Preclinical hemochromatosis in a population on a high-iron-fortified diet. Three hundred forty-seven (96.4%) of all persons aged 30 to 39 years were screened with serum iron and iron binding capacity measurements to determine the incidence of hemochromatosis in a population. No women had signs of iron overload; however, nine men (5%) had persistenly elevated serum iron levels. In four men (2%), increased iron stores was found with a distribution like that in the early stages of hemochromatosis. In combination with recent findings of clinical hemochromatosis at our hospital, this study suggests that this condition is not as rare as has been reported earlier.


Cooperative study of hospital frequency and character of transient ischemic attacks. Information was collected among six participating medial centers on frequency of performance and the percentage of abnormality of 30 tests performed on patients with complaints suggesting transient ischemic attacks (TIAs). A number of these were commonly performed and commonly exhibited abnormalities. Although the diagnosis of TIA is made by history and  physical examination, these tests were of value in aiding the physician to determine possible causes of TIA, to detect risk factors of associated conditions, to rule out alternative diagnoses, and to assess the patient's ability to tolerate different types of therapy.


Tuberculous Addison's disease and thyrotoxicosis. Addison's disease developed in two patients after they had tuberculosis. Thyrotoxicosis subsequently developed. In both cases, the adrenal glands were calcified, suggesting that Addison's disease was tuberculous in origin. Results of tests for antihyroglobulin, antimicrosomal, and adrenal cortex antibodies were normal. These findings do not suggest an autoimmune basis for the occurrence of the two endocrinopathies. The rarity of the simultaneous occurrence of both disorders suggests it to be fortuitous.


A new device for arterial blood gas sampling. Artifacts in CO2 tension measurements owing to heparin dilution are eliminated by use of a sampling device employing crystalline heparin. The absence of a plunger and the low resistance to filling allows the use of small, 23- or 25-guage needles, thus reducing pain during arterial puncture and hematoma formation.


Enforcement of school immunization law in Alaska. Investigation of measles outbreaks during the fall of 1976 led to the discovery that Alkaska's school immunization law was not being enforced. In an effort to control a large outbreak of measles in Fairbanks, children were required to show proof of measles vaccination or be excluded from school. Of the Fairbanks schoolchildren, 25% were vaccinated against measles; 1,251 (11%) of 11,727 unvaccinated schoolchildren were excluded in January, and no further cases of measles occurred. Subsequently, the school law was enforced statewide, and on March 1, 1977, all children not immunized against diphtheria, tetanus, pertussis, polio, measles, and rubella were excluded from school (7,418 [8.3%] of 89,108). One month later, fewer than 51 children still did not meet immunization requirements. More than 35,000 children were vaccinated in the immunization campaign; no adverse side effects to any vaccine were reported.


Long-term treatment of refractory hypertensive patients with minoxidil. Twenty-nine hypertensive patients refractory to conventional medications were treated continuously with minoxidil, sympathetic suppressants, and diuretics for six months to five years (mean, 30 months). All had evidence of hypertensive end-organ damage before minoxidil therapy. Good blood pressure control was obtained in 21 (72%) of 29 patients when minoxidil was given in dosages up to 40 mg/day. No tolerance was found. In the remaining eight, good control was obtained in three when phenoxybenzamine therapy was added, and in one when clonidine therapy was added. Renal failure requiring hemodialysis developed in five of 29, one had temporary hemiparesis, and one had fatal cerebral hemorrhage. In the remainder, myocardial infarctions and strokes were effectively prevented. Patients receiving minoxidil and propranolol hydrochloride had elevated plasma norepinephrine levels while those receiving clonidine had normal plasma norepinephrine levels.


Retraining inactive physicians. A seven-year experience. In 1969 the Medical College of Pennsylvania began a program to retrain clinically inactive physicians. Originally designed for women physicians who had discontinued their clinical training or practice in response to family responsibilities, the program has expanded its goals to encompass physicians in nonclinical careers who wish to reenter clinical practice. An eight week program, which provides didactic and clinical experience, has been designed as a first step or catalyst for these physicians. Since the program began, 102 physicians have matriculated to the program, and of these physicians, 78 have returned to clinical activity. Criteria have been developed in selecting those physicians most likely to return to clinical activity. There is a potential continued need for programs whose unique attributes and liabilities of retraining are a form of continuing medical education.


Transsexual surgery. A new tort?

Transsexual surgery. A new tort? Transsexual surgery became a modern reality 25 years ago when Christine Jorgenson's sex reversal shocked the world. Since that time, transsexuality has become both dilemma and controversy in medicine, psychiatry, and law. Transsexuality emerged into an interdisciplinary void. Today both scientists and courts are being asked to fill that void with answers. I have explored the legal aspects of transsexual surgery, both ancient common-law precedents and current developments, and possible answers to the sex change dilemma.


Continuous intravenous deferoxamine infusion. Treatment of secondary hemochromatosis in adults. Adult patients with chronic iron overload were given oral ascorbic acid and continuous intravenous infusions of deferoxamine mesylate. The dosage of deferoxamine mesylate was altered every 48 hours from 1 g/sq m/24 hr to 2 or 4 g/sq m/24 hr. The average iron mobilization was 55.6 mg per day at the 1 g/sq m/24 hr dosage level, 78.6 mg every 24 hours at the 2 g/sq m/24 hr dosage level, and 90.1 mg every 24 hours at the 4 g/sq m/24 hr dosage level. Iron mobilization was undiminished when successive 14-day courses of deferoxamine separated by six-week intervals were administered.


Screening for congenital hypothyroidism. Results in the newborn population of New England. During the first year of operation, the New England Regional Hypothyroidism Screening Program determined the concentration of thyroxine (T4) levels in dried blood on filter paper from 129,028 infants born in Connecticut, Maine, Massachusetts, New Hampshire, and Rhode Island. Specimens from approximately 3,800 neonates were found to have levels of T4 below the lower limit of normal (less than 6.0 microgram/dl) and were assayed for thyroid-stimulating hormone (TSH) content. Levels of TSH were elevated (greater than 20 muU/ml) in 31 infants, 23 of whom eventually proved to have unequivocal hypothyroidism. Based on these figures and including two hypothyroid infants who were not tested, the incidence of congenital hypothyroidism in the New England region is approximately 1:5,200 births. The estimation of T4 values supplemented by measurement of TSH values on specimens with low T4 values has proved to be a satisfactory approach to large-scale screening for congenital hypothyroidism.


Treatment of typhoid carriers with amoxicillin. Correlates of successful therapy. Fifteen chronic enteric carriers of Salmonella typhi were treated with amoxicillin trihydrate, 2 g by mouth, three times per day. Nine of ten patients who were able to take the full amoxicillin regimen were cured; among five patients treated with a lower daily amoxicillin dosage because of gastrointestinal (GI) side effects, only two were cured (P less than .05). The mean serum amoxicillin concentration at termination of therapy was higher (P less than .01) in five patients who were cured (10.4 +/- 1.6 microgram/ml) than in the four who failed (3.0 +/- 0.7 microgram/ml), although the latter values were all above the minimal inhibitory concentrations for infecting organisms. This study suggests that amoxicillin treatment of chronic typhoid carriers could be enhanced by treating with doses sufficient to provide suprainhibitory serum concentrations of the antibiotic. However, GI intolerance to amoxicillin could limit this therapeutic approach.


Insights into the Israeli health care system. Reflections on a medical student's experience. A two-month visit to the Chaim Sheba Medical Center, Tel-Hashomer, Israel, provided an opportunity to investigate some aspects of that country's health care system. Observations on the Israeli health care system and on the populations served, with highlights on cultural, demographic, political, and historic factors, are essential to an understanding of health care in Israel. A detailed description of the organization and administration of services at the Chaim Sheba Medical Center may aid in this understanding. It is essential to our understanding of this health care system to realize that Israel is not a purely Western nation. To gain insight into the system, we must consider the nation's political and economic situation. Such an awareness is crucial to the study of any foreign health care system.


Disease control programs in the United States. Control of streptococcal and poststreptococcal disease. Programs administered by health departments and heart associations for control of streptococcal and poststreptococcal disease differ greatly from state to state. The year 1974 was used as a representative year when studying the variety of state policies and programs regarding surveillance of streptococcal disease, primary and secondary prevention of rheumatic fever, and prevention of poststreptococcal glomerulonephritis. A uniform national policy for streptococcal control is desirable but should be based on evidence not now available concerning the impact of various elements of control programs on morbidity and mortality.


Pseudomonas folliculitis acquired from a health spa whirlpool. Three cases of an unusual Pseudomonas skin infection acquired from a health spa whirlpool were reported, and an epidemiologic survey showed 17 additional cases. This dermatosis is characterized by the abrupt onset of urticarial papules and superficial and deep papulopustules that spare only the head and neck and occur eight to 48 hours after using the whirlpool. Cultures from one patient's pustules and from the spa whirlpool environment were positive for P aeruginosa, serotype O-11. The condition cleared in all but one patient, without treatment, within seven to ten days. This patient continues to have recurrent follicular pustules three months after exposure. Samples from whirlpools at six other selected establishments were also positive for P aeruginosa.


Abuse of antiparkinsonism drugs. Feigning of extrapyramidal symptoms to obtain trihexyphenidyl. Many physicians may be unaware of the abuse potential of antiparkinsonism medications. A case report suggests that the deliberate abuse of these drugs may be considerably more widespread than has been hitherto believed. Patients may feign extrapyramidal symptoms to obtain antiparkinsonism agents. Physicians should exercise greater caution when prescribing these drugs.


The hemodynamics of cardiac tamponade.

The hemodynamics of cardiac tamponade. The changes produced by acute pericardial tamponade were examined. Tamponade produced the expected hemodynamic alteration; namely, depression on cardiac output, left ventricular pressure and LV dp/dt and elevation of right atrial and intrapericardial pressures. The mechanism of the hemodynamic disturbances was that the elevation of the intrapericardial pressure produced a negative atrial transmural pressure and disturbed atrial and ventricle filling producing the vicious cycle: diminished venoatrial gradient leads to decreased cardiac output leads to attenuated effect of ventricular systole on atrial filling, and so forth. The myocardial contractility was not impaired in cardiac tamponade.


Application of the ultrasonic technique for the pathophysiological analysis of the pericardial disease. (1) In large pericardial effusion, echography showed a revolving motion of the heart. This characteristic motion was interfered by the pericardial adhesion. Real time cross-sectional scanning was useful for detecting the adhesion, especially the localized one. When excessive cardiac motion coexisted with tachycardia, alternation of the heart position accompanied by electrical alternans was observed. Based on the results, the mechanisms for the alternation of the heart position was discussed. (2) Echogram suggesting the pericardial thickening was found in about a half of patients with constrictive pericarditis. Another findings, which may reflect the anatomical and functional changes in constrictive pericarditis, were also presented. Although each of them is not pathognomonic, concurrence of them may suggest the presence of constrictive pericarditis. (3) Inflow velocity in jugular vein was markedly decreased in cardiac tamponade. The inspiratory increase in the inflow velocity was observed in mild cardiac tamponade, but not in severe one. Flow velocity pattern of jugular vein in constrictive pericarditis was characterized by the appearance of the reverse flow being coexistent with rapidly decelerating inflow in diastole.


A clinical study on idiopathic pericarditis. 1) Thirty-eight cases of idiopathic pericarditis in our institutes were analyzed and were classified into 3; group A: clinical picture of pericarditis, group B: clinical picture of peri-myocarditis and group C: dominant clinical picture of chronic pericardial effusion. 2) All cases of group A showed a good clinical course. 3) In group B cases with complete A--V block continued to have heart block with significant myocardial changes, and the prognosis may not be good. 4) Many cases of group C belonged to elderly female and the etiology was unclear. 5) Viral pericarditis was proven in only one case.


A clinicopathological study on pericardial heart disease in the aged. A total of 87 cases of pericardial heart disease (73 of pericarditis and 14 of hemopericardium) among 870 consecutive autopsies of aged patients was studied. Fibrinofibrouspericarditis was found in 80.8% of pericarditis, neoplastic in  13.7% and purulent in 5.5%. Representative cases of each type of pericarditis were illustrated. Among fibrinofibrous pericarditis, idiopathic was the most common and the other causes included irradiation, myocardial infarction, renal failure, rheumatoid arthritis and hypothyroidism. Frequent association of congestive heart failure or anasarca with mild to moderate fibrinofibrous pericarditis was noted. Clinical and morphologic evidences of pulmonary tuberculosis were present in nearly one third of cases with fibrinofibrious pericarditis, but actual incidence of tuberculous pericarditis could not be determined. Incidence of clinical signs and symptoms of acute pericarditis was evaluated with the stress on the relatively high incidence of supraventricular tachyarrhythmias, especially in cases with histological evidence of sinus node involvement in aged cases.


Electrophysiologic manifestations in so-called "sick sinus syndrome". Electrophysiologic disorders in 17 patients with sick sinus syndrome (SSS) were assessed by recording of intracardiac electrograms, atrial overdrive pacing and extrastimulus technique. Significant suppression of the sinoatrial node (SAN) by overdrive pacing (maximum corrected SAN recovery time of longer than 560 msec) was noted in 14 or 16 patients studied. In nine patients, scanning with atrial extrastimuli, sinus rest was defined in all. In one patient there was a longer interpolation zone. Calculated sinoatrial conduction time (SACT) in individual patients varied considerably. The mean SACT was over 110 msec in 5 of 9 patients (56%). Sinus echo was demonstrated in 3; one manifested SAN- re-entrant tachycardia with rates of 72 to 77 beats/min. AV nodal echo was demonstrated in 3, two of them manifested AV nodal re-entrant tachycardia. Intracardiac electrograms revealed prolonged AV conduction time in 2 of 15 patients and prolonged His-Purkinje system conduction time in 2 of 17 patients studied. Two patients disclosed what we thought to be manifestation of intraatrial conduction disturbance. Both had considerable time interval between pacing impulse and atrial response. In one of them Mobitz type 1 and 2:1 intraatrial blocks were observed on atrial pacing and a possible internodal tract depolarization was also recorded. It is concluded that the electrophysiologic manifestations of patients with SSS cover a wide spectrum. The machanism of tachycardia can be due to either SAN or AV nodal re-entry.


Long-term follow-up after cardiac pacing in bradyarrhythmias. Fifty-nine patients aged 39-80 years underwent implantation of a cardiac pacemaker and were followed for up to 9 years (average duration of pacing 39 months). Atrioventricular conduction disturbances (complete atrioventricular block, 2 : 1 atrioventricular block, bifascicular block, and atrial fibrillation with slow ventricular rate) were present in 49 patients and sick sinus syndrome (sinus arrest or sino-atrial block, and bradycardia-tachycardia syndrome) in 10. Pacing was required because of Adams-Stokes attacks in 41 patients, 2 of whom also had congestive heart failure. It was required in 6 because of frequent dizziness, in 10 because of congestive heart failure, and in 2 because of low cardiac output. The symptomatic improvement after cardiac pacing was well recognized in most of our patients, and 32 (54 percent) of the 59 patients pursued normal physical and daily activity. Although the efficacy of pacemaker therapy was of limited value in some patients with congestive heart failure or underlying or coexisting diseases, the beneficial effects following pacemaker implantation were: (1) abolishment of transient neurologic symptoms such as Adams-Stokes attack, (2) relief from a constant fear of a recurrence of an Adams-Stokes attack or sudden cardiac death, and (3) improvement in restricted physical activity due to low cardiac output. Thus, we conclude that pacemaker implantation in most patients with bradyarrhythmias is beneficial not only for the treatment of the acute problem but also because it prolongs life and greatly enhances its quality. However, in spite of the beneficial effects after pacemaker implantation, we still observe a number of complications connected with the use of a permanent pacemaker. Therefore, our policy is to implant a permanent pacemaker following the execution of sufficient studies of the bradyarrhythmia and the etiology of symptoms, and then under taking long-term follow-up of the patients.


Surgical treatment of tachyarrhythmias.

Surgical treatment of tachyarrhythmias. As a treatment for tachyarrhythmia, we have experienced 3 cases of Kent bundle division for WPW syndrome and 7 cases for implantation of atrial pacemaker. In two cases of Kent bundle division for A type and B type WPW syndrome, reappearance of premature supraventricular tachycardia was noticed but with less frequency and in number. A case of B type was cured surgically. Seven cases (including a case with elapse of 6 years) implanted with R-F atrial pacemaker termination of tachyarrhythmia resulted by rapid atrial pacing for 10 seconds.


Concealed Wolff-Parkinson-White syndrome. Sixty-nine patients, 23 of whom had documented attacks of paroxysmal supraventricular tachycardia (PSVT), were studied electrophysiologically and the following results were obtained: (1) Antegrade concealed Wolff-Parkinson-White syndrom (AC WPW) was demonstrated in 7 out of 69 patients by atrial stimulation including extrastimulus. Six of these 7 patients presented an accessory pathway (AP) conduction of the Kent type, 5 of which showed Type A and another, Type B. The remaining one of these 7 patients showed an AP conduction of the Mahaim type. One of the 7 patients showed a combination with the James and Kent types AP conduction. (2) Retrograde concealed Wolff-Parkinson-White syndrome (RC WPW) was demonstrated in 8 out of 49 patients in whom the presence of V-A conduction was revealed by ventricular stimulation, while PSVT was documented in 7 of these 8 patients. An AP of the Kent type was identified in the left side of the heart in 5 out of 7 patients with documented PSVT, the right side in one and in the septal region in one. (3) The presence of bilateral or two APs were demonstrated in 3 patients. In another one with documented PSVT, the presence of a branched AP from a left-sided Kent bundle was assumed. In conclusion, our study demonstrated that concealed APs may be more frequent than realized. For example, the frequency of RC WPW in patients with PSVT was 30.4% (7/23) in our series. Accordingly, it is postulated that RC WPW may also be indicated for surgical therapy and that detailed electrophysiologic examination by the physician should be carried out for the sake of determining the indication.


A temporal profile of myocardial zinc changes after isoproterenol induced cardiac necrosis. Changes in myocardial zinc level was followed up over a period of 5 days after producing myocardial necrosis in albino rats by subcutaneous injection of isoproterenol, 85 mg/kg body weight. Myocardial necrosis was confirmed by ECG (Lead II), histology and serum enzyme studies (SGOT, SGPT and LDH). A decrease in myocardial zinc level was observed on all the five days. The possible mechanism and the therapeutic implications of these changes are discussed.


Studies on the normal polarcardiogram using right to left axis as the polar axis. Polarcardiograms using right to left axis as the polar axis were recorded in 112 cases of the clinically healthy subjects. The wave forms of the polarcardiogram of the normal subjects were classified into the several difinite patterns. The quantitative values obtained by the measurement of the polarcardiograms agreed well with those obtained by the vectorcardiograms reported by the various authors. Polarcardiography has advantages not only to let us know the spatial polar coordinates of the cardiac vectors at any instant very easily and quickly, but also to give us the informations of the time-related continuous pattern of the polar components of the cardiac vectors very easily which are difficult to obtain by the conventional ECG and VCG.


[Analysis of the right ventricular function by simulation (author's transl)]. In the previous experiments it was reported that either the interventricular septum of the free wall of the right ventricle was replaceable with a non-contractile prosthesis. It was also reported that a new chamber constructed on the epicardium had capability of producing a pulsatile pressure. This study was to determine contribution of the septum and the free wall on performance of the right ventricle by using a simulator. Left-ward shift of the interventricular groove was not found along the basal half of the long axis and was limited only along the apical half. Bulging of the septum toward the right ventricular cavity did not occur at all, but on contrary the septum moved toward left, denying contribution of the septal movement to pump action of the right ventricle.


[Clinical experience with sustained release cephalexin (S-6437) in pediatrics (author's transl)]. S-6437 (Sustained release cephalexin granule for pediatric use) was studied with the following results: 1) Following the single oral administration of 25 mg/kg of S-6437 in 6 children 4 approximately 6 years old, the following blood levels (average) of cephalexin were obtained: 3.1 microgram/ml in one hour after the administration, 8.6 microgram/ml in 2 hours, 8.7 in 4 hours, 7.2 in 6 hours, 4.0 in 8 hours and 1.2 in 12 hours. Effective blood levels of cephalexin by S-6437 were maintained for longer period of time than those by regular cephalexine dry syrup. In 4 of 6 children receiving S-6437, cephalexin was scarcely detected in their blood in 12 hours after the administration. From this, it is not considered that S-6437 is accumulated in body. 2) S-6437 was administered to 38 patients including: 7 with pneumonia, 7 with acute bronchitis, 1 with suppurative lymphadenitis, 4 with acute pharyngitis, 15 with acute tonsillitis and 4 with acute urinary tract infections. Out of the 35 cases, 31 (88.6%) responded to S-6437, and 3 cases could not be evaluated. 3) Transient diarrhea in 2 patients, rash in 1 and elevation of serum GOT, GPT and LDH in 1 were observed. However, these side effects were improved by discontinuation of S-6437.


[Fundamental studies on combination of antibiotics; especially on pharmacokinetics. II. Combination of gentamicin and minocycline (author's transl)]. 1. Minocycline (MNC) (10 mg/kg) and gentamicin (GM) (5 mg/kg), in combination with pre- or post-treatment, were intravenously injected to the rat or rabbit to investigate their pharmacokinetics. 2. The antibiotics in the samples were separated by the paper electrophoretic technique and their concentrations were determined by the cup thin-layer plate method using Bacillus subtilis as the test organism. 3. In the rat, the biological half life of MNC was shortened when combined with GM, and its initial level was elevated. On the other hand, the biological half life of GM was prolonged, and its initial level was decreased. Similar results were observed in the rabbit. 4. The urinary excretion rate of MNC in the rat was increased when combined with GM, while that of GM were decreased with MNC. 5. The biliary excretion rate of MNC in the rabbit was increased when combined with GM. 6. The binding rate of MNC to the serum proteins was apparently decreased when it was administered in combination with GM.


Fatal paraquat poisoning: tissue concentrations and implications for treatment. A 27-year-old male died 30 1/2 hours following ingestion of paraquat. Hemodialysis removed 72 mg of paraquat, which represented only 2% of the calculated absorbed dose; paraquat concentrations were determined in post-mortem tissue and were high in the lungs and kidneys. Prominent histologic changes were already present in the lungs, which showed extensive evidence of alveolar injury, and in the adrenal gland, which showed massive selective necrosis of the zonae fasciculata and reticularis. These findings emphasize the inadequacy of treatment regimens that attempt only to remove paraquat from body tissues. Trials of treatments designed to prevent gastrointestinal absorption, including combinations of absorbents, cathartics and gut lavage, are warranted.


[Anti-ischemic action of diuretics].

[Anti-ischemic action of diuretics]. Rat experiments were conducted for comparative study of the effect of diuretics, injected into the organism in a single dose prior to two-and-a-half-hour ischemia of an only kidney and after it, on the extent of the kidney affection and survival of the animals. It was established that furosemid, etacryn acid and mannitol exert a preventive protective effect in ischemia of the kidneys and considerably increase the survival of rats as compared to the control-group. Analysis of the renal function in the first five days of the postischemic period testifies to the property of the above-mentioned diuretics for normalizing excretory processes on the 2nd-4th days of the action of the injuring agent, and for relieving or shortening the oligoanuric phase of acute renal failure. The significance of metabolic shifts, intratubular hydrodynamics and vascular microcirculation in the mechanism of the protective effect of diuretics in ischemia of the kidneys is discussed.


[Coagulation properties of the blood and tissues of the cardiovascular system exposed to an electromagnetic field]. The effect of low-frequency electromagnetic field on the coagulant and fibrinolytic properties of blood and tissues of the cardiovascular system was studied. Phase character of changes in the coagulative properties of blood as well as in those of the heart and aorta was established. Irradiation of rats for 8 days is attended by an increase in the coagulating and fibrinolytic activity of blood and simultaneous inhibition of the thromboplastic compounds of the heart and vascular wall. Increase of exposure to 20 days leads to inactivation of tissue and plasma blood coagulation factors. The possible mechanism of these changes is discussed.


[Aging of the intima of the human thoracic aorta]. The aging of the intima of the human thoracic aorta was studied on autopsy material collected from individuals aged from 1 day to 99 years. It has been established that the density of the cell population and the thickness of the intima and the content of cholesterol and phospholipids in it are signs of intima aging. There is an exponential relation between these signs and the age of an individual. The level of cholesterol concentration in the intima depends on its thickness.


[Chronotropic reserve of the heart in stenocardia]. The rate of cardiac contractions was studied prior to and during the bicycle ergometry test and in the period of restitution in 140 patients with angina pectoris of various severity as compared to practically healthy males. In distinction to healthy individuals, patients with angina pectoris reacted to physical exertion of equal force by a higher rate of cardiac rhythm which returned back to normal more slowly in the period of restitution. They were also marked by more rapid "uneconomical" expenditure of the cardiac chronotropic reserves. In angina pectoris, the capacity of the heart to maximum increase in the rate of contractions was limited. With the growth in the severity of chronic coronary insufficiency, the attack of angina induced by muscular exertion developed at a lesser frequency of the cardiac rhythm (p is less than 0.001).


[Effect of baxacor on the hemodynamics and contractile function of the myocardium in acute ischemia (an experimental study)]. The article discusses the results of experiments on 16 dogs in which acute myocardial ischemia was reproduced with intravenous infusion of baksacor and without the infusion of the drug; control experiments were also performed on an intact heart with baksacor infusion. Hemodynamics and myocardial contractility were studied throughout the entire experiment. It was found that baksacor had practically no effect on an intact heart. In acute ischemia the maximum effect of the drug was manifested on the 5th-25th minutes. An increase of the stroke volume and normalization of the rate of shortening of the contraction component were observed. An anti-arrhythmic effect of baksacor was noted.


[Effect of a glucose load on lipid metabolic indices in coronary arteriosclerosis with varying types of hyperlipoproteinemia]. The dynamics of changes in the indices of lipid metabolism was studied in 130 patients with coronary atherosclerosis and different types of hyperlipoproteinemia (HLP) during 3 hours of the standard glucose tolerance test. It was established that a single glucose load in patients with coronary atherosclerosis caused insufficient decrease in the level of NEFA in the blood, and sometimes even led to its paradoxical increase, and parallel accumulation of cholesterol and triglycerides in the blood to a different degree in different patients. Significant differences were revealed in the changes in the lipid composition of blood in response to glucose load in patients with type IIa and type IV HLP. Analysis of the hypolipidemic effect of miscleron and liniksin depending on the type of HLP and on the reaction of the lipid metabolism indices to the conditions of a glucose load showed that besides determining the type of HLP in patients with coronary atherosclerosis it is expedient to study the dynamics of changes in the blood lipid composition after glucose intake.


[Taurine transport in the heart].

[Taurine transport in the heart]. The rat heart accumulates taurine against the concentration gradient when perfused for 60 minutes with solutions containing taurine in concentrations of 0.01 to 0.5 mM. The uptake of taurine by the myocardium at 37 degrees C is characterized by kinetic constants Km equal to 3.3 micron and Vmax equal to 0.77 micron/min. Heart taurine uptake is inhibited by sodium azide and carbonylcyanide-m-chlorophenylhydrosone and reduced by 30-50% by ouabain. Partial or total replacement of Na+ or K+ by equimolar amounts of trihydrochloride reduces taurine uptake. Competitive inhibition of taurine transport by beta-alanine and GABA is noted. The presence of alpha-alanine in the external medium does not affect the passage of taurine from the perfusate into the myocardium. It is concluded that the uptake of taurine by the rat heart  is accomplished by means of active transport through a transport system which possesses affinity to gamma- and beta-amino acids.


[Comparison of the effect of ildamen and nonachlazin on the blood supply and activities of the heart]. Instravenous infusion of ildamen (0.8-1 mg/kg) into anesthesized cats caused an increase in coronary blood flow and oxygen consumption by the heart to an approximately equal degree; the resistance of the coronary vessels diminished. The values of cardiac activity (cardiac output, contractions, pulse rate) increased simultaneously with increase of the coronary blood flow. In distinction to ildamen, nonachlasin (6 mg/kg) reduced the arterio-venous difference in oxygen and increased the content of oxyhemoglobin in the draining coronary blood. In anesthesized animals cardiac activity altered in two stages. Since beta-adrenergic blocking agents prevented the increase in coronary blood flow and the intensification of cardiac contractions induced by both drugs it is assumed that their effect is caused through  stimulation of the beta-adrenergic structures. Besides, ildamen and nonachlasin possess the property of inhibiting cardiac activity. The combination of these two opposite effects evidently plays an important role in the realization of the antianginal effect of the substances studied.


[Diagnosis and treatment of eye muscle palsies (author's transl)]. After the discussion of the clinical symptomatology of paralytic squint (diplopia, variable angle of squint, compensatory head posture etc.) the importance of modern electromyography for differentiation between myopathy (affection of the eye muscles), myastherias (affection of the neuromuscular transmission) and peripheral neurogenic palsies (affection of the peripheral neuron up to the nuclear region) is discussed. The clinical symptomatology of these affections of different levels is discussed as well as the differential diagnosis. The treatment of eye muscle palsies in principle consists in: 1. medical treatment (local and general), 2. optical treatment (glasses, occlusions, prisms etc.), 3. orthoptic treatment, 4. surgical treatment.


[Evaluation with the computer of infrared photos of the optic fundus. I. Technical basis (author's transl)]. The importance of spectral analysis for the ophthalmology is explained by means of the optical properties of hamoglobin and pigment. Basic technical provisions for the applied infraredfundusphotography as well as methods of computer aided image analysis are explained.


[Computer evaluation of infrared photos of the optic fundus. II. Clinical aspects (author's transl)]. The absorption of retina and uvea pigment is very high in infrared light of 700-1000 nm, whereas hemoglobin absorbs light of lower frequencies much better. Density-Slicing is performed by a computer receiving information from an infrared film. Pigments of nevi and melanomas are demonstratable by this method and tumor growth is possible to see as well.


[Comparative ophthalmo-dynamographic and doppler-sonographic examinations (author's transl)]. The significance of directional Ultrasound-Doppler-Sonography with measurements at the fronto-medial and fronto-lateral arteries for the presence of a haemodynamically effective stenosis of the internal carotid artery between the bifurcation and the origin of the ophthalmic artery tells us more than Infratone-ophthalmodynamography (Hager). This paper compares results in a neurological practice obtained during a period of 2 years, from which some cases in the publication complete with the curves obtained are presented.


[The influence of gravity on the distribution of fat embolism in the eye (author's transl)]. In human fat embolism we often find different grades of changes in both eyes of a patient. This was experimentally verified in rabbits. The anesthetized animals were held in lateral position so that one eye was continuously higher than the other. Labelled fat was injected intravenously, and then the activity in each eye was measured by a scintillation-counter. By this method a significantly higher rate of fat embolism was found in the upper eye.


[10 years' experience with our department for diabetic retinopathy (author's transl)]. A report is given on 10 year's experience with 2500 diabetic patients, who were followed up and treated in a special department for diabetic retinopathy at the 1st Vienna University eye clinic. The criteria for treatment of diabetic retinopathy by means of photocoagulation, intrascleral diathermy-coagulation and vitrectomy or a combination of these treatment methods are outlined. The fluorescein angiogram served as the basis for the technic of photocoagulation used in a particular case of diabetic retinopathy and for the evaluation of the success of this treatment.


[Problems of photocoagulation in simple diabetic retinopathy (author's transl)]. The simple (exudative) diabetic retinopathy remains often spontaneously benign for long time. Therefore advantages and disadvantages of the photocoagulation in such cases must be weighed against each other very accurately. Appropriate therapeutic recommendations are given.


[Disciform syndrome secondary to focal choroiditis in the macular region (author's transl)]. In 10 patients with an average age 44 years there developed from focal choroiditis in the macular region a disciform syndrome, clinically resembling the senile macular degeneration and with a poor prognosis.


[Ophthalmoscopic and fluorescence angiographic findings in a case of Batten's disease (author's transl)]. Ophthalmoscopic and fluorescence angiographic findings are an important contribution to the diagnosis of Batten's disease. The changes of retina and pigment epithelium observed in three patients are discussed. With fluorescence angiography the fundus changes of Batten's disease can be distinctly substantiated, thus facilitating the early diagnosis.


[Considerations on the rationalisation of an eye clinic (author's transl)]. The actual economical problems of hospital management demand critical considerations on the possibilities of rationalisation. Regarding the activities on an university eye-clinic in a big city the realisation of certain facilities could be well obtained: a decrease of the number of in-patients by treating of suitable cases as out-patients; shortening of the time of hospitalisation according to the progress of modern surgical and medical treatment; arrangment of departments for treating patients during the day in cases requiring intensive treatment and follow-up after full hospitalisation.


[An unusual eyelid tumor (author's transl)]. A 68-year-old man presented with a rapidly growing upperlid tumor which due to multiple recurrences was excised 5 times within 4 years; and ultimately invaded the orbit. An orbital exenteration was performed. The unusual clinical course and the A-Scan sonographical findings of this tumor were most probably due to its uncommon histological features which proved to be an undifferentiated squamous cell carcinoma with features of Epithelioma metatypique intermediaire Darier.


[Orbital tumor in Goodpasture's syndrome (author's transl)]. Diplopia and unilateral exophthalmus of a female patient, aged 34, with Goodpasture's syndrome were the indication for echographic examination. A- and B-scan echography revealed a diffuse retrobulbar tumor carrying the characteristics of the sarcoma/lymphoma/pseudotumor group.


[Enucleation: causes of extrusion of orbital implants (author's transl)]. The frequency and the causes of extrusion of orbital implants have been investigated. Of the 294 patients in which enucleation was done, in 17 cases (5.8%) extrusion of the first implant developed; in 9 cases with second or third implantations another 5 implants have been extruded. The extrusion of implants is caused mainly by the operative technique and only rarely by intolerance reactions. For a reliable healing exact sutures of the muscles and also exact closure of the implant with plenty of covering tissue is important.


[Disturbances of fusion after extensive retinal haemorrhages in new-born infants (author's transl)]. Follow-up examinations of 21 non-squinting children aged six revealed, that most children who had had extensive bilateral post-partum retinal hemorrhages had a significantly higher incidence of impaired range of fusion (25 degrees max.) as compared to the cases without perinatal hemorrhages. Not a single case of impaired fusion could be improved by orthoptic treatment. The disorder is assumed to be due to a discrete perinatal impairment of the cerebral optomotor centers.


[Treatment of covergence insufficiency by "convergence-card" (author's transl)]. A report is given on a simple possibility to influence favorably convergence insufficiencies by means of physiological diplopia; a so-called "convergence-card" is described as well as its usefulness for eye-training; the case reports of 4 typical patients are described.


[The different forms of hypermetropia and the necessity of their precise correction (author's transl)]. The author presents a detailed analysis of hypermetropia. He defines its three pathogenetically important forms:--facultative, relative and absolute, starting from the principles of Donders and based upon the dioptrics of Gullstrand. The author then deals with the pathological processes caused by hypermetropia, especially with the formation of strabismus. Finally he discusses the effects of the three forms of hypermetropia and of the associated other deficiencies of refraction.


[Pathomechanism and therapy of angle-closure glaucoma (author's transl)]. Pathogenetically three types of primary angleclosure glaucoma can be differentiated. 1. Iridolenticular block; 2. Irido-trabecular block, 3. Cilioirido-lenticular block. The different types of angle-closure glaucoma are characterized by particular morphologic and functional criteria. Their therapy varies and should be oriented toward this classifikation.


[Trabeculectomy combined with radical lobelike iridencleisis (author's transl)]. Between 1974 and 1977 the new combined operation was performed on 67 eyes with chronic, acute or secondary glaucoma. On observation i.o. pressure was found regulated in all eyes, but 15% needed subsidiary drugs. Complications did not occur more often than in the usual trabeculectomy. In performng surgery it is important to make the canal of Schlemm visible by diaphanoscopy to be sure to include it with the enlarged excision of sclerocorneal tissue. Through the method of excision and radial rupture of the iris lobe the entrance of the sclerociliary tunnel is opened widely. Imbedded iris tissue retards closing of the intended cleft and improves filtration.


[Comparative examinations in goniotrepanation and trabeculectomy (author's transl)]. In 20 patients with glaucoma simplex (15 cases) or angle closure glaucoma (5 cases) a trabeculectomy had been done on one eye and a goniotrepanation on the other eye within a period of a few days. As far as the operation-technic concerns neither ofthe two methods revealed a remarkable advantage nor a disadvantage. All patients have been controlled up to one year after the operations. There were only a few postoperative complications in both groups. There was no significant difference in the regulation of the intraocular pressure.


[Cryotherapy for glaucoma (author's transl)]. After a short survey of the development of thermosurgery for glaucoma our own experiences with 120 cryocoagulation operations of the ciliary body are described. We observed postoperatively a general reduction of intraocular pressure--but pressure regulation appeared in only 1/3 of cases.


[Special sound probe for foreign body localisation (author's transl)]. A recently developed sound probe (10 MHz and 3 mm diameter) is suitable for sparing preoperative localisation of foreign bodies in perforated eyes; especially mural foreign bodies can be exactly located intraoperatively. Followed scleral incision foreign bodies can be extracted on the optimal route.


[Siderosis bulbi et lentis produced by intralenticular rust (author's transl)]. A 17-year-old apprentice affected with siderosis bulbi and lentis of his right eye, was examined by biomicroscopy, ultrasonography and x-rays without evidence of an i.o. foreign body. After extraction of the cataractous lens all signs of siderosis disappeared within six weeks. The histologic examination of the lens showed a small particle of subcapsular rust.


[Indications for pars plana vitrectomy after perforating injuries (author's transl)]. A preliminary report is given on 100 consecutive cases of pars plana vitrectomy after perforating injuries due to nonmagnetic IOFB (9 cases), magnetic IOFB (32 cases) and lacerating injuries (19 cases). Pars plana vitrectomy was performed to remove persistent vitreous membranes, to prevent proliferative transformation with following retinal detachment or to make the IOFB become visible for extraction. These eyes were practically amaurotic but in 43 cases out of 100 a positive results could be achieved (i.e. the retina being attached, posterior pole becoming visible). Indications, technique and complications of both pars plana vitrectomy and FB extraction are discussed. As a result pars plana vitrectomy should be performed within an interval of at least 2 weeks after the first intervention (i.e. wound closure of FB extraction).


[Does indirect binocular ophthalmoscopy influence the results of retinal deteachement surgery (author's transl)]. The statistical comparison of two collectivs of patients showed, that with routine use of indrect binocular ophthalmoscopy and renunciation of drainage of the subretinal fluid (49% of the cases) the curing rate of the cases which were operated with a combination of cryopexie and plombage raised from 75% to 96%. Even the results of visual acuity improved.


[TV-pattern reversal stimulus (VECPs) in determination of refraction (author's transl)]. Pattern reversal VECPs show a dependence on visual acuity and therefore are suitable for objective determination of refraction, this method, however, was of limited clinical use for two reasons, as, on the one hand, the required impulse parameter was difficult to change using the traditional mechanically functioning pattern stimulator and, on the other hand, diagnosis war very timeconsuming. Using a pattern impulse picture presented on a monitor by an electornic impulse apparatus all impulse parameters can easily be changed and throught he introduction of a microprocessorsystem the evaluation can be observed on-line.


[Electroophthalmological investigations in amblyopia (author's transl)]. In the case of 8 amblyopic patients the ERG and the brightness VECP, as well as the TV-pattern reversal VECPs in whole field and upper and lower half field stimulation, were traced. In the ERG (a- and b-wave) and the brightness VECP significant differences were established neither in the amplitude nor in the latenz between amblyopic and healthy eyes. The amplitude of the pattern reversal VECPs in whole field and lower half field stimulation was significantly reduced in all 8 patients on the side of the amblyopic eye.


[Electrooculographic examination in paralytic and concomitant squint (author's transl)]. There are shown some possibilities of electrooculographic diagnostics in different forms of strabismus. Kinetic disturbances in fusion in concomitant squint are usually frequent but not constant and in the majority they are different from incomitances in paralytic squint. In this mind electrooculography represents subtile and perspective method in examination of ocular motility.


[Blood viscosity and red cell deformability in primary hyperlipoproteinemia (author's transl)]. In patients with primary hyperlipoproteinemia (types IIa, IV, IIb) we determined by means of a Wells-Brookfield plateconeviscometer and an Ubbelohde capillary-viscometer the serum-, plasma-, apparent and relative apparent blood viscosity as well as the red cell deformability with a filtration technique. All parameters were found to be significantly changed in comparison to those of a normolipidemic control-group: The viscosity values of type IIb showed the greatest increase and of type IIa the smallest, while the red cell deformability was reduced in all types to the same degree.


[Alcohol-related disturbances in haematopoiesis (author's transl)]. Alcohol-related disturbances are seen against the three blood cell systems. They appear after important alcohol consumption within few days and are independent from the existence of liver cirrhosis with splenomegaly. They are promptly and completely reversible after interruption of alcohol supply. Disturbances in erythropoiesis are manifested in bone marrow with megaloblasts, ring sideroblasts, and vacuoles in cytoplasma and nucleus of nucleated red cells. They are caused by folate deficiency and by perturbations of iron utilization, which is perhaps connected with impaired heme synthesis following pyridoxal phosphate deficiency. Serum iron generally increases during alcohol consumption and decreases in the following alcohol-free period. The anemia may be macrocytic and normochromic or dimorphic with hypochromic microcytes. Anemias of hard alcohol drinkers are observed also as consequence of bleeding or hemolysis of different causes. The lability against infections of drinkers is associated with changes in granulopoiesis. The most important findings are granulocytopenia, vacuoles in the immature marrow cells, perturbations in granulopoietic maturation, and decrease of marrow response. Frequently, alcohol drinkers demonstrate thrombocytopenia which is caused by ineffective thrombopoiesis and by shortened life span of platelets as direct effect of ethanol. Functional impairments of thrombocytes have been published, too.


Purine nucleotide synthesis in normal and leukemic blood cells. The present study was undertaken to obtain more precise information about the purine biosynthetic pathway in human blood cells. 5'phosphoribosyl-l-pyrophosphate (PP-ribose-P) amidotransferase was found in cell-free extracts from all leukemic cells and normal lymphocytes and therefore these cells could synthesize the first intermediate of the purine-de-novo-synthesis. Normal leucocytes, erythrocytes and bone marrow cells lack this enzyme system and have an absolute requirement for externally supplied purines via salvage pathway. Leukemic blast cells show different enzyme activities independent of their cell count. Kinetic studies with the crude enzymes showed sigmoidal substrate velocity curves for PP-ribose-P, whereas glutamine shows hyperbolic kinetics. The leukemic cell enzymes from all four donor types (ALL, CLL, AML and CML) are rapidly saturated with low concentrations of PP-ribose-P and less inhibited by the physiological feedback inhibitor, adenosine 5'monophosphate. The crude enzymes of normal spleen lymphocytes and leukemic cells were further purified (10 to 15-fold) and substrate velocity curves for PP-ribose-P and glutamine show now hyperbolic kinetics and double reciprocal plots were linear with and apparent Km for PP-ribose-P of 0.14 mM and for glutamine 2.0 mM. In the presence of different concentrations of AMP, the PP-ribose-P substrate velocity plot changed from a hyperbolic to a sigmoidal curve; no difference in the degree of the inhibition between both partially purified enzymes (normal spleen lymphocytes and leukemic cells from all four donor types) could now be observed.


In vitro stimulation with mitogen and antigen in patients with monoclonal gammopathy. Peripheral blood lymphocytes from 32 patients with defined paraproteinaemia (16 IgG, 9 IgA and 7 IgM) and from 15 healthy donors were studied for their in vitro response to various stimuli, including for unspecific mitogens such as Phytohaemagglutinin (PHA), Pokeweed mitogen (PWM) and Concanavalin A (ConA) as well as specific antigens such as purified Tuberculin, Candida, Varidase, Tetanus Toxoid, Vaccinia antigen and Vaccinia-control antigen. Mitogens and antigens were lyophilized in Microtiter plates. The lymphocytes of all tested patient-groups responded (measured by H3-Thymidin-uptake) significantly lower towards the unspecific mitogens than those of the control group. If the patients' lymphocytes were stimulated by the specific antigens, their in vitro response was significantly diminished to candida and vaccinia. Macroglobulinaemia showed significantly lower response to ConA if compared to myelomas of IgG- and IgA-type. No correlation was found between mitogen and antigen response and the serum concentration of the paraproteins or immunoglobulins. The results show that monoclonal gammopathy and especially macroglobulinaemia are associated with abnormalities of the cellular immunity which correlates with the clinical observation of increased fungal and viral infections.


[The influence of diazepam (valium) on the effect of phenprocoumon (marcumar) (author's transl)]. In 10 patients who were treated with phenprocoumon (Marcumar) for thrombembolic diseases, we examined the influence of the combined therapy with diacepam (Valium) on the effect of the anticoagulant. After stopping the therapy with diacepam we saw a significant increase of the prothrombinetime (Quick) beyond the therapeutic level of 25%. By increasing the dosis of phenprocoumon the therapeutic level was achieved again not until after 8 days. The dosis needed for maintaining this level was on the average 32% higher than during the time of the therapy in which diacepam was used. Because of the increased thrombembolic risk, when going beyond the therapeutic level of the prothrombinetime, this interaction is of clinical importance.


Anti-HBc, HBeAg and DNApolymerase activity in healthy HBsAg carriers and patients with inflammatory liver diseases. In this paper we report on anti-HBc-titers, HBcAg, DNApolymerase activity in the serum and intracellular HBsAg in healthy HBsAg-carriers and patients with HBsAg-positive inflammatory liver diseases. 32/44 patients with acure virus-B-hepatitis were negative for anti-HBc in the first week of the disease. Anti-HBc-titers in healthy HBsAg-carriers varied between 1:10 and 1:32,000 (medium titer 1:4,000). In HBsAg-positive CAH we found a medium titer between 1:32,000 and 1:64,000, in cases with CPH of about 1:16,000. All autoimmune type CAH showed anti-HBc-titers less than 1:10. By immunofluorescence we could demonstrate in a group of 71 asymptomatic HBsAg-carriers in none of the healthy HBsAg-carriers HBcAg in the liver cell nuclei. In contrast HBcAg could only be found in 4/5 HBsAg positive CAH- and 6/9 CPH patients. No elevated DNApolymerase activity could be demonstrated in healthy HBsAg-carriers. Out of 44 patients with virus-B-hepatitis only 3 showed elevated DNApolymerase activity. On the other hand DNApolymerase elevation was demonstrable in 17/37 cases with CAH and 9/15 with CPH. The investigations showed a strong correlation between the demonstration of HBcAg in the serum and the DNApolymerase activity. The characteristic findings enabled us to differentiate between "healthy" HBsAg-carriers and HBsAg-carriers with inflammatory liver diseases.


Stress at birth: plasma noradrenaline concentrations of women in labour and in cord blood. Radioenzymatically measured plasma noradrenaline concentrations, present at birth in umbilical veins of 19 healthy, 17 acutely asphyxiated, and 9 chronically distressed newborn infants were found to be elevated above maternal values proportional to the degree of distress and to plasma H ion concentrations.


Alkaline phosphatase and tartrate resistant acid phosphatase activity in cells of prolymphocytic leukemia. In a typical case of prolymphocytic leukemia, blood smears and lymph node imprints have been investigated cytologically and cytochemically. It could be shown that many leukemic cells in both blood smears and lymph node imprints contained tartrate resistant acid phosphatase activity. Furthermore, the lymph node imprints disclosed many cells with a positive alkaline phosphatase reaction. Such a reaction hitherto has not been described in malignant cells of lymphoproliferative diseases. The cytochemical results underline that prolymphocytic leukemia indeed is a separate entity which can be differentiated from hairy cell leukemia and chronic lymphatic leukemia not only morphologically but also cytochemically. In addition, the case shows that leukemic blood cells are not inevitably identical with those occurring in organ infiltrates.


The role of kininogenases, kinin formation and kininogenase inhibition in post traumatic shock and related conditions. The kinin system has for a long time been considered to play a role in the pathophysiology of trauma, particularly in blood pressure changes and in inflammatory effects. Recent findings necessitate a revision of this view. It is now necessary to differentiate between two kinin systems: 1. the plasma kallikrein-HMW kininogen-kinin-system, which besides forming kinin acts decisively in Hageman Factor activation, clotting and fibrinolysis; 2. the glandular and tissue kallikrein-LMW kininogen-kinin-system which is to our present day knowledge primarily involved in kinin formation. Kinins exert a variety of actions. By interfering with angiotensin II formation, kinins may contribute to blood pressure regulation. By enhancing cellular glucose uptake and/or metabolism, they regulate partly energy production. In post traumatic states death is preceded by a severe depletion of various factors of the system and an almost total loss of kinin forming capacity. Severity and time course of these phenomena suggest that early institution of direct (Trasylol) or indirect (heparins, cortocosteroids) proteinase inhibition, and if necessary a replacement of the lost factors, should be considered.


Investigations on latent erythropoietin (ESF) deficiency in non anemic patients with chronic renal disease using hypoxic stimulation methods. So far the question has not been elucidated whether latent ESF-deficiency exists in patients with chronic renal disease during initial development of renal anemia. Therefore, ESF was determined in urine and serum of non anemic patients being exposed to acute hypoxia: 8 healthy volunteers and 8 patients who had a Ccreat below 48 ml/min were studied while in a hypobaric chamber for 4 subsequent periods of 10 h each (simulated maximal altitude 4000 m INA = 462 mm Hg). We also determined plasma iron turnover and reticulocyte counts. 10 h after the study began, the patients showed a significantly higher ESF-level than the normal volunteers. In the course of 48 h collection periods of urine under hypoxic conditions the mean ESF excretion in patients corresponded to 9.9 and in healthy persons to 7.3 Units. With regard to plasma iron turnover and reticulocyte count an increase was shown, but no significant differences existed between the two groups. A latent ESF-deficiency as the initial cause of renal anemia does not exist.


[Angiography of the left ventricle using right atrial injection (author's transl)]. Left ventricular angiography as a diagnostic means is of considerable importance in the evaluation of myocardial and valvular dynamics. The injection of contrast medium into the left ventricle often causes premature ventricular contractions. In these cases quantitative analysis of the contraction pattern is impossible. This can be avoided by injection of the contrast medium into the right atrium. The technique described allows to obtain ventriculograms which meet the criteria for quantitative angiocardiography. 57 ventriculograms have been performed in 32 patients with various cardiac abnormalities. The study describes the technical procedure, the indications and limitations. Furthermore special applications are discussed (videometry, pressure-volume relationship).


Platelet kinetics in Crohn's disease.

Platelet kinetics in Crohn's disease. The pathogenesis of thrombocytosis in Crohn's disease was analized in ten non-treated patients using the 51Cr labelling method. The data obtained were compared to those taken from a control group. Besides platelet survival time, platelet turnover, surface radioactivity, platelet adhesiveness and morphological aspects of bone marrow were investigated. Platelet survival time in patients with Crohn's disease proved to be significantly shortened (p less than 0.001), whereas platelet turnover appeared augmented. No additional radioactivity is encountered from the organs scanned. The relative platelet adhesiveness is diminished while thrombocytopoesis in bone marrow is augmented.


[Inhibin-like activity in human ovarian follicular fluid (author's transl)]. A steroid-free proteinaceous substance with inhibin-like activity has been extracted from human ovarian follicular fluid by alcohol precipitation. This substance was capable of inhibiting the ovarian weight increase of hCG-treated immature female rats and also of suppressing the post-castration rise of serum FSH levels in immature male rats. Follicular fluid from small follicls obtained from regularly cycling women was--on the basis of protein- found to be more active than cystic follicular fluid obtained from a premenopausal woman. The possible role of inhibin in the regulation of human ovarian cycle has been discussed.


Studies on the activity of the renin-angiotensin-aldosterone system (RAAS) in patients with cirrhosis of the liver. Plasma renin activity (PRA), plasma renin concentration (PRC), angiotensinogen, angiotensin II (AT II) and plasma aldosterone were determined by radioimmunoassay in 77 patients with cirrhosis of the liver [group I: with ascites, untreated (n=23); group II: patients with ascites during treatment (n=32); group III: after removal of fluids, but under further spironolactone therapy (n=10); group IV: untreated subjects without ascites (n=12)]. With the exception of decreased angiotensinogen values in all groups ranging between 39% (group IV) and 73% (group III) no significant changes of the other parameters of the RAAS were found in untreated patients. A highly significant increase of PRA, PRC, AT II and plasma aldosterone was observed in treated cirrhotics with (group II) or without (group III) ascites. In the total series of patients AT II was closely related to PRA, PRC and aldosterone emphasizing aldosterone secretion. Plasma sodium was inversely correlated to PRA, PRC, AT II and aldosterone, but no relationship was detected between these parameters of the RAAS and plasma potassium. Our results indicate that hyperaldosteronism in cirrhosis appears unlikely to be the major determinant of avid renal sodium retention and ascites formation. An increased activity of the RAAS is most often initiated by therapeutic factors and/or markedly altered electrolyte metabolism. Therefore, basal conditions of the patients to be studied must be well defined to exclude any artificially induced stimulation of the RAAS.


Total immunoreactive angiotensin ii, its hepta-octapeptide fraction, and its hexapeptide in patients with liver disease. Arterial and venous plasma concentrations of total immunoreactive angiotensin II (AT II), its bioactive hepta-octapeptide fraction and its inactive hexapeptide were measured in normal subjects (n=16), in patients with acute viral hepatitis (n=12), and in treated (n=16) and untreated (n=17) patients with cirrhosis of the liver and ascites. Independent of normal or increased values of total immunoreactive AT II, the ratio between the hepta-octapeptides and the hexapeptide remained unchanged. This might indicate continuous octapeptide generation and balanced metabolite turnover throughout the systemic circulation. Moreover, a significant arterio-venous peptide gradient was lacking. It has to be concluded that total venous plasma AT II sufficiently reflects both the arterial hormone concentration and its major fraction of hepta-octapeptides in arterial (79%) and venous (76%) blood.


Nitrofurantoin damages DNA of human cells. Nitrofurantoin causes damage to DNA of cultured diploid human fibroblasts. As a consequence DNA synthesis is blocked. The damage is removed by the normal enzymatic DNA repair system. Xeroderma pigmentosum fibroblasts which are defective in the excision endonuclease fail to repair nitrofurantoin-caused lesions.


[Viscosity of pure pancreatic juice in chronic pancreatitis (author's transl)]. In patients with chronic pancreatitis viscosity is significantly increasesed compared to controls when pure pancreatic juice aspirated in the course of duodenoscopy is analysed. This parameter may represent a simple method for the diagnosis of chronic pancreatitis.


[Study of the body's reactivity using pharmacological tests]. Variations in the excretion of catecholamines (adrenalin, noradrenalin, dopamine and DOPA precursor) were studied in 34 test subjects who had undergone two drug tests at a two day interval: an insulin test at a dose of 0.15 Units/kg body weight and dopavein test at a dose of 800 microgram/day. In most cases these drugs caused an adequate response of the sympathoadrenal system which included its increased activity and reflected nonspecific reactions. It is concluded that a high (or an adequate) relative activity of the sympathoadrenal system during these tests is more favorable in terms of prediction of reactions of the body in harsh environments than a decreased activity of the sympatho-adrenal system, especially when it is combined with low background values of catecholamine excretion.


[Use of freeze-dried products in weightlessness]. The paper describes the manufacture of food products that can be eaten in weightlessness with the aid of regular table-ware. The consistence of products was altered as a result of an addition of water or modified starch. The resultant products were tested during short-term weightlessness aboard the aircraft-laboratory TU-104A. It was demonstrated that in weightlessness products having sufficient viscosity can be eaten with the help of regular table-ware. An addition of thickening agents, e. g. modified starch, helped to obtain products with necessary properties.


[Problems in the pathogenesis of respiratory disorders occurring under +Gz loads in combination with breathing of pure oxygen]. The effect of accelerations of different value and duration combined with air or pure oxygen breathing on the pulmonary function was investigated in centrifugation experiments on six healthy male test subjects, aged 20--23. The dynamics of the emergence and back development of the respiratory syndrome induced by the combined effect of acceleration and pure oxygen breathing, its symptoms, spyrographic and roentgenologic components were studied. It was demonstrated that both the value and duration of acceleration played a certain role in the pathogenesis of functional disorders of the respiratory system and atelectasis; however, the time factor exerted the major effect on their development.


[Verification of the effectiveness of preventing altitude decompression disorders by nitrogen desaturation of the organism through surrounding the body with an oxygen envelope]. The purpose of the present investigation was to assess the effect of nitrogen penetrating the human skin from the ambient atmosphere on the level of denitrogenization achieved by oxygen breathing. Young healthy male test subjects were exposed to denitrogenization for 5, 6 or 8 hours by breathing pure oxygen. During that time they wore an oxygen filled suit. Then they ascended an altitude of 11,000 m and remained there for 6 hours doing exercises. Altogether 38 investigations were carried out on 13 subjects, with and without a pressure suit. The investigation did not demonstrate any specific differences in the occurrence of decompression disease at an altitude of 11,000 m with or without a pressure suit. Nitrogen penetrating through the skin from the ambient atmosphere during oxygen breathing did not influence the level of denitrogenization.


[Effect of indicator location on the psychophysiological characteristics of combined activities]. Investigation was carried out to estimate how efficiently can combined tasks of visual measurement and sensomotor reaction of choice be performed against tracking the sinusoidal signal at different sighting angles between their displays and different priority. It was found that, with a change in the sighting angle between the displays from 0 to 60 degrees, the time and number of tracking errors continuously increased; the probability of erroneous replies grew with an increase in the sighting angle to 30 degrees, remained essentially stable at angles of 30 and 45 degrees and decreased at 60 degrees. Combined performance of two equally important problems in case of an increase in the sighting angle between displays (from 30 to 45 degrees) was followed by a change in the structure of data acquisition.


[Tolerance for controlled physical loading in chronic hypercapnia in man]. Young healthy test subjects showed adaptation to chronic hypercapnia during long-term exposure to an atmosphere containing 0.8--1.8% CO2 at normal atmospheric pressure: bradycardia, increase in vital lung capacity and chest movements, improvement of tests with breathing retention and further decrease in oxyhemoglobin. Simultaneously they exhibited an increase in the alkaline reserve of the blood and of the 2 min step-test index. This can be interpreted both as cause and effect: products of glycolysis are bound by buffer bases, thus reducing oxygen uptake per time unit. Study of adaptation to exercises of increasing workload demonstrated an earlier involvement of anaerobic mechanisms than under normal conditions: linear relationship between the workload and heart rate persisted only up to 150 beats/min. By the end of the second and the beginning of the third month of isolation the test subjects displayed deteriorated health state and work capacity in parallel with compensated acidosis.


[Functional reserves of the sympathetic apparatus of the heart in hypoxia]. The functional reserves of sympathetic systems, i.e. their capacity to stabilize the level of norepinephrine in the enlarged myocardium of rats exposed to chronic hypoxia, increased with their adaptation to hypoxia and decreased with their deadaptation. The level of these reserves depended at large on the rate of norepinephrine biosynthesis. The degree of myocardial hypertrophy of this genesis increased with prolongation of the hypoxic exposure. It is concluded that optimal supply of norepinephrine to the enlarged heart due to increased functional reserves of sympathetic systems is possible only up to a certain level of an increase in the myocardial mass.


[Formation of neoplasms in dogs after chronic gamma irradiation at a low-intensity dose]. In order to estimate end effects of chronic prolonged gammairradiation of dogs, an exposure of 80 animals to irradiation was terminated and they were followed up closely. Out of 80 animals 30 dogs (1st series) were irradiated for 3 years and 50 dogs (II series) for 6 years. The dogs were exposed to irradiation at doses of 21 to 190 rad per year. Out of the total number of animals 22 dogs died. Post-mortem examinations showed neoformations in 13 animals (7 malignant and 12 benign neoformations). The highest number of tumors developed in dogs of the II series (10 out of 11) one-two years after irradiation (6 malignant tumors--malignant pheochromocytoma of adrenals; malignant adenoma of the hypophysis: polymorphocellular sarcoma of the liver; leucomyosarcoma of the uterus; bladder cancer; breast cancer; and 10 benign tumors--pancreatic adenoma; liver angioma; 2 papillary adenomas of the prostate; 3 renal adenomas; lipoma; polyps of the gall-bladder). Animals of the 1st series displayed 3 neoformations (1 malignant tumor--bladder tumor and 2 benign tumorsliver hepatoma and spleen angioma) 4--5 years after irradiation.


[Combined action on the body of a mixture of the volatile products of lubricating oil thermal oxidative breakdown and of hypoxic hypoxia]. The experiments on white male mice have shown that the combined effect of different concentrations of mixtures of volatile products of thermooxidative decomposition of the lubricating oil 36/IKUA and hypoxia at altitudes 5,000; 7,000 and 8,000 m depends on the intensity of the combined factors. It is indicated that maximally allowable concentrations of the above mixtures in the space cabin atmosphere should be determined, taking into consideration the level of hypoxia.


[Motor activity and the prevention of the sequelae of hypokinesia (according to tissue metabolic indices)]. The content of protein, DNA and RNA was measured in rats that had been exposed to 90-day hypokinesia: hypokinesia alternating with unrestrained maintenance and hypokinesia combined with exercises (swimming). Adverse effects of hypokinesia on metabolism seemed to build up. Short-term passive rest was insufficient to make up deficiency in motor activity. The recovery of metabolic disorders after prolonged hypokinesia proceeded in a non-uniform and slow manner: most parameters did not return to the initial level within one month. During the first two weeks exercises produced effects similar to those of hypokinesia. By the 30th and 60th days they shower their normalizing effect on tissue metabolism. When developing work-rest cycles for the people who are exposed to partial hypokinesia during work and do exercises as a countermeasure against hypokinetic effects, biochemical analysis of blood (nonesterified fatty acids, acetone bodies, cholesterol, beta-lipoproteins, urea) and urine (potassium, calcium, creatinine) should be made to measure metabolic processes in tissues.


Perputial gland abscess in mice.

Perputial gland abscess in mice. Preputial gland abscesses were found in 321 (1.8%) of 17,422 mice from our production colonies. The lesions were observed only in males, and Staphylococcus aureus was isolated in pure culture from 84% of the cases. Experimental transmission of the disease was successfully accomplished through injection of Staphylococcus aureus into the penile urethra.


Comparative stability of physiological parameters during sustained anesthesia in rats. Rats were anesthetized with pentobarbital, pentobarbital and atropine, inactin [5-ethyl-5-(1'-methyl-propyl)-2-thiobarbiturate], ether and inactin, or urethane. Cardiovascular and arterial acid-base parameters were monitored over a 3-hour period of anesthesia. Heart rate, arterial pressures, and pH progressively decreased with duration of pentobarbital anesthesia. Changes observed in rats anesthetized with the thiobarbiturate, inactin, were similar although generally less severe. Most subjects treated with the barbiturates were markedly hypercapnic. Urethane anesthesia was characterized by a higher and more stable heart rate and greater pulse pressure. Arterial carbon dioxide and bicarbonate levels in the urethane group were substantially lower at all sampling times than the values obtained in the barbiturate groups.


Artificial insemination in the European hare (Lepus europaeus syriacus). A simple technique for artificial insemination in hares was performed and used routinely in mass breeding of hares in captivity. Sperm was collected directly from the epididymides of males. Ovulation was induced by intravenous injection of human chorionic gonadotropin. Female hares were successfully inseminated throughout the year. Pregnancy occurred in 70% of inseminated females; the range in litter size was 1--3 offspring with a mean of 1.4. It was concluded that artificial insemination greatly simplified the breeding of hares in captivity.


Effect of alfalfa and dietary fiber on the growth performance of weanling rabbits. The addition of 10%, 20%, 30%, and 40% sun-cured alfalfa meal to a high-energy, low-fiber, basal diet for weanling rabbits gave increased average daily gains as compared to gain on the basal diet. Deaths from enteritis complex occurred only at the 0% and 10% alfalfa levels. When 2.5%, 5%, 7.5%, and 10% alfalfa meal were used, the average daily gains were numerically higher for all alfalfa-fed groups than for the basal diet. Maximum gains were achieved at the 20% alfalfa level. Alfalfa extracted with 95% ethanol retained its growth-stimulating effect when added to the basal diet. Feed preference trials gave conflicting results. In one trial, the basal diet was preferred over all alfalfa  diets in a two-choice feed preference test, while in a second trial, all alfalfa diets were preferred over the basal diet. It was concluded that the growth of weaning rabbits fed a high energy diet was improved by the addition of alfalfa meal.


Two methods for producing peripheral anosmia in dogs. Two methods for producing peripheral anosmia in the dog were described. One method involved infusion of 3.5% zinc sulfate into the nasal cavity. An anosmia lasting at least 6 weeks, and, in most cases, for several months, was produced. A second technique, producing short periods of reversible anosmia, was the insertion of a tracheostomy tube with inflatable cuff. Inflation of the cuff prevented the dogs from inhaling air over the olfactory mucosa. Deflation of the cuff restored functional olfaction. The advantages and disadvantages of each technique were discussed.


[Engineering psychological principles of optimizing the control systems of flying vehicles]. Having reviewed literature publications and their own findings, the authors have formulated principles of optimization of control systems of flying vehicles which reflect certain psychophysiological patterns of human activity. Of greatest importance are the following principles: consistence of the information model to the operational image of the pilot and pattern of distribution of his attention; estimation of operational thresholds of signal perception; information integration into an integrally perceived image; selection of an optimal algorithm for the solution of flying and other problems; decrease of the load on the short-term and long-term memory. The authors have shown that the practical application of these principles requires a preliminary analysis of the psychophysiological structure of the activity of crewmembers.


Signs of impending parturition in the laboratory bitch. The most consistent and reliable physical sign of impending parturition in pregnant laboratory beagle bitches was palpable relaxation of pelvic and abdominal musculature. A drop in rectal temperature was of some value but was found to be too variable between individuals to use as the sole criterion. Abrupt changes in attitude or appetite were the chief behavioral changes observed. Since the institution of a standardized record form for all pregnant dogs, 15 consecutive term litters have been successfully derived from pregnant dogs into gnotobiotic life isolation units.


The electrocardiogram of Macaca fascicularis. Electrocardiograms from 16 male cynomolgus monkeys (Macaca fascicularis) were studied. Standard and augmented limb leads (I, II, III, aVR, aVL, aVF) were obtained with the animals restrained in a sitting position. Normal electrocardiographic parameters were determined, including PR and QT intervals; P, QRS, and T wave axes; P and QRS wave widths. Voltages in all standard and augmented limb leads were lower than previously reported for similar size monkeys.


Naturally occurring Tyzzer's disease and intestinal spirochetosis in guinea pigs. Bacillus piliformis infection (Tyzzer's disease) occurred in two young guinea pigs, causing unthriftiness and diarrhea which resulted in death. There was necrosis and inflammation of the ileum, cecum, and colon. Intestinal epithelial cells contained organisms resembling Bacillus piliformis. Spirochetes were found in the cecum and colon, mainly in crypts. Acute diarrhea occurred in another guinea pig which became cachetic and was killed. Histologically, large numbers of spirochetes were present in the wall of both the cecum and colon, and they were associated with severe necrosis and inflammation. Bacillus pilformis was not found in this animal.


An ovarian teratoma in a guinea pig.

An ovarian teratoma in a guinea pig. An ovarian teratoma was diagnosed in a one-year-old, virgin female, Strain 13 guinea pig that died unexpectedly. The left ovary was replaced by a 5.5 x 5 x 3 cm mass. Microscopically, dense fibrous connective tissue, immature neuroepithelium, central and peripheral nervous tissue, respiratory epithelium and cartilage were observed. A similar mass, 1.2 x 1 x 1 cm, composed largely of embryonal neural tissue, was adhered to the abdominal side of the diaphragm. The latter mass probably resulted from transcoelomic seeding by the ovarian tumor.


Acute peritonitis in the rabbit (Oryctolagus cuniculus) resulting from a gastric trichobezoar. A case of gastric ruputre secondary to a trihobezoar occurred in a rabbit. A review of the literature showed that, although trichobezoars are common in rabbits, antemortem gastric rupture has not been reported previously.


A record-keeping system for a pigeon breeding and research colony. Seven different records were used to monitor a 2,000-bird pigeon colony. A nest card was placed on each nest box to record current production. This information was collected monthly and transferred to a breeding pair record which was used to evaluate yearly reproductive performance as well as to maintain a record of the number of offspring produced. An individual record was maintained on each bird to record it life history and pedigree. Weekly, when new offspring were banded, a squab data sheet was taken into the pen to record the offspring's permanent leg band number, hatch date, strain, pen number, and parents' band numbers. An individual pen record was used to record the leg band numbers of each bird occupying each pen. A monthly death record and a health record were maintained to monitor the colony's health status. From examination of the death record, one could determine if the mortality was excessive and if any specific pens were involved. On the health record were recorded diet, monthly morbidity and mortality, results of monitoring programs, and any treatments rendered. The system provided ready accessibility do detailed records of production, pedigrees, pen locations of birds, colony health status, and the number, strain, and age of birds available for research.


Antiserum-induced dissociation of myelinogenesis in vitro. An ultrastructural study. Mature, myelinated cultures of mouse spinal cord tissue exposed to heated (decomplemented) sera from animals suffering from experimental allergic encephalomyelitis demonstrate a unique pattern of myelin swelling without demyelination. In the present study, three concentrations of heated experimental allergic encephalomyelitis sera (5, 15, and 25 per cent) were applied to spinal cord cultures from the time of explantation and continued for 33 days therafter. The sera were obtained from rabbits with the exposed cultures, glial cell differentiation occurred at timepoints comparable to those in normal unexposed sister cultures. Oligodendroglia produced a profusion of cytoplasmic processes which compacted to form aberrant myelin with a periodicity double that of normal myelin, containing four leaflets in the position of the normally bilamellar intraperiod line. The degree of the oligodendroglial abnormality was dose dependent, 25 per cent heated experimental allergic encephalomyelitis serum being the most potent. Frequently, in older cultures, large diameter axons, which under normal circumstances would have been well myelinated, were devoid of myelin sheaths although abundant aberrant myelin could be seen around nearby oligodendroglial cells. Rarely similar aberrant myelin was deposited around axons. It appeared, therefore, that the oligodendroglial cells had proliferated myelin which was unable to reach axons, possibly reflecting a failure in recognition between the two.


Adaptive responses of the pulmonary macrophagic system to carbon. II. Morphologic studies. The increased output of alveolar macrophages in response to a heavy load of particulate material is well known but the relationship of this cellular outpouring to the precise location of the particles is not clear. The present study utilized an overload situation in which 4 mg. of carbon were instilled into the lungs of mice; the sequential cellular events were correlated with the patterns of carbon transport over a 28-day period using light and electron microscopy. At 12 hours some free carbon crossed the type 1 cells to reach the interstitium; later it was observed in peribronchial and perivascular interstitial cells. In the alveoli, free macrophages were loaded with carbon but passage of these cells from airways to interstitium was never observed. The early increase in macrophagic output was related to monocytic migration from small pulmonary vessels. This initial cellular efflux may be a nonspecific inflammatory response that is possibly due to release of a chemotactic factor by the interaction of carbon with the type 1 cells. Maintenance of the large number of free macrophages appeared to be related to increased mitotic activity of the interstitial macrophagic population. Ii is suggested that the proliferative burst of these cells may be triggered by the arrival of free particles in the interstitium.


Alterations in rat jejunal permeability to a macromolecular tracer during a hyperosmotic load. The effects of intraluminal hyperosmolality on the intestinal permeability of a macromolecular tracer, horseradish peroxidase, was assessed in rats by light and electron microscopic cytochemistry. After 60 minutes of an intraluminal hypertonic perfusion of 600 mOsM mannitol, horseradish peroxidase was demonstrable in the intercellular spaces between adjacent absorptive epithelial cells of jejunal villi, along the microvillar brush border, in numerous pinocytotic vesicles, in multivesicular bodies, as well as in large lysosomes. Horseradish peroxidase was frequently found extending from the luminal surface of the cell through the tight junctional region and into more basal portions of the intercellular space. In occasional cells, fragments of the interdigitating plasma membranes of two adjacent absorptive cells appeared to bud off into the cytoplasm of one cell. In contrast, after 60 minutes of isotonic perfusion, horseradish peroxidase was confined to the microvillar brush border, a few pinocytotic vesicles, and occasional multivesicular bodies. These experiments suggest that the passage of macromolecules across the jejunal epithelium of adult rats is enhanced under conditions of luminal hyperosmotic stress. This may be due to an alteration in the functional integrity of the tight junctional macromolecular barrier or to an enhanced rate of pinocytosis.


Cholesterol in acute cholestasis induced by taurolithocholic acid. A cytochemical study in transmission and scanning electron microscopy. Rats were given intravenous injections of a single dose of sodium taurolithocholate, and an almost total cholestasis appeared after 10 minutes and lasted for 3 hours after the injection; then the choleresis began again and 24 hours after the injection, normal values of bile flow were restored. Ultrastructural analysis of the liver during the acute cholestasis and the restoration phase showed, beside usual modifications found in most cases of cholestasis, the "characteristic" alterations of sodium taurolithocholate-induced cholestasis. Cytochemical procedures were used, both in transmission and in scanning electron microscopy, in order to delineate the possible participation of free cholesterol in these cellular modifications. After Williamson's reaction procedure (Williamson JR:J Ultrastruct Res 27:118, 1969), not only were cholesterol-digitonin complexes found in large numbers, both in the hepatocytic cytoplasm and in the biliary canaliculi, but also their morphologic appearance revealed several new features: dark sticks and dark lamellae, frequently adsorbed on the outer surface of crystalline clear material were observed by transmission electron microscopy, and plugs, obliterating parts of biliary canaliculi, were observed using scanning electron microscopy. These observations seem to indicate that a significant amount of free cholesterol is released into the hepatocyte cytoplasm and into canalicular lumina within a few minutes after the infection of sodium taurolithocholate, probably originating from the hepatocytic membranes, especially from those limiting the canalicular lumen. Such a drastic modification in the chemical constitution of these membranes should coincide with a marked modification of their active and passive transport ability.


Plasma lipoprotein alterations and morphologic changes with lipid deposition in the kidney of patients with hepatorenal syndrome. Four patients with advanced liver disease and progressive renal failure compatible with the diagnosis of hepatorenal syndrome have been studied. All four patients had low lecithin:cholesterol acyltransferase activity in plasma, and the concentration of cholesteryl esters was markedly reduced. The main lipoprotein classes were abnormal with an increased content of polar lipids. Electron microscopy of negatively stained lipoproteins from two of the patients (H.K. and I.A.) revealed large particles with layered membranes (700 to 2000 A in diameter) corresponding to the large molecular weight fraction of the low density lipoproteins. These structures were not present in the low density lipoproteins from the other two patients. In the renal biopsy from H.K. and in the necropsy specimen from I.A.  deposition of osmophilic material was found in the glomeruli (especially located subendothelially), in the basement membrane, and in the mesangial regions. The deposits were similar to those we have previously described in patients with familial lecithin:cholesterol acyltransferase deficiency and most probably represent cholesterol and phospholipids. It is suggested that the renal deposition of lipid may be related to the large molecular weight low density lipoprotein fraction and that the mechanisms involved in this lipid deposition are similar to those occurring in familial lecithin:cholesterol acyltransferase deficiency.


Endothelial regneration. I. Quantitative analysis of initial stages of endothelial regeneration in rat aortic intima. The aortic endothelium is a naturally occurring monolayer which allows comparison between wound healing in the intact animal and similar phenomena studied with monolayers in tissue culture. We used the balloon catheter technique to abrade a defined portion of the lining of the aorta in rats. Proliferation and migration across the line of injury were quantitatively determined using tritiated thymidine autoradiography, incidenct light microscopy, and scanning electron microscopy. The findings in vivo differ from those in vitro in three ways: (1) The response in vivo is not limited to the line of injury. Cells up to 100 cells behind this line are stimulated to enter S phase and undergo a characteristic change in shape not seen in the tissue culture systems. (2) This same "regeneration zone" escapes normal controls on cell density, producing three times as many cells per unit area as in unstimulated endothelium. (3) Cell migration, but not proliferation, occurs preferentially along the axis of the vessel, equally well against and with blood flow. These findings differ from results of tissue culture studies and suggest that the "diffusion barrier" mechanism proposed for control of monolyaer regeneration in vitro does not explain contact inhibition of endothelium in vivo and that regeneration of endothelium is controlled either by factors released from the site of injury or by cell to cell interactions.


Transformation of monocytes into "fat" cells. Human peripheral blood leukocytes, when cultured in soft agar give rise to giant (100 to 500 micrometer.) "foam cells." Investigation of the origin and properties of the cells proved that they were derived from monocytes in that the cells adherent to glass after 24 hours in culture were phagocytic, elaborated lysozyme and bore receptors for complement and immunoglobulin. The increment in size was accounted for primarily by large inclusions which on histochemical and biochemical analyses were shown to consist predominantly fo neutral fat. Transformation to fat cells took place in the absence of mitosis. Fc receptors were retained but complement receptors were lost. These observations suggest a role for monocytes in the replacement of hematopoietic tissue by fat in certain hypoplastic states. The cultured monocytes may also serve to facilitate the study of fat synthesis and metabolism in vitro.


Structural characteristics of monologues in the speech of normal children: semantic and conversational aspects. Semantic and conversational aspects of monologues in the speech of normal children were investigated. Subjects were nine children, three each at Brown's language Stages I, II, and III. A two-hour language sample, containing alternations of dialogue with the examiner and monologue produced during independent play, was collected from each child. Results indicate that the semantic and conversational categories that occurred in monologue speech were similar to those that appeared in contextually matched dialogue speech but the proportional frequencies differed. Monoloque subsamples were generally short in length and had a sequencing pattern that was highly consistent and sematically organized. Results are discussed in terms of Piagetian cognitive theory and pragmatic language models.


Conversational aspects of the speech of language-disordered children: revision behaviors. Revision behaviors in the speech of language-disordered children were investigated. Subjects were 12 children, four at each of Brown's language States I, II, and III. During the taping of a one-hour spontaneous language sample from each child, one of the experimenters pretended 20 times not to understand and asked "What?". The relationship between the child's original utterance and his response to "What?" was analyzed. The results indicated a significantly greater use of revisions than repetitions or no responses at each stage and a pattern of revision behavior that was uniform across stages and qualitatively different from the previously reported patterns of normal children. The results are discussed in terms of the nature of languare disorder and its implications for pragmatic theories of language.


An experimental analysis of misarticulating children's generalization. Five children who produced /theta/ for /s/ substitutions as a misarticulation were trained to produce /s/ correctly in three syllables. Untrained exemplars of syllables and words were tested throughout baseline and training. The 60 probe items contained both spontaneous and imitated words and syllables combined with high, low, front, back, vowels, and consonants. A functional analysis reversal design was used, and the gernalization patterns were analyzed. The effect of context was found to be less influential than expected while other factors such as stimulability, amount of training, and subject characteristics appeared as important variables in generalization.


Children's use of spatial prepositions in two- and three-dimensional tasks. This study evaluates children's performance on selected spatial prepositions and determines the age levels these prepositions are acquired in both receptive and expresive language, as revealed in tasks involving both two- and three-dimensional objects. Subjects were 80 children (40 males and 40 females), ranging in age from three years to four years and eleven months. All were native English speakers with no speech, hearing, or neurological disorders, and with normal intelligence. Results indicated a significant difference in test scores according to age (older children perform better than younger), task (comprehension scores higher than production scores), referent (three-dimensional tasks showing higher scores than two-dimensional tasks), and preposition. Children's use of selected spatial prepositions is dependent on the semantic complexity of the preposition. Prepositions whose meanings can be described in terms of simple topological notions are understood and used with greater facility than those involving dimensional or Euclidean spatial notions. When the prepositional variable interacts with age, dimension, task, age + dimension, age + task, dimension + task, and age + dimension + task, overall differential response are likely to occur.


Acquisition of comprehension of the verb phrase anaphora construction. The verb phrase (VP) anaphora is a commonly used construction in English in which part of a sentence, including the verb, is replaced or deleted. The present study investigated comprehension of four types of VP anaphora constructions. Significant diffferences demonstrated that second graders performed better than first graders, and and first graders better than kindergarteners. Significant differences were also found among the different types of VP anaphoric constructions: VP deletion was easier than pro-form, pro-form was easier than prosententialization, and prosententialization was easier than gapping. Implications for evaluation of language, and specifically evaluation of comprehension of language for learning, are discussed.


An ultrasonic--EMG transducer for biodynamic research. This note describes a newly developed single-element muscle action potential/motion transducer. The transcuer was specially designed for speech research. Techniques for use of the transducer are described. Sample data are presented illustrating the capability of the transducer, and applications of the device are discussed.