New class of ribonucleic acid in Neurospora associated with the outer cell envelope. Extrinsic ribonucleic acid (RNA) can be isolated from a KCl extract of Neurospora crassa conidial cell surface products. It is heterogeneous in size. The bulk of this RNA travels as a broad band, trailing the 5.8S ribosomal marker RNA on electrophoretic gels. The extrinsic RNA, when denatured, exhibites several discrete lengths between 50,000 and 130,000 daltons. Melting profiles confirm the heterogeneity of the RNA and indicate that 58% of the bases are involved in hydrogen bonding. Analyses of alkaline hydrolysis products reveal no extensive methylation and few or none of the unusual bases present in transfer RNA. The bases are present in approximately equivalent amounts. Extrinsic RNA represents 2 to 3% of the total cellular RNA. Since this membrane-associated class of RNA does not resemble ribosomal RNA, messenger RNA, or transfer RNA and since it is extracted from the cell exterior by methods used to remove extrinsic membrane molecules, we have designated it extrinsic RNA.


Pleiotropic phenotype of an Escherichia coli mutant lacking leucyl-, phenylalanyl-transfer ribonucleic acid-protein transferase. A mutant of Escherichia coli that lacks leucyl-, phenylalanyl-transfer ribonucleic acid-protein transferase had diminished activities of L-phenylalanyl-transfer ribonucleic acid synthetase and tryptophanase, grew faster than its parent with aspartic acid as the sole nitrogen source, accumulated higher levels of enterochelin in the medium during iron limitation, and exhibited an abnormal morphology.


Gamma-Actinin, a new regulatory protein from rabbit skeletal muscle. II. Action on actin. The interaction of gamma-actinin and actin was investigated under various conditions. It has been shown that gamma-actinin affects the G-F transformation of actin, causing an increase in the number of actin monomers required to form a nucleus in the initial step of polymerization. Sonicated fragments of F-actin and heavy meromyosin caused the immediate polymerization of actin under the influence of gamma-actinin. Therefore, it can be concluded that gamma-actinin inhibits the nucleation step of G-F transformation. Actin filaments which were formed in the presence of gamma-actinin (F-actin) were shown to possess certain characteristic properties when compared with control F-actin. These were as follows: F-actin solution had a high critical concentration; F-actin showed a high rate of depolymerization; the flow birefringence of F-actin decreased with time upon incubation in the absence of free ATP; finally, F-actin was demonstrated to have ATP-splitting activity. These dynamic features of F-actin were accounted for in terms of an increase in the rate constant of depolymerization in F-actin under the influence of gamma-actinin.


Regulatory protein of bovine tracheal smooth muscle. Myosin B exhibiting Ca2+ sensitivity in superprecipitation and Mg-ATPase [EC 3.6.1.3] activity was extracted from tracheal smooth muscle. Repeated washing with 2mM KCl and 1 mM NaHCO3 resulted in the loss of these activities. However, on addition of native tropomyosin, the myosin B regained its original properties. Native tropomyosin is the regulatory system in this smooth muscle.


2,4-Dinitrophenol as a specific inhibitor of the breakdown of the actomyosin-phosphate-ADP complex. 2,4-Dinitrophenol (DNP) was found to cause a "clearing response" of myosin B in a medium in which "superprecipitation" of myosin B would otherwise take place. The effect of actin concentration on Mg-ATPase [EC 3.6.1.3] of HMM was studied in the presence and absence of DNP. The results indicate that DNP causes an increase rather than a decrease in the affinity of HMM for actin, and that it causes a decrease only in the actin-activated portion of the Mg-ATPase activity. Using a light-scattering technique, it was shown that neither the ATP-induced dissociation of acto-HMM nor subsequent reassociation is significantly affected by the presence of DNP. As for the formation of the myosin-phosphate-ADP complex in the myosin-ATPase reaction, it was shown that formation of the reactive complex is not affected by DNP. It can thus be concluded that DNP inhibits the decomposition of the actomyosin-phosphate-ADP complex, which is thought to be coupled with superprecipitation.


Effect of long-chain fatty acids and acyl-CoA on mitochondrial permeability, transport, and energy-coupling processes. The following effects of fatty acids and acyl-CoA thioesters on energy metabolism of mitochondria can now be assumed: (1) Inhibition of adenine nucleotide translocation. This effect may increase the energy state of mitochondria respiring under state 3 conditions and decrease phosphorylation potential in the surrounding medium (the cytoplasm). (2) Increased permeability to monovalent cations. This may lead to a partial energy dissipation due to a futile recycling of K+ (or another cation), namely and energy-dependent uptake and a passive outflow. (3) True uncoupling due to increased permeability to protons. This effect probably occurs at high concentrations of fatty acids only. (4) Substrate effect. Fatty acids in the form of acyl-CoA are excellent respiratory substrates for mitochondria of most tissues. Their oxidation is coupled to the generation of high energy state of the mitochondrial membrane and, consequently, to ATP synthesis.


Calorimetric studies of the interaction of myosin with ADP. A calorimetric titration method was used to study ADP binding to native myosin. Data were analyzed by assuming that the myosin molecule has n independent and identical sites for ADP binding. The enthalpy change (deltaH), the binding constant (K), and n were determined. In 0.5 M KCl, 0.01 M MgCl2, and 0.02 M Tris/HCl (pH 7.8), we found: at 0 degrees, deltaH = -57.1 +/- 3.2 kJ-mol-1, log K = 6.42 +/- 0.13, n = 1.49 +/- 0.07; at 12 degrees, deltaH = 73.1 +/- 3.2 kJ-mole-1, log K = 6.08 +/- 0.13, and n = 1.74 +/- 0.07. The average heat capacity change on ADP binding to myosin between 0 and 12 degrees is thus -1.4 +/- 0.4 kJ-mol-1-K-1. Reasonably consistent results were obtained at 25 degrees, suggesting ADP binding to myosin is as strongly exothermic as at lower temperatures, although further interpretation of this result seems unwarranted, mainly because of the instability of myosic at this temperature. The number of protons released on binding of ADP to myosin was determined in separate experiments. The value was 0.19 +/- 0.02 at both 0 and 12 degrees. The reaction of protons with Tris thus contributes about -9.5 kJ-mol-1 to the observed heat on ADP binding.


Disappearance of specific proteins from the membranes of colicin-treated cells. Two colicins that affect energy metabolism in Escherichia coli (colicins K and E1) are shown to cause loss of specific membrane proteins from treated cells. Disappearance of these proteins after treatment with colicin K occurs at low multiplicities and is independent of ATPase (EC 3.6.1.4) and phospholipase A (EC 3.1.1.4) activities. The uncouplers carbonyl cyanide m-chlorophenylhydrazone and dinitrophenol do not alter the pattern of membrane proteins.


Purification and characterization of squid brain myosin. Myosin was extracted from frozen squid brain and purified by a modification of the procedure of Pollard et al. (Pollard, T.D., Thomas, S.M., and Niederman, R. (1974) Anal. Biochem. 60, 258-266). Myosin was eluted from Bio-Gel A-15m column as a single peak of (K+-EDTA)-activated ATPase ((K+-EDTA)-ATPase) activity with an average partition coefficient (Kav) of 0.22. In sodium dodecyl sulfate-acrylamide gel electrophoresis, the purified myosin showed a predominant band with similar electrophoretic mobility as the heavy chain of rabbit skeletal muscle myosin, and two less intense bands near the bottom of the gel. No actin band was seen. The properties of the (K+-EDTA)-ATPase activity were: (a) the time course of the reaction was biphasic at 25 degrees but linear at 32 degrees; (b) the optimum rate of reaction was obtained between 0.3 and 0.8 M KCl; (c) the pH optimum was between 8.0 and 9.0; (d) the reaction was specific for ATP with an apparent Km of 0.19 mM. ATPase activity in 0.06 M KCl and 5 mM MgCl2 was increased about 1.5 times by a 10-fold excess of rabbit skeletal muscle F-actin and about 5 times by a 40-fold excess. The actin activation was inhibited slightly by the addition of 0.2 mM CaCl2 and completely by the addition of 10 mM CaCl2. Myosin formed arrowhead patterns with rabbit skeletal muscle F-actin as observed by electron microscopy of negatively stained samples. It also aggregated in bipolar filaments which attached to decorated actin filaments at different angles, as well as formed cross-connections and ladder-like patterns between actin filaments. These two forms of interactions between myosin and actin were abolished by treatment with MgATP.


Assembly of the sarcoplasmic reticulum. Biosynthesis of calsequestrin in rat skeletal muscle cell cultures. Temporal patterns of biosynthesis of the sarcoplasmic reticulum protein, calsequestrin, were analyzed and compared with rates of ATPase synthesis in primary cultures of rat skeletal muscle cells. Rates of synthesis were measured by the incorporation of radioactive leucine into the isolated proteins. Cells at various stages of differentiation were incubated for 2 h with tritium-labeled leucine and extracted with detergent. The extracts were incubated with antibodies specific against calsequestrin or the ATPase and immunoprecipitates were separated by disc gel electrophoresis. Incorporation of radioactivity into bands identified as calsequestrin or the ATPase was analyzed by counting of gel slices. In Dulbecco's modified Eagles medium (DME medium) containing 0.1 volume of horse serum and 0.005 volume of chick embryo extract, the cells began to fuse after about 50 h in culture, forming multinucleated myotubes. Calsequestrin synthesis was barely detectable after 24 h in culture. After 44 h, before fusion of myoblasts began, the rate of calsequestrin synthesis increased severalfold. The rate of synthesis continued to increase until about 72 h and then diminished. If cells were transferred at 44 h to DME medium containing 0.2 volume of fetal calf serum and 0.08 volume of chick embryo extract, fusion was delayed by about 20 h. In this medium the rate of calsequestrin synthesis diminished after a peak at 44 h but, by contrast, the rate of synthesis of the ATPase increased dramatically following fusion at about 80 h. If cells were transferred at about 40 h to DME medium containing 0.1 volume of horse serum and only 60 muM Ca2+ the cells did not fuse and, again, the rate of calsequestrin synthesis was diminished after a peak at about 40 h. By contrast the rate of ATPase synthesis increased sharply in spite of the lack of fusion. Both proteins were degraded with a half-life of about 20 h. These studies show that the synthesis of calsequestrin, an extrinsic membrane protein, and the ATPase, an intrinsic protein of the same membrane, are synthesized under separate control.


Dependence of renal (Na+ + k+)-adenosine triphosphatase activity on thyroid status. In thyroidectomized rats, a single injection of L-2,,5,2'-triiodothyronine (T3) (50mug/100 g body weight) elicited at 45% increase in (Na+ + k+)-dependent adenosine triphosphatase (NaK-ATPase) activity of the membrane-rich fraction of renal cortex at the optimal time of response, 48 h after injection. Three successive doses of T3 (50 mug/100 g body weight), given on alternate days, increased NaK-ATPase by 67% in the renal cortex but had no significant effect on the outer medulla or the papilla. Moreover, T3 had no effect on Mg2+-dependent adenosine trisphatase (MgATPase) in cortex, cedulla, or papilla. Three doses of T3 (50 mug/100 g body weight) given on alternate days to thyroidectomized rats elecited a 134, 79, and 46% increase in Vmax for ATP, Na4, and K+, respectively. There were no changes in the Km for ATP or the K1/2 values for Na+ and K+. Two methods were used to estimate the effect of T3 on the number of NaK-ATPase units (assumed to represent the number of Na+ pump sites); rat renal plasma membrane fractions were incubated with [gamma-32P]ATP, Mg2+, and Na+; the 32P-labeled membrane protein yeild was quantitatively dependent on Na+ and was hydrolyzed on addition of K+. There was a linear correlation between the specific activity of NaK-ATPase (Vmax) and the amount of phosphorylated intermediate formed, in renal cortical membrane fractions from thyroidectomized rats given T3 or the diluent. There was also a linear correlation between the specific activity of NaK-ATPase (Vmax) and the amount of [3H]ouabain specifically bound (Na+-, Mg2+-, APT-dependent) to the NaK-ATPase preparation. Injection of T3 resulted in a 70% increase in NaK-ATPase activity, a 79% increase in formation of the phosphorylated intermediate, and a 65% increase in the [H]ouabain specifically bound to the NaK-ATPase system. The T3-dependent increases in Vmax for ATP, Na+, and K+ and the proportionate increases in the phosphorylated intermediate and in the amount of [3H]ouabain bound indicate that T3 increases the number of NaK-ATPase units and that this increase accounts for the increase in NaK-ATPase activity.


Effect of triiodothyronine on the synthesis and degradation of renal cortical (Na+ + k+)-adenosine triphosphatase. The present studies concern the roles of synthesis and degradation of the large subunit of (Na+ + k+)-adenosine triphosphatase (NaK-ATPase) in the response to triiodothyronin (T3). Single doses of either the diluent of T3 (50 mug/100 g body weight) were given to two pairs of surgically thyroidectomized rats. Twenty hours after injection, the rats received 3H- or 35S-labeled methionine administered as a constant injusion into the tail vein for 1 h. The kidneys were removed either 8 h or 20 h after infusion and the eight kidneys were divided into pairs, as follows. I, 3H (diluent)/35S (T3); II, 35S (diluent)/3H (T3); III, 3H (diluent)/35S (diluent); IV, 3H (T3)/35S (T3). Partially purified NaK-ATPase was prepared from the pooled homogenates and prepared from the pooled homogenates and analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAG-electrophoresis). The large subunit of NaK-ATPase was identified by (Na+ + mg2+)-dependent and K+-sensitive incorpotation of 32P from [gamma-32P]ATP. This component had an estimated molecular weight of 92,000 and migrated as a single peptide in gels of varying total carylamide concentration, with respect to: (1) Coomassie blue staining, (b) (Na+ + Mg2+)-dependent, K+-sensitive incorporation of 32P from [gamma-32-P]ATP, and (c) T3-dependent enhanced incorporation of labeled methionine. T3 augmented incorporation of labeled methionine into the large subunit by 44% 8 h after infusion of the amino acid and by 61% 20 h after infusion. Incorporation of methionine into two adjacent polypeptides in the SDS gels was unaffected by thyroid status. The effect otical NaK-ATPase was assessed by a double label technique. Pairs of thyroidectomized rats were injected with either the diluent or 50 mug of T3/100 g body weight at 48-h after the first injection (diluent or T3, i.e. Day "zero"). Kidney cortices were processed on either Day 4 or Day 6; the partially purified NaK-ATPase fraction was prepared, labeled with [gamma-32P]ATP, and analyzed by SDS-PAG-electrophoresis. The degredation rate constants of the large subunit were similar; 0.145 and 0.124 day-1 for the hypothyroid and T3-treated groups, respectively. Thus, the T2-dependent increase in incorporation of labeled methionine into the large subunit appears to result from enhanced synthesis and this increase is sufficient to account for the entire increase in both the number of the activity of the NaK-ATPase units.


Congenital bipartite scaphoid--fact or fiction? Whether there is such a condition as congenital bipartite scaphoid has long been debated. Five cases that fulfill the established criteria are presented, supplemented by a review of roentgenograms of 17,439 hands in which no case of bipartite scaphoid was detected. Serial sections of 196 fetal hands also failed to reveal any evidence of bipartite development of the scaphoid. We concluded that bipartite scaphoid is of traumatic origin and should be treated accordingly.


Morphological changes of the adipose cell plasma membrane during lipolysis. Morphological changes of the plasma membrane in the white adipose cell associated with lipid mobilization were assessed qualitatively and quantitatively on freeze-fracture replicas of epididymal adipose tissue from fasted and from streptozotocin-diabetic rats. The number of plasma membrane invaginations and intramembranous particles were evaluated per square micrometer of membrane and per entire adipocyte. These two determinations show that the number per square micrometer (local concentration) of both structural features progressively increases with the duration of diabetes and fasting, while that at the same time their number per entire cell (total content) remains unchanged. These data thus show: (a) a reorganization of the adipose cell plasma membrane during lipolysis; and (b) that this reorganization can be detected only by determining the concentration and the total content of the structural features of the membrane involved.


Serum dehydroepiandrosterone sulfate in premature infants and infants with intrauterine growth retardation. Serum dehydroepiandrosterone sulfate (DHAS) was measured by radioimmunoassay in blood samples obtained in 128 ill newborn infants. Serial sampling was carried out in 40 infants. There were wide ranges found in the values in all gestational age groups, and there were not significant differences in the first day of life between DHAS levels in less than 30 week gestation prematures, 6819 +/- 4631 (SD) ng/ml, and near term or term infants, 4307 +/- 1498 ng/ml. Mean DHAS concentrations did not decline over the first three weeks of life in prematures less than 36 weeks gestation. In six infants, age 35-73 days, and 29-34 weeks gestation at birth, the DHAS concentration was 1068 +/- 138 ng/ml. High concentrations were frequent in prematures less than 33 weeks gestation and could be correlated to epiodes of severe clinical stress. There were no significant differences in serum DHAS levels, on the first day of life, between infants with no hyaline membrane disease, nonfatal hyaline membrane disease and fatal hyaline membrane disease. Intrauterine growth retarded (IUGR) infants, who were greater than 35 weeks gestation, had significantly lower (P less than .032) DHAS levels in the first day of life than normally grown infants. The results show that there is a persistence during the postnatal period of the prominent delta5-3beta-hydroxysteroid production by the adrenal cortex characteristic of the fetus. Low concentrations of serum DHAS in IUGR infants suggest that the fetal zone of the neonatal adrenal cortex is a major source of circulating DHAS in the newborn period.


Increased insulin binding by hepatic plasma membranes from diabetic rats: normalization by insulin therapy. Hepatic plasma membranes prepared from rats rendered diabetic by streptozotocin bound approximately twice as much insulin per 50 mug protein as control membranes. Glucagon binding of diabetic and control membranes was virtually identical. This increased insulin binding was not due to a nonspecific effect of streptozotocin, decreased degradation of insulin slower dissociation from its receptor, or a selective higher yield of membranes prepared from the diabetic livers. Diabetic and control membranes both showed negative cooperativity. Scatchard analysis suggested that the difference in binding was due to an enhanced binding capacity of the diabetic membranes rather than increased affinity of the binding sites. Increased insulin binding of diabetic membranes was returned to normal by insulin treatment. These data are consistent with the postulate that there is an inverse relationship between circulating insulin levels and insulin binding and that insulin may modulate its own receptor. However, since it has been reported that fat, muscle, and hepatic tissue from rats made diabetic by alloxan administration are insensitive to insulin, the capacity for binding can not be the sole factor determining the response to insulin in diabetes mellitus. Therefore, sensitivity of the diabetic liver to insulin is determined, at least in part, by events subsequent to the binding of insulin to its receptor.


Suprresion of in vitro lymphocyte stimulation in mice by uterine and placental extracts. The effects of uterine extracts from virgin mice and uterine and placental extracts from mice at various stages of gestation on lymphocyte stimulation in vitro were compared. Placental and uterine extracts from mice in gestation, at 1% final concentration by volume, caused marked depression of lymphocyte reactivity to phytohemagglutinin-P (PHA) and to allogeneic cells in two-way mixed leukocyte cultures (MLC). An equivalent concentration of uterine extract from virgin mice caused slight depression of uterine extract from virgin mice caused slight depression of lymphocyte reactivity. Suppression was most of lymphocyte reactivity. Suppression was most marked with uterine extracts of mice at 15 days of gestation. At least two factors of different m.w. in uterine and placental extracts were responsible for suppression of lymphocyte reactivity. The higher m.w. fraction, present in small amounts in the uteri of virgin mice, was markedly increased in uteri of pregnant mice. This fraction contained immunoglobulin G (IgG). These factors may be involved in a protective role for the fetus from rejection by the mother as an allograft, thus assuring successful pregnancy.


The effect of locally injected vasoactive amines on the elicitation of delayed-type hypersensitivity. In previous work monoamine depletion due to treatment with reserpine was shown to decrease the elicitabiltiy of DTH responses in mice. In addition, treatment with monoamine oxidase inhibitors prevented the reserpine-induced decrease. These findings led to the suggestion that serotonin-induced increased vascular permeability is necessary to the development of DTH reactions, perhaps by allowing bone marrow-derived macrophage precursor cells, which are obligate components of DTH responses, to migrate through specialized venules into the site of the reaction. We have compared classical drug tachyphlaxis (temporary inhibition of the effects of a drug by prior treatment with agonists) to serotonin in vessels of mouse feet with local inhibition of DTH after serotonin pretreatment of mice. During the tachyphylactic period, DTH responses are depressed. This suggests that serotonin-induced tachyphylaxis of local endothelial receptors can be responsible for DTH inhibition. In contrast, local injection of histamine has no effect on DTH and this drug is a much less potent inducer of tachyphylaxis to serotonin-mediated vasoactive reactions. On the other hand, histamine can inhibit in vitro T cell reactions, which are not affected by serotonin. These data help to further the concept that serotonin plays an important role in the regulation of DTH in mice and that it probably does so by acting on vascular endothelium.


Immunologically specific cytolytic activity induced in long-term mixed leukocyte culture cells by concanavalin A. Stimulation of cells from long-term primary MLC with Con A resulted in the generation of CTL activity comparable in magnitude to that induced by reexposure of the cells to the original stimulating cellular antigen. CTL generated by stimulation of long-term MLC cells with ConA had lytic activity specific for the original stimulating alloantigen used in primary MLC. The pattern of stimulation of long-term MLC cells with Con A differed from that of restimulation with alloantigen in that there was no detectable CTL activity the first 24 hr after Con A stimulation and the peak lytic activity occurred later. Unlike restimulation with alloantigen early lytic activity after Con A stimulation was dependent on DNA synthesis. PHA also proved to be an effective agent for stimulating cytolytic activity in long-term MLC cells. The response to PHA was comparable in magnitude to that generated by Con A. Stimulation of long-term MLC cells with T cell mitogens gave decreased cell recoveries relative to restimulation with alloantigen, however, the lytic activity per cells recovered was generally greater in the mitogen-stimulated cultures.


Cytotoxic lymphocytes induced by soluble factors derived from the medium of leukocyte cultures. Studies were undertaken to evaluate the cytotoxic capacity of human peripheral blood lymphocytes activated by either supernatants (CFM) derived from lymphocyte cultures or lymphocytes treated for 60 min at 45 degrees C. The effect of the addition of heat-treated cells on the cytotoxic activity of CFM-induced effector cells was also studied. CFM from either unmixed or mixed cultures of lymphocytes was capable of activating cytotoxic effector cells. These effector cells could kill any allogeneic target cells but failed to effect cytotoxicity on the target cells autologous to the responding cells. Both the heat-treated cells and CFM from cultures of these cells also activated lymphocytes to cytotoxic effector cells having specific receptors for nonself antigens. The question of whether heat-treated cells activate cytotoxic cells by themselves or through secreted soluble factor cannot yet be clearly answered. The findings of the present investigation suggest that expression of cytotoxicity induced in MLC is not necessarily restricted to the target cells syngeneic to the stimulator cells, but can be extended to any allogeneic target cells by the indirect effect of soluble factor secreted from stimulated cells that causes a polyclonal activation of cytotoxic precursors in the responding cell populations. The present findings also emphasize the need for caution in the use of heat-treated lymphocytes as innocent-bystander cells in MLC to provide additional cytotoxic specificities in the responder cells, since heat-treated cells alone can activate lymphocytes to cytotoxic effector cells that kill any allogeneic target cells.


Bidirectional amplification of macrophage-lymphocyte interactions: enhanced lymphocyte activation factor production by activated adherent mouse peritoneal cells. Adherent peritoneal cells (90 to 95% macrophages) from mice injected with Mycobacterium bovis, strain BCG, or certain noninfectious agents such as pyran copolymer or phytohemagglutinin showed increased chemotactic and tumoricidal capacity in vitro. These activated macrophages elaborated 2 to 5 times more lymphocyte-activating factor (LAF) in vitro than equal numbers of adherent cells from untreated mice. In contrast, adherent PC from mice treated with thioglycollate or mineral oil were not cytotoxic and did not produce more LAF than PC from untreated mice. Adherent PC from untreated nude mice, which have increased chemotactic and tumoricidal capacity in vitro, also exhibited enhanced LAF production compared to adherent PC from their normal littermates. Increased production of LAF was also evident with adherent PC and the macrophage-like tumor cell line P388D1 after incubation in vitro with bacterial endotoxins or with antigen-induced lymphokines. These data indicate that adherent PC can be activated either in vivo or in vitro to elaborate more LAF. Thus, activated macrophages are more effective than normal macrophages in amplification of the afferent limb of immune responses as well as in their effector functions.


Effect of intravenous or intra-amniotic injection of dehydroepiandrosterone sulphate on oestrogen levels in urine and serum in late pregnancy with live anencephalic foetuses. Dehydroepiandrosterone sulphate (DHAS) was injected intravenously or intra-amniotically into eight volunteers carrying live anencephalic foetuses (including one microcephalic foetus). Urinary and unconjugated serum oestrone, oestradiol and oestriol were measured before and after DHAS administration. In seven pregnant women with live anencephalic foetuses the urinary excretion of oestriol was very low, and the ratio of oestriol to oestrone + oestradiol was much less than that during normal pregnancy. Increases of urinary oestrone and oestradiol but no significant change in the ratio of oestriol to oestrone + oestradiol were observed 24 h after i.v. administration of DHAS to five patients. In three patients, between 1 and 12 h after i.v. administration of DHAS (100-200 mg), the concentrations of serum oestrone, oestradiol and oestriol increased to 13-5, 6-8 and 3-1 times the control values, respectively. After injection of DHAS (200 mg) intra-amniotically into two patients, the urinary excretion of all three oestrogens increased much more on day 2 than on day 1, and the ratio of urinary oestriol to oestrone + oestradiol rose greatly. On the other hand, the concentrations of unconjugated serum oestrogens in these patients increased progressively between 1 and 12 h or more after DHAS administration, and the maximal level of serum oestriol was 9-8 times the control value while those of oestrone and oestradiol were 4-6 times and 5-0 times the control values, respectively. These results suggest that in late human pregnancy DHAS in the circulation of the mother is converted to oestriol largely via the phenolic pathway (DHAS leads to oestrone leads to oestriol), whereas DHAS circulating within the foeto-placental compartment is converted to oestriol via both the phenolic and the neutral intermediates.


Developmental patterns of rat muscle histochemistry. A developmental progression of histochemical fiber typing is demonstrated in normal rat soleus muscle. By utilizing the acid lability of ATPase, the type II fibres are subdivided into type IIA, IIB and IIC. No IIB fibers are present in the newborn or adult rat soleus. In the 1-day-old animal 90% of the fibers can be differentiated into type I and II with all of the type II's demonstrating IIC characteristics. Only type I and IIC fibers are present until 18 days, when poorly differentiated IIA fibers first appear and gradually become the predominant type II fiber at the expense of IIC's. Further analysis documents the sequence of disappearance of myotubues from up to 80% of all fibers in the 1-day-old to less than 1% between 15 and 18 days. An analysis of the progression of fiber size according to type is presented.


Specific binding of K- and I-region products of the H-2 complex to activated thymus-derived (T) cells belonging to different Ly subclasses. Responder cells [C57BL/6J X A.TL)F1 lymph node cells depleted of bursa equivalent-derived (B) cells by filtration through nylon wool columns] were activated against incompatible K-region and I-region products together under conditions where these antigens are presented on separate stimulator cells. The resulting T blasts were stained with different concentrations of antisera directed against incompatible stimulator K-region or I-region products, or both. We obtained results that strongly suggest that in these cultures each activated responder blast stains with antiserum directed against either K-region or I-region products, but not both. Responder blasts from the same cultures were treated with antiserum and complement (C) directed against either Ly-1.2 or Ly-2.2 T-cell-specific surface antigens. Anti-Ly-1.2 serum and C specifically eliminates virtually all responder blasts staining with antiserum directed against stimulator I-region products; whereas anti-Ly-2.2 serum reduces to background levels the proportion of cells staining with antiserum against stimulator K-region products. The results obtained suggest that T cells binding stimulator K-region and I-region products, respectively, belong to two different subclasses distinguishable by their Ly phenotypes. Possible explanations for this association of T- cell subclass and specificity are discussed.


Detection, isolation, and functional characterization of two human T-cell subclasses bearing unique differentiation antigens. A heterologous antihuman T-cell serum (anti-TH1), raised against purified peripheral T cells, and absorbed with an autologous Ig+ line, was shown to bind specifically to T- but not to B-lymphoid cells by both a complement-dependent cytotoxic assay and indirect immunofluorescence. Whereas 90% fetal thymocytes and thymocytes were killed by anti-TH1 and complement, a consistently restricted population (50-60%) of peripheral T cells from several normal donors were lysed, indicating that anti-TH1 is directed against one or more thymus-specific antigens which are lost or reduced on a subpopulation of human T cells in the periphery. Functional analysis of the unreactive (TH1-) and reactive (TH1+) T-cell subclasses demonstrated that TH1- cells mounted a good proliferative response to a battery of specific soluble antigens (mumps, PPD, tetanus toxoid) but neither responded in MLC, nor elaborated LMF in response to tetanus toxoid. In contrast TH1+ cells proliferated in MLC and elaborated LMF but did not respond by 3H-incorporation to soluble antigens. The relevance of these findings to human T-cell functions in vivo and to previously described functional subclasses of murine T cells is discussed.


Levodopa and Huntington's chorea.

Levodopa and Huntington's chorea. Two patients with Huntington's chorea are reported whose psychiatric and neurological symptoms greatly improved after treatment with L-dopa. In both cases the basal values of CSF HVA were markedly decreased, being increased by the treatment with L-dopa.


The fine localization of ATPases in cultures in vitro of chick embryo spinal cord. A histochemical study of the ultrastructural localization of ATPases in cultures of chick embryo spinal cord has been carried out. The localization of Ca2+ and Mg2+ activated membrane ATPases appears similar: both enzyme activities are localized on the outer surfaces of plasma membranes of all kinds of cell present in the cultures, with the exception of the membranes in direct contact with the culture medium. The results are discussed in relation to data concerning the localization and function of ATPases in vivo and in relation to the possible establishment of mechanisms of nutrient uptake and transfer in cultures of nervous tissue.


Myocardial images in nonacute coronary and noncoronary heart diseases. To determine the variables that might affect interpretability of myocardial perfusion images in patients with acute myocardial infarctions, images obtained following intravenous administration of potassium-43 or cesium-129 were evaluated in 68 patients with nonacute coronary or noncoronary heart diseases, who were undergoing cardiac catheterization. Severe coronary arterial disease usually produces no distinctive perfusion defects in the resting state. Remote infarcts likewise tend to remain undetectable unless accompanied by wall-motion disturbances that can be detected by ventriculography. Left ventricular hypertrophy or cardiac dilatation can produce perfusion patterns indistinguishable from the ischemic defects of infarction. Right ventricular hypertrophy can cause image alterations that mimic infarcts in the left ventricle. In patients with acute myocardial infarction, sequential imaging studies with perfusion indicators should be of value in determining the effects of various therapeutic maneuvers on regional myocardial perfusion, but variations caused by conditions other than acute vascular occlusion limit the usefulness of perfusion imaging for diagnosing acute infarction. In suspected acute infarction, perfusion imaging will be used most effectively in conjunction with other imaging or nonimaging procedures that show the presence of damaged or necrotic myocardium. The information derived from this study should be generally applicable to the interpretation of imaging results obtained with the newer indicators of myocardial perfusion now in use or under development.


Fluid administration in the association of patent ductus arteriosus complicating respiratory distress syndrome. Daily weights and mean daily fluid volumes administered to 62 infants with birth weights of less than 2,000 gm, who required respiratory support for respiratory distress syndrome, were reviewed. In 31 infants signs of patent ductus arteriosus developed. In a comparison group of 31 infants, the mean daily fluid volume was 144 ml/kg/24 hours, and the mean body weight was 102% of expected, differing significantly from the 189 nl/kg/24 hours, and 114% of expected weight in those infants who developed PDA. Those infants who developed PDA had not differed significantly from the comparison group in either mean daily fluid volumes or expected weights prior to a period two days before clinical evidence of PDA. Seven infants developed PDA in association with increased fluid administration on more than one occasion during nursery stay. Diuresis after excessive fluid administration was associated with improvement in, or resolution of, signs of PDA in many infants. The results suggest that excessive fluid administration to premature infants with RDS may be one factor associated with the developed of PDA complicating RDS (PDA/RDS).


A new mouthstick prosthesis for handicapped patients. Most mouthstick prostheses previously described in the literature have severely limited application or availability. They are either highly specific and sophisticated and difficult to fabricate or very crude and unifunctional. Most do not conform to basic functional and physiologic criteria as outlined, nor are they sufficiently flexible to meet the various needs and physical capabilities of of a wide spectrum of patients. The prosthesis described is adaptable, and with the basic bite-stick and the friction-grip lock, the patient can change the form and function of the device to perform various tasks independently. The prosthesis is simple, inexpensive, and easy to fabricate and repair, and it needs no specialized or sophisticated parts. It enables handicapped patients to attain a greater degree of self-sufficiency than was previously possible, which improves their mental outlook.


Identifying handicapped people in general practice. This study used the age-sex register of a group medical practice as the population base for a postal and follow-up interview enquiry to locate handicapped people and examined the possibility of the combined use of a practice diagnostic index and the patients' medical records for the same purpose. The age-sex register was found to contain deficiencies and inaccuracies despite the substantial efforts of members of the practice team to maintain it, for example, 13.5 per cent of the forms were returned as the addressee was unknown at the address.The 81.5 per cent of householders who responded identified 353 impaired people who were subsequently interviewed about the nature of their impairment, the underlying condition, and the range of their activities. Depending upon the answers to these questions, a proportion of these people were classified as handicapped and were asked further questions. The number of impaired people and their distribution in sex and age-groups were broadly similar to the findings from other surveys. The diagnoses of the underlying conditions given by the impaired people were discussed with the general practitioners and confirmed or otherwise by the use of the patients' notes or the recollections of the general practitioners.It was concluded that while the use of a diagnostic index would be helpful for some conditions, there would remain a substantial number of people with a disease that is potentially disabling who would have to be approached for further screening and also a substantial number of people who are handicapped, but who would be missed.


A comparison of subcutaneous and preperitoneal emphysema arising from gynecologic laparoscopic procedures. Out of 1,300 cases of gynecologic laparoscopic procedures reviewed, three incidences of preperitoneal emphysema and several incidences of subcutaneous emphysema were noted. There were a few significant differences in the diagnosis and management of these two types of emphysema. In the medical literature reviewed by the author, preperitoneal emphysema has not been discussed while subcutaneous emphysema has received quite a lot of attention. Preperitoneal emphysema is defined as a collection of air or other gas which occurs in the tissue spaces between the abdominal fascia and the ventral peritoneum.


Cardenolide analogues. 1. A 17beta-unsaturated aldehyde. A 17beta-unsaturated aldehyde analogue [3beta,14beta-dihydroxy-5beta-pregn-17beta-trans-20-en-22-al (7)] of the cardenolides was synthesized and studied. In earlier studies by Rappoport, unsaturated aldehydes were found to be highly active electrophiles, more active, for example, than unsaturated nitriles or methyl esters. The synthesis followed in part a scheme previously reported by Thomas for the syntheses of the 17beta-unsaturated nitrile 9 and the 17beta-unsaturated methyl and ethyl esters 8 and 10. Both 9 and 8 are more Na+,K+-ATPase inhibiting and slightly less inotropic than digitoxigenin (1b). However, the unsaturated aldehyde 7 was less Na+,K+-ATPase inhibiting (I50 - 9.9 +/- 0.7 X 10(-7) M) and less inotropic (100% increase in contractile force at 8.5 +/- 1.0 X 10(-6) M) than 1b (I50 - 4.6 +/- 1.6 X 10(-7) M; 100% increase at 3.0 +/- 1.0 X 10(-7) M).


Association of D/D translocations with fetal wastage and aneuploidy. A report of four families. Four families are described with a t(13q14q) segregating. Two of them were identified through index cases with Down's syndrome; their karotypes revealed the unusual 46,XY, -13, -14, +t(13q14q), +21. The other two families were identified through a chromosomal study of parents with repeated spontaneous abortions. Analysis of data on 3 of these 4 families and on 7 other from the published reports showed no evidence of increased fetal wastage among 13/14 carriers. However, the risk of producing offspring with various types of aneuploidy may be greater among carriers than among persons with a normal chromosome pattern. Qualitative and quantitative differences in D/D translocations may account for the observed variation in clinical findings. These differences add to the problem of determining genetic risks from an analysis of grouped data.


A giant short arm of no. 21 chromosome in mother of 21/21 translocation mongol. An extreme variation of the short arm of no. 21 chromosome in the mother of a 21/21 translocation mongol is described. The possible relation between the very long short arm of chromosome no. 21 in the mother and a centric fusion type of translocation mongolism in the offspring is discussed.


The cause of G2-arrest in Chinese hamster ovary cells treated with anticancer drugs. The nature of G2-arrest was studied in Chinese hamster ovary cells after exposure to 4'-demethyl-epipodophyllotoxin 9-)4,6-0-2-thenylidene-beta-D-glycopyranoside (VM26), 1,3-bis(2-chloroethyl)-1-nitrosourea, 1,3-cis(2-chloroethyl)-1-nitrosourea, cis-4[[[(2-chloroethyl)-nitrosoamino] carbonyl] amino]- cyclohexane carboxylic acid, or neocarzinostatin. To determine whether this G2-arrest was due to a metabolic block or to damage to the genetic material, we employed the phenomenon of premature chromosome condensation to visualize the chromosomes of the G2-blocked cells by fusing them with mitotic cells. The prematurely condensed chromosomes (PCC) of the treated cells were scored for their position in the cell cycle and the extent of chromosomal damage in the G2-PCC. The data revealed a significant enrichment of the G2-fraction in all the treatments. Most of the G2- PCC from the treated cells were extensively damaged, showing 10 or more breaks and exchanges per cell. These studies clearly indicated that the treated cells accumulated in G2-phase because of their failure to progress into mitosis as a direct or indirect result of the extensive damage to the chromosomes.


Preliminary report on the therapeutic effect of mebendazole in guinea worm infection. Mebendazole was found to be effective in the treatment of patients infected with adult guinea worms. The patients consistently reported a rapid relief of pain, tenderness and swelling. The worms emerge from the ulcers in a degenerated, fragmented form. No extraction of worms is needed as the fragments are expelled spontaneously. Some cases need repetition of treatment when fresh lesions appear but healing is as rapid as in original lesions. No side-effects were encountered in spite of repetition of the course in some cases. The drug was well tolerated by all the patients included in the present study.


Thromboendarterectomy for anuria 4 1/2 years post-renal transplant: a case report. A 45-year-old woman with a functioning renal transplant for more than 4 years presented with an acute myocardial infarction and anuria. Arteriograms demonstrated an occluded hypogastric artery. Thromboendarterectomy and instillation of fibrinolysin restored renal blood flow. Although death followed recurrent myocardial infarction 1 week postoperatively, urine output was improving and autopsy revealed viable renal tissue.


Ureteral structure and ultrastructure. Part III. The congenitally dilated ureter (megaureter). A selected group of congenitally dilated ureters was examined under light and electron microscopy, and the findings were compared to the clinicoradiologic features of each ureter. These dilated ureters exhibit qualitative and/or quantitative muscular deficiencies. The obstructed megaureters secondary to posterior urethral valves and the megaureters with reflux show non-specific pathologic changes in response to increased work load or decompensation but infection within the ureter is detrimental to the muscle cells. The ureters in babies with prune belly syndrome suffer from reduced muscle cell population and a distinct myopathy involving the myofilaments within the muscle cells. The dysplastic ureter is morphologically and end stage ureter wherein the muscle cells are severely compromised. Whether this is an underdevelopment or exhaustion from repeated infections is a matter for speculation.


Extraordinary bladder clots.

Extraordinary bladder clots. The patient with hematuria and clot retention who has an abnormality in urokinase-plasmin production or coagulopathy may have extraordinary clots. An understanding of the underlying disease and pathophysiology of clot formation will enable the urologist to better evaluate and treat this type of patient. Aberrations in urokinase-plasmin production or consumption occur in many disease states that may not be recognized generally.


Spontaneous extravasation of urine from the anterior urethra. When urine extravasates from the diseased anterior urethra the subcutaneous tissues beneath Colles' and Scarpa's layers are suffused and necrosis of these tissues is inevitable. Traditionally, surgical treatment has been incision and drainage. Despite improvements in systemic antimicrobial therapy mortality rates remain high. Since necrosis of subcutaneous tissue is inevitable and since the extent of suffusion is discernible, we have treated these patients by primary excision of all edematous subcutaneous tissue. Using patients treated conventionally at our own institution as controls we have demonstrated a significant reduction in the mortality rate. We also have demonstrated that certain findings in the initial evaluation of the patient are of value in assessing prognosis.


Mixed leukocyte culture incompatibility index for donor-recipient selection in kidney transplantation. The mixed leukocyte culture test has been applied to selection of histocompatibility non-identical donor-recipient pairs for renal transplantation. The clinical course of transplant recipients who have histocompatibility mismatches but low mixed leukocyte culture stimulation is similar to that of mixed leukocyte culture and histocompatibility identical recipients. Living donor-recipient pairs with high mixed leukocyte culture stimulation had no better graft survival than cadaver recipients. An incompatibility index derived from mixed leukocyte culture may aid in the selection of satisfactory non-identical living related donors and may help avoid use of immunologically unsatisfactory living donors.


Effect of humoral modulators of morphine-induced increase in locomotor activity of mice. The effect of humoral modulators on the morphine-induced increase in locomotor activity of mice was studied. The subcutaneous administration of 10 mg/kg of morphine-HC1 produced a marked increase in locomotor activity in mice. The morphine-induced hyperactivity was potentiated by scopolamine and attenuated by physostigmine. In contrast, both methscopolamine and neostigmine, which do not penetrate the blood-brain barrier, had no effect on the hyperactivity produced by morphine. Pretreatment of mice with alpha-methyltyrosine (20 mg/kg i.p., one hour), an inhibitor of tyrosine hydroxylase, significantly decreased the activity-increasing effects of morphine. On the other hand, pretreatment with p-chlorophenylalamine (3 X 320 mg/kg i.p., 24 hr), a serotonin depletor, caused no significant change in the hyperactivity. The study suggests that the activity-increasing effects of morphine are mediated by the release of catecholamines from adrenergic neurons in the brain. And the results are consistent with the hypothesis that morphine acts by retarding the release of acetylcholine at some central cholinergic synapses. It is also suggested from collected evidence that the activity-increasing effects of morphine in mice are mediated by mechanisms different from those which mediate the activity-increasing effects of morphine in rats.


[Efficacy and tolerance of trimethoprim sulfamoxole combination in childhood (author's transl)]. CN 3123 was tested in 4 hospitals on 257 children, 218 of whom were included in the evaluation of the success of therapy. It was administered for the treatment of urinary tract infections (n = 125), bronchial infections (n = 24), intestinal infections (n = 25) and ENT infections (n = 37). The results indicated that, with a failure rate of only 7%, the drug was successfully employed. Tolerance to the medicament was good. Vomiting occurred in 7 children (2.7%) and allergic skin reactions were observed in 6 children (2.3%). A comparative study of CN 3123 and Co-trimoxazole showed the same efficacy and tolerance for both medicaments.


[Ingestion and NBT reduction capacity of polymorphonuclear leucocytes in trisomy 21 (author's transl)]. Polymorphonuclear leukocytes of 30 patients suffering from Trisomy 21 between the ages of 3 months and 21 years were examined by means of a modified NBT-test. Ingestion capacity as well as NBT reduction capacity of polymorphonuclear leukocytes showed a decrease in dependence on the age of the patients examined. It is supposed that both disorders are involved in endangering patients with Trisomy 21 by infections.


Overview of early and investigational chemotherapeutic agents in solid tumors. A tentative evaluation is proposed for the clinical status of 15 early and investigational drugs in human solid tumors.


[ATP content in Candida tropicalis cells growing at different temperatures]. The thermotolerant yeast Candida tropicalis, strain T-20, was cultivated on a chemically defined medium with glucose or malt wort in flasks with shaking at three temperatures: optimal (36degreesC), supraoptimal (38degreesC) and submaximal (41degreesC). An increase of temperature within these limits caused an increase in ATP content in yeast cells and a decrease in phosphohydrolase (ATPase) activity.


[Biological activity and mobilization of nitrogen in dark gray soil of the Chimkent Region]. Considerable amounts of easily hydrolysable nitrogen were found in the subarable layer of the dark gray soil of the Chimkent Region. The biological activity of the subarable layer was close to that of the arable layer.


[Effect of fertilizers on the number of bacteria involved in the turnover of nitrogen in pond water of the Astrakhan Region]. The type of intensification affects the distribution of bacteria involved in turnover of nitrogen in pond water. Green fertilizers (reed) stimulate the number of nitrogen-fixing bacteria, and the number and activity of nitrifying bacteria, to a higher degree than nitrogen and phosphorus fertilizers. Reed is recommended as the main means for intensification of spawning ponds of the Astrakhan Region.


[Dentistry for the handicapped].

[Dentistry for the handicapped]. The treatment of the handicapped is discussed in the light of the alterations by which they are most commonly afflicted. The relationship between such subjects and dentists is examined. The results of personal experience are presented. It is suggested that a greater degree of attention should be given to this question by the health authorities.


Brain serotonin and estradiol retention in the hypothalamus and pituitary of the rat. In order to investigate whether the capacity of hypothalamic and anterior pituitary tissue to concentrate and retain estradiol is affected by serotonin (5-HT), 3H-estradiol (3HE2) retention in these structures was measured after 5-HT synthesis inhibition by either parachlorophenylalanine (PCPA) or 6-fluoro-tryptophane (6 FTrp), or after destruction of midbrain raphe nuclei containing 5-HT cell bodies, as well as after administration of the 5-HT precursor 5-hydroxytryptophane (5-HTP). No modification in 3HE2 retention was observed after tryptophane hydroxylase inhibitors of raphe lesions; administration of the precursor only increased the steroid retention at very high, nonphysiological dose levels. It is concluded that the interaction of 5-HT with gonadotropic release cannot be accounted for by a direct effect on specific estrogenic receptors, but occurs at a different level of gonadotropic release regulating structures or directly on LH-RH neurons.


An epidemiology of disability among adults in the United States. This paper presents the findings of an epidemiological analysis of disability among adults in the noninstitutionalized continental United States population. Data were collected through interviews with a probability sample of persons 18 and over, yielding 6,493 completed schedules comprising 80.3 percent of the sample. Distinctions were made among concepts and indicators of pathology, impairment, individual performance, and social performance. Central to the analysis were two dimensions of individual performance (physical and emotional) and two dimensions of disability in social performance (work and independent living). A number of socio-demographic characteristics were included in the analysis. The results show the relative contributions of pathology and impairment to performance on the individual level, and the relative contributions of all of these factors on social performance, that is, the two dimensions of disability. Through pathology, impairment, performance at the individual level, and the socio-demographic characteristics, it was possible to account for 38 percent of the variance in work disability and 74 percent of dependence-independence in community living. Further explanations are given for variance in work disability. Estimates of the size of populations reporting varying types and severities of disability are also presented.


[Indications for selective coronary angiography]. At present, selective coronaro-angiography offers the only means of establishing the seriousness, extent and site of coronary sclerosis. It has led to the development of coronary surgery, itself a considerable advance in the treatment of coronary disease. The method is also of considerable assistance in the differential diagnosis of inexplicable ECG changes and other heart diseases. It is relatively free from risk if performed by experienced staff with suitable equipment and in line with the correct indications.


[Pericarditis in recent myocardial infarct]. Epistenocardial pericarditis, usually associated with anterior infarct, was noted in 64/400 myocardial infarct subjects admitted to an intensive care unit. No significant difference was observed with respect to this group in the case of mortality (20.6% as opposed to 26.2% in the controls) or complications of the acute stage, such as cardiac insufficiency and arrhythmia, though atrial fibrillation was more frequent (25% as against 15%). In all but one case, anticoagulant management was suspended on the appearance of pericarditis. In spite of the high frequency of atrial fibrillation, thromboembolic complications were not more frequent during brief (48-72 hr) suspension of anticoagulants. Dressler's syndrome was noted in 7 cases (1.7%), with epistenocardial pericarditis (4/7) or ventricular ectasia (3/7). Haemopericardium occurred in the case where anticoagulant management was not suspended.


Needle laparoscopy in patients with suspected bowel adhesions. Suspected bowel adhesions are generally considered to be a contraindication to laparoscopy. Among 32 patients who were refused laparoscopy for that reason, only 1 patient was found to have adhesions at laparotomy. To attempt preoperative diagnosis of intraabdominal adhesions, needle laparoscopy was performed in 21 patients using a 1.7-mm endoscope. In 20 of the patients it was possible to establish the presence or absence of adhesions and to determine the feasibility of laparoscopic sterilization. This preliminary evaluation suggests that needle laparoscopy may avert bowel perforation in some instances and may permit laparoscopic tubal sterilization to be performed in some women who would otherwise, because of multiple previous operations, be denied laparoscopy.


Laparoscopic tubal sterilization by the "burn only" technic. A 5-year combined experience of 2857 cases of the "burn only" technic for laparoscopic tubal sterilization is reviewed. One method failure resulted in an ectopic gestation. There were no operator errors. One laparotomy 36 hours after the sterilization procedure was done. No hemorrhagic complications and no bowel burns were encountered. From a review of the literature and the results presented here, it seems that adequate coagulation of a generous segment of the tube is the critical factor in preventing subsequent pregnancies. Tubal division or resection appears to offer no improvement in efficacy, and when tissue is obtained for pathologic confirmation, it is often of no value. When coagulation plus division or resection is performed, the incidence of hemorrhagic complications and bowel burns increases markedly.


Enzyme histochemistry of ovarina lipoid cell hyperplasia in a masculinized patient. In an effort to better identify the specific steroids produced by histologically similar cells of certain ovarian tumors, a battery of histochemical assays was performed on a masculinizing tumor removed from a 21-year-old patient. Certain reactions were distinguished that seemed to be specific for the histologically classic luteinized stromal cell, and these reactions can be correlated with those obtained with Leydig and hilar cells. The apparent precursors of the interstitial cells (ISC) of this tumor, and to a lesser extent the immature ISC, possess unusually high cholinesterase activity, especially with the butyryl ester. The importance of the perivascular and neural elements in the process of steroidogenesis is suggested by the findings in this case.


Sacral chordoma. A rare cause of chronic pelvic and low-back pain. A case of sacral chordoma causing chronic, persistant low-back pain for 5 years is reported. This tumor was palpable on pelvic and rectal examination in the presacral area. Early excision is the treatment of choice for this slow growing tumor of primitive notochordal origin. Diagnosis is often late and incomplete surgical excision leads to local recurrence and eventual death. Knowledge of the existence of this rare condition, together with careful pelvic and rectal examination, are the importnat keys to diagnosis and possible curative treatment.


Immmune complex glomerular disease in argyric mice. A mesangiopathic glomerulonephritis with prominent mesangial immunoglobulin deposits was induced in mice by single or multiple intraperitoneal injections of bovine serum albumin. The silver-labelled basement membrane in mice which had ingested 6mM silver nitrate in drinking water proved a useful marker indetermining that the immune deposits were on the intracapillary aspect of the basement membrane.


Some immunological aspects of preeclampsia. Objective immunological methods of determining the mother's immunological response to her husband's and cord leukocyte antigens are being used in a three-year study of women who develop severe preeclampsia during pregnancy. The maternal leukocyte response to the nonspecific mitogen phytohemagglutinin and nonspecific mitogen phytohemagglutinin and to paternal and cord leukocyte antigens in the mixed leukocyte culture suggests a tendency for toxemic women to be relatively hyporesponsive. No effect of autologous maternal serum is demonstrated in the group as a whole. Women's cord leukocyte response to their own maternal antigens is less in toxemic pregnancies. A significant immunosuppressive effect of autologous cord serum is observed in preeclamptic pregnancies. Serum seromucoid levels are elevated in the toxemic women during and after the index pregnancy; also, toxemic women show a lack of anti-HL-A antibody formation. Such data suggest, but do not prove, that immune mechanisms may be operative in preeclampsia.


The clearance rate of maternal plasma prehormones of placental estrogen formation. A method has been established for the determination of the placental clearance of maternal plasma prehormones by placental estrogen formation during human pregnancy. Utilizing this concept, the placental clearance is calculated as the product of the metabolic clearance rate from maternal plasma of the prehormone and its fractional conversion to estrogen by the placenta. This value equals the volume of maternal plasma cleared of that prehormone by the irreversible formation of its estrogenic product hormone per unit of time. The placental clearance rate technique can be performed by intravenous infusion of isotope-labeled prehormone and product, and the metabolic clearance rate as well as the transfer constant can be measured by techniques employing plasma values or by a combination of plasma and urinary methods. Utilizing this type of study, the placental clearance of plasma prehormones has been observed to be increased initially in women destined to develop pregnancy-induced hypertension but declines prior to the onset of hypertension and continues to decline until delivery is effected. Moreover, the administration of diuretics and/or the institution oental clearance of plasma prehormones from the maternal compartment in normal gravidas, in those destined to develop pregnancy-induced hypertension, and in gravidas who are hypertensive from any cause.


Renal blood flow during ureteral obstruction measured with 133Xe wash out, 86Rb uptake techniques and with an electromagnetic flowmeter. In moderate mannitol diuresis in the dog the ratio RBF-86Rb uptake/RBF-electromagnetic flowmeter decreased during ureteral obstruction from 0.923 - 0.705. In the same animals the ratio RBF-133Xe wash-out/RBF-electromagnetic flowmeter increased from 0.932 - 1.365. With the rubidium technique a significant redistribution of intrarenal blood flow was observed. No similar flow changes were seen with the 133Xe wash-out technique. The two methods do not measure during ureteral obstruction the true RBF. The change of 86Rb uptake by the individual segments of renal tissue is not an unequivocal proof for the intrarenal redistribution of blood flow, but this possibility cannot be definitely excluded.


An isothermal flowmeter with improved frequency response for measuring tissue blood flow. An isothermal flowmeter with improved frequency response for measuring tissue blood flow was developed using thermistors. Direct heating of the thermistors allows a simple construction of small (0.5 mm outer diameter) capillary probes which do not require any additional heating coil. The changes of a feedback current necessary to keep the thermistor at a constant increment above tissue temperature indicate tissue blood flow; a second thermistor compensates variations of tissue temperature. The dynamic performance of the device shows a low-pass characteristic with a cut-off frequency higher than 5 Hz. For low flow rates the output signal was found to be proportional to the flow; for higher flow rates a linearization was necessary. Since tissue temperature can be recorded continuously, intermittent quantitative in-vivo calibration seems possibly by evaluation of "heater off" curves in the perfused and non-perfused tissue. As the flowmeter is insensitive to tissue temperature, it can be used for long-term recordings.


Physical map of Neurospora crassa mitochondrial DNA and its transcription unit for ribosomal RNA. A circular denaturation and restriction map of mitochondrial DNA from Neurospora crassa is presented. The map shows the position of all twelve fragments produced by restriction endonuclease Eco R I and the position of the largest Hin III fragment along the previously established map of AT-rich sequences. The two wild type strains Em 5256 and 7A differ in the lengths of two Eco R I fragments. No difference was found between the mitochondrial mutant "poky" and its parent strain. The position of the DNA segment carrying the transcription unit for the two ribosomal RNA molecules has been determined by molecular hybridization.


Effects of para-chlorophenylalanine upon brain stimulated affective attack in the cat. Previous investigations of the effects of parachlorophenylalanine (PCPA) on affective attack have produced equivocal results. The present report examined the effects of PCPA upon attack elicited by electrical stimulation of the ventromedial hypothalamic nucleus in the cat. Using a within-animals design and postdrug testing clear potentiation of affective attack patterns was observed for a number of the components of attack behavior (approach, use of forepaws, and biting). The present results may point to possible serotonergic involvement in the inhibitory control of several aspects of affective attack.


Monoaminergic mediation of masculine and feminine copulatory behavior in female rats. Ovariectomized rats treated with testosterone propionate (TP; 100 mug/kg X 6 days) and para-chlorophenylalanine (pCPA; 100 mg/kg X 3 days), a serotonin synthesis inhibitor, showed more masculine copulatory behavior (including the ejaculatory pattern) than did females receiving either TP or pCPA alone. The facilitatory effect of pCPA on the masculine copulatory behavior in females was not potentiated by pargyline (50 or 100 mg/kg), a monoamine oxidase inhibitor; instead, pargyline antagonized the effect of pCPA. Apomorphine (100 mug/kg), a dopamine receptor stimulant, did not increase masculine copulatory behavior in TP treated females. Adopaminergic facilitatory effect was therefore not demonstrated. These results suggest a serotonin-mediated inhibition of masculine copulatory behavior in female rats. When feminine copulatory behavior was tested, females receiving TP plus pCPA plus pargyline, TP plus pargyline, or TP plus apomorphine displayed lordosis in response to mounting by male rats. Lordosis did not occur after administration of TP, PCPA, or pargyline, individually or in any other combination. The responses in pargyline groups are consistent with the hypothesis of a  noradrenergic facilitatory system for lordotic behavior. The responses in the apomorphine group are discussed in terms of a possible role for low level dopaminergic stimulation in facilitating lordosis.


Erythrocyte membrane cation carrier, relapse rate of manic-depressive illness and response to lithium. Biochemical studies of manic-depressive psychosis usually correlates biochemical findings with current affective state and hence any significant findings could be secondary to mood change. The present study attempts to correlate measures of the erythrocyte membrane cation carrier with clinical events, remote in time from the biochemical assay. Eprythrocyte sodium concentration, ouabain-sensitive potassium influx and Na-K ATPase were estimated in 11 patients before and after the cross-over point in a 2-year double blind clinical trial ratio tended to suffer most episodes of affective illness in the 2 years. Patients who had a low initial Na-K ATPase or a high initial flux sodium ATPase ratio, or in whom this ratio fell most with lithium or whose Na-K ATPase rose most with lithium, clinically responded best to lithium.


N-methylnicotinamide excretion and affective disorders. N-Methylnicotinamide urinary output is examined in 38 healthy volunteers, 52 patients with secondary affective disorders (SAD), 55 patients with primary affective disorders (PAD) and 46 healthy first-degree relatives of PAD patients. The results indicate (1) that in PAD patients and their first-degree relatives the frequency of low N1-MN excretion was significantly higher (P less than 0-001) than in healthy controls and in patients with secondary affective disorders, and (2) that PAD patients have a consistently low N1-MN output, at all times constant and independent of the clinical phases of the disease. These findings provide evidence that the low N1-MN levels may represent an index of a biological background linked to a high morbidity risk for primary affective disorders. The theoretical implications deriving from these data are briefly discussed.


Erythrocyte membrane cation carrier in mania. Erythrocyte sodium and potassium concentrations, erythrocyte membrane ATPase (Na-K specific and non-specific) and the rate of potassium influx into erythrocytes (ouabain-sensitive and insensitive) were estimated in a group of female patients suffering from mania and repeated on about two thirds of them when they had recovered. With recovery there was a statistically significant increase in the erythrocyte ouabain-sensitive potassium influx. The other parameters showed no significant overall change with recovery but the initial severity correlated significantly and negatively with the change in erythrocyte Na-K ATPase with recovery. The changes that occurred in the erythorcyte sodium concentration and Na-K ATPase activity were not random since they correlated significantly with changes in the active potassium influx.


Characteristics of tetrahydrocannabinol (THC)-produced discrimination in rats. Rats were trained in a T-shaped maze to discriminate the effects produced by i.p. injections of tetrahydrocannabinol (THC) and the no-drug state (state-dependency, StD). Several doses of both Delta8-THC (range: 0.75-5.0 mg/kg) and Delta9-THC (range: 0.75-40.0 mg/kg) were used in order to compare the number of sessions required by the animals until reaching criterion performance. An additional group of rats had to discriminate pentobarbital sodium (20.0 mg/kg) from the no-drug state. THC discrimination was proportional to dose i.e., animals that had to differentiate high doses of THC from no drug acquired the T-maze task faster than animals trained with the lower doses of THC. Acquisition data further suggest that Delta8-THC is somewhat less potent than the Delta9-isomer. Delta9-THC (10.0 mg/kg) produces strong StD, as defined by Overton (1971), since both this group and the barbiturate group reached the criterion within the first 10 training sessions. Time and dose testings suggest that stimulus properties of drugs vary in a quantitative way and that the calculated ED50 values are mainly determined by the training dose used. It was found that the higher the training dose used the higher was the corresponding ED50 value. Hashish smoke can maintain drug responding among THC-trained rats. A lowered content of brain catecholamines and/or serotonin, induced by AMPT (150 mg/kg) and PCPA (310-350 mg/kg), did not lessen Delta9-THC (2.5 mg/kg) discrimination.


Positive skin reactions to gluten in coeliac disease. Following intradermal challenge with a peptic-tryptic digest of gluten, visible Arthus-type skin reactions were observed in 33 per cent of a group of 55 adults with coeliac disease. Of the 23 with untreated disease positive skin reactions occurred in 52 per cent. There was an invariable association between serum gluten antibodies and the presence of a skin reaction to gluten, indicating that gluten antibody combination with gluten in the skin provides the basis of the skin response. Since no false positive reactions were found in 52 normal controls, skin testing with gluten may provide a useful adjunct to the diagnosis and management of coeliac disease, especially in the outpatient department.


[The nailing of fractures of the diaphysis of the femur by Kuntsher's method. A report of 44 cases]. The authors advocate the technique of blind medullary nailing with reaming of the medullary canal followed by a several weeks-traction in the treatment of compound fractures of the femoral shaft. This method is specially indicated in bursts of the bone, when no stability can be obtained after osteosynthesis and was used in 44 cases. In the same time blind nailing without traction was applied to 272 cases. The results were: sepsis: 0; non-unions: 0; malunions: 5; stiff knees: 3.


[Anatomical study of the vertebral pedicles. Surgical application]. The author think that the use of plates screwed in the vertebral pedicles is the most fiable osteosynthesis at thoracic and lumbar spine level. This opinion is based on an anatomical study detailing the measurements and orientations of the pedicles. A series of 56 clinical cases treated by this method is briefly analysed.


[The etiology of hallux valgus].

[The etiology of hallux valgus]. Modifications of the forefoot in weightbearing are conductive to hallux valgus, some are congenital and constitutional: supination of the forefoot, adductus of the metatarsal bones, metatarsus varus primus brevis. Others are acquired: transversal flatfoot. Measurement of the different angles observed on a dorsi-plantar X-ray in relation to the external and internal limits of the Lisfranc joint has an etiological signification. To look for changes in the weightbearing configuration of the foot, an element in the formation of hallux valgus, is of use in the choice of a method of correction.


[Fractures of the odontoid process. 94 cases, 61 treated by arthrodesis]. The authors have reviewed 94 cases of fractures of the odontoid process, 21 of the with neurological signs. The conclusions were as follows: 1) Conservative treatment in 26 cases led to 9 non-unions; 2) 27 recent fractures were operated on (arthrodesis) with 24 fusions; 3) 54 cases were treated more than 30 days after the accident: 15 ot them demonstrated neurological involvement, 34 of them were operated on; 4) The surgical technique is fully described, usually the operation aimed at fusing C1 to C2; 5) One patient died, none was aggravated, all were somewhat improved on the neurological standpoint; 6) On a functional standpoint neck mobility was less decreased after conservative treatment than after cervical fusion.


[Growth disturbances of the upper femoral extremity: Contribution to knowledge of normal growth in therapeutic trails]. The authors have studied the growth disturbances of the upper femoral extremity in several pathological conditions. They recall that in normal hips there is one single growth plate for the cephalic nucleus and the greater trochanter. On a functional standpoint this plate can be divided into three areas. -- Disturbances in the trochanteric area lead to coxa-valga. -- Disturbances in the cephalic area lead -- Either to a downward slip of the femoral head if the lesion is medial, -- or to a coxa vara without trochanteric ascension if the lesion is more lateral. -- Disturbances in the transitional area lead to coxa valga with ascending trochanter. The growth of the cephalic area is twice more important than that of the trochanteric area as demonstrated by the study of the growth-arrestment lines. Surgical conclusions are drawn according to the type of disturbance.


[Traumatic separation of the epiphysis of the lower end of the femur]. The authors have treated 28 cases of traumatic separation of epiphysis of the lower end of the femur. They have noted the particular severity of the initial trauma. The results were less satisfactory when the child was younger and when the plate was crashed. However, 4 cases of fractures in breech delivery had rather good results. The authors think that a good reduction is essential, either close reduction fixed by Kirchner's wires or open reduction when the former is impossible.


[Anterior tarsectomy for pes cavus: indications and long term results]. The authors have reviewed 48 cases of pes cavus treated by anterior tarsectomy with an average follow-up of two years. The clinical, anatomical and radiological features of the condition are described. The results were satisfactory in two-thirds of the cases. Failures were related to unsatisfactory indications such as children under thirteen, progressive neurological disease or associated impairment of the ankle joint (arthritis, dislocation). The indications for the procedure are discussed and compared with those for Dwyer calcaneal osteotomy, triple arthrodesis, soft tissue operations (Steindler) or resection of the metatarsal heads.


[Injuries of the condylar cartilage of the knee in athletes]. The authors have observed 8 traumatic, isolated lesions of the articular cartilage of the medial condyle of the knee in young athletes (7 football players, one judoka). The clinical, radiological signs are described. Arthrographs were usually negative. On microscopical examination, the cartilage was not pathological. Excision of the fractured cartilage gave poor results.


[Results of surgical treatment for rupture of the achilles tendon]. The authors analyse the results obtained on 53 cases of rupture of the Achillis tendon. Early minor complications were numerous (26 p. 100) the average follow-up, in 38 cases, was about 6 years. A number of ankle limitations, triceps weakness were noted. All patient had a calf atrophy. Final results were not related to the surgical technique (suture or grafting using plantaris). The authors conclude that the results obtained after surgical treatment are not as good as generally thought.


[Homografts allogeneic of the knee and hip joints]. The technique and instruments of PAP, Krompecher and Jaros allow a precise preparation of the femoral head, acetabulum, femoral condyles and tibial plateau in the donor and recipient for the application of homograft transplants of joint articular surfaces of 5 millimetre thickness. In the present series, specimens were preserved by freezing at 30 degrees below zero to prevent immunologic reactions in the recipient. Immunogenic control tests in 12 patients have shown that freezing at 30 degrees below zero does not eliminate antigens in the transplant. In future, therefore, it is intended to transplant only cartilage with living cells in relation to the HLA system. The problem of prevention of infection has been solved by a special antibiotic preparation of the specimen. Radiographic examination 4 years after operation shows that only two of 12 patients had an unsatisfactory result. Function in these two hip joints is, however, better than before operation although the transplant has been partly resorbed. The technique of homograft transplantation of the hip and knee joints is suitable for young or middle-aged individuals in whom the only alternative would be an arthrodesis. For older persons a joint prosthesis is preferable.


Delayed osteosynthesis of diaphyseal femoral fractures in adults. There is a great advantage to practise the internal fixation of femoral shaft fractures of adults by AO plate two weeks after the traumatism. This delay allows the formation of a physiological callus which protects the osteosynthesis and is a sure sign of the bone union. At the price of a longer hospitalisation of the patient, this delayed osteosynthesis leads to a quick consolidation of an exactly reduced bone. The functional readaptation is rapid and complete. This method joins the advantages of concervative and surgical treatment without their usual complications.


[Surgical treatment of long-standing anterio-internal instability of the knee. Personal experience]. The authors have reviewed 139 surgical procedures performed in the treatment of antero-medial instability of the knee, including 71 Slocum procedures, 54 Nicholas, procedures and 14 miscellaneous procedures. The clinical signs and surgical techniques are described in detail. The results show that Slocum's procedure was always satisfactory and that it can be done either in isolation or in association with Nicholas' procedure and medial transfer of part of the patellar tendon.


[Technic and natural history of Papineus's operation. Excision of cancellous graft without skin closure]. The authors present a new treatment technique of osteitis, which consists of an excision of necrotic bone followed by cancellous graft bone in two operations without a skin closure. This allows a simultaneous drying, cicatrization and consolidation. The post-operative treatment necessary in order to obtain a rapid healing is particularly detailed.


[Posturographic study of total prostheses in the leg. Apropos of 88 patients examined]. By suppressing certain articular sensory receptors, the reconstructive surgery of joints using total prostheses modifies tonic postural activity and, by this means, alters the regulation of balance in the subjects of operation. This doubtless explains certain discrepancies between the apparently excellent results in respect of joint movement and muscle strength and poor utilisation of the joint in every day life (instability, use of sticks or failure to use the joint in walking). Drawing on the experience and basic work of specialists in posture, the authors have undertaken a study of tonic postural activity in patients who had received a total prosthesis in the lower limb, both from the clinical aspect and by graphic measurement using an electronic apparatus, the statokinesiometer. Fourteen normal subjects were tested to calibrate the apparatus and 8 patients suffering from established osteoarthritis of the hip were studied as controls. Analysis of tonic postural activity was made in 66 patients who had received total prostheses in the lower limb. The results showed significant disturbance in balance in ankle prostheses, minimal disturbance in knee prostheses and not significant disturbance in hip prostheses. Certain therapeutic implications are derived from this study.


[External fixation with autopolymerizing acrylic resin]. In November 1970, a new method of skeletal fixation was devised using self-curing acrylic resin. Manipulative reduction of the displaced fracture is made using screws inserted into the bone fragments under an image intensifier. After reduction, the proximal and distal fragments are joined together with the aid of self-curing acrylic resin. Adjacent joints can be exercised immediately after operation and the fixation is so firm that the use of a plaster cast after operation is not necessary. This simple method can be used in osteosynthesis, compression arthrodesis and various types of osteotomy.


[Results of Papineua's operation. Apropos of 46 cases]. The authors analyse about one and a half years later, the results of 46 Papineau operations divided in three groups depending of the initial excision. The complete healing was obtained for 44 patients and by the sole Papineau operation in 70 p. 100 of the cases, with relatively short delays: 6 months without a solution of bone continuity, 9 months with a small solution of bone continuity, 11 months in the case of major solution of bone continuity. They insist on the absence of amputation, the small number of complications and in particular of interative fractures in this series.


[The reaction of articular cartilage to mechanical trauma. An experimental study]. Experiments were conducted in 20 rabbits to study the effects of a single measured trauma applied to the femoral articular cartilage. The author found that, at the fifteenth day, there was fibrillation localised to the area of the trauma associated with necrosis of superficial chondrocytes and clusters of young chondrocytes. Fissures in the cartilage can be seen to be lined by chondrocytes in clusters. These findings are similar to those described by other authors after different types of injury (contusion, defect, instability, repeated trauma).


[Growth of the trunk and lower limbs after the menarche]. The author has made a longitudinal biometric study of the growth in height of the upper and lower segments of the body in 45 girls. He concludes that growth after the menarche is almost exclusively in the upper segment. In 80 per cent of cases, the growth of the lower segment was less than 1.5 cms. The author shows that this residual growth depends on the maturity of the skeleton at the time of puberty. It is greater when skeletal maturity is delayed. Other important factors were the height of the child at the age of 8 and the growth rate between the ages of 8 and 10 years: the bigger the child, the smaller will be the amount of growth after the menarche. The first menstruation appeared earlier when the growth rate between the ages of 8 and 10 years was greater.


[Fracture-dislocation of the tarso-metartarsal joint. Classification. Treatment. Apropos of 81 cases]. The authors have treated eighty-one cases of fracture-dislocation of the tarso-metarsal joint and have studied 232 cases reported in the literature. They suggest a modification of previous classifications. In their conclusions, they consider that purely conservative treatment is inadequate. Reduction, when obtained by closed methods, should be maintained by Kirschner wires. Open reduction should be done when closed methods do not produce a perfec reduction. When several articular fractures are present, they advocate immediate reduction and arthrodesis. The results obtained after secondary arthrodesis were not as good as those obtained after primary arthrodesis.


[Cysts of the external meniscus].

[Cysts of the external meniscus]. The authors have treated 20 cases of cyst of the laternal meniscus of the knee. In most of the cases, the diagnosis was made late. The clinical, radiological and pathological features are described and the etiological factors are discussed. Complete meniscectomy relieved the symptoms in 17 cases.


[Effect of p-chlorophenylalanine on rat reproduction under different conditions of lighting (author's transl)]. Reproduction in female rats kept on artificial cycles of light/darkness, continuous lighting and continuous darkness, has been studied. Three weekly doses of p-chlorophenylalanine (p-CPA), 100 mg/kg, were given to half of the rats in each group during the two preconditioning months before copulation. An evaluation has been made of the insemination, fecundation, number of embryos, ovarian cycle and level of 5-HT in the hypothalamus. The administration of p-CPA had an inhibitory effect on the reproductive behavior, especially pronounced in rats kept under continuous lighting and under continuous darkness. The difference in 5-TH levels were greater among the groups kept on cycles of light/darkness without treatment and with p-CPA (0.05 greater than P greater than 0.01). The importance of 5-HT in the mechanisms of reproductive behavior is emphasized.


[Avascular necrosis of the femoral head following fracture of the neck. Early diagnosis using radioactive tracers]. The authors have injected Sr85 intravenously and studied its fixation in samples taken from the femoral head with a trephine in the course of reduction and fixation of fractures of the femoral neck. Thirty-eight cases were studied, of which ten developed secondary avascular necrosis of the femoral head. All the patients were followed up for more than three years. The standard technique is described in detail. The authors consider that this technique was valid. All the necroses were able to be predicted. The examination of the samples took about 15 minutes during the operation. The method makes it possible to choose between internal fixation and prosthetic replacement.


[Hydrolytic conditions of the conjugated steroids from human urine (author's transl)]. The hydrolisis of dehydroepiandrosterone sulfate added to human urine was studied under several hydrolytic procedures. Enzymatic and acid hydrolysis with and without the previous removal of enzymic inhibitors present in the human urine were compared. The simple precipitation of inorganic ions with barium acetate before the enzymatic hydrolysis was considered an efficient procedure giving an 81% recovery of the added dehydroepiandrosterone. Since this procedure does not involve rearrangements in the steroid molecules, and because of its simplicity it is considered adequate for the determination of the urinary steroid excretion patterns in humans allowing the quantitation of some conjugates (16 alpha-hydroxy-dehydroepiandrosterone) otherwise not detectable because of its incomplete hydrolysis and extraction.


[Rehabilitation through social communities (author's transl)]. The author is of the opinion that rehabilitation is characterised rather by stimatisation and isolation than by overall measures persuring the aim of partnership and community organisation. As a rule, the severely handicapped set an example of a social community through their own life performance. In their social community marginal groups are unknown unless the individual considers himself and his family outsiders or marginal group, and favours this situation A desirable goal, however, is that joint efforts be made on the part of all members of the community and that these efforts be based on partnership. A means to reach this goal is through the creation of local citizen groups as co-ordinating bodies of neighbourhood self-help groups, if possible, in all local districts. The author gives some examples on how this can be realised.


[Pyogenic spondylitis in adults].

[Pyogenic spondylitis in adults]. The authors have treated 50 cases of non specific spondylitis in adults and reviewed the clinical signs and diagnostic problems in this condition. They advocate a systematic surgical approach to the focus. This allows identification of the organism unless the patient has previously received antibiotics. Even then, a direct approach allows histological examinations to be made and necrotic and infected tissues to be cleaned up. In 12 highly destructive lesions, a bone graft was added. The results were more satisfactory when fusion across the disc was achieved. There were only two deaths.


[Work physiological studies performed to optimate the lever propulsion and the seat position of a lever propelled wheelchair (author's transl)]. Spiroergometric examination with defined work loads and permanent records of the common circulatory and metabolic values were carried out on a group of healthy adults and one wheelchair occupant, using a fixed wheelchair simulator with lever propulsion, which was connected to an ergometer. Comparative studies were performed in three different seat positions in relation to the lever, as well as six different lengths of the connecting rod. The best values were measured, under steadystate conditions, with increasing lengths of the connecting rod and posterior placement of the seat unit. The results are in agreement with the experience gained by other authors with respect to arm work, and show that the optimal efficiency of hand lever work is obtained in the anterior position. In this context it proved to be particularly advantageious from the ergonomic viewpoint, if, when bending forward, as necessitated by a long connecting rod, both the upper part of the body and the trunk musculature are employed. The practical consequences of the simulator tests on an adequate wheelchair design and wheelchair prescription are discussed.


Predictive tests in Huntington's disease. HD is a dominantly inherited disorder that affects mental and motor systems and includes a rigid form as well as the better known choreic form. Many articles have been devoted to predicting the future onset of the disease in patients who are at risk, but none of the suggested predictors is currently considered completely reliable. Members from individual families do tend to show a similar age of onset, and similar intellectual and motor abnormalities do develop within a single family; but the presence or absence of this dominant gene of high penetrance is not usually certain until the obvious physical signs appear. Predictive tests are of importance not only to decide which person may develop the disorder, but they may also offer a clue to associated or causal features of the disease. This chapter is a review of reported predictive tests in HD, emphasizing the rationale for their use. Psychological testing has often been abnormal early in the course of the disease of some patients, particularly when motor dexterity or apraxia  is tested. Family members often insist that various psychological traits enable them to predict which members are affected by the gene. These opinions are summarized. Neurophysiologic tests are briefly reviewed, including new data on increased liklihood of H-reflexes in HD. Electroencephalography was once touted as a possible predictive test but, although there is frequently an association of a low voltage EEG activity with HD, this change is too variable for certainty in prediction. Pneumoencephalography with specific measurements of caudate atrophy is of clinical interest, but a pneumoencephalogram is rarely needed for diagnosis and caudate atrophy may not actually be an early sign. Metabolic changes in HD include the biochemical effects of hypothalamic dysfunction, changes in growth hormone, and reported change in GABA levels in the CSF or brain. Provocative tests have utilized numerous drugs in an attempt to predict the onset of the disease, including particularly physostigmine and L-DOPA. All of the tests elucidate peculiarities of the disease, and all are of ethical as well as neurological interest. Many of the provocative tests utilize quantification of known neurologic features of the disease, such as reduction in saccadic movements of the eye, increased reflexes, or patterns of movement. The ethical problems in predictive tests, especially tests intended to provoke features of the disease, have been a matter of quiet controversy. Should a nontreatable disease be overtly diagnosed? And if so, will it benefit the patient? Can any of the tests tend to accelerate the patient's decline, either by physical or by psychological trauma? This chapter reviews the various predictive tests and their rationale and concludes that none of the tests are totally reliable. Many offer interesting insights into the effects of HD and do broaden the overall significance of this fascinating disorder of basal ganglion function.


Estimation of the hepatic blood flow in the dog with the Xe133 and hydrogen wash-out Au190 -colloid uptake techniques and with the electromagnetic flowmeter. In dogs anaesthetized with pentobarbital hepatic blood flow measured with electromagnetic flowmeters placed on the hepatic artery and the portal vein was 142 +/- 10.2 ml.min(-1).100 g(-1). The flow estimated with the hydrogen clearance technique was 64 +/- 4.4 per cent, with the Xe133 wash-out technique 78 +/- 7.4 per cent and by the uptake of colloidal radiogold 96.5 +/- 5.0 per cent of the direct measurement. In the flow range between 50 and 344 ml.min-1. 100 g-1 the respective correlation coefficient between HBF measured with the hydrogen clearance technique and with the flowmeter was 0.733, between Xe133-HBF and flowmeter HBF 0.785 and between Au198-colloid HBF and the directly measured HBF was 0.815.


[Serotoninergic and adrenergic factors influencing the ovulation and reproduction in the rat]. The action of 5-hydroxytryptamine (5-HT) on ovulation and reproduction in female rats with unique or repeated treatments of p-chlorophenylalane (p-CPA) was studied under different conditions of illumination. Histological studies were carried out on the tube and ovaries, controls of the ovarian cycle and of inseminations produce by vaginal deposits. An evaluation has been made of the insemination, fecundation, number of embryos, ovarian cycle and in anothers series hypothalamic determinations of 5-HT were carried out. In one group of rats the effect of intracerebrally administration (n. accumbens septi) 6-hydroxydopamine (6-OH-DA) (250 mug) on ovulation was studied. The administration of a unique doses of p-CPA (300 mg/Kg) induces an inhibition of the reproductive cycle in all its phases and in all the rats. Which repeated doses (100 mg/Kg) reproduction was inhibited in rats maintained under continuous illumination and under continuous darkness. Ovulation studies revealed that follicle rupture, was inhibited with a unique dose of p-CPA (300 mg/Kg). The histological study showed, marked luteinitation of ovaries. The ovarian cycle after a unique dose of p-CPA showed continuous diestrus phases. The results may indicate that a decrease of cerebral 5-HT producing a hormonal change which leads to the disappearence of the oestrogenic phase, with consequent inhibition of rupture and decrease in receptivity of the female rat. The administration of 6-OH-DA in the n.accumbens septi inhibited follicle rupture giving rise to manifest lutteynitation. A further study on the degeneration of nerve fibres, suggests the posssibility of adrenergic influence in ovulation of septal structures.


[Principle histoclinical forms of iatrogenic eruptions]. The staggering multiplication of chemotherapy and polychemotherapy, in addition to artificial substances introduced into foodstuffs (such as saccharin in certain so-called fruit juices), has resulted in innumerable visceral and cutaneous disorders. Confining ourselves to "iatrogenic" rashes, the mechanism of which is far from being a single entity, we have riviewed the six most common varieties: recurrent fixed pigmented erythema, in which stovarsol has given way to the sulphaguanidines; pigmentogenic rashes with the renewed use of amiodarone; eczema and erythrodermia which may be due to any drug, with or without the influence of the sun; iatrogenic lichens, atebrine having provided all types; bullous conditions, sometimes the final stage of the previous group; finally, Lyell's syndrome. Our aim was to study skin biopsies in all these problems, in order to attempt to discover typical lesions.