A non-linear voltage dependent charge movement in frog skeletal muscle. 1. Voltage-clamp experiments were carried out using the three microelectrode technique. Using this method membrane current density at V1 is proportional to deltaV( = V2 - V1) where V1 and V2 are voltages at distances 1 and 21 from the end of a fibre. Voltage dependent sodium currents were blocked by tetrodotoxin, potassium by tetraethylammonium ions and rubidium. Contraction was blocked by adding sucrose, 467 mM. 2. The current deltaV (control) associated with a positive voltage step from a hyperpolarized conditioning voltage to the holding potential, -80 mV, showed two components, a capacitative transient which decayed rapidly and a maintained steady level...


Effects of glycerol treatment and maintained depolarization on charge movement in skeletal muscle. 1. Voltage-clamp experiments were carried out using the techniques described in the preceding paper. 2. In one series of experiments an attempt was made to disrupt the T-system with glycerol treatment. Muscles were soaked in Ringer + 400 mM glycerol for 1 hr at room temperature, transferred to Ringer + 5 mM calcium + 5 mM magnesium for 20-30 min, and then cooled to around 2 degrees C and placed in an isosmotic test solution containing tetrodotoxin for electrical measurements. 3. The density of charge seen in isosmotic tetraethylammonium (TEA) solution with strong depolarization, normalized according to fibre capacitance, was decreased by glycerol treatment to about one third the amount seen in untreated hypertonic fibres. 4. An analysis of fibre capacitance revealed that only 0-4 of the tubular capacitance was removed by this particular glycerol procedure. If the density of charge with respect to capacitance is corrected for this decrease in capacitance, the results indicate that glycerol treatment removed or immobilized 0-77 of the charge initially present. Thus the effect of glycerol treatment to reduce charge does not depend entirely on disrupting the electrical continuity of the T-system. 5. The effects of maintained depolarization were studied using a TEA Ringer made hypertonic with sucrose. When the voltage was changed from -80 to -21 mV the measurable charge movement declined exponentially to zero with a time constant of 13-24 sec. On repolarization the process recovered exponentially to the initial level with a time constant of 21-53 sec. 6. Experiments were also carried out using a sodium Ringer made hypertonic with sucrose. For small depolarizations only charge movement currents were seen, whereas for large depolarizations large delayed ionic currents, presumably carried by potassium, were observed. With moderate depolarizations in the range V = -40 to -30 mV, both components were of comparable magnitude. 7. A plot of the fractional charge movement (Q/Qmax) vs. V fitted at moderate depolarizations is similar to that of n infinity vs. V fitted at larger depolarizations. Values of n infinity were obtained by fitting the delayed ionic current to n4(V - VK). For voltages between -40 and -30 mV the time constant for charge tauQ was always less than taun; values of taun/tauQ varied from 1-6 to 4-3. 8. Glycerol treatment had little if any effect on the kinetics of delayed rectifier currents. Values of gK measured in isosmotic solution following glycerol were about one third the values obtained in untreated fibres in a hypertonic solution (osmolality three times normal). The threefold difference in gK is probably due to a similar difference in internal potassium concentration. 9. These results and others are difficult to reconcile with the idea that the charge movement process acts as a gate for potassium channels. It seems more likely that charge movement is a step in the activation of contraction.


The voltage dependence of membrane capacity. 1. Membrane capacity of sartorius muscle fibres has been measured at membrane potentials between -200 and +50 mV. Within this potential range the capacity is not independent of potential. Dielectric saturation is present at large negative and at positive internal potentials, indicating the presence in the membrane of permanent dipoles or movable charges. 2. In normally polarized fibres there is a sharp peak in the capacity-potential relation of about -50 mV; the capacity at this peak is 50% larger than the capacity at -90 mV. 3. In depolarized fibres this sharp peak of capacity is not present. Over the range -200 to +50 mV the capacity variation is about 10% with a broad maximum at about -80 mV. 4. The dielectric behaviour of muscle membrane is most simply explained by postulating two species of permanent dipoles or mobile charges: Charge 1 present in normally polarized fibres, but neutralized or immobilized in depolarized fibres; Charge 2 present in both polarized and depolarized fibres. The distribution of Charge 1 is more steeply voltage-dependent than is the distribution of Charge 2. 5. Movement of Charge 1 from one fully saturated configuration to the other involves a charge transfer across the membrane of between 20 and 30 nC/muF. Movement of Charge 2 in depolarized fibres requires a similar transfer of charge.


Charge movement in the membrane of striated muscle. 1. Non-linear polarization currents apparently due to permanent dipoles or mobile charges in the membrane can be measured by appropriate comparison of the transient currents required to produce small and large steps of membrane potential. Integration of these transient polarization currents estimates the charge transfer associated with the movement of membrane dipoles or charges. 2. Depolarization from -100 to 0 mV requires a charge transfer of 35 nC/muF in addition to the charge transfer predicted by linear extrapolation of the charge required for a small depolarization from -100 mV. Depolarizations of varying size give a charge-voltage relation which is sigmoid saturating beyond o mV and with a midpoint at about -50 mV. The ratnged depolarization reduces or removes charge movement detected by comparing currents for small and large voltage steps from -100 mV (Charge 1). However in depolarized fibres comparison of currents from a small potential step at +40 mV and a large hyperpolarizing potential step from -20 mV reveals large movements of a second charge (Charge 2). Movement of Charge 2 is less steeply dependent on voltage than movement of Charge 2 both in magnitude and in rate. 4. In size and voltage dependence these two kinds of charge movement correspond to measured voltage dependence of capacity in normally polarized and depolarized fibres (Adrian & Almers, 1976).


Charge movement and mechanical repriming in skeletal muscle. 1. Muscles were placed in a solution which depolarized the membrane to -30 to -20 mV so that mechanical activation was made refractory. Mechanical repriming and the recovery of voltage dependent charge movement were studied using a voltage clamp technique. 2. Mechanical repriming was investigated by determining the duration of a hyperpolarizing pulse required to elicit a just-visible contraction for various post-pulse potentials. As the post-pulse potential was made more positive shorter repriming times were required to produce a threshold contraction. The relationship approached a minimum repriming time for very positive post-pulse potentials. 3. These results suggest that hyperpolarization gradually removes some component of the activation mechanism from a refractory state and that the effectiveness of the amount which has recovered depends on the post-pulse potential. A quantitative explanation is given using a simple model in which the essential component is assumed to be the charge movement process. 4. The rate of repriming contraction is voltage dependent; at -160 mV the rate is about twice that at -120 mV. Between 4 and 10 degrees C the rate has a Q10 of about 9. 5. Recovery of charge movement was studied using a repriming duration less than that required to produce a threshold contraction. The observed charge movement increased linearly with repriming time, consistent with the approximately linear initial segment of a slow exponential recovery process. Extrapolation of the recovery curve indicated that 2-5 n/CmuF of charge is reprimed in the time necessary to reprime a threshold contraction. 6. The charge which recovers during a subthreshold repriming pulse is distributed according to membrane potential in the same way as a fully reprimed charge. 7. These results are consistent with the hypothesis that voltage dependent charge movement is an intermediate step in excitation-contraction coupling. 8. The characteristics of a second type of charge movement are also described.


Chemistry and biological activities of N,N-dimethylaminoethyl acrylate, a choline acetyltransferase inhibitor. N,N-Dimethylaminoethyl acrylate (acryl-DMA) was synthesized as a tertiary nitrogen choline acetyltransferase (ChAc) inhibitor which would be able to penetrate biological membranes to inhibit ChAc in the nerve terminal. The synthesis from dimethylaminoethanol and acrylyl chloride was described and the hydration with times in an aqueous medium measured by NMR spectroscopy was presented. The autohydrolysis in water was found to be 1.75 x 10(-8) mol/min at pH 7.4 and 5.0 mM concentration. The enzymatic hydrolysis was unaffected by cholinesterases. Acryl-DMA was capable of inhibiting ChAc extracted from rat brain with I50 of 5.02 x 10(-4) M. The inhibition was reversible and displayed uncompetitive kinetics with respect to both substrates, choline and acetyl-CoA. Neither the hydrolysis nor the hydration products of acryl-DMA could inhibit ChAc. Although acryl-DMA was hydrated rapidly and completely within 1 hr at high pH (9.0), the time course of inhibition ability of acryl-DMA in aqueous medium at physiological pH was found to decrease rather slowly and by 36% in 1 hr, indicating that acryl-DMA can survive from hydration at physiological pH. Acryl-DMA was also tested for its ability to block electrically induced muscle contractions in both isolated skeletal and smooth nerve-muscle preparations. The ED50's obtained were less than 5 x 10(-4) M in both cases.


Absence of heart-rate effects in isolated frog heart irradiated with pulse modulated microwave energy. Isolated frog hearts were irradiated with pulse modulated microwave energy synchronized with the ECG. No statistically significant or otherwise observable differences were found between the heart rate of irradiated groups and the nonirradiated control group. Experiments were performed to explore the possible effects of currents induced between the recording electrodes. Increases in heart rate occurred when applied current pulses between 20 and 30 mA were synchronized with the ECG during an interval from 200 msec to 300 msec after the peak of the P wave.


Lithium transport across isolated frog skin epithelium. Transepithelial Li+ influx was studied in the isolated epithelium from abdominal skin of Rana catesbeiana. With Na+-Ringer's as inside medium and Li+-Ringer's as outside medium, the Li+ influx across the epithelium was 15.6 muA/cm2. This influx was considerably reduced by removal of either Na+ or K+ from the inside bath or by the addition of ouabain or amiloride. Epithelial K+ or Na+ concentration was respectively lower in epithelia bathed in K+-free Ringer's or Na+-free Ringer's. In conditions of negligible Na+ transport, a 20 mM Li+ gradient (outleads toin) produced across the short-circuited epithelium a Li+ influx of 11.8 muA/cm2 and a mean short-circuit current of 10.2 muA/cm2. The same Li+ gradient in the opposite direction produced a Li+ outflux of only 1.9 muA/cm2. With equal Li+ concentration (10.3 and 20.6 mM) on both sides of the epihelium, plus Na+ in the inside solution only, a stable Li+-dependent short-circuit current was observed. Net Li+ movement (outleads toin) was also indirectly determined in the presence of an opposing Li+ gradient. Although Li+ does not substitute for Na+ as an activator to the (Na+ +K+)-ATPase from frog skin epithelium, Li+ influx appears to be related to Na+-K+ pump activity. It is proposed that the permeability of the "outer barrier" to Na+ and Li+ is regulated by the electrical gradient produced by electrogenic Na+-K+ pumps located in the membrane of the deeper epithelial cells.


[Aphakia and mesopic vision (author's transl)]. The results of investigations on the twilight vision of aphakic eyes are given. In the daylight seeing range all the subjects had satisfactory visual acuity, whereas in the mesopic range, on corresponding tests, definite difficulties were recognisable for a large proportion of the subjects.


[Separation and immunological characterization of lymphocytes isolated from human appendix (author's transl)]. The isolation of viable lymphocytes from fresh human appendices is described. Under standardized experimental conditions of cell preparation no selective enrichment of either T- or B-lymphocytes was observed. The mean percentage of T-lymphocytes as judged by spontaneous rosette formation found in 34 appendices examined was 50.0%. After overnight incubation surface-Ig was detected by immunoradioautography on 46.8% of the recovered lymphocytes from 10 appendices. For the detection of surface-Ig specifically purified antibodies to heavy chains mu, gamma and alpha were used. Of the 46.8% surface-Ig positive lymphocytes the class distribution was as follows: IgM 17.7%, IgG 24.4% and IgA 4.7%. The isolated lymphocytes showed a variable mitotic response to PHA (stimulation index ranging from 3.3 to 200.9) as well as to allogeneic lymphocytes in a one-way mixed lymphocyte culture. So far, a distinct correlation could not be found between the histological degree of inflammation and the class or mitotic response of appendix lymphocytes.


Unilateral renal disease in the rat. II. Glomerular mesangial uptake of colloidal carbon in unilateral aminonucleoside nephrosis and nephrotoxic serum nephritis. Unilateral renal disease was produced in rats by left renal perfusion in situ with the aminonucleoside of puromycin or with nephrotoxic serum. The uptake of colloidal carbon by the glomerular mesangium was increased in kidneys perfused with aminonucleoside or nephrotoxic serum compared to contralateral kidneys. The quantities of carbon within the glomerular mesangium remained increased in aminonucleoside perfused kidneys 14 days later. These studies demonstrate that alterations in glomerular mesangial function in aminonucleoside nephrosis and nephrotoxic serum nephritis are related to renal factors rather than differences in host milieu and may be involved in the pathogenesis of the morphologic lesions seen in chronic proteinuria.


Medical-surgical aspects of left main coronary artery disease. Disease of the left main coronary artery compromises circulation to the major part of the left ventricle and thus threatens massive myocardial infarction and sudden death. Cardiac catheterization and coronary bypass surgery, in previous reports, have been associated with high mortality and morbidity rates. We report 50 patients with over 50 per cent narrowing of the left main coronary artery. The clinical pattern in these patients was variable and a left main coronary artery lesion could not be predicted before coronary angiography. There was only one death during cardiac catheterization. One patient died while waiting for elective surgery. Coronary bypass surgery was performed in 42 patients; one died during surgery. Forty-one patients are alive at 2 to 39 months follow-up (mean, 19 months). Thirty-six patients are asymptomatic or have minimal symptoms. Compared to the prognosis in patients with left main coronary artery stenosis treated medically, coronary bypass surgery performed on urgent basis offers a much better prognosis. Both coronary angiography and bypass surgery can be performed in these patients with a very low risk.


[Effect of centrifugal force on neck nystagmus in pigeons]. The neck nystagmus and its changes under the influence of an otolith stimulus--centrifugal force were studied in pigeons. The results show that centrifugal forces exert a dynamic effect on the nystagmus.


[Dynamics of motor components of optokinetic nystagmus during exposure of the vestibular apparatus to angular accelerations]. The effect of angular accelerations on the optokinetic nystagmus was studied on 25 test subjects using a special vestibulo-optokinetic trainer rotated according to five programs and electrooculography. Angular accelerations were found to induce indirectly changes in the amplitude and time of the optokinetic nystagmus via the vestibular apparatus. Optimization of parameters of the optokinetic nystagmus was reflected in the criterion of positive difference + delta between angular velocities of the slow component of the nystagmus and optokinetic stimuli. It is postulated that the criterion + delta is a necessary factor in the organization of optimal time relations between optokinetic stimuli and central processes that are responsible for the final result--sensory image of movement.


Coronary artery bypass with freeze-preserved saphenous vein allografts. Over the past 5 years, 13 patients had coronary artery bypass performed with freeze-preserved saphenous vein allografts. There were no operative deaths or significant morbidity. Six patients were studied postoperatively at 42, 37, 10, 7, 5, and 1 months. Six of 8 grafts were patent with good flow. There were four late deaths; two of these occurred in patients who had concomitant resection of a ventricular aneurysm. Of the 9 surviving patients, 6 (6/9) are asymptomatic and 2 (2/9) have occasional chest pains; the condition of 1 patient (1/9) is unchanged. This experience suggests that free-preserved saphenous vein allografts may be used successfully for coronary bypass when autologous veins and internal mammary arteries are unavailable or insufficient for multiple bypass.


[Effect of angular accelerations on the sensory and motor components of fixation eye movements]. The effect of angular accelerations on the eye fixation function and concomitant sensory reactions was investigated under special conditions. An illusion of target distortion towards the rapid component of the vestibular nystagmus developed in these situations. Changes in the eye fixation movements and "sensation of target" were coordinated and depended on the direction of the vestibular nystagmus. The findings indicate that during an exposure to angular accelerations the stability of target perceptions is disturbed and objectively recorded errors of its fixation by the optic apparatus are made.


[Disseminated plane xanthoma with photosensitization]. A case of diffuse normolipemic plane xanthome showing no association with systemic disease (multiple myeloma, leukemia, reticulosis, or dysglobulinaemia), in a 50 year old female, is reported. The patient presented hypersensitivity to the erythrogenic spectrum with pathological response and lowered MED. The B lymphocytes in the peripherical blood was raised. The authors postulated that B lymphocytes probably play an important role in the pathogenesis of the skin light-induced reactions.


[Collagen disease with pure red cell anemia and perimembraneous glomerulonephritis (author's transl)]. Record on a case of collagen disease with pure red cell anemia and perimembraneous glomerulonephritis. The direct antiglobulin tests with anti-IgG and anti-kappaserum were positive as were the tests on antinuclear serum-antibodies. During therapy with fluocortolon and azathioprin the anemia remitted completely even when therapy was stopped. The antiglobulin tests became negative, the glomerulitis remained active, there was no deterioration of renal function.


[Endoscopic follow-up studies of erosions of the gastric mucosa (author's transl]. From our endoscopic follow-up studies in 65 patients we are inclined to think that the various forms of erosive changes of the gastric mucosa represent different developmental stages of the same pathological process, in which the final stage may possibly be a hyperplasia of mucosal folds with gastro-intestinal loss of protein. A change into a genuine polyposis or even the development of a polypous carcinoma, as suggested by the information of Nakamura, was not observed by us, but the observation time so far has probably been too short for this anyway.


Physical mapping of the HindIII, EcoRI, Sal and Sma restriction endonuclease cleavage fragments from bacteriophage T5 DNA. The DNA of bacteriophage T5+ (molecular weight 76 X 10(6) dalton) has been dissected by various specific endonucleases. The restriction enzymes HindIII and EcoRI produce 16 and 7 fragments respectively, whereas Sal and Sma produce 4 fragments each. Complete cleavage maps were established for the enzymes EcoRI, Sal and Sma and an almost complete map for HindIII. Furthermore the location and size of the deletions St 20, St 14, b3, St 0 and b1 were determined. The correlation of the genetic and functional map of the phage with the arrangement of fragments produced by the different enzymes has been established.


Comparison of cell-mediated immune reactions in sympathetic and phacogenic ophthalmia with reactions in uveitis of other origin. Cell-mediated immunity was studied in three cases of genuine sympathetic ophthalmia, i.e. in cases without lens involvement. In control experiments, lymphocyte transformation tests (uptake of 3H-thymidine) and leukocyte migration inhibition tests (Soborg-Bendixen) gave similar results for six normal persons, six patients with uveitis and two cases of phacogenic ophthalmia. In contrast, two cases of genuine sympathetic ophthamlia, namely those with recent enucleation, showed a significantly increased lymphocyte stimulation index when tested with homologous retina, not with choroid.


Lymphocytic choriomeningitis virus-induced ocular immunopathology. Lymphocytic choriomeningitis (LCM) virus of the mice provides perhaps the most extensively studied model of viral-induced immunopathology. Intraocular inoculation of this virus in the adult mouse produces a severe and progressive uveitis with involvement also of the cornea and retina. Intracerebral infection of the newborn rat with LCM virus produces a severe retinopathy, with only minimal involvement of the uveal tract. We review in this paper recent studies on these two animal models of LCM virus disease which demonstrate: (1) the histopathology of the ocular lesion; (2) that immunosuppression after infection prevents development of the disease; (3) that passive transfer of sensitized lymphoid cells to the immunosuppressed infected animal can then trigger ocular disease, and (4) that T lymphocytes, and not circulating antibody, play the major role in the pathogenesis of this disease process.


Nonspecific immune parameters and hepatitis B antigens in patients with uveitis. In the sera of 217 patients with uveitis the immunoglobulins IgG, IgA, IgM as well as beta1A (a measurable metabolic product of the third component of complement) were measured by radial immunodiffusion. IgG was below normal levels in 12% of the patients, IgM was increased in 12%, while reduced beta1A concentrations could be found in 28%. 95 sera were also tested for the presence of antibodies against cell nuclei, smooth muscle and thyroglobulin. There was no significantly increased incidence of any of these antibodies. The data were interpreted as not being in favor of the hypothesis that autoimmune phenomena play a key role in the pathogenesis of uveitis. An unexpected finding was the high frequency of hepatitis B antigen (13%) and corresponding antibodies (23%) in sera of uveitis patients compared to other hospitalized patients and blood donors. At present, there is no explanation for this phenomenon.


Effect of levamisole on E-rosette-forming cells in vivo and in vitro in Hodgkin's disease. Incubation in vitro of lymphocytes from patients with Hodgkin's disease with 40 mug per milliliter of levamisole resulted in a rise in the number of E-rosette-forming cells from 33.6 +/- 12.5 per cent (mean +/- S.D.) to 56.7 +/- 14.6 per cent. The drug had no effect on normal lymphocytes. Ten patients with Hodgkin's disease treated six months previously with levamisole were restudied. The positive skin tests to PPD, candida and mumps persisted. However, the E-rosette-forming cells decreased to the pretreatment levels (34.7 +/- 6.4 per cent). Readministration of 150 mg of levamisole for three days raised the number of E-rosette-forming cells to 54.1 +/- 5.6 per cent. This effect was observed for at least two months. However, the drug had no effect in vitro as long as the in vivo effect persisted. These results demonstrate a clear immunologic effect of levamisole in Hodgkin's disease and indicate that the low number of E-rosette-forming cells is not due to a real T-cell depletion.


Characterization of thymus- and bone marrow-derived lymphocytes in rats by means of 3H-uridine incorporation. Lymphocytes from various lymphoid organs and of the thoracic duct of normal and thymectomized rats, irradiated and reconstituted with syngeneic bone marrow were tested in vitro in a minimal non-enriched cultivation medium with 3H-uridine, and the percentage of uridine-labeled lymphocytes was determined. The highest number of heavily labeled small lymphocytes was found in the thymus and the thoracic duct, less in peripheral blood, the lymph nodes and the spleen, and the smallest numbers in the bone marrow. A reduced ability of uridine uptake was noted in the thymectomized animals. The method of immune rosette formation was used to determine the presence of B lymphocytes in the lymphoid rat population. The highest quantity of B lymphocytes was noted in bone marrow and the least in the thymus and the thoracic duct. Thymectomized animals had a significantly higher percentage of EAC rosettes than normal and sham-operated animals. The methods employed and existing literary data enabled us to identify the heavily uridine-labeled lymphocytes as T cells, while unlabeled lymphocytes are considered to be B cells. The difference in uriding uptake by rat lymphocytes may serve as one of the T lymphocyte markers in a heterologous lymphoid population.


[Ventriculography with methylglucamine iocarmate (Dimer-X). Experimental and Clinical study (author's transl)]. Evaluation of 60% solution of Methylglucamine iocarmate (Dimer-X) for ventriculography in animal experiment and clinical cases was reported. The experimental result was compared with that of Conray 60 and Angiografin, which was reported in our previous papers. In seven intraventricular injections of 2.0 ml, administered to 6 dogs, convulsion was observed on three occasions, facial myoclonus on 1 and no symptoms on the remaining three. However, in 7 intraventricular injections of 1.5 ml for 6 dogs, 6 were symptom-free and only residual one showed convulsion. And no dog died in either experiment. No changes were seen in a subsequent ventriculogram one month after the 1st ventriculography with Dimer-X and also no histological changes of the ventricular wall were revealed one month after the first experiment. These experimental results suggested less toxicity of Dimer-X than Conray 60 or Angiografin. Clinically, in 17 neurosurgical patients, ventriculography was performed with 1-5 ml of Dimer-X. No patients showed convulsive complication, but there was one episode of vomiting in each of 2 cases and slight headache in one case. From our experimental and clinical studies, it is concluded that the Dimer-X is to be considered the best watersoluble contrast medium for ventriculography at present.


Comparing Evans' index and computerized axial tomography in assessing relationship of ventricular size to brain size. Using pneumoencephalography and computerized axial tomography (EMI scanning) Polaroid pictures, the relationship between ventricular size and cerebral size was investigated in 35 patients. Evans' index was used for pneumoencephalograms, and planimetric measurement of the ventricular and cerebral cross-sectional areas was used for EMI scanning. The percentage ratio for the latter technique is termed VBR. The correlation coefficient between the two methods was 0.9510 (p less than 0.001).


Dynamic cisternography in normal dogs and in human beings. Cisternography and ventriculography were performed in five normal anesthetized dogs to study the dynamics of tracer dispersal. Indium 111-diethylenetriaminepentaacetic acid was injected into lateral ventricles, cisterna magna, thoracic subarachnoid space, and lumbar sac. The patterns of dispersal from each injection site support a nonflow dispersal mechanism with a tendency toward ultimate equilibrium distribution throughout the cerebrospinal fluid. Quantitative data in humans complement observations made in dogs. A theory of abnormal tracer movements, based on factors observed to affect tracer dispersal in dog and man, is proposed and applied to the interpretation of abnormal cisternographic patterns seen in clinical situations.


[A radioautographic study of the dynamics of 3H-thymidine incorporation into the limb tissues of anuran amphibians during the process of loss of regenerating capacity]. DNA synthesis was studied by 3H-thymidine incorporation in limb tissues of mesodermal origin in metamorphosing common frog (Rana temporaria) tadpoles in the process of loss of regenerative ability. During metamorphosis of tadpoles, the process of histodifferentiation is accompanied by the decrease in the number of nuclei incorporating 3H-thymidine. In tadpoles capable of regeneration, during the first days after limb amputation the index of labelled nuclei decreases, as compared with that in intact tissues, and then, as the regenerate forms, increases. In tadpoles uncapable of regeneration, the index of labelled nuclei after limb amputation decreases in the stump tissues during the whole experiment but is high enough in the scar connective tissue cells. Thus, the loss of regenerative ability of anuran limbs appears to be related with the decrease in the number of DNA-synthesizing cells in tissues of mesodermal origin, due apparently to the progress of their differentiation


[A radioautographic study of changes in the intensity of total protein synthesis in the limb tissues of anuran amphibia during loss of regenerating capacity]. The intensity of total protein synthesis was estimated by 3H-lysine incorporation in the hind limb tissues of mesodermal origin in the common frog tadpoles. In the course of limb development and loss of regenerative ability, the intensity of 3H-lysine incorporation in the differentiating muscle tissue and cartilage epiphysis increased; the cartilage diaphysis is characterized by the low level of 3H-lysine incorporation. At the stage Ia of regeneration after the limb amputation the intensity of labeling in the tissues of organ residue descreases until the stage of regeneration blastema formation and then, during the formation of limb rudiment, rapidly increases. The blastema cells are characterized by the high intensity of 3H-lysine incorporation. At the stage IIIa of wound healing after the limb amputation, the intensity of 3H-lysine incorporation in the differentiated muscles and cartilage epiphysis gradually decreases. The intensity of labeling in the scar cells is high enough.


[Cell population kinetics during retinal histogenesis in Rana temporaria frogs]. The histogenesis of retina was studied by means of 3H-thymidine autoradiography in the Rana temporaria embryos at the 17-25th developmental stages. At all these stages the central zone of retina is more differentiated than the peripheral one. The index of labeled nuclei in the central zone changes from 74-80 to 1.5-2.0% and in the peripheral zone from 74-80 to 60%. The outcome of the first cells from the reproduction cycle is realized beginning from the moment of the optic vesicle invagination. During the histogenesis of retina in anurans both the reproduction and the onset of differentiation of different cell types take place. The heterogeneity of the population of proliferating cells at all the stages studied proved to be similar. The data obtained are compared with those characterizing the kinetics of cell populations during the histogenesis of retina in avian and mammal embryos.


[So-called "pseudorheumatoid" nodules in childhood (author's transl)]. This report concerns 4 patients, 2 to 2,5 years of age, with subcutaneous "pseudorheumatoid" nodules in the occipital region. None of the children suffered from any real rheumatic or rheumatoid disease, nor were there any biochemical signs of those diseases detectable. The course of the nodules was benign, they disappeared within several years, and no later rheumatic disease occurred. Extirpation and histology was performed in all 4 cases, the microscopic diagnosis being uniformly "rheumatic granuloma". The own observations are confronted with the literature. It is concluded that, inspite of the histological similarity of true rheumatic granuloma with the "pseudorheumatic" nodules, no etiologic relations between the two conditions seem to exist. The benignity of the pseudorheumatic nodules is underlined, and the diagnostic and prognostic importance of the condition is stressed.


[The presence of cold agglutinins in hemolytic uremic syndrome (author's transl)]. A boy, 2 years old, developed a HUS after a pneumonitis. He was treated with Heparin, salicylates and recurrent peritoneal dialysis and recovered slowly. The course of the disease was complicated by myocarditis, gastric hemorrhage and severe neurologic disturbances. 7 days after unset of hemolysis a cold agglutinin titer of 1:256 was detected. This fact arises the question whether infection with Mycoplasma pneumoniae and the presence of cold agglutinins in serum could be involved in the development of HUS. The possibility of a viral etiology for this disease is discussed.


[Old and new aspects of childhood tuberculosis (author's transl)]. During the preceding 8 years 50 children were treated for active tuberculosis at the University of Innsbruck Department of Pediatrics. None of them were vaccinated against tuberculosis. Three children died; one of them from a fulminant miliary tuberculosis, two others from tuberculous meningitis; both of them were neurosurgically explored due to massive increase of intracranial pressure before a definite diagnosis was established. Two other patients, out of eleven with Tb-meningitis, are suffering permanent damages. Each one of the fatal cases and those with permanent sequelae could have been avoided by early diagnosis, which would have been possible in every case. It's our impression, that, with the decrease in the number of infected patients, there is also a decrease in the awareness and knowledge of this disease. We found the same to be true for the performance and interpretation of the Tb testing. Newborns immunized with BCG have to be tested for a positive tuberculine conversion to a dilution of Mantoux 1:100, preferably 3 months after the vaccination. Children with negative delayed sensitivity to tuberculin have to be reimmunized.


Alpha1-antitrypsin deficiency and liver disease in children: phenotypes, manifestations, and prognosis. Among 424 children with liver disease, 20 had alpha1-antitrypsin deficiency associated with protease inhibitor ZZ phenotype. This disorder manifested itself as cholestasis in early infancy in 19 children. Jaundice and pruritus cleared in 16 of these by 7 months of age, but hepatomegaly and laboratory evidence of mild hepatic dysfunction persisted in all. Biliary cirrhosis and portal hypertension eventually developed or was suspected in eight, and hypoplasia of intraheptic bile ducts was demonstrated in another four. Routine screening revealed intermediate alpha1-antitrypsin deficiency in 16 other children with various types of liver disease. The phenotype in these patients was MZ, MS, or SZ. PAS-positive granules were present in liver of all patients with the ZZ phenotype and in none with other phenotypes. The findings indicate that manifestations and prognosis of this inherited liver disease are extremely variable.


Membranoproliferative glomerulonephritis in childhood cirrhosis associated with alpha1-antitrypsin deficiency. Three alpha1-antitrypsin (alpha1AT) deficient, protease inhibitor type ZZ children who died from cirrhosis and its complications had membranoproliferative glomerulonephritis at postmortem examination. During life, all three had clinical and laboratory evidence of renal disease which became apparent when hepatic decompensation developed. Immunofluorescence studies and electron microscopy performed in one patient revealed subendothelial deposits of alpha1AT, complement, and immune globulins along the glomerular basement membrane. The pathogenesis of these renal lesions is speculative. Glomerular lesions were not observed in kidney sections of 16 children who died from cirrhosis but who were not alpha1AT-deficient. The present study suggests that renal involvement may be yet another manifestation of disease associated with alpha1AT deficiency.


Frequency of detection of Hemophilus influenzae type b capsular polysaccharide in infants and children with pneumonia. Countercurrent immunoelectrophoresis was used to detect H. influenzae type b antigen in sera of 65 consecutive infants and children with clinical and radiographic evidence of pneumonia. Antigenemia was observed in only one patient who also had H. influenzae type b bacteremia. Blood cultures from four other children were positive for H. aphrophilus (one), Streptococcus pneumoniae (two), and an alpha-hemolytic Streptococcus (one). The frequency of pharyngeal colonization with H. influenzae type b was similar in children with or without pneumonia. If H. influenzae type b was the cause of pneumonitis in the children studied, it occurred without bacteremia or antigenemia.


Time course of regeneration of minced frog muscles estimated by the level of energetic substrates. 1. Gastrocnemius muscles of frogs have been excised, chopped and put back into the leg. 2. The weight of the implanted muscles increases until the 8th day after the operation and then decreases to 1/3 of that of the control by the 30th day. 3. The inulin space is twice as high in regenerating muscle as in the unoperated controls. 4. Adenosine nucleotides are in an enzymatic equilibrium set by the ratio creatine/phosphorylcreatine during regeneration of the muscle. 5. Glycolytic intermediates (hexose monophosphate, fructose-1,6-diphosphate, alpha-glycerophosphate and lactate) have been measured during the course of muscle regeneration up to the 30th day. The results suggest that the glycolysis of regenerating muscle is very active. 6. The total creatine (sum of creatine and phosphorylcreatine) is very low after the operation: 5% of that of the controls; it rises sharply after the 8th day, and reaches 30% of that of the control on the 30th day. 7. The amount of total creatine seems proportional to the progress of the muscle regeneration. It is suggested to use this substance as a biochemical reference for biochemical works on muscle regeneration.


[Acute pericarditis. Study of 50 consecutive cases]. 50 consecutive cases of pericarditis were studied. Idiopathic and viral pericarditis made up 36 p. cent of all cases. The occurrence of tuberculous or rheumatic conditions was even lower than that reported in similar series in the literature. Amongst the clinical signs of these diseases, emphasis should be placed upon the frequency of chest pain which was increased by deep inspiration in only three out of four cases. Circulatory problems associated with the pericarditis were, on the whole, minimal. However, a fall in blood pressure was seen in 6 cases and true collapse in 3 more. The electrocardiogram showed, in addition to the classical signs, sagging of the PR interval in 36 p. cent and transient atrial fibrillation in 4 cases. As far as biological tests are concerned, it should be noted that elevation of creatine phospho-kinase to levels 4 times greater than normal may be seen, creating problems with the differential diagnosis from myocardial infarction. The course was in general favourable though two deaths occurred in this series (4 p. cent), one with tuberculous pericarditis and the other with idiopathic pericarditis.


Intravascular occlusive therapy: use of interventional radiology in cancer patients. Selective transcatheter intravascular occlusion in the treatment of cancer patients is a valuable extension of interventional diagnostic radiology. Intra-arterial embolization may be performed with various substances, including autologous clot, autologous subcutaneous tissue, Gelfoam, and stainless steel coil. Clinical applications in cancer patients include control of gastrointestinal and genitourinary hemorrhage, preoperative reduction of tumor vascularity, control of local symptoms, and therapeutic reduction of tumor bulk. The technique has been used for preoperative and palliative treatment of neoplasms of the head and neck, kidney, liver, spleen, and soft tissue and bone. Transcatheter intravascular occlusion should be performed only by radiologists experienced in angiographic techniques. Inadvertent occlusion of a normal vessel and thromboembolism are possible complications.


Isolation of alpha1-antitrypsin in a new preparative electrophoresis apparatus. The construction and operation of an apparatus is described which enables alpha1-antitrypsin to be isolated from human serum by preparative electrophoresis in polyacrylamide gel. The initial pass through the chamber yields a fraction that is predominantly albumin and several alpha1-proteins. After removal of albumin by affinity chromatography, a second pass through the chamber separates the individual alpha1-proteins. A volume of 50 ml of serum may be accommodated by the chamber, and the recovery of activity in each step is greater than 60%. The entire procedure may be completed in 36 hrs.


Nonsterilizing immunity in avian malaria: an antibody-independent phenomenon. Agammaglobulinemic chickens died with fulminating parasitemias following infection with P. gallinaceum. When rescued from otherwise fatal infection by means of chloroquine therapy, B-cell deficient chickens resisted challenge infection with the same parasite. The data suggest that nonsterilizing immunity to malaria in chickens is B-cell independent.


Effect of tilorone hydrochloride on the lymphoid and interferon responses of athymic mice. Nude athymic mice, which lack T-lymphocytes and are unable to mount a cellular immune response, failed to develop the lymphopenia so characteristically produced by a 100 mg/kg oral dose of tilorone hydrochloride in normal mice. The antiviral activity detected in athymic mice 18 hr after a 150 mg/kg oral dose of tilorone was significant, although somewhat less than that found in treated normal mice. These findings suggest that tilorone hydrochloride has a specific effect on T-lymphocytes that accounts for its effect on cellular immunity, but that its antiviral activity is not primarily mediated by T-lymphocytes.


Inhibition of T-lymphocyte rosetting by HL-A alloantisera and complement. The relationship between HL-A antigens and rosetting of sheep red blood cells (SRBC) with peripheral human lymphocytes has been investigated by incubating them with HL-A antibodies. Although sensitizing the lymphocytes with HL-A alloantisera had no effect on their ability to form rosettes with SRBC, further sensitization with C6 deficient rabbit serum as a source of early complement components inhibited the formation of rosettes with SRBC. The involvement of HL-A alloantibodies in the inhibition of rosette formation was shown first by correlating the HL-A phenotype of the lymphocytes and the HL-A specificity of the alloantisera and, second, by specifically absorbing the HL-A alloantibodies from the alloantisera. Complement was needed to inhibit rosette formation since this effect was lost when rabbit serum was treated to inactivate complement. The participation of complement's classical pathway in rosette inhibition was shown by chelating the Ca2+ ions by EGTA treatment of the C6 deficient rabbit serum. Perhaps, binding of HL-A antibodies and early complement components to the lymphocyte surface disturbs the distribution of the receptors or affects the charge of the cell membrane, thus inhibiting the rosette formation with SRBC.


Induction of secondary cytotoxic T-lymphocytes in vitro does not require cell proliferation. Using a mouse in vitro allograft model, evidence has been obtained that, in contrast to the accepted view, the generation of cytotoxic effector function in T-lymphocytes does not necessarily require cell division.


The effect of tryptophan and a tryptophan/5-hydroxytryptophan combination on indoles in the brains of rats fed a tryptophan deficient diet. Rats maintained on a tryptophan deficient diet had reduced brain and serum tryptophan and brain 5-hydroxyindolacetic acid levels compared to controls. 5-Hydroxytryptophan and L-tryptophan administered to these deficient rats in a combination (5:95) produced a greater elevation of indolamines and tryptophan in the brain than either amino acid alone. In rats maintained on a normal diet the urinary output of 3-hydroxykynurenine was considerably reduced by treatment with the combination of amino acids as compared to tryptophan treatment. 5-Hydroxytryptophan reduced the induction of kynurenine synthesis in the liver produced by tryptophan, implying that it is capable of inhibiting the enzyme tryptophan pyrrolase in vivo. It is suggested that the possession by 5-hydroxytryptophan of tryptophan pyrrolase inhibitory properties may make the administration of the combination a better treatment of depressed patients exhibiting an indolamine deficit than either amino acid alone.


Angiography in the diagnosis and therapy of hemorrhage from the large bowel. Angiography has added a new dimension to the management of hemorrhage from the large bowel. In patients with diverticular hemorrhage, mesenteric angiography not only localizes the bleeding site but, in addition, the bleeding can be acutely controlled with intraarterial infusion of vasopressin, making an emergency colectomy unnecessary. Similarly in patients bleeding from inflammatory bowel disease or in patients with post-operative hemorrhage, angiography provides information about the nature of the lesion and selective arterial infusions of vasopressin can control the bleeding. At times intestinal varices have angiographically been demonstrated as a potential source of rectal hemorrhage while in patients with unexplained lower gastrointestinal bleeding and repeatedly negative barium and endoscopic examinations, angiography has been valuable for the diagnosis of angiodysplasia of the colon.


Simplified superselective catheterization of arterial bleeders. Superselective catheterization is critical when treating acute gastrointestinal arterial bleeders. The author has been using a coaxial catheter system with excellent results. The technical aspects of two representative cases are discussed. This is a particularly valuable technique when dealing with the anomalous left gastric artery which supplies the left lobe of the liver as well as the stomach.


[Delusions of skin infestations].

[Delusions of skin infestations]. Delusion of skin-parasitosis is a very characteristic disorder, and it can appear as an independent syndrome or as a concomitant phenomenon of other psychiatric illnesses. Like most delusional formations it can also be induced and appear as a symbiontic psychosis; the involutional age seems to be an essential precondition for this psychopathological phenomenon.


Ultraviolet polarized light study on isolated myocardial trabeculae and skeletal fibers. The main components of the excitable membranes are protein and lipoproteins absorbing in the ultraviolet. Contractile proteins in muscle also absorb ultraviolet light. If polarized light is used, it becomes possible to distinguish the orientation of the absorbing groups either at rest or during activity. A system of microspectrophotometry in vivo using polarized ultraviolet light has been established to study the portion of myocardial trabeculae or of skeletal fibers in the central compartment of a double sucrose gap apparatus. Thus the system also allows electrophysiological studies. On both preparations, a relation between the absorbance change at 280 nm and contractile activity has been measured. These preparations also contain a fraction of oriented compounds absorbing at 280 nm and another at 260 nm. During mechanical activity, the amount of oriented compounds increases at 280 nm and decreases at 260 nm. These changes were assigned to an increase in the ratio of oriented amino acids, tyrosine and tryptophan, and to a decrease of oriented adenosine triphosphate.


Occult gastrointestinal bleeding due to aspirin: comparison of two compounds. Occult gastrointestinal bleeding as measured by the faecal 51Cr-labelled red-cell loss was compared in eight healthy volunteers while on therapeutic doses of soluble aspirin and a new slow-release formulation of aspirin (Deskoval). While both preparations led to increased faecal blood loss, this was significantly less during administration of Deskoval than when soluble aspirin was taken.


[Interstitial pneumonia in children on cystostatic treatment for malignant systematic disease (author's transl)]. The radiologic appearances of interstitial pneumonia are described as they appeared in 39 children treated with immunosuppressive and cytostatic substances given for malignant systemic disease. At the time most of the children were in a stage of remission of their basic illness. In most of them there may have been a pneumocystis carinii infection. 15 children died of this pneumonia. In the majority of post-mortem examinations pneumocysts could be detected.


[Indications for surgery of the coronaries and its results (author's transl)]. In chronic angina pectoris surgery is indicated for all patients with bridgeable central stenoses, suitable distal vessels and patent peripheral coronary circulation, if function of the ventricle is not critically reduced. when more than one vessel is diseased and with isolated stenoses of the anterior interventricular branch of the left coronary a., it does hardly latter whether the angina pectoris can be treated conservatively or not. An absolute indication for revasculariation exists when stenoses of the main branches of the left coronary artery can be shown. Pre-infarct angina (unstable or crescendo-angina, threatened infarction) should, in younger patients, always lead to immediate diagnostic ascertainment. Where severe anatomic coronary changes are present, immediate surgery is indicated, although the real danger of infarction in such patients cannot be reliably predicated as yet. Post-infarct ventricular aneurysmus should be operated on when leftsided insufficiency increases or arrythmias cannot be controlled satisfactorily any more. Surgery can be undertaken with an acceptable risk, if patients are carefully selected. As far as we know from published statistics, the quality of life of such patients can be improved for some time. But their expectation of life after surgery cannot as yet be reliably predicted, because prospective observations of comparable groups of patients treated conservatively or surgically do not yet exist. From a prospective study of McNeer (22) it appears that in 2 randomized groups there was no significant difference in time of survival after 2 years. Neither the size of the material nor the period of follow-up are sufficient for definite evaluation.


Immunological function in patients operated on with small intestinal shunts for morbid obesity. Obese individuals, operated on with intestinal shunts, have been investigated with regard to immunological functions. After operation strong increases in skin reactions of immediate and delayed type were observed. Analysis of total WBC and differential counts, percentage T lymphocytes, immunoglobulin concentrations, and lymphocyte reactivity yielded no explanation of the findings.


Granulopoiesis in infantile genetic agranulocytosis. In vitro cloning of marrow cells in agar culture. A 3-year-old boy and a 2-year-old girl with infantile genetic agranulocytosis have been studied by in vitro cloning of bone marrow cells in agar culture. The patients display a normal concentration of colony forming cells and the morphological maturation is identical with that of control marrow cultured in vitro. The marrow cells of the patients show some degree of auto-stimulation indicating that endogenous production of colony stimulating factor is operating. As an inverse relationship is expected between the peripheral neutrophil count and the percentage of marrow colony forming cells in S-phase a high percentage was expected. On the contrary, we find that the percentage of colony forming cells in S-phase is extremely low indicating a genetic unresponsiveness of granulopoietic precursor cells to feed back regulation in infantile genetic agranulocytosis.


The content of erythrocyte 2,3 diphosphoglycerate and adenosine-5'-triphosphate in myelomatosis and leukaemia. Ery-DPG and thus the oxygen-releasing capacity of haemoglobin increases in meylomatosis and in chronic myelocytic and lymphocytic leukaemia at decreased concentrations of haemoglobin, to the same extent as in other types of anaemia. Consequently the need for blood transfusions is less than assumed in these disorders. Ery-ATP is considerably increased in chronic myelocytic leukaemia, the values correlating positively with the 'activity' of the disease. This finding can probably be used for diagnostic and prognostic purposes.


Evidence of different cell populations in the mouse thymus releasing and responding to mitogenic factor. The thymocyte population of mice treated with cortisone was examined at various times with respect to its relative capacity to be triggered to DNA synthesis by soluble phytomitogens or mitogenic factors (MF) released by lymph node cells exposed to phytomitogens. The capacity of the thymocyte population to produce MF in response to phytomitogen exposure was also examined. We found that the relative blastogenic activity of both phytomitogens and MF on thymocytes increased as the cell number of the thymus was reduced by the cortisone treatment. However, the reactivity to phytomitogens increased to a higher extent. During the subsequent regeneration of the organ the stimulability of the cells by phytomitogen decreased far below that of MF. The relative capacity of thymocytes to produce MF seemed to parallel their phytomitogen reactivities. One possible explanation of the results is that there exists one subpopulation of cells in the thymus more responsive to phytomitogens than to MF and another more responsive to MF than to phytomitogen. It is possible that the cells that are phytomitogen-responsive are those that can produce MF.


Lymphocyte populations and cellular immune reactions in juvenile rheumatoid arthritis. Ten patients with juvenile rheumatoid arthritis and age- and sex-matched healthy controls were investigated in pairs. The patients were found to have both normal proportions and normal absolute numbers of T lymphocytes, B lymphocytes, and the Fc-receptor-bearing lymphoid cells in peripheral blood. No abnormality of mitogen-induced lymphocyte transformation was observed. Lymphocyte-mediated cytotoxicity induced by phytohemagglutinin (PHA) or anti-target cell antibodies was also found to be normal. As in an earlier study, impaired delayed hypersensitivity by skin testing was observed in the patient group, thus indicating a dissociation between in vivo and in vitro parameters of lymphoid cell function.


Spontaneous rosette formation with heavily haptenated sheep erythrocytes: a marker for mouse non-T lymphocytes. Most non-T lymphocytes in nonimmunized mice spontaneously bind heavily haptenated (4-hydroxy-3,5-dinitrophenyl)acetyl (NNP)-sheep erythrocytes. Few if any T lymphocytes are rosette formers with such erythrocytes. The NNP rosette formation is suggested to be a marker for mouse non-T cells.


Elution and characterization of lymphocytes from rheumatoid inflammatory tissue. Lymphocytes were eluted from the synovial tissue of 19 patients with classical rheumatoid arthritis. The tissue was minced and dissociated by treatment with crude collagenase and DNase. The cell suspension obtained was filtered and incubated in plastic culture flasks overnight at 37 degrees C. The cells that did not adhere to the plastic surface were harvested and the lymphocytes further purified by the Ficoll-Isopaque gradient centrifugation technique. The lymphocyte yield varied from 0.64 to 32 times 10(6) cells. Differential counts showed on the average 85% lymphocytes, 12% mocrophage-like cells, and variable proportions of polymorphonuclear granulocytes, unclassified cells, and dead cells. An average of 77% of the cells were viable as assessed by the trypan blue exclusion test. This cell suspension was investigated for lymphocyte populations. T lymphocytes were predominant in all experiments (mean, 73.6%). The mean percentage of B lymphocytes was 9.7%, whereas the proportion of Fc-receptor-bearing lymphocytes was on the average 6.0%.


Lymphocyte subpopulations in the cerebrospinal fluid and peripheral blood in patients with multiple sclerosis. The cerebrospinal fluid (CSF) and blood of patients with multiple sclerosis (MS) were studied with respect to the frequency of lymphocytes with intracellular immunoblobulins of different Ig classes as well as the relative frequency of B and T lymphocytes. An increased number of Ig-postive cells were found in CSF (mean, 0.52%) when compared with blood (mean 0.18%). In CSF there was a striking dominance of IgG-postive cells, very few IgA-postive cells, and almost no IgM-postive cells. The distribution in blood was approximately normal. The ratios between chi- and lambda-postive cells in CSF were all outside the range in blood. In CSF there were fewer B cells (mean, 4.7%) and more T cells (mean 74.2%) when compared with blood (mean, 11.5%) and 61.8%, respectively). The values for MS blood were approximately the same as for normal controls. The increased number of IgG-containing cells in the CSF are in agreement with earlier studies, which showed a local immunoglobulin synthesis. The increased proportion of T lymphocytes in CSF of MS patients may indicate that these cells play a role in the pathogenesis of MS.


Continuous growth of mitogen-reactive B lymphocytes. B-cell mitogens induce continous growth of murine lymphocytes in suspension cultures. Continuous growth is observed only at low cell densitiess, below 10(6) cells/ml, in regularly renewed medium containing beta-mercaptoethanol and a growth-supporting fetal calf serum. Continuous growth of  B lymphocytes in culture appears to be favored by conditions under which maturation of Ig-secreting plaque-forming cells does not occur. On the other hand, maturation is observed whenever stimulated B cells cease to divide. This maturation leads to IgM secretion followed by secretion of IgG- or IgD-like molecules. Neither continuous growth of B cells nor the 'switch' to secretion of IgG- or IgD-like molecules requires the presence of T cells.


[Angiography in acute gactrointestinal hemorrhage]. The indications for and diagnostic value of visceral angiography in 30 cases of acute gastrointestinal bleeding are discussed. In one third of these emergency angiograms the etiology of the bleeding could not be demonstrated. In two thirds of the cases the source of bleeding was successfully localized. In half the positive angiograms the bleeding site was shown directly in the form of extravasation of contrast, while in the remaining half pathological findings were demonstrated without evidence of contrast media extravasation.


[Indications and contraindications for protease inhibitors]. Clinical interest in protease inhibitors was maximal at a time when it was believed that acute bleeding tendency in some situations was due to "primary hyperfibrinolysis". Progress in diagnostic procedures resulted in better knowledg of the true nature of such dramatic hemorrhagic diatheses, which are due in fact to disseminated intravascular clotting with "consumption coagulopathy", a situation in which proteolytic inhibitors are contraindicated. Other indications have been thoroughly investigated by controlled trials, e.g. essential hypermenorrhea and postoperative hematuria after prostatectomy. Likewise, a significant protective effect of aprotinin in acute pancreatitis has been recently demonstrated. Finally, congenital deficiencies of natural inhibitors such as alpha1-antitrypsin and C1-esterase-inhibitor may benefit from substitutive therapy with exogenous or synthetic inhibitors.


[Kinetics of neutrophil granulocytes].

[Kinetics of neutrophil granulocytes]. The kinetics of neutrophilic granulocytes are briefly reviewed. The cell traverses 3 compartments during its life cycle. After a phase of proliferation and maturation in the bone marrow for a period of about 10 days, it enters the blood for an average period of 10-12 h and then migrates into tissues where it survives for an unknown length of time. Although a quantitative understanding of normal neutrophil kinetics has emerged, our knowledge of disorders of neutropoiesis is limited. Progress in the diagnosis and treatment of disorders of neutropoiesis is anticipated with improved methods of assessing quantitatively abnormal production and its regulation.


[Proceedings: Clinical findings and coronary morphology before and after aorto-coronary venous bypass]. 37 patients (mean age 51+/-8 years) were clinically and angiographically investigated before and 11+/-5 months after implantation of an aortocoronary vein graft. The rate of bypass patency was 78%. Postoperatively 57% of the patients were free of symptoms, 35% were improved and 8% unimproved or worse. The reduced incidence of angina pectoris during exercise testing appears to be correlated with graft patency, an improved vascularization index and probably the absence of preoperative myocardial infarction. The systolic time intervals and the lung-ear time at rest are of no value for differentiation of improved and unimproved patients.


[Intestinal hemangiomatosis].

[Intestinal hemangiomatosis]. The hemangiomas of the intestinal tract are rare benign tumors. The main clinical symptom of which is bleeding. The diagnosis of hemangiomatosis may present difficulties. In all cases of unexplained intestinal bleeding the possibility of hemangiomatosis should be considered. Should conventional radiographic studies and endoscopy, including colonoscopy, fail to locate precisely the source of bleeding, further angiographic studies are definitely indicated. Angiography is the key to the diagnosis of intestinal hemangiomatosis.


[Antibodies against various nuclear antigens (especially DNA and RNA proteins) in disseminated lupus erythematosus with and without kidney involvement and in other collagen diseases. Preliminary report]. The incidence of autoantibodies to various nuclear antigens was studied in 64 patients with SLE, 137 patients with various connective tissue diseases, 63 other patients and 90 controls. A positive correlation was found between SLE, nephritis, and the presence of antibody against native DNA. Antibody to denatured DNA showed no specificity for SLE and was correlated with the absence of nephritis. Antibody to RNA-protein occurred mainly in SLE, regardless of the presence or absence of nephritis.


[The Sharp syndrome ("mixed connective tissue disease")]. A new and distinct rheumatic disease with features of systemic lupus erythematosus (SLE), progressive systemic sclerosis and polymyositis is described. Typical symptons are Raynaud's syndrome, swollen hands and fingers, polyarthritis or polyarthralgia and myositis. Other symptoms are less common and include skin lesions, decreased pulmonary diffusing capacity, diminished esophageal motility, lymphadenopathy, and polyserositis. The diagnosis of mixed connective tissue disease (MCTD) can be established by demonstration of a high titer of antinuclear antibodies and antibodies against extractable nuclear antigen (anti-ENA). Both antibodies are directed against ribonuclease-sensitive antigen substrate, which permits differentiation of patients with MCTD from those with other rheumatic diseases. A relatively favourable prognosis and a good response to corticoid medication are further characteristics of this disease. Three personally observed patients with MCTD are described.


A line, not a space, represents visual distinctness of borders formed by different colors. When observers are asked to rate the visual distinctness of borders formed by the junction of two photic stimuli, normal trichromatic subjects behave in a manner similar to that of tritanopes in a color mixture experiment. All stimuli that look the same to the tritanope produce the same border distinctness with any other stimulus. Sets of such stimuli, whose members do not form borders with each other, map as single points along a curved line, where the Euclidean distance between pairs of points representing the two stimuli is nearly proportional to the rated distinctness of the border formed between them. In the absence of luminance differences, the perception of contour apparently depends on the stimulation of only two cone types.


Urgent fibre-optic panendoscopy in upper gastro-intestinal haemorrhage. Urgent fibre-optic panendoscopy was performed in 400 patients within 24 hours of their admission to hospital for upper gastro-intestinal haemorrhage. The cause of bleeding was established by endoscopy in 87%. No cause was found in 10% and endoscopy failed in 3%. Twenty-five per cent of the patients had an additional lesion which was not the cause of bleeding. Complications owing to endoscopy occurred in 2% of the patients. Only 27% of the patients still had blood present in the stomach at the time of endoscopy. Chronic gastric ulcer was causative in 22%, and duodenal ulcer in 20% of the patients. Haemorrhagic gastritis accounted for 13%, Mallory-Weiss tear for 8%, acute ulceration for 5% and varices for 4% of the patients. Only 60% of the patients with dyspepsia were bleeding from peptic ulcers and only 64% of the patients bleeding from ulcers had a history of dyspepsia. Follow-up studies revealed that endoscopy, in experienced hands, is an accurate investigation which allows for an improved approach to management, and which probably also reduces the mortality rate.


[Cryosurgery of lung metastases (author's transl)]. Cryosurgery achieves a local tumor destruction and at least in many experimental models it also produces an antitumor immunity. Cryosurgery was therefore applied to 15 patients with multiple lung metastases. In 2 cases a good palliation with a temporary standstill of tumor growth and in 3 cases of positive effect with a decrease and disappearance of metastases was noted. In two of these cases metastases of the contralateral lung also decreased or varnished. This can be explained by an immune mechanism. Big tumors and fibrosarcomas are not suited for cryosurgery, whereas hypernephroid renal carcinomas and malignant teratomas give more promising results.


[Clinical observations and angiographic findings before and after aortocoronary benous bypass grafting (author's transl)]. 37 patients (mean age 51 +/- 8 years) were investigated clinically, mechanocardiographically and angiocardiographically before and 336 +/- 166 days after implantation of an aortocoronary vein graft. The bypass patency rate was 78%. Postoperatively 57% of the patients were free of symptoms, 35% were improved and 8% unimproved or worse. The postoperative incidence of angina pectoris during exercise testing was significantly lower in the groups with an improved vascularization-index, open vein grafts and a lack of preoperative myocardial infarction. For separating the patients only the vascularization-index and the bypass patency seem to be of value.


[Mitral valve surgery: 10 years follow-up of 501 patients (author's transl)]. The results of mitral surgery between 1961 and 1971 are presented. Pure or predominant mitral stenosis outnumbered combined mitral valve disease and mitral incompetence by two to one. Surgical treatment comprised 291 closed mitral commissurotomies, 145 open reconstructions and 81 replacements of the mitral valve. One month mortality was 2,4% for commissurotomy, 4,8% for reconstruction, and 25% for replacement. Early mortality of the latter operation decreased to 7% since 1971. For patients with no more than slight preoperative symptoms life expectany remained unaffected for 10 years after closed commissurotomy. For patients with significant preoperative limitation or symptoms at rest 5 and 10 years life expectancy after successful surgery was 93 and 79% resp. for commissurotomy, 94 and 73% for reconstruction and 79 and 53% resp. for mitral valve replacement. In spite of a higher rate of reoperations and late deterioration of valve function the reparative operations deserve preference to the replacement of the mitral valve whenever feasible.


[Comparing studies on the influence of dopamine and orciprenaline on cardiac and renal function of patients after cardiac surgery (author's transl)]. Cardiac and circulatory function (cardiac output, stroke volume, heart rate, mean arterial pressure = MAP, total peripheral resistance = TPR), further renal function (PAH- and inulin clearance, filtration fraction, urinary excretion, renal sodium- and potassium excretion) were measured on 15 patients undergoing cardiac surgery to whom Dopamine and Orciprenaline were administered in increasing doses of 100 mug - up to 500 mug/min (Dopamine) and 10 mug - to 20 mug/min (Orciprenaline). An infusion of Dopamine up to 250 mug/min caused a dosis-related increase of the cardiac output up to 31% (2P less than 0.001) without essential increasing of the MAP and of the heart rate. Dopamine caused a decrease of the TPR up to 24%. Doses of Dopamine over 250 mug/min cause an increase of the MAP and of the heart rate without a real increase of the cardiac output. Renal function improved under increasing doses of Dopamine, effective renal plasma flow (ERPF) up to 74%, urinary excretion up to 130%, sodium and potassium excretion up to 60% respectively. After administering Orciprenaline in a dosis of 20 mug/min cardiac output increases up to 28%, MAP and heart rate up to 12% and 17% respectively. After the administration of Orciprenaline (20 mug/min) and Dopamine (500 mug/min) frequent extra systoles were observed without any increase of the cardiac output; MAP increased by 12%, TPR decreased by 16% after 20 mug/min of Orciprenaline. ERPF decreased slightly after Orciprenaline. Urinary excretion was reduced by a half.


[Primary hemangiopericytoma of the lung (author's transl)]. Primary hemangiopericytoma of the lung is exceedingly rare. The following characteristics were found in a survey of the 34 cases published so far in the world literature and in one case of our own, a 29 year old man with this mesenchymal tumor. It does not show specific clinical signs. In radiographs an isolated round unidentifiable focus is seen. The differential diagnosis has to rely on the histology. About one half of these tumors are discovered by accident. It appears that it occurs at a somewhat younger age in men than in women. Both sexes are equally represented. The treatments of choice are either lobectomy or pneumonectomy. Patients with small tumors without clinical signs appear to have a better prognosis. When recurrence or metastases develop they will be noticed within a few months. Intensive follow-up of patients operated on is essential, since histology cannot provide safe criteria on which one could decide whether the tumor was benign or malignant.


[The intracardial ECG during permanent pacemaker-implantation (author's transl)]. As our researches and prevailing procedures have proved a permanent pervenous pacer implantation necessitates an additional intra-cardial ECG in parallel with the practised approach under fluoroscopy and by measuring the threshold current. The patho-physiological prerequisites are explained in detail. By means of the characteristic shape of the ST-elevation and the determination of the amplitude in mV, deciding factors for an advantageous position of the electrode may be gained. In order to ensure safe function of the demand mechanism monitoring by an intra-cardial ECG to establish a sufficient signal amplitude in mV is indispensable. This is particularly applicable in case of leads with a small surface area resulting in a low threshold current value and a low amplitude of QRS-signals.


[Isolated rupture of the interventricular septum after blunt chest trauma (author's transl)]. The mechanism, symptoms and treatment of traumatic ventricular septal defect are discussed on the basis of an own observation. To the best of our knowledge this is the first report of a rupture of the membranous septum, involving the portion between the left ventricle and the right atrium. An attempt is made to explain the mechanism of isolated traumatic ventricular septal rupture on the basis of embryological considerations. The patient died on the 11th postoperative circulatory status and inspite rather prompt diagnosis and operative treatment.


[Nonocclusive mesenteric vascular disease following atrio-ventricular block and pacemaker treatment. Gangrene of small and large bowel with occlusion of inferieor mesenteric artery (author's transl)]. A case of nonocclusive mesenteric vascular disease consequential to a low cardiac output syndrome in a patient with a temporary pacemaker is reported. Preexisting occlusion of the inferior mesenteric artery resulted in a total gangrene of small and large bowel. Experimental findings suggest that this occlusion could have resulted in a compensatory increase of blood flow in the superior mesenteric artery. The possibility is discussed that the preexisting necessary increase of superior mesenteric blood flow could be followed by equally increased sensitivity of regional organic systems in non-occlusive mesenteric vascular disease.


Cold lymphocytotoxin reactivity with lymphocytes from donors in various physiological conditions. Sera containing cold lymphocytotoxins were studied in the presence of lymphocytes from neonates, pregnant women, blood donors and old people and the degree of positivity varied according to the lymphocyte population investigated: a strongly positive response to lymphocytes from neonates and pregnant women, a weaker response to lymphocytes from old people and a very weak response to chronic leukemic lymphocytes. Cold lymphocytotoxins seem to be a supplementary method of demonstrating a difference in lymphocytic behavior.


Adaptation to tissue culture of the murine leukemia ASL1, a high producer of TL (thymus leukemia) antigen. ASL1, a murine thymus derived leukemia, was adapted to tissue culture and its suitability as a source of TL antigens was examined. Tissue culture medium was developed in which the cell grew with a mean doubling time of 12.5  h and 95% viability. The quantity of antigen expressed by the cells was determined by inhibition of lysis of 51Cr labelled leukemic cells meadiated by anti-TL 1,2,3 serum. Significant quantities of the antigens were retained by the cells during exponential growth in vitro.


Studies on the induction and expression of T cell-mediated immunity. V. Lectin-induced nonspecific cell-mediated cytotoxicity by alloimmune lymphocytes. Murine lymphoid cells sensitized against allografts express two types of cytotoxicity measured in vitro in short-term assays of 2 to 3 hr by 51Cr release. One type of cytotoxicity is specific against target cells carrying the sensitizing alloantigens, and the other type is nonspecific against both syngeneic and unrelated target cells and requires the presence of phytohemagglutinin (PHA) or concanavalin A (ConA). Several lines of evidence are presented which demonstrate that both cytotoxic systems are mediated by the same clone of alloimmune effector T lymphocytes and that the lectin-induced cytotoxicity is not attributable to mitogenic polyclonal activation of effector cells. Studies with ConA inhibitor alpha-methyl-D-mannoside suggest a mechanism of interaction that requires the lectin to be present during the reaction. Experiments with other reagents, however, that bring about physical contact of the cells but not lysis, indicate that cytolysis can occur only through specific lectin receptors on the cells. The significance of this lectin-induced cytotoxicity is discussed.


Unexpected limitations in the use of commercial antiglobulin reagents. The majority of antiglobulin sera used in blood banks in the USA are commercially prepared immune rabbit sera, designed to be reactive only with human red blood cells sensitized with immunoglobulins or complement components. Current manufacturing methods result in a product that gives reliable specific reactions provided that the test red blood cells are normal, particularly with respect to sialic acid levels. This report describes our findings of false positive antiglobulin tests caused by incompletely absorbed antiglobulin reagents when cells with low sialic acid levels were tested. An evaluation of nine commercially prepared antiglobulin reagents revealed, in many of them, the presence of anti-species antibody, anti-T, and anti-Tn. Blood bank personnel must be aware of these characteristics especially when testing either enzyme premodified or polyagglutinable cells. The use of incompletely absorbed reagents might account for positive direct antiglobulin tests that are encountered occasionally in apparently normal healthy individuals. Furthermore, recent protocols advocating the use of trypsinized cells for the evaluation of anti-C3d activity of antiglobulin sera are invalid if the reagent is inadequately absorbed of anti-species agglutinins.


The titre of IgG anti-A/B in the serum of group O mothers of incompatible infants with early neonatal jaundice. The titre of IgG anti-A/B was determined by means of a 2-mercaptoethanol test in the serum of 80 blood group O mothers, who gave birth at term to A/B incompatible infants, who developed early neonatal jaundice with a serum bilirubin level of over 10 mg/100 ml. The titres were compared with the results of the direct antiglobulin test performed on the red cells from the cord blood and the necessity for exchange transfusion. Only in mothers of group A infants, a significant correlation was found between the titre of IgG anti-A and the occurrence of a positive antiglobulin test. In no case the need for an exchange transfusion was correlated with the IgG anti-A/B titre.


[Complex compounds of heparin in obstetric hemorrhages]. The so-called uncontrollable hemorrhage in obstetric patients correlated mainly with appearance in blood of complex heparin compounds, primarily fibrinogen-heparin, adrenaline-heparin, noradrenaline-heparin and, less frequently, plasminogen-heparin. The heparin complexes were observed in circulation when the anticoagulation system was stimulated due to appearance of thrombin in the blood stream. The complexes possessed and anticoagulation and antipolymerization effects on fibrin-monomer and caused nonenzymatic lysis of unstabilized fibrin clots.


[Electrotherapy of life-threatening arrhythmia in acute myocardial infarct]. As a result of an adjustment of the experiences which were made in four clinics with the electrotherapy of life-threatening disturbances of rhythm in acute myocardial infarction recommendations for the use of this therapy are given. The value of the various methods of electrotherapy compared with medicamentous treatment are elaborated.


[Effects of blood sampling on enzyme activities in the serum of small laboratory animals (author's transl)]. Because of the difficulties in drawing blood for clinical chemistry in small laboratory animals there exist many methods for sampling blood and the preparation of serum, none of which is generally accepted or well standardised. It was the aim of this study to investigate the effects of sampling techniques on normal values of enzyme activities in the serum of rat and mouse. The activities of the following enzymes were determined: sorbitol dehydrogenase, lactate dehydrogenase, malate dehydrogenase, glutamate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, pyruvate kinase, creatine kinase, myokinase, alkaline phosphatase and leucine aminopeptidase. In addition plasmaproteins, urea and inorganic phosphorus were measured. In rats blood was obtained from the following sites: retroorbital venous plexus, jugular vein, heart and ventral aorta. In mice blood was sampled from the jugular vein and the ventral aorta. Shifts of water from the interstitial to the intravascular space due to hypovolemia occurring during the experimental procedure were followed up by measuring the hematocrit and the distribution of radioiodide labelled albumin. In rats the activities of lactate dehydrogenase, malate dehydrogenase, aspartate aminotransferase, pyruvate kinase, creatine kinase and myokinase found in blood serum obtained from the retroorbital venous plexus and the ventral aorta were too high compared to the other sampling sites. Activities of alkaline phosphatase and alanine aminotransferase were slightly  elevated when blood was sampled from the punctured retroorbital venous plexus. Small differences in plasmaproteins and hematocrit values were found to be due to acute shifts of water within the extracellular space. In mice the activities of lactate dehydrogenase, malate dehydrogenase, aspartate aminotransferase and myokinase were found to be too high in blood serum obtained from the ventral aorta. Efflux of enzymes from damaged cells and the interstitial space ive caused erroneous results too, but only to a minor extent. The most reliable method for blood sampling in rat and mouse is the cannulation of the jugular vein. The heart puncture can be recommended too. Attention should be paid, however, to the possibility of aspirating disrupted muscle cells through the inserted needle.


[Cellular immune reactions of the white mouse after superinfection with Toxoplasma gondii (author's transl)]. After superinfection of immunized mice with a virulent strain of Toxoplasma (BK) these mice don't die. There is formation of a cellrich exudate with only very few toxoplasmas. The number of the different exudate-cells (macrophages, big, middlesized and small lymphocytes and heterophils) turn in direction of the lymphocytes in that way, that after the 3rd day of infection 70% of all exudate-cells belong to the group of lymphocytes. They seem to cause the death of the toxoplasmas. After in vitro incubation of trophozoites and exudate-cells of immune mice for 2 hours at 37 degrees C nearly 80% of the added toxoplasmas are killed. Electronmicroscopical pictures show, that this killing is produced by a process of lysis.


[Therapeutic results achieved through the advantage of a combination of oral metronidazole and vaginal natamycin tablets in urogenital protozoan, trichobacterial and blastomyces infections]. Vaginal inflammations caused by Trichomonas, Leptothrix vaginalis or Candida and other less common organisms respectively, were treated very successfully with a combination of metronidazole orally and a natamycin preparation vaginally (Pimafucin vaginal tablets). In women with urogenital Trichomoniasis a cure was obtained in 96,1% of the cases (microbiologically controlled); Candida mycoses of the vagina were cured clinically in 89% of the cases after the first course of treatment and mycologically in 79% of the cases. Of special importance is the rapid and successful elimination of the mixed infection before birth, because this diminishes perinatal morbidity of the fetus. The combination treatment of bilateral, constantly interchanging Candida and Trichomonas infections of the vagina is of importance to both sexes, especially with respect to the elimination of sterility. From the onco-gynecological point of view the combination treatment with metronidazole and natamycin appeared to be of value as it limits the incidence of dyskariosis of the epithelial cells, which occur frequently in cases of inflammation of the vagina or cervix uteri. No teratogenic effect was observed with this combination when applied during pregnancy.


[Quantitative determination of potassium content of spinal motor neurons frogs by x-ray microanalysis]. X-ray microanalysis has been made of the potassium content of motoneurons in the frogs Rana ridibunda and R. temporaria. The tissue was frozen in isopentane up to-160 degrees, dried in vacuum at-50 degrees, embedded into epoxy resin and sectioned by ultramicrotome. The obtained mean value of intracellular potassium concentration-65 mM/kg of wet weight or 80 mM/l of intracellular water-is in a good agreement with the results of calculation of intracellular potassium from equilibrium potential of post-spike after-hyperpolarization.


[Seasonal changes in cutaneous blood vessel tone in the frog Rana esculenta]. Experiments have been carried out on frogs immobilized by diplacine. The diameter of arteries and veins in the web was measured before and after sectioning the sciatic nerve. Denervation of the hindlimb resulted in dilatation of web vessels, which was different at various seasons. Changes in the arterial tone were found to be polyphasic. The highest tone was observed in March, April and September, the lowest one-in May, August, October and January. Changes in the venous tone are less pronounced and follow biphasic pattern, the tone being increased in spring and summer and decreased in autumn and winter. Stimulation of the peripheral end of the sectioned nerve leads to the constriction of web vessels, its amplitude being dependent on the level of vascular tone at the given period of year. It is suggested that seasonal changes in the tone of cutaneous arteries are partially based on changes in the reactivity of the blood vessels.


[Natural immune response and immunological memory in the effects of a 2d unrelated antigen]. In combined administration of two nonaffiliated erythrocytic antigens there can be seen both depression and stimulation of the immunological response to the participating antigens. The end result of the interaction depended on the "power", the dose and the order of administration of the antigens. Distribution of the antigen in the animals whose immune response was depressed as a result of preliminary administration of the nonaffiliated antigen remained unchanged. The factor determining the effect on the immunological response to the other antigen did not serve as an antibody.


[Study of the mechanisms of autoallergic reactions in cirrhosis of the liver]. Cell and humoral immunological tests were used in clinical examination of 47 patients suffering from cirrhosis of the liver; a mixed character of autoallergy was revealed in this form of pathology. Reproduction of passive anaphylaxis on guinea pigs with the aid of the sera and leukocytes of these patients pointed to the prevalence of cell allergy. Passive transmission of increased sensitivity to human hepatocytes from guinea pigs, preliminarily sensitized with salt extracts from human hepatocytes, to intact animals was realized. Active sensitization was accompanied by the formation of mixed allergy to the antigen obtained from the liver of a person who died accidentally, with the prevalence of the immediate type of reaction.


[Properties of rhythmically active neurons of lymphatic heart center of the frog Rana temporaria]. During extracellular recordings of the activity of spinal neuronal units in situ, it was found that rhythmically active neurons respond to antidromic stimulation of ventral roots (X, XI), which include motor heart fibers. The amplitude of the responses of these motoneurons to continuous rhythmic antidromic stimulation exhibits slow rhythmic oscillations, reaching the lowest value to the onset of the spontaneous spike potentials. In isolated spinal cord preparation (from VIII segment), rhythmic activity of the center studied was preserved, which indicates the capacity of central structures to automatic activity.


[Synaptic organization of the vestibular nucleus in the medulla oblongata of the frog Rana temporaria]. Studies have been made on the synaptic organization of ventral vestibular nucleus of the frog R. temporaria. Besides numerous axo-somatic and axo-dendritic synapses, 3-component axo-axonal synaptic contacts were revealed which indicate a possibility of presynaptic inhibition in the nucleus studied. Three types of membrane specializations were found in axo-somatic and axo-dendritic synaptic contacts-active zone of chemical synapse, symmetric thickening of the membranes of desmosomal type and close linking of the membranes of electrotonic synapse. Functional role of the observed contacts is discussed.


[The palatine tonsils and immunity. Report VII. Soluble factors produced by the lymphocytes of the palatine tonsils in vitro]. A study was made of the production of a blastogenic factor and lymphotoxin in the cultures of lymphocytes of the palatine tonsils removed from patients with chronic tonsillitis; the activity of this blastogenic factor and lymphotoxin was studied in the test-cultures of autologous and allogenic lymphocytes and the transplantable HeLa cells. The antigens of the pathogenic streptococcus and staphylococcus induced production of the blastogenic factor and lymphotoxin; as to the antigens of saprophytic bacteria-they produced no such action. The antigen-specific blastogenic factor intensified the immune response to the homologous antigen, whereas the factor obtained in stimulation of lymphocytes with PHA-to all the microbial antigens under study.


[Histochemical studies of oxidative enzymes in the gastric mucosa of sheat-fishes, frogs, tortoises and pigeons]. Oxyntic cells of gastric glands of the sheat-fish Silurus glanis, frog Rana temporaria, tortoise Agrionemis horsfieldi and pigeon Columba livia exhibit intensive reactions on dehydrogenases of lactate, alpha-ketoglutarate, glutamate, succinate, malate and glucose-6-phosphate which indicate high energy metabolism necessary for the production of HCl by these cells. Cytoplasm of these cells is stained for the presence of nucleic acids, which may be associated with the other function of the oxyntic cells, i.e. the production of the enzymes of gastric juice.


Latent myocardial contractile impairment in patients with angina pectoris. Intravenous injection of Angiotensin II gives rise to a rapid and transient increase of the afterload of the left ventricle (increased peripheral resistances). In this haemodynamic setting the functional behaviour of the left ventricle, through indirect parameters such as systolic time intervals, was compared in 14 patients with angina and in 15 normal control subjects. As regards blood pressure and heart rate a similar behaviour was registered in the two groups in basal conditions; directly after the intravenous injection of Angiotensin II changes suggesting impairment of left ventricular function failure have been obsered in patients with angina pectoris.


A two compartment open model for digoxin pharmacokinetics in patients receiving a wide range of digoxin doses. The pharmacokinetic parameters for a two compartment open model were defined for six patients receiving a wide range of Digoxin doses. It was demonstrated that the two compartment model is a valid one to use for Digoxin pharmacokinetics. This model is an useful concept because it can explain the necessity to vary Digoxin dosage in patients with different body weights, the time course of the effect of Digoxin and certain causes of increased tolerance to Digoxin. There were no alterations in the parameters of this model or of the percent of an injected Digoxin dose excreted in the urine and stool in our patients in atrial fibrillation who appeared to require larger doses to control their ventricular rates. This also suggests that the kinetics of excretion of Digoxin are not influenced by altering the Digoxin dose.


Massive digoxin intoxication. Report of a case with serum digoxin level correlation. The clinical course is described of a patient who took an overdose of 15 mg of digoxin in a suicidal attempt. He developed several cardiac arrhythmias like atrial fibrillation, atrial flutter, sino-atrial block. atrio-ventricular block 3 degree and ventricular extrasystoles. His plasma digoxin level rose to 38.7 ng/ml as determined by radioimmunoassay. He was treated with Aprindine and recovered without sequelae. A survey of the complications of acute massive digoxin intoxication is offered as well as a summary of treatment.


Radiation-induced heart disease.

Radiation-induced heart disease. A 45-year old woman underwent a radical mastectomy in 1965 for carcinoma of the left breast with metastasis in the left axillar lymph nodes. Fifty per cent of the heart received 4,000 rads during post-operative X-ray therapy. Patient developed radiopneumonia and symptoms of acute pericarditis in 1967. Constrictive pericarditis developed gradually from 1972 on. A pericardiectomy was performed in June 1974 and a thickened pericardium could be removed. Light and electron microscopic examination of a surgical biopsy of the left ventricular epi-myocardium revealed epicardial fibrosis, interstitial fibrosis of the myocardium and perivascular fibrosis. The diagnosis of post-radiation pericarditis was made. The myocardial involvement may be responsible for the subsequent clinical course.


The diagnosis or ventricular tachycardia with ventriculo-atrial conduction. A 57 year old man developed recurrent tachycardia with QRS complexes of 0.13 second in duration at a rate of 140 beats per minute. Inverted P waves appeared to follow each QRS complex in the electrocardiographic leads II, III and aVF. The differentiation between ventricular tachycardia with1 : 1 V-A conduction and supraventricular tachycardia with aberrant ventricular conduction was difficult to make from the surface electrocardiogram. This differentiation is important for selection of appropriate therapy. The diagnosis of ventricular tachycardia with 1 : 1 V-A conduction was clearly established in this case on simultaneous recording of surface electrocardiogram, His bundle electrogram and high right atrial electrogram.


Radical emergency operation for prolapsed and strangulated haemorrhoids. Conservative treatement of prolapsed and strangulated haemorrhoids is still widely used. According to several recent publications, however, emergency operation is a reasonable, safe, and effective treatment. Twenty-five patients with prolapsed and strangulated haemorrhoids underwent operation by the Milligan method. The results are compared with those in a similiar group having elective operation of chronic haemorrhoids. Since there were no differences in postoperative complications, length of stay in hospital, period off work, or late results, and since conservative treatment entails lengthy, painful treatment in bed and a long period off work, emergency operation is recommended for all strangulated haemorrhoids.


[T and B lymphocytes in peripheral blood of splenectomized subjects]. The report is a part of more extensive studies on the role of the spleen in immune processes. Assessing the ability of lymphocytes T to non-immunological binding of sheep erythrocytes and the ability of B cells to bind immunological complexes through the receptor for C3 component of complement, and the presence of immunoglobulins on the surface of lymphocytes B the number of these cells in peripheral blood was determined in 14 healthy individuals who had been splenectomized. In all these subjects the degree of blastic transformation of lymphocytes in PHA-stimulated 3 day-old white blood cell cultures was determined. It was found that the number of T and B lymphocytes in the peripheral blood of splenectomized and non-splenectomized patients was similiar. Lymphocytes obtained from splenectomized patients had however, an impairment of transformation ability after PHA stimulation. It is suggested that, apart from determination of T and B cell pool in the peripheral blood, an evaluation of their transformation ability after PHA stimulation is necessary for assessment of the immunological state in vitro investigations.


The nystagmus threshold in turning test in different age groups and in patients suffering from otosclerosis. The threshold of nystagmus during angular acceleration and deceleration was investigated in two series of healthy persons with an average age of 20 and 42 years and in series of otosclerotic patients with an average age of 42 years. It was shown that age as such does not influence the thresholds, but a lesion in the inner ear, such as otosclerosis, causes higher thresholds even in younger subjects.


Immunological and histological studies of temporal arteries from patients with temporal arteritis and/or polymyalgia rheumatica. Biopsies from the temporal arteries of 62 out of 80 patients presenting the clinical picture of temporal arteritis and/or polymyalgia rheumatica showed morphologically active or healed arteritis. Fifty-five of these biopsies revealed anti-IgG activity as measured by the mixed agglutination test. In 21 of the 27 cases which could be completely studied, the anti-IgG activity was connected with the presence of IgA, either alone, or together with IgG or IgM, or both, and complement. All of these 21 biopsies showed morphologically active granulomatous arteritis with signs of tissue destruction. In 6 biopsies, the active component appeared to be some type of Fc receptor in the tissue. Morphologically these biopsies showed either non-granulomatous mononuclear arteritis without definite necrosis or they represented various stages of healing arteritis with no or minor signs of tissue destruction. Weak anti-IgG activity was often found in a morphological type characterized by minimal inflammatory activity. These lesions are easily overlooked and the mixed agglutination test proved to be a good diagnostic tool in such cases. Arteries without anti-IgG activity showed no signs of active arteritis.