Stimulation by aldosterone of the sodium efflux in barnacle muscle fibres: effects of RNA inhibitors and spironolactone. 1. Single muscle fibres from the barnacle Balanus nubilus have been studied to provide information about the mode of action of aldosterone on Na transport in a symmetric cell. 2. Neither internal nor external application of aldosterone modified the course of the Na efflux. However, fibres pre-exposed overnight to a dose of aldosterone showed a biphasic response to external aldosterone. The first phase was prompt in onset and consisted of a falling rate constant for Na efflux becoming a constant. This has been interpreted as indicating that aldosterone acts by releasing sequestered or bound Na. The second phase was delayed in onset with the average latent period being 68 min. It consisted of a step-up in the rate of Na efflux, followed by a transitory rise in the efflux rate constant. This second phase was dose-dependent, the minimum concentration being 10(-9) M. 3. Internal application of aldosterone in a concentration as low as 10(-10) M promptly stopped the rate constant for Na efflux from further falling but failed to cause delayed stimulation. 4. The response of the Na efflux into Li-ASW following external application of aldosterone was bi-phasic. The magnitude of the delayed stimulation was comparable to that found in controls. 5. No correlation between latent period or size of the internal Na bound fraction, and the magnitude of the delayed stimulation could be established. 6. Internal application of actinomycin-D, alpha-amanitin or cordycepin shortly before application of external aldosterone caused complete abolition of the delayed stimulation. 7. Overnight pre-exposure of the barnacle to actinomycin-D caused complete abolition of the falling rate constant for Na efflux, as well as the delayed stimulation caused by external aldosterone. 8. Internal application of spironolactone SC-14266 shortly before external application of aldosterone caused complete abolition of the biphasic response to the steroid. 9. It is concluded that (i) barnacle fibres can be made sensitive to aldosterone, (ii) the biphasic effects on the Na efflux depend on prior induction of RNA, (iii) the first effect caused by internal or external aldosterone involves mobilization of sequestered Na, (iv) the results obtained with spironolactone are in keeping with the current view that aldosterone interacts with a receptor system before causing de-repression. 10. The implications of the finding that aldosterone releases sequestered Na are briefly touched upon.


Amino acid movements across the wall of anuran small intestine perfused through the vascular bed. 1. L-leucine transfer across the wall of the small intestine has been studied in a vascularly perfused preparation from four species of frog. Some properties of the preparation are described. 2. A description is given of the endogenous amino acids appearing in the vascular bed and of the kinetic properties of this washout of endogenous L-leucine. 3. In the steady state of absorption, the transfer function relating the net flux of exogenous L-leucine into the vascular bed to the concentration in the lumen exhibits saturation. Under the conditions of the experiments the apparent concentration in the lumen for half-maximum transfer of L-leucine is found to be 2-1 +/- 0-4 (5) mM. 4. When Na ions are removed from the lumen the transfer of L-leucine into the vascular bed is inhibited. However, the additional removal of Na ions from the fluid in the vascular bed is further inhibitory to the transfer of the amino acid. 5. L-leucine previously absorbed from the lumen appears in the vascular bed in a biphasic fashion. Estimates are deduced of the size of the pool of L-leucine within the tissue which drains into the vascular bed. 6. These results are discussed in relation to previous work on amino acid transport undertaken with various sorts of preparation of small intestine.


The relative contributions of the folds and caveolae to the surface membrane of frog skeletal muscle fibres at different sarcomere lengths. The plasmalemmal area of striated muscle fibres is greater than the apparent surface area (A = circumference x length) because of variable folds and the invaginations of the caveolae and T-tubules. Freeze-fracture replicas of the surface membrane of sartorius and semitendinosus muscles from Rana pipiens have been used to determine the numbers and distribution of folds and caveolae at different sarcomere lengths. (1) The plasmalemma folds are variable in size and shape, but are always oriented perpendicular to the long axis of the fibre. The folds vary with stretch, being more prominent at short sarcomere lengths. The caveolae are elliptical invaginations of the plasmalemma which open to the outside by a narrow "neck" of approximately 20 nm. The caveolar lumen has an average long dimension of 81.6 +/- 11.7 nm and an average short dimension of 66.9 +/- 7.9 nm. The caveolar "necks" only can be seen in freeze-fracture replicas and these are distributed in two circumferential bands on either side of the Z-line, and in longitudinal bands separated by distances of 1-5 mum. In the sartorius muscle, at a sarcomere length of 2.8 mum, there is an average number of thirty-seven caveolae per square micrometer of fibre surface. (2) During passive stretch the opening of folds provides membrane for the necessary increase in surface area up to a sarcomere length of about 3.0 mum. This length is defined as the critical sarcomere length (Sc). The number of caveolae remains constant at all sarcomere lengths less than Sc and thus their "necks" have been used as membrane markers to determine the amount of folding at different sarcomere lengths. The membrane area contained in folds and caveolae is expressed as a fraction of the apparent surface area (A). For example, in the sartorius muscle, at a sarcomere length of 2.4 mum, the membrane area, excluding the T-tubules, is: A + 0.1A (folding) + 0.7A (caveolae) = 1.8A. (3) For stretch beyond Sc membrane is provided by the opening of caveolae. At a sarcomere length of about 8 mum all the caveolae are open and the fibres rupture with further stretch. (4) The relative contributions of folds and caveolae vary with sarcomere length in a way that is consistent with assumptions of constant volume and plasmalemma area. The maintenance of constant plasmalemma area, even after excessive stretch, suggests that the plasmalemma is relatively inelastic in this situation.


[Action of droperidol on the ionic currents and the contraction of the sino-auricular fiber of frogs. Study of its anti-arrhythmic properties]. 1. The effects of Droperidol on ionic currents were studied in frog atrial fibres by means of double sucrose-gap technique associated with an optical method for recording contraction. 2. Droperidol (5-10(-5) M) caused a significant reduction in the amplitude of the inward currents and slowed their inactivation kinetics. The decrease in the sodium and calcium current intensity may be related to the reduction in the maximum conductance for these ions. 3. A decrease in the amplitude of the first component of contractile response was shown to depend upon a reduction of the intensity of the calcium current. 4. Droperidol affected neither the potassium outward current nor the second component of the contractile response. 5. Repetitive activity induced by long-lasting depolarizing current pulses was suppressed by Droperidol. This suppression may be related to the decrease in the maximum conductance for sodium and calcium ions. 6. Droperidol increased the delay of the reactivation of the inward currents and prolonged the refractory period. 7. These results suggest that the cardiac properties of Droperidol are mainly due to a decreased conductance to Na and Ca ions.


[On decrease in spike height of nerve action potential. A comparison between sciatic nerve and ENM (author's transl)]. Employing ENM and a sciatic nerve removed from bullfrog, configuration of decrease of spike under various experimental conditions was studied. The amplitude of the membrane potential change in excitation was also recorded simultaneously with the decrease of spike in ENM (electric nerve model). Both on the nerve and ENM, with decrease of the resting potential, the amplitude of the spike and the amplitude of the change of the membrane potential were decreased. On the nerve and ENM, the decrease in spike amplitudes was induced by an elevation of the niveau and by a lowering of the top. However, the amplitude of the change of membrane potential of ENM was reduced only from the base of the spike due to an elevation of the niveau, with the top remained at a constant level. These decreases of the spike amplitude and the change of the membrane potential in nerve were consistent with that the electric constitution was the same for nerve and ENM, which is the experimental equivalent circut of the nerve fiber devised by the authors.


Alpha1-antitrypsin phenotypes in sex chromosome mosaicism. We report the alpha1-antitrypsin phenotypes of 21 patients with sex chromosome mosaicism and their parents. The proportion of heterozygotes in the group of parents is significantly greater (p less than 0.01) than that proportion in both control groups. The maternal or paternal contribution to the statistical significance of this observation cannot be distinguished in our small sample of families.


R-factor mediated beta-lactamase production by Haemophilus influenzae. Production of beta-lactamase by 15 strains of Haemophilus influenzae has been investigated. All the strains produce a constitutive beta-lactamase, which readily hydrolyses penicillin G, ampicillin, and cephaloridine. The beta-lactamase produced by these strains is indistinguishable from the type-IIIa enzyme commonly found in strains of Escherichia coli. The beta-lactamase gene has been transferred from the enzyme-producing strains of Haemophilus to strains of H. parainfluenzae and a strain of E. coli.


Effects of hypertonic urea solution on the contractility of the bullfrog ventricle. The effects of hypertonic urea solution on the excitation-contraction coupling of the bullfrog's heart muscle were investigated. Small strips obtained from the ventricular wall of Rana catesbiana were used. Contractile tension as well as transmembrane action potential were recorded in the single sucrose-gapped arrangement. The muscle weight was measured in order to check the changes in the dimension of muscle fiber both during isotonic and hypertonic perfusions. Light microscopic study was also performed to compare the effect of hyperosmolar urea with that of sucrose. 3.0 T-urea solution exerted a triphasic change in twitch tension during hypertonic perfusion and a biphasic change during the recovery perfusion. An initial rapid decline was restored to the original level within 10 min and after an overshoot a secondary gradual decrease was observed during hypertonic perfusion. In spite of parallel change in the action potential duration with the time to peak tension there was an increase in dp/dt during the restoration phenomenon. The calcium sensitivity was altered in the 3.0 T-urea solution and thus in Ca-free solution the rate constant of the slow component of twitch decline was decreased. The muscle weight remained decreased during the whole period of hypertonic perfusion. Histological study revealed that the fiber bundles soaked in hypertonic urea solution show normal appearance whereas those in sucrose exhibit a marked shrinkage. These results show that urea can penetrate the heart muscle membrane easily and that urea has some augmenting action on the E-C coupling process.


[Clinical aspects of "Endophthalmitis phacoanaphylactica" (author's transl)]. 29 cases of Endophthalmitis phacoanaphylactica were diagnosed out of a total of 1300 enucleated eyes examined histologically between 1966 and 1974. Clinically the correct diagnosis was made only once. Most frequent misdiagnoses were: phthisis, recurrent iritis, and panophthalmitis. Important factors for a correct clinical diagnosis are: 1. history of injury at least 2-3 weeks previously, 2. a cataract present at the onset of the disease, 3. an endophthalmitis, often associated with extreme i.o. hypotension. Treatment consists of an immediate and total removal of lens material, regardless of the hypotension or of inflammatory signs. The retinal architecture is usually astonishingly well preserved, even in cases with extreme destruction of the anterior segments.


[Anomaloscopic results in extrem-anomalous trichromats (author's transl)]. The results in 55 extreme deuteran and 34 extreme protan trichromats examined with the anomaloscope are reported, which make together about 9% of all red-green vision disturbances in a group of Federal Army relatives. Not only the deuteran but also the protan group make fewer mistakes with red colours as with green.


[The action of triglycylvasopressin on control subjects and patients with upper gastrointestinal bleeding (author's transl)]. Nalpha-glycyl-glycyl-glycyl-(8-lysine)-vasopressin, a hormone analogue with prolonged pharmacological action due to slow release of active nonapeptide by enzyme action in vivo, has been administered to 5 control subjects and to 14 patients actively bleeding from upper gastrointestinal sites. The control subjects showed a prolonged pressor response to 100mug/kg body weight associated with a rise in cardiac output, with no ECG signs of myocardial toxicity. 13 of the 14 bleeding patients showed not only pressor responses and haemodynamic and clinical improvement when administering doses of 20-100 mug/kg, but clear signs of standstill of upper gastrointestinal bleeding.


Improved survival after coronary artery surgery in patients with extensive coronary artery disease. Survival in patients with ischemic heart disease is closely related to the extent of coronary artery obstruction as determined angiographically. One hundred forty-nine consecutive patients underwent coronary artery bypass surgery from November, 1971, to October, 1974. There were 2 late cardiac deaths, 1 late noncardiac death, and 1 hospital death, an operative mortality rate of 0.7 per cent and a total mortality rate of 2.7 per cent. Coronary angiograms were scored according to the method of Friesinger, Page, and Ross. Fifty-four per cent (80/149) had scores of 10 or greater. Cumulative survival was analyzed according to life-table techniques; in the 80 surgically managed patients with scores of 10 or greater, survival at 3 years was 98 per cent. Friesinger's 47 nonoperated patients with similar angiographic scores had a 3 year cumulative survival of 68 per cent. Although this study compares different groups, the surgical series was composed of older patients (mean age 52 as compared to 44 years), includes 22 patients operated on urgently for preinfarction angina pectoris, and includes 18 patients with abnormal ventricular function. These data suggest that coronary artery bypass surgery can favorably influence prognosis in patients with severe coronary artery disease.


Acute myocardial infarction: a surgical emergency. Preservation of viable myocardium is the primary goal of coronary artery surgery. Our total experience with coronary artery bypass grafting is 1,612 patients, operated upon from March 13, 1969, through Jan. 31, 1975 (2.85 per cent over-all mortality rate). Four hundred thirteen patients were operated upon on an emergency basis. Of this group, 96 were having acute myocardial infarctions and 317 were in the preinfarction syndrome. Emergency coronary artery bypass surgery was performed with 5 deaths (5.2 per cent) in the acute myocardial infarction group and 4 deaths in the preinfarction group (1.26 per cent). These patients had a much lower mortality rate than that of medically treated patients in the acute myocardial infarction group. Postoperative catheterization studies on the acute myocardial infarction group showed a 96 per cent rate of primary graft patency. Follow-up studies through 3 years, 10 months show only 1 late death (4 months after the operation). The in-hospital and the first year mortality rates in a medically treated group with acute myocardial infarction were compared with the surgically treated group. The result was a mortality rate of 30 per cent with medical treatment and 6.3 per cent with surgical treatment. Actuarial analysis demonstrated a greater than 20 per cent difference in mortality rate at 1 year, in favor of surgical treatment. The lower surgical mortality coupled with the early and late clinical results prove that emergency coronary bypass is superior therapy in selected patients with acute myocardial infarction.


Preservation of myocardial ultrastructure. This study compares the effects of 2 hour periods of normothermic anoxic arrest, continuous normothermic coronary perfusion, continuous cold coronary perfusion, and topical cooling of the ischemic myocardium on survival and ultramicroscopic structure of the canine myocardium. No animal survived 2 hours of normothermic anoxic arrest. Severe ultrastructural damage was observed in the nuclei, mitochondria, and myofibrils. Topical cooling of the ischemic myocardium to 15 degrees C. markedly improved survival and preservation of the myocardial fine structure. Continuous perfusion of the coronary arteries with cold blood resulted in 100 per cent survival through the experimental period, with preservation of the normal myocardial ultrastructure. The technique of cold coronary perfusion should be particularly useful in cardiac surgical patients in whom maximal preservation of myocardial function is essential for survival.


An Haemophilus influenzae mutant which inhibits the growth of HP1c1 phage. A strain of Haemophilus influenzae, called hpm- inhibits the growth of phage HP1c1 but not S2. This inhibition is overcome by HP1c1ph mutants. Phage HP1c1 adsorbs normally to hpm- cells but only a small fraction of infected cells produce phage with a normal burst size or become lysogenic. When hpm- strains lysogenic for HP1c1 are induced, 100 percent of the cells yield phage. There is no degradation of phage DNA after infection of hpm- cells and HP1c1 can normally grow when its DNA is introduced into hpm- by transfection. The most probable explanation is that in hpm- cells the penetration of phage DNA is blocked. The hpm- property behaves as as unstable mutation.


Tests for the mutagenic actions of a number of chemicals on Haemophilus influenzae with special emphasis on hydrazine. A number of chemicals have been tested for their ability to produce novobiocin-resistant mutants in Haemophilus influenzae. Of these, hydrazine (HZ) proved unique because it induced a fairly high incidence of mutation without killing significant numbers of cells at concentrations ranging over nearly four orders of magnitude. Moreover, its dose-effect curve increased very slowly initially and reached a relatively low maximum. It is suggested that HZ may be acting as both a mutagen and an antimutagen in this system. HZ has sometimes been characterized as primarily an inactivating agent rather than as a mutagen. Obviously, quite the opposite is true for H. influenzae. Moreover, a survey of the literature shows that HZ has been used effectively to produce mutations in phage, bacteria, higher plants and Drosophila. There is reason to suspect that it produces mainly single locus mutations rather than chromosomal aberrations, but the amount of information on this point is still very small. The effectiveness of a mutagen can be markedly affected by the criterion of effectiveness used. If a high incidence of mutation with reasonably high cell survival is the criterion, then mutagens that are relatively nontoxic would probably be considered highly effective. In this case, the maximum mutation rate that can be achieved in practice may be controlled either by toxicity or by maxima like the one found for HZ. If, on the other hand, the important criteria are the concentration and exposure time needed to produce a detectable increase in mutation, then some quite toxic mutagens would be considered quite effective even though the maximum mutation that can be produced in practice is low. The first criterion is the one to use in choosing mutagens for detailed analysis of the mutation process, but the second set of criteria may be more suitable for generalizing to other organisms, for example from microorganisms to man, since toxic effects can be quite different in different cell types.


Impaired synthesis of polyclonal (non-paraprotein) immunoglobulins by circulating lymphocytes from patients with multiple myeloma Role of suppressor cells. Since patients with myeloma have serious abnormalities of humoral immunity, we applied an in vitro assay to determine the capacity of B lymphocytes to mature into immunoglobulin-secreting cells. In peripheral blood lymphocytes from 22 normal persons, geometric mean immunoglobulin synthesis was 4910 ng for IgM, 1270 ng for IgA and 1625 ng for IgG. The synthesis rates of peripheral blood lymphocytes of 22 patients with myeloma were 458 ng for IgM, 321 ng for IgA and 218 ng for IgG. Circulating mononuclear cells from three of six patients tested suppressed polyclonal immunoglobulin synthesis by cocultured normal lymphocytes. Suppressive activity was not mediated by purified T cells alone. Removal of phagocytic mononuclear cells from lymphocyte populations of one patient nullified suppressive activity. Removal of phagocytic mononuclear cells from lymphocyte populations of a second patient led to a nearly 10-fold increase in polyclonal immunoglobulin synthesis. Therefore, host suppressor cells may play a part in the decreased capacity of B lymphocytes to secret immunoglobulin in certain patients with myeloma.


Aneurysm of the internal auditory artery revealed by a partial cerebellopontine angle syndrome. A case of aneurysm of the distal portion of the middle cerebellar artery is described. The aneurysm was clipped and, as the neck was long, removed. The case is of interest not only because of its rarity but also because of the unusual course of the symptoms, the difficulty of identifying and locating the malformation, overcome with the aid of modern radiological techniques, and because of the success of surgical treatment.


The chain guide technique for selective ventriculography. A technique for selective ventriculography using a chain as a guide, utilizing gravity has been previously described by the author. Additional details of manipulation and injections are now reported. The cisterns have also been reached with the technique and narrow spaces as aqueductal stenosis has been passed through with the chain.


Maternal mortality in a teaching hospital in southern India. A 13-year study. During the 13 years 1960-1972, in a teaching hospital that serves a predominantly rural and semiurban population in southern India, there were 74,384 deliveries and 1245 maternal deaths, a maternal mortality rate of 16.7 per 1000 births. Direct obstetric factors caused 854 (65.5%) of these deaths. The leading indirect or associated causes of maternal deaths were anemia, cerebrovascular accidents, and infectious hepatitis. During the past 13 years, monthly maternal mortality meetings have helped to reduce the incidence of avoidable factors in maternal deaths among patients from the city but not among those brought from the surrounding countryside. The important causes of maternal deaths in this developing country, and their prevention, are individually discussed.


[Congenital hereditary corneal dystrophy associated with various extraoculary anomalies]. Two subjects (brother and sister), children of consanguineous parents, showed a typical congenital corneal dystrophy associated with mental retardation and a bilateral malformation of the little finger. One of them, a boy of 10, was fat and showed a hearing loss for high tones. His corneal opacity diminished during 7 years observation. Seeing that the affected tissues were of mesenchymal origin, the authors conclude that the syndrome was mesodermal.


Petechial hemorrhages of the soft palate secondary to fellatio. A 25-year-old white woman was evaluated for "spots" on the roof of her mouth of 2 days' duration. The initial history, physical examination, and laboratory data all failed to indicate any cause for the bleeding diathesis. Therefore, a more intensive history was initiated which disclosed a probable case for fellatio as the cause of the spots. The intraoral examination showed the spots to be petechial hemorrhages located on the soft palate in the area of the insertion of the tendons of the tensor veli palatini and levator veli palatini muscles. The mechanism of injury producing these petechiae was postulated to be the combined muscular actions initiated reflexively through tactile stimulation and the negative pressure created through irrumation, both acting simultaneously on the mucosa of the soft palate. This case is presented to illustrate an addition that should be made to the differential etiologic factors of intraoral petechiae.


Palatal erythema: another etiologic factor. The authors present three cases which created diagnostic problems. The etiology of these is, in the authors' experience, unique and not generally known. It is suggested that this etiology be considered whenever palatal erythema, ecchymoses, or petechiae are seen.


Endotoxin-induced release of colony-stimulating activity in man. Six healthy adult volunteers were injected intravenously with Pseudomonas endotoxin (Piromen) to determine effects on serum colony-stimulating activity (CSA). Serum was assayed with a double-layer agar cloning technique using normal human bone marrow as the target cell preparation. A marked increase in serum CSA was noted after endotoxin administration lasting up to 180 min. The colonies formed in response to postendotoxin serum were smaller than those seen with leukocyte feeder layers but were otherwise morphologically normal. These studies suggest that granulopoietic humoral factors may be modulated in man by endotoxin administration.


In utero sensitization with influenza virus in man. Following a community-wide epidemic of influenza A/England virus infection, 64 cord blood samples were evaluated for their fetal serum and lymphocyte responses to this virus. Cord sera were tested for HI antibody vs. A/England with and without 2-ME. A fourfold or greater reduction in titer was observed in four, indicating fetal IgM antibody responses. In addition, lymphocyte samples from three of 16 tested showed proliferative responses to influenza A suggesting fetal lymphocyte sensitization with influenza virus. These data suggest that, in some pregnancies, influenza virus is capable of transplacental sensitization of the fetus.


Influence of extracellular calcium and a water-soluble carboxyl group reagent on cholinergic drug-receptor interactions in skeletal muscle. Contractions of frog rectus abdominus muscles induced by suxamethonium or decamethonium, and to a lesser extent by carbamylcholine, were decreased as the extracellular calcium concentration was increased. The inhibition of all three agonist responses by 1.1 mM calcium was competitive. The contractions induced by bis-onium compounds, but not carbamylcholine, were further antagonized at higher calcium concentrations (4.4 mM) in a noncompetitive manner. This latter effect of calcium may be due to antagonism of bis-onium compounds at a peripheral anionic site. Carboxyl group carbodiimide reagents inhibited muscle contractions, and this inhibition was slowly reversible. The extent of the inhibition was increased, and its recovery delayed, by prior exposure of the muscle to an agonist. The results support suggestions that receptor activation initially involves displacement of membrane calcium. The study provides further evidence that interaction of agonists iwth nicotinic receptors results in structural changes, possibly related to increased ion flow.


[Mucous membrane specific protease inhibitors in bronchial mucus in severe chronic obstructive bronchitis and in alpha 1-antitrypsin deficiency syndrome]. In the bronchial mucus of 40 patients with chronic obstructive airway diseases we measured proteolytic activities, the total protein concentrations, alpha1-antitrypsin, alpha1-antichymotrypsin, and the free and bound proteinase inhibitors together with the total proteinase inhibition against trypsin and chymotrypsin. Without exception we always found free proteinase inhibitors together with proteolytic activities. The free-to-bound inhibitor rate was approximately 1:1 alpha1-Antitrypsin and alpha1-antichymotrypsin was measured in sputum only in very low concentrations. One patient with alpha1-anti-trypsin deficiency had no alpha1-antitrypsin, but high concentrations of total proteinase inhibitor-free and bound being in the same relation - in his bronchial mucus. In the alveolar part of the lung, the humoral proteinase inhibitors were effective. In the bronchial part of the lung the specific mucosal inhibitors had the decided importance. The proteinase inhibition of the mucosa-specific inhibitors is probably of great importance for the pathogenesis of airway obstruction, while the humoral proteinase inhibitors are responsible for the pathogenesis of emphysema.


Free rheumatoid factor in dental periapical lesions and gingivae of patients with rheumatoid disease. To determine whether evidence of rheumatoid inflammation, in the form of free rheumatoid factor, might be found in the teeth-supporting tissues of patients with known rheumatoid disease, tissues from the dental periapical lesions of one group of 50 rheumatoid and 23 control patients, and from the marginal gingivae of a second group of 58 rheumatoid patients were examined by the direct immunofluorescence technique that employed fluroesceinisothiocyanate (FITC)-labelled aggregated human IgG. The gingival tissues contained no free rheumatoid factor. Free rheumatoid factor-producing plasma cells were, however, detected in the  dental periapical lesions of 3 of the 50 rheumatoid patients, i.e. in 6%, and in 1 of the control patients i.e., in 4%. This control patient had suffered from nephritis 10 months prior to the investigation. Because free rheumatoid factor did occur, albeit infrequently, in the dental periapical lesions of rheumatoid patients, a search for IgG rheumatoid factor, known to occur in greater abundance than the IgM type although "hidden", was indicated.


An evaluation of two new screening tests for rheumatoid factors. Two further commercial screening tests for rheumatoid factors have been evaluated using both the sheep cell agglutination (SCAT) test and the Rheumaton slide test used routinely in this laboratory. In the group of sera tested, the Rheumaton test detected all sera with elevated SCAT titres; the Searle RA Latex test failed to detect a few of these sera. The Rheumaton test gave many misleading positive reactions with sera having insignificant SCAT titres. Far fewer misleading positive results were obtained with the Searle test. The Rythrotex test gave results similar to Rheumaton but was very difficult to use.


[HL-A and psoriatic rheumatism].

[HL-A and psoriatic rheumatism]. The HL-A groups, including the characteristics of 25 antigens, were measured in 61 patients suffering from psoriatic rheumatism, among them 9 with central forms (pelvispondylitis) and 52 with peripheral forms (polyarthritis with or without sacroileitis). Analysis of the results and comparison of them with those of other workers led to the following conclusions: 1) Central psoriatic rheumatism is associated mainly with W27 and Da31, less closely with HL-A13, and slightly or not at all with W17. 2) Peripheral psoriatic rheumatism has the same relationship with the HL-A system as has psoriasis without anthropathy. It is associated mainly with W17, less closely with Da31 and HL-A13, and slightly or not at all with W27. 3) By their relationship to the HL-A system, the two varieties of psoriatic rheumatism may be clearly distinguished from one another and from other inflammatory rheumatisms. The HL-A groupings are of considerable value in the differential diagnosis between central psoriatic rheumatism, peripheral psoriatic rheumatism, ankylosing spondylarthritis, the Fiessinger-Leroy-Reiter syndrome and rheumatoid arthritis.


[Presence of cryoprecipitates in the serum of patients with rheumatoid arthritis]. Serum samples from 140 controls (C) and from 72 patients suffering from defined rheumatoid polyarthritis (RP) were tested for cryoglobulins (CG). CG were found in 19.7 percent of C and 55 percent of RP : a highly significant difference (p less than or equal to 0.001). In the controls there was no correlation between the CG and age or sex. The RP with cryoglobulins seemed to have more inflammation, but systemic manifestations were not any more frequent than in the cryonegative RP. In the RP a correlation was noted between the presence of CG and the following parameters : increase in the sedimentation rate, rise in serum immunoglobulins, IgA and IgC, presence of antinuclear factors, and drop in the C4 fraction of complement. There was no correlation with the presence of the rheumatoid factor in the serum. In 33 cryoprecipitates in the RP, 7 contained IgG, 1 IgM, 22 IgM-IgG -- of which 11 contained C1q and 16 rheumatoid factor -- and 3 contained IgA-IgM-IgG -- of which 1 contained C1q and 2 rheumatoid factor. Some of the biochemical data support the hypothesis that likens these cryoglobulins to immune complexes.


[Prinzmetal's angor. Apropos of 4 cases. Review of the literature]. In the light of 4 personal observations of PPPRINZMETAL's angina, a review has been conducted of the literature in the 15 years since the condition was first described. Although the formal diagnostic criteria for this form of angina simultaneously clinical, biological and electrical - anginal attacks occurring at rest, often at night, during which elevation of the ST segment is recorded which disappears at the end of the attack without any significant rise in enzyme levels (SGOT and CPK) - the frontiers of the syndrome appear to have widened since PRINZMETAL's description: - Severe proximal stenosis of the coronary arteries is not obligatory; they may be only slightly damaged or even healthy. - Prinzmetal's angina is by no means always "spontaneous" but is often induced, either by psychic factors, which explain the fixed time of the attacks, or by organic factors, e.g. cold drinks (Observation No.2). In this event it would appear safer to speak of angina or rest as opposed to angina of effort. - In contrast to what PRINZMETAL thought, effort tests may sometimes induce angina-type pain with elevation of the ST segment, and here the borderline between this syndrome and conventional angina with ST segment elevation after effort test (5% of cases) is less clear-cut. The two nosologic entities probably reflect the same physiopathological situation, i.e. acute myocardial ischemia, and may represent the same affection in different phases of development. The prognosis is equally bad. - Attacks of rinzmetal's angina are often accompanied by severe and sometimes fatal disorders of rhythm, and this influences the therapeutic approach. - The coronary spasm posited by PRINZMETAL and others before the advent of coronarography is indeed, in the majority of cases, the immediate cause of myocardial ischemia and anginal pain, without any preliminary increase in the energy requirements of the heart as in the conventional anginal attack. - A vasoactive substance present in the circulating blood at the beginning of the affection, which may be degraded and subsequently disappear and may be secreted by the pathologic coronary artery, was demonstrated in observation No. 4: this may, in conjunction with vagal hypertonia, be the causative factor in coronary spasm. Study of its pharmacodynamic properties is now in progress.


Ultrasensitive chemosensory responses by a protozoan to epinephrine and other neurochemicals. A behavioral assay was developed based on differential tendency of a protozoan to attach to an agar gel containing the test substance. The heterotrophic marine dinoflagellate Crypthecodinium (Gyrodinium) cohnii responded negatively (less tendency to attach) to epinephrine at concentrations above 5 X 10(-15)M and to norepinephrine at concentrations above 5 X 10(-9)M. Response to choline as choline H2 citrate, choline bitartrate, and choline chloride was negative above 10(-7)M, but response to the choline analog carbachol was positve (greater tendency to attach) in the range 5 X 10(-6) to 5 X 10(-4)M. Other responses to neurochemicals at comparable concentrations were: dopa, betaine, and glycine--positive; L-glutamic acid, tryptophan, putrescine, and taurine--negative. Serotonin was inert, responses to tyrosine and gamma-aminobutyric acid were variable, and phenylalanine (6 X 10(-3)M) and 5-hydroxytryptophan (5 X 10(-4)M) were negative only at the highest concentrations tested.


Differentiation of red blood cells in vitro. Differentiation of red blood cells occurs in organ cultures of both livers and kidney tissue from tadpoles of the bullfrog Rana catesbeiana. Our evidence indicates that different red blood cell lines are produced by the two tissues and that these different cell lines contain different tadpole hemoglobins.


Studies on the pathogenicity of Ancylostoma ceylanicum. I. Blood loss in experimental dogs. Blood loss caused by A. ceylancium was determined in 13 dogs using 51Cr-labelled red cells. Blood loss was first detected in the faeces on the 10th to 13th day after cutaneous and 8th to 16th day after oral infection respectively. The mean blood loss was found to be 0.033 ml/worm/day and 0.038 ml/worm/day in these 2 groups of dogs respectively. There was a direct relationship between the number of worm and the amount of blood loss. The blood loss expressed as ml per worm per day showed a reverse relationship with the number of worms recovered. Considering a large amount of blood loss and the decrease in haematological values in these dogs, A. ceylanicum should be considered as one of the hookworm species of medical importance.


Tuberculosis in Black children. A retrospective analysis of severe cases. A retrospective study of 176 Black children requiring hospital treatment for tuberculosis showed that infants and children under the age of 3 years are especially susceptible. Extensive and disseminated disease is usually present at the time of diagnosis, which was sometimes made difficult by a low tuberculin sensitivity caused by malnutrition, measles, or overwhelming infection. Almost a quarter of the patients had received BCG. Approximately half the patients had disseminated disease; of these, 40% had tuberculous meningitis and 12% died, whereas the mortality of those with localised disease was 3%.


[Myelopoiesis--a kinetic approach].

[Myelopoiesis--a kinetic approach]. The mechanisms of haemopoietic cellular proliferation are more clearly understood when the granylocytic, monocytic and macrophagic elements of the bone marrow are studied by means of in vitro cultures. Better physiological insight into stimulating and inhibitory factors is obtained in this way. These studies are of diagnostic, therapeutic and prognostic importance in the clinical handling of myeloid leukaemia dn neutropenia. It can be accepted today that the concept of myeloid leukaemia as a neoplastic process with an increased production of autonomous cell populations is to a large extent outdated, and these cells can be induced in vitro to differentiate into mature polymorphs. In the past it has been demonstrated that in vitro successes are followed by in vivo results, and in particular it is hoped that with the development of techniques for concentration of colony-stimulating factor, that this might be of therapeutic advantage in selected leukaemia patients in the future.


Onyalai--the possible involvement of a mycotoxin produced by Phoma sorghina in the aetiology. A number of species of fungi were isolated from millet (Pennisetum typhoides Staph and Hubb) and grain sorghum (Sorghum vulgare Pers) obtained from the households of patients suffering from onyalai. Several proved to be toxic to rats and chickens, including Phoma sorghina (Sacc.) which was the predominating fungus. Cultures of P. sorghina grown on maize and wheat were added to standard rations at concentrations of 5-30%. When fed to day-old New Hampshire chickens, the majority died within 4 days, exhibiting traces of blood on the beak and the cloaca. Rats given 10% or more of the mouldered material in the diet developed thrombocytopenia after 14 days which was followed by haematuria, epistaxis, melaena, and death. Pathological, including histological examination, revealed extensive damage to the fascular system which resulted in widespread haemorrhages.


The radiological presentation of pulmonary tuberculosis in children. The children in this study had evidence of severe pulmonary disease when they were first radiographed. More than one segment, lobe or even lung was frequently involved and more than one type of lesion was often present in a patient. The right lung was more often affected. Segmental consolidation was common. Cavitary disease was particularly evident in children less than 3 years of age and many had extrapulmonary dissemination. Pleural effusions, calcification, and the acinar opacities of bronchogenic spread, were common in older children.


Tuberculosis notwithstanding BCG vaccination. In a series of 176 patients, 40 children (23%) developed tuberculosis notwithstanding BCG vaccination. The type and severity of the disease in this group were similar to those of the larger series of which this group was a part. However, BCG vaccination appeared to diminish the incidence of dissemination, especially tuberculous meningitis, and the number of deaths. The 40% incidence of tuberculous contacts probably indicates heavy exposure to infection. BCG offers a modicum of protection which the vulnerable should not be denied, but its use should not lead to complacency--the potency of vaccines and the technique of vaccination require constant surveillance. Case finding remains a priority and even BCG-vaccinated patients should be treated for tuberculosis when this is suspected.


Therapeutic transluminal arterial embolization for bleeding in the upper part of the gastrointestinal tract. Diagnosis and the treatment of gastrointestinal bleeding by selective and superselective technique and the perfusion of vasopressors have been noted to have significant success. Transluminal embolization of a bleeding site represents an alternative method in patients who represent a poor operative risk and in those in whom vasopressor therapy has failed. The potential risks include intestinal ischemia and vary with the anatomic site.


Transcutaneous nerve stimulation for treatment of pain in patients with spinal cord injury. Results of transcutaneous electrical nerve stimulation in 31 patients with spinal cord injury are presented. Success and failure are tabulated according to injury location and for type of pain perceived. Results indicate that pain at the site of injury is treated more successfully than radiating or central pain.


Transcutaneous and peripheral nerve stimulation for chronic pain states. A series of 120 patients with pain syndromes of varying sources were subjected to peripheral nerve electrical stimulation. Transcutaneous, percutaneous and depth electrode stimulation methods were employed. Thirty-eight patients obtained definite relief and twenty obtained equivocal relief. The remaining 62 patients obtained no relief. Pain sources are correlated with treatment results.


Pain suppression by peripheral nerve stimulation. Part I. Observations with transcutaneous stimuli. A systematic, strict appraisal was made of 100 patients, after preliminary clinical trials suggested that some patients with pain could be helped by peripheral nerve stimulation. Transcutaneous stimulation of different nerve trunks was done with a special electrical stimulation device with various selected electrical parameters. More than half of the patients experienced some relief; in many, this effect was obtained by stimulating nerves distant from the area of referred pain. Pain relief lasted for varying periods after stimulation. The maximum benefit was noticed after certain specific parameters were reached for each patient. A few patients had response decay, gain or worsening. Results differ to some degree from previous reports. The results seem encouraging for the treatment of certain forms of intractable pain.


Pain suppression by peripheral nerve stimulation. Part II. Observations with implanted devices. Twenty-three patients underwent implantation of a stimulator system and were followed for 6-20 months. Twenty patients estimated between 50% and 100% pain relief. The effect was largely consistent and reproducible. Reduced drug intake and improved social performance were associated with subjective improvement. The surgical technique is given, complications are analyzed and parameters are discussed.


Electrical stimulation of the nervous system. Twenty-seven patients with chronic pain had dorsal column stimulators implanted for pain control over a period of three years. Technical factors of electrode placement and type of unit were not found to correlate with the degree of pain relief. The preoperative psychological attitude of the patient correlated highly with the degree of pain relief and was the single most important factor in patient selection and evaluation. Theoretical concepts of pain psychophysiology in relation to the gate theory and areas for more extensive investigation of pain are discussed.


Dorsal column stimulation: optimization of application. Results are reviewed of dorsal column electrical stimulation for chronic pain in a series of 80 patients. In the light of the experience gained from this series, indications and patient suitability for this form of therapy are discussed. Complications occurring after implantation are tabulated.


Dorsal column stimulation for control of pain: a three-year follow-up. The long-term (three-year) effect of dorsal column electrical stimulation for chronic pain in a group of 30 patients was generally decreased effectiveness with time, and increased stimulation thresholds. Further animal and human studies of this technique are recommended.


Experience with dorsal column stimulation for relief of chronic intractable pain: 1968-1973. Dorsal column stimulators (DCS) have been implanted in 130 patients with various chronic pain syndromes at the University of California, San Francisco, between 1969 and 1973. Preoperative psychiatric evaluation and percutaneous dorsal column stimulation testing were of value in rejecting those patients most likely to have unsatisfactory long-term results with DCS. Best results occurred in patients with phantom limb or peripheral nerve pain and worst results in patients with paraplegic pain, documented arachnoiditis, pancreatitis and arthritis. The need is stressed for careful preoperative selection and for close, prolonged postoperative care in a situation permitting access to multidisciplinary facilities for patient care.


Stimulation of the dorsal spinal cord for treatment of intractable pain: a preliminary report. Electrical stimulation of the nervous system has been advocated as a means of alleviating pain in situations in which more conventional methods have been ineffective. A chronically implanted electrode on the dorsal surface of the spinal cord may prove to be a valuable adjunct to the neurosurgeon's armamentarium for pain control in selected individuals. The physiologic basis for this action is unclear but has been related to Melzack and Wall's gate control theory. This preliminary report deals with a series of patients treated with implanted dorsal cord stimulators.


Dorsal column stimulation and its prospects. Results of a series of dorsal column stimulation implants in 76 patients are tabulated and correlated to implant location, type of electrodes used and pain causes; complications are also discussed.


Electrical stimulation of the nervous system for control of pain: University of Texas Southwestern Medical School experience. A number of electrical stimulation procedures on patients with chronic pain were carried out at the University of Texas Southwestern Medical School. The procedures included dorsal column stimulation, peripheral nerve stimulation by means of implants and transcutaneous nerve stimulation. Some of the results are discussed and tabulated.


Spinal cord stimulation in post-amputation pain. One of the pre-operative screening tests for dorsal column stimulation involves direct acute precutaneous stimulation of the dorsal column. The test simulates the postoperative therapeutic situation, shows the patient's reactions to electrically induced paresthesias and enables physician and patient to evaluate beforehand the degree of pain relief to be obtained with the implant.


Dorsal column stimulation: optimization of application. Although the basic efficacy of dorsal column stimulation (DCS) has been shown, its optimal use remains to be defined. Since 1970, a program designed to maximize clinical success with DCS has been under way at Temple University Health Sciences Center. This article reviews patients screening, operative technique, new instrumentation and postoperative adjustment in DCS. Clinical results and long-term impressions of 90 implants in 75 patients are reported.


Percutaneous implantation of chronic spinal cord electrodes for control of intractable pain: preliminary report. A percutaneous technique is described for implanting a dorsal or ventral column stimulator for pain control with minimal surgical trauma. If the patient does not respond to percutaneous on-surface spinal stimulation, a percutaneous cordotomy can be carried out, as the needle is already in the correct position. Stimulation of the cord at the C1-2 level can be used for treatment of trigeminal neuralgia.


Evaluation of pain relief.

Evaluation of pain relief. Obtaining objective data on pain-relieving procedures is a simple matter. Measures of pain, activity levels and analgesic intake can be collected not only in a hospital but also in an outpatient setting. The data obtained make possible assessment of the effectiveness of a technique in any particular patient, and when combined for groups of patients, such data facilitate comparison of the effectiveness of different techniques in different pain states.


Chronic thalamic and internal capsule stimulation for the control of central pain. Thalamic electrical stimulation by means of chemically implanted electrodes and an externally placed transmitter was effected in patients with central pain. Good response was obtained in four patients with anesthesia dolorosa, four with thalamic syndrome, and one with paraplegic pain. Two patients with medullary syndrome experienced no relief. The mechanism of thalamic stimulation in the relief of pain is discussed and further clinical trials are anticipated.


Intermittent stimulation of nucleus ventralis posterolateralis for intractable pain. A number of patients with intractable pain were subjected to electrical stimulation of the nucleus ventralis posterolateralis. Positive results obtained support the theory according to which pain is caused by lack of proprioceptive stimuli reaching the thalamus. The implantation technique is discussed and improvements of electrodes and of the device are proposed. Optimal stimulation parameters are defined.


Transcutaneous electrical stimulation for treatment of chronic pain: a preliminary report. Two hundred thirty patients received transcutaneous electrical stimulation for intractable pain. Although almost 60% of the patients noted some degree of pain relief, slightly less than half (43%) of those tested decided to purchase a stimulator. About 20% of those who bought stimulators did not continue to obtain pain relief from transcutaneous electrical stimulation during the two to six month follow-up period. Many others noted a decrease in the amount of pain relief they obtained.


Distal coronary artery bypass: local occlusion vs. ischemic arrest. A retrospective study was performed on 65 patients with intractable angina and subtotal coronary occlusions undergoing aortocoronary artery bypass (ACB) to determine whether the local occlusion (L.O.) or the ischemic arrest (I.A.) technique was perferable in performing the distal coronary artery bypass. In 23 patients who had the method of local occlusion, a 45.7 percent incidence of myocardial injury was observed, compared to 42 patients undergoing ACB with ischemic arrest in whom an incidence of 22.5 percent occurred. Both serum glutamic oxaloacetic transaminase (SGOT) and creatine phosphokinase activity (CPK) determinations at 24 hours following operation in those patients not demonstrating evidence of postoperative injury were statistically higher in the local occlusion group compared to the ischemic arrest group. In the L.O. group SGOT was 155 I.U. compared to 77 I.U. in the I.A. group (p less than 0.01). CPK was 72 I.U. in the L.O. groupcompared to 34 I.U. in the I.A. group (p less than 0.05). These data suggest that, in subtotal coronary artery obstruction, the use of the L.O. technique is associated with a higher incidence of myocardial injury than is the technique of total cardiac I.A.


Further investigations on the radioprotective effectiveness of tianabol and other drugs in fractionatedly irradiated rats. Dianabol administered p.o. in the dose of 1.0 mg/kg during 10 days before irradiation-had no radioprotective effect in the fractionated irradiation (5 x 150 R). Distinct radioprotection, however, was exerted by the DMSO, Trasylol and Trichlorfon (30 mg/kg) administration.


Infection of the mosquito Aedes aegypti with infectious West Nile virus-antibody complexes. Aedes aegypti fed through chick skin membranes on West Nile virus-homologous antiserum mixtures shown by an anti-globulin neutralization test to be highly infectious complexes (in terms of plaque formation in tissue culture) failed to become infected. Control mosquitoes fed on West Nile virus--normal rabbit serum mixtures containing similar or smaller amounts of infectious virus were shown to become infected. Mosquitoes ingesting suspensions of West Nile virus previously incubated with Murray Valley encephalitis or Ntaya antiserum became infected at significantly lower rates (P = less than 0-05) than controls ingesting West Nile virus-normal rabbit serum mixtures. West Nile virus--17D yellow fever or dengue--2 antiserum mixtures did not produce significantly reduced infection rates in Ae. aegypti when compared to controls.


[Nuclear structures in the late oogenesis of the common frog. I. Light microscopic observations]. The dynamics of the Rana temporaria karyosphere formation throughout different seasons was studied in addition to morphological changes in the karyosphere components with and without hormonal stimulation of oocyte maturation in vitro. Towards the end of summer, the nuclear structure (lampbrush chromosomes and multiple nucleoli) were shown to assemble in the centre of the nucleus forming a karyosphere. The completely formed karyosphere (up to 150--200 mu in diameter) is observed during autumn and winter to consist of the central chromosome part and a surrounding capsule. The capsule consists of numerous nucleoli and a distinct fibrous component. Filaments penetrating the whole nucleolar zone of the capsule are tightly packed around the chromosomes, thus forming the inner fibrous zone of the capsule, separating the chromosomes from the nucleoli. On the periphery of the karyosphere, threads attached to the nucleoli are clearly seen. This pattern of the karyosphere construction is conserved through winter till spring. In winter, spherical nucleoli change into rings and necklaces. In spring, nucleoli become spherical again and lose their threads. In the period of oocyte maturation and disappearance of nuclear envelopes, numerous nucleoli fuse into a single conglomeration which later disappears. Only the inner fibrous zone is conserved which separates the chromosomes from the cytoplasm and yolk platelets. In this state, the karyosphere persists up to the first meiotic metaphase. The nature of the fibrous component of the karyosphere capsule, its origin and function are discussed.


A technique for separation of canine lymphocytes and their use in the lymphocytotoxic, blastogenic, and rosette assys. When the techniques established for preparing lymphocytes from human blood were applied to canine blood, the resulting preparations were contaminated with significant numbers of other blood cells. A three-step technique is described here for the separation of canine lymphocytes from blood which eliminates most granulocytes, platelets, and erythrocytes. Defibrinated blood is incubated with iron particles to allow phagocytosis by granulocytes. When mixed with Plasmagel, erythrocytes and iron-containing granulocytes sediment rapidly, leaving a lymphocyte-rich supernate plasma which is recovered and banded by centrifugation on a Ficoll-Hypaque gradient. Any erythrocytes remaining in the lymphocyte suspension aspirated from the gradient are eliminated by hypotonic lysis and centrifugation. The resulting preparation, representing 30 per cent recovery of the circulating lymphocytes, contained 85 to 94 per cent lymphocytes with a cell viability of 99 per cent. The functional capacity of the lymphocyte preparation was tested in three assays: 1) lymphoblastic transformation using phytohemagglutinin and pokeweed mitogen, 2) E rosette formation with human erythrocytes showed a mean 5 per cent rosette forming lymphocytes, 3) antibody-mediated lymphocytotoxicity using a canine anti-lymphocyte serum showed titers reproducible within one tube dilution.


[Lymphocyte blast transformation in the mouse spleen under the influence of a low-molecular humoral thymus factor in vitro]. The mitogen activity of a low molecular lymphocytosis stimulating substance isolated from the thymus (LSS) has been investigated in cultured mouse CBA spleen cells. LSS caused transformation of lymphocytes to the blast cells capable of mitotic division. The initial signs of transformation were observed after 24 hours of incubation, reaching the maximum in 48 hour old cultures. The stimulating action of LSS held true for about 7 days. The intensity of blastogenesis depended on the dose of LSS. A high concentration LSS inhibited the blastogenic response. B-lymphocytes are not sensitive to LSS. It is concluded that the low molecular humoral factor of the thymus activated specifically the thymus-depended lymphocytes.


Alpha-1-antitrypsin deficiency, mitochondrial antibodies and possible primary biliary cirrhosis. A case report and family study. A case of a 70-year-old woman with a history of gastric ulcer and several pneumonias is presented. She was found to have pulmonary emphysema, severe alpha-1-antitrypsin (alpha1AT) deficiency and raised serum mitochondrial antibodies. Surgical liver biopsy showed portal liver cirrhosis, PAS-positive, diastaseresistant globules in the hepatocytes and changes interpreted as florid duct lesion of primary biliary cirrhosis. A brother has severe alpha1AT deficiency. Two daughters had raised mitochondrial antibodies. One of the latter had a granulomatous hepatitis, a common finding in primary biliary cirrhosis. The association of alpha1AT deficiency and primary biliary cirrhosis does not seem to have been described previously.


The cause of hemifacial spasm: definitive microsurgical treatment at the brainstem in 31 patients. Hemifacial spasm, like tic douloureux and several other cranial nerve dysfunction syndromes, is a symptom caused by cross compression-distortion, usually arterial, of the appropriate nerve at the brainstem. Symptoms of disordered hyperactivity and mild loss of function can be reversed by microsurgical mobilization of the vessel away from the nerve. This appears to be a safe and definitive procedure, but it should be performed only by a trained microneurosurgeon with experience in the cerebellopontine angle.


[Immunological cell markers on lymphoblasts of patients with acid phosphatase positive acute leukemia (author's transl)]. Blast cells of 4 patients with acid phosphatase positive acute leukemia were investigated for T and B lymphocyte markers. Nearly all blast cells showed a typical T cell marker, namely spontaneous rosette formation with sheep red blood cells. No surface immunoglobulin was demonstrable on these cells. 3 of these 4 patients showed an enlargement of the upper mediastinum most probably due to the thymus. The conclusion is drawn that the acid phosphatase positive acute leukemia is a T cell leukemia. Some clinical data about these 4 patients are given.


[Treatment of progressive muscular dystrophy]. The paper summarizes experience in treating 306 patients with progressive muscular dystrophy during different phases of the disease. The treatment was made with due consideration for a disturbed protein metabolism, a decreased permeability of the membrane in muscular filaments, a normalization of the metabolic product supply from the blood, improvement of the blood flow and cardio-vascular and respiratory insufficiency. The treatment was carried out in the form of a continuous use in in- and out-patient conditions of a session of anabolic hormones, vascular dilatative drugs, anticholinesterase preparations, amino acids, vitamins, drugs facilitating the cardio-vascular and respiratory activity. Besides, the patients were treated by oxygenobarotherapy, muscular electrostimulation by currents of sound frequencies, remedial gymnastics, massage, hypdrotherapy, etc. The authors propose typical treatment complexes. A follow-up study of patients who received a full course of therapy during three years demonstrated its effectiveness which was expressed by the absence of clinical signs of progressiveness.


[Influence of homologous n-alcanols on functional properties of isolated skeletal muscles IV. Action potential]. The influence of homologous n-alkyl alcohols (C2, C4, C8) on the membrane action potentials of isolated frog skeletal muscle fibres has been studied using the sucrose-gap method. 1. The alcanols tested effect a decrease in the height of the action potential and prolong the recovery phase of the spike. The threshold for excitation is increased. 2. The amplitude of these alcanol induced effects depends on the concentration of the alcanols, on the time of exposure and on the length of the hydrocarbon chain of the alcanols. 3. Membrane resistance, membrane resting potential, and membrane capacity are not affected by concentrations of alcanols which effect changes in the membrane action potential. 4. The findings are discussed in regard to alterations induced by alcanols in the conductance changes associated with a membrane action potential.


[DNA repair in murine lupus].

[DNA repair in murine lupus]. DNA repair was investigated in New Zealand Mice strains which develop murine lupus, and compared with Swiss control mice. Unscheduled DNA synthesis demonstrated by autoriadiography was used to measure the repair capacity of spleen cells. After gamma-irradiation DNA repair was decreased in the autoimmune strains, while it was significantly increased after UV-irradiation. A possible relationship between repair capacity after gamma-respectively UV-irradiation and the etiologic factor of autoimmunity is discussed.


Hemobilia: a case with recurrent jaundice cured by removal of a blood clot from the common bile duct. A 78-year-old woman was admitted for recurrent jaundice, fever and biliary colic. At operation the common duct was found to be filled with a large blood clot. Removal of this clot resulted in a clinical cure.


Action of aprotinin on the survival of adult cerebellar neurons in organ culture. Fragments of cerebellar cortex taken from adult rats were maintained for 7 days in organ culture. Inclusion in the medium of aprotinin, a polypeptide proteinase-inhibitor which also has carbohydrate-binding properties, was beneficial to the survival of neurons in the molecular layer, Purkinje cells and axons. This effect of aprotinin was mediated during the first 3 days in vitro. In a discussion of the various actions of aprotinin, it is concluded that the principal effect of the polypeptide on cultured central nervous tissue is to inhibit neuronal lysosomal proteinases activated by the trauma of explantation.


Biasing of the summating potentials.

Biasing of the summating potentials. Summating potentials (SP) were recorded in the guinea pig cochlea, utilizing the differential-electrode technique. The effects of biasing the cochlear partition of the SP were observed under three different conditions: 1. electrical biasing--direct current polarization: 2. stimulus biasing--mechanical bias induced by low frequency sound stimulation, 3. COCB biasing--electrical stimulation of the crossed olivo-cochlear bundle. All three forms of biasing were found to have similar ellects on the SP which can be described in terms of the "absolute direction of change" in the potential. Under negative current (scala vestibuli negative; scala tympani positive), the negative phase of the stimulus bias (deflection of the cochlear partition towards scala vestibuli), or stimulation of the COCB, the SP is made more positive or less negative, as the case may be. In other words, the negative component of the differentially recorded SP is depressed, wheras the positive component is enhanced. The dominant influence os all three forms of biasing appears to be on mechanoelectric distortion arising in the hair-cell transduction process.


Fine structure of granulocytes with cytoplasmic inclusions in pleural effusions from patients with rheumatoid pleuritis, tuberculous pleuritis and pleural carcinomatosis. The fine structure of neutrophil granulocytes from pleural fluid obtained from patients with rheumatoid or tuberculous pleuritis or epidermoid carcinoma of the lung was identical irrespective of the primary disease of these patients. Homogenously stained lipid-like inclusions were present in the cytoplasm of the neutrophil granulocytes. They seemed to be formed de novo, as they lacked a distinct limiting unit membrane. The fine structure of the lipid-like inclusions gave no evidence to support the presence of immune complexes, these were probably located in the quantitative much fewer phagosomes of the granulocytes.


Biological considerations for the use of homograft tympanic membranes and ossicles. This report deals with some biological aspects of transplantation and preservation of tympanic membrane and ossicular grafts. The structure and behaviour of tympanic membrane grafts depends largely on the reaction of the preservatives with the tissue proteins. Due to these properties no observable change in the microscopical structure of the membranes and ossicles was found up to 3 years after alcohol and formaldehyde preservation. Preservation in cialit showed gradual disappearance of nuclei and an increasing disintegration of the fibrous structures. Irrespective of the mode of preservation, the fibrous tissue appeared to persist virtually unaffected for long periods. The monocellular reaction found around the grafts preserved in formaldehyde after heterolopie transplantation suggests that tissue antigens are not completely destroyed. A reaction to transplantation in the middle ear is only found around fresh heterologous grafts and around the fresh homologous grafts after previous sensitisation. As observed in rats, ossicles preserved in alcohol or cialit, obtained from revision operations in humans showed partial remodelling. Moreover in some cases these ossicular and especially the cartilaginous grafts showed areas of frank erosion.


Coronary artery bypass in patients over 70 years of age: indications and results. With recent advances in all phases of coronary care and the increasing success of coronary arterial surgery, operative treatment of coronary artery disease is more readily recommended, even for patients over 70 years of age. In a series of 3,730 patients who underwent aortocoronary bypass from November 1969 through June 1974, there were 95 patients who were 70 years of age or older. The primary indication for surgery was severe angina, which was present in 88 patients. The mean coronary arterial score was 9.51. Associated valvular lesions were treated surgically in 21 patients, and a left ventricular aneurysm was resected in 7. Improvements in surgical technique and postoperative care are responsible for the hospital mortality rate of only 4.8 percent in the 21 patients operated upon during the first 6 months of 1974 compared with the overall mortality rate of 22.1 percent in all 95 patients. Long-term follow-up among the 95 patients includes data from 33 patients: 9 patients whose condition improved, 21 who were asymptomatic and 1 "coronary death".


Myocardial revascularization after acute infarction. The purpose of this study was (1) to establish the maximal interval between the onset of ischemia and reperfusion that would permit a decrease in the size of infarction, and (2) to evaluate the relation between changes in infarct size and preservation of cardiac function. Studies were carried out in 19 dogs of which 13 had temporary (1 to 3 hours) occlusion of the left anterior descending coronary artery. The hospital course of 15 patients of whom 13 underwent myocardial revascularization within 8 hours of acute infarction was also reviewed. In dogs, the eventual pathologic infarct size was significantly reduced if reperfusion was performed within 2 hours of ischemia. After 2 hours of ischemia, the revascularized segment remained dyskinetic on angiographic assessment and cardiac function was depressed. After 3 hours of ischemia, in spite of a patent coronary artery, the extent of infarct and dykinesia was greater than during ligation of the left anterior descending coronary artery. In patients, small infarcts developed with revascularization performed more than 4 hours after infarction but with revascularization of the left anterior descending coronary artery the size of the dyskinetic area (as assessed with angiography) was similar to that in patients with a closed graft to the left anterior descending coronary artery but with a patent graft to its diagonal branch. In all patients after revascularization the extent of the left ventricular dyskinetic area was smaller and cardiac function was significantly better than in patient who did not receive revascularization for complete occlusion of the left anterior descending coronary artery. In spite of successful revascularization, electrocardiographic evidence of transmural infarction persisted postoperatively. It is concluded that reperfusion of an area of myocardium that has been ischemic for less than 2 hours in dogs or less than 4 hours in man may lead to a significant reduction in the extent of infarction as well as improvement in cardiac function. However, the revascularized area remains angiographically dyskinetic and electrocardiographically abnormal.


[Protein concentration of perilymph in guinea pigs after noise exposure]. The protein concentration in the perilymph of noise-exposed guinea pigs was investigated using a micromethod described previously. The animals were exposed to wide band noise at 140 dB for one hour unilaterally in a closed acoustic system. Perilymph was obtained after exposure at different intervals: immediately, 6 or 24 hours later. From animals exposed to noise, it is particularly more difficult to obtain perilymph without blood contamination than from normal ones. Even post mortem, it is difficult to obtain samples without blood contamination and without hemolysis, particularly from the scala tympani. Therefore, some animals were perfused intra-arterially with Ringer solution or with Infukoll M 40 before decapitation. After exposure to noise only a small increase in protein concentration of the perilymph can be detected in the noise-exposed ears of animals perfused intra-arterially. The difference in concentration is most distinct in samples extracted 6 hours after noise exposure had ceased. No reliable clue to the source of this protein could be obtained from these investigations.


A simple method to evaluate the massive dose vitamin A prophylaxis program in preschool children. A massive dose vitamin A prophylaxis program is currently in operation in several States of India. Evaluation of this program on a large scale has so far been difficult due to lack of baseline data on the prevalence of vitamin A deficiency in children. In this study, a simple evaluation method which makes use of the linear relationship that exists between age on one hand and prevalence of ocular signs of vitamin A deficiency (Bitot's spots) on the other is described. Regression coefficients between age and prevalence of vitamin A deficiency of areas not covered by the program (control areas) were found to be significantly different both from zero and from regression coefficients of regularly covered areas (experimental areas). Also, all regression lines of control areas were found to be above the regression zone of experimental areas. These differences between the experimental and control areas which were significant, indicate the impact of the program in areas where the program is in operation. The regression coefficient calculated for one area where the program was discontinued after some time was found to be significantly different from zero, also it was different from the regression zone of the experimental areas. However, the regression coefficient of the discontinued area was found to be significantly different from the experimental areas only at 10% level, indicating a lesser degree of efficiency of the program in this area as compared to regularly fed areas. It is, therefore, suggested that evaluation of the massive dose prophylaxis program be done against the null hypothesis beta = 0.0065--the regression coefficient achievable under field conditions.


Familial hypersensitivity pneumonitis.

Familial hypersensitivity pneumonitis. Two families are described in which seven members of a total of 19 were found to have hypersensitivity pneumonitis due to exposure to avian antigens. Diagnosis was made on the basis of characteristic roentgenologic changes together with respiratory function and immunologic studies. The latter included screening for precipitins, macrophage migration inhibition (MMI) to specific antigens in avian serum and droppings, quantitation of immunoglobulin and alpha1 antitrypsin (AAT) levels and assessment of the complement system. Specific precipitins to pigeon and/or budgerigar serum were found in the serum of only four of the seven patients. Six of these seven patients, however, had a positive MMI. Thus, the MMI test, at least in this group of patients appeared to be a more sensitive indicator of active disease. The finding of seven members of two families with disease led to a search for predisposing factors, either genetic or environmental. Evidence for a genetic predisposition came from tissue typing studies. In the first family, both paternal haplotypes were associated with disease; the maternal haplotype HLA3,7 was not inherited by any child with disease. In the second family, the disease developed in three of four members with the haplotype HL-A2,W15, who were significantly exposed to avian antigen. In the light of recent studies showing an association between immune response (Ir) genes, histocompatibility antigens and disease susceptibility, these findings were interpreted as possible evidence for a subtle genetically linked immune defect in hypersensitivity pneumonitis. Evidence for an environmental predisposition was less clear cut, but it is interesting that members of both families used a gamma isomer of hexachlorobenzene (Nickoff) to eradicate mite infestations in their birds which might have damaged the bronchial mucosa or acted as an immunologic adjuvant in a person with underlying susceptibility to disease. The presence of subclinical respiratory disease in two family members is reported, and the importance of performing a range of investigations of respiratory function in order to detect disease and monitor its progress is emphasized.


The decreasing value of external cephalic version in modern obstetric practice. The consequences of 1,308 attempts at external cephalic version in 866 patients over a 5 year period are reviewed. A fetal mortality rate of 0.9 per cent and an over-all complication rate of 4.4 per cent was found, and the value of attempting external cephalic version in modern obstetric practice is seriously questioned.


Endothelial alterations in congenital corneal dystrophies. We studied the clinical and ultrastructural findings in three different types of congenital endothelial dystrophies: hereditary posterior polymorphous dystrophy, congenital hereditary corneal dystrophy, and a nonhereditary congenital endothelial dystrophy. In the first patient, with hereditary posterior polymorphous dystrophy, a layer of epithelial-like cells was observed adjacent to endothelial cells on the posterior corneal surface. Descemet's membrane displayed a multilaminar pattern and consisted of an anterior, thin (3 mu), PAS-positive layer and a posterior, thicker (25 to 30 mu) zone of abnormal collagen. The second patient, with congenital hereditary endothelial dystrophy, showed a thickened multilaminar Descemet's membrane and scant endothelial cells. In the third patient with nonhereditary congenital endothelial dystrophy, the thickened Descemet's membrane was lined posteriorly by a retrocorneal fibrous membrane. A few degenerated endothelial cells were present. All three cases showed 100- to 110-nm banding posteriorly. In these three clinically distinct entities, electron microscopy was useful in demonstrating the unusual form of endothelial transformation to epithelial-like cells in one patient, in contrast to the more common fibroblast-like metaplasia of endothelial cells seen in the other two patients.


Vitrectomy and intraocular gentamicin management of Herellea endophthalmitis after incomplete phacoemulsification. A patient with Herellea endophthalmitis after incomplete phacoemulsification was treated with vitrectomy and intravitreal infusion of 8 mug/ml of gentamicin and 400 mug of dexamethasone. The vitrectomies were done through a pars plana incision with the vitrophage. Additionally, appropriate systemic antibiotics and prednisone were given.


The fine structure of thymoma, with emphasis on its differential diagnosis. A study of ten cases. In this study, thymoma is defined as a neoplasm of the epithelial-reticular framework cells of the thymus. As in the normal thymus, these cells regularly displayed branching tonofilaments, macuale adherens, elongated processes, and basal lamina. These characteristics proved useful in the differential diagnosis of thymoma from a variety of anterior mediastinal tumors including thymic carcinoid, lymphoma, germinoma (seminoma type), and fibrous mesothelioma. Lymphocytes in the thymomas often showed mitotic activity and a moderate degree of transformation. The significance of this and the gland-like spaces, vacuolated epithelial cells, starry-sky appearance, emperipolesis, and perivascular spaces is discussed.


Incidence of stress ulcer formation associated with steroid therapy in various shock states. The use of pharmacologic doses of steroids early in the shock state, within the first hour when possible, for periods of less than forty-eight hours seems to reduce the incidence of gastric ulceration and hemorrhage in low flow states associated with septic, cardiogenic, and hemorrhagic shock.


T-lymphocyte levels in the peripheral blood of patients with cancer of the head and neck. Percentage and levels of circulating T-lymphocytes were studied in forty-six patients with squamous cell carcinoma of the head and neck before and/or after treatment and compared with control values obtained in fifty-one healthy volunteers. Mean percentages of circulating T-cells and mean T-cell levels in cancer patients prior to treatment were significantly lower than control values. After surgery or radiation therapy the mean percentage of T-cells remained lower in comparison with that of the controls whereas T-cell levels in patients evaluated after surgical treatment increased in comparison with pretreatment values and were not significantly different from those of the controls.


High dose methotrexate as a preoperative adjuvant in the treatment of epidermoid carcinoma of the head and neck. A feasibility study and clinical trial. Thirty patients with operable epidermoid carcinoma of the head and neck were treated with intravenous high dose methotrexate and leucovorin rescue prior to resection. Their clinical courses were compared with those of thirty randomly selected patients matched for tumors site and clinical stage who were treated by surgery alone. No medical or surgical complications associated with methotrexate were encountered. An objective decrease in tumor size (primary lesion or nodal metastases) was noted prior to resection in twenty-three patients (77 per cent). The number of recurrences in the two groups was similar. However, these was a significantly greater disease-free interval in the methotrexate-treated patients (p less than 0.05). No significant differences in survival have been noted to date between the two groups. In view of the absence of complications, the regressions in tumor size, and the increase in postoperative disease-free interval in this trial, evaluation as preoperative adjuvants of higher doses of methotrexate and of other chemotherapeutic agents in combination with methotrexate appears warranted.


[An equidensometric method for objective evaluation of ultrasonic b-scan pictures (author's transl)]. An equidensometric procedure is presented for achieving objective evaluation of ultrasonic B-scan pictures. Using special film (Agfacontour film) it is possible to select and show individually areas of equal brightness appearing on the B-scan, so called "equidensites". This can be done by colouring each area differently or by using a system of symbols. There is a description of the way in which the Agfacontour film works and is processed. Clinical evidence can be provided to prove the equidensometric evaluation of ultrasonic B-pictures of the eye can offer a considerable amount of additional information.


Ocular pulse wave in workers exposed to carbon disulfide. Oculosphygmography (OSG), combined with electrocardiography, was performed on 38 male workers exposed occupationally to carbon disulfide (CS2) and 40 unexposed male paper mill workers. A statistical analysis of the results showed that the ocular pulse wave of the exposed group showed a significantly lower pattern than that of the unexposed group. A comparison between workers currently exposed to CS2 and those no longer exposed indicated that the hemodynamic alterations caused by CS2 exposure lead to a permanent condition. It is concluded that CS2 exposure increases the rigidity of the vascular bed of the eye. The data indicate that primarily chronic, subclinical CS2 poisoning causes capillary damage. Oculosphygmography seems to be one objective examination useful in diagnosing the subtle syndrome of chronic CS2 poisoning.


Management of dense secondary membranes with vitrophage. Seven patients underwent a pars plana approach membranectomy and vitrectomy with the vitrophage for the removal of dense secondary membranes after planned or unplanned extracapsular lens extractions. In all cases the membranes and synechias were removed with restoration of clarity to the ocular media. In three cases the final vision was limited by unrelated ocular anomalies. There were no postoperative corneal or retinal complications. The advantages to the pars plana approach are the small incision, the prevention of vitreocorneal adhesion, and the ease with which the surgery is performed.


Methods of mathematical differentiation in tonography. Our bulbar-compressure isotonographical method was applied to 28 normal and 40 glaucomatous eyes. This method was carried out twice on all patients using two pressure gradients: Pt=Po+10 and Pt=Po+30. Also, the outflow facility (C) was determined by Grant's tonography. Thus, 3 C-values were obtained with 3 varying pressure differences (Pt-Po=deltaP). With this differential tonography the mathematical determination and the graphic representation of a real C-value (Cdiff) by deltaP=O are possible. With normal eyes the average C-values were indirectly proportional to the pressure differences. This relationship was found to be directly proportional on glaucomatous eyes. The tonographical coefficients Po/Co-4, P3/CL3-7, Po-10/Co-4, and Po/Cintegral were calculated on 104 normal and 312 glaucomatous eyes. The results show small differences between the average values of the various coefficients for normal and glaucomatous eyes. The percentage of the pathological values on glaucomatous eyes varies from 57.4% to 67.3%. The diagnostic efficiency of the tonography is increased by the determination of Cdiff (percentage of positive values=70%) and the calculation of Po/Cdiff value (95%).


[Typical retinitis pigmentosa with chronic progressive external ophthalmoplegia (author's transl)]. Report of a case of chronic progressive external ophthalmoplegia combined with retinitis pigmentosa, optic atrophy, marked attenuation of the retinal vessels, maculopathy, and complicated cataract. Visual fields and acuity were severely impaired. The ophthalmoplegia was histologically identified as ocular myopathy. In a review of 181 cases with CPEO  the disease was found to be associated with retinitis pigmentosa in 7 per cent and with atypical pigmentary retinopathy in 36 per cent of the cases. A distinction of these two types of retinal dystrophy is justified by the clinical features and may indicate different hereditary patterns.


[The electrophysiological behavior of normal and glaucomatous human eyes with short term intraocular pressure elevation (author's transl)]. An electrophysiological study has been done on glaucomatous and normal eyes with briefly elevated intraocular pressure. There was no significant difference between the ERGs, but the changes in the VERs of glaucomatous eyes differed widely from those of normal eyes. This seems to be due to the high sensitivity to pressure of the prelaminary part of the optic nerve in glaucomatous eyes. Obviously this could be a method for the objective measurement of the sensitivity of the papillary vessels to raised intraocular pressure.


[Peripheral retinal circulation times in connection with retinal detachment (author's transl)]. Concerning the pathogenesis of retinal detachment 4 groups of each 10 eyes have been examined by fluorescein angiography: the periphery of normal eyes (Table 2), ophthalmoscopically inconspicuous sectors of patients with detachment (Table 3), the area of lattice degeneration, radial perivascular degeneration and round holes without detachment (Table 4) and the area of tears and holes, when detachment has taken place (Table 5). The time passing between the injection of dye into the cubital vein and the first arterial filling in the retinal periphery is practically equal in all groups. The prolongation of retinal circulation time II from the first arterial to the complete venous filling in areas of lattice degeneration etc. without detachment seems to be in connection with small vessel closures. The striking short retinal circulation time I from the first arterial to the first venous filling in the cases of detachment is apparently caused by capillary dilatations central of the tears and holes; the dilated capillaries seem to have the function of a arteriovenous anastomosis. Own measurements of circulation times in the area of optic disc (Table 1), performed for comparisments, are accordant to literature.


Life span of small lymphocytes in the thymolymphatic tissues of normal and thymus-deprived BALB/C mice. Autoradiography and scintilation counting have been used after various schedules of 3H-thymidine injections to evaluate lymphocyte kinetics in normal and thymus-deprived BALB/C mice. The thymus was found to be an active production site of small lymphocytes, the majority of these cells having thymic residence times of three to five days. Peripheral lymphoid tissues--including spleen, lymph nodes and Peyer's patches--were dominated by long-lived lymphocytes and produced very few small lymphocytes. Nearly identical percentages of long-lived lymphocytes with comparable grain counts were found in the peripheral tissues. In adult thymectomized animals, and in mice thymectomized and reconstituted with bone marrow cells following total body irradiation, percentages and lifespan of long-lived lymphocytes were found to be of the same order as in normal or sham-operated controls. It is concluded that T cells in the peripheral long-lived pool can be formed outside the thymus and that the bone marrow probably produces long-lived B lymphocytes.


The use of protease inhibitor (trasylol) and heparin in cardiorespiratory resuscitation. I. Studies of the blood clotting system. The purpose of the study was the assessment of the effect of protease inhibitor (trasylol) and heparin on the blood clotting system during cardiorespiratory resuscitation. The studies were carried out in two experimental groups of rabbits. In group I oxygen was given, cardiac massage was applied, alkalinizing agents and drugs improving the action of the heart and the peripheral circulation were administered. In group II trasylol and heparin were given additionally. The studies proved that cardiorespiratory arrest causes development of the intravascular clotting syndrome. Resuscitation management in group I failed to correct the disturbances in the blood clotting system. On the other hand, in group II they were partly corrected. The animals in this group survived the experiment. The administration of protease inhibitor and heparin increased the efficiency of resuscitation management.


[Lymphocytes. Roles in cellular immunity and humoral immunity]. The lymphocytes are now considered as ubiquitous cells which play a role in delayed hypersensitivity, the rejection of grafts and antibody synthesis. The lymphocytes are essential in the immune process, for they may both recognise the antibody and initiate the response. They act either by themselves or after differentiation into specialised cells and, usually, in coordination with other cells with phagocytic functions. After briefly recalling the morphology, localisation, circulation, sites of production and heterogeneity of the lymphocytes, the authors discuss their function, describe lymphocytic transformation, and the role of T lymphocytes in delayed hypersensitivity, in the rejection of grafts and the direct cytotoxic effect. Antibody synthesis with B lymphocytes and the intervention of mononucleated cells with phagocytic activity, the cooperation of T lymphocytes are developed. The exploration of lymphocytic functions includes the recognition of an antigen by the lymphocyte, fixation of marked antigens, rosette formation, the demonstration of delayed hypersensitivity (inhibition of macrophage migration, cytotoxicity, skin tests), the estimation of antibodies and measurement of lymphocyte transformation. Certain factors, due to antigen-host reaction, regulate the lymphocytic immune reaction. One may experimentally intervene by immunostimulation and immunosuppression.


Fibrinolysis activation after operation of spermatic cord. The authors report a case of fibrinolytic haemorrhagic diathesis after operation of vas deferens carried out under epidural analgesia. Attention is called to the diagnostic difficulties in the rare complication of these operations. Treatment of fibrinolytic haemorrhagic diathesis is discussed stressing the advantages of trasylol, which is a drug of choice in emergency states associated with bleeding from the surface of the wound when difficulties arise in carrying out full blood clotting tests.


Outcome analysis of surgical therapy for patients with angina pectoris. Surgical therapy for coronary artery disease results in improved survival rates for selected groups of patients, particularly those with left ventricular dysfunction and/or severe coronary artery disease as evidenced by involvement of two or more vessels. Successful augmentation of coronary blood flow as shown by patient saphenous vein graft is associated with improved exercise tolerance when compared with patients in whom the grafts are occluded. Patients with impaired left centricular function as a result of their coronary artery disease appear to experience an improvement in this function with the augmentation of coronary blood flow by patent saphenous vein bypass grafts. In patients with occluded grafts and impaired left ventricular function, the left ventricular function is unchanged. Ptients with normal left ventricular function who  sustain occlusion of their grafts will probably experience a reduction in their systolic ejection fraction.


Scopulariopsosis and hypersensitivity pneumonitis in an addict. Granulomatosis caused by fungal spores of a soil saprophyte is a newly recognized pulmonary complication of intravenous drug addiction. Brown, non-budding spores were histologically identified in necrotic tissue, inside giant cells of sarcoidlike granulomata, and in the vicinity of focal angiitic lesions. The fungus was identified by culture as the dematiaceous Scopulariopsis brumptii. Cultural and histopathologic studies of lung biopsy specimens established the diagnosis. We showed precipitating antibodies to fungal antigen in the serum, prepared from the patient's isolate. Similar granulomatous pulmonary lesions were experimentally produced in mice by a single intravenous injection of spores of S. brumptii. The spores remained viable but did not show evidence of growth in the animal's tissue. Precipitating antibodies to fungal antigen and immediate wheal and late necrotizing type of skin reactions were shown in the challenged mice. The studies support the notion that pulmonary hypersensitivity to fungal spores was mediated by an Arthus'-type phenomenon.


Profiles of antinuclear antibodies in systemic rheumatic diseases. The prevalence of different antinuclear antibodies was examined in systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome, progressive systemic sclerosis, dermatomyositis, discoid lupus erythematosus, and mixed connective tissue disease. Antibody to Sm antigen (a nuclear acidic protein) was found almost exclusively in serums of patients with systemic lupus erythematosus, suggesting that this antibody might be a "marker" antibody for this disease. However, antibodies to native DNA and to nuclear ribonucleoprotein were found in a variety of systemic rheumatic diseases. In systemic lupus erythematosus, antibody to native DNA was present in high titer but in other rheumatic diseases in low titer. Antibody to nuclear ribonucleoprotein occurred in certain other systemic rheumatic diseases besides the mixed connective tissue disease syndrome. These studies showed that there were distinct profiles of antinuclear antibodies in certain systemic rheumatic diseases, characterized by the presence or absence of certain antibodies and by differences in their mean titers.


[Variability of cultures and genetic variability]. Cultural selection is defined as a modification in gene frequency distributions within a population under the effects of socio-cultural factors. The conditions are examined which determine the efficiency of such a selection mechanism as a driving force for the evolution of the genetic pool of a social group in a state of relative isolation. The possible effect of the cultural variation on the genetic variation of the human species is discussed.


[Comparison of the karyotype of the orangutan (Pongo pygmaeus) to those of man, chimpazee, and gorilla]. Various banding thechniques were employed to compare the karyotype of the Orang-utan (Pongo pygmaeus) with those of Man, the Chimpanzee, and the Gorilla. The following was concluded: 1) Almost all the bands are common, their analogy being close to 99%. The four species derive, therefore, from a common ancestor. The rearrangements which occurred during evolution were generally balanced; 2) The analysis of rearrangements shows that the Orang-utan, then the Gorilla, then the Chimpanzee, and lastly Man were derived in that order from the common stemline.


[Gene localization in the chimpanzee (Pan troglodytes). Comparison with the factor mapping of man (Homo sapiens)]. Ten independant cellular hybrids were obtained from Chimpanzee (Pan troglodytes) fibroblasts and the murine cell line C11D. The comparison of electrophoretic and cytogenetic studies showed that 9 markers with known localizations in Man could also be localized on the homologous chromosomes of the Chimpanzee: pyrophosphate hydratase (PPH), phosphoglucomutase-1 (PGM1), and peptidase-C (Pep-C) on the No. 1; malate dehydrogenase MDH(NAD) on the No. 2; lactico dehydrogenase-A (LDH-A) on the No. 11; lactico dehydrogenase-B (LDH-B) on the No. 12; thymidine kinase (TK) on the No. 17; superoxide dismutase-1 (SOD-1) on the No. 21; glucose-6-phosphate dehydrogenase (G6PD) on the X. The localization of mannose phosphate isomerase (MPI) on the No. 7 could be excluded. One discrepancy between Chimpanzee and Man was noted: the localization of superoxide dismutase-2 (SOD-2) on the 6 is excluded.


[2 cases of trisomy 11q(q23.2-- qter) with the same abnormality of external genitalia]. Two unrelated individuals are reported with the same clinical picture and trisomic for the same segment of chromosome 11 (q23 leads to qter). That both were seen because of micropenis raises the possibility that genes interfering with the reproductive function are located on chromosome 11 and that the q23 band might be a preferential breakage point of chromosome 11. Certain earlier reports support such a possibility.


[2 cases of trisomy 11q(q231--qter) by translocation t(11;22) (q231;q111) in 2 different families]. Two cases of partial trisomy 11q are reported, both apparently due to segregation in both patients' families of the same translocation between a n degrees 11 and a n degrees 22. R-, T-, and G- banding showed the breakage points to be 11q231 and 22q111. The clinical syndrome results from trisomy for the q231 leads to qter segment of chromosome 11.