[Medications during psychotherapy (author's transl)]. The report is on medication in a specialized clinic for psychotherapy. The most important findings are the following: 1. The medications in the clinic in question are not more numerous than they are "on the outside" (=per capita consumption in the case of members of the compulsory health insurance); 2. personality sumptoms have great influence on the frequency of medicine given: older patients receive more medication than younger ones, women more than men. Obsessionally structured patients receive noticeably less medicine than the hysterically or depressively structured ones; 3. symptomes hardly have any influence: no decrease during the second half of therapy, no dependence on any fixed day of the week and the therapy hour. It is therefore concluded that with a totally smaller quantity the medications in the clinic in question show autonomy: they have evidently no direct relation to the psychotherapeutical course of treatment.


Barrier contraceptive practice and male infertility as related factors to breast cancer in married women. A case-control study was conducted in order to test the hypothesis that a reduced exposure to human seminal factors in the early reproductive life of women is a risk factor in breast cancer. The relative risk of exposure to the hypothetical semen-factor deficiency is 4.7 times greater for breast-cancer patients than for the controls. When the contraceptive methods alone are taken into account, the relative risk increases up to 5.3. About 16 percent of the women using barrier methods (condom, and other) and 3.4 percent of women using non-barrier contraceptive methods (diaphragm, pill, IUDs, rhythm, tubal ligation, and other) would develop breast cancer. The risk of developing breast cancer within the same population in the U.S. is 5 times greater in women who use barrier methods than in women who use non-barrier contraceptive methods. The reduction in the incidence of breast cancer by eliminating the barrier contraceptive techniques would be not less than 50 percent in married women in the entire population. The possibility of preventive measures within an adequate family planning program is emphasized.


[Morbidity patterns in a non-German population (migrant workers) (author's transl)]. Differing patterns of morbidity are demonstrated in a group of 181 foreign patients (from Turkey, Jugoslavia, Portugal, Italy, Spain) compared to an age matched group of native Germans hospitalized during a given time in the meidcal department of a regional urban hospital. In non-Germans peptic ulcers and severe infections more often lead to hospitalization than native patients. The expected statistical frequency of hospitalization is not different in the two groups investigated. Epidemiologic differences between the two populations are demonstrated by a higher percentage of tuberculosis and work accidents in the foreign group. At present there are no special obstetric problems leading to differing maternal or neonatal mortality. Concomitant imported infections do lead to complications in single cases in the foreign patient group. Parasitic infestation is more often found in the foreign group. Herditary diseases such as minor thalassemia or G-6-PD deficiency are rare as well in foreign patients. Chain infections due to imported poliomyelitis wild virus or salmonellosis have been observed in the foreign population. Epidemiologic progress may be highlighted by the decreasing percentage of hepatitis A and B antibody-positive-population in the central European countries.


[Drug prescription and distribution on the wards. Evaluation of questionnaires (author's transl)]. Weaknesses in the practice of drug prescription and distribution on the wards are presented as the result of this survey. Suggestions for improvement are made which seem suitable for increasing drug safety and reducing drug costs. It should be possible to implement the suggested improvements without much expense. Probably, these improvements would hardly involve any additional time expenditure, since complete documentation, as suggested inter alia, might eliminate time-consuming queries and searching.


A theory on the differentiation of bone-marrow stem cells. Differentiation of pluripotent stem cells is viewed in parallel with maturation of lymphoid cells. Both processes share many features each occurring within a reticular framework with its component RE cells. RE cells are seen as providing control over stem cell differentiation in marrow thus minimizing stem cell competition by concentrating differentiation stimuli of a particular kind. The differentiation molecules are considered to be histocompatibility and tissue specific antigen components derived from aging or activated mature blood cells. They are probably low molecular weight glycoproteins. Evidence that histocompatibility antigens are of importance in cellular differentiation is presented. The hypothesis presupposes positive feedback mechanisms to bone-marrow with threshold responses being determined by RE cells.


[Results of screening for risk factors in a rural community (author's transl)]. 515 women and 372 men from a rural community of 2862 inhabitants over 14 years volunteered to participate in a screening test for risk factors. We found an exceptionally high percentage of hypertension and hypercholesterolaemia as well as overweight. Women were more frequently affected than men except for smoking, which occurred 3,6 times more often in men than in women. Since the life expectancy of men in this community was clearly lower than that of women, smoking seems to have the most weight as a risk factor for cardiovascular diseases.


[Hemagglutinins and immunoglobulins in surgical patients and blood donors (author's transl)]. In our investigations 60 patients with severe consuming surgical illness and 61 patients with tumors, especially of the bowel, have shown distinctly higher values of hemagglutinins and immunoglobulins than 60 other patients with slighter disease and 1181 healthy blood donors. Therefore we conclude that those are able to form much more humoral antibodies as supposed up to now, inspite of their severe illness. The stimulation of their immune-system may be caused by resorption of intestinal mucosa, containing compounds identical to the bloodgroup substances A and B, from ulcera and during surgery, or by resorption of similar bacterial antigens e.g. Common-Antigen. The good humoral situation of the tumor patients contrasts to their supposed insufficient cellular immune defense, not tested by us. Therefore the BCG stimulation is only necessary if an insufficient cellular immune situation is proved. X-rays and cytostatica used without severe indication, will destroy the humoral antibodies found by us.


[Prognosis of thyroid carcinoma (author's transl)]. Out of more than 5200 struma resections 2.2% were treated because of thyroid carcinoma. Over a 12 year' period records of 117 patients were analysed. Treatment consisted in radical thyroidectomy, radioactive iodine or radiation therapy and hormone-substitution. Differentiated carcinomas were observed more frequently, primarily extended disease decreased. The mean 5 year survival rate of differentiated tumours was 90%. Changing patterns in thyroid carcinoma, consequent postoperative care and modern radiotherapy after radical thyroidectomy without routine neck-dissection had a favourable effect on these results.


[Postoperative hyperamylasemia: determination of serum isoamylases following surgery of the parotid gland (author's transl)]. Postoperative hyperamylasemia is found in 6 to 32% of patients undergoing abdominal and extraabdominal surgery. The minority of these patients exhibited the clinical signs of a postoperative pancreatitis. Isoamylase analysis revealed that the rise was in the pancreatic-type isoamylases or in the salivary-type isoamylases. We found an elevation of serum amylase following surgery of the parotid gland in 18 out of 20 patients, but the amylase levels were still below the normal upper limit. In 12 cases the increase of amylase activity was due to an increase of the salivary and pancreatic components of the serum amylase. 6 patients showed an increase of the pancreatic component only. The causes of the non-specific hyperamylasemia could lie in the operation itself, in the intubation and in pharmacons used during anaesthesia.


Fine structure of the arg-7 ciston in chlamydomonas reinhardi. Complementation between arg-7 mutants defective in argininosuccinate lyase. In Chlamydomonas reinhardi, the arg-7 cistron is the structural gene for the enzyme argininosuccinate lyase which catalyzes the last reaction in the biosynthesis of arginine. Fourteen mutants (nine previously analyzed and five new mutants) defective in the lyase have been investigated so far: they all map within a cistron (length: 1.0--1.6 recombination units) of the linkage group I and fall within six groups of complementation. The enzyme activity found in the diploids formed by intragenic complementation was always lower than in wild-type haploid or diploid strains. The study of the denaturation curves obtained by heat treatment of the lyase indicates that in some diploids, several enzyme varieties can be present. These results and those previously obtained with diploids formed by intragenic and intergenic complementation (Matagne and Loppes, 1972; Matagne, 1976) are discussed in relation to the recent data showing that the argininosuccinate lyase is a multimeric enzyme probably composed of five identical polypeptide chains (Matagne and Schlösser, 1977).


Effect of drugs on oxidation and precipitation of the isolated chains of human hemoglobin. The paper deals with the action of: primaquine, epinephrine, adrenochrome, acetylphenylhydrazine and sulphanilamide on the autoxidation of the isolated chains from human hemoglobin and on the precipitation which follows. The effect of superoxide dismutase and catalase on the drug induced autoxidation allows the assessment of the possible role of O2 derivatives (notably superoxide or peroxide) in the overall reaction mechanism. It is also shown that primaquine and acetylphenylhydrazine enhance precipitation of the isolated oxidized chains, while epinephrine and adrenochrome display a small inhibitory effect on precipitation. These effects do not involve O2 radicals, but have presumably to be related to a destabilizing (or stabilizing) action of the drugs on the structure of the protein.


Phospholipid composition of human erythrocyte spectrin. Human erythrocyte spectrin, which has been extracted at low ionic strength and precipitated at pH 5.1, contains 0.025 mumoles phospholipid/mg protein. The composition of the spectrin-phospholipids differs from that of the erythrocyte membrane. A remarkable similarity was found between the composition of the "available" phospholipids of the inner leaflet of the membrane bilayer and the spectrin-associated phospholipids. Rebinding studies with 125I-labeled spectrin show that the labeled spectrin binds preferentially to the cytoplasmic side of the membrane and that this binding is influenced by protein perturbations.


The influence of Ca2+ ions on the difference absorption spectra of phosphorylase kinase. A low iodide concentration causes a positive difference band in the 250-260 mm UV range. The effect of Ca2+ changes the direction of difference spectra. The concentration dependence is explained by multistage interaction. The addition of EDTA the solution restores the positive band.


Preparative density gradient centrifugation of RNA and DNA in cesium sulfate-urea mixture. A new procedure is described for a large scale separation and purification of unfixed DNA and RNA from a mixture of partially extracted nucleic acids and lysates of subcellular fractions by centrifugation to equilibrium in cesium sulfate-urea mixture. Optimum conditions are described for the separation and quantative recovery of both RNA and DNA in a pure form. The procedure allows determination of peak buoyant densities of 4-5s RNA, 7-11s mRNA and total cytoplasmic RNA. The procedure also allows fractionation of small molecular weight classes of cytoplasmic RNAs from the 18s and 28s rRNAs.


[Results of immunotherapy in 244 children with asthma or allergic rhinitis (author's transl)]. The results of immunotherapy in 244 children with asthma or allergic rhinitis have been evaluated by means of a questionaire directed at the parents. 86,9% of the children showed improvement. Additional information has been obtained about the side-effects of therapy--2,9% regularily showed dyspnoea--, the severity of symptoms before treatment and the influence of age on the above mentioned parameters. The results are discussed, compared with similar studies in adults and possible consequences for future diagnostic measures and therapy are proposed.


[Toxicity of cyproheptadine. Side effects and accidental overdosage (author's transl)]. 113 cases of accidental ingestion of cyproheptadine (Nuran) by children have been evaluated. Life threatening alterations have not been observed after doses ranging from 0.3-6.15 (x:1.89) mg per kg of body weight. Somnolence, excitation, hallucinations, ataxia, tachycardia, and muscle twitchings were observed frequently, and occasionally gastric pain, dry mucuous surfaces, mydriasis, and rubeosis of the face were present. Symptoms appeared rapidly after ingestion and generally did not last longer than 6-12 h. When given in therapeutic doses, cyproheptadine reduces the secretion of ACTH, cortisol, prolactin, and growth hormone, lowers blood glucose concentrations, and raises the levels of unesterified free fatty acids. Parents frequently complain about unsatisfactory eating habits of their children, but chronic lack of appetite needing therapeutical attention, in healthy children, is the rare exception. Cyproheptadine is an agent with considerable side effects, and it should be prescribed to children only after very careful deliberation.


[Acute viral hepatitis in children. Contribution to the epidemiology of HBsAg-positive and -negative hepatitis (author's transl)]. Between 1968 and 1975 146 patients were admitted to the Würzburg University Hospital for Children because of acute viral hepatitis. 123 (85%) turned out to be HBsAg negative (hepatitis non-B), and 23 (15%) HBsAg-positive (hepatitis B), when tested by solid-phase radioimmunoassay. Subtyping HBsAg revealed a trend from subtype D- towards subtype Y-infections. Analyzed retrospectively, 23 of the non-B and 6 of the B patients apparently had contracted their infection from family or household contacts. Amongst the hepatitis non-B patients, another 16 had contacts at school or nursery school, and 12 had spent their holidays in mediterranian countries. In any type of hepatitis 8 patients previously had been in hospital; in 4 of the 8 non-B cases hepatitis type non-A-non-B is discussed. All the persons who were the suspected source of infection for hepatitis non-B seemed to have suffered from acute hepatitis, while in hepatitis B the only two who could be traced, appeared to be chronically infected. In the Würzburg area, hepatitis non-B, most likely A predominated during infancy whilst adults mostly suffered from hepatitis B. These differences are discussed.


[Beclomethasone dipropionate seasonal allergic rhinitis treatment of children. A double blind cross over study (author's transl)]. In a double-blind cross over study on 25 children with seasonal allergic rhinitis treatment with Beclomethasone dipropionate (BDP)-Aerosol was found more effective than placebo. 17 children preferred BDP, two the placebo-aerosol, while 6 had no preferrence. During a period with very high pollen concentrations in the air the effect of BDP-therapy was no longer sufficient.


[Use of the flow-guided catheter to check the course of congenital heart-disease in children (author's transl)]. Since 1968 a flow-guided-catheter (Pulmocath) was used in 326 examinations of 217 children. This is an excellent method to control the course of congenital heart disease. The findings of children with pulmonary stenosis and with ventricular septal defect are discussed.


[Digoxin intoxication in newborns correlation with digoxin plasma concentration (author's transl)]. During childhood digitalis glycosides are most frequently used during the newborn period. Within two years, we found evidence of digoxin intoxication in eight newborns. This was suspected when specific electrocardiographic signs developed under digoxin treatment and disappeared either after discontinuation of digoxin alone, or in combination with specific treatment. These eight newborns had plasma digoxin concentrations of 5 ng/ml or more, while the concentrations in unaffected newborns averaged 2.4 ng/ml (premature newborns) and 2.2 ng/ml, (mature newborns). The clinical and pathophysiological features of digoxin intoxication specific to the newborn period are discussed. Despite certain limitations it seems reasonable to check plasma digoxin concentrations during the newborn period, since clinical and electrocardiographic manifestations of a digoxin intoxication are frequently unspecific at this age. A digoxin intoxication is very likely with plasma digoxin concentrations of 5 ng/ml or more, but unlikely with concentrations below 3 ng/ml.


[Case report of a twin-monster, dicephalus, dibrachius (author's transl)]. The dicephalus dibrachius twin malformation is a rare developmental anomaly. Spontaeous birth is impossible. Prenatal diagnosis of this condition is difficult though essential to prevent danger to the life of the mother. Radiological examination before birth is necessary. Auscultation and bimanual examination only may lead to the erroneous diagnosis of a twin pregnancy, as in this case, where in the end a cesarean sectionwas performed because unseparated twins were suspected.


Unusual dose--response of chromosome abberrations induced in human lymphocytes by very low dose exposures to tritium. Leukocyte cultures of human peripheral blood were chronically exposed for 48 h to tritiated water and [3H]thymidine using a wide range of tritium doses, and aberrations in lymphocyte chromosomes at the first metaphases were examined. In the experimental conditions, the types of aberrations induced by radiation emitted from both tritiated water and [3H]thymidine were mostly chromatid types, such as chromatid gaps and deletions. The dose--response relations for chromatid breaks per cell exhibited unusual dose-dependency in both cases. It was demonstrated that at higher dose range the yields of chromatid breaks increased linearly with dose, while those at lower dose range were significantly higher than would be expected by a downward extrapolation from the linear relation. Partial-hit or partial-target kinetic events appears at very low dose exposure.


Mutagenic and chromosome-breaking effects of azide in barley and human leukocytes. Azide (10-3 M, solution buffered at pH 3) is more effective in inducing mutations in embryonic shoots of seeds germinated between 8 and 16 h than in non-germinated seeds and in seeds germinated between 0 and 8 h and 16 to 28 h. This peak of chlorophyll-deficient seedling mutation frequency coincides with maximum frequencies of seeding lethals and DNA replication in the cells of the embryonic shoot. The mutation data suggest azide may only act on replicating DNA. Azide induced no chromosome-aberration frequencies significantly above controls in (1) embryonic shoots of barley seeds germinated for 8--12 h, (2) microspores of barley and (3) human leukocytes. It appears to be a point-mutation mutagen.


Studies on chemically induced dominant lethality. III. Cytogenetic analyses of TEM-effects on maturing dictyate mouse oocytes. A comparative cytogenetic study was done on metaphase-I oocytes and first cleavage mitoses following treatment of young mature female mice with triethylenemelamine (TEM). The ova were collected at intervals ranging from 12 h to 10.5 days after single intraperitoneal injection of TEM. Very few structural aberrations were seen in the metaphase-I cells after TEM treatment. There was, however, a very clear effect on the female genome when first cleavage mitoses were analyzed. The aberrations seen were principally chromatid deletions and interchanges, and their frequency varied with dose and the time between treatment and mating.


The effects of busulphan on the chromosomes of normal human lymphocytes. In vitro exposure of human lymphocytes to busulphan (BUS) produced an increase in chromosome aberrations and in sister-chromatid exchange (SCE) frequency. The distribution of chromosome breaks throughout the karyotype was non-random and they occurred mainly in the G-negative bands. Certain bands had a marked susceptibility to BUS and comparisons with the human chromosome-break distributions reported for a number of drugs revealed that some of these bands were equally susceptible to other alkylating agents. Both the number of chromosome gaps and breaks and the SCE frequency increased with BUS concentration, but only the SCE dose--response was a clearly defined linear relationship. Therefore a standard SCE dose--response curve was constructed for future comparison with the results of similar investigations of patients on BUS therapy.


The effects of high and low fluoride diets on the frequencies of sister chromatid exchanges. A recent report suggests that fluoride has mutagenic activity in mice. To examine the potential clastogenic effect of ingested fluoride, we examined the frequencies of baseline SCE and mitomycin C induced SCE as well as baseline chromsomal aberrations and cell-cycle kinetics in mice raised on high and low fluoride diets. The lack of significant differences in any of these parameters between the two groups of animals indicates that dietary fluoride is not clastogenic and supports the continued use of water fluoridation.


The use of short-term tests to measure the preventive action of reducing agents on formation and activation of carcinogenic nitroso compounds. The effect of reducing agents on the nitrosation of methylguanidine (MG) and on the in vitro activation of dimethylnitrosamine (DMN) was examined by measuring DNA-repair synthesis (unscheduled incorporation of [3h]TdR), shifts in alkaline sucrose gradients, frequency of chromosome aberrations, and clone-forming capacity of cultured human fibroblasts. The reducing agents examined were sodium ascorbate, cysteine, cysteamine, and propyl gallate. Since the short-term bioassays used can be quantitated, it has become relatively easy to detect the inhibitory action of reducing compounds on the nitrosation reaction of MG and metabolic activation (with S-9 preparation) of the precarcinogen DMN, to measure their effective dose range, and to establish the most effective ratios between inhibitory agent and reactant. The results indicate that DNA-repair synthesis is a suitable short-term test for studying the numerous combinations and premutations between several carcinogenic or non-carcinogenic agents, and for estimating the capacity of inhibitory agents to affect formation and activation of chemical carcinogens.


Mutagenic effect of orally given AF-2 on embryonic cells in pregnant Syrian hamsters. Pregnant hamsters were given various doses of AF-2 by stomach tube; then the cells of their embryos were isolated and cultured in normal medium. Chromosome preparations were made within 24 h after the start of primary culture, and examined for chromosomal aberrations. Marked chromosomal abnormalities were observed in cells of embryos of animals treated with AF-2 at over 20 mg/kg. Samples of surviving cells were also cultured in normal medium for 48 h, and then selected in medium containing 8AG or 6TG. This treatment with AF-2 caused marked dose-dependent induction of 8AG- or 6TG-resistant mutations: mutant colonies were even obtained after a single treatment with 2 mg of AF-2 per kg. These results show that this is a sensitive and useful mammalian system for detecting environmental mutagens.


Hemolytic-uremic syndrome after shigellosis. Relation to endotoxemia and circulating immune complexes. To investigate three possible causes of the acute hemolysis in the hemolytic-uremic syndrome, we studied prospectively 207 children and 34 adults with shigellosis in Bangladesh. Nineteen children showed acute hemolytic anemia, a leukemoid reaction, thrombocytopenia and oliguria; nine other had, in addition, a serum urea nitrogen level of over 100 mg per diciliter. Eight of the nine had pseudomembranous colitis, and six of the nine died. The frequency of bacteremia was similar in all grades of shigellosis. Circulating immune complexes were found in 10 of 20 patients with uncomplicated shigellosis and in four of six with severe hemolytic-uremic syndrome. Limulus assay for endotoxemia was positive in nine of 18 patients with hemolysis (50 per cent) and three of 61 with uncomplicated shigellosis (5 per cent) (P less than 0.001). These data support the hypothesis that severe colitis in shigellosis is associated with circulating endotoxin from the colon producing coagulopathy, renal microangiopathy and hemolytic anemia.


Normal chest roentgenograms in chronic diffuse infiltrative lung disease. We undertook this study to determine the prevalence of normal roentgenograms in chronic diffuse infiltrative lung diseases. Of 458 patients with such disorders histologically confirmed, 44, or 9.6 per cent, had normal pre-biopsy films. In this group with normal x-ray films, desquamative interstitial pneumonia, sarcoidosis and allergic alveolitis were the most frequent diagnoses. Dyspnea was the principal complaint, and fine rales were common. The vital capacity was reduced in 57 per cent, and the single-breath diffusing capacity in 71 per cent. In half, histological changes and functional impairment were moderately severe. Films may be normal in such cases because isolated foci are too small or too few, because diffuse interstitial or intra-alveolar disease may cast no discrete shadows or because the lesions primarily affect airways or blood vessels. Patients with normal chest roentgenograms and normal mechanics of breathing but with impaired gas exchange should have lung biopsy for early diagnosis and therapy.


The Passovoy defect: further characterization of a hereditary hemorrhagic diathesis. We studied a coagulation abnormality present in 12 members of five kindreds who bruised easily and bled excessively after minor trauma. Their activated partial thromboplastin times were between 32 and 39 seconds (normal, 22.8 to 28.8 seconds). Prothrombin times, thrombin times, platelet-function tests and the levels of factors XII, XI, IX, VIII, prekallikrein and high-molecular-weight kininogen were normal. Within these kindreds inheritance of prolonged partial thromboplastin times followed an autosomal and probably dominant pattern. The prolonged thromboplastin times were corrected by normal plasma and by normal plasma adsorbed with celite, but there was no mutual correction between plasmas of the patients. These subjects shared a common defect in the intrinsic pathway of coagulation that we designate by the proband's surname, Passovoy.


Factors predisposing to oropharyngeal colonization with gram-negative bacilli in the aged. To assess the factors responsible for oropharyngeal colonization with gram-negative bacilli among elderly persons in institutions, we performed a cross-sectional survey of 407 volunteers, 65 years of age and older, who had not received antimicrobials in the previous four weeks. Colonization increased with level of care: from 9 per cent in independent residents of apartments to 60 per cent in patients on an acute hospital ward (P less than 0.0001). Klebsiella species was found in 41 per cent of those with colonization, Escherichia coli in 24 per cent and enterobacter species in 14 per cent. There was no association between numbers of normal flora and numbers of gram-negative bacilli. Associated with colonization were bladder incontinence, deteriorating or terminal clinical status, inability to walk or perform activities of daily living and incapacitation due to neoplastic, respiratory and cardiac disease (P less than 0.05). Multivariate analysis indicated that respiratory disease and being bedridden contributed most to colonization.


Mortality in selected cities with fluoridated and non-fluoridated water supplies. Mortality rates (for blacks and whites only) in 24 cities with fluoridated and 22 with non-fluoridated water supplies in the United States were compared for the years 1969-1971. During these three years 570,671 deaths occurred in the cities with fluoridated water; the 1970 reference population in those cities was 15,972,817. The figures for the cities with non-fluoridated water were 351,053 and 11,106,746 respectively, so that the crude death rates for all causes were 1190.9 (fluoridated) and 1053.6 (non-fluoridated) per 100,000 person-years. Adjustments for age, sex and race reduced differences for some causes and removed them for others. Further correction, using analyses of covariance for city characteristics that influence mortality, gave adjusted death rates for all causes of 1123.9 and 1137.1, and for malignant neoplasms 195.3 and 196.9, in the cities with fluoridated and non-fluoridated water respectively. I found no evidence of a harmful effect of fluoridation.


Myasthenic antibodies cross-link acetylcholine receptors to accelerate degradation. The decrease of acetylcholine receptors at neuromuscular junctions of myasthenic patients has been attributed to an antibody-mediated autoimmune process that accelerates receptor degradation. We studied the mechanism of this process in skeletal-muscle cultures, using intact antibodies and antibody fragments. Addition of myasthenic IgG or its divalent fragment, F(ab')2, to cultures accelerated the rate of acetylcholine-receptor degradation threefold. By contrast, the monovalent fragment, Fab, from myasthenic serum had no effect on degradation, although it bound to acetylcholine receptors. Addition of a second, "piggyback" antibody to cross-link the Fab:receptor complexes resulted in a threefold increase of the degradation rate. Similarly, when acetylcholine receptors with bound alpha-bungarotoxin were cross-linked by the addition of specific antibody against alpha-bungarotoxin, the degradation rate increased approximately threefold. The effect of myasthenic patients' antibodies in accelerating degradation of acetylcholine receptors is attributed to their ability to cross-link the receptors.


Prediction of chain turns in globular proteins on a hydrophobic basis. Peptide chain turns are those parts of a globular protein where the backbone changes its direction. A simple, non-empirical hypothesis is presented to account for both the turns and the hydrophobic core of the protein using only the amino acid sequence.


DRB-induced premature termination of late adenovirus transcription. Exposure of HeLa cells to 5,6-dichloro-1-beta-D-ribofuranosylbenzimidazde (DRB) late in the course of adenovirus 2 infection results in the inhibition of virus-specific RNA synthesis from all parts of the previously identified, very long (approximately 28 kilobases) late transcriptional unit, except for the first approximately 400-800 nucleotides. It is suggested that DRB acts not as an inhibitor of RNA chain initiation, but rather causes "premature" chain termination close to the promoter. A practical aspect of these findings may be that RNA sequences near promoter sites that are responsible for mRNA formation can be isolated from DRB-treated cells.


Mechanism of resistance to thiostrepton in the producing-organism Streptomyces azureus. An antibiotic-producing organism, Streptomyces azureus, defends itself against its own toxic product by methylating the RNA of its ribosomes.


Why do nucleic acids have 3'5' phosphodiester bonds? Details of the stereochemistry of the 2'5' and 3'5' dinucleoside monophosphates of polynucleotides have been delineated in aqueous solution using nuclear magnetic resonance spectroscopy. Incorporation of these experimentally determined geometries into the structure of polynucleotides reveals that the intrinsic spatial configurations of the 2'5' bonds cannot support helical structures whereas the geometries of 3'5' bonds allow the formation of helical configurations for RNA.


The covalent and tertiary structure of bovine liver rhodanese. Bovine liver rhodanese is a single polypeptide of 293 amino acids in which the halves of the molecule assume analogous tertiary structures in the absence of substantial sequence homology. The sulphur atom transferred during catalysis is bound in persulphide linkage to Cys-247. Substrate binding seems to involve Arg-186 and Lys-249.


Nucleotide sequence and secondary structure of potato spindle tuber viroid. The viroid of the potato spindle tuber disease (PSTV) is a covalently closed ring of 359 ribonucleotides. As a result of intramolecular base pairing, a serial arrangement of double-helical sections and internal loops form a unique rod-like secondary structure. PSTV is the first pathogen of a eukaryotic organism for which the complete molecular structure has been established.


Relation between the chemical structure and acute toxicity of 1-phenyl-3-methyltriazenes as activated metabolites during the carcinogenic action of 1-phenyl-3,3-dimethyltriazenes. The mol LD50 values were correlated with Hammett sigma constants in terms of the Hansen empiric equation 6 for para substituted derivatives of 1-phenyl-3-methyltriazene. Good agreement was achieved and the line slope of the correlation, 0.3, is the same as that found during an identical experiment with derivatives of 1-phenyl-3,3-dimethyltriazene [1]. This is an indirect evidence that the considered mechanism of the interaction with biological substrate goes through the "activated carcinogen" - derivatives of 1-phenyl-3-methyltriazene, formed through the oxidative N-demethylation of the initial 1-phenyl-3,3-dimethyltriazenes.


The effects of continous irradiation on histological picture and deoxyribonucleoprotein content in spleen of rats. The histological picture and deoxyribonucleoprotein (DNP) content in the spleen of the white male Wistar rats continuously irradiated with the daily dose rates 9.57 mGy (1 R), 95.7 mGy (10 R), 478.5 mGy (50 R) and 657.0 mGy (100 R) were studied. The animals were examined within the day until 60 of irradiation. The number of lymphocytes permanently decreased at the daily dose rates 95.7 mGy and higher ones. The increased activity of reticulum with the simultaneous multiplication of the erythroid cells in the red pulp of spleen was observed at day 10 and 60 of irradiation with 9.57 mGy and 95,7 mGy. Simultaneously DNP content in spleen increased in accordance with the increased activity of reticulum and extramedullar erythropoiesis. The significant decrease in DNP content alter the onset of irradiation with the daily dose rates 478.5 mGy and 957.0 mGy was caused mainly by the fall of lymphocytes. The incidence of eosinophilic leukocytes increased from day 40 irradiation with the daily dose rates 9.57 mGy, 95.7 mGy and 478.5 mGy and decreased with the daily dose rate 957.0 mGy. The plasma cells tended to increase in accordance with the increasing accumulated dose of irradiation with all daily dose rates.


Inhibition of leukocyte migration by tumor-associated antigen and its modification by serum; IgA as a blocking factor. Based on the investigations of patients the migration inhibition assay proved to be a useful method for the detection of antitumorous cellular immunity. Out of the twenty patients tested 15 gave migratory inhibitory effect against specific tumor antigen. In 8 cases out of the above 15 the blocking activity of sera has been proved. This blocking activity is bound to IgA subclass. The complement played an "unblocking" role. The modifying role of serum factors in cellular immunity against tumors was discussed.


Individual serum proteins and acute phase reactants in monoclonal immunoglobulinopathies (a study in patients with IgG myeloma). In 92 patients with multiple myeloma and IgG monoclonal proteinemia concentrations of seventeen different serum proteins were specifically determined. Prealbumin, albumin, alpha, HS-glycoprotein, alpha-macroglobulin, transferrin and immunoglobulins IgA, IgM and IgD were significantly decreased in patients with IgG myeloma. On the contrary the means found for the typical acute phase proteins i.e. haptoglobin, orosomucoid and CRP were significantly elevated. No significant differences were demonstrated for less typical acute phase protients, i.e. alpha1-antitrypsin, ceruloplasmin and C3-component as well as for hemopexin and beta2-glycoprotein I. CRP values were strongly elevated in some sera, however in majority of patients they were within the normal limits. Negative correlation was found between monoclonal IgG and the most of the studied proteins inclusive immunoglobulins IgA, IgM and IgD. No correlation was demonstrated between the monoclonal IgG and the triad of typical acute phase proteins. Positive correlation was found between monoclonal IgG and the total serum protein and further among the proteins negatively correlated with monoclonal IgG as well as among the individual acute phase proteins. Explanation of the correlations reported has been suggested.


Pharmacokinetics of butocine.

Pharmacokinetics of butocine. The pharmacokinetics of Butocine (glycine, N-[1-oxo-5-(1H-purin-6-ylthio)pentyl], ethyl ester) was studied in 8 individuals with malignant tumor after a single oral dose of 500 mg. Butocine is quickly absorbed from the alimentary tract. Highest serum levels were found 45 minutes after administration. Its urinary excretion is very low (2.5 per cent in 15 hours), 1.7 per cent being eliminated 3 hours after administration. Its renal clearance is likwise very low, i.e. 1.5 ml/min compared with endogenous creatinine clearance of 81.2 ml/min.


Drill biopsy in the diagnosis of metastic and primary neoplasms of lymph nodes. The author analyses the results of 300 drill biopsies, performed on peripheral lymph nodes of 266 patients. The usefulness of this method in the histological diagnosis of metastatic and primary neoplasms of lymph nodes is assessed. Drill biopsy proves to be especially valuable in the diagnosis of metastatic cancer. By means of the first biopsy, 90.4% of cases of metastatic cancer were diagnosed. In the great majority of cases, the histological type of metastatic neoplasms was precisely defined. Accuracy in the diagnosis of malignant lymphomas was lower. Drill biopsy of peripheral lymph nodes can be performed in outpatients.


Anaplastic transformation of medullary thyroid cancer. The paper presents a detailed microscopic study of a case of medullary thyroid carcinoma with the loss of amyloid production and of argyrophilic cellular granules combined with the prevalence of giant multinucleated cells in a part of the primary tumor and namely in metastatic deposits. These changes are believed to give evidence of anaplastic dedifferentiation. Similar cases to that reported are reviewed with the conclusion that not only differentiated thyroid cancers but medullary thyroid cancers as well are capable of anaplastic transformation. However rare the medullary thyroid cancers are, they should be diagnosed and radically treated so as to prevent their fatal anaplastic transformation.


Porphyria cutanea tarda-like syndrome in hemodialyzed patients. Among 500 patients on maintenance hemodialysis, 6 patients (5 young women and a 49-year-old man) developed bullous dermatosis, 2-54 months after initiating dialysis treatment. The skin lesions occurred mainly in sunlight-exposed areas, and 4 out of the 6 patients showed increased cutaneous fragility in response to trauma. Skin biopsy revealed subepidermal blisters for all of them, and skin immunofluorescence studies were negative for 2 patients. No increase in fecal or red cell coproporhyrin and protoporphyrin levels was found in any of the 6 patients. The syndrome was clinically and histologically indistinguishable from porphyria cutanea tarda.


Measurement of urinary renin activity by radioimmunoassay: sequential studies in acute renal failure in man. Urinary renin activity (URA) was measured by radioimmunoassay in sequential studies of 5 patients with acute renal failure (ARF) and in 13 normal volunteers. URA was elevated during the oliguric phase of ARF and fell to low levels prior to resolution of oliguria. Plasma renin activity (PRA) varied approximately in response to changes in intravascular volume status. In normal volunteers, the very low URA values did not change following furosemide-induced increases in PRA. A simple, rapid, and accurate method is described for the measurement of URA in humans by radioimmunoassay of angiotensin I generated during incubation of urine with homologous plasma substrate. The urinary enzyme exhibited the same properties as purified human renal renin and the incubation product appeared identical to angiotensin I standard. Renin activity in urine was directly proportional to enzyme concentration and no evidence was obtained for interference from other proteolytic activities or from inhibitors or promoters of renin in urine.


Diabetic nephropathy: clinical course and effect of hemodialysis. The clinical course of diabetic nephropathy was evaluated in 150 patients and the effect of hemodialysis in 68 of them. Proteinuria was the first sign of renal disease. Once renal dysfunction becomes evident, there is a rapid deterioration leading to dialysis within 3.0 +/- 0.2 years. Hypertension and circulatory congestion are common complications. The hypertension is probably volume dependent. Retinopathy was not invariably present at the onset of renal insufficiency but appeared with progression of renal failure. The course during hemodialysis was complicated by continued progression of diabetic vascular disease manifested by vascular access difficulties, worsening of retinopathy and blindness, and cardio- and cerebrovascular deaths. Mortality was higher than in nondiabetic dialysis patients.


[Oligodendroglioma. Clinical course in relation to histological grading]. The history of 99 patients, operated on for oligodendroglioma, has been related to the microscopic picture of the tumours which were graded in three stages of malignancy. Clinical course and histological grading fit together well. Certain signs and symptoms correlate with the kind of tumour. The prognosis in oligodendroglioma is as bad as in astrocytoma. The danger of recurrence is high, even after radical operation. Radiation therapy is useless.


The analysis of the intracranial pressure by the concept of the driving pressure from the vascular system. In order to understand the pathogenesis of intracranial hypertension, the intracranial pressure (ICP) has usually been studied with the concept of volumetric pressure. In other words, the ICP is held to derive from the volume of the intracranial elements (e.g., brain, blood and cerebrospinal fluid). In this paper, the authors propose a new concept of the so-called driving pressure and apply it to both clinical and experimental studies. The driving pressure (DP) consists of the combined pressure continuously exerted on the ICP by the arterial pressure (ADP) and venous pressure (VP) systems.


Cavernous angiomas of the skull.

Cavernous angiomas of the skull. The authors present a series of 25 cases of haemangioma of the skull and review the literature. Frontal localization was the most frequent, contrary to the data in the literature which suggest predominance in the parietal region. The reported predominance of females has not been confirmed. In the present series the relation of males to females was 17:8. The radiological findings and treatment of haemangiomas are discussed. Direct puncture and injection of contrast medium is the best method of visualization of the tumour. Treatment should be surgical, consisting of total extirpation of the tumour with a margin of healthy tissue. Simple extirpation is indicated only when the soft tissues are involved and there is no bone lesion. Excision en bloc is the tehcnique of choice.


Effect of indomethacin on CO2-induced hyperaemia (CO2-response) in the rabbit brain. It was studied in rabbits whether indomethacin, a prostaglandin-synthesis inhibitor, influences cerebral hyperaemia induced by inhalation of carbon dioxide (CO2-response). The aim of this experiment was to show whether prostaglandins are involved in the regulation of cerebral vascular tone. The animals were repeatedly ventilated with a CO2-room air mixture before and after the injection of indomethacin solution. Regional cerebral blood flow in one hemisphere was continously measured using a thermo-clearance method. In 10 out of 13 rabbits no effect of indomethacin on the CO2 response could be observed. In the other 3 animals a reduction of the CO2-response only occurred in the 15-45 minutes interval after the indomethacin injection. The authors, however, do not exclude the possibility of this reduction being an artefact. The reasons are discussed.


Giant intramedullary ependymoma. A case report. After a review of the international literature, the authors report a case of intramedullary ependymoma extending from the 1st cervical level to the 1st lumbar level completely removed in a one stage operation. The good functional recovery of the patient is emphasized.


Cranial dermal sinuses in childhood and adolescence. Forty-six cases of cranial dermal sinus found in patients up to 16 years of age are described: forty cases are recorded from the literature, six are personal cases. The clinical anatomical and radiological features, as well as the surgical findings of these unusual cranial congenital lesions are reviewed.


[Surgical treatment of intracranial hematoma in an infant with hemophilia B (author's transl)]. Surgical experience of intracerebral hematoma in an 8-month-old boy with severe hemophilia B, which was not diagnosed preoperatively, was presented. Carotid angiography and removal of hematoma by craniotomy were carried out quite safely under fresh-blood-transfusion. After several months ventriculoperitoneal shunt was placed, because of progressing hydrocephalus and multiple porencephaly, this time, under the cover of the factor IX complex. The clinical features of the intracranial hemorrhage in hemophilia were discussed, with analysis of 52 operation cases. Whenever we encounter a patient with intracranial hemorrhage, especially in infancy, hemorrhagic diseases, as hemophilia, must always be borne in mind. Although intracranial hemorrhage is still the most fatal complication of hemophilia, the surgical risk has been greatly diminished by advanced replacement therapy. We stress the need of immediate diagnosis and positive surgical treatment with adequate replacement therapy, if indicated.


The angiographic ocular choroidal crescent: distortion with intraorbital and remote intracranial pathology. The ocular choroidal plexus can be identified on virtually all normal internal or common carotid angiograms. Posterior flattening of the choroid is often seen with retrobulbar tumors. This angiographic appearance can also be observed in some patients with papilledema and increased intracranial pressure. In these patients, ampulliform dilatation of the dura and subarachnoid space just posterior to the globe produces a retrobulbar mass effect that can mimic true retrobulbar tumor. Enlargement of the ocular choroid crescent is an unusual angiographic finding and can be seen with intraocular expansile lesions such as unilateral axial high myopia with posterior staphyloma. An abnormally small, shrunken choroidal blush can be seen with microphthalmia, extreme degrees of hyperopia, and in the phthisical eye.


Microradiographic study of cerebral and ocular aneurysms in hypertensive rabbits. Cerebral and ocular microaneurysms were produced in rabbits made hypertensive by surgically induced silk-turpentine perinephritis combined with contralateral nephrectomy 7 days later. The aneurysms distributed throughout the brain and iris were studied by microradiography; a few representative aneurysms selected from the microradiographs were studied histologically. The microradiographic findings and histological sections correlated well. Intracranial microaneurysms were multiple and frequently located in the basal ganglia and near the cortex. Arterial changes in the iris paralleled intracranial arterial changes in degree and type except for the addition of hemorrhage around some microaneurysms. The results of this study show the potential of microradiography and histological sections guided by microradiography for studying the natural history of hypertensive arterial lesions and support the contention that hypertension, microaneurysms and intracerebral hemorrhages are related.


Duplicate origin of left vertebral artery. A verified case of duplicate origin of the left vertebral artery in association with a large aneurysm arising from the aortic arch immediately distal to the left subclavian artery is presented. An anomalous left vertebral artery arises directly from the aortic arch between the left common carotid and subclavian arteries, and joins with the normal left vertebral artery in the transverse foramen of the fifth cervical vertebra.


The occipital artery. Anatomy--normal arteriographic aspects--embryological significance. An anatomical and radioanatomical study of the intracranial branches of the occipital artery is presented and attempt to systematize the muscular branches of the occipital trunk and its vertebral anastomosis. An embryological hypothesis is presented to explain and memorize all the artrial variations of this area.


Bilateral dural arteriovenous fistula in the region of the cavernous sinus. The case of a patient with a fistula between the left internal carotid artery and the cavernous sinus, and another fistula between the right external carotid artery and the cavernous sinus, is reported. The clinical symptomatology, which was of spontaneous onset, was unilateral and consisted of exophthalmos and injection of the conjunctiva on the left side. Almost complete remission occurred after angiography.


[Stable contrast B-scan in thyroid diagnosis]. A new technique of bidimensional reproduction (B-Scan) is proposed. This is based on successive impressions on the same photogram of the same sections carried out at different amplification and on different frequencies. Frequency and amplification variations are based on constant A-Scan control for the bidimensional detection of echoes which at low frequency and weak amplification are not memorized.


[Case of Pelger-Huet anomaly in its exceptional homozygotic variant]. After briefly recalling the cytomorphological aspects of Pelger-Huet anomaly, its statistical occurrence, the modalities of hereditary transmission and its differentiation from pseudo-Pelger, a case of the homozygotic variant is reported. The practical and theoretical importance of the anomaly is commented on briefly.


[Old or elderly?].

[Old or elderly?]. The factors involved in and the significance of the so-called "aging" phenomenon, with particular regard to its manifestations in Italy and Sicily are discussed with particular regard to the different meaning of "being elderly" as a biological and clinical phenomenon linked with considerable individual variations to aging, and "being old", as a social and psychological exclusion factor connected with the essentially segregational and excluding attitude of society in general with regard to the old. The conditions for preventing a state of "being old" are indicated in terms of geriatrics methodology, sociosanitary aspects connected with health service structures, and personal aspects involving the responsibility of the aging man.


[Neurologic complications of diabetes mellitus]. Neurological complications in the light of their clinical and topographical pattern are discussed with regard to the literature and 40 personal cases. Peripheral neuropathy is the most common (average frequency 26%). The main clinical, anatomical, histological and pathogenetic features of polyneuritis in diabetes are illustrated. Diabetic amyotrophy is a true clinical entity, though its site (neural or muscular) and pathogenesis are still the subject of discussion. Cranial nerve damage (oculomotor paralysis in particular) has the typical clinical, anatomical and histological picture of peripheral forms. Myelopathy leads to three distinct anatomical and clinical patterns: pseudo-tabes caused by degeneration of the roots and posterior cords; chronic anterior poliomyelitis due to degeneration of the cells of the anterior cornua; myelosis attributable to combined degeneration of the posterior and anterolateral cords. The main features of encephalopathy and the relation between epilepsy and diabetes are also examined.


[Clinical significance of the determination of serum phosphohexose isomerase in malignant neoplasms]. The results of a preliminary study on the serous level of PHI in patients undergoing treatment at the Catania Oncology Institute are reported. Of 53 subjects with ongoing cancer, higher than normal values were encountered in 70% of cases. This percentage rose to 82.3% in cancer patients with metastasis affecting the skeleton. Of 12 subjects who underwent mastectomy with no clinical signs of recurrence only three showed abnormal values while in no case of fibrocystic mastopathy were levels higher than normal observed. A constant correlation was identified between effectiveness of surgical, radiotherapeutical or medical treatment and reduction in serous level of PHI. The usefulness of this investigation in oncology is thus confirmed.


[Positive effects of chenodeoxycholic acid (CDCA) on the biohumoral clinical aspect of cholesterin calculosis of the gallbladder]. The efficacy and possible sideeffects of chenodeoxycholic acid have been studied in 35 patients with biliary calculosis lithiasis. In 53% of the cases treated for six months or more partial or complete gallstone dissolution was observed. The action of this drug on hematic triglyceride level and on severity and frequency of the hypostenic dyspeptic symptoms and biliary colic is interesting from the viewpoint of new therapeutic prospects. Diarrhea has been the only relevant side-effect.


[Voluntuary stramonium poisoning. 2 clinical cases]. Two cases of acute voluptuary poisoning by infusions of dry leaves of stramonium are reported. Symptomatology was characterized by confusion and hallucination (visual hallucinations, loss of space-time relationships, etc.) associated with neurovegetal symptomatology ascribable to the active principles contained in the preparation used: mydriasis, disturbances in visual accomodation, dryness of the fauces. Tachycardia was observed in one case, bradycardia in the other. Symptoms were resolved in one case by administration of neuroleptics, and spontaneously in the other after about 12 hours. A brief description of the preparation employed is given, and risk of poisoning stressed.


[Oogenesis in Hydra. III. The growth and fusion of the oocytes]. The ultrastructure of oocytes in Hydra has been studied prior to the beginning of their phagocytic activity. The formation of Golgi complexes and vacuolar system by means of the rough endoplasmic reticulum budding and the formation of numerous enzymatic granules within the Golgi complex are considered with respect to the preparation of cells for the processes of phagocytosis and intracellular digestion of structures. The oocyte situated in the center of each accumulation of syncytially connected cells, descendants of one interstitial cell, becomes the egg, whereas all others are consumed by it and transform into endocytes. The partial and complete confluence of oocytes is described. In the first case, a part of cytoplasm of the cells surrounding the growing oocyte is torn away and included in this oocyte. In the second case, the confluence of large oocytes containing endocytes in their cytoplasm takes place. The growing oocyte forms pseudopodia and cytoplasmic processes which move apart the epithelial-muscle cells, reach the mesogloea and come in contact with the gastroderm cells. The role of these contacts in the oocyte growth is discussed.


[Comparative study of the changes in lactate dehydrogenase isoenzymatic spectra in the course of organogenesis in mice]. The dynamics of changes in the lactate dehydrogenase (LDH) spectra during organogenesis in CBA mice has been studied by means of ultramicroelectrophoresis. The embryonic period of development is characterized by the predominance of cathodic isozymes (LDH-5 and LDH-4) in all the organs under study. The increase of anodic isozymes (LDH-1 and LDH-2) takes place in the heart, kidneys and brain as the development proceeds. The first reliable differences in the LDH spectra of different organs appear on the 11th day of embryogenesis. On the basis of comparison with the help of criterion gamma, the LDH spectra of the organs under study can be divided into two groups: I--heart, lungs, kidneys and brain (tendency towards the increase of H-subunits) and II--intestine, liver and muscles (tendency towards the increase of of M-subunits). The LDH spectra of adult animals are divided into 4 distinct groups: I--heart and kidneys, II--brain, III--lungs and muscles, IV--liver.


[Change in the tissue spectrum of carboxylic ester esterases in the postnatal period in rats]. A comparative investigation of the composition of electrophoretic fractions of esterases of compound ethers of carbonic acids has been carried out in the rat tissues. Carboxyl, aryl, acetyl and choline esterases were identified by the sensitivity to inhibitors. Changes in the composition of these esterases during the postnatal period were followed.


[Effect of prednisolone injections in early postnatal ontogeny on the circadian rhythm of corticosteroid function in adult rats]. The effect of prednisolone injections during the early postnatal ontogenesis on the diurnal rhythm of corticosteroid function and stress reactivity in adult animals has been studied in rats. The injections of prednisolone to 7--9 days old rats resulted in the subsequent disturbance of diurnal rhythmicity in the suprarenal cortex functioning: the diurnal fluctuations of the content of 11-oxycorticosteroids in the blood plasma are smoothed out; the diurnal changes in the hormonal reaction to the stress stimulation disappear. This disturbance appears to be due to changes in the central mechanisms of the control of hypophysis-suprarenal system. The reactivity of this system per se suffered no changes.


[Effect of experimental arrest of eye growth on the proliferation and polyploidization of the retinal pigment epithelium in rats]. Following the lens removal from the left eye of the newborn rats, animals were obtained with one normal (control) and another microphtalmic eye. The animals were sacrificed on the 2nd, 3rd, 5th, 7th and 9th days of postnatal development after four injections of 3H-thymidine during 19 hrs. The number of labelled nuclei and mono- and binuclear cells in the central zone of the eye fundus was counted on the autographs. After the initial increase of the index of labelled nuclei in the operated eyes (on the 2nd, 3rd and 5th days) it fell below the control level (on the 7th and 9th days). The number of binuclear cells in the operated eyes, as well as in the control, attains on the 5th day 50% of the total number of cells and remains at this level up to the end of the experiment, whereas in the control eyes the number of binuclear cells increases up to 60% on the 7th and 80% on the 9th day. The results obtained have shown that in rats the factors of total eye growth participate in the control of proliferative activity and polyploidization of the pigment epithelium cells in the retina.


[Melanin granule metabolism in the iris and retinal pigment epithelium in adult tritions after completion of eye regeneration]. It was concluded that the newly synthesized melanin granules were replaced in the pigmented tissues of the newt eye on the basis of redistribution of the cells of pigment epithelium of retina and iris labelled by 3H-DOPA 2.5 and 6.5 months after the isotope injection. The replacement of melanin granules and, correspondingly, melanin synthesis proceed more actively in the peripheral zones of the pigment epithelium of retina. The depigmentation of cells preceding the melanin synthesis appears to be realized with the participation of macrophages.


[Dynamics of neurospecific protein S-100 accumulation in the brain of AKR/J and DBA/2J strain mice in the process of postnatal development]. The content of total S-100 protein and its water-soluble fraction was determined in the brain of DBA/2J and AKR/J mice during postnatal development. Reliable differences between the two strains were found in the content of total S-100 protein (from the 27th day after birth on) and its water-soluble fraction (from the 35th day).


[Cell proliferation study at various stages of gastrulation in axolotl embryos]. A study of cell proliferation in different regions of axolotl embryos has shown a rather uniform distribution of the S phase and mitotic indices in the animal half of the early and midgastrulae. The dorsal blastoporal lip is characterized by a very low S phase index as compared with the other regions of the embryo.


Surgical complications of pars plana vitreous surgery. Evaluation of 200 consecutive pars plana vitrectomies shows delayed corneal epithelial healing after intentional scraping and formation of a posterior subcapsular cataract, presumably due to exposure to inadequate infusion fluids. Posterior retinal holes occur frequently, whereas entrance site complications have been reduced to an acceptable minimum. Temporary rise in intraocular pressure is common.


Late complications of pars plana vitreous surgery. Late complications (following hospital discharge) occurring in 206 consecutive pars plana vitrectomy cases, comprising a subgroup of 100 consecutive cases for diabetic retinopathy, are reviewed. Ocular hypertension, occurring as neovascular glaucoma, was present in 18% of diabetic eyes, but other causes of ocular hypertension gave an overall incidence of 26%. Electron microscopy, scanning, and transmission photographs document the devastating ocular neovascularization occurring postvitrectomy.


Complications of phacoemulsification.

Complications of phacoemulsification. Charles Kelman performed the first phacoemulsification operation in 1967, but it was not until 1971 that the technique had been sufficiently refined to allow its use by others. Now over 2,000 surgeons have been trained in the technique, and more than 100,000 cases have been performed. However, extended follow-up in any given series has been difficult because of the wide geographic distribution of patients, and interpretation is hampered by the frequent insertion of intraocular lenses in these patients. The present series attempts to carefully document operative and postoperative complications encountered in a consecutive series of patients whose senile cataracts were treated by phacoemulsification.


Retinal detachment following phacoemulsification. In a consecutive series of 1,500 eyes in which phacoemulsification had been performed, the incidence of subsequent retinal detachment was 3.6%. Vitreous loss occurred in 4.2% (63) of the 1,500 cases, and in this group of eyes the incidence of retinal detachment was 14% (9). The characteristics of retinal breaks and the configurations of retinal detachments following phacoemulsification were in general similar to cases following intracapsular surgery. The surgical reattachment rates in these eyes compared favorably to previous reports on the repair of retinal detachments.


A one-year follow-up of cystoid macular edema following intraocular lens implantation. Retrospective and prospective techniques were used to analyze a consecutive series of 406 eyes to identify factors contributing to cystoid macular edema following lens implantation. Vitreous loss and rupture of the posterior capsule were highly significant in the production and persistence of this complication.


Intraocular lenses: secondary membranes; cystoid macular edema. In 650 consecutive Binkhorst lens implants, secondary membrane surgery was required more than eight times as frequently after an extracapsular than after an intracapsular cataract extraction. The visual acuity results after discussion were uniformly good. Transpars plana vitrectomy was reserved for more severe cases. The pupils were cleared, but the visual acuity results were mixed. A fluorescein angiographic study revealed little difference in the incidence of cystoid macular edema in implant and nonimplant cases. There was a lower incidence after extracapsular than intracapsular extractions in implant cases.


Dwyer instrumentation of the spine.

Dwyer instrumentation of the spine. The evolution of the Dwyer procedure during the past 10 years has enabled us to better define the indications and contraindications for the procedure. The role of the Dwyer procedure in the treatment of thoracolumbar or lumbar curves in both the adolescent and the adult has been found to be significant. When combined with Harrington rod instrumentation it can be used for either paralytic curves, curves associated with pelvic obliquity, or curves in which posterior elements are absent.


Analytical radiography and the progressive approach in talipes equinovarus. 1. A radiographic method is described for making the diagnosis of talonavicular subluxation before ossification of the navicular occurs. 2. Seven basic deformity combinations are thought to occur in clubfoot. 3. Preoperative analytical radiography enables the surgeon to determine which of these combinations exists in a particular foot. 4. The progressive approach, a comprehensive sequential plan of corrective surgery, indicates the appropriate treatment for each of the seven deformity combinations that may exist in a clubfoot following initial conservative treatment. 5. At the time of surgery the surgeon uses analytical radiography during the operation to determine whether the surgery has been successful or whether the next stage of the progressive approach will be required to correct the deformity combination.


Pathology of congenital metatarsus varus and its relationship to other congenital deformities of the foot. Congenital metatarsus varus may be regarded as a deformity caused by a dislocation and in that respect is similar to congenital clubfoot and vertical talus but not to calcaneovalgus. The dislocation causes adaptive bone changes as well as secondary contracture of the soft tissues. That the dislocation in the forepart of the foot may occur in a maximally dorsiflexed foot also may explain the valgus position of the hindfoot. The secondary changes in bone and soft tissue may explain the lack of spontaneous recovery and the difficulties in effecting correction in severe cases. It is still not possible to explain why the dislocation arises.


The pathoanatomy of congenital clubfoot. Patients with resistant clubfeet were reviewed in their second and third decades. For comparison, normal embryological and fetal feet, untreated clubfeet, a recurrent clubfoot, and an amputated foot were dissected. In no child with a resistant clubfoot was the bone architecture normal. In untreated and recurrent clubfeet we found the lateral malleolus to be directed posteriorly, the head of the talus pointed laterally, and the navicular subluxated medially toward the medial malleolus. An operative technique to restore normal alignment of the talus in the ankle mortice, of the navicular and talus, and of the talus and os calcis is described.


Neonatal surgery in clubfoot.

Neonatal surgery in clubfoot. Neonatal surgery for clubfoot is conducted according to the following rules: One must work as close to the lesions as possible. It is important to avoid going beyond abnormal tissues. Dissection should be precise and economical. Opening of Lisfranc's joint or sectioning of the medial ligament must be avoided. One must operate with maximal accuracy. All areas of fibrosis must be excised, but care must be taken not to enter the interarticular space. If a bone deformity is present, one must accept an incomplete correction. One must act as soon as possible. This is the inverse of classic management in which orthopedic surgery was postponed. We prefer early surgery followed by intensive postoperative rehabilitation.


Muscular dystrophy: diagnosis and treatment. The clinical signs and symptoms of the most common muscular dystrophies are presented. Plans for treatment and genetic counseling are outlined. A new operation for correction of scapular winging is described with illustrative cases.


Studies on the mechanism of callus cartilage differentiation and calcification during fracture healing. The morphologic and biochemical events during fracture callus cartilage differentiation and calcification are presented. 1. Histologic studies have demonstrated that unimmobilized fractures heal through endochondral ossification. 2. Biochemical studies have demonstrated an increase in the activities of alkaline phosphatase, enzymes involved with aerobic glucose metabolism, and lysosomal enzymes and a decrease in activities of enzymes involved with glycogen synthesis and anaerobic glycolysis. Hexosamines and hydroxyproline show a net decrease with cartilage differentiation. 3. Electron microscopic studies have demonstrated the intracellular origin and aggregation of collagen molecules, the cellular origin of matrix vesicles, and the early sites of calcification in the fracture callus.


The management of arthrogryposis.

The management of arthrogryposis. Arthrogryposis has an evil reputation among orthopedic surgeons, for the deformities are known to be resistant to correction and relapse during growth is common. It is suggested that many of these difficulties have been due to a delay in initiating treatment, to the use of unsuitable methods such as manipulation, and to a lack of appreciation of the pathologic changes. The author's experience with a large number of personally treated cases has convinced him that aggressive surgical treatment in infancy and early childhood is more successful than previously accepted methods of care (Figs. 22, 23).


[Value and incidence rate of the inflammation of the bowels in a general children's autopsy material during twenty years (author's transl)]. The acute enteritis in the postneonatal period with or without dyspepsia appeared with an incidence ranging from 18,9% to 27,6% during twenty years period (1956--1975) observations in a general children's autopsy material. Bacteriological and serological analysis may be of success and complete the pathologic-anatomical diagnoses. Infective enteritis often is accompanied by pneumonia and/or otitis media. The acute enteritis can always be detected as an important feature in regard to the cause of death. Most children die within less than twenty-four hours from hospital admission. The hemorrhagic, ulcerous and necrotic form of the enterocolitis predominate the perinatal and neonatal period, frequently combined with peritonitis and bowel perforation. Bacteriological examinations should be obtained. This form of the acute enteritis and enterocolitis of the newborns must be taken into consideration of the ileus symptoms differential diagnosis.


[Biochemical studies on familial neuroblastoma]. According to the two-mutation model of neuroblastoma several investigations were performed in order to find the gene carrier in a family with familial neuroblastoma. The results of these former studies are as follows: 1. Neither chromosomal analyses of the peripheral blood nor the examinations of catecholamines nor of cystathionine in the urine could mark the first step to neuroblastoma. 2. Since cystathioniuria was not only seen in blood-relations but also in relatives by marriage and since vitamin B6 deficiency was revealed, cystathioninuria was interpreted as secondary to vitamin B6 deficiency. In this study the normal values of cystathioninuria and vitamin B6 supply were examined. Furthermore the effect of oral vitamin B6 loading on cystathioninuria and oxaluria in familial neuroblastoma was investigated and the vitamin B6 supply in the neighbours of the family was analysed. The results permitted the following conclusions: 1. In 46 of 58 children and adults cystathioninuria was found in an immeasurable range by column chromatography. Only in 12 persons it could be measured quantitatively. With the exception of 6 explanable elevations no value exceeded 20 mumol/24 hr. These results show that the acceptance of the limiting value of 20 mumol/24 hr for increased cystathioninuria is justified. 2. Vitamine B6 deficiency was found in two of 7 patients. In one child this could be explained by the underlying disease. This finding supports the suggestion that vitamine B6 deficiency can relative frequently observed. 3. The examinations of cystathioninuria and oxaluria before and after loading with vitamine B6 showed different results. Whereas oxaluria decreased after loading cystathioninuria was not surely influenced. 4. The neighbours of the members with familial neuroblastoma showed mostly a reduced vitamine B6 supply. This fact could be an indication of exogenous reason of vitamine B6 deficiency in familial neuroblastoma.


[Determination of faecal fat in infants and children with bacterial and viral infections (author's transl)]. In 100 infants and children with bacterial or viral infections determination of faecal fat was done. None of the patients showed signs of malabsorption prior to investigation. The faecal fat content is expressed as percent of the dry weight of the stool. A fat content of up to 14% of the dry weight of the stool can be regared as normal. A faecal fat content of 15 to 20% is indicative for an elevated fat excretion, and a fat content of more than 20% gives evidence for steatorrhoea. In 80% of the infants with bacterial and in 50% of the infants with viral infections steatorrhoea could be demonstrated. In children with bacterial infections 18% showed a normal, 69% an elevated fat excretion ain 13% there was a steatorrhoea. In children with viral infections 6% showed a normal fat excretion whereas 81% had an elevated excretion and 13% exhibited steatorrhoea. Thus viral infections compared with bacterial infections seem to cause disturbances of fat absorption more frequent. Whereas the degree of the disturbance seems ot be less intense in viral infections.


[The value of scintigraphy for the early detection of osteomyelitis (author's transl)]. For therapy and development of acute haematogenic osteomyelitis early detection of this disease is decisive. In our study 74 children were investigated scintigraphically with Tc-pyrophosphat because of suspicion of an inflammatory bone process. In all 23 cases of osteomyelitis scintigraphy showed an indication in form of increased activity in the respective bones; so the sensivity of this investigation, found in our study, was 1.0. In 10 of 51 cases without osteomyelitis scintigraphy, however, also showed increased activity. Because of this limited specifity of scanning further investigations are needed in the diagnosis of osteomyelitis. The main advantage of scintigraphy as compared with roentgen observation is the high sensitivity in the first days of illness. In addition scanning may supply valuable informations about the inflammatory process as long as it is active.


[Renal glycosuria with loss of phosphate (author's transl)]. Three of six members of one family have a renal glycosuria of variable degree. In addition to this they have a mild loss of phosphate under normal conditions. In one patient the phosphate-loss becomes very high after a loading dose. After describing the different data the mechanism of renal glucose transport and its relationship to phosphate transport as well as the genetic of renal glucosuria are discussed. The combination of renal glycosuria and renal loss of phosphate is very rare. The difference in regard to gluco-phosphaturia is mentioned.


[The value of the "impression smear" in detecting giardia lamblia infection (author's transl)]. Giardia lamblia has a cosmopolitan distribution. The organism exists in two stages--the trophozoite and the cystic stage. Infected children may have acute or chronic diarrhea, crampy abdominal pain, anorexia, malasorption and poor weight gain and may be misdiagnosed as celiac disease. Infection may be selflimited or chronic even over years. Diagnosis is usually made by finding the characteristic cyst in stool specimens or by duodenal aspiration. Histological sections and impression smears (AMENT) of intestinal mucosa biopsies have been proved to be the most reliable method for detecting giardiasis. Evaluation of impression smears for parasites is easier and quicker than examining serial sections of biopsies. Out of 175 selected patients with intestinal complaints which were undergone small intestinal biopsy 11 were infected with giardia lamblia (6.2%). All infected children were symptomatic, malabsorption could be demonstrated in 5/8, lactase levels were reduced in most children. Examination of duodenal aspirates, stool specimens and histological sections (routine histology) alone would not have been diagnostic in every case. Evaluation of impression smears proved to be a reliable method in detecting giardia lamblia infection and is recommended whenever an intestinal biopsy is performed.


[Vitamin K deficiency bleeding as a leading symptom in celiac disease (author's transl)]. Haemorrhagic diathesis was a leading symptom in diagnosing celiac disease in 4 patients. In all 4 patients, a duodenal biopsy showed total villous atrophy. Although 3 of the children were typically dystrophic, the weight of the 4th child, an 8 month old boy, was within the normal range. In this patient, who suffered from neither diarrhea nor vomiting, heavy cutaneous and mucous membrane bleeding were the only symptoms of the disease. In all 4 cases the haemorrhagic diathesis could be explained by a low prothrombin complex, whereas the rest of the coagulation tests were normal. After the administration of Vitamin K1 there was an immediate rise in the prothrombin complex and bleeding was quickly stopped. Noteworthy is that due to infections, 3 of the 4 patients, received antibiotics just before the onset of the bleeding. In celiac disease, the conversion from a K-hypovitaminosis into a K-avitaminosis by the administration of antibiotics is discussed.


[Dimenhydrinate poisoning in childhood (author's transl)]. Treatment of a Dimenhydrinate poisoning (Vertirosan B6) with Physostigmine salicylate (Antrilirium) is reported. The symptoms of this anticholinergic poisoning (hyperactivity, ataxia, tremor, rubeosis faciei, hallucinations) disappeared rapidly after a single intravenous injection of Physostigmine salicylate. A table of some of the most common drugs capable of producing anticholinergic poisoning is added.


[Hemostasis in hereditary hemorrhagic telangiectasia (author's transl)]. The investigation of a girl aged 8 with hereditary hemorrhagic telangiectasia showed an abnormality of primary hemostasis. The bleeding time was at the upper end of normal and platelet adhesiveness was decreased to a variable extent. Platelet life span was shortened, presumably due to the telangiectatic lesions typical of this disease. Platelet aggregation and ADP-content were normal as was the plasma coagulation system.


[Combined therapy for a compulsion neurosis (author's transl)]. Within the scope of the care of mother and child arranged according to behaviour therapeutic and playtherapeutic aspects, manifest fears of separation of a 6 year old, normal talented girl, could be largely reduced after ten meetings. The repeated occurrence of the primary symptoms after a longer, exclusive stay of the patient in her family, confirms the belief, that the striking behaviour of the girl does not express a starting psychotic process but points much more to the symptom-releasing and -reinforcing effect of the family environment. It is planned to continue the treatment in a family-therapeutic way.


[Treatment of pulmonary infections with cephalexin (author's transl)]. The efficacy of Cephalexin--an oral cephalosporine--was assessed in 20 children with pulmonary infections including bronchopneumonia and infiltrative peribronchitis in an open study. In 16 patients prompt resolution of clinical and radiological signs was observed. The drug was well tolerated, there were no side effects or allergies to be demonstrated. Among the therapeutic agents for infections of the respiratory tract cephalexin should be considered among the antibiotics of first choice.


Significance of pain in psychiatric hospital patients. In a consecutive series of 227 psychiatric hospital admissions, data were recorded in respect of the complaint of pain. Eighty-six (38%) had pain. Fourty-four (19%) mentioned it spontaneously and 49 (22%) had no relevant physical cause. Women were affected more often than men (P less than 0.01) and tended to complain more often of severe pain (P less than 0.01). Severe pain was more often reported spontaneously (P less than 0.02). Also, the longer pain lasted the more likely the patient was to report it spontaneously (P less than 0.02). Men more often had a relevant physical diagnosis (P less than 0.05) and the low back was the commonest site of pain in them. Pain was relatively often associated with diagnoses of anxiety and personality disorder and relatively infrequently with schizophrenia, organic brain syndromes and transient situational disturbances. It is concluded that whilst there is a strong association between pain and psychiatric illness, this is less prominent, paradoxically, in some of the more severe psychiatric disturbances.


The dissatisfied patient with chronic pain. Patients with chronic pain may become dissatisfied because of their lack of improvement. Thirteen such patients, encountered in a pain-management program, registered formal complaints of their dissatisfaction. From their histories they were found to be the most chronic and treatment-refractory patients encountered, with problems of medication dependency, accident proneness, and dissatisfaction with previous treatment efforts. During hospitalization they opposed psychologic approaches, further manifested their dependency on medication, and some of them had circumscribed delusions. The pain-management program was difficult to apply to these patients; and further, they resisted other recommendations for treatment and even resisted discharge in in some instances. Further psychiatric screening is necessary to avoid the complications presented by this type of patient.


[Morphology and development of the cysticercoids of Paricterotaenia porosa (Cestoda: Dilepididae)]. Studies of the development of Paricterotaenia porosa in its intermediate host Chironomus sp. were carried out. At 20 degrees C the development of the larva is completed in 24 days. The primary cavity is formed in 9 days, the separation of the cercomere anlage--in 11 to 12 days and the invagination of the larva--in 19 days. The larval development of P. porosa is characterized by its passing in the cavity of the external cyst, by the complete separation of anlages of the body of the larva and cercomere at the metamere stage and by the intensive growth of the cercomere after the invagination of the larva. The analysis of the cercomere structure suggests its protective function.


[Facts that explain the host specificity of helminths]. Extracts from larvae of Trichinella spiralis, mature Ascaridia galli and Ascaris suum and blood sera of their possible hosts (rats, pigs, chicks, guinea pigs, mice and men) were investigated by the method of electrophoresis in polyacrylamide gel. The protein component was found to be most identical in helminth and its obligate host. The host specificity is supposed to depend on the community of the protein content of the parasite and its host. The data on the difference in protein spectra are given and the peculiarities of the evolution of mono- and polyhost helminths are discussed.


[Acroloxus lacustris (fam. Ancylidae) as a new intermediate trematode host in the USSR]. 585 specimens of the mollusk Acroloxus lacustris were parasitologically investigated in the Divichin Bay of the Caspian Sea. 3 species of cercarians (Echinostoma sp., Echinoparyphium recurvatum, Asymphylodora sp.), 2 species of parthenites (Echinostomatidae gen. sp. Redia I, Echinostomatidae gen. sp. Redia II) and 4 species of metacercarians (Metacercaria gen. sp. I, Metacercaria gen. sp. II. Metacercaria gen. sp. III, Tetracotyle sp.) were found in the specimens examined. A. lacustris is first reported as an intermediate host of trematodes.


[Population density of Ixodes persulcatus ticks (Ixodidae) in the western Sikhote-Alin]. The paper presents data on the population density of active ticks in different landscape zones of West Sykhote-Alyn as well as the material on the absolute abundance of ticks in four experimental 400 m2 areas. The abundance of active Ixodes persulcatus and Haemaphysalis japonica on vegetation at the peak of their activity was found to amount to half of all hibernated adult ticks.


The detection of porphyria in photosensitive patients. The biochemical diversity of the various porphyris often leads to incomplete investigation of photosensitive patients and porphyria may be excluded wrongly on the basis of normal urinary porphyrins alone. Establishing a biochemical referral centre for photosensitive patients suspected of having porphyria led to the diagnosis of 5 cases of porphyria cutanea tarda (PCT) and 2 cases of erythropoietic protoporphyria (EPP) among 34 patients referred by dermatologists over a period of 12 months. Iron overload was conformed in 3 the PCT patients by plasma ferritin assay. Studies on the available families of the two EPP patients revealed elevated red cell protoporphyrin levels in several clinically asymptomatic relatives.


[Revision of the mites of the genus Miyatrombicula (Trombiculidae) in the fauna of the USSR]. 6 species of the genus Miyatrombicula are recorded from the fauna of the USSR: M. esoensis, M. reptilica, M. muris, M. balcanica, M. caucasica, M. ramitensis sp. n. Characteristic of the genus, redescription of known and description of new species are given. Larvae of the mites parasitize in general small mammals. In addition, some of these species were found in West Europe, Japan and North America.


Striatonigral degeneration.

Striatonigral degeneration. Striatonigral degeneration is a relatively uncommon form of parkinsonism. It is clinically characterized by greater debility and a relatively rapid course, often with other superimposed extrapyramidal signs and a poor response to L-dopa. Pathologically it si a multi-system degeneration of the central nervous system, dominated by atrophy of the neostriatum with striking putaminal pigmentation. The clinical and pathological features of this condition are illustrated with a case report and the entity as a nosologic problem is discussed in the light of a review of the literature. The pathogenesis of this condition and its position among the degenerative disorders of the nervous system remain unelucidated.


[Lactate dehydrogenase isoenzyme study of Trichinella larvae of different ages]. LDH isoenzymes of Trichinella larvae isolated from experimentally infected guinea pigs were investigated between days 30 and 400 inclusive after infection. It was found that on the 30 th day after infection the larvae have two isoenzymes while from the 40th to the 400 th day--three isoenzymes. The first of the latter is of fast responce and is located in the anod area near the indicator while the two others are of slow response and are located between the isoenzymes LDH-3 and LDH-5 of the muscular tissue of guinea pigs. This indicates that energetic metabolism of Trichinella larvae proceeds in muscular tissues by aerobic and anaerobic way. Since electrophoretic specificity of LDH-isoenzymes of Trichinella larvae differ from that of LDH-isoenzymes of muscular tissue the former are apparently characteristic of Trichinella larvae.


An improved screening method for 3-methoxy-4-hydroxy mandelic acid excretion in urine. A screening method is described for urinary 3-methoxy-4-hydroxy mandelic acid using an initial ion exchange procedure, vanillin formation and extraction into toluene. The technique, is simple, rapid and specific, with a reference value up to 35 mumol (7.0 mg)/day established on 92 normal human subjects. Over 200 patients' urines were analysed by the method of which 18 gave values above the reference range. The majority of these increased excretions are attributed to the metabolic effects of drugs, one patient suffered from phaeochromocytoma and only 2 results remaining unexplained.


[Experience with the laboratory cultivation of the mosquito, Aedes togoi (Culicidae)]. For cultivation of Aedes togoi the aquatic infusion of fallen leaves, peat and dry sphagnum (0.15%S) was used and a larval diet (children's haematogen with an addition of polyvitamin "Undevit" and glutamic acid) was offered. Such cultural medium provides a rapid development of larvae and their survival, high stable weight of pupae, high fecundity and viability of imago. 7 generations were obtained without reducing the quality of culture.


Tissue culture of isolated human glomeruli. Glomerular cells have been grown in a reproducible manner from 5 normal human kidneys. A technique is described which combined mechanical disruption of renal cortex and microdissection, and provides large numbers of pure glomeruli within 30--45 mintues. Histological examination shows this technique produces intact glomeruli without cell disturbance. During tissue culture, glomeruli attach to the flask and the intrinsic cells migrate onto the flask and divide. Variations of culture conditions have shown that glomeruli are robust without fastidious culture requirements. Intact kidney tissue can be left at 4 degrees C for perios up to 24 hours prior to isolated of individual glomeruli without affecting subsequent cellular growth in culture. They grow in most commonly used media although the cells require 20% foetal calf serum for optimum growth. Their pH optimum is between 7.0 and 7.4 with temperature optimum of 37 degrees C. as glomeruli must attach prior to cell growth, minimum movement is critical to promote optimum growth. Under these optimum conditions a regular and predictable growth of cells of two distinct types, has been observed over 14 days; one of these types is probably epithelial.


Nitroblue tetrazolium (NBT) activity in human leucocytes after freezing. Human peripheral blood leucocytes (neutrophil-rich) were collected either with heparin or acid citrate dextrose, frozen with dimethyl sulphoxide at a controlled rate, stored in liquid nitrogen at--196 degrees C and reconstituted with a solution containing dextran. After reconstitution, 20.2% of cells (in absolute numbers 1 in 5 fresh cells) showed a strongly positive nitroblue tetrazolium (NBT) reaction. The quantitative NBT test confirmed the synthesis of formazan/10(6) reconstituted neutrophilsa s15% of the fresh capacity. A slow titration reconstitution method for cells did not improve the functional capacity of thawed leucocytes as judged by the NBT test. When comparing anticoagulants, heparin increased the post-reconstitution cell yields after freezing and increased the absolute number of reconstituted cells capable of developing a positive NBT reaction.


[New species of mosquito, Aedes (Stegomyia) sibiricus sp. n. (Culicidae)]. The description of female, male and 4th stage larva of a new species of mosquito, Aedes (Stegomyia) sibiricus, from Siberia and Far East of the USSR is given. This species belonging to the albopictus subgroup of the scutellaris group of species was formerly confused with A. (S.) galloisi Yam. The geographical distribution of A. sibiricus is related to the south of the East taiga and Okhotsk districts of the Euro-Siberian province of the Circumboreal subregion of the Palearctic, while A. galloisi is spread in the Chinese-Himalayan subregion and has been recorded in the Soviet Union from the Sakhalin Island only (the geographical distribution of this species is shown on a map).


Towards unified analyses in chemical pathology. The use of different units, methods and instruments in chemical pathology has produced a situation in which different laboratories may produce numerically different results for the same analysis. The more complete use of SI, the introduction to Australia of reference methods and the production in Australia of a pool of reference material will reduce the extent of this problem.


[Epithelial ultrastructure of the midgut of the horsefly, Hybomitra schineri (Tabanidae)]. The study of the midgut of Hybomitra schineri by means of electron microscopy has shown that epithelial cells are of cylindrical shape. According to the electron density of cytoplasm the cells can be arranged into three subtypes. The apical surface of all the cells is covered by microvilli with filamentous glycocalyx. The peritrophic membrane of the 1st type is formed in females only during the blood digestion. Two types of secretion of digestive enzymes (merocrine and macroapocrine ones) were found, the latter being prevalent at the carbohydrate feeding.


Posterior fossa measurements. I. The normal size of the posterior fossa. The posterior fossa area was defined as that situated below Twining's line while the one above was called the supratentorial area. A ratio has been calculated: Posterior fossa area/Supratentorial area X 100 = posterior fossa ratio. Above 7 years this was (mean) 16.5% +/- 2 and below 7 years 14.0% +/- 4, with the ranges (13.2-20.2) and (9.0 - 19.4), respectively. When the ratio falls below 13% and 9% respectively, this implies therefore a malformation of the posterior fossa, i.e. too flat a space. Two formulas for calculation of the areas mentioned as well as two other ratios are also introduced.


Posterior fossa measurements. II. Size of the posterior fossa in myelomeningocele. In seven myelomeningocele patients, six were operated upon while in one severe case no surgery was performed. The posterior fossa areas were measured and expressed by the posterior fossa ratio method. In two shunted patients both ratios were primarily below the lowest normal limit, but following shunt operation the ratios become normal. In five patients who were not shunted one only showed a normal ratio, two showed borderline values and in a fourth instance the ratio normalized but before two years had passed. The fifth case remained unoperated and therefore the natural course could be followed. In this case the decrease in the posterior fossa ratio explained the progress of hydrocephalus.


Right aortic arch with left descending aorta (circumflex aorta). Roentgenographic diagnosis. Right aortic arch with retroesophageal segment is a rare anomaly with distinctive roentgenographic features. We present 2 patients, who on the barium oesophogram had an additional finding which has not previously been described. The typical features include an indentation on the right upper barium filled oesophagus (in the antero-posterior view), an oblique indentation descending from right to left (caused by the retroesophageal segment) and the left descending aorta. The oblique identation has not previously been described. The embryology and incidence of the lesion are briefly discussed.


Radiological abnormalities associated with anomalies of the ninth chromosome. The clinical and radiological features of Trisomy of the short arm of the ninth chromosome and of the Nail Patella Syndrome, both of which conditions are related to abnormalities of the ninth chromosome, are compared. Dislocation of the head of radius is seen in both conditions, as is a diminished patello condylar ratio. Several of the features described as being sporadic anomalies in the Nail Patella Syndrome are also seen in some patients with Trisomy of the Ninth Chromosome. The Trisomy 9 group also have several anomalies which are shared with Trisomy 21, Trisomy 17/18, Trisomy 13/15 and Trisomy 4, suggesting that some of these changes are a non-specific result of chromosome abnormality rather than being specific to the Trisomy 9.


Wandering spleen in three children.

Wandering spleen in three children. Three children with wandering spleen are presented. Liver-spleen technetium99m sulphur colloid scintigraphy is a helpful diagnostic tool that will demonstrate the abnormally located spleen or absent splenic activity when the blood supply is interrupted by a twisted pedicle. The diagnosis can also be made by angiography, but this relatively elaborate procedure is usually not necessary. Absence of the normal ligamentous attachments of the spleen associated with a long splenic pedicle may well be the cause of the wandering spleen and its torsion.


CT whole-body scanning in pediatric radiology. In an 8 month period 57 scans in 28 children have been performed using an EMI-CT 5005 General Purpose Scanner. Thirteen primary malignant tumours were evaluated, and scanning was of great value in localizing and delineating the lesion, and hence predicting the operability. Furthermore, secondary spread of malignant tumours was easily detected. In the continuing evaluation of treated malignant tumours CT has been used to estimate regression and relapse.


Angiographic evaluation of conjoined twins. Two sets of conjoined twins were studied by angiocardiography and cerebral angiography. Conjoined heart was demonstrated in the thoracopagus twins and surgical separation was impossible. Cerebral angiography disclosed the separate circulations in craniopagus twins and surgical separation was performed.


Thoracic and lumbar dural ectasia in a two-year-old boy. A two year old boy, admitted for evaluation of failure to thrive was found to have multiple paraspinal masses and a widened spinal canal. The masses proved to be lateral meningoceles, present varying degrees at every thoracic and lumbar level.


Passage of Gastrografin into the small mesenteric veins during an opaque enema. An opaque enema was carried out with Gastrografin. The patient was a 2-year-old French boy. As the enema progressed we saw the small mesenteric veins opacify: no significant consequence followed. This is the first report of such an incident.


Ileal duplication cyst: the importance of sodium pertechnetate Tc 99m scanning. Duplications of the alimentary tract may cause extensive bleeding when ectopic gastric mucosa is present. A successful diagnosis can be made preoperatively with the use of conventional barium studies as well as sodium pertechnetate Tc 99m scans.