Histoincompatibility and maternal immunological status as determinants of fetoplacental weight and litter size in rodents. Studies conducted upon inbred strains of mice, hamsters and rats have shown that following the interstrain matings the now familiar covert reactivity of pregnant females to the alloantigens of their conceptuses may benefit the latter in two ways; firstly, it exerts a significant influence upon placental weight, and indirectly upon the birth weight of the fetus-allogeneic placentas tending to be heavier than syngeneic placentas, and mothers specifically presensitized against alien paternal tissue antigens gestate fetuses with heavier placentas than normal females. Specifically tolerant mothers, on the other hand, produce smaller, F1 hybrid, fetoplacental (fp) units. The classic notion that the disparity between the birth weights of F1 hybrid and homozygous offspring is due to hybrid vigor has been challenged by the finding that DA and (DA times F1)F1 hybrid blastocysts transferred to the uteri of genetically tolerant (DA times F1)F1 hybrid rats produce fp units of similar weight Maternal immunological reactivity against the fetus qua allograft may make a significant contribution here. Additional support for the premise that maternal reactivity against fetal alloantigens in some way promotes the growth of the fp unit was afforded by the finding that excision of the para-aortic lymph nodes (which drain the uterine horns) from females before interstrain matings resulted in smaller fp units than in females subjected to sham operations. The finding with one rat strain combination that passive immunization of females with serum against their F1 hybrid conceptuses promoted the growth of the latter suggests that a humoral rather than a cellular immunity may be involved. Secondly, in the three species studied, it was observed that genetic disparity between a conceptus and its mother significantly improved its chances of implantation and development to term.


Genetical control of B-cell responses. IV. Inheritance of the unresponsiveness to lipopolysaccharides. The inheritance of B-cell responsiveness to lipopolysaccharide (LPS) was studied in 55 crosses between mice of the low-responder strain C3H/HeJ and the high-responder strains B10.5M and C3H/Tif. F1 hybrid mice between the low-and the high-responder strains, showed in every case responses which were intermediate between the responses obtained with each parent. The responsiveness among F2 hybrid and backcross mice to either high- or low-responder parents, segregated into intermediate, high, or low categories, respectively. The present results are compatible with the hypothesis that responsiveness to LPS is determined by one single, codominantly expressed, autosomal gene. The capacity to develop a specific thymus-independent response to a hapten-LPS conjugate, also under genetical control, was found to segregate together with the capacity to develop polyclonal responses to LPS.


Distribution of fibroblast surface antigen in the developing chick embryo. Fibroblast surface (SE) antigen is present in fibrillar surface structures of cultured normal fibroblasts, shed to the extracellular medium, and is also found in circulation (serum and plasma). Malignant fibroblasts (transformed by viruses) do not express SF antigen on the cell surface. In this study the in vivo differentiation and distribution of SF antigen has been investigated in the developing chick embryo using cryostat sections and immunofluorescence. The major findings were: (a) SF antigen was detectable in the loose connective tissue of very early (2-to 3-day old) embryos. (b) Condensation of SF antigen was seen in various boundary membranes such as the glomerular and tubular basement membranes of the kidney, the boundary membranes of the notochord, yolk sac, and vitelline membranes and liver sinusoids. (c) SF antigen was found to be cell-type specific. It was seen as a fibrillar network in the loose connective tissue of different organs but not in the parenchymal cells. It was not found in muscle cells at any stage of development. (d) The antigen was present in the undifferentiated mesenchymal cells of the kidney; but not found after their development into epithelial cells of the secretory tubules. (e) Both in vivo and in fibroblast cultures SF antigen was distributed as a fibrillar network. These data indicate that SF antigen is a "differentiation antigen" restricted to certain cells of mesenchymal origin and character, and that is accumulates in the connective tissue during embryogenesis.


In vitro selection and extended culture of antigen-specific T lymphocytes. I. Description of selection culture procedure and initial characterization of selected cells. Specific selection of antigen-responsive guinea pig peritoneal exudate lymphocytes (PELs) was achieved by a selection culture procedure. This procedure involved the addition of PELs from immune donors to monolayers of antigen-pulsed adherent peritoneal exudate cells from nonprimed syngeneic donors. PELs which failed to adhere were discarded at 24 and 48 h; after 1 wk of culture, lymphocytes were obtained which were highly responsive to the antigen for which they were selected but which demonstrated little or no response to other antigens to which the original donor of the lymphocyte was immune. These selected cells were largely T lymphocytes and could be maintained in culture for 2-5 wk in an antigen-responsive state and, in 20-30% of cases, for 8-10 wk in an antigen-independent state.


Selective utilization of clinical diagnosis in treatment of pharyngitis. Exudate, adenopathy, and fever were used to predict clinically whether pharyngitis was streptococcal, nonstreptococcal, or questionable in 466 adults and 234 children. Clinical accuracy was: nonstreptococcal - adults 94.6 percent, children 86.9 percent; streptococcal - adults 44.2 percent, children 53.5 percent. Significance of results was determined by calculating the cost of routine cultures compared to risk of rheumatic fever. The economic justification of cultures was lowest in nonstreptococcal adults, streptococcal adults, and streptococcal children. Therapy of streptococcal patients presented an additional risk: anaphylaxis. The fatality risk after penicillin injection compared to the increased risk of rheumatic fever after oral penicillin is: adults 7.5 percent (clinical diagnosis), 3.3 percent (laboratory diagnosis); children 1.8 percent and 0.8 percent respectively. It is recommended that throat culture be obtained for all questionable patients and clinically nonstreptococcal children. Penicillin should be administered orally in the majority of adults.


Hematospermia.

Hematospermia. During a 15-year period, 200 patients with hematospermia were seen at the Mayo Clinic. General physical examination, including digital rectal palpation and urinalysis, was performed on all 200 patients. Of these, 26 had no additional urologic evaluation. In the remaining 174 patients, cystoscopy and K.U.B. roentgenography were done. The results of urologic evaluation in the 174 patients revealed various minor abnormalities in 64; however, in no instance was there significant urologic disease. During follow-up of five to 23 years in 150 of the 174 patients, 106 had no further hematospermia whereas 44 had recurring hematospermia, which persisted in some for more than ten years. None of these patients developed any significant disease related to the hematospermia. In our experience, the occurrence of hematospermia in an otherwise asymptomatic man with normal findings on physical examination, including digital rectal examination, seems not to be associated with the presence of, and does not lead to future development of, significant urologic disease.


A critical review of periodic health screening using specific screening criteria. 3. Selected diseases of the genitourinary system. Despite the increasing interest in recent years in prevention and early recognition of asymptomatic disease, an objectively based program for periodic health screening of asymptomatic adults has yet to be proposed for the primary care physician. This is the third in a series of four articles which will critically examine the feasibility of screening procedures for 36 selected diseases. Six basic criteria are adopted as necessary to justify periodic screening. Specific screening recommendations are made for each disease, and a longitudinal screening program for asymptomatic adults will be proposed in the concluding article of this series.


A synthetic strand of cardiac muscle: its passive electrical properties. The passive electrical properties of synthetic strands of cardiac muscle, grown in tissue culture, were studied using two intracellular microelectrodes: one to inject a rectangular pulse of current and the other to record the resultant displacement of membrane potential at various distances from the current source. In all preparations, the potential displacement, instead of approaching a steady value as would be expected for a cell with constant electrical properties, increased slowly with time throughout the current step. In such circumstances, the specific electrical constants for the membrane and cytoplasm must not be obtained by applying the usual methods, which are based on the analytical solution of the partial differential equation describing a one-dimensional cell with constant electrical properties. A satisfactory fit of the potential waveforms was, however, obtained with numerical solutions of a modified form of this equation in which the membrane resistance increased linearly with time. Best fits of the waveforms from 12 preparations gave the following values for the membrane resistance times unit length, membrane capacitance per unit length, and for the myoplasmic resistance: 1.22 plus or minus 0.13 x 10-5 omegacm, 0.224 plus or minus 0.023 uF with cm-minus 1, and 1.37 plus or minus 0.13 x 10-7 omegacm-minus 1, respectively. The value of membrane capacitance per unit length was close to that obtained from the time constant of the foot of the action potential and was in keeping with the generally satisfactory fit of the recorded waveforms with solutions of the cable equation in which the membrane impedance is that of a single capacitor and resistor in parallel. The area of membrane per unit length and the cross-sectional area of myoplasm at any given length of the preparation were determined from light and composite electron micrographs, and these were used to calculate the following values for the specific electrical membrane resistance, membrane capacitance, and the resistivity of the cytoplasm: 20.5 plus or minus 3.0 x 10-3 omegacm-2, l.54 plus or minus 0.24 uFWITHcm-minus 2, and 180 plus or minus 34 omegacm, respectively.


Missense suppression in Coprinus lagopus associated wtih a chromosome duplication. Amongst some 70 recessive suppressors of a met-I mutation in Coprinus lagopus, one unstable suppressor was identified. The unstable suppressor, designated sup-6plus, could be maintained on minimal medium, but was lost within 24h on minimal medium containing more than 1-7 p.p.m. DL-methionine or 0-75 p.p.m. L-methionine. Isolation of hyphal tips from the monokaryotic strain carrying sup-6plus yielded three types of colony: the unstable parental type, the stable met-I auxotroph and a stable prototroph which was slow-growing and inhibited by methionine in the growth medium. This stable sup-6plus type was recovered with difficulty by resolving dikaryons formed between the unstable sup-6plus strain and strains carring the wild-type allele of the suppressor gene. From sexual crosses, neither the unstable nor stable sup-6plus type segregated, only the met-I auxotrophic revertant. The unstable sup-6plus strain is thought to have an extra chromosome carrying the sup-6plus mutation. For vigorous growth the wild-type allele, sup-6, is indispensable and would be carried on the homologous chromosome. The selective pressures on different media account for loss of the duplicated chromosomes. The results are interpreted as missense suppression by a mutant of an indispensable tRNA.


A novel actinomycete from sugar-cane bagasse: Saccharopolyspora hirsuta gen. et. sp. nov. A new species of nocardioform actinomycete isolated from spontaneously heated sugar-cane bagasse is described as Saccharopolyspora hirsuta gen. et sp. nov. It has affinities with species of both Nocardia and Actinomadura but can be distinguished from both genera by its morphology, sporulation, wall and lipid analyses, antibiotic resistance, degradation and carbon utilzation tests.


Purification and Characterization of two bacteriocins from Streptococcus faecium. Two bacteriocins were found in the supernatant fluid and in an extract of Streptococcus faecium strain EI. The small soluble enterocin EIA represented more than 90% of the total activity in the supernatant fluid, and was purified 400-fold by ammonium sulphate fractionation, gel filtration on Sephadex G-75 and chromatography on DEAE-cellulose. Enterocin EIB, with a particle weight greater than 4 x 10(6), was the predominant type in the extract. It was released in appreciable quantities after breakage of the bacteria and was purified 100-fold by differential centrifugation, chromatography on Sepharose 4B and density gradient ultracentrifugation. Enterocin EIA, a basic substance with a molecular weight of about 10000, was resistant to heat and was attacked by trypsin, whereas enterocin EIB was less thermostable and insensitive to proteolytic enzymes. The activity of enterocin EIB was unchanged by treatment with DNAase. Sensitivity to enterocin action was confined to certain strains of various enterococcus species, Streptococcus salivarius and Listeria monocytogenes; all the other Gram-positive and Gram-negative bacteria tested for sensitivity were unaffected by either enterocin.


Extremely thermophilic gram-negative bacteria from hot tap water. Two strains of heterotrophic, non-motile, Gram-negative extreme thermophiles have been isolated from hot tap water. These strains (NH and DI) have been characterized and compared with strains of genus Thermus. Few of the single organic compounds tested supported growth in the presence of ammonium salts, and, like Thermus strains, growth on undefined media was restricted to dilute tryptone-yeast extract-mineral salt solutions. Nutrients agar and similar common laboratory media did not support growth. The growth rate was similar to that of Thermus strains, as was the unusual pattern of antibiotic resistance. Mean base composition of NH was 61-4% guanine plus cytosine (G+C), and DI was 62-0 to 62-2% G+C, which are several per cent lower than  the G+C contents of other strains so far described.


Modification of the membrane composition of Mycoplasma mycoides subsp. capri by the growth medium. Mycoplasma mycoides subsp. capri was grown in different media. The amounts of the lipids in these media were varied, resulting in altered lipid compositions of the cells. Lowering the amounts of cholesterol in the media resulted in less cholesterol incorporation into the cell lipid, with a concomitant decrease in the amount of phospholipid. The changes in the phospholipid/cholesterol ratio in the mycoplasmas were very small compared with the large changes in the amounts of cholesterol which occurred when the cholesterol content in the medium was altered. Changes in the amounts of glycolipid and glyceride in the cell lipid also resulted from alterations of the cholesterol concentration in the media. Under these conditions cell with reduced cholesterol contents were more sensitive to lysis by digitonin. No changes were observed in the polyacrylamide gel electrophoretic pattern of cellular or membrane proteins when the cholesterol was replaced by other sterols.


Genetics of a primaquin-resistant yeast. Primaquin specifically inhibits mitochondrial function in yeast. Mutants resistant to primaquin have been isolated. Genetic analysis revealed that the expression of resistance in one of them was under the control of both a nuclear gene and a cytoplasmic factor (possibly a mitochondrial gene).


Sex pili as immunogens.

Sex pili as immunogens. Groups of chickens were vaccinated intravenously with live cultures of Escherichia coli K12 possessing transfer factors F, I, A2 or no transfer factor (Tra-minus) and their immunity challenged by injecting them intravenously with an F-plus strain of Salmonella heidelberg or an F-plus or I-plus strain of Salmonella typhimurium. Compared with the Tra-minus strain, vaccination with the F-plus, but not the I-plus or A2-plus, K12 strain significantly reduced the mortality rate caused by the F-plus salmonella strains; vaccination with the I-plus or A2-plus, but not the F-plus, K12 strain significantly reduced the mortality rate caused by the I-plus salmonella strain.


A comparison of analytical methods for the numerical taxonomy of yeasts. Four methods of numerical analysis were tested to assess the taxonomic relationships of species of yeasts in 20 genera using characters obtained from standard descriptions. Relationships varied according to the analytical method employed. It is suggested that a reduction in the present number of genera may be necessary to justify the taxonomic rank of genus.


Genetical studies of serum resistance in Escherichia coli. One induced and one spontaneous serum-resistant mutant were derived from smooth serum-sensitive Escherichia coli strains. There was little difference in the yield or the O-side-chain-sugar to core-sugar ratio of lipopolysaccharides from the mutants compared with the parental strains. The mutations to serum resistance were not accompanied by increases in either the amount or haemagglutination-inhibiting activity of acidic polysaccharides extracted from the strains. Two colonially rough forms, designated 17fa and 17gb, were isolated from an aged culture of serum-resistant mutant 17. Escherichia coli 17fa appeared to be a som mutant and was rapidly killed by serum. Escherichia coli 17gb retained serological O-specificity, and 17gb lipopolysaccharide contained a full complement of O-side-chains; the strain was killed by serum but only after a delay of 1 h. Escherichia coli K-negative O8 donor Hfr59, which was serum-resistant, was crossed with rough serum-sensitive E. coli strain F470 and his+ recombinants were selected. The majority of his-+ recombinants inherited a full complement of lipopolysaccharide O-side-chains but were killed by serum after a delay of 1 to 2 h. These results suggest that lipopolysaccharide O-side-chains are responsible for a delay in the killing by normal human serum of smooth E. coli strains but that other factors determine full serum resistance. No evidence was found of a role for K-antigens in serum resistance.


Therapeutic reversal with benxtropine in schizophrenics. Practical and theoretical significance. The effect of an anticholinergic antiparkinsonism drug, benztropine, on the therapeutic course of neuroleptic treatment in 18 schizophrenics was investigated in a double blind cross-over study involving haloperidol and chlorpromazine. Significant therapeutic reversal was observed with benztropine in terms of the social, affective,and cognitive dysfunctions chracteristically seen in schizophrenic psychosis. The hallucinatory behavior and disturbed attention were not so affected. The aspects of the clinical picture to show significant nontherapeutic change with benxtropine differed with the stage of treatment and seemed to be determined by the kinetics of the therapeutic process. The effect was one of exacerbation of the disorder and not a toxic confusional state sometimes associated with anticholinergic drugs. The practical and theoretical significance of these findings was discussed. It was suggested that the benztropine reversal of therapeutic changes provided a valuable pharmacological model for understanding the neurobiological basis of schizophrenic decompensation and its restitution with neuroleptics. The reported data were considered as indirect evidence suggesting that cholinergic neuronal mechnisms are involved in both of these processes. It was speculated that these mechanisms may well be the cholinergic suppressor systems, such as the periventricular catecholamine pathways in the limbic organization and bsal ganglia known to be affected by neuroleptics.


The effects of electrosleep on insomnia revisited. Ten subjects who had suffered from sleep onset insomnia for a minimun of 2 years participated in a double blind study of the effects of electrosleep on this disorder.  This paper reports a 2-year follow-up of these subjects.  Of the five subjects who received 24 live treatments, four appeared to be able to fall asleep with little difficulty and to awake feeling moderately to very well rested.  Only one appeared to have relapsed during the 2-year-no-treatment period.  Of those receiving sham treatment four were having quite a bit of difficulty falling asleep but three of the five awoke feeling moderately well rested.  Although the number of subjects is small, the trends appear consistent with the interpretation that sleep habits were improved for most of the real treatment subjects and for few of those receiving sham treatment.


Plasma concentrations of L-dopa and 3-methoxydopa and improvement in clinical ratings and motor performance in patients with Parkinsonism treated with L-dopa alone or in combination with amantadine. Six patients with idiopathic Parkinsonism were treated with a combination of amantadine and L-dopa and after 12 to 24 weeks amantadine was replaced by placebo for a six week period in a double-blind trial. Although there was a tendency for clinical disability ratings and scores on objective ratings of motor skills to deteriorate initially after amantadine removal, there was no significant deterioration in clinical improvement or motor performance during the period of amantadine withdrawal. Amantadine withdrawal also failed to cause any significant change in plasma concentrations of L-dopa or its metabolite 3-methoxy-dopa in these patients. In a group of 27 patients seen regularly as outpatients measurements of plasma L-dopa failed to correlate significantly with either oral dose or with clinical improvement scores. The plasma concentration of 3-methoxy-dopa, however, was on average 2.8 times higher than that of L-dopa, and there was a significant correlation between plasma levels of this metabolite and clinical improvement. It is suggested that 3-methoxy-dopa may contribute significantly to the therapeutic actions of L-dopa in Parkinsonism.


Epidemiology of Creutzfeldt-Jakob disease in England and Wales. Some aspects of the epidemiology of Creutzfeldt-Jakob disease in England and Wales in the decade 1964-73 were studied with the object of detecting evidence of natural transmission of this slow virus encephalopathy. Some geographical clustering and possibility of contact between cases was found.


Amphetamines in the treatment of Parkinson's disease. Twenty-two patients with Parkinsonism were treated with levoamphetamine and 12 of these with dextroamphetamine. Levoamphetamine resulted in a significant improvement in disability from Parkinsonism, although the reduction in total disability, tremor, akinesia, and rigidity scores was slight (ca 20 percent). Dextroamphetamine in lower dosage also reduced disability by some 17 percent. The most disabled patients, including those also on levodopa, showed the greatest response to amphetamines. Previously, amphetamines have been reported to be a selective treatment for the oculogyric crises of post-encephalitic Parkinsonism. Amphetamines are thought to cause the release of catecholamines from central neurones. Their action in Parkinson's disease may be limited because of pre-existing striatal dopamine deficiency. Side-effects of amphetamines, anorexia, and CNS stimulation are different from those caused by levodopa in patients with Parkinson's disease.


Intraventricular cryptococcal granuloma. A case is reported of a cryptococcal granuloma occurring within the lateral ventricle. The findings on angiography and brain-scanning led to a preoperative diagnosis of intraventricular meningioma. There are no previous reports of an isotope brain-scan in this condition and angiography usually shows an avascular swelling.


Clinical syndromes of arteriovenous malformations of the transverse-sigmoid sinus. Arteriovenous malformations or fistulae shunting arterial blood from branches of the external and internal carotid and vertebral arteries into the transverse-sigmoid sinus may produce different clinical syndromes. The literature is reviewed with 96 patients including six personal cases. Usually these malformations have a congenital origin and only in 4% of the series was there a previous history of a severe head injury. Clinical groups are defined and the role of angiography assessed. Direct surgical approach with occlusion or removal of the vascular malformation is the treatment of choice. Possible methods of treatment by selective embolization are discussed.


A phenothiazine derivative in the treatment of spasticity. The efficacy of a selective fusimotor suppressant, the phenothiazine (+/-)-10-3-dimethylamino-2-methylpropyl)-2-valeroylphenothiazine, has been assessed in a double-blind crossover trail in eight patients suffering from cerebral spasticity and one patient suffering from spinal spasticity. Dosage was 40 mg daily. Independent clinical and electromyographic methods of assessment were used. The active agent produced a small but significant reduction in spasticity, although this was of clinical value in only a few patients. There were few side-effects. It is recommended that further studies using higher dosages be undertaken.


Cyclophosphamide in exacerbations of multiple sclerosis. Therapeutic trial and a strategy for pilot drug studies. Cyclophosphamide (CY) has been shown to reverse the signs of experimental allergic encephalomyelitis (EAE) even after the onset of neurological deficits. Because of the analogy of EAE to exacerbations of multiple sclerosis (MS) a clinical trial of CY in acute MS exacerbations was undertaken. A 'sequential criterion' method was used to minimize the size of sample needed for this pilot study. CY failed to alter significantly the course of acute exacerbations of MS. Possible reasons for this failure, and the value of the sequential criterion method in pilot studies, are discussed.


Cerebral haemorrhages with atypical clinical patterns. A study of cerebral haematomasusing CSF spectrophotometry and computerized transverse axial tomography ("EMI scanning"). Twelve patients with 13 cerebrovascular incidents presenting with atypical clincial patterns where thecombination of CSF  spectrophotometry (CSF-SPE) and computerized transverse axialtomogrpahy(CTAT, "EMI-scanning") showed cerebral haematomas, with or without haemorrhage into the CSFare reported. The high diagnostic significance of SDF-SPE as well as the value of using a combination of CSF-SPE and CTAT examinations in cerebrovascular disease has preveiouslybeen  established by the authors. The present patient group comprised some 10% of a totalseries of patients with cerebrovascular disease hitherto studied in this fashion. Conclusive findings were found in only 1 fo the 5 cases examined by angiography and in none of the5 cases studied by isotope scan. Since many cerebral haemorrhages obviosly haveatypical clincalfeatures as compared with the "classical" pattern, the combined use of CSF-SPE and CTAT examinations in the diagnosis of cerebral haematomas is a prereguisite for rational therapy.


Ligation of the vertebral (unilateral or bilateral) or basilar artery in the treatment of large intracranial aneurysms. The author reports the use of vertebral artery ligation, unilateral and bilateral, for the treatment of large vertebral-basilar aneurysms in 14 patients with one delayed death. Extracranial ligation was carried out unilaterally with a Selverstone clamp in three patients. In two, where the aneurysm filled only from one vertebral artery, there was extensive thrombosis within the sac and dramatic clinical improvement after decompression. Extracranial ligation was done bilaterally in three patients, temporarily in two. A 14-year-old boy is well after 5 years but the bilateral vertebrobasilar aneurysm did not undergo extensive thrombosis until both vertebral arteries were occluded at their intracranial entrance above collateral flow. In two others, the clamp had to be reopened on the second artery. In one patient, death from delayed thrombosis of a huge aneurysm and pontine infarction might have been prevented with anticoagulants. In the other, the aneurysm ruptured again fatally 18 months later. Unilateral intracranial occlusion of a vertebral artery was done in eight cases, with no morbidity and complete or nearly complete thrombosis in all but one aneurysm. Seven patients had excellent or good results while one showed little recovery from an existing medullary syndrome. Occlusion of the basilar artery was done in seven cases. In five it was used deliberately as the only treatment, but in two it was forced when an aneurysm burst during dissection. Only two of the patients in the first group and one of the second group have made complete recoveries. The results of vertebral artery occlusion are encouraging and the technique deserves further consideration. Extensive collateral circulation enhances the safety of cervical vertebral artery occlusion but can be of a degree to make the occlusion ineffective. For intracranial occlusion knowledge of the size and distribution of each vertebral artery is essential. Occlusion of the basilar artery is dangerous, although it seems to be effective in producing extensive thrombosis in the aneurysm. It should probably be done under anesthesia only when the artery fills spontaneously from the carotid circulation. Otherwise, even when reasonable posterior communicating arteries are demonstrated, it is best to test occlusion under local anesthesia.


Scintiphotography in diagnosis of urinary fistula after renal transplantation. Scintiphotographic studies in six patients with ureteral fistula following renal transplantation are presented. Images were obtained using 99m-Tc-Sn-DTPA or 131-I-orthoiodohippurate. Urinary leakage was accurately detected in each case but the pattern of extravasation is highly variable. When carefully performed, radionuclide scintiphotography is a safe and effective method for detecting urinary leakage after renal transplantation.


Effect of obstructed mediastinal venous return on dynamic brain blood flow studies: Case report. Three patients are described who had unusual isotope brain flow studies in which the injected isotope refluxed into the internal jugular vein, entered the transverse dural sinuses, and returned proximally to a variable extent through the contralateral internal jugular vein. Mediastinal flow studies revealed obstructed pathways of venous return in the upper mediastinum. One patient had lymphoma, another had had a pneumonectomy, and the third had no demonstrable disease process to explain the flow pattern. The internal jugular-cerebral system apparently permits reversal of flow in the presence of unilateral obstruction proximal to the internal jugular vein.


The bonding of a polymeric fissure sealant to topical fluoride-treated teeth. The tensile bond strength of a polymeric fissure sealant to enamel treated with a variety of topical fluorides was determined. Application of acidulated phosphate fluoride solutions (APF) prior to and after acid etching reduces the tensile bond strength of Nuva Seal from 36-6+/-9-0 kg/cm2 to 4-9+/-3-3 kg/cm2 and 23-8+/-6-3 kg/cm2 respectively. The treatment of the etched enamel with freshly prepared 8% stannous fluoride solution prior to Nuva Seal application significantly increases the tensile bond strength to 55-7+/-17-1 kg/cm2. It is recommended that clinical procedures such as the application of fissure sealants, acid etch composite restorations and the direct attachment of orthodontic brackets, all of which involve etching of the enamel, should not be precedded by the topical application of APF solutions.


Relationship of the maxillary central incisors and canines to the incisive papilla. Four hundred and thirty dentulous casts in normal alignment and Angle's Class I Relationship were examined. The results indicated a relationship between arch shape and the incisive papilla. The suggestion is made that in the preliminary location of the anterior teeth during construction of full dentures, the average distance of incisors and canines from the incisive papilla could be used as starting points.


Carisoprodol in the treatment of myofascial pain-dysfunction syndrome. The effects of carisoprodol and a placebo were compared in a sample of 60 patients with the clinical diagnosis of myofascial pain-dysfunction syndrome using double-blind design.  Carisoprodol failed to show a significantly greater effect than the placebo.  The side effects were about the same with both agents.


The testis in mice infected with Mycobacterium leprae. Following inoculation either locally or intravenously with Mycobact. leprae of human origin, the histopathology and bacteriology of the testis in experimental mice is described. Normal mice, and mice rendered immunologically deficient by thymectomy and whole-body irradiation, were studied. Attention is drawn to a heavy bacillation of the testis in mice from both groups. Bacilli were found in and beneath the tunica albuginea, but mainly in interstitial cells and in macrophages surrounding the tubules. The percentage of solidly staining bacilli was high, and globi were frequent. The study showed that the testis in mice is particularly favourable for the lodgement and multiplication of Mycobact. laprae following either local or intravenous inoculation. The significance of this in relation to the metabolism of the leprosy bacillus and to the frequent occurrence of testicular damage in the lepromatous male patient is discussed. This work was supported by grants to A. G. M. Weddell and A. C. McDougall from the Medical Research Council and the British Leprosy Relief Association (LEPRA).


Hyperacute rejection of guinea-pig to rat cardiac xenografts. I. Morphology. The morphological changes occurring in xenograft hyperacute rejection, using guinea-pig to rat cardiac transplants, have been studied. Ultrastructural evidence of platelet aggregation in myocardial capillaries and veins first occurred two minutes after revascularisation. Small amounts of fibrin, associated with platelet degranulation occurred at three minutes. From four minutes, platelet aggregates increased in number and endothelial damage first appeared in those vessels containing platelet aggregates. Rejection was complete by 12 minutes and platelet aggregates then filled many capillaries, veins, arterioles and arteries. Polymorphonuclear leucocyte infiltration was not seen.


Development of preschool-aged children of different social and ethnic groups: implications for developmental screening. The developmental status of 1,180 children representing a cross section of Denver's ethnic and parental occupational groups was compared with that of 1,055 children (349 Anglo, 354 Spanish surname, and 352 Black) whose parents were unskilled workers. The children varied in age from 2 weeks to 6.4 years and were evaluated with the Denver developmental screening test. Comparisons were made in developmental achievements as reflected by individual item differences for Anglo children from unskilled families with Anglos from cross-sectional families. A second comparison of Anglo, Spanish, and Black children of the unskilled sample was also made. The first analysis comparing 910 Anglo children from the cross-sectional sample with 349 Anglo children from the unskilled families demonstrated significant differences (p smaller than 0.05) for 39 of the 105 items. Below 20 months of age, children of the unskilled sample were more advanced, whereas after 20 months of age, the children of the cross-sectional sample were advanced in all test sectors except for items in the personal-social sector. Comparisons of Anglo, Black, and Spanish surname children from the unskilled families showed fewer differences in rates of development.


Inadequacies in the pharmacologic management of ambulatory children. The compliance with treatment of acute otitis media in 300 pediatric outpatients was evaluated. Complete compliance in taking prescribed antibiotics was noted in 7.3% of the patients. Pharmacists dispensed less than prescribed amounts of antibiotics to 15% of patients. Bottles were incorrectly labeled 3% of the time. Volumes of 130 "teaspoons" examined varied from 2 to 9 ml. Parental understanding of the illness and of the effects of medication was inadequate and erroneous in many instances. Parents gave fewer than the prescribed number of doses in 36% of cases, and therapy was discontinued early in 37%. Recommendations for improving the quality of therapy for ambulatory pediatric patients are outlined.


A reappraisal of the value of the IgM fluorescent treponemal antibody absorption test in the diagnosis of congenital syphilis. To re-evaluate the usefulness of the IgM fluorescent treponemal antibody absorption test in the diagnosis of congenital syphilis, three groups of infants were investigated. Group 1 infants showed that the test was always negative in normal neonates born to seronegative mothers. From Group 2 infants we determined the standardization of the test using commercially prepared conjugate to allow the maximum exclusion of false positive and negative results. Studies on Group 3 neonates confirmed that the standardized test was extremely successful in determining whether or not an asymptomatic infant was infected with Treponema pallidum. Finally it was shown that the standardization of the test varies with different commercially prepared conjugates. From the investigation it was concluded that the IgM FTA test, if suitably standardized, was a highly successful method for diagnosing congenital syphilis, especially in asymptomatic neonates.


Congential dyserythropoietic anemia--type IV. Congenital dyserythropoietic anemia is characterized by ineffective erythropoiesis and increased numbers of multinucleated red cell precursors in the marrow. This syndrome has been subclassified on the basis of morphologic differences in the red cell precursors. Type I is characterized by megaloblastoid erythropoiesis and macrocytosis; Type II, by normoblastic multinuclearity and normocytosis; and Type III, by frequent giant multinucleated erythroblasts and macrocytes. Type II is further distinguished from the other types by serologic and ultrastructural abnormalities. The patient presented in this report does not fit any of the above categories; her red cells are similar to Type II congenital dyserythropoietic anemia cells, but no characteristic ultrastructural or serologic abnormalities are present. It is suggested that this patient may represent an additional variant of congenital dyserythropoietic anemia, Type IV.


The early use of continuous positive airway pressure in the treatment of idiopathic respiratory distress syndrome. Infants with IRDS were treated with CPAP early (0.40 FIO2; WITH PaO2 less than 60 mm Hg) or late (0.70 FIO2; with PaO2 less than 60 mm Hg). There was no difference in survival, duration of CPAP therapy, total time of oxygen administration, or complications. The early treated infants needed a lower FIO2 (maximum 0.55) and had a less severe clinical course. The late treated infants were subjected to 0.70 or more FIO2 for an average of 24 hours and were in greater than 0.40 FIO2 significantly longer than those given CPAP early. Infants who weighed less than 1,500 gm and had severe disease did not do well regardless of when CPAP was applied.


Energy metabolism and hormonal profile in children with edematous protein-calorie malnutrition. Modifications in energy metabolism and endocrine homeostasis (plasma insulin and growth hormone values, glucose and free fatty acid levels, serum thyroxine and TSH, free thyroxine index, and urinary catecholamines) were investigated in eight children with edematous protein-calorie malnutrition. Caloric expenditure was low at admission and correlated linearly with increased caloric intake throughout the study. The hormonal changes at admission were characterized by a negligible insulin response to intravenous arginine or glucose and by markedly elevated growth hormone levels which were neither increased by arginine nor suppressed by intravenous glucose. Serum thyroxine values were low, but free thyroxine index and serum TSH levels were within normal limits. At admission to the study, 24-hour urinary excretion of dopamine and norepinephrine was relatively reduced in relation to the excretion of epinephrine. All these modifications were corrected at time of the recovery study. It is suggested that in edematous protein-calorie malnutrition, insulin acts as the primary regulator of peripheral fuel release and that the high, nonsuppressible growth hormone levels may form part of an important homeostatic mechanism to provide substrates for brain metabolism via lipolysis.


Clinical evaluation of a quaternary ammonium-containing mouthrinse. This was a double-blind, radomized, crossover study of adult subjects to evaluate the effect of a test mouthrinse (Cepacol) on plaque accumulation. The study was divided into two parts, four weeks each, one in which only a mouthwash was used (part I) and the other in which a mouthwash and toothbrushing were used (part II). 1. The test mouthrinse produced a satistically significant reduction in dental plaque when compared to a placebo rinse. 2. The GI averaged approximately 1.0 throughout the study regardless of which mouthrinse was used. 3. A possible carryover effect of the test mouthrinse was noted. 4. A lower plaque score was seen in 67 to 75% of all patients during the period in which the test mouthrinse was used as compared to the placebo. 5. Ten subjects reported a burning sensation of the tongue with the test mouthrinse. No objective adverse effects were seen.


Personality assessment and test interpretation of Mexican Americans: a critique. Reviews the personality test assessment of Mexican Americans. Although there is a paucity of available research there are some indications that Mexican Americans differ in response patterning on projective devices. On objective instruments, problems involving fluency in English obscure the findings. Several recommendations are offered for increasing the efficiency of these instruments for use with Mexican American clients.


Artistic quality of drawings and judges' evaluations of the DAP. When art quality varied for a set of figure drawings, judges were unable to differentiate hospitalized schizophrenic females from a matched nonpatient group. Both trained and naive judges erroneously tended to see drawings of low are quality as a patient origin, and drawings of high overall quality as of nonpatient origin. When art quality was held constant judges did slightly 0etter than chance in differentiating the patient vs nonpatient drawings. Psychologists were no more accurate than untrained judges. Results support the position that art quality of drawings influences judges' evaluations, and, in terms of the present investigation, represents a major source of error in drawing interpretation. Even when art quality was controlled, however, judges' rate of success was low, casting doubt on the status validity of the Draw-A-Person test (DAP).


Female homosexuals' concepts of self, men, and women. Twenty-four female homosexuals and 24 female heterosexuals matched for age and education were given the Draw-A-Person Test (DAP) and, on the Gough-Heilbrun Adjective Check List (ACL), were asked to describe themselves, men in general, and women in general. Results indicated that homosexuals, relative to the heterosuxual controls: (a) sexualized their drawings (p smaller than .02) and embellished the female figure more (p smaller than .05); (b) showed no evidence of confusion in gender identity on the DAP or ACL; (c) scored sifnigicantly higher on Autonomy, Change, and Exhibition on the ACL; and (d) scored significantly lower on Abasement, Defensiveness, Deference, Endurance, Order, Personal Adjustment and Self-control on the ACL. It was concluded that the female homosexual may be more independent, changeable, and sexually preoccupied and less well adjusted than her heterosexual counterpart.


Gas chromatographic determination and pharmacokinetics of 4-hydroxybutrate in dog and mouse. A rapid and reproducible method was developed to extract 4-hydroxybutyrate from plasma as 4-butyrolactone for subsequent gas chromatographic (GLC) assay. The drug, an intravenous anesthetic and oral hypnotic in man, was infused into four dogs and the plasma concentration was determined by 14C-isotope dilution and GLC. Pharmacokinetic parameters for distribution and elimination were calculated. A capacity-limited process appears to be involved in the elimination fo 4-hydroxybutyrate in the dog. Macroautoradiogrpahy recieved the distribution pattern in normal and pregnant adult mice.


Synthesis of (4-quinolinoamino)aminoalkyltetrahydronaphthalene derivatives for possible antimalarial activity. (4-Quinolinoamino)aminoalkyltetrahydronaphthalene derivatives were synthesized in an attempt to introduce new agents with antimalarial activity.


Synthesis and biological properties of alkyl esters of polyene antibiotics. Several new alkyl esters of polyene antibiotics were prepared by an improved general procedure, and their toxicity and microbiological activity were tested. Some of these alkyl esters were more active than the nonesterified polyenes against Candida albicans but were less effective than the known methyl esters. Their toxicity was much less than that of the parent compounds.


Genetic effects of providone-iodine.

Genetic effects of providone-iodine. Povidone-iodine is capable of specifically altering the DNA of living cells. This alteration may result in the induction of mutations of the base-substitution type. Because of the known relationship between mutagenic potential and the ability to induce cancer in animals, the present findings raise serious questions concerning the safety of this topical disinfectant.


Absorption, distribution, and metabolic fate of 7-chloro-3,3a-dihydro-2-methyl-2H,9H-isoxazolo-(3,2-b)(1,3)-benzoxazin-9-one in rats, dogs, and humans. The absorption and metabolic fate of 7-chloro-3,3a-dihydro-2-methyl-2H,9H-isoxazolo-(3,2-b)(1,3)-benzoxazin-9-one (I) was studied in rats, dogs, and humans. Orally administered I was readily absorbed by all species. In the rat, orally administered I was converted to its metabolite, 5-chlorosalicylic acid, by the intestinal wall. The half-lives of blood radioactivity, after the oral administration of I-9-14C, were about 18 and 12 hr in the rat and beagle hound, respectively. In human subjects, no intact I was detected in the bloodstream; however, the clearance of the metabolite, 5-chlorosalicylic acid, had a half-life of about 33 hr. Cleavage of the oxazine ring of I generated 5-chlorosalicylic acid, which was excreted both in the free form and conjugated with glycine and glucuronic acid. The isoxazole moiety was converted to beta-hydroxybutyric acid and its metabolites carbon dioxide and fumaric, citric, alpha-ketoglutaric, succinic, and malic acids. Binding of I to plasma proteins was extensive but was less than that of 5-chlorosalicylic acid.


The relationship between nitro group reduction and the intestinal microflora. The capacity of rats to reduce a 25-mg dose of p-nitrobenzoic acid (PNBA) was measured by quantifying the amount of this compound recovered in the urine as p-aminobenzoic acid (PABA) and its conjugates. It was found that germfree rats converted approximately 1% of PNBA to PABA; in conventional rats the conversion was approximately 25%. Various bacteria isolated from the rat cecum were selectively associated with germfree rats and it was demonstrated that these bacteria colonized their gastrointestinal tracts. In assoication with Lactobacillus plantarum, the conversion of PNBA to PABA increased to 3.9%. When these rats were further associated with Clostridium sp. and Streptoccocus faecalis, the conversion increased to approximately 12%. A general correlation was found between the capacity of constituents of the microflora to reduce PNBA in vitro and when associated with the germfree rat. Cecectomy, which removes a substantial portion of the microflora of the rat, decreases the capacity of the conventional rat to reduce PNBA. Similar experiments with p-nitrobenzenesulfonamide indicate that this compound is also largely reduced by the flora. Evidence that the reduction of the nitro group in these compounds is carried out by the intestinal microflora explains previous observations in which the reduction of these compounds in rats did not correlate with the activity of liver enzymes putative for these reactions.


Intestinal smooth muscle contraction and the effects of cadmium and A23187. Pretreatment of the guinea-pig ileal longitudinal muscle preparation with cadmium (Cd++) in the concentration range 5 to 1000 muM resulted in an inhibition of the phasic and tonic contractions induced by both high potassium and the muscarinic agonist, cis-2-methyl-4-dimethylaminomethyl-1,3-dioxolane methiodide. The K+ contracture was significantly more sensitive to the inhibitory action of Cd++ in the concentration range 5 to 100 muM, but not at concentrations of Cd++ above 100 muM. Low concentrations of Cd++, 0.1 to 0.01 muM, were found to increase by an atropine-sensitive mechanism, the spontaneous activity of approximately 50% of the preparations tested. It was also shown that the ionophore A23187 produced a concentration-dependent contraction in the guinea-pig ileal longitudinal muscle that was dependent upon the presence of extracellular calcium. When 1.8 mM Cd++ was added to a tissue that had been incubated in Ca++-free media for 60 minutes and pretreated with 5 muM A23187 for 15 minutes, a slow contractile response was recorded. Similar, but significantly smaller, contractions were also recorded when 1.8 mM Ca++, Mn++, Sr++, Pb++ and Ba++, but not when Co++, Ni++, Hg++, UO2++, and Tm++ and Th++++ were administered. It was concluded that the contractile action of these cations was dependent on ionic radius, hydration energy, valency and, perhaps, coordination number, and was due to the intracellular entry of the cation where it resulted in the release of bound Ca++ and/or directly activated the smooth muscle troponin system.


Ionic mechanism of the efferent olivo-cochlear inhibition studied by cochlear perfusion in the cat. 1. A method for perfusing the scala tympani of the cat's cochlea from basal turn to apex is described. The perfusion with modified Krebs solution did not interfere with the recording of cochlear microphonic (CM) and neural responses to sound, nor with the efferent inhibition elicited by stereotaxic stimulation of the crossed olivo-cochlear bundle (COCB) in the medulla. 2. Cochlear perfusion with solutions in which most of the chloride was replaced by large anions (sulphate or gluconate) decreased or eliminated auditory nerve or the ventral cochlear nucleus. These effects were reversible. They were only observed if the rate of perfusion (2-20 mul/min) was adequate to reduce the chloride concentration in perilymph below about 80 mM, this being estimated, in different perfusion of the same cochlea, by a chloride-selective electrode. 3. The COCB-induced negative shift of the endocochlear potential recorded with a glass micro-electrode inserted into the scala media was abolished by I.V. strychnine o.2 mg/kg. It was decreased when the perilymph chloride was reduced to 50-70 mM and could be abolished when the perilymph chloride dropped to about 5 mM. 4. The COCB-induced potentiation of the cochlear microphonic potential was also reduced by chloride substitution but the pattern of this effect differed from that of neural inhibition. 5. Similar cochlear perfusions with a solution in which the small diameter bromide anion was substituted for chloride did not affect the COCB-efferent effects. 6. The data indicate that the inhibitory transmitter released by COCB terminals elicits an increased conductance to small anions (normally to chloride) in the membrane of the auditory dendrite and of the outer hair cell. The significance of the COCB-induced negative shift of endocochlear potential and of the potentiation of CM is discussed, as well as the pre- and post-synaptic mechanisms involved in the efferent gating exerted on the auditory input. The latter would seem to involve primarily a post-synaptic mechanism at efferent axo-dendritic synapses.


Gastric, antral and fundic pouch secretion in sheep. 1. Fundic secretion of HCl and pepsin was studied in sheep with both fundic and antral pouches. The antral pouches were of the entire pyloric region. Continuity of the alimentary tract was restored by an abomasoduodenal anastomosis. 2. Secretion from fundic pouches was continuous. It was reduced in volume and acidity, was pepsin output, by resection of the antral pouches. 3. Teasing with food, feeding and injection of pentagastrin stimulated fundic acid and pepsin secretion in animals with antral pouches before and after antrectomy. 4. Pouches prepared from the entire pyloric region showed continuous secretion with variations not related to feeding or fasting. Antral secretion was increased after s.c. injections of histamine, carbachol and pentagastrin. 5. It is concluded that although the pyloric antrum contributes to the magnitude of the secretory response of an abomasal fundic pouch, the direction of the secretory response is similar whether or not the pyloric antrum is present as a separated pouch, or is removed.


A denture tray technique for remake dentures. A technique is described to fabricate a replacement denture for your patient. It reduces patient and laboratory time. The technique does not compromise the patient's existing denture, the impression, jaw relation records, or esthetics. It provides superior trays and effective occlusion rims, thus simplifying recording techniques. A denture duplicating flask may be substituted for the two plastic impression trays to duplicate the denture. The duplicating flask may improve realignment of the upper and lower molds, but additional irreversible hydrocolloid is required to fill the mold.


Postinsertion changes in complete dentures. The influence of denture changes, occurring during a period of use ranging from one to 15 years, was studied in a group of 35 complete denture subjects. Clinical and electromyographic data were collected. N0 correlation was found between denture serviceability on the one hand and masticatory performance and muscular coordination during chewing of test food on the other. However, a significant correlation was found between a subject's satisfaction and his masticatory performance, as well as his muscular coordination during chewing of test food. It appears that, as soon as the time-linked and insidious imperfections of complete dentures are compensated for by feedback-controlled neuromuscular adaptation, the subject's adjusted pattern of function does not affect his performance and comfort and consequently his satisfaction. Despite the obvious differences among the respective subjects, the number of masticatory strokes in the same individual was rather constant. Obviously, a subject's satisfaction may easily camouflage lack of denture fit, including its potential concomitant pathologic sequelae. Therefore, periodic examinations and adequate corrections are essential to successful complete denture treatment.


The use of natural teeth in overlay dentures. A method has been described for the construction of tooth-supported dentures where the natural tooth was utilized and the acrylic resin for the denture base processed directly to the prepared cast. Based on the 112 dentures that were made, this technique is economical, provides support and stabilization, and has full patient acceptance.


Conditioning dentures for problem patients. We have had considerable success with difficult patients through the use of conditioning dentures. Patients with severe gagging problems have been able to gradually accustom themselves to the presence of dentures in the privacy of their homes and at their own rate of progression. Patients without previous denture experience are given a chance to adjust to problems of speech, salivation, and taste prior to receiving their new dentures. We believe that conditioning dentures should be a part of the treatment sequence for all patients being prepared for their first dentures. Many problems are faced by the new denture patient, and anything the dentist can do to prepare him for this difficult time can increase the chances for success.


Stressbreakers and the removable partial denture. A laboratory study was designed to determine the effect of ""deactivation'' of stressbreakers on abutment tooth movement and ridge displacement. The Ticonium hidden-lock and the pin-Dalbo precision stressbreakers were tested. Results showed that ridge displacement was significantly decreased when the Dalbo was made rigid, and tooth movement was significantly decreased (during bilateral loading) when the hidden lock was made rigid.


Preparing guide planes for removable partial dentures. The freehand technique for preparing parallel guide planes offers several advantages. There is a direct transfer of the index from the surveyor to the mouth. The procedure adds little time to routine removable partial denture construction. The method is effective. The only disadvantage of the method is the inability of the dentist to clinically establish perfect parallelism. An occlusal divergence of 3 to 4 degrees from absolute parallelism may result. Care in making the index and increased skill will reduce inaccuracies.


The paradoxes of fixed prosthodontics.

The paradoxes of fixed prosthodontics. (1) The replacement of a missing tooth or teeth by a fixed prosthesis as a preventive device is a paradox. (2) When a missing tooth is replaced by a fixed prosthesis, iatrogenic problems may occur. (3) The problems caused by the fabrication of a fixed partial denture must be recognized and controlled by both the patient and dentist. (4) Concerning the prognosis of any particular fixed prosthesis, we can only predict, from experience, the longevity of the replacement. The acutal life of the replacement is dependent upon the proficiency used in the maintenance procedures and the ability of the dentist to reduce or minimize the iatrogenic factors inherent in any fixed bridge.


A study of temperature changes during removal of amalgam restorations. Because tooth preparation is only one of several potent causes of trauma to the pulp during clinical procedures, the objective should be to increase the chance of pulp survival by reducing this trauma wheneve- possible. In case of tooth preparation, this study shows that there is far less potential for pulpal damage when water is used as a coolant.


Anterior condylar displacement: its diagnosis and treatment. A deflective slide in centric relation to centric occlusion does not necessarily mean anterior condylar displacement. Its diagnosis and treatment depend on the correlation of three factors: the direction and magnitude of the mandibular slide from centric relation to centric occlusion, the change in vertical dimension of occlusion during the slide, and the position of the condyles in the fossae when the teeth are in the maximum occlusion (centric occlusion). When the change in vertical dimension almost equals to amount of slide from the deflective contact in centric relation to maximum intercuspation, very little anterior condylar displacement would be expected. Conversely, with proportionately little change in vertical dimension, more anterior condylar translation is required for a given degree of anterior slide. Examples of each type of anterior slide were related to the TMJ radiographs of the condylar position. If the direction and magnitude of the deflective occlusal contact can be correlated with the TMJ radiographs, the centric relation is ""functional,'' and the clinically retruded mandibular position should be used. When this correlation does not exist, the centric relation is ""dysfunctional'' and the terminal hinge position (retruded mandibular position) should not be used for restorative or corrective procedures. Examples of anterior condylar displacement were given, including deviation, with a comparison of ""before'' and ""after'' TMJ radiographs.


Fabrication of intraoral radiotherapy prostheses. An accurate, short method of fabricating intraoral radiotherapy prostheses has been described. With it, there is no need of mounting casts on an articulator, wax-up, or flasking. Almost all procedures can be accomplished by the dental technician. Most important, the prostheses can be ready for use a few hours after the impressions are made. The technician can prepare the walls and cylinders beforehand and keep them in stock until needed. Also, it would be advisable for the radiotherapist to be present at the initial fastening of the bases to the cylinders. In this manner, the accuracy of the function of the prosthesis will be assured.


Effect of the antiphagocytic agent cytochalasin B on macrophage invasion by Leishmania mexicana promastigotes and Trypanosoma cruzi epimastigotes. Unstimulated mouse peritoneal exudate cells were cultured on coverslips in Medium 199 containing 10 per cent (v/v) calf serum. Cytochalasin B dissolved in dimethyl sulphoxide (DMSO) and diluted in Medium 199 was added to cultures to give final concentrations of 1, 5 and 10 mug/ml. Equal numbers of Leishmania mexicana promastigotes, Trypanosoma cruzi epimastigotes and sheep red cells were added to 24 hr cultures incubated at 37 C. The macrophage monolayers were fixed and stained at various time intervals. L. mexicana promastigotes sheep red blood cells were found to attach to macrophages in the presence of the drug but did not enter the cells. When the medium containing the cytochalasin was replaced with normal medium phagocytosis of the adherent parasites and red cells followed rapidly. T. cruzi epimastigotes were found inside macrophages in both drug-treated and drug-free cultures although the number found to be intracellular in the latter was significantly greater. This study suggest that L. mexicana promastigotes enter macrophages by being phagocytosed, whereas T. cruzi epimastigotes can actively penetrate these cells.


[Evaluation of the parietal factor interfering in the measurement of cardiac output by external detection with the aid of 99mTc labelled red cells (author's transl)]. The results of a radioisotopic exploration are not independant of the physical characteristics of the tracer used. Thus in the measurement of cardiac output index by external detection, the substitution of 131I fastened on the human serum albumine by 99mTc fastened on red cells introduces a systematic average error of +20% whose origin is double. Because of the plasma or red cell kind of the tracer, the average error done on the volume is, in 130 measurements, 26% whereas that which results from the difference of photon energy is -6%. Only this last error affects the measurement of the cardiac output and, by that time, it is demonstrated that a direct determination of the cardiac output index by STEWART-HAMILTON'S relation is impossible.


[Radiographic aspects of aseptic osteonecrosis following renal transplantation. Apropos of 65 localizations in 30 patients]. The authors report 30 cases of aseptic osteonecrosis in 65 different bones, including 37 hips, 13 knees, 5 taluses, 1 cuboid, 8 shoulders, 1 humeral condyle, following renal transplantation. One patient had osteonecrosis in six different bones. In 24 cases, the necrosis occurred before the end of the 18th month following the graftmin 21 cases, radiodiagnosis of the first localisation was made before the end of the first month following the first clinical sign. The usual presenting symptom of osteonecrosis is a clear, sub-chondral crescent. In 2/3rds of cases of osteonecrosis of the femoral neck, there is a rapidly destructive form often well tolerated clinically. In 1/3rd of cases, the course was slow with mainly osteocondensation. The course is particularly destructive when, following failure of the graft, the transplanted patient is submitted to periodic hemodialysis. In 8 cases, the femoral condyles were involved, and in 4, the tibial condylesm the appearance may be that of osteochondritis dissecans, but more often the course resembles the destructive form of aseptic necrosis of the femoral head. Shoulder involvement leads to a radiological picture identical with that of the hips. One transplanted patient out of 5, has a chance to develop osteonecrosis within two years following the graft.


The macromolecular organization of membranes and its bearing on events leading up to fertilization. Current concepts of the macromolecular organization of membrances and of ways in which membrane organization may change during membrane fusion are considered briefly. The properties of the sperm membrane at different phases of its development up to fertilization are then examined in the light of this more general model.


A comparison of gas and liquid for hysteroscopy. Attempts to inspect the uterine cavity heretofore have been thwarted because of inability to obtain its sustained adequate expansion, concern about introducing infection into the peritoneal cavity through the tube with liquid or gaseous media and the provocation of endometrial bleeding during manipulation. Recent mechanical and optical innovations may give the gynecologist the capability of overcoming these problems. In this presentation the focus was on the comparison of gas and liquid as the distending medium for hysteroscopy.


Marrow origin of canine alveolar macrophages. Pulmonary macrophages were obtained from a canine radiation chimera 221 days after irradiation. A variant of soluble glutamic oxaloacetic transaminase was utilized to demonstrate that these cells were of donor origin, providing evidence that pulmonary macrophages in the dog are of marrow origin.


The influence of antigenic stimulation on the ontegeny of lymphoid aggregates and immunoglobulin-containing cells in mouse bronchial and intestinal mucosa. The requirement of Ag for the localization of precursors of IgA-producing cells in mucosal surfaces was tested in a model in which fetal tissues develop in an Ag-free adultA/J mice. At 30 days after transplantation primitive Peyer's patches )gut associated lymphoid tissue) and bronchus associated lymphoid tissue were seen in 1/3 of the animals examined and in all animals examined at 60 days. Immunoglobulin A-containing cells first appeared between 5 and 15 days in transplanted fetal guts. Their numbers increased to reach a plateau at 60 days at which time they approximated that of germ-free animals and were about 1/3 that of 60 day old normal mice. Immunoglobulin G and IgM containing cells were rarely seen, Few Ig-containing cells were present in fetal lungs. Fetal gut lumenal IgA sedimented in sucrose density gradients as if it were larger than serum IgA. Thus, in the absence of Ag, IgA plasma cells are present in mucosal tissues but their numbers are reduced.


Nuclear antigens and antinuclear antibodies-their role in joint inflammation. Nuclear antigens, including native DNA, denatured single-stranded DNA and soluble nucleoprotein are found in synovial effusions from a majority of all types of inflammatory joint disease. On the other hand, antinuclear antibodies are rarely detected in joint fluids, except in rheumatoid arthritis. Evidence that nucleoprotein and DNA immune complexes contribute to rheumatoid joint inflammation is reviewed.


Inhibition of phenylalanyl-tRNA synthetase by aromatic guanidines and amidines. Aromatic guanidines and amidines were investigated for their ability to inhibit phenylalanyl-tRNA synthetase from E. coli B. 2-Phenylacetamidine (1), benzylguanidine (2), and N-benzylbenzamidine (3) are competive inhibitors with respect to phenylalanine, binding nearly as well as the substrate, The remainder of the inhibitors was unexpectedly found to be noncompetitive, indication the presence of a secondary binding site on the enzyme. Inhibition by these compounds appears to be specific for phenylalanyl-tRNA synthetase and requires the presence of a phenyl ring as well as the amidine or guanidine moiety.


Pattern recognitiion and structure-activity relationship studies. Computer-assisted prediction of antitumor activity in structurally diverse drugs in an experimental mouse brain tumor system. This paper reports the application of pattern recognition and substructural analysis to the problem of predicting the antineoplastic activity of 24 test compounds in an experimental mouse brain tumor system based on 138 structurally diverse compounds tested in this tumor system. The molecules were represented by three types of substructural fragments, the augmented atom, the heteropath, and the ring fragments. Of the two pattern recognition methods used to predict the activity of the test compounds the nearest neighbor method predicted 83% correctly while the learning machine method predicted 92% correctly. The test structures and the important substructural fragments used in this study are given and the implications of these results are discussed.


Synthesis and biological activity of luteinizing hormone-releasing hormone and related peptides. Syntheses of the decapeptide luteinizing hormone-releasing hormone, less thanGlu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH2 are described. The basic properties of arginine can provide a simple repetitive isolation procedure for arginine-containing peptides. The biological activities of the decapeptide, of a range of fragments and modified fragments, and of two analogs with alteration in the series at position 4 were measured by in vitro incubation with sheep pituitary slices, measuring the liberated LH by bioassay. None of the compounds of shortened sequence were active, with the exception of less thanGlu-His-Trp which showed 1% of the decapeptide in one of four experiments. Neither [Ser(But)4]-LH-RH-nor [Leu4]-LH-RH showed significant activity indicating (despite the known activity of [Ala4]-LH-RH) the importance of this part of the structure for full biological activity.


7-N-amidinocephalosporins.

7-N-amidinocephalosporins. 7-Aminocephalosporanic acid tert-butyl ester reacts quantitatively at--20 degrees with iminium chlorides to give amidino derivatives. Removal of the tert-butyl protecting group with trifluoroacetic acid and treatment with 1 equiv of triethylamine yield the corresponding zwitterions. These compounds were less active than their penicillin analogs.


Synthesis and biological activity of some antitumor benzophenanthridinium salts. A facil synthesis of benzophenanthridinium salts has been developed and used for preparing a number of these compounds.  The antitumor activities in mouse leukemia L1210 (LE) and P388 (PS) were determined as well as some selected antimicrobial activities.  Although antitumor activity was exhibited by several of the derivatives, none was as active as the naturally occurring alkaloid fagaronine.  Fagaronine was made available as a synthetic by an improved procedure.  Some structure-activity relationships among antitumor benzophenanthridinium salts are discussed.


Quinoxaline studies. 23. Potential antimalarials. Substituted 5,8-dimethoxyquinoxalines. Two series of 2,3-disubstituted 5,8-dimethoxy-6-[N- (omega-dimethylaminoalkyl) amino] quinoxalines were prepared: the first series with identical 2,3-substituents H, CH3, C6H5, C6H4-4-Cl, and CH2C6H5; and the second with identical styryl groups CH=CHC6H5, CH=CHC6H4-4-Cl, CH=CHC6H3-3,4-C12, CH=CHC6H4-4-F, CH=CHC6H4-4-CF3, and CH=CHC6H4-4-NO2. None of the substances possessed antimalarial activity; several were toxic at highest dosage levels.


Synthesis and antibacterial activities of some chloro analogs of 3 amino-3,4-dihydro-1-hydroxycarbostyril. The effects of a chloro substituent upon the microbiological activities of 3-amino-3,4-dihydro-1-hydroxycarbostyril were determined. The 5-, 6-, and 7-chloro analogs were synthesized by reductive cyclizations of the appropriately chloro-substituted o-nitrophenylalanines, while the 8-chloro analog was obtained from the N-trifluoroacetyl-3-chloro-2-nitrophenylalanine ethyl ester. All of these compounds were observed to inhibit the growth of Escherichia coli 9723, Leuconostoc dextranicum 8086, and Lactobacillus plantarum 8014. The relative inhibitory activities of the chloro analogs were 7-Cl greater than 6-Cl greater than 8-Cl greater than 5-Cl in E. coli and 7-Cl greater than 6-Cl greater than 8-Cl = 5-Cl in L. dextranicum and L. plantarum. In each of the three microorganisms, the 7-Cl analog was a more effective growth inhibitor than the parent unsubstituted compound. The growth inhibitory activities of this class of compounds were demonstrated to be much more effective than those of the four corresponding lactams, the 5-, 6-, 7-, and 8-chloro analogs of 3-amino-3,4-dihydrocarbostyril.


Mafenide acetate solution dressings: an adjunct in burn wound care. A continuation of the study of 5% aqueous Sulfamylon solution dressings in burned patients was analyzed in 150 consecutive cases. The rate of invasive infection and mortality was not excessive. Dressings were used as an adjunct to other topical chemotherapeutic agents as well as homo/heterograft skin in the overall burn care program. Sulfamylon soaks were shown to be effective for debridement, granulation tissue protection and preparation, and bacterial control. The dressings were comfortable when in place and the wounds appeared clean. Epithelialization was not hampered so that the dressings could be utilized in partial thickness wounds as well as for mesh autografts on extensive burn surfaces=


Acute common femoral arterial trauma.

Acute common femoral arterial trauma. 1) Acute common femoral arterial injuries remain relatively uncommon in both military and civilian practice. 2) The recent experience in Vietnam has provided the most complete statistics regarding this type of injury. Among 1,000 acute major arterial injuries, the incidence of common femoral arterial trauma was approximately 5%. This present study reports 109 acute common femoral arterial injuries. Nearly two thirds of the injuries were caused by fragments and slightly more than one half of the injuries were lacerations. It was possible to perform autogenous vein graft repairs in about 57%, end-to-end anastomoses in about 25%, and lateral suture repair in about 10% of the injuries. Prosthetic material was used in only three repairs. 3) The overall complication rate was 28.3%, the amputation rate was 13.2%, and the mortality rate was 2.8%. 4) In the treatment of iatrogenic injuries associated with diagnostic catheterizations of the common femoral artery at Walter Reed Army Medical Center, there were no complications and no mortalities.


Penetrating abdominal injuries in children and adolescents. One hundred thirty-two children and adolescents with penetrating abdominal trauma have been reported. Eighty-two of these patients had intraperitoneal injuries. Five of the injured patients died, and 35 suffered complications. Patterns of organ injuries were found to be similar to a previously studied adult series. Satisfactory results were obtained by simple management of specific injuries. Ninety-five per cent of the injured patients and 80% of uninjured patients could be accurately identified at initial physical examination. Selective observation of penetrating abdominal injuries can be safely employed in children and adolescents.


Advantages of double releases in axillary, antecubital and popliteal contractures. The advantages of the double release technique in axillary contractures are discussed. The procedure is useful for releasing contractures involving the antecubital and popliteal spaces as well. The risk of cutting vital structures involved in the scar tissue is minimized; also, the skin in the center of the axilla, if infected or ruptured, can be covered without as much threat to the axillary space. In addition, by placing the skin grafts on the surfaces at edges of the antecubital or in the popliteal space, the take of the skin graft on a flat surface is better insured.


[Incomplete duplication of the urethra with intra-rectal opening of the posterior chanel (author's transl)]. We have described two cases of urethro-rectal fistulae: outstanding by their absence of anorectal abnormality. This type of malformation must be separated from the fistula observed in imperforated anus. We consider it as an incomplete duplication of the urethra; the posterior part ending in the rectum: this is a very rare abnormality. The treatment involves a separation of the posterior urethra from the rectum to bring it up to the preneum then continue as in an hypospadias usig the Duplay and Leveuf (Cecil) techniques. Seemingly normal urethra is hypoplastic in part or entirely.


[Treatment of infra-vesical obstructions in neurologic bladders. 27 cases]. Of a total of 176 cases of spina bifida observed from a urological standpoint, we detected an infra-vesical obstruction in 27, the diagnosis being based upon urological findings alone: dysuria, residue and infection. The 11 boys had a disorder of the striated sphincter justifying sphincterotomy, the technique and results of which are discussed, in terms of symptoms and signs resulting from the obstruction, with respect to continence and the effects on the upper tract. 16 of our patients were female and the nature of the infra-vesical obstruction was far more uncertain. A disorder of the striated sphincter was present in the girl treated by a Y-V plasty of the anterior aspect of the bladder neck passing low down on the anterior aspect of the urethra. We also present results relating to residue, retention, dysuria, continence and the upper urinary tract. Overall, these results are too recent and difficult and no definite conclusions may be drawn.


Polyamines in bacteriophage R17 and its RNA. Bacteriophage R17 and its RNA were found to contain significant amounts of spermidine but not of putrescine. When isolated at 0.01 M KCl, up to 1,000 molecules of spermidine were associated with the virion. The phage RNA isolated with phenol plus sodium lauryl sulfate contained approximately 70 to 90 molecules of spermidine. The association appeared to be ionic because the bound spermidine could be dissociated by KCl, MgCl2, or both. Effects of polyamines on in vitro translation were studied using both poly(U) and phage R17-RNA as mRNA. Addition of spermidine to the system at suboptimal concentrations of Mg2+ resulted in marked stimulations of the rate of protein synthesis. Putrescine alone had no effect but stimulated the incorporation in the presence of suboptimal concentrations of spermidine plus Mg2+. The isolated amino acid-incorporating system contained suboptimal soluble and bound polyamines. A comparison of incorporation was made in this system using R17-RNA with and without bound spermidine. No effects of these bound cations were detected on the rate or extent of incorporation of valine. The ratio of incorporation of histidine (present in non-coat proteins) to valine (total protein) revealed little difference as a functions of cation in the system or a function of the spermidine present in R17-RNA.


Effect of UV irradiation on transduction by coliphage T1. Lysates of the virulent coliphage T1 transduce seven markers between strains of Escherichia coli with reproducilble efficiencies which range from 10(-7) to 10(-5). The ability of a UV-irradiated lysate to transduce Arg(+), Str(R), Trp(+), Lac(+), and Pro(+) is 90% and Bio(+) is 99% inactivated by doses which inactivate plaque formation of T1 by six orders of magnitude. A dose of irradiation which causes a 1- to 2-log drop in the titer of T1 stimulated Gal(+) transduction by two- to three-fold; no other marker tested was stimulated. Irradiation causes dislinkage of some co-transducible markers but not others.


Interaction of P2 bacteriophage with the dnaB gene of Escherichia coli. The dnaB gene product of Escherischia coli is required for multiplication of temperate phage P2. At 37 C in dnaB-ts mutnats, P2 will not plaque and gives a very small burst of progeny. P2 mutants have been isolated which can grow well enough to plaque under these conditions. This type of phage mutant is cis dominant, and one such mutant (P2rlb1) has been mapped near the left end of the early gene B and to the right of the cox4 (excision) mutation. The rlb1 mutation does not lie at the replication origin, but may affect transcription in the early region, which includes the replication origin. It may also represent a site on the P2 DNA which interacts with the dnaB gene product.


Discriminative effect of rifampin of RNA replication of various RNA bacteriophages. Rifampin interferes exclusively with RNA replication in vivo of the group I phages MS2, f2, and R17, whereas QbetaRNA replication is unaffected by the drug. In addition, rifampin has a discriminative effect of group I phage RNA replication. In the experimental system employed by us the antibiotic differentially interferes with the synthesis of minus RNA strands in f2, whereas it has almost no effect on the synthesis of progeny plus strands. In MS2, the drug differentially arrests the synthesis of progeny plus strands and almost fails to affect the synthesis of minus RNA strands. In R17 both steps of its RNA replication are affected by rifampin, although each step is only partially (approximately 50%) inhibited. The relation of the present results to the possible role of bacterial proteins and tertiary structure of phage  RNA in the process of template recognition is discussed.


Replication of bacteriophage M13 IX. Requirement of the Escherichia coli dnaG function for M13 duplex DNA replication. Temperature-shift experiments with an Escherichia coli dnaG strain indicate a requirement for the dnaG function for M13 phage production only at an early stage of infection. Mutant cells infected at nonpermissive temperature form the parental RF (SS leads to RF) but do not replicate further. A shift to nonpermissive temperature after infection inhibits RF leads to RF replication but not RF leads to SS synthesis. The synthesis of both strands of the duplex RF was inhibited equally after a temperature shift during RF leads to RF replication. We infer that the dnaG protein is required for M13 production only during RF replication and that it is required for the synthesis of both strands of the RF.


Synthesis of complex forms of bacteriophage phiX174 double-stranded DNA in a temperature-sensitive dnaC mutant of Escherichia coli C. Fast-sedimenting forms of bacteriophage phiX174 double-stranded replicative-form DNA observed in normal infections continued to accumulate at the nonpermissive temperature in a temperature-sensitive dnaC mutant of Escherichia coli. These complex molecules accounted for up to half of the DNA synthesized during short pulses at the nonpermissive temperature. They were the dead-end products of DNA synthesis, not intermediates in normal replicative-form replication. The data suggest that these higher-than-normal-molecular-weight DNA molecules result from abnormal initiation of phiX174 replicative-form DNA replication.


Biological functions of the bacteriophage T3 SAMase gene. Certain differences between phage T3 on the one hand and T3sam- and T7 on the other hand indicate that the T3-coded SAMase function is responsible (i) for the development of the pseudolysogenic state by preventing T3 DNA methylation, and (ii) for the partial protection of the phage DNA against restriction by the P system.


Lysozymes from bacteriophages T3 and T5. Lysozymes produced in host cells infected with bacteriophages T3 and T5 were found to have the same enzymatic specificity toward the peptidoglycan from Escherichia coli as T7 phage lysozyme, which has been shown to be an N-acetylmuramyl-L-alanine amidase.


Renal autotransplantation using hypothermic storage and pulsatile perfusion. Three patients with severe hypertension secondary to renal artery stenosis were treated by renal autotransplantation. Of these 3 patients 2 had solitary kidneys and 1 had 2 renal arteries to each kidney, all of which were stenosed. Renal autotransplantation with hypothermia of the kidney was performed in all 3 patients rather than the more conventional arterial bypass or endarterectomy because 1) hypothermic preservation permitted a prolonged ischemia time and 2) there was improved exposure for the vascular anastomosis. Postoperatively 2 patients remained normotensive without drugs for 9 and 12 months and 1 patient died of septicemia not directly related to the autotransplant. All 3 patients required expansion of the intravascular volume postoperatively to overcome the loss of vasoconstrictor substances following restoration of renal blood flow.


Medrogestone: a prospective study in the pharmaceutical management of benign prostatic hyperplasia. Medrogestone is a progestational agent that may reduce outflow obstruction secondary to benign prostatic hyperplasia. Five of 8 patients taking 15 mg. oral medrogestone twice daily and 5 of 7 patients taking 7.5 mg. oral medrogestone twice daily experienced an increase in mean urine flow (averaging 55.8 and 30.1 per cent, respectively), while no change was noted in 4 untreated patients. Five of the 8 patients taking 15 mg. and 6 of the 7 patients taking 7.5 mg. experienced an increase in peak urine flow (averaging 60 and 37.6 per cent, respectively), while 2 of the 4 controls had an improvement of only 12.2 per cent. Repetitive residual urines and digital examination were inaccurate to assay sequential changes in prostatic size. Certain side effects, such as hypertension, abnormal glucose tolerance and impotence, were encountered in isolated patients but in no instance was the side effect hazardous to the health of the test subject and in each instance it could be reversed by withdrawal of the medication.


Seminoma in a renal transplant recipient. A case is reported of testicular seminoma developing de novo 13 months post-transplantation. Two other post-transplant scrotal complications were noted, that is hydrocele and testicular atrophy. The question raised is what type of therapy would be best for this patient.


Studies on the oral infectivity of rabies virus in carnivora. Mature and immature red foxes (Vulpes vulpes) and striped skunks (Mephitis mephitis) were fed varying numbers of white mice infected with street isolates and a fixed strain of rabies virus. Rabies deaths and the development of serum neutralizing antibody to rabies virus occurred in both species. The epizootiological implications of these findings are discussed.


Vaccination of foxes against rabies using ingested baits. A method for immunizing foxes against rabies was evaluated. Fifteen of 36 red foxes (Vulpes fulva) fed baits impregnated with modified live virus rabies vaccine developed serum rabies neutralizing antibody. The vaccine-bait proved unstable when held at 4 C or 25 C for 96 hours prior to feeding. For safety testing the vaccine virus was administered to opossums (Didelphis virginiana), cotton rats (Sigmodon hispidus), hamsters (Mesocricetus auratus), and chickens (Gallus domesticus) in either liquid or bait form. One of ten cotton rats fed liquid vaccine died of vaccine induced rabies. No animals which ate the vaccine-baits died of vaccine induced rabies.


Serologic observations during an outbreak of rat borne plague in the San Francisco Bay area of California. Results of a serologic study of a plaque outbreak among rats (Rattus norvegicus) and associated wild rodents are presented. Bacteriologic and serologic evidence points toward mutual exchange of fleas and plaque infection between the intermingled rat and wild rodent populations. Results emphasize the value of serologic methods for epizootiologic studies of plague in North American rat populations.


Bacteriuria in the catheterized patient.  Cystitis or pyelonephritis? Seventy-two patients with indwelling urethral catheters had urine specimens cultured to detect bacteriuria.  Bacterial sediments were examined to find the source of the bacteria, with use of an antibody immunofluorescence (IF) technique.  Antibody coating demonstrated by fluorescence was considered evidence for pyelonephritis.  In cystitis, the bacteria did not fluoresce.  Repeat culture and immunofluorescence studies were done 3 to 18 week later.  One third of the patients had a urinary infection.  Two (13%) of the patients catheterized for one day and 17 (55%) catheterized four or more days had appreciable bacteriuria.  One patient catheterized less than three days had positive IF, while 5 patients (16%) catheterized four or more days had positive IF.  Only two of the ten patients observed, with an initial infection, had sterile urine on follow-up culture.  On follow-up study, of the four patients with bacteriuria of renal origin, one showed a sterile urine, two had cystitis, and one still had pyelonephritis.


Trimethoprim-sulfamethoxazole vs ampicillin in chronic urinary tract infections. A double-blind multicenter cooperative controlled study. A multicenter, prospective, double-blind, controlled study was performed to compare the efficacy of trimethoprim-sulfamethoxazole with that of ampicillin in the treatment of chronic urinary tract infections. The incidence of adverse clinical signs and symptoms as well as abnormal laboratory values were comparable in the two treatment groups. This study appears to establish the fact that trimethoprim-sulfamethoxazole is an acceptable alternative to ampicillin for the treatment of chronic urinary tract infections caused by susceptible Escherichia coli.


The 12th Report of the Human Renal Transplant Registry. Prepared by the Advisory Committee to the Renal Transplant Registry. This report, the 12th, from the Renal Transplant Registry summarizes current results of kidney transplantation in man. There has been a trend toward increasing use of cadaveric sources for kidney transplantation. Results are summarized in five-year life-table analyses of recipient survival and graft function. Also, a summary of the results of special studies is provided. These include preparation of the recipient for transplantation by nephrectomy in various disease states, comparison of simple flushing with machine perfusion in cadaveric kidney storage, results of transplantation in the pediatric recipient, and the development of malignant neoplasm in graft recipients. A large study relating typing to graft function presents information at some variance from previous reports published in the United States.


Factitious meningitis. Diagnostic error due to nonviable bacteria in commercial lumbar puncture trays. A cluster of five false-positive cerebrospinal fluid (CSF) Gram stains led to an investigation of possible causes of specimen or smear contamination. Specimen tubes supplied in commercial lumbar puncture trays from the lot being used in the involved hospital were shown to contain nonviable bacteria, When filled with a test solution and processed in a manner similar to that used for processing CSF specimens, 10 of 12 tubes evaluated yielded Gram stains containing either Gram-negative rods, diplococci, or coccobacilli. Before this problem was recognized, the patient from whom the first false-positive smear was obtained was treated for bacterial meningitis. It is important to realize that microbial contamination of commercial CSF specimen tubes can result in findings simulating those of early bacterial meningitis.


Quantitation of bidirectional shunt from a single dye-dilution curve. A method for quantitating intracardiac bidirectional shunt and estimating its blood flow is presented. Three curves, defined as "right-to-left shunt curve", "normal pathway curve", and "left-to-right shunt curve" were separately drawn from the original downstream dye-dilution curve, and their areas ?A'', A, A', respectively, were calculated in the conventional manner. A'/A showed left-to-right shunt ratio (QL-R%) even in the presence of right-to-left shunt. However, right-to-left shunt ratio (QR-L%) was given by (1-A'/A)/(A/A'' + 1--A'/A), and equalled A''/(A + A'') only when left-to-right shunt was absent (A' equals O). A''/(A + A) should become increasingly higher than QR-L% with rise in QL-R% (equals A'/A). The relationship between A''/(A + A'') and QR-L% for various A/A isopleths is shown by figure. A good agreement (r equals 0.848, p less than 0.001) was found between QL-R% values by the present method and those calculated by the oxygen method. In contrast, QR-L% values by the present method were consistently lower than those by the oxygen method; the difference was exaggerated especially in cases with history of cardiac failure, and these cases tended to show lower systemic flow. The average difference in QR-L% between the two methods, found in cases free from failure, was 7 per cent. This was thought to be ascribed to intrapulmonary physiological shunt.


Comparative studies on generalized transducing bacteriophages of Proteus mirabilis, phim and pi1. Comparative studies were made on the generalized transducing bacteriophages of Proteus mirabilis phim (Nakaya and Rownd), pi1(Böhme), and a clear plaque-forming mutant phim-c, derived from phim. Electron microscopic observations revealed that these phages were morphologically identical, indicating that they belonged to the group C of Bradley's classification, or to the type C1 of Ackermann's classification. Phages phim and pi1 formed characteristic turbid plaques different from each other, and the plaques of pi1 were smaller in size than those of phim. The plaques of phage phim-c were clear and also were the largest in size among those studied. Average latent periods of phim and pi1 were 70 and 60 min, respectively. Average burst size was found to be 30 and 10 plaque-forming units per infected cell for phim and pi1, respectively. It was confirmed by cross neutralization tests that phim and pi1 differed serologically  from each other. The host range of the two phages also differed, and phage phim was more sensitive to heat than pi1. These results indicate that phages phim and pi1 are different types of phages. Majority of the properties of phage phim-c were nearly identical with those of phage phim except that the multiplication of phim-c was more strongly inhibited by methylene blue than that of phim and pi1. Phage phim-c is considered to be a clear mutant of phim.


Nonspecific  elicitation of antibody-forming cells in the mouse spleen by bacterial lipopolysaccharide. Mechanisms of nonspecific elicitation of anti-sheep erythrocyte (SRBC) hemolytic antibody plaqueforming cells (PFC) in mouse spleens with an injection of bacterial endotoxin (lipopolysaccharide (LPS)) were studied in comparison with the genesis of naturally occurring "background" PFC in normal mouse spleens and of rapidly arising PFC in mouse spleens after immunization with SRBC. The cytokinetic pattern of anti-SRBC PFC response after an injection of LPS was quite different from that of the response elicited after immunization with SRBC. In addition, even though LPS nonspecifically elicited anti-SRBC PFC response in mice, LPS could not confer any immunological memory on mouse immunocytess for a "secondary-type" anti-SRBC PFC response to restimulation with LPS or SRBC. The administration of rabbit anti-mouse thymocyte immunoglobulin or anti-SRBC antiserum in mice markedly suppressed the PFC response after immunization with SRBC, but did not do so after stimulation with LPS. Neonatally thymectomized mice could still respond to stimulation with LPS, producing anti-SRBC PFC in their spleens. Injections of actinomycin D or cyclophosphamide into mice resulted in obvious reductions of the PFC responses elicited by either LPS or SRBC. However, injections of these immunosuppressive antisera or drugs did not affect the number of anti-SRBC PFC in normal mouse spleens. These results suggest that the genesis of anti-SRBC PFC developed under different conditions, i.e., background PFC, LPS-stimulated PFC, and antigen-stimulated PFC, are quite different from each other, and that the nonspecific elicitation of anti-SRBC PFC by LPS does not require the helper function of T lymphocytes. No obvious difference, however, was observed in the time of ontogenic maturation among these three different anti-SRBC PFC in the mouse spleens judging from when they were first manifested after birth.


[Characteristics of the islet apparatus of the pancreas in rats with genetic spontaneous hypertension]. In spontaneously hypertensive rats (SHR) at the age of 7-9 weeks a poor development of the beta-cellular part of the islet-cell tissue was found, as compared to normotensive Wistar rats of the same age (a lower number of beta-cellular islets, decreased mass of the islet-cell tissue). With glucose load in SHR hyperglycemia was more distinct and longer lasting, which indicates the development of insulin insufficiency in them, in a situation demanding forced insulin incretion. A histochemical examination proved a reduction of the insulin content in the islet-cells of these animals, as compared with the control ones. The above mentioned changes evidently do not pertain to the primary genetically-determined pathology of their pancreas, but are of a secondary nature of atrophy of the insulin-forming tissue, that is probably conditioned by the decreased tissue requirements (target) for insulin due to the increased permeability of the cell membranes.


Liver cirrhosis: immunofluorescence and biochemical studies demonstrate two types of collagen. Pepsin solubilization of small and large noduled liver cirrhosis yielded two types of collagen (precipitated at 1.7 and 2.5 M NaCl concentrations) as demonstrated by electronmicroscopy. The 1.7 M NaCl precipitate was identified as type III collagen using an immunofluorescence technique. The 2.5 M NaCl precipitate appeared to be type I in the electronmicroscope. However, immunofluorescent and biochemical studies indicated that it was not type I but a type of collagen not yet described.