Diffuse glomerulonephritis in rabbits with Streptococcus viridans endocarditis. Intravenous administration of live microorganisms to rabitts with cardiac catheters produces an experimental model of infective endocarditis. Despite the development of infected valvular vegetations, positive blood cultures, splenomegaly, and focal embolic renallesions, glomerulonephritis has not been found in these animals. In the present study, acute diffuse proliferative glomerulonephritis, featuring endothelial and mesangial proliferation, capillary occlusion, and leukocytic infiltration was produced in rabbits immunized withthe infecting agent prior to the establishment of left sided alpha-streptococcal endocarditis. Controls receiving immunization alone, immunization and sterileendocarditis, or infective endocarditis alone did not develop diffuse glomerulonephritis. Electron microscopic findings of occasional subendothelial electron-dense deposits and immunofluorescence deposition of IgG and C3 in a peripheral  granular capillary pattern were consistent with an immune complex type nephritis. Decreased serum complement levels were demonstrated in those animals developing diffuse glomerulonephritis, and some animals developed circulating rheumatoid factor. In view of the morphologic findings and the necessity of preimmunization for development of glomerular changes, it is concluded that immune mechanisms play a role in the diffuse glomerulonephritis associated with this model of infective endocarditis.


Experimental glomerulonephritis in the mouse associated with mesangial deposition ofautologous ferritin immune complexes. Mice undergoing prolonged (5 to 8 weeks) immunization with cadium-free feeritin were studied 1 to 32 days following the last ferritin injection.  Urine protein was measured and renal tissue examined by light, immunofluorescence, and electron microscopy.  Immunized animals developed significant proteinuria and circulating antibody to ferritin.by light microscopy, proetinuric animals had a proliferative glomerular lesion with mesangial hypercellularity and martrix increase, focal and segmental necrosis, fibrin deposits, and occasional crescents.  Iron stains revealed prominent mesangial iron deposition.  In immunized animals, IgG and C3 deposits were localized mainly in the mesanglium.  Electron microscopic studies revealed marked deposition of ferratin complexesexpanded mesangial matrix and mesangial interposition.  Ferratin immune complexes were also visualized in epithelial spaces.  In the latter location ferritin immune complexes occasionally formed characteristic electron-dense subepithelial deposits.  In this model, mesangial and subepithelial localization of autologous ferritin immune complexes is associated with development of glomerulonephritis and characteristic mesangial lesions resembling those seen in some types of human glomerulonephritis.


The effect of continued cigarette smoking on the patency of synthetic vascular grafts in Leriche syndrome. The effects of continued smoking were studied in 187 consecutive patients who underwent aorto-iliac or aorto-femoral grafting because of Leriche disease and who left the hospital with well-functioning grafts. The patients were divided into the following groups: (1) never smoked, (2) stopped smoking after the operation, (3) continued to smoke less than a pack a day and (4) continued to smoke more than a pack a day. The patency of the grafts was evaluated at regular intervals during a follow-up period ranging from 6 months to 10 years. A significant difference in the patency in the favor of the nonsmokers was found, with the "more than one pack a day" group having more than triple the occlusion rate of the nonsmokers, both absolutely and in month-patency time. We recommend that the surgeon make a most sincere effect to induce patients undergoing vascular operations for occlusive vascular diseases to give up smoking. Failure to promise to stop the smoking habit should be regarded as a relatively strong contraindication for surgery in patients not directly threatened with loss of an extremity.


Cystic thymoma simulating contrictive pericarditis. The role of echocardiography in the differential diagnosis. A case is presented of a 60-year-old woman with fatigue, dyspnea, and chest pain. A chest x-ray film revealed an abnormal cardiac silhouette. Echocardiography revealed a large, echo-free area with well-demarcated, discrete borders adjacent to the right heart border. This structure decreased in size with inspiration and did not show pulsatile cardiac motion. Cardiac catheterization confirmed the extracardiac nature of the lesion and also showed a "constrictive" pattern with equalization of diastolic pressures. Surgical exploration revealed a large cystic thymoma. With removal of the tumor, intracardiac pressures returned to normal.


Preclotting of knitted Dacron prosthesis. A scanning electron microscope study. A scanning electron microscope study of preclotting on knitted Dacron prosthesis is reported. Five steps of the interaction are well identified: (1) before any blood contact (virgin Dacron), (2) during the first 3 minutes (fibrin and platelet aggregates), (3) fifth minute of contact (clotting), (4) 15 minutes of contact with heparinized blood (thin fibrin network), and (5) the following minutes (invasion of fibrin, which enmeshes blood cells).


Surgical correction of congenital left coronary artery-main pulmonary artery fistula in association with anomalous right coronary artery. The association of a left coronary artery-main pulmonary artery fistula and an anomalous right coronary artery originating from the main pulmonary artery is the subject of this report. This unique combination of congenital cardiac anomalies establishes a double coronary steal from the left coronary artery, which hemodynamically represents the sole source of myocardial perfusion. The left coronary artery-main pulmonary artery fistula was closed and the coexisting anomalous right coronary artery reimplanted into the anterior aspect of the ascencing aorta. A dual coronary supply was therefore established and thus eliminated the potential threat of total myocardial ischemia should the left coronary artery become critically compromised. Patency of both the left coronary artery and the transplanted right coronary artery was documented 1 year postoperatively by aortic root angiography.


Traumatic coronary artery-right heart fistula. Report of a case and review of the literature. Although the left coronary artery is the most frequently injured vessel of the heart, traumatic fistulas appear more often in the right coronary vessels, as the initial injury to the left coronary artery usually results in early death prior to hospitalization. Indications for surgical repair include cardiac decompensation and signs of shunt progression. In asymptomatic patients with no changes in cardiac function, consideration for repair includes the following: (1) enlargement of the fistula, causing a large runofff into the low-pressure chamber, and reduction of blood supply to the local myocardium distal to the fistula; (2) progressive dilatation of a pseudoaneurysm when it exists; and (3) the presence of bacterial endarteritis. Surgery usually has been indicated in reported cases of coronary artery fistula. Conservative management is applicable when the shunt is small and cardiac function is normal, as evidenced by the present case report and the first case cited in the literature. Oversewing of the area of the fistula and bypass grafting from the ascending aorta to the distal coronary tree might provide an additional mode of management in selected cases.


Left ventricular outflow obstruction in Taussig-Bing malformation. In a patient recently undergoing total intracardiac repair of the Taussing-Bing malformation the immediate cause of death appeared to be an obstruction to left ventricular outflow. Examination of this and other specimens of Taussig-Bing malformations revealed that the obstruction appeared to be a portion of the pulmonary conus. This area may be overlooked in the preoperative evaluation and is so located that the obstructive nature of this muscle mass may not be appreciated at the time of surgical repair. The obstructive part of the pulmonary conus can be excised and this appears to be a more common component of the Taussig-Bing anomaly than has previously been appreciated.


Thrombus generation within the artificial heart. The sites of thrombus formation in the Jarvik III artificial heart were studied in 20 consecutive calf experiments. Identical design and implantation procedures were used with two different surfaces. The 10 anticoagulated calves receiving Dacron-fibrilized silicone rubber surfaces survived an average of 296 hours. In contrast, the 10 nonanticoagulated calves with smooth poyurethane hearts survived 545 hours. The polyurethane surfaces were constantly clean. However, the rough surfaces were coated with variable amounts of thrombi. The sharp angle between the diaphragm and housing contained varying amounts of thrombi deposits in 75 per cent of the cases. Thrombe deposition occurred on 41 per cent of the valves. These thrombe were the source of emboli into the kidney, brain, and lungs. Turbulences and stagnation areas generated thrombus formation. Anticoagulation did not prevent thrombus formation. It would appear that heart free of turbulence and stagnation areas must be designed to eliminate thromboembolism.


Effect of intrahepatically implanted islets of Langerhans on hepatic function in the rat. Diabetes mellitus is satisfactorily controlled in the rat by hepatic implantation of isolated, isologous pancreatic islets.  The transplanted islets appear to be viable for at least 6 months after implantation, and hepatic function studies (serum bilirubin, alkaline phosphatase, glutamic-oxalacetic transaminase, prothrombin time) and microscopic examination indicate that they do not interfere with hepatic function.


Australia antigen, autoantibodies and cell-mediated immune responses in patients with Down's syndrome. The prevalence of Au antigen, autoantibodies and impaired cell-mediated immune responses was studied in 66 patients with Down's sydrome and 66 other mentally retarded patients in a South Australian institution. The antigen was detected in three of the former and none of the latter. This unexpectedly low carrier rate in patients with Down's syndrome was thought to be due either to good hygiene and state of nutrition in the institution or to the high age of which the patients had been admitted to hospital (eight to nine years). Because of the incompleteness of the association between impairment of cell-mediated immunity and antigen carriage, it was thought unlikely that the former was the sole reason for the latter.


Bacterial flora of the ear, nose and throat in aboriginal infants from brisbane and cherbourg. A total of 1,044 nose and throat swabs and 54 ear swabs were collected from 219 Aboriginal babies in Brisbane and at Cherbourg over a two-and-a-half year period.  The incidence of Staphylococcus aureus was found to be similar for both localities (approximately 20% in nasal swabs and 12% in throat swabs).  Enterobacteria were found much more commonly at Cherbourg (43% in nasal swabs, 60% in throat swabs).  Fifty-four ear swabs produced a wide variety of organisms with proteus species most common.  Changes in the nose and throat flora over the period of examination are noted.


[Ventilation and pulmonary perfusion in chronic obstructive airways disease under Fominoben author's transl]. In 20 patients with chronic obstructive airways disease the distribution of ventilation and perfusion was measured by means of scintigraphy before and after giving Fominoben, a new respiratory stimulant substance. Perfusion and ventilation which in most patients were preferentially distributed to the apices of the lung could be redistributed to a considerable degree to the lower lung zones in 17 patients (perfusion) and 13 patients (ventilation) respectively. In 4 of the 7 patients where the recaudalisation of both perfusion and ventilation was not observed both parameters remained unchanged or moved both further to the apex. The reasons for the preferential perfusion and ventilation in patients with chronic obstructive airways disease and the mechanism of the redistribution under Fominoben are discussed. The question of autoregulation of ventilation and perfusion is shortly dealt with.


[Incidence of ampicillin rashes in childhood (author's transl)]. In a retrospective clinical trial 6056 pediatric medical records were analysed concerning the incidence of ampicillin rashes. Out of this population 1482 children of different agegroups were treated with ampicillin for various diagnoses. 44 rashes had developed in patients, equivalent to an overall incidence of rashes attributable to ampicillin of 2.9%. 907 newborns, in the age of 0 until 30 days, did not show any exanthema; elder babies, aged 31 until to 365 days, showed an incidence of rashes associated with ampicillin therapy in 4.06%. Children of the age-groups 1 to 4, and 5 to 15 years had developed skin reactions in 9.9% and 8.8%, respectively. If the large group of newborn babies is not taken in account, the average incidence of ampicillin rashes increases from 2.9% to 7.6%. Eruption of exanthema after start of ampicillin therapy occured changed between the 1st and 21st day, usually after 4 and 5 or 7 to 12 days. The mostly morbilliform rashes vanished in the average after 2 to 4 days. In the beginning of or during exanthema the number of eosinophile leucocytes was increased in 30% of patients. In 93% the ampicillin therapy was ended after skin reactions were noticed; the rashes of children, who were treated further with ampicillin, did not show any difference to those exanthema of children, whose therapy was stopped.


[Xanthofibrogranulomatosis, pontine glioma, multiple nevocytic nevi and albinism (authors transl)]. A case of retroperitoneal fibrosis with ureter compression is reported. Clinical picture and course were determined by the presence of an additional tumor (astrospongoblastoma) of the pons. Extraretroperitoneal tissue changes found at post mortem examination were shown histologically to be foreign tissues of the same type deposited in the retroperitoneal space (disseminated xanthofibrogranuloma). Possible connections between the disseminated xanthofibrogranuloma, the pontine tumor and an albinism also present and multiple nevocytic nevi of the skin are discussed.


Caffeine and the antiparkinsonian response to levodopa or piribedil. The ability of orally administered caffeine to modify the antiparkinsonian efficacy of levodopa of piribedil, a putative dopamine receptor against, was studied in six patients. At doses that induced unequivocal central nervous system stimulation, caffeine produced no change in the therapeutic response to either antiparkinsonian agent. On the other hand, patients with levodopa dyskinesias reported an increase in the duration of their involuntary movements with caffeine coadministration. Since caffeine is known to stimulate both dopaminergic mechanisms and motor activity in the experimental animal, the results of this study cast doubt on the value of these factors as predictors of therapeutic efficacy in parkinsonian patients.


The abdominal cutaneous nerve entrapment syndrome. Entrapment of the abdominal segmental nerves within the rectus abdominis muscle may produce abdominal pain simulating surgical or genito-urinary disease. The diagnosis can be made by localising with one finger an area of tenderness close to the lateral border of the muscle. Pressure at this site will usually reproduce the pain and precise injection of local anaesthetic will abolish the pain immediately. Effective long-term relief is usually obtained by the injection of long acting steroid or a small volume of 7 percent aqueous phenol.


Clinical and radiological assessment of leg length. This paper compares a clinical and a radiological method of measuring leg-length discrepancy in 107 adults, showing that clinical estimation is unreliable and suggesting that moderate degrees of leg-length difference play little, if any, part in the aetiology of backache.


Laparoscopic tubal surgery in infertility. Besides its diagnostic value, laparoscopy is a useful operative tool in the treatment of infertility. We have used dilatation of phimotic tubal ostia and salpingolysis by laparoscopy as our primary approach. In the total series of 33 cases a pregnancy rate of 42.1 percent was obtained.


Treatment of endometriosis with an antigonadotropin, Danazol. A laparoscopic and histologic evaluation. Antigonadotropin (Danazol) was administered to 39 patients with endometriosis diagnosed at laparoscopy and confirmed by laparoscopic biopsy. None of the patients had surgical resection of the lesion prior to the treatment. While on the drug, all patients developed evidence of ovarian suppression both in regard to ovulation and steroidogenesis. The results were evaluated by repeat laparoscopy and biopsy. The extent of the disease was documented before and after treatment by photography and drawing. There was marked decrease in the extent of endometriosis after treatment: 59% of patients had no evidence of disease, 26% had peritoneal adhesions and hemosiderin deposits but no active endometriosis, and 15% had residual endometriosis. Histology in the latter group revealed atrophic changes in the uterine and ectopic endometrium and the evidence of a healing process.


Ovarian and adrenal contributions to peripheral androgens in hirsute women. Serum levels of testosterone (T), 5alpha-dihydrotestosterone (DHT), androstenedione (A), dehydroepiandrosterone (DHEA), dehydroepiandrosterone-sulfate (DHEA-S), 17-hydroxyprogesterone (17-P), and cortisol (F) were measured in 33 hirsute women. Ten were hirsute and eumenorrheic (H-E), and 23 were hirsute and oligomenorrheic or amenorrheic (H-OA). Daily morning blood samples were obtained for 6 consecutive days. Dexamethasone (Dex), 2 mg/day was administered starting after venipuncture on the second day and continuing for 5 days. Human chorionic gonadotropin (hCG) was administered intramuscularly on the afternoon of the fourth and fifth days. The mean levels of all steroids measured under basal conditions in the hirsute women as a group were significantly  elevated when compared to nonhirsute premenopausal women. Dehydroepiandrosterone-sulfate was the only steroid which showed significantly different mean levels between the two groups of hirsute women, being higher in the H-OA patients. Individual hirsute patients showed an elevated serum 17-P level as the most consistent finding; it was present in 90% of the patients in both groups. Significantly more H-E patients showed Dex-suppressible DHT (90% vs 40%; P less than 0.05) and A (70% vs 25%; P less than 0.05) than did H-OA patients. Dex-suppressibility of 17-P was observed in only 20% of the H-E and 15% of H-OA patients. A positive response to hCG was observed in all patients for serum 17-P and in about half or less of the patients for the other steroids. These dynamic tests of adrenal suppression and ovarian stimulation suggest that the ovary may be the main source of 17-P overproduction in both groups of patients. Although 17-P has been previously postulated to have androgenic activity, it is not yet known whether this steroid has a causal relationship to hirsutism.


Female sterilization. II. A comparison of methods. An analysis was made of 1757 female sterilization procedures performed over a 5 1/2-year period. The majority of these were accomplished by one of 8 technics: puerperal abdominal tubal ligation (TL), cesarean section plus TL, hysterotomy plus TL, interval abdominal TL, colpotomy TL, laparoscopic TL, vaginal hysterectomy, and abdominal hysterectomy. The various technics have been compared with respect to 55 variables. The procedures having the shortest hospital stay, lowest morbidity, lowest blood loss, and shortest operating time were interval laparoscopic TL, colpotomy TO, and puerperal abdominal TL. The more major procedures were attended by significantly more morbidity and longer hospitalization and should be used only when specific indications justify the increased cost and risk.


Composite materials for dental implants. The requirements of endosteal dental implants are unique and stringent. The materials currently applied to implantation do not offer convincing evidence of satisfying these needs. This preliminary study reports on attempts at developing materials which would aid in obtaining a mucosal seal to maintain the integrity of the osseous, periosteal, and submucosal compartments from the oral environment and the attachment to bone as related to stress distribution. The materials that were under study were ceramic bonded to base metals and Dacron.


[Study of the concentration of glycosaminoglycans in cartilage from normal and osteoarthritic femoral head]. The biochemical composition of cartilage was studied in relation to the site of the sample and the age on 20 normal femoral heads and in relation to the histological appearance of the tissues on 34 arthrosic femoral heads. The collagen and glycosaminoglycan content of normal cartilage is identical in the four poles of the femoral head but becomes reduced with age. The chondroitin sulphate content falls slightly but slowly during ageing. In arthrosis, the glycosaminogylcan content is reduced when the cartilage is eroded and remains roughly normal when the cartilage is macroscopically normal or osteophytic. The cartilage of the osteophyte differs, however, radically from normal articular cartilage by a very high water content and by the presence of glycosaminoglycans which are mainly dialysiable. Similar modifications, that are less marked, occur in the macroscopically normal cartilage of the arthrosic femoral head and suggest the role of a disorder of glycosaminoglycan synthesis in the etiology of certain cases of arthrosis.


Sensitivity of Haemophilus vaginalis (Corynebacterium vaginale) to oleandomycin and spectinomycin. Haemophilus vaginalis is highly sensitive to oleandomycin. The MIC ranged from 0.035 to 0.15 mug/ml. The sensitivity of H. vaginalis to spectinomycin was 2.5-5.0 mug/ml. The sensitivity of H. vaginalis to spectinomycin is 3-4 times higher than that of Neisseria gonorrhoeae. A favourable effect in the treatment of vaginitis caused by H. vaginalis could thus be expected.


A comparative study of heart myosin ATPase and light subunits from different species. Heart myosin ATPase (measured with 10 mM CaCl2, and 0.60 M KCl) was found to be higher in rats (423 nmoles of Pi/min/mg) than in guinea-pig (268 nmoles of Pi/min/mg), dogs (139 nmoles of Pi/min/mg) or rabbits (94 nmoles of Pi/min/mg). Rat heart myosin ATPase was found to be higher than that from a pure red skeletal muscle myosin (soleus from guinea-pig: 286 nmoles/min/mg) and only one third lower than that from fast skeletal muscle myosin from rabbits. The heart myosin ATPase from rat, guinea-pig, and rabbit correlates with the maximum velocity of shortening at zero load of the myocardial muscle, as determined by other authors. These four cardiac muscle myosins have the same two light subunits (M.W.: 27000 and 18000) in SDS polyacrylamide gel electrophoresis; one of them (M.W.: 18000) exists in guinea-pig and dog as two different molecules having a different charge, as shown in urea electrophoresis, but in the rat, this subunit is also unique in urea gel electrophoresis. Rat heart, apparently, does not possess the phosphorylated light subunit (M.W.: 18,000) described by others in rabbit heart myosin. Attempts have been made to obtain a highly purified myosin, but this procedure does not suppress the striking difference which exists between rat and dog heart myosin ATPase.


Coronary blood flow in rats native to simulated high altitude and in rats exposed to it later in life. In rats exposed to a simulated high altitude of 3500 m for their whole prenatal and postnatal life a severe cardiac hypertrophy develops. In rats born and first staying 5 weeks at sea level and then being exposed to simulated high altitude, only a unilateral right cardiac hypertrophy occurs. In both groups nutritional coronary blood flow was estimated in left ventricle, right ventricle, and septum and was compared with control animals of similar age. Coronary blood flow was measured at hypoxia in all groups. At first cardiac output was determined by the Fick principle, then  86Rb was applied and the animals were killed after 55 sec. Activity of 86Rb was measured in both cardiac ventricles and septum and the fractional uptake was calculated. According to Sapirstein (1956, 1958) the distribution of 86-RB follows the distribution of cardiac output and from both these data the nutritional blood flow to the parts of the heart may be estimated. Cardiac output was similar in rats exposed to simulated high altitude later in life ('newcomers') and in control animals, but it was significantly lower in rats born in the low pressure chamber ('natives'). Fractions of cardiac output supplying cardiac ventricles and septum in rats from both hypoxic groups were significantly higher than in control animals. In the 'natives' they were significantly higher than in the 'newcomers'. The fractions of cardiac output in both 'newcomers' and 'natives' remained significantly higher than those of the control animals, also when calculated per gram of heart tissue. Nutritional coronary blood flow (in ml/min) was higher in both ventricles and septum of the 'newcomers' and in the right ventricle of the 'natives', and lower in the septum of the 'natives', when compared with control animals. Coronary blood flow per gram of heart tissue (in ml/min.g) was significantly higher in all cardiac parts of the 'newcomers', but it was about the same in all cardiac parts of the 'natives' when compared with controls. The importance of observed changes concerning myocardial tissue oxygenation is analyzed by using Krogh's cylindrical tissue model.


Changes in pancreatic tryptophan in the rat in response to fasting. The effect of B-cytotoxic agents and variation through the oestrous cycle. The concentration of tryptophan not incorporated into protein or polypeptides in the pancreas of male rats rose two- to three-fold in response to a 24 hrs period of food deprivation. On refeeding or intra-peritoneal administration of glucose the level of tryptophan in the pancreas fell, while that in the serum rose. The pancrease B-cytotoxic agents alloxan and streptozotocin both abolished this response to fasting, while neutral red (an A-cytotoxic agent) had no effect. It therefore appears that the tryptophan which accumulates in the pancreas during fasting is located mainly in the B-cells of the Islets of Langerhans. In female rats, the concentration of tryptophan in the pancreas was greater at dioestrus than at any other stage of the oestrous cycle. The increase in pancreatic tryptophan was maximal at metoestrus and minimal at oestrus.


Na-KATPase activity and intracellular ion concentrations in the lactating guinea pig mammary gland. Studies on Na-K activated adenosine triphosphatase, XXXVI. The intracellular sodium, potassium and chloride concentrations in slices of lactating guinea pig mammary gland have been determined by chemical analysis and the use of appropriate values for extracellular space. These ion concentrations after 1 hr incubation at 37 degrees C in a Krebs-Ringer bicarbonate solution are 45mM Na+, 138 mM K+ and 44 mM Cl-, which values are in agreement with those found in fresh mammary gland slices. Inhibition of the NaK activated ATPase cation pump system of the tissue by 10(-4)M ouabain, anoxia or cooling to 0 degrees C Causes a gain of Na+ and an equimolar loss of K+ without a significant change in chloride concentration. The effect of cooling (0 degrees C) is reversible by reincubation at 37 degrees C. Water content of the tissue (76.5% of wet weight) and extracellular space (40.5%) do not change under these conditions. The results permit the conclusion that the NaK activated ATPase system is responsible for the maintenance of the intracellular Na+ and K+ concentrations, but do not support the presence of a chloride pump.


Correlation of the dynamic behaviour of deefferented primary muscle spindle endings with their static behaviour. 20 deefferented primary muscle spindle endings, 8 afferents from the extensor digitorum longus muscle (EDL) and 12 from the tibialis anterior muscle (TA), were investigated in 12 anesthetized cats. Dynamic responses of muscle spindles to ramp stretches were correlated with their static responses. The variation in the state and dynamic behaviour was found to be interdependent. The correlation coefficients were higher for EDL spindles than for TA spindles. The correlation coefficients depended upon the definition of the dynamic responses.


Comparison of the local effects of amiloride hydrochloride on the isotonic fluid absorption in the distal and proximal convoluted tubule. The isotonic fluid absorption (Jv) was measured under standard conditions in the proximal and distal convolution of the rat kidney. The peritubular blood capillaries were perfused simultaneously. Amiloride was applied either intraluminally or peritubularly. When applied intraluminally, amiloride strongly inhibited Jv in the distal tubule at concentrations up to 10(-6) M. In the proximal tubule similar effects were obtained only after intraluminal application of one thousand-fold greater concentrations of amiloride. In contrast to amphibian epithelia, amiloride also inhibits Jv in the distal tubule when applied peritubularly, but at higher concentrations and less completely than after intraluminal application. Amiloride was found to be generally more effective in the distal tubule than furosemide and mefruside, although in the proximal tubule it was less effective than these diuretics. That amiloride is most effective after intraluminal application in the distal tubule would suggest a dominant action at the luminal membrane of the distal tubule cell, while not excluding a concomitant effect at the peritubular membrane.


[Mannonidosis. Apropos of 5 cases].

[Mannonidosis. Apropos of 5 cases]. Mannosidosis remains an extremely rare entity (9 published cases). Our personal experience, based upon 5 cases, suggests that the diagnosis may be based upon both positive as well as negative clinical and paraclinical data, which differentiate the disorder from other diseases which it resembles. The use of simple methods--thin layer chromatography of oligosaccharides and measurement of serum mannosidase at pH 3.5 and 4.5--render diagnosis easy. It should, however, be mentioned that there exists no valid treatment for this apparently autosomal recessive disorder but that ante-natal detection is theoretically possible.


The cleavage of transfer RNA by a single strang specific endonuclease from Neurospora crassa. Endonuclease from Neurospora crassa (NcNase), an enzyme with specificity for polynucleotides lacking an ordered structure, was shown to cleave su+3 tRNATyr from E. coli preferentially in the anticodon region. The enzyme cleaved unfractionated tRNA primarily to 30 - 50 nucleotide size fragments, implying that most or all tRNA species are also cleaved in the anticodon region. The 3' terminal sequence C-A was cleaved as well. The results are discussed with respect to the three dimensional structure of tRNA.


Sexual conseling of the physically disabled. Sexual satisfaction and feelings of self-esteem play an important role in the ability to adapt to an acquired physical disability. A framework has been presented to show how sexual function is affected by different types of physical disability, and spinal cord injury has been selected as a specific example. Sexual counseling for the disabled differs little from that for the able-bodied--the same principles apply. It is appropriate to remind not only the counselor but also the disabled that (1) loss of sensation does not mean loss of feelings, (2) loss of potency does not mean loss of ability, (3) loss of urinary continence does not mean loss of penile competence, and (4) loss of genitalia does not mean loss of sexuality.


An electrocardiographic survey of the aged. In a short-term study, 38% of a group of hospital and clinic patientsat least 75 years of age were found to have normal resting electrocardiograms. Other surprising findings were a higher incidence of atrial fibrillation than of atrial premature contractions, a relatively low incidence of acute or residual myocardial infarction, and a very low incidence of digitalis intoxication among the patients treated with this drug.


Interrelationship of dietary silver with copper in the chick. Adding 900 p.p.m. silver (as silver nitrate) to a practical diet for chicks significantly depressed growth, increased wet and dry heart weight to body weight ratios and markedly increased mortality during a four-week experimental period. Blood packed cell volume was not affected. Supplementing the diet containing silver with 50 p.p.m. copper prevented cardiac enlargement and mortality, but only partially corrected the growth depression. Glycogen content of the heart was not affected, but aortic elastin content was significantly reduced by silver and restored to normal by supplemental copper. Dietary silver significantly reduced the copper content of blood, spleen, brain, liver, but except for the brain, the level of copper in these tissues was restored to normal by dietary copper supplementation. No significant differences in copper content of kidney tissue were observed among the treatment. Copper content of the excreta was not significantly increased by adding dietary silver, but was greatly increased by adding 50 p.p.m copper to the diet containing silver.


Biological properties of plasmin digests of S-carbamidomethylated human growth hormone. Reduction and carbamidomethylation of the intrachain disulfide bridges of human growth hormone did not destroy its ability to stimulate weight gain or cartilage metabolism in hypophysectomized rats. The reduced and alkylated hormone also stimulated glucose oxidation in isolated adipose tissue of hypophysectomized rats when added in vitro. When the S-carbamidomethylated hormone was incubated overnight with human plasmin, approximately 95% of the starting material was completely digested, as judged by polyacrylamide gel electrophoresis. The plasmin digest retained the ability to stimulate weight gain, cartilage metabolism, and glucose oxidation. A fraction consisting of two major electrophoretic components was isolated from the digest by chromatography on tsephadex G-50. This fraction possessed the biological properties of the whole digest.


Cardiac hypertrophy: synergistic effects of pericardiectomy and mild exercise in rats. Removal of the pericardium in combination with a mild exercise program of swimming resulted in a significant increase in heart weight and heart weight/body weight ratio of young rats. Either exercise or pericardiectomy alone did not significantly alter these parameters as compared to the control group of rats. This finding further substantiates the pericardium's physiologic effect on the heart. The effects of pericardiectomy should be considered in experimental studies of cardiac hypertrophy and in clinical studies involving cardiac surgery.


Effect of cortisone in delineating thymus cell subsets in advanced age. The mixed lymphocyte reactivity of thymus cells from normal and cortisone-treated, young and old C57BL/6J mice was evaluated. The results indicated that while in the young mice cortisone treatment caused a 12-fold increase in the reactivity of thymus cells, it had no effect on the response of thymus cells from old mice. The significance of the disappearance of cortisone-resistant mature thymus cells in old mice is discussed regarding the general decline in immunocompetence and the increase of autoimmune manifestations in old age.


Para-chlorophenylalanine, serotonin and killing behavior. Both p-chlorophenylalanine (PCPA) and PCPA methyl ester were found to reliably induce mouse-killing in non-killer rats only when unusually large doses were used (three successive daily injections of 300 mg/kg) and brain serotonin (5-HT) concentration was drastically reduced (about 90 percent). Neither three doses of 100 mg/kg of PCPA nor p-chloroamphetamine (3 times 3.5 mg/kg) caused similar effects in spite of the fact that these compounds depleted brain 5-HT by 85 percent and 60 percent, respectively. PCPA-induced mouse killing was reversed by 5-HTP (100 mg/kg) only when this serotonin precursor completely restored levels of 5-HT. The topography of PCPA-induced killing did not resemble normal interspecies aggression and was also directed toward fat pups. These findings suggest that 5-HT depletion might facilitate nonspecific killing reactions, but is not a sufficient condition to induce the species-specific predatory behavior in rats.


Behavioral changes following VMH lesions in rats with controlled insulin levels. The effects of ventromedial hypothalamic (VMH) lesions were studied in female rats made diabetic with streptozotocin that were given twice daily injections of protamine zinc insulin (0.75 mu/100g/day) and in non-diabetic animals of the same sex. Hyperphagia resulted from VMH lesions in both diabetic animals whose insulin levels were controlled and in non-diabetic animals. All animals with lesions exhibited persistent increases in feeding during the light protion of the light-dark cycle. Significant increases in body weight gain were observed in both diabetic and non-diabetic lesioned animals, but the magnitude of wegith gain was greater after VMH lesions in non-diabetic rats. VMH lesions also reduced wood-gnawing and increased emotionality, aversion to quinine and reactivity to electric shock. None of the behavioral changes were dependent on hyperinsulinemia, although hyperinsulinemia may contribute to the magnitude of certain of these effects.


Failure of antiserotonergic agents to modify levallorphan-induced stereotypy in rats. The possibilty that the stereotypic behaviour induced by levallorphan, a narcotic antagonist, might be influenced by a serotonergic system was examined.  Two antiserotonergic agents, methysergide and parachlorophenylalanine, failed to modify such stereotypy implying that serotonin is not involved.  It is suggested that dopamine might be the principle mediator of this behaviour.


Role of serotonin in the discriminative stimulus properties of mescaline. Rats were trained to discriminate intraperitoneally administered mescaline from saline in a two-lever operant chamber for food reinforcement. Reward was contingent upon responses made greater than 15 sec apart (DRL-15) on the appropriate lever paired with either drug or saline administration. Following the establishment of discriminative response control by mescaline, the animals were tested for stimulus generalization produced by mescaline after: (a) blockade of periphreral and central serotonin (5-HT) receptors with cinanserin, methysergide, or cyproheptadine; (b) blockade of peripheral 5-HT receptors with xylamidine tosylate; and (c) depletion of brain 5-HT with the tryptophan hydroxylase inhibitor p-chlorophenylalanine (PCPA). The results show that all three central 5-HT antagonists greatly reduced the discriminability of mescaline while the peripheral antagonist, xylamidine tosylate, was without effect. Furthermore, these agents at the doses employed did not effect the discriminability of saline. Depletion of 5-HT with PCPA potentiated the effects of a sub-threshold dose of mescaline and slightly reduced the discriminability of saline. The results indicate that mescaline produces its discriminative stimulus properties by directly stimulating central serotonergic receptors.


Inhibition not facilitation of sexual behavior by PCPA. It has been proposed that estrous behavior in the female rat may be under tonic inhibition by a central serotonergi system. Studies conbining estrogen priming and the pharmacological depletion of serotonin have provided some support for this hypothesis. Some evidence, however, is not consistent with this hypothesis. In the present study estrogen primed ovariectomized-adrenalectomized rats were administered p-chlorophenylalanine and were tested for lordosis behavior 66 and 70 hr later. Lordosis was not facilitated. The animals were then administered progesterone and retested at hour 74. PCPA inhibited progesterone-induced lordosis behavior in a dose dependent manner.


Biogenic amines and the effect of short term lithium administration on open field activity in rats. Experiments were performed to examine whether the effects of short-term lithium administration on cerebral biogenic amine metabolism might be related to its action on open field activity. Rats received intragastric injections of lithium chloride (1.5 mEq/kg) twice daily for 5 days. This lead to a decrease in exploratory behavior in the open field. Administration of imipramine, which blocks the efffects of short-term lithium administration on norepinephrine turnover and uptake in the brain, failed to influence the effect of lithium on exploratory activity. Parachlorophenylalanine, which inhibits cerebral serotonin synthesis and depletes brain catecholamines, prevented the behavioral effect of lithium. Injection of pargyline, which inhibits cerebral monoamine oxidase activity, counteracted the effect of lithium on exploratory behavior and also influenced the emotionality of the animals in the open field. The findings are consistent with the hypothesis that cerebral monoamine levels and monoamine oxidase activity play a role in the effect of short-term lithium administration on open field activity in rats.


Drug discrimination in rats: the effects of phencyclidine and ditran. Choice responding in a T-shaped maze has been made contingent upon whether or not rats experienced certain drug effects. The drug discriminative cues used in the present state-dependent (StD) model were those of phencyclidine (PCP) and ditran. The specificity of these cues and their possible drug inhibition and antagonism was studied. It was found that the lower the training dose used the slower the appearance of the drug discriminative formation. Transfer testings with ketamine and cyclohexamine showed that they were interchangeable with PCP. The order of their relative potency was: cyclohexamine greater than PCP greater than ketamine. Atropine transferred to ditran. Administration of compounds not structurally related to the training drugs did not show transfer. Pretreatment with parachlorphenylalanine (p-CPA) or tetrabenazine (TBZ) plus imipramine did not indicate inhibition or antagonism in PCP trained rats. Tacrine (THA) and especially physostigmine effectively antagonized the ditran-induced cues. Yohimbine and neostigmine did not.


Possible serotonergic mediation of tonic immobility: effects of morphine and serotonin blockade. Small doses of morphine, within the range of 0.02 mg/kg to 10.15 mg/kg were administered to chickens (Gallus gallus) and the effect on the fear-based tonic immobility (TI) response determined. All doses at and above 0.13 mg/kg enhanced the TI response significantly above the levels produced for the 0.2 mg/kg dose and the distilled water control group. Administration of a single large dose of p-chlorophenylalanine prevented the morphine-induced enhancement of TI. It was suggested that serotonin systems mediate morphine effects on tonic immobility in chickens.


Congenital heart disease in Liverpool: 1960--69. The incidence of congenital heart disease (C.H.D.) in Liverpool from 1960 to 1969 inclusive has been determined from the Liverpool Congenital Abnormalities Registry with a follow-up period of 3 to 12 years. The incidence is 6-6 per 1000 total births and this probably represents a very small degree of under-reporting. There is no consistent seasonal variation in the incidence of any of the main congenital heart lesions. In general, infants with C.H.D. tend to be of lower birth weight and born after shorter gestation than controls. This is most conspicuous with patent ductus arteriosus (P.D.A.). Females preponderate in P.D.A. and males in transposition. There is probably also a male preponderance in coarctation and aortic stenosis. Fallot's tetralogy is associated with increased maternal age and parity. Pregnancies leading to the birth of a baby with C.H.D. are complicated by threatened abortion more frequently than are controls. The concordance rate for C.H.D. in twins is low. Monozygotic twins are more liable to C.H.D. than are dizygotic twins. The incidence of C.H.D. in the siblings of affected propositi is 2-3 times that expected. Affected sibs often have the same lesion. About 20 per cent of infants with C.H.D. have associated major defects notably monogolism and defects of the alimentary, skeletal, genito-urinary and nervous systems. These are responsible for the early death of about one quarter of all infants born with C.H.D. The data presented here suggest that environmental rather than genetic factors are predominantly responsible for congenital heart disease.


Interpreting chest radiographs without visual search. Ten radiologists were shown a series of 10 normal and 10 abnormal chest films under two viewing conditions: a 0.2-second flash and unlimited viewing time. The results were compared in terms of verbal content, diagnostic accuracy, and level of confidence. The overall accuracy was surprisingly high (70% true positives) considering that no search was possible. Performance improved as expected with free search (97% true positives). These data support the hypothesis that visual search begins with a global response that establishes content, detects gross deviations from normal, and organizes subsequent foveal checking fixations to conduct a detailed examination of ambiguities. The total search strategy then consists of an ordered sequence of interspersed global and checking fixations.


Residuae, sequelae, and complications of surgery for congenital heart disease. Definitive, if not curative surgery is available for the eight most common congenital cardiac defects-ductus arteriosus, ASD, coarctation, pulmonary valve stenosis, aortic valve stenosis, tetralogy of Fallot, and transposition. The results of surgery for uncomplicated cases of DA, ASD, VSD, and coarctation usually can be determined by clinical means (including chest radiogram and ECG). Postoperative heart catheterization is recommended for evaluation of the patient who has had surgery for pulmonary valve stenosis or artic stenosis and is necessary after tetralogy of Falot or transposition of the great arteries repair to identify the important postoperrative residua and sequelae. The term "curative" surgery probably shoud be reserved for operation for divion of ductus arteriosus unassociated with pulmonary hypertension and performed in childhood. After closure of ASD, patients should continue to be observed for late development of arrhythmias and persistent cardiac enlargement, although the incidence of these problems is low. After VSD closure the patient is still followed at intervals for possible ill effects of the ventriculotomy scar, manifest as arrhythmias, ventricular aneurysm or myocardial insufficiency. The patient with coarctation repair must be observed for a possible late complication from one of the several clinically silent cardiovascular or cerebrovascular anomalies as well as for the change of restenosis or unrelieved hypertension...


Energy reserves in transplanted and sham-operated carciac tissue=. Tissue levels of creatine phosphate (CP), creatine, adenosine-triphosphate(ATP), inorganic phosphate (Pi), glycogen, glucose and lactate were determined in heterotopically transplanted and recipient hearts as well as in the myocardium of sham-operated rabbitsmthe ATPase activity in these tissues was also estimatedmthe results revealed no biochemical indication of ischemic conditions in the transplanted organs relative to the other investigated tissue. The tissue levels of CP in the donor heart were even higher then in both the recipient and sham-operated organs. The concentrations of the other above listed compounds in all the studied tissue were similar throughout the first 5 post-operative days. The effect of surgery  was manifested in decreased levels of CP, still prevailing 3 days post-operative in all of the investigated tissue. However, on the fifth day after surgery, the tissue concentration of CP showed a trend toward recovery. The activity of Na,K-ATPase in both donor and recipient hearts was similar. One day after surgery, the activity of the Mg-ATPase was 27% lower relative to its value on days 3 and 5 post-operatively. However no correlation was obtained between the change in Mg-ATPase and tissue concentrations of ATP.


Irreversible inhibition of Na-+ +K-+ -ATPase by strophanthidin 3,5-bid-p-benzoyl benzoate, a photochemical analogue of strophanthidin. A photoactivatible analogue of strophanthidin, strophanthidin 3,5-bis-p-benzoyl benzoate (SBB), was synthesized and tested as a photoaffinity label for the cardiotonic steroid binding site of Na-+ +K-+ -ATPase. SBB inhibited rat brain Na-+ +K-+ -ATPase with an I50 of approximately 1 times 10-minus 5 M and displaced (3-H) ouabain from its specific binding site on this enzyme while the photoaffinity group, methyl p-benzoyl benzoate (me-pBB), alone was not effective. Ultraviolet photoactivation of SBB which had been specifically bound at the cardiotonic steroid binding sites of this enzyme produced 35% irreversible inhibition of enzyme activity. However, only slightly less irreversible inhibition was observed in the absence of cardiotonic site directed binding of SBB and photoactivation of me-pBB itself produced marked inhibition of the enzyme. It was concluded that the bulk of the photoactivated inhibition occurring with SBB does not involve the cardiotonic steroid binding site and that a substantial reduction in the concentration of non-specifically bound SBB is required to expose any site directed labeling.


Effects of ryanodine on a myocardial membrane vesicular fraction. The effects of ryanodine on calcium transport were examined on a microsomal fraction isolated from guinea pig atrial muscle by sucrose density ultracentrifugation. The Ca+2 binding capacity of the fraction was sufficient to account for relaxation and was unaltered by the addition of 5x10(-5)M ryanodine. Exposure of the sarcoplasmic reticulum (SR) to concentrations of ryanodine which produce negative inotropy significantly reduced ATP-dependent calcium transport which was associated with a significant increase in the Ca+2 activated ATPase activity. The effect of ryanodine was to reduce the Ca/P ratio by 50%. These results suggest that the negative inotropic effect of ryanodine in guinea pig atrium is associated with the uncoupling of Ca+2 transport from ATP hydrolysis.


The effect of some drugs on the urinary excretion of some aryl alkyl amines in the rat. The urinary excretion levels of meta tyramine (mTA), para tyramine (pTA) and beta-phenylethylamine (PE) in the untreated rat have been established. The effects of intraperitoneal injections of a precursor (L-Dopa) and some inhibitors of monoamine oxidation (pargyline), decarboxylation (Ro4-4602) and hydroxylation (iprindole, imipramine and para chlorophenylalanine (PCPA) are consistent with the interpretation that PE arises essentially as a result of decarboxylation of phenylalanine, pTA by hydroxylation of PE and mTA by dehydroxylation (and decarboxylation) of a catechol.


Inhibition of the adrenal chromaffin cell membrane calcium pump by caffeine and various divalent cations. Caffeine, 50 mM, inhibited ATP-mediated 45Ca uptake by plasma membrane vesicles from bovine adrenal medullary microsomes by 40 percent. Hg++ (0.09 mM) completely inhibited 45Ca uptake, while Cd++ (0.3 mM) and Ba++ (0.3 mM) produced mean depressions of 80 and 41 percent, respectively. 45Ca uptake in the presence of Zn++ (0.3mM) was not significantly different from controls. Inhibition of calcium accumulation in plasma membrane vesicles by these agents was not correlated with their ability to inhibit the enzyme Ca++-ATPase. Caffeine and certain divalent cations may modify secretory responses by inhibiting the active extrusion of calcium through the adrenal medullary plasma membrane.


Epidemiology of methicillin-resistant Staphylococcus aureus in dairy herds. Sixty-eight methicillin-resistant Staphylococcus aureus strains were isolated from mastitis milk samples originating from 20 Belgian dairyherds. All these strains appeared to be representatives of one single strain which was probably of human origin. Evidence is presented indicating a rapid in vivo evolutionary change in this strain. The following characteristics were found to be variable: the production of beta haemolysin inversely connected with fibrinolysin (staphylokinase) activity; the production of lipase, enterotoxin B and delta haemolysin; the resistance to neomycin, chloramphenicol, tetracyclines, methicillin and spectinomycin associated with constitutive or inducible macrolide resistance.


A comparative enzyme histochemical and histological study of the effect of ischaemia and post mortem change on rat kidneys. A histochemical study of the effect of ischaemia on rat kidneys showed that changes were demonstrable in adenosine triphosphatase, alkaline phosphatase and succinic dehydrogenase within 2 h. Further changes occurred with increasing time. The activity of acid phosphatase was little affected up to 24 h although at this time there was marked tubular disruption. Paraffin embedded H and E sections also showed marked changes within 2 h. Enzyme histochemical and histological changes in kidneys taken at varying periods after the death of the animal showed very similar changes to those in ischaemic kidneys. Differences were mainly in the rate and extent of the changes.


Specifically decreased MLC response of lymphocytes from CBA mice injected with cells from the H-2-compatible, M-antigen-incompatible strain C3H. Lack of such effect after injection of H-2-disparate C3H-hybrid cells. The mixed lymphocyte culture (MLC) response of lymphocytes from CBA mice against C3H cells was studied after injection of spleen cells from C3H mice or C3H hybrids. Intravenous infusion of C3H cells resulted in a strongly suppressed specific MLC response, but this was not the case when cells from H-2-incompatible hybrids of C3H mice were injected. However, when mixtures of cells from the two parental strains--C3H cells and H-2-incompatible cells--were injected into CBA mice, there was a strongly suppressed MLC response to C3H cells. Mice that were hybrids between CBA and an H-2-disparate strain showed a depressed MLC response against C3H after injection of cells from hybrids between C3H and the same H-2-disparate strain. The results may indicate that a suppression of the MLC response to the strongly stimulatory non-H-2 antigen on C3H lymphocytes develops only when the immunizing cells can survive in the host for long periods, thus exhausting the pool of specifically responsive cells. The presence of another foreign transplantation antigen, such as H-2, on the same cells shortens the survival of the cells in the recipient.


Relapsing polychondritis: review of current status and case report,. This communication has attempted to review the present state of published knowledge on the syndrome of relapsing polychondritis. Basic anatomic, physiologic, and biochemical changes in this disorder are summarized and the role of metabolic and immunologic alterations in the pathogenesis discussed. An additional case of relapsing polychondritis is reported, and the clinical features of this case, plus those of 131 previously reported, are reviewed with discussion of present day therapeutic experience and prognosis.


Practical office technics for physiologic vascular testing. The development of the Doppler ultrasonic flow velocity detector has improved diagnostic accuracy in peripheral arterial occlusive disease. Survey of the peripheral vessels with the Doppler ultrasonic flow velocity detector, measurement of systolic arterial blood pressure at the ankle and arm, and exercise testing are three easily done tests which may be readily carried out in the doctor's office and which provide useful information. Noninvasive vascular testing should be in the armamentarium of all primary care physicians.


Current concepts of toxic epidermal necrolysis. Toxic epidermal necrolysis consists of two distinct clinical entities. The Ritter type, seen mostly in children under age 10, is the severest manifestation of staphylococcal disease. A toxin has been isolated which is postulated to be the cause for clinical lesions. High epidermal necrosis occurs. Treatment is with one of the penicillinase-resistant penicillins, and prognosis is good. The Lyell type is seen mostly in adults, is drug-related, and may be the severest form of the Stevens-Johnson syndrome. Full-thickness epidermal necrosis occurs. Treatment consists of withdrawing the offending drug. Good nursing care is essential. Prognosis is guarded.


Xanthine, hypoxanthine and muscle pain. Histochemical and biochemical observations. A suspected case of xanthine oxidase deficiency has been further investigated. The patient complained of arthralgia and myalgia. Further studies included histochemical and ultramicroscopic analysis of muscle sarcoplasmic reticulum, and biochemical studies. High levels of xanthine and hypoxanthine were found, while uric acid was absent in the muscle extracts.


Measurement of urinary mucopolysaccharides. The fact that the polyanionic long chains of mucopolysaccharides (MPS) can be precipitated with detergents such as cetylpiridiniumchloride (CPC) has been used in the development of a method for the quantitative estimation of total MPS in urine. Urine samples are all brought to an osmolarity of 300, after which an equal volume of 0,1% CPC is added to each sample. The turbidity is determined spectrophotometrically after 5 minutes. Chondroitin sulphate A was used as an internal standard. Normal values obtained for different age groups in the population of Pretoria are discussed.


Pancreatic transplantation in diabetic rats: renal function, morphology, ultrastructure, and immunohistology. Serial renal morphologic, ultrastructural immunohisotlogic and functional studies were done on diabetic Lewis rats to evaluate the course of nephropathy and to study the effects of early pancreatic isografts on renal disease associated with streptozotocin diabetes. Three groups of experimental animals and one group of agematched controls were used. Group 1 consisted of 12 animals which were made diabetic with streptozotocin and which did not receive transplants. Early in the course of diabetes, these animals developed an increase in mesangial matrix, electron-dense material in themesangium, with immunoglobulin G, C3, and occasionally fibrinogen deposits in the glomerular mesangium. Alterations were progressive and mesangial bars, proximal tubular degeneration, tubular vacuolization, and myeloid figureswere present later. Progressive increase in protein excretion and increase in glomerular filtration rate were observed. Persistent glycosuria, hyperphosphaturia, andhypercalcuria. In contrast, only an occasional animal from Groups 2 and 3 with a pancreatic transplant showed renal in age-matched controls. These studies have demonstrated the evolution of renal glomerular and tubular changes in streptozotocin diabetic rats, and they have showed functional, and immunohistochemical changes.


Bacteremic infectability of vascular grafts: the influence of pseudointimal integrity and duration of graft function. This report describes an experimental study in which dogs with prosthetic graft replacement of the infrarenal abdominal aorta were challenged at progressive time intervals following graft placement with a single intravenous infusion of Staphylococcus aureus in order to determine the duration of susceptibility to graft infection of bacteremic origin. The results demonstrate that the susceptibility of a prosthetic graft to infection by bacteremic seeding virtually was 100 percent up to 1 month following graft placement. The incidence of infection then began to progressively drop but never was eliminated as demonstrated by a 30 percent incidence of graft infection in dogs so challenged 1 year graft placement. Careful scrutiny of the intimal surface of the harvested grafts, 3 weeks following bacteremic challenge, revealed that all grafts in which the pseudointimal coverage was complete were insulated effectively from infection by bacteremic seeding in that their cultures were negative. All grafts that had positive cultures for Staphylococcus aureus were noted to have either an incomplete or absent pseudointimal lining.


The use of in vitro procedures in teratology. The capabilities of investigators in the fields of teratology and toxicology are greatly enhanced by the use of tissue culture procedures in unraveling the mechanisms of drug action. Techniques currently available for the culture of postimplantation mammalian embryos permit evaluation of their metabolic responses to potential teratogens even when the length of time embryos survive and develop in culture is too short to allow a conventional teratologic survey of malformations. A simple procedure for culturing mouse embryos during early organogenetic stages is described in this report that will be of value to teratologists; it avoids the requirements of special glassware and equipment by using ordinary capped test tubes which are rotated tomaintain and efficient nutritional and gaseous evnironment. Some studies concucted with this procedure to monitor the metabolism of embryo during the first 24 h of culture are summarized. Another aspect of tissue culture, organ culture, provides further manipulative capability by which embryonic organs can be maintained for long periods of time during which they develop and differentiate to an extent that their morphological and biochemical responses to a teratogen can usually be made. Comparative effects of several teratogenic agents and the relative concentration of each that produces a similar degree of response are summarized. It is concluded that organs are more sensitive to teratogens in culture than they are in vivo, and that different teratogens possess enough specificity to isolate their simple growth-retarding effect from the role they play in distrubing other specific developmental events.


Plasminogen-plasmin system IX. Specific binding of tranexamic acid to plasmin. Interactions between tranexamic acid and protein were studied in respect of the antifibrinolytic actions of tranexamic acid. Tranexamic acid did neither show any interaction with fibrinogen or fibrin, nor was incorporated into cross-linked fibrin structure by the action of factor XIII. On the other hand, tranexamic acid bound to human plasmin with a dissociation constant of 3.5 X 10-5 M, which was very close to the inhibition constatn (3.6 X 10-5 M1 for this compound in inhibiting plasmin-induced fibrinolysis. The binding site of tranexamic acid on plasmin was not the catalytic site of plasmin, because TLCK-blocked plasmin also showed a similar affinity to tranexamic acid (the dissociation constant, 2.9-4.8 x 10-5m). in the binding studies with the highly purified plasminogen and TLCK-plasmin preparations which were obtained by affinity chromatography on lysine-substituted Sepharose, the molar binding ratio was shown to be 1.5-1.6 moles tranexamic acid per one mole protein. On the basis of these and other findings, a model for the inhibitory mechanism of tranexamic acid is presented.


A simple freezing and storage method to preserve the stimulating function of leukocytes in the mixed leukocyte reaction. Human peripheral blood leukocytes retain their capacity to function as stimulating cells in the one way MLR after freezing and storage at - 70 degrees C by a simple and inexpensive method. This storage method facilitates the use of a standard stimulating pool of cells from three donors which may provide a quantitative assay for testing the ability of cells to respond to allogeneic cells in culture.


The assessment of histocompatibility by mixed lymphocyte reaction as measured by the macrophage electrophoretic mobility (MEM) test. The mixed lymphocyte reaction (MLR) between donor and recipient lymphocytes has been measured by the macrophage electrophoretic mobility (MEM) test and the modified (MOD-MEM) test. Its value as a measure of compatibility has been assessed by comparison with conventional HL-A serotyping and with the outcome of renal transplantation. Thirty-six living donor/recipient pairs and 59 cadaver donor/recipient pairs for transplantation have been studied. Whilst uniovular twins gave lymphocyte interactions, measured as macrophage slowings of about 1%, the slowing produced by paired allogeneic lymphocytes ranged from 2% to 26% depending on the number of HL-A matches. The test measurement of lymphocytic interaction was significantly correlated with histocompatibility measured by HL-A serotyping, in both living and cadaver donors. One way MEM-MLR showed the dominant role of the second HL-A sublocus in mixed lymphocyte reactivity. The long term success of the renal graft correlated with the pre-transplant initial reaction between donor and recipient lymphocytes. The test has advantages in the field of human histocompatibility assessment since no particular reference to individual antigens is made and it may be performed in a matter of hours.


MLC results among unrelated can be predicted. Typing for LD determinants which has been practicable for some time is shown to be very predictive for the MLC response between unrelated, since LD identical individuals-selected and paired solely on the basis of LD typing-mutually show very low or no MLC reaction.


Effect of coumarins on mitochondrial function I. Uncoupling of oxidative phosphorlation. 8-Acetyl-5,7-diemthoxy-4-phenylcoumarin at concentrations 0.03 to 0.3 mM uncoupled oxidative phosphorylation, in vitro, in rat liver mitochondria. Preincubation of mitochondria with the compound enhanced this effct. Similar uncoupling was observed with 5,7-dihydroxy-4phenylcoumarin; 7-acetonyloxycoumarin; 6,7-dimethyl-4-phenylcoumarin and 4-phenyldaphentin also. All these compounds stimulated mitochondrial ATPase activity three- to eight-fold. However, coumarin, the paretn substance of all these compounds had no effect on oxidative phosphorylation in mitochondria.


Direct analysis of dehydroisoandrosterone in plasma. DHA (1) has been measured in plasma by a radioimmunoassay procedure using an antiserum to DHA-7-BSA whose specificity is such that the procedure is carried out directly on diluted, unextracted plasma. The method has been used to obtain plasma DHA secretory patterns and mean concentrations and the data are in accord with those determined by related but more laborious techniques.


Cerebral atherosclerosis and its relationship to selected diseases in Nigerians: a pathological study. Factors which are known to be associated with cerebral atherosclerosis were evaluated in Nigerian Africans. Of 465 autopsied adult Nigerians, 62 (13%) had cerebral atherosclerosis. The frequency and severity of atherosclerosis among Nigerians with hypertension, particularly male subjects, were higher than in normotensives. Although there was a similar frequency of hypertension among autopsied Nigerian and Minnesota Caucasian populations, the severity and extent of atherosclerosis were greater in the Minnesota Caucasian populations, the severity and extent of atherosclerosis were greater in the Minnesota population. The relatively short duration of hypertension in the Nigerian before death might be an important factor which did not permit progressive development of cerebral atherosclerosis. Other factors which predisposed the Nigerian to increased frequency and severity of atherosclerosis included increased heart weight and diabetes mellitus. The relatively low frequency of cerebrovascular disease in the Nigerian may be explained on the basis of a low degree of cerebral atherosclerosis and relatively short duration of hypertension.


[Closed cerebrocranial trauma].

[Closed cerebrocranial trauma]. During recent 20 years (1946--1966) in Leningrad City the incidence of cranial trauma increased from 9.0 to 57.7%, while that of cerebral injuries--up to 25% of all hospitalized traumas. Fractures of cranial bones with respect to all kinds of fractures increased from 7% (in 1955) to 13.4% (in 1971), whereas the mortality index (per 100 000 population) as a result of cerebral traumas increased during 5 years (1965--1971) from 1.6 to 5,6. Simultaneously, the scientific medicobiological progress has contributed to improvement of the old classification for closed cerebral trauma, its complex pathogenesis, clinic, diagnosis and treatment. Some useful practical recommencations are given.


[Place of laparoscopy in the diagnosis of acute surgical diseases of the organs of the abdominal cavity]. The author reports the results of 76 laparoscopies performed in 75 patients with clinically suspected acute surgical diseases (22), peritonitis (38), injuries to internal organs in a blunt abdominal trauma (16 patients). As a result of laparoscopic studies the precise clinical diagnosis was established in 39 patients, and the necessity of urgent therapy was supported, in 3 cases the operation was postponed. Acute surgical diseases were excluded in 33 of 75 examined subjects. There were no cases of pseudonegative diagnosis.


[Some problems of treatment and surgical approach in acute appendicitis]. According to the author's data within a 7-year period in the Regional Hospital 1329 appendectomies were performed, in 7 per cent--for chronic appendicitis. Annually, 51 persons are operated upon per 10,000 population. Late terms of hospitalization were noted in 19.7%, preoperative complications--in 5.2%, mortality--in 0.08%. Some aspects of treatment and complications are discussed.


Ultrastructural evidence for lack of tissue damage in a local immune complex reaction: a study of a mild passive Arthus reaction. An electron microscopic study of a mild reversed passive Arthus reaction (RPAR) was performed using a horeradish peroxidase (HRP)-anti-HRP system to demonstrate the biological usefulness of the process which exists to clear tissue of immune complexes.  To disclose the antigen, HRP, the biopsy material was subjected to a peroxidase reaction.  HRP was mainly detected within irregular electron-dense precipitates which were considered insoluable HRP-anti-HRP immune complexes. Neutrophils were found to phagocytose and digest the deposited immune complexes in a similar way as described previously.  But there was no vascular and other tissue damage.  This study provides morphological evidence that the process of clearing tissues of immune complexes need not be harmful to the host.


[Studies on the complete enzymatic hydrolysis of steroid conjugates in urine (author's transl)]. The incubation of urine with beta-glucuronidase/arylsuphatase from Helix pomatia results in the incomplete hydrolysis of urinary steroid conjugates, because inhibitors of these enzymes are present in urine; The inhibitors can be separated from the steroid conjugates by chromatography of the urine on a column of Amberlite XAD-2. By this method a complete enzymatic hydrolysis of urinary steroid conjugates is possible in 24 hours at 37 degrees C or in 2 hours at 55 degrees C.


[Cariostatic effect of calcium-, phosphorus- and fluoride-containing toothpastes in animal experiments]. The paper described the results of experiment performed on animals concerning the effect of fluoride tooth-pastes on a calcium-phosphate and sodium-phophate basis in the field of caries prevention. The caries infection is ascertained for varying test durations on the basis of serial grindings. It turns out that the anti-carieseffect of fluoride is greatly diminished if soluble calcium salts are present in the paste.


[Demonstration of blood group antigens of ABO system in human teeth]. The absorption-elution method allows the determination of the blood group properties of the ABO-System from human teeth. The results of own investigations carried out on a larger number of specimens are reported. The significance of the determination of the blood group antigens in teeth for the forensic stomatology is emphasized.


[Survey of the sensitivity of the strains Neisseria gonorrhoeae to antibioticas in the CSSR during 1957-1973 (authors transl)]. Although the preponderant majority of gonococcal strains is belonging to the most susceptible micro-organisms in respect of the action of antibiotics, certain variations of sensitivity which might be of importance not only for the genetics of microbes, but also for biochemistry and, above all, for therapy may occur also among them, perhaps as a consequence of along-time pressure by antibiotics. In a preceding study (J. Hyg. Epidem. Microb. Immunol. (Prague) 12,296, 1968), the authors analyzed the situation in Czechoslovakia from 1957 to 1967 by means of 911 strains of N. gonorrhoeae isolated from male patients suffering from gonorrhoea. It was also pointed out that there was a certain tendency towards reduced efficacy of penicillin G and a presence of streptomycin-resistant strains. In later years, the studies were extended to include also strains isolated from female patients and sensitivity to some more modern antibiotics was tested. In the present report, a survey is given of the state of antibiotics resistance among gonococci in Czechoslovakia in a chronological order of 17 years which is intended to serve as a basic information for those who are dealing with this subject.


[Comparative characteristics of the immunologic structure of children's collectives as regards scarlatina in different climatic zones]. An immunological study (in respect to scarlet fever) of children in children's collective bodies was conducted in 1971-1972 simultaneously in two towns-Ashkhabad and Petrozavodsk located in the contrast climatic zones. Results of Dick's test and passive hemagglutination test indicated no significant differences in the level and intensity of antitoxic immunity in children of both cities; only during the autumn period, corresponding to the seasonal increase in the incidence of scarler fever in Ashkabad, the number of immune children in this town proved to be greater than in Petrozavodsk, this being connected with a more active process of "mute" immunization. At the same time differences were revealed in the level and dynamics of antibodies to the leading types of M-antigens of hemolytic streptococci. Consequently, a higher immunological reactivity of the organism in children in Ashkhabad (promoting rapid formation of both the antitoxic and the antimicrobial immunity and limiting of the spread of marked scarlet fever affections) underlied the differences in the level of scarlet fever morbidity in different climatic zones.


[A-like effect of a proteinpolysaccharide containing extract from bovine cartilage]. In regard to the undecided immunological role of protein polysaccharides (of the glycosaminoglycan type) for pathogenesis of connective tissue diseases a protein polysaccharide-containing extract from bovine nasal cartilage was tested by the absorption method, precipitation and immunization. An A-like effect of the extract was found.


In vitro parameters of cell-mediated immune reactions in healthy individuals following immune-stimulation attempts with levamisole. In vitro parameters of cellular immune reactions were followed by 10 healthy individuals during administration of levamisole. Leucocyte migration tests, lymphocyte transformation tests and ATP-ase activity of peripheral blood lymphocytes were investigated. Levamisole did not influence resting human lymphocytes of the stimulation response of lymphocytes. The metabolic activity of lymphocytes expressed by their ATP-ase activity was not significantly changed after levamisole administration.


[Light- and electron microscopy studies on the cerebellum in 12-day-old rats after treatment with 6-aminonicotinamide (6-AN)]. Light- and electron-microscopie studies were performed in glia cells and neurons of the cerebellum of 12-day-old rats until 48 following intraperitoneal application of 8 mg/kg 6-aminonicotinamide (6-AN), an antimetabolite of nicotinamide that inhibits the oxidative pentose-phosphate pathway. Particularly sensitive were the neuroblasts of the external granular layer. The migration of the neuroblasts was clearly reduced. Parts of the internal granular layer were damaged, while the Purkinje cells and astrocytes remained unchanged. Oligodendrocytes and astrocytes showed vacuolar degeneration. Swelling of the myelin sheath occurred in the form of a status spongiosus. 48 h after 6-AN injection some mitoses and phagocytic cells were found in the internal granular layer.


Blink reflex in Huntingon's chorea and Parkinson's disease. The electrically-evoked late response (R2) of the blink reflex has been determined in 8 well-documented cases of Huntington's chorea and in 19 Parkinsonian patients. The results obtained from the two groups are compared with those from 10 normal subjects. A statistically significant difference of some components of the blink reflex was obtained when the three groups were compared. In both pathological conditions, the habituation index, latency and differential latency can be considered to represent the opposite extremes from the same scale, providing further evidence of the neurophysiological antagonism between the two disease states. The blink reflex pattern in Huntington's chorea probably reflects a diminished brain-stem interneurone basal activity through an over-inhibition of dopaminergic receptors in the striatum. The electrophysiological analysis of the blink reflex in incipient Huntington's chorea can provide an objective diagnostic assessment. It might be an effective method of detection for dopaminergic-activated carriers asking for genetic counseling.


[Sodium reabsorption and the membrane systems of vertebrate kidneys]. Sodium reabsorption is low in coldblooded animals (the lamprey Lampetra fluviatilis, red salmon Oncorhynchus nerka, carp Cyprinus carpio, frog Rana temporaria, tortoise Agryonemis horsfieldi) being much higher in warmblooded ones (chicken, pigeon, rat). High level of Na transport in warmblooded animals is paralleled by high activity of succinate dehydrogenase as compared with the activity of Na,K-ATPase. The content of monoenoic fatty acids in the glycerophosphatides from frog and tortoise kidneys is higher than that from pigeon and rat ones.


HL-A histocompatibility antigens in optic neuritis. HL-A and MLC typing in 54 patients with optic neruitis showed increased frequencies of the HL-A3, 7 and LD-7a determinants of approximately the same magnitude as in patients with multiple sclerosis. The frequencies of the same three determinants were not different in the 11 patients who developed multiple sclerosis during the period of follow-up compared to the remaining patients. There was a significant increase in the frequency of the HL-A3 determinant in patients with oligoclonal IgG of the cerebrospinal fluid at the onset of disease. The connection between this determinant and the occurrence of cerebrospinal fluid changes is not clear. The results suggest that optic neuritis and multiple sclerosis represent different aspects of the same disease entity, rather than two distinct diseases. HL-A and MLC typing did not seem to offer prognostic information as to the later development of multiple sclerosis in these patients, but the observation period is still short.


The excretion patterns of urinary glucosaminoglycans in a family with progressive familial myoclonus epilepsy. The urinary excretion of uronic acid and the electrophoretic composition of urinary glucosaminoglycans were studied in 10 members of a family, of which 3 had progressive familial myoclonus epilepsy. This seems to be the first detailed investigation of the excretion of urinary glucosaminoglycans in patients suffering from this neurologic disease. The uronic acid excretion was found to be increased in the affected family members exclusively, whereas the excretion of the unaffected members were found within the normal limits characterized in this investigation. The urinary glucosaminoglycans could be separated into 5 fractions by electrophoresis. One or two of these fractions were increased in the urines of the three affected family members, the clinically most affected member showing the most abnormal electrophoretic results. An abnormal electrophoretic distribution of fractions was also found in the urines of 5 other members, clinically not affected. Only the maternal part of the family (mother and maternal grandmother) was shown to have a normal electrophoretic distribution of urinary glucosaminoglycans. The implication of these electrophoretic differences in the paternal and maternal family on the conditions for the development of the disease is discussed. The two fractions in question (designated fraction-0.65 and fraction-0.71) have until now been regarded as glycoproteins, but the present results show that they are true glucosaminoglycans (acid mucopolysaccharides), probably of low sulphate content.


Lack of relationship of red cell enzyme activity to bilirubin and carboxyhemoglobin levels in healthy term infants. A total of 32 term infants were studied in an attempt to confirm and extend the recent observation of Petrich & associates (14) that minor degrees of transient deficiences of the red cell enzymes glucose phosphate isomerase and glyceraldehyde-3-phosphate dehydrogenase were related to hyperbilirubinemia in otherwise healthy term infants. No relationships could be observed between the activity of these enzymes and the bilirubin level on day three. In addition, no correlation was present between bilirubin values and carboxyhemoglobin levels on day three, suggesting that in the healthy term infant excessive hemolysis is not usually responsible for the variations observed in bilirubin levels.


A 21-year psycho-social follow-up of 524 unselected cases of down's syndrome and their families. The death rate was followed, and a life table has been constructed. Three crucial events were examined: 1. the period of diagnosis, 2. the problem of institutionalization versus homecare, 3. the ageing and death of the parents and its consequences for the person with D.S. Several other medical problems, psychological implications and social consequences for the person with D.S., for his parents and siblings are highlighted. The worst problem for parents with the child at home was social isolation; for the parents with the child at an institution it was the very existence of the child. To both groups the most encouraging fact was that their child was happy, friendly and in good spirits. Finally, emphasis is laid upon the medical and paramedical problems which must be discussed and solved to make a harmonious and social life for the person with D.S., for his normal siblings, and for the parents.


Relationship between length of the left main coronary artery and heart weight. The length of the left main coronary artery (LMA) was determined in post-mortem, non-fixed hearts of normal weight (heart weight less than 400 g, group I) and hypertrophic hearts (heart weight greater than or equal to 400 g, group II). Hearts from 76 men and 88 women in group I and 136 men and 61 women in group II were studied. The mean length of LMA in group I was 9.1 mm in men and 8.4 mm in women. Corresponding values in group II were 10.3 mm and 8.8 mm. There was no significant sex difference in the length of LMA in group I, but the sex difference in group II was significant (p less than 0.01). The difference in length of LMA between groups I and II reveals that the difference in men was significant ( less than 0.02), but insignificant in women. In the case of both sexes no significant correlation between heart weight and the length of LMA was found either in group I or group II. There was a significant correlation between the area of the left coronary ostium and the length of LMA in men in group I (p less than 0.05), but not in women. Corresponding comparisons of both sexes in group II were statistically insignificant.


Staphylococcus aureus in cystic fibrosis: antibiotic sensitivity and phage types during the latest decade. Investigation of the occurrence of protein A and some other properties of recently isolated strains in relation to the occurrence of precipitating antibodies. During the recent decade, 1651 isolates of Staphylococcus aureus from 111 patients with cystic fibrosis have been tested for antibiotic sensitivity and half of the isolates have been phage typed. All the patients were followed in one clinic and the policy of antibiotic treatment was consistent during this period. The results show a dynamic situation where "epidemic" phage types during recent years have been gradually replaced by other types and, during the same period, the prevalence of strains resistant to more than one antibiotic decreased. Multiresistant strains including strains resistant to methicillin were infrequent in these patients. From 23 per cent of the patients, the same strains were repeatedly isolated for more than 1 year despite an apparently successful chemotherapy. Recently isolated strains were found to produce cellbound as well as extracellular protein A. Ninety-one per cent of the strains produced extracellular lipase and only 8 per cent were resistant to mercury chloride. Eighty-one per cent of the patients produced precipitating antibodies agains S. aureus as judged by crossed immunoelectrophoresis. The investigated properties of S. aureus were not significantly correlated with the occurrence of precipitating antibodies against these bacteria. The possible significance of protein A in the pathology of the respiratory tract infection is discussed.


Consequences of myocardial structural adaptation on left ventricular compliance and the Frank-Starling relationship in spontaneously hypertensive rats. The Frank-Starling relationship of hearts from adult spontaneously hypertensive rats (SHR, Okamoto 1969), representing the established phase of hypertension, and of young SHR, representing the initial phase of hypertension, was investigated by using the isolated working heart preparation. In the "normal" diastolic pressure range (5 to 10 cm H2O), the left ventricle of both SHR groups displayed significantly reduced stroke volumes compared with hearts of normotensive controls (NCR); the degree of reduction being proportional to the left ventricular hypertrophy. This is suggested to be due to a reduced left ventricular diastolic compliance in SHR, as indicated by direct measurements of ventricular wall thickness and end-diastolic volumes in arrested hearts exposed to different end-diastolic filling pressures. Such a progressive shift of the Frank-Starling relationship to the right with duration of hypertension could, in combination with the gradual development of "structural autoregulation" of the precapillary resistance vessels, constitute dominating factors in shifting the hemodynamic situation in labile hypertension into that characterizing the established, or "fixed", state of hypertension.


Effect of aurothioglucose on some allergic and non-allergic skin reactions in animals. The antiphlogistic effect of aurothioglucose was examined in reversed passive Arthus reaction, delayed-type hypersensitivity and carrageenan oedema. A close association existed between the antiphlogistic effect of aurothioglucose and the pathogenetic role of polymorphonuclear leukocytes. In reversed passive Arthus reaction and in carrageenan oedema the drug decreased the inflammation considerably, whereas in delayed hypersensitivity, where the leukocytes play a less important part, it exerted only a mitigating effect.


Risk factors revisited.

Risk factors revisited. There is growing and increasingly firm evidence that certain remediable risk factors predispose to coronary artery disease. The most important of these appear to be systolic hypertension, cigarette-smoking, elevated blood lipids and glucose intolerance. When electrocardiographic left ventricular hypertrophy is also detected, a considerable further element of risk is imposed. Left ventricular hypertrophy and cigarette-smoking may predispose to sudden death. Tables are now readily available for assigning each patient a factor, and physicians can place their patients on an active program to reduce risk factors and possible to prevent development of coronary artery disease. Despite lack of absolute proof that such programs will be efficacious, the information presently available to us suggests that this represents a prudent approach to preventive therapy of this major international health problem.


Studies on the tolerance of silk, nylon, dacron and collagen suture material in the cornea of the rabbit. With rabbit corneas we did comparative biomicroscopical and histological investigations on material tolerance of the following threads at present used in microsurgery: Barraquer silk (virgin silk), nylon 30 mum (Tübinger nylon), dacron (polyester) 40 mum and plain collagen 7-0. The sutures were implanted into the cornea intra-lamellarly, completely under the microscope. The examinations showed only very little tissue reaction in all these materials.


Studies on the experimental production of endomyocardial fibrosis and cardiomegaly of unknown origin by dietary means. Three groups of rats were kept on diets similar to those eaten by indigenous inhabitants in parts of Africa where CUO and EMF are commonly found, for 30 months. Many of the animals on a tryptophan-deficient diet developed CUO whereas those on a tryptophan-deficient diet which contained a 5-HT content also developed lesions similar to EMF. The third group of rats, which ate a diet similar to this second group but supplemented by a high-protein intake, did not develop any cardiac lesions.


The superior QRS axis in ostium primum ASD: a proposed mechanism. The influence of abnormal hemodynamics, ventricular hypertrophy, and right bundle branch block on the AQRS was studied pre- and post-operatively in 29 patients with OPSD. The AQRS markedly diminishes with the surgical correction of abnormal hemodynamics and the subsequent resolution of RVH or BVH. With the persistence of ventricular hypertrophy postoperatively or the surgical induction of RBBB, the AQRS either remains unchanged or, in the latter instance, becomes more superior and rightward. The dependence of the superior AQRS on these factors suggests that a left anterior hemiblock is not responsible for this AQRS. In OPSD early activation of the posterobasal region of the left ventricle through an abnormally short posterior fascicle results in a minimal superior AQRS which is then exaggerated in the presence of abnormal hemodynamics, ventricular hypertrophy, or RBBB. Thus, the superior AQRS in OPSD with associated RBBB does not represent a true bifascicular block and has a different natural history and clinical significance.


Contractility of the hypertrophied human left ventricle in chronic pressure and volume overload. Nine patients with normal left ventricles (C), 10 patients with pressure load (PL) due to predominant aortic stenosis, and 9 patients with predominant volume load (VL) due to aortic incompetence were studied by left ventricular high-fidelity pressure measurements and cineangiography. Peak measured velocity of the contractile elements (Vpm) used as index of contractility and left ventricular muscle mass (LMMI) were determined. The patients with PL and VL were matched with respect to LMMI. In PL LMMI was 241 +/- 41 and in VL 254 +/- 42 gm. per square meter. Both were sizably increased (P smaller than 0.001) as compared to LMMI in C (89 +/- 24 gm. per square meter). Vpm was 1.41 +/- 0.20 ML per second in C. In PL and VLVpm was reduced to 1.05 +/- 0.26 (P smaller than 0.01) and to 1.07 +/- 0.33 ML per second (P smaller than 0.02). Vpm in PL was not different from Vpm in VL. Heart rate showed no major difference in the three groups. It is concluded that in two groups of patients with predominant PL and VL matched with  respect to LMMI left ventricular contractility was depressed to a similar extent regardless of the stimulus to hypertrophy.


Left main coronary arterial obstruction: Long-term follow-up of 141 nonsurgical cases. The prognosis of 141 patients with obstructive left main coronary artery disease was studied. The patients were followed up for 5 to 10 years from the date of coronary arteriography. The 5 year cardiac mortality rate was 51 percent. During the first 3 years after diagnosis, the mortality rate was especially high, 21.9, 34.7 and 43 percent, respectively. Among patients who died in the 1st year after diagnosis, evidence of left ventricular hypertrophy or conduction delay in the electrocardiogram and multiple vessel involvement indicated poor prognosis. Severe angina pectoris, evidence of congestive heart failure and generalized decrease in left ventricular contractility increased the 5 year mortality rate. More than 97 percent of the total patient population had additional lesions elsewhere in the coronary arteries.


Diastolic compliance of the left ventricle in man. Two coordinates of left ventricular end-diastolic pressure (P) and volume (V) were provided by the infusion of angiotensin in 22 patients. The slope (k) of the ln P-V relation, coupled with knowledge of the operating (end-diastolic) pressure allows determination of end-diastolic volume compliance (dV/VdP). Estimates of end-diastolic compliance from a single coordinate of pressure and volume compared well (r equals 0.90) with the two coordinate method, whereas for specific compliance (deltaV/V1 deltaP) appeared to be misleading in cases of idiopathic hypertrophic subaortic stenosis and congestive cardiomyopathy. Since volume compliance is determined in part by the operating pressure, compliance may be reduced in small, normal or enlarged  ventricles. Left ventricular linear compliance was derived from volume compliance and was normalized for left ventricular wall thickness. The product of linear compliance and end-diastolic stress provides an index of myocardial strain, termed "muscle fiber stretch," which may be related to systolic performance and thus allow comparison of length-performance relations in ventricles with normal and abnormal compliance.


Successful partial excision of an intramural fibroma of the left ventricle. A report of the only surviving adult to undergo partial excision of an intramural cardiac left ventricular fibroma is presented. Good results were obtained by relieving outflow tract obstruction through partial excision of the tumor from the septum and left ventricle. The need for conservative surgical treatment of patients with this rare, benign tumor is emphasized.


Familial Down syndrome due to t(10;21) translocation: evidence that the Down phenotype is related to trisomy of a specific segment of chromosome 21. This report deals with a reciprocal t(10;21) translocation which is observed in three generations of a family. Included are examples of the balanced translocation, adjacent-2 segregation producing three patients with trisomy of the distal long arm of chromosome 21 and the Down syndrome, and 3-1 disjunction producing trisomy of the proximal segment of chromosome 21 in a mildly mentally retarded boy without phenotypic features of the Down syndrome. These data provide evidence that the Down phenotype is attributable to trisomy of the distal long arm of chromosome 21.


Adrenal and ovarian vein androgen levels and laparoscopic findings in hirsute women. Hirsute women pose a diagnostic dilemma when urinary 17-ketosteroid and serum testosterone levels are normal.  To locate the site of androgen excess in 19 hirsute women, blood samples were collested from the left ovarian and adrenal veins via a catheter insertedinto the right femoral vein.  Laparoscopy and bilateral ovarian biopsies were also preformed in 18 of the 19 patients studied.  Nine women had elevated 17ketosteroid (fivepatients) and/or antecubital serum testosterone (five patients) levels.  Fourteen womanhad elevated testosterone concentrations distributed as follows: ovarian vein (six), adrenal vein (one), adrenal and ovarian veins (seven).  Androstenedione was elevated in theovarian vein (seven) and both adrenal and ovarian veins (11) in 18 patients.  Laparoscopic examinations revealed that less than 50 per cent of the enlarged ovaries could be detected by pelvic examination.  Histologic studies suggested that these patients comprised two groups: a group (six patients) who appeared to ovulate and a group (12 patients) who lacked evidence of ovulation.


Acute glaucoma in systemic mucopolysaccharidosis I-S. Two siblings, a 56-year-old white man and a 44-year-old white woman, with systemic mucopolysaccharidosis I-S (Scheie's syndrome) developed acute glaucoma successively in each eye. Their management was complicated by an inability to visualize the anterior chamber angle due to corneal clouding by acid mucopolysaccharide (AMP) deposition. The mechanism of their glaucoma resembled angle closure, which may have been related to thickening of anterior ocular structures due to abnormal AMP storage.


Immunopathologic and morphologic studies of skeletal muscle in Chagas' disease. Skeletal muscle biopsies from 21 individuals infected with Trypanosoma cruzi were studied my means of immunofluorescence, ultrastructural immunochemical, light and electron microscopic, and histochemical procedures.  In 12 cases, definite morphologic alterations were found.  These alterations were coincident with the presence of circulating antibodies against the plasma membrane of striated muscle fibers and endothelial cells (EVI antibodies).  In almost all cases the lesions also presented autologous immunoglobulins bound to the plasma membrane of muscle fibers and endothelial cells.  Interstitial inflammatory exudate was not observed in the diseased muscle.  On the basis of these observations, it is suggested that the EVI antibody is related to some of the pathogenetic mechanism of skeletal muscle damage in Chagas' disease.