yielded by investigations at Hiroshima and Nagasaki. Hence it is to be supposed that also plasmacytomas can be induced by thorotrastosis of the reticulohistiocytic system.


Urothelial neoplasia: what constitutes adequate follow-up? The need for constant vigilance in the follow-up care of patients with transitional cell carcinoma is illustrated by the case reports of 12 patients whose tumors recurred after tumor-free periods of eleven years and longer. Emphasis is placed on monitoring, which includes pyelographic study, cytologic study, and cystoscopic examinations for as long as the patient survives.


Developments in preoperative staging of bladder tumors. We have found that routine bilateral selective angiographic studies for patients considered candidates for radical cystectomy is a useful technique. Our experiences since 1968 to present have indicated that early bladder invasion and occult metastases can be detected at a rate exceeding that of clinical staging alone. Angiographic staging in D lesions, when supplemented by lymphangiogram, can approach 100 per cent accuracy. Our current false negative lymphangiogram rate is relatively low, that is, 1.9 per cent. The over-all angiographic and lymphangiographic staging accuracy prior to surgery in our most recent series of cystectomy patients was nearly 79 per cent. Such techniques and reliability of data are discussed in detail including the factors which interfere with the exact angiographic staging of bladder cancer. These techniques in no way are meant to surplant routine preoperative clinical evaluations which are appropriately used with additional accuracy and success.


Ectopic ureterocele, hydroureter, and renal dysplasia: an embryogenic triad. A review of the literature of the embryogenesis of ectopic ureterocele is presented. A theory linking the triad of ectopic ureterocele, hydroureter, and renal dysplasia to a primary intrinsic developmental abnormality of size and position of the ureteral bud is postulated.


Extensive renal involvement by renal cell carcinoma. Experience with the management of 3 cases of bilateral adenocarcinoma and 1 case of unilateral carcinoma in the solitary kidney is presented. Two patients died of metastases six and thirteen months postoperatively, while one is alive with metastases at fourteen months and another is alive without metastases at four months. The literature is reviewed, and the various treatments are discussed.


Renal artery trauma.

Renal artery trauma. The ability to preserve renal function in patients with renal artery trauma is a goal sought by all urologists. We have reviewed our own experience as well as data published in the literature to formulate guidelines concerning which patients should be treated with revascularization and what factors are most likely to make this procedure successful.


Single-stage reconstruction of urinary tract after loop cutaneous ureterostomy. Three patients with four renoureteral units have undergone single-stage reconstruction involving ureteroureterostomy and ipsilateral ureteroneocystostomy following temporary loop cutaneous ureterostomy. Preliminary loop cutaneous ureterostomy diversion allowed adequate ureteral recompensation such that ureteral tapering was unnecessary in any of these cases. Rich collateral circulation as well as strict preservation of adventitial ureteral vasculature allows the performance of upper and lower ureteral procedures in a single session.


Incidence of later ureteral obstruction after antireflux surgery in infants and children. Forty infants and children who underwent antireflux surgery for primary reflux had long-term follow-up with intravenous pyelograms (IVP). The IVPs were evaluated for the incidence of late ureteral obstruction. Although 4 cases (5.5 per cent) of early ureteral obstruction were noted, no instances of late ureteral obstruction were found. After antireflux surgery, patients should have a follow-up IVP within the first six months to rule out the possibility of early ureteral obstruction. The need for performing periodic IVPs for many years postoperatively, when obstruction is absent in the immediate postoperative period, is questioned.


Hemitrigone: renal agenesis or single ureteral ectopia. Hemitrigone is pathognomonic of either renal agenesis or single ureteral ectopia. The latter may present as urinary incontinence in the female patient, with prostatitis or seminal vesiculitis often occurring in the male.


Plasma testosterone in patients receiving diethylstilbestrol. With accurate, inexpensive plasma testosterone assays now available it is possible to monitor the efficacy of hormonal manipulation in the patient with adenocarcinoma of the prostate. We monitored plasma testosterone in our patients receiving diethylstilbestrol (DES) 1 mg. per day. We found no statistical difference in mean plasma testosterone between patients with adenocarcinoma of the prostate and castrated patients with prostatic carcinoma, all receiving DES, 1 mg. per day. We recommend that plasma testosterone be closely monitored in patients receiving hormonal therapy for adenocarcinoma of the prostate.


Blue collection bag after ileal diversion. Five children with ileal diversions have shown asymptomatic blue staining of the urine collection bags. A tryptophan derivative (indican) in the urine that oxidizes to indigo blue on exposure to air is thought to be the cause of this benign transient phenomenon.


Strangulation of glans penis by hair.

Strangulation of glans penis by hair. Three cases of strangulation of the glans penis by hair are reported. Ensuing complications such as urethrocutaneous fistula and gangrene of the glans are described. The need for prompt diagnosis and treatment is stressed.


Low-velocity gunshot injury to ureter.

Low-velocity gunshot injury to ureter. An unusual type of ureteral injury is described. The conventional surgical management of a penetrating ureteral injury was not utilized. Because debridement was not necessary in this case, we did not use an internal ureteral stent. A good postoperative result was obtained with this conservative treatment.


Liver and prostate adenocarcinoma: an "estrogen-free" environment? We believe that the probable "estrogen-free" site which is present in the liver while a patient is on estrogens gives a conductive environment for local growth of prostate malignancy. We report 1 patient who improved with local irradiation and 2 others who stabilized and symptomatically improved with chemotherapy. Hopefully, future reports will shed more light on the treatment of hepatic metastases from prostatic adenocarcinoma.


Liposarcoma of spermatic cord.

Liposarcoma of spermatic cord. Four patients with myxoid liposarcoma of the spermatic cord are presented, three of whom have survived longer than five years. Wide local excision is usually the treatment of choice with radiotherapy reserved for control of either extensive local disease or following incomplete removal of the lesion.


[Effectiveness of orotic acid and calcium pangamate in experimental liver dystrophy]. In tests staged on albino rats with acute dystrophy of the liver provoked with carbon tetrachloride the effect of orotic acid and calcium pangamate on the functional state of the liver was studied. Combined application of orotic acid and calcium pangamate was found to promote a more complete restoration of an intensive secretion of bile, synthesis and secretion of cholates together with bile, formation and secretion of bilirubin, excretion of cholesterol than this could be achieved by separate application of these compounds.


[Modern principles of assessing the effectiveness of dietetic nutrition in internal diseases]. Modern dietology is based on the metabolic principle. In all internal diseases it is composing a balanced diet adapted, above all, to metabolic disorders inherent in a given malady, that is envisaged. The range of current investigation methods permits it to ensure a strict control over the proportions of nutritional components in the dietary and to establish the limits of permissible increase or restriction of the content of each of them. Substance is given to dietetic approaches to various nosological forms of the disease that include the nutritional pattern, caloricity, qualitative and quantitative content of the nutrients.


[Evaluation of the vegetable oil taken up into the duodenum as a factor in pancreozymin liberation in healthy persons and in digestive organ diseases]. Investigations carried out in 14 healthy volunteers, 29 patients with chronic pancreatitis and 15 patients with chronic hepatitis showed that infusion into the duodenum of an optimally tolerable quantity (25 ml) of vegetable oil makes for a release of an amount of pancreozymin, which, by the criterion for stimulating secretion of pancreatic amylase, is equivalent to 0.5 Un/kg of pure preparation of pancreozymin and, as to the degree of stimulating the secretion of lipase and trypsin, it exceeds the effect of 0.5 Un/kg, but is less than that of 1.5 Un/kg of pure pancreozymin. These data should be taken into account in evaluating the ability of some alimentary fats to stimulate the release of endogenous pancreozymin.


[Effect of massive doses of ascorbic acid on oxidative and glycolytic processes in the tissues]. Ascorbic acid in a dose of 500 mg/kg was given perorally to guinea pigs once in 24 hours. Investigations were carried out on animals receiving ascorbic acid in single doses and also with its administration of 7, 14, 21, 60 and 90 days. Subject to studies were tissue respiration and glycolysis of the skin, liver and kidneys as well as oxidative phosphorylation in hepatic homogenates. With introduction of large doses of ascorbic acid the tissue respiration of the kidneys and the effectiveness of oxidative phosphorylation in the liver were found to be on the increase. Both effects depended on the time during which massive doses of ascorbic acid were administered. The liver and kidney glycolysis did not show any changes with any duration of the ascorbic acid loading. The skin glycolysis intensity gained somewhat in strength with ascorbic acid administration for 21 days.


[Interaction of vitamins K and C in the body of rats]. The influence of ascorbic acid on the content and intracellular distribution of ubiquinone in the tissues of K-avitaminotic rats was investigated. Following introduction of pelentan (30--40 mg/kg), a vitamin K antagonist, a rise in the level of ubiquinone in all of the study organs, occurring both at the expense of the post-mitochondrial fraction of the liver, heart, spleen and also at that of the cardiac and splenic mitochondria, could be registered. The ubiquinone concentration in hepatic mitochondria was going down. In K-avitaminotic rats, which received ascorbic acid, the co-enzyme content in the tissues approached control values. Vitamin C exerted a positive action on the ubiquinone level in the mitochondria of the liver, heart and spleen. The cited data suggest that vitamin C abolishes manifestations of the K-vitamin deficiency affecting the ubiquinone pool and secures its optimal content in the mitochondria. Considering the significance of vitamins K, C and ubiquinone in the tissular redox processes an interaction of the said vitamins at the level of the tissue respiration chain is presumed.


[Changes in carbohydrate and lipid metabolism in rabbits with a limited mobility and an excess sacharose consumption]. Under restricted motor activity an excess of the introduced saccharose is used not for replenishment of the spent energy which, judging by the glycolysis level, was less marked than in controls, but rather for maintaining the synthetic processes, being, first of all, incorporated in glucose-aminoglycanes. At the same time, the activity of the pentophosphate way of the carbohydrates assimilation increased in the brain, liver and heart and in consequence of this the cholesterol and triglycerides content rose in the blood serum and liver. The triglycerides concentration in the aorta proved to be lowered.


[Effect of a varying ascorbic acid allowance in guinea pigs on the metabolic indices in their bodies to cold exposure]. Changes in the content of ascorbic acid in the blood, urine and suprarenals and also of glucose and 11-oxycorticosteroids in guinea pigs with different vitamin C allowances under conditions of cold stress were studied. The data obtained suggest that the degree of the vitamin C allowances is essential for adequate reactions of the organism exposed to the action of cold, but the shifts in metabolic transformations point to the need for a more reserved utilization of high ascorbid acid doses.


[Biological value of canned baby food with added protein enrichment]. The biological value of new canned meat baby food "Kroshka" with an addition of a protein enrichment agent was investigated. The introduction of protein enrichment in the formulation of the canned food was found to increase its biological value, the latter being related to the concentration of the protein addition. Moreover, the study of canned food containing an additional protein enrichment agent had a beneficial effect on hemopoiesis as well as on the function of the liver and on some aspects of the mineral metabolism.


[Fatty acid make-up of the muscle tissue lipids of ocean fish]. Consequent upon the results of investigating fatty acids composition in the tissue lipids of a number of marine fish (marmoreal and green nototenia, merow, stavrida, klykach, lufar, marine perch and marine bream) of different degrees of fatness there were ascertained substantial differences in the correlation of basic acid components and the nutritional value of the lipids. A comparison between the overall lipid content and the quantity of highly unsaturated acids enabled it to disclose a possible relative resistance of the studied fish to the oxidative lipids decay.