Lymphocyte function related to survival curves in patients with metastatic melanoma treated by chemoimmunotherapy. Thirty-eight patients with metastatic melanoma were evaluated immunologically prior to chemoimmunotherapy. The assays used included recall antigen skin hypersensitivity; lymphocyte count; nonspecific T, non-T, and K cell lymphocytotoxicity; and T and B cell rosette enumeration. Survival curves were computed for each of four ranges of values of a given immunologic test. The higher ranges of positive skin tests, lymphocyte count, cytotoxicity, and T and B subpopulation numbers were consistently associated with the longer survivals. The differences reached statistical significance for non-T cell cytotoxicity and B and T cell peripheral blood counts. Pretreatment immune reactivity, particularly that involvingg non-T cell function, appears related to length of survival.


A summer camp for children with cancer.

A summer camp for children with cancer. The prognosis for children with cancer has changed significantly over the past 10 years. Currently, it is anticipated that cure can be achieved in approximately 50% of newly diagnosed cases of childhood cancer. The quality of life for these children depends not only on their medical treatment but also on the successful management of the psychological problems related to their diagnosis. A summer camp was established in Florida as a part of our psychosocial rehabilitation program for pediatric cancer patients. Participating in the day-to-day camp life were 26 children with various forms of cancer. Each child not only had the opportunity to enjoy a normal out-of-door life style, away from their overprotective parents, but experienced daily contact with other children who shared a similarly stressful existence. It is felt the awareness gained through the realization that they were not along in their plight and the independence instilled through separation from parents was beneficial to each child. It is anticipated that future camps with the inclusion of psychological testing will provide us with the opportunity to further assess the need for psychosocial rehabilitation for the child with cancer.


A preliminary study of cyclophosphamide (NSC-26271), adriamycin (NSC-123127), imidazole carboxamide (NSC-45388), and actinomycin D (NSC-3053) with or without MER-BCG in patients with advanced sarcomas. Polychemotherapy for soft tissue sarcomas has been reported to produce response rates ranging from 24--60% (1, 2). Immunotherapy has reportedly prolonged survival after surgery for some tumors and enhanced the effectiveness of chemotherapy (3, 4). This report summarizes our preliminary experience with the combination of cyclophosphamide, adriamycin, imidazole carboxamide (DTIC), and actinomycin D (CAIA) with or without methanol extraction residue of BCG (MER) in patients with advanced sarcomas.


[Renal cell carcinoma in childhood. Case report and review of the literature (author's transl)]. 14 year old patient suffering from a renal cell carcinoma was treated by surgery and irradiation. 1 1/1 years after diagnosis he developed multiple metastases in the brain, skin, bones, and in regional lymph nodes. Cyclophosphamid and vincristin did not reduce the metastases. The literature is reviewed with regard to symptoms, diagnostic procedures, therapy, and prognosis of hypernephrome in childhood.


[Thrombo-embolic occlusion disease of the aorta ascendens in a patient with hypoplastic left heart syndrome (author's transl)]. Three days after delivery a healthy looking newborn with a hypoplastic left heart syndrome died within 15 min due to a thrombosis in the radix aortae. The thrombus had closed the coronary arteries like a valve causing sudden death by infarction.


[On additional food for young infants on commercially prepared milk formulae before the age of four months (author's transl)]. Infants often get extra food ("Beikost") in addition to their milk formula at an earlier time than recommended in text-books of pediatrics. The dangers connected with such feeding practices, i.e. insufficient protein and calcium supply and an overnutrition with carbohydrates, are pointed out. Gluten sensibilisation as a result of early feeding with milk-pap, the high content of sugar in fruit preparations, the addition of salt and the nitrate content of vegetables are discussed. A better label of the composition for industrially prepared "Beikost" is recommended. There exists no nutritional or psychological reason to start with "Beikost" before the 4th month of life for infants fed on industrially prepared milk formulae with added vitamines and minerals.


Effects of mitomycin C on sister chromatid exchange in normal and Bloom's syndrome cells. Bloom's syndrome lymphocytes, which are characterized by a high incidence of sister chromatid exchanges (SCE: 80.6 per cell), were treated with mitomycin C (MMC) and the effect of the chemical on SCE frequency compared with that in normal cells. Raising the concentration of MMC from 1 X 10(-9) to 1 X 10(-7) g/ml led to about 10-fold increase (61.7 SCE per cell) in the SCE frequency over the base line in normal lymphocytes (6.4 SCE per cell), though chromosome aberrations remained at a relatively low frequency. MMC caused about a two-fold rise in SCE in cells of Bloom's syndrome (128.8 SCE at 10(-9) g/ml; 139.3 SCE at 10(-8) g/ml). The frequency of chromosome aberrations in Bloom's syndrome cells at concentrations of MMC of 1 X 10(-9) and 1 X 10(-8) g/ml was 0.350 and 0.825 per cell, respectively, and low when compared to the increased number of SCE. The increased frequency of SCE in normal and Bloom's syndrome cells is in contrast to the reported findings with cells from Fanconi's anemia and xeroderma pigmentosum. The distribution of SCE in MMC-treated normal cell correlates with that of spontaneous SCE in cells of Bloom's syndrome.


Quantification of chemical mutagenesis in diploid human fibroblasts: induction of azaguanine-resistant mutants by N-methyl-N'-nitro-N-nitrosoguanidine. The toxic and mutagenic effects of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) on cultured diploid human fibroblasts were studied. When 10(5) cells per 60 mm dish were exposed to MNNG for 4 h in Ham's medium F10 containing 0.02 M HEPES buffer at pH 6.8, MNNG concentrations of less than 1 X 10(-6) M resulted in cell survivals near 100%, while the average survival was less than one percent at concentrations greater than 5 X 10(-6) M. After treatment with MNNG, cells were subjected to selection using optimal conditions for the detection of diploid human fibroblasts that are resistant to the guanine-analogs AG and TG because they contain altered or deficient HPRT. The induced mutant frequency was maximized by allowing a 5 to 7 day post-treatment interval for the expression of the mutant phenotype and by replating the cells at the beginning of selection at a population density of less than 450 cells per cm2. Careful attention was given to counting statistically adequate numbers of mutants and to accurately determining cell survival and replating cloning efficiencies. Independent dose-response experiments gave induced mutant frequencies as high as 7.0 X 10(-4) to 8.8 X 10(-4) mutants per viable cell at about 5% survival, compared to a spontaneous mutation rate of 3.7 X 10(-6) to 7.2 X 10(-6) mutants per cell generation. The AGr mutants observed after treatment with MNNG were phenotypically stable and closely resembled prototype AGr cultures derived from humans who have inherited mutant X-chromosomal alleles for HPRT.


Cytogenetic effects of myleran in vivo on bone-marrow cells from male mice. The cytogenetic effects of Myleran were examined in bone-marrow cells from male mice. To study the dose--response relationship the male mice were injected with 5, 10, 20 or 40 mg of Myleran/kg. Bone-marrow samples were prepared 24 h later. The time response was investigated by examining bone-marrow samples 1, 2, 4 or 10 days after i.p. injection of 40 mg of Myleran. Most of the structural aberrations were of the chromatid type and the dose--response relationship was linear. The chromatid and chromosomal aberrations were maximal at 2 days and decreased sharply after longer intervals of time.


Induction of dominant-lethal mutations after administration of ethylenethiourea in combination with nitrite of the n-nitroso-ethylenethiourea in mice. Mutagenic potentials of ethylenethiourea (ETU) in combination with sodium nitrite or of N-nitroso-ETU, a nitrosation product of ETU in vitro, were investigated in the mouse dominant-lethal test. Simultaneous 5-day p.o. administration of ETU (150 mg/kg) and sodium nitrite (50 mg/kg) caused a significant decrease in the percentage pregnancy and the number of implants in weeks 5 and 6 of testing, although no effects were obtained on these indices when the chemicals were applied separately. However, in the group treated with 30 mg ETU plus 10 mg sodium nitrite per kg no dominant-lethal mutations were induced. 5-day oral administration of 100 mg of N-nitroso-ETU per kg also exhibited similar effects to those observed after treatment with 150 mg ETU plus 50 mg sodium nitrite per kg.


Hypoventilation in obstructive lung disease. The role of familial factors. To determine the role of familial factors in the hypoventilation of chronic obstructive lung disease we measured chemical drives to breathe in normal offspring of two groups of patients with an equal degree of obstruction. One group of five patients had repeatedly normal arterial carbon dioxide tension (PaCO2), whereas PaCO2's were elevated in the other group of six. Two adult offspring of each patient were studied. Drives were measured as the ventilatory response to isocapnic hypoxia, and the slopes of the ventilation/PCO2 relation (the hypercapnic ventilatory response). The mean response to isocapnic hypoxia was lower (P less than 0.01) in offspring of patients with high PaCO2's than in the offspring of patients with normal levels (71 +/- 7.8 [S.E.M.] vs. 113 +/- 10.3); one offspring of each patient with high PaCO2 had a response below the range found in offspring of all patients with normal PaCO2. Lower hypercapnic ventilatory responses (P less than 0.05) were also found in the offspring of patients with high PaCO2. Familial factors in the control of breathing may be an important determinant of ventilation in chronic obstructive lung disease.


Metabolic effects of dichloroacetate in patients with diabetes mellitus and hyperlipoproteinemia. Dichloroacetate is known to reduce plasma glucose and triglycerides in diabetic and starved animals and to lower plasma lactate under various experimental conditions. To investigate its metabolic effects in man, we administered oral doses (3 to 4 g) of dichloroacetate as the sodium salt to patients with diabetes mellitus or hyperlipoproteinemia or both for six to seven days. Dichloroacetate significantly reduced fasting hyperglycemia an average of 24 per cent (P less than 0.01) from base line and produced marked, concomitant falls in plasma lactate (73 per cent; P less than 0.05 to less than 0.01) and alanine (82 per cent; P less than 0.01 to less than 0.001). In addition, it significantly decreased plasma cholesterol (22 per cent; P less than 0.01 to less than 0.001) and triglyceride (61 per cent; P less than 0.01) levels while increasing (71 per cent; P less than 0.01) plasma ketone-body concentrations. Plasma insulin, free fatty acid and glycerol levels were not affected. Serum uric acid rose, whereas excretion and renal clearance fell. Some patients experienced mild sedation, but no other laboratory or clinical evidence of adverse effects was noted during or immediately after the treatment phase.


Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. A substance producing cytotoxicity in tissue culture was detected in stool specimens from all of four patients with pseudomembranous colitis due to antibiotics and in one of 54 with antibiotic-associated diarrhea. These stools also caused enterocolitis when injected intracecally into hamsters. On each occasion, cytotoxicity in tissue culture and enterocolitis in hamsters were neutralized by pretreatment with gas-gangrene antitoxin. The toxicity in both tissue cultures and hamsters could be reproduced with broth cultures of clostridia strains isolated from four of the five stools. These results suggest that toxin-producing clostridia are responsible for antibiotic-associated pseudomembranous colitis.


Direct comparison of theoretical and experimental melting profiles for RF II phiX174 DNA. The determination by Sanger et al. of the comple nucleotide sequence for phiX174 DNA has made it possible for the first time to compare directly theoretical and experimental DNA melting profiles. The comparison shows that the theory predicts the observed shape of the differential melting curve surprisingly well. Calculation of the denaturation maps allows the peaks on the curve to be correlated with cooperative melting out of concrete regions on the sequence of nucleotides.


Structure of pyruvate kinase and similarities with other enzymes: possible implications for protein taxonomy and evolution. The structure determination of pyruvate kinase shows that each subunit of the tetrameric molecule consists of three domains. The largest of these domains has a remarkable similarity to the structure of triosephosphate isomerase. Another domain shows similarities to many other nucleotide binding proteins. We discuss these similarities and their implications for current arguments on protein taxonomy and evolution.


Novel cell cycle control of RNA synthesis in yeast. During the fission yeast cell cycle, the rate of polyadenylated messenger RNA synthesis doubles when the cell reaches a critical size. This size-related control maintains average mRNA content in balance with total cell mass during exponential growth, even in cells growing at different absolute growth rates per cell.


[Physiopathology of celiac-mesenteric insufficiency]. The discrepancy between the high incidence of coeliac-mesenteric impairment at necropsy and its low frequency diagnosis intra vitam is stressed and brief mention made of the anastomotic ways which link the coeliac and mesenteric systems. These are useful not only for understanding certain pathological situations in which anatomic damage is not followed by clear-cut clinical phenomenology but also for explain in the ischaemic forms favoured by congenital alteration in such anastomotic systems. After analysing experimental contributions in the literature, the physiopathological aspects of the various forms of acute and chronic coeliac-mesenteric insufficiency are discussed.


[Clinical aspects and medical therapy of celiac-mesenteric vascular insufficiency]. A distinction is drawn between coeliac-mesenteric occlusion in intestinal infarct, vascular insufficiency, and fully compensated occlusion. The clinical picture of the first is that of acute abdomen with serious circulatory shock syndrome, whereas chronic insufficiency is marked by episodic pain triggered by eating, effort, drugs, etc., canalisation disturbances, meteorism, constipation or diarrhoea, intestinal stenosis, wasting and malabsorption. Their medical management and its principles, possibilities and limits are discussed.


[Angiography in the diagnosis of changes in the celiac-mesenteric area]. Notes on radiological anatomy are followed by a statement of the advantages of Seldinger's technique for visualisation of the coeliac-mesenteric vascular system. Examples of the principal lesions encountered in the arterial district are illustrated.


[Creatinine index in the diagnosis of myopathies. New method for determination]. A new spectrophotometric method for determination of creatine and creatinine values, and hence calculation of the creatine index, is reported. Micropipetting of fingerprick quantities (0.3 ml) of blood enables values to be obtained from obese and progressive muscular dystrophy subjects, whose veins are difficult to find without damaging the tissues.


[Stauffer's syndrome. Report of a clinical case]. The clinical case of a 52-year-old man with hypernephroma, abnormal hepatic function tests and no evidence of liver metastasis or abnormal histology is described. Liver function tests returned to normal values after nephrectomy. This case presents the features of the syndrome described by Stauffer in 1961 and can be added to the eighty or so cases reported since then.


A study of the effect of papaverine in neuroblastoma using the experimental C1300 murine system. The effect of papaverine on transplantable C1300 murine neuroblastoma model was evaluated. Subcutaneous inoculation of A/J mice with 10(6) C1300 cells resulted in predictable tumor growth and animal death in 36 +/- 5 days. In 33% of control animals, lung and liver metastases were observed. Subcutaneous injections of papaverine prior to tumor inoculation and during the tumor growth failed to show any detectable effect on local growth of the tumor. Benign transformation of the primary tumor was not observed. However, papaverine injection 21 days after tumor inoculation was associated with only 9% incidence of metastatic development. Papaverine treatment, when started one day prior to tumor inoculation or 10 days after tumor implant, resulted in complete prevention of all detectable metastatic growth, while having no apparent effect on local tumor growth. Further study of papaverine effect in the neuroblastoma murine model is indicated.


Ascitic versus solid growth of Ehrlich ascites tumor influenced by immunological factors. A certain number of CBA mice injected intraperitoneally with 1 X 10(6) or fewer Ehrlich ascites tumor (EAT) cells did not develop ascites tumors but solid tumors at the inoculation site. The incidence of solid tumors proved dependent on the level of immunological reactivity of recipients, being increased in mice with increased immunological potency and absent in mice in which this potency was reduced. Mice bearing solid tumors had increased level of cytotoxic antitumor antibodies in serum. Possible reasons for a greater immune resistance of cells growing in subcutaneous tissue, than in the abdominal cavity, are discussed.


Hypothesis for the mechanism of elevated serum copper in cancer patients. Neoplastic growths seem to interfere with normal processes regulating the serum level of ceruloplasmin, a copper-containing oxidase, which accounts for 96% of serum copper. Normal catabolism of ceruloplasmin in the liver follows desialylation. However, in patients with tumors, ceruloplasmin may be resialylated at the tumor cell surface or in peripheral blood. Decreased catabolism due to resialylation of asialo-ceruloplasmin could account for the increased concentration of serum copper noted in patients with neoplasia.


Classification of the diffuse chorioretinal heredodystrophies or peripheral tapetoretinal dystrophies. The best classification of the diffuse chorioretinal heredodystrophies (predominantly peripheral tapetoretinal dystrophies) is that which is based on the mode of heredity. Thus, it is possible to distinguish the autosomal recessive forms (Leber's disease, pigmentary retinopathy, Bietti's crystalline fundus dystrophy, albipunctate retinopathy, choroidal atrophy and gyrate atrophy of the chorioid and retina), the autosomal dominant forms (certain forms of pigmentary retinopathy, choroidal atrophy, progressive cone dystrophy and Sorsby's pseudo-inflammatory dystrophy), and the sex-lined forms, whether recessive (pigmentary retinopathy), dominant (pigmentary retinopathy) or intermediate (pigmentary retinopathy and choroideraemia).


[Peripheral retinal lesions in aphakia]. The peripheral retina of 150 aphakic eyes with uncomplicated extraction was studied with the Goldmann three-mirror contact lens. The patients were examined 1 month to more than 2 years after cataract extraction. In addition to degenerations which are descirbed everywhere and are seen both in phakic and aphakic eyes, the authoris have emphasized lesions which they consider to be specific of aphakia. These lesions are retinal haemorrhages of wich four types are described; pigmentary anomalies and retinal tears and holes. Taking into consideration the great frequency of aphakic retinal detachment in comparison with phakic detachment, it is evident that such lesions must be held liable in aphakic retinal detachment.


Mitosis in the nontumorous parts of the retina with retinoblastoma. Uninvolved retina in the posterior pole in an enucleated eye was examined by electron microscopy for retinoblastoma. A mitotic figure was occasionally found in the outer and inner nuclear layers. The dividing cells were clearly separated from the tumor mass by 450-600 micrometer. They were identified as immature Müller cells based upon the fine structural features. The existence of the dividing cells in the posterior retina after birth was abnormal and indicated immaturity of the retinal development.


Retinoblastoma in a microphthalmic eye.

Retinoblastoma in a microphthalmic eye. A case of simultaneous occurrence of microphthalmus and retinoblastoma in an eye removed from a 1-year-old monozygote twin with bilateral retinoblastoma, is reported. The other eye was of normal size, and was treated with irradiation (local application of Stallard disc). This case seems to be the first one published showing that one cannot be usre of the absence of tumours in small eyes although it is extremely rare.


Keratoconus: A disease that can be treated with soft lenses. 10 patients with keratoconus and very reduced vision were treated with soft contact lenses with good results both in visual acuity and comfort Some patients were able to read 1.0 and demonstrated that soft lenses can give as good visual acuity as hard lenses, a fact quite contrary to the generally established opinion in the contact-lens world. Observation time 9 months.


[Ophthalmophlegic polyneuritis. A clinical contribution to Fisher's syndrome]. This paper describes 6 patients with the syndrome of ophthalmoplegic polyneuritis fairly identical to that described by Fisher. The most striking symptom of the ophthalmoplegic polyneuritis is the acute ophthalmoplegia, usually total and bilateral, often with sparing of the pupillary reflexes and of the levater palpebrae. The disturbances may simulate a paralysis of gaze or a internuclear palsy. Following features may announce this illness: mild harmless infectious disease, sensory deficits, generalized hyporeflexia or areflexia, albuminocytologic dissociation. There is without a specific treatment a complete recovery within months. Often it is impossible to clarify the etiology.


Total responsibility of the surgeon in the management of traumatic spinal paraplegics and tetraplegics. Surgeons of whatever speciality concerned with the acute treatment of spinal cord injuries have to accept total and not fragmented responsibility in the management of these patients. This involves certain key responsibilities which are discussed in detail in the light of professional liabilities.


Some experience with paraplegia in a small hospital in Nepal. Paraplegia is a common problem in developing countries. They are the most pitiable group of cases seen, but they can all be offered some help, however limited one's resources. The main causes are Potts Disease, arachnoiditis, tropical spastic paraplegia, trauma, lathyrism and cord compression. The usual trauma is falling from trees and the use of trained monkeys to gather leaves and nuts whilst humorous should not be dismissed. The author saw some 35 cases of paraplegia, of which four are described--two good results and two bad. The physician going to a developing country is advised to prepare himself for the care of these cases and to be prepared to motivate staff, patients and relatives. He will find local medical assistants are kind and enthusiastic and rapidly acquire the necessary skills. Nearly all cases should receive a simple and inexpensive anti-tuberculous regime, vitamins and a very generous diet. Necessary equipment required for the home should be locally made and nothing requiring more than simple maintenance should be used.


The costs of spinal cord injury.

The costs of spinal cord injury. An ongoing study of medical care and associated costs relative to spinal cord injury is being conducted at the University of Alabama in Birmingham, one of 11 federally funded Model Regional Spinal Cord Injury Centres. It was hypothesised such costs would be lower among patients admitted into an organised continuum of care (system) soon after injury than among patients whose entry into the organised system of care was delayed (non-system). A comprehensive economic data set has been acquired on 142 of 233 (61 per cent) patients admitted since implementation of the project. Analysis of these data reveals: (1) system patients require, on average, expenditures of almost $5,000 less than their non-system counterparts; (2) there is little difference in medical or associated costs and length of hospitalisation between tetraplegics and paraplegics; (3) spinal cord injuries secondary to motor vehicle accidents have higher associated costs and longer lengths of stay than do those injuries resulting from other causes including acts of violence.


First year hospitalisation costs for the spinal cord injured patient. This retrospective, descriptive study presents the actual first year hospitalisation costs for a series of 85 spinal cord injured patients, covered by Workmen's Compensation Insurance and cared for in a variety of United States institutions. Mean first year hospital costs for all patients was $35,767. For quadriplegics, $42,240; and paraplegics, $32.619. During initial hospitalisation only, the average length of stay was 184 days and mean cost was $28.637. Room and board comprised 52 per cent of cots; special services, 36 per cent and professional services, 11 per cent. Major special service costs were private duty nursing, medications, medical supplies, respiratory and physical therapy. Major professional charges were centred in the surgical and physical medicine specialties. Home care costs averaged $4000 per patient or $37.00 per day. When compared with the other studies, the costs presented here are higher though the differential is reduced markedly when median rather than mean costs are presented. When compared with the one other known study based on actual and not estimated costs, the results are markedly similar. Differences in costs between this and other studies and the reasons for same are discussed.


Classification of the severity of acute spinal cord injury: implications for management. Sensory and motor function scales using a comprehensive neurological examination in emergency departments were developed during a 5-year prospective study of the epidemiology of acute spinal cord injury. Cross-classification of the scales on 133 patients identified 18.8 per cent who had severe motor impairment but minimal or no sensory loss. This discrepancy was not associated with older age or comorbidity but these patients tended to have a higher prevalence of fracture dislocations, hyperesthesia and Brown-Sequard Syndrome. The discrepancy between sensory and motor function was almost certainly due to the pathology of the cord lesion. Overall, motor function was more likely than sensory function to show improvement during the acute hospitalisation. This was especially true for patients admitted with good sensory but poor motor function. These patients need to be delineated soon after injury if we are to fully understand the aetiology of spinal cord injury and appropriately manage and evaluate different therapeutic modalities.


Autonomic hyperreflexia during cystoscopy in patients with high spinal cord injuries. Cystoscopic procedures were performed on 102 patients with histories of traumatic spinal cord lesion; 57 patients had sensorimotor levels above T7, and the remaining 45 patients had levels below T7. In 40 of the 57 patients (70 per cent) with levels above T7, signs and symptoms of autonomic hyperreflexia were seen during bladder distension and cystoscopy; the remaining 17 of these patients (30 per cent) did not have this response. No autonomic hyperreflexia was seen during cystoscopy in any of the 45 patients with sensorimotor levels below T7.


Hydatid cyst causing spinal compression. This report deals with two cases of spinal cord compression, one secondary to hydatid disease of C4 vertebra and the other due to a posterior mediastinal hydatid with an intraspinal component. After a brief review of the pertinent literature and pathogenesis of the disease, the distinguishing radiological features have been brought out.


Coping behaviour and the moratorium following spinal cord injury. Coping with severe traumatic injury involves three interwoven processes--denial, depression and restitution. Denial and depression are seen as adaptive processes in the appropriate context. A moratorium during the coping process is described; its duration and implications for patient care are discussed.


Pain and cervical traction variation during manual turning [proceedings]. An experiment using a dummy with a cervical traction recorder was used in place of a patient. Nurses and orderlies from the Spinal Unit carried out manual lifting and turning techniques, used in the conservative treatment of spinal injury. Variation in manual traction continues throughout a turn. Traction force may be quadrupled or quartered. Inco-ordination between the individuals lifting, causes bending forces in the neck. This, together with sharp variation in traction, elicits pain. Manual traction, lifting, and turning, should be totally avoided, by employing kinetic nursing, provided by the use of the Roto Rest Spinal Bed.


About pain and its treatment in paraplegics [proceedings]. Apart from pains by removal of inhibition, there are pains by hyperstimulation as well, even with apparently complete paraplegia. Successively, the author first reviews specific sub-lesional pains, then lesional pains (some of them are probably due to deafferentation), and at last, supra-lesional pains which are the most numerous ones and for which examples of hyperstimulation are given. The therapeutic rules used by the author are enumerated. To ease their suffering about 8 per cent of the patients are given antidepressive drugs, which most of the time can be gradually stopped after several months.


Semiological value of painful sensitivity of the testis in spinal cord injuries [proceedings]. About 85 cases of spinal cord male injured patients; the authors bring their experience of the painful sensitivity of the testis by squeezing the gland. This sign has a semiological value about the topography and the level of complete and incomplete cord syndromes. It is of no value for the testicular fertility. The rehabilitation of neurological bladders must take this sign into account so as to appreciate the type of micturition.


The corkscrew sperm defect in Danish bulls--a possible indicator of nuclear fallout? The characteristic corkscrew defect in the middle piece of the bull sperm was observed by the author in two infertile bulls in 1958 and described the following year. Since then the spermiograms of all Danish A.I. bulls (about 1200) have been examined yearly, and a total of 60 cases showing more than 2% corkscrew sperms in their semen have been recorded. The sperm defect was found mostly in older bulls and was often accompanied by testis degeneration. The Red Danish breed seems to be highly predisposed. The cause of the defect and the testis degeneration is obsecure. However, by comparing the curves for nuclear fallout during the observation period and the number of cases observed, there seems to be some correlation. It is striking that the maximum of ten new cases of the corkscrew defect was found in the peak year for nuclear testing in the atmosphere (1962), when a total of at least 133 tests were performed, thus polluting grassland all over the world. Since 1963, when a partial test ban treaty came into force, most nuclear testing has been done underground. From that time the number of yearly cases of the corkscrew defect in the Danish bull population has decreased and the defect is now practically non-existent. Attempts to produce the condition experimentally by feeding young bulls with the fission product Iodine131 have so far been negative.


In vitro antibiotic sensitivity test of Staphylococcus aureus isolated from mastitic milk. The antibiotic susceptibility of 2297 strains of Staphylococci aureus isolated from mastitic milk has been tested. The percentage of strains of S. aureus "resistant" to penicillin was 16.5%. Approximately 97% of these strains were susceptible both to tetracyclines and sulfonamides. The frequency of "resistant" strains is in good agreement with the results from a comparable survey done ten years ago. In this investigation, however, the strains of S. aureus showed great variation in their sensitivity to penicillin according to their geographical origin. Thus, the percentage "resistant" strains within counties varied from a minimum of 9.26 to a maximum of 53.05.


[A case of mastatitis in a goat. Cytological and bacteriological examinations of milk samples throughout the entire lactation period (author's transl)]. A case of mastitis in a goat caused by S. aureus is described. Cytological and bacteriological examinations of milk samples throughout the entire lactation period were made. The average cell counts/ml in millions in milk samples were 6,12 (right half with mastitis) and 0,51 (left half which was normal) throughout the entire lactation period.


[The cell count in milk of goats and the diagnosis of mastitis in goats (author's transl)]. The cell counts in milk of goats seem to vary quite a lot. It is difficult to diagnose mastitis in goats using only cell counts as a criterion. Clinical symptoms correlated with bacteriology and differences in the cell counts of milk samples from the two halves are probably the criteria of choice in the laboratory mastitis diagnosis in goats.


[Two cases of hepatoencephalopathia in the dog (author's transl)]. Two cases of congenital anomalies in the portal system in young dogs are described. Clinical findings such as poor general condition with chronic weight loss and failure to grow, signs of central nervous disease, are typical for the hepato-encephalopathy syndrome. Clinical and radiological examination revealed a small liver and in one dog large kidneys. Hematological data (hemoglobin, leukocytes and PCV) were normal but elevated bromosulphtalein retention was seen in both cases. Furthermore, low serumprotein, due to reduced albumin fraction, low urea-N and large amounts of ammoniumbiurate  crystals in the urine are typical findings in portal anomalies with hepatoencephalopathy. In one dog hepatic insufficiency was due to a porta-cava shunt localized just outside the liver, and in the other dog an intrahepatic porta atresia was found with secondary fibrosis of the liver parenchyma. The liver was atrophic and the kidneys revealed chronic glomerulosclerosis. It is concluded that the clinical and pathological findings were results of vessel anomalies.


Clinical and electroencephalographic data indicative of brain tumours in a seizure population. One hundred and two patients suffering from seizures, with focal EEG signs (101 cases) and focal seizures but generalized EEG abnormalities (one case) were divided into tumour (twenty-one cases) and non-tumour (eighty-one cases) groups on the basis of contrast radiological studies. Retrospective analysis of various clinical data and EEG abnormalities, determined before the contrast radiological examinations, showed that the following were statistically significantly different between the two groups in favour of a tumoral aetiology for the seizures: age at onset of fits (greater than 20 years), presence of focal neurological signs and increased intracranial pressure, presence of focal unilateral delta waves without accompanying epileptic discharges, beta asymmetry between the cerebral hemispheres and hyperventilation-induced electrical seizures. A brain scan was a very useful screening test for the detection of a tumoral aetiology for seizures.


Acute myocardial infarction and arterial embolectomy. Emboli of a main artery cause serious complications in patients suffering from acute myocardial infarction, in whom the surgical risk is high. In order to save the limb, embolectomy is indicated and should be considered. Early diagnosis and prompt surgical intervention with the use of the Fogarty catheter simplify the embolectomy procedure and enable restoration of circulation to the ischaemic limb. Thirty-two embolectomies were performed in twenty-eight patients suffering from acute myocardial infarction. Patients with cardiac compensation survived the surgery and recovered. However 50% of the patients in whom acute myocardial infarction was accompanied with congestive heart failure and arrhythmias died. The cause of death was the underlying disease. Considering the severity of the acute myocardial infarction this group of patients represents the expected mortality.


Furosemide and acute renal failure.

Furosemide and acute renal failure. High dose of intravenous furosemide (2 g/24 hr) was given to six patients with acute renal failure due to leptospirosis. The results, based on urine flow, changes in serum creatinine and creatinine clearance, were compared with a control group of eight patients with the same disease and comparable degree of renal failure. Excellent diuresis was observed following furosemide therapy but renal function and the clinical course of the disease were unaltered. The duration of renal failure was the same in both groups.


Obsolete but dangerous antacid preparations. One case of acute hypercalcaemia and two of recurrent nephrolithiasis are reported in patients who had regularly consumed large amounts of calcium carbon-ate-sodium bicarbonate powders for more than 20 years. The powders had been obtained from pharmacists unknown to the patients' medical practitioners. It is suggested that these preparations were responsible for the patient's problems, and that such powders should no longer be freely obtainable.


Myocardial ischaemia in migraine sufferers taking ergotamine. Two cases of acute myocardial ischaemia precipitated by oral ergotamine therapy for migraine are described from patients with no previous history of ischaemic heart disease. The relevant literature is briefly reviewed.


Phaeochromocytoma with nocturnal elevation of blood pressure. A 47-year-old woman with phaeochromocytoma showed blood pressure changes characterized by the regular appearance of hypertension at night. The urinary excretion of catecholamines and their metabolites showed augmentation roughly parallel with the elevation of the blood pressure. During normotensive periods, the urinary excretion of catecholamines and their metabolites was elevated. The findings suggested that the pressor effect of catecholamine hypersecretion was compromised to a certain degree and that the regular nocturnal appearances of hypertensive paroxysm conceivably resulted from a spontaneous cyclic augmentation of the catecholamine secretion from the tumour.


Chronic active hepatitis, haemolytic anaemia and Listeria monocytogenes bacteraemia. The association of chronic active hepatitis with haemolytic anaemia is well known. Both conditions may respond to steroid therapy which, in common with other causes of suppressed T-lymphocyte function, predispose to many types of infection. A case is described in which transient Listeria monocytogenes bacteraemia occurred and the patient recovered without antimicrobial therapy.


A comparison of unrefined wheat and rice diets in the management of duodenal ulcer. Twenty-one chronic duodenal ulcer patients in a rice-eating area were put on to an unrefined wheat diet and twenty-one continued on their previous rice diet. After 5 years only 14% of the first group had had relapses compared with 81% of the second group. A similar 5-year relapse rate (80%) was obtained in a group of thirty patients from another area with a more varied rice diet. The author attributes this difference to the increased mastication required by the unrefined wheat diet, which is associated with an increase in saliva, lower stomach acidity and reduced bile output.


Scopolamine does not affect footshock sensitivity in the rat. To test the generality of the finding of Feigley, et al. [8] that scopolamine increases sensitivity/reactivity to footshock, rats were tested under either scopolamine or saline conditions for sensitivity to footshock in an automated version of the flinch-jump paradigm. There was no significant trend toward increased sensitivity following scopolamine injection at any of the response magnitudes assessed. Since the previous study included an operant response in the measure of sensitivity, it was suggested that apparent effects of scopolamine on reactivity to footshock are dependent on the inclusion of an operant response in the measure of reactivity, and are not due to changes in sensory thresholds.


Hypokinesia produced by anterolateral hypothalamic 6-hydroxydopamine lesions and its reversal by some antiparkinson drugs. Hypokinesia produced by stereotaxic microinjection of solutions of 6-hydroxydopamine into the anterolateral hypothalamus of male rats is accompanied by a generalized reduction in brain noradrenaline levels and a reduction of dopamine in the striatum and cerebral cortex. The hypokinesia is reversed by the putative dopamine-receptor agonists apomorphine, ET-495 and CB-154 as well as by the amino acids L-Dopa and m-tyrosine when administered in combination with the peripheral decarboxylase inhibitor Ro 4-4602. The relative importance of noradrenergic and dopaminergic systems in the mediation of the action of anti-akinesia drugs is discussed.


ADH and related peptides: effect of pre- or posttraining treatment on puromycin amnesia. The peptide Z-Pro-Leu-Gly-NH2 attenuated puromycin-induced amnesia in mice when administered 5 days prior to training, while arginine vasopressin, lysine vasopressin and cyclo(Leu-Gly), were effective when given 24 hr before training. The activity of all peptides to inhibit puromycin-induced amnesia decreased as the interval after training and before peptide administration increased, suggesting that the peptides influence memory processes rather than generalized arousal mechanisms.


Experience with a consortium for exploring and arranging clinical eduction programs. The Clinical Allied Health Education Center, a prototypic agency, was established to assist in addressing clinical education issues of various allied health professions within the western half of lower Michigan. The agency aids in coordinating the clinical phase of the education of students in the educational programs. In the process of establishing new clinical education sites, the individuals involved in the physical therapy educational program and at the potential site address issues related to the exploration, evaluation, development, and implementation of the clinical education program. The experience and process in establishing the relationship between the Curriculum in Physical Therapy at the University of Michigan and the Clinical Allied Health Education Center are described.


Six design factors for planning and evaluating regional continuing education. Four characteristics of a configurational strategy for planning regional continuing education in medical allied health are identified in this article. These characteristics are restated as criteria for six design factors in the planning and evaluation of a regional continuing education program. A perceptual motor dysfunction workshop was planned and evaluated utilizing the configurational strategy.


How to care for your neck.

How to care for your neck. This paper was written in order to share the comprehensive guidelines I use as handout material when teaching daily living activities to patients with cervical pain. I have found the information to be helpful to patients in their understanding of their disability and in their learning to protect themselves.


Long-term results in epiphyseal transplants in congenital deformities of the hand. Experiences in several decades of doing epiphyseal transplants, as free grafts or in island flaps, are described. The long-term results are noted. Based on the latter, some specific policies for the treatment of ectrodactylic hands have been formulated.


Anastomosis of masseteric nerve to lower division of facial nerve for correction of lower facial paralysis. Preliminary report. Another method to reanimate the corner of the mouth in facial paralysis is by reinnervation of the perioral musculature. We have done this in 3 cases by anastomosing the masseteric nerve to the nearby lower division of the facial nerve. The results varied, but are promising.


A radical method of correcting the nasal deformity in adult patients with repaired unilateral lip clefts. A method of rhinoseptoplasty is described, which combines principles of several well-known procedures, with innovations introduced by the author, for the purpose of eliminating the causes of complex distortions of the lip, maxilla, and nose in unilateral clefts. This method aims at creating a secure support for the atrophic alar cartilage with a pedicled cartilage flap taken from the normal alar cartilage. Elevation of the dome and elongation of the columella on the cleft side are achieved by interdigitating mucocutaneous flaps. To improve symmetry and relieve nasal obstruction, the ala on the normal side is also corrected, as well as the deflected septal cartilage and the anterosuperior margin of the vomer.


Evaluation of prognosis in Stage I cutaneous melanoma. A review of the literature on melanoma indicates that age, sex, size, ulceration, presence of satellites, absence of melanin, and whether or not the tumor is markedly raised above the surface of the surrounding skin are all useful criteria in evaluating the prognosis in Stage I cutaneous melanoma. Histological factors include the tumor type, the mitotic rate, and the maximum thickness of the tumor. The last is accurate for prognosis--objective, reproducible, and directly proportional to the mortality rate. Tumors less than 0.76 mm thick rarely, if ever, metastasize--and it appears that the size of the resection margin can safely be reduced for such thin tumors. The level of invasion (Clark) is less accurate in predicting the mortality.


Blindness after blepharoplasty: mechanism and early reversal. Based on our close personal observation of several patients after blepharoplasty who developed retrobulbar hemorrhage progressing to blindness, the mechanism appears to operate through ischemia of the anterior optic nerve head. Relief of this blindness has followed prompt surgical intervention, with supportive medical therapy. The importance of close nursing observation for some hours after the operation is stressed, as it may be the only means of detecting this complication while the sight can still be saved.


Breast reconstruction following radical mastectomy, using custom designed implants. Procedures are described for total breast reconstruction in patients who have undergone radical and modified radical mastectomies. The reconstruction includes restoration of the contour of the breast, including the nipple-areola complex and filling the defect from loss of the pectoral muscles. The reconstructions have been done in 37 patients with good results, and several are illustrated.


Cystic lesions of the parotid gland.

Cystic lesions of the parotid gland. In a series of 708 parotidectomies (partial or total), we found 23 cystic lesions. Of these, 16 met the criteria for so-called "branchial cysts"; five were retention cysts of duct origin, and the remaining two were epidermal inclusion cysts. The principles of diagnosis and treatment of parotid cysts are presented.


Contouring the neck in rhytidectomy by lipectomy and a muscle sling. Accurate diagnosis of the cause of the objectionable contour problems is necessary for the execution of appropriate and adequate surgical technique for correction. For improving neck contour, I use an adequate lipectomy combined with deep support provided by a sling made from full-width platysma muscle flaps.


Tissue gases in human hypertrophic burn scars. The partial pressures of oxygen and carbon dioxide have been measured in hypertrophic scars in burned patients, using mass spectroscopy. The pO2 in scar tissue was significantly depressed in comparison to the pO2 in normal dermis (a decrease of 13.1 +/- 2.9 mm Hg). The pCO2 was noted to be increased in the scar tissue (2.6 +/- 1.6 mm Hg). The possible significance of these findings is discussed.


Spatial play.

Spatial play. More than sharpening our tools or making them sterile, our task in psychotherapy and analysis is to enliven them, find in them the organic, the animate, and the fecund. For our tools are formed of language, more like living nets than like knives, dies, taps, or templates, and our familiary with them might as well be a marriage of love as one of convenience. One's own onymy (Forrest, 1973) of words and phrases that seem to be one's property and private treasury will include, in the case of a doctor who uses words, several such verbal tools that have acquired greater frequency of use and richer and deeper meanings with experience. For me the word play in its affinity for very spatial senses has grown increasingly helpful in meeting both the practical demands of therapeutic communication and the personal need to maintain theoretical structures to support therapeutic work. I wish here to explore the concept of play--contributions to its definition, its developmental stages, applications of play, and its extended properties.


The therapeutic relationship in neighborhood psychiatry: impact of clinical setting on clinical practice. The relationship between psychotherapist and patient in neighborhood mental health practice differs in important ways from the therapeutic relationship established in other clinical settings. Obviously, no matter where therapist and patient meet, their personality characteristics and the clinical methodology will shape the relationship between them. Most clinical approaches emphasize personality and technique--therapists of all schools are trained to scrutinize these aspects of psychotherapy. But therapists are generally less well prepared to comprehend the clinical impact of the organizational setting itself (Newton and Levinson, 1973). Consequently, the practitioner may not recognize how much the system in which he works influences the way he and his patient relate to each other.


Primal-scene experiences as recalled and reported by college students. Theoretical and clinical anecdotal studies have assigned considerable significance to the witnessing of and fantasizing about parental sexuality for a person's later understanding and behavior, especially with regard to sexuality and male-female relations. Little is known, however, about the psychology of primal-scene experience, especially if one seeks any systematic or formal data. Even such basic facts as the incidence of recalled primal-scene exposure or fantasy are unavailable, as are any normative data regarding the reactions that may be provoked by such experience. In this study, 345 college student respondents completed questionnaires stating their age and reactions at the time of their initial awareness of their parents' sexual relationship, any actual primal-scene observations, and their ideas and reactions to the idea of their parents' present sexual lives.


Schizophrenics' mutual glance patterns.

Schizophrenics' mutual glance patterns. The schizophrenic patient is often quite incommunicative about his current or past interpersonal relationships. Many workers feel that interviews with the schizophrenic's parents are also unreliable means of getting direct verbal information. Such pessimism is based on their experience that parents of schizophrenics often distort or delete information because of a concern with appearances, an inability to communicate adequately, or an investment in maintaining the patient status of their offspring. Difficulty in getting verbal data limits the therapist's understanding of the schizophrenic and his relationship with people. Observation of implicit communications through gestural interaction provides an important alternate means of getting information about interpersonal relationships which does not necessarily require the cooperation of the patient or his parents. As research in gestural communication improves, it should be possible to attempt a more detailed investigation of the interaction between the schizophrenic patients and others. Through the use of gestural or other implicitly communicative indices, such qualities as seductiveness, hostility, dependency, dominance, and others may ultimately prove to be measurable. Research has demonstrated that gestural behavior as a means of imlicit communication is indicative, in a gross sense, of the quality of interaction between people (Ekman, 1965; Exline and Winter, 1965). This study is concerned with mutual glances--moments in which two people look directly at each other at the same time so that their eyes meet.


Group psychology and the analysis of the ego--a lifetime later. In a retrospective evaluation of Freud's essay, the author discusses the formation of emotionally fused mass movements, the implications of drastically changing social patterns and staggering population increases. He sees the critical faculty of the individual ego as the only safeguard against the pull of mass regressions. However, for people long held in subjection, fusion in a common political purpose can constitute a first step toward individual self-awareness, although their leaders may be terrorists, agents of the accumulated aggression. Only the concept of a death drive fully explains the recurrence of mass regression; only the fear of our enormous destructive power may offset its terrible seduction.


Conscious dream synthesis as a method of learning about dreaming: a pedagogic experiment. Stimulated by Freud's comments on the unique perspectives offered by "building up dreams by synthesis," the authors applied this idea to the St. Louis Psychoanalytic Institute's introductory course on the psychology of dreaming. Each student was assigned the task of purposefully and consciously synthesizing a dream, utilizing certain assigned information and meeting the specified criteria. In the use of this device, it was anticipated that the conscious active effort required to duplicate the usually passively experienced processes of dreaming and the unconscious dream work would lead to a deeper understanding and appreciation of the dream.


Pyromania and the primal scene: a psychoanalytic comment on the work of Yukio Mishima. In the writings of the Japanese novelist, Yukio Mishima, primal scene experiences and derivative expressions of them recur persistently. The element of fire figures prominently in connection with the wish to wreak vengeance on the persons originally observed in the act of intercourse. As a destructive, attention-compelling spectacle, fire is a particularly suitable vehicle for this purpose. In Mishima's works, revenge takes the form of retaliation in kind: parental figures, or their surrogates, are put into the position of having to observe the child, or substitutes for him, in the act of sexual infidelity. These observations as well as clinical reports in the literature suggest some insights into fantasies of pyromania. They also make possible certain speculations concerning Misima's turbulent life and dramatic suicide.


Ego function assessment of the psychoanalytic process. Pressing needs for objective and rapid clinical assessment of the psychoanalytic process are emerging in the current climate of social and medical change. The Ego Function assessment (EFA) method is presented as an available, valid, and reliable quantitative technique which can be used by clinicians for such objective evaluations. EFA formulations are dynamically highly relevant. They are directly derived from psychoanalytic theory and practice.


The developmental prestages of defenses: diagnostic and therapeutic implications. In the interest of clarifying the distinction between psychopathology based on structural conflict and psychopathology rooted in an arrest in ego development, the hypothesis is offered that there is a developmental line for each defensive process and that a defense mechanism represents the endpoint of a series of developmental achievements. Clinical material is presented to demonstrate the decisive diagnostic and therapeutic consequences of distinguishing between the defenses of projection, incorporation, and splitting, on the one hand, and their specific developmental prestages, on the other.


Protection and safety in the X-ray department. It should be obvious from the foregoing that the greatest protection to the patient and to the radiographers is a constant awareness of the potential hazards from ionising radiation, combined with a regular check on all procedures and all equipment.


A 2 hand phantom.

A 2 hand phantom. A technique for embedding hand and wrist bones in plastic resin is described.


Vascular pseudo-tumours of the mediastinum in asymptomatic patients. A tomographic study. I. Arteries. This is the first of two articles which discuss the radiological features of asymptomatic mediastinal pseudo-tumours of vascular origin, detected accidentally on routine chest X-rays. With a view to possible subsequent surgery, it is of vital importance not to confuse a vascular pseudo-tumour of the meadiastinum with a neoplasm. The radiological appearances of the penetrated chest X-ray, and oesophagographic and tomographic findings, are fairly characteristic. The tomographic features are given special attention. A distinction is made between vascular pseudo- tumours of arterial and of venous origin. The first article discusses pseudo-tumours of arterial origin, the majority of which are based on a tortuous descending aorta, buckling innominate artery, aneurysm of the aorta or congenital anomalies of the aortic arch and its major branches.


Selective scintiangiography of the kidney with xenon-133. Measurement of the spatial distribution of the clearance rate of xenon-133 from the kidney after its injection into the renal artery for estimating intrarenal blood flow can easily be combined with selective X-ray angiography as a routine method. Using a gamma camera as detection equipment anand applying a special computer analysis technique, 'functional images' can be obtained, by which the spatial distribution of the blood flow in the kidney is quantitatively mapped. Experiments with a rather heterogenous group of 12 patients suggest that in at least one type of renal pathology the xenon-133 flow study is more indicative for clinical evaluation than the X-ray angiography


Discussion of radiobiological factors operating in low dose rate irradiation. Low dose rate irradiation may have advantages over fractionated daily irradiation apart from the small treatment volume, connected with curie therapy. Radiobiological factors such as low OER with dose and low dose rate, per cell cycle time and redistribution effects are discussed.


Use of the computer in high-energy electron therapy. The experimental determination of the dose distribution in the body of patients treated with high-energy electrons is very difficult and inaccurate as, among other things, the body contours and the size of the patient's organs are seldom identical with those of a phantom. With the aid of the computer, it is possible to elaborate quickly for each treatment isodose plans sufficiently accurate for practical application. The dose distribution depends on the following factors: number of fields or rotation angle, size of the radiation fields, electron energy, curvature of the body surface and shape and composition of the organs. With the aid of the computer, which is capable of simulating a multiple-field or moving-beam irradiation by the summation of the dose values of two or more single fields, the above-mentioned parameters can be changed as required and thus various types of treatment plans can be prepared. Prior to the treatment, the radiotherapist can select the optimal plan for the case in question from a number of possibilities.


Diagnostic value and limitations of selective spinal angiography in different lesions of the vertebral bones. The technique, diagnostic results and significance, differential diagnostic considerations and limitations of selective spinal angiographies in chronic inflammatory processes (Pott's disease 11 cases). hemangiomas (21 cases) and aneurysmal bone cysts (9 cases) as well as benign and malignant tumors (26 cases) of the vertebral bones and adjacent tissues are described and demonstrated with regard to radiological findings.


Hippel-Lindau disease. A case history of one family. This article describes the results of a prospective study in the 4 asymptomatic members of a family affected with Hippel-Lindau disease after the death of 2 patients and the surgical findings of the third. It stresses the multicentric and bilateral origin of renal cell carcinoma in Hippel-Lindau disease, usually combined with renal cortical cysts. The walls of these cysts often contain carcinoma cells. It is important that all relatives of a patient with the Hippel-Lindau disease are adequately screened.


Ulcerative colitis.

Ulcerative colitis. The clinical symptoms of ulcerative colitis are described and three main points are emphasized: 1. The importance of associated diseases of ulcerative colitis (hepatic involvement, arthropathy, skin affections, uveitis and thyroiditis). 2. The importance of psychopathological conflicts in the pathogenesis and treatment of the disease. 3. The necessity to have a well-balanced team of pediatricians, pediatric surgeons, psychologists or psychotherapists, pathologists, social workers and stoma therapists for optimal therapy.


Congenital duodenal obstruction: a review of 82 cases. We report our experience with 82 cases of congenital duodenal obstruction. Forty-seven had intrinsic and 35 extrinsic lesions. Treatment of duodenal occlusion resulting from maldevelopment of the common mesentery is well standardized. Treatment of occlusion due to duodenal atresia or complete diaphragmatic obstruction needs re-evaluation. Our critical study of the anastomoses commonly used emphasizes that duodenojejunostomy and gastrojejunostomy should be avoided. The recommended operative technique had the following aims in order to utilize fully the duodenal circuit: 1) Reduction in size and remodeling of the proximal dilated duodenal segment; 2) End-to-end anastomosis of the proximal duodenum with the distal duodenum or the jejunum. Only the "annular pancreas" lesion is not fully amenable to this technique but, even here, an end-to-side anastomosis is eminently feasible.


Presinusoidal extrahepatic portal hypertension: a review of thirty-five cases variously treated. Thirty-five cases of proven preinusoidal extrahepatic portal hypertension in children have been reviewed with particular reference to etiology, clinical course, therapy, and long-term follow up results. Thirty-three patients has significant gastrointestinal bleeding and 31 were operated upon. There were no operative deaths. Portosystemic venous shunts were successful in 12 of 21 patients. A variety of procedures were used for 15 of the 17 "unshuntable" individuals. Some form of esophagectomy and proximal partial gastrectomy with colon substitution appears to be the most effective operation for control of hemorrhage in the "unshuntable" patients. Expectant treatment is preferred in the infant and younger child, but the older child should have a definitive shunt or direct attack on the varices since recurrent bleeding is usually the rule.


The basis of immunosuppressive treatment in ulcerative colitis. Clinical signs and immunological findings suggest that causation and subsequent progress of ulcerative colitis are related to the body's immune systems. Among the immunological findings, the following are of special importance: the appearance of humoral antibodies against colonic antigens, the presence of specific adapted lymphocytes against fetal colonic epithelium, the decrease of complement (especially in severe types of the disease), and immunohistological changes in the colonic mucosa. The histological changes in the region of the affected segment of intestine and the regional lymphnodes are also characteristic of an immuno-inflammatory disease. However, it is not yet known whether the immunological mechanism is responsible for causing the disease or whether it occurs together with a disease which has no immunological basis.


Long-term study of Crohn's disease.

Long-term study of Crohn's disease. Nineteen children and 160 adults with Crohn's disease were examined. The children had been under treatment between 1972 and 1974. There were 11 boys and 8 girls. Their main symptoms were general malaise, diarrhea, abdominal pains, anemia and weight loss. Clinical examination showed pallor, malnutrition, and abdominal tenderness on palpation. In 7 of 19 cases, rectosigmoidoscopy showed pathological changes. Radiologically, the most frequent site of the disease was observed to be in the ileocecal area. Since conservative therapy is associated with the risk of grave local and general complications, resection of the affected intestinal segment was the method of choice. Resection must be carried out through healthy tissues. Although the intestinal absorption of B12, fat and bile acids deteriorated after resection of the ileum, the general state of health of the patient improved. Body weight, serum albumin, serum iron concentration and the total iron binding capacity increased and the patient developed normally. Relapses occurred in 8 of the 19 cases. From the large number of adult patients who were studied, it could be shown that the risk of a relapse was greater in the ileal and ileocolic disease than in disease restricted to colon.


Follow-up results of the pull-through operation for ulcerative colitis in children. The value of the ileoanal pull-through operation in the surgical treatment of children with ulcerative colitis is shown by this 10-year postoperative follow-up study of 6 patients. The results are based on a questionnaire and the performance of ileoscopic and histological follow-up examinations. In 5 of the 6 children (now adults), normal continence was present and there were no complaints. Postoperative difficulties in a girl now 17 years of age are attributed to an incorrect initial diagnosis.


Neonatal necrotizing enterocolitis.

Neonatal necrotizing enterocolitis. Forty-six cases of neonatal necrotizing enterocolitis are reported, with a 46% mortality rate. Unlike most other series, low birth weight children accounted for only half the cases. The recognized initiating factors of hypoxia and hemodynamic changes were not always present. A high index of suspicion in the child with non-specific malaise and earlier positive diagnosis provide the most likely means of improving results.


Surgical problems in necrotizing enterocolitis in childhood. The problem of necrotizing enterocolitis is discussed based on the experience with 24 patients. It has been found that the time factor plays an important role in the decision whether to operate. The indications for operation are intestinal perforation, threatening perforation, and penetration of a covered perforation. Operation is carried out in order to treat the peritonitis caused by perforation. The various operative methods are described and evaluated. Intestinal resection, exclusion enterostomies, and suture of the perforation may all be justified, depending on the findings at operation. The difficulties in the differential diagnosis are discussed. The importance of late complications are stressed, and it is pointed out that every case will require routine controls long after discharge from the hospital. The high mortality is directly related not to the surgical complications, but rather to the septicemia which so often develops.


Oxytocin-stimulated production of prostaglandin F2alpha by isolated endometrium of rabbit: modulation by ovarian steroids. To test the hypothesis that ovarian steroid hormones modulate oxytocin-induced release of prostaglandin F2alpha (PGF2alpha) from uterine endometrium, 2 ovariectomized rabbits were pretreated with progesterone (5 mg/day for 10 days), 2 with estradiol-17 beta (25 microgram/day for 10 days), 2 with both steroids, and one with sesame oil only. On the last day of treatment, endometrial fragments were excised and incubated in vitro with or without oxytocin (100 muU/ml). Although endometrium from rabbits pretreated with combined steroids released more PGF2alpha immediately after excision than did tissue from animals pretreated with either steroid by itself, endometrium from animals pretreated with estradiol-17 beta alone released the most PGF2alpha during sustained incubation in vitro. Moreover, only this tissue exhibited significant oxytocin-dependent release of PGF2alpha. At the dosages used, progesterone completely antagonized both of these effects of estradiol-17 beta. The results support the hypothesis that ovarian steroid hormones regulate oxytocin-dependent release of PGF2alpha from endometrial cells. A posible mechanism of action is suggested.


Impaired renal production of prostaglandin E2: a newly identified lesion in human essential hypertension. To test the hypothesis that impaired renal prostaglandin production may accompany the hypertensive state, we have measured urinary PGE2 by radioimmunoassay in 52 normotensive and 50 hypertensive subjects. PGE2 levels were lower in females, and were not affected by Na+ intake or age. Patients with essential hypertension had significantly lower PGE2, particularly those with low-renin hypertension. Forty percent of the hypertensives excreted less than 70 ng/24 hr, values never observed in normotensives except after receiving indomethacin, a well-known prostaglandin synthetase inhibitor. It appears that impaired renal prostaglandin production is commonly encountered in patients with essential hypertension, perhaps contributing to their increased renal resistance. The data further suggest a role for renal prostaglandins in the pathogenesis of low-renin hypertension.


Fetal effects of cervical ripening with extra-amniotic prostaglandin E2 in gel. A gel containing 0.5 mg prostaglandin E2 (PGE2) was extra-amniotically instilled 90 clinically normal gravidae at term, for ripening of the cervix before elective induction of labor by amniotomy and intravenous PGE2. An acceptable increase in the Bishop score was noted to have occurred in 87/90 women, when assessed eight hours after administration of the gel; 14 of these women were then in established labor, which progressed uneventfully. Four of the 90 subjects required cesarean section for cephalopelvic disproportion. No adverse maternal or fetal effects of the procedure were detected under careful clinical, electronic and biochemical monitoring. However, epidural anesthesia adversely influenced the acid-base equilibrium of the fetus.


Uterine rupture: a complication of midtrimester abortion. The intraamniotic injection of prostaglandin F2alpha and/or hypertonic saline may be associated with serious uterine and cervical trauma. Multiparity and superimposed uterotonic stimulation by oxytocin are generally thought to be contributory. A patient is described who failed to abort vaginally after an uneventful intraamniotic infusion of prostaglandin F2 alpha in combination with hypertonic saline; 48 hours later she evacuated the uterine contents into the peritoneal cavity through a rent in the uterine fundus. The uterine rupture occurred even though there had been no uterotonic stimulation by oxytocin.


Accelerated ovum transport in rabbits induced by endotoxin II. Changes in oviductal smooth muscle activity. Oviductal mortility, measured with open-ended perfused catheters in anesthetized animals injected with human Chorionic Gonadotropin (hCG), is depressed 2 h following endotoxin injection and returns to control levels by 3 h after endotoxin injection. This decrease in motility is prevented by indomethacin. Endotoxin did not affect spontaneous or phenylephrine (PE)-induced contractions of oviduct when it was added to the bathing medium of in vitro tissues. Oviductal segments removed 2 h after endotoxin (26 h after hCG) showed electrical activity confined to the ampullary-isthmic-junction (AIJ), where ova were located; the dose-response curve for PE was shifted to the right and the maximum contraction was depressed. Activity of tissues removed 4 h after endotoxin more closely resembled control tissues except that the maximum contraction to PE was depressed, ova had passed out of the oviduct and a proovarian bias in the isthmus was not present. The response of the oviduct to prostaglandins (PGs) in vivo is critically dependent on the previous exposure to PGs. In endotoxin-treated animals PGE then PGF levels increase and the decrease in motility coincides with increased PGE levels, but accelerated ovum transport with the return of motility and activation of the isthmus.


Prostaglandins and renin release: II. Assessment of renin secretion following infusion of PGI2,E2 and D2 into the renal artery of anesthetized dogs. The influence of intra-renal infusions of prostaglandin (PG) I2, PGE2 and PGD2 on renin secretion and renal blood flow was investigated in renally denervated, beta-adrenergic blocked, indomethacin treated dogs with unilateral nephrectomy. All three prostaglandins when infused at doses of 10(-8) g/kg/min and 10(-7) g/kg/min resulted in marked renal vasodilation. Renin secretory rates increased significantly with both PGI2 and PGE2 at the 10(-8) g/kg/min and 10(-7) g/kg/min infusion rates in a dose dependent manner. However, PGD2 was inactive. At 10(-7) g/kg/min, PGI2 infusions resulted in systemic hypotension indicated recirculation of this prostaglandin. These findings suggest that PGI2 should be included among the cyclooxygenase derived metabolites of arachidonic acid to be considered as possible mediators of renin release.


Central cardiovascular effects of clonidine and another imidazoline derivative ST [600] in adult fowls. In adult fowls (Gallus domesticus) with cannulae stereotaxically implanted into the III cerebral ventricle and into the hypothalamus, the effects of clonidine and another imidazoline derivative (St 600) were studied on arterial blood pressure and heart rate. It has been shown that clonidine and St 600 administration into the III ventricle or into the hypothalamus produced an immediate profound and long lasting decrease in blood pressure and heart rate. Contrary to the intravenous administration, this response was not preceded by an initial rise in blood pressure. On an equimolar basis St 600 appeared to be at least one-tenth as potent as clonidine. Prior intraventricular administration of alpha-adrenoceptor blocking agents, phentolamine and phenoxybenzamine, prevented changes in cardiovascular effects following intrahypothalamic infusion of clonidine and St 600. In conclusion, present experiments indicate that in fowls the hypothalamus represents the site or sites through which hypotension and bradycardia evoked by clonidine and related compounds are mediated.


Effects of inhalation and cutaneous exposure to styrene on drug metabolizing enzymes in the rat. The effects of inhalation and cutaneous exposure to styrene on the drug metabolizing enzymes were studied in the rat. Rats were exposed eight hours per day, for seven successive days to 450 ppm concentration of styrene or received one cutaneous dose of styrene daily for seven consecutive days (0.5 and 3.0 g/kg). The animals were killed one day after the last dose. Styrene inhalation increased the activities of epoxide hydrase and UDPglucuronosyltransferase (4-methylumbelliferone as substrate) in liver (1.5- and 1.7-fold, respectively). Ethoxycoumarin deethylation was enhanced 1.7-fold in the kidney. The content of cytochrome P-450 in the liver and the activities of NADPH cytochrome c-reductase, benzpyrene hydroxylase and glutathione S-transferase in the liver and kidney were not altered. No changes in the enzyme activities were detected in the lung. Styrene depressed the epoxide hydrase activity in liver when administered cutaneously. No signs of enzyme induction could be seen after cutaneous administration.


Formation of catechol-like and monophenolic metabolites of propranolol by the rat liver 9000G supernatant. The oxidation of the naphthalene ring system of propranolol by the rat liver 9000g supernatant has been studied by gas chromatography-mass spectrometry. Two dihydroxy metabolites, one of which possibly catechol-like, and four monophenols were identified based on the mass fragmentation pattern and retention times of their trimethylsilyl and d9-trimethylsilyl derivatives. These observations emphasize the complex oxidation pattern of this drug. All metabolites identified are proposed to be associated with significant biological activity.


The interaction of iopanoic and iophenoxic acids with human serum albumin. Iopanoic and iophenoxic acids are strongly bound to human serum albumin, as revealed from ultracentrifugation experiments. About two or three high affinity binding sites were found for both drugs. Within the concentration range investigated iopanoic acid is stronglier bound than iophenoxic acid. The binding to only one of the high affinity binding sites produces extrinsic Cotton effects. Further saturation of the high affinity binding sites decreases the extrinsic Cotton effects, possibly due to a binding induced change of the protein conformation.


Differential effect of ethanol ingestion on the protein synthetic activities of free and membrane-bound ribosomes from liver of the weanling rat. The influence of chronic ethanol ingestion on the protein synthetic activities of free and membrane-bound ribosomes was studied in vitro in the liver of young rat. Ethanol administration caused about 120% increase in the amino acid incorporative activity of free ribosomes. In contrast, membrane-bound ribosomes from the livers of ethanol-fed animals exhibited a 25% decline in their protein synthetic activity. This decline in the activity of membrane-bound ribosomes was abolished after dissolution of membranes by Triton X-100. Evidence was obtained suggesting that the observed alterations in protein synthesis due to ethanol intake are attributable to changes in pH5 enzyme fraction, altered amount of ribosome-associated mRNA and a damage to the endoplasmic reticulum membranes.


Effect of levamisole on aggregation of platelets stimulated with compounds associated with the prostaglandin synthetic pathway. Levamisole, L-2,3,5,6-tetrahydro-6-phenylimidazo-(2,1-b)-thiazole-hydrocholoride at various concentrations (2.5 to 40 microgram) added to platelet rich plasma inhibited aggregation of platelets. The 50% inhibition concentrations (IC50) of levamisole in platelet aggregation induced by hydrogen peroixde (9.4 x 10(-1) mM), epinephrine (1.0 x 10(-1) micrometer), endoperoxide-analog (2.9 x 10(-1) micrometer) and arachidonic acid (3.3 micrometer) were 11.0, 8.0, 11.5 and 16.0 microgram/test, respectively. It is suggested that levamisole like imidazole inhibit platelet aggregation and this factor should be considered in the administration of levamisole, especially in cardiovascular diseases.


Long-term effects of adrenal and ovarian ablation on the regulation of energy exchange in the female rat. Body weights of female rats in six postsurgical groups were observed over 120 days. Ovariectomy increased body weight as compared with controls, whereas adrenalectomy decreased it. Weights of animals that were both ovariectomized and adrenalectomized were intermediate between those of controls and adrenalectomized groups. The body weights of adrenalectomized rats that were not salt dependent resembled those of animals that had not undergone adrenal surgery. Plasma levels of corticosterone and progesterone were determined by radioimmunoassay. Adrenalectomy that resulted in salt dependency, whether or not in conjunction with ovariectomy, markedly decreased corticosterone levels. Ovariectomy alone or in conjunction with adrenalectomy decreased progesterone levels. The increased body weight of the group that was both ovariectomized and adrenalectomized over the group that was only adrenalectomized suggests that the decreased body weight generally observed for adrenalectomized animals may relate to mechanisms of voluntary regulation rather than frank debilitation.


7,N,N-Trimethyltryptamine: a selective inhibitor of synaptosomal serotonin uptake. 7,N,N-Trimethyltryptamine (TMT) was synthesized and evaluated as an inhibitor of synaptosomal biogenic amine uptake in rat forebrain homogenates. In addition to inhibiting 3H-serotonin uptake (IC50 = 0.4 micrometer), TMT appears to be quite selective and is much less potent in blocking either 3H-norepinephrine or 3H-dopamine uptake (IC50 = 180 micrometer and 61 micrometer, respectively).


Anti leukemia activity (Dunning ascitic) of 6-mercaptopurine and its metallo complexes in rats. Six-mercaptopurine and its Pt, Pd and Bi complexes were used at various dosage levels to treat Dunning ascitic leukemia in rats. Significant anticarcinogenic activity was found in all compounds with toxicity apparent at the highest dosage level of all but the platinum compound.


The effect of 1,1,3-tricyano-2-amino-1-propene (TCAP) on RNA synthesis in chick embryo sciatic nerves. Injections of 1,1,3-tricyano-2-amino-1-propene (TCAP) into chick embryos increases the synthesis of the myelin enzyme 2',3'-cyclic nucleotide 3'-phosphohydrolase (CNP). Whether this increase is associated with altered RNA synthesis was investigated by examining pulse 3H-uridine labelled RNA from in ovo and in vitro TCAP treated sciatic nerves. Characterization of the resultant TCAP-RNAs by polyacrylamide gel electrophoresis revealed that they met several criteria of messenger-RNA.


Hepatic intracellular distribution of pregnenolone-16alpha-carbonitrile and its influence on adenyl cyclase activity in rat liver cells. Pregnenolone-16alpha-carbonitrile (PCN) enhanced adenyl cyclase activity in the liver cells of female Sprague-Dawley rats. Injection of 14C-PCN and fractionation of hepatocytes into nuclei, mitochondria, total ribosomes, endoplasmic reticulum (ER) membranes, cytosol and plasma membranes revealed that after 4 h there was a preferential localization of the cyanosteroid in ER membranes. Total ribosomes and cytosolar proteins seemed to contain less PCN after 4 h, the optimal time for maximal penetration and intracellular establishment. On the other hand, PCN was localized preferentially in plasma membranes after 2 h and this diminished with time. Only trace amounts of the cyanosteroid were found in the nuclei and mitochondria, from the time of its intracellular introduction to the time of its apparent removal from the hepatocyte.


Serologic response of gilts of breeding age to human influenza vaccines containing A/New Jersey/76 (HSW1N1) antigen. Twenty-four cross-bred gilts of breeding age were used in two studies to access the antigenic response to commercially produced human influenza vaccintes containing A/New Jersey/76 viral antigens. In experiments 1 only one of seven animals responded with an HI antibody titer of 1:40 or above. In the second experiment five of six gilts responded to higher dosages of vaccine with HI antibody titers of 1:40 or above. The positive titers persisted at least eighty-one days in two vaccinates in experiment 2.


Adenosine as a prostaglandin antagonist. Possible mechanism of the defect in combined immunodeficiency disease due to adenosine deaminase deficiency. Adenosine inhibition of cell division in EB-virus-transformed human lymphocytes and in normal lymphocytes stimulated by phytohemagglutinin can be overcome by prostaglandin (PG) E2. Analysis of adenosine/PGE2 interactions in smooth muscle suggests that adenosine causes immuno-deficiency by blocking a PG-dependent calcium stage of lymphocyte activation.


Selective inhibition of protein synthetic activity of cerebral membrane-bound ribosomes as a consequence of ethanol ingestion. Ethanol ingestion by weanling rats results in an inhibition of protein synthetic activity of cerebral membrane-bound ribosomes. Among various amino acids tested, the incorporation of serine was inhibited to a maximum degree. In contrast to membrane-bound ribosomes, the activity of free ribosomes was enhanced as a consequence of ethanol treatment. Aminoacylation of tRNA in pH 5 fraction was also reduced in the brain cortices of ethanol-fed animals.


Effect of age on acute morphine response in the rat. The importance of age as an experimental variable in the evaluation of the analgesic, thermic, and respiratory depressant effects to morphine was studied in male rats one and one-half, six, and ten months of age. Significant age-related responses were observed in both the analgesic and thermic responses to morphine. Also, following a dose of 30 mg/kg morphine, animals six and ten months of age exhibited significantly higher plasma levels of morphine, a slower decline in both plasma and brain levels of morphine, and lower brain/plasma ratios of morphine indicating possible age-related changes in metabolism, excretion, and the blood-brain barrier. The dose of morphine which produced respiratory depression was significantly higher in the youngest age group; this was accompanied by higher brain levels of morphine in this group. These studies illustrate the importance of age as an experimental variable in the evaluation of drugs.


Aminotetralin analogs of methoxamine as potential hypertensive agents. Cardiovascular effects of methoxamine and some aminotetralin derivatives (5,8-ADT, DR-31 and DR-17) were studied after systemic intravenous or intraarterial injection into different perfused vascular beds in anesthetized dogs. Intravenous administration of the compounds produced dose-related prolonged increases in blood pressure, which were antagonized by phentolamine. After intro-arterial injection into the perfused hindlimb, mesenteric artery or the saphenous vein, all compounds produced dose-dependent increases in perfusion pressure indicative of vasoconstriction. Phentolamine antagonized these effects. It was demonstrated that desipramine significantly reduced the vasoconstricting actions of intra-arterially injected tyramine in the hindlimb, but did not alter the responses induced by methoxamine and the aminotetralin derivatives. The data indicate that these compounds elicit peripheral vasoconstriction in the dog, through a direct action on the alpha adrenergic receptors.


Pharmacokinetics of digoxin in the cat and comparisons with man and the dog. Digoxin doses of 14.3, 5.72 or 1.43 mcg/kg were administered to 8 cats and the plasma digoxin concentrations (concns) were measured as a function of time for 96 hr. Pharmacokinetic linearity was evidenced by: (1) mean plasma clearance (Clp) of 4.05 ml/(kg x min) with a coefficient of variation of 34.6% and a range of 2.69-6.71; (2) linear relationship between total area under the plasma concn-time curve and the administered dose. Further evidence for linearity was the lack of dose-dependence of apparent elimination half-life (beta). The volume of distribution and beta for cats were respectively (mean +/- s.d.) 20.4 +/- 5.35 L/kg and 0.0120 +/- 0.0030 hr-1. Results from cats were compared with literature data for dogs and man. The order of Clp in units of ml/(kg x min) were: infant greater than dog greater than cat greater than adult man.


Presence of circadian rhythm in the mitotic index of the ruminal epithelium in sheep. Mitotic indices of the ruminal epithelium of two castrated male sheep fed at 11:00 h were determined at 00:00, 04:00, 08:00, 12:00, 16:00 and 20:00 h. The schedules were repeated in four trials done in December 1975, February, March and June 1976 respectively. The indices ranged from 0.13 to 0.92 per cent, both animals showing a similar tendency in these fluctuations. The mean rate of cell division was low in the morning, high in the afternoon and in the evening, and declined at about midnight. Another pair of male castrated sheep were fed at 07:00, and rumen samples were biopsied six times in three days. The mean rate of epithelial cell division in the rumen was low at 08:00, but high at noon, suggesting that the rate possibly was affected by the food intake of the experimental animals.


The role of sulphide and sulphide oxidation in the copper molybdenum antagonism in rats and guinea pigs. The sulphide metabolism of rats fed molybdate up to levels of 1000 ppm molybdenum was examined and large decreases in hepatic sulphite oxidase activity observed; overall sulphide oxidation capacity was also reduced. Molybdate but not tungstate caused increases in the total plasma copper of guinea pigs but in particular the appearance of a new TCA-insoluble fraction. The effect was increased by the addition of 500 ppm sulphur as sulphide, to the molybdate diet whereas the addition of 500 ppm S as sulphate was ineffective. 100 ppm Mo was less effective as thiomolybdate (MoS4=) than as molybdate. The significance of these results in relation to the role of sulphide in the Cu-Mo-S interaction is discussed.


Ocular squamous cell carcinoma: immunological responses to tumour tissue and phytomitogens. Cows with histologically confirmed ocular squamous cell carcinoma were injected with autochthonous tumour brei in adjuvant. Lymphoproliferative responses of isolated peripheral blood lymphocytes exposed to phytomitogens and inhibition of cell migration indicated that afflicted animals were immunocompetent. Similar but lesser responses were evident when autochthonous tumour homogenates were used to stimulate lymphocytes.


Use of laser nephelometry to measure dog lysozyme: immunological cross-reactivity with human lysozyme. Use of the newly developed laser nephelometer provides a sensitive immunochemical assay for lysozyme in dog sera by detection of antigen-antibody complexes formed upon cross-reaction with sheep-anti-human lysozyme. Results of lysoplate and nephelometric assays correlate well.


The role of various antigenic fractions of Bacteroides nodosus in eliciting protection against foot-rot in vaccinated sheep. Sheep were vaccinated against foot-rot with various antigenic extracts of Bacteroides nodosus and challenged to assess their resistance. The protective immunogen was shown to be a heat-labile, high molecular weight surface antigen which was removed by ultrafiltration and was either identical to or closely associated with the fimbriae of the organism. Resistance appeared to be associated with the presence of a single high molecular precipitinogen distinct from the 0 antigen. Agglutinating antibodies to the surface antigen in immunised sheep were predominantly IgG1 whereas the 0 antigen induced predominantly IgM indirect haemagglutinating antibodies. Reactions at vaccination sites were less marked to the surface antigen than to the 0 antigen.


Mycotoxic tremorgens of Claviceps paspali and Penicillium cyclopium: a comparative study of effects on sheep and cattle in relation to natural staggers syndromes. Claviceps paspali sclerotia were dosed orally at various levels to sheep and cattle and the neurotoxic effects are described. Evidence is presented which indicates that the tremors are produced by a neutral tremorgen fraction. The ergot alkaloids, principally D-lysergic acid alpha-hydroxyethylamide and its isolysergic acid isomer, are not involved. The mixture of C paspali tremorgens has not been separated and characterised but its components are chemically related to other known tremorgens, such as penitrem A, produced by saprophytic moulds, notably Penicillium cyclopium. P cyclopium mycelium and C paspali sclerotia were dosed to produce comparable effects in sheep and in cattle. Similarly, effects of penitrem A and tremorgen concentrate of C paspali were compared after intravenous dosage to sheep. Observed enurotoxic effects of both moulds were identical in most respects. A low level of tremorgenic activity was detected at the honeydew stage of C paspali. These findings are discussed in relation to staggers syndromes occurring in grazing livestock.


An indirect haemagglutination test for the sero-diagnosis of C ovis infection in sheep. An indirect haemagglutination (IHA) test for the diagnosis of caseous lymphadenitis in sheep is described; the test uses purified Corynebacterium ovis toxin to sensitise formalinised sheep erythrocytes treated with bis-diazobenzidine. Animals with titres of 1/16 and above were considered positive to the test. Examination of sera from proven cases of caseous lymphadenitis by the IHA test and anti-haemolysin-inhibition (AHI) tests showed that the IHA test was more sensitive than the AHI test.


Further attempts to immunise lambs using metabolites and in vitro grown larvae of Ostertagia circumcincta. Attempts were made to immunise lambs by the intramuscular injection of either lyophilised or concentrated metabolites produced by Ostertagia circumcincta when grown in vitro, or macerated fourth and fifth stage worms. The lyophilised metabolites did not stimulate protection against the establishment of worms in nine-months-old lambs but the macerated worms and concentrated metabolites elicited protection in six-months-old and three-months-old lambs respectively. The worm burdens and worm egg counts of the immunised lambs were less than those of control lambs.


Pathological and biochemical observations on subclinical cases of fatty liver-haemorrhagic syndrome in the fowl. A high incidence of subclinical fatty liver-haemorrhagic syndrome (FLHS) was found in three flocks of laying hens in which deaths from FLHS had occurred. There was so significant difference between the affected hens and the remainder of the block in egg production or quality, but the former were more obese and had higher concentrations of lipids in their livers, suggesting a pathogenic relationship between hepatic steatosis and haemorrhage. Soluble protein tended to accumulate with the fat in the livers. Reticulolysis had occurred in over half the haemorrhagic livers examined. Histological examination and DNA estimations provided no evidence of generalised hyperplasia. From the composition of the liver lipids it was concluded that the steatosis resulted mainly from an increase in lipogenesis from dietary carbohydrate. Lipid levels in the plasma were weakly correlated with those in the liver. No change was detected in the plasma protein pattern.


Influence of dietary cereal and energy content on the accumulation of lipids in the liver in fatty liver-haemorrhagic syndrome in the fowl. Isocaloric diets supplying about 2900 kcal/kg and based on maize, wheat and barley respectively, were fed to pullets for 13 weeks from point of lay. The number of cases of subclinical fatty liver-haemorrhagic syndrome and the mean total lipid, triglyceride and monoglyceride content of the liver decreased in the above order of diets. The final body weight, weight gain and abdominal fat score followed the order wheat greater than maize greater than barley. Reduction of the energy content of the wheat and barley diets to 2670 and 2490 kcal/kg respectively by the omission of animal fat was associated with a reduction in the lipid content of the liver only in the case of the wheat diets. Egg production and quality were uniformly high and no difference was detected in plasma triglyceride and free fatty acid levels.


Pharmacokinetics and dosage of oxytetracycline in dogs. The pharmacokinetics of oxytetracycline, which was given as a single intravenous dose (5 mg/kg), was studied in normal beagle dogs. Renal function was evaluated by the single injection technique and based on clearance of the radioiodine compounds 125I-iothalamate and 131I-iodohippurate. Values of GFR (4.42+/-0.77 ml/kg/min) and ERPF (12.91+/-1.49 ml/kg/min) showed normal renal function. The disposition curve describing decline of oxytetracycline activity in serum was described mathematically by a triexponential expression. Body clearance was 4.23+/-1.29 ml/kg/min. A dosage regimen (intravenous route of drug administration), based on overall elimincation rate constant (0.1155 h-1) and apparent specific volume of distribution (2 litre/kg), and consisting of a priming dose (10 mg/kg) followed by maintenance doses (7.5 mg/kg) at 12 h intervals was proposed. This dosage regimen was predicted to rapidly achieve and maintain steady state serum concentrations within the range 1.25 to 5.0 microgram/ml, which is therapeutic level for the majority of susceptible microorganisms.


The oestrogenised chick as an experimental model for fatty liver-haemorrhagic syndrome in the fowl. A syndrome resembling fatty liver-haemorrhagic syndrome in laying hens was reproduced in six- to seven-week-old chickens by injecting oestradiol-17beta-dipropionate intramuscularly (total dose 20-50 mg/kg). The degree of hepatic steatosis and the severity and extent of haemorrhage from the liver varied with the dose and the results suggested a pathogenic relationship between the two conditions. There was no evidence of reticulolysis in the liver. When food was withdrawn for 24 h after the last injection there was a dramatic fall in the haemorrhage score and a reduction in the lipid content of the liver.


The 'normal range' and precision of phytohaemagglutinin-induced equine lymphocyte transformation in vitro. Data are presented on lymphocyte transformation by phytohaemagglutinin in 20 normal horses. The logarithms of transformation ratios were found to have an approximately normal distribution, giving (for the transformation ratios themselves) a geometric mean of 23.6, a range of 1.92 to 97.3, and an estimated 95 per cent tolerance interval of 1.1 to 488. Analysis of variance on the logarithms of the transformation ratios gave a coefficient of variation of 140 per cent of the transformation ratios themselves for the variation between horses; whereas the coefficient of variation between duplicate samples was only 20 per cent, that is, small compared to the variation between horses. In addition, wide fluctuations of response of individual horses over weekly periods of measurement (comparable with the variation between the horses themselves) suggest that a single set of measurements at one time cannot be taken as evidence of abnormality in a given horse.