Prinzmetal's variant angina.

Prinzmetal's variant angina. Two patients are described with a typical Prinzmetal's variant angina. Both patients were young, active males with angina of recent onset. They experienced angina only at rest and in one patient the angina had a cyclic character appearing only between 4 and 10 a.m. In both patients there was no correlation whatsoever between the angina pectoris and effort, emotion or change in temperature and the angina reacted promptly to nitroglycerine sublingually. The number of attacks and the intensity of the pain were increasing rapidly over a short period of time in both cases. The stenoses in both patients did not exceed 50% of the lumen of the coronary arteries, but coronary surgery has been performed on clinical grounds because both patients were completely disabled and one of them suffered from life-threatening dysrhythmias. For respectively 18 and 6 months after saphenous vein bypass surgery both patients have been symptom-free and able to resume their work. The problems concerning the diagnosis Prinzmetal's variant of angina pectoris are discussed.


[Hepatic lesions and coagulation disorders in pulmonary embolism: a clinico-pathological case]. The authors described the case of a 49-patient suffering from obstructive broncho-pneumopathy and ischemic myocardiopathy complicated by multiple pulmonary embolism. The clinics were dominated by signs of major hepatic deficiency and of intravascular disseminated coagulation with fibrinolysis. The clinical and biological parameters evoking pulmonary embolism in that intricated chart were discussed.


[X-ray documentation of the anamnesis and physical data in patients with rheumatism within the scope of the medical information system WAMIS]. A computerized on-line system of evaluating of symptoms and physical data in rheumatology is presented. Case history, previous treatment, and physical examination are documented. The documentation of the latter may be performed in two ways: one records only joint symptoms, the other includes joint measurements. In comparison to the former off-line method, all data are much better available. Moreover, we believe it to be considerably timesaving. This system should also allow an electronic differential diagnosis of rheumatic diseases, after completing laboratry and X-ray documentation.


[Effect of distraction by various forces on the elbow joint in rabbits]. The elbow joints of 115 adult live rabbits have been subjected to experimental distraction by various forces and for different intervals. The forces applied were one tenth and one half, respectively, of the mean body weights; thus, a calculated reduction of one eleventh and five elevenths, respectively, of the force transmitted through the articulating joint surfaces was achieved. The distraction was performed for periods of 1, 2, 4 and 8 weeks. The forces were administered by means of an extraarticular device which allowed motion of the joints. Controls had been provided for to prove the noneffectiveness of the distraction device per se to the joint structures under study. Both upper limbs--one side always served as control--were subjected to radiological, histological/histochemical, angiographic and cytological examination; cartilage in addition was treated by vital staining or, alternatively, by producing splitting lines. The results were as follows: (1) Extensive local and more generalized hyperemia involving the whole limb in question was produced regardless of strength and duration of distraction. (2) Under all experimental conditions subsynovial hemorrhage and hemarthrosis developed. (3) Subsynovial hemorrhage caused the development of granulomatous and, subsequently, fibrous synovitis with simultaneously demonstrable hemosiderin depots. (4) Hemarthrosis was persistent during the entire period of observation. (5) Articular cartilage revealed moderate signs of degeneration and also irregularities of the usual pattern of splitting lines after continuous distraction for 8 weeks. At the same time, subchondral bone atrophy appeared. Vital staining revealed increased cartilage staining under mild distraction; moderate and marked distraction caused definitively less staining. Subsynovial hemorrhage and hemarthrosis are explained as partial vacuum effects. Concerning the moderate cartilage changes, a multifactorial genesis is presumed; the possible role of chemical, nutritional and mechanical factors is discussed. The widespread hyperemia most likely is caused by mechanical stimulation going along with joint distraction; capsular hyperemia might be a phenomenon immediately related to synovitis. Finally, the experimental results are discussed relative to observations made during clinical traction therapy.


[Complete alpha-1-antitrypsin deficiency in a patient with Ehlers-Danlos syndrome]. Complete alpha-1-antitrypsin deficiency of the type PiOO associated with chronic obstructive lung disease, cutaneous hyperextensibility and hyperlaxity of joints were found in a nineteen-year-old Moroccan boy. On a nosological point of view, this patient could be included as a 8th form, in the Ehlers-Danlos syndrome which now groups seven clinical variants. A causal relationship between the biological deficiency and the clinical alterations (pulmonary, cutaneous and articular) could be assumed according to the biological and ultrastructural findings.


The response of alpha-motoneurons of different size to stretch and vibration of extensor muscles after injection of 5-hydroxytryptophan in spinal cats. 1. Vibration of the GS muscle at 100/sec, and the peak-to-peak amplitude of about 100 mu, produced slight reflex activity of homonymous and heteronymous alpha-motoneurons in the spinal, unanesthetized cat. 2. Intravenous injection of the 5-HT precursor 5-HTP (25 mg/kg, L-form) performed in the spinal preparation facilitated the responses of single extensor alpha-motoneurons to both vibration and stretch of the corresponding muscle. The 5-HT antagonist methysergide (0-5 mg/kg i. v.) blocked almost completely the facilitation of the vibration and stretch induced motoneuronal discharges produced by 5-HTP in the spinal cat, indicating that the facilitation was 5-HT specific. 4. A comparison of the types of alpha-motoneurons participating in the reflex responses elicited by the different stimuli in the spinal cat following injection of 5-HTP showed that both small-tonic and large-phasic alpha-motoneurons take part in both stretch and vibration reflexes. 5. It is concluded that the alpha-motoneuron pool of the GS muscle represents an homogenous population, no matter what kind of synaptic drive is used for its activation, and that the susceptibility of a motoneuron to discharge depends on the amount of the afferent excitatory input rather than on the modalities of sensory stimulation.


Preparation and testing of goat anti--thymocyte globulin. This study details methods of production, purification and testing of large volumes of uniformly potent, non-toxic, anti-human thymocyte globulin (ATG). Plasma from 70 goats immunised with human thymic lymphocytes was fractionated by ammonium sulphate precipitation to its IgG component. Contaminating antibodies were removed by absorption methods. After fractionation and absorption, ATG retained its ability to inhibit the formation of rosettes by human lymphocytes with sheep red blood cells. Antibodies to human glomerular basement membrane were not detected in any tested preparation. Tests performed on monkeys, mice and rabbits revealed low toxicity.


[Experimental studies on the possibility of influencing mast cells in experimental carrageenin-induced rat paw edema. Histological study on the effects of some non-steroidal anti-inflammatory agents (author's transl)]. The protective effect on mast cells of some non-steroid antiphlogistics in the carrageenin-induced edema of the rat hind paw was studied with histological methods. The number of the mast cells was counted in the inflamed connective tissue of unpretreated animals and also such pretreated with acetylsalicylacid, phenylbutazone and indometacin and the results of the test periods were compared with one another. The number of mast cells in the inflamed connective tissue of unpretreated animals was reduced in comparison to the controls during the first 5-35 min after inflammation. Six hours after inflammation the number of mast cells increased. Our investigations demonstrated that the used antiphlogistics produced a significant reduction of mast cell degeneration during the first 5-70 min after inflammation. The results are discussed.


[Activity inhibiting leukocyte migration in human sera of healthy subjects and of subjects with delayed hypersensitivity and findings of possible serum factors with antagonistic activity (author's transl)]. The AA. have tested human sera from subjects with a clinical condition of delayed hypersensitivity (TBC and eczematous contact dermatitis) in order to detect factors affecting leukocyte migration in agarose plates. They found either inhibiting or stimulating factors of cellular migration. According to the most recent data about the same area they emphasyze a sort a regulatory mechanism of LIF or factors with activity LIF-like, due to antagonistic substances present in sera of their patients. Furthermore they suggest a list of factors able to inhibit or to enhance cellular migration.


Aspecific transfer factor in children with Hodgkin's disease. Six children suffering from Hodgkin's disease (HD), in different stages and free from chemo- and radiotherapy from at least four weeks, were treated with transfer factor (TF). PPD skin test, PHA-responsiveness, E-rosettes, B-lymphocytes were checked before TF therapy, after 6 and 9 TF doses and compared to the data at the onset of the disease. Two children with HD who did not receive TF, were examined as controls. PPD skin tests, PHA-responsiveness, E-rosettes did not ameliorate following TF treatment, while it has been noticed an increase in B-lymphocytes, both in percentage and absolute number. The Authors conclude that TF might have induced a slight B lymphoproliferation.


[Interposition meso-caval shunt for haemorrhage or ascites in hepatic cirrhosis. Report of twenty-eight cases (author's transl)]. The results are set out of emergency or electiver surgery for bleeding oesophageal carices or for intractable ascites in hepatic cirrhosis. The procedure adopted, a meso-caval shunt with prothesis interposition, led to a low percentage of thrombosis, markedly lowered portal pressure, and gave effective clinical results. Although angiography indicated that the portal flow to the liver had dropped considerably, or even ceased altogether, the bad effect on liver function and the incidence of encephalopathy seemed reduced than generally reported after porta-cava shunts. No deaths occurred among the patients for who surgery had been planned, but the rate was still high in emergency cases. This indicates that although well tolerated, the interposition meso-cava shunt is best performed after careful pre-operative selection and preparation.


[Receptors for murine red blood cells on normal lymphocytes and in chronic lymphocytic leukemia]. The ability of unfractionated and purified B and T peripheral lymphocytes to form rosettes EAC and E with sheep and mouse red blood cells was assessed in thirty healthy controls and in five patients with chronic lymphocytic leukaemia. E mouse rosettes is a marker of B cells in man and its percentage in peripheral blood lymphocytes is 9.3% in normal subjects on the contrary patients with CLL had a high rosette count with mouse red blood cells (mean 57%) and a low count with sheep red blood cells (mean 13.7%).


Alfa-antitrypsin increase in lung cancer. The Authors controlled the content of A1AT in the sera of 100 patients with L.Ca. As controls there were examined: 20 cases of metastatic neoplasm of the lung, 5 cases of systemic sarcomatosis, 10 cases of acute bacterial bronchopneumonia, 4 cases of bronchiectasis and emphysema. Moreover, the levels of A1AT was studied in 15 pl.fl., neoplastic and not, in comparison with the levels of the sera. None of the controls demonstrated an increase in A1AT, excepting the cases of acute bronchopneumonia, in which the levels were very high but only for a few days. The results indicate that in more than 90% of the L.Ca. the level of the A1AT is significantly higher than in the sera of the controls, with possible variations during the disease. There is a clear trend towards increase parallel with the worsening of the condition of the patients. A course of chemotherapy may bring down the levels, proportionally to the length and intensity of the treatment. After discontinuance, the level increases again more or less quickly, reaching the previous values.


[Present position of non-shunt surgery for bleeding oesophageal varices (author's transl)]. This is a critical retrospective study of a homogeneous group of 24 patients with hepatic cirrhosis and portal hypertension who underwent emergency surgery for bleeding oesophageal varices. The adopted procedure was the porta-azygos disconnection, according to Torres-Degni, with or without splenectomy. The criterion derived from the need to stop bleeding, from contraindications to a portal-systemic shunt, or from other situations which are illustrated. The difficulty of selecting in these cases the appropriate surgery and the high operative death rate (46%) is commented. In survivors, the long-term outcome depends on the progress of the underlying liver disease.


[Behavior of hemagglutination-inhibiting antibodies against measles and rubella in a group of children with chronic hepatitis]. The Authors studied the amount of anti-measles and anti-rubella heteroantibodies during chronic hepatitis and the possible role of these antibodies in eliciting and maintaining the hypergammaglobulinemic picture, characteristic of this morbid condition. The results they obtained in an almost exclusively pediatric case-list (37 cases) show, whenever the contact with these viruses (measles and rubella) occurred, a percentage of subjects with comparatively higher levels among chronic liver patients in comparison with control patients, of the same age. The percentage of subjects with previous rubella infection and hemagglutination-inhibiting antibody levels higher than 1:256 is about 45% among chronic liver patients, compared with 13% in healthy subjects. As far as measles virus is concerned the percentage drops from 11% to 4%. The most reliable hypotheses to explain this interesting phenomenon, which, however, does explain only partially, and concerning some cases only, the entity of the hypergammaglobulineamia, are set forth briefly.


[Further comments on changes in hepatic function after interposition meso-caval shunt (author's transl)]. Further to a previous paper, the Authors followed up ten cirrhotic patients who had all undergone meso-caval shunt with Dacron prosthesis, for ascites or haemorrhage, Functional and anzymatic investigations were carried on over periods up to 10 months. No constant changes in hepatic function parameters were found during the post-operative period, compared to those before surgery. This observation suggests that these investigations might be more useful in defining liver disease than in practical assessment of transient, post-operative liver failure.


[Studies on various parameters of the T-dependent lymphocyte system in the course of osteosarcoma]. Some parameters of the T-lymphocyte dependent system have been studied in 20 patients with osteosarcoma. The functional condition of T lymphocytes, stimulated with mitogens (PHA and Con-A) has been investigated by evaluating DNA neosynthesis by means of the incorporation of the tritiated thymidine in lymphocyte cultures. The percentage of rosette-forming T l-mphocytes with sheep erythrocytes has been assessed. The findings would indicate a constant inhibition of DNA biosynthesis in patients with osteosarcoma, only in correspondence of PHA stimulation. This finding would agree with E rosette pattern. In this case also neoplastic patients do show, in comparison with the controls, a constant drop of the number of T lymphocytes forming rosettes with sheep erythrocytes.


[Dissection-ligation of the oesophagus according to Vosschulte for bleeding varices (author's transl)]. Ligation of the oesophagus on a Vossschulte prosthesis provides interruption of the venous back-flow in gastro-oesophageal wall occurring in portal hypertension, and therefore renders more effective the disconnection techniques used for oesophageal varices when liver function is too severely impaired to permit a portal-systemic shunt. According the literature and their own initial experience, the Authors stresse the possibilities of the method in controlling active haemorrhage and preventing further bleeding, and discusse its possible complications, represented by portal thrombosis, fistulae and oesophageal stenosis. Unlike shunts, this procedure does not give rise to any worsening in hepatic function, but should nevertheless seriously considered especially if the oesophago-gastric junction is radically isolated.


[Recent studies concerning the effect of phytohemagglutinins (PHA) on the rosette E formation from the part of peripheral human lymphocytes]. In a previous paper it was demonstrated that the treatment of human peripheral lymphocytes with phytohaemagglutinin increases their ability to form E-rosettes, probably inducing rosette formation also by B-lymphocytes. In this paper new data are reported concerning the machanism of this phenomenon.


[Postoperative gastrointestinal hemorrhages after pulmonary resections (author's transly]. Postoperative gastrointestinal hemorrhages are a infrequent complication of pulmonary resections. Nevertheless they are threatening seriously patient's life because a critical illness as gastrointestinal hemorrhage in such casses hit patients whose vital functions are compromised from recent thoracic surgery. The pathogenetic questions, as well critical problems of diagnosis and treatment, are discussed on the basis of three observed cases.


[Effect of damage to the zone of the medial forebrain bundle and preoptic area on the activiy of a penicillin-induced epileptiform focus (phenomenon of the hyperactive determinant dispatch station)]. It was shown in experiments on cats under nembutal anesthesia that a lesion of the medial forebrain bundle (MFB) and partly of the preoptic region at the side of local penicillin application on the cerebral cortex (g. suprasylvius medius) results in depression of the epileptiform activity in the penicillin-induced focus, as well as in the secondary "mirror" focus, which appeared in the symmetrical cortex area of the other hemisphere. The MFB lesion at the "mirror" focus side led to depression of the seizure spike potentials in this focus only and did not change the activity in the primary epileptiform one. The described effects are considered from the aspect of the conception on the role of the determinant dispatch station (DDS) in the central nervous system: the primary epileptiform focus plays the role of the hyperactive DDS which induces the secondary focus and determines the character of its activity. The results of the study substantiate a suggestion that the MFB can take part in the modulation of the cortical epileptiform activity.


[NAG-infection in grass frogs (Rana temporaria) subjected to hypothermia]. Rana temporaria kept under hypothermic conditions approaching anabiosis were inoculated with NAG-vibrios and examined clinically, bacteriologically, histologically, and electron microscopically. Oral inoculation of hypothermic frogs with NAG-vibrios resulted in 18 to 24 hours in the development of acute NAG-infection resembling the cholera-like syndrome, and characterized by general intoxication and local enteropathogenic effects. NAG-vibrios persisted in the frog gastrointestinal tract for a long time after the cessation of the acute period of the disease.


[Mathematical model of the immune response]. A model of immune reaction is suggested, ahich takes into account the delay in the development of an immune response. The model depending on parameters values describes: an asymptotic decrease of antigene quantity, approach of its quantity towards constant value, periodic course of the illness, unlimited growth of the antigene quantity. It is shown that the course of the reaction essentially depends on the duration of delay. Parameters regions corresponding to different regimes are determined.


[Phenomenon of human peripheral blood lymphocyte interaction with autologous erythrocytes]. Phenomenon of the lymphocyte interaction with autologous erythrocytes was revealed in the patients with auto-immune diseases. Macroscopically this phenomenon appeared in the form of hemagglutination, and microscopically--of "rosette" formation. No lymphocyte interaction with autologous erythrocytes was found in the group of normal subjects and patients without autoimmune disorders.


[Functional activity of splenic T- and B-cells during the process of tumor growth]. Functional activity of B- and T-cells was studied in mice during the growth of the inoculated tumours; it appeared that in the course of the tumour growth the capacity of B- and T-cells to the interaction in the immunization with sheep erythrocytes was disturbed. B-cells were affected earlier than T-cells.


[Histochemical studies of the sensitivity of frog retinal cells to stimulus movement and flashes]. The technique of quantitative UV-cytophotometry of RNA was used for comparative study of the sensitivity of frog retina cells to the movement of stimuli and flashings. A corresponding set of stimulators which includes the movement of mounted stimuli and heterogenous flashings of diffuse light showed that a type of cells exists in the interior nuclear layer of the retina which is specifically sensitive to the movement. It is suggested that in the formation of this property a dynamic reciprocal lateral inhibition on the level between bipolar and amacrine cells takes place. Application of heterogenous flashing light allowed also to reveal functional variety of bipolar cells.


Progress in standardization: 4 immunological reagents. The need for material standards in the field of clinical immunology, together with the mode of operation of the combined World Health Organization/International Union of Immunological Societies programme for the provision of such standards, are discussed. Attention is drawn to the importance of the use of International Units in reporting concentrations of complex constituents, e.g., immunoglobulins in body fluids, and to the availability of standard materials against which such components can be calibrated. The necessity for the standardization of nomenclature is also emphasized.


Prolonged medial forebrain bundle unit responses to rewarding and aversive intracranial stimuli. In unanesthetized cerveau isolé rats, brief medial forebrain bundle (MFB) and dorsal midbrain reticular (RET) stimulus trains elicited prolonged MFB unit responses lasting up to ten or more seconds. On the MFB unit responses studied, the effects of MFB and RET stimuli were basically similar, although the stimulations were probably rewarding and aversive respectively. These data agree with the previously reported anatomical localization, in medial regions of thalamus and pallidum, of opposite single cell responses to the behaviorally opposite inputs, and suggest that unit responses to rewarding stimuli should not be characterized as reward-related when aversive stimuli elicit similar responses in the same unit.


Infant rats: hypothalamic unit activity. Single-unit recordings were made from lateral hypothalamic area (LHA) neurons of infant (8 through 21 days of age) male and female albino rats. Basal (or spontaneous) firing rates of LHA neurons were recorded for 20 min from rats 8 through 21 days of age, and mean basal firing rates did not differ across ages. Basal firing rates of LHA neurons in infant rats ranged from less than 1 spike/sec up to 27 spikes/sec, with 56% of the basal rates less than 1 spike/sec. Infant rats also received hypertonic saline injections (and control injections) to determine osmosensitivity characteristics of LHA neurons. Across ages, 56%--88% of LHA neurons were osmosensitive, with the highest percentages of osmosensitive units found in rats 14--21 days of age. Infant rats showed LHA unit electrophysiological characteristics that were quite similar to those obtained from LHA neurons in adult rats with respect to basal firing rates and osmosensitivity, however, LHA neuron activity in infants was not modulated by sensory stimuli as is frequently reported for adults. The results are discussed in terms of functional development of the LHA.


Observations on the swarming and mating behavior of Anopheles culicifacies Giles in nature. The mating and swarming behaviour of A. culicifacies Giles was investigated during December 1975 at a cattle shed near the village of Sattoki, Lahore District, Punjab, Pakistan. On average, swarming commenced 20.9 min before sunset (light intensity 1414.4 lx) and ended 21.0 min after sunset (5.4 lx) with pairing restricted to the period from 6.1 min before (467.2 lx) to 15.8 min after sunset (26.9 lx). The swarms were principally composed of males, with females entering only for mating. On average, copulation lasted 27.2 s and was completed in flight. Most females (71.8%) collected while mating had taken a partial blood meal either the previous evening or on the same evening as mating. All females in the swarms were nulliparous and 82.6% had ovaries developed to at least Christophers' stage IIa.


Field studies of a rapid, accurate means of quantifying Schistosoma haematobium eggs in urine samples. A new means of quantifying schistosome eggs has been adapted from the laboratory to the field. Urine from 510 individuals in areas of Kenya with a high prevalence of schistosomiasis haematobia was injected in aliquots of 10, 5 and 1 ml on to transparent Nuclepore filters, 13 mm in diameter. The filters were placed face down on glass slides and were read without staining at x40 magnification. The method has been shown to be accurate, sensitive, and reproducible, and also extremely rapid.


Effect of sulfadoxine on transmission of Vibrio cholerae infection among family contacts of cholera patients in Calcutta. Sulfadoxine, a long-acting sulfonamide, and tetracycline were compared as regards their effectiveness in reducing transmission of cholera infection among the contacts of cholera patients in Calcutta. A total of 109 healthy family contacts of confirmed hospitalized cholera patients were treated with a single oral dose of sulfadoxine graded according to age. Another similar group of 101 contacts received 6 divided doses of oral tetracycline over a period of 3 days. All these contacts were bacteriologically examined for 15 days. Results showed that tetracycline was effective in significantly reducing the load of cholera infection from the 2nd to 6th day, while sulfadoxine was effective from the 3rd to the 6th day. The advantages and disadvantages of the two drugs as chemoprophylactic agents in cholera are discussed.


Doxycycline in the treatment of cholera. Doxycycline was compared with tetracycline in the treatment of cholera. Four types of treatment were compared: Group A was given 200 mg of doxycycline on admission and 100 mg on the second day; Group B was given 200 mg of doxycycline on admission only; Group C was given 300 mg of doxycycline on admission only; and Group D received 500 mg of tetracycline every 6 h for 48 h. Tetracycline showed a slight advantage in respect of duration of diarrhoea and vibrio excretion compared with doxycycline given as a single dose of 300 mg, but fluid intake and output were about the same in these two groups. The other two doxycycline treatment schedules did not compare well with tetracycline treatment.


Global surveillance of antibiotic sensitivity of Vibrio cholerae. Strains of Vibrio cholerae-1156 from various parts of the world-were examined by standardized antibiotic sensitivity tests in one centre, to determine the global incidence of antibiotic resistance in this organism and to assess the extent to which differences in methods of sensitivity testing might be responsible for discrepancies in the reported incidence of resistant strains. Of the strains examined, 1127 were fully sensitive to ampicillin, chloramphenicol, tetracycline, furazolidone, and three different sulphonamides, 27 showed stable and reproducible resistance to one or more of these agents, and 2 proved to contain a minority of cells with unstable, presumably plasmid-borne, resistance to chloram-phenicol. Unstable resistance to antibiotics may be common in V. cholerae but rarely recognized, and may account for some of the discrepancies in the reported incidence of resistant strains.


Value of phage typing of Vibrio cholerae biotype eltor in West Africa. The epidemiological value of phage typing of El Tor vibrios in West Africa was assessed by testing 211 representative strains from all outbreaks of the cholera epidemic in Togo (1970-73) with the prophage typing method of Nicolle et al. and the lytic El Tor phages of Basu & Mukerjee. Prophage typing proved to be of limited epidemiological value in Togo since 203 of the 211 strains tested belonged to the same phage type-namely, type 2 of Nicolle et al., which corresponds to the Celebes type of Takeya. Six strains belonged to type 1, 1 strain to type 4, and 1 strain was untypable.Tested by the lytic El Tor phages, 175 strains were found to belong to type 4 of Basu & Mukerjee, 35 strains to type 1, and 1 strain was untypable. All but two strains of type 1 were isolated from 3 outbreaks in which this phage type was found almost exclusively. The results are in good agreement with epidemiological data collected during the epidemic. El Tor phage V reacted with a specificity of over 99% when tested against 601 strains of El Tor and NCV vibrios from Togo and may be recommended for the rapid identification of El Tor vibrios.


Type B and non-B viral hepatitis in Jerusalem. In a two-year survey of adult patients hospitalized with acute viral hepatitis in Jerusalem, 27% were reactive for the hepatitis B surface antigen (HB(s)Ag) by radioimmunoassay and therefore diagnosed as having hepatitis B. The majority of patients (73%) were non-reactive for HB(s)Ag and their diagnosis was non-B hepatitis ("type unspecifiable"). Thirty-one per cent of patients with hepatitis B and only 5% of patients with non-B hepatitis had histories consistent with parenteral transmission of hepatitis by blood transfusion or drug use. An additional 19% of the patients with hepatitis B had possible parenteral exposure and 50% had no obvious parenteral exposure, indicating that non-parenteral transmission of the hepatitis B virus (HBV) may be a significant epidemiological factor (50-69%) in the Jerusalem area. The prominent role of non-parenteral transmission of HBV is further evidenced by the relatively high prevalences of HB(s)Ag (0.97%) and antibody to hepatitis B surface antigen (anti-HB(s)) (19.0%) in healthy blood donors. These findings are consistent with the view that personal contact and intra-familial spread may be important factors in the epidemiology of HBV and indicate that non-parenterally transmitted HBV contributes significantly to endemic viral hepatitis in the Jerusalem area.


Rough determination of the cost-benefit balance point of sanitation programmes. Resources for sanitation programmes in developing countries are limited and therefore must be used judiciously to obtain the best possible effect. Cost-benefit analysis is a tool that permits the better utilization of available resources. A simple method for rough determination of the cost-benefit balance point has been devised which requires little computation. To reduce the computations to a minimum, nomograms have been constructed which require little or no mathematical skill for their use. While the method falls short of perfection, its simplicity makes it useful for a rough evaluation of the benefits from sanitation programmes aimed at disease control in countries whose resources are not available for more sophisticated analysis.


Exposure to pesticides in agriculture: a survey of spraymen using dimethoate in the Sudan. There is a need for objective data on the exposure of spraymen to pesticides in agriculture in order to assess minimum requirements for practicable protection in tropical areas. To provide data, a survey was carried out in the Sudan on spraymen using dimethoate. No cholinesterase depressions were found and the calculated dose received by each man per day was within safe limits in the circumstances of this survey. Respiratory exposure was only a minor part of total exposure. The methodology of such surveys is discussed and the need for the use of a standard protocol is emphasized.


Validating a method of psychiatric case identification in Jamaica. There is an urgent need for simple, reliable instruments for psychiatric research in developing countries. Limited resources, however, make the development of instruments de novo difficult. A simple method for establishing the validity of a method of case identification in a new population is described. A shortened version of a standard general health questionnaire was shown to be an effective method of identifying non-psychotic disorders in Jamaica, subject to a recalibration.


A comparison of serological tests for detecting antibody to plague. A study was undertaken of the relationship between the passive haemagglutination and haemagglutination inhibition tests used in serum surveys for specific plague antibodies. Both techniques gave similar titres for sera of albino Rattus norvegicus convalescent from plague infection. They appear to be equally suitable for plague surveillance and control programmes.


Chlamydiae as agents of sexually transmitted diseases. Chlamydiae are being increasingly recognized as an important cause of human disease. The known geographical distribution of lymphogranuloma venereum and the role of chlamydiae as agents of sexually transmitted diseases are reviewed. The presence of chlamydiae in the urethra and the cervix, and their etiological relationship to genital infections, first recognized in connexion with ocular infections, have been proved in a number of studies in selected populations in a few countries. Chlamydiae appear to be the most important agent of nongonococcal urethritis, which in some cases appears now to be more frequent than gonococcal urethritis. In addition to their association with cervicitis, chlamydiae appear also to be fairly frequent in the cervix of apparently normal, asymptomatic, and sexually active women. The role of chlamydiae as agents of other human diseases still requires to be clarified. The organisms have been found in association with pelvic inflammatory disease, neonatal pneumonia, pharyngitis, and otitis. There is need for additional studies in view of the fact that effective chemotherapy is available. An outline is given of laboratory methods that may be useful for the diagnosis of chlamydial infections.


Large-scale use of freeze-dried smallpox vaccine prepared in primary cultures of rabbit kidney cells. A lyophilized smallpox vaccine made from infected monolayer cultures of primary rabbit kidney cells was used together with a calf lymph vaccine in a field trial in Lombok, Indonesia, in 1973. About 60 000 children below 15 years of age were vaccinated: some 50 000 with the tissue culture vaccine and about 10 000 with calf lymph vaccine. Similar results were obtained with both vaccines in primary vaccinees and in revaccinees as regards the take rate, pock reactions, and serious secondary reactions.


Preliminary parasitological results of a pilot mollusciciding campaign to control transmission of Schistosoma mansoni in St Lucia. A mollusciciding campaign was begun in Cul-de-Sac Valley, St Lucia, at the end of 1970, following several years of epidemiological studies in which transmission of Schistosoma mansoni was found to be high in settlements on the valley floor but low in hillside settlements. Postcontrol (1971-73) findings in children, when compared with precontrol data and with data from an adjacent valley having a similar transmission pattern, show significant reductions in prevalence, incidence, and intensity of infection.


Medical management of mycetoma.

Medical management of mycetoma. A number of drugs and drug combinations were tested both in vitro and in vivo against pathogens causing actinomycetoma and maduromycetoma. Of 144 patients with actinomycetoma treated, 63.2% were cured, 21.5% showed great improvement in their condition, and 11.1% showed some improvement. Treatment was successful even when there was advanced bone involvement. The most effective treatments involved dapsone plus streptomycin sulfate or sulfamethoxazole-trimethoprim plus streptomycin. Sulfadoxine-pyrimethamine plus streptomycin or rifampicin plus streptomycin also gave good results. Griseofulvin plus penicillin showed some promise in the management of maduromycetoma caused by Madurella mycetomi but at the present time this should be used only as an adjunct to surgery. All mycetoma patients undergoing drug therapy should be carefully monitored and treatment should be temporarily suspended if anaemia or leucopenia develop.


Nutritional status of children in Nepal, 1975. Using a random start, fixed interval method of population proportionate sampling, the survey teams visited 219 villages in rural Nepal and collected data on height, weight, and age from 6501 preschool children. During training and at specific times during the survey, systematic standardization methods were utilized to improve the quality of the collected data. Using 80% of the reference median weight-for-height as the cut-off point, the prevalence of acute undernutrition was 6.7%. Using 90% of the reference median height-for-age as the cut-off point, the prevalence of chronic undernutrition was 52%. The prevalence of chronic undernutrition was significantly higher in the hilly areas. Mean haemoglobin values of blood samples collected from one-fifth of the survey population increased with age with no difference between hill and terai areas. A Nepal urban elite population was measured for comparison. The survey method used indicators that are economical in terms of money, time, and personnel and that provide objective data on the extent and distribution of protein/energy undernutrition and of low haemoglobin values in preschool children.


Residues of DDT and its metabolites in human blood samples in Delhi, India. Blood samples from 182 people in Delhi, India, were examined for DDT residues. All except 8 contained DDT and its metabolites. The average total DDT concentration in the whole blood ranged from 0.177 to 0.683 mg/litre in males and from 0.166 to 0.329 mg/litre in females. The DDT metabolites detected were p,p'-DDE, p,p'-DDD, and o,p'-DDT. DDE accounted for most of the total DDT.


Resistance of Salmonella serotypes to chloramphenicol. A total of 704 Salmonella strains isolated from various sources were tested for their resistance to chloramphenicol. The results indicate that 36 out of 46 serotypes, comprising 671 strains (95.4%), were sensitive to chloramphenicol up to a level of 10 mug per ml of medium. Most of the strains were sensitive at concentrations between 2 mug and 4 mug of chloramphenicol per ml of medium. None of the strains isolated from animals, including poultry, was resistant. The results indicate that in India resistance of Salmonella strains to chloramphenicol has not increased over the years though this may have occurred in other parts of the world.


Periaortic denervation in reconstructive surgery of coronary vessels. Stimulation of sympathetic nervous conductive pathways and ganglia innervating the heart leads to a sudden increase in the cardiac performance and to a qualitative change in the phasic blood flow within the coronary vascular bed. This so-called malignant increase in the blood flow is accompanied by relative coronary insufficiency and increased mechanical stress imposed upon the coronary arteries. A denervation operation according to Arnulf does not prevent the propagation of excitation from the right stellate ganglion to the heart. A complete denervation is obtained by additional cutting of the right-side postganglional fibres. Then in a dog no changes occur in the coronary arterial blood flow measured at rest during the operation. In reconstructive surgery of coronary vessels in man, after denervation the peroperative blood flow in the aortocoronary bypass to the anterior interventicular branch increases. After a surgical denervation operation, the prevention of propagation of sudden neurogenic stimuli via the cervical sympathetic segment to the heart ventricles is the most striking result. Such a "protection" of the heart might retard the development rate of coronary insufficiency accompanying the ischaemic heart disease.


Primary mediastinal choriocarcinoma in a man. Choriocarcinoma with a primary site in the chest is rarely found. Characteristically, it is seen in young men presenting with cough, gynecomastia and chest pain. The disease is invariably fatal. The presently accepted therapy (triple therapy), consisting of methotrexate, actinomycin D and chlorambucil, has been unsuccessful to date.


Ischemic myocardial injury following aorto-coronary bypass surgery. To assess the incidence of acute myocardial injury following aorto-coronary bypass surgery 151 patients (136 men and 15 women) were evaluated by studying serial preoperative and postoperative ECGs and SGOT, LDH and CPK levels. The mean age of men was 49.1 and of women, 53.1 years. Following surgery 15 patients (group I, 9.9 percent) developed new myocardial infarction as judged by Q wave criteria, 33 patients (group II, 22.5 percent) developed significant ST-T changes, and 103 patients (group III, 68 percent) had no significant ECG change. Mean postoperative SGOT values were: group I,126.2; group II, 100.6; and group III, 72.8. Only the difference in SGOT values between group I and III was significant (P less than 0.01). There was no correlation between type and site of surgery and the incidence of myocardial infarction. There were five deaths (3.3 percent). The combination of death and diagnosed myocardial infarction amounted to 12.6 percent of patients for this widely used elective procedure.


Effect of hypothalamic surgery on prolactin release induced by 5-hydroxytryptophan (5-HTP) in rats. Intravenous injections of varying doses of 5-HTP (1, 3 and 5 mg/100 g body wt), a precursor of serotonin, caused a significant and dose-related increase in plasma prolactin concentrations in urethane-anesthetized rats. Increases in plasma prolactin concentrations caused by 5-HTP (1 mg/100 g body wt iv) were abolished by the concomitant administration of L-DOPA (2 mg/100 g body wt iv). Plasma prolactin levels were also significantly elevated following the injection of 5-HTP in rats with complete hypothalamic deafferentation, whereas 5-HTP had no significant effect on plasma prolactin levels in rats with extensive hypothalamic ablation. These results suggest that 5-HTP causes prolactin secretion by stimulating the serotoninergic mechanism in the hypothalamus.


Destruction of afferent nerve terminals in the inner ear of frog by aminooxyactic acid. The drug aminooxyacetic acid, which inhibits GABA-transaminase, destroys the afferent nerve ending in the inner ear of the frog. The efferent nerve endings and the sensory cells are not affected.


Dissociation between cytotoxic activity and delayed hypersensitivity against syngeneic or allogeneic tumor grafts. Cytotoxicity against tumor-specific antigen and allogeneic antigens in mice was raised by immunization with viable tumor cells in saline, but not by immunization with tumor cells in complete or incomplete Freund's adjuvant. On the other hand, strong delayed hypersensitivity as demonstrated by macrophage migration inhibition was detected in the mice immunized with tumor cells in complete or incomplete Freund's adjuvant in both syngeneic and allogeneic systems. After immunization with viable tumor cells, delayed hypersensitivity was raised to a moderate degree in allogeneic, but not at all in syngeneic mice. Cytotoxicity was retained after a booster with syngeneic tumor cells in complete Freund's adjuvant in the mice which had been immunized with viable tumor cells. Cytotoxicity was raised after a booster with viable syngeneic tumor cells in the mice which had been immunized with tumor cells in complete or incomplete Freund's adjuvant. Thus, the development of cytotoxicity depended entirely on the presence of viable tumor cells as an immunogen. Activation of helper T cells was not found in the syngeneic mice immunized with viable tumor cells or tumor cells in complete or incomplete Freund's adjuvant. In allogeneic mice, the activity was facilitated slightly by immunization with viable tumor cells or tumor cells in complete Fruend's adjuvant but not with tumor cells in incomplete Freund's adjuvant. This sytem may be useful for analytical studies on cellular immunity, since cytotoxicity, delayed hypersensitivity, and helper cell activation can be induced in dissociated forms.


[Position and bony structures of the vestibular apparatus in the guinea pig]. The study of the inner ear of the guinea pig intended to give an explanation to what extent there are differences discernible in relation to the human labyrinth. Additional histological research should clarify the question, if structural differences exist in the osseous labyrinth capsule of the same animal. It has turned out that in normal headbearing the position of the semicircular canals deviates from the human vestibular apparatus. The semicircular canals are nearly vertical to each other, but in comparison to the human labyrinth they are shifted around the longitudinal axis of the utriculus caudal by ca. 30 degrees. In general the position of the vestibulo-cochlear organ is fixed to a great extent by the inclined course of the petrosal pyramid. This different position of the semicircular canals in man and animal is supposed to be due to the phylogenetic evolution and the adjustment to upright walk. Size and extension of the single semicircular canals are very different within the same animal. These differences in size indicate causalities of form and function. The relations in the build of the osseous labyrinth are extremely complicated. Compared to the other corporal regions the static parts of the petrosal pyramid are exceptional massive and of remarkable hard consistency. In the inner capsule of the ear there are three different bone strata to be seen. The characteristic lamel structure is most solid nearest to the semicircular canals. The fetal characteristics in the maturing process of the petrosal bone were traced a long while in the postnatal life. The typical building of the labyrinthal bone structures contributes to the mechanical stability of the capsule.


[Studies of gamma-oryzanol. (2) The antiulcerogenic action]. Investigations were performed in male Wistar rats to determine the effects of gamma-oryzanol on circadian rhythm of stress ulcer and on various kinds of experimental ulcers, and the modification of antiulcerogenic action of this drug when combined with the inhibitors or precursors of amine metabolism. Circadian rhythms were observed in stress ulceration with a peak at 2 : 00 p.m. and a reduction at 8 : 00 p.m. The inhibitory action of gamma-oryzanol was significant when stress was loaded for 6 hr from 2 : 00 a.m., 5 : 00 a.m., 11 : 00 a.m. or 2:00 p.m. An 8-day treatment with gamma-oryzanol, 100 mg/kg, s.c., showed a significant inhibition of fasting ulcer, while the 5-day pretreatment exerted slight effects on ulcers by pylorus-ligation or stress-atropine. A 10-day treatment with the same dose of gamma-oyzanol in acetic acid ulcers lowered the serum level of gastrin. Treatment with reserpine, alpha-MT or PCPA prior to stress loading abolished the anti-ulcer effect of gamma-oryzanol, 100 mg/kg, s.c. for 5 days in stress ulcer. Treatment with L-DOPA or 5-HTP revealed a tendency toward restoration of the anti-ulcer effect of gamma-oryzanol. It is suggested that the monoaminergic neuron system is involved in the anti-ulcer action of gamma-oryzanol.


Measurement of 5-hydroxyindole compounds during L-5-HTP treatment in depressed patients. L-5-hydroxytryptophan (L-5-HTP), and immediate serotonin precursor, was given to the hospitalized depressed patients in an open clinical trial of the Phase 2 study for antidepressive effects of the agent. A relatively small dose, 150 mg orally for seven days, was employed, and seven of 14 patients responded to the treatment with mild or moderate amelioration of their depressive symptoms. Urinary excretion levels and plasma concentrations of three 5-hydroxyindole compounds, 5-HTP, 5-HT and 5-HIAA, were measured during the drug treatment. Approximately 70% of the orally administered dose of L-5-HTP was recovered from the urine of depressed patients. Major part of urinary indoleamine metabolites was free and conjugate 5-HIAA. Excretion levels of these compounds in urine were not consistently altered in the depressed patients as compared to those in normal subjects. Clinical response to L-5-HTP treatment  appeared to have some correlation with the biochemical measures in the depressed patients, that is, non-responders exhibited significantly lower excretion levels of 5-HT and 5-HIAA in urine, and lower plasma levels of 5-HT than responders. Administered L-5-HTP may not be fully utilized in the depressed patients who did not react to the agent.


Optimal strategies in immunology. I. B-cell differentiation and proliferation. The optimal strategy available to the immune system for responding to a non-replicating thymus-independent antigen is examined. By applying Pontryagin's maximum principle to a set of mathematical models of lymphocyte populations and their antibody production, it is found that the optimal strategy of bang-bang control appears robust. In a variety of structurely related biological models, similar behaviour is observed. The models that we consider assume that antigen triggers a population of B-lymphocytes. These triggered lymphocytes can either proliferate and secrete modest amounts of antibody or differentiate into nondividing plasma cells which secrete large amounts of antibody. For biologically reasonable parameter values it is found that for low doses of antigen, immediate differentiation into plasma cells is optimal, while for high antigen doses a proliferative state followed by differentiation is the best strategy.


[Concordant deuteranomaly in monozygotic twin sisters (author's transl)]. Colorblind twin sisters were born from the marriage of a hemizygote with a carrier for colorblindness. The proof of monozygosity is given by the blood-group typing and the dermatoglyphs. The deuteranomaly is of the same degree in each but is more marked in one of the sisters. The mother has none of the microsymptoms sometimes found in carriers.


The frequency of 7S rheumatoid factors and 22S complexes in human sera with positive latex tests for rheumatoid factor. In sera with positive latex tests for rheumatoid factors, the immunoglobulin class of the antiglobulins is influenced by the quantity of immunoglobulins present in the serum. Sera with 7S antiglobulins have high levels of IgG and IgA immunoglobulins.  22S complexes tend to be found in sera with high levels of IgM immunoglobulins. These findings suggest that the occurrence of antiglobulins and 22S complexes may be influenced by the hypergammaglobulinemia.


Restoration of diminished T-cell function in adjuvant induced disease by methotrexate: evidence for two populations of splenic T-cell suppressors. Diminished splenic T-cell function, as measured by their response to phytohemagglutinin and Concanavalin-A, was noted only during the active phase of adjuvant induced disease. This diminished function is due to at least two types of suppressor cell: (a) cells which adhere to glass but not plastic, and which are sensitive to methotrexate in vitro; (b) cells which adhere to plastic and glass, and which are relatively insensitive to methotrexate in vitro. Methotrexate treatment in vivo inhibits adjuvant induced disease, and is associated with the absence of both types of suppressor cells in the spleen.


Lymphopenia in Sjögren's syndrome with rheumatoid arthritis: relationship to lymphocytotoxic antibodies, cryoglobulinemia, and impaired mitogen responsiveness. Lymphocyte subpopulation studies in 21 patients with Sjögren's syndrome and rheumatoid arthritis revealed an absolute lymphopenia and a normal percentage of T- and SIg-cells. In one patient, a large percentage of lymphocytes bore both IgG and IgM; after cell trypsinization only IgM was resynthesized. This surface IgM was capable of binding human IgG, suggesting that the presence of multiple classes of immunoglobulins on the surface of these lymphocytes was due to surface rheumatoid factor activity. Profound lymphopenia was associated with high concentrations of cryoglobulins and the presence of lymphocytotoxic antibodies. These antibodies were broadly reactive, causing cytotoxicity of T- and SIg-cells from normal subjects, from viral and lymphoproliferative disease subjects, from different organs, and SIg-cells from human lymphoblastoid cell lines. Lymphocyte transformation after phytohemagglutinin and pokeweed mitogen stimulation was impaired in comparison to normal subjects. Warm washing of the lymphocytes and purification to greater than 80 per cent T-cells did not restore mitogen responsiveness to normal, suggesting that cell coating by an antibody and diminished responder cell number were inadequate explanations for the impaired transformation.


Therapeutic trials with levamisole and other agents in NZB/W mice. The effects of levamisole, ribovirin, and cyclophosphamide in preventing the spontaneous autoimmune disease of NZB/W mice have been evaluated. These drugs all had a significant effect, both in delaying mortality, and in postponing the development of antinuclear antibodies and proteinuria. Single-stranded DNA linked to IgG was also used but had no demonstrable effect. The results of therapeutic studies in murine lupus must be interpreted with caution in relation to the human disease, but as both levamisole and ribovirin are now being used in man, our results suggest that further studies with these drugs are warranted.


Effects of metabolic inhibitors and ouabain on static afferent discharges from the isolated frog muscle spindle. Effects of metabolic inhibitors and ouabain on the rate of afferent discharges from isolated muscle spindle of the bullfrog were examined in vitro to elucidate the mechanism for generating afferent action potentials. Dinitrophenol, NaCN, iodoacetic acid, and ouabain gradually reduced the rate of discharges. These drugs were without direct effect on the nerve axon. The rate of discharges was also reduced by Li+, which is known to be minimally extruded from the interior of cells by an active transport mechanism. The rate of discharges remained approximately 50% in the presence of NaCN or in the absence of oxygen, suggesting that the energy required for the maintenance of the Na+-pump can be supplied to some extent in an anaerobic condition. It appears that the metabolic inhibitors and ouabain reduce the afferent discharges from the frog muscle spindle by affecting the Na+-pump in fibers of nerve terminals.


Significance of T and B lymphocytes in different chronic internal diseases with immune processes. The T and B lymphocytes were determined by the rosette test in the peripheral blood of 100 patients with internal chronic diseases with immune processes such as: chronic hepatitis, systemic lupus erythematosus, myasthenia gravis, chronic lymphocytic leukemia and lymphosarcoma. The values obtained were compared with those in 10 controls. The mean per cent values of the T lymphocytes in the controls were 33 (29-38%) and of the B lymphocytes 25.2 (16-43%). In the patients investigated the values varied, namely: in chronic hepatitis and systemic lupus erythematosus the T lymphocytes were generally low while the B lymphocytes were moderately high. In myasthenia gravis both T and B lymphocytes were below the control values. In chronic lymphocytic leukemias and lymphosarcomas the per cent values of the T lymphocytes were generally low while those of the B lymphocytes were high. The significance of these results for the immunologic implications of the lymphocyte populations is discussed and an attempt is made to correlate these data with the nucleologram variations.


[Effect of sensory and sympathetic denervation of the frog tongue on the catecholamine containing cells of the taste buds]. The structure of catecholamine-containing dumb-bell shaped cells of the taste buds was studied by luminescent microscopy in the epithelial layer of the frog's tongue (Rana temporaria). On the unilateral section of the lingual nerve, a maintained adrenergic innervation of vessels and of the epithelium was observed, a decreased number of dumb-bell shaped cells in the taste bud, and their significant enlargement, and increased cathecholamine luminescence. With desympathization, no adrenergic nerves were observed on the vessels and the epithelium of the tongue. The size of the taste buds in desympathized cells of the tongue is sharply decreased and their number is increased. There is a tendency to grouping of the dumbbell shaped cells into 3--4 taste buds in one fungiform papillina. The experiments with sensory and sympathetic denervation of the frog tongue distinctly showed the trophic action of sensory and sympathetic nerves on the taste organ of the frog.


[Mechanisms of action of synthetic polyelectrolytes and polyampholytes on the immune response]. We investigated the effect of polyacrilic acid (PAA) on the immune response in mice of various strains on sheep red blood cells and also the influence of poly-2-methyl-5-vinyl-pyridine (PMVY), PAA and their statistical copolymers on antibody-forming cells (AFC) production in cultures of T- and B-lymphocytes in vivo. PAA was seen to increase accumulation of AFC in the spleen of mice depending on their genotypes. PMVP and PAA were found to intensify the cooperating interaction of T- and B-lymphocytes, whereas their copolymers exert quite an opposite effect. The injection of copolymers to the recipients of cooperating T- and B-lymphocytes practically results in the complete elimination of the cooperation effect between T- and B-lymphocytes in the immune response to sheep erythrocytes without cytostatic action of cell proliferation.


Myasthenia gravis: mitotic activity of thymus-dependent and blood-lymphocytes. The thymus and blood lymphocytes of 20 thymectomized patients with myasthenia gravis, including 3 cases of thymoma, have been studied for mitotic activity (spontaneous mitotic activity of native thymocytes, responsiveness of cultured cells to PHA, DNA-polymerase specific activity). The myasthenic thymus gland was found to be the site of a spontaneous DNA-synthesis of similar intensity as the mitotic activity of the thymus in infancy. This was also reflected by the DNA-polymerase activity of the cells. While the thymocyte cultures responded well to PHA stimulation in 50% of the cases, the blood-lymphocytes were found unresponsive. There was a partial correlation between the individual parameters of mitotic activity, but practically none between the mitotic activity and the clinical severity of myasthenia or the histological features of the thymus or of thymoma. Except in the latter cases, a correlation was found between mitotic activity and preoperative immunosuppressive treatment. It is suggested that the T-lymphocytes are not directly involved in the pathomechanism of myasthenia gravis.


Cellular immune reactivity to nuclear antigens in systemic lupus erythematosus. The leucocyte migration test (LMT) was used for the study of cellular responsiveness to nuclear factors, i. e. to calf thymus desoxyribonucleic acid (DNA), calf thymus desoxyribonucleoprotein (DNP), calf liver ribonucleic acid (RNA), in 20 subjects with SLE and in 20 non-immunopathological cases serving as controls. The nucleic acid preparations were found to produce a positive LMT in the SLE-patients as well as in the controls. The proportion of positive responses reached its highest percentage in the cases of active SLE. Two cases were followed up by repeated LMT in the course of immunosuppressive treatment with cytostatics and/or antilymphocyte globulin (ALG) administration indicated by the activity of the process. The LMT proved suitable for assessing the intensity of immunosuppression by cytostatics or by ALG. A critical evaluation of the procedure is given. It is pointed out that inhibition and stimulation of migration are likewise manifestations of cellular immune responsiveness. Both inhibition and stimulation are more marked if serum-free nutrient is used.


Functional significance of the ventral and lateral funiculi in the frog's spinal cord. The spinal cord was transected at the level of calamus scriptorius either completely (spinal preparation) or partially (funicular preparation). In the operated frogs and in normal controls cranial and peripheral receptive fields were stimulated by natural stimuli. Results indicated that the information necessary for somatic activation of the protective flight ascends in the dorsolateral funiculus, which can be characterized as an ascending part of the reflex arc of somatotopically guided avoidance behavior. The tectal region is apparently a center of responses. The information necessary for activating different patterns of locomotion adequate to environmental conditions goes unilaterally through the ventral and ventrolateral funiculus. A diminished specificity of these motor patterns observed after injury of the ventrolateral funiculus seems to be related to a reduced feedback from the periphery. Lacking of aquatic pattern of limb movements (even when terrestrial patterns of locomotion were undisturbed), and drowning in water seem to be related to an injury of a vestibulo-spinal system in the ventral funiculus. It is concluded that the ventrolateral area of the frog spinal cord, i.e., the area between median fissure and dorsal root, forms a closed system providing afferent and efferent information sufficient to evoke normal behavior.


Approaches to selectivity in cancer chemotherapy. Most chemotherapeutic agents utilized in the treatment of cancer have toxic effects, not only on tumor cells but also on the normal replicating cells of the body. Some of these toxic effects on the normal tissues by the drug may be diminished, or more promising is the utilization of more selective drugs based on differences between the normal and the neoplastic cell.


[The genetics of the protease inhibitor system and osteospongiosis. Statistical study in 199 patients]. Since the trypsin activity of the inner ear fluid appears to be essential in the evolution of otosclerosis towards a cochlear deafness it was obvious that the protease inhibitor system which is an excellent genetic marker ought to be studied during the onset and the evolution of otosclerosis. No differences with the statistical data from the normal population was found the origin of the trypsin that destroys the inner ear is to be found locally the histiocytes of the otosclerosis focus.


[Characteristics of epidemiology and pathomorphosis of tuberculosis at the present-day stage]. The article deals with data confirming changes in epidemiology of tuberculosis and its pathomorphism during the last years. A considerable decrease in the incidence rate among children, adolescents, young people is noted. Prevalence of tuberculosis and death rate have also dropped. Primary tuberculosis in children most often takes a form of minor bronchoadenitis, and in adults -- a form of a pulmonary process. As a result of natural and induced pathomorphism pulmonary tuberculosis in adults, particulary in old age, is accompanied by secondary nonspecific changes in various organs, which with years become more important in thanatogenesis.


The use of 5-hydroxytryptophan in a child with Lesch-Nyhan syndrome. The effects of 5-hydroxytryptophan (5-HTP), a serotonin precursor, were studied in a boy with the Lesch-Nyhan syndrome. During the course of drug treatment, self-mutilation, crying, sleep state architecture, serum dopamine B-hydroxylase (DBH), and cerebrospinal fluid levels of 5-hydroxyindolylacetic acid and homovanillic acid were studied. Treatment with 5-HTP failed to affect this child's biting behavior. However, the drug significantly reduced irritability as measured by crying time. Moreover, 5-HTP may have affected sleep state architecture, making it more normal in character. Serum DBH levels were normal throughout the study. Neither the patient's mother nor his maternal grandmother showed a hypertensive response on the cold pressor test.


[Pharmacologic activity of pyrimidoindole derivatives]. The spectrum of the psychotropic activity of a number of new pyrimidoindole derivatives and the relation between their chemical structure and activity were studied experimentally. The research was done on mice by employing tests usually applied in estimating neuroleptics and antidepressants of tricyclic structure. The study of indole derivatives are shown to display a sedative action. 5-methyl derivatives of pyrimido- and tetrahydropyrimido [3,4-a] indole without any substituent in the 2nd position are 5-oxytryptophan antagonists. The 2,5-dimethyltetrahydropyrimido [3,4-a] indole derivatives electively potentiate the central effect of 5-oxytryptophan and display in experiments a specific spectrum of the pharmacological action, resembling antidepressants by a number of tests. As concerns their activity these compounds, however, are inferior to amitriptyline and pyrasidol.


Handling of induced hypercalcaemia in children with rheumatic and rheumatoid affections. Induced hypercalcemia in rheumatic and rheumatoid children revealed the following : 1. Rheumatic and rheumatoid patients deal more effectively with induced hypercalcemia than control children. 2. A higher percentage of infused calcium in these patients is retained. This may by due to higher calcitionin activity relative to controls. 3. Induced hypercalcemia resulted in an increase in urinary 17 OH C.S. This is suggested to be due to stimulation of the adrenal cortex. These findings suggest that calcium infusion is an effective additional measure in the treatment of rheumatic and rheumatoid affection in the absence of contraindication to calcium.


Incorporation of newly formed lecithin into peripheral nerve myelin. Radioactive choline was used to study the metabolism and movement of choline-containing phospholipids in peripheral nerve myelin of adult mice. Incorporation at various times after intraperitoneal injection was measured in serial segments of sciatic nerve as well as in myelin isolated from those segments. At no time (1 h to 35 days) could a proximal-distal difference in the extent of labeling be demonstrated. This finding suggests that incorporation of precursor choline phospholipids into nerve membranes is a local event, with little contribution from the neuronal perikaryon via axoplasmic transport. Autoradiographic investigations were undertaken to elucidate the pattern of movement of radioactive choline-labeled phospholipids, predominantly lecithin, into the myelin sheaths of the sciatic nerve. A sequence of autoradiographs was prepared from animals sacrificed between 20 min and 35 days after a microinjection of precursor directly into the nerve. Analysis of these autoradiograms revealed that labeling is initially concentrated in the Schwann cell cytoplasm. Later, the label moves first into the outer regions of the myelin sheaths and is eventually distributed evenly throughout the inner and outer layers of the sheath. At no time is there a build-up of label in the axon. The rate of uptake of precursor and subsequent redistribution of lecithin into the myelin were also examined in frog sciatic nerve (18 degrees C). Both uptake and redistribution processes were considerably slower in the cold-blooded animal.


Control of chromosome behavior in amphibian oocytes. II. The effect of inhibitors of RNA and protein synthesis on the induction of chromosome condensation in transplanted brain nuclei by oocyte cytoplasm. We studied the effects of actinomycin D, alpha-amanitin, puromycin, and cycloheximide on the cytoplasmic activity of maturing Rana pipiens oocytes that induces chromosome condensation in transplanted brain nuclei. Treatment of oocytes with each inhibitor suppressed the chromosome condensation induced by metaphase oocytes to varying degrees depending upon the dose of inhibitor, despite the fact that untreated metaphase I oocytes already possessed chromosome condensation activity (CCA). Treatment of brain nuclei before injection completely suppressed condensation at all doses used. Chromosome condensation induced by metaphase II oocyte cytoplasm, however, was insensitive to all the inhibitors, even when the brain nuclei were pretreated. Oocytes treated with alpha-amanitin throughout maturation induced chromosome condensation when tested at metaphase II. Removal of the oocyte chromosomes after the germinal vesicle (GV) broke down did not prevent the development of CCA, whereas removal of the entire GV before initiation of maturation deprived oocytes of CCA. The results suggest that metaphase I oocyte cytoplasm stimulates synthesis of brain nuclear RNAs that are translated into proteins necessary for chromosome condensation, whereas metaphase II oocytes possess all the factors for chromosome condensation. In both cases, GV nucleoplasm appears indispensable for the development of CCA, whereas immediate activity of the oocyte genome is not required.


Verruca plantaris: a review of the problem. Verruca plantaris, caused by papovavirus, is frequently seen in patients between the ages of 12 and 16 years. Some type of tissue destruction is used in most methods of treatment. The author discusses electrodesiccation which the considers the treatment of choice as excellent cosmetic results are usually obtained and recurrences are minimal.


Immunogenicity of lysozyme derivatives lipid-conjugated to various degrees in mice treated with and without cyclophosphamide: dissociation of delayed-type hypersensitivity and helper function. Lysozyme and a series of its lipid-conjugated derivatives without adjuvant were examined in mice for their abilities to induce delayed-type hypersensitivity (DTH), helper T-cell activity, and antibody formation. In addition, the effect of cyclophosphamide (CY) on the immune responses was assessed in mice immunized with these lysozyme derivatives. Precipitated lysozyme without lipid conjugation was a good inducer of both antibody and DTH responses. Lipid conjugation to lysozyme to intermediate degrees readily caused the failure only in inducing the antibody response. As lysozyme was lipid-conjugated more heavily, DTH response was also reduced and finally abolished. In contrast, the helper activity was little affected by any degree of lipid conjugation. These results indicate that the helper T-cell activity was dissociated from the both DTH response and the antibody production. CY pretreatment extensively enhanced DTH response induced by such lipid-conjugated derivatives that failed to induce antibody response. Furthermore, CY pretreatment in doses in a wide range enhanced not only DTH response but also antibody formation. It is, therefore, concluded that the enhancement of DTH response by CY does not necessarily entail suppression of antibody formation.


Analysis of the slow excitatory postsynaptic potential in bullfrog sympathetic ganglion cells. The ionic mechanism of the slow excitatory postsynaptic potential (slow EPSP), i.e. the muscarinic action of acetylcholine (ACh), was studied either by stimulating preganglionic nerves or by applying ACh in curarized sympathetic ganglion cells of bullfrogs. There are three different types of cells characterized by the effects of membrane hyperpoliarization on the amplitude of slow EPSP. One group of cells showed an increase in amplitude (type 1 cell) and, in two other groups of cells, it remained unchanged (type 2 cell) or decreased (type 3 cell), when the membrane was hyperpolarized. Under the muscarinic effects of ACh, the slope membrane conductance was increased (type 1 cell), unchanged (type 2 cell) or decreased (type 3 cell) at 10-20 mV hyperpolarized levels, while it was unchanged (type 1 cell) or decreased (types 2 and 3 cells) at resting and depolarized levels. In all cells, the slow ACh potential, corresponding to the slow EPSP, was almost completely suppressed in a high K+, Ca2+-free, Na+-free solution. These results suggest that the slow EPSP is generated by increases in Na+ and Ca2+ conductance and also by a simultaneous decrease in the K+ conductance.


The muscarinic effects of acetylcholine on the action potential of bullfrog sympathetic ganglion cells. The direct effects of acetylcholine (ACh) on Na+- or Ca2+-dependent action potentials of curarized sympathetic ganglion cells in bullfrogs were investigated under a condition where membrane depolarization caused by the muscarinic action of ACh was nullified by means of a hyperpolarizing current. ACh decreased the after-hyperpolarization of Na+-action potentials in Ringer's solution, and increased the after-depolarization of Ca2+-action potentials in the isotonic Ca2+ solution. In both solutions, the maximum rates of rise of the spikes were decreased and the slope membrane resistance at the original resting level was increased. The effects of ACh were abolished by atropine. On the other hand, ACh showed no significant effects on action potentials of bullfrog spinal ganglion cells which possessed no synapses. These results suggest that the ion conductance channels for generation of action potentials of sympathetic ganglion cells are under the direct control of transmitters, such as ACh.


Spontaneous regression of sarcoma.

Spontaneous regression of sarcoma. Three pathologic processes generally regarded as nonneoplastic conditions are presented and discussed as examples of poorly controlled proliferations of lymphoid tissue. A study of these three disorders (infectious mononucleosis, hyperthyroidism, and Dilantin-induced lymphadenopathy) provides clues to an understanding of the pathogenesis and occasional spontaneous regression of the malignant lymphomas.


An unexpected effect of L-5 hydroxytryptophan-ethyl-ester combined with a peripheral decarboxylase inhibitor on human serum prolactin. While the 5-HT precursors tryptophan and 1-5-HTP cause an increase in serum prolactin concentration, a combination of 1-5-HTP with a peripheral decarboxylase inhibitor was found to reduce the serum prolactin concentration. This combination seemed to behave like a DA agonist. This effect is not produced by the decarboxylase inhibitor per se. A possible explanation is that 5-HTP is converted to 5-HT in CA-ergic neurons, that 5-HT supersedes the CA from the stores, and that some of the CA reach the synaptic cleft and stimulate CA receptors. Another possible explanation is that 5-HTP decarboxylase is centrally inhibited as well, and that an effect of 5-HTP itself is involved here. In view of the observations made it is doubtful whether the therapeutic effect of 5-HTP combined with a peripheral decarboxylase inhibitor in depressions and myoclonus can in fact be atributed to activation of central serotonergic systems.


[Study on tumor affinity of technetium-99m-labeled radiopharmaceuticals. (1) 99mTc-pertechnetate, 99mTc-human serum albumin, and 99mTc-trasylol]. This paper describes biologic distributions, sequential images and macroautoradiograms of 99mTcO4 (pertechnetate), 99mTc-Sn-HSA (human serum albumin) and 99mTc-Sn-TSL (trasylol) in tumor-bearing mice as the first report on tumor affinity of 99mTc-labeled radiopharmaceutical. (1) Maximum tumor concentration (% administered dose/g of tissue weight) of 99mTcO4, 99mTc-HSA and 99mTc-TSL in Ehrlich's tumor-bearing mice resulted in 2.03+/-0.57 at 1 hr, 4.02+/-0.19 at 3 hr and 1.97+/-0.31 at 1 hr respectively. (2) However, tumor to blood concentration ratio of 99mTc-HSA was lowest among them. (3) The corrected tumor accumulation (% 100g dose/g of tissue wt.=% dose/% body weight) of 99mTc-TSL to Ehrlich's tumor in mouse was not different from that of Yoshida's sarcoma in rat, on the contrary to our expectation that the tumor concentration of 99mTc-TSL in them might be different due to differency of the tissue fibrinolytic activity between the respective tumors. (4) Sequential images of the implanted tumor in mouse was best positively delineated with 99mTc-HSA. (5) Macroautoradiograms of Ehrlich's tumor with 99mTcO4, 99mTc-HSA and 99mTc-TSL demonstrated the following findings: all of them were not only accumulated markedly into the tumor cells which were shown as basophilic tissue with Hämatoxylin-Eosin staining but also accumulated around the tumor tissue and on the interstitial tissue which were stained as eosinophilic tissue with the above same staining.


Antigen perception by T lymphocytes. Influence of the major histocompatibility complex. There is considerable evidence that T cell activation to soluble antigens occurs only if this is processed by macrophages and displayed appropriately on the plasma membrane in association with products of the genes of the major histocompatibility complex. The genes responsible differ according to the antigens involved. For cytotoxicity, targets and killer T cells must share K or D region gene products. For delayed type hypersensitivity to fowl gammaglobulin in mice, I-A identity is necessary; for dinitrofluorobenzene, identity at either the I, K or D region is sufficient. Experiments using three different approaches do not support the notion that these genetic constraints are due to the necessity for the T cell and stimulator cell to match an identical gene product or "cell interaction molecule." Rather they favour the hypothesis that activated T cells recognize antigen and products of genes of the major histocompatibility complex. The implications of the results are discussed in terms of the mode of action of immune responsiveness (Ir) genes and of the possible parallel evolution of T cell receptors for antigen and gene products of the major histocompatibility complex.


Dependence of the heat production of active muscle on the length of muscle. The dependence of the heat production of muscle on length was examined in isometric (with stretch) and isotonic (free of stretch) tetanuses of 2 s. The isometric heat production was significantly greater than the isotonic one at any length of muscle. The isometric heat coefficient (Flo/Q, where F is the active tension development of muscle measured in ponds, lo is the resting length measured in cm, Q is the heat production during the contraction at a given length measured in mcal) was not constant but dependent on the length of muscle, and had an extreme value near the resting length (lo). A close positive correlation was found between the active tension development and the heat production of the muscle.


The effect of anti-lymphocyte and anti-thymocyte serum on the pathogenesis of Rauscher leukaemia in inbred mouse strains. Rauscher virus causes in inbred Balb/c mice a rapidly progressing hyperacute, in C57B1/10Sn mice an incipient, spontaneously healing leukaemia. In DBA/1 and DBA/2 mice the appearance of leukaemia is followed by a partial remissions then by an exacerbation of the disease. The infection in C57B1/10Sn, DBA/1 and DBA/2 mice results in a significant tumour-specific immune response. Inhibition of the immune response is followed by an increased progression of leukaemia in DBA/1 and DBA/2 mice only. It is assumed that in C57B1/10Sn mice the remission of incipient leukaemia is associated with a resistance determined in the target cells, whereas in DBA/1 and DBA/2 mice the remission is due to a tumour-specific immune response. As in animals treated with anti-lymphocyte and anti-thymocyte serum the course of the disease runs proportionally to the degree of the inhibition of the immune response, the tumour-specific antibodies play a decisive role in the elimination of the tumour cells. In Balb/c, DBA/1 and DBA/2 mouse strains failing to exhibit a spontaneous reversion of the tumour cells, the appearance of a significant tumour-specific immune response depends on the resistance against the helper component of the Rauscher virus complex.


[Role of salivary kallikrein in the pathogenesis of periodontosis]. In patients with parodontosis the distinct increase in salivary kallikrein secretion was found. In Wistar rats the intensity of age atrophy of alveoli dentalis correlated with BAEE-esterase activity of mixed saliva. Desalivation considerably decreased the rate of age atrophy of parodontosis in rats. Salivary kallikrein, penetrating in active form into parodontal tissues, caused the pronounced vasodilation in dogs and golden hamsters. By means of kallikrein preparations an intensive inflammatory-dystrophical process was reproduced in parodontal tissues of Wistar rats. The local treatment of patients with parodontosis by kallikrein inhibitors was found to be especially effective.


The rate of initiation of treatment for hypertension in a community, 1971--1975. In 1971 persons aged 50-59 in a community were screened for hypertension and those with diastolic BP greater than or equal to 110 mmHg were notified. On reviewing the sample in 1975 the treatment rate had doubled to 22%. Screening in 1971 was followed by an immediate rise in numbers starting treatment, most being notified cases. Thereafter initiation of treatment at a rate of 3-8 cases per 100 persons per year chiefly reflected identification of subjects deemed to need treatment in the ordinary course of medical practice. Of those starting treatment during the four years 25% had stopped it by 1975. The influence of screening and other factors on the rate of initiation of treatment and adherence to it are discussed. With an already high attendance rate at doctors, regular screening of this whole age group seems feasible within the framework of general practice. The high treatment rate found in 1975 underlines the urgent need for the indications currently used for starting treatment to be validated.


Thymus with B lymphocytes in chronic lymphocytic leukaemia. A 67-year-old man with a diagnosis of chronic lymphocytic leukaemia died suddenly following a coronary occlusion. Peripheral blood lymphocytes labelled with fluorescein conjugated polyvalent antisera to immunoglobulin and immunoglobulin G, and failed to label with absorbed antithymocyte serum. At necropsy, a large thymic tumour, and enlarged mediastinal lymph nodes also contained immunoglobulin G bearing B lymphocytes. The paradoxical finding of B lymphocytes with monoclonal surface immunoglobulin in a thymic mass is most unusual in chronic lymphocytic leukaemia.


Immunological changes and liver disease associated with alpha1-antitrypsin deficiency. A female aged 60 years with heterozygous alpha-1-antitrypsin deficiency developed a progressive and ultimately fatal liver disease with the clinical, biochemical, immunological and histological characteristics of active chronic hepatitis. It is suggested that the hepatic disease of A-AT deficiency be included among the types of liver disease which may initiate a progressive immunopathic response.


[Histiocytosis management (author's transl)]. Seven cases of Histiocytosis have been treated with VB and PR. Five of them that belong to grup C (according to Oberman's classification) experimented favorable resuts. Likewise, we have been able to prove that prognosis of these children depend on: their age at the onset of the disease; the original site of the disease; the extension of the lesions and the maintenance of prolonged therapy.


[Study of the heterogenetic antigens in vaccinal preparations of V. cholerae]. There proved to be a serological similarity between the antigens of the human small intestine, the stomach and the liver, and the antigens of various cholera vibrio fractions. No antigenic similarity was revealed in examination of the heart and kidney. Heterogenous antigen was found not only in the somatic V. cholerae antigen, strain 569 (B), but also in the cholerogen-toxoid obtained from it. At present it is the most widespread prophylactic preparation.


Impact of control measures on malaria transmission and general mortality. This paper is an attempt to relate modifications observed in general and infant mortality rates with the dynamic changes in transmission induced by malaria control measures. The observations indicated relationships between the efficacy of control and a decrease in mortality. The daily parasitological inoculation rate was reduced from 0.00958 infective bites per individual before treatment to 0.00037 after treatment (a decrease of 96%). In two years, general mortality decreased from 23.9 to 13.5 deaths per 1000 population and infant mortality decreased from 157 to 93 per 1000 live births. This indirect benefit of malaria control deserves attention in a wider assessment of measures directed against vector-borne diseases.


The impact of propoxur on Anopheles gambiae s.1. and some other anopheline populations, and its relationship with some pre-spraying variables. A significant and stable difference in the residual night-biting collection (NBC, observed/expected) of A. gambiae s.l. was observed among different villages of the West African savannah when sprayed for 2 years with propoxur. The residual mosquito density of a given village was positively associated with some of its pre-spraying characteristics: the NBC/PSC (pyrethrum spray collections) ratio, the median biting hour, and possibly the proportion of species B. It was not significantly associated with several other pre-spraying characteristics (absolute mosquito density, the ratios between NBC indoors and NBC outdoors, between ETC (exit-trap collections) and PSC, between fed and gravid in the PSC or ETC, between males and females in the PSC), and was not associated with variations in recorded coverage, with latitude, or with distance from unsprayed villages.In a comparison between A. gambiae s.l., A. funestus, and A. pharoensis, the residual NBC (observed/expected) was positively associated with the pre-spraying NBC/PSC ratio, and was negatively associated with the median biting hour.The pre-spraying NBC/PSC ratio thus appears to be a predictor of the variation, between villages or species, in the reduction of the NBC by residual spraying, and may assist in forecasting the effect of a residual insecticide. The limitations of any absolute prediction must, however, be kept in mind.


Aircraft disinfection: the physical and insecticidal characteristics of (+)-phenothrin applied by aerosol at "blocks away". A 2% formulation of (+)-phenothrin dispensed from 340-g or break-off tip aerosol cans was highly effective against mosquitos in aircraft disinsection trials. Two minutes after application at "blocks away", the mass median diameter of the dispersed drops was 5.1-6.2 mum. The concentration of the insecticide in the cabin fell to 10% of the original concentration after 9.2 min. No odour or irritation was caused by the use of this insecticide.


Techniques for estimating densities of Bulinus truncatus rohlfsi and its horizontal distribution in Volta Lake, Ghana. Bulinus truncatus rohlfsi is the intermediate host of urinary schistosomiasis, which is highly endemic in the man-made Volta Lake. In 1971, a WHO/UNDP schistosomiasis project was established in the Pawmpawm branch and part of the Afram branch of Volta Lake. Malacological findings of the preliminary phase indicated that the snails were distributed in the littoral zone of the lake, and that this distribution was correlated with the presence of vegetation, especially Ceratophyllum. Transmission nearly always occurred in "water contact sites", i.e., places where people come into contact with water.A snail-sampling technique with palm-leaf mats was developed and standardized after it had been shown in sensitivity trials to compare favourably with a modified version of the "man-time" sampling method, in which the number of snails collected per man-hour is recorded. It is recommended that both these methods should be used to conduct ecological studies of B. rohlfsi in water contact sites.


Effects of environmental factors on the molluscicidal activities of slow-release hexabutyldistannoxane and copper sulfate. Laboratory experiments were conducted to study the molluscicidal activities of slow-release hexabutyldistannoxane (TBTO) and copper sulfate under various environmental conditions. Organic materials such as mud and weeds reduced the molluscicidal efficacy of both chemicals. TBTO can be considered a good long-lasting molluscicide but, because of uncertainty as to its general toxic effects, it should not be used in field trials. The molluscicidal activity of slow-release copper sulfate was short-lived in plain lake water and was nil in the presence of mud or weeds at the concentration used.


Snail control in urban sites in Brazil with slow-release hexabutyldistannoxane and pentachlorophenol. Slow release formulations of hexabutyldistannoxane (TBTO) and pentachlorophenol (PCP) were tested for the control of Biomphalaria tenagophila in 52 urban sites in Rio de Janeiro. TBTO acted faster and lasted longer than PCP and at 15 g/m(2) it eliminated snails from 76% of the treated sites for 1 year. Water pollution and rate of flow had no significant influence on the molluscicidal properties of either compound, but alkalinity lowered the activity of TBTO. Failure to control snail populations was due mainly to human interference and to the non-treatment of adjacent breeding sites that were temporarily dry and therefore overlooked.


Assay of togavirus haemagglutination-inhibition antibodies by the micro method: loss of information and its rectification. Haemagglutination inhibition (HI) activity was assayed by the micro and macro methods in immune sera prepared against four togaviruses. HI titres were always 4 to 8 times lower by the micro method, and coincided with 4 to 8 times lower haemagglutinin titres in micro method assays. Because of this phenomenon, positive sera with HI macro method titres lower than 1: 80 will be false negative for HI by the micro method when tests begin at a 1: 10 serum dilution. This was confirmed for a number of human sera tested for West Nile virus HI activity. As a consequence of the difference between titres given by the two assay methods, results of seroepidemiological studies may be distorted. Use of a system that combines both the macro and micro methods could rectify this distortion.


Characteristics of the spread of a wildlife rabies epidemic in Europe. The control of rabies in wildlife by reducing the fox population has led in Europe to inconsistent results, since little was known of the dynamics of the fox population and the interaction between rabies epidemics, host populations, and control measures. As part of the WHO/FAO Coordinated Research Programme on Wildlife Rabies in Europe, data on epidemics and persisting reservoirs of the disease were processed by computer. The results led to a better understanding of the mechanism of spread of the epidemic and to proposals for the improvement of rabies control in animals and the protection of man.


Gastric metastasis from breast carcinoma: emergency snare-ectomy for control of hemorrhage. In a 65-year-old woman, radiological and endoscopical findings of gastric metastasis from breast carcinoma are described. Significant upper gastrointestinal bleeding necessitated an emergency gastroscopy. The ulcerated nodular lesion was bleeding and removed by diathermy loop via fiberoptic gastroscopy.


The Mallory-Weiss-syndrome: a clinical study of 20 cases. This is an account of 20 cases of MWS, representing 8% of a series of 247 consecutive upper GI-bleedings. Men above 40 years and persons with severe concomitant disease are specially at risk. The prognosis is rather good, mortality from bleeding being 10%. Surgery should not be undertaken unless all conservative measures, including vasopressin infusion and even Sengstaken-Blakemore tube have been applied. The typical history, a hiatal hernia and alcohol intake are frequently missing. Neither studies of gastric acid secretion nor esophageal manometry disclosed new pathogenic aspects.


Psyche and rheuma.

Psyche and rheuma. The paper is based on discussions which took place in a seminar at the European League against Rheumatism Meeting in Helsinki in 1975. The importance of assessing the emotional response in rheumatoid disease, as well as the disease process, is stressed. It is important to consider the effect of the discovery by the patient that severe disease is present. Considerable support by general practitioners and consultants may be necessary at this time. There has been much discussion as to whether patients suffering from rheumatoid arthritis have a different type of personality than other subjects. The evidence is not convincing. The role of stress in the aetiology of rheumatoid arthritis is not properly understood. Anxiolytic and antidepressant drugs may help patients to overcome the anxiety and depression associated with rheumatoid arthritis. Children suffering from the disease present a special problem. The incapacity and isolation, especially in old age, which osteo-arthritis brings may lead to depression and antidepressant therapy is often required. When rheumatic pain seems out of proportion to the physical findings, psychogenic rheumatism should be considered. Rheumatic pains occur in masked depression and low backache may be a depressive equivalent. Pain may be used by some patients to communicate distress.


Electrical stimulation in multiple sclerosis. When electrodes were implanted in the spinal cord of a patient with MS--for dorsal column stimulation to relieve intractable pain--she regained considerable movement in her legs. Subsequently such stimulation has been employed in more than 70 other patients, and many have regained voluntary control over their arms, legs, and sphincters. The procedure is detailed and its implications are explored.


[Effect of lithium on the central serotonin- and adrenergic processes after its chronic administration]. With its chronic administration in a dose of 100 mg/kg lithium carbonate inhibited shaking of the head induced in mice with 5-hydroxytryptophan (5-HTP). This effect did not differ from the action following a single injection of lithium, when the interval between injection of lithium and of 5-HTP was one hour. With the interval lengthened to 24 hours the frequency of shaking diminished only under the effect of chronic administration. At the 5th, 10th and 21st day of a daily administration lithium failed to produce any effect on the hypothermal action of a reserpine-like agent Po 4-1284, but would reduce the protective action of imipramine in a ptosis test. A single injection of lithium made against the background of a chronic injection of water produced an opposite effect, viz. it significantly reduced the protective action of imipramine in hypothermia, but did not affect it with reference to ptosis. Hence, chronic administration of lithium leads to potentiation in its action of the serotonin-negative and central adreno-negative componets and to extenuating the peripheral adreno-negative component.


[Toxicity of benzhydrylurea under experimental conditions]. Benzhydrylurea, which displays an anticonvulsant action and is of low acute toxicity in capable after a 3-month administration to rats to inhibit the growth of male-rats, intensify the excretion of protein with the urine, raise the blood sugar level (with its single administration--to reduce), provoke dystrophic changes in the liver, kidneys and central nervous system. Following a 1--3-week introduction of the substance guinea pigs and cats demonstrate hemorrhagic erosions in the stomach and small intestine (but not rabbits, dogs and rats), the appearance of pathological forms of erythrocytes, while guinea pigs suffer from leucopoietic disorders.


Cancer in a familial IgA deficiency patient: abnormal chromosomes and B lymphocytes. Two primary cancers were found in a patient with a familial IgA deficiency. Although cytogenetic studies showed nonconsistent pseudodiploid chromosomal pattern in the peripheral blood lymphocyte cultures, there were two metaphases with a deleted short arm of an E (17-18) chromosome and several metaphases with an abnormally large chromosome, larger than chromosome number 1. Also, there were 37 B lymphocytes per mm3 in her peripheral blood which was much lower than other radiation-treated cancer patients. The absence of IgA, the decrease of peripheral B lymphocytes and the chromosomal abnormality might have played a role in her developing the cancers.


[Free radical processes in the embryogenesis of Anura]. The localization of free radical processes and changes in their level during the common frog development have been studied by means of grafted copolymerisation and autoradiography. The maps of distribution of relative concentrations of free radicals were obtained for the beginning of cleavage, blastula, gastrula and neurula. The distinct regionalization was found in the beginning of cleavage: the concentration of the free radicals in the cortical layer and dorsal half of embryo is lower than in the central area and ventral half, resp. At the early blastula stage this regionalization is preserved in its general features. The region of embryo characterized by active free radical processes corresponds to the presumptive endo- and mesoderm in the period of inductive interaction. The possible participation of regional changes in oxidative metabolism in the fertilized egg in the determination of cytoplasmic localization of morphogenetic potencies is discussed. At the later stages there were variations observed in free radicals concentration, which are discussed as being related to the determination and morphogenesis of some rudiments of embryo. A local rise of free radicals concentration was also found out in the eye rudiment just before the onset of its components differentiation.