Sub-miniature end-plate potentials at untreated frog neuromuscular junctions. 1. Some properties of unusually small spontaneous miniature end-plate potentials (sub-min.e.p.p.s) at untreated end-plates of adult frogs have been examined. 2. These small potentials, which show a fast time course, add a highly skewed component to the normal Gaussian distribution of min.e.p.p. amplitudes. 3. Sub-min.e.p.p.s were not evoked by single nerve stimuli, though their frequency could be raised by tetanic nerve stimulation. 4. When min.e.p.p. rate was raised by addition of lanthanum, submin.e.p.p. frequency was also increased, though by a smaller factor than normal min.e.p.p.s. In contrast, sub-min.e.p.p. frequency was unchanged when min.e.p.p. rates were raised by either ethanol or hypertonic solutions.


Re-innervation of twitch and slow muscle fibres of the frog after crushing the motor nerves. 1. The conduction velocities of individual motor axons innervating twitch and slow muscle fibres of the frog were determined by intracellular recording of junctional potentials elicited by stimulating the motor nerves at two different points. 2. In normal pyriformis muscles twitch and slow fibres were found to be innervated by two distinct populations of motor axons. Twitch fibre axons conducted at 10-18-7 m/sec, while the conduction velocities of slow fibre axons ranged from 0-5 to 5 m/sec (at 7-9 degrees C). The thresholds for electrical stimulation were significantly lower in the fast than in the slow axons population. 3. Following denervation by crushing the sciatic nerve fast  axons which re-innervated the muscle had lower conduction velocities than normal but could still be identified. These lower conduction velocities were measured proximal to the site of the crush and did not recover over a period of 446 days. 4. Fast motor axons regenerated more quickly than slow axons and re-innervated twitch as well as slow muscle fibres non-selectively. About 1 month later slow axons re-established synaptic contacts with slow (and some twitch) muscle fibres. Simultaneous re-innervation by fast and slow motor axons was occasionally observed in slow muscle fibres. Finally, the slow muscle fibres were innervated by slow axons only, while synapses of fast axons could no longer be found in this type of muscle fibre. 5. Action potentials were observed in denervated as well as in re-innervated slow muscle fibres; they disappeared as re-innervation progressed. 6. It is concluded that non-selective re-innervation of slow muscle fibres is present in the frog; it is, however, a transient phenomenon followed by restoration of the original innervation pattern.


Relationship of lymphocytotoxic antibodies to lymphopenia and parameters of disease activity in systemic lupus erythematosus. Peripheral blood lymphocyte subpopulations determined in 40 patients with systemic lupus erythematosus, revealed significant lymphopenia in comparison to normal controls. The lymphopenia was caused by decreases in the absolute numbers of both T cells and surface immunoglobulin bearing (SIg) cells. There were significant percentage decreases in T cells and normal percentages of SIg cells, resulting in an increased percentage of "null" cells. The lymphopenia was significantly greater in patients considered to have active disease on the basis of clinical parameters, and was strongly correlated with lymphocytotoxic antibodies, DNA antibodies, and hypocomplementemia. The lymphocytotoxic antibodies were reactive with both T and B lymphocytes from normal and ill donors, human organs, and various lymphoblastoid cell lines. In 30 patients who were followed for up to 22 months, the lymphopenia was clearly seen to develop during, but not before, periods of clinical disease activity, independent of changes in therapy.


Triple helices formed by polyuridylic acid with some amino deoxyadenosine derivatives. The stability of helical structures formed by polyuridylic acid with nucleosides and nucleotides derived from adenosine is not significantly affected by replacing hydroxyl groups by hydrogen, amino, or azido functions. Stability is affected by the position of the phosphate group.


Aspects of obstetrical defibrination in West Malaysia. Five patients illustrate various aspects of obstetrical defibrination in West Malaysia, resulting from exaggeration of changes in fibrinolytic-coagulation equilibrium that occur at delivery. Hypofibrinogenaemia and fibrinolysis may occur in association or either feature predominate. These patients are from a population in which a variety of genetic and environmental factors may interact, e.g. abnormal haemoglobins, cold agglutinins, viral and other infections, introducing additional complications.


[Characteristics of changes in the kinin system of blood in hypertensive disease]. The state of the kinin system of blood was studied in terms of its content of kininogen, prekallikrein, kallikrein inhibitor and the spontaneous esterase activity. The examination was conducted in 10 normal individuals and in 81 hypertensive patients with labile and stable arterial pressure and an uncomplicated course. The studies were conducted at rest, during the transfer into an orthostatic position, and after 15 or 60 minutes of walking. The normals demonstrated an activation of the kinin system that ensued in orthostasis, but was more distinct at walking. A significant correlation was noted between the content of prekallikrein and kininogen in all the states under examination. In cases of labile arterial hypertension an increased activation of the blood kinin system was observed at rest, a lack of its activation at walking, and disorders in the correlation between the content of prekallikrein and kininogen. The observed changes in the kinin system may affect the central haemodynamics and the formation of the hyperkinetic type of circulation.


Estimation of IgG-antiglobulins in sera of patients with rheumatoid arthritis and chronic liver disorders. Antiglobulin factors of the IgG class were measured in human sera by a modified immunoadsorbent-technique involving absorption to and elution from insoluble preparations of horse IgG. 32 mg of horse IgG insolubilized with bisdiazotized benzidine were used for quantitative immunoadsorption of IgG antiglobulins from 100 mul serum. Different IgG-antiglobulin concentrations could be obtained in two control groups differing in age. Elevated IgG-antiglobulins levels were found both in seropositive (mean value 23.21 +/- 7.08 mug/ml serum) and seronegative (mean value 20.06 +/- 8.39 mug/ml serum) RA patients. High values of IgG-antiglobulins were found in chronic liver disorders, particularly in the group of CAH patients (mean value 25.10 +/- 6.1 mug/ml serum).


Uptake, localization and secretagogic action of some biogenic amines in the submandibular and pancreatic glands of the guinea pig. The effects of noradrenaline, 5-hydroxytryptamine (5-HT) 5-hydroxyptophan (5-HTP), dopamine, L-DOPA and carbamylcholine on the secretion of amylase from guinea pig submandibular gland and pancreas were studied. Carbamylcholine stimulated both pancreatic and salivary gland amylase release, whereas the biogenic amines elicted amylase secretion only from the submandibular gland. L-DOPA and 5-HTP, the precursor amino acids of dopamine and 5-HT, were without effects. In both glands 5-HT and dopamine were accumlated to a greater extent than their precursor amino acids. The uptake of biogenic amines into acinar cells and their effects on amylase secretion are compared and dicussed in terms of receptor specificity.


Patient participation in the problem-oriented system: a health care plan. The problem-oriented system can be used to encourage the involvement of the patient in his health care. A Health Care Plan is described, the purposes of which include facilitation of provider-patient communication, and emphasis on the shared responsibility of provider and patient in problem solving and health maintenance. The Health Care Plan is not designed to supplant other parts of the system such as the problem list or audit.


[Lepromatous leprosy after BCG vaccination]. The authors describe an eruption of cutaneons nodules after a BCG vaccination. Investigation demonstrated that the lesions were caused by Lepromata. An increased number of B lymphocytes was observed in the bloodstream. Ryphampycin was used with good results.


The ototoxic effects of ethacrynic acid in man and animals. A review of the literature was carried out to summarize the ototoxic effects of ethacrynic acid on man and animal. The effects of this drug on the electrolytes of the endolymphatic and perilymphatic systems, on the cochlear potentials and the auditory cortical-evoked responses, were reviewed. Histological animal studies determined by light and electron microscopy were described. Potentiation of this drug with previous aminoglycoside therapy was discussed. In this paper, a human case report with temporal bone findings was present in addition to the histopathological effects of this drug which were shown in a series of animals receiving this drug over a period of time. Edematous and cellular changes in the stria vascularis, especially with animals receiving large doses of the drug, were described. No permanent alterations in the cochlear potentials resulted from the long-term therapy with ethacrynic acid.


The simultaneous binaural bithermal: a caloric test utilizing electronystagmography. The simultaneous irrigation of both external auditory canals with the bithermal stimulus of Fitzgerald and Hallpike yields responses which demonstrate a greater sensitivity than the alternate irrigation of each ear. The responses were recorded utilizing electronystagmography and were compared to the alternate or regular bithermal performed on the same paitent.


Biotransformations with plant tissue cultures. Suspension cultures of Catharanthus roseus, Apocynum cannabinum and Conium maculatum were examined for their capacity to transform aniline, anisole, acetanilide, benzoic acid and coumarin. None of the cultures transformed acetanilide but each produced acetanilide when fed aniline. All three cultures converted benzoic acid to its para-hydroxy derivative. Coumarin was selectively hydroxylated at the 7-position by Catharanthus and Conium and anisole was O-demethylated only by older Catharanthus tissue.


[Current aspects of differentiation and treatment of pneumocystis carinii pneumonia (author's transl)]. There are two types of Pneumocystis carinii pneumonia. One is seen in premature and atrophic infants mainly during the 2nd to 6th month, with massive interstitial proliferation of plasmacells and acute respiratory crisis. The second typ is observed in immunodeficient children and adults with only little or no plasmacell infiltration due to the hypoimmune, hypoergic state. Pentamidine is the drug of choice in the therapy of Pneumocystis carinii pneumonia; in serious cases it will be combined with Pyrimethamine. The cocktail Hydergine + Promethazine proved good as a symptomical drug. There have been reports about recoveries in adults under the treatment with Pyrimethamamine + Sulfamethazole. This combination has been recommended as prophylaxis as well.


Reversions of two proline-requiring auxotrophs of Haemophilus influenzae by n-methyl-n'-nitro-n-nitrosoguanidine and hydrazine. New mutation detection systems are described for Haemophilus influenzae. They involve two independently isolated proline auxotrophs which appear to be mutants at different sites in a proline locus (proB) that is very closely linked to a locus (thd) for thymidine requirement. One of the mutants, proB1, appears to revert to prototrophy only by mutations at the locus. The other, proB2, reverts both by mutation at the locus and by unlinked suppressors. The latter account for about 90% of the reversions induced by MNNG and by HZ. The close linkage of proB to thd was used to distinguish between true revertants and suppressors by a transformation test. A comparison was made between the mutation induction kinetics of the different classes of revertants and mutations to novobiocin resistance with MNNG and HZ. The very different induction kinetics for these two mutagens previously reported for the novobiocin resistance system were also found for the proline systems. There were some differences between the detection systems, however, in the frequency of induced mutation relative to the spontaneous frequency and, in one case, in the form of the induction curve. It is concluded that the major features of the induction curves reflect the amount of damage done to DNA and so are general for all systems, but that there are some features which are locus-or site-specific.


Fixation and loss of hydrazine-induced premutational damage in Haemophilus influenzae. Premutational damage induced in Haemophilus influenzae by hydrazine appears to be fixed as final mutation only at replication as judged by the transformation assay. Fixation at replication is independent of the rec1 gene, unlike the case with nitrosocarbaryl. Prior to replication premutational damage induced by hydrazine disappears by an unknown process that is not dependent on the presence of a pyrimidine dimer excision system nor on the rec1 gene. Hydrazine does not produce detectable single-strand breaks or alkali-labile sites in the treated DNA nor gaps in DNA newly synthesized after treatment. In these respects it also differs from nitroso compounds. It is concluded that hydrazine acts to produce and altered base, possibly N(4)-aminocytosine, that produces mutations by mispairing at replication rather than by error-prone repair.


[Use of I125 labelled poly(I). poly(C) for determination of antibodies to double-stranded RNA by immune complex absorption to nitrocellulose filters]. 125I-labeled double-stranded polyribonucleotide complex was used for detection of antibodies to double-stranded RNA in sera from people and immunized animals by the method of immune complex adsorption by the nitrocellulose filters. The technique is simple and sensitive. Antibodies to double-stranded RNA WERE detected in sera from patients with different diseases and from normal individuals. Systemic lupus erythematosus sera contain as a rule higher amounts of antibodies to double-stranded RNA. Often these antibodies were measured together with those directed towards native and denatured DNA. Anti-double-stranded RNA antibodies from sera of immunised animals and patients with systemic lupus erythematosus are highly specific.


[Role of the ventriculocisternostomy in the treatment of non-communicating hydrocephalus]. 44 ventriculo-cisternostomies were carried out on infants and children who manifested non communicating hydrocephalus. They were performed through perforation of the floor of the 3th ventricle with the aid of a leukotomy trochar which was introduced through a frontal ventriculography burr hole, and then guided under X ray control. The study of this group showed that the operation is benign, although the mortality is not null, and is effective except in the case where non communicating hydrocephalus develops after meningeal haemorrhage of meningitis. The late results seem good, but the time lapse is too short for a final conclusion. The preoperative radio-isotopic cisternography does not unable prediction of the cases which will be failures; it does however sometimes make it possible to foresee those which will be successful. The post-operative radio-isotopic cisternography is useful in checking on the permeability of the shunt.


[Selective ventriculography according to the Corrales technique. Its value in the diagnosis of tumors of the 3d ventricle and posterior fossa]. The authors relate their experience of selective ventriculography. The methode previously described by CORRALES needs a small gold chain with fine links which can reach by gravity the cavity of the fourth ventricle through the third ventricle and the aqueduct of Sylvius. This small chain is used as a leader for a flexible catheter which permits selective clouding of median ventricular cavities. This technique was used in 18 patients. In one case only, the small chain went down without any difficulty into the cisterna magna. The ventricular system was normal. In the 17 other cases, the progression of the small chain was stopped at some point of the ventricular cavities. In each of those cases, the stopping of the small chain appeared to be linked with the presence of a growth directly obstructing or compressing the ventricular cavities and gave a first clue as to its location. Introduction of the catheter into the aqueduct of Sylvius was the only true difficulty; in 3 cases, anatomical (large massa intermedia) or pathological obstacle (right angle bending of the aqueduct of Sylvius) made it impossible. In those 3 cases a satisfactory selective clouding of the fourth ventricle was nevertheless obtained by injecting the dimer either into the posterior part of the 3rd ventricle or into the upper part of the aqueduct of Sylvius. In all cases the trouble some superpositions due to clouding of lateral ventricles were thus avoided and a tomographic investigation, specially useful for the diagnosis of expanding lesions of the third ventricle and posterior fossa was allowed.


The ascending pharyngeal artery: normal and pathological radioanatomy. A radioanatomical study of the ascending pharyngeal artery has been performed. Based on 10 injected specimens of anatomical material and 8 superselective, normal and pathological angiograms. The meningeal role of the ascending pharyngeal artery and its anastomoses with the middle meningeal and/or occipital arteries is emphasized.


Posterior fossa, aqueduct and fourth ventricle of the living mouse studied by positive contrast and plain radiography. Radiographic techniques have been applied to the measure the size, volume and relationships of the posterior fossa, aqueduct and fourth ventricle in two strains of laboratory mice. Significant differences in the size of posterior fossae between strains were observed. Using ventriculography in the living mouse, the outflow tract of the fourth ventricle was demonstrated, together with a communication that exists between the third ventricle and the subarachnoid space.


Lymphocyte subpopulations in human cerebrospinal fluid. Lymphocyte subpopulations in both human cerebrospinal fluid and peripheral blood were identified and compared by rosette techniques. In patients without neuroaxial disease, the percent distribution of Fc receptor and T-lymphocytes reflected peripheral blood values, although there was a significantly higher percentage of T cells in normal CSF. Alterations in lymphocyte cerebrospinal fluid populations were observed in various systemic and neurologic diseases.


Chronic cerebellar stimulation in cerebral palsy. Data are presented for the first 50 patients with cerebral palsy who underwent chronic cerebellar stimulation for symptom alleviation. We observed significant shorter and longer term improvement in spasticity as well as athetosis, speech, and functional status. Continuing increments in improvement were noted as a function of time on stimulation. In many instances, psychometric test scores and behavior also were improved. There was one death in this series. There were no neurologic complications due to cerebellar stimulation. The results of this study warrant the judicious use of cerebellar stimulation for symptomatic and functional relief in cerebral palsy.


Acute flexion-extension injury of the neck. Electronystagmographic study of 309 patients. Three hundred and nine patients, whose chief complaint was dizziness following a flexion-extension type of acceleration neck injury, were examined in the Neurosensory Laboratory of Temple University Health Sciences Center between 1965 and 1972. Specific attention was devoted to vestibular tests, including a search for latent and positional nystagmus, bithermal calorics, and rotatory tests. All tests were performed with the aid of electronystagmography; latent nystagmus was present in 29 percent of the patients, caloric tests were abnormal in 57 percent, and rotatory tests were abnormal in 51 percent. These findings suggest that many of these patients have a verfiable objective vestibular disturbance as a cause of dizziness, even though the neurologic examination may be normal. Furthermore, in order to detect this objective vestibular dysfunction, the patient should be tested with aid of electronystagmography since nystagmus may be inhibited by visual fixation.


Beneficial effects of serotonin precursors in postanoxic action myoclonus. In two patients with postanoxic action myoclonus, L-tryptophan or a monoamine oxidase inhibitor induced a moderate improvement, but L-5-hydroxytryptophan had greater therapeutic effect. Methysergide, a potent blocker of serotonin receptors, consistently induced a marked deterioration in myoclonus. Pretreatment cerebrospinal fluid 5-hydroxyindoleacetic acid levels were reduced significantly in both patients. These findings suggest that postanoxic action myoclonus likely is associated with insufficient serotonergic activity in the central nervous system. Data are inadequate to determine whether this apparent insufficiency reflects structural changes in 5HT-containing raphe nuclei due to a direct anoxic damage to these structures of functional changes caused by a secondary reduction in the activity of intact serotonergic neurons.


Ontogeny of mouse B lymphocytes and inactivation by antigen of early B lymphocytes. Taking advantage of recent findings about membrane fluidity, we have studied and compared the biosynthetic capacities of fetal or neonatal mouse B (bone-marrow derived) lymphocytes (until 10 days after birth) and adult B lymphocytes. Although both early and adult lymphocytes can synthesize surface immunoglobulins, they have a different physiological behavior after interaction with a ligand (anti-immunoglobulin sera or antigen), either in vivo or in vitro. Fetal and neonatal lymphocytes bearing surface immunoglobulins do not reexpress their membrane receptors after capping and endocytosis promoted by anti-immunoglobulin sera. On the other hand, adult lymphocytes resynthesize completely their receptors after the same treatment. Furthermore, intrafetal injections of hemocyanin in pregnant mice lead to a striking decrease in the number of hemocyanin-binding cells. It seems plausible that this non-reexpression of surface immunoglobulins could be the first step in tolerance establishment.


Role of major histocompatibility complex gene products in delayed-type hypersensitivity. Sensitized thymus-derived (T) lymphocytes can transfer delayed-type hypersensitivity (DTH) to naive mice only if there is identity at the major histocompatibility complex (MHC). The MHC region responsible differs according to the antigen used for sensitization. For transfer of DTH to fowl gamma globulin identity at I-A is necessary; for dinitrofluorobenzene, however, identity at either K, D, or I region is sufficient. T cells of one genotype, sensitized in a chimeric environment, transferred DTH to both parental strains even though these were MHC incompatible. However T cells from F1 hybrid mice, sensitized not in the F1 but in one parental strain, transferred DTH only to that parental strain, not to the other, in contrast to F1 T cells sensitized in the F1 which could transfer DTH to both parental strains. Macrophages pulsed with antigen in vitro could be used to sensitize syngeneic or semi-allogeneic mice for the transfer of DTH. Transfer was, however, successful only in the strain syngeneic to that from which the macrophages were derived. Evidence is also presented that genetically low-responder mice can be made to exhibit DTH provided they are pretreated with cyclophosphamide two days before sensitization. When considered in toto these results strongly argue in favor of the notion that there are receptors on activated T cells which recognize antigenic determinants and MHC gene products. The implications of these findings are discussed in relation to the role of macrophages in antigen presentation and to the possible parallel evolution of MHC gene products and of T cell receptors for antigen.


Diverticular disease.

Diverticular disease. Diverticular disease comprises a spectrum of illness beginning with the irritable bowel syndrome and progressing to the life-threatening complications of diverticulitis and hemorrhage. Step-wise progression of this disease may be seen but is not invariably present; many patients with diverticulosis do not have preceding symptoms of the irritable bowel syndrome. The typical complaints of irregularity of bowel habits and abdominal pain will usually respond to the relatively new treatment modality of a high fiber diet with added wheat bran. Barium enema x-ray examination remains the primary diagnostic modality in the investigation of diverticular disease, and colonoscopy should be used only in the presence of certain specific circumstances. Surgery, aimed at the treatment of complications of this disease, has progressed to the point where one-stage extirpation of the diseased bowel is recommended.


[Electrocolloidotherapy].

[Electrocolloidotherapy]. Electro-colloidal therapy opposes the electro-colloidal precipitation that governs or participates in the development of pathological conditions. This therapy is carried out using an apparatus that re-establishes or maintains the correct electrical and colloidal state in the human body. The use of electro-colloidal therapy combined with the usual types of vascular therapy gives results that would not be possible with either type alone. The indication of choice for electro-colloidal therapy is vascular thrombosis. All the 68 cases treated were improved by the electrical treatment. Arteritis and vascular tissue degeneration in general represent the second and more controversial indication for electro-colloidal therapy.


Alpha-1-antitrypsin deficiency and liver in adults. Thirteen adult patients (aged 16 to 73 years) form 12 families are described with liver disease and alpha- 1- antitrypsin deficiency. Long-term observation of several of these patients suggests that the liver disease may be only slowly progressive, but review of possible factors aggravating this has failed to reveal any obvious clues. Progression to death from hepatic failure was the commonest outcome, but one patient developed a malignant hepatoma and two others died because of intraperitoneal haemorrhage due to ruptured cirrhotic nodules--a complication not hitherto described in association with this condtion. Diagnosis of alpha-1-antitrypsin deficiency was based on serological, histological, immunopathological and genetic studies. The most useful screening test in liver disease was found to be the demonstration of PAS positive globules in liver biopsy material which is diagn by immunofluoresence or immunoperoxidase, the latter being a superior technique. Serum estimation of alpha-1 -antitrypsin deficiency was performed by immunoelectropharetic and immunodiffusion techniques, the former being preferred because it gave more consistent results. Both methods, however, were of limited value since wide variations in the serum values are commonly found in normal and abnormal states. Genotyping was carried out using starch gel electrophoresis and although of value in family studies, its value as a diagnositc aid is limited because of technical difficulties and also because alpha-1-antitrypsin accumulation in the liver may be found in both homozygous and heterozygous states. It is suggested that adult liver disease associated with abnormalities in alpha-1-antitrypsin may be more common than has hitherto been reported. This condition should be systematically sought in all cases of liver disease of uncertain aetiology.


[Pitfalls during phlebology consultation]. For a patient suffering with his legs, the pain is usually associated with the presence of one or more varices that can be seen. The physician must not fall into this trap. Questioning is vital. Establishing the kind of pain and the conditions under which it occurs may elok for (1) a rheumatological etioloty: sciatic or crural nerve pain, calcaneal pain: (2) a surgical etiology: an inguinal or particularly a crural hernia, a popliteal cyst; (3) a medical etiology: exogenous polyneuritis, hypokalaemia resulting from the abuse of laxatives or of diuretics, etc.


Fibrogenesis imperfecta ossium.

Fibrogenesis imperfecta ossium. The case history, clinical course and laboratory findings in a 66-year-old woman with fibrogenesis imperfecta ossium are reported, the sixth case in the literature. The condition is characterized clinically by intractable skeletal pain and progressive immobility. Though serum alkaline phosphatase has been raised in all patients, there are no specific haematological or biochemical findings. The radiological features of coarse and dense trabecular pattern with symmetrical and diffuse involvement of all bones without expansion or change of shape, together with periosteal reactions and soft tissue calcification are characteristic. The macroscopic appearance of bone shows large areas of opaque white and brittle trabeculae. The histological findings mimic those of osteomalacia unless examined under polarized light which shows the loss of normal birefringence. On electron microscopy the normal lamellar pattern made up of orientated collagen fibrils all about 80 nm diameter is replaced by a random tangled pattern of much thinner irregularly curved fibrils, some as thin as 5nm. The condition appears to be acquired, leading to erosion of the normal skeleton and replacement with an abnormal fibre deficient matrix. There is no definitive therapy at present.


Clinical and immunological aspects of cutaneous vasculitis. Thirty-five patients with cutaneous vasculitis were studied. Sixteen had raised serum levels of cryoglobulins. In all but one the cryoglobulin was an immune complex. Eleven patients had anticomplementary sera and five had a low serum IgM. Clinically, the cryoglobulinaemic patients were not readily distinguishable from the non-cryoglobulinaemic in that cold sensitivity occurred in only six of sixteen patients with cryoglobulins. Peripheral neuropathy and lesions in the upper respiratory tract were confined to those with cryoglobulinaemia. An immunopathological classification for the purpuric vasculitides is suggested.


Neuroradiological applications of the Ommaya reservoir system. By way of a frontal burr hole a subcutaneous reservoir connected to a flexible catheter inserted through a foramen of Monroe into the third ventricle is installed. The use of this device facilitates contrast and radioisotope ventriculography, reducing both trauma and stress to the patient at the same time. The procedure greatly improves the quality of contrast studies in space-occupying lesions in the posterior fossa by rendering simultaneous cisternography technically possible and safe.


Transcatheter therapeutic embolization in the management of massive upper gastrointestinal bleeding. Two methods of controlling life-threatening hemorrhage are infusion of vasospastic agents and embolization of the bleeding vessel. Gelfoam powder, Gelfoam sponge, and isobutyl cyanoacrylate have been used to control severe arterial and variceal hemorrhage from the upper gastrointestinal tract. The authors summarize their results and discuss gastric necrosis, a serious complication.


Transcatheter therapeutic arterial embolization. Transcatheter therapeutic arterial embolization was employed in 11 patients with gastrointestinal hemorrhage and 8 patients with bleeding from other sites. Hemorrhage was stopped successfully in all of the patients with gastrointestinal bleeding and 6 of the 7 patients with active bleeding from other sites. There were no significant complications or sequelae, although ischemia msy cause problems in such patients. Embolization is of considerable value when pharmacological therapy fails or is not appropriate due to the site of bleeding. In some cases it may represent the definitive treatment, as in pelvic trauma or renal hemorrhage; in others, embolization may serve to halt bleeding long enough to permit surgery. Therapeutic embolization should be considered whenever active extravasation of contrast material is demonstrated.


Alterations in gastric physiology caused by selective embolization and vasopressin infusion of the left gastric artery. Alterations in gastric physiology caused by selective embolization and vasopressin infusion of the left gastric artery were evaluated in 29 dogs. Gastric acidity was not significantly altered following Gelfoam embolization but decreased sharply with vasopressin infusion. These results suggest that the segmental occlusion caused by Gelfoam embolization permits significant collateral blood flow to the gastric mucosa, while the arteriolar and capillary constriction caused by vasopressin effectively decreases mucosal blood flow. These findings are consistent with the clincal observation that embolization is more effective in controlling bleeding ulcers, while vasopressin infusion is more effective for controlling hemorrhagic gastritis.


Effects of beta-carbolines of plasma corticosterone in mice. 6-Methoxy-1, 2, 3, 4-tetrahydro-beta-carboline, a drug which has been reported to increase brain serotonin (5-HT) but not norepinephrine, was tested for its acute effects of pituitary-adrenocortical activity in CF1 mice. The drug produced dose- and time-dependent increases in plasma corticosterone concentration which could be prevented by blocking adrenocorticotropic hormone secretion. Administration of other beta-carbolines or the 5-HT precursor 5-hydroxytryptophan also resulted in plasma corticosterone elevations. Further studies will be needed to determine whether beta-carbolines stimulate pituitary-adrenocortical activity through a central serotonergic system or by some alternate mechanism.


[Contribution of axial computer assisted tomography to the diagnosis of aresorptive hydrocephalus]. In a comparative study, 18 patients presenting with progressive mental deterioration were investigated by means of radio-isotopic cisternography and by computerized axial tomography (CAT) in order to establish morphological criteria for CAT which would enable malresorptive hydrocephalus and atrophic hydrocephalus to be differentiated. Except for one case, malresorptive hydrocephalus was characterized by supraand infratentorial ventricular dilatation without any signs of cortical atrophy of the convexity. In most cases, ventricular dilatation was more important in cases of malresorptive hydrocephalus and, in 6 out of 7 cases, the trigone and the occipital horns were particularly dilated. Only in malresorptive hydrocephalus did we find less than juxtaventricular aedema greater than possibly indicating compensating transependymal absorption of cerebrospinal fluid. In atrophic hydrocephalus, on the other hand, CAT shows a moderate degree of ventricular dilatation associated with dilatation of the cortical sulci.


A colchicine-sensitivity test for leukaemic lymphocytes. Non-dividing lymphocytes from patients with chronic lymphocytic leukaemia were more sensitive than normal lymphocytes to reagents as prednisolone, cytarabine, vincristine and colchicine. The maximum difference was obtained when the cells were incubated with colchicine at 37 degrees C for 20 h. The sensitivity was measured by a 'sensitivity index' which was an estimate of the average percentage of lymphocytes killed by 1.0 and 0.1 mug/ml of colchicine. The index was 0-15% for lymphocytes from the blood of 14 normal persons and was 61-98% for 23 of 25 leukaemic patients with absolute lymphocyte counts of 8,000 X 10(9)/l or more. 3 of 4 untreated patients with presumptive diagnoses of early leukaemia had low absolute counts of 3,300 to 7,600 X 10(9) lymphocytes/l and high sensitivity indices of 41 to 83%. Tests on treated patients with lymphocytes counts less than 8,000 X 10(9)/l suggested a correlation of the index with remission and relapse. Hairy cells from 3 patients with hairy cell leukaemia were resistant to colchicine. Sensitivity to colchicine seemed useful at a test for leukaemic lymphocytes and as an aid in the haematologic evaluation of patients with chronic lymphocytic leukaemia and malignant lymphoma.


Transplantation of bursal stem cells into cyclophosphamide-treated chicks. Lymphoid repopulation of splenic structures. After transplantation of bursal stem cells into cyclophoshamide-treated newly hatched chicks, the first lymphoid cells in the spleen of the recipients were observed on the first day after the cell transfer and the first plasma cells on day 3. The repopulation of the Schweigger-Seidel sheaths started from their periphery on day 6. The first germinal centers were detected 20 days after the cell transfer. In cyclophosphamide-treated birds without cell transplantation, only the periphery of the Schweigger-Seidel sheaths became repopulated, and no plasma cells or germinal centers were observed. The results indicate that already at the age of 3 days the bursa contains some cells of postbursal maturity, able to home to the spleen.


Volar tenosynovectomy in the rheumatoid hand. Rheumatoid involvement on the flexor aspect of the hand is common, but is easily overlooked because of difficulty in clinical examination. It is our experience that this localization of the disease process is extremely important and that surgical treatment should be given high priority. In this study a series of 235 operations on the flexor aspect of the hand performed on 139 patients are presented. The results are very gratifying as far as tenosynovectomy in the carpal tunnel and the pain is concerned. When performed on the fingers, however, varying degrees of postoperative flexion contractures developed in no less than 44%. It was found that this problem arose when the synovectomy was extended beyond the level of the middle flexion crease of the finger being caused by excessive postoperative scar formation in the region volar to the proximal interphalangeal joint between the tails of the superficial tendon. It is concluded that less extensive surgery should be aimed at in this particular area.


Ambulance transport of obstetric emergencies. Ninety-eight patient records from obstetric flying squad calls were reviewed. The reasons for call-out and the effect of transport on maternal and foetal cardiovascular parameters were analysed. The main reason for calling the flying squad is now antepartum haemorrhage. Transporting the patient to hospital has little effect on the cardiovascular state.


Binding of C-reactive protein to antigen-induced but not mitogen-induced T lymphoblasts. The C-reactive protein (CRP), an acute phase reactant which binds selectively to T (thymus-derived) lymphocytes, was found to bind to lymphoblasts formed upon stimulation with antigens but not with mitogens. Binding of CRP thus serves as a marker for antigen-reactive (-reacted) as opposed to mitogen-reative (-reacted) T cells, suggesting that these represent separate subpopulations, and supports the developing concept that CRP play an important role in the regulation of responses critical to  inflammation, host defense, and tissue repair.


1,25-Dihydroxyvitamin D in biological fluids: a simplified and sensitive assay. A competitive binding assay for 1,25-dihydroxyvitamin D [1,25-(OH2D] in plasma has been developed in which intestinal cytosol preparations from rachitic chicks are used as the binding protein. A new method of extraction and two new chromatographic procedures are used for this assay. The method is sensitive to as little as 10 picograms of 1,25-(OH)2D, and triplicate assays can be done on 5 milliliters of plasma. This assay shows that in the plasma of normal adult subjects there is a 1,25-(OH)2D concentration of 29 +/- 2 picograms per milliliter, while none can be detected in the plasma of nephrectomized subjects and end-stage renal failure patients.


Gastric devascularization: an alternate approach to the surgical treatment of massive, diffuse hemorrhage from gastritis. During a three-year period on the surgical services at the University of Texas in San Antonio, eight critically ill patients had various types of gastric devascularization to control erosive hemorrhagic gastritis. Among these patients were two women and one child. There were five chronic alcoholics, one aspirin abuser, one severely burned patient, and one patient with sepsis. Esophagogastroscopy was used in six patients but was diagnostic in only three. All of the patients were given intensive medical preoperative care, including an average of eight units of blood each. In four of the five known alcoholics, preoperative tests showed severely deranged clotting function. All of the patients received at least a four-point gastric vessel ligation. In addition, four had gastrotomies, three had vagotomies and pyloroplasties, and two had "complete" gastric vessel ligation. There was no significant rebleeding in five patients. Of the three patients with significant recurrent gastric hemorrhage, two were chronic alcoholics with poor clotting function, and neither was considered operable. One patient, the child, had massive rebleeding one week after gastric devascularization with vagotomy and pyloroplasty and required a subtotal gastrectomy. Of the four patients who ultimately died, three were chronic alcoholics and one had sepsis.


Cerebellopontine angle meningioma presenting as subarachnoid haemorrhage. Two cases of cerebellopontine angle meningioma causing subarachnoid haemorrhage are described. Their clinical and pathological significance is discussed.


In vitro effect of thymosin on T cells from immunodepressed surgical patients. In preparation for the use of bovine thymosin, a thymic hormone, as a specific T cell stimulator in immunodepressed patients, we studied its effect on E rosette formation of peripheral lymphocytes from patients with (1) advanced malignancies, (2) extensive burns, and (3) septicemia. E rosette formation in vitro with and without thymosin was evaluated in 52 patients with carcinoma of the breast (25) or lung (27) in relation to adjuvant therapy and/or surgery. The depression of E rosettes in cancer patients was most striking when adjuvant therapy, irradiation, and/or chemotherapy were used; in 20 patients this was elevated by incubation with thymosin. There was a delay in recovery of depressed E rosette levels after radical mastectomies in four patients, recovery being accelerated by thymosin. In ten burn patients (40 to 80 percent of body surface area, second and third degree burns), the depression in E rosette levels occurred in the first week and was most marked in 3 to 4 weeks. In eight patients this was elevated by thymosin in vitro. In four septic patients, all undergoing operation, serial studies suggested that recovery from sepsis was accompanied by spontaneous rise in E rosette levels. This process was accelerated by thymosin in vitro. This study as well as previous experiments with animals suggest that thymosin may influence depressed host resistance favorably by increasing T-cell-mediated immunity.


Free internal mammary artery for coronary bypass. An improved technique of free internal mammary artery (IMA) to ascending aorta anastomosis for coronary bypass is described. A small patch vein with a suitable side branch or branches is interposed, connecting the proximal end of a detached IMA to the ascending aorta. A single or double free IMA alone or in combination with an additional saphenous vein graft was performed in 77 patients. A total of 125 free IMA grafts were done. The hospital mortality was 2-7% and late mortality 1-4%. Seventy-one of the 74 surviving patients had no angina and returned to a normal life. Postoperative coronary arteriography in 65 patients showed a patency rate of 96%. On year's experience with this technique is very encouraging. However, prolonged follow-up is necessary to determine if free IMA, as used by us, will increase the long-term patency rate.


[Antimycotic antibiotics (author's transl)]. A number of antibiotics having an antimycotic action are reviewed. The physicochemical and pharmacotoxicological properties, antifungal range, mechanisms of action, dosage and preparations of griseofulvin, amphotericin-B, natamycin, nystatin and pecilocin are discussed.


Passive immunological enhancement of muscle allografts in rats. The effect of the passive administration of antiserum obtained from recipients immunized with antigens from H-1 + non-H-1 incompatible donors on muscle allograft survival in rats was studied. In transplantation across the non-H-1 antigenic barrier (H-1 compatible but non-H-1 incompatible) a satisfactory degree of immunological enhancement was achieved. Recovery of contractile properties of muscle allografts after different immunological treatments of the recipients was compared.


[The effect of hypertonic solutions on contracture of a tonic muscle fiber]. Effect of glycerol, sucrose and NaC1 hypertonic solutions exerted on potassium contracture and resting membrane potential in isolated frog tonic muscle fibres were studied. Sucrose and NaC1 hypertonic solutions induce a stable depolarization and depress potassium contracture, while glycerol results in a transient depolarization followed by recovery of resting membrane potential and contracture reactions. The removal of 400 mM glycerol induces an insignificant depolarization and disappearance of contracture reactions, however, after the removal of sucrose of NaC1 hypertonicity both the parameters tend to restore. The isolated phasic and tonic fibres lose irreversibly potassium contracture reactions after the removal of 100 mM and 400 mM glycerol, respectively, the latter being more resistant to this procedure. Nevertheless it is concluded that the T-system is equally important for excitation--contraction coupling in tonic and in phasic fibres.


[Nuclear structures in the late oogenesis of Rana temporaria. III. Electron microscopic studies]. The ultrastructural organization of the vitellogenic oocyte nucleus (stage VI, according to Duryee, 1950) was studied in normal and in vitro hormone-stimulated maturing oocytes of Rana temporaria. At this stage, numerous nucleoli are gathered around the knot of highly contracted chromosomes (the karyosphere) thus making the karyosphere capsule. Light microscope observations reveal three zones in the capsule: a central fibrous zone separating the chromosomes from the nucleoli, a middle zone, consisting of numerous nucleoli and a distinct fibrous componen; in addition a fibrous zone on the capsule periphery is seen. The nucleoli are fibrillar, bear no proribosomal granules and do not synthesize RNA. This period is characterized by an intensive fragmentation and segregation of the nucleolar material. Numerous micronucleoli and nuclear bodies occur in the nucleus. The nucleoli are normally compound and irregular in shape to become spherical in hormone-stimulated maturing oocytes. In the central fibrous zone of the capsule, separating the chromosomes from the nucleoli, some peculiar abundant accumulations of annuli were detected lacking the membranes component. Annuli are linked with the fibrous material and are regularily packed making peculiar pseudomembranes (PMM). The chromatin is connected with PMM directly. In the middle zone of the capsule, accumulations of PMM are also seen, though less abundant and less regularly packed; along with annuli, membranous areas of various size and form are met in PMM. PMM are connected with the micronucleoli with filaments 20 nm thick. In the peripheral zone of the capsule, a variety of membranous structures is detected: intranuclear annuli lamellae, component of the capsule consists of different membranous and pseudomembranous (with annuli) structures. A question of the contribution of the chromatin material in the formation of the fibrous capsular component (PMM and membranous structures) is discussed.


Impact of BCG vaccination programmes in children and young adults on the tuberculosis problem. There is general agreement that BCG vaccination with a potent strain, when given to previously uninfected subjects, is highly effective in preventing the development to tuberculosis among them. This "direct" effect may be measured in practice in terms of the proportion of cases prevented in the age-groups in which the vaccination has been made. It is also clamined that mass BCG vaccination-especially at school-leaving age-can be expected to yield benefits not only directly, but also indirectly, by breaking the chain of transmission and so preventing the development of tuberculosis in unvaccinated subjects. This "indirect" effect may be measured, by analogy, in terms of the reduction in the numbers of cases in the age groups in which no vaccinations have been performed (the older age groups, and also young children, if BCG vaccination is given, for instance, to school-leavers). The indirect effect will be observed in terms of changes in both smear-positive and smear-negative cases. However, because smear-positive cases are the principal sources of infection, it is more meaningful to measure the indirect effect in terms of the reduction in the numbers of smear-positive (infectious) cases. The present paper falls into three parts: I. A comparison of the trends in the incidence of infectious tuberculosis in Norway, Denmark and The Netherlands. The study confirms that the substantial direct effect of BCG vaccination on the total tuberculosis incidence, which was shown by Bjartveit and Waaler, also applies to the incidence of infectious tuberculosis. II. A comparison of the trends in the incidence of infectious tuberculosis in the three countries and in different age groups over 30, and in the incidence of all forms of tuberculosis in children, in whom BCG vaccination has not been used. These comparisons suggest that the indirect effect of BCG on infectious cases of tuberculosis in persons aged 30 years and over, and on all forms of tuberculosis in children, in whom BCG vaccination has not been used, is not readily detectable, and so may not be large. However, the trends in tuberculosis incidence measure the total effects of all the policies for control used in the three countries under study. The comparisons between the three countries can therefore not isolate the "pure" direct and indirect effects of BCG from the effects of other differences between the control policies. For this reason a theoretical study of the problem has been made. III. A theoretical examination of the maximum likely indirect effect of a mass BCG vaccination policy in diminishing the prevalence of sources of infection in the population. This shows that the effect of BCG in preventing smear-positive cases in developing countries (if a constant risk of infection of about 3 per cent is presumed), is between 0.3 per cent and 2.0 per cent per year. This effect depends mainly upon the efficacy of BCG vaccine, the population covered and the duration of protection from BCG vaccination...


The antigenicity of venous allografts.

The antigenicity of venous allografts. Segments of rat inferior vena cava modified by proteolytic digestion and dialdehyde starch tanning were found to retain their ability to sensitize allogeneic recipients both in the intradermal and intra-aortic positions. Furthermore, these grafts had a very high aneurysm formation (100%) and aneurysm rupture rate (63%), even when used as isografts, suggesting that the modification procedure so damages the structural integrity of the grafts that use in clinical situations may have disastrous consequences. Clinical trials must be undertaken with great caution and a mild, brief course of immunosuppression may be indicated when modified venous allografts are contemplated in potential organ transplant recipients. Furthermore, prosthetic mesh may be required for support whenever modified allogeneic veins are used for arterial substitutes. In the absence of autologous tissue, the bovine xenograft is probably the material of choice for reconstruction or bypass of small vessels.


[Acute thrombophlebitis and phlebothrombosis of the portal vein in the postoperative period]. The symptomatology of acute thrombophlebitis and phlebothrombosis of the portal vein is described. The clinical difference between these two grave and rarely observed pathological processes in emphasized. Two observations are reported.


[Use of low-frequency currents in the treatment of severe intestinal paralysis]. Low-frequency impulse currents (Bernar current) are suggested for treatment of paralytic intestinal obstruction. The method was used in 108 patients, in whom the cause of paresis was as follows: acute purulent peritonitis, pancreatitis, operations on the abdominal aorta and its branches. In 102 patients the stimulation proved to be effective, in 6 cases of progressive purulent peritonitis no effect was gained. In a number of patients the procedure had to be repeated during 2--3 days. Generally, diadynamic currents were employed in a complex with other measures: syphon enema, paranephral blockade, cholinergics, etc. A grave cardiac pathology and oncological diseases are considered as contraindications.


[Hemorrhage after endoscopic polypectomy of the stomach]. 46 endoscopic electroexcisions of gastric polyps were performed in one case this procedure was complicated with bleeding, that would not be arrested via an endofibroscope. This operative procedure is described, and also some considerations concerning endoscopic electroexcision of gastric polyps are given.


[Arrest of gastroduodenal hemorrhage under the control of a fibroscope]. The method of electrocoagulation of gastroduodenal bleeding sources by means of a fibroscope allows a reliable and easy arresting of bleeding even in emaciated and exsanguinated patients, This method seems to be especially valuable in cases, when the source of bleeding is diagnosed only under endoscopy. In such cases a high diagnostic precision is associated with therapeutic manipulations, and in some cases it gives the chance to avoid surgery at the height of bleeding. An electrode used by the author is simple in design and readily available. Visual hemostasis, the formation of a solid crust in the hemorrhagic region and disappearance of clinical manifestations of gastro-duodenal hemorrhage may serve as a criterion of the effective arrest of bleeding.


[Evaluation of the hazard of surgical intervention at the height of gastroduodenal hemorrhage]. Based on the experimental data obtained, it was concluded that the danger of surgery at the height of the primary hemorrhage, although massive it may be, is somewhat exaggerated by surgical specialists. Recurrent in a short period of time hemorrhages are believed to be more inherent in danger than an operation in primary bleeding. The results of the experiments are supported by observations over 70 patients, operated upon for ulcerous bleeding, and in 11 patients who were subjected to surgery for profuse hemorrhage from cancerous gastric ulcers.


Differentiation of human leukemic from normal lymphocytes by Limulus serum agglutination. Human peripheral chronic lymphocytic leukemic lymphocytes and a line (B411-4) of cultured human B cells are agglutinated by Limulus serum to a significantly higher titer and score than peripheral normal human lymphocytes or a line (MOLT-4-F) of cultured human T cells.


Risk factors and coronary artery obstruction in male and female patients with aortocoronary bypass operation. In order to learn about some possible reasons for the low proportion of women among the patients with aortocoronary bypass operation (12-20%) we have compared the prevalence of hypertension, hyperlipidemia, history of smoking and chest pain in 110 women and 813 men with this surgical intervention. In spite of the similar or even higher prevalence of abnormal risk factors, the women patients showed less extensive coronary artery impairment than the male patients indicating their higher tolerance of the risk factors and lesser need for the bypass operation.


[Structural organization of nephrons in the kideny and proximal reabsorption in representatives of different vertebrate classes (according to microdissection and micropuncture studies)]. By microdissection method, single nephrons have been isolated from the river lamprey Lampetra fluviatilis, teleost fish Myoxocephalus scorpius (White sea), frog Rana temporaria, lizard Agama caucasica, hen Gallus domesticus and albino rat Rattus norvegicus (Wistar strain). Tubular reabsorptive capacity was measured in kidneys of lampreys and rats by the split oil droplet method. In the animals studied, each of the nephrons consists of the glomerulus, proximal, thin and distal segments. Relative length of the proximal segment does not depend on phylogenetic position of a species. Transtubular isotonic water reabsorption from the proximal tubule in rats is significantly higher than in lampreys. The level of proximal reabsorption is not related to the length of the proximal tubule in the Verterbrates studied but depends on the intensity of tubular transport. The structure which is similar to Henle's loop is present already in Cyclostomes [12]. Further stage of the progressive development of the uriniferous tubules is presented by uneven localization of nephron populations within the kideney in Reptiles. These data suggest that the effective system of osmotic concentration appeared in evolution not as the result of Henle's loop formation, but on the basis of the development of the medullar substance formed mainly by intercortical and juxtamedullar nephron populations.


[A direct microfluorimetric study of organic acid passage through the proximal tubule cells of the surviving Rana temporaria frog kidney]. Accumulation of acid fluorochrome in proximal tubuli in the frog surviving kidney has been investigated. Mean concentration of fluorochrome in the tubuli is linearly related to the duration of incubation. Changes in the mean rate of transport of fluorochrome into the tubuli induced by changes in its external concentration are satisfactorily described by Michaelis-Menten equation, Michaelis constant being equal to 2.1-10(-4). Some equations are suggested which describe the kinetics of organic acid transport across basal and apical membranes of cells.


[Distribution of three types of muscle fiber in the skeletal muscles of Rana temporaria frogs (according to histochemical findings)]. On 15 skeletal muscles with different functional profile (flexors and extensors, trunk muscles and muscles of the head) and different embryonic origin (somatic and visceral), it has been shown that muscles of R. temporaria are mixed. Muscle fibers are divided into three groups which differ in the content of lipids, the activity of succinic dehydrogenase and localization of myofibrils on a cross section. On the basis of the data obtained and those in literature, these fiber groups are qualified as phasic, tonic and transitional (slow phasic) ones. Both phasic and tonic fiber groups are uniform, whereas transitional fibers form a broad specturm. Most of the muscles studied contain all the three types of fibers. In muscles of the extremities (especially in flexors), tonic fibers together with transitional ones usually form more or less compact bundles. The highest content of tonic and transitional fibers was found in muscles which do not directly participate in locomotion. If muscles contain only two types of fibers (phasic and transitional ones), these fibers form a mosaic structure.


[Resistance to heating and trypsin of glutamate dehydrogenase from liver mitochondria of frogs differing in thermotaxis]. The resistances to heat and trypsin hydrolysis served as indirect indices of conformational flexibility of glutamate dehydrogenase molecules. No difference in heat resistance was found between crystalline eletrophoretically homogeneous preparations of glutamate dehydrogenase from liver mitochondria of two species of frogs, the more southern Rana ridibunda and the more northern R. temporaria. However, glutamate dehydrogenase from R. ridibunda is digested by trypsin at a lower rate than that from R. temporaria, which may be explained by its lower conformational flexibility. Therefore positive correlation between conformational flexibility of glutamate dehydrogenase and mean ambient temperature of the species studied is revealed only with respect to resistance to proteolysis.


[Gastrontestinal hemorrhage following thoracic surgery]. The authors discuss eight cases who suffered hemorrhaging stress ulcers out of 200 cases on whom Thoracotomies were performed. Presented is the common factor of the onset of this complication, it's diagnosis, and therapy. Listed below are the diagnoses and operative procedures used on these eight patients. Cysta Aerea Permagna Lobi Inf. Pulm. Dexter/operation: Mytomis Longitudinalis Ooesophagi. Caverna Bronchiectatica Permagna Lobi Inferior Pulmo Dexter/operation: Lobestomia Typica. Echinococcus Heaptis Complicatus, Empyema Pleurae Dexter/opetation: Decorticatio. Haemathorax Spontaneous Lobus Sinister/operation: Decorticatio Pleurae Sinister. Echi Comp. Cupolae Hepatis Permagnus/operation: Thoracotomia Phrenotomia, evacuatio, Triplex Drainage. Bronchiectasiae Lobi Medius et Inferior Pulmo Dexter/operation: Biblobectomia Typica. Carcinoma Bronchi Lobi Inferior Pulmo Dexter/operation: Lobectomia Typica. Gastric problems had troubled four of these eight patients in their past history. Bleeding in three patients occurred three days postoperatively, and in the remaining five, thirty days following their operation. Six patients had to be treated conservatively because of serious contraindications to reoperation. Four of them expired. Autopsy revealed: Pyothorax, Dehiscention Bronchi, Empyema, and Gastritis Errosiva with multiulcerations, hemoragia, and dilatation of the right heart. Two patients with recent stress ulcers were reoperated on, and were cured. The authors estimate that the occurrence of hemorrhaging stress ulcer following thoracic surgery are basically due to Hypoxia. The chain of events whic brought about the stress ulcer, however, began even before the operation, continued throughout the operation, and appeared postoperatively due to postoperative complications. The authors point out that these complications can be foreseen (early and late), but firstly, an attempt should be made to treat the patient with conservative therapy. Inasmuch as the hemorrhaging does not respond to conservative measures, conservative surgery is indicated; Suture and Vagotomy, and eventually pyloroplasty.


[Anuria caused by mercury poisoning (apropos of 15 cases)]. 15 cases of acute renal failure following ingestion of bichloride of mercury were studied at Pahlavi medical center, university of Teheran, between 1962 and 1972. All the patients admitted suicide attempts. All had oliguria and uremia except one, in whom oliguria was moderate without azotemia. There were four deaths among the 15 patients, three of them with gastrointestinal hemorrhage; secondery infection and the prolonged acute uremia probably were the cause of death in another one. Early administration of B. A. L. and early frequent hemodialysis helps to support the patient through the period of oliguria and possibly to remove the mercury B.A.L. Complex. Although the mortality of mercury intoxication has decreased, gastrointestinal hemorrhages and secondery infections make its prognosis still unfavorable.


[Circadian cycles of wakefulness and rest in Rana temporaria frogs]. In the diurnal activity of the frog R. temporaria, rest and awakefulness stages were investigated. Resting stage was differentiated into daily and nocturnal phases. During daily rest, plastic tone in neck muscles was registered. During this phase, the head might be subjected to unnatural position which is maintained for a certain period. The heart rate was minimal, respiration could not be recorded. During nocturnal rest, in contrast to daily one, the animal changed its positon when touched at the head and kept itself in this positon. Cardiac contractions exhibited evident rhythmicity. Sleep episodes were rare and occasional; they were accompanied by eye closing and relaxation of the body.


Ventriculography with methylglucamine iocarmate (Dimer-X). Experimental and clinical study. In an attempt to study the use and value in ventriculography of meglumine iocarmate (Dimer-X), previously accepted as a water soluble contrast medium safe for myelography, we have conducted animal experiments to compare Dimer-X with megulumine iothalamate (Conray 60) and meglumine diatrizoate (Angiografin). We also made clinical studies of Dimer-X. In  the animal experiments, 1.5 ml and 2.0 ml of Dimer-X were injected into the ventricles of 7 dogs. We noted the apparent superiority of Dimer-X over Conray 60 and Angiografin as far as side effects were concerned, but there were no particular differences in the intensities of the ventriculograms obtained. Morphological studies of the ventricles and histological examinations of the ventricular walls 1 month after intraventricular injections of Dimer-X showed no abnormalities. In the clinical studies, ventriculography with 1-5 ml Dimer-X, performed on 17 cases, aged 8 months to 62 years, with diseases of the central nervous system, produced ventriculograms of good diagnostic value with no side effects, such as convulsions, apart from mild headache or vomiting in 4 instances.


Cerebellopontine angle tumours, other than acoustic neuromas. A report on 34 cases. A presentation of 7 bilateral acoustic neuromas. The symptoms, preoperative diagnostic results and histological findings in 34 cerebellopontine angle tumour cases, other than acoustic neuromas, are presented. The meningeomas dominate by far this group of tumours. The symptomatology is much less uniform than that of the acoustic neuromas, where the VIII nerve is dominant. The facial nerve is less involved, whereas the other cranial nerves give symptoms more frequently. One remarkable sign is the presence of severe trigeminal neuralgia, which we have not encountered in acoustic neuromas. Only 35% of the 'non-neuroma' patients had elevated spinal fluid protein, compared with 100% in our acoustic neuroma cases. Furthermore, 7 patients with bilateral acoustic neuromas are presented. The connection with von Recklinghausens disease and multiple meningeomas is discussed.


Some cellular aspects of chronic inflammation in joint disease. We have examined the nature of some mononuclear cells from inflamed synovial membranes of patients with rheumatoid arthritis. It was found that cells which remained in the supernatant medium after overnight culture of trypsinized tissue contained a variable number of lymphocytes which were shown to be T cells by rosetting and mitogen response. This suggests a source of T cell lymphokines with an effect on macrophages and thus a role in the maintenance of inflammation. Another role for mononuclear cells is suggest by the cytotoxicity of blood mononuclear cells directed against cultured synovial cells. This was found to occur in an autologous system using fibroblasts from rheumatoid synovium, but was not specific for rheumatoid arthritis. Stimulatory factors from rheumatoid joint effusion macrophages for blood lymphocytes were sought, but although blast transformation occurred, the results were equivocal. In this communication we set out to examine the nature of lymphoid cells in the synovial membrane and the role which they may play in the pathogenesis of chronic inflammation. We also briefly consider cell-mediated mechanisms of tissue injury. Since an active role of lymphoid cells pre-supposes the presence of an agent or agents which serve to stimulate them, we also report some recent attempts to find evidence for this. One of the striking histological features of the inflamed synovial tissue in rheumatoid arthritis, but also in some other forms of chronic arthritis, is the presence of lymphocytes and plasma cells. Immunofluorescent studies and organ culture studies have shown the presence and synthesis of immunoglobulins, predominantly the domain of plasma cells. The production of immunoglobulins, formation of complexes and activation of complement is a major factor in pathogenesis, but lymphocytes may also have a direct role through the production of lymphokines. Until recently these substances have been attributed to T lymphocytes, but Rocklin et al. (1) have recently shown that B cells may also be involved in certain experimental circumstances. The availability of synovectomy specimens from patients with rheumatoid arthritis has enabled us to examine the nature of lymphoid cells from synovial membranes. (This part of the work is reported fully elsewhere.


Adjuvant-induced arthritis in four inbred strains of rats. An in vitro study of peripheral T and B lymphocytes. The lymphoblastic response (LTT) to non-specific mitogens (PHA, PWM and ConA) of peripheral lymphocytes was investigated at days 0, 7, 14, 21 and 28 after adjuvant injection in four strains of inbred rats: Wistar (WAG), Long Evans (LE), Lewis (LEW) and Brown Norway (BN). LTT was assessed by using 18 hours H3 TdR incorporation in 5 days cultures of whole blood (micromethod). The statistical treatment of data, using principal components multifactorial analysis and analysis of variance showed a striking difference between strains. In control animals the responses to PHA and PWM were correlated and were higher in LE and WAG than in LEW and BN (BN=LEW less than LE=WAG). The response to ConA was independent of that to the other mitogens. It was generally low, but significantly higher in LEW and BN than in WAG and LE. In adjuvant-injected animals the responses to PHA and PWM were still correlated, but modified compared to control: in LE and LEW, but not in WAG and BN, a marked decrease of the response was found, reaching a minimum value within days 7 and 14. In the same time the response to ConA increased in the four strains, later in LE than in the others. However the intensity of the ConA response varied from one strain to another: it was constantly low in LE and WAG compared to LEW and BN. So the most striking modification of LTT were observed in LE and LEW, which both developed the most severe arthritis. However these different behaviours after adjuvant injection were not explained by the initial level of LTT to the different mitogens. These data suggest that the development of intense arthritis is associated with the proliferation and the release into the blood stream of a lymphocyte subpopulation, which exhibits a low response to PHA and PWM and a high response to ConA. These LTT modifications are not paralleled by quantitative variations of B-cells assessed by surface Ig immunofluorescent staining and EAC rosetting.


[Protein study on perilymph susbstitution during cerebrospinal fluid flow through cochlear aqueduct]. Total protein contents in the perilymphy of Scala vestibuli and Scala tympani as well as in the cerobrospinal fluid (CSF) of guinea-pigs were determined, by which specimens were taken under the following various conditions: With or without subarachnoidal puncture before perilymph collection, by varying the amount of perilymph taken from Scala tympani, by fractionating collection and under post mortem condition. The results suggest that under physiological conditions the CSF also flows through the cochleae aqueduct and the protein concentration in the Scala tympani decreases especially in the basal winding. Because the protein content in CSF is inaverage four times lower than in fluids of the inner ear it is of preference to consider the question of connection between the CSF and the fluids of the inner ear. In the specimens taken the blood contamination was estimated on the basisof erythrocytes in the connection capillaries under microscope. The protein content in the perilymph of Scala vestibuli was found significantly higher in relation to perilymph of Scala tympani.


Unrelated delayed hypersensitivity reactions accelerate the recovery of immunological responsiveness of specifically depleted cell populations. Normal CBA mouse spleen cells were specifically depleted of cells spontaneously reacting to pigeon erythrocytes (PRBC) by two methods, the first allows specific depletion of anti-PRBC thymus derived (T) rosette  forming cells (RFC) whereas the second depletes bone marrow derived (B) anti-PRBC hemolytic plaque forming cells (PFC). Depleted populations transferred into lethally irradiated syngeneic recipients and stimulated with PRBC failed to develop any significant response but they normally responded to a stimulation with sheep erythrocytes (SRBC). When spleen cells were taken from mice skin painted with picryl (trinitrophenyl: TNP) chloride 12 days before and the recipients were challenged in the same way and stimulated with PRBC, they become capable of producing a definite response to this antigen. Moreover in these animals, a consistent although low number of cells was found, which simultaneously reacted to both native PRBC and TNP conjugated SRBC. These findings show that unrelated delayed hypersensitivity reactions promote the immunological recovery of specifically depleted cell populations.


Factors which determine the accumulation of immunoblasts in gut and skin. The capacity of immunoblasts from two sources (1) peripheral lymph nodes draining the site of application of a contact sensitizer and (2) mesenteric lymph nodes from mice infected with the gut parasite T. spiralis to migrate to the gut and to inflamed skin sites were compared. The peripheral lymph node blasts readily entered skin sites in a non-specific way but failed to migrate to the gut even when inflammation was induced. By contrast, the mesenteric lymph node blasts readily migrated to the gut in normal mice and in increased amounts to the gut of mice infected with T. spiralis or inflamed with oral turpentine. A small proportion of mesenteric lymph node blasts did, however, migrate, non-specifically to the skin but in much smaller amounts than peripheral lymph node blasts. We conclude that the migration of immunoblasts to the gut has some specificity related to the source from which the cells were taken but little specificity with regard to intraluminal antigen.


Autoantibodies in D-penicillamine treated rheumatoid arthritis. The D-penicillamine (D-Pen.) treatment can induce some diseases accompanied by autoantibodies: lupus, pemphigus, myasthenia. The authors present the results of a systematic study of autoantibody occurrence during D-Pen.-treatment of the rheumatoid arthritis (RA): (1) Anti-nuclear antibodies are slightly positive in 34% of the untreated RA. They appear or enhance in 44% of the treated patients (22/50). They reach high titers (1/500) in two clinical-induced lupus and in three asymptomatic cases. (2) Anti-native DNA antibodies are not found in untreated patients. They become markedly enhanced in two clinical lupus as in three asymptomatic cases (3/50). (3) Anti-epidermal intercellular substance-antibodies are absent in non-treated as well as on pemphigus-free treated patients (0/40). They are slightly elevated in 5 induced pemphigus. (4) Anti-striated muscle antibodies are absent in non-treated patients, rarely and moderately elevated (3/40) in the asymptomatic D-Pen.-treated group. These findings could have a practical interest for the survey of the treatment.


Fatal hemorrhage complicating carcinoma of the esophagus. Report of four cases. Four cases of esophageal carcinoma complicated by fatal hemorrhage are reported. All four patients had recently completed radiation therapy. An aortoesophageal fistula was present in two cases; fibrinoid necrosis of the esophageal arteries was present in the other two. The esophageal tumor was localized in two cases and had disappeared in one case. In one patient it had metastasized widely. Ninety-nine other reports of esophageal cancer and fatal hemorrhage are reviewed from the literature. Aortoesophageal fistula was the cause of hemorrhage in 78 cases. Occlusion of the vasa vasorum by thrombosis, inflammation, neoplastic cells or radiation injury appears to be the cause of aortic necrosis and fistula formation. Prompt surgical approach, if possible, should be used to control hemorrhage, as the primary tumor may be localized to the esophagus only.


Mental retardation in a national population of young men in the Netherlands. II. Prevalence of mild mental retardation. The prevalence of mild mental retardation in 19-year-old survivors of male births during 1944-1947 is derived from military records. The data are singular in that they are national, virtually complete for a total population of more than 400,000 men and include attributes not previously examined. They allow for the simultaneous use of three criteria: education (history of special schooling), psychometric (Raven intelligence test score), and clinical diagnosis (ICD (1948) 325.2, 325.3), which yielded rates per 1000 of 30,58 and 61, respectively. Rates by all three criteria varied in similar fashion with father's occupation and with religious affiliation. Rates by the psychometric and diagnostic criteria were higher for rural- and urban-born, while rates by the special schooling criterion were lower for rural-born. These variations are presumed to indicate deficiencies in rural provisions of special schooling on the one hand, and a substantive increment in "true" prevalence on the other. Marked variations in rates by province are not accounted for by social class and urban/rural birthplace. A rise in rates in the 1947 birth cohort on the psychometric and diagnostic criteria but not on the schooling criterion is attributable to a scoring change in the IQ criterion. Relative risks are estimated for the psychometric criterion of low Raven test score according to father's occupation, urban-rural origin, and religious affiliation. The overlap of identification among individuals designated by one, two, or three of the criteria is examined, and the issue of labeling is explored.


Alpha 1 antitrypsin M1: a new common genetically determined variant. A new common variant (M1) of alpha 1 antitrypsin was detected by isoelectric focusing of serum in a pH gradient of 3.5-5.0 in polyacrylamide gels. The variant can be clearly distinguished from the common M type only when alpha 1 antitrypsin M is present in the same serum. It cannot be recognized on starch gel electrophoresis. The gene frequency in a population sample of United States whites was .09.


A behavioral classification of welfare children from survey data. From survey data on 1000 urban Welfare AFDC children aged six to eighteen, a hierarchical cluster analysis yielded six distinct behavioral types of Welfare children. Characteristics of each type, and its relationship to treatment, ethnicity, and other variables are discussed. Advantages of this system of behavioral classification for research and population assessment are outlined.


[Prevention of microaggregation in stored blood (author's transl)]. Microembolism is still a feared complication during and after blood transfusions. Up to now they could only be diminished by special filter systems. In spite of much research it has not been possible as yet to fine adequate remedies for the preservation of blood cells and for the decrease of aggregation in stored blood. As foregoing studies have shown the inhibition of aggregation is combined with a considerable impairment or even loss of platelet function. In these clinical experiments, however, it has been shown, that aggregations in stored blood are significantly stunted by early addition of Aprotinin. It is clinically important, that no inhibition of platelet function occured.


[Histiocytosis X (author's transl)].

[Histiocytosis X (author's transl)]. Two cases of histiocytosis X shown by clinical observation as forms of Abt-Letterer-Siwe are presented. Both have a high score following the scale on Lahey, according with the young age of the patients. Both had a very bad evolution. Treatment applied on each case, as well as the possibility and need to arrive at an early diagnosis is discussed.


The local anesthetic activity of tetrodotoxin alone and in combination with vasoconstrictors and local anesthetics. Tetrodotoxin (TTX), alone and in combination with various vasoconstrictors and local anesthetics, was evaluated for its ability to produce peripheral nerve blocks in the rat and central neural blocks in the cat and dog. High frequency and long duration of block can be attained if sufficiently high concentrations of TTX are used, although latency is long and high dosage may produce systemic toxicity. Frequency and mean duration of block can be increased and systemic toxicity reduced if TTX is administered with a vasoconstrictive agent. Conventional local anesthetics also enhance the nerve-blocking activity of TTX. When appropriate concentrations of TTX and local anesthetics are used, a high frequency of blocks characterized by short latency and long duration can be demonstrated. The studies present some indirect evidence that local anesthetics enhance TTX activity by reversibly increasing the permeability of various neural barriers to TTX.


Aspects of treatment. The anatomical basis for portal decompressive surgery. Definitive surgical techniques used in the treatment of portal hypertension all aim to achieve portal venous decompression. The historic development of the various procedures currently employed provides a broad repertoire of surgical operations. Each of the procedures merits consideration and may be specifically indicated in a given situation. Description of the operative steps emphasizes the importance of the anatomical relationships of the various structures.


Anaesthesia for injection of bleeding oesophageal varices. Patients with haemorrhage from oesophageal varices associated with portal hypertension are poor risks for anaesthesia and surgery. One method of controlling such haemorrhage is injection of the oesophageal varices (sclero-therapy) via an oesophagoscope. Careful preoperative preparation and use of the Sengstaken-Blakemore tube in combination with the anaesthetic technique of intermittent Althesin and suxamethonium with artificial ventilation with nitrous oxide and oxygen enables sclerotherapy to be carried out successfully.


[2 cases of "ganglionic sinusal histiocytosis". A new term in cervical and rhino-pharyngo-laryngeal pathology?]. By 1974, Rosai, who is keeping a world-wide register of a condition described for the first time in France by Destombes, had collected 60 cases: the condition is called ganglionic sinusal lipid histiocytosis. The disease manifests itself principally in the form of adenopathies, usually cervical adenopathies, showing intermittent development over several years. It is rarely found in the viscera. The authors describe two cases, one typically confined to the ganglia, the other naso-ganglionic.


Yeast-like fungi recovered from normal human skin in Nsukka (Nigeria). The incidence of yeast-like fungi on normal skin was investigated in 52 healthy Nsukka individuals comprising 21 adults, 24 children, and 7 infants. Eighty-six isolates of yeasts and 2 of Geotrichum candidum were recovered. The yeasts included Candida tropicalis-36 isolates, C. guilliermondii-3, C. parapsilosis-2, Candida spp. (unidentified)-16, Cryptococcus albidus-6, Trichosporon cutaneum-7, Trichosporon spp.-8 and Rhodotorula spp.-8 isolates. The isolates originated from various sites, predominantly from nails and finger clefts. The significance of the findings is discussed with particular reference to the absence of C. albicans and the frequent isolation of C. tropicalis, T. cutaneum and C. albidus.


[A biochemical and cytological explanation of cochlear otospongiosis]. Carrying on their study about the enzymatic activity of the otospongiotic micro-foci and the hydrolytic activity of the perilymph, the authors present their work concerning the value of trypsin and alpha-1-anti-trypsin in the perilymph of otospongiotic patients operated on by stapedectomy. They describe the method used and give the obtained results which permit to believe that the values of trypsin, and a contrario of anti-trypsin, appear to constitute an index of the severity of the progression. Moreover, the authors have investigated the eventual toxic action of various trypsin concentrations on the hair cells of the Corti organ in the guinea-pig. This study has been carried through successfully by means of the electron microscopic scanning method which allows to obtain an "electron cochleogramme in situ". They explain the method and come to the conclusion that the intensity and extension of the Corti hair cells alterations in a cochlea receiving a perfusion with trypsin solutions, are tightly related to the trypsin concentration. However, they do not pretend so far that these results reflect exactly the anatomo-pathologic reality during the slow progression of otospongiosis towards cochlear deterioration. These two series of experimentation appear to confirm their enzymatic concept of otospongiosis: the long, slow and extremely capricious progression of the disease is the duplicate of its cytologic progression, the contact between hydroltic enzymes and Corti cells having the same capricious character. These findings perfectly corroborate the previus ones they made in this field, as well as the correlations they have established between hydrolytic activity of the perilymph and audiometric progression. Consequently, they believe that the mechanism of the otospongiotic disease is provoked by the rupture of the balance trypsin/anti-trypsin in the otospongiotic micro-foci and thus in the inner ear fluids.


L-Sorbose metabolism in Agrobacterium tumefaciens. The pathway of L-sorbose metabolism in Agrobacterium tumefaciens strain B6 was determined to be: L-sorbose leads to D-glucitol (sorbitol) leads to D-fructose leads to D-fructose-6-phosphate leads to D-glucose-6-phosphate. The reduction of L-sorbose and the oxidation of D-glucitol were mediated by NADPH- and NAD+-linked oxidoreductases, respectively. The intermediates, D-glucitol and D-fructose, were isolated from in vitro reaction mixtures by column chromatography on Dowex 1-borate, and identified enzymatically. D-Fructose was identified chemically by its 1H-NMR spectrum and the IR spectrum and the melting point of the fructosazone. D-Glucitol was characterized chemically by the melting point and the IR spectrum of its hexaacetate. A. tumefaciens ICPB TT111, a representative of another genetic race of Agrobacterium, lacked L-sorbose reductase and therefore failed to grow on L-sorbose; it grew normally on D-glucitol.


Nematophagous fungi: new species of the Lagenidiales endoparasitic on Rhabditis. Two new species of the Lagenidiales endoparasitic on the nematode Rhabditis are reported from Ontario soils. In Myzocytium lenticulare the biflagellate zoospores encyst at any point on the cuticle of the host and penetrate directly through the wall. Sexual reproduction in this species is by oogamy. The antheridial protoplast migrates through a pore in the adjacent wall and fuses with the oogonial protoplast to produce a thick-walled reticulate oospore. In Lagenidium caudatum large biflagellate zoospores encyst at or near the body orifices of the host. Many of the zoospores possess a distinct tail-like appendage. Germination tubes from the encysted zoospores penetrate the body orifices to infect the host. The thallus in this species is distinctive in being composed of narrow, irregular hyphae which fill the host. No sexual stage is known.


Differentiation of pathogenic species of Candida by their recovery characteristics following ultraviolet irradiation. Each of seven pathogenic species of Candida exhibits a unique pattern of light and dark recovery responses to ultraviolet irradiation. C. guiliermondii, C. parapsilosis and C. pseudotropicalis photoreactivate whereas C. albicans, C. krusei, C. stellatoidea and C. tropicalis do not. Within each of these groups, individual species are distinguishable by whether or not they express differential dark recovery during postirradiation growth at 25 C or 37 C on oxidative vs fermentative carbon sources, on inorganic vs amino acid nitrogen sources or in the presence rather than absence of ergosterol. Equivalent recovery patterns are obtained for species of Candida and the ascosporogenous species which are their corresponding perfect forms. These observations indicate strongly that the post-irradation recovery is a reliable, species-specific characteristic of yeasts.


On the contribution of the acrylate pathway to the formation of propionate from lactate in the rumen of cattle. The effect of chloral hydrate, an inhibitor of methanogenesis, on the participation of the acrylate pathway in the formation of propionate from lactate in rumen contents of cattle was studied in vitro. Addition of chloral hydrate resulted in only a small stimulation of the acrylate pathway, much lower than the stimulation of propionate production by chloral hydrate. This means that the flux of carbon through both the acrylate and the dicarboxylic acid pathway is increased during chloral hydrate feeding. The influence of time of sampling after feeding on the contribution of the acrylate pathway was studied in a separate experiment. A marked drop in the participation of the acrylate pathway in propionate formation from lactate during at least 2 h after feeding was observed, whereafter a rapid rise to prefeeding levels occurred.


Purification and properties of two fructose-6-phosphate phosphoketolases in Bifidobacterium. Fructose-6-phosphate phosphoketolase was purified from type strains of two species of the genus Bifidobacterium: B. globosum and B. dentium. The first species has a preferred "animal" habitat, like feces of animals and rumen of cattle; the latter is harboured in "human" habitat, like feces and dental caries of man. Two electrophoretic types of phosphoketolase (F6PPK) were previously distinguished and called "animal" and "human" type according to the habitat of the bifid organism. The purified preparations of these two phosphoketolases displayed very different optimum pH range, metal activator and molecular weight; outstanding difference was found in the substrate specificity: the enzyme from B. globosum was able to split xylulose-5-P as well as fructose-6-P, whereas the phosphoketolase from B. dentium appeared to be specific for fructose-6-P.


Oxidation of ethylene by soil bacteria.

Oxidation of ethylene by soil bacteria. The course of the biological oxidation of ethylene by soil was dependent on the type of soil used as well as on other factors. As evidenced from an increase in oxidation rate, the ethylene-consuming microorganisms in soil could grow at the expense of ethylene, even when the gas was present at concentrations of 50 ppm or less. Five strains of bacteria strongly resembling each other were isolated from different soils. These pleomorphic, gram-positive, acid-fast, obligate aerobic, ethylene-oxidizing bacteria grew also on saturated alkanes and on ordinary carbon sources. An apparent Km for ethylene of approximately 40 ppm was estimated for whole-cell suspensions of strain E20 by following the disappearance of the gas from the atmosphere.


Antibacterial activity of delta9-tetrahydrocannabinol and cannabidiol. The minimum inhibiting concentrations (MIC) of delta9-tetrahydrocannabinol (THC) and cannabidiol (CBD) for staphylococci and streptococci in broth are in the range of 1-5 mug/ml. In the same range, both compounds are also bactericidal. In media containing 4% serum or 5% blood the antibacterial activity is strongly reduced (MIC 50 mug/ml). Gram-negative bacteria are resistant to THC and CBD.


Immunologic responses in patients with lepromatous leprosy. Immunologic responses were measured in 46 patients with lepromatous leprosy. These patients were not distinguishable from controls on the basis of responses to soluble intradermal antigens, sensitization to contactants, peripheral blood T- and B-cell percentages, in vitro lymphocyte responses to a mitogen, or the prevalence of autoantibodies. Generalized immunologic abnormalities in patients with lepromatous leprosy are neither predisposing causes nor necessary accompaniments of lepromatous leprosy, but are probably remote sequellae of the illness. By implication, the generalized immunologic abnormalities reported in other diseases are likely to be remote sequellae of the particular illness.


Administration of antirheumatic drugs.

Administration of antirheumatic drugs. A study of 200 rheumatic patients attending an outpatient clinic and 72 general practitioners (GPs) was undertaken in relation to the administration of antirheumatic drugs. (1) Both patients and GPs agreed that effectiveness, absence of toxicity, and once daily administration were the important features of administration. (2) Significant differences between GPs and patients were noted in that patients more frequently preferred capsules than tablets. (3) GPs thought red was the best colour for an antirheumatic tablet, whereas patients thought white, this opinion being partly determined by the possible confusion of red tablets with sweets by children. (4) In a survey of 174 outpatients with rheumatic diseases, those with rheumatoid arthritis did not like blister packaging. A detailed assessment of 30 patients with rheumatoid arthritis in hospital confirmed this. Patients with moderate or severe rheumatoid disease of the hands often could not extract tablets from blister packs. Those who could found the packs difficult to open, the tablets broke, and came out suddenly, falling to the floor.


Relationship of phytohaemagglutinin-induced lymphocyte transformation to disease activity in systemic lupus erythematosus. Phytohaemagglutinin-induced lymphocyte transformation was studied in 19 patients with systemic lupus erythematosus (SLE) in relation to disease activity, peripheral blood lymphocyte count, serum iron and folate levels, and corticosteroid treatment. Similar studies were performed on a group of 28 age- and sex-matched controls and on 10 patients with facial palsy who were examined before and after 7 days of high-dose corticosteroid treatment. The patients with SLE were found to have an impairment of lymphocyte transformation which was most marked in active stages of the disease and associated with a lymphopenia. This depressed transformation, which improved with the development of a remission, could not be attributed to the effects of corticosteroid treatment, inhibitory serum factors, iron deficiency, or any numerical reduction in blood lymphocytes, thus indicating along with evidence from other sources that SLE patients have a defect of cell-mediated immunity. The aetiological implications of these findings are discussed.


Drug-associated deaths of medical inpatients. Of 7,423 medical inpatients, 16 (0.22%) died of drug-associated causes. The overall mortality for all medical inpatients was 6.5%. Eleven of the 16 patients who died of drug-associated causes had been terminally ill; the rest had been seriously ill before the fatal drug reaction occurred. Half of the patients had had either hematologic malignant changes or lupus nephritis. Antineoplastic drugs, azathioprine, prednisone, and heparin sodium were the most frequently implicated drugs. In other studies, we have found widely differing incidences of fatal drug reactions, due to a number of different drugs; these disparities are probably related to variations in the types of illnesses amoung different hospital populations and to varying interpretations of the term "drug-associated death." Extrapolation from the available data to a national incidence of drug-associated deaths is not possible. Drug-associated deaths are relatively uncommon and usually occur in the cases of severely or terminally ill patients treated with potentially highly toxic drugs.


Aortoenteric fistula. A complication of renal artery bypass graft. The incidence of gastrointestinal bleeding secondary to aortoenteric fistula has increased in recent years consequent to more frequent aortic reconstructive procedures. It is necessary to approach any such patient with this diagnostic consideration in mind, since early specific therapy may decrease the mortality. In this setting, there is usually sufficient time available to perform definitive tests to establish the correct diagnosis. We report a 37-year-old patient in whom aortoenteric fistula developed following a renal artery bypass graft.


Rhodopseudomonas sphaeroides forma sp. denitrificans, a denitrifying strain as a subspecies of Rhodopseudomonas sphaeroides. From polluted water of a lagoon pond a new type of denitrifying photosynthetic purple bacteria was isolated. With respect to morphology, fine structure, photopigments, requirement for growth factors, the range of utilization of organic substrates for phototrophic growth and DNA base ratio, the denitrifying strains show the closest resemblance to Rhodopseudomonas sphaeroides and were therefore described as a subspecies named R. sphaeroides forma sp. denitrificans. The new isolates grow well with nitrate anaerobically in the dark accompanying the evolution of nitrogen gas. They cannot assimilate nitrate as the nitrogen source for growth.


[Alpha-1 antitrypsin and idiopathic respiratory distress of the newborn infant. Study in serum and lungs]. Serum level of alpha-1-antitrypsin is significantly reduced in newborns with idiopathic respiratory distress when compared to matched controls. This decrease was predominantly due to the group of infants who died from I.R.D., provided that alpha-1-antitrypsin determination was carried out on the first day of life. Alpha-1-antitrypsin was demonstrable by indirect immunofluorescence in hyaline membranes whereas fluorescence was negative in the alveolae of infants who had no hyaline membranes.