Growth metabolism of diaphragm in Swiss albino mice. During the postnatal growth of diaphragm in swiss albino mice, a continuous decline in glycogen content reciprocates with the increasing SDH-activity and protein accumulation. An inverse relationship between DNA-contents and the basic protein levels points towards the regulatory behaviour of the latter during protein synthesis. While the variations in the contents of DNA and RNA speak of a feedback mechanism operative between the 2 nucleic acids during the postnatal growth, the fluctuations in RNA appear to be significant in determining the amount of acidic proteins, in this muscle.


Effect of pancreatic duct ligation on exocrine pancreatic function and structure in the rabbit. 4 weeks after pancreatic duct ligation in the rabbit, fecal and luminal chymotrypsin were detected in concentrations similar to the control group. Pancreatic changes in the ligated group were marked dilatation of the main pancreatic duct, proliferation and distention of ductules and fibrosis. Despite pancreatic duct ligation and fibrosis, proteolytic enzymes continued to secrete into the duodenal lumen. These results suggest that pancreatic duct ligation in the rabbit is not associated with total pancreatic insufficiency.


Effect of adaptation level on maintained firing and sensitivity in receptive field center of X and Y cells. Maintained firing rates of X cells and Y cells were compared at 6 adaptation levels (AL) between -2.71 log cd/m2 and 2.28 log cd/m2 (10 mm2 pupil size). X cell maintained firing was higher at all ALs and was statistically different at medium and high ones. Changes in AL had nearly identical effects upon X and Y cell suprathreshold sensitivity to a flashing spot in the center of their receptive fields; the Weber function had a slope of 0.744 for Y cells and 0.743 for X cells. These values are not statistically different.


Increased resistance to satiation in diazepam-treated pigs. Sated pigs, having a previous history of operant responding according to a CRF schedule, resumed responsing when put back in the Skinner box after 1 mg/kg diazepam. This effect did not appear to be related to the disinhibition of an extinction process.


Filamentous bodies in human glomerulonephritis. Filamentous bodies have been identified in the glomerular cells of human kidney biopsies. These structures have a close morphological resemblance to ciliary rootlets, although the cells of the glomerular tuft only occasionally bear cilia. Their significance could be, as for cilia, of a cellular disdifferentiation of a pathological cellular proliferation.


Different effects of synthetic delta 9-tetrahydrocannabinol and cannabis extract on steroid metabolism in male rats. Repeated oral administration of cannabis extract as well as synthetic delta9-tetrahydrocannabinol to male rats produced significant changes in excretion of androgenic steroids and their metabolites as detectable in blood and urine. Cannabis extracts were found to be significantly more active than the mixtures containing same amounts of synthetic cannabinoids.


Does increased gastric mucus play a role in the ulcer-protecting effects of zinc sulphate? Zinc sulphate pretreatment i.p. produces dose-related reductions in stess ulcer incidence in pylorus-occluded rats. The associated increases in gastric wall mucus, in stressed and nonstressed animals, suggest that a similar effect may contribute to its ulcer-reducing ability in man.


Chemical protection of mouse spermatocytes against gamma-rays with 2-mercaptopropionylglycine. The radiosensitivity of primary spermatocytes in pachytene stage was estimated by counting the number of spermatids in the testes of control and MPG-treated mouse after exposure to 500, 1000 and 1500 R of Co60 gamma-rays. For this purpose, control and MPG-treated mice were killed 5 days after irradiation and countings of spermatids was made in stages I and II of the tubules. It has been observed that, although there was a death of primary spermatocytes in irradiated MPG-protected groups, quantitatively significant protection was afforded by this drug at all the 3 dose-levels studied.


Histochemical studies on two types of cells containing catecholamines in sympathetic ganglia of the bullfrog. The excitation/emission spectra maxima obtained from orange fluorescing small cell clusters and greenish yellow fluorescing ganglion cell bodies were at 400--410/490--560 nm and at 400--410/470--500 nm, respectively.


Agglutination of leukemic cells and daunomycin entrapped erythrocytes with lectin in vitro and in vivo. Wheat germ agglutinin (WGA) agglutinated the L1210 leukemic cells and daunomycin entrapped erythrocytes in vitro. Comparing with control preparations, the greatest increase in survival was obtained in vivo when the daunomycin entrapped erythrocytes and WGA were given to BDF1 mice bearing L1210 cells.


Evidence for the presence of viable endothelial cells in cultures derived from dissociated rat brain. The morphology and histochemistry of dissociated newborn rat brain was studied in tissue culture. Direct microscopy of developing cells, electron microscopy and the alkaline phosphatase activity were used to identify the capillary endothelial cells.


Decreased serum responsiveness by primary monolayer cultures of preneoplastic and neoplastic mammary epithelial cells. Monolayer cultures of normal, preneoplastic and neoplastic murine mammary epithelial cells were exposed to various types of mammalian serum. A progressive decline in levels of thymidine incorporation together with a change in the ordering of sera which stimulates optimal incorporation was observed in the transformed cells.


[Mammotropic and somatotropic pituitary cells in spontaneous mammary tumor bearing C3H female mice. A quantitative electron microscope study]. Pituitaries of mammary tumor-bearing mice (C3H) were examined by quantitative electron microscopy. The results indicate that considerable modifications occur in mammotropic and somatotropic cells. Both types show an increase of the surface of the endoplasmic reticulum and a decrease of the volume of secretory granules (in percent of cytoplasmic volume), suggesting a heightened secretory activity of these cells during mammary carcinogenesis.


Structure of pyrazolo[1,5-a]pyrimidine methylderivatives. In the course of researches on pyrazolo[1,5-a]pyrimidine compounds, methylation reactions with (CH3)2SO4 and CH2N2 are studied. Methylderivatives structure is assigned by means of a spectroscopic investigation. A relationship between the kind of reagent and the methyl group position is stressed.


[Synthesis of 2-substituted derivatives of 5H-1,2,4-thiadiazolo[3,2-a] [1,3,5]triazin-5-one]. The synthesis of 2-substituted derivatives of 5H-1,3,4-thiadiazolo[3,2-a] [1,3,5]triazin-5-one, obtained from 5-substituted 2-amino-1,3,4-thiadiazoles is described. The structure of the new compounds is confirmed by U.V. and I.R. spectra and partly by mass spectrometry.


Polymorphism of 1-methyl-2-nitro-5-vinylimidazole. Three polymorphic forms of 1-methyl-2-nitro-5-vinylimidazole, a potential antimicrobial drug, have been isolated and characterized by thermomicroscopy, differential scanning calorimetry, infrared spectroscopy and X-ray powder diffraction. On the basis of some infrared bands, the hypothesis has been made that the different packing of forms I and II was due to the existence of the molecule in two different conformations in the two forms. The direct confirmation of the hypothesis has been sought by X-ray diffraction of single crystals, but a suitable crystal was obtained only for form II. Form II is orthorhombic, space group Pbca, with unit-cell dimensions: a = 13.05, b = 10.83, c = 10.21 A; Z = 8. From the X-ray analysis, carried out by direct methods, the molecule is planar and the vinyl group is cisoid to the heterocyclic CH group. Then, the existence of the molecule as transoid conformation in form I still remains a hypothesis.


[Glycinamide derivatives of norbornane]. Three groups of glycinamides derivatived respectively from 4-aminomethyl-2,2,3-trimethylnorbornane, from 1-aminomethyl-2,2-dimethyl-3-methylennorbornane and from 1-aminomethyl-2,2,3-trimethylnorbornane are prepared and described.


Pyrrolnitrin analogues. V. Knorr's pyrrole condensation between N-(4-nitrophenacyl)-3,5-dimethylaniline and ethyl acetoacetate. The reaction between N-(4-nitrophenacyl)-3,5-dimethylaniline and ethyl acetoacetate in boiling ethanol afforded 3-carbethoxy-5-(1-carbethoxyacetonyl)-4,5-dihydro-1-(3,5-dimethylphenyl)-4-hydroxy-2-methyl-4-(4-nitrophenyl)pyrrole and in low yield 3-carbethoxy-1-(3,5-dimethylphenyl)-2-methyl-4-(4-nitrophenyl)pyrrole. Chemical transformation of the former compound into 5-acetonyl-1-(3,5-dimethylphenyl)-2-methyl-4-(4-nitrophenyl)pyrrole is described. The structure of 3-carbethoxy-5-(1-carbethoxyacetonyl)-4,5-dihydro-1-(3,5-dimethylphenyl)-4-hydroxy-2-methyl-4-(4-nitrophenyl)pyrrole has been established by the aid of N.M.R. spectral data. The above reaction, when carried out in boiling ethanol in the presence of a catalytic amount of 3,5-dimethylaniline hydrobromide, led to the formation of 3-carbethoxy-1-(3,5-dimethylphenyl)-2-methyl-4-(4-nitrophenyl)pyrrole and 4,6-dimethyl-2-(4-nitrophenyl)indole, the former formed in a very good yield. Some pyrrolnitrin analogues have been prepared starting from 3-carbethoxy-1-(3,5-dimethylphenyl)-2-methyl-4-(4-nitrophenyl)pyrrole.


Polymorphism of chenodeoxycholic acid.

Polymorphism of chenodeoxycholic acid. Polymorphism of chenodeoxycholic acid was studied by differential thermal analysis and X-ray diffraction. Four polymorphic forms (three crystalline and one amorphous) were characterized.


[Synthesis and pharmacological activity of esters and amides of 4-phenylcoumarin-3-carboxylic acid]. The synthesis and pharmacological activity of a series of dialkylaminoalkyl esters and dialkylaminoalkyl amides of 4-phenylisocoumarin-3-carboxylic acid are described. The esters show anticoagulant activity whereas the amides show marked antiarhythmic activity.


Effects of 15(S)-15-methyl prostaglandin F2 alpha methyl ester-containing silastic discs in male rats. Silicone rubber discs containing 15(S)-15-methyl prostaglandin F2 alpha ester (15-Me-PGF2 alpha) in the matrix were implanted in the left side of the scrotums of Sprague-Dawley rats. The effect of 1% and 2% drug concentration was examined for 10, 20, or 28 days and compared with the effects of Silastic discs containing no prostaglandin. The discs containing prostaglandin reduced mean testicular and accessory gland weights. Histologically the testes and epididymides showed decreased or absent spermatogenic elements and hypertrophy of the interstitial cell masses in comparison with other cells. Implanted prostaglandin significantly depressed serum testosterone, luteinizing hormone, and follicle-stimulating hormone (FSH) concentrations when 15-Me-PGF2 alpha plasma concentrations exceeded 2 ng/ml. Hormone concentrations returned to control values as drug concentrations declined. FSH concentrations significantly exceeded control values 10 and 20 days after implantation, when prostaglandin concentration was nondetectable. The acute suppression of all three hormones suggest that 15-Me-PGF2 alpha either may act directly on the tests to suppress testosterone production or may suppress testosterone production or may suppress gonadotropin secretion, resulting in depressed testosterone output.


Fertility of male rats treated with 15(S)-15-methyl prostaglandin F2 alpha methyl ester-containing silastic implants. Male Spraque-Dawley rats receiving implants of silicone rubber discs containing 1% or 2% 15(S)-15-methyl prostaglandin F2 alpha methyl ester (15-Me-PGF 2 alpha) or no prostaglandin were tested in successive breeding trials for potency and fertility. One week after implantation, discs containing 1% 15-Me-PGF2 alpha reduced potency and fertility, which returned 2 weeks after implantation. Animals receiving implants of the 2% discs were apparently impotent the 1st week following implantation; potency returned before full fertility returned 11 weeks after implantation.


Danazol as a luteolytic agent.

Danazol as a luteolytic agent. Danazol, a synthetic 2,3-isoxazol derivative of 17 alpha-ethinyltestosterone, was administered to healthy nonpregnant volunteers to determine wheter a luteolytic effect could be detected by observation of cycle length, duration of the luteal rise, and luteal steroidogenesis. Danazol administration resulted in a decreased duration of the luteal rise and a decrease in progesterone output in three of four subjects, but no decrease in total cycle length. The administration of human chorionic gonadotropin during danazol administration increased progesterone output. Therefore, danazol would be unlikely to be effective as a luteolytic contraceptive agent.


The effect of intrauterine devices containing zinc and copper on their levels in serum. Serum levels of copper and zinc were determined in 11 health women in whom Latex Leaf intrauterine devices (IUDs) containing copper and zinc had been inserted. Patients with low levels of serum copper or zinc before insertion usually had increased levels of either of these metals while using the device, but they did not exceed the upper limits of normal values. When the group was considered as a whole, the serum levels of zinc showed a slight tendency to increase with duration of IUD use, whereas there was no statistical difference between the serum levels of copper before and after insertion of the IUD.


Clinical investigation of the menstrual cycle. I. Diagram of the normal menstrual cycle. The clinical definition of normal menstrual cycles has been attempted by using the basal body temperature charts of patients without gynecologic dysfunction who conceived in the following cycle. A second-species linear regression method has been used for statistical comparison of lengths of both follicular and luteal phases. A graphic representation of the equation of the tolerance limit about 46 normal cycles is proposed which can be considered a nomogram of the menstrual cycle.


Microsurgical two-layer vasovasostomy: laboratory use of vasectomized segments. A microsurgical laboratory model is described which uses optimally preserved human vasectomy segments. These preserved specimens retain their natural appearance and handling qualities, permitting ready availability of material for practice, which is mandatory before clinical performance. If laboratory facilities are not available, the model can be used for practice in a convenient area of the operating suite.


Quantitative evaluation of testicular biopsies in varicocele. Testicular biopsies from 81 patients with varicocele were evaluated by the score count method. Thirty-two patients sought treatment for infertility. Bilateral biopsies were performed in 47. Spermatogenesis was generally reduced in patients with varicocele, but there was no difference between the right and left tests. The testicular biopsy mean score correlated significantly with the total sperm count. There was no correlation between the size of the varicocele and the reduction in spermatogenesis. Although varicocele is nearly always left-sided, its mechanism of action must involve both testes. This mechanism is still unknown.


Quantitative evaluation of testicular biopsies before and after operation for varicocele. Testicular biopsies and semen samples were examined before and approximately 1 year after operation for varicocele in 39 men. Two men were excluded because of Sertoli-cell-only syndrome. Of the remaining 37, 22 were operated upon for infertility. The testicular biopsies were quantitated with the score count method. The operation for varicocele significantly improved the testicular tissue. THe numbers of tubuli obtaining a high score increased and the biopsy mean scores also increased significantly. However, few testes became perfectly normal. The duration or the size of the varicocele apparently has little effect upon the state of the testicular tissue or the change in it after operation.


Testosterone rebound therapy: a neglected modality. A summary of the literature and a 20-year review of our own experience with testosterone rebound therapy is presented. Of 225 patients followed, 52% rebounded to fertile levels followed by pregnancy in the wives of 25%. Pregnancy occurred in 3 wives (8%) of the 38 initially azoospermic patients. There was only a 4% incidence of failure to return to at least the pretreatment sperm count following therapy, and no persistent azoospermia was observed. These results are consistent with other recent reports of several large series of patients. Proper screening and selection of patients is mandatory. Testosterone rebound is a neglected form of therapy meriting consideration in selected patients.


Follicle-stimulating hormone, luteinizing hormone, and testosterone levels found in human seminal plasma. Radioimmunoassays were performed on the seminal plasma of normospermic, oligospermic, and azoospermic men to determine the levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone. FSH levels in the seminal plasma of all three groups were found to be similar to the levels normally found in blood serum. LH levels in the seminal plasma of azoospermic and oligospermic men were within the normal range found in blood serum but were elevated in the normospermic samples. Testosterone levels in the seminal plasma of all three groups tested were considerably lower than the normal range found in blood serum.


Deciliation in the puerperal fallopian tube. Tubal segments obtained from patients at cesarean section and at intervals during the first 5 postpartum days were examined to evaluate puerperal changes in the tubal epithelium. The specimens of tubal epithelium were examined under the scanning and transmission electron microscopes. Ciliated cells were most densely distributed on the fimbria and in the ampulla, and were relatively sparsely distributed in the isthmus. Progressive diminution of numbers of ciliated cells and deciliated of individual cells were noted in specimens obtained during the puerperium. Nonciliated cells were in the resting stage at term pregnancy. Secretory activity returned during the puerperium.


Inhibitory effect of various gestagens upon the pregnenolone 3 beta-ol-dehydrogenase-delta 5-4-isomerase system in human corpora lutea of menstrual cycles. The inhibitory effect of various gestagens upon the pregnenolone 3 beta-ol-dehydrogenase-delta5-4-isomerase system in 10,000 X g supernatants of human corpora lutea of the menstrual cycle has been investigated in in vitro experiments. The Km value for pregnenolone was 1.3 X 10(-6) M. All gestations reduced the rate of conversion of pregnenolone to progesterone. As compared with controls, average relative rates of reaction with additives were as follows: progesterone, 47%; 17-hydroxyprogesterone, 64% norethisterone, 33%; chlormadinone acetate, 47% medroxyprogesterone acetate, 53%; dydrogesterone, 62%; and allylestrenol, 74%. The data substantiate that natural or synthetic gestagens, at least in vitro, inhibit the conversion of pregnenolone to progesterone by human corpora lutea and that natural progesterone itself is a potent inhibitor which appears to acut noncompetitively (K1 =2.2 X 10(-5) M).


Comparative study of serum luteinizing hormone levels in human subjects as measured by radioimmunoassay and radioreceptorassay. A rapid, precise, sensitive, and specific radioreceptorassay (RRA) for serum luteinizing hormone (LH), using a 15,000 X g pellet from bovine corpora lutea, was developed. A comparative study of the serum LH levels in human subjects as measured by this RRA and by radioimmunoassay (RIA) using the same standard preparation was then conducted. The serum LH profile throughout the entire menstrual cycle and the pituitary responsiveness to LH-releasing hormone (LH-RH) stimulation during the two phases of the cycle were studied in two normal women. In addition, LH levels in two normal postpubertal men were measured in blood samples obtained before and after LH-RH administration. Similar, although not identical, LH profiles were found in all cases by both hormone assay methods. Higher RRA-assayable LH values were obtained throughout the menstrual cycle as compared with those obtained by RIA. A significant LH-RH pituitary response in terms of LH in both RRA and RIA during the luteal phase was observed as compared with that observed during the early follicular phase. In the two normal men, the LH values obtained with RRA were higher than those obtained with RIA. It is concluded that the LH RRA is a practical and efficient tool for clinical research.


[Peptide transport and peptidase localization in the small intestine of chickens]. The mechanism of peptide transport was studied in vitro in the small intestine of chicks and accumulating preparations of mucosa using glycyl-1-tryptophan. A special criterion was proposed to differentiate the processes of intracellular and membrane hydrolysis of dipeptide basing on the analysis of transport intensity of amino acids released into the serosal solution after hydrolysis of dipeptide. 1-tryptophan released at hydrolysis was transported considerably more slowly than free amino acid. 1-tryptophan from the mixture with glycyne demonstrated the highest transport intensity in serosal solution as well as the highest accumulation in the mucosa cells from all forms of 1-tryptophan. At the same time the peptide form of glycyne was transported with the same intensity as that from the mixture with 1-tryptophan. According to the criterion applied it is supposed that unequal levels of 1-tryptophan and glycyne in the serosal solution prove the membrane hydrolysis of glycyne-1-tryptophan during ist transport in enterocytes.


[Distribution and functional characteristics of N- and M-cholinoreceptors in structures of the striopallidal complex]. Microapplication of arecoline, nicotine, methamizil, and beta-ethydiphazil in unanesthetized immobilized rabbits through chemotrodes implanted into the head of nucleus caudatus, putamen, globus pallidus, hippocampus, reticular formation and frontal cortex revealed inhibitory and activating effects of arecoline and nicotine. Specific antagonism between the effects of M- and N-cholinomimetics and between corresponding M- and N-cholinoblockers, was shown. Existence of M- and N-cholinoreactive biochemical systems with reciprocal relations is supposed in different zones of the striatum.


[Mechanism of development of secondary hypocoagulation in frogs following intravenous thrombin administration]. Appearing of thrombin in vessels leads to formation of fibrin clots followed by consumption of clotting factors and developing of repeated hypocoagulation. In dissolution of fibrin the important role belongs to fibrinolysis, leucocytes, and reticuloendothelium. I. v. administration of thrombin in frogs with destroyed spinal cord caused intravascular clotting with following readjustment of blood flow. Dissolution of the clots in vagotomized frogs occurred more slowly than in intact frogs.


[Effect of adrenaline on rat atrial and ventricular chronoinotropy]. The atria and ventricles were shown to differ from each other in: temporal course of contractions, relations between the strength of contractions and the interstimuli interval, resting potentiation, transitional processes after intermissions, character of response to adrenaline. For the first time the adrenaline was shown to annihilate differences in restitution processes occurring in atria and ventricles. The differences of responses in atria and ventricles seem to be due to concentration of endogenous catecholamines which modulate the electromechanical coupling of the rhythmically working myocardium.


[Compensatory-adaptive responses of the microcirculatory bed of rat mesentery in hypoxia]. Television microscopy and stroboscopic determination of the blood flow speed showed that linear and volumetric speed of the blood flow in arterioles with gauge 40--20 mcm and venules with gauge 40--50 mcm diminished during repeated action of hypoxia and constrictory reaction. In capillaries and postcapillary venules with gauge 11--39 mcm, there was a dilatation with an original increase and subsequent decrease of the blood flow speed.


[Digestive enzymes in rat saliva following selective or total removal of the salivary glands]. After partial or total removal of salivary glands, parotid glands secreted practically the whole amount of alpha-amylase, DN-ase, and major portion of RN-ase, the submandibular glands providing more than 2/3 of the whole production of salivain. Comparison of output of enzymes with or without pilocarpin stimulation showed parotid glands to be the glands with periodical secretion and submandibular glands--with permanent secretion.


[Secretion of amylase and lipase in bile]. In chronic and acute experiments on dogs, secretion of amylase and lipase in bile, under conditions of basal and stimulating feeding and before and after the ligation of pancretic ducts and i. v. administration of pancreatic gland tissue extract, was studied. Amylase and lipse were found to be normal physiologic components of the bile, the latter's secretion depending on functional state of liver and maintenance of enzyme in the blood. The transition of hydrolase from blood into the bile is considered to be one of mechanisms of securing the enzyme homeostasis. For starting amylo- and lipolytic activity of the bile, the processes of their recretion from the blood are considered to be very significant.


[Relationship between the frequencies of pacemaker and action potentials in the duodenal smooth muscle of dogs]. In dogs with electrodes indwelled into the duodenum, four phases of the change of duodenum pacesetter potentials were revealed at rest in hunger whereas no such changes were observed during digestion. The frequency ranges of both the pacesetter potentials and the bursts of action potentials were wider in hunger than during digestion. Without the digestive activity, the periodicity of the frequency oscillations of the pacemaker potentials corresponded with the periodicity of action potentials, whereas during the process of digestion the constancy of the pacesetter potential frequency corresponded with the action potential constancy. The regularities of optimal conditions for action potentials of the duodenum smooth muscles are discussed as well as the methodological conditions for revealing the authentic character of changes in the pacesetter potential frequency.


Dapsone in the treatment of pemphigus vulgaris. This is a report on two cases with pemphigus vulgaris effectively controlled by dapsone. In one, dapsone was added to the treatment after a failure of combined prednisone and methotrexate therapy to control the disease completely. It is suggested that dapsone may offer a means in an attempt to minimize adverse reactions met with during the long corticosteroid regimen required in pemphigus.


Yersinia enterocolitica as a cause of erythema nodosum. 54 cases of erythema nodosum, seen in the Department of Dermatology at the St. Raphael University Hospital, Louvain, were reviewed for their possible aetiology. A search for Yersinia enterocolitica (Y.e.) agglutinins was performed in 21 patients of whom 8 had significant serum antibody titres. These cases are presented and discussed. Gastro-intestinal symptoms, preceding by 2 weeks the erythema nodosum, are strongly suggestive for an aetiologic link with Y.e. Our observations confirm and extend to this part of Europe, the experience of other, mainly Scandinavian, authors.


Animal models of percutaneous penetration: comparison between Mexican hairless dogs and man. In an attempt to find better animal models for percutaneous penetration studies relevant to man, urinary excretion of 14C-labeled compounds was studied in the Mexican hairless dog and in man. With benzoic acid, progesterone and testosterone, the total absorption and maximum absorption rate were greater in man than in the hairless dog. As urinary excretion lasted days longer in the dog than in man, it is possible that the thin dog skin held the chemicals longer than man. Surface-counting experiments with a Geiger counter with a thin mica window protected by a special screen of fine stainless steel wires showed that benzoic acid and progesterone did persist on the dog skin far longer than on human skin. We conclude that the Mexican hairless dog has permeability characteristics significantly different from those of human skin.


Effect of topical salicylic acid on animal epidermopoiesis. In contrast to its antihyperplastic effect on pathological proliferation of the epidermis, salicylic acid promotes epidermopoiesis in the normal guinea pig skin. After the application of 1% w/w salicylic acid in acetone-ethanol for 4 weeks, the thickness of the surface epithelium was increased by 40% and that of the deep epithelium by 19%. The mitotic index rose by 17%.


Atypical granuloma annulare. Transition from erythema to multiple type. We studied a 53-year-old housewife who had atypical granuloma annulare (GA) which began as erythematous patches on the legs. After 2 months, multiple flat papules, histologically characteristic of GA, developed over the erythematous background. 1 1/2 years later, a typical annular lesion appeared on the right index finger. Differential diagnosis of the erythematous form of GA based only on the clinical manifestations is difficult.


Uniphasic insulin-secretory response in the pancreatic vein of dogs after an enteric glucose load. The insulin secretory response to an enteric glucose load was measured in 11 dogs after intrajejunal instillation of a 25 per cent glucose solution (1.75 gm./kg.) in five minutes. Insulin outflow rate was measured every minute for 10 minutes, then at increasing intervals through 60 minutes. Starting at two minutes after onset of glucose loading, mean arterial plasma glucose rose steadily throughout the hour. This was paralleled by a similarly progressive rise in mean pancreatic venous plasma insulin output starting at seven minutes and peaking at 50 minutes, despite partial masking by a simultaneous fall in pancreatic venous plasma flow rate after the fourth minute. The data indicate that the normal insulin response to an enterically administered glucose stimulus is a smoothly rising uniphasic one, in contrast to the typical biphasic insulin response to a "square-wave" intravenous glucose stimulus.


The size of the loading dose as an important determinant of the results of the oral glucose tolerance test: a study in subjects with slightly impaired glucose tolerance. In the oral glucose tolerance test (OGTT), divergent doses of glucose remain in use by virtue of the prevailing conviction that the size of the loading dose hardly affects the outcome of the test. We compared the results of OGTTs with 100-gm. and 50-gm. loads in 85 patients, who were selected for slightly impaired glucose tolerance (plasma glucose at 120 minutes after 100 gm. of glucose was between 130 and 200 mg./dl.) The mean between-load difference in this group appeared to be nearly three times as great (54 mg./dl. at 120 minutes) as reported in the literature for normal subjects. The small impact of the dose in normal subjects could be confirmed in a group of 22 controls. As subjects with normal and with slightly impaired glucose tolerance react divergently to a change in the glucose dose, tests with different loads are not comparable and select different populations. The results can therefore also not be converted to one another by conversion formulas. The finding might be explained by the delay of the additional rise of the plasma insulin in patients after the higher load.


Prevalence of diabetes mellitus in school-age children in Minnesota. The prevalence of diabetes in Minnesota school-age children was found to be one per 529 students (1.89 per 1,000), 95 per cent of whom were receiving insulin. Data were obtained by a mail survey of the public schools in the state. Enrollment in public schools represents 90 per cent of the student population in Minnesota, and data were received from 96 per cent of the public schools. This return rate by schools accounts for 95 per cent of the total student enrollment. Diabetes increased linearly with age, representing a yearly prevalence increase of 0.16 cases per 1,000 students.


Hyperglycemia, hypoinsulinemia, and hyperglucagonemia in acute water intoxication. When acute (four-hour) hyponatremia with clinical signs of water intoxication was produced in normal weanling mice by the use of hypotonic glucose or deionized water, there was a two-to-fourfold increase in plasma glucose concentration. Concomitantly, concentrations of plasma insulin fell 63 to 68 per cent, whereas plasma glucagon increased to 262 per cent of control. The findings are compatible with stress-induced catecholamine release.


The immunogenicity of different insulins in several animal species. The immunologic properties of homologous and heterologous insulins have been investigated. Pigs, dogs, cows, sheep, goats, rabbits, guinea pigs, and rats were immunized with different hormone preparations alone or in combination with complete Freund adjuvant. The results obtained provide convincing evidence that in pigs homologous insulin cannot produce specific antibodies, whereas heterologous insulin can. Because the insulins of dogs and pigs have identical amino acid sequences, no antigenicity of porcine insulin in dogs could be observed either. In cattle, sheep, and goats, not only heterologous but also homologous insulins stimulated antibody production. Sheep and goats proved to be excellent reactor animals. Most of the small laboratory animals developed specific antibodies against insulin after hyperimmunization. In rabbits, not only the groups injected with nonchromatographed bovine insulin but also those hyperimmunized with single-component bovine insulin responded with a high serum level of specific antibodies. The data suggest that highly purified insulin preparations have not less antigenic activity than nonchromatographed insulin. Immunologically, des-Phe-B1-insulin acted exactly like the original hormone. Histologic examination of the pancreases of 45 pigs, 22 of which had high antibody titers, did not reveal insulitis. The results of the present paper point out that the production of specific antibodies is essentially a question of species specificity.


Tryptophan and hepatic coma.

Tryptophan and hepatic coma. To clarify the involvement of tryptophan in the pathogenesis of hepatic coma, plasma and cerebrospinal fluid (CSF) tryptophan was studied in three patient groups (hepatic coma, stable cirrhosis, and control). An assessment of free fatty acids, some of the amino acids reported to compete with tryptophan for brain uptake, and albumin was also made. The data demonstrated that, whereas the elevated CSF tryptophan levels in cirrhotic patients compared to controls may have been attributable to decreased plasma branched chain amino acids, the elevated CSF tryptophan levels in hepatic coma compared to stable cirrhotic patients were probably attributable to increased plasma free tryptophan concentrations. Associated with the elevated plasma free tryptophan in coma patients was an increase in plasma free fatty acids and a marked decrease in serum albumin levels. Of all the amino acids investigated in the CSF, only tryptophan was significantly increased in patients in hepatic coma compared to cirrhotic patients not in coma.


Hepatotoxicity of salicylates in monolayer cell cultures. The influence of graded doses of sodium salicylate on rat liver cells cultured in monolayers was assessed by measuring lactic dehydrogenase activity in a culture media after incubation. Morphological alterations were studied by electron microscopy. The influence of different albumin concentrations in the media on toxicity was also evaluated. Lactic dehydrogenase concentrations rose with increasing doses of salicylate up to 40 mg per dl. High concentrations of albumin were associated with reduced salicylate toxicity. These findings suggest that salicylate-induced hepatic injury is dose related and my be influenced by serum albumin levels


Effect of substance P on intestinal muscle. The mode of action of synthetic substance P on intestinal motility was investigated in vitro. Results have indicated that substance P has a major stimulating effect on the intestine by eliciting mechanical contraction and bursts of spike potentials. On a molar basis, substance P was 1.6 X 10(3) times more potent than acetylcholine. Unlike the gastrin peptide analogue caerulein, the effects of which were mediated through the release of acetylcholine from the enteric plexuses, the site of action of substance P appeared to be directly on the muscle cells because its effects were resistant to atropine, tetrodotoxin, and Lioresal. These data strongly suggest a possible physiological role of substance P in the modulation of intestinal longitudinal muscle motor activity.


Effect of glucagon on aspirin-induced gastric mucosal damage in man. The effect of glucagon on aspirin-induced damage to human gastric mucosa and its effect on gastric mucosal potential difference were studied in 27 healthy volunteers. Intragastric instillation of 600 mg of aspirin suspended in 100 ml of isotonic saline caused significant damage to 21 +/- 3% of surface epithelial cells and a marked reduction in gastric potential difference within 15 min of aspirin instillation. Glucagon, 2 mg given intravenously, caused hyperglucagonemia, hypophosphatemia, hyperinsulinemia, increased blood glucose levels and gastric pH, as well as significant prolonged elevation of gastric potential difference. Glucagon injection given 15 min before aspirin instillation effectively prevented surface epithelial cell damage, decreasing percentage of damaged cells to 3.5%. Glucagon did not prevent the drop in gastric potential difference evoked by aspirin, but did, however, prevent potential difference from falling below base line values after aspirin. This study showed in man that glucagon protects gastric mucosa against aspirin damage and suggests possible therapeutic value in clinical situations requiring prevention of aspirin-induced gastric mucosal damage.


Gastric emptying and antral motility in reflux esophagitis. Effect of oral metoclopramide. The gastric emptying of the liquid phase of a meal and the fasting antral contractility were studied in 13 patients with reflux esophagitis and in 9 age-matched control subjects. Gastric emptying half-time (t 1/2) in reflux esophagitis patients was no different from that of control subjects (P less than 0.30). Antral contractility (number of antral contractions and the cumulative antral activity), however, was lower in reflux esophagitis patients than in control subjects (P less than 0.001). Oral metoclopramide (15 mg) accelerated gastric emptying, increased the number of antral contractions as well as the cumulative antral activity in patients with reflux esophagitis (P less than 0.001). However, it only increased the cumulative antral activity in normal subjects (P less than 0.01). These results suggest that metoclopramide may be potentially beneficial to reflux esophagitis patients by reducing the volume of gastric contents available for gastroesophageal reflux.


Giardiasis with total villous atrophy.

Giardiasis with total villous atrophy. A patient who developed symptomatic giardiasis after a tour of the Soviet Union is presented. The diagnosis was established by duodenal aspiration. A small intestinal biopsy revealed total villous atrophy in the absence of celiac sprue or a gastrointestinal immunodeficiency syndrome, a finding not previously described. The biopsy remains normal after a single course of metronidazole (Flagyl), despite subsequent exposure to gluten.


Effect of one-month treatment with cimetidine on gastric secretion and serum gastrin and pepsinogen levels. The inhibitory effects of cimetidine on gastric acid and pepsin secretion were studied before and after 1 month of treatment with 300 mg of cimetidine four times a day in 15 male duodenal ulcer patients. Cimetidine inhibited both pentagastrin- and peptone meal-stimulated acid secretion significantly better before, than after, 1 month of treatment. Similarly cimetidine inhibited pentagastrin-stimulated pepsin secretion significantly better before treatment. Meal-stimulated serum gastrin concentrations were significantly higher after treatment. The mechanism(s) of these effects was not apparent.


Bioavailability of cimetidine in man.

Bioavailability of cimetidine in man. The bioavailability of parenteral cimetidine was tested in 12 volunteers in a balanced three-way crossover study. Blood levels and urinary excretion were compared after intramuscular and intravenous injection and oral administration of 300 mg of cinetidine. The results indicated that the intramuscular and intravenous routes are virtually interchangeable for parenteral cimetidine, and that the oral liquid, although exhibiting a reduced area under the blood level curve as compared with the parenteral doses, nevertheless demonstrated equivalence with respect to the time the blood level remained above 0.5 microgram per ml. The 300-mg cimetidine tablet formulation was found in another group of 12 volunteers to be bioequivalent to a 300-mg dose of oral liquid.


Cimetidine in the treatment of gastric ulcer: review and commentary. Cimetidine therapy in gastric ulcer disease has been evaluated in four complete and one incomplete controlled, double blind trials. A sixth trial, still under way, is partially blind. Treatment duration ranged from 2 to 6 weeks; doses ranged from 0.8 to 1.2 g daily. Two studies also evaluated the influence of hospitalization on ulcer healing and symptoms. Relatively large doses of antacid taken with cimetidine confounded the evaluation of cimetidine efficacy in two of the trials, without answering the question of antacid efficacy. Cimetidine was more effective than were small doses of antacid in healing ulcers in one study but was not significantly superior to treatment with larger quantities of antacid in two other trials. Preliminary results indicate that cimetidine is more effective than carbenoxolone in healing ulcers. Hospitalization for 2 and 3 weeks conferred no advantage, but patients were not randomly assigned to hospitalization. Definitive studies on whether cessation of cimetidine therapy is followed by accelerated ulcer recurrence have not been reported. The efficacy of chronic or intermittent cimetidine therapy has not been studied in gastric ulcer disease.


Effect of histamine and histamine antagonists on human lower esophageal sphincter function. The purpose of this study was to evaluate the effect of histamine phosphate and specific histamine antagonists on human lower esophageal sphincter (LES) pressure. Continuous intravenous infusions of histamine at doses of 2.0 to 40.0 microgram/kg-hr gave graded increases in LES pressure with a peak response of 378 +/- 4.6 mm Hg at 20.0 microgram kr-hr. The LES response was not altered by an H1-antogonist, diphenhydramine (50 mg, intravenously), but was completely blocked by infusion of the H2-antagonist, cimetidine (4.0 mg/kg-hr). Also, oral cimetidine (300 mg) antagonized any increase in LES pressure during histamine infusion at a dose shown to give the maximal LES response. Despite this effect of cimetidine in antagonizing the maximal LES response to histamine, oral cimetidine at 200, 300, and 400 mg failed to alter basal LES pressure over a 3-hr period. Cimetidine also failed to alter the LES response to intravenous pentagastrin or oral beef hydrolysate. These studies suggest that: (1) human LES pressure increases in response to intravenous histamine phosphate through its action at an H2-receptor; (2) the H1-receptor has no apparent role in the human LES response to histamine; and (3) H2-antagonism with cimetidine has no effect on the human LES basal pressure or its response to gastrin stimulation.


Report on the United States experience with cimetidine in Zollinger-Ellision syndrome and other hypersecretory states. Sixty-one cases of the Zollinger-Ellison syndrome, encountered over a 2-year period, have been treated with cimetidine, half of them for over 1 year. Two-thirds of the patients responded to 300 mg of the drug every 6 hr by mouth. Others required up to 600 mg every 6 hr. In adequate doses the  drug was highly effective: it controlled pain and dyspepsia, restored weight, abolished diarrhea, and allowed healing of ulcers and other inflammatory conditions. Missed or reduced doses led to rapid return of symptoms. Progression of the basic neoplastic process, with associated secretory drive, was unimpeded. Patient acceptance of the drug was 100 percent, and apart from minor transient abnormalities, gynecomastia (5 cases) and liver dysfunction (3 cases), which resolved while treatment continued, no serious adverse effects were seen. Of 61 patients 48 are still on the drug, 3 who were well controlled were treated surgically, 5 died for reasons unrelated to therapy, and 5 had significant problems. The drug provides an alternative to total gastrectomy and can be recommended with confidence for the suitably selected patients. The drug was also beneficial in some cases of the short bowel syndrome, systemic mastocytosis, and endogenous hyperhistaminemia due to leukemia.


Effects of renal failure on blood levels of cimetidine. Serial blood samples for determination of drug levels were obtained after intravenous administration of 300 mg of cimetidine. Sixteen patients with varying degrees of renal failure were studied. There was a prolongation of drug half-life in patients with renal insufficiency compared with that in normal controls (P less than 0.001). A significant inverse relationship between the half-life and the creatinine clearance was noted (r= 0.69; P less than 0.01). The effect of hemodialysis was studied in 12 patients. Cimetidine was found to be dialyzable. This was demonstrated both by a shortening of the half-life of the drug during dialysis and by measurement of dialysance. This suggests that the dose schedule should be modified for patients with renal insufficiency and for those on hemodialysis. A single intraveno us dose of cimetidine was well tolerated by the patients. One patient developed an urticarial skin rash, believed to be allergic in nature. There was a transient, mild (but significant) rise in blood urea nitrogen and serum creatinine concentration in 5 patients with moderate renal failure.


Safety of cimetidine.

Safety of cimetidine. Our review of published material, manufacturer's files, and submissions to the United States Food and Drug Administration indicates that cimetidine is safe for short term use (up to 8 weeks). This judgment is based on a total experience with over 3000 patients. Clinically insignificant elevations of serum creatinine occur in a high percentage of patients, persisting until the end of therapy, then disappearing. Gynecomastia occurred in some patients on long term therapy.


Diagnosis and treatment of the preleukemic syndrome (hemopoietic dysplasia). Retrospective and prospective observations have established the existence of a recognizable hematologic syndrome preceding the development of acute nonlymphocytic leukemia. This syndrome, which has been termed the "preleukemic syndrome" or "hemopoietic dysplasia", appears to be a stage in a multiphasic myeloproliferative disorder, rather than a separable disease with a propensity to develop leukemia. All products of the marrow stem cell are involved. The panmyelopathy begins as a red cell disease (eg, a refractory or sideroblastic anemia) and progresses to involve megakaryocytes and platelets and finally granulocytes or monocytes, or both; the terminal event is acute nonlymphocytic (myelomonoblastic) leukemia. Prospective documentation is needed in order to define the natural course of this marrow disease. Such studies are now in progress and should provide important information concerning the pathophysiology of acute nonlymphocytic leukemia.


Treating acute nonlymphocytic leukemia.

Treating acute nonlymphocytic leukemia. Acute leukemia is no longer an uncommon disease among the middle-aged and elderly. In recent years, treatment programs available for acute nonlymphocytic leukemia have improved dramatically. While remission rates in patients over age 50 are not as high as in younger age groups, combination chemotherapy is effective in a significant number of older patients, and complete remissions can be obtained in 20 to 50%. Recent years have also witnessed much progress in the ability to provide essential supportive therapy during periods of marrow hypoplasia. Because acute leukemia is uniformly fatal if untreated, aggressive therapy should be made available to all these patients, regardless of age.


Effect of age on collagen fibril formation. The rates of collagen fibril formation are, under otherwise identical conditions, a function of the age of the acid-soluble rat tail tendon collagen utilized. The rate is most rapid with young adult (165 day) collagen, which exhibits no induction period before collagen multimerization begins. In contrast, 21-day collagen exhibits both a 30% slower rate and an induction period. Collagens from older animals also have age-dependent fibril formation rates going from a maximum at 165 days to 80% of that for 1,100-day-old material. These age-related differences in collagen fibril formation kinetics appear to be related to the degree of cross-linking of the collagen involved.


Collagen age and platelet aggregation.

Collagen age and platelet aggregation. Rat tail tendon collagen-initiated platelet aggregation exhibits a collagen age-dependent lag time. This lag time is an inverse function of the previously determined rate of fibril formation of collagen, and corresponds to the elapsed time necessary to form a collagen fibril of requisite size under the platelet aggregation conditions chosen. Such fibers exhibit native spacing and appear to be 45 to 90 A in diameter. Fibers preformed to that size (less than 2 min for 21- to 1,100-day-old collagen), no matter what the age of the collagen, give rise to identical platelet aggregations. Fibers formed after more prolonged incubation, greater than or equal to 20 min, have impaired platelet aggregating ability.


Characteristics of the 'life spanning' phenomenon in Amoeba proteus. Independent nuclear and cytoplasmic ability to impose finite 'life span'. Amoeba proteus given adequate food grows exponentially and clones of amoebae are normally immortal. After periods of food supply restriction to that necessary for maintenance, or food intake restriction by agitation, cells subsequently given a normal growth diet produce clones of finite life span. Reciprocal nuclear transfer between maintained and normal cells demonstrated that the nucleus and cytoplasm of maintained cells have acquired the independent ability to impose a finite life span on clones developing from cells whose other components are normal. In clones developing from maintained cells, inviable cell production is enhanced and inter-division times are prolonged. Inter-division times and clones mean doubling times do not show normal distribution.


Effect of sulfamerazine and exercise on life span of rats and hamsters. Rats and hamsters of both sexes were divided into exercise and non-exercise groups with and without small amounts of sulfamerazine in the diet. In every case rats on exercise lived longer than their controls. The females outlived the males while hamster males lived slightly longer than females. Sulfamerazine had a significantly beneficial effect on life span of rats and apparently increased that of male hamsters. All rats fed sulfamerazine attained higher maximum weights than their controls. There was no consistent change in bone densities.


An investigation into the ability of elderly patients continuing to take prescribed drugs after discharge from hospital and recommendations concerning improving the situation. An investigation was made by an Occupational Therapist into the problems encountered by 50 elderly patients in the self-administration of drugs prior to discharge home. The questions asked the patients are enumerated and recommendations are made concerning how improvements can take place so that many more of the elderly will take the prescribed drugs in the right doses at the right time on discharge home.


[Developmental abnormalities of the gallbladder--two cases]. Two cases of a psudoatresia of the gallbladder are referated. Only by intraoperative cholangiography the real situation could be shown. Without any exception this radiological method should be used in all operations of the biliary system.


[Pupillary reflex dynamics studied with infrared pupillography]. With a modified method of infrared pupillography--especially developed for the use in clinical neurological routine diagnosis--the time course of the direct phasic pupillary light reflex in man was investigated under physiological and pathological conditions. The described method allows a high resolution of the time course of the light reflex and is superior to kinematographic as well as video-methods described so far. Normally the physiological time parameters are bilaterally symmetrical, also in cases of so-called physiological anisocoria. On the other hand in pathological anisocorias of various etiology pronounced side-differences and abnormal time parameters can be found. Also in cases of isocoria with clinically no abnormal findings of pupillomotor response pathological side-differences can be determined by infrared pupillography. Disturbances of the afferent arc, of the efferent arc and of combination of those as well as pupillary abnormalities to be located in the midbrain area, can be exactly analyzed and documented. Furthermore the method allows an objective documentation of the course in cases of dysfunction of the autonomic nervous system, like in intoxications, or to monitor drug-induced therapeutical measurements. The investigations and findings indicate that infrared pupillography, an objective method for analyzing the dynamics of the pupillary light reflex, is suitable for clinical neurological routing diagnosis.


[Therapy of urinary incontinence using pessaries]. The application of pessaries with different effect in the treatment of genital prolaps and urinary incontinence is demonstrated. The mechanism of effect can be shown by radiological studies.


[Tobacco abuse in adolescents].

[Tobacco abuse in adolescents]. The existing literature on smoking among young people in the Federal Republic of Germany is reviewed. Smoking is spread differently among the German youths, varying from place to place. Smoking is more widely spread in the cities than in the country. It is spread more widely in the commerce schools than in other schools. The boys smoke more often and more heavily than the girls. The difference between the two sexes is greater in the country than in the cities. As a rule, the young people smoke filter cigarettes with medium strong tobacco. The majority of the school students smoke less than five cigarettes per day.


[Splenic cysts: clinical aspects, diagnosis and differential diagnosis]. 328 patients were splenectomized from 1967 until 1976. In this period only 4 splenic cysts were observed and operated. Three cysts were posttraumatic and one was of lymphatic origin. The case history and diagnostic management is reported with special reference to preoperative angiography and differential diagnosis. There were no postoperative complications observed.


[The clinical significance of hyperuricemia for the prognosis of pregnancy toxemia]. This study demonstrates that uric acid serum levels are of importance in the prognosis of pregnancy complicated by hypertension. In early pregnancy the uric acid level probably is the most sensitive parameter to select the risk-prone pregnancies with EPH-gestosis to conduct the further course of pregnancy under medical care. Pregnant hypertensives with high uric acid levels develop more often retardation of the fetus, the incidence of eclampsia increases. In case of hypertension in pregnancy complicated by high uric acid levels careful monitoring and normalizing high blood pressure under medical observation improves the prognosis for fetus and mother.


[Quantitative aspects of the ontogenic development of the visual regions of the brain]. Quantitative light-microscopic studies on the ontogenetic development of 11 visual brain regions of Tupaia belangeri were done. The fresh volumes of the visual brain regions showed a heterochronical and heterotypical development. Brain regions with overshooting or monotonously increasing growth could be found using computer calculations of logistic curves. Studies on the development of the number of nerve cells and glial cells showed an overshooting growth of the nerve cell quantity and a monotonously increasing growth of the glial cell quantity in the nuclei nn. oculomotorii et trochlearis. A compartment analysis with computer aided stereological procedures was done for the nucl. n. oculomotorii. The present findings as well as those from proceeding investigations serve as the basis for a hypothesis describing the significance of the growth curve for fresh volumes, and especially for the spontaneous degeneration of neurons in the formal genesis of the nervous system.


[Current concepts in the diagnosis of knee injuries]. The exact diagnosis of affections of the knee is most important, especially of the capsulo-ligamentous lesions. To-day more and more younger patients are suffering from knee-instability. The modern possibilities of operative reconstruction lead to excellent results if the operation is performed at an optimal date. During the last years progress also was achieved concerning the knowledge of the mechanics and the pathophysiology of the knee. New methods of clinical investigation and new clinical findings were possible. Specific tests for the diagnosis of instability of the anterior cruciate ligament have to be emphasized. These tests are specially important if there is only an insufficiency of the anterior cruciate ligament which cannot be proven by the other clinical findings. X-ray examination is necessary to search for a fracture or an avulsion of the bone. In all other problems the exact clinical examination leads to the diagnosis.


[Problems of surgical management of old knee joint injuries]. The problems in reconstructive surgery of old ligamentous injuries arise with the claim for restoration of normal function and anatomy. Based on new findings they are achieved by passive stabilization of the injured ligamentous structures as well as by their active reinforcement by the hamstring muscles. Surgical procedures may be traced back to a sort of integrated system; according to our own experiences these can be performed in any combination when reconstructing rotatory instabilities. Procedures eliminating one plain instability should only be applied with special indication.


[Femoral neck fractures and pertrochanteric fractures due to skiing accidents]. Pertrochanteric and femoral neck fractures are common in elderly patients. These fractures are mostly caused by domestic accidents. Femoral head necrosis and non-union are severe complications. Even if these fractures are not typical skiing-fractures, 101 fractures of the proximal femor were found to be caused by a skiing-accident. The age of the patients averaged 41 years, only one third were female. More than half of all patients participated in a control examination about one year after the accident. All fractures were operated according to the principles of the ASIF. The results showed twice an infection, in 3% dystrophia of the bone and in 3% mild osteoarthritis. There were no necroses of the femoral head, no non-union and no breaking of the implanted material. In 90% the results were good or excellent from the point of view of the patient as well as the orthopedic surgeon.


[Treatment possibilities of the non-specific (psychosomatic) pain syndrome of the locomotor system]. The so-called psychosomatic pain syndrome of the locomotor system, particularly of the back (brachialgia, lumbalgia, sciatica), is often associated with deeper psychic disturbances, sometimes even with masked depressions or advanced neurotic conditions. Certain cases require special treatment such as psychotherapy or antidepressive pharmacotherapy. In many cases, however, a psychoanalgesic drug, Dolo Visano, has proven effective in these non-specific pain syndromes of the locomotor system. Dolo Visano is a combination of acetylosalicylic acid, codeine phosphate, diphenhydramine hydrochloride, nicotinic acid and meprobamate. The results of a clinical trial in 50 patients are described in detail. The drug was generally well tolerated.


[Amaurosis fugax in obliterations of the carotid artery]. Lesions at the carotid bifurcation frequently cause transient cerebral ischemia and especially visual disturbances by microembolization. An early diagnosis is vital in order to prevent definitive blindness. Transient monocular blindness is an early diagnostic sign of ulcerated atheroma of the extracranial carotid artery. Symptomatology, diagnosis and therapeutic aspects are discussed.


[Epilepsies due to cerebrovascular disorders]. We stress the importance of differential diagnosis between late onset epilepsies and incidental fits in higher age. This is not merely a nomenclatory play but of great therapeutical consequence. Epileptic and non-epileptic attacks with onsets in higher age, either of generalized or of lateralized phenomenology, form an important precursor of impending stroke. "Vaskuläre Präkursivepilepsie", so called by us, within this group of premonitory signs is of special importance and may open way to adequat prophylactic therapy, medically or surgically (mainly in the sence of carotid surgery). Late onset epilepsy in itself can be treated with relative low dosis of antepileptics plus cardiotonic and vasoactive medication. Hence, the status epilepticus as accompanying symptom of a stroke is difficult to treat and very often forms a signum mali omniis leading to death by exhaustion of the predamaged brain.


[Tremor. Mechanical effect of the discharge behavior of motor neurons]. From the accordance of the discharge and recruitment behaviour of motor units with the Fourier-analysis of the tremor ripples it is shown that the action tremor originates from any muscle innervation and is equivalent to the mechanical effect of the discharges of all motoneurones of a particular muscle. The power spectrum of tremor is mainly caused by the twitch contractions between recruitment (7--8/sec) and total fusion (25/sec) of the discharging motoneurones. The maximum of the frequency spectrum, which represents the dominant tremor rate, corresponds to the discharge frequency just after recruitment of each motoneurone. The twitch contractions of these newly recruited motor units are mechanically least fused. The power spectrum of the tremor in patients with motor disturbaces parallels the changes in the discharge and recruitment behaviour of motoneurones during voluntary contraction. The correlation between the discharges of two simultaneously recorded motor units shows a tendency to synchronization of all discharge rates the extent of which corresponds to the individual tremor intensity.


[Incompatibility reactions following the infusion of colloidal volume substitutes during anesthesia]. A case of incompatibility reaction after Macrodex infusion during anesthesia is reported. The possibility of activating the so-called "alternative pathway" by dextran is shown. The early recognition of this reason for incompatibilities may help to prevent the development of severe, possibly fatal forms of dextran incompatibility. Strict observation of the patient during, especially at the beginning of the infusion and an exact recognition of the symptoms are necessary if dextran infusions are applied.


[Clinical pathology. Current tasks and developmental trends]. An enormous increase of histological and cytological examination has been observed during recent years. Further, the examinations performed today have to be more extensive. In oncology, the trend runs towards an individualized therapy according to histomorphology, grade and stage. As a consequence the importance of surgical pathology is increasing. The surgical pathologist is engaged in applied research. This is necessary as well as basic research in pathology. In classical European pathology, the autopsy room is the central room of the institute. On the contrary, surgical pathology considers operating theaters and endoscopy rooms as focus. It has gained an importance and will continue to do so in the future.


[Differential diagnosis of ophthalmological findings in various forms of ichthyosis]. The ophthalmological manifestations in the various types of ichthyosis are very different. Regarding genetic criteria, history, clinical and histological observations, four different keratopathies characteristics for one of each type of ichthyosis, were found.


[Struma. Results of surgical management]. Case report about 3620 struma operations and comparison of the results with the publications of other authors. The situations of malignant strumas are considered separately. Postoperative complications, causes of death and mortality are also considered. The necessity of postoperative hormon-substitution is pointed out.


[Gait analysis in children with cerebral movement disorders]. The study comprises the results of gait analyses that were carried out by means of three-dimensional motion films. The gaits were recorded by two synchronized film-cameras from different angles. Enlarged on a screen a frame to frame analysis was possible. Various statements were obtained on the kind and severeness of the handicap. By computerizing the data the results were proved to be of statistical significance. The research finally included studies on electromyographic activities of several muscles in the lower extremities.


[Poisonous-snake bites. Therapy and preventive measures]. It is estimated that every year about 500 000 people around the world are bitten by poisonous snakes. Between 30 000 to 50 000 persons die due to snake-bites; the highest frequency is reported from Southern Asia. Clinically three types of snake-bites can be distinguished: 1. Bites with local damage (extreme pain, edema, necrosis), 2. Bites followed by generalized hemorrhagic symptoms and 3. bites with neurotoxic effects of the poison (no local pain, paralysis of cerebral nerves, coma). For tropical snake-bites snake-venom is live-saving. As in many cases the biting animal cannot be identified it is advisable to use polyvalent sera. These are heterologous sera which contain antitoxins against several poisonous snakes of a certain area. Often there is some delay until the snake-venom becomes available. Therefore local and symptomatic treatment is valuable: cleaning of the wound, superficial incision to remove poison, venous congestion, oral and intravenous fluid-therapy, antihistaminic drugs, steroids and prophylaxis of shock. Tourists are only rarely endangered by poisonous snakes, they do not need to carry anti-snake venom; this is recommended for scientific excursions in areas with dense vegetation and for persons living in warm countries.


Services for schizophrenics: a lifelong approach to treatment. Mental health services in the 1960s reflected then-current beliefs in the effectiveness of crisis-oriented services and broad social programming to treat and even prevent serious mental disorders. The result was an unwarranted emphasis on the single-episode user of services and lack of interest in patients such as schizophrenics who needed repeated services. Numerous more recent studies indicate that many cases of schizophrenia have a heritable biological component and respond well to neuroleptic medication. For effective out patient treatment of schizophrenics who might otherwise be repeated users of hospital service, the author advocates a program of continuous, or nearly continuous, neuroleptic medication, combined with counseling and social and crisis services. The patient would be educated to take a role in self-regulation of medication, within a prescribed range, which would appear to improve safety, precision, and reliability.


Rediagnosis of schizophrenia as bipolar affective illness. Ten patients in a Veterans Administration hospital who had been diagnosed and treated as schizophrenic were rediagnosed as having bipolar affective illness and were shown to be responsive to lithium. The authors feel that the diagnosis of schizophrenia is made too frequently and often is made with inadequate information. A further complicating factor in diagnosis is that some patients exhibit schizophrenia-like symptoms during the acute manic phase. The authors found that valuable aids to rediagnosis of such patients include a good premorbid and interepisodic adjustment, a history of depressive episodes, a family history of affective disorder, and a favorable response to a therapeutic trial on lithium carbonate.


The use of fluphenazines in a continuing-care program. The author describes his experience in using long-acting injectable fluphenazines with chronic schizophrenic patients in a continuing-care program in San Diego County. He has found the drug to be economical, long-lasting in therapeutic effect, and less likely than other drugs to produce serious side-effects, particularly tardive dyskinesia. In addition, use of injectables makes it possible to avoid depending on untrained operators of residential facilities to see that the patients take their drugs.


Staff response to suicide of hospitalized psychiatric patients. The authors cite seven case histories of inpatients who committed suicide over a five-year period and analyze staff reaction and the changes in policy and procedures that followed. They conclude that staff feelings of guilt and failure brought about by inhospital suicides may result in the implementation of procedures designed to  decrease risk, but that such procedures would not necessarily have prevented the suicide that led to their introduction. They maintain that staff acceptance of total responsibility for preventing suicide may achieve short-term safety at the expense of increased long-term risk, and that suicides can occur even when all reasonable precautions have been taken.


The impact of the Health Professions Educational Assistance Act on state mental health systems. One effect of the Health Professions Educational Assistance Act of 1976 is to severely limit the number of foreign medical graduates entering the United States. To examine the impact of the law in Michigan, the authors gathered data on the number of psychiatrists practicing in the state and projected future manpower needs. They conclude that it is unlikely that, given other provisions in the law, American medical graduates can numerically replace foreign medical graduates, and that alternative manpower resources will have to be developed. State mental health systems must form new relationships with universities and the private psychiatric sector, and new methods of training personnel and sharing resources must be developed. The authors emphasize the importance of giving state mental health systems sufficient time and resources to develop effective manpower plans.


The role of family therapy in treating physical illness. Family relationships, behavior patterns, and the manner of responding to stress are important causal factors in physical illness and in health. Using case examples from his own practice as well as a review of the literature, he demonstrates ways that families help create and complicate physical illness. Elements of his family therapy program that he feels contribute to its success include helping the family focus on the past in relation to present concerns, investigating ways the family reacts to the illness, asking the patient why he is ill, conducting classes in stress release, and helping the family change patterns of interaction.


Meeting families' treatment needs through a family psychotherapy center. A small group of mental health professionals in St. Louis established a private-practice family therapy center staffed by therapists of various disciplines and theoretical orientations. Families receive a comprehensive, five-phase evaluation at the end of which the panel of evaluators recommends the type of family therapy and the therapist most suited to deal with the central problem. During the center's first two years of operation, 42 families received a complete evaluation and 36 began treatment, most of them in marital therapy. Of the 21 who completed treatment, 16 were rated as improved and five as unchanged. Thirty members within those 21 families manifested serious psychopathology, but none had to be hospitalized during treatment.


A study of outpatient satisfaction with mental health center services. In 1972 the authors conducted a study to determine the effect of encouraging patients to express their dissatisfaction with services received at a community mental health center in New York City. Half of the out-patients admitted to the center over a six-month period, a total of 270, were sent welcoming letters signed by the center director soliciting suggestions and complaints about services and listing staff members to whom they could be reported. Follow-up telephone interviews both with recipients of the letter and with nonrecipients, who formed a control group, showed that the recipients had fewer complaints about the center's services than did the nonrecipients. However, they failed to use the suggested channels to report a number of relatively serious complaints. The authors discuss the implications of the findings.


What does the patient think? An evaluation of a general psychiatric ward. The authors used patients' ratings of treatment effectiveness, resolution of problems, and helpfulness of various staff to evaluate the effectiveness of a treatment program on a general psychiatric ward staffed mainly by nonprofessionals. The evaluation also included comparisons with the hospital's other general psychiatric wards on length of stay, cost, and other variables. Patients were found to be generally satisfied with the care provided and with improvements in their condition. The authors believe greater considerations should be given to patients' opinions of the treatment they receive.


Identifying and meeting clients' needs in six community mental health centers. Using an intrument called SNAPOR--Services Needed, Available, Planned, Offered, and Rendered--the authors investigated the mental health service needs of 643 clients in six community mental health centers and the adequacy with which they were met. The centers' intake workers completed the first part of the instrument, immediately after the initial interview, to identify which of 13 services clients needed and to estimate the availability of the services. Follow-up eight weeks later indicated which of the needed services had been offered and which were actually given. Individual sessions and medication were the needs most often identified. The percentages of needed services that were ultimately provided ranged from lows of 3 to 10 per cent, for various kinds of rehabilitation, to a high of 84 per cent, for 24-hour hospitalization.


Does patient satisfaction correlate with succes? The authors studied the relationship between patient satisfaction and success of treatment in a group of out-patients consecutively admitted to two community mental health centers in California in 1975. The study is based on patient ratings of the satisfaction with treatment and the success of treatment at the second visit, the last visit, and follow-up, as well as on therapists' ratings of treatment success at the second visit and the last visit. At both time points the therapists' mean ratings of treatment success were significantly lower than the patients'. Significant but low correlations between satisfaction and success indicate that satisfaction ratings cannot replace success ratings or other outcome indicators in assessments of quality of care.


Sisters as union members: what do NLRB and courts say? The NLRB and the appellate courts are more in conflict than in harmony over the inclusion of members of religious congregations in hospital collective bargaining units. The NLRB has bound several bases for exclusion; consequently, unless a hospital affiliated with a congregation is free of these conditions or is willing to assume the burdens of appellate litigation, members of a religious congregation in that hospital are unlikely to be included in a bargaining unit there.


Guaranteeing OB rates to reduce bad debts. In an effort to reduce its obstetrical department's "bad debt ratio", St. Margaret's Hospital, Spring Valley, IL, has instituted a program of guaranteed rates for maternity patients. Both patients and the hospital benefit--patients from knowing what they will have to pay and doing so in advance, and the hospital from greater security about payment. Therefore, St. Margaret's has high hopes for the plan's success.


The nonprofit hospital: not requiem but revival! Rather than federal regulatory efforts moving the nation's health care system toward the death of voluntary nonprofit health care, evidence points toward development of nonprofit multihospital systems that remain community oriented. The article outlines the vital attributes of "publicly owned community service" and voluntary nonprofit hospitals that lend themselves to this trend, and it refutes the scenarios of death for nonprofits.


Social institutions and economic decision making. Perpetuating the present U.S. health care system, which spends more and more to produce about the same output, is irrational. Incentives that affect insurers and insureds, physicians, hospitals, and government are a necessity if a viable voluntary health care system is to survive.


Five keys to effective management of hospital data processing. In implementing a successful data processing department, a hospital should analyze its unique needs in regard to five key elements: (1) department personnel, (2) management style, (3) the department's relationship to the total organization, (4) independence from vendor, and (5) the organization's personality orientation.


Hospital-college relationships: ingenuity increases benefits. During the past decade, the primary location of training programs for nonphysician health care personnel has shifted from the hospital to the college or university. This shift has brought with it strong interdependence between health care and educational institutions and has led to a new willingness to implement mutually beneficial methods of support and exchange.


Nurse practitioners in prevention and health education. The Where? How? Who will pay? and Who will provide? of preventive medicine and health education can be answered. And a promising answer is the family nurse practitioner, who may be able to handle 60 to 80 percent of routine tasks normally done by physicians and to provide health education as a part of routine care.


Vatican II and pluralism in pastoral care. The documents of Vatican II imply that the ever increasing plurality of needs in the world and in Catholic health care institutions must be met by plurality in Christian response. Catholic hospitals should welcome onto their pastoral care teams people with diverse credentials and use them to promote the spiritual care of patients--Catholic and non-Catholic. In addition, this pluralistic ministry should extend itself beyond institutional walls toward the social needs of the community.


A new role for the RN: discharge coordinator. St. Vincent Charity Hospital, Cleveland, analyzed its discharge planning service and in response to identified problems created the position of RN discharge coordinator within the social service department. After two years of experience with the new approach, the hospital has documented the elimination of some of the target problems and feels it now offers a more comprehensive and professional aftercare placement service.


Marketing health care: its untapped potential. Hospitals should not equate marketing with Madison Avenue styled promotional campaigns. A neutral instrument, marketing offers a range of highly developed basic techniques of data gathering, data analysis, market segmentation, advertising research, and a host of others, from which hospitals can pick and choose to discover the needs and desires of the communities they serve and to better meet these needs and desires.


CEO: an agent of planned change.

CEO: an agent of planned change. CEOs are evolving from traditional administrative roles to accept the mandate of today's health care delivery system--the mandate that administrators take broad social views and be innovators in dealing with medical developments and in changing services to meet changing demands. CEOs must have or develop the skills to integrate available resources for coping with the forces impinging on the modern hospital.


Health planning premises in conflict.

Health planning premises in conflict. Should the current interplay of consumers and providers continue to shape the supply of health care or should the activity of an intellectual elite replace market forces? These questions represent dichotomous points of view toward the health delivery system--each resting on a number of allied assumptions--which must be reconciled if the health care delivery system is to act in the public interest.


Data profiles: a tool for decision makers. Systematic, long-range planning is increasingly important to hospitals because government is scrutinizing their costs and quality ever more closely. This level of planning requires that institutional decision makers have adequate data available in usable form. A set of data profiles needed by hospitals to do this job is suggested.


Speech and hearing services in hospitals. Because professionals in treating communication disorders work with otolaryngologists, pediatricians, surgeons, radiologists, physiatrists, dental specialists, etc., the hospital is a logical base for these shared services. Structuring a communication disorders unit within the hospital requires identifying needs, setting objectives, and developing a program that has appropriate capital support.


Health care amid religion and revelation. Are hospitals places primarily of medicine or of religion? Can religion be hazardous to one's health? Is Christianity a religion? Is pastoral care of the center or at the margin of Catholic health care facilities? Discussion of these paradoxical questions is meant to facilitate some new understanding of "how Christian community and faith build upon the experience of life and upon life's quest for life beyond dying".


Prosthetic heart valves: which ones and why. The type and to some extent the size of prosthesis are by far the most important factors determining the patient's prognosis. Extensive necropsy experience shows that in terms of hemodynamics, thrombogenesis, and deterioration-the three major criteria-none of the four main types of prosthetic valves in use today is ideal. Emphasis placed on the role of the referring cardiologist in the choice of surgeon and prosthesis.


Special problems of the newborn.

Special problems of the newborn. Rapid diagnosis on the basis of simple clinical signs and immediate, aggressive therapy are required in handling such newborn problems as persistence of fetal circulatory patterns, respiratory distress syndrome, and acute necrotizing enterocolitis.


Genetic studies on the Savara and Jatapu Tribes of Andhra Pradesh, India. A total of nearly 300 persons belonging to the Savara and Jatapu tribes in the Srikakulum District of northern Andhra Pradesh have been tested for electrophoretic variation in 13 red cell enzyme systems, and also haemoglobin. The gene frequencies for the systems showing variation are within the range for other South Indian populations, and there are no significant differences between the two tribal groups investigated in this report except in the case of adenylate kinase. The Jatapu (along with the Kadar of Kerala) have the highest frequency of AK1 so far reported in India. Both the Savara and Jatapu showed a low frequency for Hb AS, and LDH-Calcutta 1 was not detected in either population.


Trisomy 4p and deletion 4p- in a family having translocation, t(4p-; 12p+). Chromosome studies on a newborn infant with the clinical features of 4p-syndrome revealed a 46,XY,4p-karyotype with deletion of bands distal to 4p14. Investigation of the family revealed normal chromosomes in the mother and a balanced translocation rcp(4;12) (p14;p13) in the father, the paternal grandfather and an uncle. A severely retarded and malformed aunt is a partial trismoy for the short arms of chromosome 4, with the unbalanced karyotype 45,XX,12p+. It appears that monosomy of bands 4p15 and 4p16 leads to the full clinical features of 4p-syndrome, while trisomy of this region causes disabilities consistent with the rather more variable 4p trisomy syndrome. From currently reported cases, a summary is presented of the results of pregnancies of both male and female translocation carriers.


A silent gene (C3-) producing partial deficiency of the third component of human complement. A family is described with 3 members in 3 generations being heterozygous for the silent gene C3-: one girl, her mother and grandfather had half normal C3 levels and were apparently incompatible homozygous. No significant deviation in the total hemolytic complement activity, serum concentration of Bf and C4 component was found in the affected individuals.


The polymorphism of red cell esterase D in Italy. 1,153 unrelated individuals from three different areas of Italy were tested for the red cell esterase D polymorphism. The gene frequencies found in the three groups do not differ significantly from each other. The EsD2 allele in the total sample has a frequency of 14.6% but it is difficult at the present stage to know if this figure is valid for the whole Italian population. If so, the Italian EsD2 allele frequency lies at the upper limit of the range of the European values. No variant phenotypes were observed.


Genetic polymorphisms in juvenile-onset diabetes. Nine genetic polymorphic systems (ACP1, PGM1, ADA, AK, G-6-PD, Hp, ABO, Rh, MN), were studied in a series of 138 subjects affected by JOD. Differences between diabetic patients and controls were observed in the distribution of phenotypes of the red cell acid phosphatase (ACP1), and the ABO and MN blood groups.


HLA antigens and affective disorders.

HLA antigens and affective disorders. A total of 168 patients with different types of affective disorders were examined with respect to their HLA antigens. The frequency of the A10 antigen was found to be increased in the patients particularly in those with the unipolar type of disease. The frequency of the A1 antigen was decreased among unipolar patients. A decreased frequency of the B7 antigen was found in the total material of patients, and in particular in those with a bipolar type of disease. Our results were in disagreement with findings by other investigators. So far there is no conclusive evidence for association between any HLA antigen and affective disorders.


Studies of the radioallergosorbent test and the lymphocyte stimulation index in symptomatic ragweed pollenosis. We followed 47 ragweed hay fever patients (not on immunotherapy) through a ragweed season by means of clinical evaluation and symptom scores. The radioallergosorbent test (RAST) and lymphocyte stimulation index (LSI) were done to determine their reliability as predictors of clinical symptomatology. Symptom scores of 10 or above, denoting at least moderate daily symptoms, occurred in 36 patients (80%). Preseasonally, RAST class 2 or above was found in 34 patients (75%), of whom 29 patients (64%) had symptom scores of 10 or above. At that time, LSI was elevated in about 50% of the patients. Patients in RAST class 3 had the highest LSI as a group. Seasonal exposure boosted the LSI in 50% of the patients, whereas 25% were unchanged and 25% showed a decrease. The results suggest that neither RAST nor LSI are reliable predictors of clinical severity in ragweed pollenosis.


Immune response in malnutrition. Effect of protein deficiency on the DNA synthetic response to alloantigens. To evaluate the DNA synthetic response to alloantigens by lymphocytes from mice fed diets with normal (27%) and low (8%) protein content, we quantitated the uptake of 125IUDR in spleens of lethally irradiated adult F1 hybrids injected with cells with parental C57BL/6 donors kept on either diet. Thymocytes, spleen and lymph node cells from protein-restricted parental mice synthesized higher amounts of DNA than those from normally fed controls. Added thymocytes from either malnourished or normal F1 hybrids had similar inhibitory effects on the response of an active parental inoculum. The results indicate that cells from mice kept on a moderately protein-deficient diet for 3--5 weeks after weaning, have increased capacity to proliferate in response to alloantigens, suggesting a high proportion of reactive cells and/or changes in the ratio of the interacting cell populations in their lymphoid organs.


Further studies of a humoral chemotactic abnormality in glomerulonephritis. Chemotactic activity in the sera of patients with glomerulonephritis was compared under three simultaneously performed conditions: (1) incubation with buffer at 37 degrees C (CF-UNACT); (2) incubation with immune complexes at 37 degrees C (CF-ACT); (3) immediate heating at 56 degrees C (CF-56 degrees C). In all cases the generation of chemotactic factors was terminated by standard 'heat-inactivation' at 56 degrees C. Patients' CF-UNACT was similar to that of controls; patients' CF-ACT was significantly less than controls', but patients' CF-ACT and CF-56 degrees C was significantly greater than controls'. Patients CF-ACT and CF-56 degrees C were largely C5-dependent and were quantitatively similar. These divergent abnormalities could not be explained by spontaneous in vivo or in vitro (i.e., blood clotting) generation of complement chemotactic factors, the absence of Hageman factor-dependent chemotactic activity, or the presence of humoral inhibitors in patients' sera. It appears that inital 56 degrees C heating liberates C5-dependent chemotactic activity, a procedure that is usually believed to block its formation. Terminal 56 degrees C heating after 37 degrees C incubation did not generate such activity in CF-UNACT. The duration or sequence of heating at 56 degrees C, or both, are critical determinants for final expression of chemotactic activity in patients' sera, when viewed in relation to 37 degrees C incubation with immune complexes or buffer.


Further studies on the structural requirements of sugars as antagonists of the changes in vascular permeability produced by sugar polymers in rat skin. Hexoses and pentoses, but not tetroses or trioses, are potent inhibitors of the increase in vascular permeability in rat skin produced by the polysaccharides--dextran, mannan and glucan. The most active sugars are those with a D-threo type of structure in their cyclic form. The alcohols corresponding to the active sugars are much less inhibitory in this test. The results provide further information on the possible role of carbohydrate structures in antibody binding.


Suppression of reaginic antibodies with modified allergens. II. Abrogation of reaginic antibodies with allergens conjugated to polyethylene glycol. The two immunogenic preparations, ovalbumin (OA) and the nondialysable constituents of the aqueous extract of ragweed pollen (RAG), were conjugated with polyethylene glycols of molecular weights of 6,000 and 20,000 (PEG6 and PEG20) with the aid of cyanuric chloride. The i.v. administration of OA-PEG6 or OA-PEG20 into normal mice or into mice sensitized to a state of immediate hypersensitivity to dinitrophenylated OA (DNP3-OA) resulted, respectively, in the suppression of the primary or secondary IgE responses to DNP and OA. Similarly, the administration of RAG-PEG6 abrogated the primary as well as the ongoing anti-RAG reaginic responses in mice sensitized to RAG. The unresponsiveness of spleen cells from animals which had received a tolerogenic dose of OA-PEG6 was also maintained after transfer into X-irradiated (550 rad) mice. The suppressive effects of the tolerogenic PEG conjugates of OA and RAG were shown to be immunologically specific. It is, therefore, suggested that PEG-modified allergens may prove useful for the abrogation of the IgE response to a variety of allergens responsible for conditions of common hypersensitivity in man.


Contribution to the regulatory role of insulin in inflammation and anaphylaxis. Insulin, in doses which did not influence the blood sugar level, potentiated the anaphylactic shock in ovalbumin-sensitized CFLP mice and moderately inhibited the carrageenan-induced paw edema. Higher doses were found to produce a dose-dependent inhibition of the inflammatory process at the 2nd hour, and caused less suppression at the 4th hour of the swelling. These results suggest that insulin may play a complex regulatory role in hypersensitivity and inflammatory reactions, and its effect is not necessarily related to hypoglycemia.


A simple grating test for contrast sensitivity: preliminary results indicate value in screening for glaucoma. Using a new test, in which patients are asked to view printed sinusoidal gratings of varying contrast, we have established normal population values and have investigated a small series of glaucomatous patients. In these, test scores are higher than the normal range and increase with the severity of the disease. Patients with raised intraocular tension, normal discs, and no field loss may give abnormal results. The test can be scored so that a very sharp distinction may be made between normal and glaucomatous eyes. The test is simple, quick to perform, portable, and can be done in almost any situation.


Temporality across the life-span.

Temporality across the life-span. In seven studies, 7300 U.S., 891 Iranian, 534 Indian, and 216 Ghanaese persons aged four to ninety-nine were interviewed regarding their consciousness. For U.S. nationals: (a) at any given moment, persons were most apt to be thinking about the present and least apt to be thinking about the past, (b) frequency of future-orientation declined while, (c) frequency of present-orientation inclined with age, (d) in "typical thought" persons generally thought further into the future (a few months) than into the past (a few weeks), but (e) regarding those things that persons often think about that have or are yet to occur, they thought further into the past (5 years) than into the future (a year), (f) frequency of future-orientation did not vary as a function of social class, while degree of claimed planfulness was greater among the higher social class, and (g) claimed planfulness was curvilinearily related to age, with those aged eighteen through thirty-nine scoring highest. There were cross-national differences.


Adult male daydreaming across the life span: a replication, further analyses, and tentative norms based upon retrospective reports. Using the Imaginal Processes Inventory, aspects of daydreaming and related mental activity were examined in a replication sample of males aged seventeen to ninety-one years. The characteristics of daydreaming obtained in an original sample were obtained in the replication sample thus supporting the outcomes reported earlier. Combining the original and replication sample allowed for some finer grained analyses and provided some tentative norms for the populations sampled. Some of the more salient outcomes were that with old age daydreaming does not increase or primarily focus on the past. Furthermore, at any age daydreaming does not concentrate on the weird, outlandish, and improbable. Factor analysis revealed a "Neurotic-Anxious Absorption in Daydreaming" factor inversely related to age. "Obsessional-Emotional Daydreaming," "Personal Acceptance-Utilization of Daydreaming," and "Imaginal-Emotional Intensity of Daydreaming" factors were also obtained and were unrelated to age.


Quantitative verification of the existence of high molecular weight protein aggregates in the intact normal human lens by light-scattering spectroscopy. The method of quasi-elastic light-scattering spectroscopy was used to establish quantitatively the concentration of high mmolecular weight (HMW) aggregates present in the normal human intact lens as a function of age. The concentration of HMW proteins increases monotonically with age. HMW proteins are absent in the infant lens, but represent 3% of the total soluble lens protein at age 60 years. The percent concentration of HMW proteins measured in intact lenses of various ages by quasi-elastic light scattering is in striking agreement with values determined biochemically.


Performance of institutionalized and community-active old persons on concrete and formal Piagetian tasks. This study investigates the effects of age, level of education, and institutionalization on the development of logical thinking. Seven Piagetian tasks, encompassing three levels of difficulty, were administered to thirty-four persons sixty-eight years of age or older. A significant positive relationship was found between success on task and educational level. With education controlled, Community-active elders performed significantly better than Institutionalized elders. Within the limitations of a cross-sectional design, results supported the hypothesis that cognitive abilities in old age retain an orderly structure.


Transscleral electroretinography.

Transscleral electroretinography. We studied the electroretinogram in normal patients, patients with opacities of the anterior segment, and patients with vitreous hemorrage, using a high-intensity light stimulus delivered either through the sclera or through the pupil. We found the response obtained with transscleral stimulation a consistent indicator of gross retinal function. Since the stimulus entered the eye through the sclera, it provided a method for studying the retinal responses independent of opaque or translucent media.