Immuneglobulin investigations in inflammatory diseases. 1. The agar electrophoresis of the cerebrospinal fluid and the quantitative immune globulin determination contribute essentially to an assessment of the immunity state in inflammatory diseases of the CNS. 2. It is necessary to distinguish protein augmentation due to brain-barrier disturbances (accompanying proteinosis of the cerebrospinal fluid), which we find in metabolic and traumatic diseases, from a genuine increase in cerebrospinal fluid protein. 3. Autochthonous formation of cerebrospinal fluid protein can be demonstrated by means of quantitative IgG, IgA and gamma3-globulin determination.


[Prophylaxis and therapy with gamma globulin. General characterization and clinical use of gamma globulin preparations]. For accurate evaluation of the usefulness of gamma-globulin treatment, the clinical indications for passive immune prophylaxis and immunotherapy and the specific characteristics of commercially available gamma-globulin preparations have to be considered. Detailed investigations of currently used gamma-globulin preparations have shown that as yet no ideal product is available. Classical standard gamma-globulin and, in particular, enzymatically treated (Gamma-Venin, Veinoglobuline) or chemically modified preparations (Gamma-Globulin i.v. SRK, Intraglobin) for intravenous use have some deficiencies and involve potential risks for the patient. Nor is the infusion of "fresh frozen plasma" a safe and generally applicable alternative to the use of gamma-globulin concentrates. Thus from the outset the preconditions for effective treatment with gamma-globulin are not optimal. Standard and hyperimmune preparations, given once intramuscularly, are suitable for the prophylaxis of viral and bacteriotoxic diseases. In patients apt to react abnormally it is important to distinguish clearly between the few accepted indications and those that are more doubtful. Anti-D immunoglobulin is essential for the prevention of Rhesus sensitization after the delivery of a Rhesus-positive child. In general, gamma-globulin is recommended for substitution therapy and for the prophylaxis of recurrent acute bacterial infections in patients suffering from transient, congenital and acquired antibody-deficiency states. In such cases, high doses of an intravenously administrable preparation with a relatively long biologic half-life are recommended. The evidence for the effectiveness of gamma-globulin treatment of bacterial infections in patients without manifest disturbance of humoral immunity is equivocal. This is true, for example, of the oft-recommended combined use of antibiotics and high doses of intravenous gamma-globulin which is said to provide optimum antibacterial and antitoxic protection. There is even less chance of obtaining beneficial effects if gamma-globulin is given as an "ultimo ratio" in severe generalized bacterial infections resistant to antibiotic treatment. Localized and predominantly chronic infections are barely influenced by gamma-globulin. It is still too early to make a final assessment regarding the place and value of immunoglobulin concentrates for prophylactic and therapeutic purposes. This will only be possible if a preparation becomes available which contains all immunoglobulins in a biologically optimum state and concentration, is well tolerated and can be given in adequate doses both intramuscularly and intravenously.


Mirex in the environment: its degradation to kepone and related compounds. The chlorocarbon mirex undergoes slow, successive loss of chlorine in the field to a series of related compounds that had lost one or more chlorine atoms. Soil samples were recovered 12 years after treatment at 1 part per million (ppm), and ant bait was recovered 5 years after an aircraft crash. As much as 50 percent of the original mirex was recovered at levels of about 0.5 and 640 ppm, respectively. Kepone was present at levels of 0.02 ppm in soil and 10 ppm in the bait or up to 10 percent of the recovered mirex, as determined by combined techniques of chromatography and mass spectrometry. This constitutes the first observation of the degradation of mirex in nature, and demonstrates a pathway for its eventual disappearance from the environment.


Revertants of human cells transformed by murine sarcoma virus. Revertants of nonproducer human osteosarcoma (NP/KHOS) cells induced by Kirsten murine sarcoma virus were isolated after incubating at high temperature (40.5 degrees C) overnight and subcloning at 36 degrees C. The morphologic variants, from which murine sarcoma virus could no longer be rescued, had growth properties similar to those of the nontransformed, parent human osteosarcoma cells and did not release RNA-dependent DNA polymerase activity. These revertants were nontumorigenic in nude mice. The revertants supported leukemia virus growth and showed an enhanced sensitivity to murine sarcoma virus superinfection. Thus, the revertants were from human cells transformed by an oncogenic RNA virus.


Antinuclear antibodies (ANA): immunologic and clinical significance. The methods currently used for the detection of ANA have been analyzed, with emphasis on their practical application to the diagnosis of the CTD. The use of the indirect IF-ANA test was recommended as a screening procedure to detect ANA. The need to standardize the technique using a single substrate and fluorescent conjugates with uniform F/P ratios was stressed. Most importantly, the value of titrating ANA for the diagnosis of the CTD was discussed. ANA titers higher than 1/500 are usually very significant clinically, often found in spontaneous or drug-induced SLE and few other CTD. The immunologic aspects of ANA and their potential value as aids in the diagnosis and management of the CTD were discussed. Anti-nDNA antibodies have been found to have a high degree of specificity for SLE and high titers of these antibodies correlate well with low levels of serum complement and severity of kidney involvement. The spectrum of ANA in the sera from patients with SLE has been expanded with the finding of anti-Sm antibodies which, when detected by gel precipitation with prototype serum, have been found so far only in SLE. Some of these antibodies have been found to have prognostic significance. Patients with MCTD  and a group of patients with SLE have high titers of serum ANA with specificity for an RNase-sensitive component of ENA. The group of SLE patients defined by the presence of these antibodies (anti-Mo) have a better prognosis and in general develop only mild nephritis or have no kidney involvement at all. High titers of pure antinucleolar antibodies probably are found almost exclusively in the sera of patients with scleroderma. Some ANA have organ specificity, and GS-ANA have been found in all patients with Felty's syndrome and in a large proportion of patients with RA. One of the great advances in the field has been the recognition that ANA can be induced in the human and in experimental animals by the use of a number of therapeutic agents. Some of these agents can also induce a clinical picture resembling spontaneous SLE, though kidney involvement does not occur or is extremely mild. It is interesting that the whole spectrum of ANA can be found in drug-induced LE except anti-nDNA antibodies which have been associated to the pathogenesis of immune complex nephritis in spontaneous SLE. There is no doubt that research on ANA has contributed a great deal to the understanding of the CTD and will continue to be a valuable tool for the clinician and the investigator.


A preliminary investigation of the mechanism of anti-pain and counter-injury effects of the acupuncture anaesthesia. In accordance with dialectical materialism and by dint of experimental acupuncture anaesthesia, the present investigation has: (1) Made an objective evaluation of the efficiency of acupuncture anaesthesia. (2) Brought forth some experimental evidence about the material basis of the anti-pain and counter-injury effect of acupuncture anaesthesia as well as the significance of its induction period. (3) Proposed the concept of humoral anaesthesia and its technique in order to improve the efficiency of animal laparotomies with acupuncture anaesthesia. Furthermore, it attempts to offer a theoretical explanation of the process of acupuncture anaesthesia under the combination of Chinese and Western medical theories and thereby gives some support to the "meridian-cerebral cortex-viscera inter-correlation hypothesis."


The role of radionuclides in clinical oncology. The major role of radionuclides in clinical oncology is, in the broadest sense, "tumor scanning". This includes evaluating specific organs for the presence of tumor (usually with different radiopharmaceuticals for each organ) or the entire body (generalized tumor searches with radiopharmaceuticals with 67Ga-citrate or 111Inlabeled bleomycin). The clinician uses these agents in the initial evaluation of the extent of tumor (staging) and in the subsequent management of the patient with cancer to assess response to treatment, to detect early relapse, and to assist in making decisions concerning treatment. The uses and limitations of the agents currently available for tumor scanning are summarized in this review (by major tumor type) from the perspective of the practicing oncologist. Other potential roles for radionuclides, including use as components of combined modality treatment programs, use as labels for antibodies or as drugs for both diagnosis and treatment, and use in the prediction of response to treatment, which are of great interest now and which will become realities for the oncologist in the future, are also considered.


An immunologic approach to tumor imaging. There seems little doubt that the ability to prepare antibodies with a unique specificity for surface tumor antigens will have a tremendous usefulness in the diagnostic and therapeutics of cancer. This usefulness will be wide-ranged when the antibodies are labeled with radioisotopes as tools for screening for primary lesions to determine the presence and location of metastases. Therapeutically, such preparations can be used to deliver high doses of radiation to specific areas, as carriers of chemotherapeutic drugs, as well as take advantage of the intrinsic cytotoxicity of such materials. The major problem preventing general application is the production and purification of the tumor-specific antigen which can be used to prepare subsequent reactive antisera. Intensive efforts are going on into research in this area as well as the preparation and problems inherent with using specific antibodies on a diagnostic and therapeutic basis. Present research indicates that the former problem may be resolved reasonably soon and it is felt that this will lead to successful diagnostic and therapeutic tools. The various studies and problems are presented in this review in relation to their ultimate potential clinical usefulness.


Radiolabeled antitumor agents.

Radiolabeled antitumor agents. Bleomycin serves as a useful prototype for a study of the various properties required in a radiopharmaceutical for tumor imaging. Both in vitro and in vivo results using bleomycin labeled with a large number of different radionuclides have now been reported. In general, it has not been possible to predict in vivo biologic behavior solely from in vitro data. For example, 57Co-bleomycin and 111In-bleomycin both have identical patterns in several different chromatographic systems and do not break down with prolonged storage in saline, exposure to heat, or other cations. However, when the labeled bleomycin is exposed to serum transferrin (and to other as yet unidentified ligands in the body) a difference in stability becomes obvious. The stability and biologic activity of 57Co-bleomycin in humans demonstrate the validity of metal chelation as a labeling technique for this specific molecule, and also suggests that other stable chelates will have useful applications. Although 57Co-bleomycin has the most desirable biologic characteristics of all the chelates of bleomycin, the extremely long physical half-life of 57Co of 270 days creates a significant contamination problem in the hospital. Because of this, the use of 57Co-bleomycin is limited to a few specialized centers. All users have emphasized the need for a better radionuclide to produce a labeled bleomycin with the same or superior biologic characteristics to 57Co-bleomycin. Unfortunately, the elements forming the most stable chelates with bleomycin (copper, zinc, cobalt, and nickel) do not have radionuclides with suitable physical characteristics for scanning. Copper-67 may become available in the future from high-energy linear accelerators. However, even if it were available, copper will probably not have as good chemical properties as cobalt.


The medical approach to management of pain caused by cancer. Every physician at some time must manage pain associated with advanced cancer. In spite of the hopeless prognosis, the problem of pain deserves an intelligent appraisal and a systematic plan for relief to conserve the patients's physical, mental, and moral resources and social usefulness as long as possible. Selection of a method of tumor therapy from an array of laternatives demands study of the individual patient and careful consideration of the appropriate measures-the possibilities for success and the limitations, benefits, and risks.


The cytochemistry of acute leukemia: a diagnostic and prognostic evaluation. A combination of cytomorphological features and cytochemical staining reactions in the diagnoses of the different types of acute leukemia removes much of the subjective difficulty of diagnosis. The number of cytochemical stains used may be limited, and in our experience the PAS, combined NCE and ANE reactions, and either SB or Px staining will yield as much diagnostic information as needed in most cases. With regard to the prognostic implications, it would appear at the present time that the amount of ANE staining in the cytoplasm of blasts is inversely proportional to the chances of remission induction and length of survival in cases of acute leukemia. However, further studies must be carried out to verify this finding before using the information to compliment other prognostic variables, such as age of patient, previous therapy, cytokinetics, etc.


Subacute necrotizing encephalopathy (Leigh's disease): two unusual cases. Two unusual cases of subacute necrotizing encephalopathy are described. In one, a marked hirsutism led to a suspicion of adrenal tumor or other endocrinopathy. In the other case, there was an agenesis of the corpus callosum, the second instance in which a malformation of the corpus callosum was associated with this condition. Electron micrographs from a case of Leigh's disease showed examples of marked axonal swelling and occasional splitting of the lamellae of the myelin sheath, probably responsible for the spongy state seen under light microscopy. That such marked changes were not seen in the "internal control" tended to exclude postmortem changes. The ultrastructure and histologic structure of striated muscle appeared normal in the one case examined.


A comparative electrophoretic study of the proteins in cerebrospinal fluid. Comparative polyacrylamide electrophoretic studies were done on the cerebrospinal fluid (CSF) of rabbits, pigeons, frogs and snakes. The results are compared to the pattern of normal human CSF and it is suggested that significant differences between the human and lower animals might exist.


Clinical aspects of hepatocellular carcinoma in man. The clinical and biochemical findings in 207 Black patients with hepatocellular carcinoma are presented. A bruit over the liver was heard in 25% of the patients, a previously underemphasised sign. In 28 of the 30 biopsy-proven cases alpha-fetoprotein levels were elevated. Hepatitis B antigen was found in 41% of the patients.


The core pathobiology and integrated medical science of adult acute respiratory insufficiency. The straightforward core pathobiologic facts needed for the clinician's basic understanding of the clinical course and pathophysiology of progressive acute respiratory insufficiency (ARI) seen in surgical practice are summarized in the opening paragraphs. The remainder of the article provides the detailed evidence for elucidating the morphogenesis, i.e., the sequence of pathologic events, which determines the natural and the therapeutically altered clinicopathophysiologic courses of ARI. The attempt is to integrate observations concerning altered structure, cell biology, pathophysiology, physiologic function test data, bioengineering principles, clinical course, therapeutic management, and historical aspects of the disease process, into a detailed multidisciplinary but comprehensive explanation of this very complex, difficult disease process.


Active enhancement of canine liver allografts--effect of pretreatment with prednisolone and donor-specific antigen. We investigated the active enhancement of liver allografts in 44 pairs of beagle dogs by pretreatment with semisoluble and soluble donor-specific spleen antigens. If the antigen were administered together with prednisolone, time of survival was significantly prolonged--with soluble antigen by 36.8 +/- 5.9 days and with semisoluble antigen by more than 3 years. Antigen pretreatment alone or antigen in combination with postoperative treatment of minimal immunosuppressive drugs had no significant effects. We found no correlation between the titer of lymphocytotoxic antibodies in the serum of recipients at the time of transplantation and survival times.


Plasmin inactivation in plasma.

Plasmin inactivation in plasma. Inhibition and inactivation of plasmin is ascribed to alpha2-macroglobulin, alpha1-antitrypsin and c1-esterase inhibitor. In an "overall" inactivation test of plasmin in plasma, which comes perhaps closest to rapid inactivation of plasmin in the circulating blood, we only found a correlation between the immunological concentration of alpha2-macroglobulin and the plasmin-inactivating capacity of the plasma, but no correlation with the immunological concentration of the other inhibitors mentioned. Therefore, alpha2-macroglobulin seems to be the most important plasmin inhibitor in relation to thrombosis.


[Palliative surgery in bronchial carcinoma and surgery for metastases (author's transl)]. Report on 54 patients with bronchial carcinoma, where a primary palliative resection of the tumor has to be done. Indications were central abscess of the carcinoma, bleeding of the tumor by arrosion, pain because of infiltration of chestwall, patient's demand on operation. Beneath lobectomy and pneumonectomy parietal pleurectomy, exstirpation of subclavian lymphnodes of the carcinoma and endobronchial resections of the tumor were done. In addition from 1970 to 1975 on 61 patients 66 resections of pulmonary metastasis were done. Surgical therapy of coin lesions without long preoperative surveillance is mandatory.


[Results of surgical treatment for bronchogenic-carcinoma with positive findings in mediastinoscopy (author's transl)]. We are reporting on the survival rate of a consecutive series of 182 patients with bronchogenic carcinoma in relation to mediastinoscopic findings and following treatment. 42 patients of this group underwent "radical" resection; only 2 patients of 11 with positive mediastinoscopy survived more than 1 year. If mediastinoscopy was negative, 26 of a whole group of 59 patients survived more than 1 year after resection. Many more different aspects are reported: the bad results of lung resection for bronchogenic carcinoma and positive mediastinoscopy allow only in special cases a surgical procedure.


[Palliative surgery in upper thoracic venous obstructions]. 33 patients (4.6%) of 711 surgical patients with thoracic disease had symptoms of upper thoracic venous obstructions. Histological differentiations proved the majority of tumors to be malignant. New successes in oncology-treatments of these tumors made early histological diagnosis mandatory. Our results lead to mediastinoscopies in these patients, although literature considered the risk of mediastinoscopy in upper thoracic venous obstructions as to high. We found no major complications in this group of patients and would like to emphasize the need of early histological diagnosis through mediastinoscopy in upper thoracic venous obstructions.


[Palliative and corrective cardiac surgery in Down's syndrome (author's transl)]. Since 1970 46 infants and children with Down's Syndrome were subjected to palliation of congenital heart disease, and 54 mongoloid children underwent correction of their cardiac defects. The most common cardiac malformation was endocardial cushion defect (72%). Palliation consisted in pulmonary artery banding (PAB) with or without division of a patent ductus arteriosus (PDA) in 16 infants, and sole division of a PDA in another 16 infants with large left to right shunts due to common canalis atrioventricularis (avcanal) or ventricular septal defect (VSD). An aorto-pulmonary anastomosis was performed for relief of severe hypoxia due to right ventricular outflow tract obstruction (RVOTO) in 14 patients. Operative mortality was 41% for PAB, 21% for aortopulmonary anastomosis, anastomosis, and 0% for division of a PDA. In the group of corrective cardiac surgery the operative mortality rate was 0% in ostium primum defects and 4% in VSD closure. Correction of complete av-canal and of malformations with RVOTO had a high mortality rate of 20 and 40%, respectively. Similar results were obtained in nonmongoloid children operated upon for the same cardiac defects. The complications and causes of death were due to the complexity of the cardiac malformations and had no relation to the Down's Syndrome itself. Mongoloid children do not pose additional medical problems to management of congenital heart disease. Their results do not differ from those obtained in nonmongoloid children.


[Surgical treatment for tetralogy of Fallot with unilateral absence of a pulmonary artery (author's transl)]. Among 843 patients with Tetralogy of Fallot, 10 showed unilateral absence of a pulmonary artery. In 7 cases the cause was congenital aplasia, whereas thrombosis of one of the pulmonary arteries following systemic-pulmonary anastomosis was the cause in the remaining 3 patients. According to the reports of other authors and to our own experiences, this rare malformation is treated best with palliative operations, the technique depending on the patient's age and on the individual anatomical condition. Only in very few cases with an acceptable pathologic anatomy there will be a reasonable chance for successful repair with reconstruction of the continuity from the right ventricle to the affected lung. However, if complete repair is performed, reconstruction of the absent pulmonary artery usually will be necessary for avoidance of pulmonary hypertension of the contralateral lung.


B cell antigens of the HLA system: a simple serotyping technique based on non-cytotoxic anti-beta2-microglobulin reagents. A modification of the NIH cytotoxicity test for recognizing B cell (D-associated) antigens and antibodies, when sera also contain anti-HLA(ABC) activity is described. The method is based on the observation that anti-beta2-microglobulin reagents are able to block lympholysis only when due to HLA(ABC) antigens.


The antigens 4a and 4b in rhesus monkeys and stumptailed macaques. Small panels of rhesus and stumptailed macaques were tested in a cytotoxic assay against human and chimpanzee 4a and 4b alloantisera. The human antisera were also absorbed by macaque platelets and the effect on the serum titer against human cells considered. Results of both types of testing conclusively demonstrated the presence of 4a- and 4b-like antigens on the cells of these two macaque species. Although the frequencies of both specificities were different from those observed for man and chimpanzee, they showed an alternative distribution in the monkey populations as they do in the highest primates.


Eight groups of human endothelial cell alloantigens. Human endothelial cells were shown to express a new system of alloantigens. Using 63 selected sera eight specificities could be defined. Each group was characterized using two to seven sera which had high correlation coefficients among them. The distribution of the phenotypes among 30 cells gave the appearance of an allelic system. Only one cell with a triplet was observed. Approximately half of the possible genes were detected with sera defining these eight groups.


[Radiotherapy results in brain metastases (118 cases)]. Results of palliative radiation therapy in cerebral metastases of various primary tumors are reported. The radiation therapy consisted in a large-volume irradiation which encompassed the whole cerebrum, using single dose of 200 rd (calculated for the center of the skull) five times a week, amounting to a total dose of 4000 rd, sometimes up to 5000 rd. In some cases, a saturating irradiation of a small volume reached 5000 or 6000 rd. A significant improvement in symptomatics was obtained in about 70% of the patients. The average time of survival after accomplishment of the radiation therapy amounted to six months. Own results and the summarized results of the other authors justify the irradiation of cerebral metastases as a rewarding palliative indication.


Purification and interaction with estradiol-17beta. The combination of polyacrylamide gel electrophoresis and Concanavalin-A-Sepharose affinity chromatography has permitted the isolation on a preparative scale, of four molecular forms of rat alpha1-fetoprotein: a "slow" and a "fast" fraction, each separable into Concanavalin-A-adorbed ("high carbohydrate", i.e. rich in accessible alphaD-Mannosyl and alphaD-Glucosyl residues) and a Concanavalin-A-non adsorbed ("low carbohydrate") fractions. These four iso-alpha-fetoproteins (iso-AFP) bind estradiol-17beta. However, they disclose differences in both their association constants and number of binding sites for this hormone. Very high affinity sites (10(9)) are mainly located on the "slow-low carbohydrate" form. Low affinity, high capacity sites are preferentially located on the "high carbohydrate" form. These results confirm the molecular and functional heterogeneity of rat AFP and suggest that the carbohydrate moiety of the protein may have a role in estrogen-AFP interactions.


The natural modulation of the amplification phase of complement activation. As C3 cleavage represents the most critical step in the elaboration of the biologic effects of the complement system, the modulation of this reaction by formation and function of the C3b-dependent C3 convertase may well determine whether the initial activation of the complement sequence eventuates in beneficial or detrimental effects to the host. Stabilization of the amplification C3b-dependent convertase, C3bBb, is achieved with P and C3NeF, respectively, after their binding which exhibits different molecular and temperature requirements. Control of this amplifying step occurs at three levels: intrinsic decay of the inherently labile C3bBb convertase; extrinsic decay by displacement of Bb from the convertase with beta1H; and inactivation by C3bINA of C3b after its generation from native C3 or removal of protective Bb by intrinsic or extrinsic decay. In the presence of the stabilizing factors the control proteins must function in sequence with beta1H-mediated decay preceding C3b inactivation.


An in vitro assay of cell-mediated cytotoxicity. Terminal labeling with 3h-leucine. A method is described for measuring cell-mediated cytotoxicity, based on the incorporation of labeled leucine into actively synthesized proteins in viable target cells which have survived interaction with effector lymphocytes. The method was studied with in vitro or in vivo sensitized lymphocytes in xenogeneic or allogeneic systems. This method was found to be applicable to quantitative determination of cell-mediated cytotoxicity by in vitro sensitized lymphocytes against a syngeneic tumor.


A standardized technique for efficient platelet and leukocyte collection using the Model 30 Blood Processor. The Model 30 Blood Processor is a safe and simple means of harvesting blood cell components. Presently cell collection depends on a visual assessment by the operator of the indistinct boundaries of cell fractions. To determine when each cell component could best be harvested, serial samples were taken from the output port at fixed intervals anf the results of counts and differentials were graphed and tabulated. Studies in normal donors were done using acid-citrate-dextrose (ACD), 2 per cent sodium citrate in 6 per cent hydroxyethyl starch (HES), or heparin as anticoagulants. There was considerable overlap between the latter part of the platelet band, the leukocyte band and the rising hematocrit with all three anticoagulants. Normally functional lymphocytes could be harvested efficiently (approximately 80%) using ACD or heparin. Platelets could be harvested from ACD very efficiently (approximately 90%). Granulocytes could not be harvested from ACD (less than 10%) since they were dispersed in the red blood cell (RBC) layer. Using HES, granulocytes could be harvested efficiently (approximately 70%) by extending collection into the RBC layer. Based on these data, a standard technique for cell collection has been devised. The flow rate is slowed to 20 ml/min and collection is carried 30 ml (90 seconds at a rate of 20 ml/min) for platelets. The RBC loss is approximately 6 to 8 and 2 to 3 ml/pass respectively. These studies indicate that the Model 30 is a highly efficient apparatus for blood cell separation, but the volume of blood processed is limited by the intermittent blood flow.


Sepcific tubercle antigen.

Sepcific tubercle antigen. Identification and isolation of the specific antigen of M. tuberculosis with the aid of an antiserum against the antigen antibody complex prepared by Goudie's method from the serum of tberculous patients is described. The position of the specific antigen on the disc electrophoresis column comprising four protein bands has been identified and separated. The antibody has been identified as IGg. More sophisticated techniques should enable the isolation of the specific antigen in practical amounts. The availability of such an antigen should greatly advance the serological diagnosis of tuberculosis.


Acid-fastness of Mycobacteri,m tuberculosis H37Rv following infection by mycobacteriophage DS6A. Mycobacterium tuberculosis H37Rv demonstrates a loss of acid-fastness following exposure to specific mycobacteriophage DS6A. No effect was seen with another mycobacteriophage GS7 which does not lyse this organism.


A system for the examination of tubercle bacilli and other mycobacteria. Methods are described for the examination of mycobacteria cultured from clinical specimens. In the "screening" procedure used for new isolates tubercle bacilli are non-pigmented, do not grow at 25 degrees C and are sensitive to p-nitrobenzoic acid as well as normally to anti-tuberculosis drugs. Classification is extended when necessary by the use of four tests--temperature requirements, pigmentation, oxygen preference and Tween hydrolysis. These define 15 species or groups meeting the needs of clinical bacteriology. Drug-sensitivity tests are described which relate the end-points of titrations to the modal response of normal wild strains of M. tuberculosis. They are used not only as a guide to chemotherapy but also to support and amplify classification.


[Proteinemia in young cattle during nutrition-induced muscular dystrophy]. The origin and course of enzootic white muscle disease affecting young cattle in spring months after transfer from stables to pastures were accompanied by an apparent tendency to dysproteinemia. Clinically diseased animals showed a decrease of total protein in the blood serum and considerable changes in the protein spectrum. In comparison with findings in the set of clinically healthy controls, the animals affected by the white muscle disease showed a depression of albumins and a simultaneous increase of alpha- and beta-globulins and a decrease of gamma-globulins.


Elastin VII: aging effects on vascular elastica staining by oil soluble nigrosin dyes. Neutral hydroalcoholic stains with spirit soluble nigrosin (C.I. 50415) and nigrosin base (C.I. 50415B) were applied to a series of human arteries from individuals ranging from newborn to 82 years of age for the demonstration of the selective staining by these dyes of the aging change in their elastica described by Lillie, Pizzolato and Donaldson (1974). The staining is absent in infants and children. It first appears in slight grade in some individuals at age 18. It increases in frequency and intensity with advancing age. It is often seen without obvious other histologic lesion and is regularly present when fibrous and fibroatheromatous plaques appear. In this series it was studied in the aorta of children and in grossly relatively normal areas of the superior mesenteric artery which was selected for the survey because of its usual rather slight involvement in arteriosclerosis. The intensity of the neutral nigrosin staining of the elastica of this artery appeared to be uninfluenced by the extent or severity of aortic lesions in the same individual. This nigrosinophilia appears to be an integral early phase in the development of the arteriosclerotic process and may precede appearance of fibrous or fibroatheromatous plaques by some years. The nigrosinophilia has been assigned (1974) to a lipoprotein alteration of arterial elastica. Prolonged storage in formol in plastic bags induced a strong neutral Solvent black 5 and 7 staining of arotic elastica in the normally negative 10-20 year age group. This reaction is presently considered artifactual, but is being studied further experimentally.


Histologic characteristics of insulinomas and gastrinomas. Value of argyrophilia, metachromasia, immunohistology, and electron microscopy for the identification of gastrointestinal and pancreatic endocrine cells and their tumors. In a first step of our investigation the staining characteristics, especially the argyrophilia and metachromasia, of immunohistologically identified endocrine cells of the pancreatic islets and of the gastroduodenal mucosa were tested. These staining characteristics were then examined on insulinomas and gastrinomas. Contrary to normal B cells which generally react positively with aldehyde fuchsin and pseudoisocyanine but not argyrophilic with the Grimelius method, the neoplastic B cells give inconsistent results with conventional staining methods. Yet neoplastic B cells often show argyrophilic structures. Immunohistologically, most benign insulinomas are rich in insulin-containing cells, whereas in malignant types such cells are rare. The carcinomas, however, show a typical and distinct Grimelius argyrophilia. The tumor cells of gastrinomas are Grimelius argyrophilic and slightly metachromatic, as normal G cells, yet, contrary to A1 cells, they are only exceptionally stainable with the Hellerström method. Despite the great number of Grimelius positive tumor cells, generally only a few reacted with antigastrin serum. Nevertheless, the immunohistology is the most reliable method for the diagnosis of gastrinomas. Electron microscopic results are often difficult to interpret, since gastrinomas, as well as undifferentiated or malignant insulinomas, may predominantly contain atypical secretion granules.


[Distribution of gamma-hexachlorcyclohexane in subcellular fractions of the liver and brain]. The character of the gamma-HCCH distribution in the subcellular fractions of the liver and brain of albino rats with peroral threefold introduction of the compound in doses of 34 mg/kg (1/5 LD50) and in a dose of 1.7 mg/kg (1/100 LD50) for a space of 1, 3 and 6 months was investigated. It was found that gamma-HCCH penetrates the cells of the liver and brain and is non-uniformly distributed among subcellular fractions, viz. nuclear, mitochondrial and supernatant. Both in acute and chronic experiments the greatest amounts of the preparation were found in the nuclear fraction of the cell. The established features distinguishing the accumulation and distribution of the preparation in the subcellular fractions of the liver and brain explain the previously elicited biochemical and physiological shifts occurring in the organism after entrance of gamma-HCCH thereinto.


[Comparative analysis of the antigenic composition of the hemagglutinins of influenza viruses A/England/42/72, A/Port Chalmers/73 and A/USSR/053/74]. The presence of three antigenic determinants was demonstrated by the method of selective adsorption of inhibitor-free sera (HI test) and complement-fixation test (CFT) in hemagglutinins (HA) of influenza A/Port Chalmers/73 and A/USSR/053/74 viruses. These variants with closely similar antigenic composition have two antigenic determinants related with NA of A/England/42/72 virus, whereas the third antigenic determinant is specific only for them and is lacking in A/England/42/72 virus NA. According to the results obtained the antigenic composition of HA of these viruses may be designated in the following way: A/England/42/72--H3 H6 H7, A/Port Chalmers/73 and A/USSR/053/74--H3 H7 H8. A method is suggested for preparation of monospecific serum to the antigenic determinant H3 common to all variants of the Hong Kong variety of influenza virus. This serum is free from nonspecific inhibitors, contains no antibody to the host cell antigens and may be used both in CFT and HI test for rapid identification of new influenza virus isolates.


[Antigenic characteristics of chicken influenza viruses]. Data on isolation of chicken influenza virus strains in this country during epizootics in 1970--1975 are presented, and the antigenic characteristics of the isolates are described. All the strains had a mixed hemagglutinin type (GP6-H3N2) and neuraminidase H2. Neuraminidase of the strains had more marked antigenic relationship with H2 human influenza A/Singapore/57 (H2N2) virus than H2 of other human influenza virus strains. The size of KM of neuraminidase is similar in all chicken influenza virus strains their antigenic formula is suggested [A(GP6-H3N2)].


[Experimental studies into syncarcinogenesis. 7th communication: Syncarcinogenic effects of polycylic aromatic hydrocarbons (PAH) in epicutaneous tests in mice]. A mixture of 11 carcinogenic and noncarcinogenic hydrocarbons was applied to the shorn skin of the back of 3400 female NMRI-mice. The proportion of the hydrocarbons in the mixture corresponded to the analytical findings in condensates of cigarette smoke, automobil exhaust gas, and preservation curing smoke and tar. Antagonistic effects by the individual hydrocarbons in the mixture were not observed, on the contrary the substances in the mixture showed additive effects. There were no differences in the mode of action of the different mixtures.


[Age dependent morphokinetics of the thyroid gland. Histochemical, morphometric, light-microscopical and functional investigations (author's transl)]. The aim of the animal experiments was to investigate the question of the age dependence of the morphokinetic reactions of the thyroid gland under standardised conditions. Through the administration of pharmaceutical substances, it was possible to produce defined functional states of the thyroid in the various age groups. Materials and Methods 700 Albino rats of the Chbb: Thom (SPF) strain, age 0 days (newborn) to 110 weeks, were used in the investigations. The animals were divided into 4 groups each with 12 subgroups according to age. One group received 300 mug/kg/day triiodothyronine (T3) for 10 days for the suppression of thyroid gland function, one group received methylthiouracil (MTU) for 10 days to block hormone synthesis, and one group received 10 IU/kg/day thyrotrophic hormone (TSH) for 5 days to stimulate the gland. The control group received distilled water. Investigations carried out: Protein-bound iodine (PBI) and total thyroxine (T4) in the serum; enzyme histochemical demonstration in the thyroid of alkaline phosphatase (a. Ph.), acid phsophatase (s. Ph.), cytochrome oxidase (Cyt. ox.), succinic dehydrogenase (SDH), iso-citric acid dehydrogenase (ICDH), ATP-ase and nonspecific esterase. The height of the follicular epithelium and the nuclear diameters of the follicular epithelial cells were estimated in embedded material. Light-microscopical investigations were performed using Paraplast and Epon embedded material. Staining methods: H. and E., Azan, PAS-alcian blue, Elastica-van Gieson, Perl's method for iron, Gomori's reticulin stain and von Kossa's calcium method (in aged animals). Staining of semithin sections with toluidine blue, Movat's stain and Morgenroth's stain. Biometric analysis of results: Simple and two factor analysis of variance, Scheffé test, graphic demonstration after polynomial fitting of third to fifth degree. Results a. Histochemical findings In the thyroid gland, all the above mentioned enzyme histochemical reactions studied show a mostly distinct age dependent relationship in the intensity of enzyme activity. Age dependent changes in the histo-topochemical behaviour of individual reactions are also demonstrable on light-microscopical examination. In control animals at the time of birth, alkaline phosphatase and cytochrome oxidase react moderately, the others weakly. With hydrolases the activity of alkaline phosphatassr remains at a moderate level throughout the life span, while acid phosphatase and ATP-ase show a marked increase up to puberty, and the reaction is still mnd I.C.D.H. an increase during the growth period, a marked response in middle life, and a lessening of activity in ageing animals can be demonstrated. Cytochrome oxidase increases up to the seventeenth week of life, and then decreases in older animals. The activity of nonspecific esterase increases up to the eleventh week, remains at a high level up to the forty fourth week and then lessen after one year of life...


[Spectrum of serum proteins following surgery for gynecologic carcinomas]. 1. After operations conducted for malignant gynecological tumours the changes in serum proteins and their spectra had in the main the same pattern as after operations indicated for diseases of a benign character. 2. The changes took place however at a markedly lower proteinemia level and issued from values occasinally strikingly affected by the presence of the malignant tumour. 3. A particular phenomenon was the presence of changes in the concentration of the electrophoretic gamma-globulin fraction which showed, in cases of advanced ovarian tumour, a rapid increase during the first postoperative days. 4. The changes in serum proteins found after operations made for malignant tumours were less regular and took place in some cases in form of irregular oscillation.


Localization of the tri- and digalactosyl diglyceride in the thylakoid membrane with serological methods. Trigalactosyl diglyceride was isolated from leaves of Urtica dioica and characterized by thin layer chromatography, infrared spectroscopy and by its fatty acid composition. An antiserum to the trigalactolipid was obtained by immunization of rabbits. By means of inhibition experiments with oligosaccharides and mono- and digalactosyl glycerol it was demonstrated that the antibodies are directed towards the alpha-galactosyl-(1 leads to 6)-alpha-galactosyl-(1 leads to 6)-beta-galactosyl-(1 leads to 1)-glycerol configuration of the trigalactosyl diglyceride. Monogalactosyl diglyceride and sulfoquinovosyl diglyceride do not react with this antiserum. However, a cross reaction was observed with digalactosyl diglyceride. The presence of antibodies to tri- and digalactosyl diglyceride was demonstrated in antisera to different chloroplast preparations of Antirrhinum majus and Spinacia oleracea. The antiserum to the trigalactolipid agglutinates stroma-freed chloroplasts. Membrane fragments obtained by the ultra sonication were precipitated. The antiserum is exhausted by trigalactosyl diglyceride but not by digalactosyl diglyceride or digalactosyl glycerol. The antiserum treated with digalactosyl glycerol and digalactosyl diglyceride also agglutinated stroma-freed chloroplasts. 1 g stroma-freed chloroplasts binds 0.17 g antibodies to trigalactolipid. Membrane fragments bind more antibodies to trigalactolipids than stroma-freed chloroplasts. From the agglutination tests it follows that the antigenic determinants of the trigalactolipid and the digalactolipid are localized in the outer surface as well as in the surface directed towards the inside of the thylakoid membrane.


[Liver function tests under the influence of sequential treatment using ethinyl estradiol-norethisterone acetate and ethinyl estradiol-chlormadinone acetate]. 30 young healthy women were investigated during the first therapy cycle with ethinyl-estradiol-norethisterone acetate and ethinyl-estradiol-chlormadinone acetate as a sequential regime. The following laboratory data were achieved by each of the investigated group of young women: serum aminotransferase (GOT and GPT), serum alkaline phosphatase and alpha-amylase-activity in serum, serum proteins, serum cholesterol, serum bilirubin, serum ZST, serum TTT and the indocyaningreen-clearance of the liver. The serum protein pattern was determined by the paper electrophoretic method. A significant decrease of the aminotransferase GPT was viable during the sequential therapy with ethinyl-estradiol and norethisterone acetate. This viable decrease of the GPT was induced through the application of norethisterone acetate to estrogen. The alkaline phosphatase was significant lightly lower and the beta-globuline lightly elevated at the end of the therapy cycle. The sequential therapy with ethinyl-estradiol and chlormadinone acetate induced only a significant increase of the ZST in serum.


Antigenic degradation in Escherichia coli. Strains of Escherichia coli isolated in a maternity unit were examined serologically. On primary isolation the strains were shown to be O-antigenically distinguishable, although having the same H antigen, biotype and antibiogram. Subsequent detailed serological studies revealed that the colonial variants derived from them showed similar antigenic diversity, irrespective of the original antigenic structure.


[Electron microscopic study of the I, II phases and R-forms of Sh. sonnei]. Electron microscopic study of the microbial cells of the I, II phases and the R-form was carried out. Intact cells were examined by negative contrasting, and morphological differences of various bacterial phases were shown: cells of the I phase had a relatively smooth surface, bacteria of the II phase had a smooth surface, but many cell wall fragments were split from them; the surface of the R-form cells was coarse, folded, and cell wall fragments were split from the majority of bacteria. Antigenic determinants responsible for phasic specificity in bacteria of the I and II phases were located at some distance from the external membrane of the cell wall; as to the R-form cells--they were localized on the wall.


[Immunochemical characteristics of a factor causing antigen-specific lysis of thymus-dependent lymphocytes]. A factor capable of lysing in vitro, in the presence of a specific antigen, the cells of the lymph nodes and the thymus of intact mice was revealed in the supernatant obtained after the centrifugation of a suspension of viable cells of the lymph nodes and the thymus of the immunized mice. It was found by immunochemical methods that this factor had a mol. wt. of about 30000 dalton and an electrophoretic mobility in polyacrylamide gel exceeding that of mouse blood serum albumin. Besides, it was revealed by the precipitation reaction in agar that it was not an immunoglobulin or its chains.


[Immunodiffusion analysis of plasma proteins in the canine family]. Immunodiffusion studies have been made on the plasma of 9 species (Vulpes vulpes, V. corsak, Alopex lagopus, Canis aureus, C. lupus, C. familiaris, C. dingo, Nyctereutes procynoides, Fennecus zerde) from the family of Canidae using milk antisera. Unlike rabbit antisera used earlier, milk antisera make it possible to detect more significant antigenic divergency with respect to 5 alpha- and beta-globulins. These globulins seem to have a higher evolution rate of antigenic mosaics as compared to other plasma proteins in the family investigated. The family Canidae serologically may be divided into two main groups: 1) the genus Canis which includes the wolf, domestic dog, dingo, jackal and 2) species which significantly differ from the former (the fox, polar fox, dog fox, fennec). In relation to these two groups, the raccoon dog occupies special position.


Intensification of cobaltous sulphide precipitate in frog nervous tissue. Dorsal and ventral roots of the frog's spinal cord were filled with cobaltous chloride through axonal transport. Following incubation in different buffers saturated with H2S, the resulting CoS was intensified with two kinds of physical developers, the one containing gum arabic, the other tungsto-silicic acid as protective colloid. Optimum circumstances for CoS formation were found at high pH values in model experiments. NaOH and CuSO4 pretreatments of tissues enhanced the intensification power of the physical developer containing tungsto-silicic acid. The structural integrity of tissues was best preserved when phosphate buffers saturated with H2S were employed to precipitate cobalt in histological specimens. Of the two developers the one containing gum arabic gave a finer staining of neural elements, but its intensification effect was somewhat capricious. Histological results suggested that within the range of cobalt transport (10-20 mm), neural elements filled with cobalt were quantitatively and selectively shown. At the present state of experiments neural elements with a process to the periphery are only accessible to staining with this technique.


Species-common antigen of connective tissues. Collagen-free extracts were prepared from bovine, porcine and canine hyaline, elastic and fibrous cartilages, articular capsule, tendon, aorta, cortical bone and regenerating articular surfaces. The extracts were investigated with antisera to bovine nasal septal cartilage, dog articular cartilage and non-collagenous protein fraction of bovine cortical bone. Immunodiffusion, immunoelectrophoresis, and immunohistochemical methods were used. In the different supporting tissues of the three animal species a common antigen, probably of proteoglycan origin, was demonstrated. The finer differences in antigenicity between the different tissues are probably due to the variations in proteoglycan composition of the given supporting tissues. Owing to the wide-spread occurrence of the antigen, the authors suggest the term "species-common connective tissue antigen" instead of the "species-common cartilage antigen" used so far.


Localization of the ruthenium red-positive substance in the myoneural junction of rat. Ruthenium red staining of myoneural junctions was examined in the flexor digitorum brevis muscle of the rat. Ruthenium red-positive electron dense substance was observed to emerge from the outer layer of the presynaptic axolemma and post-synaptic sarcolemma towards the synaptic cleft. Also the cleft substance was intensely stained, usually consisting of a medium dense layer between pre- and postsynaptic membranes. The probable function of acid mucopolysaccharides in the neuromuscular transmission is discussed.


The thyrotrophin receptor in human thyroid plasma membranes: effect of serum immunoglobulins. A homologous receptor assay system using human thyroid membranes and 125I-labelled human TSH (hTSH) was used to study the effect of serum and serum fractions on the binding of [125I]hTSH to the membranes. Scatchard analysis showed a single population of binding sites for TSH. Gamma globulin fractions prepared from sera of patients with Graves' disease were able to displace [125I]hTSH from the membrane to a greater extent than normal gamma globulin in 21 out of 45 cases. Increased displacement activity was seen in patients with thyroiditis, hot nodules and euthyroid eye disease but not in patients with toxic multinodular goitres. Further fractionation of the gamma globulin fraction showed that the stimulatory activity was not confined to the IgG fraction. Scatchard plots showed gamma globulin fractions decreased the number of receptor sites available for TSH binding but did not alter the affinity of the receptor for TSH. IgG fractions showed different slopes and intercepts and appeared to decrease the affinity of the receptor for TSH. LATS activity in human serum may be explained on the basis of these observations on the properties of the TSH receptor.


The penicillin antigens: presentation in the leucocyte migration test (a study with penicillin and penicilloylated proteins). The response of the leucocyte migration test (LMT) to benzyl penicillin (BP) was compared with the response of LMT to benzyl penicilloylated human gamma globulins (BPO HGG) and to benzyl penicilloylated human serum albumin (BPO HSA). Patients with and without hypersensitivity to penicillins were investigated. No statistical differences were found between the response to BP and to BPO HGG or BPO HSA; this finding supports the fact that the BPO groups generated by BP are mainly implicated in the triggering of the LMT when BP is used as antigen. A strongly penicilloylated HSA appeared to be the most effective mode of the antigen presentation for the detection of BPO-specific cellular immunity in patients with and without clinical symptoms of hypersensitivity to the penicillins.


Potentiation of cutaneous reactivity and blood leucocyte histamine release by deuterium oxide in human beings. Deuterium oxide (D2O) is known to potentiate non-cytotoxic histamine release in vitro. It has been shown (5) that D2O could also potentiate in vivo immediate-type hypersensitivity in dogs and monkeys. Present studies demonstrate potentiation in vivo by D2O of the cutaneous reactivity in 48/80, PHA and Dermatophagoides cutaneous reactions in human beings. PHA histamine release from human leucocytes is also potentiated by D2O in vitro.


Congo red vital staining of cornea and conjunctiva. Vital staining with an aqueous solution of 1% Congo red has been studied in the slit lamp. In 98 cases the dye was mixed with 1% lissamine green, in 120 eyes subsequent staining was performed with 0.125% fluorescein, and in 80 cases the mucous thread from the inferior conjunctival fornix was microscoped. Congo red stains dead cells, degenerate cells, and mucus. The dye discloses keratitis, corneal erosion, contact lens damages, corrosions, etc. It stains like lissamine green and rose bengal, though less frequently and less intensely than these. Congo red is a pH indicator. Acid reaction beyond its pH-range (3.0-5.2) has not been demonstrated. Amyloid-specific colour reaction (red-green dichromatic polarisation) has been noticed in mucous fibrils, most often in relation to infectious conjunctivitis and corrosion, never in normal eyes. The phenomenon is believed to indicate degeneration of the mucous fibrils (on the analogy of toluidine-blue-stained mucus), whereas not presence of genuine amyloid. It is, in other words, an important phenomenon in the differential diagnosis. Congo red is hardly indicated in ordinary clinical practice for vital staining of cornea and conjunctiva. Fluorescein, combined with rose bengal or lissamin green should be preferred.


The effect of prostaglandin on iridial blood vessel permeability. Light and electron microscopy is used to examine the effect of exogenous PGE1 on the permeability and reactivity of rat iridial blood vessels. Results show that topical PGE1 causes an increase in the permeability of iridial vessles to carbon particles (200 A diameter). The technique of carbon labelling is used to quantitate increases in permeability caused by varying concentrations of PGE1 (0.001-1.0 mg/ml). Regression analysis shows that there is a linear relationship (P less than 0.02) between carbon labelling and PGE1 concentration over the range of concentrations tested. In other experiments rats were treated with the systemic histamine liberator Compound 48/80, or with topical applications of histamine diphosphate in order to examine the effects of exogenous and endogenous histamine upon iridial blood vessel permeability. These procedures produce only minimal labelling of iridial vessels. It therefore seems likely that PGE1 has a direct effect on iridial vessels and does not act indirectly by bringing about the liberation of endogenous histamine.


In vitro uptake of 5-hydroxytryptamine and dopamine by rat mast cells after exocytosis induced by antigen or compound 48/80. Mast cells from the peritoneal and pleural cavities of actively sensitized rats were isolated and incubated with biogenic amines (5-hydroxytryptamine and dopamine) with or without pretreatment with specific antigen. An anaphylactic reaction resulting in the release of 20-25% of the histamine in the cells led to a slightly reduced amine uptake. At concentrations which induced histamine release comparable to that during the anaphylactic reaction compound 48/80 had a similar effect on the uptake of the two amines. Histamine release induced by higher concentrations of compound 48/80 led to a more pronounced reduction in the uptake of the amines, the reduction being roughly proportional to the extent of the histamine release. It is concluded that the reduction in the in vitro amine uptake after anaphylactic and compound 48/80-induced histamine release is due to the fact that there are a fewer intact granules capable of storing histamine and not primarily due to a damage to the mechanisms by which mast cells take up biogenic amines in vitro. The observations further strengthen the view that anaphylactic and compound 48/80-induced histamine release are non-cytolytic processes.


Radiation therapy of adrenal cortical carcinoma. The role of radiation therapy in the management of adrenal cortical carcinoma has had little documentation in the literature. Fourteen patients with this malignancy were given 18 courses of palliative, preoperative or postoperative irradiation. The clinical results are presented. Significant palliation was obtained in all patients along with occasional long term local control of unresectable lesions.


Microcalorimetric measurements of heat production in human erythrocytes. II. Hyperthyroid patients before, during and after treatment. Heat production has been measured in erythrocytes of 17 hyperthyroid patients both before treatment and when the patients had become clinically euthyroid. The decrease in heat effect during treatment was significant. The initial mean value was significantly higher than the corresponding value for normal subjects. A good correlation was found between heat effect values and the clinical condition. Measurement of heat production in erythrocytes can provide useful information about the peripheral effect of thyroid hormones.


Immunological defects in children with chronic otitis media. A total of 59 children with chronic otitis media were examined for possible immunological defects by determination of serum gammaglobulin and immunoglobulins IgG, IgA and IgM, and by a tuberculin test, and additionally by noting any lymphopenia. Some divergence from normal values was found in 38 patients (64%). 14 children (24%) showed pathologically low immunoglobulin levels and 7 (12%) even a subtotal absence of one of the immunoglobulin fractions. 8 of the cases (14%) also showed a reduction of gammaglobulin level. In 20 children (34%), the level of one or more of the three major Ig classes was elevated. All except one became clinically normal within a few years, showing normal gamma or immunoglobulin levels when tested. The tuberculin test was positive in all patients. The length and course of the disease in these cases was similar to that in patients with normal test values. Gammaglobulin therapy did not have any beneficail effect. Consequently, it is concluded that although humoral immunological defects may be one aetiological factor, they do not play any major role in the course of chronic otitis media in children.


Effect of the areA gene on regulation of arginine catabolism in Aspergillus nidulans. The areA gene which is known to be involved in ammonium repression in Aspergillus nidulans was found to participate in regulation of arginine catabolism. Mutations in this gene are hypostatic to mutations in arcA, suDpro and suEpro genes which are responsible for regulation of synthesis of arginine catabolic enzymes.


Bacteriophage N3 of Haemophilus influenzae. II. Infection of transformable cells by bacteriophage DNA. Transfection of H. influenzae with N3 bacteriophage DNA shows a dependence on concentration of DNA and a sigmoidal shape of uptake of DNA. The efficiency of transfection is decreased in the two types of recombination-defective strains of H. influenzae; rec1- and rec2-. The fact that N3 bacteriophage can code for its own recombination system but transfection is dependent on host recombation system allows the conclusion that the primary recombination during transfection with N3 phage DNA is mediated exclusively by the bacterial recombination system.


Effect of polaymines on yeast cell-free protein synthesizing system. I. Influence of spermine and spermidine on aminoacyl-tRNA transfer reaction. Spermine and spermidine added to a Saccharomyces cerevisiae cell-free protein synthesizing system increased phenylalanine polymerization reaction several-fold at suboptimal concentration of Mg2+ and approximately two-fold at optimal amounts of Mg2+. The addition of polyamines greatly stimulated the enzymatic and nonenzymatic binding of phenylalanyl-tRNA and N-acetylphenylalanyl-tRNA to ribosomes. The binding of the acetylated derivative was higher than phenylalanyl-tRNA, however, as it was shown the former was bound exclusively to the A site of the ribosome. Contrary to the binding process, the puromycin reaction was not stimulated by spermine added at a concentration which enhanced the polyphenylalanine synthesis. These results indicate that polyamines have not only a sparing effect on the Mg2+ requirement for yeast protein synthesis in vitro and suggest that one of the possible sites of polyamines action might be the binding of aminoacyl-tRNA to ribosomes.


Effect of polyamines on yeast cell-free protein synthesizing system. II. Increase stability of cell-free system in the presence of spermine. The addition of spermine, at concentration which stimulates protein synthesis, to the yeast cell-free system significantly increases the thermal stability of the latter. Similar stabilizing effect of polyamine is observed for ribosome-poly U-ac-phe-tRNA complexes. These results suggest that the stimulatory effect of polyamines on the in vitro protein synthesis might be partly due to the increased stability of ribosomes and ribosome-peptydyl-tRNA complexes.


Utilization of lactose and production of corrinoids in selected strains of propionic acid bacteria in cheese-whey and casein media. Comparative studies were carried out with 23 strains (14 species) of propionibacteria in two media-cheese-whey and casein. The degree of lactose fementation and the efficiency of the corrinoids synthesis were studied. Lactose fermentation showed great differences even within one species (e.g. 13.3% and 66.1% for various strains of P. shermanii). The differences were particularly sharp in casein medium (0% or 100%). The highest capacity for utilizing cheese-whey lactose (70--80%) was found in two strains of P. shermanii and P. petersonii and P. arabinosum. No definite correlation, however, was found either in the cheese-whey or in the casein medium, between the capability of lactose fermentation and the efficiency of the corrinoids. As the most technologically effective strains have been recognized P. shermanii 1, P. shermanii 566 and P. petersonii J.


Studies on the biodegradation of nonionic surfactants applied in the polyester fiber industry. I. Activated sludge bacteria degrading the surfactants. The paper presents characteristics of 76 strains of bacteria capable of utilizing nonionic surfactants Cirrasol FP, Cirrasol SF 200 and Cirrasol TCS as the source of carbon. The strains were isolated from two activated sludges adapted to the purification of wastes containing the above compounds at concentration 150--200 mg/l. The isolated strains belonged to the genera: Achromobacter, Alcaligenes, Arthrobacter, Flavobacterium, Mycobacterium, Nocardia, Pseudomonas and Xanthomonas. With load 0.11 mg surfactant/mg d.w./day bacteria belonging to Alcaligenes were dominating. With load 0.18--0.31 mg surfactant/mg d.w./day microorganisms were dominated by Pseudomonas. The highest intensity of degradation of the studied surfactant was shown by species: Alcaligenes viscolactis, Nocardia blackwellii and Pseudomonas rathonis.


Studies on the biodegradation of nonionic surfactants applied in the polyester fiber industry. II. Effect of activated sludge load on microorganisms. The effect of selected nonionic surfactants Cirrasol FP, Cirrasol SF 200 and Cirrasol TCS on activated sludge organisms purifying wastes from the polyestre fibre industry was studied. The toxic effect of the mentioned surfactants towards bacteria, protozoa, rotifera and nematoda occurred at loads exceeding 0.32 mg surfactant/mg d.w./day and in periods of large fluctuations of the employed loads. Morphological changes of activated sludge flocs are also observed in similar conditions.


Effect of acetic and trans-aconitic acids on citric acid production by Aspergillus niger. The effect of acetic and trans-aconitic acids on citric acid production by A. niger at different pH values was studied. The presence of acetic acid at pH 2 prevented spore germination, while it decreased the fungal growth and citric acid production at other pH values. In the presence of trans-aconitic acid the inhibition was less marked at lower than at higher pH values.


Studies on the purification of wastewater from the nitrogen fertilizer industry by intensive algal cultures. I. Growth of Chlorella vulgaris in wastes. The possibility of growth of intensive cultures of Chlorella vulgaris on industrial wastewater from nitrogen fertizer plant containing ammonia, urea and nitrate was investigated. Good growth of algae was obtained when the waste was enriched with phosphorus and inoculum contained a high number of cells. The optimal pH for the culture was 7.0--8.0. The main factor limiting growth of algae on wastes on the concentration of ammonia nitrogen. Chlorella vulgaris grows quite well in wastes containing 600 mg NH4-N/l but is inhibited at concentration about 100 mg NH4-N/l.


Valuation of characteristics of water purity. I. Estimation of the usefulness of some microbiological and hydrobiological characteristics. The titres of physiological processes in bacteria (hydrolysis of urea, nitrification), total number of bacteria and photosynthesis were found to show high correlation with standard characteristics: BOD5 and saprobic index. The classificatory values of BOD5 and saprobic index depend on the pollution of waters (with BOD5 less than 3 mg O2/l more information on the extent of pollution is given by the saprobic index whereas with higher values BOD5 is better). The content of NH3-N and titres of ammonification and H2S production depend on the type of pollution and should not be used for determination of water purity without additional studies. Of increasing importance as a measure of pollution is the BOD5/BOD2 quotient.


Valuation of characteristics of water purity. II. The use of numerical methods for the taxonomic appreciation of selected characteristics of water purity. Numerical methods have been employed to determine the taxonomic value of a number of microbiological, hydrobiological and chemical characteristics of water purity either in current use or proposed. Numerical methods have at the same time served to evaluate the usefulness and correlation coefficients of these characteristics in classification of the degree of pollution in different stretches (sites) of rivers.


Valuation of characteristics of water purity. III. The use of numerical methods for qualitative and quantitative evaluation of the degree of pollution. The taxonometric methods of centrifugal correlation and principal components were used to classify sites along the investigated river with respect to quantity and quality of pollution. The degree of pollution was determined with the use of a collection of microbiological, hydrobiological and chemical characteristics selected by statistical methods.


Valuation of characteristics of water purity. IV. Classification of pollution of waters based on norms of microbiological, hydrobiological and chemical characteristics determined by numerical methods. Norms of microbiological (coliform titre, nitrification titre, urea hydrolysis titre, number of bacteria, BOD2 and BOD5), hydrobiological (intensity of photosynthesis, saprobic index, number of algae) and chemical (oxidability, DMDT content) characteristics, determining the ecological quality of water, are suggested. Their taxonomic value has been appraised with the use of numerical methods: centrifugal correlation and principle components, used for the classification of a collection of sites with respect to pollution.


Determination of growth of aquatic bacteria by measurements of incorporation of tritiated thymidine. Evaluation was made of a novel technique, combining semi-continuous culture on membrane filters and assessment of the incorporation of titrated thymidine. The optimal temperature of incubation is 20--25 degrees, the period of incubation--3 hours; the initial activity of tritiated thymidine--0.5 muC/ml. There is a linear relation between the initial number of bacteria on a filter and the level of 3H-thymidine incorporation. The incorporation is dependent on nutrient content in the examined water.


Epidemiology and prevention of ventricular ectopic rhythms. Current work of the Laboratory of Physiological Hygiene is reviewed on the epidemiology and prevention of ectopic ventricular rhythms (VPB). The evidence suggests that uniform simple VPB at rest, or exercise-induced, are prognostically important only in those having clinically manifest coronary disease. A simple rhythm strip is an effective first screen method for detecting individuals having rather frequent VPB, and frequency of VPB is correlated with complex ectopic rhythms. A multifaceted stress induction test induces VPB and does it consistently. Hygienic intervention, in which cardiac stimulants are removed and conditioning exercises given, is being tested as VPB suppressive therapy.


Sclerosing hyaline necrosis in noncirrhotic chronic alcoholic hepatitis. A group of 18 chronic alcoholic patients who had sclerosing hyaline necrosis in noncirrhotic livers was compared with a group of 12 similar individuals with acute alcoholic hepatitis, but no centrilobular fibrosis. In cases with sclerosing hyaline necrosis, the most characteristic features were portal hypertension with very large, tender livers and unusually high glutamic-oxalacetic transaminase values; these were associated with centrilobular fibrosis and abundant alcoholic hyalin. Three of these patients died within two years and in two of these, early cirrhosis was found at necropsy. In the cases of acute alcoholic hepatitis, hepatomegaly was the most conspicuous finding, and only a single patient died; death here was unrelated to hepatic disease, the liver being unremarkable at necropsy. Patients who had sclerosing hyaline necrosis tended to remain ill for significantly longer periods. These observations, in conjunction with evidence gathered from the literature, seem to suggest that sclerosing hyaline necrosis is an obligatory step in the natural evolution of alcoholic hepatic disease, especially in cases that evolve into cirrhosis.


Serum alpha-fetoprotein. A prognostic indicator of liver-cell necrosis and regeneration following experimental injury by galactosamine in rats. The serum concentrations of alpha-fetoprotein of rats following experimental galactosamine-induced liver-cell necrosis accurately reflect the severity of preceding liver-cell damage as determined by elevation of serum transaminases. There is a very close correlation between the highest SGOT or SGPT serum activity found 1-2 days after induction of necrosis and the subsequent elevation of alpha-fetoprotein at 2-6 days. Elevations of alpha-fetoprotein are associated in time with restitutive proliferation of the damaged liver. These experimental results clarify the temporal relationship between alpha-fetoprotein and repair of liver-cell damage, which has been suggested by similar observations in cases of patients who have acute or sub-acute viral hepatitis. The correlations support the concept that serum alpha-fetoprotein concentrations may be used as a prognostic indicator of the extent and course of fulminatn or subacute hepatitis.


Selective staining with hematoxylin, applications and theory: a review. The uses of hematoxylin in special histologic staining procedures are outline, with emphasis placed on those methods involving application of the dye in combination with selected metallic mordants. The theoretical basis for the demonstration of various intra- and extracellular components is discussed, and newer generalizations regarding preformed metal-complex dye staining mechanisms are reviewed.


A gram stain for smears of blood cultures, body fluids and tissues. A new Gram stain method for blood cultures was adapted from a method for tissue sections. This was accomplished by comparing various modifications of the latter method on positive smears prepared from a 24-hour negative blood culture seeded with Staphylococcus aureus and Escherichia coli. A blind study was then conducted using the new method and Hucker's method on 24-hour and 72-hour blood cultures as well as a limited number of other body fluids and tissues. Of the 35 positive blood cultures detected by the new method, the Hucker method failed to detect 14 positive specimens (40 per cent) upon initial examination. Ten additional cultures were negative using both stains, but were positive on subculture at three days. The 18 additional cultures positive after ten days were detected using only the Hucker stain.


A thermostable antigen associated with ovarian cancer. Ovarian carcinoma contains an antigen (TA) which is stable at 100 degrees. Rabbit antisera to glycoprotein-rich extracts of tumors detect TA in 70 per cent of ovarian malignancies, in some benign ovarian cysts, certain normal lung preparations, normal cervix, and squamous-cell carcinoma of the cervix. Highest levels may be associated with mucin secretion. No detectible antigen was present in normal ovary, plasma, A, B, and O erythrocytes, leukocytes, placenta, brain, heart, liver, corpus uteri, spleen, skeletal muscle, or kidney. Prolonged digestion of boiled tumor extracts with papain, trypsin, chymotrypsin, on Sephadex G-150 corresponding to a globular protein of 27,000 to 36,000 molecular weight. A beta-globulin mobility is seen in immunoelectrophoresis. It appears that TA differs in tissue specificity and molecular size from other known ovarian cancer associated antigens.


Evaluation of choledochoduodenostomy in the treatment of malignant obstruction of the biliary tree. The results of direct decompression of the common duct for malignant obstruction of the distal biliary tree by side-to-side choledochoduodenostomy are presented. Thirty-three patients were treated with twenty-four (73 per cent) having carcinoma of the pancreas. Seventy-two per cent of the patients had had previous cholecystectomy or cholelithiasis whereas the common duct was utilized in preference to cholecystojejunostomy in six patients. The operative mortality was 12 per cent and six patients had complications. No deaths could be attributed to the choledochoduodenostomy, and complications did not significantly affect palliation. Mean postoperative survival was 10 +/- 0.9 months. Two patients had obstruction of the anastomosis as a terminal event. This study suggests that appropriately applied choledochoduodenostomy is a simple, effective means to decompress the common duct obstructed by tumor.


Prediction of intestinal viability by intra-arterial dye injection: a simple test. A vital dye solution injected intra-arterially stains only the viable parts in intestine of questionable viability. After various periods of ischemia, the viability of rat intestinal loops was assessed by three methods: on clinical basis; by detection of reactive hyperemia using an electronic thermometer; and by intra-arterial dye injection. The accuracy in viability prediction was 36, 69, and 84 per cent, respectively. The intraarterial dye injection method proved to be a simple, easy, and inexpensive way to accurately predict the viability of ischemic rat intestine.


Teaching aids.

Teaching aids. A teaching aid is exactly what it says it is--an aid to teaching. No matter how exciting the aid may be, its production is not an end in itself, merely a means to an end. Teaching aids are most effective and can be best justified when a need for them has been demonstrated and when they can be shown to clarify the teaching of points and problems which students have formerly found difficult to understand. The best teaching aids are the result of a combination of imagination and enthusiasm. Aids should always be evaluated to determine whether the costs of production are justified by an improvement in learning.


The depletion of the granules of argentaffin and argyrophile cells of monkey duodenum by reserpine. The influence of reserpine (5 mg/kg) on the argentaffin and argyrophile cells has been studied in 4 monkeys, and in 4 controls. In the treated animals, there is a marked and obvious reduction in the number of argentaffin cells; the cells that remain also show signs of partial depletion. Reduction of the number of argyrophile cells is not obvious on casual examination, but cell counts reveal a statistically significant reduction. The persisting argyrophile cells show signs of partial depletion.


Application of Bathurin and borax in the biological control of Monomorium pharaonis in housing estates. Of two apartment houses infested with ants of the species Monomorium pharaonis, one was treated with a biological, the other with a chemical substance. In the first case we used Bathurin in combination with borax at a concentration of 1.3% for both substances. In the first week, borax was added to the bait (minced beef), within the next three weeks, the bait was mixed with Bathurin. The procedure was repeated 5 times. After this period, we achieved complete control of the ants on the infested premises.--Our results obtained with the chemical substance (the insecticide Anthrix) were less successful. This indicates that the first method, although time-consuming and requiring a perfect collaboration with all inhabitants, is safer, because it leads to the complete eradication of ants in the infested premises.


[Queens' technic in Pharaoh's ant control. 2. Synergistic effects]. The alkylating (Tepa, Metepa, Thiotepa, Apholate) and non-alkylating (Hempa, Hemel) chemosterilants have been tested in a screening programme together with 6 synergists of insecticides (Pieronylbutoxide, Bucarpolate, Sulfoxide, Safroxan, Demethylsulfoxide, S-421) for cumulative and synergistic effects. Since all of the insecticide synergists were repellent in contrast to the chemosterilants, the substances have been screened only by the dipping test. The synergists increased in solutions of acetone in contrary to the chemosterilants not the mortality of the queens. A combination of Tepa acetone in contrary to the chemosterilants not the mortality of the queens. A combination of Tepa and Piperonylbutoxide resulted in real synergistic effects. The sterility of the queens of the pharaoh's ant was increased at a relation of 1 part of Tepa to 5 parts of Piperonylbutoxide up to twentyfold. It is probably the first evidence of synergism between conventional chemosterilants and insecticide synergists. Unfortunately this excellent effect can not be used for practical control measures because only the baiting method leads to an eradication. - All the other screened combinations showed neither cumulative nor synergistic effects.


[Anaphylactoid complications related to the use of 40,000- molecular weight dextran]. The intravenous administration of Dextran 40,000 (Rheomacrodes) was responsible in eight cases, for grave accidents, arising at the beginning of the injection. These were five cases of cardiovascular collapse and three of cardiac arrest. In 50 p. 100 of the cases, there was associated generalised erythma. The course was lethal in one case.


[Anaphylactic shock in anesthesia].

[Anaphylactic shock in anesthesia]. The notion of anaphylactic shock under anaesthesia implies sensitization, with a minimum delay of 1 week, on the occasion either of a previous anaesthesia with the responsible product, or with taking a drug with common antigenic determinants. Clinically this is reflected by the rapid and explosive appearance of symptoms which are always comparable: tendency to vascular collapse, respiratory bronchospastic distress, erythematous rash and Quincke's edema, gastrointestinal disorders, etc. These signs and symptoms of anaphylactic shock are closely related to the pharmacological actions of substances liberated during the reaction, of reaginic orgin (histamine, S.R.S.A.). It is reproduced by the direct effects of numerous anaesthetics on the liberation of theses very substances without the intermediary of an immunological mechanism. In consequence, the clinical argument alone is not sufficient to assert the true anaphylactic nature of a shock. Consequently, the elements of the history must be strongly borne in mind: notion ofsensitization during a previous anaesthesia, to the responsible product or to a drug which could have a crossed antigenicity with it.


[Specific and non-specific histamine liberation]. Histamine-liberation occurs mainly from the mast cells and basophils, the sitr of synthesis of histamine, and other intermediary substances such as serotonin, S.T.S.A. The possible causes for this histamine-liberation are numerous and varied. Histamine-liberation of immunological order only represents a particular case in this chapter as a whole. The study quite specifically deals with histamine-legeration provoked by the direct pharmacodynamic action of drug substances, in particular those which are used in anaesthesiology. These substances are numerous and act according to two essential mechanisms: action by diffusion in the region of the histamine carrying cell (the case of substances of low molecular weight), enzymatic action on the cell membrane (the case of substances with high molecular weight). From the standpoint of clinical consequences, discrimination between specific and non-specific histamine-liberation is therefore risky. In practice, in the face of a symptomatology of histamine shock, it is necessary to bear in mind what is known of the pharmacological action of the substances used, and on the other hand not to neglect the resources of the history, and to employ the laboratory tests capable of providing arguments for or against anaphylaxis.


[Bronchomotor tonus: per-operative bronchospasm]. The comprehension of the occurrence of bronchospasm during surgery is based on the knowledge of the factors which control bronchomotility: parasympathetic or cholinergic system, essentially bronchoconstrictor; sympathetic adrenergic system, with beta-2 effect, bronchodilator, and with alpha-bronchoconstrictor effect. It is also worth bearing in mind the chemical midiators, in particular, histamine contained in the mast cells, "slow reacting substance of anaphylaxis" which is a bronchoconstrictor substance of slow and prolonged action, Serotonin whose role is more modest. The last mediators known, prostaglandins, play an important role in the regulation of bronchomotility, PGE' are bronchodilators, PGF 2 alpha are bronchoconstrictors. With reference to the development of bronchospasm during anesthesia, one must bear in mind the background, and in particular of the allergy, of a past history of asthma and of the pre-operative functional respiratory condition. One must also bear in mind the anaesthesia, and the pharmacodynamic action of the substances used which can interfere with the phenomena controlling bronchomotor tone.


[Various risk factors in the precipitaiton of complications caused by anesthetics and muscle relaxants]. From this study an important notion emerges concerning the risk factors in accidents due to general anaesthetics and myorelaxants. Among these factors, three are clinical parameters which can be assessed by any anaesthetist: the presence of atopy, of a previous drug allergy, of previous, repeated general anaesthesia, close together in timel Two factors were the subject of an experimental study, routinely investigating an abnormal histamine reactivity of the skin, and a latent spasmophilia. No definite conclusion can be made from the results, bearing in mind certain criticisms of technical order and the small number of subjects investigated. However, these works merit being pursued. Thus, if all subjects are not equal when faced with the risks inherent to anaesthesia, a thorough study of individual risk factors will enable a preventive approach, utilising a premedication prescribed with mature consideration.


[Histamine liberation in extracorporeal circulation]. Extra-corporeal circulation (E.C.C.) has been held responsible for histamine liberation incidents, essentially by a mechanical cause. In order to prove this, the authors assayed the overall histaminaemia at different times during E.C.C. in 11 patients. The results are discussed in terms of the patients' backgrounds, temperature, hematocrit, blood gases and the acid-base balance, and electrolyte balance. Histaminaemia, corrected depending on the dilution, did not show any significant variation, even in two patients who clinically had anaphylactic manifestations.


[High-risk factors in anesthesiology and methods of detection]. This study demonstrates the importance of allergies to drugs used in premedication and enables one to realize the practical difficulty in picking out the causal drug allergies in anaesthetic accidents. From the practical point of view, it is evidently impossible to carry out L.T.T.s in all patients, considered as being exposed to an allergic risk in anaesthesia. It could however be envisaged carrying out ingestion tests such as are used in order to demonstrate intolerance to iodine, by the administration of small doses of Lugol's iodine or tablets containing iodine, and which lead to benign digestive intolerance reactions.


[In vivo blood histamine during anesthesia]. The authors studied the variations in histaminaemia in the plasma on the one hand, and in whole blood on the other hand: In volunteers:-after administration of histamine in an intravenous infusion ranging from 18 to 90 ng/min/kg;-after administration of thiopental, methohexital and propanidide. In volunteers, by means of the different parameters measured, the authors found that the mean plasma concentration was 0.69 +/- 0.26 ng/ml. In the whole blood, the histaminaemia was 54 +/- 18 ng/ml. The perfusion of histamine up to 45 ng/kg/min led to no symptomatology in 3 volunteers. Propanidide led to an average increase of 350 p. 100 in the initial normal figure of plasma histaminaemia approximately 5 minutes after the beginning of the injection. But there is no agreement between the figures obtained and the clinical signs (tachycardia, mild hypotension). The injection of thiopental led to an analagous symptomatology: i.e. tachycardia and mild hypotension, arising before the maximum increase in plasma histaminaemia. Methohexital, and althesin are also histamine-liberators. Only estomidate, a new pure hypnotic product as yet not commercialised, did not lead to histamine-liberation.


[In vivo blood histamine during anesthesia]. Assays of overal histaminaemia were carried out, in 150 patients anaesthetised according to three different techniques, apart from any surgical act. 119 anaesthesias took place without any incident, 33 were disturbed by the appearance of rashes or of bronchospasm. The overall histaminaemia varied according to three types of graphs (a flat graph, an ascending graph, or a descending graph) without it being possible to evoke any relationship between this course and the clinical signs. It seems that the presence of a background predisposing to histamine-liberation is however responsible for greater frequency of the descending graphs, and that the method of administration of the anaesthetic product is a factor which can intervene in the genesis of the phenomena of histamine-liberation during anaesthesia. An interpretation of the variations in the graphs of histaminaemia is attempted by the authors.


[Preventive tests and their limits. Management before the risk of complications]. The carrying out of preventive tests (Shelley's test) is studied in the light of results obtained in cases of definite accidents, on the one hand, and in similar preventive enquiries with local anaesthetics. The positivity does not exceed 25 p. 100 of the cases during definite accidents, and 10 p. 100 during preventive tests, and as risks of error are produced in both directions, the author advises against preventive tests in the majority of cases.


[Anaphylactoid complications due to the use of anesthetic products and adjuvants. Apropos of 18 cases]. Eighteen grave anaphylactic accidents arising during induction or during anaesthesia, are analysed. By order of frequency, the clinical signs are cutaneous manifestations (70 p. 100 of the cases), bronchospasm (65 p. 100), cardiovascular collapse (45 p. 100). In four cases, cardiac arrest occurred. The course was always favourable, with no after-effects. Immuno-allergic tests enabled one to make the diagnosis of true anaphylaxis in eight cases (seven shocks due to succinylcholine, one due to propanidide), of non specific histamine-liberation in five cases; in the other cases, it was impossible to express an opinion.


[Complications of histamine liberation during anesthesia]. Eight clinical cases of anaphylactic accidents are presented: six arising during anaesthetic induction (four being probably true allergy) and two secondary to massive histamine-liberation during perfusion of Rheomacrodex.


[Histamine-type reactions seen in general anesthesia]. The article analyses the results of a test conducted in 7 departments of Anaesthesia and Reanimation, concerning accidents of a histaminic type which occured following the administration of anaesthetic agents. It seems that very few of the products used lack the property of releasing histamine. The accidents observed may have more complex origins, such as the release of serotonin or bradykinin, etc...,but they seem, nevertheless to be closely linked to the histaminic level and vary in seriousness in relation to that level. The study of the very kind of accident observed attempts to explain the cardiac arrests reported in our enquiry. The difficulty of putting into effect an eventual immuno-allergic process is evoked. Finally, the treatment seems to be sterotypic and effective as there was only one death among the 66 cases recorded.


[Interference between histamine liberation and drugs used in anesthesiology. Prevention and treatment of the complications of histamine liberation]. The authors report the complications associated with the administration of some anaesthetics using propanidide. In one of the controls, premedication using an antihistamine was sufficient to avoid, during a third administration of propanidide, complications which included a fall in blood pressure and which had occurred when the second anaesthetic had been given. In one patient with high plasma histamine concentrations, circulatory arrest occurred during the second and third anaesthetic, despite meclastinum. Only the addition of a glucocorticoid to the premedication made possible an anaesthetic without problems. During a third propanidide anaesthetic given to this same patient, we were able to confirm our hypothesis by a premedication combining meclastinum and a glucocorticoid, despite the high plasma histamine level found. In certain other cases, however, plasma histimine concentration did not increase despite the development of erythema and urticaria of the face and neck. Serious complications were successfully dealt with using a combination of glucocorticoids, adrenaline derivatives and an antihistamine.


[Histamine liberation and its mechanism]. The author, on the basis of his personal work, proposes a classification of the mechanisms of histamine liberation: a metabolic mechanism (acting like anaphylaxis) and a mechanism by amine displacement. Subsequently, the action on histamine of two hydrosoluble vitamins: ascorbic acid and nicotinamide is considered, in the animal as a whole and on the mastocytes of rat peritoneum.


The reliability of gastric smears by auramine-rhodamine staining technique for the diagnosis of tuberculosis. From 1972 to 1974, all sputum specimens and gastric aspirate specimens submitted to the University of Michigan Laboratory for acid-fast smear and culture were studied. Specimens were paired for culture and smear results using the auramine-rhodamine staining technique. Of 1,893 patients, 75 patients without prior antituberculous therapy were found to have either a positive smear or a positive culture of either sputum or gastric material. The data analyzed by patient source revealed the following. (1) Staining sputum with auramine-rhodamine is a clinically reliable technique for detecting pulmonary tuberculosis. It demonstrates a sensitivity of 78 per cent and a relative fraction of false positive smears of only 11 per cent. (2) Staining gastric-aspirated material by the auramine-rhodamine technique is not a clinically reliable method as a routine procedure for the detection of pulmonary tuberculosis, because of a sensitivity of only 58.8 per cent and a relative fraction of false-positive smears of 33 per cent. (3) In the absence of sputum in suspected clinical granulomatous disease, quantified gastric smears may be helpful. In this study, when more than 6 organisms per high power field were found, the patient's sputum or gastric material yielded a pathogenic mycobacterium on culture.


[Modification of chromatids before fixation: production of G bands by various stains]. Acridine orange, coriphosphine, toluidin blue, or pyronin, when added to the hypotonic solution, allow G-banding when the fixed slides are stained in the usual way. Apart from this simple practical application, these modifications of chromatid structure by a treatment applied before fixation shed some light on the molecular mechanisms responsible for chromosome banding.


Antihistamines. Guidelines and implications. Antihistamines may be used to maximum benefit for the allergic patient if the physician adheres to four guidelines. These guidelines are based upon 1) an appreciation of certain structural and pharmacologic differences among antihistamines, and 2) an understanding of their mechanism of action. Around the clock administration is advisable, the dosage should be titrated for the individual patient, substitutions to another antihistamine should be to a different class of antihistamine, and the efficacy of any single antihistamine usually will diminish with prolonged use, either on the basis of true tolerance or because of psychic factors. There is good theoretical evidence when alpha-adrenergic sympathomimetics, employed as decongestants in combination with antihistamines, should not be given to allergic patients. Two newer drugs, disodium cromoglycate and beclomethasone, may provide symptomatic relief for allergic rhinitis patients. They may benefit the patient who does not obtain full symptomatic relief from antihistamines.


[A probable glucidic allotypic pattern carried by the Fab fragment of rabbit IgG (author's transl)]. An allotypic specificity of rabbit immunoglobulins designated as A90 has been studied. The A90 pattern found on the Fab fragment and gamma chain of IgG, is located on the constant region of the Fd fragment of IgG. Aa+ molecules (which carry a specificity of the  a series) and Aa- molecules (which lack the a series specificity) isolated from the same serum carry the A90 pattern. A90 distribution in a given serum has been studied in several IgG fractions separated by DEAE cellulose chromatography; the most negatively charged of equally concentrated IgG fractions has ten times more A90 allotypic concentration than positively charged ones. The gene controlling A90 allotypic concentration than positively charged ones. The gene controlling A90 synthesis is not linked to a genes. The percentage of IgG molecules carrying the A90 pattern decreases with the age of the rabbits. Part of the anti-A90 antibodies combine with human IgG (of different subclasses) as well as with sheep and mouse IgG (among which they do not differentiate). The absence of linkage between A90 and a genes suggests that the A90 pattern has a glucidic part. We discuss this hypothesis, comparing some features of the A90 pattern to those of IgG human allotypic pattern for which a glucidic structure has been proposed.