Specific and nonspecific cooperation between M-locus-incompatible T and B cells during adoptive anti-hapten antibody responses in mice. CBA and AKR mice are identical at the major histocompatibility locus (H-2) but differ at the strong, non-H-2, mixed leukocyte culture (MLC)-stimulating M-locus. Adoptive secondary in vivo antibody responses using immune spleen cells from mice of these strains demonstrate two interesting findings. One is a non-specific augmentation of the anti-hapten antibody response of CBA B cells by AKR T cells. This allogeneic effect is unidirectional in the same sense as the MLC between cells from these two strains. The second is that, despite an ongoing allogeneic effect, M-locus-incompatible T and B cells show strong specific cooperation. Thus, it seems unlikely that the failure of H-2-incompatible T and B cells to collaborate specifically is due to inhibitory allogenic reactions.


Medical records in family practice. A review. The organisation of general practice in England is outlined and the independent contractor basis of the family practioner emphasised. Data from family practice, like data from hospital practice, may be used for clinical management, practice management, or research. Examples of applications in each of these fields are given. The basic records used in family practice--the medical record envelope, the prescription form and the claim for sickness benefit--are described. Some practices record morbidity (E Book or Diagnostic Index), some record systematically details of their activities (L Book or Activities Ledger) and some maintain age and sex registers and other registers of their patients; all these developments are outlined. Attention is drawn to the introduction of problem orientated records and to the use of computers in family practice, but these innovations are not discussed. Outstanding issues are the same as those in hospital record systems--accuracy, definitions, coverage, confidentiality, clerical support and costs, and the use made of the information.


Multiple sclerosis and high incidence of a B lymphocyte antigen. Multiple sclerosis patients were tested for six new antigens present on human B lymphocytes. The group 4 specificity occurred in 83.9% of the 56 patients as compared to 32.5 percent in 72 healthy controls (P less than .003). The antiserums defining the five other B lymphocyte specificities reacted at a lower frequency to B cells from multiple sclerosis patients, showing that increased reactivity to group 4 antiserum was specific. Linkage of a hypothesized multiple sclerosis susceptibility gene with certain haplotypes of HLA-A3, HLA-B7 HLA-DW2, and the new B group 4 can be inferred.


Aneurysms of the hepatic artery.

Aneurysms of the hepatic artery. Aneurysms of the hepatic artery are rare and, when symptomatic, they may present a triad of upper abdominal pain, gastrointestinal bleeding, and obstructive jaundice. Asymptomatic and unsuspected aneurysms are demonstrated occasionally by abdominal arteriography or are encountered infrequently during abdominal operation for an unrelated disease. Hepatic artery aneurysms have great potential for rupture with bleeding into the peritioneal cavity, the common bile duct, or an adjacent hollow viscus. Morbidity and mortality with a ruptured aneurysm are high, and aggressive and imaginative operative therapy is required. Patients with an asymptomatic aneurysm should have operation to prevent subsequent rupture and hemorrhage.


Lasiodiplodia theobromae as a cause of keratomycoses. Four cases of human keratitis caused by the tropical fungus Lasiodiplodia theobromae have been encountered in Miami, Florida bringing to 8 the number of cases reported in the world literature. Two of the ulcers were mild. Three patients recovered without severe impairment of vision after topical polyene treatment, but 1 patient with a severe ulcer required therapeutic keratoplasty after 11 days of topical natamycin. Histopathology revealed fungus deep in the cornea, invading Descemet's membrane. L. theobromae appeared to have collagenase activity in vitro. Inoculation of L. theobromae into the corneas of rabbits produced progressive ulcers. The fungus was endemic in Miami on home grown and imported bananas. Polyene antimycotic antibiotics were fungicidal for L. theobromae in vitro. Thiabendazole was effectively fungistatic but varied in fungicidal effect. Clotrimazole and miconazole were only incompletely fungistatic. Of 7 strains of L. theobromae tested, 4 were relatively resistant to 5-flurocytosine.


Experience with jejunoileal bypass for obesity. Fifty-eight patients less than 30 years old but who are more than 300 pounds in weight were considered for investigation of jejunoileal bypass. Thirty patients had operations, and the functioning bypass included 40 centimeters of jejunum and 10 centimeters of ileum. In 14 patients, intestinal continuity was restored by either end-to-end or end-to-side anastomosis according to random choice, and in 16 patients, end-to-end anastomoses were used. At present, the follow-up period is one to four years, and the weight loss, so far, has not been significantly related to the type of reconstruction used. Weight loss correlated possitively with the preoperative weights up to one year after operation. Also, weight loss correlated positively with the total measured length of the small intestine during the first six postoperative months, but this correlation currently is showing a trend toward negativity. Food intake decreased by 2,682+/-690 calories per day at six months after operation as a result of the bypass. Chronic acidosis was common. Results of an endocrine evaluation revealed an unexpected significant decrease in parathormone levels within the normal range. A new complication, colonic pseudo-obstruction, has occurred one year or more after operation in five patients or 17 per cent of our group. This complication is related to the intestinal anaerobic flora in proximity of the defunctionalized limb; its symptoms and signs can be alleviated by giving antibiotics or Lactobacillus to change the intestinal flora. Although 90 per cent of our patients are pleased with their progress and the results of routine evaluation corroborate their satisfaction, detailed analysis of the research data available to us revealed that only 43 per cent have had beneficial effects from a jejunoileal bypass without any of the serious sequelae. We consider jejunoileal bypass for obesity justified when carried out by interdisciplinary groups dedicated to the long term follow-up study of the patient and periodic reporting of the results. The long term future for the operation is, as yet, not completely understood, and when the conditions we have recommended are not present, we cannot currently endorse the operation.


Immunologic studies in von Willebrand's disease: alteration of factor VIII/von Willebrand protein after transfusion with plasma concentrates in patients with von Willebrand's disease. Two patients with a severe von Willebrand's disease characterized by no detectable factor VIII related antigen in their plasma received transfusions of cryoprecipitate. The bleeding time was corrected for a short period of time and returned to its pretransfusional value although the other parameters of the disease were still corrected. Electrophoretic and immunologic properties of factor VIII related antigen infused were determined serially after transfusion. Modifications of these properties occurred progressively after transfusion. The half disappearance time of F. VIII R.A. was determined and found to be considerably shorter than in hemophilic recipients. This study suggests an alteration in vivo of F. VIII R.A. infused into von Willebrand recipients.


The platelet-endothelial cell--VIII axis. Cultured human endothelial cells synthesize and secrete a protein(s) which has factor VIII antigen and von Willebrand factor activity. Subcellular membrane and granule fractions derived from human platelets also contain the factor VIII antigen and von Willebrand factor activity. Circulating platelets constitute a significant reservoir of VIII antigen containing approximately 15% of the amount present in platelet poor plasma. Thus normal platelets contain surface bound as well as intracellularly stored von Willebrand factor, a protein synthesized by endothelial cells which is required for normal platelet function.


Importance of protease inhibition in studies on purified factor VIII (antihaemophilic factor). According to some authors factor VIII procoagulant activity may be dissociable from carrier protein (MW approximately 2 X 10(6) by agarose gel filtration, e.g. at high ionic strength. We were able to reproduce this phenomenon. However, addition of protease inhibitor (Trasylol) prevented the appearance of low molecular weight peak of factor VIII procoagulant activity both at high ionic strength and elevated temperature (37 degrees C). We conclude from our results that procoagulant activity and carrier protein (von Willebrand factor, factor VIII antigen) are closely associated functional sites of native factor VIII macromolecule. Consequently, proteolytic degradation should be avoided in functional and structural studies on factor VIII and especially in preparing factor VIII concentrate for therapeutic use.


Induction of cytotoxic lymphocytes directed against public alloantigens. The response of H-2k lymphocytes to in vitro stimulation by H-2b and HI2d spleen cells has been monitored for the production of cytotoxic lymphocytes (CL). Using cells from H-2b strains CL which were capable of lysing both H-2b and H-2d target cells (TC) were generated. These results, together with competitive inhibitor studies of the cytotoxic activity against H-2d TC, demonstrated that T lymphocytes can respond to both public and private alloantigens of the H-2 complex. When H-2d cells were used for stimulation two of the three strains tested induced CL with cytotoxic activity towards both H-2d and H-2b TC. These observations indicate that the T cell response to alloantigen, leading to the production of cytotoxic lymphocytes, can be multicomponent like the established B cell response and can be expected to be subject to as much phenotypic variation. The full complexity may only be revealed by examing a number of combinations of stimulating strains, methods of stimulation and different kinds of target cells.


Colony-forming cells in culture and colony-stimulating activity of the urine and the serum in a case of cyclic neutropenia. A 22-year-old female with cyclic neutropenia was studied. Her bone marrow cells showed high colony-forming activity in soft agar through the cycle, though there were slight fluctuations in the number and the shape of colonies. On the other hand, the peak of urinary colong-stimulating activity (CSA) occurred at the neutropenic stage. The dialyzed serum showed two peaks of CSA, i.e., at the peak and the valley of the neutrophil count, although the undialyzed serum showed only one peak at the neutroenic stage. It is suggested on the basis of these data that humoral factors may play a role in maintaining the neutrophil cycle.


Alpha1-antichymotrypsin in rheumatoid arthritis. Serum alpha1-antichymotrypsin (alpha1-ACT) of the patient with rheumatoid arthritis was studied by means of single radial immunodiffusion method. There was a significant elevation of the alpha1-ACT concentration in the patients with rheumatoid arthritis, and positive relationships were observed between the concentrations of alpha1-ACT and of other glycoproteins such as alpha1-acid glycoprotein and alpha1-antitrypsin in individual patients, and between C-reactive protein (CRP) rates and the (CRP) rates and the alpha1-ACT concentrations in individual specimens. These facts suggest that alpha1-ACT belongs to a group of acute phase proteins like alpha1-antitrypsin or CRP. An inverse proportional correlation was revealed between alpha1-ACT and fibrinolytic activity. No influences were observed on the alpha1-ACT concentration, activity index or articular index by the oral administration of alpha-chymotrypsin in patients with rheumatoid arthritis.


Drug effects on the fine structure of Trypanosoma rhodesiense: puromycin and its aminonucleoside, Cordycepin and Nucleocidin. The effects of four trypanocidal adenine nucleosides on the fine structure of a monomorphic strain of Trypanosoma rhodesiense have been examined. All four drugs, Puromycin and its aminonucleoside, Cordycepin and Nucleocidin, induced electron-lucent cytoplasmic clefts in the cytoplasm, which were generally acicular or spindle-shaped, with long axes lying in any direction. The clefts had an intimate relationship with the rough endoplasmic reticulum. The drugs also produced excessive lysosomal vacuolation, and two, Cordycepin and Nucleocidin, caused nucleolar fragmentation and probable segregation, indicative of interference with RNA synthesis. The significance of the lesions is discussed in relation to known properties of adenine nucleoside drugs.


Acute gastric changes in patients with acute stroke. Part 1: with reference to gastroendoscopic findings. A gastroendoscopic study was performed on 177 patients with acute stroke. Gastric changes were found in 92 among them (52%), including ten with acute ulcer. A high frequency of gastric changes was found in patients with serious stroke and/or in patients whose cerebral lesions were located close to the hypothalamus or its centrifugal tract. The mortality in patients with gastric changes was high, especially in patients with acute ulcers, multiple erosions and petechiae. The frequency of brown gastric juice and coffee grounds at gastroendoscopic examination (gastric hemorrhage) was three times as high as that of melena and/or hematoemesis. On the other hand, the mortality of patients with gastric hemorrhage differed little from that of patients with melena and/or hematoemesis.


Cerebellar hemorrhage: reliability of clinical evaluation. Surgery without confirmatory radiological contrast studies has been advocated in patients suspected of having a cerebellar hemorrhage. To determine the reliabiligy of the clinical evaluation, records were reviewed of 33 patients in whom the diagnosis of cerebellar hemorrhage was initially suspected or subsequently confirmed. In 13 patients the correct diagnosis had been made initially by clinical evaluation, but in ten patients the correct diagnosis was not suspected at the initial evaluation. The remaining ten patients had typical backgrounds, symptoms, and signs of a spontaneous cerebellar hemorrhage, but radiological contrast studies and clinical observation indicated that other neurological lesions were responsible. Thus, utilizing solely the clinical evaluation, the diagnosis of cerebellar hemorrhage may be made only with difficulty and not with the certainty required for emergency surgery.


Progressive human cone-rod dysfunction (dystrophy). The author has classified progressive human cone-rod dysfunction into primary and secondary types. The primary type, identified by early ERG cone and usually also rod abnormalities, was further subdivided into types 1 and 2 based on, amoung other distinguishing characteristics, the extent of associated retinal pigment epithelial defects. Secondary cone-rod dysfunction apparently results from disease initially affecting the retinal pigment epithelium. Initially normal ERG findings and the presence of flecks characterize this (type 3) progressive cone-rod dysfunction.


[Relaparotomy in acute hemorrhage after operations on the abdominal organs]. In the paper, an analysis of acute postoperative hemorrhages in 30 patients after operations on the abdomen is presented. In these patients 42 relaparatomies have been performed with lethal issues in 16.7%. The causes of this complication are analysed, and recommendations how to prevent them are given.


[Retrograde mammary-coronary anastomosis and its place among other methods of myocardial revascularization]. Under consideration is a special kind of mammary-coronary anastomosis--a retrograde mammary-coronary anastomosis, first suggested by the authors. An anteretrograde mammary-coronary anastomosis was performed in 104 patients, a retrograde one--in 6. The use of a retrograde mammary-coronary anastomosis yielded favourable results, which in some cases are remained for 4-5 years.


[Immune response of the chicks from immune layers vaccinated at 1 and 4 days of age against Newcastle disease]. The study of antihemagglutinins in day-old chicks revealed the presence of congenital antibodies against the Newcastle disease virus, having an average geometric titer of lg2 7.9. In the vaccinated 1,500 chicks on the first and fourth day with a La Sota vaccine there was four days later a drop in the antibody titer. Then again a rise in the antibody titer was noted that reached on the 14th day an average geometric value of lg2 7.6 which remained unchanged up to the 40th day. The antihemagglutination titers in the untreated chicks on the 40th day of age dropped to lg2 1.8. As many as 70 per cent of the control chicks died at challenging on the 24th day of age, while all of the treated birds (100 per cent) were given protection through vaccination by the spray method or ocularly and nasally, withstanding challenge on the 20th and 24th day following treatment.


[Quantitative determination of alpha1-antitrypsin in lung tissue from adults with emphysema and newborns with respiratory-distress-syndrome (author's transl)]. In a small number of patients, lung emphysema can be attributed to a remarkable deficiency of alpha1-antitrypsin. Concentrations reduced about 50% of the normal value represent a predisposing factor. In most cases of newborns with respiratory-distress-syndrome the concentration of alpha1-antitrypsin is decreased. Its determination can be used for the early diagnosis of the respiratory-distress-syndrome.


[Quantitative determination of blood loss by means of 51 Cr-labeled erythrocytes in occult hemorrhages of the gastrointestinal tract]. By means of 51 Cr-labelled erythrocytes the stools of 17 patients were examined for occult admixtures of blood. Hereby a method well suited for routine work was developed, the manipulations with stool were reduced to a minimum measure. As measuring device an animal total body counter was used. The average excretion of blood in persons without diseases of the gastro-intestinal tract was 0.49+/- 0.38 ml/d. In three patients a haemorrhage could be proved. The quantitative determination of blood losses through the intestine is diagnostically valuable. It is useful particularly in unclear iron deficiency anaemis. A combination of the method with the determination of the survival time of erythrocytes is possible.


[Behavior of thymus-arised lymphatic cells in the peripheral blood in acute leukoses]. On the basis of their ability of the spontaneous formation of rosettes by unsensibilised sheep erythrocytes the proportion of thymic lymphatic cells in 7 acute and 3 chronic lymphatic leukaemias was determined. Further observations on the content of T-cells in the peripheral blood were performed in leukoses, whereby the remission was begun with prednisone and cytostatics, under the immune stimulation with BCG during the remission and in 3 children with lymphogranulomatosis before and after splenectomy. The results of the acute stage of leucosis refer to the possibility of a prognostic evidence with the subclassification of the ALL. The T-cell-leukaemias revealed a particularly unfavourable course of disease. Cytochemically they were acute lymphatic leukaemias of undifferentiated type. In leucoses with smaller proportion of T-cells the blasts above all revealed a granular PAS-reaction.


[The antithrombotic treatment and prevention of recurrence with acetylsalicylic acid in myocardial infarct]. A comparison of the therapy, especially of the long-term recidivation prophylaxis of the myocardial infarction with acetyl salicylic acid and anticoagulants, on the basis of 314 observations allows of the following opinions: By means of the thrombocyte aggregation inhibitor acetyl salicylic acid an antithrombotic therapy and recidivation prophylaxis of good value can be performed. The application of acetyl salicylic acid is, concerning the course of the disease after the onset of the infarction and the frequency of recidivation, adequate to the treatment with classical anticoagulants. The practical performance of the long-term therapy with acetyl salicylic acid is significantly simplified for physician and patient compared with the application of anticoagulants. The daily dose lies uniformly at 1.5 g. There is no fear of acute haemorrhagic complications. As control only the occasional establishment of the Hb-value as well as of the time of haemorrhage is indicated. The only, however, very decisive disadvantage of the acetyl salicylic acid, the bad compatibility for the stomach, is certainly not abolished with the new drug "Micristin", but much diminished.


[Studies on the frequency and diagnostic value of hepatomegaly]. In 4 groups of patients (I = 1 621 internistic in-patients, II = 2 073 donors with increased SGPT-values, III = 2 619 after-examined patients with hepatitis, IV = 514 patients of a sanatorium for liver diseases) frequency and diagnostic validity of the symptom enlargement of the liver are tested. The most frequent cause of hepatomegalia is in group I an insufficiency of the right heart. The highest percentage, however, is to be found in liver diseases, then come heart insufficiency, diseases of stomach and gall-bladder, diabetes, rheumatic diseases. In these diseases liver biopsy detects additional changes in many cases. The validity test in the 4 groups yields very different results, dependent on the number of patients and the diagnostic questioning. The symptom hepatomegalia cannot be used as a screening test, but it is of high diagnostic value in the clinical diagnostics.


[Prerequisites and possibilities of immunotherapy in acute leukemias]. Nowadays there are references that immuno-reactions of patients with carcinoma against tumour-associated antigens are of essential significance for the development and progressing of tumours. Also the frequent appearance of neoplasms in primary immunodeficiency syndromes indicates this fact. Also in human leukaemias there exist leukaemia-associated antigens. Humoral as well as cell-bound immunoreactions may be proved. Possibly leukaemia-associated immunoglobulins are blocking factors which prevent the cellular immunoreactions against leukaemia-associated membrane antigens. The presence of specific reactions against antigens on leukaemia-cells was the condition for a successful immunotherapy. Despite many theoretical possibilities the immunotherapy in the clinic at present restricts to the BCG-vaccination and to the application of living or irradiated leukaemia-cells. The hitherto reported results are encouraging.


[Endoscopy of postoperative hemorrhage in the upper gastrointestinal tract]. In hemorrhages from the upper gastrointestinal tract, emergency endoscopy is becoming more and more significant. Hemorrhages during the early postoperative stage, particularly in abdominal surgery, require particular attention due to the generally difficult postoperative situation. In most instances, intragastral hemorrhages are due to erosions and anastomotic bleeding. A detailed knowledge of the surgery performed may contribute to a quick and successful examination. Among the most important premises for a high rate of correct diagnoses are the experience of the examining physician as well as an early or immediate identification of the indications. In addition to the diagnostic significance, under favorable circumstances endoscopy makes possible definitive or temporary staunching of the bleeding by means of diathermy, laser beam or sclerotization.


[Abdominal roetgen diagnosis in intensive care patients]. Following the discussion on special clinical issues with respect to patients in surgical and internal intensive care wards, technology and special methods used in conventional thorax and abdominal X-rays are elaborated on. The wide range of information obtained through large spectrum abdominal X-rays taken in the ventrodorsal direction with the patient lying on the left side is stressed. Small quantities of free air are visualized better in this position than in the upright one. The importance of additional X-rays of thorax and epigatrium in a seated position is accented. Subject of discussion is also the indication for visualizing by contrast medium and the selection of a contrast medium with due consideration of clinical criteria. The urgent need of an X-ray diagnosis in such a group of patients requires high standards in terms of techniques and methods used for examination--something that lies within the realm of the radiologist. Close cooperation with the attending team of physicians is a must if optimum interpretation of the X-rays is to be guaranteed.


[Mechanism of the effect of sera from rats subjected to high external temperature on rosette formation by splenic lymphocytes from non-immune animals]. Serum of rats subjected to the action of moderately high external temperature increased the immunogenicity of heterologous erythrocytes, but became inactive at a temperature of 2 degrees C and after the treatment with a polyvalent proteinase inhibitor--trasilol. Incubation of sheep erythrocytes with the serum of heated rats intensified the reaction of rosette formation by the lymphocytes of the spleen of intact rats. Incubation of the spleen cells with the sera of intact and heated rats failed to influence the rosette formation. After trasilol treatment the serum of heated rats completely lost the property to intensify the reaction of rosette formation. Phenomenon of intensification of rosette formation was revealed in case of treatment of erythrocytes with the sera at a temperature of 37 degrees C and was not reproduced at a temperature of 2 degrees C. Investigations carried out indicated that the increase in the immunogenicity of sheep erythrocytes and the intensification of their binding with the lymphocyte receptors of intact rats under the effect of the serum of heated animals were caused by the action of the same factor.


Bypass to anterior descending coronary artery in patients with aneurysm or scarring of left ventricle. Fifteen cases who have had myocardial infarction with aneurysm formation or severe scarring of the left ventricle as a result of occlusion of left anterior descending coronary artery are presented. Bypass to left anterior descending coronary artery using internal mammary artery or saphenous vein was done in all of these patients. Ten of these had plication or excision of the left ventricular aneurysm. All of them survived the operation and are doing well. Early results in this series of patients indicate that left anterior descending coronary artery bypass in these patients is of great value by allowing perfusion to patent brances of left anterior descending coronary artery.


[Perforation of the interventricular septum, a complication of myocardial infarct]. The authors report nine surgical attempts in ventricular septal rupture following myocardial infarction and compare their experience with data from the literature. Two of the three long-term successes have been obtained by the association of infarcectomy and myocardial revascularisation to the repair of the septal rupture.


[Cardio-respiratory assistance with the extracorporeal membrane oxygenator for massive pulmonary embolism]. A 39 year old pneumectomized patient presents a massive pulmonary embolism, dies within 3 hours and is supported inefficiently by cardiac massage with recurrent mydriasis during 2 hours. At that time, under extracorporeal cardiopulmonary bypass with a membrane oxygenator, the cardiac activity recovers immediatly due to right decompression and coronary perfusion. The patient is conscious within 5 hours. The cardiopulmonary bypass with a membrane oxygenator appears to be the best therapy when the cardiac massage fails to restitute a normal myocardial function. No embolectomy was performed. The patient died when the bypass was stopped after 48 hours. We conclude that the prolonged peripheral extracorporeal bypass followed by embolectomy is the best therapy of pulmonary embolism.


Single right ventricle (double-inlet right ventricle). A pathological specimen with comments on embryology. This paper describes a pathological specimen of double-inlet right ventricle in which no remains of a hypoplastic left ventricle were found. An ontogenetic explanation of the malformation is presented based on the development of the normal human embryos. This case may be an example of exaggerated displacement of the atrioventricular canal towards the bulbus cordis in which the left ventricular cavity is extremely hypoplastic or aplastic and is not recognizable. The concept of early and late displacement is introduced.


[Complete atrioventricular block in bacterial endocarditis]. A case of bacterial endocarditis complicated by complete auriculoventricular block is reported. The pathological findings and data from previously reported cases point to the fact that this complication is generally indication of very extensive cardiac and valvular damage. Surgery, although dangerous, should be attempted in the circumstances.


Cilia-forming potentials of endocrine organs originating from the foregut. Cilia were found in intracellular localizations or on the surface of certain cells of frog thymus and chicken parathyroid gland and ultimobranchial body. The experimental observations suggest that ciliogenesis is probably a general property of branchiogenic epithelium, which either persists, or can be activated by certain influences after the functional differentiation of endocrine organs arising from the foregut.


Ampicllin sensitivity and biotypes of recent Danish isolates of Haemophilus influenzae. Among 148 strains of Haemophilus influenzae isolated in 1975 from different localities in Denmark, none was found to be resistant to ampicillin. A majority of the strains belonged to biotypes I, II and III and the presence of a partial correlation between biotype and origin was confirmed.


The relationship between pregnancy, HCS and B lymphocytes. The quantitative distribution of the lymphocyte subpopulations (B, T and null) and the serum concentrations of Human Chorionic Somatomammotropin (HCS), immunoglobulins IgG, IgM and IgA, complement component C4 and C1 inactivator, were estimated in venous blood samples from 32 women at various stages of pregnancy and compared with a control series of 7 non-pregnant normal women. A significant decline in the B cell percentage during pregnancy was seen. The fall in the percentage of the B lymphocytes was found to be concomitant with the rise in HCS concentration. No significant changes in the other parameters studied were present.


Intracranial pressure during ventriculography using meglumine iothalamate. A small increase in ventricular fluid pressure (1.3 +/- 0.3 mm Hg) occurs on isovolumetic addition of meglumine iothalamate to the lateral ventricle. A marked increase (46.3 +/- 3.2 mm Hg: P less than 0.001) in pressure occurs on passage of the contrast medium into the posterior part of the third ventricle; the aqueduct and the fourth ventricle. Theoretical mechanisms are discussed.


The structure of the rhombencephalic roof in the frog. The structure of the rhombencephalic roof has been studied by serial section histology in 12 adult frogs, 3 recently metamorphosed frogs and 8 tadpoles of the species Rana temporaria. The roof of the rhombencephalon caudal to the choroid plexus consists of a delicate layer of ependyma which appears to be intact from the time of its development in the tadpole until the stage of metamorphosis. In the adult frog it is an attenuated structure displaying variable deficiencies with an apparent communication between the rhombencephalic ventricle and the surrounding subarachnoid space. The significance of this acquired communication between internal and external cerebrospinal fluid compartments in the adult frog is discussed in relationship to the classical concepts of bulk flow of the CSF in humans. Some of the limitations of these classical concepts are also discussed, and the approach to these problems by studying the comparative morphology of the CSF system in vertebrate animals is justified.


Angioimmunoblastic lymphadenopathy with dysproteinemia. Immunohistologic and ultrastructural studies. Immunoblasts of the B-cell line and immunoblasts of the T-cell line have very similar light-microscopic appearances but different immunologic compositions. The immunoblasts of a patient with angioimmunoblastic lymphadenopathy with dysproteinemia were found to bear surface immunoglobulin and complement receptor. They lacked receptor for cytophilic antibody. Surface villous projections were demonstrated by scanning electron microscopy. These features strongly indicate their B-cell origin.


Portal hypertension. A new beginning for an old problem. There are two types of shunts for the treatment of esophageal varices: total shunts or selective shunts. The various total shunts are designed to "decompress" both the portal and the variceal venous systems. In contrast, a selective shunt decompresses the varices only, and the portal pressure and presumably portal flow are not affected. The very purpose of the total shunt is the total or partial diversion of portal flow. This is the case no matter which branches of the portal and systemic venous systems are connected and whether the anastomosis is a direct one or is through a graft. In an ongoing prospective, randomized clinical trial, which now includes 46 patients, a total shunt (mesorenal H graft) and the selective distal splenorenal (Warren) shunt are compared. The operative mortality rate and the frequency of postoperative bleeding are the same. However, encephalopathy is more frequent after the total shunt (P less than 0.05), and a trend is developing which suggests a better long-term survival rate after the Warren shunt. If these trends continue, then the superiority of the Warren shunt is established in a selected group of patients who have bled at least once from their varices. If these patients continue to remain free of encephalopathy and hemorrhage will not recur, then it is probable that the Warren shunt could improve the chances of survival of cirrhotic patients with esophageal varices who did not bleed yet. The "prophylactic" value of the Warren shunt will require a multicenter, cooperative, controlled clinical trial.


Diagnostic accuracy of fiberoptic panendoscopy and visceral angiography in acute upper gastrointestinal bleeding. Emergency fiberoptic panendoscopy and visceral angiography both had comparable diagnostic accuracy in our series of 55 patients with actively bleeding upper gastrointestinal lesions. The diagnostic accuracy of the barium meal was found inferior to both fiberoptic panendoscopy and visceral angiography. Panendoscopy proved capable of quickly and safely diagnosing site and source of the active bleeding lesion. Visceral angiography requiring additional time, expense and personnel commitment proved an effective back-up procedure when panendoscopy was unsuccessful or contradictions existed. Emergency angiography was well tolerated by gravely ill patients. The therapeutic advantage of angiography with infusion of vasopressin upon completion of the diagnostic study remains to be shown as an advantage over panendoscopy.


Tritanopia.

Tritanopia. The color-matching functions of individual tritanopes differ significantly from those predicted with the assumption that the two cone pigments of the tritanope are those which underlie the matches of the standard observer. The differences cannot be explained completely by the abnormal luminosity curve of the standard observer nor by abnormalities in transmissivity of the eye media. Individual tritanopes differ significantly in their color matches in ways not entirely accounted for by eye media differences. The results are consistent with the view that there are a variety of different long- and medium-wave-sensitive cone visual pigments among different tritanopes.


Mitochondria-rich cells of frog skin in transport mechanisms: morphological and kinetic studies on transepithelial excretion of methylene blue. The following study combines histological observations on the localization and density of mitochondria-rich cells with a kinetic study of the part played by these cells in transport phenomena. In the ventral skin, mitochondria-rich cells and granular cells are equally abundant in the first living cell layer. The mitochondria-rich cells were shown to excrete methylene blue [3,9-bis-(dimethylamino)-phenozathionum chloride]. A kinetic study of this excretion across the isolated epithelium of Rana esculenta skin showed that the mechanism of the excretion was a saturable one. An important fraction of methylene blue excretion depends on the absorption of sodium; the absence of this ion, or the inhibition of its transport by ouabain or amiloride, inhibits the excretion of the organic base. The mitochondria-rich cells, however, do not appear to play a determining role in sodium transport.


Lactate and contractile force in frog muscle during development of fatigue and recovery. The relationship between lactic acid concentration and twitch tension was reevaluated in electrically stimulated frog sartorius muscle. In muscles stimulated under anaerobic conditions at a rate of 30 stimuli/MIN CONTRACTILE FORCE DECREASED TO 36% OF THE INITIAL VALUE IN 15 MIN, Concomitantly lactate increased from 3.3 to 18.7 mumol/g of muscle. The correlaiton between the increase in lactate and the decrease in contractile force was significant (r = -0.99, P less than 0.000001). Recovery occurred in two phases. A rapid increase in contractile force, which represented 20% of the total recovery, took place during the first 15 s and occurred concomitantly with an increase in ATP from 3.9 to 4.6 mumol/g. Lactate concentration did not change significantly during this period. The second phase of recovery of contractile force was complete in 50 min. Lactate concentration and contractile force were significatly correlated during recovery (r = -0;92, P less than 0.00001). However, recovery of contractile force lagged behind the decrease in lactate; a given concentration of muscle lactate was associated with a higher contractile force early during development of fatigue than late during recovery.


Gastric H+ secretion in presence of substrates: absolute dependence on secretagogues. Spontaneously secreting gastric mucosae of the bullfrog (Rana catesbeiana) were brought to resting states in the absence of both the exogenous secretagogue and energy-yielding substrate, either by treatment with burimamide or by the classical method of prolonged preincubation. Glucose, pyruvate, lactate, and tricarboxylic acid cycle intermediates were compared with short- and long-chain fatty acids as potential substrates on these resting mucosae to determine if the latter could initiate and sustain H+ secretion in the absence of added secretagogues. The experimental data indicate that fatty acids cannot stimulate acid secretion from the resting state by preempting the requirement for secretagogues. Although fatty acids may serve as preferred substrates in comparison with glucose, glycolytic intermediates, and tricarboxylic acid cycle intermediates, acid secretion is obligatorily dependent on the presence of endogenous or added secretagogues. The implications of this finding with respect to one of the recently proposed hypothesis for secretagogue regulation of gastric hydrochloric acid secretion are discussed.


Effect of muscle length on 45Ca efflux in resting and contracting skeletal muscle. The increment of the slow component of 45Ca efflux from frog skeletal muscle that is produced by electrical stimulation is reduced by 70% when the muscle has been stretched to 160% of in vivo length. No change in the efflux from resting muscles or the increment in influx associated with stimulation was produced by increased length. The increased efflux produced by 8 mM caffeine was not altered by increased muscle length. Resting and action potentials were unchanged by the stretching. No morphological changes were seen in the transverse tubules or their junction with the terminal cisternae even at sarcomere lengths of 3.8 muM, but the terminal cisternae themselves were elongated at this length.


Postemetic hematomas: a variant of the Mallory-Weiss syndrome. Of forty-four patients with the Mallory-Weiss syndrome, nine (20 per cent) had endoscopic evidence of small submucosal hematoma(s) lying in or adjacent to the region of the the tear. These small hematomas are believed to occur most commonly as a variant of the Mallory-Weiss lesion.


A retroperitoneal cystic leiomyosarcoma spontaneously draining into the stomach. An unusual case of a retroperitoneal cystic leiomyosarcoma clinically resembling a pancreatic pseudocyst with subsequent spontaneous cystgastrostomy drainage is presented.


Lysosomal enzymes in subretinal fluid.

Lysosomal enzymes in subretinal fluid. Samples of subretinal fluid (SRF) from patients with primary rhegmatogeneous retinal detachment of various duration were studied using standard enzymologic techniques. The protein content in SRF increased with the duration of detachment. The activities of lysosomal enzymes in SRF, which were acid phosphatase, beta-glucuronidase, and cathepsin D, also increased with the duration of detachment. Especially cathepsin D, which was not detected in serum, was present in SRF. The activity of a nonlysosomal enzyme, i. e., lactic dehydrogenase, which was used as a marker of cell disruption and of serum transudation was the same as that of serum. Because lysosomal enzymes are known to be able to degrade cells and tissues, the enzymologic analysis of SRF contributes to our understanding of the pathology of primary rhegmatogeneous retinal detachment.


[Possibilities of cartographically documenting changes of the vitreous body, when examining the eye with a three-mirror contact glass (author's transl)]. After some remarks about the technique of the examination of the vitreous body with the three-mirror contact lens, the usual charts for documentation of vitreous changes are described. Furthermore, a new method of direct diagrammatic documentation of biomicroscopic findings of vitreous changes is presented.


Enzymologic and histologic investigations in normal and pressure-ischemic retina of rabbits. Histologic investigations together with histochemical and photometric measurements of enzyme activities were performed in retina of rabbits, whose blood supply had been totally interrupted for 1h. A retinal edema developed affecting the internal layers between the inner limiting membrane and the internal plexiform and ganglion cell layer. Although this edema was quite remarkable at the posterior pole of the eye, it diminished toward the periphery, disappearing near the ora serrata. The activities of the following enzymes were investigated: hexokinase, glucose 6-phosphate dehydrogenase, aldolase, glyceraldehydephosphate dehydrogenase, lactate dehydrogenase, malate dehydrogenase, succinate dehydrogenase, ATPase, and phosphorylase. The most striking finding was the total disappearance of phosphorylase activity under pressure ischemia. ATPase and aldolase showed a decreased activity in the ischemic retina, and malate dehydrogenase a slightly diminished one. Concerning the other enzymes, no significant differences between normal and ischemic retina were observed.


The role of lactic acid in retinal neovascularization. In order to gain information on the possible role of lactate in the development of neovascularization following retinal malperfusion, the lactate content in vitreous-retina-choroid specimens of 02-treated kittens and streptozotocin-diabetic rats was determined. In both experiments there was no significant difference of lactate content between the diseased eyes and healthy controls.


[Stereoscopic vision with alternating presentation of stereo pairs (author's transl)]. The threshold values for stereopsis with alternating monocular presentation of the corresponding member of a stereo pair was examined in relationship to the stimulus duration and the interocular delay. The maximum interocular delay for short stimulus durations was approximately 190 msec. The maximum stimulus duration was between 400-500 msec. At this stimulus duration the interocular delay must approach zero if stereopsis is to be maintained. In the threshold region the stereo effect diminished. One can possibly explain this phenomenon as a partial sensorial fusion. For normal appreciation of stereopsis, the critical frequency was about 2 Hz over the threshold values found with a given stimulus duration.


[On aplasia of the optic nerve (author's transl)]. The occurrence of aplasia and hypoplasia of the optic nerve in man and in mammals is described. A secondary aplasia may result from additional malformations of the central nervous system. Primary aplasia may be studied in mutants of the house mouse, which show that not only the blood vessels, but also changes in time and location of the physiologic cell necrosis may be important.


[Thyrotropia].

[Thyrotropia]. The significance of the radioimmunological dosage of the thyrotropic hormone (TSH) is examined as regards accordance between the experimental measure and the real behaviour of the hormone; as a matter of fact, in some particular conditions the problem of the specificity of dosage must be taken into account because of the possible interference of other hormones. From the clinical point of view the TSH radioimmuno assay is advisable for its accuracy, sensibility and specificity. On the other other hand, it is a lengthy and complex determination; instability of the labelled hormone is to be pointed out as the worst shortcoming. The procedures for clinical study of TSH are also examined with reference to an indirect evaluation of the thyroid function. tthe clinical application of TSH dosage in endrocrinology diagnostics, concerning both thyroid and hypophysis pathology, are discussed.


Experimental autoimmune myasthenia gravis: cellular and humoral immune responses. Rats inoculated intradermally with eel acetylcholine receptor protein(AChR) with adjuvants developed autoimmunity to skeletal muscle AChR. This is evidenced clinically as two episodes of experimental autoimmune myasthenia gravis (EAMG), an acute phase that occurs early (8 days) and is transient, and a chronic phase (30 days) that is usually progressive. Positive delayed cutaneous reactivity appeared at day 4 and serum antibody to eel AChR was detectable by day 7 postinoculation. After day 25 the titer of antibody to syngeneic muscle AChR  rose abruptly. Antibody to muscle AChR sedimented as 7S.  Lymph node cells from rats sensitized to AChR  were capable of transferring EAMG to normal recipients. Thymectomy after the onset of EAMG  had no effect. Early treatment in vivo with antithymocyte serum suppressed acute  but not chronic phase EAMG. Experiments combining thymectomy, x-irradiation and reconstitution with distinct populations of lymphocytes indicated athat thymus-derived lymphocytes are required for induction of EAMG  and antibody to AChR. These data suggest that both cellular and humoral responses to AChR, either sequentially or in combination, contribute to the pathogenesis of EAMG.


HL-A antigens, autoantibody production, and associated diseases in thymoma patients, with and without myasthenia gravis. The sera of 67 patients with thymomas-43 with myasthenia gravis (thymoma(+) MG(+)) and 24 without myasthenia gravis (thymoma (+) MG (-)) from 5 Dutch centers were examined with the indirect immunofluorescence test for the presence of antibodies reacting with skeletal muscle (AMA), thyroid tissue, gastric parietal cells, adrenocortex and antinuclear antibodies (ANA). The data were compared with those obtained in a group 83 MG patients in whom a thymoma was excluded by histological verification (thymoma (-) MG (+)) and with 1106 controls from the normal population. Histocompatibility (HL-A) antigens were tested in 24 thymoma (+) MG (+), 23  thymoma (+) MG (-), and 43 thymoma (-) MG (+) patients and 533 controls from the Dutch population. AMA was found in all thymoma (+) MG (+) cases, in 42% of thymoma (+) MG (-), in 11% of thymoma (-) MG (+), and in less than 1% of the controls. The differences between each of these groups are significant (p less than 0.01, Table 3.) ANA was found in 54%, 50%, 18%, and 4%, respectively, of the above mentioned groups. The differences between the thymoma (+) and the thymoma (-) groups are significant (p less than 0.001. Table 4). The frequencies of antibodies reacting with thyroid tissue, gastric parietal cells and adrenocortex were low and showed no differences between the groups. The frequencies of HL-A8 were significantly decreased in both thymoma groups that had a relatively high incidence of associated immunological disorders (Table 5). Patients with MG and without antimuscle antibodies have no thymomas: This rule is of practical value in the management of the MG patient.


Characterization of peripheral blood lymphocytes in sarcoidosis. In the basal state, patients with sarcoidosis have reduced numbers of circulating T lymphocytes and a normal number of circulating B lymphocytes. The lymphocytes show impaired DNA synthesis in response to several mitogens and antigens and impaired K-cell cytotoxicity. Circulating atypical cells of lymphocytic origin are present belonging to both T- and B-cell lineages. After work (with mobilization of lymphocytes) the T-cell deficiency is further accentuated compared with normals. Moreover, after work a deficiency in the number of circulating B cells is also encountered. The atypical cells do not increase. Compared with normals the impaired K-cell cytotoxicity and lower levels of DNA synthesis also persist. It is suggested that the deviations found in sarcoidosis are consequences of a disease process affecting the lymphoid tissues and successively replacing the normal structures. The presence in vivo of DNA-synthesizing circulating lymphocytes may indicate a persistent antigenic stimulation.


A preliminary report on a study of serum alpha-1-antitrypsin and immunoglobulin levels in lepromatous leprosy. IgG, IgA, and IgM immunoglobulins and alpha-1-antitrypsin globulin in sera from 30 patients with lepromatous leprosy were determined and compared with 30 age- and sex-matched healthy controls. Mean levels of IgG, IgM, IgA, and alpha-1-antitrypsin were significantly elevated in the sera of lepromatous leprosy patients in comparison with levels found in normal subjects. Statistical analysis of the relationships between levels of alpha-1-antitrypsin and immunoglobulins in the sera of lepromatous leprosy patients and controls revealed no correlation. It is therefore concluded that factors responsible for concentrations of immunoglobulins and alpha-1-antitrypsin are independent of each other in patients with lepromatous leprosy.


Immunological identification of subpopulations of mononuclear cells in sarcoid granulomas. The quantity of both circulating B and T lymphocytes in patients with sarcoidosis is diminished, although the relative percentage of each cell type appears normal. Immunocompetent cells comprising B and T lymphocytes, plasma cells, and histiocytes have been recognized in the sarcoid granuloma and the implications of these findings have been discussed.


Immunological studies in sarcoidosis: a comparison of disease activity and various immunological parameters. We found it valuable to separate the heterogeneous types of sarcoidosis into more homogeneous groups on the basis of activity and duration of the disease. This view is supported in the present study by the finding of a marked depression of T-cell function in patients with chronic-active sarcoidosis. Patients with acute or chronic-inactive disease had only moderately depressed T-cell function as measured by tuberculin skin test and DNCB index. These results are in agreement with those of some previous investigations. The remainder of the abnormal findings, particularly low total number of circulation T lymphocytes, elevated serum IgG levels, and presence of autoantibodies, could not be correlated to disease activity, extent of the disease, or T-cell function. We have found no explanation for the presence of autoantibodies but suspect that they may be nonspecifically related to the disease process.


Intravitreal erythromycin in the treatment of induced staphylococcal endophthalmitis. Intravitreal injection of 500 mcg of erythromycin as the gluceptate caused no toxicity to ocular structures. This dose maintained bacterial inhibitory concentrations in the vitreous for up to 24 hours. Consistent aqueous levels were not obtained with intravitreal injection. Intravitreal treatment of Staphylococcus aureus endophthalmitis was successful in 11 of 13 rabbit eyes compared to 2 of 13 treated with subconjunctival erythromycin.


Surgical management of ventricular septal defect complicating myocardial infarction. In an 18 month period six patients were treated by operation for ventricular septal defect occurring as a complication of acute myocardial infarction. Each septal defect occurred within one week of the myocardial infarct but the interval from infarction to operation ranged from 8 days to 7 months. All patients had intractable cardiac failure and two were in cardiogenic shock at the time of operation. Preoperatively right and left heart catheterisation with left ventriculography and biplane coronary arteriography was performed in every case. At operation the principle of "total correction" of all the cardiac defects was followed so that in addition to closure of the septal defect each patient required one or more additional operative procedures such as resection of left ventricular infarct or aneurysm, mitral valve replacement or coronary artery vein bypass grafts. All six patients survived operation but one died four weeks postoperatively from perforation of an acute peptic ulcer. In one patient the ventricular septal defect recurred and was successfully closed four months later. The surviving patients remain well at follow-up.


Selective proximal vagotomy. A preliminary report. Eearly results of a prospective clinical trial of selective proximal vagotomy (SPV) with or without pyloroplasty are reported. The total number of patients was 41, of whom 39 had chronic duodenal ulcer, one gastric ulcer and one heamorrhage gastritis. The follow-up period in our preliminary series now averages 18 months. Recurrent duodenal ulcer appeared in two patients with proved incomplete vagotomy (5%), and two other patients suffered postoperatively from gastric retention. All the symptomatic patients underwent SPV without pyloroplasty. The promising early results warrant continuation of our trial in order to asses the role of SPV in the surgical treatment of duodenal ulcer.


[Study by gel electrophoresis, of alpha chains and of CNBr peptides of collagen from epiphyseal cartilage in chondrodysplasia]. The alpha chains and the major CNBr - derived peptides of collagen of growth cartilage were studied in the following syndromes: thanatophoric dwarfism, pseudothanatophoric dwarfism, achondroplasia, pseudoachondroplasia, diastrophic dwarfism, metatropic dwarfism, Kniest disease, parastremmatic dwarfism, multiple exostoses, Blount disease and pycnodysostosis. After extraction of proteoglycans the collagen was solubilized by limited pepsin digestion purified, and the alpha chains were analysed by electrophoresis. The major CNBr - derived peptides were obtained by cleaving directly the cartilage after proteoglycan extraction. In some syndromes purified collagen was also cleaved. The CNBr peptides were analyzed by disc electrophoresis in SDS-polyacrylamide. Human normal growth cartilage and baboon cartilage were used as controls. The pattern of alpha chains and of major CNBr peptides was similar in all the cases studied, except one case of lethal diastrophic dwarfism in which the pattern of peptides showed the presence of type I collagen in quantities detectable by the present method. However in a milder case of diastrophic dwarfism the pattern of CNBr peptides was found normal. The present study does not exclude possible abnormalities of collagen at a higher lever of supramolecular organization in osteochondrodysplasias.


[De novo trisomy 4p by 4p isochromosome]. A new example of trisomy 4p is reported, due in this case to formation of an isochromosome i(4p). The long arm of chromosome 4 was translocated onto the short arm of chromosome 1.


[Reciprocal translocation in the family of 2 prositas with partial trisomy of the chromosome 7q]. Two patients with partial trisomy 7q are reported. The fathers of both patients are distantly related and carry the same balanced translocation - 46,XY,rep(4;7) (q35;q32).


[Partial trisomy of the long arm of the chromosme 11 by malsegregation of a maternal translocation t(11;22)(q23 1;q1 11)]. A case of partial trisomy for the long arm of chromosome 11 due to malsegregation of a balanced maternal translocation is reported.


[Localization of the gene of the glyceraldehyde 3 phosphate dehydrogenase on the distal segment of the short arm of the chromosome 12]. The enzymatic activity of G3PD and LDH-B in erythrocytes has been assayed in three patients carrying a rearrangement of the short arm of chromosome 12. The first patient is trisomic for the whole short arm. The second is trisomic only for the distal part and the third is monosomic for the proximal part. G3PD: Activity increased in patients 1 and 2 and normal in patient 3. LDH-B: Activity increased in patients 1 and 2 and decreased in patient 3. From these observations it is concluded that the erythrocytic G3PD locus is localized on the distal part of 12p, between 12p12.2 and 12 pter, and that LDH-B locus is on the middle third between 12p12.1 and 12p12.2


[Partial deletion of the short arm of the chromosome 9]. Monosomy 9p is reported in a boy with trigonocephaly and advanced bone age.


[Genealogic proximity and genetic proximity]. Data collected concerning the Kel Kummer Touareg tribe permitted the characterization of each person by (a) a "geneological profile", by which the genetic contributions made to him by various of the founders of the tribe can be seen; and (b) a "hematological profile", which shows the different alleles existing in the tribe which have come to him. The study of the correlation between these two approaches shows that, overall, a person is defined better by his membership in a population than by his geneological network.


[Compared cytologic study of (in situ and isolated) metaphasic chromosomes from KB cells, after incorporation of 5 bromodeoxyuridine (5 BrdU)]. Substitution of thymidine by 5 BrdU indduces the same morphological and cytological changes in in situ and isolated metaphase chromosomes of KB cells: a dichroïc fluorescence and a difference in the affinity of each chromatid for Giemsa stain. However, the precursor does not seem to modify the appearance of G or Q bands in in situ and isolated chromosomes. The fibrilar unit which can be seen with electronic microscopy, shows no difference before and after 5-BrdU incorporation.


Digestive haemorrhages induced by traumatic cerebral lesions. Three cases of severe craniocerebral injuries are presented wherein haemorrhagic types of digestive lesions occured at various intervals. Commonly, the cerebral lesions involve manily the rhinencephalic structures, whereas the digestive disturbances consisted mainly of vasodilatation and vasparalysis. Thus, a relationship between rhiencephalic function and digestive haemorrhages is suggested.


Neonatal pyridoxine responsive convulsions due to isoniazid therapy. A 17-day-old infant on isoniazid therapy 13 mg/kg daily from birth because of maternal tuberculosis was admitted after 4 days of clonic fits. No underlying infective or biochemical cause could be found. The fits ceased within 4 hours of administering intramuscular pyridoxine, suggesting an aetiology of pyridoxine deficiency secondary to isoniazid medication.


Alpha 1-antitrypsin deficiency and infantile liver disease. Infantile liver disease with deficiency of serum alpha1-antitrypsin is illustrated by a description of the clinical, biochemical, and pathological findings in two affected families. The simplicity of the diagnostic tests is emphasized. Review of 61 biopsies of liver from children and adolescents provided a further 3 cases. It is prudent to exclude this metabolic defect in children with a history of "neonatal hepatitis".


Screening for cystic fibrosis by analysis of serum protein in faeces. Faecal specimens from 51 infants free of cystic fibrosis (CF) and from 9 infants with the disease were analysed for albumin and alpha1-antitrypsin content. Faeces from infants with no CF had a mean albumin content of less than 0-1 mg/g dry weight and a mean albumin: alpha1-antitrypsin ratio value of less than 0-1. Faeces from infants with CF had, with one exception, an albumin content of more than 2-0 mg/g dry weight and a ratio value greater than 3-0. It was subsequently found that the duodenal aspirate from the child with CF but whose faeces had a low albumin content and ratio value, had tryptic activity though at a much reduced level compared to the activity in aspirates from healthy infants.


Mode of action of veratridine on perfused frog ventricle. Veratridine exerts a biphasic action on the perfused frog ventricle. The initial immediate response is a depression, which is maximal at 10(-10) M. The initial depression is followed by a late potentiation of contraction which is maximal at 10(-6) to 10(-7) M veratridine. Reduction of external calcium from 1.0 mM to 0.5 mM prevents the initial depression and allows only the potentiation of contraction to be observed. The force of contraction in 0.5 mM Ca2+ is increased by veratridine to 200% of the contraction observed at 1.0 mM Ca2+. The primary site for the enhancement of contraction in the frog ventricle by veratridine is the adrenergic nerve fibers whose increase in excitability leads to an increase in epinephrine release. The beta blocker sotalol at 10(-6) M prevents the increase in contractility by veratridine in 0.4 mM Ca2+. Calcium itself depressed potentiation of contractility by veratridine by stabilizing the adrenergic nerves and antagonizing the labilizing action of veratridine. The mode of action of veratridine on the frog ventricle is attributed to the enhancement of transmitter release from cholinergic and adrenergic nerve fibers.


The anti-inflammatory and analgesic effects of norvedan a novel, non-steroidal agent. Norvedan (2-phenyl-4-p-chlorophenyl-thiazole-5-ylacetic acid) has been investigated for anti-inflammatory activity using an 'adjuvant arthirits' in rats and for analgesic activity using a writhing test in mice and a pressure test in rats. At oral doses of 10, 30 and 100 mg/kg Norvedan caused a dose-related inhibition of the primary swelling of the paw injected with adjuvant and the development of secondary lesions was also inhibited. Writhing induced in mice by i.p. administered acetic acid was also reduced by Norvedan at oral doses of 30 mg/kg and above and the response was related to dose. Against pain induced in rats by application of pressure to an inflamed paw Norvedan alsp showed good activity which was present for at least 6 hr after dosing.


Preliminary studies on blastic transformation of peripheral blood lymphocytes in bursectomized chicks. Lymphocytes from six-week-old chicks which had been bursectomized when three days old showed greater tendency to blastic transformation stimulated by phytohemagglutinin (PHA) than those from control chicks. The observations suggest the possibility of B lymphocytes influencing immunological reactivity of T lymphocytes.


Comparison of modifications of the rosette test for detecting T lymphocytes. Experiments were carried out with blood lymphocytes from 30 healthy subjects and 70 patients with chronic lymphocytic leukemia (CLL). Results of the rosette test with sheep red blood cells (SRBC) were compared by the methods of: I) Wybran (incubation at room temperature, reading after 3 hr); II) Jondal (incubation at temp. 310.15K (37 degrees C) and 277.15K (4 degrees C), reading after 24 hr; III) Weiner et al. (neuraminidase-treated SRBC, incubation at 273.15K (0 degrees C), reading after 15 min; IV) as in method III, but reading after 24 hr. The method of Wybran gave lowest results, statistically significantly differing from the results obtained by the other methods. The other modifications gave results that did not differ significantly. Neuraminidase treatment of SRBC accelerates formation of stable rosettes and this method is recommended in cases where a brief period of incubation is required. In other cases, the method of Jondal may be used.


Influence of D-penicillamine and beta-aminopropionitril on the metamorphosis of Rana temporaria. Tadpoles of Rana temporaria (size 5-7 mm) were kept in solutions of D-penicillamine (DPA), beta-aminopropionitril (betaAPN), and L-thyroxine at different concentrations for 18 days. The influence of the substances on metamorphosis was investigated. In low concentrations (1 or 10 mg/100 ml) D-penicillamine accelerates the process of metamorphosis. At these concentrations investigated skeletal malformations could not be observed. A content of 100 mg of DPA/100 ml is toxic. After 8 days of exposure only 4 of the 15 test animals had survived. In all concentrations investigated, beta-aminopropionitril has a toxic action. In low concentration (1 mg/100 ml) deformities are found which could be described as bending of the femur and twisting of the whole hind limb. The animals are non-viable, they die shortly after termination of metamorphosis. Higher concentrations (10 or 100 mg/100 ml) are lethal within the first 10 days. L-thyroxine (0.01 mg/100 ml) shows the wellknown metamorphosis-accelerating effect.


Haematemesis and Melaena: surgical management. A prospective study of the surgical management of 100 consecutive patients with benign, non-variceal upper gastrointestinal bleeding is presented. The manner of presentation, precipitating factors, investigations and associated medical problems are discussed. Chronic duodenal ulceration was the most common cause of haemorrhage. Vagotomy and drainage with oversewing or excision of the bleeding ulcer was the surgical procedure performed in 71 of the patients in the series. The incidence of recurrent bleeding was 7%; no patient in this category required further operation. The mortality rate was 6%, and there were no deaths recorded in the patients who underwent vagotomy and drainage. The reasons for the relatively low surgical mortality are discussed.


Lymphocytotoxic antibody activity in cryoprecipitates from serum of patients with SLE. Complement-dependent cytotoxic activity against normal human peripheral blood lymphocytes was detected in 11 of 17 cryoprecipitates from the serum of patients with systemic lupus erythematosus (SLE). The lymphocytotoxicity was eliminated by treatment with 2-mercaptoethanol and iodoacetamide, and it was inhibited by antibody to human IgM but not anti-IgG. The titers of lymphocytotoxic activity in the cryoprecipitates were roughly proportional to the corresponding serum titers, but when they were normalized for IgM concentration it was apparent that selective concentration of lymphocytotoxic antibody occurred in the cryoglobulins. The relationship between cryoprecipitable lymphocytotoxicity and a number of laboratory and clinical parameters of SLE was studied. The amount of protein in the cryoprecipitates,  which was greatest in patients with significant renal disease, correlated with a reduction of serum complement and the amount of antibody to DNA. However the lymphocytotoxic activity of the cryoglobulins did not correlate with the severity of SLE. The titer of lymphocytotoxic antibody was independent of a) the presence or absence of active lupus nephritis, b) the total protein or immunoglobulin content of the cryoprecipitates, c) serum complement levels, and d) the amount of circulating antibody to DNA. These findings cast doubt upon the pathogenetic significance of cryoprecipitable lymphocytotoxic antibody.


Study of thymic factors. II. Failure of thymosin to alter the natural history of NZB and NZB/NZW mice. The effects of daily injections of thymosin, bovine fraction V, on the natural history of NZB and NZB/NZW F1 mice were investigated. With the use of several dose schedules, no significant differences were discovered in treated versus control groups when survival, autoantibodies, and mitogen responsiveness were compared. These results provide further evidence that thymosin may have little or no role in the treatment of the autoimmune disease of New Zealand mice. More encouraging research in thymic extracts and their measurement is necessary before clinical trials in SLE are considered.


Antibodies to dAT detected by membrane filtration. Sera from patients with active systemic lupus erythematosus caused the retention of the radioactively labeled synthetic polynucleotide 14C-dAT on cellulose nitrate filters. The amount of 14C-dAT bound correlated with the presence of hypocomplementemia and active renal disease. Sera containing only anti-single-stranded DNA antibodies did not bind 14C-dAT but did bind 125I DNA from E coli that had been prefiltered to remove ssDNA contamination. Inhibition experiments also indicated the presence of antigenic differences between 14C-dAT and prefiltered 125I-E coli DNA. The data suggest that dAT carries one of the major antigenic specificities for antinative DNA antibodies in SLE, and that cellulose nitrate filtration fails to remove a significant proportion of contaminating single-stranded DNA determinants in non-synthetic DNA.


Lymphocyte response to mitogens in progressive systemic sclerosis. Lymphocyte responses to the mitogens phytohemagglutinin P(PHA-P), concanavallin A (Con A), and pokeweed (PWM) were studied in 18 patients with progressive systemic sclerosis (PSS). A subgroup of these patients with multisystem involvement showed a significantly decreased lymphocyte response to both Con A and PWM when compared to normal controls. However those PSS patients with myositis, although having multisystem involvement, had normal lymphocyte response to all three mitogens. PHA-P stumulation was normal in all PSS patients. Antinuclear antibodies, elevated sedimentation rates, and positive latex fixation were noted only in the multisystem disease group with abnormal lymphocyte function.


New data on the mechanism and speed of action of nitroimidazoles on prokaryota and eukaryota with and without mitochondria. The spectrum of action of nitroimidazoles ranges from anaerobic bacteria to aerobic bacteria which are also capable of growth, although sometimes with difficulty, in anaerobic atmosphere and to protozoa without and with mitochondria; in the latter case the anti-protozoal activity depends on the importance of the extramitochondrial enzymes which respond to nitroimidazoles. The more anaerobic the organisms, the greater their sensitivity. In the most sensitive protozoa, the trichomonads, most of the enzymatic reactions inhibited by these drugs take place in the hydrogenosomes; these are cytoplasmatic organelles surrounded by a membrane whose disintegration, in fact, is the first visible effect of the action of the nitroimidazoles. Various nitroimidazoles act with different speed on these and other protozoa, whose membranes can difinitely possess different degrees of permeability towards substances with different chemico-physical characteristics. In the treatment of trichomoniasis, the specific speed of action of a drug is perhaps as important as its half-life in man.


Carcinomatous polyarthritis. The presenting symptom of an ovarian tumor and association with a platelet activating factor. A 59-year-old white female presented with an acute polyarthritis, fever, and mental confusion. Accompanying blood changes included positive tests for rheumatoid factor and antinuclear factor, anemia, leukocytosis, thrombocytosis, and a circulating factor that stimulated serotonin release from normal platelets. Exploratory laporatomy for a mobile pelvic mass revealed an adenocarcinoma of the left ovary which was completely resected. Shortly thereafter the patient's acute symptoms subsided. After 2 years of follow-up the patient has remained free of symptoms and the serologic changes have reverted to normal.


[On the pharmacodynamics of alpha- and beta-escin after oral application (author's transl)]. Contrary to the almost water insoluble crystalline beta-escinic acid, the water soluble forms of escin -- such as alpha-escinic acid or its salts, Na-b-escinate and the amorphous beta-escinic acid -- are so well absorbed by the gastro-intestinal tract that the effects after oral application could be compared with those of the reference substances furosemide, hydrocortisone, acetylsalicylic acid, azapropazone and phenylbutazone. Escin was tested in the stasis edema, cotton-pellet-granuloma, and UV-erythema, i.e., in test models which seem specially suited to characterize the properties of this substance. In these tests which reflect both the prophylactic and the therapeutic treatment escin has proven antiexudative-antiphlogistic effects. They are based on a favorable influence of permeability and diuresis.


Peripheral blood T- and B-lymphocytes in operating theatre personnel. The effect of operating theatre work on peripheral blood T- and B-lymphocytes was studied by the rosette method. There was no statistically significant difference between operating theatre personnel and the controls in the number of T- and B-lymphocytes. This study supports the view that work in operating theatres does not cause changes in the immune response.


An anti-A-like lectin of Rana catesbiana eggs showing unusual reactivity. A lectin was isolated from Rana catesbiana eggs that agglutinated blood group A-erythrocytes but did not agglutinate blood group B- or 0-erythrocytes. The lectin was purified by Sephadex G-75 gel filtration and by acrylamide gel electrophoresis at pH 4.3 and was proved to be homogeneous on electrophoresis, and the molecular weight was determined as 210 000. The specificity of A-like activity seems to direct towards three monosaccharide units: GalNAcalpha1 leads to 3(or 4)-Galbeta1 leads to 4(or 3)GlcNAcbeta1 leads to R based on inhibition of A-like hemagglutination by various monosaccharides, oligosaccharides and glycolipids, and based on precipitin reaction with various glycolipids and glycoproteins with known structures. Uniquely, A-like agglutination was inhibited not only by alpha-N-acetylgalactosamine analogs but also by N-acetyllactosamine analogs. The lectin showed therefore, two correlated specificities: one directed towards alpha-N-acetylgalactosamine residue at the terminal, and the other towards the subterminal Galbeta1 leads to 4betaGlcNAc (N-acetyllactosaminyl) residue. The reactivity due to the N-acetyllactosamine structure which is also found in erythrocyte ganglioside and in H-active chain might be blocked by sialyl or alpha-L-fucosyl substitution at the terminal, as the reactivity appeared after elimination of these sugar residues. In the A structure the reactivity due to N-acetyllactosaminyl residue seems not to be blocked by the presence of alpha-N-acetylgalactosamine at the terminal as A-agglutination was strongly inhibited by N-acetyllactosamine and its analogs. Although the lectin showed a single band on electrophoresis under different conditions, there is a possibility that the lectin may be a mixture of two proteins with different specificities as mentioned above.


Phospholipid metabolism of stimulated lymphocytes. Comparison of the activation of acyl-CoA:lysolecithin acyltransferase with the binding of concanavalin A to thymocytes. Calf thymocytes were isolated and incubated with concanavalin A. The effect of the mitogen on the enzyme activity of membrane-bound lysolecithin acyltransferase (acyl-CoA:1-acylglycero-3-phosphorylcholine-O-acyltransferase, EC 2.3.1.23) was determined as also the binding of 125I-labelled concanavalin A to intact cells and isolated membranes. The lysolecithin acyltransferase was found to be activated three times in microsomal membranes. The activation occurred directly after binding of concanavalin A and was temperature independent, since similar activities were found in cells treated with concanavalin A at 0 and 37 degrees C. The acyltransferase activation using increasing concentrations of concanavalin A revealed a different behaviour, as compared to the binding of concanavalin A. While the binding of concanavalin A to intact cells expressed a normal hyperbolic saturation function the activation process of the acyltransferase described a sigmoidal relationship. Correspondingly, the interaction coefficients for both functions were different (Sips coefficient for binding = 1.0 and Hill coefficient of the enzyme activation = 1.8). These results indicate that the acyltransferase activation is due to a cooperative interaction between the ligand-receptor complex and the enzyme.


Electrophoretic mobility of lymphocytes in new born. T lymphocytes in normal new born at the 4th day after birth have an electrophoretic mobility of 1.04, quite slower than adult normal T lymphocytes (1.13), but the same of the EM of lymphoblasts of ALL (1.04).


Dynamics of the aromatic amino acid residues in the globular conformation of the basic pancreatic trypsin inhibitor (BPTI). II. Semi-empirical energy calculations. The molecular conformation of the basic pancreatic trypsin inhibitor (BPTI) is known in considerable detail from both X-ray studies in single crystals and NMR studies in solution. The NMR experiments showed that the aromatic rings of the phenylalanyl and tyrosyl residues can undergo rapid rotational motions about the C beta--Cv bond. The present paper describes a model investigation of the mechanistic aspects of these intramolecular rotational motions. From calculations of the conformational energies for molecular species derived from the X-ray structure by rotations of individual aromatic rings, it was apparent that the rotational motions of the aromatics could only be understood in a flexible structure. Flexibility was simulated by allowing the protein to relax to an energetically favorable conformation for each of the different rotation states of the aromatic rings. It was then of particular interest to investigate how the perturbations caused by different rotation states of the aromatic rings were propagated in the protein structure. It was found that the rotation axes C beta--Cv were only slightly affected (delta X1 approximately less than 20 degrees. The most sizeable perturbations are caused by through space interactions with nearby atoms, which move away from the ring center and thus release the steric hindrance opposing the rotational motions. The values for the energy barriers obtained from the energy minimization are of the same order of magnitude as those measured by NMR.


Acquired angioedema with lymphoproliferative disorder: association of C1 inhibitor deficiency with cellular abnormality. A patient with a lymphoproliferative disorder, angioedema, and an acquired deficiency of the inhibitor of the activated first component of complement was studied. The patient's complement profile revealed depletion of the first component of complement, which has not been seen in angioedema of the hereditary type. There was no evidence for C1-depleting activity in the patient's plasma. The majority of the patient's peripheral blood mononuclear cells resembled B cells in their memebrane receptor properties and in that they carried easily detectable immunoglobulin, predominantly IgM. However, these cells were unusual in that they phagocytosed both latex particles and C3-coated erythrocytes. Morphological study of the cells infiltrating the patient's lung revealed immature, atypical, and plasmacytoid lymphocytes and immunoblasts. Both the patient's peripheral blood mononuclear cells and a suspension of cells from the pulmonary infiltrate were capable of depleting the first component of complement and its inhibitor from homologous plasma. Normal ABO-compatible cells did not possess this property. The data suggested that the patient's abnormal lymphoid cells may have interacted with the complement system to produce a biochemical defect and a clinical syndrome closely resembling angioedema of the hereditary type.


Effect of ionophore X-537A on desensitization rate and tension development in potassium-depolarized muscle fibres. The effects of the ionophore X-537A were studied on carbamylcholine (carbachol)-induced densitization and on tension development in relaxed potassium-depolarized frog sartorius muscles. 2 X-537A accelerated carbachol-induced desensitization in Ca2+-deficient solutions without having any effect on the conductance of the membrane in the absence of carbachol or on the extent of the carbachol-induced increase in conductance. 3 In Ca2+-deficient solution, the acceleration of desensitization by the ionophore was concentration-dependent. No effect was observed with concentrations less than 5 muM and maximal acceleration was evident with 10 muM. 4 The influence of X-537A on desensitization was time-dependent. At 20 muM X-537A, there was a marked acceleration of desensitization by the end of 5 min exposure. An additional gradual acceleration occurred during a 5 to 30 min treatment. No acceleration of desensitization was evident when X-537A was simultaneously applied with carbachol to the end-plate region without prior exposure to the ionophore. 5 Desensitization also was accelerated by 30 min exposure to 20 muM X-537A in solutions containing Ca2+ or deficient in both Mg2+ and Ca2+; the rate being increased 2.8-fold in Ca2+-containing solutions, 2.9-fold in Ca2+-deficient solutions containing Mg2+, and 2.5-fold in divalent cation-deficient solutions. 6 Tension development gradually occurred in relaxed potassium-depolarized muscle preparations exposed to 20 muM X-537A. The onset of tension development occurred only after approximately 25 min of exposure both in preparations kept in Ca2+-deficient or Ca2+-containing solutions. By the end of 90 min in the ionophore, the tension developed was approximately 12% and 23% of the initial potassium contracture in those preparations maintained in the Ca2+-deficient or Ca2+-containing solutions, respectively. 7 We assume that the increase in desensitization rate following exposure to X-537A results from an elevation of the intracellular Ca2+ concentration. That muscle tension gradually increased during exposure to the ionophore supports this conclusion. The acceleration of densitization by X-537A in the absence of external Ca2+ supports the view that the site of calcium acceleration is not on the external surface of the end-plate membrane either at or near the agonist-recognition site but rather on the inner surface.


Periodic alternating nystagmus.

Periodic alternating nystagmus. Three patients with periodic alternating nystagmus (PAN) are described in detail. Digital computer methods were used to quantify their disordered eye movement in an attempt to understand the pathophysiology. One of the patients was unusual in showing rebound nystagmus with fixation and PAN without fixation. Each patient had hyperactive vestibular responses and the phase and gain of the PAN cycles were altered in a predictable fashion by vestibular stimuli. It is postulated that PAN represents cyclical firing between reciprocally connected groups of inhibitory neurons within the vestibular and oculomotor nuclei. The cyclical firing is initiated by a critical imbalance of tonic input to either group of normally functioning neurons.


The New A /New Jersey/ 76 influenza strain. This Memorandum reviews the information available on the new strain of influenza virus, A/New Jersey/76 (Hsw1N1), that first appeared at Fort Dix, NJ, USA, in February 1976. Recommendations are given concerning measures to be taken to detect spread of this strain and to meet the challenge if an epidemic should occur.


Population replacement in Culex fatigans by means of cytoplasmic incompatibility. 2. Field cage experiments with overlapping generations. Three experiments were carried out in field cages to test the principle of "transport" of a desirable gene or chromosome into a wild Culex fatigans population as a result of the sterility in cross-matings associated with cytoplasmic incompatibility. Cycling populations of Delhi origin were established in the cages and daily releases were made of the IS31B strain, which has Paris cytoplasm and carries a male-linked translocation. It was shown that, if sufficient releases were made to establish a majority of the Paris cytoplasmic type, complete replacement by this cytoplasmic type subsequently occurred. However, as a result of partial compatibility of males of the Delhi population with Paris females, "recombinant" males with Paris cytoplasm and no translocation were produced. In an experiment in which a continuous low rate of "immigration" of a strain of Delhi origin was simulated, a gradual increase of the Paris cytoplasm nontranslocated type occurred, and renewed IS31B releases were necessary after 5 months to restore the predominance of this type. The results are compared with computer predictions and discussed in relation to the transport of genes for filaria refractoriness or chromosome translocations into wild populations.


A simplified membrane technique for feeding blackflies (Diptera: Simuliidae) on blood in the laboratory. In order to overcome the difficulties of colonizing Simuliidae in the laboratory, a membrane system has been developed which was successfully used to feed Simulium vittatum and S. verecundum on out-dated human whole blood. Thirty-seven (41.1%) of 90 S. vittatum and 4 (8.6%) of 46 S. verecundum took blood meals in 6 trials. The membrane system was also shown to be more effective and consistent in providing blood meals compared with the use of laboratory animals.


A new technique for the determination of microfilarial densities in onchocerciasis. Precise measurement of the parasite load in helminthic infections makes it possible to correlate morbidity, the individual response to treatment, and the best control methods. A membrane filtration technique was recently developed for quantifying Wuchereria bancrofti microfilaraemia. The present paper describes its application to onchocerciasis in a study on 107 patients in northern Togo. The technique is cheap and simple to apply under field conditions, and is extremely efficient at recovering microfilariae from skin snips.


Relationship of serum copper and zinc to human hypertension in Nigerians. Serum copper and zinc levels were determined by atomic absorption spectroscopy in 48 hypertensive Nigerians and in 37 normotensive controls. Serum copper and total cholesterol levels were significantly increased in the hypertensive patients, but their serum zinc levels did not differ from those of the controls.


The measles eradication programme in the German Democratic Republic. After 3 years of intensive preparations the Ministry of Health of the German Democratic Republic started a national measles eradication programme in 1967. Vaccination was at first voluntary, but became compulsory in 1970. Through a vaccination campaign using Leningrad-16/SSW attenuated live vaccine, the disease was virtually eliminated throughout the country by 1972. In 1973 and 1974 only sporadic cases of measles were observed. The number of vaccination failures was negligible. Combined immunization against measles and poliomyelitis provoked no unusual reactions, and the difference between the seroconversion rates following combined or separate immunization was not statistically significant.


Ricettsioses studies. 2. Natural foci of rickettsioses in east Slovakia. Natural foci of Q fever and of spotted fever group rickettsiae in the Kosice district of east Slovakia are described and discussed. It was established that the natural focus of Q fever was a secondary one. Cattle were observed to be the main source of human infection and a high proportion of synanthropic rodents was found to be infested with Coxiella burnetii. The natural focus of spotted fever group rickettsiae was shown to be of a primary character, such rickettsiae circulating among ticks and small mammals. It is suggested that natural foci of spotted fever group rickettsiae in east Slovakia may be connected with the natural distribution of Dermacentor ticks.


Enzyme immunoassays in diagnostic medicine. Theory and practice. Serological methods are playing an increasingly important role in the diagnosis and epidemiological assessment of diseases. Simple, inexpensive methods for large-scale application are urgently needed. The enzyme immunoassay methods developed recently and reviewed here hold great promise for application in a wide variety of conditions. Under laboratory conditions they can be as sensitive as radio-immunoassay, but they can also be adapted as simple field screening procedures. These methods are based on the use of antibodies or antigens that are linked to an insoluble carrier surface. This is then used to "capture" the relevant antigen or antibody in the test solution and the complex is detected by means of an enzyme-labelled antibody or antigen. The degradation of the enzyme substrate, measured photometrically, is proportional to the concentration of the unknown "antibody" or "antigen" in the test solution. The application of these techniques to endocrinology, immunopathology, haematology, microbiology, and parasitology is reviewed.


Research needs in taeniasis-cysticercosis. This Memorandum discusses the epidemiology of taeniasis-cysticercosis, particularly the survival of taeniid eggs in nature, and goes on to consider diagnostic procedures (parasitological and serological), resistance to infection, pathogenesis and clinical pathology, chemotherapy, and the economic and social consequences of infection. Topics requiring further research are listed, and recommendations are made concerning the approach to the problem.


Haemagglutination-inhibiting antibodies against swine influenza and Hong Kong influenza viruses in swine sera in the USA. Previous reports have established that swine in the midwestern states of the USA have a high incidence of classical swine influenza and that swine become infected with Hong Kong-like influenza viruses when these are prevalent in the human population. This investigation was undertaken to estimate, on the basis of 2245 sera collected randomly from swine going to slaughter in the USA during the summer months of 1974, how many of the animals had haemagglutination-inhibiting (HI) antibodies against swine influenza and Hong Kong influenza viruses. Based on HI titres of 20 or greater, our serological survey revealed that swine influenza virus infection was widespread throughout the USA, since 20.45% of the sera tested had positive HI titres. However, serological evidence of infection of swine with Hong Kong-like viruses was present in only 2.63% of the sera tested.


Psychosocial aspects of abortion. A review of issues and needed research. The literature on psychosocial aspects of abortion is confusing. Individual publications must be interpreted in the context of cultural, religious, and legal constraints obtaining in a particular society at a given time, with due attention to the status and availability of alternatives to abortion that might be chosen by a woman with an "unwanted" pregnancy. A review of the literature shows that, where careful pre- and post-abortion assessments are made, the evidence is that psychological benefit commonly results, and serious adverse emotional sequelae are rare. The outcome of refused abortion seems less satisfactory, with regrets and distress frequently occurring. Research on the administration of abortion services suggests that counselling is often of value, that distress is frequently caused by delays in deciding upon and in carrying out abortions, and by unsympathetic attitudes of service providers. The phenomenon of repeated abortion seeking should be seen in the context of the availability and cost of contraception and sterilization. The place of sterilization with abortion requires careful study. A recommendation is made for observational descriptive research on populations of women with potentially unwanted pregnancies in different cultures, with comparisons of management systems and an evaluation of their impact on service users.


Immunologic regulation of spontaneous antibodies to DNA and RNA I. Significance of IgM and IgG antibodies in SLE patients and asymptomatic relatives. Nine individuals from four families of patients with systemic lupus erythematosus (SLE) were studied by sucrose density gradient fractionation and filter radioimmunoassay for the presence of 19S IgM and 7S IgG antibodies to DNA, poly rA, and poly rA-poly rU. One individual in each family was totally asymptomatic, and at least one had actively systemic lupus erythematosus (SLE). The results indicate: (1) a correlation between 7S antibody to DNA and RNA and active SLE, and (2) the presence of 19S antibody to RNA in the asymptomatic relatives. These findings suggest that SLE may be a disorder of immunological regulation. The distribution of antibodies between IgM and IgG is closely related to disease severity. the asymptomatic relatives may have a partial regulatory abnormality resulting in the limited production of IgM antibodies to RNA. SLE patients may have a more complex failure of regulation permitting the additional synthesis of IgG antibodies to DNA and RNA.


Disease activity in the nephritis of systemic lupus erythematosus in relation to serum complement concentrations. DNA-binding capacity and precipitating anti-DNA antibody. Serum C4 and C3 concentration and binding of double-stranded-DNA (ds-DNA) were measured in sera from ninety-nine patients with systemic lupus erythematosus and clinical evidence of nephritis. C3 and C4 concentrations correlated poorly with ds-DNA binding. In sera from fifty-three patients, precipitating antibody was sought using the counterimmunoelectrophoretic technique. Precipitating antibody was detected on at least one occasion in 44% of the patients, and these sera with precipitating antibody showed higher binding of ds-DNA and lower C4 concentrations than those without precipitating antibody. In thirty-two patients, serial assessments of the activity of the renal disease were made using decline or improvement in glomerular filtration rate, degree of proteinuria, oedema and hypertension as indices of "activity". All patients were receiving immunosuppressive drugs. Active nephritis was rarely found in patients showing, at that time, a normal serum C4 or normal ds-DNA binding; but a raised ds-DNA binding or lowered serum C4 were found in both active and inactive nephritis. There was no correlation of activity with serum concentrations of C3, or the presence or absence of precipitating antibody. We conclude that measurements of serum-complement concentrations and binding of ds-DNA are of most use in the diagnosis of systemic lupus erythematosus, and that in patients with nephritis and taking immunosuppressive drugs, these tests are of limited use in guiding treatment.


The use of cryopreserved lymphocytes for longitudinal studies of immune function and enumeration of subpopulations. The responses of fresh and frozen lymphocytes to mitogens and antigens have been compared using samples collected on five separate occasions from one normal donor. The day-to-day variation seen with the fresh cells was eliminated by the use of frozen cells. Thawed cells from one donor collected on one occasion but studied on five separate occasions and compared to fresh cells on the same days, showed fluctuations from day to day as well, confirming that the day-to-day variation seen is due to technical and not biological phenomena. Cryopreserved cells showed a decrease in responses to specific microbial antigens, a slight shift in the PHA dose-response curve, but no significant difference in responses to Con A or PWM. The relative proportion of lymphocyte subpopulations changed with freezing and thawing. The proportion of T cells increased slightly and the proportion of B cells decreased.


Human lymphocyte subpopulations effect of epinephrine. The effect of administration of 0-2 mg of epinephrine (Parke-Davis) on circulatory lymphocytes was investigated in fifteen normal subjects. Blood samples were taken prior to, 10 and 20 min after, subcutaneous injections. Thymus-derived (T) cells were assayed by sheep red blood cell rosettes, bone marrow-derived (B) cells by their complement receptors and immunofluorescent detection of Fc receptors plus surface immunoglobulins. Their percentages prior to injections were 72-2 +/- 1-4, 13-8 +/- 1-1, and 20-3 +/- 1-3. Ten minutes after injections, the absolute concentrations of these cells increased to 164 +/- 14%, 326 +/- 57%, and 272 +/- 45% respectively of the values prior to injection (averages +/- standard errors). Further, when cells with receptors for both sheep red blood cells and complement were assayed by simultaneous rosette technique, they increased from 2-5 +/- 0-4% to 10-5 +/- 1-3% of the lymphocytes. Such changes were also observed in three subjects who had undergone splenectomy more than 2 years previously, but not in four subjects receiving injections of saline instead of epinephrine.


The effect of Levamisole on peripheral blood lymphocyte subpopulations in patients with rheumatoid arthritis and ankylosing spondylitis. Although Levamisole, an antihelmintic drug, has shown to have some modulatory effect on the immune response in clinical trials and experimental models, its mode of action remains obscure. In a group of fifteen patients with rheumatoid arthritis and ankylosing spondylitis receiving Levamisole on an intermittant regime, simultaneous determinations of the lymphocyte subpopulations were made prior to Levamisole administration and 3 months thereafter. No significant changes were observed either in the absolute or in the relative number of T- and B-cell populations, while a statistically significant reduction was found in the "null" cells. These findings suggest that the immune potentiating effect of Levamisole may at least partially be due to a maturation process of the "null" cells.