The Bankart procedure: a long-term end-result study. Of 161 patients with 162 shoulders operated on during a thirty-year period (1946 to 1976), 124 were re-examined and twenty-one answered a questionnaire. The lesions found at surgery were separation of the capsule from the anterior glenoid rim in 85 per cent, a Hill-Sachs lesion of the humeral head in 77 per cent, and damage to the anterior glenoid rim (including fracture) in 73 per cent. There were five recurrences (3.5 per cent) after repair by the method described in the 145 shoulders that were followed. Only one of the forty-six patients with dislocation on the dominant side and one of the thirty-one with dislocation on the non-dominant side failed to return to the competitive athletic activities in which they participated prior to injury. The results at follow-up were rated excellent in 74 per cent, good in 23 per cent, and poor in 3 per cent. Ninety-eight per cent of the patients rated their result as excellent or good. Sixty-nine per cent of the shoulders had a full range of motion, and only 2 per cent of these shoulders redislocated. A fracture of the rim of the glenoid did not increase the risk of recurrence, while a moderate to severe Hill-Sachs lesion increased the risk only slightly. We concluded that with the meticulous technique of the Bankart repair as described, postoperative immobilization is not necessary, early return of motion and function can be expected, and resumption of athletic activities with no limitation of shoulder motion is possible for most patients.


The thigh-lacer: ambulatory non-operative treatment of femoral shaft fractures. Thirty patients with fractures of the femoral shaft were treated by closed reduction, tibial-pin traction for three to six weeks, and early ambulation with crutches in a plastic thigh-lacer. Extensive quadriceps-strengthening exercises were performed. When the patient achieved active extension of the knee against gravity, weight-bearing as tolerated was encouraged. All of the fractures united. Follow-up ranged from eight to forty months. Malunion (angulation greater than 10 degrees) occurred in three patients and there was some loss of knee motion (less than 90 degrees of flexion) in one patient. Infection, refracture, non-union, and shortening of greater than two centimeters were not seen. This method of treatment yielded results comparable to those obtained with cast-bracing, without the high incidence of loss of knee motion, angulation, and prolonged cast treatment associated with that form of treatment.


Open fractures of the tibia: a review of one hundred and two cases. One hundred and two consecutive open fractures of the tibial shaft were treated from 1970 to 1976. Four required primary amputation. The remainder received standardized wound care, consisting of surgical débridement and delayed primary wound closure. Soft-tissue injuries were classified according to severity, because the initial injury was the most important prognostic factor. All patients received a seventy-two-hour course of parenteral antibiotics. Fifty-six fractures were managed with cast immobilization, thirty-five with rigid internal fixation, and seven with rigid external pin fixation. The over-all rates of infection (15 per cent) and delayed union (13 per cent) are not directly comparable to other series because one must consider the severity of each injury when analyzing results. Management of the fracture itself should be individualized. The risk of primary wound closure does not appear to be warranted.


Posterior iliac osteotomy for fixed pelvic obliquity. In nine children with a myelomeningocele and fixed pelvic obliquity due to uncorrectable lumbosacral scoliosis, a bilateral posterior iliac osteotomy was done and a wedge of bone was transferred form the low side to the high side of the pelvis. This produced a mean correction of 14 degrees (41 per cent) of the pelvic obliquity and a mean correction of the trunk list from the midline of seven centimeters (69 per cent). Two to seven-year follow-ups showed that the correction was permanent, without tendency for the obliquity to return as long as the scoliosis did not progress. The procedure resulted in several complications, including fracture of the pelvis and transient sciatic-nerve palsy; however, it provided a means of correcting pelvic obliquity that could not be corrected by standard procedures.


The effects of extraperiosteal and subperiosteal dissection. I. On blood flow in muscle. Blood flow was studied in traumatized and untraumatized flexor digitorum longus muscles of rabbits before and after surgical dissection of the periosteum of the tibia. Neither extraperiosteal nor subperiosteal dissection diminished blood flow in untraumatized muscles, but when the muscles had been crushed, only extraperiosteal dissection appeared to severely compromise their collateral circulation. Because subperiosteal dissection did not diminish the blood flow in injured muscles, it seems to offer some advantages as a surgical approach to bone in a severely traumatized extremity.


The effects of extraperiosteal and subperiosteal dissection. II. On fracture healing. The effects of subperiosteal and extraperiosteal dissection on the healing of tibial osteotomies were studied in fourteen rabbits killed three weeks after the osteotomy. Of the tibiae exposed subperiosteally, 71 per cent healed; of those exposed extraperiosteally, only 7 per cent had solid union. The first group had a significantly lower level of hydroxyproline in the callus and higher values for breaking load, breaking strength, and absorption of energy to failure. In ten animals that also had muscle transection at the osteotomy site, the rate and type of healing was similar whether no dissection, subperiosteal dissection, or extraperiosteal dissection had been done, but the callus showed lower calcium levels and higher hydroxyproline levels than in either of the groups with muscle trauma. This implies retardation of healing caused by muscle injury. Our data suggest that in the absence of muscle damage, subperiosteal dissection results in earlier healing than does extraperiosteal dissection. Muscle transection markedly retards healing; then, after transection, neither type of dissection appears to retard healing more than the other.


Mechanical response of the lumbar intervertebral joint under physiological (complex) loading. Nineteen fresh, intact lumbar intervertebral joints (two vertebrae and the intervening joint) from twelve spines were loaded in a materials testing machine to determine their mechanical behavior. The loads applied were pure axial compression and complex loading conditions simulating physiological states. The measurements made included vertical load deflection, disc bulge, and strains in both the anterior and the lateral aspects of the vertebral body and in one lamina. The results showed that the posterior elements transmit considerable force during quasistatic complex loading, particularly in extension and frontal shear. When a healthy specimen is subjected to complex loading, "yielding or failure" occurs in the vertebral body and not in the annulus fibrosus of the disc.


The abnormal lateral patellofemoral angle: a diagnostic roentgenographic sign of recurrent patellar subluxation. On roentgenograms made with the patient supine, the knees flexed 20 to 30 degrees, the x-ray tube between the ankles, and the cassette held proximal to the knees and perpendicular to the x-ray beam, it was found that a line between the femoral condyles and a line between the margins of the lateral facet of the patella formed the lateral patellofemoral angle, an angle that was of diagnostic value in patients with subluxation of the patella. In 100 clinically normal patients, these lines were parallel in three and formed an angle open laterally in ninety-seven. In thirty patients with subluxation of the patella, the lines were parallel in twenty-four and formed an angle open medially in six. In 100 patients with chondromalacia of the patella, however, the roentgenographic study was of no diagnostic value since the lines were parallel in ten and formed an angle open laterally in ninety.


Ligament repair in the knee with preservation of the meniscus. In early surgical repair of forty acute ruptures of the medial ligament of the knee in patients sixteen to twenty-four years old, the meniscus was resutured when it was avulsed from the bone and was excised only when there was central disruption (three knees). Follow-up of one to six years in thirty-six patients whose menisci were preserved showed that thirty-three had no limitations due to knee impairment. Twenty-six patients were re-examined; sixteen had no medial instability and twenty-one had no anterior rotatory instability. We concluded that in the absence of significant advantage from meniscectomy, an intact meniscus should not be removed.


Some normal variations of knee arthrograms and their anatomical significance. Knees obtained after amputation were fixed with formalin after the joint space was distended with air. The joints were then either dissected or frozen and sectioned vertically with a band saw in planes comparable to those visualized during arthrography. By comparing these anatomical specimens and arthrograms, the anatomical explanations for some normal variations visible or arthrograms could be identified. These variations included the appearance of the popliteus tendon and the posterior part of the lateral meniscus, the air-filled cul-de-sac posterior to the medial meniscus, and the interconnections of the joint space and the gastrocnemius and semimembranosus bursae.


Proximal strain distribution in the loaded femur. An in vitro comparison of the distributions in the intact femur and after insertion of different hip-replacement femoral components. The distribution of strain in the proximal part of loaded cadaver femora was measured in vitro using strain gauges applied to the cortex. The loading conditions simulated single-limb stance and the strains were recorded first with the femora intact and then with the femoral components of six different designs inserted. Each femur served as its own control. After insertion of a femoral component, the pattern of strain in the proximal part of the femur was reversed compared with that in the intact femur, in that the maximum strain occurred around the tip of the prosthesis rather than at the calcar femorale. A massive decrease in stress in the region of the calcar femorale was found when the implants were in place, and it was concluded that this decrease could contribute substantially to the calcar femorale resorption sometimes observed in patients after total hip replacement. Transfer of load directly to the calcar femorale through a larger collar in direct contact with the cortical bone restored 30 to 40 per cent of the normal strain to the calcar femorale and shifted the strain pattern toward normal. Compared with the less stiff stems tested, the larger, stiffer stems, which provide more protection against fatigue failure, did not affect the strain pattern adversely.


Occupational acro-osteolysis.

Occupational acro-osteolysis. Occupational acro-osteolysis is a serious disease definitely related to the inhalation of agents involved in the polymerization of vinyl chloride. After variable periods of latency, the more or less characteristic clinical picture appears. A Raynaud's phenomenon is usually a premonitory sign indicating that alterations in bone will probably ensue. Scleroderma-like skin lesions and systemic involvement of variable degree occur frequently. The pathophysiology of the disease is unknown, but obstructive lesions of small peripheral arteries are thought to cause osteolysis of the distal phalanges of the fingers.


Bone-lengthening for shortness of the fourth toe. Short fourth metatarsals were observed in 102 patients, often bilaterally. Forty-six of these patients were treated by variations on Jinnaka's bone-lengthening method--that is, interposing a spindle-shaped bone graft within the metatarsophalangeal joint. We examined twenty-six patients clinically and roentgenographically after a follow-up averaging 11.4 years. Satisfactory results were obtained in 74.4 per cent.


Concentration of antibiotics in normal bone after intravenous injection. The concentrations in serum, cancellous bone, and cortical bone of three antibiotics--nafcillin, cefazolin, and gentamicin--were measured in eleven normal dogs. All antibiotics rapidly penetrated into bone. The peak concentration in serum was reached within twenty minutes of intravenous injections, and the concentration in bone generally paralleled that in serum. Cancellous bone had higher concentrations than did cortical bone because of the admixture of blood.


Antibiotic prophylaxis in operations on trochanteric femoral fractures. Short-term prophylaxis against infection using cephalothin and cephalexin was studied in 140 patients operated on for trochanteric fractures of the femur. The group given the drug during preparation for anesthesia, intraoperatively, and for two days postoperatively had an infection rate of 1.8 per cent (one patient), whereas the group without prophylaxis had a rate of 16.9 per cent (twelve patients). The two groups were similar with regard to factors that may have influenced the infection rate, for example, age, time required for surgery, and blood loss. Staphylococcus aureus was the most common infecting organism, but several patients had mixed infections with intestinal bacteria.


Affinity chromatography of proteases of hydroxyalkyl methacrylate gels with covalently attached inhibitors. The efficient isolation of trypsin and chymotrypsin from a crude pancreatic extract was achieved by affinity chromatography on specific adsorbents prepared by coupling of both naturally occurring protease inhibitors and also synthetic low-molecular-weight protease inhibitors to hydroxyalkyl methacrylate gels. Specific sorbents prepared with synthetic inhibitors are stable and are suitable for the isolation of chymotrypsin and trypsin even on a large scale.


Tryptophan and hydrogen sulfide reaction from modified trypticase soy agar. The use of Trypticase soy agar modified by the addition of 0.05% ferric ammonium citrate and 0.01% sodium thiosulfate for the determination of indole, phenylpyruvic acid, anthranilate, kynurenine, and hydrogen sulfide reactions is described.


Rapid diagnosis of gram-negative bacterial meningitis by the Limulus endotoxin assay. The Limulus amoebocyte lysate endotoxin assay was evaluated as a method for rapid diagnosis of acute bacterial meningitis in a series of 305 patients. The results of Limulus assays on cerebrospinal fluid (CSF) samples from these patients were compared with the results for each patient of routine bacterial cultures and Gram stains. Positive Limulus tests were obtained on initial CSF specimens from 84% of patients with culture-proven bacterial meningitis, including all patients with meningitis due to gram-negative organisms. Initial Gram-stained smears revealed the presence of organisms in 68% of the patients. One patient with pneumococcal meningitis had a weakly positive Limulus assay, whereas patients with meningitis due to other gram-positive organisms, those with aseptic meningitis, or patients without meningitis had negative CSF Limulus tests. The Limulus assay also demonstrated the persistence of endotoxin in the CSF of certain patients during antibiotic therapy, especially patients with Haemophilus influenzae meningitis. The Limulus test proved to be a rapid, reliable indicator of the presence of gram-negative organisms in the CSF of patients suspected of acute bacterial meningitis.


Persistence of immunoglobulin G and immunoglobulin M antibodies after postnatal rubella infection determined by solid-phase radioimmunoassay. The appearance and persistence of immunoglobulin M (IgM) and IgG antibodies in postnatal rubella infections were studied by employing a solid-phase radioimmunoassay test. Altogether, 222 serial serum specimens from 51 patients with acute rubella infection were tested. Both IgG and IgM antibodies developed rapidly and appeared in all patients within 4 days after the onset of rash. In some patients, the IgM antibodies clearly preceded the IgG antibodies; however, the reverse situation was also noticed in a few cases. The IgG antibodies showed only minor changes after 8 to 10 days from the onset of rash. The IgM titers also reached a maximum level at approximately 8 to 10 days after the onset of rash, after which time a rapid decrease was normally seen. The mean half-life of IgM antibodies after 15 days from the onset of rash was 4.5 days, giving for IgM antibodies persistence times from 43 to approximately 80 days. Two patients with a prolonged IgM antibody response were detected. One of these patients had bilateral arthritis of the knee as a complication, whereas in the other patient no complication caused by rubella virus was detected. The IgM antibody response and its value in diagnosis are discussed.


Pseudomonas putrefaciens as a cause of bacteremia in humans. Pseudomonas putrefaciens has been presented as an opportunistic pathogen in a few isolations from humans. This is the first documented report of a local infection of P. putrefaciens complicated by invasion of the blood stream. The organism was twice isolated from the blood culture and once from the wound exudate of a 73-year-old woman hospitalized for extensive ulcerations on the legs. Parenteral ampicillin and gentamicin together with local antiseptic treatment led to an uneventful recovery.


Use of bacteriophage typing to distinguish Propionibacterium acne types I and II. Strains of serotypes I and II of Propionibacterium were compared for phage sensitivity. The two serotypes could be distinguished by using a typing set consisting of 16 bacteriophages at concentrations that demonstrated selective lysis of serotype I or II bacterial strains. Seven phage types were found; three were composed exclusively of serotype I, and four were exclusively composed of serotype II organisms. Generally, serotype I strains were more sensitive to phage lysis than were serotype II strains. No correlation was found between phage type and site of isolation.


Bioavailability of oral and intramuscular phenobarbital. The absorption of phenobarbital was compared in healthy adult subjects after oral and intramuscular therapeutic doses. Serum levels of phenobarbital were determined for 21 days after dosing by means of radioimmunoassay. Serum levels were similar from both dosage routes, with peak levels occurring at 1-3 hours after dosing and then declining slowly with an elimination half-life of about 90 hours. The overall efficiency of phenobarbital absorption from intramuscular doses was approximately 80 per cent of that from equivalent oral doses. Except in cases where oral dosing is not appropriate, there is no clinical advantage in giving phenobarbital intramuscularly to adult patients.


Plasma protein binding of d-propoxyphene in normal subjects and anephric patients. The free fraction of d-propoxyphene in the plasma of normal subjects is 0.24 +/- 0.02 (mean +/- S.D.) and is not concentration dependent in the usual therapeutic and toxic conentration range. Renal failure and relatively high concentrations of d-norpropoxyphene, the major metabolite of d-propoxyphene, have no significant effect on the plasma protein binding of d-propoxyphene.


Acute massive chloral hydrate intoxication treated with hemodialysis: a clinical pharmacokinetic analysis. A 38-year-old female became comatose and exhibited signs of cardiac toxicity 2 hours after ingestion of approximately 38 Gm chloral hydrate. Hemodialysis was initiated 21 hours after ingestion, using twin coils in series, and was continued for 4.5 hours. Trichloroethanol, the active metabolite of chloral hydrate, was measured in plasma and dialysate. Two hours after ingestion, the plasma level was 330 micrograms/ml (average therapeutic level is 12 micrograms/ml or less). The predialysis level was 216 micrograms/ml and after dialysis declined to 141 micrograms/ml. The pre- and post-plasma half-life values were 35 hours, while on dialysis the half-life was only 6 hours. The average dialysis clearance was 120 ml/minute, and the amount of chloral hydrate removed by dialysis was 5.79 Gm. By the end of dialysis, the patient could respond to verbal commands and was ambulatory 36 hours later. In conclusion, hemodialysis can be a clinically important method of treating chloral hydrate overdose.


The Gestalt approach to stuttering.

The Gestalt approach to stuttering. This article describes the application of Gestalt therapy concepts to the treatment of stuttering. Within this framework stuttering is seen as an organized self-system rather than a symptom. This self-system is maintained and reinforced by the stutter's experience of this physical self, self-expectancies, self-messages, projections on others, and total viewing of self as a limited and inadequate person. The individual enmeshes himself or herself into this system and restricts himself to familiar behaviors, in this case stuttering, because he has no framework for other ways of functioning. The Gestalt therapeutic framework as a basis of unlocking the individual's limited style of functioning is explored.


The use of time-expanded speech in the identification of part-word repetitions of stutterers. The purpose of this investigation was to explore the possibility of using time-expanded speech to aid clinicians in the identification of one-, two-, and three-unit repetitions of stutterers. Tape-recorded samples of nine stutterers (five adults and four children) were time-expanded to 0%, 150%, and 200% of original time. Thirty graduate student clinicians listened individually to the speech samples under the three listening conditions. The three conditions were presented in a counterbalanced order. Clinicians were asked to indicate each occurrence of one-, two-, or three-unit part-word repetitions on a response sheet. Results indicated that time expansion of the stutterers' speech by 150% or 200% of the original time resulted in significantly (P less than 0.05) more accurate identification one-unit part-word repetitions. Time expansion did not, however, provide a perceptual advantage for the identification of two- and three-unit part-word repetitions. Implications for clinical application and further investigation are discussed.


Fundamental frequencies in the oral reading behavior of stuttering and nonstuttering male children. The fundamental frequencies of the voices during oral reading of 12 stuttering and 12 nonstuttering 7-to-12-year-old males matched according to age, height, weight, and race were studied. No statistically significant differences were found between the stutterers and nonstutterers with respect to the mean fundamental frequency, the lowest fundamental frequency, the highest fundamental frequency, and the difference between the lowest and highest fundamental frequency values.


Antimicrobial activity in vitro of cefaclor, a new oral cephalosporin. The antimicrobial activity of cefaclor, a new orally administered cephalosporin derivative, was studied in vitro against a variety of Gram-positive and Gram-negative clinical isolates. Both penicillin-resistant and penicillin-susceptible strains of Staphylococcus aureus were susceptible to cefaclor, with mean MICs of 1.44 and 0.93 microgram/ml, respectively. However, the MBC for penicillin-resistant S. aureus was higher than that for the penicillin-susceptible strains. All strains of Streptococcus pyogenes, Streptococcus viridans, and Streptococcus pneumoniae tested were highly susceptible to cefaclor; all strains of Streptococcus faecalis were highly resistant to cefaclor. Strains of Escherichia coli, Klebsiella sp., Proteus mirabilis, and Hemophilus influenzae were susceptible to cefaclor. Eighty per cent of strains of H. influenzae were inhibited by 5 micrograms/ml of cefaclor. Most strains of Enterobacter sp., indole-positive Proteus, Pseudomonas sp., and Serratia sp. were resistant to cefaclor.


Elicited imitation in language assessment: a tool for formulating and evaluating treatment programs. Four different clinical populations were administered an elicited imitation task before and after therapy to determine the usefulness of elicited imitation procedures for formulating and evaluating language treatment programs. Children's imitations were analyzed according to the numbers and patterns of omission errors, substitution errors, and correct responses. Results indicated that (1) patterns of responding could be identified; (2) specific patterns were associated with different clinical populations; (3) performance on pretherapy measures could be efficiently analyzed and utilized for formulating language treatment programs; and (4) changes in posttherapy performance could be readily evaluated using this procedure. The data suggest that the elicited imitation procedures can be effectively used to increase the precision of the evaluation and clinical programming of children with language disorders.


Comprehension of Standard English at varied speaking rates by children whose major dialect is Black English. Comprehension of spoken Standard English was measured via a picture selection task for 80 Black English (BE) speaking and 80 Standard English (SE) speaking children at four age levels between 5 years, 6 months, and 9 years, 6 months. Test stimuli consisted of four syntactically matched groups of eight sentences divided into two levels of difficulty. The four groups of sentences were heard by all Ss at four different speaking rates from 4.9 (fast) through 2.5 (slow) syllables per second. Results showed that BE speaking children had greater difficulty comprehending spoken SE than the SE speaking control Ss. Significant age and difficulty effects were found for both groups; a significant rate effect was found for the BE speaking group only; and sentence difficulty was found to interact differently with age for the two groups.


The effect of furosemide and bumetanide on warfarin metabolism and anticoagulant response. In a study of 11 normal subjects who received either furosemide or bumetanide, response to warfarin was unaffected by either diuretic. The mean prothrombin times after a single oral dose of 50 mg warfarin were 18.8 +/- 0.7 sec before and 19.6 +/- 1.7 sec during furosemide administration, and 18.3 +/- 1.4 sec before and 19.7 +/- 1.3 sec during bumetanide administration. Mean plasma warfarin half-lives were 43.2 +/- 2.8 hr before and 37.8 +/- 1.7 hr during furosemide treatment and 39.9 +/- 9.5 hr before and 37.4 +/- 2.4 hr during bumetanide treatment. Hypoprothrombinemic responses, plasma warfarin concentrations, and warfarin half-lives were not significantly influenced by treatment with either diuretic. Both loop diuretics furosemide and bumetanide can be safely administered during warfarin anticoagulant therapy without risk of clinically significant interaction.


An apomorphine-induced vomiting model for antiemetic studies in man. Apomorphine-induced vomiting is often used for preclinical efficacy testing of putative antiemetics in normal volunteers. The usual technique of individual intravenous titration for finding the threshold emitic dose of apomorphine in each subject is slow and tedious. We used a uniform dose of 0.05 mg/kg apomorphine given subcutaneously to test the antiemetic action of metoclopramide and votracon in ten healthy, young male volunteers. All ten subjects vomited in response to this dose of apomorphine when pretreated with placebo. Pretreatment with metoclopramide prevented vomiting in all subjects, and votracon prevented vomiting in two. Apomorphine, 0.05 mg/kg, subcutaneously appears to be an appropriate challenge dose for testing compounds for antiemetic activity in normal human volunteers.


The relationship between perceptual dysfunction and language disorders: a case report. The acquisition of language is discussed in relation to two specific perceptual processes: first, identification and discrimination of recurring aspects of an experience, and second, integration of the language form with the specific aspect of the event being represented. The analysis of the language of a child with perceptual and integrative deficits revealed expressive use of language without comprehension and limited knowledge of concepts. Explanations of these behaviors are presented in light of the child's perceptual and integrative dysfunctions. Implications for clinical management of a perceptually based language disorder are discussed.


Effects of response delay and token relocation on token test performance of aphasic subjects. Performance of 12 aphasic subjects was analyzed on a delayed response task using commands similar to those found in the Token Test, under Relocation, and Nonvisual conditions. In Standard Condition, subjects could see the tokens as commands were presented and during delay intervals that were interposed between the end of the command and the subject's response. In Relocation Condition, subjects could see the tokens during command presentation and delay intervals, but the tokens were repositioned before the subject was allowed to respond. In Nonvisual Condition, no visual information was available to the subject until the delay interval was over. Results suggested that performance was not significantly affected by the presence of delay except in Part III of the test. The effects of delay appeared only in Part III, where most aphasic subjects began making errors. No appreciable differences in performance were found across conditions. These results suggest that aphasic subjects did not rely to any great extent on visual or visual-spatial strategies to perform successfully on the delayed response task. It appears that subjects may have been using some type of verbal strategy to mediate the delay interval, in spite of their impaired language systems.


Disfluency changes in children as a function of the systematic modification of linguistic complexity. This investigation determined the influence of modeling on the complexity of language in 5-year-old youngsters, and the effect of simple and complex language usage on the occurrence and topography of disfluency. Forty children balanced for age, sex, and educational level served as subjects, and a repeated measures design was implemented to examine changes in linguistic complexity and disfluency between "simple" and "complex" language modeling conditions. The investigation demonstrated a significant modeling effect and suggested a significant relationship between linguistic complexity and disfluency in children. The results are discussed in terms of grammatical load and its possible effect on speech interruption.


The number and distribution of ganglion cells in the retina of the brush-tailed possum, Trichosurus vulpecula. The distribution of ganglion cells in the retina of the adult brush-tailed possum was determined by light microscopy of Nissl stained retinal whole mounts. Qualitatively, the distribution in this marsupial retina shows features, such as an area centralis and a visual streak, which are found separately or together in eutherian mammals. The possum retina is avascular and the eye has a weak tapetum in the superior fundus.The retinal area is 260 mm2 and there are about 280,000 ganglion cells. The diameters of the ganglion cell somas range from 5 micrometer to 26 micrometer and the frequency distribution of soma size classes is skewed and unimodal (mean" 12.8 micrometer) with 62% of the cells falling in the class of diameters 7-13 micrometer. Maps of ganglion cell density were made for five retinae. These maps show that there is a band of high ganglion cell density (greater 2,000 cells mm-2) which extends across the retina about 0.6 mm above the optic disc in the tapetal region of the fundus and which lies in the plane of the animal's horizon when the eyes are in their primary position. By analogy with other species, this band is termed the visual streak. Near the temporal end of the visual streak, 2.9 mm from the optic disc, the ganglion cell density reaches a localized maximum of approximately 5,000 cells mm-2 thereby defining the centre of an area centralis (greater than 3,000 cells mm-2). The posterior nodal distance of the possum eye was estimated at 7.8 mm, which corresponds to a retinal magnification of 136 micrometer per degree of visual field. There are up to 30,000 glial cells which lie in, or slightly vitread to, the layer of the retinal ganglion cells.


Qualitative and quantitative study of synaptic displacement in chromatolyzed spinal motoneurons of the cat. Qualitative and quantitative cytological evidences show a reduction in number and percentage of coverage of terminals on chromatolyzed spinal motoneurons 4 to 90 days after severance of their axons in the ventral root. The reduction in number and percentage of boutons on the surface membrane is due to detachment of synapses. This detachment is associated with changes in specialized regions (synaptic complexes: Conradi, '69) of synapses which involve disappearance of both pre-and postsynaptic membrane thickenings and widening of the synaptic cleft (width of 400-1,400 A). The separation of terminals from surface membrane is also associated with the presence of reactive astrocytes and microglia. Most areas of surface membrane bared of synaptic contact are occupied by astrocytic processes. The astroglial responses coincide with the loss of synapses. Microglial cells, although extending to neuronal surface membrane, cover only a small portion of it. An extensive separation of boutons by microglia is not observed. Most microglia are seen located at some distance from surface membrane and are frequently separated by sheets of astrocytic processes. Synaptic restoration occurs by about 90 days after axotomy. Some motoneurons show good recovery, while others show only a limited amount.


Prevalence of nevocytic nevi on lateral and medial aspects of arms. The numbers of clinically diagnosed, elevated nevocytic nevi (at least 2 mm in diameter) within 50 sq cm areas on the lateral and medial aspects of the arms of 1,000 subjects (age range 2 to 87 years) were compared. A total of 349 nevi was found on the lateral aspects and only 116 on the medial aspects of arms. Nevi were found on the lateral aspects of the arms in 23.4% (234) of the subjects and on the medial aspects in but 10.9% (109) of the subjects. These differences are highly significant in both men and women. Nevi were found in 30.2% (281) of the 930 whites but in only 9.1% (5) of the 55 blacks included in the study. Also, blacks did not show greater prevalence of nevi on the lateral as compared to the medial aspects of their arms. One explanation for the greater prevalence of nevi on the lateral over that on the medial aspects of the arms is that sunlight plays a role in the induction of acquired nevocytic nevi.


A flap suspension technique in blepharoplasty on lower lids. Blepharoplasty on lower lids frequently results in a downward pull on the free border of the lid and inferomedially on the lateral canthus. Extending the incision in the lower lid upward and lateral to the outer canthus allows most of the excision to occur laterally. Closure then pulls superolaterally, which tends to prevent the commonest complications of blepharoplasty on lower lids.


The skin incision in the excision of the prepatellar bursa. Commonly used incisions to remove a prepatellar bursa in patients with bursitis are often ill placed and give rise to unnecessary morbidity, such as tender or contracted scars or areas of anesthesia or hyperesthesia in pressure-bearing areas.


Indications and technique of biopsy for diseases of the scalp. Indications for biopsy of scalp skin are discussed and the technique for obtaining adequate tissue for histologic examination is described.


Treatment of nevi aranei by means of an argon laser. Sixteen patients with 18 telangiectatic lesions have been treated by means of an argon laser over a 7-year period. The physics and medical uses of the laser are reviewed and the pathology of the laser wound is discussed. Seventeen of 18 lesions responded satisfactorily and suggest that the argon laser is a simple, effective clinical tool for the treatment of cutaneous vascular lesions.


Cryotherapy of basal-cell carcinoma by a simple method of standardized freeze-thaw cycles. One hundred seventy-seven basal-cell carcinomas treated by cryotherapy with liquid nitrogen according to a standard protocol had a recurrence rate of 2.3% in a mean of 4.8 years of follow-up. The cryotherapeutic method used freeze-thaw times rather than temperatures measured by thermocouples as indices of adequacy of freeze.


Factors affecting food behavior and the quality of husbands' and wives' diets. One hundred sixteen husband-wife couples were interviewed to determine: (a) The influence of socioeconomic factors on their food behavior and (b) the relationship between these factors and the quality of their diets. According to the respondents, important sources of influence were: Personal preference, as determined by concern for taste and nutrition; influences of the immediate family; and cost. Factors external to the family, i.e., nutrition courses, the mass media, and reference groups, were perceived as having only slight influence. Factors which were significantly related to a better diet included the influence of the wife, a concern for personal and family health, nutrition classes, and nutritional information from the mass media.


Effect of nutritional supplementation in pregnancy. I. Outcome of pregnancy. Women judged to be at high risk of delivering low-birth-weight infants were assigned to one of three supplements--high-protein beverage, low-protein beverage, or a vitamin-mineral preparation--to determine the effect these nutritional supplements would have on the outcome of pregnancy. In comparing prenatal nutrient intake and the birth weight of their infants, no significant associations were found. However, since the women were well nourished and since the sample size was small, changes in birth weight may have gone undetected. Nevertheless, a trend of increased birth weight with higher protein intake was observed.


Diets in the first six months of infants in western Massachusetts. I. Energy-yielding nutrients. Two hundred sixty-eight infants under six months of age from three ethnic and three income backgrounds were surveyed by trained nutritionists. The cross-sectional findings were based on maternal information on familial and socioeconomic background, prenatal health history, weight and length measurements at birth, health and development of the infant, and finally, a nutritional history and a 24-hr. recall of food intake. Total daily caloric intakes of infants in this group were not significantly different from intakes of the children studied in Denver by the Child Research Council (5). However, the composition of the diets differed. Differences in the carbohydrate, protein, and lipid are due to the use primarily of evaporated milk formulas with gradually decreasing addition of sugar and the high-cholesterol and low-linoleic acid content in the CRC study, and of premodified formulas with constant sugar content and low cholesterol and high linoleic acid in this study.


Diets in the first six months of infants in western Massachusetts. II. Semi-solid foods. The early introduction of solid foods was observed in three ethnic and income groups in a survey of 268 infants in western Massachusetts. By four weeks of age, cereal had been introduced into the diets of 57 per cent and fruit to 32 per cent of the infants. Patterns of introducing and feeding solid foods to breast-and formula-fed infants were similar and were related more to income than to type of milk fed. The cost of infant feeding can draw heavily on the family's food budget.


Methods of dietary inception in infants with PKU. Information on methods of initiating the phenylalanine-restricted diet was obtained from the medical personnel of sixteen clinics in the Collaborative Study of Children Treated for Phenylketonuria. The four dietary methods used initially to lower serum phenylalanine were: Normal dilution Lofenalac, Lofenalac, with phenylalanine added as milk, Lofenalac with milk added to provide 200 mg. phenylalanine per day, and alternating bottles of normal dilution Lofenalac and cow's milk during the first four days of therapy. During the first week of treatment, eight clinics obtained serum phenylalanine determinations daily or every other day. The nutritionist prescribed the phenylalanine-restricted diet following diagnosis in nine of the clinics. In most clinics, the nutritionist was responsible for obtaining information relating to dietary management and follow-up contacts during the first month of treatment. The initial dietary instruction was accomplished in most clinics by a combination of lecture/discussion/demonstration methods. Both parents attended the initial dietary instruction in thirteen clinics. Neither the professional person(s) nor the method of initial dietary instruction, if detailed and comprehensive, made any difference in control of serum phenylalanine during the first year of life.


Fatty acid composition of prepared infant formulas. The fatty acid composition of eight American, eight European, and four Japanese prepared infant formulas were determined and compared with fat sources listed on labels. Unsaturated fatty acids ranged from 20 to 83 per cent of the total. Generally, the fatty acid composition was consistent with the types of ingredients used; those with corn or soy oil had the highest levels of unsaturated fat, and those with milk fat the lowest; formulas of mixed composition fell in between. The formulas were compared with values for the fatty acid composition of human milk in the literature.


Nutrient content of spices and herbs.

Nutrient content of spices and herbs. Values for the nutrient content of spices and herbs culled from an extensive search of the literature and of unpublished sources are tabulated. Spices were generally high in ash and fiber. The protein content of many spices was comparable to that of whole grains and mature dry legumes. Average values for calcium, magnesium, iron, sodium, and potassium were higher in speces from leaves (herbs) than in those from other parts of plants. Spices from seeds were highest in phosphorus. A few spices--celery seed, cumin, coriander leaf, dill weed, cloves, and especially parsley flakes--were very high in sodium (3 to 9 mg. per 2 gm). Their use might be contra-indicated in therapeutic diets in which sodium is highly restricted.


Thyroid function tests in elderly hyperthyroid patients. Several tests of thyroid function were performed in 35 hyperthyroid patients over the age of 65 (elderly). The results were compared to those of similar tests in 48 hyperthyroid patients under the age of 65 (young). Total serum thyroxine (T4) was within the normal range in 14 percent of the elderly and 11 percent of the young hyperthyroid patients. The free thyroxine index (FTI) was within the normal range in 11 percent of both groups. The triiodothyronine uptake (T3U) proved to be a poor test in both groups. Although elevation of the triiodothyronine (T3) level allowed a diagnosis of "T3-toxicosis" in 2 elderly and 3 young hyperthyroid patients, the T3 level was normal in 34 percent of the elderly and 13 percent of the young subjects. Correction of the T3 range for age reduced the number of normal T3 values to 12.5 percent in the elderly hyperthyroid patients. The 24-hour uptake of radioactive iodine was normal in 12 percent of the young hyperthyroid patients, 27 percent of the elderly patients with Graves' disease, and 70 percent of the elderly patients with toxic nodular goiter, despite recent readjustment of the normal range for the test. It is concluded that the diagnosis of hyperthyroidism in the elderly may be difficult and that no single test can be relied upon to exclude the diagnosis.


Colestipol hydrochloride for treatment of hypercholesterolemia in a family practice: five-year study. Colestipol hydrochloride (Colestid) lowered the serum cholesterol level significantly more than did placebo in hypercholesterolemic patients (21 colestipol, 19 placebo) treated for up to 5 years. In the 21 colestipol-treated patients, the average decrease in serum cholesterol levels was 19 percent during the first year and 23 percent during the second through fifth years. Seven patients (age range, 44 to 59 years) took colestipol for the full 5 years. The data showed a consistent lowering of the serum cholesterol level. The only side effect was constipation.


Counselling the elderly on nutrition in a community health care system. A study was made of the effects of community nutrition services on 234 noninstitutional elderly aged 65 or older. Many of the problems were related to overweight and longstanding inappropriate food habits. The results indicated that counselling can stimulate an increased awareness of nutrition and improvement in the knowledge of nutrition and food selection. These elderly persons seemed to have a definite desire to achieve good health and were receptive to the nutritionist's recommendations. However, economic and physical limitations often influence their ability to adhere to the recommendations. In counselling the elderly, the nutritionist should be able to made a quick assessment of the elderly person's physical capabilities.


Suicide pact in a depressed elderly couple: case report. An elderly depressed couple with multiple physical problems decided that death was preferable to their present lifestyle, and made a suicide pact. At the last minute the wife felt unable to go through with it and the couple entered a psychiartic hosptial. During their 3-week stay they were treated appropriately with amitriptyline and psychotherapy. Since discharge they have been followed closely for two years. Some psycho- and socio-dynamic and therapeutic aspects are discussed.


The biologic aspects of cancer of the breast: a challenge. The crude incidence rate for cancer of the breast far exceeds that for any other type of cancer found in either sex. In women it is nearly twice the rate for the next most common malignant disease found in both men and women. The percentage of patients with localized disease has gradually increased but now is approaching a plateau. There is a definite increase in the incidence of breast cancer is premenopausal women which counterbalances the better results with reference to age-specific death rates. The absolute survival rate indicates that mortality rates continue to be "above normal" for a considerable period beyond the five-year point. It is important, therefore, to study the challenge which confronts us, to keep in mind the natural history of the disease, to review the known high-risk factors and tumor-host relationships, and to evaluate continually all available diagnostic and therapeutic measures. These measures include those not used in routine practice, and especially those involving new concepts.


Face-form frames.

Face-form frames. Face-form frames may be appropriate for sunglasses but present many problems if used for prescription lenses especially when the power is strong. Angling the lenses affects the power and location of the cylinder axis and makes it difficult to attain the right P.D. The problems of mounting the lenses in the frame are magnified. Angling also generates unwanted sphere and cylinder in the periphery as well as distortion. These effects can be measured and even calculated ahead of time and cannot be dismissed lightly. The increased field of view is not needed.


The effect of accommodative changes on the brightness of the fundus reflex. This paper demonstrates how accommodation and refractive changes affect the brightness of the reflex observed during retinoscopy. The amount of light entering the peephole of the retinoscope was monitored while accommodation was varied. The light entering the peephole reaches a maximum when the far-point of the eye is co-incident with the retinoscope and drops when the far-point moves behind or in front of the retinoscope. A reduction in the accommodative lag during book retinoscopy would result in brightening of the reflex along with a shift in the "against" direction.


Vision screening project--Eilat, Israel. The author relates his experience in developing and conducting a vision screening program for 1,522 children between age one to six of Eilat, Israel. He describes a method similar to the Modified Clinical Technique which he adapted to the specific circumstances and devised a simplified two-minute procedure which proved very effective in use. The author clearly demonstrates the need and advantage of a professionally conducted program with cooperation of the Yosepthal Hospital, the public health nurses and the teachers of the Eilat school system. The results indicate a low overall referral rate of 7-1/2%, probably due to the early and careful attention most children receive. His conclusions support the importance of a vision screening program and substantiate the value of a Modified Clinical Screening procedure.


The allergy--part 1.

The allergy--part 1. The available statistics indicate that many Americans have problems with varying degrees of allergies. What is an allergy? How does it work? What can be done? This article attempts to trace the literature history to the current thinking on the subject. From an optometric viewpoint, experience would suggest that a higher percentage of contact lens patients have allergies than the general population. The innocent contact lens is often held accountable for symptoms that have their etiology in diametrically opposed areas.


Laterality and directionality--optometric clinical applications. Five rationales for the optometric evaluation of laterality and directionality are identified in this paper. These include an application of particular studies in the infant's vision literature along with theories of Hershenson, Piaget, Gesell and Kephart and the phenomenon of reversal confusion frequently associated with learning-disabled children. Selected optometric testing procedures are viewed in the context of these rationales.


Vision care services in the HMO's.

Vision care services in the HMO's. The HMO Act and its amendments present a rather clear picture of specific requirements for federal qualification as an HMO. The probable future status of vision care services and optometric participation in these organizations is predictable on the basis of an analysis of the act and prior experiences in HMO prototypes.


Distribution of gamma-aminobutyric acid, glycine, glutamate and aspartate in the cochlear nucleus of the rat. The distributions of gamma-aminobutyric acid (GABA), glycine, glutamate and aspartate were measured in cochlear nuclei of two rats by quantitative histochemical mapping procedures. The levels and distributions in the two rats were comparable, and resembled those previously reported for cat cochlear nucleus. The results are consistent with a concept that these putative transmitter amino acids have similar levels and distributions in the cochlear nucleus among mammals.


Mast cell granule formation in the beige mouse. The formation of mast cell granules was studied in the beige mouse utilizing histochemistry and electron microscopy. The time and sequence of appearance of heparin, histamine and the chymotrypsin-like protease were normal. By electron microscopy, the initial formation of progranules and subsequent aggregation was normal, but the granules from early stages were abnormally large. Reorganization of intermediate granule forms to homogeneous mature granules was delayed. Late fusions of intermediate and/or mature granules were not observed. Our findings indicate that the defect lies in the excessive initial fusion of progranules rather than in continued formation of new progranules or in fusion of mature granules with one another.


A simple procedure for distinguishing dopamine from noradrenaline in peripheral nervous structures in the fluorescence microscope. The difference between dopamine and noradrenaline after ordinary histofluorescent procedures cannot be discerned. Reserpine treatment results in depletion of fluorescent material from dopaminergic and noradrenergic peripheral nervous structures. Administration of reserpine, 1 mg/kg subcutaneously for 3 hr, followed by intraperitoneal injection of 200 mg/kg levodopa methyl ester on 0.9% saline for 90 min, result in refluorescence of dopaminergic (glomus cells of the carotid body) but not noradrenergic (sympathetic ganglion cells, nerves of atrial heart muscle and blood vessels) structures. Hence, the sequential administration of these readily available drugs and the application of ordinary histofluorescent techniques result in a simple procedure for distinguishing dopamine from noradrenaline in the fluorescence microscope.


Measurement of cellular DNA mass by flow microfluorometry with use of a biological internal standard. Use of a biological standard (chicken erythrocytes) mixed with experimental cell populations allows control of all variables in flow microfluorometric determination of DNA content. These variables include both staining and instrument procedures. In addition, the use of a biological standard allows determination of cellular DNA mass in unperturbed cell populations. DNA mass measured by FMF technique correlates closely with values reported in the literature that used biochemical techniques.


Studies on the secretory process in exocrine pancreas cells. II. C57 black and beige mice. Published electron microscopic and cytochemical studies (thiamine pyrophosphatase and acid phosphatase) on exocrine pancreas cells of guinea pig, hamster, rat and rabbit have demonstrated that the nascent secretory granules, or condensing vacuoles, are part of GERL. The studies reported here show this to be true of the mouse pancreatic exocrine cells as well, thus permitting comparison of this cell type in the C57 black mouse and its "beige" mutant. This is of considerable interest because GERL is very much enlarged in these cells of the beige mouse. Most of GERL consists of wide dilated portions filled with electron-opaque materials that appear to be packaged into huge residual body-type lysosomes ("anomalous granules"). Acid phosphatase activity is demonstrable not only in these portions of GERL, but also in the condensing vacuoles as in pancreatic acinar cells in the black mouse where these dilated lysosome-producing regions are not present.


Identification of rosette-forming cells in permanent preparations. A method is described for the identification of leucocytes in permanent cytocentrifuge rosette preparations made with the fluorescent methyl green pyronin-SITS (MPS) staining technique. The percentages of rosettes in stained slides agree well with the results obtained with the conventional haemocytometer method. Application of the MPS staining to cytocentrifuge preparations permits reliable morphological differentiation between free and rosetting leucocytes, and should be particularly valuable in studies on lymphocyte subpopulations in patients.


A radial hemolysis method in agarose for the functional assay of properdin. A simple one-step radial hemolytic assay for properdin has been devised. In this assay, the test material is introduced into a well in an agarose plate containing optimal concentrations of normal human serum immunochemically depleted of properdin (RP), EGTA, magnesium ions and unsensitized guinea pig erythrocytes. Following radial diffusion, the area of the hemolytic zones resulting from the activation of the alternative complement pathway and bystander lysis of guinea pig erythrocytes was directly proportional to the concentration of properdin in the test material. The assay is specific reproducible and sensitive and the correlation with the radioimmunoassay for properdin is very good. The assay has been used to measure properdin activity in animal sera.


A simple method for the isolation of murine peripheral blood lymphocytes. A simple, rapid and reproducible semi-microtechnique was developed for the isolation of murine peripheral blood lymphocytes. Murine peripheral blood was collected from brachial vessels and centrifuged through a Ficoll--Hypaque gradient in a microfuge tube yielding 1--1.5 X 10(6) lymphocytes per mouse.


Use of a radioactive double labeling technique in the chemical analysis of the mediators of cellular immunity. Radioactive double labeling was adapted for the analysis of mediators of cellular immunity. Two identical lymphocyte cultures were simultaneously labeled with [3H]- or [14C]leucine. Each of the cultures was stimulated with antigen or mitogen. The combined supernatants were then subjected to various fractionation procedures. By determining the isotope ratio in each fraction it is possible to identify those products of activated lymphocytes that have been produced either de novo or in increased amounts. The method proved sensitive enough to detect lymphocyte activation products in supernatants of activated lymphocyte cultures from guinea pig, mouse, and man.


Study of DNA metabolism of lymph-node cells by direct lymphatic administration of tritiated thymidine. A method for studying DNA metabolism in lymph-node cells by injecting tritiated thymidine intralymphatically is described. The administration of [3H]thymidine through a lymph vessel enabled a high concentration to be attained with only a small quantity of the precursor in close proximity to the cells. The significance of the method is that it may also be used in studies of metabolic processes in human lymph-nodes.


Complement receptors: specific detection by molecular complexes. Immune complexes of BSA-anti BSA (IgG F(ab')2) will activate human complement by the alternate pathway. The C3 bound to these complexes binds to human peripheral blood mononuclear cells which bear complement receptors. This interaction is visualized by fluoresceinated antigen (BSA-FITC) or fluorescein conjugated antisera directed at the C3 component of complement. The assay appears to be more sensitive than the usual IgMEAC rosette technique and correlates well with the rosette method.


An immunoglobulin E assay using radiolabelled Fab' and ammonium sulfate. An immunochemical assay is described in which a radiolabelled antibody fragment, Fab', is bound specifically to immunoglobulin E (IgE), and precipitated with ammonium sulfate. The radioactivity in the precipitate is a measure of the amount of IgE in the sample. Results for six serum samples are compared using the double antibody and ammonium sulfate methods as well as the PRIST.


Aspects of bradykinin radioimmunoassay.

Aspects of bradykinin radioimmunoassay. 125I-derivatives of Tyr1-kallidin, Tyr5-bradykinin, and Tyr8-bradykinin were prepared. A technique for purification of the monoiodinated derivative is described. Bradykinin antisera were tested for their ability to bind the mono-iodinated analogues. Each antiserum had a characteristic preference for one of the three labeled peptides. The sensitivity of each antiserum was greatest when it was used with the label bound most avidly by that antiserum. The specificity of an antiserum was not changed by varying the labeled analogue. Some common enzyme inhibitors had significant effects on the antigen-antibody reactions. Lecithin interfered with the reaction between antiserum and Tyr1-kallidin. The data suggest that antisera for bradykinin radioimmunoassay be tested with several radioactive iodobradykinins to maximize their usefulness. In addition, enzyme inhibitors used to stabilize levels of kinins in biological fluids should be tested for their effects on the assay. Biologic samples rich in lipid may give spurious radioimmunoassay results unless they are freed of those phospholipids that can bind labeled and unlabeled peptides.


The use of high speed gel filtration for the detection of rubella-specific IgM. Three new gels, Ultrogels AcA 22, AcA 34 and AcA 44 have been compared with Sephadex G-200 for the detection of rubella-specific IgM. Ultrogel AcA 44 did not achieve an adequate separation of IgM and IgG. Ultrogels AcA 22 and AcA 34 gave clear separation of IgM and IgG but only the latter could be operated at flow rates significantly higher than Sephadex G-200. With rubella convalescent sera fractionation with Ultrogel AcA 34 leads to a 2-4-fold loss of sensitivity for the detection of the first peak of rubella HI activity which is associated with recent infection. This is largely due to the occurrence of specific IgA antibody in the first peak of rubella HI activity after Sephadex G-200 fractionation but not after Ultrogel AcA 34 fractionation.


Psittacosis: the reservoir persists.

Psittacosis: the reservoir persists. During a one-year period, 101 parakeets and parrots were submitted for laboratory examination. The birds were sick, dead, or from premises where morbidity had been observed. Tissue specimens from these birds were tested for the presence of Chlamydiapsittaci by two methods. A tissue culture system using McCoy cells treated with 5-iodo-2-deoxyuridine was found to be more sensitive than intraperitoneal inoculation of mice for isolation of the chlamydiae. Chlamydiae were recovered from 21 (34%) of 61 parakeets and 16 (40%) of 40 parrots tested. This high rate of infection persists despite the availability of effective chemotherapeutic regimens for control of chlamydial infection in psittacines. The origins of some of the infected birds were traced to aviaries where subsequent treatment with chlortetracycline was successful in eradication of the chlamydial infection. Other infected birds had been imported recently and could be traced back to quarantine centers where (by law) the birds received chemoprophylaxis for chlamydial infection. Our results suggest that this program is an administrative failure.


Hepatitis B virus infections among Danish dentists. Since type B hepatitis is generally regarded as an occupational risk for dentists, the participants at the 1976 annual meeting of the Danish Dental Association were examined for hepatitis B surface antigen (HBsAg) and antibody to HBsAg (anti-HBs). A total of 1,338 dentists (89% of the dentists at the meeting and 29% of all Danish dentists) were included in the study by completion of a questionnaire and by radioimmunoassay of a blood sample for HGsAg and anti-HBs. None of the dentists was HBsAg-positive, but 110 (8.2%) had anti-HBs. An increasing frequency of anti-HBs was found with increasing age, but the figures were similar to the findings in a control population. Evidence is presented that hepatitis found before admittance to or during the time at dental school was predominantly not of type B. In contrast, type B hepatitis predominated during the professional activity of the dentists. On the basis of the serological findings in 29% of all Danish dentists, it is concluded that dentists cannot be regarded as a high-risk group for hepatitis B.


Pathogenesis of the rubella exanthem: distribution of rubella virus in the skin during rubella with and without rash. In a previous assessment of the role of rubella virus in the pathogenesis of the rubella exanthem, virus was consistently isolated from cell cultures of skin biopsy specimens of the rash, and it was concluded that presence of virus in the skin was essential to evolution of the rash. For determination of whether virus is present in the skin only in association with rash, punch biopsies were performed concurrently on areas of skin with and without rash. Among paired skin specimens of 16 patients, virus was isolated from sites of rash in 12 and from the uninvolved skin in 10. In another patient, shown by serologic response and recovery of virus from the pharynx to have rubella without a rash, virus was also isolated from the skin. It is concluded that rubella virus is widely disseminated in the skin of patients with rubella irrespective of the presence or distribution of the rash, and that the presence of virus in the skin, although a constant feature of the disease, is only one of the factors involved in the pathogenesis of the exanthem.


Topical treatment of vaccinia virus infection with an interferon inducer in rabbits. Ointment containing 1.7 mg/g of the interferon inducer poly (ICLC) (a complex of polyriboinosinic-polyribocytidylic acid and with poly-L-lysine and carboxymethylcellulose) was effective both prophylactically and therapeutically against vaccinia virus infection in rabbit skin. Poly (ICLC)-treated animals developed higher titers of local interferon and of circulating virus-neutralizing antibodies than placebo-treated animals. Serum levels of greater than 100 units of interferon/ml were found 24 hr after application of the poly (ICLC) ointment to the skin of uninfected rabbits.


Stability of four antifungal antimicrobics in vitro. The stability of amphotericin B, amphotericin B methyl ester, 5-fluorocytosine, and miconazole was assessed under conditions encountered in bioassay and susceptibility testing in vitro. Although the amphotericins were labile as compared with other drugs, tests should be reliable with all four antimicrobics in view of the rapid action of the polyenes and the relatively slow action of 5-fluorocytocine and miconazole.


Prostaglandin production by intra-uterine tissues from periparturient sheep: use of a superfusion technique. A technique for the continuous superfusion of small tissue samples in vitro has been applied to the study of prostaglandin production by ovine intra-uterine tissues. Basal and oxytocin-stimulated production of prostaglandins was studied at 120-125 days of pregnancy and after dexamethasone-induced delivery. In general, the relative rate of prostaglandin production by tissues was: foetal cotyledon = maternal cotyledon greater than myometrium and in quantitative order the prostaglandins produced were prostaglandin E (PGE) greater than prostaglandin F (PGF) = 13,14-dihydro-15-oxo-prostaglandin F (PGFM). Considerable variations was found between the rates of prostaglandin production in individual sheep. Oxytocin had no effect on the production of prostaglandins by tissues obtained before labour but myometrium and maternal cotyledon obtained at delivery exhibited a significant increase in production of PGE and PGF (though not PGFM) in response to oxytocin. Administration of arachidonic acid increased the production of PGE and PGF by the foetal cotyledon.


Progesterone-induced oestrogen receptors in the rat uterus. In ovariectomized rats progesterone acts like oestradiol at the endometrial, but not at the myometrial level, by increasing the number of oestrogen receptors in the cytoplasm. After 3 days of progesterone priming, the number of endometrial oestrogen receptors was found to be three times higher (P less than 0.05, Student's t-test) than control values. This progesterone-induced oestrogen receptor molecule appears identical in its physico-chemical properties (sedimentation coefficient, kinetic constants, steroid specificity) to that induced in the endometrium and myometrium under the influence of oestradiol. However, in the myometrium progesterone acts antagonistically reducing significantly (P less than 0.001, Student's t-test) the oestradiol-induced increase in the number of oestrogen receptors.


Hypothalamic paraventricular unit activity during labour in the rat. The spike activity of 191 antidromically identified paraventricular units was recorded during labour and the oestrous cycle of rats under urethane anaesthesia. Accelerated bursts of neuronal activity, as reported to occur during suckling, were not observed and changes in firing rate were not correlated with individual uterine contractions. There was, however, an increase in the magnitude of the mean spontaneous firing rate of antidromically identified neurosecretory cells during labour, as compared with all stages of the oestrous cycle. This increase was mainly caused by (1) a marked reduction (greater than 25%) in the percentage of totally silent cells and (2) an increase in the magnitude of the mean firing rate of the phasically firing units (1.58-3.44 spikes/s). It was concluded from these increases in spike activity that the tonic release of neurohypophysial hormones is stimulated during labour, and that this may contribute to the induction and course of labour.


Characterization and assay of the progesterone receptor in rat uterine cytosol. The synthetic progestogen R5020 (17,21-dimethyl-19-norpregna-4,9-diene-3,20-dione) binds with high affinity (Ka = 8.8 X 10(8) l/mol at 0 degree C) to the progesterone receptor from rat uterine cytosol. At nanomolar concentrations, equilibrium is attained in less than 90 min. R5020 has a very low affinity for other specific steroid-binding proteins (corticosteroid-binding globulin and oestrogen receptors) present in relatively high concentrations in the urine cytosol. The affinity of the receptor for the natural hormone progesterone is remarkably low (Ka = 1 X 10(8)-1.7 X 10(8) l/mol at 0 degree C) which explains the instability of progesterone-receptor complexes. Advantage may be taken of this property to remove endogenous progesterone easily by charcoal treatment at 0 degree C, a treatment which does not modify the concentration of receptors. A method based on these characteristics is described for the assay of the total number (progesteron-bound and unbound) of receptor sites in uterine cytosol. This assay may be used in various physiological situations where endogenous progesterone is present at unknown concentrations.


Progesterone receptors in the rat uterus: variations in cytosol and nuclei during the oestrous cycle and pregnancy. The concentration of progesterone receptors in rat uterine cytosol and nuclei was measured during the oestrous cycle and pregnancy. The method used allowed the measurement of the total concentration of binding sites (unbound and hormone-bound). During the oestrous cycle, the concentration of receptors in the cytosol peaked at prooestrus, low concentrations were observed at oestrus and metoestrus, and in increase was seen at dioestrus. In the nuclei, maximum concentrations occurred at pro-oestrus and dioestrus. The number of receptors in the cytosol was very low during the first half of pregnancy, but the concentration increased progressively after day 15 to attain a very high level (about 26 000 binding sites/cell) on day 22. In the nuclei, the concentration of receptors was low at the beginning of pregnancy. On day 5 (day of implantation) there was a slight increase, which corresponded to a decrease in the number of cytosolic receptors and a small peak in the level of progesterone in the plasma. Maximum concentrations were attained during a 'plateau' period between days 9 and 15. Thereafter, there was very low; in some animals, probably on the verge of parturition, no receptors were detectable in the nuclei.


Circadian variation in the sensitivity of the pituitary-adrenal system to dexamethasone suppression. Intact female rats were injected with 100 microgram dexamethasone/kg body weight or saline at 12.00, 24.00 or 04.00 h. Four hours later, i.e. 16.00, 04.00 or 08.00 h respectively, a double bleeding procedure was used to obtain blood samples from stressed and unstressed rats for subsequent fluorometric determination of corticosterone levels in the plasma. The difference between the level of corticosterone is stressed and unstressed rats (the stress increment) was determined and used as an index of the response of corticosterone in the plasma to stress. Increments in the levels of corticosterone in the plasma evoked by stress in rats injected at 12.00 h with dexamethasone and bled 4 h later were significantly (P less than 0.05) less than those in rats given dexamethasone at 24.00 or 04.00 and bled at 04.00 or 08.00 h respectively. In contrast, stress-induced increments in the level of corticosterone in the plasma of rats treated with saline did not vary with the time of day.


Blood-testis barrier: evidence for intact inter-Sertoli cell junctions after hypophysectomy in the adult rat. To study the hormonal dependence of the blood-testis barrier, adult rats were hypophysectomized and the ultrastructural integrity of the inter-Sertoli cell junctional complex was examined at various times with a lanthanum tracer technique. It was found that the structural integrity of the inter-Sertoli cell junctions and their capacity to exclude lanthanum from the adluminal compartment were preserved up to 35 days after hypophysectomy. Furthermore, transport of newly formed spermatocytes through the inter-Sertoli cell junctions still occurred 20 days after hypophysectomy. It is therefore concluded that the function of the inter-Sertoli cell junctional complex is not directly dependent on gonadotrophic or androgenic hormones, but is regulated by other mechanisms.


Histological data: Hollard and Davison (1971). As Mogenson and Cioé (1977) have assumed that our electrodes aimed at the ectostriatum (Hollard and Davison, 1971) were actually located there, we feel that a presentation of the histological data is necessary. Following termination of further experiments (Hollard, 1974) the pigeons, numbered 93, 95, and 119, were sacrificed and perfused with saline followed by 10% formalin. Sections, 50 microns thick, were cut on a freezing microtome. Prints were made by mounting each unstained section of a microscope slide and placing them in a standard photographic enlarger. The electrode tips of Pigeons 93 and 119 were located in the paleostriatal complex. The sections of Pigeon 95 were damaged and precise localization was not possible. Further work in this laboratory has also found that, using the same coordinates, electrode tips tend to fall in the paleostriatum, rather than in the more dorsal ectostriatum at which they are aimed. The paleostriatal placements tended to sustain self-stimulation, whereas others located in the ectostriatum sustained relatively low or unstable rates.


Measurement of electrogenic-pump current in Aplysia neurones with constant-current and constant-voltage techniques. 1. The responses of the abdominal and pleural giant cells to warming and cooling were studied using constant-current and constant-voltage techniques. 2. The potential change upon warming from about 7 degrees C to 22 degrees C was reversed by application of maintained inward current. The reversal potential was -77 +/- 12 mV. 3. The membrane conductance increased with warming, but was not affected by pump-blocking agents. 4. The electrogenic-pump current was found to be about 16 nA for a model in which the pump acted across the membrane ionic conductance. This model could explain the reversal of the warming response with hyperpolarization. 5. In voltage-clamped cells, the response to warming was converted from an outward to an inward current by hyperpolarization. The reversal potential for the current response 31 +/- 7 mV more negative than resting, or about --80 mV. 6. The pump currents measured under voltage-clamp conditions were the same as those calculated for the hyperpolarizing responses in unclamped cells.


Peripheral control of responsiveness to auditory stimuli in giant fibres of crickets and cockroaches. Auditory stimuli initiate ascending activity in large fibres of the ventral nerve cord of the cricket, Acheta domesticus, and the cockroach, Periplaneta americana. This auditory responsiveness is reduced during locomotion. An earlier study concluded that the depression of responsiveness was mediated by descending inhibition. However, the auditory responsiveness is reduced during locomotion even after section of the ventral nerve cord anterior to the abdominal recording electrodes. Further, auditory responsiveness of isolated abdomens attached to intact animals is inhibited during locomotion of their hosts. Laminar wind streams over the cerci depress responsiveness to sound, but only at velocities markedly higher than those encountered by freely walking animals. Although the exact mechanism is not known, the depressed auditory responsiveness can occur independently of any descending influences.


Ventilation in an aquatic and a terrestrial chelonian reptile. 1. Periods of breath-holding are interrupted by episodes of continuous breathing in the aquatic turtle Pelomedusa subrufa, whereas single breaths and short periods of breath-holding alternate in the terrestrial tortoise Testudo pardalis. This implies that partial pressures of O2 and CO2 in expired air are stable in Testudo in contrast to cyclic fluctuations in Pelomedusa. 2. In spite of this, air convection requirements (VA/VO2, ml BTPS/ml STPD) are not significantly different for the two species (25.4 in Testudo, 27.3 in Pelomedusa), and differences in weight-specific ventilation between the mean body weight. 3. The end-tidal PCO2 in Pelomedusa (mean 15.2 mmHg) is lower than in Testudo (mean 24.7 mmHg), which reflects aquatic CO2 elimination in Pelomedusa. 4. In Testudo, the time course of ventilation correlates with the time course of increase of end-tidal PCO2 during CO2 breathing, but no simple relationship is evident between ventilation and blood PCO2 in Pelomedusa. 5. In both species tidal volume as well as respiratory frequency increase approximately in proportion to the end-tidal PCO2, although the response to 6% CO2 breathing could be less than expected from extrapolation of the responses to 2 and 4% CO2. Both species also increase ventilation during hypoxia, but hyperoxia depresses ventilation.


Ion-selective electrode studies on the effects of 5-hydroxytryptamine on the intracellular level of potassium in an insect salivary gland. Potassium-sensitive microelectrodes were used to measure the intracellular level of potassium in Calliphora salivary glands. During stimulation with 1 X 10(-8) M 5-HT, the potassium concentration increased from a resting level of 133.2 to 139.0 mM. When the external concentration of potassium was reduced below 2mM there was a rapid loss of potassium which could be partially reversed by 5-HT. During 5-HT stimulation, the addition of ouabain had no effect on a number of parameters including the rate of fluid secretion, the ionic composition of the saliva and the intracellular level of potassium. The possibility that potassium enters the cells passively is discussed.


Giant nerve fibre activity in intact, freely moving earthworms. 1. An approach is described for recording and characterizing giant nerve fibre activity in intact, freely moving earthworms. 2. Medial giant fibre (MGF) spikes were conducted in an anterior-posterior direction at a mean rate of 32.2 m/s; lateral giant fibre (LGF) spikes were conducted in a posterior-anterior direction at a mean rate of 12.5 m/s. 3. Rates of giant fibre spike conduction and maximal frequencies of firing (up to 500/s) in intact animals were higher than values previously reported in isolated preparations. 4. MGF spikes were followed 1:1 by presumed giant motor axon spikes and facilitating muscle potentials. 5. Single MGF or LGF spikes evoked by applying tactile stimulation were not accompanied by longitudinal contraction, but a series of two or more MGF spikes or three or more LGF spikes were accompanied by such contractions. 6. MGF and LGF spikes occurred infrequently during locomotory movements in the absence of any experimenter-applied stimulation, suggesting that sensory inputs associated with normal locomotion over an irregular substrate are sufficient to excite giant fibres.


The permeability of the skin of the aquatic anuran Xenopus laevis (Pipidae). The undirectional transcutaneous fluxes of Na, Cl, water and urea were measured, in vitro, in the pipoid anuran Xenopus laevis. An active uptake (outside to inside) of Na was observed but Cl movements appeared to be passive. The effluxes of Na and Cl were low compared to those measured in other species of amphibians. The active Na transport was less than that of more terrestrial species and, although it could be stimulated by vasotocin, aldosterone was ineffective. The permeability of the skin to water was also low and although it was increased in the presence of vasotocin the magnitude of the response was much less than seen in more terrestrial anurans. The skin was permeable to urea but the movement of this solute was not remarkable when compared to that in other amphibians. These properties of the skin are discussed in relation to the animal's aquatic manner of life.


Propagation of action potentials through electrotonic junctions in the salivary glands of the pulmonate mollusc, Helisoma trivolvis. The secretory cells of the salivary glands of the snail, Helisoma trivolvis, exhibit regenerative, overshooting action potentials whose ampliture may exceed 100 mV. The salivary glands consist of paired, tubular, epithelial structures with acinar outpocketings. The secretory cells display extensive electrical coupling which allows action potentials to propagate along the glandular epithelium. Salivary glands from nine genera of gastropod molluscs were examined. The genera comprised one opisthobranch, one prosobranch, two terrestrial pulmonate slugs, one terrestrial pulmonate snail, and four aquatic pulmonate snails. Action potentials were recorded from all of the examined glands, suggesting that the production of action potentials in salivary glands is a general phenomenon among gastropods.


Control of the salivary glands of Helisoma by identified neurones. The neural regulation of an exocrine gland was investigated at the level of identified effector neurones. The salivary gland neuroeffector system of Helisoma consists of a pair of acinous glands innervated by two symmetrically located, identified buccal ganglion neurones (4R and 4L). Neurones 4R and 4L usually are electrically coupled and display synchronous activity. Action potentials in these neurones elicit EPSPs and action potentials in epithelial cells of the salivary glands. Spontaneous miniature potentials similar to those seen at neuromuscular junctions can be recorded from many of the glandular cells. Neurones 4R and rL, and thus also salivary gland cells, can display bursts of action potentials phase-locked with those seen in buccal mass motoneurones during feeding.


Nonrandom inclusion of H-2K and H-2D antigens in Friend virus particles from mice of various strains. Friend murine leukemia virus (FV), isolated from infectious serum of several mouse strains, has been examined for the presence of H-2 antigens. Following banding of the virus on a discontinuous sucrose gradient, pelleting, and disruption with Nonidet P-40 detergent, virus preparations were tested for their capacity to inhibit the lysis of target cells mediated by various anti-H-2K or anti-H-2D antisera. Virus from mice homozygous for the H-2b, H-2d, H-2g H-2k, and H-2ol haplotypes or heterozygous for the H-2g/H-2k, H-2b/H-2d, and H-2b/H-2k haplotypes was used. Of the six H-2D or H-2K alleles examined, the products of only two, H-2Db and H-2Kk were detected. Virus preparations contained no, one, or both antigens, depending on the genotype of the host animal. Control preparations from normal mouse serum and preparations in which the virus had not been disrupted demonstrated no H-2 activity. Furthermore, attempts to neutralize FV spleen focus forming activity with anti-H-2Db or anti-H-2Kk antisera yielded negative results.


Modulation of the formation of the amplification convertase of complement, C3b, Bb, by native and commercial heparin. Native rat mast cell macromolecular heparin proteoglycan and commercial hog heparin glycosaminoglycan chains inhibit generation of the amplification convertase, C3b, Bb. The inhibitory action of heparin is not due to chelation of magnesium. Heparin is most active in inhibiting convertase formation on cellular intermediates formed with the lowest C3b input and developed with the highest B concentration, thereby suggesting the receptor site for B on C3b as the point of heparin action. This interpretation is consistent with the demonstration that heparin prevents B utilization during the fluid phase interaction of C3b, B, and D. Inhibition is observed also when C3b,Bb generation takes place on cellular intermediates in the presence of P or C3NeF, which yield stabilized forms of the convertase. 50 times the concentration of heparin required to inhibit convertase generation does not accelerate the decay of the unstabilized or the C3NeF-stabilized convertases and has only a modest effect on the P-stabilized convertase. An additional effect of heparin is to impair beta1H-mediated decay-dissociation of C3b,Bb. The concentration of native or commercial heparin which prevents convertase formation is in the same range as that required for the demonstration of its anti-coagulant and anti-thrombin III cofactor activities. The additional finding that this inhibitory action of heparin can be expressed by the isolated mast cell granule suggests that native heparin may contribute to the modulation of the amplification pathway of complement.


Membrane receptors of mouse leukocytes. II. Sequential expression of membrane receptors and phagocytic capacity during leukocyte differentiation. Analysis of four mature cell markers on mouse bone marrow leukocytes grown in vitro, demonstrated a distinct sequence of marker appearance during the terminal phases of granulocytic cell differentiation. A similar pattern of marker expression was also suggested by analysis of mature neutrophils and macrophages isolated from normal tissues. Among cultured neutrophils, receptors for the Fc portion of IgG (FcR) were first expressed on myelocytes and metamyelocytes, and then subsequently on more mature cells. Morphologically mature colony neutrophils (polymorphs) from agar cultures contained only FcR and complement receptor type two (CR(2)) (C3d receptor), and lacked both complement receptor type one (CR(1)) (C3b receptor) and the capacity to ingest latex, bacteria, or iron particles. Neutrophils from 2 and 3 wk liquid media cultures of marrow cells differed from agar grown neutrophils in that they had phagocytic capacity (particle ingestion) [Pi] in addition to FcR and CR(2). Furthermore, in the 4th and 5th wk of these continuous liquid cultures, CR(1) was also expressed, completing the surface marker profile of normal blood neutrophils. Based on these studies, the following order of appearance of these four markers on cells from the myelocytic series was proposed: FcR {arrow} FcR CR(2) {arrow} FcR CR(2) Pi {arrow} FcR CR(2) Pi CR(1). Differential studies of tissue leukocytes containing these same markers revealed that a heterogeneity existed among morphologically mature neutrophils. Even though 95 percent of blood polymorphs contained all four markers, the same was true of only half of spleen polymorphs and only 20 percent of bone marrow polymorphs. Cells of the monocyte-macrophage series were studies in parallel with neutrophils. Cultured marrow monocytes acquired the four mature cell markers so rapidly that the order of receptor appearance could not be determined. However, it was found that CR2 was lost during the terminal phase of monocyte maturation into activated macrophages.


The genetic basis of susceptibility to leukemia induction in mice by 3-methylcholanthrene applied percutaneously. Susceptibility to leukemia induction in mice by skin painting with 3-methylcholanthrene (MCA) is strain-specific, occurring only in strains relatively resistant to MCA-induced skin tumors. The Ah locus, which has a dominant allele (Ahb) for inducibility of the aryl hydrocarbon hydroxylase (AHH) enzyme system and a recessive allele (Ahd) for noninducibility, appears to be the major determinant of this trait. MCA-painted mice of strains and crosses carrying the Ahb allele usually show a high incidence of skin tumors (papillomas which may evolve into malignant tumors) and little or no leukemia, whereas in mice homozygous for the Ahd allele the treatment usually induces a high incidence of leukemia and few or no skin tumors. Among mice of a segregating backcross generation including both Ahb/Ahd heterozygotes and Ahd homozygotes, the occurrence of skin tumors was correlated directly with AHH inducibility and inversely with the leukemic response. Mice of Ahb strains with a high level of endogenous murine leukemia (MuLV) expression (C58, PL) show a much weaker skin tumor response than expected but no increase in leukemia incidence, and this observation tends to confirm the previous finding that MuLV infection of mice of low-MuLV strains results in reduced susceptibility to MCA tumorigenesis.


Rapid active transport of immunoglobulin A from blood to bile. Immunoglobulins were isolated from the serum or ascitic fluid of Lou/Wsl rats bearing plasmacytomas and labeled with 125I. When labeled IgA was injected i.v. it disappeared from the blood serum much more rapidly than IgG2 so that after 3 h less than 10% remained. This rapid disappearance of the injected IgA was not seen in rats with ligated bile ducts. In rats with cannulated bile ducts, the labeled IgA appeared rapidly in the bile so that 25% of the injected dose was recovered in 3 h; at the peak of this biliary excretion the specific radioactivity of the bile (cpm/milligram protein) was about 200 times greater than that of the blood serum. Thus much of the IgA which finds its way into the blood is rapidly and actively transported across the liver so that it enters the gut lumen via the biliary tract.


Macrophage activation: increased ingestion of IgG-coated erythrocytes after administration of interferon inducers to mice. In vitro phagocytosis of IgG-opsonized sheep erythrocytes (EA) was used to measure the in vivo activation of mouse peritoneal macrophages. Uptake of EA as enhanced by the extraperitoneal administration of Newcastle disease virus, vesicular stomatitis virus, tilorone or polyinosinic-polycytidylic acid. Ingestion of EA was similarly stimulated by lipopolysaccharide or killed Corynebacterium parvum. Dose-response curves relating concentrations of IgG to phagocytosis were parallel for both treated and control animals. This indicates that the heterogeneity of the macrophage populations did not change and that the overall populations were activated with respect to phagocytic ability. Numbers of macrophages were not increased (except in C. parvum-treated mice), suggesting that resident, rather than newly recruited macrophages, were activated by the different agents.


Drug interference in clinical chemistry: studies on ascorbic acid. The expert group "Drug Interference in Clinical Chemistry" of the Bureau of Reference, Directorate General for Research, Science and Education of the Commission of the European Communities, consisting of one participant of each member of the European Communities, presents this first report on the final results of its activities. Within the framework of a first stage basic program, the paper describes interferences of therapeutic and elevated doses of ascorbic acid on commonly used clinical chemical methods. This is the result of a bipartite study that was jointly planned, carried out and evaluated. Local and personal influences have been eliminated, as have variations due to methodology, measurement equipment and reagents, in order to be able to present distinct causal effects of ascorbic acid. No definite influence of ascorbic acid on analytical values for urea, cholesterol, calcium, protein, bilirubin, aspartate aminotransferase and alkaline phosphatase could be detected. At therapeutic concentrations, ascorbic acid distinctly interferes with the analysis of glucose, uric acid, creatinine and inorganic phosphate. The extent and direction of interferences vary, depending on the type of reaction, kit and apparatus. In some cases the influence of ascorbic acid results in severe disturbance of the analytical methods leading to useless values.


[Uroporphyrinogen synthase in erythrocytes in acute intermittent porphyria: new pathobiochemical aspects (author's transl)]. Uroporphyrinogen synthase (EC 4.3.1.8) was determined in the erythrocytes of 380 patients, of which 21 showed clinical symptoms of acute intermittent porphyria. The normal range of a random sample was 61 +/- 23 mumol/1.h(x +/- 2s, n=302), including the activity of uroporphyrinogen cosynthase and the subsequent enzymes; when all the latter enzymes were destroyed by heating the haemolysate, the normal range for uroporphyrinogen synthase was 65 +/- 25 mumol/1.h(x +/- 2s, n=274). The respective activity of uroporphyrinogen synthase in patients with acute intermittent porphyria was 35 +/- 12, and 40 +/- 18 mumol/1.h which was significantly lower (p less than 0.001) than the control values. In the 21 cases of acute intermittent porphyria, the diagnosis had already been made from the presence of porphyrin precursors and porphyrin in the urine. In 7 of the 21 cases of acute intermittent porphyria, and in 6 relatives of the patients, the activity of the uroporphyrinogen synthase was in the overlap zone (40-50 mumol/1.h). 32 relatives of 9 of the patients with acute intermittent porphyria were investigated: 22 showed a significant decrease of uroporphyrinogen synthase, and 7 of these showed pathological urinary porphyrin precursors and porphyrin. The relative activity of uroporphyrinogen synthase in patients with acute intermittent porphyria was 57%. A decrease of the uroporphyrinogen synthase activity of greater than 30% compared with the mean of the controls is a sure indicator for the presence of a primary enzymic defect in the gene carrier for acute intermittent porphyria.


The precision of clinical estriol and total estrogen estimations in pregnancy urine. 1. A study of the precision of clinical estriol- and total estrogen determinations in late pregnancy urine was carried out in collaboration with 26 clinical laboratories in the Netherlands and one laboratory in Suriname. 2. Ten urine samples were circulated twice with an interval of 2 weeks. 3. It was shown, that repeated analysis of the same sample in the same clinical laboratory in different assays can yield differences in results up to 40%. This interassay variation can be regarded as the main source of uncertainty of results of clinical estriol and total estrogen determinations. 4. The quantitative differences between results of total estrogen methods and a gas chromatographic method, which measures only estriol, were shown to be caused primarily by the lower recovery of the glucuronide of estriol (both native and added) in the latter method. 5. As expected, methods based on the principle of Ittrich (1960), Acta Endocrinol. 35, 34-48) proved to be more susceptible to the disturbing influence of glucose than a gas chromatographic method that measured estriol specifically. 6. Various recommendations to improve the precision of clinical estrogen determinations in pregnancy urine resulted from this study.


[Gas chromatographic determination of di- and trisaccharides (author's transl)]. Three new methods are reported for the gas chromatographic analysis of di- and trisaccharides. Method I: Sugars are converted into their methoximes by reaction with methoxylamine hydrochloride in pyridine, followed by esterification with acetic anhydride. The separation is performed on OV 225 at 260 degrees C. Method II: Disaccharides are reduced to the alditols with sodium borohydride in aqueous solution, followed by acetylation with acetic anhydride in pyridine. In this method, only one peak is observed for each sugar. The derivatives are separated on OV 225 at 260 degrees C. Method III: Sugars are converted into their methoximes by reaction with methoxylamine hydrochloride in pyridine, followed by trifluoroacetylation with N-methyl-bis (trifluoroacetamide). The trisaccharide derivatives still show sufficient volatility. The separation is performed on OV 101 at 130 degrees C for disaccharides, and at 160 degrees C for trisaccharides. The retention times for biologically occurring di- and trisaccharides such as maltose, maltotriose, lactose, and sucrose are reported. The reliability criteria for method I are reported for the analysis of lactose, maltose and sucrose.


[Topical immunochemical consideration of the structure of the tumour cell membrane (author's transl)]. Fundamental experiments and results in the elucidation of cell membrane structure are reviewed in detail. Special consideration is given to the topochemical organisation and immunochemistry of the glycolipids and glycoproteins that are integrated into the cell membrane, and which form a major component of the surface receptor mosaic. This, in turn, underlies a transmembrane, cytoskeletal control, a mechanism that can only be explained by the modern concept of a fluid membrane. The investigations discussed here provide an interpretation of the behaviour and properties of the membranes of the tumour cell, as observed in the effect of cell transformation on the topography of the plasma membrane, and during the cell cycle and cell growth. In this connection, the so-called tumour associated antigens are discussed fully and their biochemistry and immunology treated in detail. Concepts of tumour immunity and escape mechanisms are then elucidated and defined with the aid of model systems. Using examples, it is shown why the results of this fundamental research form a sound basis for the immunodiagnosis and therapy of tumours.


The need for process research on psychophysical judgment: comments on "Ratio and subtractive processes in psychophysical judgment" by Veit. This article is a commentary on Veit's article "Ratio and Subtractive Processes in Psychophysical Judgment." Veit's article makes an important contribution to the area of psychophysical judgment by providing a systematic approach that combines measurement and psychological theory. Using multi-factor designs and a cross-task scale-invariance criterion, Veit shows how to concurrently examine the integration rule, response-transformation function, and psychophysical function for judgment tasks. The need to expand this methodology to further understand the operations and processes underlying psychophysical judgment is stressed in the present article, and an illustration involving feedback mechanisms is provided.


Comment on internal feedback as a theory of judgment: a reply to Levin. Levin's suggestion that internal feedback strategies be employed in judgmental and learning tasks is discussed. The predictions of an internal feedback notion are seen as inconsistent with Veit's ratio and difference task data. Scale-free frameworks and scale-convergence criteria used in previous research are described as useful techniques for separating integration from judgmental processes in information-integration as well as learning-task situations.