The ureteral pressure profile: an experimental study in canine ureters. In 10 anesthesized mongrel dogs ureteral pressure profiles were obtained with two types of high density polyethylene catheters. During the profilometry X-ray image intensification was performed. The data obtained from both ureters and also from both types of catheters did not show any statistically significant difference (p less than 0.05). Near the uretero-vesical junction a statistically significant biphasically shaped graph with mean pressures of 89.2 +/- 5.25 and 81.7 +/- 8.43 (SEM) mm Hg for the proximal and distal top, respectively, was seen (p less than 0.05). This phenomenon corresponds with the morphology, as mentioned in literature and as investigated in this experiment by X-ray photographs at post-mortem specimens.


Contractility of the pyeloureteral pacemaker system. The patterns of mechanical contractility in the pyeloureteral pacemaker system were explored in an effort to identify some of the properties of initiating ureteral peristalsis. Rabbit renal pelvises were studied in vivo, in vitro perfused with Krebs solution through the renal artery and in segments. The results show that all segments of renal pelvic smooth muscle are capable of spontaneous contractions, the fornix having the highest frequency with respect to the pelvis. It is also demonstrated that the pelvic contractile wave concentrically accelerates along the renal pelvic perimeter. Under steady state conditions, renal pelvic pressure undergoes a low frequency oscillation having a period of 1--2 min which is flow-rate dependent. The results are discussed within the context of the pyeloureteral pacemaker system and the possible existence of a feedback mechanisms between the renal pelvis and the perfusion of the kidney.


Glucose metabolism in renal stone formers. Epidemiological studies indicate that renal stone disease is a rapidly increasing problem, already affecting around 10% of the entire adult male population. It has been suggested that environmental factors are responsible for this development, among them particularly disorders of carbohydrate metabolism. In the present study, therefore, 156 patients with active renal stone formation were investigated with respect to glucose tolerance and glucose-stimulated insulin response. Similar to other reports it was found that hypercalciuric subjects had evidence of an impaired glucose metabolism. However, this was mainly attributed to a tendency towards overweight in this group of patients and there were no firm indications of a true disorder of carbohydrate metabolism connected with hypercalciuria or the process of stone formation.


Observations on the value and limitations of infusion pyelography in anuric patients. Infusion pyelography was performed in 103 anuric patients with no attendant mortality. It was useful in 83 cases in distinguishing obstructive uropathy from renal parenchymal disease. However, in the remaining 20 cases when either renal parenchymal disease co-existed with obstructive uropathy or obstructive uropathy existed alone under certain circumstances, opacification of the collecting system did not occur. The clinicopathological setting of some of the latter group of cases is illustrated by examples.


Axonal transport of horseradish peroxidase: a new method for tracing nervous control of the bladder. A new method for tracing the nervous control of the bladder is described. A protein substance, horseradish peroxidase, has been shown to be absorbed and transported by nerve fibers. The substance was injected into the bladder neck region of a series of dogs. After uptake by motor neurons the horseradish was carried to the spinal cord segment controlling micturition. Implications regarding the neurophysiology of the urinary tract are discussed.


Clinical study on correlation with the 60-min plasma phenolsulfonphthalein concentration and other renal function tests. An analysis of the reliability of the 60-min plasma phenosulfonphthalein concentration (PSP60) as a renal function test has been made in 40 patients with or without urinary dead space. PSP60 correlates with 15-min urinary PSP excretion and 24-hour endogenous creatinine clearance in patients without urinary dead space. 15-min urinary PSP excretion showed unreliability as a renal function test in patients with urinary dead space. However, we confirmed that PSP60 and 24-hour endogenous creatinine clearance were reliable indicators of renal function in these patients.


[Liver helminthic cenosis study of sheep]. A total of 2400 incomplete helminthological postmortem examinations were carried out with sheep in 1972-1976. Four species of helminths were found in the liver: D. lanceatum (80.7 per cent), Ech. granulosus (68.4 per cent), F. hepatica (25.6 per cent), and Cyst. tenuicolis (1.7 per cent). Mixed infections were established in 68.2 per cent of the livers: F. hepatica, D. lanceatum, Ech. granulosus--11.5 per cent; F. hepatica, D. lanceatum--6.8 per cent; F. hepatica, Ech. granulosus 3.8 per cent; and D. lanceatum, Ech. granulosus--46.1 per cent. Single worm infections were observed in 26.9 per cent of these organs: D. lanceatum--16.3 per cent; Ech. granulosus--7.1 per cent; F. hepatica--3.5 per cent. Cysticercus tenuicollis was established in 1.7 per cent of the cases. Worm-free were only 5.2 per cent of the livers. In decending order the parasite burden ranked as followes: Ech. granulosus, D. lanceatum, F. hepatica, Cyst. tenuicollis.


[Thermal stability of paneled swine-breeding structures]. Veterinary and hygienic evaluation was made of the thermal stability of panel buildings of the standard BS-70 for the breeding and fattening of pigs. A low correlation was established between the temperature amplitude in- and out-doors, i.e., the thermal stability of the ethologic totality of the buildings was considerable. The correlation between the temperature outdoors and the temperature difference (deltat) as regards the temperature indoors was high and negative, i.e., at lower outdoor temperature the gradient deltat rose, and vice versa. Buildings without heating, having a BS-70 construction retained an optimal temperature regime in the sections for breeding sows, which was within the range of -15 degrees C up to +26 degrees C and in those for fattening--from -21 degrees C up to +24 degrees C. Summer droughts constitute a technologic and technical problem.


[Changes in the serum proteins of cattle with leukemia]. Studied was the content of total protein and the protein fraction ratio in the blood serum of 14 normal and 58 leukosis-affected cattle. It was found that in the initial phase of leukosis there were no essential changes in the serum proteins. In animals with a more advanced course of the disease (up to 25000 leukocytes per ml, with 65-85 per cent lymphocytes) no drop of the albumins and rise of the alpha-globulins and gamma-globulins were observed, however, there were cases presenting comparatively high lymphocytosis (up to 23000 lymphocytes) without changes in the serum proteins. In animals with well manifested tumoral changes there were almost invariably a strong drop of the albumins (up to 15-20 per cent) and a rise of the alpha1-globulins (up to 15 per cent), alpha2-globulins (up to 18 per cent), and gamma-globulins (up to 51 per cent).


[Toxicity studies of Pharmachem's tylosin tartrate for broilers and turkeys]. Studied were the acute, subchronic, and chronic toxicity of the Pharmachim tylosin tartrate as well as the tolerance of chicken broilers and turkeys. The mean lethal dose of the antibiotic at subcutaneous application to 28-32 day-old broilers was 620 mg/kg; the oral dose was 1500 mg/kg. In the case of 42-45-day-old broilers these values were 740 and 5400 mg/kg. The LD50 at i/v infusion for 75-77-day-old ones was 48 mg/kg. Beside the age and route of introduction toxicity was found to depend on the initial biologic activity of tylosin tartrate. The subcutaneous injection of tylosin tartrate at the rate of 30 mg/kg for 20 days did not lead to changes in the appetite, behaviour, growth, and structure of viscera. A 42-day treatment at the same rate, however, resulted in slightly manifested and fully reversible dystrophic changes in the liver and kidneys. Higher doses (90 and 150 mg/kg) led to transient depression, stunting of growth, and a rise of the urea level and the activity of blood transaminases as well as to moderate destructive changes in the liver and kidneys. The stimulation of growth and the improvement of feed conversion (without deviations in the clinical and biochemical indices of the blood and the structure and development of the viscera in broilers) were recorded after the application of a water-soluble formula of tylosin tartrate for a period of 98 days offered via the drinking water in amounts equal to or exceeding 2 to 4 times the ED50. Turkeys' tolerance for the preparation was evaluated as very good so far as single i/m injective applications were concerned in doses exceeding 3, 5, and 10 times the average effective rates, no differences in this respect being noted with the comparative use of tylosin tartrate produced by the Elanco firm.


[Production of a polyglobulin preparation against respiratory diseases in calves]. On the basis of literature data concerning the production of polyglobulins from animal sera with the employment of appropriate, short term methods, and using the author's personal experience a method was tested for the production of specific polyglobulins against the respiratory complex in calves. A particular scheme was used for the purpose, hyperimmunizing adult cattle with killed vaccines against parainfluenza-3, adenoviruses 1 and 3, and IBR. The hyperimmune serum obtained was further treated by the etanol short term method to produce a high-titer polyglobulin. The preparation was tested in the field in the control of respiratory diseases in calves, showing very good prophylactic effects with an abrupt drop of the morbidity rate. In the case of disease outbreaks among treated animals these responded positively to an effective causal therapy. Thanks to its usability the method is recommended for the practice.


[Lactate dehydrogenase isoenzymes in the colostrum of cows]. Investigated was the isoenzyme spectrum of lactatedehydrogenase in the colostrum of cows which was obtained at various intervals after calving. It was found that the activity of lactate dehydrogenase was most effective immediately following calving when a total of 5 isoenzymes were established, which lowered their activity with the extention of milk secretion.


[Cases of nacrobacillosis in calves].

[Cases of nacrobacillosis in calves]. Necrobacillosis was established in 48 out of a total of 90 calves aged from 1 to 6 months, raised on a common premise. The disease affected only calves under the age of 3 months, running a more severe course with high mortality in the younger animals. Along with the clinical manifestations associated with the organs involved there was also bradicardia in most of the diseased calves. Nonreactive necroses were observed in the digestive organs, liver, spleen, lungs, and lymph nodes with adjacent resorptive foci of histiocytes, fibroblasts, and giant cells.


[Effect of the protein content in the ration of sheep on the development and pathogenic action of F. hepatica]. Examined were two groups of 12 sheep each, infected with metacercaria of Fasciola hepatica. The first group were given a ration that contained 14 g crude protein per kg of metabolic weight, and the second group--a ration, containing 8.24 g, i.e., as much as was fed to animals in the field. In animals that were given higher amounts of protein developed 29.1 per cent less Fasciolae, on an average, and 5.2 per cent less worms reached sexual maturity as against the group that was offered less protein. The higher content of protein in the diet was shown to produce a protective effect against the strong clinical development of facioliasis.


Possible existence of hybrid glycosyltransferase in heterozygous blood group AB subjects. The human blood group glycosyltransferases A and B have a dimeric structure, i.e., the A enzyme is an aa dimer and the B enzyme is a bb dimer. Considering the fact that the ABO blood group determinant are not x-linked, i.e. both A and/or B genes are expressed in a given cell, a hybrid enzyme (ab dimer) may exist in heterozygous A1B subjects. Because the A enzyme, but not the B enzyme, adsorbs with Sepharose 4-B, the adsorption characteristics of the A and B enzymes from plasma fo various phenotypes were examined to look for this hybrid enzyme. The A enzyme activity from A1 plasma and from a mixture of AU and B plasma was completely adsorbed to Sepharose 4-B, while 25-50% of A enzyme activity from heterozygous A1B plasma was not adsorbed. The results indicated that heterozygous A1B plasma contains an additional enzyme component which does not exist in a mixture of A1 and B plasma, suggesting the existence of a hybrid heterodimer (ab) in heterozygous A1B subjects.


The Redelberger antigen Rba.

The Redelberger antigen Rba. A new low frequency antigen, Rba, has been found in three blood donors. Studies on their families show that the antigen is inherited as a Mendelian autosomal dominant character. Rba segregates independently from ABO, MNSs P1, Rh, Kell, Duffy, Kidd, ACP1 and PGM1. Anti-Rba is not common in sera containing multiple antibodies ot low frequency antigens.


An improved method for the identification of Gc1 subtypes (group-specific component) by isoelectric focusing. The occurrence of common subtypes of the Gc1 gene in a German population (n = 261) was investigated by isoelectric focusing on thin layers of polyacrylamide in the pH range 4-6. Six common phenotypes designated Gc 1S, 1F, 1F-1S, 2-1S, 2-1F, and 2 are considered as gene products of three common alleles with the following frequencies: Gc1S=O.603, Gc1F=0.125, and Gc2=0.272. The sum of the allele frequencies of Gc1S and Gc1F corresponds with that of the 'old' Gc allele. Family investigation are in agreement with an autosomal codominant way of inheritance. the method employed provides an identification of the subtypes within 4 h without using anti-Gc-serum for immunoprecipitation.


Ethanol and heat-treated plasma fractionation methods in South Africa. Modifications of the Cohn techniques are the methods of choice for the preparation fo dilute albumin (PPS) and gamma-globulin solutions on an industrial scale. For the manufacture of refined albumin solutions, however, considerable labour and material is saved if crude, ethanol-precipitated fractions are heated in the presence of stabilisers in order to purify the albumin. The technique is simple and cheap, and yields a safe product of high quality. Bacterially contaminated and highly haemoglobinized plasma can be successfully heat-treated.


Local Shwartzman-like phenomenon prepared with haptoglobin-hemoglobin complex and provoked with prostaglandin. Intradermal injection of haptoglobin-hemoglobin (Hp-Hb) complex followed by intravenous injection of prostaglandin (PG) F2a or E2 produced a local Shwartzman-like phenomenon (LSLP) in rabbits, whereas PGE1 has no provoking action. Intradermal injection of hemoglobin or erythrocytes also produced LSLP when provoked with endotoxin or PGF2alpha. The provoking action of endotoxin in the local shwartzman reaction may not be entirely mediated through PGs.


Inhibition of the local Shwartzman reaction by turpentine, prostaglandin E2 and carbon tetrachloride. The conventional local Shwartzman reaction (LSR) did not occur in rabbits whose plasma haptoglobin (Hp) was lowered by treatment with carbon tetrachloride, nor in animals in whom Hp was elevated after treatment with turpentine, or PGE2 or endotoxin. The possible mechanisms of such inhibition of the LSR are discussed.


Fy (a-b-) phenotype in Czechoslovakia.

Fy (a-b-) phenotype in Czechoslovakia. A family of gypsy origin, with 5 Fy(a-b-) members was found in Czechoslovakia. The involvement of the silen allele, Fy, in paternity testing is discussed.


[The intestinal hormones secretin and pancreozymin, and the study of the secretory pancreatic function in man advanced in years (author's transl)]. The values of the pancreatic function obtained after stimulation with secretin and pancreozymin have to be regarded as a variant of the geriatric norm. They are of significance for functional diagnostics and for differentiating between peculiarities of the pancreatic function caused by old age on the one hand and pathological changes on the other. The decrease in the exocrine pancreatic function, which was observed in actually healthy persons at an advanced age under normal conditions, goes on in most cases without symptoms. In the event of stress situations (faulty diet, diseases of other organs than the gastrointestinal tract) and likewise in the presence of a clinically marked indigestion, the prescription of a substitution therapy is indicated in particular for persons at an advanced age and old people.


[Age-specific features of hypothalamus-hypophysis-suprarenal gland action on liver cells of rats (author's transl)]. Relevant studies show that there is a reduction in the regulation of hormonal stimulation of the genetic system in the cells and tissues at old age, which results in the early appearance of the "fatigue" reaction at old age and in reduced stimulation of the ferments tested. In the hypothalamus-hypophysis-suprarenal gland system the hypothalamus has the smallest regulation range; it reveals manifest changes due to ageing.


[Cytochemical studies of the alkaline leucocyte phosphatase activity (ALPh-A) in ageing and old patients suffering from acute pneumonia (author's transl)]. 1. An ALPh activity increase is evident up to advanced age in patients suffering from unspecific acute pneumonia 2. In ageing and old patients, the ALPh activity diminishes manifestly with increasing age 3. ALPh-A diminishes at a slower rate with increasing age than the left shift according to Schilling 4. Cytochemical examination of the ALPh-A can be successfully used for obtaining reliable clinical and paraclinical diagnoses of acute pneumonia.


[Results later many years after TEA in femoro-popliteal segment (author's transl)]. Our results later many years after 231 TEA in femoro-popliteal segment are based to examinate the indications of this reconstructive operation and to compare with other methods of arterial reconstruction. Resulted: the TEA is always a good method of biological worth without risk. This method authorized to indicate the reconstruction of chronical arterial occlusions. However the method is not to apply to all arterial occlusions without criticism only to selected patients.


[Development of standard psychological values for measuring brain performance at different ages under normal and pathological aspects (author's transl)]. The studies have shown that especially those tests that put the person tested under intense time pressure (d2 test and Pauli test) are suited for detecting diminished brain performance caused by cerebrovascular and other defects. The d2 test has proved to be the most sensitive and at the same time the most economical one (5 min). On the other hand the findings made by Löwe, Eitner et al. show that ageing people suffering from cerebrovascular disease but still able to work should be assigned work that requires a great deal of care rather than work that has to be done under time pressure. The determination of the flicker fusion frequency is seen in literature as a measure of vigilance. But the influences are of a very complex nature. We have found no correlation between the tests conducted by us, the attention test, the concentration pattern test and the Pauli test.


[Changes in the social situation of old-age pensioners in a city (an interval study) (author's transl)]. The results of the study reveal that on the one hand a considerable share of the care required by ageing citizens is provided by members of their family, their friends and neighbours, but on the other hand that due to the forms of life of modern society, especially in cities, the management and organization of the care of the aged must be improved in all its stages in order to register and help every single person in this category in need for help. To achieve this objective all bodies concerned with caring for aged people should work jointly and in a co-ordinated fashion. Owing to the fact that, in our opinion, the present organizational forms of social care no longer meet the requirements determined by the humanitarian objectives of our socialist state the authors propose that new approaches should be elaborated, discussed and introduced.


[Experience gathered through a sociological analysis within the framework of a gerontological longitudinal study (author's transl)]. The authors present the results of a sociological analysis within the framework of a longitudinal study and discuss their relevance.


[The situation existing in some vital forms of care of ageing citizens in an urban district of Leipzig (author's transl)]. 513 old-age pensioners aged 66 to 70 were asked about various aspects of their life in compliance with the "Guideline for interviewing ageing citizens". Special attention was paid to simple vital domestic work and conclusions were drawn with regard to improving the care of ageing citizens.


[To the process of registration of ageing process (author's transl)]. A cybernetical scheme and a corresponding system of differential equations, describing the dehydration and the diminishing metabolism rate of the aging cell as well as of the whole of the organism, are generalised to adapt them also to other phenomena of aging. The resulting expressions are tested by comparison with a number of representative theoretical and experimental dates of various aging processes.


[The aging changes of biological variability (author's transl)]. 1. Examples are given to justify the concept that biological variability is dependent on age. 2. It appears possible that the variability of fundamental parameters of those with a strong genetic fixation increases toward the middle of the life span and decreases again in the senium. 3. The variability of most variables increases with age. The more complex the variables, the greater the increase. 4. Originally unitary statistical populations may split up into several populations in the course of life. These will then require separate statistical treatment. 5. Our considerations seem to have some significance for the economical planning of tests and the selection of test persons.


[Initial results of investigations into the proliferation kinetics of enterocytes (author's transl)]. The changes of absorption appearing in man and caused by aging are probably due to disturbances of the proliferation and exfoliation kinetics of the enterocytes of the small intestine mucosa. The relevant experimental examinations available are insufficient because the results were obtained from a few animals only. Our own systematic autoradiographic examinations of rats are designed to contribute to a clarification of this problem which is important for practice.


[Intestinal absorption in the elderly (author's transl)]. The extent of intestinal absorption and malabsorption may be exactly stated by means of the method "generalized absorption". According to first-hand examinations an alteration of absorbing kinetics of D-xylose dependent on age could have been demonstrated. The velocity of absorption decreases in the elderly  and the general absorbing process are prolonged. The extent of absorption restriction in the elderly are under physiological circumstances without clinical value. The health elder man disposes of the same power for a complete absorption of an offered substrate like the younger one. An increasing of cases with a malabsorption in the age may be explained by a increased multmorbidity in the elderly.


[Enzymes of carbohydrate and lipid metabolism in dependence on age (author's transl)]. The levels of the rat liver enzymes glucose-6-phosphate-dehydrogenase, alpha-glycerophosphate-dehydrogenase and citrate cleavage enzyme decrease between the age groups of 3 and 18 months. The half-life time of these enzymes is uneffected by age and the diminished levels of the enzymes in the liver of old rats can be ascribed to a reduced rate of enzyme synthesis. The half-life time of malic enzyme decreases as a function of age and this increased enzyme destruction may contribute to the diminished malic enzyme level of old rat liver.


[Age dependence of lipoprotein lipase activity of adipose tissue (author's transl)]. The lipoprotein lipase activity of adipose tissue of rats decreases as a function of age. A diurnal rhythm with a maximum at 14 h was observed in the lipoprotein lipase activities of both 3 month and 18 month old rats.


[The biosynthesis of fatty acids in dependence of age (author's transl)]. We determined the synthesis of fatty acids in rat liver in vitro, using the method of labeling the fatty acid with tritiated water. After the well-known increase of the biosynthesis of fatty acids in the postnatal period we found an age-dependent decrease which is positively correlated with the activity of lipogenic enzymes of rat liver.


[Dependence from age of reaction time by acoustical stimulation (author's transl)]. The reaction time by optical and acoustical stimulation decreases until 20 years, and ascends then. The acoustical reaction time is shorter than the optical, with the exception of some unexplicable falls in the senium.


[A modification of the Gompertz plot resulting from the age index by Ries and an approximation of the survivorship curve (author's transl)]. The shape of the survivorship curve can easily be interpreted on condition that the probability of death is proportional to an exponentially rising function of ageing. According to the formation of a sum for determining of the age index by Ries it was investigated to what extent the survivorship curve may be approximated by a sum of exponentials. It follows that the difference between the pure exponential function and a sum of exponentials by using possible values is lying within the random variation. Because the probability of death for different diseases is variable, the new statement is a better one.


[Living condition of aging working women in family, marriage, and profession (author's transl)]. Our research has elucidated the important role of family life and intimate sphere for the way of living of women in the conversion phase (40-60 years). It is shown that negative factors lie in too hard housework, in deficiency of help by husband, in familiar conflicts and conflicts of married life, and in unfavourable conditions of employment. The necessity of integrating gerosexualhygiene in measures for preparing for an active and harmonious old age was deduced from our results.


[Aging changes of passive electrical and mechanical properties of human skin (author's transl)]. Mechanical and electrical properties of human skin are definable by a apparatus, developed by Pliquett and Rollius (1975). Using this method was determined a value, correlate to the product of the elasticity and the electrical conductance on 90 healthy persons. This value depends in a characteristically way on age, with a maximum near 25 and 55 years. The amount of the maximum depends on sex and profession of the probands.


[The value of physical training as a preventive measure in chronic ischemic heart disease]. A critical valuation of the hitherto achieved results concerning the problems of the influence of a permanent training on the course of the chronic ischaemic heart disease with the following result is performed: -A perseverance training which was begun in adolescence and permanently continued allows to expect a genuine preventive effect concerning the chronic ischaemic heart disease, though not in every case. Moreover it certainly contributes to retard temporarily the beginning of the chronic ischaemic heart disease and to restrict the sequels of a myocardial infarction. -When a chronic ischaemic heart disease exists no effects on the arteriosclerosis in general and the sclerosis of the coronary arteries in particular is to be expected. These show a progredience which cannot be influenced by training. -Also the effects on the myocardium, particularly on the formation of collaterals and the evoking of adaptive effects in the myocardiac cell itself are not to be expected, when the chronic ischaemic heart disease has already developed. Nevertheless, under this condition a perseverance training seems to be not fully hopeless, since through peripheral effects and general effects secondary effects on the heart are possible.


[Simultaneous diagnostic studies of bacteriuria as related to method of urine collection]. In a direct comparative series were compared 204 functional, catheter, and mid-stream urines which were got simultaneously in patients with chronic pyelonephritis. In suprapubic vesical puncture 113 had a sterile urine, 91 showed a bacteriuria. After catheterisation 103 specimens were still sterile and 101 were bacterially infected. Of the mid-stream urines only 90 proved sterile, and 114 times pathogenic agents could be proved. While in males mid-stream urines achieved good results, in females a contamination was pretty frequent. Repeated investigations, estimation of the number of germs, and optimum taking essentially improve evidence. Though in females by means of catheterisation better bacteriological results may be achieved, in rare cases there is the danger of the invasion of germs. A clear judgment is possible, using the suprapubic vesical puncture.


[Optimization of therapy using cardiac glycosides]. By the estimation of the serum glycoside concentration during the last years numerous new recognitions have been got, particularly concerning the pharmacokinetics of the heart glycosides, which increasingly will be reflected in the clinical practice. Apart from thoughts on pharmacokinetics the author adopts a definite attitude to glycoside tolerance, to the influence of age and bodyweight as well as to the importance of disturbances of the renal function. Moreover it is referred to new aspects in the dosage of heart glycosides, in which case the revision of the central therapy recommendations seems to be necessary.


[Effect of bronchial reactivity on the whole-body plethysmographic inhomogeneity parameter REmax/RE0 and its value in the early diagnosis of chronic nonspecific lung diseases]. Examinations performed with the help of the body-plethysmographic inhomogeneity parameter REmax/RE0 prove the close connection between the development of chronic unspecific pulmonary diseases and the appearance of disturbances of the ventilatory distribution. The functional disturbance metioned is further increased by the bronchial provocation and may partly be demonstrated in a characteristic way also in inconspicuous initial findings. The body-plethysmographic inhomogeneity parameter REmax/RE0 is, however, not suited for the early diagnosis of chronic unspecific pulmonary diseases, since with its help the verification of disturbances of the ventilatory distribution is successful only then, when the total resistance is already increased. For the final judgment of the aptitude of the bronchial reactivity test for the increase of the valency of methods of the distribution analysis in the early diagnosis further examinations are necessary.


[Determination of glycogen phosphorylase B--a contribution to the enzymatic diagnosis of acute myocardial infarct]. On the basis of a small number of patients with the tentative diagnosis acute myocardial infarction the diagnostic valency of the glycogen phosphorylase was tested. A separation between severe stenocardia and myocardial infarction is possible. After simplification of the methodology the glycogen phosphorylase might substitute in higher specifity the creatinine kinase.


[Bone fluorosis without occupational exposure in chronic renal insufficiency]. Report on a 70-year-old male with bone fluorosis which was ascertained radiologically, by section and fluor analysis in the bone ash. With empty professional anamnesis as cause was found the presence of a chronic renal insufficiency with simultaneously increased fluor content of drinking water. The decreased renal excretion of fluoride might have led to the pathological development in the bones. It is referred to the significance of extra-medical fluor load and the knowledge of the renal function when halogen is therapeutically used.


[Open disponibility before self - on Medard Boss' Basis of Medicine and Psychology]. In this book, written in collaboration with Heidegger, Medard Boss endeavours for the first time to use Heidegger's late philosophical oeuvre as a basis for medicine and psychology. Boss attempts to uncover behind the understanding of man as existence, which prevail in "Sein und Zeit" and which has been so influential for Binswanger's existential analysis, a more original understanding of man as eksistence, as "open disponibility" (Offenständigkeit). The interest of this view resides in the resulting general principle of classification and interpretation of all forms of disease, giving rise to an "existenialistic pathology". The problematic aspect consists in the failure to integrate the "being-onself" in the understanding of human existence as open disponibility, which leads to a one-sided interpretation of disease processes.


[Understanding implicit behavior].

[Understanding implicit behavior]. The point of departure of the present paper is the comprobation that the visible behaviour of an individual conveys information about his internal state to others, yet the description of this information transfer is limited by an insufficient conceptual framework. The most important historical approaches to the field of expressive behaviour are discussed. The peculiarity of language in information transfer as an "explicit" system of rules is constrasted with all the other kinds of behaviour which also play "informative" and "communicative" roles. For these the concept of "implicit" system is proposed and discussed. It is further shown that a strict distinction between "implicit" and "explicit" is not possible for behavioural manifestations, but rather they constitute poles of a continuum in which all communicative modes could be incorporated. Dichotomies most commonly used in human and animal communication and interaction researach are compared with the presented implicit - explicit dichotomy. The advantages of the latter are seen in the semantic clarification it could provide, thus leading to a somewhat clearer approach to different forms of behaviour research.


[The social partners of depressives].

[The social partners of depressives]. The interactional behavior of depressed individuals and that of control subjects was observed by means of a coding system. The partners of depressed individuals showed different categorial frequencies than the partners of non-depressed individuals. In addition, differing categorial frequencies were displayed by long-term and short-term partners. Short-term partners of depressed individuals were reserved and considerate whereas long-term partners tended to display more demanding and critical behavior. The results are discussed in behavioral terms.


[Psychic disturbances in adopted children--an overview of the postiion of clinical research]. Empirical studies on the psychopathology of adoptees are summarized and discussed with regard to the possibility of a relationship between adoption and psychic disturbances. The results leave the question open as to whether adoptees are more prone to psychic disturbances than other individuals. Those under treatment do not seem to be more severely disturbed than others. Whereas however the adoptees display more disturbances in their social behavior rather than neurotic disturbances, the relationsship is reversed in the population of the non-dopted. The causes seem to lie in the conditions in early childhood and in the experience of being adopted itself.


Lymphokines. VI. Factors in human and other heterologous sera inhibiting the migration of guinea pig macrophages. Different heterologous sera including human, rabbit, bovine and fetal calf serum (FCS) showed a strong inhibiting effect on the migration of guinea pig peritoneal macrophages (GPPM), compared to the migration of GPPM in homologous guinea pig serum. The inhibiting effect of these sera on the migration of horse monocytes on the other hand was much less marked. Fractionation of human and rabbit serum showed the 4 S fraction to be most inhibitory on GPPM migration. The migration inhibiting effect of heterologous sera on GPPM was prevented by addition of homologous (GP) serum, by absorption of the sera by various guinea pig cells, by heating at 56 degrees and by addition of alpha-L-fucose. Human sera were found to be strongly cytotoxic for 51Cr-labelled guinea pig erythrocytes and lymphocytes, but not for horse lymphocytes. Upon absorption with guinea pig erythrocytes, lymphocytes and kidney cells, the cytotoxicity of the human sera was strongly reduced. Accordingly, the role of heterophilic antibodies and/or of heat-labile MIF-like factors in heterologous sera has to be considered in al macrophage migration experiments where heterologous sera are being used. These factors may differ from the heat-stable MIF activity generated upon antigen- or mitogen-induced stimulation of cultured lymphocytes.


[Determination of the association constant K0 and the number of combining sites n of the mitogenic lectin I and its structural relationship to the nonmitogenic lectin II from the sponge Axinella polypoides (Schmidt) (author's transl)]. The association constant K0 and the number of combining-sites n for the mitogenic lectin I from the sponge Axinella polypoides was determined. K0 was found to be 2,8 . 10(2) 1/mol and n = 1. Immunoelectrophoretic investigations demonstrated, that lectin I and the nonmitogenic lectin II of Axinella polypoides have structural relationships but have also domains which are unique to them. The correlation between these findings, their carbohydrate specificity and mitogenicity is discussed.


A special constraint on the evolution of composite signals. Many animals use composite signals, combining e. g. auditory and visual components. If the components travel at different speeds, the time lag between reception of the components increases with increasing distance from the sender. Problems arising especially from rhythmical repetition of composite signals are discussed and possible solutions are indicated.


[Clinical and morphological characteristics of chronic endometritis]. 130 cases of chronic endometritis, defined by the histologic criteria, were reviewed retrospectively for etiologic antecedents and clinical course. The over-all incidence of chronic endometritis in the present series was 2.32 per cent. The presence of plasma cells in the endometrium is essential to the diagnosis of chronic endometritis. Irregular vaginal bleeding is the commonest presenting symptom. The treatment of chronic endometritis should be individualised and related to the ovarian function.


[Development of pregnancy in genetic risk patients with special reference to transabdominal amniocentesis]. A complex 3-stage-method of pregnancy evaluation in genetic patients with a planned-transabdominal amniocentesis reduces essentially the risk of the intervention; the state of maternal organism, placental function and fetal growth are repeatedly assessed. Fetal growth retardation together with poor placental function indicated in 4 cases a malformation of the type not be able to be diagnosed cytogeneticylla. Our experience is derived from 404 pregnancies followed before and after transabdominal amniocentesis.


[Effect of antibiotics on the early stages of embryogenesis]. Tetracycline and Fusidin have the ability to flow through the placenta in a high quantity. It is proved, that these preparations in the early stage of ontogenesis developed considerable embryotoxic quality. High danger in the pregnancy is given with Tetracycline. Therefore the application of these antibiotics during the pregnancy is not indicated.


[Late toxicosis, disseminated intravascular coagulation disorders and acute fatty liver during pregnancy (Sheehan's disease II)]. The authors discuss some etiologic and clinical aspects of M. Sheehan II based on 2 histologically proven cases. They point out the consecutive connection between the preeclampsia, DIG and the development of the syndrom. The role as starters of some medicaments beside other factors is suggested. The paramount importance of an immediate diagnosis and adequate and correct therapeutic measures, which include a prompt interruption of pregnancy and treatment of the acid-base dysbalance, the renal and haematologic failure is stressed, as well as the prophylactic measures.


[Pros and cons in the therapy of hypertensive gestoses. I. Pre-eclampsia and eclampsia]. The authors report on the modern trends and the pro and contra in treatment of pre-eclampsia and eclampsia. Ambulatory therapy is only allowed in mild preeclampsia by rest, high-protein lowcaloric diet and mild sedation. Also during the stationary therapy diuretics should be commonly avoided. As sedative drugs magnesium sulfate, diazepam, clomethiazole and barbiturates are recommended. Antihypertensive drugs are given when the blood pressure exceeds 180/110 mm Hg. Favoured drugs are hydralazine, methyldopa and beta adrenergic substances. For the treatment of eclampsia well tried standardized methods with few drugs as magnesium sulfate and when necessary barbiturates and hydralazine are mentioned, furthermore, the combination with new therapeutic managements as the osmo onco-therapy and the modern anaesthetic technics. There is agreement that in severe preeclampsia induction of labor should be performed before term. The indication for that is facilitated by the modern perinatal diagnostics.


[Pros and cons in the therapy of hypertensive gestoses. II. Chronic hypertension]. The authors discuss some controversial aspects of the therapy of chronic hypertension in pregnancy. In cases in whom the blood pressure has been treated before conception the therapy should be continued. But there is no agreement about beginning of the hypotensive therapy during pregnancy. Some authors recommend an early treatment, others give hypotensive drugs only for those women who show no fall of the blood pressure in the second trimester or when the blood pressure exceeds 170/110 mm. Hg. These controversial opinions result from our defective notice of the uteroplacental blood flow during a long-continued application of antihypertensive drugs and their dose-response. As hypotensive agents methyldopa, hydralazine and beta adrenergic substances are recommended, on part of internists also medicaments which are used in nonpregnant patients. In severe chronic hypertension premature induction of labor is necessary. In hypertension III degree and IV degree the pregnancy should be interrupted.


[Colposcopic picture of blood vessels in the early stages of cervix cancer]. A case of carcinoma in situ with the beginning of invasion is presented. In contradistinction to the changes characteristic of such cases, in this case branching vessels completely typical of a normal transformation zone were found. This suggests only adaptive vascular hypertrophy without vascular neoplasia, in spite of the cancerous changes in the epithelium in situ.


[Our experiences with prehypoglycemic insulin treatment in the care of pregnant diabetics]. Results are shown obtained from 88 patients who were pregnant and diabetic, treated from November 1972 until November 1976 at the "Gonzalez Coro" Hospital and the Endocrinology Institute of Havana. These patients received a therapeutical regime which took into consideration an increase in the dosis of simple, regular insulin, until the "maximum tolerated dosis" was reached in each case, which was capable of situating this patient in a real prehipoglicemic status. Among the modifications which were introduced was the diet with calories requirements estimated attending to the weight, height and age of the pregnant women. We employed two classifications for the patients: that from Pricilla White modified by Pedersen, and our own institution's, which was  aimed to know the "mother-fetus-prognosis". The group includes 17 patients of type A, 14 of type B, 20 of type C, 29 of type D and 8 of type F. These last ones were diagnosed through kidney-biopsia during the puerperium. A fix date for birth was not predeterminated; each patient was allowed to go ahead with her pregnancy until spontaneous delivery began. The rate of cesarean operation was 52%, and the weight of the newborns was within the average limits, except in 4 cases. The perinated death-rate of the group was 3,4% and the Apgar-score at the first minute of life was satisfactory in 79,5% of the group. It is concluded that the individual normoglicemia is essential for the control of the diabetic woman, and that mother's glicemia will have an effect on the fetus, producing a reduction of the gradient of mother-fetus glicemia and, on account of this, also a reduction of the hiperinsulinism reaction of the fetus with all its ill results.


[Cytohistologic correlation of stage III using Papanicolaou's method]. 200 cytologic smears classified as Papanicolaou's class III at the department of cytopathology of the "America Arias" gynecobstetric teaching hospital are studied. Gynecological procedures, cytologic and histological techniques used in the study of each patient are described. Considerations on the age of appearance of cervix and endometrium benign and malignant lesions are made. Conclusions derived from the final histological diagnosis of patients are made.


[Ultrastructural changes of the terminal placental villi in placental insufficiency]. Ultrastructural changes of the placenta in toxemia of pregnancy and in diabetes are described. In toxemia of pregnancy in the placenta definite morphological changes were observed; marked atrophy of the syntitial layer was followed by hyperplasia of the cytotrophoblastie cells. The most expressed changes occurred in the vessel wall: swelling of the endothelium, narrowing of the vessel-lumen, deposition of filamentous material in the cytoplasma. Morphological changes in the placenta in diabetes are moderate as compared to those observed in toxemia. Thickening of the basal membrane seems to be most characteristic. Ultrastructural changes are almost identical to those observed in toxemia. Morphological changes revealed may be responsible for the  insuffiziency of the placenta and the intrauterine damage to the foetus.


[Investigations on strain-specific differences in the relationship between hemagglutination-inhibition titers and the number and quality of antibody molecules oriented to influenza virus type A strains (author's transl)]. For a series of influenza virus A strains, the number of antibody molecules per ml (A) and their quality in terms of the equilibrium constant K was determined. The relationship between the values of A and K and the HI titers was examined and the following results were obtained: 1. For the majority of strains tested, no significant differences in the number of antibody molecules per HI unit were found. For some strains, significantly differing A/HI values were recorded. However, it cannot be excluded that these differences were artifacts, reflecting different numbers of antigenic sites per virus particle for the strains compared and not different numbers of antibody molecules per HI unit. 2. N2 antineuraminidase (= AN) antibodies were found to influence both the A and HI values in like manner when allowed to react simultaneously in presence of antihemagglutinin antibodies with homologous virus. As a consequence, the A/HI ratios were not measurably influenced by AN antibodies, reflecting antihemagglutinin antibodies, only. 3. For the sera tested, the HI titers were found to depend primarily on the values of A and much less on the values of K. The results are interpreted to suggest that the ratios of HI titers measured against different influenza A strains will in first approximation reflect the ratios of the concentration of antibody molecules.


[Stimulatory action of Brassica oleracea var. sabauda (Savoy) on mycobacteria and mycobacterial infection (author's transl)]. Eleven vegetable species were investigated for the presence of growth-stimulating activity on mycobacteria. It was found that savoy juice (Brassica oleracea var. sabauda), given orally, posessed a pronounced stimulating effect on M. tuberculosis, M. bovis, M. kansasii, M. avium and M. intracellulare serotype Davis in the serum of experimental animals when tested in auxanograms (Table 1). Another 2 species, paprica (Capsicum frutescens) and radish (Raphanus sativus var. albus) showed only insignificant stimulating activity. Oral application of savoy juice in addition to ordinary diet had an aggravating effect on guinea pigs infected peritoneally with M. kansasii. Tuberculosis of the spleen was found only in the groups treated with savoy juice (in 28.57% after administration of 1 mg and 47.36% after that of 10 mg of mycobacteria). The counts for animals with tuberculous lesions of the lung and liver were significantly higher in the groups treated with savoy juice (Table 2, Fig. 1) as compared with those for infected, but untreated guinea pigs. The possible influence of stimulating substances in vegetables on mycobacterial infection, especially during malnutrition, is discussed.


[Present-day status of tularemia prevention in the USSR and further tasks]. Despite the presence of natural foci of infection at the territory of all the Union republics (excluding the Kirghiz SSR) and intensive epizootics among rodents, tularemia in the USSR is under full control from 1965. Further differentiation of antitularemia measures, depending on local conditions of economy management and the presence of natural foci of infection is necessary.


[Mechanism of the erythrocyte de-agglutination reaction]. The effect on the indication sensitivity of the level of antigenic sensitization of erythrocytes, molecular parameters of sensitin and of the antigen determined was revealed on various models of agglutinates and antigens determined with the aid of erythrocyte deaggregation reaction (EDR). By its dependence on the EDR sensitivity from the hemosensitization level this reaction was analogous to the passive hemagglutination inhibition test described earlier. Specific deaggregation activity of the antigens depended on their molecular parameters in the same way as their specific agglutinating activity in respect to the erythrocytic antibody diagnostic agents--both of these properties were more intensive in larger antigenic molecules.


[Effect of Freund's complete adjuvant on the catecholamine content in the adrenals and brain of white rats]. The authors studied the effect of a single subcutaneous injection of 0.3 ml of complete Freund's adjuvant on catecholamine content in the adrenal glands and the brain of Wistar rats. There proved to be a sharp reduction of adrenaline and noradrenaline content per gm of adrenal gland raw tissue, and per one adrenal gland at periods of from 1 to 5 weeks after the adjuvant administration, and also a loss of the adrenal gland weight. A less pronounced, but significant increase in the noradrenaline and DOPA concentration was revealed in the brain tissue during the first week after the adjuvant administration, and, of dopamine at all the periods of study. It is suggested that both the peripheral and central links of the sympathoadrenal system were activated by the nonspecific stimulant.


[Change in the nonspecific cytotoxic activity of the lymphocytes depending on the method of their isolation]. The authors present the results of comparative study of nonspecific cytotoxicity of lymphocytes, obtained by different methods, on the cells of cultivated melanoma. The lymphocytes were obtained from defibrinated and heparinized blood of normal donors on a column made of cotton and of phycoll-verographine mixture. Lymphocytes obtained on the latter proved to possess greater cytotoxicity than those obtained on the former. Lymphocyte suspensions from the column, containing platelets were less toxic than lymphocyte suspensions without any platelets. Lymphocytes obtained on the column were more toxic against the melanoma cells of the 22nd--29th passage than against the cells of the 35th--41st passage. This regularity was more pronounced for lymphocyte-platelet suspensions.


[Study of Vibrio cholerae fractions. II. A comparison of the immunochemical and biological properties of preparations of alkaline extracts (vibrionin) and the endotoxin of Vibrio cholerae]. Comparative study of immuno-chemical and biological properties of vibrionin and cholera vibrio endotoxin showed vibrionin to contain up to 73.5% of protein, whereas endotoxin preparations contained only 25% of protein. Use of disc electrophoresis in polyacrylamide gel permitted to determine the relative electrophoretic mobility of the protein component bands of both preparations. Residual quantities of O-antigenic cholera vibrio determinants were revealed serologically in the vibrionin preparations. Study of biological properties of vibrionin (cholera allergen) demonstrated a possibility of using vibrionin in the capacity of a new bacterial allergen.


[Study of Vibrio cholerae fractions. III. The gel chromatographic and immunochemical characteristics of vibrionin]. Three fractions differing by molecular weight (fraction 1--greater than 14 x 10(4)--less than 2 x 10(6) dalton, fraction 11--greater than 7 x 10(4)--less than 14 x 10(4) dalton, fraction III--greater than l0(4) less 35 x 10(3) dalton) were isolated from vibrionin, a preparation of cholera allergen, by gel chromatography on Sephadex G-150. These fractions possessed a different immunochemical activity and were capable of detecting the state of increased sensitivity to cholera vibrio.


[Production of L forms of the plague microbe]. Experiments were conducted in vitro. The process of formation of unstable L-form cultures of Pasteurella pestis under the effect of penicillin was studied. A comparatively high frequency of this phenomenon in various strains was demonstrated. A possible role of the L-transformation process in the persistence of the causative agent in the organism of wild animals in endemic foci of infection is put forward.


[Dynamics of humoral immunity indices in patients with the generalized form of meningococcal infection]. A possibility of using the passive hemagglutination test with meningococcus diagnostic agents of groups A and C for observing the changes in the infectious process was demonstrated. Sera of patients with generalized form of meningococcus infection showed an increase (by the 2nd--3rd week) and a rapid reduction (by the 4th week) of the specific antibodies titres to the levels seen during the first days of the disease. At the remote periods after the disease--in 2 to 5 years--hemagglutinins were revealed in the same titres as in healthy persons (1:10--1:13). Study of physico-chemical nature of antibodies demonstrated that at the early stages of meningococcus infection there formed antibodies referred chiefly to macroglobulins, and at the remote periods (after 3 months)--to microglobulins.


[Ultrastructure of the L forms of cholera and NAG vibrios]. Ultrastructure of L-forms of cholera and NAG-vibrios obtained under the effect of penicillin, tetracycline, in prolonged cultivations, and isolated from the external environment was studied. There proved to be no principal differences in their ultrastructural organization. Cells of sphero- and protoplastic type were distinguished in the colonies. The presence in the cell cytoplasm of mesosomes of the lamellar, vesicular type, myelin-like structures, multiple ring-like formations liberated into external environment, and freely lying membranes served as the peculiarity of the L-forms under study. Budding process as a result of which there formed elemental bodies was revealed.


[L-asparaginase activity of microorganisms]. L-asparaginase content was studied in 67 different microorganisms, bacterial strains of E. coli, Pseudomonas, Erwinia, Proteus, Alcaligenes, Bacillus, Bacteria. Xanthomonas, and yeasts and fungi-Saccharomyces, Candida, Aspergillus, Epidermophyton, Trichophyton. All the bacterial strains studied possessed L-asparaginase activity, which varied greatly depending on the representative (10-1200 IU/g dry weight of cells). Yeasts and fungi displayed low L-asparaginase activity.


[Isolation of bacteria of the Klebsiella genus in diarrhea in polar researchers]. Representatives of Klebsiellae tribe (K. pneumoniae, Ent. cloacae, Ent, aerogenes) were isolated in examination of pharyngeal discharge and feces of members of the polar expedition suffering from diarrhea and their contacts; the same microbes were revealed in the antarctic lake which served as the source of drinking water. The mentioned bacteria possessed typical cultural and morphological, as well as biochemical properties. K34 serovar was determined in serological identification of Kl. pneumonia. At the same time it was demonstrated that Klebsiella--representatives of Enterobacteriaceae could be facultative psychophils and persist in the external environment under low temperature conditions; entering human organism they could cause diarrhea, i.e. could act as pathogens.


[Characteristics of the enterobacteria strains isolated from the urine in urinary tract infections]. Study of biochemical properties of 421 strains of enterobacteria permitted to refer them to the following taxonomic groups of which E. coli constituted 83,4 +/- 3.6%, Enterobactercloacae--97 +/- 3.0%, Klebsiella 4.0 +/- 2.0%. Enterobacter aerogenes, Enterobacter hafnia, Citrobacter, Proteus rettgeri, Proteus vulgaris were revealed in individual cases (0.2-1.0%). As a result of serological typing there were revealed 105 serological types of Escherichia differing by 55 O-antigen variants, 26 H-antigen variants, and the presence or absence of K-antigen. The following groups occurred most frequently-01, 02, 04, 06, 08, 09, 015, 016, 017, 018, 025, 028, and 075. There were also revealed new 0154 and 0155 groups. In 30.9 + 5,3% of cases Escherichia did not belong to the known 157 O-groups; among them 87.1 +7,2% of the strains had H-antigens which could not be referred to any of the known variants according to the international designation.


[Toxicity and the protective activity of a complex staphylococcal antigen obtained by water extraction]. The toxicity and the protective activity of a complex staphyloccus antigen was studied. Its insignificant toxicity for mice when injected intraperitoneally and protective activity under conditons of experimental infection on mice, rabbits, and guinea pigs were demonstrated. In particular it was shown that the antigen obtained in doses under study protected rabbits from septic staphylococcus infection more than antitoxin and corpuscular vaccine. Under conditons of local experimental infection on mice the complex antigen promoted a more rapid than corpuscular vaccine elimination of the local focus of infection.


[Enterocin typing of enterococci].

[Enterocin typing of enterococci]. The author worked out a method of enterocinotyping on enterococci. A possibility of enterococcus typing by means of a set of enterocinogenic enterococcus strains was shown. A mobile enterococcus 4 (10 p) strain, possessing a high antagonistic activity, is suggested for enterococcus identification. Differentiation of enterococcus species by the enterocine sensitivity proved to be impossible.


[Serum immunoglobulin content in donors]. Simple radial immunodiffusion method was applied to the study of serum immunoglobulin A, M, and G content in healthy persons (donors), depending on age, sex and blood group reference by the ABO system. Mean serum immunoglobulin level in (IU/ml) in healthy persons was found to be as follows: A--123.8 +/- 3.4, M--143.3 +/- 3.8, and G--139.9 +/- 2.8. There were revealed higher indices of immunoglobulins of class  G, and particularly of M in women; no statistically significant differences were found in the serum immunoglobulins content depending on age and blood reference, at the same time their connection with sex (in women) was detected.


[Wound microflora in injured patients].

[Wound microflora in injured patients]. The authors present the results of bacteriological study of fresh wounds in 165 traumatological patients and data on the character of microbial flora in the occurrence of purulent inflammatory complications. Microbes revealed in fresh wounds proved to differ by their species composition and antibiotic sensitivity from these causing suppuration. Purulent inflammatory complications were mostly caused by microbes which were not revealed in the wound at first.


[Role of mediators in the quantitative and qualitative changes in the intestinal contents of rabbits with experimental cholera intoxication]. Experimental cholera intoxication caused in 40 rabbits (control--40 rabbits) by intravenous injection of cholerogen was accompanied by disturbance of the mediator balance in the blood plasma and the intestinal wall, chiefly in the samll intestine. Against the background of an increased catecholamine content in the intestinal wall the amount of fluid containing mostly the sodium and potassium bicarbonates and chlorides increased in the lumer of its corresponding sections. The detected regularity possibly served as one of the pathogenetic factors in the mechanism of fluid accumulation in the intestine under the effect of cholerogen.


[Incidence among children of Candida yeast-like fungi]. The incidence of Candida fungi in healthy children and those suffering from noninfectious diseases was studied. In dealthy children--from the time of birth to 7 years--it constituted 39%, and in sick children treated with antibiotics--53%. Dependence of the frequency of Candida fungi state on age was revealed; there was also a correlation between the amount of the fungi and the presence of lesions on the oral mucosa. Candida fungi were also revealed in the washings from the environmental objects, on the pharyngeal mucosa and hands of the personnel, and in the samples of food for children.


[Urgent problems in the teaching of epidemiology]. According to materials of the symposium at the XVI All-Union Congress of Microbiologists and Epidemiologists the author presents some trends in the improvement of teaching epidemiology, including renovation of the programs and teaching plans at the sanitary-hygienic faculty, development of practical habits and rationalization in the organization of practical work at the therapeutic and pediatric faculties.


[Structural study of Mycoplasma by a scanning electron microscopy method]. Scanning electron microscopy was applied to the study of Mycoplasma arthritidis, Myc. gallisepticum, and Acholeplasma laidlawii. Small spherical elements (0.3--0.5 micrometer) formed a reticular "framework" of the colonies in which larger (1--1.5 micrometer) spheroid or irregular-shaped cells (in case of Myc. gallisepticum) and also rod-shaped (1--3 micrometer), filamentous (3--5 micrometer) forms and "large bodies" (5 x 3--8 x 3.5 micrometer) were located. Apparently the latter represented conglomerates of adherent spheroid elements that resembled somewhat "large bodies" of L-forms. Small spheroid buds were revealed on the surface of all the elements.


[Fertility and the crossing system in Vibrio cholerae]. A system of crossing of 2 biotypes of cholera strains and nonagglutinating vibrios was worked out by means of modified Parker and Romig's method. The most frequent inheritance of the sex factor was noted in conjugation of strains belonging to the classic biotype. Inheritance of chromosomal genes (pur) was less incident. Sex pili 9 to 10 nm in diameter were revealed in donor V. cholerae 569 (B) P+ strain.


[Transfer of cellular immunity to the causative agent of coccidioidosis using the transfer factor in mice]. Experiments conducted on non-linear mice demonstrated a possibility of transfer by the intact recipient of delayed hypersensitivity by means of Lawrence'transfer-factor from mice immunized with Coccidioides immitis. The transfer factor administered 48 hours before the intranasal infection protected mice from the lethal dose of coccidioides. This indicated that in coccidioidosis it was possible to transfer delayed hypersensitivity and cellular immunity with the transfer factor.


[Ultrastructure, metabolism and function of the white blood cells in the process of the formation of an immune response and in exposure to glucocorticoids. II. The effect of immunization on the number and sub-microscopic structure of granulocytes in rabbits]. The absolute count of different types of granulocytes was determined and their ultrastructure was studied in the blood of rabbits immunized with bovine serum albumin. Both the primary and repeated antigen administration were followed by regular quantitative and qualitative changes in neutrophils, basophils, and eosinophils whose degree and character were determined by the stage of the immune response formation.


[Changes in the cytochemical activity of the lymphocytes to antigenic action. I. Lymphocyte dehyrogenases on the administration of bovine serum albumin and ram erythrocytes]. A study of the changes in dehydrogenase level in lymphocytes after injection of different antigens--bovine serum albumin (BSA) and sheep red blood cells (SRBC) was made. The activity of succinate and alpha-glycerophosphate dehydrogenases altered during the first days after the antigens administration, but before the appearance of antibodies in the peripheral circulation. These changes were specific of BSA and SRBC, respectively.


[Importance of carbohydrate tests for interspecies differentiation of staphylococci]. The authors present the results of interspecies identification of coagulaso-negative staphylococci isolated from different sources. Modification of the method of aerobic carbohydrate and alcohols fermentation of hard media is described. Use of the latest recommendations of the International Subcommittee on taxonomy of staphylocossi and micrococci permitted to identify the greater part of 120 strains studied as Staph. epidermidis and Staph. saprophyticus; however, 1/3 of the cultures differed from these species ("intermediate" strains). Galactose and mannose fermentation was characteristic of Staph. epidermidis, and the absence of fermentation of these carbohydrates--of Staph. saprophyticus. The differences in the fermentation of mannite and tregalose, on the one hand, and on mannose and galactose--on the other, were characteristic of 57% of the "intermediate" strains. The data obtained permitted to draw a conclusion on nonhomogeneity of the group of coagulase-negative staphylococci by their reference to different carbohydrates and alcohols, and on a possibility of existence of not only of different species of these staphylococci, but also of their biochemical variants.


[Changes of electroretinograms following hippocampus stimulation]. In chronical experiments the ERG of 5 rabbits were recorded before and after stimulation of the hippocampus. Stimulation of the hippocampus causing short generalized afterdischarge produced changes of the b-wave amplitude. Immediately after the stimulation the b-wave amplitude was larger than the amplitude in the control series. If the intensity of hippocampal stimulation was lower (no generalized afterdischarges) changes of b-wave amplitude were also produced, though being less pronounced. The results suggest that retinal processes are influenced by hippocampus.


Plasma concentrations of insulin and free fatty acids in dietary-induced obesity of Wistar-rats before and after glucose stimulation. Colony-bred Wistar-rats develop obesity after long term feeding with a high-fat diet (50% fat, w/w). According to previous investigations a disturbed glucose tolerance after i.v. glucose load could be described for obese rats. Therefore, we measured peripheral IRI-concentrations before and after glucose stimulation in controls and fat-fed rats. In obese animals we observed a basal hyperinsulinemia in the dynamic phase of development of obesity. In controls and fatty rats, no differences in the peripheral insulin response to an i.v. glucose stimulation could be demonstrated, nor did we find indications of an impaired early insulin response in fatty rats. In accordance with the glucose tolerance study, obese rats in the dynamic phase showed lower FFA-levels (fasting state) and a slower decrease of FFA-concentrations after the glucose-induced insulin enhancement. Changing the feeding schedule at 20 weeks of age, e.g. feeding control diets to fatty rats for 4 weeks, reduced basal IRI-concentrations in these animals to control values. Assuming the secondary nature of the basal hyperinsulinemia in obese rats, our present results demonstrate that the observed impairment of glucose tolerance may be related to the peripheral insulin resistance of skeletal muscle and/or hypertrophied adipose tissue.


[Vasal flow measurements at the aorta ascendens using the ultrasonic doubler technique in chronic experiments on rabbits]. The conditions under which flow measurements using the ultrasonic doppler technique can be successfully carried out at the Aorta ascendens in chronical experiments were studied in 25 normal rabbits. Pressure necroses of the vascular wall at agar-agar-gel coupling arise only if the implanted pick-off with its inner diameter is less than the outer diameter of the aorta + about 10%. The ultrasonic intensity permissible in a chronic experiment is only about 0.3 W/cm2. With the 13 implantations the animals were maximally usable for 86.6 days; 70% of them were killed in good health. In a beat-to-beat analysis were determined: (1) heart rate, (2) discharge duration, (3) maximal rate of discharge, (4) acceleration of blood flow, (5) deceleration of blood flow, (6) beat volume, (7) contraction force of the left ventricle, and (8) discharge resistance. The control recordings obtained over several months are on the average within normal limits.


[Changes in the excitation contraction coupling in the myocardium of rabbits fed a cholesterol-containing diet]. It was of interest whether a hypercholesterolemia after feeding a diet containing 2 g cholesterol in sunflower oil per day during 12 weeks induces changes of the myocardiac cells of rabbits which must not necessarily be the consequence of a diminished bloodstream on account of coronary stenosis or the consequence of a lesion of the wall of the vessels. The contractile force and the indirectly measured shortening velocity of the isometrically working papillary muscle out of the left ventricle were not reliably changed. As a result of the feeding the isometric force rose after paired pulse stimulation and after a pause during the rhythmic action, although a considerable deposition of fat within the cells and disseminated necrosis in the myocardium could be observed. Because of the increasing loss of sodium into sodium-free solution in parallel with an increasing sodium content of the myocardium it has been concluded that the permeability of the cell membrane for this ion should be elevated. Furthermore it is assumed that the activation of the ionic pumps is elevated which is recognizable from a higher positive inotropic action of both the application of strophanthine and the substitution of NaCl by LiCl. But it seems that one elevation could not completely compensate the other one. The mean value of the velocity of relaxation related to the isometric force was increased. It has been postulated that after the diet rich in cholesterol and sunflower oil the cardiac cell shows a retarded restitution of the contraction during the interval between beats and elevated content of calcium. This may be one of the causes for the observed necrosis besides the ischemic component of the injurant feeding.


Pancreatic and hepatic balances of endogenous insulin and of glucose in the anaesthetized dog during primed and non-primed infusions of glucose and of mannitol. Simultaneous monitoring of pancreatic and hepatic blood flows and serial analyses of blood glucose and immunoreactive insulin activity in arterial, portal, intestinal and hepatic venous blood were performed in anaesthetized laparotomized dogs. Based on these measurements, the rates of pancreatic insulin secretion, of hepatic insulin uptake and the hepatic glucose balance were computed. Under basal conditions pancreatic output was about 40% of the total hepatic insulin input. 30% of hepatic insulin inflow were actually taken up in the liver. During a primed i.v. glucose infusion (steady blood glucose concentration about 330 mg/100 ml) pancreatic and hepatic blood flows increase rapidly and the insulin secretion exhibits a biphasic pattern. The relative part of hepatic insulin inflow taken up in the liver remained unchanged. A non-primed i.v. glucose infusion provoked a slow increase of blood flow and a rapid but monophasic increase of insulin release. Under these conditions the relative hepatic insulin uptake was transiently increased. During both loads hepatic glucose balance switched from release to uptake. However the non-primed infusion was more effective. When pancreatic and hepatic blood flows were increased without any blood glucose alteration by an infusion of mannitol, insulin secretion did not change; hepatic uptake of insulin decreased, but hepatic glucose output was clearly reduced. A correlation between the rates of insulin secretion, of hepatic insulin inflow and of insulin uptake was observed under all conditions. However, the hepatic glucose balance was correlated to the inflow of insulin or glucose and to the hepatic insulin uptake under certain conditions in individual experiments only.


Asymmetric behaviour induced in caudate nucleus lesioned mice: interaction of aminergic and cholinergic agents. Mice with unilateral caudate lesions exhibit a postural asymmetry or turning towards the lesioned side after application of apomorphine and towards the intact side after oxotremorine injections. The apomorphine effect was counteracted both by oxotremorine and by physostigmine. Both this antagonism and the oxotremorine effect itself were abolished by scopolamine. Adamantine reduced the effectiveness of oxotremorine in inducing asymmetric behaviour. The antagonism of oxotremorine and apomorphine was shifted in parachloramphetamine pretreated mice to an increased apomorphine reaction mode. The significance of lesions became apparent by a 50% decrease of dopamine content in the lesioned side. The 5-hydroxytryptamine content was unchanged. Parachloramphetamine lead to a small alteration of the 5-hydroxytryptamine and 5-hydroxyindolacetic acid content, different in normal and lesioned animals.


Inhibition of adrenaline-potentiated thrombin-induced reaction of human blood platelets by dihydroergotoxine. The potentiating effect of adrenaline on thrombin-induced aggregation and release reaction of human blood platelets has been studied in vitro. Both reactions are inhibited by low doses of dihydroergotoxine. The inhibition of aggregation is of competitive type. The adrenaline-potentiated thrombin-induced platelet aggregation is inhibited also after intravenous injection of dihydroergotoxine. The pathophysiological implications of these findings are discussed.


[A 3H-thymidine paper strip method for stimulation of lymphocytes. I. Culture conditions for human or murine lymphocytes and reproducibility of the paper strip method]. A simple method for stimulation of human or murine lymphocytes is described. As a possible more rapid test than the standard estimation of [3H]-thymidine uptake after solubilisation of cell sediments, paper strip counting in a liquid scintillation counter was studied in 80 individuals and 20 mice. Counting efficiency approaches 1%, the reproducibility is good within the acceptable 16% range.


[Manipulations of immune reactions by antigen-immunosuppressive agent-conjugates. VI. Antigen specific binding of 6-mercaptopurine-protein conjugates by lymphocytes]. The immunologic specificity of 6-mercaptopurin-protein conjugates has been determined by rosette inhibition test using antigen-stimulated lymphocytes and antigen-coated sheep erythrocytes. The specific binding of antigen-immunosuppressive agent-conjugated onto immunocompetent cells is as strong as the binding of the native antigen. The increasing aggregation of the conjugates in consequence of the higher coupling ratio and the thus increased multivalence of the antigen may compensate the effect of antigen determinant loss.


[Tissue extracts of malignant human lymphomas in the leukocyte migration test]. Water-soluble lymph node extracts and sera from 23 patients with benign and malignant lymphomas and tissue extracts from liver, spleen, kidney, and muscle of one patient without any lymphatic disease were analyzed using the direct leukocyte migration test (LMT). The leukocytes were obtained from healthy persons. 10 of the lymphomas and 3 of the tissue extracts varied the leukocyte migration. In most cases of chronic nonspecific lymphadenitis, in 2 cases of Hodgkin's disease, and in extracts of liver, spleen and muscle inhibitory effects were found. Stimulating effects could be demonstrated in 2 cases of immunocytoma and in 4 cases of Hodgkin's disease. The results indicate that in cases of stimulation the target cells might be influenced by a pathological migration inhibitory factor.


[Frequency response of the abdominal stretch receptor neurons of the crayfish Orconectes limosus (RAF.) to intracellular current stimulation]. In the slowly adapting stretch receptor neurons the temporal decline of the impulse frequency in response to intracellular current stimulation can be interpreted--apart from the high initial overshoot--by the sum of two exponential functions with time constants of approximately 1 and 10 s. In the rapidly adapting cells the discharge frequency decays--after only a little initial overshoot by current step stimulation--nearly rectilinear with about 8 imp./s2 and stops suddenly mostly in the range of 5 s. The current-frequency-characteristic curves show for both receptor cell types nearly straight lines to 7 nA.


[Influence of early postnatal nutrition on body height in adolescence]. Females who were purely bottle-fed during the first trimenon of life showed a significantly increased incidence of overweight at 15 years of age as compared to those who were purely breast-fed or breast plus bottle-fed. Similar findings were obtained in males. In purely bottle-fed females, furthermore, a significant positive correlation was found between the body weight at 3 months of age and body height at 15 years of age.


[Theoretical studies on the influence of binding constants of hemoglobin for ATP and 2,3-diphosphoglycerate on erythrocyte glycolysis]. In the red blood cell exist a binding equilibrium of ATP and 2,3-DPG with hemoglobin. For the metabolism only the free active levels of organic phosphates are relevant. The binding constants of hemoglobin increase with decreasing temperature and pH. Using a stoichometric model of glycolysis, the change of free concentrations by altered binding constants and its import on the energy metabolism of the erythrocyte was theoretically studied. The results are: 1. Total ATP-content (bound plus free ATP) does not depend on the binding properties of hemoglobin. 2. Total 2,3-DPG-content is changed by altered binding constants of hemoglobin. The direction of change depends on the ratio energy-consumption/substrate-uptake. 3. In the case of strong binding of organic phosphates to hemoglobin the experimentally measurable total ATP-content does not reflect the free ATP-concentration in the cell water. As a result of binding, free ATP may be low even if total ATP is unchanged. 4. The free concentration of 2,3-DPG always parallels the total content.


Insulin, growth hormone and catecholamines as regulators of energy metabolism in the course of surgery. Six patients subjected to major surgery (esophageal resection, group I) and eight patients undergoing moderate surgery (exploratory laparotomy, group II) were investigated in order to study the effects of surgery and glucose infusion on the blood glucose, plasma FFA, serum insulin and growth hormone concentrations as well as on the urinary excretion of adrenaline, noradrenaline and nitrogen. In the patients undergoing esophageal resection, blood samples were taken at short intervals during five 24-hour periods, covering a time span from the second preoperative to the tenth postoperative day. In the case of exploratory laparotomy four such periods up to fifth postoperative day were similarly investigated. For adrenaline, noradrenaline and nitrogen, urine was collected in two 12-hour samples for each 24-hour period in order to roughly estimate the "day" and "night" excretions. The results and conclusions can be summarized as follows: A rapid rise in blood glucose and plasma FFA concentrations occurred after the beginning surgery. The zeniths of the curves were recorded about 4--6 hours after the skin incision in both patient groups, despite the different duration of the operations. This suggests that the regulatory mechanism is spontaneously active for a certain time after being initially triggered. Insulin secretion was usually suppressed 4--5 hours after the beginning of surgery. A marked increase of insulin secretion occurred after this time, the rise of IRI being associated with a fall of BG and FFA. Maximum insulin secretion was recorded during the night after surgery. Because excretion of noradrenaline was maximal during this time in group I, noradrenaline activity is perhaps a less likely explanation of the suppression of insulin. The response of growth hormone secretion to surgery and anesthesia was not uniform. Trauma apparently causes no constant rise, whereas a rather regular elevation of serum GH levels follows the fall in BG and plasma FFA concentrations, In group I there was a decrease of insulin and GH secretion and the number of insulin and GH "peaks" in the postoperative period, possibly reflecting a weakening of central stimuli after major surgery. The same was not always noted in group II, in which the mean secretion of insulin was postoperatively somewhat elevated compared to the preoperative values. Urine analyses revealed no day--night rhythmicity in catecholamine excretion except possibly on the day of operation, when the "day" samples contained absolutely and proportionately more adrenaline than the "night" samples.


Changes in serum zinc and copper induced by operative trauma and effects of per- and postoperative zinc infusion. Serum zinc, albumin and copper levels were monitored for 5 days after operative trauma in 22 patients. As in earlier studies, a decrease in serum zinc and albumin levels was found. The mean fall in serum zinc was 40% and in albumin, 20%, of the preoperative values. Serum zinc increased after postoperative day 2; albumin remained decreased, indicating a rise in filtrable zinc. A correlation between the fall in serum albumin and serum zinc was found in individual patients. In contrast to previous studies, we found a decrease in serum copper postoperatively. A further 23 patients were supplemented with a zinc and copper containing infusion per- and postoperatively. These patients showed a marked (significant) reduction in the serum zinc fall, the serum level being normalized after 5 days. An insignificant reduction in the fall of serum albumin was also found.


Effects of early wound healing and wound treatment with zinc tape on intestinal absorption and distribution of zinc in rats. In rats operated with large excisional skin wounds which were not treated with zinc tape, the serum zinc concentration was decreased at every observation time during the first post-operative day and the absorption of zinc from the intestine was increased. Slight decreases in the zinc concentration were seen in some tissues while liver zinc was very high. In rats with wounds treated with zinc tape, serum zinc was markedly increased at 6 hours, lower but above control levels at 7 and 12 hours and markedly increased again at 24 hours. The absorption of zinc from the intestine was low. Zinc concentration were elevated in most tissues sampled; they were high in testis and kidney and very high in liver. The results strongly indicate that the operative trauma and/or acute inflammatory conditions in the wounds in animals not treated with zinc tape initiate a movement of zinc from serum, some tissues and the content of the intestine to the liver. In the zinc tape treated group the increase in liver zinc was supplied mostly by the zinc tape. It is assumed that these large increases in zinc concentration in the liver are the result of the incorporation of zinc into certain zinc containing proteins which are produced in response to the inflammatory process in the wound. An increase was also found in the copper concentration in the liver of zinc tape treated animals and a decrease in the iron concentration in the liver of both groups of operated animals compared to controls.


Parathyroid localization in patients with previous neck surgery. The results of parathyroid arteriography and venous parathyroid hormone assay were evaluated in thirteen patients reexplored for persistent or recurrent hyperparathyroidism. The operative findings in these patients were ten adenomas and eight hyperplastic parathyroid glands. Angiography disclosed eight of the adenomas and failed to visualize one. Only two of the hyperplastic glands were disclosed by angiography. By venous sampling the correct side was predicted in seven out of eight cases of unilateral lesions--in one case of an adenoma no hormonal maximum was found. In two cases of bilateral lesions a maximum was found on one side only, while in three cases of unilateral two-lesions the maximum was correct in two cases and contralateral in one. We conclude that a combination of angiography and venous sampling gave localization or lateralisation in 12/13 patients with previous neck surgery for hyperparathyroidism and found the methods to be complementary to each other and prefer both done in these cases.


Clinical experience of parathyroid autotransplantation. Parathyroid tissue was transplanted from the neck to the muscles of the non-dominant forearm in 18 patients. The difference in concentration of parathormone between the transplant arm and the contralateral arm was used as a test of parathyroid function. All patients showed a difference in concentration between the arms. Three patients needed calcium supplement for 2 months after surgery, and one patient with no parathyroid tissue left in situ also needed vitamin D for 8 months. The results indicate that parathyroid tissue transplanted to the arm continues to function, and is able to keep the patient normocalcaemic even when no parathyroid tissue is left in situ.


Clinical and socio-economical aspects of hand injuries. A prospective investigation of all hand injuries seen at a major general hospital during a period of one year has been made. Over 900 hand injuries have been registered and systematically been followed up during the period of treatment. The survey includes the frequency, severity and treatment of the hand injuries. Furthermore there is an estimation of the medical and socio-economical consequences of the hand injuries. It is shown that hand injuries are extremely usual and imply enormous costs to the community. Postgraduate tranining in hand surgery is therefore desirable for all those general and orthopaedic surgeons, who deal with the treatment of patients with hand injuries.


Intraoperative angiography in arterial surgery. Intraoperative angiography was performed in 136 cases of surgical reconstruction of the aorta, iliac, femoral and carotid arteries. In 39 cases pathological angiograms were found at operation, some of them quite unsupected. The most common pathological finding was non-occluding thrombosis, but intimal lesions caused by vessel clamps and incomplete endarterectomies were not uncommon. Immediate surgical reexploration and revision resulted in a high frequency of open reconstructions at follow-up, which was performed 1--24 months postoperatively. On the other hand, nonrevised reconstructions with pathological angiograms usually failed in the early postoperative period. In cases with normal intraoperative angiograms the result at follow-up was excellent. In addition to electromagnetic flow determination, intraoperative angiography is a most valuable adjunct in the assessment of vascular surgery during operation and should be used more frequently. All pathological findings in the angiograms must be seriously considered and lead to reexploration and revision.


Retroperitoneal approach for implantation of aorto-iliac and aorto-femoral vascular prosthesis. During the period 1963--76, sixty-nine patients underwent aorto-iliac of aorto-femoral by-pass operation at the department. Fifty-two of the operations were performed through a retroperitoneal approach. The operative procedure is described. The approach is found gratifying and the statement of earlier authors concerning fewer cases of paralytic ileus and smoother convalescence is confirmed.


The timing of cholecystectomy in patients with gallstone pancreatitis. A retrospective analysis of 89 patients. A retrospective analysis has been made of 89 patients, who were treated for acute pancreatitis and later underwent cholecystectomy. The object was to elucidate whether cholecystectomy can be performed soon after recovery from the pancreatitis ('early operation') or must be postponed a few months ('elective operation'). While waiting for operation a quarter of the patients in the elective group had a recurrent attack of pancreatitis or acute cholecystitis. A further quarter of the patients had slight symptoms. The postoperative complications were few, their frequency being comparable in both groups. No damage resulted to the common bile duct, there was no postoperative bleeding and only one case of postoperative pancreatitis in the group of patients operated early. It is concluded that 'early operation' is to be preferred provided a firm diagnosis of gallstone disease has been made. However, the oral cholecystogram is unreliable during the first three weeks after the attack of pancreatitis. If an oral cholecystogram is performed during these weeks and shows nonvisualization of the gallbladder but no stones, a repeated examination must be performed.


Gastric ulcer in old age.

Gastric ulcer in old age. One hundred and eleven (16%) of 701 patients with gastric ulcers, admitted to Kommunehospitalet, Copenhagen, from 1955 to 1964, were 70 years of age of older. Of those elderly patients, 43 were treated surgically, 68 non-surgically. The incidences of hemorrhage and extragastric diseases were significantly greater in older patients, whereas the incidence of pain, site of pain, ulcer size, and location, incidence of combined ulcers and gastric retention did not differ from those observed in younger patients. The duration of symptoms was shorter in the aged, though the difference was not significant. Prognosis was less favourable in the aged, largely due to a higher incidence of hemorrhage (47%) and of accessory diseases (47%). The mortality in elderly patients suffering from hemorrhage and accessory diseases was 64% during hospitalization, but only 4% in patients without accessory diseases. Follow-up and autopsy studies of discharged patients revealed that ulcers healed in only half of the non-surgical patients and that surgery was ultimately necessary in 50% of these. It was concluded that the factors which prescribed surgical treatment in elderly patients with gastric ulcers did not differ considerably from those in younger patients. The risk was greater, but this was also true in non-surgical treatment. Close cooperation between surgeon and physician was essential, both pre- and postoperatively, since accessory diseases were very significant for the outcome.


Assessment of completeness of vagotomy and surgical experience 10 days and 3 months after proximal gastric vagotomy. Spontaneous and maximum acid secretion was measured before, and 10 days and 3 months after proximal gastric vagotomy (PGV) to determine the optimal time for testing the completeness of vagotomy. Insulin tests were done 10 days after PGV and it was investigated whether any of the tests could distinguish between experienced and less experienced surgeons. Sixty-eight patients were studied, 38 being operated by experienced and 30 by less experienced surgeons. No significant changes were found in BAO and PAO from 10 days to 3 months after PGV in any of the groups. In contrast to the insulin test results, measurements of BAO and PAO did not discriminate between the two groups of surgeons. However, very incomplete vagotomies according to insulin test results were identified by measurements of PAO 3 months after PGV. It is concluded that early postoperative insulin tests are preferable. The surgeon remembers details of the PGV, the patients is liable to accept the test at this time and insulin tests are more sensitive in discriminating between experienced and less experienced surgeons. Measurements of maximum acid secretion should only replace these tests in patients with cardiac diseases and they should then be performed 3 months after PGV.


Operative technique for recurrent ulcer after vagotmoy and Jaboulay gastroduodenostomy. Seven patients with ulcer recurrence following primary operation by vagotomy and Jaboulay gastroduodenostomy were treated by methods depending on the site of recurrence. A recurrent ulcer in the stomach was treated with a broad Billroth I reconstruction. In the anterior wall of the duodenum it was necessary to excise the penetrating ulcer cutting throught the bridge to the resection edge in the first part of the duodenum. A solid longitudinal closure is practical provided that the medial collar of the second part of the duodenum is at least 1 cm from pancreas. Recurrent ulcer in the posterior duodenal wall was in one case treated by leaving a collar of the antrum after removing the mucosa. This collar was used to close the gastroduodenostomy. If a large recurrent ulcer involves the second part of the duodenum, as in three of the referred patients, it was necessary to resect not only the duodenal bulb but also the proximal extent of the second part of the duodenum. One patient developed significant postoperative complications following this procedure. We feel that the procedure itself is technically difficult and should be taken account of by all who contemplate introducing gastroduodenostomy as a routine drainage procedure.


Function and morphological picture of the liver in obese patients before and after jejunoileostomy. In 40 obese patients, the liver function and the morphological picture were examined before and after jejuno-ileostomy. In 94% of the patients, distinct fatty liver was observed already before the small bowel exclusion, and the function tests showed an impaired function of this organ in 25% of the subjects before the operation. No clinical symptoms of liver insufficiency were recorded during the postoperative period. During one to three months after surgery, an increased impairment of the liver function was ascertained but, later on, a gradual improvement. More than one year after jejuno-ileostomy, the function test results were considerably better than before the operation. The degree of steatosis increased in the majority of the patients within 6 months after surgery, and some time later a considerable decrease in fatty liver was observed. Within 18 to 24 months after the jejunoileostomy, the morphological picture of the liver did not differe from the normal. The impaired function and the increased degree of steatosis were noted during diarrhea and rapid loss of body weight. The reson for this is most probably the protein malnutrition caused by the radical reduction in the absorption surface of the small bowel. The improved function and morphological picture of the liver are related to the progress of adaptation changes of the active part of small bowel. The results of the author's research do not confirm the hypothesis of permanent, harmful effect of jejuno-ileostomy on the state of the liver. The symptoms observed are definitely of a periodical and transient character, and are therefore not contra-indicated in the application of this operation in morbid extreme obesity treatment.


The surgical treatment of ulcerative colitis. Indications for surgery and results. During the eight-year-period from 1968 to 1975 14 patients have been operated on because of ulcerative colitis. A severe, or fulminant, colitis attack was the cause in 48 of these. Most of these patients had been referred from other hospitals. Eight died, six having had a bowel perforation prior to operation, the others having received protracted conservative treatment and came to operation very late. Five of the patients were more than 58 years old. The indications for elective operations were chronic severe symptoms and/or risk of malignant change. In a conservatively treated patient material and with total involvement of their colitis, the cumulative risk of cancer after 30 years follow-up was over 35%. The mortaility in elective surgery was 3%; are all patients up to 1977 included the mortaility is less than 2%. Ileo-rectoanastomoses gave very poor long-term results. Patients with an ileostomy have shown themselves to be well adjusted both socially and psychologically. There are, however, some risk of sexual disturbances.


Massive parathyroid hemorrhage in a case of water-clear cell hyperplasia. A case of water-clear cell hyperplasia of the parathyroid glands is reported. As far as we know this case is unique in respect of the following features. All the parathyroids were located in the superior mediastinum. One abnormal parathyroid gland was removed with the help of a mediastinoscope. The patient survived a massive parathyroid hemorrhage. This case draws attention to the facts that enlarged parathyroid glands can appear as mediastinal tumours and that massive bleeding can occur in abnormal parathyroid glands.