[Basic factors in the cerebellar Purkinje cell polyploidization in chicken embyogeny. II. The changes in the content and concentration of proteins, protein SH-groups and RNA in the cytoplasm of Purkinje cells in the process of their differentiation and specialization]. Cytophotometric study of the cerebellum Purkinje cells in the chick embryos(10th-21st day) showed that the total amount of protein increased at this period proportionately to the growth of cells, its concentration remaining relatively constant. Thebasic and acid proteins ratio changed, the acid proteins increasing. Content of the protein SH-group increases considerably during the tigroid and eneurofibrillas formation, - simultaneously with the conent of RNA. The periods of intensification of the protein synthesis coincide with the morpho-functional maturation of neurons and formation of signs characterizing the maturity of the embryo as a whole. Supposedly the changesin the activity of nuclear apparatus of the cells, manifested in the increase of nuclear size and the number and size of nucleoli, underlie this process.


[Electrical characteristics of normal and transformed fibroblasts in tissue culture]. The two-electrode method of input resistance measuring was shown to give lower values of resistance compared with the one-electrode balance method. Gradual growth of estimates of input resistance and membrane potential in the cause of experiment is associated with decrease in the shunting effect of the electrode puncture. The mean values of steady Rin of sparse and confluent culture did not differ when the cells were electrically disconnected (38 plus or minus 1.2 MO and 41 plus or minus 1.8 MO respectively) and differed in electrically coupled fibroblasts (54 plus or minus 4.9 MO --sparse; 29 plus or minus 2.2 MO -- confluent culture). This difference is thought to be associated with shunting effect of electrical connections. The specific resistance of membrane was estimated in normal and transformed fibroblasts.


[Quantitative characteristics of the migration ability of different types of fibroblast-like cells cultured on substrates with an ordered relief]. Reactions to the geometrical configuration of the underlying surface of fibroblast-like cells of various species (mouse, rat, chick, hamster, human) were compared quantitatively. All normal cells migrated from 25-40 mcm deep grooves but not from the less deep ones -5-15 mcm. Migration ability was the highest in the mouse cells;it was less pronounced in rat and chick cells; hamster and human cells had the lowest migration ability. The offered quantitative method can be used for estimation of the reaction to the ordered relief of the substratum of different minds of cultured cells - normal as well as pathologically changed.


[Degradation of yeast mitochondria induced by anaerobiosis at the early stages of growth of the culture]. Prolonged anaerobiosis of Saccharomyces cerevisiae cells result in degenerative changes in mitochondria which can be revealed when measuring the enzyme activities of the respiratory chain in isolated organellas and by electron microscope examination of the cells. The sensitivity of yeast mitochondria to anaerosiosis alters as the culture growth. Mitochondria are especially labile during the early expotential growth phase. Possible reasons for and mechanism of degradation of mitochondria in vivo are discussed.


Analgesic abuse syndrome: a frequently overlooked cause of reversible renal failure. The incidence of analgesic nephropathy in the United States is greater than previously reported. Because of the characteristic radiographic features of papillary necrosis, this diagnosis may be made while it is still clinically unsuspected. Early diagnosis is extremely important because cessation of analgesic abuse may avert progressive renal damage. Uncovering the diagnosis calls for special care in obtaining the telltale history. This must be sought in patients with radiographic evidence of papillary necrosis when a history of diabetes mellitus, obstructive uropathy, or sicle cell anemia is absent, or in patients with unexplained nephrocalcinosis or nephrolithiasis.


Renal transplantation and placement of ileal stoma. The literature has been reviewed to present the techniques used by others when renal transplantation is done in conjunction with ileal segment urinary diversion. A successful technique for the convenient placement of the ileal stoma away from the transplanted kidney in the left lower abdominal quadrant while placing the donor kidney in the right iliac fossa is described and recommended, using a fourteen-year-old patient as an illustrative case.


Preliminary reticulum cell sarcoma of prostate gland. A case of primary reticulum cell sarcoma of the prostate gland is presented. This is the seventh well-documented case we have found in the literature. No evidence of extraprostatic extension has been found two and a half years after diagnosis was made, despite no chemotherapy nor radiotherapy.


Evaluation of an iodophor teat spray in the control of infections and cellular reactions in the udder. A strictly controlled field trial was designed to assess the value of an iodophorpost-milking teat disinfectant in the prevention of new mastitis infections in a 132 cow herd. The disinfectant was applied by a hand spray, a method acceptable, effective, and less costly than conventional teat dipping methods. Only the left side of the udder was treated, the right quarters acting as controls. Dry-cow therapy and other methods of mastitis control were already practised, and no change in routine was introduced apart from half-udder teat spraying. Fifty-eight new cases of mastitis were found to occur on the teat-sprayed side, compared with 91 in the untreated quarters; 35 and 23, respectively, were clinical. No Group B streptococci existed in the herd, and the principal reductions were in Group C streptococci and coagulase-negative staphylococci, the percentages of which were halved. The percentage of coliform infections on the teat-sprayed side was, in contrast, doubled. The incidence of new clinical and subclinical disease without infection was in reverse ratio to that of infections, being 29-9 per cent higher in the quarters which were teat-sprayed. Analysis of cumulative CMT reactions from regular monthly surveys indicated that exponential cell-count values on each side of the udder were identical. Thus, while new infections were significantly reduced, overall cell counts were not, and there is clearly a need for further research into factors other than bacteria which may initiate teat damage and inflammatory changes in the udder.


[The place of ultrasound diagnosis in internal medicine]. The applications of ultrasound diagnosis within the framework of general medicine are discussed on the basis of case reports. Ultrasonic equipment with manual moving of the probe is used in this department for the investigation of the abdomen in cases of occult neoplasms and metastases to differentiate between cysts and solid tumours and to determine the situation and size of parenchymatous organs like liver and kidney and spleen. Special fields of application are: follow up of patients after renal transplantation, investigation of systemic haematological diseases such as lymphogranuloma, or the demonstration of abnormal fluid masses such as haematomata in haemophilic patients, ascites or pericardial effusions.


[Functional risks in the surgical therapy of urinary incontinence and prolapse (author's transl)]. In addition to the known surgical risks in the treatment of incontinence or prolapse there exists a functional risk inherent in the surgical methods, which can even cause a deterioration in the functional condition if the surgical aim is not achieved. The vaginal bladderneck sutures are only worth as much as the tissues they hold together. The surgical treatment of certain cases of prolapse can eliminate the stopcock mechanism of the urethra and lead to the manifestation of a preoperatively-existent incontinence. With the sling operations success depends, among other factors, on the degree of restraint and the correct placement of the sling. The outcome of hysterectomy is endangered by failure to recognize a coexistent prolapse or enterocoele. With Ward's manipulation, high peritonization and adequate treatment of the overextened posterior vaginal vault, the involved functional risks can be minimized. Typical examples are mentioned in the text. Particular emphasis is placed on the necessity of exact knowledge of the circumstances threatending the functional success and their recognition by means of wick-urethrocystocolporectography. For the maintenance of a good doctor-patient relationship, the patient may receive prior to surgery an understandable explanation of the limitations of the methods used in achieving a functional cure.


[Equilin sulphate in the treatment of the menopausal syndrome (author's transl)]. 0.25 sodium equilin sulphate and 0.625 mg Premarin were compared as to their effects in 12 postmenopausal syndrome. The initial daily dosage of 0.25 mg equilin had a stronger oestrongenic effect in the alleviation of vasomotor disturbances than subsequently-administered Premarin. No significant difference was found in effect on the vaginal epithelium or the endometrium or in the incidence of irregular bleeding. The number of women in whom withdrawal bleeding was reported was considerably reduced by lowering the dosage to 0.2 mg equilin sulphate. Consequently 0.2 to 0.3 mg equilin sulphate must be considered the optimum dosage.


[Intensive care therapy of newborn infants (author's transl)]. Intensive care of newborn babies consists of immediate resuscitation during the very first minutes after birth, intensive management during the transportation and treatment at the intensive care unit. The importance of immediate resuscitation for the following therapeutic management is stressed. The modern system of correct and well-organized transport for newborn babies is also described. As to the diagnostic and therapeutic management in the intensive care unit, attention is called to the fact that it does not consist only of artificial respiration; in particular, temperature, blood glucose concentration, blood gas analysis and all vital functions must be constantly controlled. The importance of exact dosage of the administered oxygen during the intensive care of newborn babies is demonstrated. The indications, practical management and complications of artificial respiration are detailed. Finally, the good results which can be achieved in this field, with a significant reduction in mortality of artificially-respirated infants, are shown by the present investigation. Good organization, modern technical equipment and, especially, well-trained staff are indispensable foundations for the successful management of newborn infants requiring intensive care.


[Clinical and immunological studies in idiopathic adrenal insufficiency]. The application of 2 special methods to the pathogenetic elucidation of idiopathic Addison's disease is discussed in the light of a clinical case. In accordance with the literature, this patient with idiopathic Addison's disease showed a normal adrenomedullary response (as gauged by the catecholamine excretion and the increase in plasma renin activity) to 2-deoxy-D-glucose administration. Moreover, IgG antibodies were demonstrable in the patient's serum with respect to adrenocortical antigens of the cytoplasmic components of the endocrine cells of the zona glomerulosa and zona fisciculata.


[Clinical pharmacology of Opino-gel--the demonstration of its effectiveness (author's transl)]. The effectiveness of topically-applied buphenin (in a gel basis) was demonstrated by rheography in a double-blind study. This finding was additionally corroborated by experimental local vascular (venous) rheography. The flow volume of the tested vessels showed an improvement.


[Results of surgical management of scoliosis and kyphoscoliosis in adults (author's transl)]. Report about 60 operated scoliosis and kyphoscoliosis experienced at adults above 18 years. After separating the patients into male and female groups, age and localisation the most severe preoperative findings which make the operative treatment more difficult, will be described. Much impact will be put on pre-operative respiratoric and cardial impairment. The evaluation of scoliosis in adults will be proofed by examples. The operative technique, whose basis is the Harrington instrumentation in the modification by Stagnara, will be described also. 72 operative treatments have been necessary at 60 patients. In many cases rip-resections and dorsal osteotomies of the spine have been done. In oposition to the correction results of 46.2% on scoliosis and 56.5% on kyphoscoliosis there is one pulmonary embolism ending deadly and one irreversible paraplegia.


[Investigations of contact tissues of Blount vitallium staples using the instrumental neutron activation analysis (author's transl)]. Instrumental neutron activation analysis with Gamma-spectroscopy is a very sensitive method for testing trace elements. Specimens of contact tissue around 5 Blount's vitallium clamps were, after preparation at the Nuclear Research Institute Jülich irradiated with thermic neutrons and their element-specific gamma spectra were measured after 33 and 125 days. In contact tissue a significant rise in concentration of the alloy-specific elements cobalt and chromium was found. The unspecific elements silver, caesium, iron, rubidium, antimon, scandium and zink were either within or very close to the normal. The metallosis of contact tissue is due to corrosion of the surfaces of cobalt-chromium implants.


[Electron-microscopic demonstration of virus-like structures in the synovial membrane in chronic progressive polyarthritis]. The recent demonstration of ultramicroscopic "virus-like" cell inclusions in various organs in patients with collagen and autoimmune diseases suggest that viruses may play an aetiological role in these diseases. This paper reports briefly on some of the evidence for such "virus-like" structures in different cells of the synovial membrane from two patients with rheumatoid arthritis. The inclusions were localised in the vaculoes of the endoplasmatic reticulum of endothelial cells, lymphocytes, macrophages, fibroblasts and perithelial cells. They appear as tubular bodies of approximately 250 A. diameter. The tubules join together so that they form a 3-dimensional network. The possible viral or non-viral nature of these inclusions is discussed. A ultramicroscopical resemblance to the RNA-containing paramyxo-viruses suggests their virus nature. However, the negative results in testing with serum antibodies and immunofluorescence techniques argue against this. The authors suggest that the demonstration of these inclusions in other than collagen diseases points more in the direction of the correlation of these inclusions with immune globulin synthesis rather than the presence of a virus.


[Effect on quinoline derivatives, nucleotides, D-penicillamine,cytostatic and antiphogistic drugs on the rheumatoid factors other immune antibodies]. Cytostatics have no effect on antigen-antibody reactions in vitro. Immunosuppression by cytostatics is mainly based on the inhibition of immunocytes. Prednisolone inhibits RA-factors in the Waaler-Rose-test; the mechanism of this effect is not understood at the present time. Acetylsalicylic acid has no influence on the antigen-antibody reactions investigated. Nucleotides inhibit only ANA; the effect is probably based on a cross reaction with ANA. D-enicillamine inhibits RA-factors and other IgM-antibodies by splitting SS-bonds in macromolecules of immunoglobulins. Quinoline derivatives inhibit RA-factors, ANA, cold agglutinins and IgG-isoantibodies and autoantibodies to erythrocytes. Contrary to nucleotides, prednisolone and d-penicillamine, which also inhibit antigen-antibody reactions, chloroquine is splitting immune complexes; after the aplitting of the complexes the reactivity of antigens and antibodies is not impaired. The mechanism of action of chloroquine might be connected with physical and chemical processes of the antigen-antibody reaction. The reduction of the surface charge of human red cells is not related to the inhibition of antigen-antibody reactions by the  substances investigated.


Mixed gonadal dysgenesis.

Mixed gonadal dysgenesis. Mixed gonadal dysgenesis (MCG) is a rare intersexual disorder, characterized in most cases by the presence of a testis and a contralateral streak gonad; in some cases the contralateral gonad may be rudimentary not having differentiated into an ovary or into a testis and in other cases it may be absent. A personal case was recently studied by the authors in some detail: A 51-year-old individual reared as a female with primary amenorrhea, short stature, subnormal intelligence, male type habitus, hirsutism, moderate breast development, ambiguous external genitalia with a 5 x 2 cm phallus, labia majora with scrotal type skin, and a urogenital sinus. Internal genitalia consisted of a hypoplastic vagina and uterus, a streak gonad on the right and intraabdominal testis, fallopian tube, and epididymis on the left side. The dysgenetic testis contained a gonadoblastoma and the streak a gonadoblastoma and dysgerminoma. A buccal smear was chromatin negative and karyotype analysis revealed XO/XY mosaicism. Thyroid and adrenocortical function was normal. A plasma testosterone level of 0.15 mu-g% rose to 0.45 mu-g% with 3 days of HCG administration. With bilateral gonadectomy the plasma testosterone level fell to 0.06 mu-g% and there was no response following HCG administration. 109 cases of MGD and 2 cases of unilateral gonadal dysgenesis reported in the world literature between 1937 and 1973 were reviewed. On the basis of their clinical and pathological features, the latter two patients were excluded from the category of MGD. In 15 of the 109 cases of MGD, a gonadoblastoma obscuring the gonad of origin was opposed by a dysgenetic gonad with or without a gonadoblastoma or no gonad. In these cases the presence of a testis was not proven histologically and their clinical-pathological features were similar to those found in pure gonadal dysgenesis. Of the remaining 94 cases of MGD, 72 had testicular tissue on one side and a streak or embryonic gonad on the other while 22 had a testis and no contralateral gonad...


[Choice of recipent in human cardiac transplantation]. The favourable clinical results of cardiac transplantation merit wider application of this therapeutic measure in the management of non-obstructive primary cardiomyopathies and diffuse myocardial fibrosis secondary to coronary artery disease and in its terminal phase, in the absence of any absolute contraindication (pulmonary resistance too high, diabetes, gastrointestinal disorder, infection, patient too old.). Close cooperation between departments of cardiology and surgical transplantation centres, with systematic study of the patients pre-operatively and the setting up of a waiting list of recipients, will make possible in the future the improvement of the already encouraging results of cardiac transplantation.


High-frequency positive-pressure ventilation (hfppv) during transthoracic resection of tracheal stenosis and during peroperative bronchoscopic examination. Operation of a patient with intrathoracic tracheal stenosis using a new ventilation technique (HFPPV) is described. The technique permits tracheoscopy during ventilation and operation, thus enabling exact location of the stenosis to be obtained. Further, peroperative tracheoscopic checking of the anastomosis can be carried out. Resection and anastomosis can be performed without interference of a bulky endotracheal tube.


Effects of different inspiratory gas flow patterns on thoracic compliance during respirator treatment. Nine patients under general anaesthesia and 26 intensive care patients undergoing respirator treatment were investigated with special reference to changes in compliance under the influence of different inspiratory gas flow patterns during intermittent positive pressure ventilation (IPPV). Pressure recordings were performed in the respirator tubings, in the trachea and in the oesophagus. Flow rate was measured with pneumotachography. Total compliance showed an increase with a decelerating flow compared to an accelerating flow in the anaesthetized group as well as in patients with low compliance and high resistance, and also in patients with chronic respiratory disease. These findings were explained by an inproved evenness in the distribution of gas in the greater airways during the inspiratory phase. A separation of total compliance into lung and chest wall compliance did not reveal any significant variation correlated to flow pattern. The change in compliance occurred within minutes and remained during a 30-minute setting period.


Effects of different gas flow patterns on central circulation during respirator treatment. The effects of different inspiratory gas flow patterns on the central circulation during respirator treatment were investigated, first with a retrospective study consisting of 15 patients, where the effects on the mean intrathoracic pressure were represented by the variations in the amplitude and time development of the oesophageal pressure curve. In another study on eight intensive care patients undergoing respirator treatment, right-sided heart catheterisation was performed with pressure recordings in the central venous position, the right ventricle, the pulmonary artery and in the pulmonary capillary venous position. Estimations of the arterial-mixed venous oxygen content difference were also made. The development and transmission of the airway pressure curve to the central circulation were illustrated and discussed. The results showed very small effects on the mean intrathoracic pressure from different inspiratory gas flow patterns, and, therefore, it could be expected that the effects on the central circulation would be insignificant. This was also the conclusion in the catheterisation study. No important changes in the pressures of the a-vo2 difference occured. Most of the characteristics of a particular gas flow pattern are lost during the passage through the airways and are not transmitted to the oesophagus or the central vessels.


Blood-brain barrier lesions in acute hypertension in rabbits after unilateral X-ray exposure of brain. Acute hypertension was induced by metaraminol at different time intervals following irradiation in rabbits exposed to unilateral X-ray irradiation against the brain (3000 R) and in control animals. Hypertension resulted in a few areas of Evans blue extravasation in control animals. In the irradiated animals there was a marked increase in tracer extravasation on the half of the brain exposed to X-rays, indicating an increased vulnerability of cerebral vessels to blood pressure increase after irradiation.


Treatment of imminent premature labour.

Treatment of imminent premature labour. In this study, 194 imminent premature deliveries were treated. The pregnancies were in the 28th to 36th week. Uterine contractions were demonstrable in all patients and amniotic membranes were intact. All patients were treated with bedrest. Two betasympathomimetics were used in a double-blind study: Nyldrin hydrochloride (43 cases) and Isoxuprine hydrochloride (60 cases). A placebo was given to 41 patients, and ethyl alcohol to 50 patients. Intravenous and intramuscular treatment given in the hospital was continued with oral administration at home, and follow-up examinations were repeated at short intervals. Taking a minimum birth weight of 2500 g as the criteria of successful treatment, the success rate in the placebo group was 71%, in the Nylidrin hydrochloride group 86%, the Isoxuprine hydrochloride group 75% and the alcohol group 70%. When premature delivery was postponed 7 days, the pregnancy advanced., to the 37th week or later in 73, 77, 62 and 56% in their respective groups. The beta-sympathomimetics, especially the Nylidrin hydrochloride, were in every respect more efficient than placebo or alcohol. The therapeutic effect of alcohol was no better than that obtained with placebo. From the fetal point of view, the drugs used in the present study showed no adverse-effects.


Retrograde degeneration of the cochlear nerve. Retrograde degeneration of the cochlear neurons has been studied in different types and degrees of peripheral cochlear damage such as acoustic trauma, intoxication, heredodegenerative deafness and others. It starts only when the peripheral dendrites to the inner hair cells are irreversibly damaged. About 10% of the neurons are not affected by retrograde degeneration. They correspond to the type II and III neurons, which also survive after transection of the cochlear nerve and are mainly associated with the outer hair cells. Cochlear damage due to vascular impairment usually leads to a complete loss of cochlear neurons. In hereditary abiotrophic deafness, neuronal degeneration is slower and its extent varies considerably according to the various genetic syndromes.


Cellular sites of immunoglobulins . VI. Localization of immunoglobulins in the human thymus. IgG-, IgM and IgA-containing cells in the human thymus and mesenteric lymph nodes were studied by direct, double-antibody immunofluorescence techniques. Ig-containing cells were identified in the thymic medulla but not in cortical or paracortical zones. About 93 percent of the medullary Ig-containing cells were IgG-containing (vs. 5 percent IgM containing and 2 percent IgA - containing). By contrast, lymph nodes contained about 53 percent IgG, 31 percent IgA and 16 percent IgM type immunocytes. In addition, Ig-containing cells were about one-tenth as numerous in thymus as in lymph nodes.


Involution of polycystic kidneys during active treatment of terminal uremia. Following institution of chronic dialysis and/or renal transplantation for terminal uremia, four consecutive patients observed for 15-48 months with their polycystic kidneys in situ invariably showed a rapid relief of symptoms (pain, hematuria) followed by a gradual, but steady, involution of the kidneys. The mechanism and the practical clinical implications are discussed.


Comparative hemodynamic effects of placebo and oral isosorbide dinitrate in patients with significant coronary artery disease. Comparative hemodynamic effects of placebo and 10 mg of oral isosorbide dinitrate were studied in patients with significant coronary artery disease (larger than or equal to 75 per cent lumen narrowing) proved angiographically. Isosorbide dinitrate or placebo was given to eight and 10 patients, respectively, in a double-blind fashion. Cardiac performance at rest and during supine leg exercise was evaluated before and 60 minutes after drug administration. In the resting state, isosorbide dinitrate compared to placebo significantly reduced the left ventricualr (systolic and diastolic), mean pulmonary artery and mean aortic pressures, cardiac index, stroke index, left ventricular work index, stroke work index, and mean systolic ejection rate. Isosorbide dinitrate also significantly reduced left ventricular (systolic and diastolic and mean pulmonary artery pressures during exercise. This study indicates that 10 mg of isosorbide dinitrate has a significant influence on ischemic left ventricular dysfunction 60 minutes after its oral administration.


Review of computer applications in hospital pharmacy practice. A comprehensive literature review of the applications of computers in hospital pharmacy practice is presented. Articles are categorized as: accounting and drug usage review; purchasing and inventory control; controlled substances; outpatient services;drug distribution; drug information; and clinical services.


Adolescent hypertension.

Adolescent hypertension. The present appraisal indicates that blood pressure patterns in adolescence differ from those in adulthood and that the design of hypertension detection programs needs to be modified for this age group. Routine blood pressure screening within the school system would appear to be the most effective means for early detection of hypertension. Links with established hypertension clinics, preferably within an adolescent unit, should be forged so that health preservation becomes a meaningful part of the educational process. Although primary hypertension has been documented in the adolescent age group, the incidence is unknown and careful diagnostic evaluation is warranted until our knowledge of its characteristics is more fully expanded.


Electron dense alteration of kidney basement membranes. A renal lesion specific of a systemic disease. Described here are the findings of a clinical, anatomic and chemical study of 40 patients having an original lesion of the basement membranes of the kidney. This lesion is characterized by an ultrastructural modification of the basement membrane substance which appears very dark (black) and homogeneous in electron micrographs. It affects the basement membranes of the glomerulus, Bowman's capsule and the renal tubules. Patients with this lesion all manifest the clinical course of a chronic enphritis and is almost invariably accompanied by proteinuria and microscopic hematuria. The disease evolves generally with intermittent episodes towards irreversible renal failure. Eight patients received kidney transplants. Study of these transplants has shown that the lesion recurs in the transplanted kidneys during the year following transplantation. Moreover, it is never found in kidneys transplanted into patients who did not have it in their own kidneys. This ultrastructural lesion can therefore be placed in the framework of a systemic disease whose etiology is not yet known. The study of these transplants also shows that the lesion can exist despite the absence of any detectable clinical or biologic signs and be well tolerated for periods which now exceed 4 years for three patients.


Alternative C3 pathway activiation in pneumococcal glomerulonephritis. Glomerulonephritis following pneumococcal infection has been observed, but possible immunopathologic mechanisms have not been adequately explored. Multiple serologic studies as well as light, immunofluorescence and electron microscopic evaluation of kidney biopsy tissue from a 4 year old girl with pneumococcal glomerulonephritis were performed. Clinical studies at the onset of the disease showed normal serum C3 and C4 levels (third and fourth components of complement) with progression to selective C3 hypocomplementemia from days 2 to 58. A serum factor capable of breaking down C3 in normal human serum was present during the period of maximum C3 hypocomplementemia. Renal glomerular histology revealed a mesangial proliferative glomerulonephritis. Glomerular bound C3 and type 14 pneumococcal antigen were associated with similar, but less extensive, deposits of properdin. Minimal immunoglobulin M (IgM) and C4 were seen, but immunoglobulin G (IgG) and fibrinogen were absent. Ultrastructurally, subepithelial "humps" and intramembranous electron dense deposits were noted. It is hypothesized that the pneumococcal polysaccharide can activate the alternate complement pathway and may be responsible for a limited course of glomerulonephritis.


Meningococcal antigen in diagnosis and treatment of group A meningococcal infections. Meningococcal antigen was measured by countercurrent immunoelectrophoresis in the blood and cerebrospinal fluid of 200 patients with group A meningococcal meningitis. Antigen was detected in the blood of 27 (13.5 per cent) patients. These patients had a worse prognosis and a higher incidence of allergic complications, such as arthritis and vasculitis, about 5 days after the start of antibiotic treatment. Antigen was found in the CSF of 129 (67.5 per cent) patients); antigen often persisted in the cerebrospinal fluid despite antibiotic treatment before admission. A combination of immunoelectrophoresis and routine bacteriologic study was used in the diagnosis of 162 (84.8 per cent) patients with meningococcal meningitis. High levels of antigen and a slow antigen disappearance were associated with neurologic damage. The antigen is stable and may be detected from specimens of cerebrospinal fluid dried on filter paper.


Microangiopathic hemolytic anemia in renal allotransplantation. Repart of a successfully treated case and review of the literature. The development of microangiopathic hemolytic anemia after renal transplantation in a 17 year old white boy is reported, and the literature is reviewed. In this patient microangiopathic hemolytic anemia developed 6 weeks after renal transplantation during a second episode of rejection. Light, fluorescence and electron microscopy demonstrated the renal vascular lesion associated with this syndrome. In contrast to the other four previously reported cases of microangiopathic hemolytic anemia associated with renal allotransplantation, this patient had complete resolution of the microangiopathic hemolytic anemia with heparin therapy and improved allograft function, presumably with diminution of the vascular lesion. He survived a complicated early period after renal transplantation and has shown no recurrence of microangiopathic hemolytic anemia in the 18 months since transplantation. Special red blood cell and fibrinogen studies are discussed.


Complications of keratoplasty.

Complications of keratoplasty. The complications of keratoplasty have been greatly reduced in recent years by virtue of finer instrumentation, microsurgery, new drugs to minimize postoperative complications, and improved methods of donor cornea preversation. A 49-year-old woman, following uncomplicated keratoplasty with donor material from a patient who had died of a slow virus disease, developed the same condition and died 18 months later. Until more evidence is available, donor material from individuals dying of obscure chronic central nervous system disorders should be used with extreme caution.


Geometric analysis of radial buckling.

Geometric analysis of radial buckling. Tension analysis along the retinal surface demonstrates the advantage of meridional buckles over limbal-parallel buckles. A cylindrical sponge generates tensional forces in the retina along the long axis of the buckle and perpendicular to it. The tension perpendicular to the sponge is positive, and the retina and retinal pigment epithelium stretch in that direction. The tension along the long axis is positive (stretching) when the buckle is less than 90 degrees arc length; and negative (compression), greater than 90 degrees for a 5-mm sponge. Consequently, retinal compression folds on the buckles occur for buckles of arc length greater than 90 degrees. These tension forces at right angles to each other explain the development of (1) concave retinal detachment or retinal folds off short limbal-parallel buckles, (2) retinal folds on long limbal-parallel buckles, and (3) fishmouthing of horseshoe tears overlying a limbal-parallel buckle. The buckle increases retinal surface area overlying the buckle. The significance of this is not clear, but it may explain the lessening or disappearance of compression folds on the buckle in time.


Acute hemorrhagic pancreatitis (massive necrosis) with fat necrosis induced in mice by DL-ethionine fed with a choline-deficient diet. Female, albino mice were fed a choline-deficient diet containing 0.5% DL-ethionine. All animals died within 5 days due to the development of an acute hemorrhagic pancreatis with fat necrosis throughout the peritoneal cavity. The apancreatitis was characterized by a massive necrosis of the exocrine parenchyma with intense hemorrhage and inflammatory reaction of the stroma. The sequence of histologic and ultrastructural alterations occurring in the acinar cells of the pancreas were studied in mice fed the diet for 1, 2, and 3 days. Major findings consited of accumulation of zymogen granules, vacuolation due to foci of cytoplasmic degradation, and alterations in the morphology of the zymogen granules. The pancreatitis appears to be due to intraparenchymal activation of zymogens, resulting from a synergistic action of choline deficiency with the basic toxicity of ethionine toward the acinar cells of the pancreas. The experimental model simulates closely the acute hemorrhagic pancreatitis with fat necrosis occurring in humans and may prove useful for exploring the pathogenesis of this condition.


Vascularization of normal and neoplastic tissues grafted to the chick chorioallantois. Role of host and preexisting graft blood vessels. Adult, embryonic, and tumor tissues were grafted to the chorioallantoic membrane of the chick embryo to determine whether blood vessels originally within implants were reused in the establishment of a new blood supply. Grafts were examined daily by in vivo stereomicroscopy and in histologic sections. Colloidal carbon injections into the host vasculature served to confirm the precise onset of graft circulation; Preexisting tumor blood vessels disintegrated by 24 hours after implantation and revascularization occurred at 3 days by penetration of proliferating host vessels into the tumor tissue. Adult tissues did not revascularize, and the original graft vasculature progressively disintegrated during the 9 days of observation, Most embryonic tissues revascularized in 1 or 2 days by reperfusion of the existing graft vasculature. Anastomosis of host and graft blood vessels seemed to result from connections between newly formed vascular sprouts arising from both vasculatures. This study indicates that only tumor grafts acquire their blood supply solely by formation of new blood vessels from the host microvasculature. By contrast revascularization of normal tissues, when it does occur, is predominately the result of perfusion of the preexisting graft blood vessels.


Depression, Delusions, and Drug Response. Depressed patients with delusions were found to be markedly unresponsive to tricyclic drug therapy during an ongoing study of depressed patients. After four weeks of administration of imipramine hydrochloride, only 3 of 13 delusional depressed patients had responded to the drug, but 14 of 21 nondelusional depressed patients had responded. The authors conclude on the basis of these data and those of other researchers that delusional depressed patients should not be treated with tricyclic antidepressants and that current research with depressed patients should be reevaluated in the light of this finding.


Methylphenidate and caffeine in the treatment of children with minimal brain dysfunction. In this double-blind, crossover study of 8 boys with minimal brain dysfunction, 20 mg of methylphenidate daily was significantly better than 160 mg of caffeine in controlling behavior, especially impulsivity and hyperactivity, and methylphenidate alone was superior to decaffeinated coffee and placebo. The tentative results of this study confirm the primary position of sympathomimetics in the pharmacotherapy of minimal brain dysfunction and, in addition, suggest the involvement of dopamine pathways in this disorder. The authors urge further study of this hypothesis.


The nature and significance of sheep red blood cell rosettes. Rosette formation between human thymus-derived (T) lymphocytes and sheep red blood cells (SRBC) was inhibited by T cell specific antisera but not by sera directed against other lymphocyte antigens. We conclude that the SRBC receptor is closely linked to T specific antigens.


Evaluation of soluble-antigen fluorescent antibody test for antibodies to Trichinella spiralis in Experimentallly infected swine. The soluble-antigen fluorescent antibody (SAFA) test was evaluated at intervals from 7 days to 1 year in 42 swine infected with 25, 100, 500, 2,500, 12,000, or 250,000 Trichinella spiralis larvae. Serums were test positive as early as 14 days after exposure in swine fed 25 larvae and as early as 7 days in swine fed 100 or 500 larvae. Serums of all swine fed larger numbers of larvae were test positive by day 17 and remained test positive for the duration of the experiment. Fluorescence obtained in tests of serums from noninfected, laboratory-raised swine varied significantly; field tests were not done. The test couldbe done with whole heparinized blood, dried blood, or serum eluted from paper disks. Time required for the test procedure was reduced to approximately 45 minutes. The SAFA test detected antibodies to T spiralis earlier in swine fed smaller numbers of larvae and for longer duration than any other serotest which has been evaluated in swine. The test, particularly if automated, seems adequate as a mass screening test for surveillance and control of trichinosis in swine.


Macrophages in bovine milk.

Macrophages in bovine milk. The high vacuolated mononuclear cells in milk from normal bovine mammary glands, usually designated epithelial cells, were examined for properties characteristic of macrophages. In vitro, these cells concentrated neutral red into cytoplasmic vacuoles, adhered rapidly to and spread on glass, and phagocytosed viable Streptococcus agalactiae and Staphylococcus aureus. Neutral red uptake was demonstrated in vivo, and the vacuolated mononuclear cells phagocytosed formalinkilled S aureus in vivo. These results suggest that these cells are macrophages.


In utero immunization of calves against colisepticemia. A total of 21 bovine fetuses was inoculated in utero with Escherichia coli antigen to determine if nonserotype-specific resistance to colisepticemia could be induced. (Seven of these fetuses were inoculated through the intact flank of the dam.) After birth, the calves were deprived of colostrum and challenge exposed to a serologically distinct E coli which killed nonvaccinated controls. Of 21 calves vaccinated as fetuses, 10 survived challenge exposure, 8 died of colisepticemia, and 3 were stillborn. Premature birth precluded an adequate period of vaccination in 6 of the calves that died of colisepticemia. A relationship was not observed between E coli serum antibody and survival after challenge exposure. The results indicate that in utero vaccination with a single serotype of E coli can result in heterogenetic protection against neonatal colisepticemia. However, the occurrence of stillbirth and premature birth in calves vaccinated in utero indicates  need for furthur research before field application of this technique.


Propagation of Anaplasma marginale  in bovine lymph node cell culture. Anaplasma marginale was propagated in cell cultures derived from bovine lymph node (LN). Treatment of host cells with diethylaminoethyl dextran (DEAE-D) before inoculation and centrifugation of inoculum onto the monolayers resulted in significant numerical increases of A marginale. The direct fluorescent antibody technique (FAT) was used for detection of the organism in culture. The rat was combined with the standard microscopic count procedure to obtain numerical estimates of the organism in cell culture. Infection of LN cells was irregular, with some cells containing many organisms and others containing none. The organisms were dispersed or in inclusions in the cytoplasm of LN cells. Numerical increases of organisms occurred within 6 hours and these were greatest at 12 to 24 hours. After 24 hours, the organisms decreased rapidly, but small numbers of them were observed for at least 7 days. The average generation time in culture was approximately 17.1 hours.


Frequency of isoproterenol hydrochloride-induced cardiac arrhythmia in 19 patients with chronic obstructive pulmonary disease: a prospective study. The incidence of adrenergic-induced arrhythmias was studied in 19 patients with chronic obstructive lung disease uncomplicated by respiratory failure or cardiac desease. The effects of isoproterenol hydrochloride and a placebo were studied, using a randomized double blind technique and continuous monitoring of the cardiac rhythm. Two of the patients had episodes of arrhythmia associated only with nebulization of isoproterenol hydrochloride. Ten patients had no abnormality associated with isoproterenol hydrochloride or placebo nebulizations. In the remainder, episodes of arrhythmia occurred but could not be consistently correlated with placebo or drug nrbulizations. None of the patients was aware of any cardiac irregularity. A chi square analysis of the dataindicated no relationship between the isoproterenol nebulizations and cardiac arrhythmias. In our patients with uncomplicated chronic obstructive lung disease, nebulization of adrenergic bronchodilators seemed an infrequent cause of cardiac arrhythmias.


Postnatal growth and development of the lung. The lung is qualitatively different at birth, compared to adult life, in many species. In the neonatal period, the peripheral part of the acinus is formed by primary saccules, and it is from the walls of these that alveoli develop postnatally in rats, mice, and rabbits. Alveolar development starts in utero in man and probably in several other species, including sheep, cat, and, probably, mammals with relatively advanced physical development at birth. A sequence of events is well established in rats and mice in the postnatal period. A phase of expansion first occurs, during which lung growth lags behind the increase in body weight and lungs enlarge primarily by expansion, but new tissue is laid down in the saccular wall. This is succeeded by a phase of tissue proliferation during which the saccule is subdivided by numerous secondary crests that develop in the saccular wall and result in the formation of alveoli. During this stage, the rate of lung growth exceeds the rate of body growth and there is a rapid increase in alveolar surface area. Elastic tissue plays a key role in the development of alveoli, and elastic fibers lie in the free margins of the secondary crests and around the mouths of the alveoli. At approximately 2 weeks of age, the rate of cellular multiplication and formation of alveoli is markedly diminished and the lung grows mainly by cellular enlargement, dilatation, and modification of pre-existing structures...


Antibody to herpes-like virus in sarcoidosis. Anti-hepes-like virus antibody titers in samples of serum drawn from 70 consecutive patients at the time of diagnosis of sarcoidosis were compared with those found in control subjects without sarcoidosis or granulomatous disease, matched for age, sex, and race. Antibody was detected in all 70 sarcoid and control sera; in general, titers were higher for the sarcoid patient than for the matched control subject, but the difference in the geometric mean titer was only 0.5 of a twofold dilution step. Only 21 (30 per cent) of the sarcoid and 8 (11 per cent) of the control sera had titers greater than or equal to 1:600. The difference in the geometric mean titer between patient and control subject did not vary significantly with sex, race, or type of sarcoidosis. A second sample of serum was drawn from 45 of the 70 sarcoid patients after an interval varying from 18 to 60 months. Among these 45 patients the titers were virtually unchanged: 39 (87 per cent) had the same titer on the second occasion, 4 were higher by one dilution, and 2 were lower by one dilution. There was no correlation between the titer of the initial sample of serum and the progression, regression, or attainment of inactivity of the sarcoidosis. From this study we conclude that the elevated anti-herpes-like virus antibody titer found in patients with sarcoidosis are most likely to be related to the ability of these patients to show enhanced humoral antibody responses.


Subdural hematoma in regularly hemodialyzed patients. Thirteen of 394 (3.3%) regularly dialyzed patients of the Regional Kidney Disease Program developed subdural hematoma. The following factors contributed to formation of subdural hematoma: head trauma, ultrafiltration to control excessive accumulation of fluid and hypertension, anticoagulants, and frequent vascular access infection and clotting. Neurologic symptoms and signs, which may be similar to dialysis disequilibrium, aid only in signifying the presence, not the ultimate localization, of subdural hematoma. Our experience underscores the frequency of bilateral disease, irrespective of neurologic findings. Skull films, lumbar puncture, and electroencephalography were of little diagnostic help. Although valuable and safe, brain scanning was not as useful as desired due to occurrences of false-negative studies and failure to identify bilaterality of lesions. Cerebral angiography was always diagnostic. Surgical intervention yielded disappointing results, and only 2 patients (15%) survived. A review of 9 other patient reports is included.


D-penicillamine induced Goodpasture's syndrome in Wilson's disease. Fatal pulmonary hemorrhages and rapidly progressive glomerulonephritis occurred in three patients with Wilson's disease (hepatolenticular degeneration) who had been treated with penicillamine for 2 to 31/2 years. Light microscopic studies of the kidneys showed severe glomerulonephritis with crescent formation, and the lungs showed intraalveolar hemorrhages. Although the clinical and pathologic abnormalities were those of Goodpasture's syndrome, immunofluorescence microscopic studies in the one case tested showed an interrupted, rather than linear, fluorescence pattern.


Pulmonary function: relation to aging, cigarette habit, and mortality. The relation of pulmonary function to aging and cigarette habits has been examined cross sectionally and longitudinally in the Framingham cohort. On cross-sectional analysis, women were found to have lower forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV-1) values than men even after adjusting for height. Their FEV-1 percent was, on the other hand, higher than those of men. As the population aged over 10 years, their FVC and FEV-1 declined 9% to 27% depending upon age and sex. The FEV-1 percent, however, showed a decline only in the older age groups. In a cross-sectional analysis, cigarette smoking showed an inverse association to FVC and FEV-1 percent. Longitudinally, cigarette smokers showed a more rapid decline in FVC in 10 years than nonsmokers. On giving up smoking their FVC became more like that of the nonsmokers. A striking relation of FVC to mortality was noted in both sexes, which is not accounted for by associated cigarette habits.


Pneumocystis carinii pneumonia: a cluster of eleven cases. An unusual cluster of 11 patients with Pneumocystis carinii pneumonia occurred in a 3-month period at Memorial Hospital, New York. Ten of the 11 patients had lymphoma or leukemia. In 7 patients, corticosteroid therapy was decreased or stopped shortly before pneumocystis pneumonia was diagnosed. The pediatric patients had extensive contact in the outpatient department, and three of them had roomed together, suggesting the possibility of man to man transmission. Tree of 4 adult patients with Hodgkin's disease and pneumocystis pneumonia had the same physician. This physician had an indirect immunofluorescent titer of 1:16, as did an infectious disease resident involved in the care of 6 patients. Three of 9 patients tested showed indirect immunofluorescent titers of 1:16 or above, with rising or falling titers on serial specimens. Although definitive evidence of communicability was not established, patients with suspected or proved pneumocystis pneumonia are now isolated in this hospital.


The nature of "spots" on soft lenses.

The nature of "spots" on soft lenses. Of 278 consecutive therapeutic soft lens wearers, 19 (6.8%) developed discrete lens opacities on the anterior (air) surface of the lens. The incidence rose to 16.6% in patients fitted for dry eye syndromes, to 19% in bullous keratopathy and to 20% in exposure keratitis and trichiasis, if worn for longer than 2 weeks. These opacities were not associated with medications. Scanning electron microscopy demonstrated cracks on the anterior lens surface associated with these opacities. Transmission electron microscopy demonstrated the opacities to be amorphous material with extensions of the contact lens polymer into the substance of these opacities. Lipid, as demonstrated by histochemical methods, was found in these opacities. It is likely that the combination of dryness, stress on the lens surface, and lipid deposition act to alter the structure of the plastic and cause these opacities.


Comparison of suturing techniques in keratoplasty for keratoconus. The results of 48 consecutive penetrating keratoplasties for keratoconus were analyzed. The overall success rate was 93% clear grafts and there was no significant difference in the percentage of success, the amount of the spherical equivalent of the myopia, or the types of complications between the technique using 9-0 interrupted virgin silk sutures and 10-0 monofilament nylon running suture. The average astigmatic error was 25% less in the series employing the running suture.


Corneal intrastromal cyst following lamellar keratoplasty. A case is reported documenting formation of an intrastromal corneal cyst following lamellar keratoplasty. A patient with keratoglobus sustained trauma to the left eye. The trauma resulted in rupture of the cornea, which was repaired with an overlay conreal graft. Two and one-half years later, an intrastromal fluid-filled cyst of the cornea was found in the visual axis. Cytologic examination of the aspirated cyst fluid revealed epithelial cells.


Prevention of corneal opacification in open sky vitrectomy: Part I. An in vitro study. We tested the effects of various physiologic solutions with known osmotic pressures on maintenance of corneal transparency in vitro and compared them with the effects of other solutions that exert both oncotic and osmotic pressures. Normal saline solution, 5% glucose and normal saline solution, tissue culture 199, and plasma were bathing solutions tested. Increases in hydration and endothelial cell damage for the various media were compared. We found that plasma preserved corneal dehydration and endothelial viability better than other physiologic solutions.


Review of calcium methodologies.

Review of calcium methodologies. A review of calcium methodologies for serum has been described. The analytical systems developed over the past century have been classified as to type beginning with gravimetry and extending to isotope dilution-mass spectrometry by covering all of the commonly used technics which have evolved during that period. Screening and referee procedures are discussed along with comparative sensitivities encountered between atomic absorption spectrophotometry and molecular absorption spectrophotometry. A procedure involving a simple direct reaction for serum calcium using cresolphthalein complexone is recommended in which high blanks are minimized by repressing the ionization of the color reagent on lowering the dielectric constant characteristics of the mixture with dimethylsulfoxide. Reaction characteristics, errors which can be encountered, normal ranges and an interpretative resume are included in its discussion.


[Physicochemical properties of some antibiotics]. Some physico-chemical properties of 3 antibiotics, i.e. kanamycin, neomycin and monomycin dried in the evaporating-drying apparatus IDA-ITE-6 constructed at the Institute of Technical Thermophysics of the UkSSR Academy of Sciences were studied. The properties of their 6 and 18 percent solutions and sorption properties of the antibiotic powders were described. It was found that the properties of the 3 antibiotics were close.


[Caffeine as an inhibitor of the conjugation transfer of R-factors. A study of certain aspects of the mechanism of action of caffeine on the conjugation transfer of R-factors]. Some aspects of the inhibitory effect of caffeine on conjugation transfer of R-factors described by the authors earlier were studied. The effect of the above substance on the donor and recipient competence was tested in experiments with cultivation of the parent strains for 18 hours in the presence of caffeine. For this purpose the effect of caffeine on reduction of the donor and recipient cell competence after starvation in a physiological solution was investigated. It was shown that caffeine markedly decreased the donor competence of strain 15-3Mdrd of E. coli in the experiments of both types. Caffeine also inhibited reduction of the recipient competence of strain C600 of E. coli after starvation without its changing on 18-hour treatment. For the study of the caffeine effect on formation of the conjugation pairs experiments were carried out with dilution of the conjugation mixture after definite intervals which practically stopped formation of new conjugation pairs and eliminated further effect of caffeine on conjugation. Under such conditions transfer of R-factors may occur in the conjugation pairs after elimination of caffeine by dilution, if they were formed in the presence of caffeine before the mixture dilution. The experiments showed that caffeine inhibited not the formation of the conjugation pairs but the genetic transfer of R-factors. In addition, it was found that the substance insignificantly inhibited the process of phenotypic manifestation of the resistance markers. Inhibition of conjugation R-transfer by caffeine was associated with its eliminating effect, since the concentrations used did not induce elimination of the resistance markers in R+ strains.


[Level of "internal" resistance of E. coli cultures to benyzlpenicillin]. Interaction of benzylpenicillin inactivation by beta-lactamase and the growth of E. coli in the presence of various antibiotic concentrations was studied. It was found that penicillin inactivation began immediately after addition of the culture to the medium in spite of the fact that the number of the viable cells at that time decreased. The culture began to multiply only when benzylpenicillin concentration in the medium lowered up to a definite level (6-7 gamma/ml). Such a concentration must determine the level of the "inner" culture resistance to benzylpenicillin, not connected with the beta-lactamase effect. Moreover, the "inner" resistance proved to be the same for the cultures of E. coli, markedly differing by the amounts of beta-lactamase produced and the resistance levels to benzylpenicillin. Therefore, the routine method for determination of the "inner" resistance of the beta-lactamase-producing cultures to penicillins, using low innoculation doses produced higher results as compared to the real "inner" resistance. Significant differences observed between the values of the "inner" resistance (6-7 gamma/ml) and the MIC of benzylpenicillin at high innoculation doses with respect to E. coli 2 (129 gamma/ml) and E. coli 82 (15000 gamma/ml) may probably be explained by destruction of the drug by beta-lactamase.


[Intrauterine sensitization to benzylpenicillin in an experiment on rabbits]. Antibodies of benzylpenicillin in the posterity of various ages of female rabbits were found with reaction of passive hemagglutination (RPHA) and degranulation of the basophiles after their immunization with the antibiotic. This provided an assumption of intrauterine sensitization. Treatment of the sera of the sensitized animals with 2-mercaptoethanol partially decreased their activity in the RPHA which indicated to the presence of the antibodies of classes IgG and IgM.


[Theoretically probable assessment of the effectiveness of individualized combined antibiotic therapy of patients with suppurative inflammatory processes]. Efficiency of individual combined antibiotic therapy of patients was estimated in comparison to the use of single antibiotics of their fixed combinations without any special control group. Since the essence of the study was practically in successive appliance of the 2 methods of therapy to the same group of the patients, it was possible to carry out theoretically probable estimation of the final result as a summation effect of both methods and to define the probable result of the 2 nd method. The study of the results of the treatment of the patients with purulent-inflammatory processes showed significant advantages of the individual combined antibiotic therapy.


Effect of enrichment procedure upon auxotroph recovery in Escherichia coli K-12. Proline-requiring auxotrophs are recovered preferentially after mutant enrichment procedures (e.g., penicillin) which perturb the cell envelope, but not after procedures (e.g., thymineless death) which affect other cellular targets. This probably stems from effects of penicillin and similar antibiotics upon proline metabolic and transport enzymes associated with the cell envelope.


Selective inhibition of growth by the proline analogue thiazolidine-4-carboxylic acid and its probable mode of action in Saccharomyces cerevisiae. Cells of Saccharomyces cerevisiae showed differential growth inhibition when cultured on various carbon sources in the presence of the proline analogue thiazolidine-4-carboxylic acid (TZ). On 0.5% yeast extract, 2% glucose and TZ (10 mg/ml) medium, growth lags from 8 to 10 h were observed, after which cells recovered and growth proceeded normally. Growth was totally inhibited on a medium of 0.5% yeast extract, 3% ethanol, and 5 mg of TZ per ml. This inhibition was not due to the inability of cells to undergo aerobic respiration, since similar media containing glycerol instead of ethanol allowed growth. Proline added to the culture medium reversed the lag on glucose and TZ medium but did not promote recovery on ethanol and TZ medium. TZ was found to have two probable modes of action in yeast. It was a noncompetitive inhibitor of yeast alcohol dehydrogenase, and it was also found to be incorporated into cellular protein. Uptake studies using (14)C-labeled TZ showed that the recovery on glucose was correlated with the progressive exclusion of the analogue from cells.


Effect of lincomycin and clindamycin on peptide chain initiation. Lincomycin does not affect initiation factor-dependent formation of 70S initiation complexes formed with fmet-tRNA(F), the initiation triplet A-U-G, and 70S ribosomes, whereas its 7-chloro-derivative clindamycin substantially stimulates this process. Conversely, lincomycin stimulates nonenzymatic formation of the 70S complex, but clindamycin does not. Both antibiotics stimulate the assembly of non-enzymatically formed 70S initiation complexes with R(17) phage ribonucleic acid and exert little effect on those formed in the presence of initiation factors. The formation of 30S initiation complexes is stimulated or remains unaffected by lincomycin or clindamycin except when initiation occurs in the presence of very low Mg(2+) concentrations. In this case, both antibiotics inhibit the assembly of the 30S complexes regardless of the messenger present.


Comparative effect of tetracycline and doxycycline on the occurrence of resistant Escherichia coli in the fecal flora. Antibiotic-induced changes in the fecal microflora after oral administration of tetracycline hydrochloride and doxycycline for 8 to 10 days were compared. A significant difference was noted in the concentrations of Escherichia coli resistant to tetracyclines. With tetracycline hydrochloride, there was a mean increase of approximately 10(4) resistant strains per g compared to only 10(1)/g for doxycycline. This difference is ascribed to reduced intestinal concentrations of bioactive drug with recommended oral dosage for doxycycline.


Relationship between polyene resistance and sterol compositions in Cryptococcus neoformans. Six mutants of Cryptococcus neoformans resistant to nystatin and pimaricin and three mutants resistant to amphotericin B were isolated by ultraviolet irradiation techniques from two wild-type strains. The major sterols of the wild-type strains were Delta(7)-ergosten-3beta-ol and ergosterol. All six mutants resistant to nystatin and pimaricin showed either loss of ergosterol and concurrent production of Delta(7, 22)-ergostadien-3beta-ol and Delta(7)-ergosten-3beta-ol, or loss of both the wild-type sterols, with production of Delta(8(9))-ergosten-3beta-ol and Delta(5, 8(9), 22)-ergostatrien-3beta-ol. The mutants producing Delta(7, 22)-ergostadien-3beta-ol and Delta(7)-ergosten-3beta-ol showed relatively low levels of resistance to nystatin and pimaricin, whereas the mutants producing Delta(8(9))-ergosten-3beta-ol and Delta(5, 8(0), 22)-ergostatrien-3beta-ol showed a high level of resistance to either drug. Although highly resistant to amphotericin B, however, the three mutants produced sterol compositions identical to those of the wild types, indicating that the strains acquired resistance other than by alteration of the membrane sterols. The mutants producing Delta(8(9)) and Delta(5, 8(9), 22) sterols were not virulent for mice, showed reduced growth rates at 25 C, and failed to grow at 37 C. The other mutants showed a slightly reduced rate of growth both at 25 and 37 C, and the virulence in mice was slightly reduced in comparison with that of the wild types. These comparisons were on gross observations and were not statistically analyzed.


Nystatin-induced changes in Saccharomyces cerevisiae. Nystatin (5 to 10 mug/ml) was fungicidal to Saccharomyces cerevisiae NCYC 361. There was an initial rapid uptake of nystatin by the yeast cells at 30 C, the uptake being pH dependent, with a maximum at low pH values (3 to 4). Photomicrographs indicated that nystatin-treated cells became granular. The effect of growth temperature on the subsequent sensitivity of the yeast cells to nystatin was investigated. Cells grown at 20 C were the most susceptible to all concentrations of nystatin tested; as the pretreatment growth temperature increased, the subsequent uptake of antibiotic by such cells decreased both in intensity and in overall extent, the most marked difference occurring between 20 and 25 C grown cells. Leakage of K(+) and the optical density of suspensions treated with nystatin were similarly affected by growth temperature. Differences in the electrophoretic mobilities of cells grown at different temperatures were also observed. The total ergosterol content of 20 C grown cells was markedly higher than that of 40 C grown cells, with 30 C grown cells having an intermediate value.


Bacteriological studies with morphine-like narcotics: relevance to narcotic actions in mammals? A search for active bacterial growth inhibitors among seven highly potent morphine-like narcotics revealed that NIH 7591 and etorphine inhibited the rates of growth of Escherichia coli by 50% at 1.9 x 10(-4) M. Bacterial cultures escaped from growth inhibition by NIH 7591 after times which were proportional to the drug concentrations and inversely proportional to the initial bacterial densities. Populations of E. coli could adapt to resist and cross-resist growth inhibitions by NIH 7591 and phenazocine. Resistance was lost after growth in drug-free medium for a few doubling times. The agonist-antagonist pair, etorphine and diprenorphine, inhibited growth of E. coli additively without any indication of antagonism. Actions of narcotics in bacteria is considered a theme in its own right.


Cinoxacin: in vitro antibacterial studies of a new synthetic organic acid. Cinoxacin (compound 64716) is a synthetic organic acid with antibacterial activity against most aerobic gram-negative bacilli. Minimal inhibitory concentrations of cinoxacin (agar-dilution method) were determined for 419 strains. Escherichia coli was the most susceptible group of organisms. The majority of Klebsiella sp., Enterobacter sp., Proteus sp., and Serratia marcescens were inhibited by 8 mug of cinoxacin per ml. Pseudomonas aeruginosa and all gram-positive isolates tested were resistant to 64 mug or less of cinoxacin per ml. Zones of inhibition using a 30-mug disk correlated well with agar-dilution minimal inhibitory concentrations (r = -0.9). Cinoxacin was bactericidal when tested with inocula of 5 x 10(6) organisms per ml. Resistance to cinoxacin was readily developed in all three strains tested by serial passage on drug-containing agar. The in vitro properties of this agent were similar to those of nalidixic acid.


Comparative effects of amoxycillin and ampicillin in the treatment of experimental mouse infections. Amoxycillin was significantly more active than ampicillin in the treatment of intraperitoneal mouse infections when administered by oral and parenteral routes, although the causal bacteria were equally susceptible in vitro to the two penicillins. Amoxycillin produced higher antibiotic blood concentrations in mice than ampicillin after oral administration, and this was a possible explanation for the superior oral activity of amoxycillin. In contrast, antibiotic blood concentrations were the same for both compounds after subcutaneous injection, but it was demonstrated that amoxycillin was more effective than ampicillin by this route in reducing bacterial counts in the peritoneal cavity and in the blood of mice infected with Escherichia coli. Amoxycillin was also significantly more active than ampicillin in the treatment of infection by intraperitoneal dosing as a result of greater bactericidal activity in infected mice together with the production of higher antibiotic blood levels. The results of these studies on the effects of parental treatment of experimental infections with the two penicillins show that the superior chemotherapeutic activity of amoxycillin was associated with the greater bactericidal activity of amoxycillin in vivo and with differences in the distribution of the two penicillins in the infected animal.


Antibiogram and lipid analysis of a pigmented strain of Serratia marcescens and its nonpigmented variants. Antibiograms and lipid analyses of Serratia marcescens pigmented strain 08 and its nonpigmented variants are compared. The overall lack of significant differences between pigmented and nonpigmented strains suggests that the role of pigment formation may not be related to antibiotic susceptibility.


Streptomycin dependence in Escherichia coli: effects of antibiotic deprivation on ribosomes. The inhibition of cell division and the ultimate loss of viability after removal of streptomycin from growing cultures of streptomycin-dependent bacteria are not the result of "unbalanced growth" or of the breakdown of ribosomes. The streptomycin-dependent strain of Escherichia coli K-12 studied continued to synthesize ribonucleic acid (RNA) and protein during streptomycin starvation. There was no evidence of a gross imbalance in the ratio of RNA to protein synthesized or of selective degradation of either protein or RNA. Using the sedimentation of subunits in sucrose as the criterion, normal ribosomes were synthesized even after 18 h of streptomycin deprivation, although the rates of appearance of mature 30S and 50S subunits decreased with time of deprivation. Once formed, these ribosomes appeared stable, as did those synthesized before the onset of starvation. Ribosomes isolated from starved dependent cells were as "functional" as ribosomes from cells grown with streptomycin in their capacity to bind aminoacyl-transfer RNA in response to polyuridylic acid or natural messenger RNA to interconvert between active and inactive transfer RNA binding states, and to synthesize proteins in cell-free systems. The effects are consistent with an impaired rate of synthesis of ribosomal components or assembly of ribosomes resulting in a continually diminishing rate of protein synthesis. The effect on cell division may be the result of a decreased rate of protein synthesis in general and the requirement for a specific protein(s) in particular.


Immunologic studies in patients with sarcoidosis and cryptococcosis. Immunologic studies were performed in two patients with sarcoidosis, who developed cryptococcosis. Polymorphonuclear leukocyte function, complement, and serum antibodies were normal. Both patients had depressed cell-mediated immunity (cmi) to Cryptococcus neoformans and other antigens that persisted after therapy for their infection. These findings suggest that the patients' impaired CMI predisposed them to cryptococcal infection, which complicated their sarcoidosis. Evaluation of sarcoidosis cases should include studies of immune function, and the possibility of a secondary infection should be considered in patients with long-standing sarcoidosis, who develop unexpected changes in their clinical status.


Microcytotoxicity and serum blocking factors in malignant melanoma and halo nevus. Microcytotoxicity assays of patients with malignant melanoma and halo nevi were performed. No good correlation could be found between percent cell inhibition and histopathological level of melanoma or the clinical staging. The percent cell inhibition was usually an index of response to vaccinia virus immunotherapy. Actively regressing halo nevi showed high levels of percent cell inhibition, whereas inactive halo nevi had low levels of percent cell inhibition and blocking factor. Immunologic reactivity to melanoma cells may be a common feature of melanoma and halo nevus.


Double-blind comparison of halcinonide and betamethasone valerate. Use with occlusive dressings in psoriasis treatment. In a double-blind, paired-comparison study of the effectiveness of corticosteroid creams used under occlusion for the treatment of moderate to severe psoriasis, a new drug, halcinonide cream, was superior to betamethasone valerate cream, a steroid widely and effectively used for the treatment of psoriasis. This superiority was demonstrated in patients after both one and two weeks of treatment.


Cat-scratch disease skin test. Studies of specificity and histopathologic features. Microscopical examination of biopsy specimens from cat-scratch skin test sites, performed in patients with cat-scratch disease (CSD), sarcoidosis, tuberculosis, and other granulomatous diseases, showed noncaseating granulomatous dermal inflammation in 11 of 12 patients with CSD and in some patients with sarcoidosis or tuberculosis. Biopsy of cat-scratch skin test sites may be a useful ancillary procedure in diagnosing CSD if other granulomatous diseases are excluded.


Percutaneous absorption of salicylic acid. The potential hazards of repeated topical application of salicylic acid under occlusion to large areas of the body was evaluated by measuring the percutaneous absorption and serum salicylate concentrations in four patients with active psoriasis. Serum salicylate concentrations never exceeded 5 mg/100 ml in any of the patients, and although greater than 60 percent of the salicylic acid applied was absorbed, no evidence of accumulation or toxicity was observed. This form of treatment appears to present little potential hazard even in patients with extensive skin disease. Therapy could be hazardous for patients with impaired hepatic or renal function or for smaller children. The urinary excretory products of salicylate metabolism were compared following topical and intravenous salicylate administration to determine if the skin plays any part in the biotransformation of salicylate during percutaneous absorption. Our data are too limited and inconclusive to answer this question.


Identification of foreign material in lung by energy dispersive x-ray analysis. A new approach to silicosis. Conventional methods for the detection of foreign material in the lungs are not only difficult but make it impossible to study any relationship  between the material and the surrounding tissue. The present study employs energy dispersive x-ray analysis and scanning electron microscopy as the basis of a rapid and accurate method for determining the amount of silicon in the lungs of normal subjects and subjects with silicosis. A statistical evaluation of the data suggests that a silicon/sulfur ratio below 0.2 may be considered normal, whereas, a ratio above 0.3 may be considered to indicate silicosis.


MIF production of lymphocytes from patients with rheumatoid arthritis with antigen-antibody complexes. Immune complexes, human erythrocytes coated with human IgG antibody, inhibit the migration of lymphocytes from rheumatoid arthritis (RA) patients. No correlation could be observed between migration inhibition and Waaler-Rose titre (sheep cell agglutination titre) in inidvidual patients. Production of migration inhibitory factor (MIF) could be detected in 16 of 20 cultures of RA lymphocytes incubated with antigen-antibody complexes, when the supernates were tested with guinea pig macrophages. Only two supernates of healthy persons showed migration inhibition activity under these conditions. The results suggest that migration inhibition by antigen antibody complexes in RA represents a true reaction of delayed hypersensitivity.


Feprazone, a new anti-inflammatory agent. Studies of potency and gastrointestinal tolerance. Two studies are reported; a double-blind cross-over trial of feprazone 600 mg daily and aspirin 3.6 g daily in the treatment of rheumatoid arthritis, and an uncontrolled open study of gastrointestinal tolerance in twenty rheumatoid arthritis patients with known intolerance to other drugs. The first study showed that feprazone was significantly superior to aspirin in all the parameters tested. In the second study all twenty patients showed an improvement of their gastrointestinal symptoms, nineteen reporting no symptoms at all when taking the new preparation.


Closure of colostomy.

Closure of colostomy. We analyzed the records of 77 cases of loop colostomy closure in Vietnam War Casualties. All records were complete from the date of injury to discharge following colostomy closure. Simple of the loop colostomy was performed in 44 patients and resection of the stoma and reanastomosis of bowel segments was performed in 33 patients. Average operating time for simple closure of the loop was 70 minutes compared to 115 minutes for resection and anastomosis. Nasogastric suction was used less frequently and for a shorter time with simple loop closure. The total postoperative complication rate was 9% with simple loop closure as compared to 24% for resection and anastomosis. Simple closure of the loop described in this report is technically easier and as safe as resection of the stoma and reanastomosis.


Lung thermal volume in pulmonary edema: effect of positive end expiratory pressure. Effects of intermittent (IPPB) and positive eng-expiratory pressure (PEEP) ventilation on accumulation of pulmonary edema were compared, in dogs, after infusion of oleic acid. Pulmonary extravascular water was approximated as lung thermal volume (LTV), a double indicator method based on differential transit time for simultaneously injected right-to-left conductivity and thermal pulses. LTV was found to be decreased in animals treated with PEEP. The possibility that observed LTV changes reflect only the effect of PEEP on flow distribution, not lung water, was examined by alternating PEEP  and IPPB; short-term changes in LTV did not occur. Mean values of other factors influencing pulmonary water transfer, e.g., pulmonary capillary wedge pressure, serum protein, arterial blood gasses, were not significantly different with or without PEEP. It was concluded that, for the oleic acid lesion, PEEP effects a small reduction in the rate of accumulation of pulmonary edema.


Quantitative bacterial analysis of comparative wound irrigations. It is a biologic fact that all open wounds contain bacteria and remain contaminated with varying levels of bacteria until successful wound closure has been accomplished. The sine qua non in the management of the contaminated wound has been and remains adequate sharp debridement. In a standardized experimental model, three methods of irrigation were compared employing quantitative bacteriology of tissue to evaluate their effectiveness at decreasing bacterial levels and reducing wound infection. The pulsating jet lavate was found to be significantly better than gravity flow irrigation or wound irrigation with a bulb syringe. These data on tissue biopsies support previous reports using surface and wound exudate cultures.


Choice of abdominal operative incision in the obese patient: a study using blood gas measurements. Although many factors may influence the choice of the operative incision, physiologic safety in  terms of the degree of postoperative hypoxemia should be considered. No data currently exist to delineate in markedly obese patients the effect of the operative incision on the extent or duration of this hypoxemia. Fifty-four consecutive patients of both sexes, scheduled for elective jejunoileal bypass for morbid exogenous obesity, were studied. In 23 patients the operation was performed through a transverse incision and in 25 patients through a vertical incision. In 6 patients, cholecystectomy was also performed in addition to the jejunoileal bypass. Postoperatively there was a significant fall in PAO2 both in the transverse and vertical incision groups and this continued through day 4. On day 5 statistically significant hypoxemia was present only in the vertical incision group. In addition, the decrease in PaO2 was significantly greater on days 4 and 5 in the vertical group than in the transverse group. On days 2 and 3 again the mean decrease in PaO2 was greater in the vertical group but this was not statistically significant. The effect of added cholecystectomy on PaO2 was studied in 6 women with midline incisions. The results were compared with 6 subjects who had small bowel bypass without cholecystectomy and who were matched for incision, age weight, girth/height ratio, weight/height ratio, smoking habit, and percentage of predicted ERV. In both groups there was a significant fall of PAO2 from day 1 through day 4, but there was no significant difference between the two groups. Although the numbers studied were small, these limited results would suggest that the type of incesion rather than the intraoperative procedure is the important factor in determining postoperative PAO2 changes. These studies also suggest that in patients with an increased potential for postoperative hypoxemia (i.e., markedly obese), the transverse abdominal approach shoudl always be seriously considered.


The hepatorenal syndrome: recovery after portacaval shunt. Reversal of the morbid hepato-renal syndrome has been achieved in a cirrhotic patient with ascites following successful side-to-side portacaval shunt. The hepatorenal syndrome is defined as progressive unresponsive renal failure with previously normal kidneys in the presence of impaired hepatic function. Although the etiologic mechanism has not been defined, it is suggested the relationship of increased intrahepatic sinusoidal pressure on the thoracic duct and subsequent decreased lymph flow are interrelated to increased levels of aldosterone and manifested by (chylous) ascites. Laboratory and clinical evidence suggest that cirrhotics with ascites have remarkably high levels of aldosterone secretion via the rennin-angiotensin-adrenal cortex mechanism. This is the group that develops hepatorenal syndrome. Reduction of the intrahepatic pressure and decompression of the portal hypertension can be successfully achieved with a side-to-side shunt which should return the aldosterone-rennin-angiotensin axis to normal and subsequently reverse the hepatorenal syndrome.


Strike-through of moist contamination by woven and nonwoven surgical materials. A test is described which correlates the stress of stretching surgical gown and drape material with moist bacterial strike-through. By application of this test to a number of woven and nonwoven surgical gown and drape materials, it was found that not all of these materials, either woven or nonwoven, are impermeable to moist contamination for equal periods of time. Nonwoven disposable materials now in use range from those which remain impermeable to moist bacterial permeation through all tests while some remain impermeable for limited periods of time, and others almost immediately permeable to moist bacterial penetration. The same situation holds for woven materials. Under conditions of our test, Quarpel treated Pima tight-woven cotton cloth was impermeable to moist bacterial strike-through, through up to 75 washing and sterilizing cyclings, while ordinary linen and untreated Pima cloth permitted bacterial permeation almost immediately. These results have significance in lengthy wet surgical operations.


A universally applicable continuous suture technique for insertion of aortic valve prostheses. In a series of 55 consecutive patients with both single- and multiple-valve disease and aortic aneurysm, the aortic valve was replaced using a continuous suture technique. The technique is applicable for both ball- and disc-valve prostheses. This method resulted in a marked reduction in cardiopulmonary bypass time with a very low incidence of perivalvular leak. It has major advantages over other continuous and interrupted suture techniques.


[Research on the effectiveness of gynecological prescreening (author's transl)]. Malignant tumors are determined by abnormal values of DNA as well as in its precursors. The cytophotometric analysis of smears allowed the determination of DNA of higher number of cells and therefore was presented as prescreening. But higher amounts of DNA caused by colpitis was reached too in this case. Therefore the presented research tried to limit points of malignancy by determination ofDNA, RNA, Histones, and Heterochromatin of cytologically classified cells. The discussion of results with literature pointed out, that this object is only reaching today by simultaneous determination of DNA and Heterochromatin of selected "atypical" cells.


[Group B-streptococci in the female genitals (author's transl)]. Swabs taken from the vagina, cervix and urethra of 152 women without any clinical signs of infection were studied for the presence of group B streptococci. 36.8% of these women were found to have group B streptococci in their genital tract. Isolation of streptococci took place by way of enrichment and selective culturing, determination of biochemical criteria as well as serological grouping and typing. Streptococci of human or animal origin which may be identified by precipitating group B antiserum were found to be identical. There were no criteria for a differentiation between human and animal (bovine) group B strains. Epidemiological associations between human infections and the consumption of raw milk containing galt streptococci have never been confirmed. Group B streptococci are present indepently in animals and humans. In humans, they may be present as saprophytes in the throat and female genitals and also cause severe disease like endocarditis and meningitis. There is no proof of the etiologic role as an agent of zooanthroponoses.


Amino acid residues of serum and CSF protein in multiple sclerosis. Clinical application of statistical discriminant analysis. Statistical discriminant analysis of the amino acid compostion of serum and cerebrospinal fluid (CSF) proteins provides an objective method for distinguishing between normal controls and patients with multiple sclerosis (MS). This method also results in a high degree of specificity in separating MS patients from those with other diseases of the nervous system. The CSF protein serine residue is highly correlated with the CSF IgG and holds promise for a more sensitive diagnostic test for MS than the currently used CSF IgG. Finally, the serum/CSF protein serine ratio seems to correlate best with clinically determined degree of activity for the disease, the most active cases having the lowest ratio. These results suggest that investigation of the amino acid composition of serum and CSF protein in multiple sclerosis and, possibly, in other diseases might lead to the development of clinically useful tests of diagnosis and degree of activity of MS.


Acquired toxoplasmosis. A neglected cause of treatable nervous system disease. The neurological manifestations of six cases of acquired central nervous system toxoplasmosis are compared with the 39 well-documented cases from the literature. Half of the patients had underlying systemic diseases (18 malignant neoplasms, two renal transplants, three collagen vascular diseases) treated with intensive immunosuppressive therapy. The remainder had primary toxoplasmosis. Three major neurological patterns were seen: (1) diffuse encephalopathy with or without seizures, (2) meningoencephalitis, and (3) singular or multiple progressive mass lesions. Routine neurological diagnostic studies were not helpful. The Sabin-Feldman dye test or IgM indirect fluorescent antibody test or both were effective in confirming the diagnosis. Twenty-seven patients died without a clinical diagnosis of toxoplasmosis. The diagnosis was made terminally in four additional patients. Thirteen of fourteen patients who received a full course of sulfadiazine or pyrimethamine or both did well. Toxoplasmosis should be considered in the immunosuppressed patient who appears with neurological involvement.


Chloramphenicol in aqueous humor after topical application. Chloramphenicol 0.5% ophthalmic solution was applied topically to patients at various times before cataract surgery. The aqueous humor was obtained at the time of surgery and analyzed for chloramphenicol content by thin-layer chromatography. Aqueous humor chloramphenicol levels ranged from 3.5mn-g/ml to 6.7mn-g/ml at the initial sampling period one to two hours following topical administration. Chloramphenicol was measurable in samples for up to five hours following administration. The compound measured in the aqueous humor samples was chemically identified as intact chloramphenicol, and no metabolites of chloramphenicol were shown.


Antigenicity of cryopreserved corneas.

Antigenicity of cryopreserved corneas. The antigenicity of fresh and cryopreserved corneal tissue was analyzed by performing 5-mm interlamellar xenografts in albino rabbits using dog corneas as the donor tissue. The cryopreservative solutions contained 10% rabbit albumin, dimethyl sulfoxide, and sucrose. Fifty-nine rabbits received interlamellar xenografts using donor tissue prepared by one of the three following methods: (1) fresh, (2) cryopreserved, and (3) immersed in the cryopreservative solutions, but not frozen. Approximately one third of the grafts became cloudy within six weeks, and no statistically significant difference was noted clinically or histologically between the three preparations of donor tissue used. The results indicate that cryopreservation has no significant effect on the antigenicity of corneal tissue as exemplified by the interlamellar xenograft reaction in rabbits.


An automatic objective optometer. Description and clinical evaluation. Automatic objective optometers provide a possible alternative to conventional clinical methods of refracting the human eye. Quantitative evaluation of one of these instruments (Dioptron), including a comparison between optometer and subjective refractions, was undertaken to determine how automatic optometers may be utilized most effectively in clinical situations. The results show a high degree of instrument validity and reliability. The conclusion is that the Dioptron has substantial promise as a means of estimating ametropia-as a replacement for retinoscopy and for screening or monitoring ametropia. However, the use of this instrument as a substitute for subjective refraction procedures does not seem warranted at this time.


Polyglycolic acid suture in strabismus surgery. Polyglycolic acid, synthetic, absorbable braided suture was compared to gut with respect to handling, strength, and tissue reaction in 70 strabismus procedures. This new suture material produced less tissue reaction than gut and had handling characteristics that were similar to silk. It can be used in smaller sizes than gut because of its greater strength and firm knot. Polyglycolic acid suture appears to be a useful addition to ophthalmic suture materials.


[Diagnostic problems in new and old injuries]. Due to mass participation in certain sports combination injuries of the knee joint have greatly increased in number. To a certain extend injuries of the cruciate ligaments are typical. According to our own follow-up studies the immidiate suture of the ligaments leads to better results than late reconstructions which emphasises the early diagnosis of an injury to the cruciate ligaments. Old and new injuries to these ligaments present diagnostic problems. Therefore the mechanism of injury, the symptomatology, and both clinical and radiological possibilities for the diagnosis of damage to the cruciate ligaments are demonstrated.


Carbohydrate absorption. Studies on the glucose transport by isolated brush border membranes. A contribution towards an understanding of the molecular mechanism of sugar absorption. From investigations, mainly on intact in vitro preparations of small intestine, it has been established that the epithelial cell carries out digestion as well as absorption of carbohydrates, i.e. the luminal (brush border) plasma membrane contains di- and poly-saccharidases for the degradation of carbohydrates to monosaccharides as well as transport systems for monosaccharides. Recently, an intact glucose transport system has been demonstrated in isolated membranes from rat intestinal brush borders. In the isolated membranes, glucose transport has the characteristics expected for 'facilitated diffusion' of glucose coupled to Na+ translocation. The Na+-dependent uptake of glucose can be influenced by electrical potentials across the brush border membrane, which indicates that the positive charge of Na+, associated with sugar uptake, is not compensated by the counter-movement of another cation, e.g. K+, or by the co-movement of an anion via the same glucose 'carrier'. In other words, the Na+-coupled D-glucose transport is linked to a charge translocation - it is electrogenic. The apparent Na+ independence of glucose transport in vivo and the accumulation of glucose against a glucose as well as a Na+ concentration gradient by isolated epithelial cells may be explained by the 'ion gradient' model of Crane and Schultz and Zalusky provided the electrical membrane potential is high under these conditions and the electrochemical potential of Na+ serves as driving force for 'active' glucose transport.


Vitamin A a absorption - nutritional aspects. A brief review of the present knowledge of vitamin A (both performed and precursor forms) absorption is outlined with special emphasis on the dietary factors involved in this process. Some details are discussed related to the techniques used for measurement of vitamin A absorption from different sources and under different experimental conditions. Suggestions are also made to standardize appropriate procedure in this respect; this might enable comparisons and wide use of respective results obtained in various laboratories. Nutritional significance, including advantages or disadvantages of the liver test in these studies, is specifically highlighted with special reference to the determination of vitamin A bio-potency in various products. Some selected results and experience in this field are briefly presented.


Overproduction of lysine by mutant strains of Escherichia coli with defective lysine transport systems. Mutants selected on the basis of their resistance to S-(beta-aminoethyl) cysteine and overproduction of lysine were found to be defective in the lysine transport system. The overproduction of lysine was not due to mutation affecting either of the two regulatory enzymes aspartokinase and dihydrodipicolinic acid synthetase. Uptake of labeled lysine by the lysine-specific transport system was reduced to a negligible level, while uptake by the lysine, ornithine, arginine system was also affected. A hypothesis regarding the nature of these mutations and their effects on the regulation of lysine biosynthesis is discussed.


Antilymphocyte antibodies in systemic lupus erythematosus. Effect on lymphocyte surface characteristics. Antilymphocyte antibodies in SLE bind to normal lymphocytes and are not always associated with lymphocytotoxic activity. Detection of these antibodies on the surface of normal lymphocytes by immunofluorescent techniques is enhanced by short incubation periods, reduced temperature, and metabolic inhibition. The same effects occur in SLE blood and may influence the enumeration of B lymphocytes as determined by surface immunoglobulin. The percent of T lymphocytes forming sheep erythrocyte rosettes is not affected by these antibodies.


Depression of cellular-mediated immunity in systemic lupus erythematosus. relation to disease activity. Cellular-mediated immunity was examined in 6 consecutive patients with active SLE, 6 patients with low active SLE 6 patients with DLE, 8 patients with other collagen diseases, and 9 healthy controls. The following parameters were measured: delayed hypersensitivity, in vitro lymphocyte blast transformation, and MIF production after stimulation with five common antigens, DNA, and two nonspecific mitogens (PHA, PWM). The 6 active SLE patients were anergic and had a markedly depressed response in vitro to the specific antigens and PWM (P less than 0.001). When CMI was retested in 5 patients as early as 5 days after the start of prednisone (60 mc/day), the results were significantly improved in 4 who also improved clinically, and they remained unchanged in a fifth patieht who failed to improve. There was a less marked impairment of CMI among the low active SLE group, whereas the DLE and OCD patients did not differ significantly from the control subjects. DNA did not cause significant stimulation of blast transformation in any of the study groups.


Lymphokines in the rheumatoid joint.

Lymphokines in the rheumatoid joint. Joint fluids and culture supernatants of synovial tissue were examined for the presence of two lymphokines. Migration inhibitory activity was found in 16 of 22 rheumatoid fluids (73%), in 3 of 15 osteoarthritis fluids (20%), and in 3 of 11 fluids from patients with various inflammatory arthritides (27%). Blastogenic activity was present in 14 of 15 rheumatoid fluids and in 1 of 7 nonrheumatoid effusions. The active materials eluted with the third peak from Sephadex G-200 and were therefore smaller than immunoglobulin or immune complexes. These findings suggest that lymphokine-like substances were present in effusions and synovial tissue of most patients with rheumatoid arthritis and some patients with other forms of chronic synovitis.