Bilateral subclavian artery aneurysm associated with idiopathic cystic medial necrosis. Although cystic medial necrosis, either idiopathic or associated with Marfan's syndrome, usually becomes manifest as an ascending aortic aneurysm, aortic insufficiency, aortic dissection, or a combination of these disorders, a rare case of bilateral subclavian artery aneurysm secondary to idiopathic cystic medial necrosis has occurred. Subclavian artery aneurysms most commonly represent poststenotic dilatation from anterior scalene or cervical rib compression, occasionally are associated with generalized arteriosclerotic peripheral vascular disease, and rarely are secondary to syphilitic or mycotic infections. Subclavian artery aneurysms have a major risk of rupture, embolus, or thrombosis, and therefore should be repaired. A reverse saphenous vein or prosthetic bypass graft from the carotid to the axillary artery provides adequate flow to the upper extremity. The aneurysm should be completely excised if possible, since reexpansion through small collaterals or through insufficient closure by ligation can occur and compress the brachial plexus after successful bypass. The clinical presentation, angiographic findings, and operative repair of a subclavian artery aneurysm secondary to cystic medial necrosis are described.


Percutaneous transthoracic aspiration needle biopsy. An experience based on 1,211 patients has shown aspiration needle biopsy to be a valuable technique for diagnosing bronchogenic carcinoma and other localized intrathoracic lesions that are beyond the reach of the fiberoptic bronchoscope. In 896 patients with malignant intrathoracic neoplasm, the aspirate demonstrated malignant cells in 96%. A false cytological diagnosis of carcinoma occured in 2 patients, for a true positive rate of 99%. However, the true negative rate was only 87%. In 77% of 31 immunosuppressed patients, the causative agent of a focal infectious process was diagnosed. Pneumothorax was the only notable complication, occuring in 24% of patients, with 14% requiring chest tube drainage. The procedure is relatively simple and rapid, generally causes little patient discomfort, and can be performed in virtually any hospital.


Roentogenographic chest screening in the detection and survival of patients with lung cancer. Cooperative Study Group for Early Detection of Lung Cancer in the German Democratic Republic. In the German Democratic Republic (GDR), annual mass roentgenographic screening of the chest was introduced twenty years ago. To ascertain its value in the detection of lung cancer, data were collected about treatment results at the country's main chest clinics. The study cover 13,283 operations and 10,838 resections, accounting for nearly 90% of all patients with lung cancer treated surgically in the GDR from 1949-1974. From 1965 to 1968, the five-year survival was more favorable in patients who were screened than in those who were diagnosed after clinical symptoms had appeared (36% for the former, 29% for the latter). For improvement of overall results, we recommend differentiated regular chest roentgenographic screening of men 40 to 70 years of age, individualized on  the basis of tobacco usage, and full exploitation of all diagnostic and surgical tools now available.


Extended indications for median sternotomy in patients requiring pulmonary resection. We have employed median sternotomy in 9 patients for resection of both benign and malignant lung lesions. The most frequent use of this approach was for bilateral wedge resection, though unilateral resection was done in 2 patients. Our experience supports the previously documented usefulness of median sternotomy for minor bilateral resections and suggests that more complex pulmonary resections are possible when an appropriate indication exists. We compared the effects of median sternotomy with those of lateral thoracotomy on postoperative vital capacity and peak airway flow. Both incisions results in a marked loss of measured lung function, but recovery occurs notably sooner after median sternotomy than ater lateral thoracotomy.


An appraisal of blood trauma and blood-prosthetic interface during left ventricular bypass in the calf and humans. Mechanical circulatory support was accomplished in 20 calves (mean, 140 days) and in 5 patients following operation for acquired heart disease (range, 1 hour to 8 days) employing a pneumatically actuated xenograft-valved assist pump interposed between the left ventricular apex and aorta. Following pump implantation in calves, hematocrit and platelets decreased transiently and returned to normal within 14 days. Plasma hemoglobin and erythrocyte mechanical fragility values were elevated for 48 hours. Platelet survival was slightly reduced, but erythrocyte survival values were similar to controls. In patients who received assist pumps, plasma hemoglobin and erythrocyte mechanical fragility were transiently elevated, but rapidly decreased to normal. Thrombocytopenia occurred only in the presence of bleeding and renal failure requiring hemodialysis. Pump flow of the left ventricular assist device was maintained above 2.0 L/min/m2 despite serious arrhythmias. Postmortem examination revealed no evidence of thromboemboli in the clinical patients although anticoagulant agents were not administered.


Encircling endocardial ventriculotomy: a new surgical treatment for life-threatening ventricular tachycardias resistant to medical treatment following myocardial infarction. Ventricular tachycardias occurring after myocardial infarction (MI) and resistant to medical treatment were successfully treated in 5 patients by encircling endocardial ventriculotomy. All patients had a history of MI. The delay between MI and ventricular tachycardias ranged from 1 month to 8 years. A reentrant mechanism was demonstrated by laboratory studies. Under cardiopulmonary bypass, the left ventricle was entered through the thin fribrous scar. Encircling endocardial ventriculotomy was carried out from the inside of the ventricle, through the whole thickness of the normal myocardium, and along the border of the endocardial fibrosis, which delineated the area of diseased myocardium. The ventriculotomy was placed in the free wall or in the septum or in both of these locations. It was repaired and the left ventricle was closed. Drug therapy was discontinued after operation. No ventricular tachycardias recurred during a follow-up period of 6 to 24 months. The effectiveness of encircling endocardial ventriculotomy is explained by the exclusion of the entire diseased area, especially the border zone and the septum. This technique is useful in any location of MI.


Operative treatment of congenital aortic stenosis. The operative treatment of 131 patients with congenital aortic stenosis is reviewed. Of the 131 patients, 77% had left ventricular outflow tract (LVOT) obstruction at a single level and 23%, major obstruction at more than one level. There were 3 operative deaths (2.3%) and 10 late deaths (7.8%). Twenty of the 128 discharged patients have undergone a second procedure and 6 a third procedure for recurrent or residual LVOT obstruction. The 26 reoperations included 7 aortic valve replacements, 4 left ventricular apical-abdominal aortic (LV-AA) valved conduits, and 15 extensive aortic valvotomies with or without supravalvular aortoplasty. Five of the 20 patients undergoing reoperation died; 4 of these deaths occurred in patients who had valve replacement at reoperation. The 4 who received LV-AA conduits have sustained excellent hemodynamic and clinical results with no complications. Highly satisfactory clinical results can be obtained with minimal operative risk, regardless of the level of LVOT obstruction. Reoperation for recurrent or residual LVOT obstruction, however, is comparatively more hazardous, and alternative surgical approaches (LV-AA conduits) should be considered.


Late results of operation for acute aortic dissection producing aortic insufficiency. Since July, 1970, 8 patients with acute dissecting aneurysms of the ascending aorta producing aortic insufficiency have undergone immediate operation employing a technique in which the origin of the dissection is resected, the dissected base of the aorta is lined with nondistensible prosthetic cloth for support, and the native aortic valve is resuspended. Aortic continuity is then reestablished with end-to-end anastomosis or use of a short segment of woven graft (not necessarily circumferential). There were no operative deaths. Mean follow-up has been 60 months (range, 25 to 82 months). One late death has occurred (cerebral hemorrhage at 48 months); of the remaining 7 patients, 2 have faint murmurs of aortic insufficiency, but all are in New York Heart Association Functional Class I. This technique of aortic reconstruction in acute ascending dissections allows preservation of the native aortic valve while preventing late aortic root dilatation or major valve insufficiency.


Natural history of arteriosclerotic thoracic aortic aneurysms. Out of 28 patients with arteriosclerotic aortic aneurysm seen between 1965 and 1975, 22 were not surgically repaired. Of these 22 patients, 9 subsequently died of rupture and 7 of unrelated cardiovascular disease, and 6 are living at the time of this study. Mean survival for the group is less than 3 years. All but 1 rupture occurred in aneurysms larger than 10 cm, and recent increase in size preceded rupture in all patients for whom serial roentgenograms were available. This study documents the high risk of rupture of arteriosclerotic aortic aneurysms of the descending thoracic aorta and suggests a more uniform use of surgical management depending on the patient's age and underlying state of health.


Maintenance of permanently implanted cardiac pressure catheters in experimental animals. Two techniques for maintaining permanently implanted cardiac catheters in experimental animals are described. Polyvinylchloride catheters are coated with TDMAC-Heparin, a polymer complex currently used clinically to prevent thrombogenesis in vascular shunts. Long-term catheter obstruction and thrombus formation have been obviated by using this method. Also, to assure multiple, painless studies in awake animals, a somewhat different technique for pressure catheter access has been developed and is detailed in this report.


Limits of myocardial protection with potassium cardioplegia. Preservation of left ventricular function with various potassium-based cardioplegic solutions has been considered to be effective for at least 60 minutes during occlusion of the ascending aorta. The purpose of this study was to define the limits of protection offered by potassium alone. A single bolus of 150 ml of potassium (24 mEq per liter) in normal saline solution at 30 degrees C was injected in the aortic roots of foxhounds at the initiation of periods of 45 minutes, 60 minutes, and 75 minutes of aortic occlusion at a core temperature of 30 degrees C. Data derived from postischemic recovery phase ventricular function curves and force-velocity relations demonstrated excellent protection during 45 minutes of ischemia, inconsistent protection at 60 minutes, and poor protection at 75 minutes.


The effects of intermittent ischemic arrest on the perfusion of myocardium supplied by collateral coronary arteries. Six weeks after placement of an ameroid constrictor on the circumflex coronary artery, blood flow in a collateral region was compared with flow in myocardium supplied by normal arteries during cardiopulmonary bypass (80 mm Hg). Myocardial blood flow was determined using radionuclide-labeled microspheres (8 to 10 mu) before 10 minutes of ischemic arrest and after 1, 5, and 10 minutes of reperfusion. The retrograde circumflex pressure was monitored continuously and served as an additional index of perfusion of the collateral region. During reperfusion, endocardial flow in the collateral region remained unchanged despite a threefold increase in a similar layer having normal arteries (p less than 0.01). Following ischemic arrest, mean transmural and subendocardial hyperemic responses both persisted for longer than 10 minutes in normal regions. Simultaneously, peripheral circumflex pressures decreased at 1 and 5 minutes of reperfusion (p less than 0.001) but returned to control within 10 minutes. Persistently elevated endocardial flow in the normal arteries and the absence of a hyperemic response in the collateral region during an associated decrement in retrograde circumflex pressure may indicate incomplete flow repayment even after 10 minutes of reperfusion. Marked transmural flow imbalances despite adequate coronary perfusion pressures suggest that intermittent ischemic arrest may cause cumulative ischemia, and this occurrence may be detrimental especially in collateral regions of myocardium.


Autotransfusion following open-heart surgery. Autotransfusion following cardiopulmonary bypass has been used infrequently. Certain patients are noted for the potential of serious hemorrhage following conclusion of bypass. A new autotransfusion technique for use in such patients is described. The method involves a simple modification of the basic cardiopulmonary bypass setup and requires no separate autotransfusion unit. It can be utilized for several minutes after the administration of protamine. Blood salvage can be considerable and at times lifesaving.


Gastroesophageal reflux following gastric operation. The combination of previous gastric operation and gastroesophageal reflux produces major difficulties in obtaining effective symptomatic relief. Seventy patients were studied by history, radiology, endoscopy, and esophageal manometry before surgical reflux control. Twenty-eight had had vagotomy and pyloroplasty; 4, vagotomy and gastroenterostomy; 11, Billroth I gastrectomy; and 27, Billroth II gastrectomy. In all patients reflux control was accomplished by hernia repair, and in 14 patients bile diversion was added for control of bile gastritis. A variety of reflux control operations were used. However, the most effective results were achieved with total fundoplication gastroplasty, and in this group of 22 patients there has been no anatomical recurrence and no reflux. The partial fundoplication gastroplasty (Belsey type) was ineffective in reflux control and should not be used in patients who have had a previous gastric procedure. Reflux control and, when necessary, bile diversion give effective relief to patients with bile gastritis and esophageal reflux following gastric operation.


Operation or indomethacin for the premature ductus. Indomethacin constricts the patent ductus arteriosus in approximately 70% of premature infants, but temporarily inhibits synthesis of all prostaglandins. Early toxicity of indomethacin is not prohibitive, but the possibility of late neurological deficits is raised by results of laboratory experiments. As yet, no late toxic effects of indomethacin have been observed. However, this possibility and the low morbidity (less than 2%) and mortality (less than 2%) of surgical ligation of the patent ductus arteriosus in premature infants favor operation except in carefully controlled and limited clinical trials.


[Nutritional evaluation of protein concentrates of beans (Phaseolus vulgaris) and lentils (Lens esculenta)]. The composition and nutritive value were determined in navy bean meal (Phaseolus vulgaris) and lentil meal (Lens esculenta), and in their respective protein concentrates obtained through extraction followed by isoelectric precipitation. Sulfur amino acids per gram of nitrogen were lower in the concentrates than in the meals, while there was no difference for lysine and threonine. The white bean protein concentrate had a lower biological value than the meal but better digestibility, although trypsin inhibitor concentration was unchanged. Digestibility greatly improved with heating but it did not increase beyond 81% even after autoclaving. Autoclaved samples supplemented with methionine reached a biological value of 83. The lentil protein concentrate also had a lower biological value than the meal but digestibility was high for both samples (91%) and remained unchanged after heating. Trypsin inhibitors were absent. After supplementing with methionine, a biological value of only 63 was obtained, due to the low level of tryptophan, the second limiting amino acid. In spite of the concentrates' lower biological value, it was proved that they equalled the meals' potential for complementing cereal, as their content in lysine and threonine is high. The concentrates have the additional advantage of allowing effective supplementation without increasing the legume-cereal ratio.


[Effect of various heat treatments in the hemagglutinin content and in the protein quality of beans (Phaseolus vulgaris)]. The effect of pre-soaking raw seed beans upon detoxification and the biological quality of its protein were evaluated. In whole raw seed beans (Phaseolus vulgaris) var. "tórtola", the net protein utilization (NPU), true digestibility and hemagglutinin titer were determined after 60', 90' and 120' of heat treatment, with and without 14 hours of pre-soaking. It is concluded that soaking prior to cooking is not necessary to eliminate the toxicity of dry beans, but that it does contribute to the softening of seeds and reduction of cooking time. The hemagglutinin levels of six commercial bean flours were evaluated, concluding that almost all of them presented toxic levels. The effect of the cooking methods upon the toxicity of bean flours was studied. Two raw bean flours, var. "tórtola" and "burro" at 10% and 20%, were cooked employing different boiling times (5, 10, 15 and 30'). The two raw samples contained high hemagglutinin levels which were inactivated at 10% with 10' cooking. The presence of toxic levels was detected at 20% after 15' cooking and these were eliminated at 30' of cooking.


[Nutritive value of the spirulina algae (Spirulina maxima)]. Nine experiments were conducted, five of them in vivo to determine the limiting amino acids and digestibility of spiruline algae for the rat, and four in vitro to determine the digestibility of the product in pepsin and ruminal liquid. None of the amino acids studied (lysine, methionine, histidine) added alone or in combination to 10% protein (either crude or true) diets provided exclusively by spiruline, seems to be limiting although the results could be masked by the low palatability and acceptability of the product by the rats. The apparent digestibility of the algae was 67.4%. For the in vitro tests, the algae were subjected to several physical or chemical treatments, and the digestibility of the resulting product determined by four different techniques. In no case did the tested treatments have any effect on its digestibility.


[Evaluation of coffee pulp as a possible substitute for corn in poultry rations]. A study was conducted to determine the possibility of using coffee pulp as an ingredient of chick rations. Another objective of the study was to evaluate the biological effect of adding sodium metabisulfite on the nitritive value of the agricultural by-product. Fifteen day-old chicks were fed rations containing 10, 20 and 30% coffee pulp, untreated and treated with 1 and 2% solutions of sodium metabisulfite. After three weeks on these rations, the animals were switched to one containing 30% coffee pulp, for five weeks. Results of the first experimental period showed a negative effect of coffee pulp on weight gain, feed conversion and water consumption on a water intake/weight basis. Apparently, treatment of coffee pulp with a 2% solution of sodium metabisulfite improved the above parameters but without reaching those attained by the control ration. In the second part of the study, the groups fed 30% coffee pulp, with and without metabisulfite treatment, gained less weight and showed lower feed conversion efficiencies than the control group. An interesting fact was the absence of mortality even in those groups fed 30% coffee pulp in the first part of the study. From these data it is concluded that coffee pulp at levels of 10% can be used with no problem in chick rations. It is necessary, however, to carry out additional studies before recommending the use of this by-product in poultry rations.


[The nutritional factor in the growth and development of children from 0 to 6 years of age: methodology of a longitudinal study]. In order to pursue a study on the growth and development of French-Canadian children from birth to 6 years of age, 496 pregnant women were selected in the Montreal area. A complete survey of the family's social and medical background, along with the parents' height and weight was recorded through a prenatal interview that generally took place towards the last trimester of pregnancy. In the course of the same interview the mother participated in a quantitative investigation of her own diet during pregnancy, and filled in a 24-hour food record that was revised by the nutritionist to further precise the actual quantities of food ingested. Perinatal events and anthropometric measurements at birth were recorded. The babies were examined at the Center every 3 months up to the age of 18 months, and then at 24 months old; thereafter they are seen annually within more or less 7 days of the date of their birthday. The medical examinations are performed by a multi-professional team responsible for analyzing the various factors influencing the growth and development of the child. Since nutrition is one of the outstanding aspects of this study, the present article deals with the investigation of two known methods for evaluating the mother's nutrition during pregnancy, as well as that of the child during his first years of life.


[Use of tests based on the analysis of expired air in nutritional studies]. Tests based on the analysis of the gaseous components of expired air have been developed to study intestinal absorption and intermediary metabolism of various nutrients. This paper reviews the breath-analysis tests based on the measurement of CH4, H2, and isotopically-labelled CO2 for studying the intestinal absorption of carbohydrates, fats, and bile salts, and intrahepatic metabolism. New technology employing mass spectrometry allows the use of the stable isotope, carbon-13, instead of the radioactive isotope, carbon-14, for CO2 breath tests. The nutritional application of the breath-analysis tests is discussed, and the advantages of the non-radioactive, non-invasive procedures, especially for use in children and pregnant women in whom standard investigational methods represent a discomfort or a radioactive hazard, are emphasized.


[Effect of storage on the levels of ascorbic acid and beta-carotene in freeze dried red guava (Psidium guayava L.)]. The retention of ascorbic acid, beta-carotene and sensory properties of freeze-dried red guava pulp stored during 18 months in hermetically sealed brown glass flasks, at room temperature (ca. 25 degrees C) was studied. The results showed that the losses during freeze-drying were of 8.13% for ascorbic acid and 0.63% for beta-carotene. During storage more pronounced losses of these elements occurred during the first six months, becoming progressively smaller and almost irrelevant at the end of the period. The sensory evaluation of the reconstituted pulp showed that the retention of flavor was good. A Gompertz curve was fitted to observe data and showed to be efficient in explaining the trend of reduction for both elements under study. The excellent retention of ascorbic acid, the relatively fair retention of beta-carotene during processing and storage of freeze-dried red guava pulp, and the good conservation of flavor of the reconstituted pulp are evidences of the importance of this process for preserving and storing fruit pulps.


Hatchery waste: nutritional evaluation of non-hatched eggs. Hen's non-hatched eggs were processed by boiling for 30 minutes, milling in a meat grinder, and drying at 60 degrees C with continuous ventilation. The product contained 36% of protein, 27% of ether extract, 17% of ash, 10% of calcium, and 0.6% of phosphorus. The quality of the protein was comparable to that of a reference casein and of fresh egg meal, as determined by protein efficiency ratio and apparent net protein utilization.


[The heparin-dependent inhibition of the accumulation of 131J-fibrinogen in the solid form of Walker-256-carcinosarcoma of the rat (author's transl)]. The intravenous injection of 131J-fibrinogen results in a selective accumulation of radioactivity in the solid Walker-256-carcinosarcoma of the rat. An effective anticoagulation with heparin beginning before administration of the radio-iodinated fibrinogen and continued up to the end of the experiment inhibits the enrichment of radioactivity. It is supposed that the radioactivity in the tumor is correlated to the deposition of 131J-fibrin. A clotting process in tumor transforms both fibrinogen and 131J-fibrinogen to fibrin resp. 131J-fibrin. This conversion is thrombin-dependent might be blocked by heparin. The tumor growth is not influenced by the presence of heparin.


[Test of 0,0-dimethyl(1-hydroxy-2,2,2-trichlorethyl)phosphonate (Trichlorfon) for carcinogenic activity in Syrian golden hamsters (Mesocricetus auratus Waterhouse) by intraperitoneal administration (author's transl)]. 0,0-Dimethyl(1-hydroxy-2,2,2-trichlorethyl)phosphonate (Trichlorfon; TCP) was tested for carcinogenic activity in male and female Syrian hamsters (Mesocricetus auratus Waterhouse) by intraperitoneal administration. The period of administration was 90 weeks, when maximum total doses of 204 mg (male) and 206 mg (female) TCP per animal had been injected. The study was terminated at 100 weeks. There was no statistically significant difference, when compared the total tumour incidence, or the incidence of malignant and benign tumours separated, of the groups of treated and control animals. These findings were independent from whether the groups of TCP-injected animals and controls were combined or divided by sex.


[Studies on the immune status of melanoma patients: cell-mediated immune reactions in intracutaneous and epicutaneous tests in the lymphocyte transformation test and the leukocyte-migration inhibition test before and during BCG immunotherapy (author's transl)]. Active immunotherapy with BCG was carried out postoperatively in 22 patients with malignant melanoma. At the beginning and 6 months after treatment cell-mediated immune reactions were checked by both in vivo tests (intracutaneous test with tuberculin and patchtest with DNCB) and in vitro tests (lymphocyte stimulation and leukocyte migration inhibition with tuberculin and DNCB). The results have shown that stimulation of immune response may be obtained by systemic BCG therapy.


Epidemiologic data for environmental determination of urinary system tumours and nephropathy in an endemic region. One hundred and thirty-eight patients diagnosed for urinary system tumours (UST), 714 patients with endemic nephropathy (EN) and 55 cases of UST and EN combined, all from endemic villages of Vratza district, Bulgaria were investigated for their familial pattern and time of diagnosis compared with the age at diagnosis. There were 144 spouses among these patients and nearly half of them came from non-endemic families and villages. The familial pattern followed the size of the population found to be at greater risk, i.e. people 40-60 years old, in particular women. Among the investigated 91 pairs of parents and children and 166 pairs of siblings the mean diagnostic interval was shorter than the mean difference of age at diagnosis. Therefore the epidemiologic data provide support to the hypothesis that possibly environment plays a predominant role in the familial aggregation and in the etiology of UST and EN in the endemic region.


Alterations of membrane constituents in carcinomas and drug resistant tumour cells. The cell surface changes occuring during malignant transformation are discussed. In malignant tumours, the amount of some membrane associated proteins (LETS1), myosin, collagen etc) is decreased while the amount of glycoproteins and the activity of glycosyltransferases is increased. The activity of some hydrolytic enzymes is also increased in transformed cells. The composition of membrane lipids is remarkably altered in malignant cells. The cell surface properties of the drug resistant and sensitive tumour cells are different. We found the resistant L1210 cells to be less agglutinable than the sensitive line. Pretreatment with Colchicin and Vincristin significantly reduced the agglutinability of sensitive L1210 cells. The sensitive L1210 cells are able to incorporate 3H Colchicine and 14C Vincristine more readily than the resistant L1210 cells. Growth stimulating agents like insulin, high serum concentration etc. are more effective with drug sensitive cells than with the drug resistant line.


[Biological and social aspects of migration of the Andes population]. The effect of migration on the biology of human populations is almost unknown. While some studies of populations moving from areas which are poor and without medical care clearly show that movement into more prosperous areas improves general health, these studies fail to show the specific effects of changing physical environments. In the present study migrants from the altiplano of Southern Peru to the adjacent low altitude zones were examined. The data were compared to similar data on migrants from low altitude areas and native low altitude people. Preliminary analysis of the information collected suggested the following: 1. Adult women increase slightly their completed fertility when they move from high to low altitude. Child spacing is particularly decreased but birth sex ratios are not affected. 2. Highland migrants at low altitude produce larger newborns than they do at high altitude and these infants grow more rapidly than high altitude infants. 3. Migrants from high to low altitude suffer more respiratory symptoms than low altitude migrants or lowland natives. 4. Although highland migrants quickly adopt low altitude life styles and diets they do not show the age increases in blood pressure or high levels of serum cholesterol common in lowland natives. On the basis of these findings it is concluded that migration may have some detrimental effects on human health and physical fitness. However, more importantly they show that the specific physical environment in which an individual develops has a significant effect on the health fitness of a migrant to a new environment.


[Hormonal variation during physical exertion at high altitude]. The influence of the physical exercise at high altitude on the endocrine function was studied in 8 normal native men of sea level and in 8 natives men of high altitude. The sea level dwellers were studied both, at sea level, during an acute exposure to low barometric pressure and after 3 months of acclimatization to altitudes over 3,500 meters above the sea level. The experiments at high altitude were conducted at an altitude of 4,500 meters above the sea level. Two types of exercise were carried out, sub-maximal and maximal, at fasting state, between 8 and 10 a.m. During an acute exposure to altitude the physical exercise produced a marked rise of glucose, cortisol and growth hormone and a fall in the insulin content of plasma. In the sea level dwellers, acclimatized to altitude during 3 months, an elevation of growth hormone was observed only during maximal physical effort. Marked variation in glucose and cortisol were observed during both types of exercise. This shows that in these subjects some adaptative changes have ocurred but of lesser extent as those observed in altitude natives. In the high altitude native higher basal concentrations of growth hormone and glucagón as well as a lower glucose concentration in blood, were found. During exercise the high altitude dweller showed no significant changes in somatotropin, meanwhile an important elevation of cortisol occurred. These findings indicate that the high altitude native has metabolic and endocrine responses to exercise similar to those found in well fitted atletes of sea level. The exposure to altitude provoked a rise in glucagon concentration directly proportional to the time of exposition ot altitude. The physical exercise did not elucidate any change in the glucagon content of blood.


Changes of the stria vascularis induced by ethacrynic acid. Histological changes in the stria vascularis of guinea pigs after the injection of ethacrynic acid (50 mg/kg) were investigated using a transmission electron microscope and a scanning electron microscope. The changes in permeability in the stria vascularis was also observed using horseradish peroxidase as a tracer. The pathological changes originating in endothelial cells of stria blood vessels and intermediate cells spread into the marginal cells and basal cells. The most remarkable changes were observed one hour after the injection of ethacrynic acid. Subsequently, recovery began in the cells around the blood capillaries and was most complete 3--4 hours after the injection. It is presumed that the strial damages by the ethacrynic acid are caused not only by the direct effect of this drug on the strial cells but also by the disturbances of blood flow and permeability of the capillaries.


Densitometric studies on the shadows of paranasal sinuses in sagittal projection. In taking a X-ray photography of the head in sagittal projection, it is most important that the center of the X-ray beam passes exactly through the median-sagittal line. If the subject turns his head either to the right or to the left, the paranasal sinuses become denser on one side, leading to erroneous interpretation of the radiographic findings. In order to eliminate such a misinterpretations, studies were carried out on the following: 1) Application of a standard of what degree of head turning to either side would start to influence judgment of the shadow of the paranasal sinuses. 2. Application of a standard to judge whether they are projected to an exact center position or not in actually diagnosing the X-ray films.


Combined surgery, radiotherapy and regional chemotherapy in carcinoma of the maxillary sinus. In order to avoid post-operative cosmetic and functional disabilities, we introduced simultaneous surgery, radiotherapy and regional chemotherapy in treating carcinomas of the maxillary sinus in October 1964 and have been working to perfect this procedure ever since. This combined therapy consists of 1) a "reduction operation," i.e., reduction of the tumor mass, succeeded by daily cleaning of the residual tumor, 2) six external irradiation (mean dose is 1,200 rads/over a period of nine days) treatments and 3) five intra-arterial infusions of 5-fluorouracil (5-FU) (250 mg daily) and broxuridine (BUdR) (500 mg daily). The degenerative changes of the tumor cells, as observed by histopathological examinations, appear so rapidly that, when six irradiation treatments and five infusions were given, 80% of the cases showed marked irreversible change. This degeneration is not affected by the degree of differentiation. In other words, no variation was observed between well and poorly differentiated squamous cell carcinomas. In 77 cases infused with 5-FU alone, the five-year survival rate was 55%. Seventy-six percent of 45 cases infused with BUdR as well as 5-FU were still living after five years. We want to emphasize that these survivors are able to return to normal life with their eyes and palates well rehabilitated.


The use of pulmonary scintigraphy for endobronchial foreign bodies. Pulmonary scintigraphy using 99mTc-MAA clearly demonstrated a perfusion defect in the entire left lung of an 11-month-old girl with endobronchial foreign body. Other initial examinations, including a chest roentgenogram, showed only minimal changes. Repeated pulmonary scintigraphy 24 hr after endoscopic removal of a peanut fragment from the left main stem bronchus demonstrated almost normal blood flow in the left lung. The well-known physiological explanation for diminished pulmonary blood flow due to endobronchial foreign bodies is as follows; alveolar hypoxia caused by hypoventilation due to bronchial check-valve obstruction leads to a pulmonary vasoconstriction with resultant diminution of the regional perfusion. Furthermore, the increase in alveolar pressure caused by bronchial check-valve obstruction may play a significant role in decreased pulmonary blood flow.


An investigation of the removal of coarse plant material from lupin stubble paddocks for the control of ovine lupinosis. The removal of course lupin material from lupin stubble paddocks did not reduce the incidence or severity of liver damage caused by the toxins of Phomopsis leptostromiformis. Furthermore, sheep grazing paddocks from which the coarse lupin material had been removed showed body weight changes no different to sheep grazing normal lupin stubbles. In addition, it was found that 6-month old wethers suffered more severe liver damage than 18-month-old wethers, and that lupin material in the paddock remained toxic for a least 6 weeks.


Histological ageing of bruises in lambs and calves. Groups of 10-day-old calves and 5-month-old lambs were bruised 48 hours, 24 hours, 8 hours, or the instant before slaughter. By gross examination, 48-hour-old calf bruises had a characteristic red-yellow colouration, but other bruises could not be differentiated reliably. By microscopic examination, bruises of all ages could be differentiated by cellular criteria common to both species. Unlike fresh lesions, 8 hour bruises contained numerous neutrophils. Twenty-four hour old bruises contained equal numbers of macrophages and neutrophils and at 48 hours macrophages, fusiform cells and new capillaries were present in the damaged muscle. The criteria established in this study could be used to determine the ages of spontaneous bruises in abattoir carcases and so provide a basis for an investigation aimed at detection of the traumatic episode from which they result.


Bovine onchocerciasis: aspects of carcase infection. The distribution of the three known species of Onchocerca in Australian cattle is described. O. gutterosa was found in the ligamentum nuchae, on the scapular cartilage and in the hip, stifle and shoulder regiobns. Nodules of O. gibsoni were found in the brisket, stifle and hip regions, while O; lienalis occurred along the gastrosplenic ligament and above the xiphisternum. O. gutturosa is potentially the most important species to the meat industry since it is widely distributed in the carcase and is easily missed during inspection. Trimming procedures which could be used to ensure removal of known sites of infection are outlined.


The isolation and characterisation of a Newcastle disease virus from an exotic parrot. A newcastle disease virus was isolated from a salmon-crested cockatoo (Cacatua moluccensis) illegally introduced into Australia, Viral-characterisation and chicken-transmission studies indicated that the isolate, G5320/1, was a lentogenic pathotype. It caused a severe respiratory disease in chickens exposed oronasally at 1-day old and in chickens housed at 1 day of age with chickens infected with Newcastle disease virus. No harmful effects were detected in 5-week old chickens inoculated intravenously or oranasally with the virus.


Effective sedation of rabbits, guinea pigs, rats and mice with a mixture of fentanyl and droperidol. A minimun effective dose rate for Innovar-vet was established for producing sedation of rabbits, guinea pigs, rats and mice. The level of sedation permitted a minimum of restraint and abolished painreactions. No special precautions were necessary and administration was by simple intra-muscular injection. Recovery occurred within 1-2 hours and was uneventful and without excitement. A single operator was able to carry out bleeding safely, and would be able to carry out other minor procedures with minimal stress to the animal.


Isolations of akabane virus from sentinel cattle and Culicoides brevitarsis. A total of 14 isolations of Akabane virus were made from the blood of five cattle during sub-clinical infection. The serial isolation of this virus from four of these animals suggests a viraemia of at least 3 or 4 days. Neutralising antibody to Akabane virus in the serum of infected calves reached an initial peak titre of 32 to 256 four to five days after the viraemia but later uose further to a range of 64 to 512. Three isolations of Akabane virus were made from Culicoides brevitarsis collected nearby in the same period. C. brevitarsis was the dominant haematophagous midge present during that time. These findings strengthen the case for C. brevitarsis to be considered as a vector of Akabane virus.


Effectiveness of broad spectrum anthelmintics against selected strains of Trichostrongylus colubriformis. A field population of Trichostrongylus columbriformis was divided into 4 lines for exposure to selection in the laboratory. The first line was selected with 50 mg/kg thiabendazole, the second with 4 mg/kg morantel tartrate, the third with 50 mg/kg thiabendazole followed by 4 mg/kg morantel tartrate and the fourth line was not selected for drug resistance. Following at least 9 generations of selection there was no difference in LD50 OR LD95 between the unselected and single selected strains of worms. The strain selected by both tiabendazole and morantel tartrate had a significantly higher LD50 against thiabendazole, morantel tartrate and levamisole than did the other three strains. The single selected strains had LD95's of 172, 21.5 and 2.3 mg/kg for thiabendazole, morantel tartrate and levamisole respectively, compared with corresponding values of 111, 17.3 and 2.4 in the unselected strain and 124, 15.5 and 3.0 in the double selected strain. The estimated efficiency of the recommended dose of each anthelmintic against the unselected field strain was;-thiabendazole (44 mg/kg) 50% efficient, morantel tartrate (8.8 mg/kg) 76% efficient and levamisole (7.0 mg/kg) 99.9%efficient.


[Methods of treatment of perferating plantar pain by using a pneumatic sole]. A--A natural hydrostatic phenomenon, at the level of the ends of the plantar arcs, diffuses body weight, as PAIN plays the role of outsentry (fig.--1) (5); B--Plantar perforating ulceration (PPU) is caused by a combination of INSENSITIVITY and TRAUMATIS (1); C--The patient reposing, as body weight (traumatism) effects disappear, cicatrization process can be easily observed; D--PNEUMATIC INSOLE, being elastic, diffuses localized compression at the ends of the plantar arcs, reduces attrition, makes easier blood circulation, as well as cure and prophylaxis of PPU (fig.--6) (3).


[Observations in relation to the epidemic outbreak of cutaneous leishmaniasis in the Ribeira Valley (São Paulo), 1978]. The author relates peculiarities of epidemical irruption of the Tegument Leishmaniasis, occurred in the Ribeira Valley, São Paulo State, Brazil, in 1978. The work is divided into three parts: I--Geographical and ecological aspects of the place where the irruption occurred; II--A concise review of the clinic-epidemiological characteristics of the tegumental leishmaniasis; III--Informations on epidemic level about the epidemical irruption and the setting of the subject in order to debate the probable causes of the event.


[Morphometric analysis of lymphoid organs in the orchiectomized rat]. Morphometrical analysis of lymphoid organs has been performed 30 days after bilateral orchidectomy in Wistar rats. The percentage of thymus cortical area and of lymph node paracortical areas (filled with large lymphoid cells) has been found increased. These morphological changes seem to indicate that orchidectomy enhance lymph node cell-mediated immune response in the rat.


[Morphometric analysis of lymphoid organs in the ovariectomized rat]. Morphometrical analysis of lymphoid organs has been performed 30 days after bilateral ovariectomy in Wistar rats. The percentage of thymus medullary area and lymph node cortical area (containing numerous large germinal centers) have been found increased. No significant changes there were in paracortical areas. The enlarged thymus medullary area, showing small lymphocytes in lymphatic vessels, could be correlated with the hyperfunction of "helper" T-lymphocytes. These findings indicate that morphological signs of increased antibody mediated immunity of the lymphoid organs appear in ovariectomized rats.


[Morphometric analysis of lymphoid organs in the hypophysectomized rat]. The effects of hypophysectomy on the lymphoid organs were evaluated in Wistar rats by morphometrical analysis: after 30 days the percentage of thymus cortical area and lymph node paracortical areas were reduced. In the thymus cortex, signs of orthological involution (e.c.: nodular cortex) appeared. A significant enlargement of lymph node cortical areas, containing a high number of germinal centers with degenerative changes, could be seen. These findings suggest a significant trophic action of hypophysis on thymus and, perhaps, an impaired lymph node antibody mediated response due to the loss of T-B cooperation.


Adult human autoimmune thymus transplantation into nude mice - functioning of human thymus epithelium  in nude mice. Thymuses from patients with autoimmune disease were transplanted into nude mice. The thymus transplants survived for over 40 days and evidence of restoration of thymic function was observed. The de facto loss of human thymocytes from the implanted tissue resulted in an in vitro culture of pure thymus epithelium. The results suggest that adult human autoimmune thymus has the functional ability to restore immunocompetence for a thymusless mouse, and that human "thymic hormone" is a substance which does not have species specificity. This new approach to the functional activity of thymus epithelium may also be useful for a study in the pathogenesis of autoimmune disease.


Cytotoxic effects of peptichemio on synchronized EUE cells. The effect of Peptichemio (PTC) on cellular growth and on macromolecular syntheses was analyzed through the cell cycle of EUE cells. The cell response to the various treatments was measured by determining plating efficiency, growth rates and incorporation of labelled precursors of DNA, RNA and protein syntheses. Three maximum inhibition points were found on cell survival, one corresponding to the early G1, another to the middle S and a last one to the late G2. Parallel experiments of incorporation of labelled precursors of DNA, RNA and proteins revealed an effect only on DNA during the early and middle S phase.


The aggregational status of cholera enterotoxin fragment A following biochemical fractionation. Aggregates of frabment A of Vibrio cholerae enterotoxin were revealed following isoelectric focusing in 8 M urea of molecular sieve chromatography in 4% (v/v) formic acid. These aggregates consisted of dimers which required the presence of 10 M urea, 1% sodium dodecyl sulfate (SDS), 2 mM ethylenediaminetetracetic acid (EDTA) and heat (60 degrees C for 1 h) for complete dissociation. All aggregates were homogeneous when tested by standard analytical and SDS polyacrylamide gel electrophoresis or immunodiffusion analysis. Aggregates of fragment A were biologically active in the mouse Y1 adrenal cell assay.


Cytometric observations on hemopoietic kidney tissue in catfish (Ictalurus melas). Peroxidase-positive and negative lymphoid hemoblasts present in Catfish kidney were measured, in order to verify whether large lymphoid hemoblasts give rise to the granulocytic leukocytes and small lymphoid hemoblasts give rise to the erythrocytes, thrombocytes and lymphocytes. The cytometric study indicates that granulocytic cells arise prevalently by large and intermediate sized hemoblasts, but also by small hemoblasts. The other cells arise prevalently by small and intermediated sized hemoblasts and by large ones as well. Two different types of hemoblasts were distinguished but not on the basis of their size.


Sex pheromone of Poecilocerus pictus (Fabricus) (acridoidea: pyrogomorphidae): I. Experimental identification and external morphology of the female sex pheromone gland. Bioassay experiments showed the presence of sex pheromone in females of Poecilocerus pictus. It was further confirmed experimentally that the sex pheromone substances are secreted in the metathoracic and first two abdominal segments. Dissections of the females revealed the presence of a thin sac-like gland in the metathoracic segment. Ethernal extract of this gland was tested in a bioassaying apparatus to confirm its identity as a sex pheromone producing organ.


The influence of certain B12-antagonists upon trichomonas foetus. The antagonistic substances used in our experiments showed various relationships to the pathogenic protozoa Trichomonas foetus. Theseinacid and L-2-Methyl-2-Aminoaethenole demonstrated comparable inhibiting influences on the Trichomonas population. Puriniribosid, 6-Mercaptopurine, 4-Mercaptopteridine and Decobald-Cobamide exercised no recognisable influence on the Trichomonas foetus.


Proline metabolism in heteroptera from different environment. Free amino acids composition of six Heteropteran insects belonging to aquatic and terrestral habitate has been observed and it is suggested that the distribution of proline is related to the habitate of these insects. Proline probably plays a role in the retention/conservation of the water in terrestrial insects.


The markers of pig heart mitochondrial sub-fractions. II. - On the association of malate dehydrogenase with inner membrane. Malate dehydrogenase, reputed to be a soluble matricial enzyme, is shown to be also strongly associated with the inner membrane, in pig heart mitochondria. Repeated sonications, water washes, freezing-thawing cycles are not very effective to remove malate dehydrogenase activity from inner membranes, which whatever the treatment, remains important. This activity is only partly solubilized by the substrates, malate or oxaloacetate. High ionic strength treatments by either NaCl-carbonate or 3M KCl have a strong effect, but they also remove cytochrome c oxidase and rotenone-sensitive NADH-cytochrome c reductase, reputed inner membrane intrinsic enzymes, thus strongly damaging the inner membrane. After the action of phospholipase A from Naja Naja Venom, the residual activity is about twenty per cent and only phosphatidyl choline and phosphatidyl ethanolamine decreased significantly, the other phospholipids being unchanged. It is suggested that the enzyme is deeply buried in the membrane and mainly interacts with phosphatidyl choline.


Phospholipid metabolism of 3T3 mouse fibroblasts after serum stimulation and through the G1 and S cell cycle phases : incorporation and disappearance of 32P. Phospholipid metabolism of 3T3 mouse fibroblasts has been studied after serum stimulation of arrested cells. The study of [32Pi] incorporation shows : a) in the case of PE and PC an early peak of incorporation in the G1 phase of the cell cycle, 6 hours after serum addition; b) in the case of PI an intense initial increasing of the incorporation which continues up to a S phase peak. The study of the disappearance of [32P] Phosphate from the different phospholipids points out: a) at the beginning of serum stimulation, an intense breakdown of PI, that continues through the G1 and S phases. Except at the onset, the breakdown of PI, is at any time exactly compensated for by synthesis : the two phenomena are closely linked; b) a synthesis of PE, from PC probably, at the G1 phase, 4 hours after the serum addition and the beginning of the chase experiment.


Separation and biological properties of Phaseolus vulgaris isolectins. Two isolectins (L4E0-PHA and L0E4-PHA) from red kidney beans (Phaseolus vulgaris) were isolated by affinity chromatography on immobilized thyroglobulin and by chromatography on hydroxyapatite. The L4E0-PHA isolectin was not retarded on the affinity column and was eluted from the hydroxyapatite column with a 0.1 M Phosphate buffer. This isolectin had no erythroagglutinating activity but had high lymphoagglutinating and lymphocyte stimulating activities. The L0E4-PHA isolectin was adsorbed on the affinity column and was eluted from the hydroxyapatite column with a 0.25 M Phosphate buffer. This isolectin has a higo lymphocyte stimulating activity. These two isolectins are shown however to be closely related with respect to their oligomeric structure and reactivity towards anti-PHA antibodies. The lack of mitogenic activity of the L0E4-PHA isolectin suggests that in the other isolectins, the E monomer is not responsible for their mitogenic activity and that the membrane glycoproteins, which contain the E monomer - specific oligosaccharide, are not involved in the process inducing mitosis.


Human placental glutamate dehydrogenase. Purification--kinetic and regulatory properties--physicochemical studies. Glutamate dehydrogenase (EC. 1.4.1.3) has been purified more than 9,000 times from human placental alcoholic subfractions as a homogenous protein of 55,155 daltons (subunit molecular weight). Kinetic constants for the reverse reaction (reductive amination of alpha-ketoglutarate) have been shown to be similar to those of the bovine liver enzyme, while the kinetic constants for the forward reaction were markedly different as well as some regulatory properties (lack of activation by ADP in the reverse reaction). The amino acid composition differs from the bovine liver enzyme composition. Furthermore, the tryptic peptide patterns of the placental enzyme and the human liver enzyme have been compared. Besides the low specific activity of this enzyme, the results indicate that human placental glutamate dehydrogenase is closely related to other mammalian glutamate dehydrogenases.


Mechanisms of development of morphological changes in mammals aboard biological satellites. After orbital space flights lasting 19.5--22.5 days, disturbances are observed in mineral metabolism in rats, which are morphologically manifested as osteoporosis of the spongy sections of long hollow skeletal bones, periosteocytic osteolysis of them, atrophy and dystrophy of skeletal muscles, and inhibition of erythroid growth of bone marrow, which occurred and developed in weightlessness as a result of deprivation of motor activity due to removal (or reduction) of static load from the musculoskeletal system. Development of stress reaction, which is apparently intensified at certain stages of flight (lift off and touchdown) and during transition from weightlessness to conditions of gravitational force on earth, leads to corresponding changes in the structure and cellular composition of lymphoid organs, and to changes in the hypothalamic-hypophyseal neurosecretory system, adrenal glands, and other organs. Changes in the receptor apparatus of the vestibular system are associated with local circulatory changes occurring during weightlessness and G forces, while retinal injuries are associated with the effect of heavy charged particles of cosmic radiation. All changes are reversible and disappear completely or to a substantial degree a month after completion of the flight.


Ultrastructural changes in cells of transplanted mammary gland carcinoma at different stages of their development. The process of development and death of cells of primary mammary gland carcinoma was studied in rats in various hormonal situations, using electron microscopy. It was shown that the death of cancer cells is not preceded by their differential and specific functioning, which is postulated by certain authors. The problem of hormonal induction of the phenomenon of differentiation of malignantly degenerated cells is discussed.


Mechanism for the origin and the evolutionary significance of heterochronia. Using material on the evolution of the fundus of the oral cavity in amphibians, four principles were established for the origin of heterochronia: efficiency of ontogenesis; adaptability of an earlier (than in ancestors) beginning for functioning of traits; loss of the adaptive significance of a trait at a previous stage, but a preservation of it at a subsequent stage; and, a prolongation of the adaptive significance of a trait at later stages. The origin of heterochronia is associated with changes in the succession of the functioning of genes, with reorganization of systems of morphogenetic correlations, and with change in the traits themselves that undergo heterochronia. The uniqueness of heterochronia as an adaptation consists of an increase in the evolutionary flexibility of specific stages of ontogenesis.


Current status of the problem of the mechanism of gravity reception in plants. Basic work carried out recently on the role of the structural-functional condition of cell organelles in the development of geotropic reaction in higher plants is reviewed. On the basis of analysis of theoretical proposals and experimental investigations of the molecular mechanism of perception and realization of the gravity stimulus, a hypothesis was developed that the key factor in the development of geotropic reaction is an interaction of cell organelles with membranes of the endoplasmic reticulum as a result of their sensing the gravity stimulus.


Influence of organic matter on the effectiveness of mineral fertilizers. The influence of composted peat on the effectiveness of different doses of mineral fertilizers was studied in model greenhouse experiments with barley of the Pirkka variety cultivated in sand and poorly cultivated sandy-loam soil. It was shown that the use of a large amount of composted peat (10% of the weight of the substrate) contributed under the experimental conditions to a pronounced increase in plant productivity only when increased doses of mineral fertilizers were used (NPK at 0.2 g/kg of substrate). A direct correlation between yields and number of microflora in the rhizosphere was not revealed. Conditions were modeled under which increased yield occurred when development of microflora was poor, while the lowest yields were noted when there was an increase in the number of microorganisms. At the same time, the variants with maximal numbers of microorganisms and size of yields did coincide.


Use of nitragin in the USSR.

Use of nitragin in the USSR. In this paper we present the results of an analysis of data on the effectiveness of nitragin for the principal leguminous crops in the various soil and climatic zones of the country during the period 1971--1975. It was shown that in the majority of the experiments (75%) nitragin not only increases the yield of leguminous crops but also leads to an elevated protein content in these. Data on the application of nitragin in the USSR and in other countries are given.


Influence of external factors on the composition of the soil microflora. The changes in the soil microflora as a result of introducing various organic substances (gelatin, chitin, cellulose and beech sawdust) into the soil were studied. The work was supplemented by electron-microscopic observations. Substantial shifts in the quantitative composition of the microorganisms take place only in the case of compounds easily accessible to them. Certain substances induce changes in the ratio of the groups comprising the soil micropopulation.


Quantitative investigation of the changes in the cell composition of the spleen during the growth of Worker's carcinosarcoma. The weight of the spleen and its cell composition as a function of the weight of the tumor was studied during the development of Worker's carcinosarcoma. The progression of the dependence is presented in the appropriate mathematical form. It is shown that with development of the process of tumor enlargement, erythro- and myelopoiesis are intensified in the spleen. The overall quantity of erythroblastic elements reaches a maximum value when the weight of the tumor reaches 30 g and subsequently remains at the same level. The kinetic curves of the changes in the number of lymphocytes in the spleen and also their graphical dependence on the weight of the tumor are of an extreme character. At late stages in the development of the tumor, the number of cells of the granulocyte type begins to increase.


The place of symmetry in the study of biological macromolecules. The various aspects of symmetry involved in discussions of biological macromolecules are analysed. Among these are geometrical symmetry of the macromolecule itself, the symmetry of its binding isotherms and the underlying thermodynamic and mathematical relations, the role of symmetry in different allosteric models, and the effect of symmetry on the number of relaxation times shown by a macromolecule in its approach to equilibrium or a steady state. Finally there is the symmetry of the group of potentials and the resulting linkage relations which govern the response of the macromolecule to its ligands and embody the grammar of a macromolecular language.


Thymus morphology in NZB mice after multiple dosage with somatotropin. Cortical matter increased in the thymus after ten-day dosage of Coombs-positive NZB mice with somatotropin and thyroxine; cortical matter predominated over medullar matter. Secondary lymphoid follicles disappeared and the number of mast and plasma cells decreased. With administration of the hormone, rosette-forming cells began to appear in the thymus.


Lifetimes of complexes of the antibiotic X-537A (lasalocid A) with physiological cations in methanol. Determination by NMR using a dissociative shift reagent. Using a magnetic resonance method we have determined the lifetimes of the following complexes of X-537A (HX) in methanol solution at 25 degrees C, BaX+, 132 microseconds; SrX+, 34 microseconds; CaX+, 24 microseconds, and KX, 15 microseconds, each with an estimated uncertainty of 30%. For NaX and LiX the lifetimes are too short to measure by the present method. The lifetime found for BaX+ is considerably shorter than the result obtained by Patel and Shen using a different method. The present method depends upon the broadening of the resonance lines of certain protons in X- due to reactions such as X- + Ba2+ = BaX+, when the resonance of the proton in the "free" X- has been shifted from its normal frequency by Pr(III) which acts via the exchange PrX3 in equilibrium PrX2+ + X-. To determine the lifetimes of interest the equations for a three-state spin system were derived; under the relevant conditions the final equations take the form of the Swift-Connick equations for a two-state system, with the characteristics of one of the states dependent upon the PrX3 concentration. This dependence is used to extract the life-times from the data in a novel and simple way.


Growth of races of the fungus Macrosporium solani Ell. et Mart. in culture with various sources of nutrition. Races of the fungus Macrosporium solani Ell. et Mart., inducing tomato macrosporiosis, differ from one another with respect to sources of carbon, nitrogen, phosphorus and sulfur nutrition. Mono- and disaccharides and nitrates and organic forms of nitrogen were found to be most suitable for culture of the races. Addition of compounds containing phosphorus and sulfur to artificial nutrient media stimulates the growth of mycelium.


Process of infection of the root system of the pea by root nodule bacteria in the presence of straw. The application of straw enhances the process of formation of specifically distorted root hairs with a primary focus of infection in 8--9 day old pea plants inoculated with bacteria, but somewhat retards the process of formation of infective filaments in such root hairs. On the 13th to 15th day the number of these and other root hairs in the variant in which straw has been applied is considerably higher than in the absence of straw. This is correlated with the number and weight of nodules formed.


Activity coefficients of salts in highly concentrated protein solutions. I. Alkali chlorides in isoionic bovine serum albumin solutions. In order to understand the thermodynamic state of simple salts in living cells, the mean activity coefficients of LiCl, NaCl, KCl, RbCl, CsCl were determined in concentrated isoionic bovine serum albumin (BSA) solutions by use of the EMF method with ion exchange membrane electrodes. The protein concentration range extended up to 22 wt%, whereas the salt concentration was kept constant at 0.1 mole per kilogram water. These solutions may be regarded as crude but appropriate model systems for the cytoplasm of cells as far as type and magnitude of the macromolecular component influence on the chemical potential of the salts is concerned. The mean stoichiometric activity coefficients of the alkali chlorides in the isoionic BSA solutions decreased linearly with the protein molality; this decrease, however, did not exceed ca. 10% compared with the pure 0.1 molal salt solutions. Only very small differences in the behavior of the different alkali chlorides were observed. The results may be interpreted by the superposition of the effects of specific Cl- ion binding to BSA and BSA bound "non-solvent" water with probably electrostatic long range interactions of the BSA(Cl-)nu polyions with the salt ions in solution. The resulting mean activity coefficients, corrected for ion binding and non-solvent water, showed a very slight linear dependence on the protein concentration. The departure from the value in the pure 0.1 molal salt solutions did not exceed +/- 2%.


Lipid composition of strains of the fungus Ustilago zeae (Beckm.) differing as regards their hybridization type. The composition of the intracellular lipids was studied in four strains of Ustilago zeae differing as regards their hybridization type. In all strains, irrespective of the hybridization type, the bulk of the lipids are formed during the first three days of growth and constitute 43.2--55.7% of the weight of the dry cells. It was established that the total lipid fraction is composed of: phospholipids + monoglycerides, sterols, free fatty acids, diglycerides and sterol esters. The qualitative composition of the total lipids was found to be identical in all four strains regardless of the time of incubation of the cultures. While the qualitative composition remains constant, the ratio of the individual fractions changes in the various strains during the process of incubation. However, compatible strains with respect to hybridization do not differ as regards the amount of individual lipid fractions, while strains incompatible with respect to hybridization differ as regards this trait.


Intracellular membrane structures of the mycoplasma-like organisms inducing carrot yellows. Intracellular membrane structures from 16 to 22 nm wide were found in the mycoplasma-like organisms causing carrot yellows. These structures are composed of five layers, three electron-dense and two electron-transparent. The membrane structures are situated, as a rule, in the central nucleoid zone of the cells of the mycoplasma-like organisms and may be seen to be in direct contact with the DNA fibrils. Ribosomes may be seen around the membrane structures. In this work we show the morphological connection between the membrane structures and the external elementary membrane of the mycoplasma-like organisms and also invagination of the external membrane into the cell. It is proposed that the intracellular membrane structures arise by means of invagination of the external elementary membrane and form a single system with this. This is the first instance of discovery of intracellular membrane structures in mycoplasmata.


Microbiological processes in the soil under various methods of irrigation. A study was made of the effect of various methods of irrigation on yields of spring wheat and development of soil microorganisms in the cultivated layer and the layers below of dark-chestnut soil of the Saratov Oblast. Irrigation increases the number of microorganisms in the plowed layer and the layer beneath. Sprinkling has a greater effect on yield of agricultural crops and on microbiological processes.


Kinetics of dimerization of the Bence-Jones protein Au. The dimerization reactions of complete Bence-Jones protein Au (VC-Au) and of its variable fragment (V-Au) were compared in 0.2 M (ionic strength) sodium phosphate buffer, pH 6.8 at 20 degrees C. The dimerization constant for VC-Au (6.6 X 10(4) M-1) was slightly smaller than a previously published value for the fragment (1.1 X 10(5) M-1). The reaction enthalpies were positive for both processes. Temperature jump experiments exhibited two kinetic phases. The relaxation time of the fast phase as well as its concentration dependence and amplitude were almost identical for VC-Au and V-Au. Only small differences were observed in the slow phase. These close similarities between the reactions of the two proteins demonstrate that dimerization occurs mainly via interactions between the variable domains and that the constant domains interfere very little. From the observation of two relaxation times it follows that the dimerization mechanism for both VC-Au and A-Au must include at least three reacting species. Mechanisms with an isomerization between monomers in two conformational states and a single dimer species are excluded by the data. Alternative mechanisms with a single monomeric species but isomerization between dimers give a rather unsatisfactory fit. A good fit can be obtained if it is assumed that both monomers and dimers can exist in two states. Rate constants of the association and dissociation steps are of the order of 10(7) M-1 s-1 and 10(2) s-1. Isomerization rate constants are in the range of 10 s-1.


Limiting laws and counterion condensation in polyelectrolyte solutions. V. Further development of the chemical model. Counterion binding to polyelectrolyte chains is formulated as a chemical reaction Mz (free) leads to Mz (bound). Expressions for the chemical potentials of free and bound counterions are set equal to obtain the reaction equilibrium. The results are equivalent to those in the previous paper of this series. An additional result obtained here is that a polyion holds its bound counterion layer with a strength on the order of 100 kcal/(mole cooperative unit). The method is then applied to the calculation of the polarizability along the chain due to the bound (condensed) counterions.


[Autofluorescent cells in the sacculus rotundus in the rabbit]. Many autofluorescent cells, rich in yellow pigment are described in the rabbit's sacculus rotundus. This pigment stained positively with Sudan black, PAS and Masson-Hamperl techniques. The cells correspond to those described in rat and in mice lymphatic organs. The possible origin of the pigment is discussed.


[Functional anatomy of a completely ossified hyoid apparatus in man. Study with cineradiography]. Radiocinematographic study of the laryngo-pharyngeal area in a man showing an entirely ossified hyoid system, made during the course of chewing, swallowing, and sound utterance. Two facts seem noteworthy: 1) from the morphological point of view, we should search in organogenesis for an explanation of the ossification of the hyoid apparatus; 2) from the functional point of view, one notes considerably reduced movements of the bone, without any change in the swallowing, or in the speach functions.


[Exploration of fetal erythropoiesis].

[Exploration of fetal erythropoiesis]. Rat embryos (8-14 days) were fixed, included and cut. Others in all cases from the same litter, were crushed on smears, in toto or after dissection. A comparative study of the two types of samples is necessary to obtain good results. Primitive erythropoietic stem cells seem to arise by the extra-endothelial way in the yolk sac mesodermic layer. They disappear when blood islands are connected to the vascular net. Primitive red cells, Perls-positive, are always intravascular in hepatic buds, normoblasts always extravascular. When grown on a medium containing hematopoietic factors, primitive (megaloblastic) cells remain megaloblastic and mature, as do the (normoblastic) definitive red cells. On a poor culture medium (Parker 199) normoblasts do not become megaloblastic. The two series, yolk sac primitive and hepatic definitive red cells, seem to proceed from individual cellular clones.


[Thoracopagus. Possibilities of surgical separation]. A new case of thoracopagus twins is reported. Radiological, hemodynamical and surgical explorations showed a communication between the two hearts, situated at the atrial level and associated with digestive and cardiovascular malformations. These abnormalities were definned by the anatomical study realized after vascular injection:hypoplastic pulmonary artery (associated with a persistent atrio-ventricular canal in one case, with a tricuspid atresia in the other case), a large fused liver, common pancreas and ileum. A bibliographic study allows the authors to define surgical separation possibilities. The prognosis depends essentially on cardiovascular abnormalities associating abnormal connections between the twins' hearts with malformations often too severe for surgical repair.


[Note on the variability of the basicranial axes]. On 114 lateral radiographies of skulls, we looked for the best basicranial axis, i.e. the least variable, the most stable. One should discard the foramen magnum plane (too variable due to the basion lack of precision); the same is true for the axes passing through the sellion point, because the Sella turcica center is situated relatively lower in women and in toothless persons (at least in our series); the studies on the sphenoidal angle are thus tainted with error, the jugum and clivus planes being still more unprecise. Incidentally, let us report the little value of the palatine plane (but not of the nasal plane). The positive results are as follows: compared to the bregma-lambda axis, the nasion-opisthion axis is less variable than the auriculo-orbitary Francfort plane. But this last plane contracts higher correlations with the bregma-nasiolambda angle. Thus Francfort and nasion-opisthion axes both look equally good.


[Anatomical aspects of the elements of interpretation of lateral chest radiographs of adults]. Anatomo-radiological study of the thorax based on 110 lateral chest radiographs and 11 necropsies of normal adults. The authors show the interest of this lateral projection which has been too long considered as a simple contribution to the anterior-posterior projection. This incidence exhibits many anatomical details, which could not be seen on any other standard incidence.


[Abnormal fusion of 2 primitive trigeminal arteries: apropos of an anatomo-radiological case]. Agenesis of the internal carotid artery was discovered during emergency cerebral angiography carried out on a comatose 28 year old man. The left cerebral hemisphere was supplied from the controlateral carotid artery, via a large vessel running through the sphenoid bone, between the intracavernous portions of the internal carotid arteries. Postmortem examination showed that death resulted from massive haemorrhagic infarction of the cerebellum and brain stem. Absence of the cervical and petrosal portions of the left internal carotid artery was confirmed. The anastomotic vessel was found to run through the spongiosa below the dorsum sellae. The heart, major vessels and circle of Willis were otherwise normal. An intercarotid anastomosis of this type has been reported on three previous occasions, in none of which was there anatomical confirmation.


[Anatomical and embryological study of a case of bladder exstrophy with duplication of the urethra]. An exceptional case of a double urethra associated with an extrophied bladder in a neonate boy is reported. This particular malformation allows an ideal procedure with the recovery of a good continence. After the anatomic study of the anomalies, the authors try to find an embryologic explanation. The usual theories of the development in the cloacal region are discussed. Only the embryologenesis as described by SOLERE can explain this malformation.


[Tracheo-bronchial malformation associated with an aberrant left pulmonary artery]. A new case of pulmonary artery sling in a three months old boy is reported. After the sudden death of the patient, a precise anatomic study of the malformation was realized. With a complete cartilaginous ring usual in this malformation, there is a right upper lobe bronchus arising from the trachea above the anomalous vessel. The other anomalies of the tracheobronchial tree are discussed.


Combined posterior interosseous and ulnar nerve compression in a hemophiliac. A case is reported of a combined posterior interosseous nerve and ulnar nerve decompression in a patient with hemophilia after appropriate blood factor replacement. The importance of avoiding unnecessary delay in surgical intervention and careful attention to details of operative and postoperative care are stressed.


Scoliotic index: a comparative evaluation of methods for the measurement of scoliosis. A new technique of measurement--Scoliotic Index(SI)--was devised to obtain more accurate determination of the spinal curvature. In comparison with previously established methods (Ferguson, Cobb), the SI is a more comprehensive and accurate representation of the scoliotic curve. It measures that the deviation of each involved vertebral segment from the vertical spinal lines with multiple points taken along the scoliotic curve. The development of this technique proved by serendipity that the Ferguson and Cobb measurements of the angle of scoliosis are reliable and comparable at all degrees of curvature.


Congenital vertical talus.

Congenital vertical talus. A classification of Vertical Talus deformities into three types is proposed. The three types, Teratogenic, Neurogenic and Acquired have different etiologies, clinical features and behavior characteristics. It is anticipated that this classification will permit easier recognition of these entities and development of more individualized treatments.


Functional obstruction of the ureter and renal pelvis. A histological and electron microscopic study. Histological, histochemical and electron microscopic techniques have been used to compare dilated and normal calibre segments of ureter and renal pelvis in cases of idiopathic hydronephrosis and primary obstructive megaureter. In both conditions a marked increase in collagen and elastic tissue occurs in the wall of the distended segment and this infiltration extends throughout the proximal dilated ureter and renal pelvis. Evidence is presented to show that in the dilated segment, smooth muscle cells are directly involved in the synthesis of connective tissue elements. These findings support the view that the primary anomaly in idiopathic hydronephrosis and primary obstructive megaureter can be attributed to a malfunction of smooth muscle cells in the ureter and renal pelvis. However, the possibility remains that the changes in smooth muscle are secondary and have been induced by obstruction and distension caused in these pathological conditions by unknown aetiological factors.


Pre-operative balloon occlusion of the renal artery for radical nephrectomy. Six of 8 patients with renal tumours were successfully catheterised pre-operatively and the renal artery occluded by a Swan Ganz balloon tipped arterial catheter. At subsequent radical nephrectomy early ligation of the renal vein was readily accomplished and there was noticeable decrease in vascularity and engorgement of the kidney and its tumour.


An unusual case of persistent renal collar in a human adult male. There are relatively few reports in the literature on accessory renal veins, and particularly that anomaly described as a persistent renal collar. The present paper describes a case in which a left renal vein is encountered in a human adult, both anterior and posterior to the abdominal aorta, though without a persistent left inferior vena cava.


Has bromocriptine a place in the treatment of the unstable bladder? A clinical study of bromocriptine in the treatment of 18 patients with an unstable bladder is reported. All patients had previously received drug therapy and/or vesical distension, without success. Ten of the 18 patients had side-effects, and 2 of these did not complete the study. Only 2 patients noted moderate improvement in their urinary symptoms. Bromocriptine appears to be of little value in the treatment of the unstable bladder.


Bone scanning and plasma phosphatases in carcinoma of the prostate. Bone scanning with 99mTc-Sn-HEDP, radiographic skeletal survey and determination of plasma acid and alkaline phosphatase values were carried out in a consecutive series of 90 untreated patients with carcinoma of the prostate. 99mTc-Sn-HEDP provided satisfactory bone imaging and was convenient in use. The addition of bone scanning to radiographic survey increases the detection rate of skeletal metatases by 16%. Radiography increases the accuracy of bone scanning by identifying false positive scans due to benign disease and false negative scans when there are diffuse symmetrical bony metastases. The plasma phosphatases alone are less accurate staging tests. The acid phosphatase data support the validity of scan positive--X-ray negative findings. Bone scan abnormalities due to secondary deposits usually precede elevation of plasma alkaline phosphatase.


The role of bone scanning in the assessment of prostatic carcinoma. Fifty new cases of carcinoma of the prostate were assessed prior to treatment to determine the incidence of bony metastases. The radioisotope bone scan was the most sensitive method of detecting metastases and of localising them. It was twice as accurate as the serum acid phosphatase estimation. Skeletal X-rays were the least accurate method. Forty-six per cent of patients had abnormal bone scans at presentation. The histological grade of the tumour correlated well with the bone scan. The higher the grade, the more likely was the bone scan to be abnormal. There is need for greater accuracy in detecting metastases, and the bone marrow acid phosphatase estimation, either alone or in conjunction with the bone scan, may provide this accuracy.


The significance of bone marrow acid phosphatase in patients with prostatic carcinoma. The levels of total and l-tartrate labile acid phosphatase were studied in 49 patients with prostatic carcinoma. The results were compared with the results from a control group. The acid phosphatase levels from the bone marrow were above the upper normal limit of serum acid phosphatase both in the control group and in patients with prostatic carcinoma. This may be due to acid phosphatase released from blood cells during haemolysis. There was a positive correlation between serum and bone marrow acid phosphatase levels in patients with prostatic carcinoma. Significantly raised levels of bone marrow acid phosphatase (above the upper limit of the normal range from the control group) were observed only in advanced stage IV patients with significantly increased serum levels. The levels of bone marrow acid phosphatase gave no supplementary diagnostic information in any of the patients with prostatic carcinoma. Doubt is expressed concerning the hypothesis that raised levels of bone marrow acid phosphatase are diagnostic of early metastases from prostatic carcinoma.


Outflow obstruction in neuropathic bladder dysfunction: the neuropathic urethra. Urethral pressure profiles were recorded in a series of patients with traumatic lesions of the spinal cord producing vesico-urethral dysfunction. Patients were classified into groups depending upon the relationship of the lesion to the sympathetic outflow to the bladder and urethra from the spinal cord. Using alpha-adrenergic blocking agents, the smooth muscle contribution to the maximum urethral pressure was ascertained in each group and differences in both the configuration of the profile, and the smooth muscle component, were found. Increases in the maximum urethral pressure in response to a change in posture were also investigated, and the extent of the increase found to vary according to the level of the spinal lesion in respect of the sympathetic outflow, and with the integrity of the sacral cholinergic reflex arcs. The hypothesis that these changes may be due to urethral "decentralisation supersensitivity" from alterations in circulating catecholamine levels is suggested.


Pyeloplasty in infants and children with particular reference to the method of drainage post-operatively. Sixty-three consecutive Anderson-Hynes pyeloplasties in infants and children have been reviewed with particular reference to any influence the method of drainage might have on the post-operative course and the final radiological result. Extra-anastomotic drainage usually with a sump drain, was used in 40 cases and pyelostomy drainage in 23 cases. Fewer post-operative complications were encountered in the former group. The final radiological result was not influenced by the method of drainage except that, in patients under 2 years of age, those with pyelostomy drainage fared rather better. It is concluded that (a) extra-anastomotic sump drainage is the method of choice following pyeloplasty in children over 2 years of age, and (b) in infants under 2 years of age pyelostomy drainage probably should be combined with a trans-anastomotic splint.


The value of provocative and acute urography in patients with intermittent loin pain. Twenty-two patients with intermittent loin pain thought to be typical of primary pelvic hydronephrosis but with normal appearances at standard excretion urography were subjected to diuretic urography using Frusemide-induced diuresis. If this was normal, acute urography was performed when the patient had pain. Abnormal appearances were shown in only 15 patients. In 4, only the erect films revealed the hydronephrosis. Dilatation occurred in response to a diuretic load in 9 and the abnormality was shown at the time of an attack of pain in 4. The hydronephrosis was shown only during the attack of pain in 2, a diuretic urogram having been normal. In 2 patients the nephrographic signs of acute obstruction were shown to be due to occlusion of the pelvi-ureteric junction at the time of an attack of pain. The importance of sequential examination, the value of erect films and acute urography are stressed.


Ureteric reimplantation for vesico-ureteric reflux in the adult. A retrospective study of 32 adult patients undergoing ureteric reimplantation for reflux has been carried out. Reflux and reimplantation in relation to urolithiasis, pregnancy, renal failure, hypertension and bladder neck obstruction have been discussed. Eighty-four per cent of patients with primary reflux had pyelonephritic scarring compared with only 34% of patients where reflux was secondary. Reimplantation has been technically successful in preventing reflux in every patient in this series, with 18 patients (65%) becoming symptom free. Pyelonephritis, hypertension and renal failure were not significantly improved but no progressive changes were observed in the follow-up period after reimplantation.


The site of recurrence of non-infiltrating bladder tumours. A study of 56 cases of non-infiltrating bladder tumour showed a striking difference in the distribution within the bladder of the primary and the recurrent tumours. More than three-quarters of the primary tumours were confined to a restricted area near a ureteric orifice whereas only one-fifth of recurrent tumours were found in this site. By far the commonest site for recurrent tumours was the postero-superior wall of the bladder. Forty-five recurrent tumours formed in the air bubble region, a site in which no primary tumour was found in the whole series. The postero-superior wall of the bladder is subject to mild trauma and abrasion by the tip of an endoscope and the air bubble region is the recipient of hot gas produced by the diathermy. These gas bubbles may also convey detached tumour cells to the recipient site. Local trauma may encourage tumour formation either by producing a raw surface which allows implanation of tumour cells, or possibly also by reducing local resistance to the primary carcinogenic factor.


Results of prolonged bladder distension as treatment for detrusor instability. Forty-six patients with urinary symptoms associated with unstable (uninhibitable) detrusor contractions have been treated by a total of 58 bladder distensions; 43 of these were fully re-evaluated urodynamically thereafter and none showed conversion from unstable to stable detrusor behaviour. Four patients with unstable bladders were symptomatically improved but 5 patients reported symptomatic deterioration. We have concluded that while over-distension may sometimes improve a patient's symptoms, it did not result in the abolition of detrusor contractions or the reversal of unstable detrusor behaviour.


An objective assessment of the unstable bladder of psychosomatic origin. An objective assessment of 40 female patients with an unstable bladder was made. An organic or structural cause had previously been eliminated. In all patients an emotive or psychogenic origin for their urinary symptoms was discovered. The diagnosis of detrusor instability was confirmed by cystometry and bladder drill retraining was employed for 3 months. Cystometric investigation was then repeated and the patient was reassessed from the symptomatic point of view. The cure rate was 82.5%.


Biofeedback in the treatment of detrusor instability. Detrusor instability has remained resistant to conventional forms of treatment. An attempt to use biofeedback methods in its management is described. Six female patients with symptoms of frequency, urgency and urge incontinence due to detrusor instability were conditioned to auditory and visual stimuli for 6 to 8 1 h sessions. They were assessed clinically and urodynamically. The results are presented as well as detailed case studies of 3 patients. Subjectively, 3 were cured, 2 improved and 1 remained the same; objectively, 3 were cured, 1 improved and 2 remained the same. No significant side effects were encountered.


Ultrasonic lithotriptor for urethral and bladder stones. Bladder or urethral calculi in 50 patients were effectively fragmented and removed per-urethrally using an ultrasonic lithotriptor with the probe vibrating at 30,000 implulses/s. In adults, local anaesthesia was employed and the operation performed as an out-patient procedure. The method has the advantages over others discussed in that a small (23 F) sheath is used and that damage to the bladder or urethra by the probe is avoided. Using a newer, modified sheath resembling that for punch prostatectomy, larger stones can be fragmented by engaging the stone in the fenestrum of the sheath.


Technique and results of the colonic conduit, continent by means of a new magnetic stoma seal an experimental study. On the basis of satisfactory results with a new magnetic stoma seal in colostomy patients this seal, consisting of a magnetic ring and cap, was used in an experimental study to convert the colonic conduit into a continent reservoir. Complete continence was obtained in all of the 12 animals which survived the operation. All rings were well accepted by the tissue when the procedure was staged by implanting the ring transperitoneally several weeks prior to fashioning of the conduit. Residual urine was low, owing to an ideal energy-balance pattern. Coloureteric reflux was successfully prevented in all cases where a long-tunnel-modification of the Leadbetter-Clarke technique was used. Hyperchloraemic acidosis and deterioration in renal function were not observed. All conduits were infected.


Carcinoma of the penis.

Carcinoma of the penis. Sixty-three patients with squamous cell carcinoma of the penis have been reviewed. The 3 year survival was 77%, and the 5 year survival was 59%. Prognosis was related to both clinical staging and histological grading. Stage I and II carcinomas were best treated by surgery alone. Stage III and IV carcinomas were best treated by local amputation of the penis combined with radiotherapy to the inguinal nodes. Surgery as a primary treatment for clinically positive nodes was successful in less than half the cases treated, and in this series was always followed by wound infection and lymphoedema. Tender, enlarged inguinal lymph nodes should be observed for up to 3 months following primary treatment, as a large percentage of these nodes are inflammatory and subside spontaneously.


Radiograph measurements and contralateral renal size in primary pelvic hydronephrosis. Renal size was estimated from the radiographs in 47 cases of primary pelvic hydronephrosis. The area of functioning renal tissue of the side opposite to the disease was greater in patients with severe hydronephrosis treated by pheloplasty, compared with those with moderate disease (P less than 0.05). This suggests that compensatory hypertrophy had occurred in the contralateral kidney. This finding did not appear to affect the outcome of pyeloplasty. It is suggested that the finding of compensatory hypertrophy in the kidney opposite to a severe hydronephrosis is not a contra-indication to conservative surgery.


The relationship between urinary bilharziasis and urolithiasis in the Sudan. Nine hundred and ninety-seven Sudanese patients presenting to a urological unit in Khartoum were divided into a group consisting of 144 patients with a history or evidence of urinary bilharziasis and a second group of 853 patients with no history or evidence of this disease. Thirty-one per cent of the patients with bilharziasis and 32% of those without were found to have urinary calculi. In the bilharzial group there were recurrent stones in 7% compared with 12.4% in the non-bilharzial group. In the bilharzial group the stones were renal in 63.6%, ureteric in 27.3% and vesical in 9.1%, while in the non-bilharzial group 57% were renal, 30% ureteric and 13% vesical. Comparison of the incidence, rate of recurrence and site of stones in both groups suggests that urinary bilharziasis does not contribute to the high incidence of urolithiasis in the Sudan.


Coagulum pyelolithotomy.

Coagulum pyelolithotomy. In 25 patients undergoing pyelolithotomy a supplementary coagulum technique has been used. Initial difficulties were found in the preparation, instillation and extraction of the coagulum, but with experience a satisfactory technique has been developed. The type of stone situation most likely to benefit from coagulum pyelolithotomy would seem to be where there is a small, mobile stone or stone fragment lying in a calix or in a wide renal pelvis.


Ureteric involvement with abdominal aortic aneurysm. The clinical presentations of 3 patients found to have an abdominal aortic aneurysm with ureteric involvement have been described. The world literature concerning this problem and methods of surgical treatment have been reviewed. The importance of medial displacement of the ureters as an early diagnostic sign indicating the presence of an abdominal aortic aneurysm is again emphasised. The possibility of a relatively benign course for the aneurysm should be considered in patients with renal or cardiorespiratory complications. In such cases, treatment of the ureteric involvement alone is justified.


Adoptive immunotherapy and radiotherapy in the treatment of urinary bladder cancer. Thirty-one patients with invasive transitional cell carcinoma of the urinary bladder were treated either by infusion of tumour immune pig mesenteric lymph node cells into the tumour blood supply, followed 6 weeks later by 5500 rad, or by radiotherapy alone. The patients were paired prior to treatment, using 4 criteria: age (nearest decade), sex, clinical stage (T3 or T4) and histological grade (average or high). The first patient in each pair then received combined treatment and the second radiotherapy alone. Administration of pig cells before radiotherapy offered no advantage to the patient in terms of the incidence of remission or the length of survival after treatment.


Congenital parameatal urethral cyst in the male. Three cases of parameatal cysts in boys are reported. Two cysts were present at birth and the other was found in early infancy. Aetiology and treatment are discussed.


Recanalisation of vas after vasectomy. Evaluation of various techniques in dogs. A critical study of various techniques for end-to-end vaso-vasostomies without or with internal splints on 41 dogs is presented. The results of vaso-vasostomy without any internal splint were significantly better than those with splints, both for primary as well as secondary repair after 6 weeks. The presence of an internal splint was associated with a high incidence of severe infection in the vas, epididymis and testis. An end-to-end mucosa-to-mucosa anastomosis using either 6/0 silk or Prolene under magnification is recommended as a simple and successful methods of recanalisation of the vas in clinical practice.


The distinction between obstructive uropathy and nephropathy by radioisotope transit times. Deconvolution analysis of different regions of interest on gamma camera renography enables obstructive lesions causing impairment of nephron function to be distinguished from obstructive lesions which parenchymal function is unimpaired. Quantitation of isotope transit time through the parenchyma is a reliable method of diagnosing upper urinary tract obstruction.


A new urinary test for stone "activity". Rapid evaporation of urine to osmolarity 1200 results in a high incidence of envelope Wedellite and calcium phosphate crystals. The Wedellite crystals closely resemble those seen in untreated urine samples of stone formers. The incidence of crystalluria produced by these tests is higher in the stone formers than in the normal subjects, reduced by thiazides and increased by cellulose phosphate; combined thiazide and cellulose phosphate therapy was most effective in reducing crystalluria. Simple calcium and oxalate concentration products were calculated and did not correlate well with incidence of calcium oxalate crystalluria. Although the product is important, inhibitors of crystal formation must be equally important. It is postulated, but not proven, that the evaporation tests may indicate normal subjects at risk to stone formation when exposed to chronic dehydration and whether a stone former is still metabolically active.


The effect of allopurinol on urinary oxalate excretion in stone formers. Allopurinol is a drug which could be valuable in the treatment of stone patients. In 29 subjects treated with 300 mg of the drug per day it has been found that there was a significant fall in urine oxalate excretion if the blood urate was above 330 mumol/l. In 10 subjects followed for 1 year the urine oxalate was significantly reduced and maintained at a lower level than the original.