Biochemical changes produced by Fusarium T-2 toxin in the chicken. The administration of 350 microgram T-2 toxin to six-week-old chickens by intramuscular injection produced a temporary reduction in food intake, changes in plasma triglyceride and total cholesterol levels, increases in plasma aspartate transaminase, alanine transaminase and lactate dehydrogenase activity, falls in the activities of plasma acid and alkaline phosphatases, a reduction in the weight of the pancreas, enlargement of the liver and an apparent exacerbation of hepatic haemorrhage. It also delayed and reduced the hyperlipaemic response to the injection of oestradiol-17beta-dipropionate. These changes were attributed to cytotoxicity involving the liver, intestine and possibly muscle, and an inhibition of enzyme synthesis.


Estimation of effective parabronchial gas volume during intermittent ventilatory flow: theory and application in the duck. The difference in gas exchange performance between continuous and intermittent ventilatory flow is theoretically studied in the alveolar lung model. When measurements obtained with intermittent flow are analyzed assuming continuous flow, an apparent diffusing capacity. Dapp, results which is an underestimate of the true value, D. This true value, D, may be assessed from measurements at continuous flow. With decreasing effective lung gas volume, Veff, Dapp increasingly deviates D. The dependence of Dapp/D on Veff in the parabronchial lung seems to be similar to that in the alveolar lung. Experimental data of Dapp/D (Scheid et al., 1977) are used to assess Veff for the duck lung. The average value of Veff thus obtained, 93 ml, exceeds the anatomical estimate of parabronchial gas volume. Gas transfer across the open parabronchial ends may contribute in enlarging the parabronchial gas volume to the volume, Veff, that is effective as gas capacity in conditions of non-steady ventilatory flow.


A theoretical analysis of the barometric method for measurement of tidal volume. The barometric method is unique in allowing measurement of tidal volume in a manner that requires no tactile contact with the subject. The equations used by previous investigators to calculate tidal volume described only events occurring during inspiration. Neglect of events during expiration caused a systematic error. Additional equations needed to calculate tidal volume for the barometric method are derived. An error sensitivity analysis is performed to assess quantitatively the accuracy of the calculated tidal volume due to propagation of errors in the experimentally measured variables. Numberical evaluation for typical cases indicates that the limit of accuracy for tidal volume measurement lies between 10 and 15%.


Determination of binary diffusion coefficients of various gas species used in respiratory physiology. In order to provide data required for quantitative analysis of gas diffusion in lung airways, diffusion of He, CO, O2, CO2 and SF6 in various gases used in respiratory physiology was studied in vitro at 37 degrees C and 25 degrees C. The gases were allowed to mix by diffusion in a closed cylindrical tube (length 2 m, internal diameter 1 cm), one half of which was initially filled with 1% test gas in a second gas and the other half of which was filled with the second gas only. Kinetics of diffusional equilibration was determined by withdrawal of spot samples analyzed by gas chromatography. The binary (mutual) diffusion coefficients (D) computed there from were in most cases in good agreement with values calculated on the basis of the Chapman-Enskog theory.


Analysis of gas exchange between air capillaries and blood capillaries in avian lungs. A number of models is analyzed to study gas exchange between blood capillaries and air capillaries in the avian parabronchial wall when diffusion is the only transport mechanism in the air capillaries. The existing anatomical arrangement of blood capillaries that traverse the periparabronchial tissue from peripherally located arterioles to draining venules at the luminal surface appears to provide a particularly high gas exchange efficiency. Application of the theory to measurements in the hen using histological estimates suggests that substantial concentration gradients exist inside the air capillary gas whose magnitude vary along the parabronchus. Thus at the gas inflow end of the parabronchus the partial pressure drop within the air capillaries could amount, for both O2 and CO2, to about 10--15 torr at rest and to 30--40 torr during exercise. Due to the peculiar arrangement of capillary blood flow to the air capillaries the effects of these gradients on gas exchange are very slight during rest. During exercise, however, the diffusional resistance inside the air capillaries may become limiting for the over-all gas exchange, and other mechanisms may be needed to secure respiratory gas transfer.


The effects of changes of maternal PaO2 and PaCO2 on the fetal PaO2 and PaCO2--in vivo study. Umbilical PaO2 and PaCO2 were continuously monitored in vivo in acute fetal lamb preparations with a semipermeable membrane connected to a mass spectrometer. The response time of this system (0 to 90% of final value) was 36 sec. In seven pregnant sheep (128--135 days gestation) the maternal inspired mixture was abruptly changed and the following changes in fetal PaO2 and PaCO2 were observed: (1) 100% O2 to room air: PaO2 decreased from 21.5 +/- 0.8 (mean +/- SEM) to 14 +/- 1.1 mm Hg at a rate of 1.63 +/- 0.33 mm Hg/min. Following return to 100% O2 the PaO2 returned to 21 +/- 1.1 mm Hg at a rate of 2.44 +/- 0.4 mm Hg/min. (2) 100% O2 to 12% O2/10% CO2: after 6 min the PaO2 fell from 19.3 +/- 1.3 to 6.3 +/- 0.3 mm Hg at a rate of 4.65 mm Hg/min and the PaCO2 rose from 37 +/- 8 to 70 +/-5 mm Hg. At 100% O2 the PaO2 returned to 19 +/- 1.0 mm Hg at a rate of 11.76 +/- 0.086 mm Hg, the PaCO2 to 39 +/- 7 mm Hg. (3) 100% O2 to 90% O2/10% CO2. The PaO2 and PaCO2 increased by 4.7 and 22 mm Hg, respectively. The changes of fetal PaO2 and PaCO2 occurred after 1 minute of changing in maternal inspired mixture except in the transition from 12% O2/10% CO2 to 100% O2 (34 +/- 12 sec). Following the reinstitution of 100% the fetal PaO2 and PaCO2 returned to their previous values within 4 and 16 min, respectively.


A mathematical description of the airways of the human lungs. To study the physiological implications of the morphological structure of the conducting airways of the human lungs algorithms are derived for Model I of Horsfield et al. (1971). These algorithms produce descriptions of every pathway from the trachea to the respiratory bronchioles in terms of the combined airway orders. The distributions of surface area and circumference with airway order for this model are given. Also illustrated is the frequency distribution of pathway lengths in the lungs. Computations involving fluid flow in the airways are illustrated by developing a model for mucociliary clearance.


A new variant of glucosephosphate isomerase deficiency with mild haemolytic anemia (GPI-MYTHO). A new case of glucosephosphate isomerase deficiency with mild haemolytic anaemia was observed in a 6-year-old girl. Deficient enzyme was characterized by a profoundly decreased activity in the red cells, a normal electrophoretic phenotype, normal isoelectric point, normal optimum pH, a molecular instability and a clearly decreased Michaelis constant for fructose-6-phosphate. Propositus was double heterozygote for a 'silent gene' inherited from the mother and an abnormal enzyme from the father. Because this abnormal enzyme has undescribed characteristics, it responds to a new variant for which we propose the name GPI-MYTHO.


Inhibition of haemopoietic stem cell proliferation by a diffusible product of bone marrow cells. In a double diffusion chamber (DC) culture system bone marrow cells elaborated diffusible factor(s) that prevented spleen colony-forming cells (CFU-S), but not PHA stimulated lymphocytes, from entering cell cycle. Mature granulocytes and macrophages did not produce such factors(s). Various number of steady-state or regenerating mouse bone marrow cells were cultured in single diffusion chamber for periods up to 7 d. After the initial cell loss,the net growth of CFU-S was inversely related to both total cell number and CFU-S number in DC. Diffusible factors rather than cell-to-cell contact appeared to be involved in the inhibition, even though we were not able to demonstrate inhibition of net growth of CFU-S with the double chamber approach.


Syndrome of thrombocytopenia and absent radii: qualitatively normal platelets with remission following spenectomy. A 41-year-old female with TAR syndrome and a normal number of megakaryocytes in the bone marrow improved after splenectomy. There were no signs of a qualitative platelet defect. She was followed for nearly 2 years during which the bleeding time was increased without clinical bleeding, however.


Fatal aplastic anaemia complicating infectious mononucleosis. A 7-year-old boy developed fatal aplastic anaemia, 2 weeks after the first signs of infectious mononucleosis. Although some drugs were administered, infection with the Epstein-Barr virus, leading to infectious mononucleosis, is assumed to be the cause of this aplastic anaemia. Some mechanisms possibly leading to the aplasia are discussed.


Polycythaemia vera-transformation to myelofibrosis and subsequent reversal. A woman aged 67 who developed polycythaemia vera 21 years ago has been seen regularly since the diagnosis was first made. She was treated initially with pyrimethamine and then for 10 years by repeated venesections. After a 4 year period when her myeloproliferative disease was considered to be transitional a complete transformation to myelofibrosis occurred. She was treated by splenic irradiation and later with alkylating agents in an attempt to give her symptomatic relief from massive splenomegaly. Repeated and massive haemorrhage from gastro-oesophageal varices was treated initially by percutaneous transhepatic sclerosis of the gastro-oesophageal collateral vessels. A subsequent dacron mesocaval jump graft operation was successful in preventing further haematemesis and melaena. During the last year transformation back to polycythaemia vera has occurred. The evolution of her myeloproliferative disease has been fully documented by detailed blood counting, bone marrow aspirates and trephine biopsies, blood volume studies and other radioisotope investigations including the quantitation of functional erythropoietic tissue with 52Fe.


Iron stores in blood donors evaluated by serum ferritin. Male and female blood donors were grouped according to their blood donations, and the iron stores were estimated by a two-site immunoradiometric assay for ferritin. Hb serum iron, serum transferrin and transferrin saturation were also measured. A remarkable low serum ferritin concentration was found in male donors, who had donated blood one or two times. This might indicate that the serum ferritin concentration in male blood donors is not linearly correlated to the iron stores. Among 30 female donors 14 had ferritin values below 10 ng/ml, which have been shown to be indicative of iron deficiency. The serum ferritin concentration could not be used to predict the donors who developed low Hb values by the blood donation which followed. Serum ferritin was correlated to serum iron in men and to serum transferrin and transferrin saturation in both men and women.


Sensitivity and precision of activated partial thromboplastin time (APTT) methods. A multicenter study. The Activated Partial Thromboplastin Time (APTT) test, Cephotest, was compared to other APTT methods in current use in 4 specialized coagulation laboratories. In 3 of 4 laboratories, the sensitivity of Cephotest was superior (P less than 0.001) to that of the local APTT method. There was no statistically significant difference between the APTT methods with regard to precision of repetitive testing. In each laboratory, the normal range of Cephotest was estimated on freshly collected plasma samples from healthy subjects. A mean value between 28.8 and 35.8 s, with a standard deviation of 1.1-3.3 s, was obtained. It is concluded that the composition of the APTT method if of importance for the sensitivity of this test, but does not influence the precision of repetitive testing to a significant degree. The use of a standardized reagent facilitates comparison of the results obtained with the APTT method from one laboratory to another.


[Microangiopathic hemolytic anemia in malignant tumors. 2 cases]. Two cases of microangiopathic hemolytic anemia in disseminated carcinoma are reported. Both showed the classical features of this illness, namely acute generalized hemorrhagic diathesis, severe hemolytic anemia, thrombocytopenia, fragmentation of erythrocytes in the peripheral blood smear, increased erythropoiesis and megakaryopoiesis or tumor cell invasion in the bone marrow, tumor cell emboli in venules and disseminated intravascular coagulation. In both cases the microangiopathic hemolytic anemia was the first sign of the disseminated carcinoma. Differential diagnosis, pathogenesis and therapy are discussed.


[Anti-HBc within the framework of hepatitis B virus infection: correlation to the form of inflammation and to the viral expression]. 168 HBAg seropositive and 105 HBAg seronegative liver biopsies were studied for correlations between anti-HBc titers (indirect immunofluorescence method) and tissue expression of HBsAg and HBcAg (immunofluorescence), Dane particles in blood (immune electron microscopy) and inflammatory reaction. 98.8% of the HBAg seropositive patients were positive for anti-HBc. The mean titers showed statistically significant differences mainly between chronic aggressive hepatitis (1:2(11.3)) versus lobular hepatitis (1:2(10.1)), chronic persistent hepatitis (1:2(9.9)) and nonspecific reactive hepatitis (1:2(7.6)). Due to the considerable deviation of titers within the histological groups, however, titers below 1:2(11) are of low diagnostic relevance, whereas titers above 1:2(12) are mainly indicative of chronic aggressive hepatitis, although acute lobular hepatitis with signs of possible transition to chronicity or chronic persistent hepatitis with strong inflammatory activity may occur. Among HBAg seronegative patients 20% were positive for anti-HBc (mean titer = 1:2(7.7)). Among 78 patients also tested for anti-HBs, 10.2% were positive for both anti-HBc and anti-HBs. In an additional 12.8%, anti-HBc was the only marker of past hepatitis B virus infection. Anti-HBs was the only marker in a further 33%. In none of the HBAg seronegative patients and in only 59% of all HBAg seropositive patients, there was an association of anti-HBc with complete virus synthesis as measured by the demonstration of HBcAg in tissue or Dane particles in blood. It is concluded that anti-HBc is not a criterion of infectiosity but a specific, although non-characteristic, marker for HBAg seropositive acute and chronic hepatitis as well as for terminated HBV infection of all possible inflammatory and HBAg expression types.


[Schizophrenia and the ability to drive]. Based on the files of the Zurich Forensic Medicine Institute, the driving ability of 100 clinically and diagnostically proven schizophrenic cases was studied with the aid of case histories, police and traffic records and personal statements. The data obtained were compared with a healthy control group of equal age and sex. The schizophrenics showed significantly inferior driving performance to the control group over a six-year observation period. The schizophrenics could be divided into sub-groups whose performances varied significantly. The basic character of the patients and the type and degree of delusions had an important bearing on their driving records. The results were especially unfavorable in those with religious type delusions, but favorable in those with a cautious, anxious character. The driving ability test should be administered by an experienced medical expert. Besides investigation of the actual sickness, the basic character and the total personality of the patient should always be considered.


[Sonographic diagnosis of gallbladder diseases]. In a prospective study of 174 patients referred for cholecystography, an ultrasound study (gray scale technique) was also carried out and the results of the two examinations were compared. The ultrasound examination served to demonstrate a normal gall bladder in 96% of the patients and, based on typical sonographic findings, permitted the diagnosis of cholecystolithiasis in 97%. The ultrasound examination can be carried out prior to the X-ray study as a screening method and has particular value in the work-up of patients with unclear right upper quadrant abdominal pain.


[Prognosis of diabetes mellitus after an early diagnosis by means of glucosuria screening. Results of a 10 year course control]. The 10-year course of diabetes in 250 patients detected by glucosuria screening in 1963 was evaluated in an inter-individual pair comparison with patients from the same territory admitted during the same calendar year. Pairs were grouped according to age, sex, and weight. Judged by mortality, survival time, causes of death, and vascular complications, the medium-term prognosis was not improved by screening, although in the screening group a strict diet could be maintained to a greater extent. Problems of evaluation and effectiveness of mass examination in chronic diseases are discussed. Glucosuria and hyperglycemia do not suffice as screening criteria for the early recognition of the complex risk of arteriosclerosis in maturity onset diabetes. Multi-screening in groups with especially high diabetes risk is expected to yield higher effectiveness than the mass screening hitherto performed.


[Papillomatosis coronae glandis. Frequency of occurrence and clinical picture]. The clinical picture of pearly penile papules (PPP) is described on the basis of the literature and the authors' own investigations. Although symptomless and without functional significance, PPP may lead to damaging therapeutic measures if not recognized as such by physician and patient. The incidence of PPP has been investigated in 642 19-year-old Swiss men originating from the same geographical region. PPP were found in 33%, in 9.2% as the major variant and in 23.8% as the minor variant.


[Lung emphysema].

[Lung emphysema]. 1. Elastic recoil, size of the perfused surface for gas exchange and flow resistance of the small airways influence the symptomatology and lung function of pulmonary emphysema independently of each other. 2. The loss of elastic force and surface for gas exchange are predominant in panlobular emphysema. Ventilation-perfusion disturbances due to increased airway resistance during inspiration and expiration predominate in chronic obstructive bronchitis with centrilobular emphysema. 3. In the presence of identical values for vital capacity and FEV1.0, arterial blood gas studies during rest and exercise provide the most reliable information on gas exchange surface and ventilation-perfusion disorders.


[Endogenous factors in the development of emphysema]. The relationship between the development of pulmonary emphysema and the presence of proteolytic enzymes with elastolytic properties released by polymorphonuclear leukocytes or by alveolar macrophages is briefly reviewed. The possible role of various antiproteolytic substances present in the lung is also described. The pathogenesis of pulmonary emphysema is discussed in the light of hypotheses recently put forward implicating an excess of proteolytic factors and/or a relative or absolute lack of protection substances.


[Clinical and radiological diagnosis of chronic obstructive lung syndromes]. The clinical signs produced by the respiratory movements reveal the main patho-physiological types in patients with chronic obstructive lung disease. Roentgenological signs do not correlate with the severity of ventilatory disorders and pre-capillary hypertension. Conversely the roentgenological signs of the post-capillalry hypertension are precocious and reliable.


[Lung function tests in emphysema].

[Lung function tests in emphysema]. Several lung function tests are capable of detecting typical functional abnormalities in pulmonary emphysema, such as reduced elastic recoil of lung tissue, elevation of intrathoracic gas volumes, expiratory bronchial collapse or uneven patterns of ventilation. The measurement of elastic recoil by means of an esophageal catheter also seems to be a reliable technique for detecting early stages of emphysema, but its use for routine clinical investigations remains impracticable. The elevation of intrathoracic gas volumes determined by body plethysmography or helium dilution technique may sometimes be influenced by reversible bronchial obstructions or additional restrictive ventilatory defects. Expiratory collapse of the intrathoracic airways, however, proves to be a regular finding in advanced pulmonary emphysema. It results from decreased stability of the peripheral and central bronchial wall as well as from a shifting of bronchial and transmural pressure gradients to the peripheral airways. The occurrence of a pressure dependent expiratory stenosis can easily be demonstrated by the spirometric flow-volume curve during forced expiration, thus differentiating patients with asthma from those with chronic bronchitis and emphysema. The minimal program for detection and evaluation of emphysematous alterations of the lung by functional tests should consist in the measurement of intrathoracic gas volumes, recording of the forced expiratory volume and the analysis of the flow-volume curve.


[Morphometry in central bronchi and tissue sections. A supplemental method in pneumopathology]. Comparative clinical-pathological studies of pneumopathology call for quantitative analyses of bronchi and pulmonary tissue. Quantification of pathological findings is possible by morphometry. The most important stereologic definitions and the laws of morphometry are briefly described. Methodologic problems are discussed. Baseline data of central bronchi of 5 autopsy cases are calculated (volume densities of the different tissue compartments and the surface density of bronchial basement membrane in three reference volumes). The five patients had normal lung function tests during life.--Further, the grading of emphysema by point-counting on papermounted macrosections is reported. Grading of emphysema on lung slices correlated very well with grading of emphysema by point-counting.


[The problem of airway collapse in lung emphysema. Correlation between intravital lung function measurements and morphometric data]. Lowering of forced expired volume in one second as a percentage of vital capacity (FEV1%VC) and check-valve phenomenon of expiratory flow curve (CVPh) are clinical signs of bronchial collapse. In this study the correlations between these functional parameters and morphologic findings are studied. The study comprises autopsy cases in which lung function had been tested 1.5 years on average before death. In 138 cases emphysema was graded on papermounted macrosections and in 52 cases bronchi were studied by morphometry. 19 of the latter were analysed more thoroughly; 9 had shown CVPh. The results were as follows: 1. Collapse phenomena occur more frequently in cases with destructive emphysema than in cases without. However, it is not exclusive to the former. 2. FEV1 and CVPh correlate with hypertrophy of bronchial glands. 3. Cases with CVPh show hypertrophy, not atrophy, of the walls of central bronchi. It follows that bronchial collapse phenomena are mainly influenced by increased bronchial secretion of viscous mucus and not by emphysematous destruction of lung parenchyma. On forced expiration, mucus plugging probably leads to a decrease of intrabronchial pressure in the downstream bronchi. Thus, the downstream bronchi may collapse because the equal pressure point between intrabronchial and intrathoracic pressure shifts from the central to more peripheral bronchi.


[Fatal outcome of emphysema without increased bronchial resistance and 6 cases of chronic dyspneic hypoxemic bronchial disease with normal spirometry]. The cases of seven patients with dyspnea, hypoxemia and normal ventilatory tests are presented. Closing volume was measured in 6 and was increased. Two were heavy smokers, 2 were obese, and 2 were exposed to inhalation of industrial irritants. The last patient had severe dyspnea and pronounced hypoxemia which eventually resulted in pulmonary hypertension and right ventricular failure. Lung scan was normal. Plethysmography showed normal bronchial resistance. Autopsy revealed chronic bronchitis, bronchiolectasis and emphysema. This case was interpreted as an example of fatal outcome of small airway disease.


[Benign spontaneous pneumothorax: possibilities and prognosis of conservative therapy]. There is much divergence of opinion as to how spontaneous pneumothorax should be treated or even whether it should be treated at all. Nowadays this benign pulmonary disease is primarily treated surgically, although conservative management of spontaneous pneumothorax seems to provide equally good results, as already indicated in 1932 by KJAERGAARD. Histories and clinical findings for 87 patients who were initially treated for spontaneous pneumothorax were reviewed and the factors responsible for the choice of treatment established. The mean age of the patients was 34 years, and 60% of the patients were below 30. Males predominated over females by 8:1. No coexisting pulmonary diseases were found in 80% of the patients. 54 patients were treated conservatively (no treatment except antitussives or analgesics). 46 conservatively treated patients had pneumothorax for the first time; 4 patients each had pneumothorax for the second or third time or more. 46 of 66 patients with idiopathic pneumothorax received no treatment, whereas 12 of 20 patients who had coexisting pulmonary diseases were treated surgically. The pneumothorax did not recur in 30 of 37 patients treated conservatively and observed for 1--15 years. These data suggest that conservative management is as effective as surgical treatment in uncomplicated spontaneous pneumothorax.


[Distribution of the HL-A antigens in patients with pigeon breeder's lung]. HLA B8 was found in 29% of patients suffering from pigeon fancier's lung, as compared with a normal frequency of HLA B8 of 17%. In patients suffering from the acute form of the disease HLA B8 was found in 42%. HLA B13 and HLA BW17 could not be demonstrated in any patient with pigeon fancier's lung.


[Experimental hyperammoniemia].

[Experimental hyperammoniemia]. The effect of chloralose anesthesia and of hypoxia or hypercapnia of altogether 40 minutes' duration on the concentrations of ammonia in the arterial blood was investigated in mongrel dogs. The NH3 values increased marginally as a result of chloralose anesthesia and only slightly as a result of severe (Pao2=32 mm Hg), acute hypoxia. Hypercapnia (Paco2=75 or 111 mm Hg) induced with a mixture of gases was accompanied by an increase of commensurate degree in the blood ammonia levels which was presumably attributable to an augmented protal-to-systemic shunt circulation.


[Partial lipodystrophy and intramembraneous glomerulonephritis]. The case is presented of a young woman with partial lipodystrophy and intramembranous glomerulonephritis. Light and electron microscopic changes in the kidney biopsy are described and discussed. With immunosuppressive therapy very slow progression of the renal insufficiency was observed. Finally, regular dialysis treatment was required to sustain life. The follow-up after detection of intramembranous glomerulonephritis lasted 8 years.


[Preventive health actions. Various levels of time, of the role of health professions and of individual participation]. At a time when increasing emphasis is placed on promotive and preventive measures in health care, it is important to bear in mind that the ways and means of prevention are diverse and multidisciplinary. The author briefly discusses the levels which are to be considered, in regard to the timing of the intervention (primary, secondary and tertiary prevention), the requisite professional contribution, and the importance of the individual's active participation. Participation is highly desirable, and is in fact indispensable for improvement of the "civilization" health problems we are now facing. It is not always easy, however, to determine its optimal pattern and intensity. It is also necessary to take into account the inteface situations between preventive measures and freedom, at the individual as well as the social level.


[Long-term comparative study: diclofenac (voltaren) and naproxen (proxen) in arthritis]. Two non-steroidal antirheumatic drugs, diclofenac (Voltaren) and naproxen (Proxen), were compared with respect to their analgesic effect and the observed improvement in joint mobility in two groups of patients, each consisting of 20 males with either cox-arthrosis or gonarthrosis. The duration of treatment was up to six months. The therapeutic response was assessed by the mean scores of spontaneous and exercise-induced pain, the clinical state of joints and painfree time of walking. Both drugs led to a persistent improvement in the condition of most patients, but the clinical impression would appear to point to a more marked analgesic effect of diclofenac. The daily maintenance dosage from the fourth week of treatment onwards was 75 mg diclofenac and 500 mg naproxen. Both drugs were generally well tolerated. Occasionally gastrointestinal side effects were observed (more frequently in the naproxen group). Laboratory controls were carried out periodically, but no evidence of organ toxicity or hemotoxic effects was found.


Autoradiographic image intensification: applications in medical radiography. The image of an 80 to 90 percent underexposed medical radiograph can be increased to readable density and contrast by autoradiographic image intensification. The technique consists of combining the image silver of the radiograph with a radioactive compound, thiourea labeled with sulfur-35, and then making an autoradiograph from the activated negative.


DNA synthesis in cartilage cells is stimulated by oscillating electric fields. External oscillating electric fields (1166 volts per centimeter, 5 hertz) enhanced the incorporation of [3H] thymidine into the DNA of chondrocytes isolated from the proliferative layer of embryonic (16 days) chick epiphysis. Verapamil or tetrodotoxin at 10(-6)M concentrations completely blocked the electric field effect. Tetracaine reduced the incorporation of [3H] thymidine in both control and electrically stimulated cells. The findings support the hypothesis that Na and Ca2 fluxes generated by the electrical perturbation trigger DNA synthesis in these cells.


Earnings-replacement rate of old-age benefits, 1965-75, selected countries. This study is about the earnings-replacement rate of the old-age benefit for the average worker in manufacturing who had average earnings throughout his career. It updates previously published data for earlier years and compares the replacement rate of the combined social security and private pension benefits for selected countries, in an attempt to show what a more complete benefit package might be. The study also traces what has happened to the replacement rate during the decade beginning in the mid-1960's. In several countries the intent has been to raise social security benefits over a period of time to a level sufficient to permit a retired worker to maintain his previous standard of living. The study looks to see if such policies have succeeded in reaching these goals, especially in view of the economic turbulence--recession and inflation--during the 1970's.


First year impact of SSI on economic status of 1973 adult assistance populations. During 1973, interviews were conducted with more than 11,000 adult assistance recipients in the Survey of the Low-Income Aged and Disabled. The sample members were reinterviewed during the last 3 months of 1974, approximately 1 year after the implementation of SSI. This article analyzes the impact of SSI on the economic status of the 1973 adult assistance populations. The analysis considers the United States sample as well as samples for five individual States. Most of the 1973 adult assistance recipients were automatically transferred to SSI on January 1, 1974. The majority realized an improved economic situation during 1974, at least in part because of their transferral to SSI. There was significant improvement for the residents of each of the separate States considered because of increased assistance payments, but SSI generally proved most beneficial to the poorest persons transferred from the State public assistance programs.


Pension coverage and benefits, 1972: findings from the retirement history sutdy. This article, based on data from the Retirement History Study, examines coverage by an employee pension plan on the longest job and the extent to which covered workers received an employee pension upon retirement and the size of their benefits. It also examines the joint receipt of employee pension and OASDI benefits and the size of the combined benefits. Each of these pension variables is analyzed for differences by class of worker (private wage and salary or government), sex, and characteristics of the longest job (industry, occupation, tenure, recency of job, extent of employment, and annual earnings rate). The majority of completely retired individuals in their early to middle sixties in 1972 did not receive employee pension benefits in that year. Women employed in private industry on their longest job were the most disadvantaged in this regard. Even when they were fortunate enough to receive retirement benefits from employee pension plans, their benefits were substantially lower than those of men or of women employed in government.


Value of arterial pressure measurements in the proximal and distal part of the thigh in arterial occlusive disease. A prospective study was carried out comparing two techniques of segmental arterial pressure measurements of the leg to detect, localize and quantify regional arterial occlusive disease. The measurement of pressures of the proximal and distal parts of the thigh with the narrow cuff technique permitted correct anatomic localization of aortoiliac, femoropopliteal or combined disease in 78 per cent of diseased extremities, including all limbs with isolated aortoiliac or femoropopliteal disease. A single wide cuff arterial pressure measurement of the thigh correctly localized arterial obstructions in only 19 per cent of diseased extremities. Although a wide cuff is associated with less artifactual elevation in measured arterial pressure at the thigh, this advantage is outweighed by the limitation of diagnostic accuracy in localizing segmental arterial occlusive disease. We recommend that segmental arterial pressure measurements of the limb be made at four levels on the lower extremity, including arterial pressures of the proximal and distal parts of the thigh to achieve maximal diagnostic accuracy.


A suggested classification and reappraisal of mortality statistics for ruptured atherosclerotic infrarenal aortic aneurysms. A retrospective review of 80 ruptured infrarenal abdominal aortic aneurysms with classification of the patients into clinical groups based upon the findings at laparotomy was undertaken. Patients with small hematomas confined to the area of rupture were uniformly salvaged. Those with free intraperitoneal blood almost invariably died. Intermediate groups had mortalities od 37.5 and 62.5 per cent. It is concluded that operative mortality is related to the clinical group to which the patient belongs. Attention must be focused upon the potentially salvageable intermediate groups, with regard to early laparotomy and prompt, effective proximal and distal control of the aorta before entering the retroperitoneal hematoma. Major improvements in survival have occurred with smaller ruptures but little has been achieved with larger ruptures during the past 25 years.


Pharmacologic management of postoperative overdistention of the bladder. Postoperative bladder distention, accompanied by serious difficulties in micturition, is not a rare occurrence in surgical patients. Two similar groups of patients undergoing surgical treatment were studied. In one group of 21 patients who received phenoxybenzamine prophylactically only one patient had urinary retention develop; nine of 22 patients in the control group who did not receive prophylactic phenoxybenzamine postoperatively had urinary retention develop. All of the latter patients who then received phenoxybenzamine were ultimately relieved of voiding difficulties. Phenoxybenzamine, an alpha adrenergic blocker, is recommended as an effective and safe drug in diminishing or abolishing obstructive urinary symptoms postoperatively.


Vagotomy and drainage for elective treatment of peptic ulcers. Two hundred and thirty-one patients were treated electively for the complications of peptic ulcer disease other than massive gastrointestinal hemorrhage. In this group, there was one operative mortality, an incidence of 0.4 per cent; 99.7 per cent were successfully observed for periods extending up to 25 years. The proved rate of recurrence was 3 per cent, with an additional 1.3 per cent suspected of recurrence. It has been repeatedly shown by ourselves and other that vagotomy with drainage is the procedure of choice for patients with peptic ulcer disease presenting with massive gastrointestinal hemorrhage. On the basis of these data, we also believed that, until the advocates of other procedures can present convincing series of patients observed as thoroughly and as long, that truncal vagotomy with drainage remains a viable choice of surgical therapy for all manifestations of the peptic ulcer.


Urinary bladder calculus formation on sutures in rabbits, cats and dogs. Cystotomies were performed upon 152 animals with various suture materials. The bladders were examined for the presence of concretions at intervals ranging from three to 120 days. Calculi were found with regularity in rabbits but not in cats or dogs, irrespective of the suture material used. Urinary calculi persisting later than seven days postoperatively were seen only in those rabbit bladders repaired with nonabsorbable sutures. Despite major differences in the geometry and chemical composition of the suture, the two absorbable sutures polyglycolic acid and catgut showed an equivalent incidence of early, reversible calculus formation in the rabbit urinary bladder. The property of suture materials that contributes most to the formation of persistent urinary calculi is nonabsorbability. Surface characteristics and cross sectional geometry appear to play little, or no, role in the calculus formation in the bladders of animals.


Management of unusual traumatic ruptures of the aorta. Blunt injuries to the ascending aorta and branches of the aortic arch are unusual but must be considered in any victim of a high speed decelerating injury. Because there are no characteristic clinical or roentgenographic findings, aortography is the only definitive method of establishing the diagnosis. Aortography should therefore, be performed upon any patient who has had a high speed decelerating injury, regardless of the clinical or the roentgenographic findings. An early operation will prevent exsanguination.


Secretory function of isolated canine pancreas perfused with fluorocarbon emulsion. A canine gastroduodenopancreatic block was isolated and perfused ex vivo with fluorocarbon emulsion, oxygenated in vitro, and containing a simulated physiologic protein-free solution. Pancreatic and gastric secretions were collected. The pancreas was stimulated with secretin or cholecystokinin infused intra-arterially. The response of the pancreas to both hormones was essentially identical to that observed under in vivo conditions or during perfusion of the isolated pancreas with homologous blood. Secretin induced pancreatic secretion was rich in bicarbonate and poor in total protein. Cholecystokinin induced pancreatic secretion contained less bicarbonate and more protein than secretin induced secretion. Differences between secretory responses of the pancreas to these hormones were significant. Gastric secretion was alkaline and contained fluorocarbon emulsion. The results of this study demonstrated that, under the experimental conditions described, external secretory function of the isolated canine pancreas was preserved during perfusion of isolated organs with fluorocarbon emulsion.


The pulmonary alveolar capillary membrane during hemorrhagic hypotension in dogs. Hemorrhagic hypotension is associated with increased lung water accumulation, secondary to loss of integrity of the alveolar capillary membrane. Whether this increased permeability of the alveolar capillary membrane occurs during hypotension or after resuscitation with intravenously administered fluids remains controversial. In an attempt to answer this question, we measured the movement of various molecular weight substances from pulmonary capillaries to the fluid filled alveolus using an in vivo saline solution filled dog lung model. During hemorrhage, T1/2--time to 50 per cent equilibration between blood and alveolar liquid--decreased for urea and dextrans of 3,000 and 10,400 molecular weight. There was no change compared with the base line figures for dextran 20,000 molecular weight and albumin, 69,000 molecular weight. In addition, during hemorrhage, lung liquid--but not blood--histamine levels increased significantly. We conclude that hemorrhagic hypotension leads to increased permeability of the alveolar capillary membrane to molecular weight substances less than 20,000 molecular weight. This increased permeability may be mediated by histamine.


Mesentericocaval shunt with the internal jugular vein. Seventy-nine mesocaval shunts using the internal jugular vein and 54 side-to-side portocaval shunts have been performed during the past six years. Patients were evaluated from the stand-point of protection from recurrent bleeding, patency of the shunt, encephalopathy, rehabilitation and long term survival. All of the patients underwent follow-up observation. In a selected group of patients, postoperative angiographic control was performed, and serum levels of octopamine were examined. In the mesentericocaval group, patency of the shunt was demonstrated in 82 per cent, the incidence of encephalopathy was 35 per cent and the long term survival rate, as computed by the actuarial method, was 65 per cent. In the portocaval group, the incidence of encephalopathy was 54 per cent and the survival rate, 38 per cent. There was no correlation between octopamine serum levels and encephalopathy. Persistent perfusion of the liver was documented in 95 per cent of the patents controlled by arteriography in the mesentericocaval group with patent shunts. The mesentericocaval shunt seems to be an effective technique in terms of incidence of encephalopathy and survival rate, but a randomized study will be necessary to prove that this technique is more effective than the standard portocaval shunt.


Cytologic findings of aspiration of tumors of the breast. Fine needle aspiration biopsy for cytologic diagnosis has been shown to be an effective adjunct to the clinical evaluation of masses of the breast by physical examination and mammography. In addition to adequately decompressing cystic masses, the procedure has been beneficial in obtaining a pathologic interpretation of any mass that is to be observed. Preoperative knowledge of the malignant nature of a mass of the breast allows the physician to investigate more selectively the possibility of metastatic disease and to consider more intelligently treatment options. Furthermore, the psychologic agony of the unknown for the patient and her family is avoided. Although histologic confirmation is always recommended before proceeding with mastectomy, a positive cytologic diagnosis can suffice when clinically advanced carcinoma is present or when there are medical contraindications to surgical treatment. Because of the false-negative rate of aspiration cytologic diagnosis, all clinically malignant or suspicious masses should have a biopsy in the face of benign cytology. This point cannot be over emphasized and is particularly pertinent to those patients in whom high risk factors of carcinoma of the breast are present. Inconclusive aspirates should be repeated or a biopsy of the mass should be done.


Some etiologic concepts of actinomycosis of the greater omentum. Since 1955, 33 patients with actinomycosis were treated at the University Hospital, Saskatoon, Sixty-seven per cent of the lesions involved the cervicofacial region; 24 per cent, the abdomen, and 9 per cent, the thorax. Trauma, inflammation or immunosuppression may have been partly responsible for the infection in 14 of the patients. Follow-up data were available for 21 patients. One of these patients died of thoracic actinomycosis, having received immunosuppressive therapy for leukemia. The others progressed well after treatment. In one patient with intra-abdominal actinomycosis, the disease was confined to the greater omentum and was apparently unrelated to the gastrointestinal or genitourinary tracts. He recovered after excision of the greater omentum and large dosages of penicillin. A search of the literature reveals that other reports on seemingly isolated intra-abdominal actinomycosis describe disease adjacent to hollow organs which required their removal. Immunologic studies demonstrated that a saline suspension of Actinomyces israelii was capable of inhibiting phytohemagglutinin stimulation of both the lymphocytes of the patient and of those of three normal donors. This may play a part in the progression of the disease.


Microlymphangiographic study of lymphatic regeneration following intestinal anastomosis. Using a technique of intestinal microlymphangiography, the canine intestinal lymphatic system was studied. Appearance of a two dimentional network above the muscularis mucosa layer was found to be characteristic. A study of the lymphatic regeneration pattern of the intestinal anastomosis showed a cross circulation through newly reconstructed lymphatics to commence on the seventh postoperative day and to be completed by the 21st day.


The surgical management of recurrent parotitis. Twenty-eight parotidectomies were carried out upon 26 patients with chronic parotitis. The lesion considered is chronic inflammation of the parotid gland associated with such intraglandular defects as sialadenitis secondary to ductal obstruction by calculi, cellular debris, stenosis or infiltrating lesions, that is, Mikulicz's or Sjögren's syndromes and sialoangiectasis, either primary or secondary to obstruction of the duct. Seventeen near total parotidectomies were done without significant complications or a recurrence of symptoms. Eleven superficial parotidectomies were performed in which symptoms recurred on the 12th postoperative day in one patient. No permanent weakness of the facial nerve occurred in any of the 28 parotidectomies. Based upon this experience, near total parotidectomy with removal of the parotid duct can be performed safely and should be the procedure of choice in patients with chronic, relapsing parotid sialadenitis.


Morbidity and mortality after thyroidectomy. To assess the morbidity and mortality of thyroid operations, Professional Activity Study records of the Commission on Professional and Hospital Activities, representing an estimated one-third of all thyroidectomies performed in the United States in 1970, were reviewed. The mortality after a thyroid operation for nontoxic goiter was 0.02 per cent for patients less than the age of 50 years but increased with age to 0.66 per cent for those 70 years and older. No in-hospital deaths followed thyroidectomy for malignant goiter in 766 patients less than 40 years of age. Thyroidectomy for diffuse toxic goiter had a mortality fivefold greater than did operations for a benign nontoxic goiter. Total thyroidectomy was used for the treatment of nontoxic, nonmalignant goiter for one in 12 patients and resulted in greater morbidity than did partial or subtotal thyroidectomy. Rational choice of operation for the treatment of goiter for individual patients should be based upon knowledge of the specific risks of surgical treatment, which vary greatly depending upon the age of the patient, whether or not the goiter is toxic or nontoxic and whether or not subtotal or total thyroidectomy is performed.


Iatrogenic injuries to the biliary ductal system. One hundred patients who sustained complete transection or ligation of the common bile duct during cholecystectomy were selected from a much larger number of patients admitted to The New York Hospital for surgical correction from 1932 to 1976 for review. The methods of restoration of bile flow from the liver to the intestine were described with an indication of the success and failure that followed. The results were varied and unpredictable. Perhaps the propensity of the transected or ischemic duct wall to form scar tissue with sufficient reduction of the lumen to cause partial to complete obstruction is the reason for some of the failure.


Repair of rectovaginal fistulas.

Repair of rectovaginal fistulas. Twenty patients with rectovaginal fistulas involving the middle portion of the rectovaginal septum were repaired without failure. The transanal approach would appear to be superior since it allows better access to the rectum which is the high pressure side of this fistula. This technique gives excellent results in benign rectovaginal fistulas occurring within 6 centimeters of the dentate line. The transanal approach also allows for the correction of any concomitant anorectal pathology which might compromise the repair. It is not to be used in instances of inflammatory disease or postradiation carcinoma.


A new technique for diagnostic peritoneal lavage. Because of the unique anatomic relationships present in the umbilical ring, peritoneal lavage puncture is recommended at this site, Lacking in subcutaneous fat, adherent to peritoneum, the umbilical ring appears well suited for lavage puncture. As a locus of entry, it eliminates the necessity to incise down to the peritoneum and obviates the usage of epinephrine. Entry into the peritoneal cavity is enhanced by the intimate relationship between skin and peritoneum. Finally, the strength of the inferior portion of the ring, resulting from the fibrosis and scarring of the urachus and both umbilical arteries, vitiates the potential of postpuncture umbilical hernia.


Extradural hematoma due to traumatic pseudoaneurysm of middle meningeal artery. Extradural hematoma due to rupture of post-traumatic pseudoaneurysm of the middle meningeal artery is a very rare clinical entity. Only fourteen such cases have been reported in the literature. A 52-year-old, right-handed Mexican male was admitted with motor aphasia and right-sided signs but no history of unconsciousness. He had been struck by an automobile almost 24 hours earlier. His neurological signs appeared shortly thereafter. A left temporoparietal linear fracture of the skull was recognized as well as a fracture of the right knee. Angiography revealed a lenticular parietal avascular area with depression of the middle cerebral artery and a shift of the anterior cerebral artery. An aneurysm was observed on the left middle meningeal artery below the skull fracture. At craniotomy a large extradural hematoma was evacuated and the aneurysm removed. The patient had a complete recovery.


Pituitary pseudotumor.

Pituitary pseudotumor. Non-tumoral aqueductal stenosis with hydrocephalus causes dilatation of the third ventricle. This in turn may compress the hypothalamus and optic nerves and erode the clinoids and enlarge the sella turcica. In female patients, amenorrhea or oligomenorrhea is the predominant endocrinologic symptom. Symptoms usually disappear after the drainage of cerebrospinal fluid. Third ventriculostomy by microtechnique was used for operative treatment of our three cases. In all of these, the hydrocephalus was arrested.


Epidural lipoma simulating lumbar disc protrusion. Spinal lipomata are usually associated with congenital anomalies. A lipoma, presenting with symptoms, signs and myelographic findings suggestive of a lumbar disc protrusion, is rare. Asymmetry of the origin of some of the scaral nerve roots may be the clue for suspecting epidural lipoma pre-operatively.


Nonsuture microvascular anastomosis using magnet rings: preliminary report. An original method of nonsuture microvascular anastomosis was developed using magnet rings and hollow cogwheel-shaped metal devices held together by magnetic power. Only 8.3 minutes was required on average for the anastomosis with a high rate of patency. Histologically, a continuity of vascular wall is noted. This method of simple, rapid and reliable microvascular anastomosis appears to be the best one at present.


Reconstruction of the supraorbital ridge using aluminum. Aluminum was used to reconstruct the supraorbital ridge and adjacent frontal bone in six patients. Its malleability makes it particularly useful for this purpose. Each cranioplasty was done several months after injury. The longest follow-up is 19 years and the shortest three years. There were no complications. The results are satisfactory.


Anterior choroidal artery aneurysms: their anatomy and surgical significance. The experience of the senior author was 16 anterior choroidal artery aneurysms is reviewed. The anatomic variations of the origin of the anterior choroidal artery are discussed, and the danger of sacrificing the artery in aneurysm surgery is stressed. The surgical procedure upon these aneurysms has frequently been difficult, requiring careful microdissection. This was due to variations of the origin of the aneurysm in respect to the artery and their frequent contiguity.


Pathogenesis of intracranial arachnoid cysts. The pathogenesis of intracranial arachnoid cysts is reviewed. Light and electron microscopic features of arachnoid cysts are presented in support of the hypothesis of Starkman et al, that these cysts are truly intraarachnoid in location and are formed by splitting or duplication of the arachnoid membrane. Documentary evidence is provided to prove that Richard Bright's original description in 1831 contains these concepts, which have passed unnoticed for nearly a century and a half. A brief description of the meninges and the subarachnoid spaces is given.


Traumatic occlusion of internal carotid artery in an infant. A case of an 11-months-old girl with traumatic occlusion of supraclinoid portion of internal carotid artery is reported. The patient died about 22 hours after the craniocerebral trauma.


Five years experience with penetrating craniocerebral gunshot wounds. This report reviews the clinical course and treatment of 83 cases  of civilian penetrating craniocerebral gunshot wounds seen over a five-year period. The factors that determine mortality and morbidity are discussed. A conservative surgical approach in neurologically intact or less severely injured patients is re-emphasized. Increased intracranial pressure appears to be a significant factor in more severely injured patients, and should be monitored and treated vigorously.


Intracerebral meningioma with disseminated arachnoidal ossification. A case of intracerebral meningioma associated with disseminated plaques of arachnoidal ossification is presented. The osseous plaques were situated on the same side and predominant in the neighborhood of the tumor. Histologically the ossification was thought to have originated from the wall of the pial vessels.


Effects in mice of simultaneous prenatal exposure to ochratoxin A and T-2 toxin. Aspergillus ochraceus and Fusarium tricinctum are food contaminating molds whose toxic metabolites, ochratoxin A and T-2 toxin, are known mammalian teratogens. In order to determine the possible effects of simultaneous exposure to such environmental agents, ochratoxin A (2 or 4 mg/kg) and T-2 toxin (0.5 mg/kg) were injected ip, either together or individually, in CD-1 mice on gestation days 8 or 10. Ochratoxin induced craniofacial malformations when given alone on day 8, but not on day 10. T-2 toxin induced tail and limb anomalies particularly when given on day 10. When the two toxins were given together on day 10, ochratoxin exacerbated the incidence of T-2 induced gross malformations. An increase in fetocidal effects was also noted in groups treated at the high dose combination on either day, and effects on fetal growth of the high dose combination given on day 10 were greater than those of the other treatments. Few skeletal or visceral malformations were noted. These results indicated that two teratogens with presumably differing mechanisms of teratogenesis may have additive effects when administered concurrently to the same animal. Such results could be due to generalized toxic effects on the fetus or to more specific mechanisms, but further information is needed to differentiate between the two possibilities.


Teratogenicity testing in humans: a method demonstrating safety of bendectin. We investigated the incidence of birth defects in the offspring of women who took Bendectin during pregnancy. Copies of all prescriptions issued for Bendectin in two Cities, Leeds and Liverpool, over periods of 12 and 14 months, respectively, were scanned and a record initiated for each patient. Birth notifications were later searched for matching with indexed patients. Births were traced for 2,298 patients and the incidence of major defects compared with those in the relevant populations. We found no evidence to suggest that Bendectin is teratogenic in humans.


Potentiation of methotrexate embryolethality by aspirin in rats. The augmentation of methotrexate-induced embryotoxicity by aspirin was studied. Pregnant Charles River CD rats were given methotrexate or aspirin alone or in combination on gestation day 9 or 12. The frequency of fetal abnormalities was not affected and fetal body weight loss was not additive in the combined treatment. However, pretreatment with aspirin (200 mg/kg) significantly enhanced the embryolethality of methotrexate given at soes of 0.2 mg/kg on day 9 and 1.5 mg/kg on day 12. Studies with tritiated methotrexate in pregnant rats demonstrated that aspirin delayed the renal excretion of methotrexate and increased the concentrations of methotrexate in maternal plasma and the embryos. It is suggested that these effects are responsible for the observed potentiation of embryolethality.


Congenital anomalies of the central nervous system incidence in British Columbia, 1952-72. The records of an ongoing health surveillance registry that utilizes multiple sources of ascertainment were used to study the incidence rates of congenital malformations of the central nervous system in children born in British Columbia during the period 1952-72. No overall increase in incidence rate of these anomalies was detected over the study period and the total frequency ascertained was three per thousand births. For anencephaly, spina bifida, hydrocephaly, and other CNS anomalies, the estimated incidence rates per 1,000 births are 0.6, 0.8, 1.0 and 0.5 respectively. A greater incidence rate or neural tube closure defects was found in females than in males and this difference was most marked amongst the stillbirths. The data indicate that multiple sources of ascertainment and follow-up of children beyond one year after birth are necessary for adequate reporting even for these sorts of defects which have generally been though to be readily recognized at or shortly after birth.


Palate development after fetal tongue removal in cortisone-treated mice. Morphological studies of cortisone-induced cleft palate have shown retardation in the rotation of palatine shelves from a sagittal to a transverse plane. Cortisone also reduces fetal muscular movements, which may explain why displacement of the tongue from between the palatine shelves is delayed. Previous work with extrauterine development of control fetuses demonstrated that fetal membranes and tongue were major obstacles to shelf rotation. Thus, removal of these obstacles might permit rotation and fusion of palatine shelves in cortisone-treated fetuses. In the present experiment, fetuses from cortisone-treated strain CD-1 mice were released from uterus and membranes and allowed to develop for eight hours in a fluid medium with the umbilical cord left intact. Compared to 4% fusion in utero, there was palatal fusion in 20% of fetuses released from membranes. When the fetal tongue was removed during extrauterine development, the frequency of fusions increased to 61%. Fusion appeared normal by the criteria applicable through light microscopy. Thus, cortisone induces cleft palate primarily through interference with shelf rotation. The palatine shelves of treated fetuses retain their ability to fuse when they can come in contact during the normal time for palate closure.


The craniofacial skeleton in anencephalic human fetuses. I. Cranial floor. Twelve anencephalic and four normal fetuses 26 to 40 weeks gestational age were compared by anatomic, radiographic and histologic methods in order to gain information concerning morphogenesis. In the anencephalics, alterations located within the body of the sphenoid bone led to a reduced cranial floor angle and a more vertical clivus. The reduced lateral extension of the lesser and greater wings of the sphenoid constricted the anterior and middle cranial fossae respectively. The posterior cranial fossa tended to have an increased transverse dimension related to the supraoccipital and exoccipital bone orientation. The increased anterior and inferior position of the lateral end of the petrous temporal ridge was positively correlated with the degree of dorsal schisis in the anencephalics. Alterations in the size, form, or duration of the neural functional matrix are suggested as the cause of changes in the cranial floor.


Methylmercury: some effects on embryogenesis in the Japanese Medaka, Oryzias latipes. Japanese Medaka (Oryzias latipes) eggs were treated with 40, 60, and 80 parts per billion (ppb) methylmercuric chloride (MMC) for a period of 10 to 25 days in order to observe gross teratogenic and lethal effects caused by methylmercury during embryogenesis. Over the period tested, 40 ppb-treated embryos were less affected than other treated animals. Embryos treated with 60 ppb MMC showed greater effects in that there was a higher death rate and those which survived ranged considerably in size, degree of gross teratogenic defects, and behavior if development was normal enough for hatching to occur. Most did not hatch during the 25-day test period. Embryos treated with 80 ppb MMC were very abnormal in development, being stunted, poorly pigmented, and they showed various eye defects. None hatched in 25 days. Many did not incorporate the heart into the body. Methylmercuric chloride in trace amounts caused various defects and presents a potential hazard to development of embryos of aquatic vertebrates.


HLA system and Balkan endemic nephropathy (a collective study with the collaboration of all participants in the HLA workshop--Sofia 1976). Balkan endemic nephropathy, a fatal family disease with unknown aetiology and pathogenesis is typical for three neighbouring regions in Bulgaria, Yugoslavia and Rumania. HLA typing of 180 patients from the endemic area in Bulgaria was done and the antigen frequencies were compared with 1264 healthy controls. An increased frequency (P less than 0.001) of the antigen HLA-B18 in the patients was demonstrated.


[Clinical results of pre-operative irradiation in case of adenocarcinoma of the kidney (author's transl)]. 145 patients with adenocarcinomas of the kidney were submitted to tumor resection and irradiation. The irradiation was executed before the operation (in most cases with a focal dose of 1200 to 1600 rd in two days or 2400 to 3500 rd in 2 1/2 to 3 1/2 weeks) and/or after the operation. The survival rates of the different therapy groups were examined with regard to the tumor extension and to its degree of differentiation. It was found out that the pre-operative short term irradiation was somewhat superior to the pre-operative long term irradiation except in case of very extensive, hardly operable tumors. On the whole, the combined pre- and post-operative irradiation seems to be more advantageous than the post-operative irradiation alone.


[Studies using loperamide in patients with diarrhea following telecobalt irradiation of malignant abdominal tumors (author's transl)]. 45 patients with diarrheas appearing after exposure of the gastro-intestinal region to ionizing radiation were given loperamide in the course of a study. A few days after administration of the loperamide, normalization of the stools took place, except in three cases. Simultaneous tenesmic gripes, some of the patients had also suffered from, disappeared completely, with the exception of two cases where, however, normalization of the stools was obtained by means of the loperamide therapy. Subjective side-effects did not occur. Also no alterations of the blood count, hematological features, liver function tests or urine have been observed.


["Massfunktionen" as limit conditions of an optimization scheme for the telecobalt therapy (author's transl)]. The basic ideas of the "Score-Funktionen-Modell" of Hope and his collaborators are used for the establishment of the first stage of an optimization scheme for the telecobalt therapy. The new "Massfunktionen" for the telecobalt therapy are limit conditions for the criterion of the optimum, i.e. the dose distribution in a body section. The "Massfunktionen" are an analytic registration of parameters for the dose distribution such as dose homogeneity in the focal region and sparing of the subcutaneous tissues, the radiosensitive organs and the sound surroundings of the tumor. The functions are derived from the dose conditions in the irradiated body section. At the actual stage of development of the optimization scheme, these functions allow to decide whether an irradiation scheme is acceptable or not.


[Draining of radioactive waste water from departments working with radioactive material after introduction of the law for radiation protection (author's transl)]. In order to establish the drainage of radioactive waste water 1976 in the Federal Republic of Germany a new law for radiation protection was introduced. In this paper a concept is introduced how to determine specifications for constructing a decay plant using the given data of a department for nuclear medicine. The given boundary conditions were to secure a low concentration of radioactive material in order to establish the drainage of extreme low activities without diluting it.


[Investigations of the influence of radiation therapy upon the course of the DNA repair in peripheric lymphocytes and tumorous tissues from patients with malignant disease (author's transl)]. The influence of radiation therapy upon the capacity of DNA repair in peripheric lymphocytes and tumorous tissues was studied in eleven patients with malignant manifestations. A comparison was made between the effects of short-term and of long-term irradiation. The individual cases presented differing results. An enhancement of DNA repair as well as a diminution was observed in peripheric lymphocytes as a response to irradiation. In tumorous tissues, on the contrary, a total inhibition of DNA repair was generally found.


Cytological and quantitative cytochemical studies of post-radiation dysplasia. A total of 60 vaginal smears from 19 women treated with ionizing radiation for malignancies of the genital tract in the past seven years in the Division of Radiation Therapy of Emory University School of Medicine were studied for the presence of post-radiation dysplasia (PRD) by means of Feulgen cytospectrophotometry and cytological analysis. PRD was diagnosed on the basis of the presence of dysplastic cytological changes, absence of clinically detectable lesions, and presence of aneuploid DNA values in the dysplastic cells. PRD was detected in 21% of the studied cases. Uniform criteria for PRD, describing premalignant and malignant post-radiation lesions, diagnosed on the basis of aneuploid DNA values, as well as cytological observations is suggested.


MPG protection and goblet cell kinetics in mouse jejunum. Experiments were undertaken to study the goblet cell changes in the jejunum of mice irradiated in the presence and absence of the protective drug 2-mercaptopropionylglycine (MPG). One group of adult Swiss albino mice of 6 to 8 weeks was injected with the drug (MPG) intraperitoneally and a second group was injected with distilled water in the same manner and served as a control. 15-30 minutes after injection animals from both the groups were exposed to a Co-60 source to give a total dose of 1000 R at the rate of 25 R/min. Three animals from each group were sacrificed at different successive intervals. 5 micron paraffin sections of the jejunum were prepared and goblet cells were counted in the crypt and villus region. The results from the two groups were compared. The results from MPG treated mice indicated that there was a protection from the radiation-induced changes. The drug accelerated the regeneration process leading to the restoration of normal number of goblet cells by the last interval studies.


Pyrogen reactions associated with the infusion of normal serum albumin (human). In November, 1974, eight patients in three hospitals had pyrogen reactions associated with the infusion of 25% Normal Serum Albumin from the same lot. The reactions were recognized because the same physician or nurse observed several patients having recurrent reactions or because a single patient receiving several vials had consecutive reactions. The remaining albumin in three vials associated with reactions had apparent endotoxin concentrations of 4, 16, and 32 ng/ml and that 22 vials from recalled supplies had a median concentration of 4 ng/ml (range: 2 to 64) as determined by the Limulus amebocyte lysate test, but the lot again passed the rabbit pyrogen test. In a prospective study to determine the efficacy of the Limulus test in quality control, patients had their temperatures taken hourly during albumin infusions and the remaining fluid was tested by the Limulus assay. The albumin in 443 of the 662 vials infused (65%) gave a positive test and 311 of these vials (45%) had apparent endotoxin concentrations of 4 to 64 ng/ml, but no patient had a reaction. Because of the limitations of both the rabbit pyrogen and Limulus test, the detection of some pyrogenic lots continues to depend on hospital surveillance and reporting os suspect reactions.


In vitro and in vivo comparison of single-donor platelets and multiple-donor pooled platelets transfusions in leukemic patients. In vitro and in vivo studies were done to evaluate efficacy of fresh, single donor platelets (SDP) obtained by Latham-bowl plateletpheresis and multiple donor, pooled platelets (MDPP) obtained by conventional centrifugation for transfusion of leukemic patients. Results indicate increased effectiveness, both in vitro and in vivo, of single donor platelets as compared to multiple donor pooled platelets.


Elevated red blood cell 2,3-diphosphoglycerate levels in black blood donors. Mean levels of 2,3-diphosphoglycerate (DPG) were significantly increased in erythrocytes (RBC) from 43 nonanemic black blood donors (4.80 +/- 0.06 micromoles/l RBC) compared with 22 white donors 4.47 +/- 0.08 micromoles/l RBCs from eight of the 12 black donors with DPG levels greater than 5 micromoles/l RBC. Although a potentially hemolytic disorder could be defined in four (AS hemoglobin, beta-Thalassemia minor, G6PD deficiency), reticulocyte counts were normal. However, when RBCs from the subgroup were compared to RBCs from an additional 25 unselected white donors, the following suggested an abnormally large population of young RBCs in the subgroup: 1) normal or elevated RBC-ATP with normal serum phosphate level; 2) significantly increased activities of RBC age-dependent enzymes hexokinase (p less than 0.02), pyruvate kinase (p less than 0.05), and glutamicoxaloacetic transaminase (p less than 0.01), with normal activity of phosphoglycerate kinase, an age-independent enzyme; 3) decreased dense (older) RBCs as determined by sedimentation in phthalate esters. Since DPG is increased in young RBCs and falls as the RBC ages, loss of older relatively DPG depleted RBCs due to shortened survival could account for the elevated DPG levels seen in the subgroup.


Platelet preservation. IV. Preparation and cryopreservation of platelet concentrates from fresh and overnight-stored human blood. Two methods were used for the preparation of platelet concentrates from fresh and overnight-stored human ACD blood. In a two-step method prostoglandin E1 was added to platelet rich plasma and the mixture was centrifuged to obtain platelet concentrate. The IBM 2991 Blood Cell Processor was used in a one-step method. The concentrates were stored in the frozen state. Concentrates prepared with the two-step method had a higher platelet recovery and a lower leukocyte contamination than did concentrates prepared with the one-step method. Based on serotonin uptake volocity, response to hypotonic stress and available platelet factor 3, no essential differences were observed between platelet concentrates prepared from fresh and overnight-stored blood. Concentrates prepared with the one-step method had a higher serotonin uptake velocity than those prepared with the two-step method. This did not result in a better recovery after cryopreservation.


Motivation of plateletpheresis donors.

Motivation of plateletpheresis donors. Twenty randomly chosen voluntary plateletpheresis donors were interviewed in depth. Information on their family histories, past histories, present psychosocial adjustment, and history of blood donation was elicited. Most donors had a high level of commitment and drive to achieve, frequently related to low self-image dating from childhood. The act of platelet donation had several important meanings for the subjects. It improved their self-esteem, making them feel more worthy and responsible persons. It provided them with an opportunity to establish relationships with others. The data obtained in this survey suggest that the altruistic behavior of the voluntary donors should be seen both as an act of giving and also one of receiving emotional gratification which fulfills one's important psychological needs. Utilization of these data in recruitment of plateletpheresis donors is suggested.


Utilisation by sheep of herbage under tree crops in Ghana. A study conducted into the utilisation by sheep of herbage under a mango/cashew plantation at Kade (Ghana) showed the native herb, Asystasia gangetica to be the most preferred herbage. Centrosema pubescens was preferred to Pueraria phaseoloides. The physical condition of the herbage affected their preference but the crude protein content did not have any influence. The mean daily digestible dry matter intake of yearling rams (g/kg W0.75) was 34, 31 and 39 for animals on Brachiaria lata/Pueraria phaseoloides, Pueraria phaseoloides and Centrosema pubescens/Aystasia gangetica stands respectively. Intake was not correlated with crude protein levels of the herbage. The mean carrying capacity of the associations was found to be between 11 and 18 sheep/ha/annum.


Stocking rate and the productivity of Rhodes grass pastures on the Lilongwe Plain, Malawi. An experiment was undertaken over three wet (summer) seasons to investigate the effects of different set stocking rates on animal performance from fertilised Rhodes grass pastures. The three set stocking rates were 2.5, 5 and 7.5 livestock-units/ha (1 livestock unit=342 kg liveweight). Pasture productivity was related to stocking intensity. Animal gain per hectare was directly related to stocking rate. Gain per animal, gain per livestock unit and number of grazing days were all inversely proportional to stocking rate. Animals on the low stocking rate were carried through almost to the end of the dry (winter) season with only small changes in liveweight. The practical significance of the results is discussed.


Effects of Fenwal 4C2423 transfusion microfilter on microaggregates and other constituents of stored blood. The effects of a new micropore transfusion filter (Fenwal 4C2423) on stored whole blood have been examined. Five filters were preloaded by passage of two units of outdated type specific bank blood, and the effects of filtration on a third unit, consisting of 21-day-old blood, flowing under 150 mmHg pressure, were measured. Filtration did not significantly alter red blood cell count, total hemoglobin, red blood cell fragility, plasma sodium, potassium, albumin, or globulin. Some platelets and white blood cells were removed and a small amount of hemolygis of erythrocytes (less than 0.1%) was observed. Removal of microaggregates, assessed by Coulter counting, screen filtration pressure, total screen porteins, wet and dry weights of material retained, and scanning electron microscopy, was shown to be excellent over the entire range of particle size. Comparison of the Bentley PFS-127, Fenwal 4C2417, Johnson & Johnson Intersept, Pall Ultipore, and Swank IL200 filters led to the conclusion that the Fenwal 4C2423 was both a significant improvement over the previous Fenwal design and comparable to the most efficient of these filters for both the removal of microaggregates during massive blood transfusion and for the blood flow rates obtained.


A study on the erythrocyte aggregating properties of polybrene and protamine sulphate. By observing the aggregation of erythrocytes in protamine sulphate or Polybrene it is possible to predict MN phenotypes with 97 per cent accuracy. It is probable that one factor influencing aggregation is the relative site density of a receptor common to both M and N antigen structures although other nondiscriminating receptor sites on a lower layer of sialic acid are possible also involved.


Massive extracorporeal blood clotting during discontinuous flow leukapheresis. A case is reported in which massive extracorporeal blood clotting necessitated the discontinuance of leukapheresis and loss of the product. An investigation of the cause of the massive clotting is reported along with suggested precautions to prevent similar occurrences in pheresis programs.


Studies on the livestock of Southern Darfur, Sudan. V. Notes on camels. Observations on camels have been made over two separate periods of about 18 months each. Information is provided on population structure and on type, with particular reference to weight and shoulder height. A growth curve has been derived, formulae for estimating weight from girth provided, and a mean population weight has been calculated. Details of live and slaughter weight and dressing percentages of 60 camels are given. The weights and percentages of empty body weight and of edible and nonedible parts are presented. Some notes are made of the unusual method of slaughter. The role of camels in transport and draught is discussed. Camels used for ploughing and for pressing oil from local crops produce more power than other domestic animals doing similar work.


The incidence of Trypanosoma theileri among cattle in Iran. T. theileri has been reported as a parasite of cattle from many parts of the world. The parasites generally are scanty in the peripheral blood and more readily detected by cultural methods than by microscopical examination of stained smears (Herbert, 1964; Wells, 1971). The presence and distribution of the parasite in Iran has not been reported previously. This communication presents the results of studies which have been undertaken to find T. theileri and to determine its seasonal distribution in this country.


Therapy with factor IX concentrate resulting in DIC and thromboembolic phenomena. The development of subclinical DIC in a patient with factor IX hemophilia receiving concentrate replacement therapy during surgery is discussed with respect to pertinent laboratory features. Subsequent thromboembolic phenomena are presented in the context of current literature. Of significance is the failure of heparin given with the factor IX concentrate to prevent DIC. The value of adequate laboratory monitoring during therapy is stressed.


Variation in gamma counter efficiency used in radioimmunoassay testing for hepatitis B surface antigen and antibody. Occasional discordant results on testing samples by radioimmunoassay for hepatitis B surface antigen and antibody led to this analysis of gamma counters used by different hospitals and testing laboratories. Eight dilutions of purified 125I were sent under code to 11 institutions doing radioimmunoassay testing. Results demonstrated a wide range in background counts-per-minute (cpm) as well as considerable variation between gamma counters in per cent counting efficiency for 125I (ranging from 20 to 48%). These data support the need for regular monitoring and calibration of gamma counters to ensure low background cpm as well as maximum counting efficiency. This will give reproducible and reliable results in radioimmunoassay testing.


The effect of high passage Mycoplasma strain F38 on the course of contagious caprine pleuropneumonia (CCPP). In comparison with an equal number of untreated controls, goats inoculated with high passage culture of mycoplasma strain F38 were significantly less susceptible to contact infection from CCPP cases.


Heartwater in Nigeria. II. The isolation of Cowdria ruminantium from live and dead animals and the importance of routes of inoculation. A study was carried out to determine which materials from animals dying or dead of heartwater could initiate the disease in susceptible goats, using the intravenous and subcutaneous routes. C. ruminantium was consistently isolated by intravenous injection of the whole blood or of lung macrophages and by subcutaneous injection of brain homogenate. In animals dead of heartwater, it appeared that isolation of the organism was achieved only when extensive post-mortem autolysis had not supervened. Experiments with blood fractions showed that leucocytic and plasma fractions of infective blood transmitted heartwater; the erythrocytic fraction consistently failed to induce an infection.


[Acetylation of histone and acid proteins of rat liver cells chromatin complex in postnatal ontogenesis]. No significant differences in acetylation of acid proteins was found in 1, 3- and 12-month animals in the process of postnatal development, but in old rats this process is noticeably intensified. The acetate label incorporation into histones H2 and H3 does not vary essentially in impuberal and young animals but intensifies in adult and old animals. A gradual intensification of acetylation during the whole postnatal development is registered for lysin-rich histones Hla and Hlb. The old animals differ by the highest level of acetate label incorporation into all studied fractions of chromatin proteins.


[Study of hormonal activity of phytoecdysones on house fly larvae and codling moth caterpillars]. Preparations of ecdysterone, ponasterone A and sum of ecdysones isolated from the plant sources possess a high hormonal activity with respect to house fly larvae and codling moth caterpillars. The latter may be recommended for using as a sensitive test of the ecdysones hormonal activity.


[Effect of sex hormone on the respiration and glycolysis processes in female rabbit placenta tissue]. The respiratory and glycolytic activity of the female-rabbits placenta tissue on the 11th and 30th days of pregnancy was studied as affected by progesterone, estrone and chorionic gonadotrophin. The tissue respiration of the placenta at the end of pregnancy is established to be more sensitive to administration of the hormones under study than at the beginning of pregnancy. The glycolytic activity of the placenta tissue under the effect of hormones is decreased both at the beginning and at the end of pregnancy. Only anaerobic glycolysis is an exception when progesterone is administered at the beginning of pregnancy.


[Molecular weight determination of nuclear proteins by disc-gradient polyacrylamide gel electrophoresis]. A technique of molecular weight estimation in proteins according to their electrophoretic mobility in the gradient polyacrylamide gel is used. The method permits analysing the highly heterogenic protein mixtures and determining the molecular weight of proteins within the range of 5000--400.000 simultaneously. The data of the protein spectrum analysis of the liver cell nuclei and some tumors are presented.


[Nucleic acid content in calf tissue nuclei]. The content of cytoplasmic mRNA, rRNA precursors and the content of total RNA in the nuclei of liver, abomasum and intestine mucosa and endometrium were studied. It is established that mare serum gonadotropin and the complex hormone and vitamin preparation increase the level of investigated RNA fractions in the heifers tissues. During the digestive tract disorders in the calves the level of the RNA fractions in the nuclei decreases. Treatment of the disk calves with the premix "nucleostimol" and hormone and vitamin preparation results in their recovery and increases the level of RNA fractions.


[A device for protein preparative separation in polyacrylamide gel]. A device of simple design is suggested for proteins preparative separation in polyacrylamide gel. The design of the device include glass and plexiglas elements and ensures bilateral cooling of polyacrylamide gel and continuous elution of protein fractions. Separation of the bull brain neurospecific antigens S-100 and D was performed by the device.


[Determination of C-terminal amino acid content in dog prothrombin]. In the process of dog prothrombin hydrazinolysis 1 M of glycine is relased in 1 M of protein. It was concluded that glycine is the C-terminal amino acid of the prothrombin.


[Effect of motor regimes on water-soluble and membrane proteins and cholinesterase activity in subcellular fractions of rat brain tissue]. Albino rats were kept for a year under conditions of everyday motor loading or of a constant hypokinesia. An increase of the motor activity results in rise in the acetylcholinesterase activity determined in the synaptosomal and purified mitochondrial fractions while hypokinesia induces a pronounced decrease in this enzyme activity. The butyrylcholinesterase activity somewhat decreases in the synaptosomal fraction after hypokinesa but does not change under the motor loading regime. Motor loading causes an increase in the amount of synaptosomal water-soluble proteins possessing an intermediate electrophoretic mobility and seem to correspond to the brain-specific protein 14-3-2. In the synaptosomal fraction the amount of membrane proteins with a low electrophoretic mobility and with the cholinesterase activity rises. Hypokinesia, on the contrary, decreases the amount of these membrane proteins.


[Effect of ascorbic acid and oat polyphenols on respiration and oxidative phosphorylation in liver mitochondria in alloxan diabetic rats]. 30 mg of ascorbic acid and 80 mg of dry oats extracts were administered to rats with alloxan diabetes during a day per 1 kg of live weight. Administration of these preparations during 6, 12 and 24 days prevents the uncoupling action of respiration and oxidative phosphorylation, that was observed in the rats with alloxan diabetes which were not given ascorbic acid and oats polyphenols. The P/O coefficient on the alloxan diabetes rats on the 6, 12 and 24 days was 1.32 +/- 0.027; 1.26 +/- 0.013; 1.22 +/- 0.18, respectively; in the rats which were given ascorbic acid and oats polyphenols to P/O coefficient was 1.85 +/- 0,026, 1.80 +/- 0.024 and 1.75 +/- 0.028, respectively.


[Changes in phospholipid composition of mitochondria after freezing-warming in the presence of Na2S204]. The phospholipid composition of mitochondria membranes subjected to rapid freezing (300-400 degrees C per 1 min) to -196 degrees C and subsequent slow warning (at 20 degrees C) was determined by the method of chromatography in the thin layer of silicagel. Under such conditions of freezing and warming a significant decrease in lecithin and ethanolamine phosphatide content is observed in the mitochondria membranes. When freezing the suspension of mitochondria in the medium containing Na2S2O4 in a concentration of 0.05 M only the lipid component changes slightly.


[Sterol composition of Palaemon adspersus]. The sterol composition of Palaemon adspersus is studied. It is established that the nonsaponifiable fraction of Palaemon adspersus contains cholesterol, 7-dehydrocholesterol, desmosterol, substance "240" and inconsiderable amounts of other still nonidentified sterols.


[Effect of sterols of cholesterol series on secretion of hydrochloric acid in mucosa of animals]. Secretion of hydrochloric acid of frog gastric mucosa in vitro was studied as affected by some sterols of the cholesterol series. This effect is found to depend on both the sterol molecule structure and the substance concentration. 7-dehydrocholesterol and its products of oxidation are supposed to have a specific effect on the process of hydrochloric acid secretion. Possible mechanism of this effect is under discussion.


[A spectroscopic examination on intermolecular interaction of ergosterol with lecithin]. The ergosterol and lecithin absorption IR-spectra were studied in a nonpolar anhydrous medium. The thermodynamical and spectral characteristics of dimeric associates and the enthalpy value for trimeric associates of this sterol are determined. Thermodynamical and spectral parameters of ergosterol intermolecular associates with lecithin in a nonpolar anhydrous medium are found. It is established that the intermolecular interaction of lecithin with ergosterol occurs according to the mechanism of hydrogen bond. A conclusion is drawn that the presence of binary bonds and methyl groups in the cyclic and aliphatic parts of the sterol molecule affects greatly the structure of the model membrane and its strength. It is shown that under conditions of the experiment the oxygen of the phosphate group contributes to formation of the molecular associates of lecithin with sterols and not that of the carbonyl group. The obtained experimental data may be at use when studying structural disturbances of native membranes in norm and with different pathologies.


[Effect of dehydration on lipid metabolism]. Control of 25 sportsmen-wrestlers determined that accelerated loss in weight leads to a significant increase of ketone bodies evacuation with urine. The loss in weight for a 10-11 days period before a competition results in a less pronounced hyperketonuria. In experiment on rats it is shown that 48 and 98 hour hyperthermia and dehydration lead to the inhibition of the glucose-6-phosphate dehydrogenase activity in the liver. The mentioned permits supposing that under indicated conditions the inhibition of fat acid synthesis caused by NADPH2 and an increase of ketone bodies and cholesterol synthesis are observed.


[Effect of interferon-inducing complex on thymidine 3H-labeling of DNA, RNA and proteins of marrow cells after total X-irradiation of mice]. Interferonogen is shown to intensify the RNA synthesis only slightly, practically having effect neither on DNA synthesis nor on protein one. Interferonogen administered 2h before irradiation impedes development of the pronounced inhibition of DNA, first of all. Basing on the fact that the mentioned regularities were manifested at the early stages of the post radiation period (up to 3-4 h) and coming from the previously established radioprojection efficiency of interferonogen it is supposed that interferonogenesis takes part in regulation of the cell reparation systems.


[Content of SH-groups in some fractions of rat hemoglobin]. Eight fractions of rat hemoglobin obtained by electrophoresis in polyacrylamide gel were studied. Having used parachloromercuric benzoate (PChMB) and 5,5-dithio-bis (2-nitrobenzoic acid) it was established that fractions of 3 and 3a carboxyhemoglobin contain 6 available SH-groups and the rest one (1, 2, 2a, 4, 5, 6) about 4 SH-groups. In all fractions only 2 masked SH-groups are found. A problem is discussed on SH-groups localization in the polypeptide chains of certain hemoglobin fractions in rats.


[Somatotropin-releasing activity of rat hypothalamus with hypo- and hyperthyroidism]. The somatotropin-releasing activity of rat hypothalamus was studied in the experiments in vitro incubating of adenohypophysis with the hypothalamic extracts or the whole hypothalamus and serotonin. The studied activity is shown to be increased in the thyroidectomized and hyperthyroid rats. Exogenic somatotropin prevents this increase. A conclusion is drawn that a link of hypothalamic adenohypophysotropic hormones of the regulatory system of the somatotropic function is not an area of the specific disturbances with hypo- and hyperthyroidism which might lead to hyposomatotropism.


[The internist's view of hematuria (author's transl)]. The symptoms of hematuria are easily and accurately detected through careful sediment diagnosis. The path from initial indications to diagnosis often means a major expenditure of laboratory methods, of bioptic excisions, and of radiologic procedures for the examination. Above all, vascular and infected lesions of the kidneys and of the eliminative urinary tracts can cause hematuria, which in every case requires clarification.


[Can recurrent urinary tracts infections with existing vesicoureteral reflux be checked (author's transl)]. Of 35 female patients with vesicoureteral reflux, 9 had a cessation of their urinary tract infections while the reflux persisted. These findings contrast with the thesis that vesicoureteral reflux is the major cause of susceptibility to urinary tract infections in these patients.


[Hydronephrosis of the right kidney caused by retrocaval course of the ureter (author's transl)]. The genesis, diagnosis, and therapy of the retrocaval course of the ureter are described with reference to one of the author's own cases. The clinical significance of this anomaly is due to the development of a hydronephrosis. This can be corrected surgically with preservation of the organ by division of the renal pelvis, repositioning, resection of the retrocavally running ureter, and oblique end-to-end anastomosis. An enquiry as to the incidence of this condition revealed 32 retrocaval ureters at 53 West German urology departments in five years.


[PTH radioimmunoassay on selective venous samplings as a method of localization of parathyroid adenomas in primary hyperparathyroidism (author's transl)]. Preoperative localization of parathyroid adenomas by various methods is today in increasing clinical use. The practical value of the methods is discussed, with particular reference to the PTH radioimmunoassay on selective venous samplings, which is the most reliable. The authors report on their 38 cases with suspected primary hyperparathyroidism during the last six years.


[Diagnosis of primary hyperparathyroidism based on determination of parathormone in venous blood of the neck (author's transl)]. Experiences with 77 patients with primary hyperparathyroidism (HPT) are reported. Among the diagnostic parameters, the serum calcium level is the most significant; a definite diagnosis can be made through PTH-RIA. The problem of HPT diagnosis are discussed. For standardization, our own human PTH preparation, produced from tissue culture of operatively removed human adenoma of the parathyroid gland, has been used. For determination of parathormone, venous blood should be selectively extracted from the neck before every relapse-necessitated operation. The technically expensive and difficult examination methods do not excuse the surgeon from carefully exploring all of the parathyroid glands, though the general procedures to be applied before the first operation are still disputed.


[Hemorrhagic calico papillitis. Clinical picture of pyelitic hematuria with special reference to cytodiagnostic problems]. A case is reported of hemorrhagic calico papillitis showing unilateral hematuria. There was no evidence of pathological changes either in i.v.P. or in retrograde pyelogram, angiogram, or angiogram with epinephrine. Large were found in the urine papillary cellgroups, suspicious for papilloma of the renal pelvis. It is pointed on the difficulty of differentiating such cellgroups from real papillomas of the renal pelvis. Possible are discussed causes of this mucosa proliferation and dysplasia. If there is found the following trias: unilateral hematuria, pseudopapillomatous cellgroups in urine, missing pathological changes in urological X-ray examinations (or only minimal blurs at the fornices) the diagnosis of calico papillitis has to be considered carefully.


[Long-time observation of a case of retroperitoneal fibrosis with Klinefelter's syndrome (author's transl)]. The etiology of retroperitoneal fibrosis still is largely unknown. Autoimmunologic mechanisms, traumata, systemic diseases, and drugs have been discussed as possible etiologic factors. The presented case was found to have a Klinefelter's syndrome besides retroperitoneal fibrosis. We do not believe that there is a relation between the two diseases. The retroperitoneal fibrosis of this case responded well to glucocorticosteroid therapy and the severly reduced renal function became normal.


[Collateral circulation through uretral arteries caused by chronical central renal artery obstruction (author's transl)]. In 48-year old hypertonic patient, angiography showed obstruction of the right renal arterial ramus ventralis. Collateral circulation, especially through the ureteral plexus and lumbal arteries, developed. Differential diagnosis, embryologic background, and therapy are discussed.


[Pseudotumor of the renal pelvis during nonspecific inflammatory granuloma (author's transl)]. Differential diagnosis of tumors of the renal pelvis cannot be assured preoperatively in every case. A 69-year-old man is reported who had an inflammatory granuloma of the renal pelvis after perforation of an unspecific abscess. The granuloma appeared radiologically like an advanced tumor of the renal pelvis.