Degenerative changes in masseter muscle following injection of lidocaine: a histochemical study. Changes in succinic dehydrogenase, adenosine triphosphatase, and phosphorylase activities occurred in masseter muscle by 15 minutes following injection of 2% lidocaine. Abolishment of phosphorylase activity suggested an effect on the sarcoplasmic reticulum. Increased staining for succinic dehydrogenase and adenosine triphosphatase activities suggested damage to mitochondria and myofibrils, respectively. Leucine aminopeptidase and glucose-6-phosphate dehydrogenase activities appeared in macrophages.


Patterns of activation and inhibition of fibrinolysis in the normal skin of rat, guinea pig, and rabbit. The distribution and intensity of fibrinolytic activity and of inhibitors of fibrinolysis in the normal skin of the rat, guinea pig and rabbit were studied with histochemical techniques. Rat skin exhibited the highest overall fibrinolytic activity and rabbit skin the lowest, with guinea-pig intermediate. The distribution of fibrinolytic areas differed in the different species. The fibrinolytic activity was caused by an activator of plasminogen related to the blood vessels or in some instances (mainly in the rabbit) to the epidermis. The ability to inhibit plasmin was highest in guinea pig skin and lowest in rat skin, with rabbit skin intermediate. In all 3 species the inhibition was related chiefly to the muscular layer. Epidermis was an additional source of inhibition.


Skin surface glycerol levels in acne vulgaris. Free glycerol would be expected from biochemical considerations to be an end product of lipolysis of sebum triglycerides. Glycerol was measured in skin surface washings of acne vulgaris patients, in acne vulgaris patients treated for at least 3 mo with oral tetracycline and in control subjects. Surface glycerol in untreated acne subjects was significantly less than that expected theoretically, whereas the amounts of such glycerol in treated acne patients and in control subjects closely approached the theoretically expected values. It is suggested that glycerol may be an in vivo substrate for Propionibacterium acnes.


Carbonic anhydrase (acetazolamide-sensitive esterase) activity in the blood, gill and kidney of the thermally acclimated rainbow trout, Salmo gairdneri. 1. Gill, kidney and blood levels of acetazolamide-sensitive esterase (carbonic anhydrase) activity were estimated at acclimation temperature and at a common temperature (25 degrees C) in rainbow trout acclimated to 2, 10 and 18 degrees C. Plasma levels of sodium, potassium and chloride were also examined for possible acclimatory variations. 2. Plasma sodium and chloride levels, and the sodium:chloride ratio were unaffected by thermal acclimation; potassium concentrations were significantly elevated at 18 degrees C. 3. Significant, but modest changes in renal and branchial carbonic anhydrase activity were observed under physiologically realistic incubation temperature conditions. Blood carbonic anhydrase activity was sharply elevated at higher acclimation temperatures. 4. The data are discussed in relation to the hypothesis that carbonic anhydrase in this relatively stenothermal freshwater salmonid, through its intimate association with the coupled HCO-3/CL- and H+ +NH+4/Na+ exchange systems may provide for relatively thermostable basal rates of sodium and chloride uptake from the medium and recovery from urine. The renal, and more notably the branchial (Na+/K+)-stimulated ATPase systems, and erythrocytic carbonic anhydrase may then serve primarily as high-temperature amplifiers of sodium and chloride recruitment respectively.


Suppression of the mixed lymphocyte reaction in man by a soluble T-cell factor. Specificity of the factor for both responder and stimulator. J.H., an HLA-Dw2 homozygous multiparous woman, fails to respond to her husband, W.H. (HLA Dw1,-) in the unidirectional mixed lymphocyte reaction. T cells from J.H. were previously shown to suppress the responses of Dw2-positive cells but not Dw2-negative cells to W.H. We now report that a soluble factor released into the supernate of the mixed lymphocyte reaction by J.H. T cells, mediates this suppression. Like the cell from which it is derived, the factor is highly specific for HLA Dw2 in the responder cell and partially specific for the stimulatory alloantigen.


T-lymphocyte response to H-2 mutants. I. Proliferation is dependent on Ly 1+2+ cells. We have determined the Ly phenotype of the T lymphocytes which proliferate in response to mutant H-2K and H-2D alloantigens in primary mixed lymphocyte culture. Responder T cells proliferating in reciprocal cultures of H-2d(KdDd) and H-2da(KdDda) lymphocytes were typed Ly 2+ through selective depletion with specific alloantiserum plus complement. Further, B6-Ly 1a lymphocytes proliferating in response to B6-H-2ba and B6-H-2bf stimulators were typed as Ly 1+2+ through similar analysis. These results are discussed with regard to their impact on views of lymphocyte differentiation and factors determining the identity of alloreactive lymphocytes.


Kidney transplants in mice. An analysis of the immune status of mice bearing long-term, H-2 incompatible transplants. Kidney transplants between strains of mice which are incompatible at either the K or the D end of the H-2 complex usually function for prolonged periods supporting the lives of nephrectomized recipients. This occurs with no recipient treatment. With multiple H-2 and non-H-2 determined incompatibilities, transplants may be rejected but more slowly than skin grafts. In the strain combination studied most extensively in these experiments (B10.D2 to B6AF(1)) in which the incompatibility was confined to the K end of the H-2 region, about 70 percent of recipients survived for many weeks with normal blood urea nitrogen levels. Skin grafts between untreated members of these strains were rejected promptly (mean survival time of 13.5 +/- 1.1 days) as were kidney transplants to recipients of prior skin grafts. Donor strain skin grafts to recipients of kidney transplants after kidney transplantation enjoyed greatly prolonged survival whereas skin grafts from a third party (A.SW) were rejected normally. If kidney tissue was transferred in the form of free grafts without primary vascular union, it was rejected promptly leaving its recipient highly immunized. Cellular and humoral immunity to donor antigens declined over the first few weeks after transplantation, and the spleens of long-term recipients contained no "killer cells." Recipient lymphoid cells could mount active graft versus host reactions to donor strain antigens on transfer to neonatal mice. Nevertheless, they were distinctly less able to respond specifically by the production of killer cells to donor strain antigens after sensitization in vitro. No evidence that this defect was associated with the presence of suppressor cells was forthcoming from several types of in vivo and in vitro tests.


Postnatal differentiation and growth of skeletal muscle fibres in normal and undernourished rats. A histochemical and morphometric study. The postnatal differentiation and growth patterns of the different histochemical muscle fibre types were studied at frequent age intervals in the extensor digitorum longus (EDL) muscle of normal rats and animals subjected to pre- and postnatal protein-calorie undernutrition. Three stepwise changes were seen in the fibre type composition of the EDL muscle during maturation. In newborn normal rats 2 histochemically and morphometrically distinct fibre populations occurred: small foetal type (type F) fibres or myotubes (about 90%), with the staining characteristics of the so-called type 2C fibres, and larger type 1 fibres (10%). At 5 days of age the percentage of type F fibres had dropped to 50 simultaneously with the emergence of a new population (40%) of type 2B fibres, intermediate in cross-sectional area between the remaining type F fibres and type 1 fibres. Between 15 and 20 days the small type F fibres practically disappeared with the emergence of a corresponding percentage (40%) of type 2A fibres, smaller than both type 1 and type 2B fibres; Between 20 and 60 days the percentage of type 1 rose from 10 to almost 30, type 2B fibres correspondingly diminishing in number but growing at a faster rate than either type 1 or type 2A fibres. In the undernourished rats the histochemical differentiation was retarded at birth, all fibres or myotubes being of the foetal type; However, large type 1 and type 2B fibres were seen at the age of 5 days and the histochemical maturation proceeded almost normally at later stages. On the other hand, at all ages there was a proportional reduction in the cross-sectional area of all fibre types, amounting to about 50% at 180 dyas, and not fully restituted by nutritional rehabilitation. These observations suggest that type F (type 2C) fibres are the undifferentiated precursors of all mature muscle fibres, their stepwise histochemical transformation raising the question of maturational differences in the different types of motoneurones.


Frequency-response analysis of vestibular-induced neck reflex in cat. II. Functional significance of cervical afferents and polysynaptic descending pathways. 1. Three major inputs to cervical motoneurons were analyzed with frequency-response methods in decerebrate and unanesthetized cats: the afferent system including the gamma-loop, the vestibulospinal tract, and some polysynaptic tract that transmits vestibular influences in the vestibulocollic reflex. 2. The dorsal roots C1-C4 were cut in order to open the feedback loop through the gamma-fiber spindle-afferent system. No effects were observed on the gain and the phase lag of motor-unit response. However, the DC components of the response were consistently decreased by deafferentation both in motor-unit and compound EMG responses. Firing of muscle spindle afferents was modulated during oscillation of the turntable. The majority of responses of spindle afferents was in phase with the simultaneously recorded extrafusal motor activity. These results indicate the existence of alpha-gamma coactivation in the vestibulocollic reflex. 3. Intracellular recording from cervical motoneurons showed that monosynaptic EPSP's were induced by dorsal root stimulation. By far the larger EPSP's, however, were observed with latencies of 10-15 ms, showing the existence of more powerful polysynaptic routes. It is postulated that the cervical afferent system controls the gain of the reflex by changing the number of motor units participating in the vestibulocollic reflex through some polysynaptic pathways, and that the afferent system scarcely changes, the gain or phase lag of individual motor units through a short stretch reflex loop. 4. The medial vestibulospinal tract in the MLF was interrupted, but no effects were detected on the dynamic characteristics of the frequency response. This shows the existence of other effective descending pathways which function as an integrator. 5. Remarkable phase advances were induced by intravenous infusion of Nembutal. This suggests that the Nembutal decreased the activity of the polysynaptic pathways and that the neural integrator, composed of polysynaptic networks, was prevented from fulfilling its ordinary function.


Odontogenic keratocysts: a clinical and histological study with special reference to enzyme histochemistry. Of a total of 1,420 odontogenic cysts, 52 (3.3%) were diagnosed as odontogenic keratocysts. Clinical and histological findings in these 52 cysts are reported. Frozen sections of 26 of the keratocysts were incubated to show the following enzyme activities: NADH2- and NADPH2-diaphorase, glucose-6-phosphate dehydrogenase, glutamate dehydrogenase, acid phosphatase, leucine aminopeptidase and ATPase. Furthermore, keratinization was studied with the rhodamine B method and lipids with the oil red O, the OTAN and the acid hematein methods. Sections from epidermis, oral mucosa, radicular cysts, residual cysts and follicular cysts served as reference material. The oxidative enzymes showed strong activity in the keratocyst epithelium which contrasted with weak activity in the reference cysts. Acid phosphatase activity was weak in all epithelia except that in keratocysts, which displayed a marked activity. In the fibrous capsule of the keratocyst a high activity of leucine aminopeptidase was recorded. This high activity contrasted with a weak activity in the reference material. The significance of the histochemical results in relation to the aggressive behavior of the keratocyst is discussed.


Muscle spindle responses in man to changes in load during accurate position maintenance. 1. Single unit and multi-unit recordings of muscle spindle activity were made from the peroneal nerves of human subjects. While the subjects attempted to maintain a constant ankle joint position, an external load on the receptor-bearing muscle was altered unexpectedly. 2. The spindle discharge produced by a sudden increase in load was of similar strength when the receptor-bearing muscle was relaxed as when it was contracting at the moment of the impact. A motor response at a latency consistent with a spinal reflex mechanism occurred only when the muscle was contracting. It is concluded that the potentiation of the reflex mechanism during contraction was not due primarily to a fusimotor action. 3. Sudden decrease in load produced a pause in spindle discharge followed by a pause in on-going e.m.g. activity at a latency consistent with spinal reflex mechanisms. 4. Slow changes in load produced parallel changes in e.m.g. and spindle discharge. It is suggested that the voluntary effort involved in maintaining joint position in the face of gradually changing loads results in corticospinal activity adjusted in strength to the opposing torque and operating on alpha and gamma motoneurones in parallel.


Autogenetic reflex action on to gamma motoneurones by stretch of triceps surae in the decerebrated cat. 1. Tonically firing gamma motoneurones of known conduction velocity (total eighty-seven, range 15-43 m/sec) have been isolated in peripheral muscular nerves to triceps surae. Their responses to stretch of triceps surae have been studied in decerebrated cats. A small amplitude, quick stretch and release was used to provide a selective stimulus for primary endings of muscle spindles. 2. To check the selectivity, recordings were made from 135 afferents from triceps surae under conditions closely similar to the reflex experiments. The threshold of all but a few primary endings of muscle spindles law below 50 micrometer whereas threshold was above 50 micrometer for the majority of secondary endings and tendon organs. A 20 micrometer stretch excited approximately half the primary endings but only one of thirty-six secondaries and no tendon organs responded to such a small stretch. Nine group III afferents were also studied but none responded to stretch. 3. Stretch of up to 50 micrometer excited twenty-three and inhibited eleven gamma motoneurones while thirty-three remained unaffected. A further twenty showed mixed responses, being inhibited initially before being excited at longer latency. Thresholds for reflex responses of gamma motoneurones frequently occurred below 20 mum and responses were close to maximal for stretch of 50 micrometer. 4. Excitation always had a lower threshold to stretch than did inhibition for those gamma motoneurones showing mixed responses and was the more potent of the two effects. 5. Excitation to stretch had central delays, to the incoming group Ia volley, ranging from 5 to 14 msec while similarly calculated delays for excitation of alpha motoneurones ranged from 0.6 to 3.0 msec. Central delays of the gamma inhibitory responses lay in an intermediate range of 1.7-7.0 msec. 6. The long central delays of excitation of gamma motoneurones in response to stretch do not reflect transmission in supraspinal pathways since the reflex persisted following spinal section. 7. Excitation of gamma motoneurones was weak in comparison with that of tonically firing alpha motoneurones recorded in the same preparations and it was always necessary to sum a number of responses in order to reveal an effect...


Muscle spindle activity in man during shortening and lengthening contractions. 1. The responses of forty-one muscle spindle endings, mostly in tibialis anterior, were studied in human subjects during voluntary movements of the ankle joint performed at various speeds against different external loads. 2. During slow shortening contractions, the discharge rates of spindle endings in the contracting muscle accelerated after the appearance of the first e.m.g. potentials but before sufficient force had been generated to move the limb. With some endings, the discharge rate decreased during the shortening movement while the e.m.g. activity was increasing, but it always remained higher than before the onset of contraction. If the speed of the movement was increased fewer spindle discharges were seen during muscle shortening. If the shortening contraction was opposed by an external load, so that greater effort was required to perform the same movement, more discharges were seen and the discharge pattern became less modulated by the change in muscle length. 3. These findings indicate that during shortening contractions the fusimotor system is activated together with the skeletomotor system. However, the fusimotor drive is generally insufficient to maintain a significant spindle discharge unless movement is slow or the muscle is shortening against an external load. 4. During lengthening contractions the spindle responses were greater than to passive stretch of similar amplitude and velocity, suggesting heightened fusimotor outflow. 5. During shortening and lengthening contractions small iregularities in the speed of movement occurred commonly. Unintended acceleration of a shortening  movement caused a pause in spindle firing, and unintended acceleration of a lengthening movement caused an increased discharge from spindle endings. These spindle responses were associated with corresponding alterations in the discharge pattern of the voluntarily activated motor units at latencies consistent with the operation of spinal reflex mechanisms. 6. It is suggested that a functional role for the fusimotor activation during slow shortening contractions is to provide spindle endings with a background discharge so that they can detect irregularities in the movement and initiate the appropriate reflex correction.


Lack of functional immunoregulatory cells in a patient with mycosis fungoides and circulating Sézary cells. Peripheral blood lymphocytes obtained at various intervals from normal individuals and from a patient with mycosis fungoides (MF) were cultured with phytohemagglutinin (PHA) for 3 days to activate suppressor cells. After being cultured, the PHA-treated cells were irradiated, washed, and then transferred to fresh medium with PHA. The PHA responsiveness of the cells from normal individuals was suppressed approximately 90% by autologous or normal allogeneic lymphocytes activated for 3 days with PHA, whereas the cells activated for 3 days with PHA from the patient with MF lacked the capacity to inhibit the mitogenic response of autologous or allogeneic lymphocytes. These data suggest that this patient lacked suppressor T-cells that have a specificity for helper T-cells.


Effect of 2-nicotinamidethyl nitrate (SG 75) on coronary circulation. The effect of a new chemical agent, SG 75, on coronary blood flow of anesthetized dogs has been examined. Intravenous administrations of this agent in a dose of 10 microgram/Kg or over caused a significant increase in blood flow of non-constricted coronary artery. Percent increases in flow were 40 (10 microgram/Kg), 95 (50 microgram/Kg), 145 (100 microgram/Kg), and 195 (250 microgram/Kg). The increases were significantly larger than those caused by the same doses of diltiazem, verapamil, nitroglycerin, isosolbide dinitrate, and papaverine. The durations of the increase in flow were 12 (10 microgram/Kg), 23 (50 microgram/Kg), 28 (100 microgram/Kg), and 46 min (250 microgram/Kg), and they were longer than those caused by diltiazem and verapamil. A slight reduction in left ventricular tension and an increase in aortic blood flow were also observed following the administrations of SG 75 in a dose of over 50 microgram/Kg. A decrease in heart rate was produced with a dose of over 500 microgram/Kg. However, PQ interval of electrocardiogram became shorter. Intravenous administrations of SG 75 in doses of 50 and 150 microgram/Kg caused an increase in blood flow of the constricted coronary artery, while nitroglycerin (10 and 30 microgram/Kg) and nifedipine (1 and 3 microgram/Kg) reduced it. The results indicate that SG 75 is a potent and long-acting coronary vasodilating agent and it causes an increase in blood flow of constricted as well as non-constricted coronary artery.


Maximum tolerable afterload and afterload reserve for the evaluation of ventricular performance. The concept of a maximum tolerable afterload and an afterload reserve was proposed for evaluating ventricular function. A maximum tolerable afterload was defined as the systolic ventricular pressure during gradual proximal arterial obstruction, at the point where a distal arterial pressure or flow began to fall. An afterload reserve was defined as the difference between a maximum tolerable afterload and a basal afterload. By using right heart bypass preparations in dogs, a maximum tolerable afterload and an afterload reserve were compared with the ventricular function curve. An improved ventricular function curve was always associated with a greater maximum tolerable afterload and a greater afterload reserve, whereas a depressed function curve with a smaller maximum tolerable afterload and a smaller afterload reserve.


The sexual needs of the handicapped.

The sexual needs of the handicapped. One of the basic needs of life to the handicapped, as well as to all individuals, is the understanding of one's own sexuality. Sex education can help handicapped individuals in finding sexual satisfaction and may foster self-responsibility, maturity and positive actions toward other rehabilitation goals. Traditionally, the teachings of sexuality to handicapped persons have run into objections resulting from society's negative attitude toward the handicapped and parental apprehension regarding the decision-making skills of their children in relation to acceptable and unacceptable sexual behaviors. However, the Education for All Handicapped Children Act of 1975 has provided a way for parents and health professionals to put pressure on local, state and federal programs to allocate funds for the development of a sound sex education program. As professionals in health education it is our challenge and responsibility to see that the sexual needs of the handicapped are not forgotten.


Chemically evoked hypothermia in the mouse: towards a method for investigating thermodynamic parameters of aging and death in mammals. Any thermodynamic study of aging and death in laboratory mammals is dependent on techniques which would allow for the chronic manipulation of the core body temperature of these organisms. Accordingly, the hypothermic response after parenteral administration of chlorpromazine, L-dopa, reserpine, and p-chlorophenylalanine was investigated in the mouse. Mice injected at 24 hour intervals with chlorpromazine exhibited a diminished response (tolerance) with repeated administration. The degree of induced hypothermia and resistance to tolerance was greater in male mice than in femal mice. L-dopa was unable to potentiate chlorpromazine hypothermia but did evoke a non-adapting hypothermic response when administered alone. Reserpine also evoked a non-adapting hypothermia. Further, animals treated with small doses of reserpine exhibited an increasing response with repeated injections. p-Chlorophenylalanine induced hypothermay that became intermittent with successive administration. The results presented here indicate that both reserpine and L-dopa would be of value as hypothermic agents in long term investigations.


[The origin of malignant tumors of the upper-airways, the digestion tract and the ear. Organ-resistance and organ-disposition (organotrophy) by the origin of malignant primary tumors (author's transl)]. Carcinomas of the nose, the trachea, the mouth, the esophagus and the middle ear are rarely observed. Those of the larynx and of the bronchial system are more often found. The reason for this cannot be related to differing contacts with carcinogenic substances. The differences in frequence ar dependent on the varied resistance and disposition of the organs involved (Organotrophy, Histotropy). This is comparable to the incidence of epithelial and mesenchymal tumors. The tissues do not only vary in their structure. The differences are found in 1. the velocity of cell regeneration, 2. the ability to repair nucleic acids, 3. the concentration of tissue specific proteins (chalones) inhibiting cell proliferation and tumor growth, 4. the increase of metabolism before and during cancerization, 5. the unspecific mesenchymal reaction, 6. the immunologic response against tumor cells, 7. the reactions on radiotherapy, 8. the affinity of tissue to chemical carcinogenic substances.


[Enzyme deficiencies of blood cells in bone marrow insufficiency (author's transl]. Numerous enzyme defects-deficiency of pyruvate kinase, phosphofructo-kinase, glocosephosphate isomerase, adenylate kinase, 2,3-diphosphoglycerate mutase and glutathione reductase--in red blood cells have been described to be connected with dyserythropoietic or refractory anemias and panmyelopathies of different origin. These enzyme deficiencies also have been demonstrated in red cells of patients with acute leukemia. Most likely the enzyme deficiencies are acquired and are not important for the origin of anemia or bone marrow insufficiency. Partial derepression of fetal genes, qualitative and quantitative perturbations of genetic expression, and posttranslational variations of the enzyme protein by low molecular factors from plasma, erythrocytes or leukemic cells have been discussed as a reason of enzyme deficiency. The decrease of glutathione reductase deficiency is dependent of FAD deficiency.


[Molecular nitrogen fixation in eutrophic Beloye Ozero]. The rate of production and mineralization of organic matter and the rate of fixation of molecular nitrogen were assayed in th eutrophic lake Beloye (near Moscow) at the end of summer stagnation (1976). The content of hydrogen sulphide reached 6.8 mg per litre which resulted in a change of the ecological environment in the lake. The fixation of molecular nitrogen in water layers was characterized by three maxima: 5.0 mcg N per litre per 4 hours (surface); 4.2 mcg N per litre per 4 hours (metalimnion) and 2.8 mcg N per litre per 4 hours (at bottom). The fixation of nitrogen in the trophogenous layer involved mainly the blue-green alga Anabaena. In the sulphide zone, molecular nitrogen was fixed by butyric and sulphate-reducing bacteria.


Brain Tumor Study Group: a survey of current activities. Improvement in the treatment of patients harboring malignant glioma will probably be seen as small incremental changes as new modalities of treatment are proposed, tested, and substantiated. Uncontrolled phase II studies may provide hints of efficacy. However, the results must be substantiated in carefully controlled phase III evaluations. The Brain Tumor Study Group of the National Cancer Institute has demonstrated that mithramycin is not effective in the treatment of malignant glioma and the overall median survivorship experience is no different than the 23 weeks found in historic controls. Radiotherapy can bring about a meaningful increase in survival as can 1,3-bis(2-chloroethyl)-1-nitrosourea. The combination appears to produce more long-term survivors than either treatment above. Methyl-1-(2-chloroethyl)-3-(4-methylcyclohexyl)-1-nitrosourea does not appear to be additive to radiotherapy but is more effective than no therapy at all. Studies of the oncolytic effect of corticosteroids in contradistinction to their cerebral edema controlling effects are being done and will provide meaningful data on this important symptomatolytic therapy.


Effect of diazepam on the gamma motor system indicated by the responses of the muscle spindle of the triceps surae muscle of the decerebrate cat to the muscle stretch. The experiments were performed on 37 intercollicularly decerebrate cats. The triceps surae muscle was subjected to trapezoidal stretches of 10 mm/s or 2 mm/s over a length of 14 mm. The reflex arc was left partially or fully intact. The effect of diazepam given intravenously on the discharge frequencies of group Ia afferent fibres from muscle spindles in the belly of the triceps surae muscle was studied. Diazepam depressed both the dynamic and the static gamma motor responses. When gamma motor fibres were selectively blocked by procaine a parallel shift of the tension-extension curve was observed. From comparison of the effect of procaine and diazepam on the phasic and static responses of the muscle spindle it was concluded that directly after the injection of diazepam the gamma motor activity was completely abolished at a dose as low as 0.1 mg/kg whereas the alpha motor system was only partly depressed even at higher doses. Differences in the effect of diazepam on the dynamic and static gamma system respectively, could not be found.


[Responses to the spindles of "fast" and "slow" muscles to mechanical stimulation in the presence of hypokinesia]. The activity of muscle spindles was investigated in fast (extensor digitorum longus) and "slow" (soleus) muscles of the cat hind limb 2-5 weeks after immobilization. The spontaneous activity of spindles in both muscles remained unchanged. The background activity, the frequency of dynamic and static phases of stretching in primary as well as in secondary endings was much higher in immobilized muscle than in control. This increase in spindle activity was more pronounced in the "slow" muscle.


Effect of oral contraceptives on plasma androgenic steroids and their precursors. Plasma dehydroepiandrosterone (DHEA), its sulfate ester (DHEAS), and androstenedione (A2), delta5-pregnenolone (delta5-P), and 17 alpha-hydroxypregnenolone were measured in women using estrogen-containing oral contraceptives and in female controls of similar age. All three androgenic steroids and their two C21 precursors were reduced in the oral contraceptive users compared with the controls. It is concluded that oral contraceptives cause a decrease in plasma DHEA, DHEAS, and A2, one possible mechanism for which is the inhibition of delta5-P synthesis from cholesterol.


Uterine suspension through the laparoscope. We present a series of 20 patients who underwent uterine suspension performed through a laparoscope, as part of conservative treatment for infertility and pelvic pain. The operative technique is easily mastered by a skilled laparoscopist who is prepared to deal with intra- or postoperative complications. Avulsion of the round ligament was the most serious complication experienced. Operating time was brief, and the hospital stay was short.


Parasites of domestic and wild animals in South Africa. IV. Helminths in sheep on irrigated pasture on the Transvall Highveld. The seasonal incidence of helminth infestation in sheep on newly established irrigated pastures was determined by the slaughter of pairs of tracer lambs exposed for periods of approximately 33 days from October 1968--July 1970 and of sets of 3 lambs from March 1971--May 1973. It took several months for the infestation to become established on the pasture, but thereafter, of the various species present; Haemonchus contortus was most prevalent. In general, peak burdens of this species were recovered from January--May or June, while marked inhibition of larval development was evident from April--August. Ostertagia circumcinta usually occurred in increased numbers from April--October, and larval development was inhibited during July and August. Although the sizes of the burdens varied considerably from year to year, Trichostrongylus spp. were present mainly from April--August. Oesophagostomum columbianum, although present in the lambs slaughtered during the first 5 months of the survey, virtually disappeared until May 1971. After this it reappeared in small numbers in nearly all the sheep, reaching peak burdens during April and May 1972, and May 1973. Moniezia expansa were generally recovered from the lambs slaughtered from November--May.


Fungal diseases in Shiraz.

Fungal diseases in Shiraz. In 122 patients with fungal diseases studied over a six month period, sixty were seen with dermatophyte infections. Tinea pedis, cruris and ungruium occurred mainly in adult males attending the private hospital and tinea corporis and capitis children attending the University Hospital. The organisms found were Trichophyton rubrum, T. mentagrophytes, T. schonleinii, T. tonsurans, Epidermophyton floccosum and Microsporum canis. Infections with Candida albicans occurred both in the urban and rural population and included case of familial chronic muco-cutaneous candidiasis. Pityriasis versicolor was the commonest fungal disease seen.


Initiation of adenovirus DNA replication does not occur via a hairpin mechanism. Models have been proposed suggesting that initiation of adenovirus DNA replication might occur via a hairpin mechanism. A consequence of the models is a covalent linkage of progeny and parental DNA in newly completed molecules. Analysis of mature molecules from KB cells infected with adenovirus type 5 indicates that, if a hairpin mechanism is involved, the length of the hairpin must be shorter than 50 basepairs long. Recent nucleotide sequence analysis of the termini of adenovirus type 5 DNA (P.H. Steenbergh et al. (1977) Nucl. Acids Res. 4, 4371-4389) has shown that a hairpin of this size does not exist and that therefore a hairpin mechanism is unlikely.


Molecular alteration in a Neurospora crassa morphological mutant and its phenocopy. A procedure using ion exchange chromatography has been developed to detect alterations in a polysaccharide produced by Neurospora crassa. The polysaccharide, isolated from medium that has supported the growth of a culture, is highly responsive to the 3-methyl-2-benzothiazolinone hydrazone assay, indicating a high hexosamine content. The substance elaborated by wild-type N. crassa can be fractionated into two components that appear by rechromatography to be closely related. When isolated from mutants of the peak (pk) locus, the corresponding polysaccharide cannot be resolved into two components. Instead, a single component is consistently found. This variant chromatographic pattern cosegregates with morphological effects of the pk allele after crosses with the wild type. The polysaccharide isolated from a wild-type culture that has been induced by sorbose to phenocopy the hyphal characteristics of pk mutants elutes from the ion exchange column in a manner similar to the corresponding polysaccharide from the pk mutants.


Calcium exchange and calcium-related effects in normal and sickle cell anemia erythrocytes. There is an exchangeable calcium pool in both normal and sickle cell erythrocytes, comprising about 10-15% of the total cellular calcium. Sickle cells show increased calcium as compared to normal cells in the oxygenated state. Specific differences between sickle and normal cells which may be associated with this fact are an increased rate of calcium exchange in sickle cells at low external calcium, an increased "leak" of calcium into sickle cells (i.e., phosphate independent exchange), and a pattern of magnesium loss in sickle cells which is consistent with a Mg-Ca exchange diffusion resulting in the increased intracellular calcium in these cells. The exchangeable calcium in sickle cells is more labile, almost all of it being available for re-exchange out of the cell over a short-time-course experiment. Analyses of flexibility and osmotic fragility of sickle cells are consistent with expected effects of increased intracellular calcium.


Degradation of basic protein in myelin by neutral proteases secreted by stimulated macrophages: a possible mechanism of inflammatory demyelination. In inflammatory demyelinating diseases such as multiple sclerosis and experimental allergic encephalomyelitis, myelin destruction occurs in the vicinity of infiltrating mononuclear cells. The observations that myelin can be altered prior to phagocytosis and in areas not contiguous with inflammatory cells suggests a common mechanism for the initial stages of demyelination. Because stimulated macrophages secrete several neutral proteases, including plasminogen activator, we have investigated the possibility that myelinolysis could be mediated directly or indirectly by these enzymes. Isolated myelin was incubated with conditioned media from cultures of thioglycollate-stimulated mouse peritoneal macrophages in the presence and absence of plasminogen. Myelin appeared to be vulnerable to attack by at least two proteolytic activities secreted by the macrophages, a plasminogen-dependent and a plasminogen-independent activity; of the major proteins in myelin, the basic protein was most susceptible. The direct myelinolytic activity of macrophage-conditioned media was abolished by EDTA, and the plasminogen-dependent hydrolysis was abolished by p-nitrophenylguanidinobenzoate, an inhibitor of plasminogen activator and plasmin. These results suggest that the plasminogen activator released by the stimulated macrophages generated plasmin which hydrolyzed basic protein in intact myelin. This interpretation was confirmed by the observation that urokinase, a plasminogen activator, in the presence of plasminogen brought about marked degradation of basic protein in myelin. We propose that the release of neutral proteases by stimulated macrophages involved in cell-mediated reactions, and its amplification by the plasminogen-plasmin system, may play a significant role in the demyelination observed in several inflammatory demyelinating diseases.


Open field activity and avoidance behavior following serotonin depletion: a comparison of the effects of parachlorophenylalanine and electrolytic midbrain raphe lesions. Three experiments were performed in order to compare the behavioral effects of electrolytic destruction of the dorsal and median mesencephalic raphe nuclei (MR lesion) and parachlorophenylalanine (pCPA; 300 mg/kg, IP) administration. Forebrain 5-hydroxytryptamine (5-HT) was measured in all animals following completion of behavioral testing. In the first experiment open field behavior (one 50 min session) and two-way (shuttle) conditioned avoidance acquisition (50 massed trials) were examined 68-72 hr after vehicle or pCPA administration in rats which had received control operations or MR lesions two weeks earlier. Only the MR lesion and the MR lesion + pCPA groups evidenced increased open field activity and facilitated two-way avoidance learning. Although the reduction in forebrain 5-HT of the pCPA group (85%) was greater than in the MR lesion group (55%), the pCPA treated animals did not differ from the control group. In the second experiment animals were tested in the open field 24, 48 or 72 hr after pCPA treatment to determine its effects on activity level as a function of the time after injections. No differences between the vehicle and pCPA groups, however, were found. In the third experiment, the effects of pCPA (72 hr postinjection) on the acquisition of an unsignalled one-way avoidance response was examined. MR lesion rats tested in the same apparatus and with the same procedure repeatedly have been shown to be impaired in this task. The pCPA and vehicle animals, however, did not differ. Reduction in 5-HT following electrolytic MR lesions and pCPA administration, thus, produce different behavioral effects. MR lesions, but not pCPA treatment, result in (1) increased activity in a novel environment, (2) facilitated two-way conditioned avoidance learning, and (3) impaired acquisition of an unsignalled one-way avoidance response. These data support earlier studies suggesting that the behavioral effects of electrolytic MR lesions are not due primarily to their disruption of ascending 5-HT pathways. The role of 5-HT in avoidance conditioning and the regulation of activity level, furthermore, remains to be elucidated.


para-Chloro-D, L-phenylalanine induced filicidal behavior in the female rat. The administration of para-chloro-D, L-phenylalanine (PCPA) produces a high incidence of aggressive (filicidal) behavior in pre-, postpartum, and nulliparious rodents. PCPA inhibits brain tryptophan 5-monooxygenase and can produce a reduction in whole brain serotonin. Apparently PCPA mediates the release of a natural latent aggressive tendency which is potentiated by the interference in, or reduction of, a suppressing system governed by serotonin. Latency of attack, intensity phases, and characteristics of the filicidal behavior were found to vary inversely with brain serotonin content, and be reversed or eliminated by replacement of serotonin i.e., via 5-hydroxytryptophan, serotonin's immediate precursor. Although aggressive tendencies were in evidence prior to filicide, filicide became evident once the apparently minimal whole brain level of serotonin reached ca 0.10 microgram/g. Neither the parturition process nor severe food deprivation are strong causative factors in the precipitation of filicidal behavior. Since not all animals become filicidal, other behavioral and/or biological variables must be involved in the mediation of this aggressive phenomenon.


Anticonvulsive effect of p-chlorophenylalanine in mice on a low magnesium diet. We have reported previously that para-chlorophenylalanine prevented seizure manifestations in an inbred strain of mice genetically predisposed to audiogenic seizures. We now find that this protective effect is not limited to a particular inbred strain of susceptible animals but can be demonstrated in Swiss-Webster and CF No.1 strains which were not originally subject to audiogenic seizures but in which we have induced audiosusceptibility through maintenance on a low magnesium diet.


Stimulation of rat prolactin secretion by indolealkylamine hallucinogens. The hallucinogenic indoleamine drugs N,N-dimethyltryptamine (N,N-DMT), psilocybin, bufotenin, 5-methoxy-N,N-dimethyltryptamine, and N-methyltryptamine, increased rat plasma prolactin (PRL) levels. The increase in plasma PRL produced by N,N-DMT, psilocybin, and bufotenin was inhibited by methysergide, a serotonin receptor blocker. Parachlorophenylalanine (PCPA), an inhibitor of serotonin synthesis, significantly potentiated the increase in PRL produced by N,N-DMT, and psilocybin. Parachloroamphetamine, a relatively selective toxin for serotonin neurons, also stimulated the increase in PRL produced by N,N-DMT. These results suggest that the indole hallucinogens stimulate PRL secretion by a serotonergic agonist mechanism. Bufotenin has been reported to pass the blood-brain barrier poorly, but of the indoles studied it had the most potent effect on PRL secretion. This raises the possibility that the serotonin receptors which promote PRL secretion may be outside the blood-brain barrier or that the central 5-HT receptors which mediate PRL secretion may be especially responsive to bufotenin.


Incidence na dprevalence of Down's syndrome in the city of Ribeirão Preto, São Paulo (Brazil, 1972. An incidence rate of 1.66 was determined for Down's syndrome by a check of hospital birth records in the city of Ribeirão Preto for the year 1972, based on the premise that most births in the population residing in the urban area of Ribeirão Preto occur in hospitals. The prevalence rate was estimated as being 25.2. A search for affected individuals born before 1972 was carried out by physical examination of all persons receiving medical care or educational and social assistance from several city institutions. The prevalence value must be considered as an underestimate since the methods used allowed only for the detection of cases which were getting some kind of assistance.


[Fractures of limbs with associated craniocerebral injuries]. The authors have studied 37 cases of severe head injury with fractures of the limbs in Vienna. In 11 cases there was also a lesion of the trunk. The results of treatment are analysed. The authors conclude that early internal fixation of fractures is beneficial and leads to a lowered mortality by diminishing the number of secondary cerebral complications.


[Cephalic prostheses in femoral neck fractures: Comparison of immediate complications and late functional results of Moore's prosthesis and sealed prosthesis]. In this study the authors compared the mortality of fractures of the neck of the femur treated by femoral prostheses with early walking compared with trochanteric fractures treated by a nail plate and non-weight bearing activity for 2 to 3 months. The mortality in the two series (about 20 per cent) was the same. The authors then compared two series of fractures of the femoral neck, one treated by Moore's prosthesis without cement and the other by an alternative type of femoral prosthesis with cement. They conclude that the mortality was the same in the two groups but that the cemented prosthesis had better functionnal results. Long-term tolerance of the acetabulum was the same in the two types of prosthesis. Total hip replacement is very rarely indicated in recent fractures of the femoral neck.


[Fatigue fractures: apropos of 8 cases]. Eight cases of fatigue fracture were observed by the authors. In two patients, they presented in metatarsal bones; others were in the lower end of the tibia, in the shaft of the fibula, in the patella, at the upper end of the fibula, in the shaft to the tibia and in the neck of the femur. The main features of these fractues, which occurred in previously intact bones, are reviewed. The role of previous muscle imbalance, or metabolic disturbance, (by age or in pregnancy) is discussed. Good results were obtained by simple immobilization. Surgery may be indicated in the two situations: 1. To eliminate the possibility of a bone tumour by biopsy and, 2. For internal fixation in special sites such as the femoral neck to avoid coxa vara or when healing is very slow, as occurs particularly in the femoral shaft.


[The social and medical situation of people suffering from multiple sclerosis--considerations on the basis of an epidemiologic field study (author's transl)]. Within the framework of an epidemiologic field study conducted in South Niedersachsen a standardised questionnaire was used to obtain data on the social and medical situation of persons with multiple sclerosis. Of the 195 people with multiple sclerosis questioned in that area in 1976 answers were received from 178 (91%). The mean age was 46 years, the average history of disease 15 years. Family status and social position corresponded to social average. A social downfall as a result of the disease was not found to have taken place. Approximately 50% who had been employed prior to the disease (N = 147) had given up their jobs at the time of the survey. The monthly net income was found to be average. Of the studied persons 42% were living in their own houses or flats. A lower percentage, compared to the general public, was living in lodgings (58% instead of 65,7%). The majority (56%) was living in flats suitable for the disabled. 13% of the surveyed persons lived alone, 5% in homes. Social care was found to be very poor in comparison with medical treatment. The introduction of compulsory notification for this disease was advocated by 83% of the people questioned.


[Reactions vis-a-vis the disabled. Critical comments on G. H. Neumann's article: prejudices and negative attitudes towards the disabled--their origin and methods of elimination from the viewpoint: of behavioural science and biology (author's transl)]. Neumann's opinion that prejudices towards the disabled are decisively determined by inborn reactions, i.e., the reaction towards outsiders and the fear reaction towards strangers, is put to question. Ethological and ethnological research results demonstrate that the studies of human and animal behaviour towards the "disabled" are still in an elementary stage and that hitherto available results only permit the conclusion that animals as well as human beings display a very complex and differentiated behaviour vis-a-vis the disabled. In connection with human beings this complexity is seen as evidence of the outstanding significance of societal factors--in their broadest sense--for the formation of prejudices towards the disabled. The necessity of a goal-oriented elimination of these prejudices is stressed. Furthermore, attention is drawn to terminological problems and the difficulties or comparisons between human beings and animals.


[The treatment of septic non-union of femoral shaft fractures (author's transl)]. The authors describe their views of management of septic non-union in fractures of the femoral shaft. Since 1967 they have used the same procedures: 1. Surgical clearance of debris in the region of the fracture focus and from sinuses. This clearance must be complete but not too extensive. 2. Closure of the wound with suction drainage or continuous irrigation with antibiotics. 3. Immobilization of the fracture by external fixation. 4. Secondary cancellous bone grafting, in most cases by grafts placed on the medial aspect of the bone. Twenty-eight cases were treated in this way and 27 united. The results are analysed with special reference to residual sinuses, shortening, knee stiffness and functional rehabilitation.


[Prejudices and negative attitudes towards the disabled: critical comments on the controversial statements of R. Zimmermann and H. J. Kagelmann (author's transl)]. In an article published in this journal (pp. 101-106, 1977) I stated that prejudices towards the disabled cannot only be attributed to societal factors and stressed that the world-wide existence of these negative attitudes can be explained by two biological pre-dispositions, i.e., the inclination to a specific reaction towoards outsiders and the fear reaction towards strangers. Zimmermann and Kagelmann criticise this opinion. They are convinced that these negative attitudes are almost exclusively caused by societal conditions. In this article I reply to their viewpoints and demonstrate that it is not contradictory, as my critics say, that we observe, on the one hand, the widespread existence of a specific reaction towards outsiders, and on the other hand, the occurence of social help amongst animals and human beings. These two attitudes are only antagonistic components of social behavior. The problem of the applicability of animal research results to human behaviour is studied. Zimmermann and Kagelmann's statement that ethologists do not want to see the dangers inherent in the theory of inborn dispositions is vigorously repudiated. It is demonstrated that "inborn" does not mean that this behavioural disposition is determined by fate, since genetic pre-dispositions, too, can be influenced by environmental factors such as education.


[Integration of the physically handicapped into a regular school (author's transl)]. Owing to manifold changes in the external conditions of the Freiherr-vom-Stein-Schule and the rehabilitation centre "Lichtenau" as well as the shift of emphasis in society's attitudes vis-a-vis the disabled, it seemed necessary to prepare a further report on the experiences gained with this school experiment in Hessisch-Lichtenau. A short survey of the school's personnel and facilities as well as the organisational structure of the co-operation between these two institutions is followed by a detailed description of the underlying paedagogical conception and the tasks resulting from it. Despite existing limitations and numerous difficulties it can be said that this school experiment has yielded positive results. This is evidenced by the impressive number of physically handicapped people who have left this school with a qualifying examination and are now--as far as it is known--in gainful employment. These figures and the public education efforts carried out by the rehabilitation centre have given rise to the setting up of similar facilities. The article closes with a report on a training programme developed on behalf of the Hessen Minister of Cultural Affairs, which is intended to provide all student teachers working at general schools a basic knowledge in special education.


Calcium and sodium transport processes in patients with cystic fibrosis 2. Mg2+- dependent, Ca2+ ATPase activity in fibroblast membrane preparations from cystic fibrosis patients and controls. Mg2+-dependent Ca2+-ATPase activity was determined in membrane preparations of fibroblasts grown from skin biopsies of cystic fibrosis patients and age-matched controls. This enzyme was stimulated by increasing free calcium concentrations with an apparent Kdiss for calcium of approximately 45 micron. Although there was a great deal of variation in Ca2+-ATPase activity observed between individual strains, there was a significant decrease in the maximal activation of the Ca2+-ATPase in membrane preparations of fibroblasts obtained from cystic fibrosis patients compared to the controls (P less than 0.05). This observation indicates that decreased Ca2+-ATPase activity is a generalized phenomenon in cystic fibrosis found in more than one cell-type. This decrease in Ca2+-ATPase activity may have a number of implications that may explain some of the manifestations of the disease.


[Ttoal hip arthroplasty after arthrodesis (desarthrodesis)]. A report is given on 24 cases of desarthrodesis of the hip long after arthrodesis, in one case after 73 years, the patient being a woman of 84, and in several cases after 40 years. In all cases the results were satisfactory and recovery was excellent despite the long duration of the arthrodesis. Desarthrodesis is therefore a valuable operation which may be indicated in cases where position is poor or lumbalgia inhibits the function.


Calcium transport and adenosine triphosphatase activities of erythrocyte membranes in congenital spherocytosis. Calcium transport from red cells was measured in seventeen patients with congenital or hereditary spherocytosis (HS). The efflux remained at a lower level in resealed ghost cells of patients than in normal cells both in the presence and absence of adenosine triphosphate (ATP). We studied the activities of Ca2+,Mg2+-ATPase, ouabain-sensitive Na+,K+-ATPase, Mg2+-ATPase and Ca2+-(spectrin-)ATPase in cell membranes prepared by washing the cells with hypotonic medium. The mean +/-SD Ca2+,Mg2+-ATPase/Mg2+-ATPase of HS patients was 3.34 +/- 1.06, and 2.81 +/- 0.42 in control subjects. Na+,K+-ATPase/Mg2+-ATPase was 2.38 +/- 0.38 in HS cells compared to 2.01 +/- 0.41 in normal cells. Ca2+-ATPase/Mg2+-ATPase of HS membranes was 0.57 +/- 0.18 and the control value 0.43 +/- 0.08. These data indicate calcium retention in the erythrocytes of HS patients in spite of increases in Ca2+,Mg2+-ATPase activity in the majority of patients.


The influence of different sodium loads on renin release in hypertensive and normotensive states of chronic renal failure. The purpose of the present study was to examine the influence of different sodium loads on renin release in the hypertensive and normotensive state of chronic renal failure. Blood pressure (BP), plasma renin concentration (PRC) and exchangeable sodium (NaE) were measured in eighteen patients with advanced chronic renal failure, nine hypertensives and nine normotensives, and in seven normal subjects (a) 6 days after a fixed sodium intake of 10 mmol/day, and (b) 6 days after a fixed sodium intake of 150 mmol/day. Mean NaE was 14-19% higher in the hypertensives compared with the normotensives and values of NaE correlated significantly to values of mean BP. No significant differences were present in PRC between the groups of patients and controls on either of the sodium regimens and no correlation was found between BP and PRC. However, average decreases of PRC in the hypertensives on high sodium intake, 33-34%, were significantly lower than the corresponding values of 69-71% in the normotensive patients and controls, respectively. Furthermore, the percentage changes of PRC on high sodium intake correlated significantly to mean BP as well as to NaE. These results suggest that renin release is relatively unresponsive to different sodium intakes in hypertension following chronic renal failure. This alteration in renin release may contribute to the maintenance of hypertension in chronic renal failure, PRC being "inappropriately' increased in relationship to the sodium excess.


Reversible changes in cytolytic T lymphocyte function induced by hyperthermia. The ability of cytolytic T lymphocytes (CTL) generated in vitro in mixed leucocyte cultures (MLC) to "repair" functional damage induced by moderate hyperthermia has been investigated. Repair of CTL function was assessed in a split dose system in which MLC cells were exposed to a total of 20 min at 43 degrees C delivered either as a single treatment or as two 10 min fractions separated by an interval at 37 degrees C. Significant repair was observed within 15 min at 37 degrees C in the split-dose protocol and maximum repair (corresponding to a 30-100-fold increase in lytic activity) was seen after 1.5-2 h. Repair was both temperature and energy dependent and was apparently related to a reversible lesion in the cytolytic mechanism itself. The effect of a number of metabolic inhibitors (and other agents) on repair was determined, but the precise nature of the heat-induced lesion could not be identified.


Role of the thymus in generation of lymphocyte functions. III. Further studies of the alloreactivity of lymphocytes developing in mouse thymus organ cultures. Thymuses of 14-day-old mouse embryos could be maintained in organ culture, using serum-free medium, with generation of lymphocytes that showed strong proliferative reactivity to allogeneic spleen cells in mixed lymphocyte cultures (MLC). Such organ culture derived thymocytes also developed cytotoxic activity against target cells carrying the alloantigens of the stimulating spleen cells in the MLC. The generated cytotoxic activity was, however, proportionately lower than that seen with thymocytes of young mice. A time course study showed that cells with apparent reactivity to both allogeneic spleen cells and to the mitogen Concanavalin A (Con A) first appeared in the thymus organ cultures on day 8-9.


[Results of operative treatment of artial septal defect in the adult (author's transl)]. 55 of 59 patients with artial septal defect, who had been operated in adult age, were examined postoperatively. The mean time interval from the operation was 43,8 months. Two patients had died immediately after the operation; there were no late deaths. The majority of the reexamined subjects was free of symptoms, in no case was there congestive heart failure. Persistence of postoperative symptoms increased with increasing age at the time of operation, but only up to the fourth decade of life. In 26 cases hemodynamics were examined. Mean pulmonary arterial pressure was normal at rest and during a slight ergometric load. In 5 patients there was moderate pulmonary hypertension. In 8 subjects there was minimal, in one patient moderate increase of pulmonary vascular resistance. Heartsize in chest roentgenogramm was increased in about 25% of cases, in more than 50% the pulmonary vessels were accentuated. Irregularities of cardiac rhythm were not more frequent postoperatively, than they had been prior to surgery. However, surgery was followed by a marked decrease of right axis deviation and of EKG signs of right ventricular hypertrophy. Pulmonary function studies revealed a slight decrease of vital capacity and of maximal breathing capacity. These results are favourable compaired to medically treated groups of patients as described in the literature. It is concluded, that even in later adult age the atrial septal defect as a rule is an indication for surgery.


Clioquinol toxicity in the dog.

Clioquinol toxicity in the dog. A number of instances have been reported in the scientific literature in which acute intoxication with halogenated oxyquinolines has led in some species to convlusions, often followed by death. The toxicity of repeated doses of clioquinol has been investigated extensively in the dog. The clinical syndrome induced in this species is characterized by anorexia, weight loss, extremem muscle weakness and emaciation. In some animals surviving this impairment of condition for several weeks, neuropathy of the central nervous system, but not of the peripheral nerves ensued. It is suggested that these toxicological manifestations are less dependent on the dose-level than on the degree of absorption. Some suggestions regarding the aetiology of the lesions are made.


[The problem of documentation in pedodontics]. The efficiency of paedodontics increases with the number of children involved in regular dental supervision. This requires complete and reliable information about the individual factors, especially dental development, at any consultation (whether mass examination or treatment). The current methods of documentation are often inadequate to this purpose. For this reason, the author presents a method of documentation by means of key-word cards that essentially meets the demands to be made on a treatment chart.


[The use of the dental hygienist in the field of health education in pedodontics]. On the basis of legal regulations, the author discusses the use of the dental nurse specialized in dental and oral hygiene in paedodontics which is mainly supported by three pillars: dental and oral hygiene, fluoride application, and nutrition counselling. The effective use takes place in kindergartens and schools, special and rehabilitation centres, and depends upon good co-operation with the District Commission for Health Education on the one side, and the National Education Authorities on the other side.


Suicide attributed to work.

Suicide attributed to work. Workers' compensation laws provide death benefits for the survivors of those who commit suicide as a result of a work-incurred physical or psychological injury. A study of claims resulting from suicidal acts reveals that included in the indicted work conditions were sudden changes in organization, conflict of loyalties resulting from work change, reactions to pain and suffering following a physical work injury, and the economic and status deprivation resulting from disability and unemployment. Those treating subjects whose jobs were the sources of stress failed to recognize their patients' desperation and urged them to stay at their jobs.


[Anion-sensitive ATPase of the rat heart mitochondria]. The properties of anion-sensitive ATPase of rat heart mitochondria were studied. Na2CO3, NaHCO3 and Na2SO3 stimualted ATPase activity by 69, 41 and 110%, respectively. Azide, tiocinate and perchlorate inhibited bicarbonate-stimulated ATPase. Bivalent cations increased ATPase activity in such a sequence: Zn2+ greater than or equal to Cd2+ greater than or equal to Co2+ greater than or equal to Mg2+ greater than or equal to Mn2+ greater than Ni2+. In the presence of bicarbonate and sulfite. ATPase activity was maximally stimulated with magnesium. Ni2+ and Ca2+-ions inhibited Mg2+-dependent activity of bicarbonate-stimulated ATPase. AMP uninhibited ATPase activity. The 4 mM concentration of ADP inhibited activity of HCO-3-ATPase. Activity of ATPases decreased at lower temperatures. The properties of anion-sensitive ATPase of rat heart mitochondria and that of HCO-2-ATPase of other cells are discussed.


[Cytochemical study of various stages of life cycle of Toxoplasma gondii. 10. Phosphatases in the parasites during developmental stages in cat's intestines]. Several methods of acid and alkaline phosphatese and ATPase detection using both natural and artificial substrates were applied to the intestinal stages of Toxoplasma gondii with negative results to reveal enzymatic activity in all the stages except the microgametocyte. Possible explanation of this unexpected phenomenon is discussed taking into account host-parasite relationships with intestinal stages of Toxoplasma and with coccidia in general.


[Restoration of the abdominal wall in generalized defects by an autoplasty method]. The clinical experience with surgical reconstruction of the abdominal wall in vast defects in 172 cases of big and giant postoperative hernias by means of modified autoplasty methods with the formation of the doubling with a deep superposition of aponeurotic-muscular grafts is presented. Good results allow the author to recommend the described autoplasty methods to the use in surgical practice.


Jejunal endocrine tumor composed of somatostatin and gastrin cells and associated with duodenal ulcer disease. A case of malignant endocrine tumour of the jejunum, associated with severe duodenal ulcer is described. The tumour and a local metastasis were examined by immunohistochemistry and found to contain abundant somatostatin-immunoreactive cells together with less numerous cells displaying gastrin immunoreactivity. This is to our knowledge the first case of intestinal somatostatinoma. The presence of gastrin cells in the tumour may explain the ulcer diathesis.


Myopathy associated with chronic alcohol drinking. Histological and electrophysiological study. Muscles of the lower legs of rats given 25% ethanol in water ad libitum for up to 9.5 months were studied using histological, histochemical and electrophysiological techniques. Ethyl alcohol was substituted for about 20% of the total calorific input of the animals. The observations were compared with the structure of the gastrocnemius muscle of five alcoholics with clinical neuropathy. Fibrillation potentials and angulated atrophic fibers were observed in the muscles of animals on alcohol for 9.5 months. No fiber type grouping was present. There was also phagocytosis of the muscle fibers and changes in their internal structure, as reflected by the distribution of NADH-diaphorase. The observed muscle changes in the alcoholics and those in the experimental animals on alcohol differed mainly quantitatively, the only exception being the presence of fiber type grouping in the biopsies from the alcoholics.


Extracellular growth hormone deposits in pituitary adenoma. Ultrastrucutral examination of 184 pituitary adenomas demonstrated the presence of extracellular accumulations of electron dense material in 3 out of 64 cases with acromegaly. Fibrillary structures were seen in larger deposits of such material. This material was only observed in biopsies fixed directly with osmium tetroxide; initial fixation with glutaraldehyde did not retain the material and left empty spaces. Positive immuno-histochemical reaction with specific antibodies demonstrated that the extracellular material contained growth hormone (GH). The presence of this extracellular material could not be related to the age or sex of the patient nor to the duration of symptoms, size of the tumor, presence of diabetes mellitus, or concomitant secretion of prolactin. The pericapillary fibrous sheath was heavily thickened in the patient with the longest duration of symptoms, intermediate in thickness in the second and normal in the third.


Identification of soluble fibrinogen fibrin monomer complexes by non-enzymatic polymerisation in the tissue. In states of plasmic hypercoagulability and consumption coagulopathy ethanol favours the non-enzymatic polymerization of circulating soluble fibrinogen fibrin monomer complexes (FFMC) in vitro. The ethanol-gelation test of Godal and Abildgaard makes use of this phenomenon, called paracoagulation. The present studies show that it is also possible to visualize soluble FFMC by means of ethanol-gelation. In the electron microscope, FFMC, polymerized non-enzymatically by ethanol in the spleen, are characterized by plump or slender mycelioid fibrillar precipitates that show a uniform rhythmic transverse striation, a period-coincidental filamentary arrangement and an average periodicity of 23 nm. The ultrastructure demonstrates these ethanol-induced filaments to be in vitro-polymerized fibrin monomer derivatives. Paracoagulation with ethanol allows the identification of soluble FFMC in the tissue prior to the formation of highly polymerized fibrin-rich microthrombi, the established equivalents of the DIC-syndrome. The electron microscope studies also show the existence of a second type of fibrillary structure in the tissue polymerized by ethanol. This second type lacks the characteristic periodicity of fibrin and the period-coincidental arrangement of the filamentary structures, but is characterized by closely packed or chain-like aligned, irregularly sized spherical bodies. There is some evidence that these spherical bodies in vitro represent non-enzymatically polymerized complexes of fibrin monomers and fibrin degradation products (FDP), the equivalent of a limited local or generalized fibrinolysis in vivo.


[Echocardiographic changes in a defect of the interatrial septum]. The echocardiographic changes in 43 patients with defects of the interrauricular septum, confirmed by catherization were studied. In 42 out of 43 (98%) cases considerably enlarged dimensions of the right ventricle and right auricle were found. Paradoxical movement of the interventricular septum was found in 39 out of 43 (91%) cases. The paradoxical movement of the interventricular septum is characterized by a considerable amplitude towards the right venticle. The tricupid valve shows an increased amplitude of opening (CE), enlarged A wave, accelerated speed of opening (OE segment), accelerated speed of backward movement in early diastole (EG segment) and decelerated closing (AC segment). The enlarged dimensions of the right ventricle, the paradoxical movements of interventricular septum and the changes of the tricupid valve are a characteristic EchoC-triad, never absent in the hemodynamically significant volume loading of right ventricle, originating from the left-right shunt at an auricle level.


[Comparative laparoscopic, bioptic and clinical enzymological studies in liver cirrhosis and other chronic liver diseases]. The activity of GOT, GPT, APh, liver APh, gamma GTP, AAP and serum cholinesterase were determined in 80 patients with chronic liver diseases, diagnosed clinically, laparoscopically and by liver biopsy. Out of the patients with liver cirrhosis (51), those with portal cirrhosis (40) have a considerably higher activity of gamma GTP, intestinal APh than the patients with postecrotic cirrhosis (11). Cholinesterase activity is markedly lower in patients with cirrhosis and ascites than in the patients without ascites. With the histological data about the activity gamma GTP and GOT are considerably higher without activity. Examinations were carried out also upon patients with chronic aggressive hepatitis (4), chronic persisting hepatitis (9), liver cancer (12) and liver steatosis (4). The data revealed that the majority of the enzymes are with a higher sensitivity (especially gamma GTP, GOT, liver APh, cholinesterase) but with more restricted diagnostic and differential-diagnostic potentialities in view of the great dispersion of the enzyme activities with the separate liver diseases.


[Contribution to the treatment of acute haematogenous anc chronic secondary osteomyelitis in children (author's transl)]. The possibility of utilizing antistaphylococcal vaccine and local phage lysate for complex therapy of chronic and acute haematogenous osteomyelitis in children is demonstrated on three clinical cases. The study reassurmes good experience with this therapy in adult patients with chronic osteomyelitis. The results obtained so far in children suggest that the application of antistaphylococcal vaccine and of local phage lysate positively influences the course of the osteomyelitic disease and reduces the number of relpases. In order to specify and intensify the clinical effect of the above mentioned preparations, this method is being employed in other cases of chronic and acute haematogenous osteomyelitis.


[Electron microscopical findings of the myocardium in Fallot's disease and of the ventricular septal defects (author's transl)]. Ultrastructural quantitative and qualitative investigations of the myocardium of 7 children with Fallot's disease and 3 children with a ventricular septal defect (VSD) have shown bizarre nuclei and a slight increase in the myofibril share of the volume (Fallot's disease: 51.22%; VSD: 56.85%). This may be interpreted as a sign of a cellular hypertrophy. The mitochondria have a proportion of 35.07% and 33.75%, respectively. The glycogen content is relatively high. The lipofuscin bodies originate mainly from mitochondria having a percentage of 1.43 and 1.67, respectively. Particular signs of a lesion could not be observed. From the ultrastructural findings on the morphology of heart muscle cells it can be deduced that operations of vitia may be safely carried out.


[Results following ovarian cyst puncture using laparoscopy]. 154 aspirations of ovary cysts by laparoscopy are reported. 16% of cysts have relapsed  after 1 till 7 years. Cytologic investigation and investigation of tissue of cysts are recommended. The advantages of aspiration by laparoscopy over the vaginal blind aspiration are discussed.


[Metabolic disorders in Huntington's chorea]. The results of biochemical studies conducted in 42 patients with Huntington's chorea are presented. The authors marked the decrease of tolerance to glucose, the increase of cholesterol concentration in the blood serum in some patients. Uric acid concentration in the blood serum and its excretion with urine were decreased in all examined patients. Ceruloplasmic activity in the patients' blood did not differ from the normal level. Cuprum concentration in the blood serum and the patients' urine was within the normal fluctuations.


[Effect of heliogeophysical factors on the course of epilepsy]. A statistical analysis of 1499 admissions of epileptic patients to a hospital for the period of 1957--1969 taking into account the 11-year sun circle was conducted. A significant dependence of a course of epilepsy on massiveness of heliogeophysical factors (the Volph numbers, square of sun-spots and geomagnetic pole). At the periods of maximal sun activity a number of patients with initial diagnosis of epilepsy significantly increases (182 cases were studied for the period of 1968--1970). Establishing a relationship between occurrence or exaggeration of epilepsy and days of zero sun activity a reliable confirmation of "outstripping or lag" reaction was obtained.


High dose methotrexate in acute lymphocytic leukemia in childhood. Gonadal and other types of leukemic "sanctuaries" are probably the main causes of hematological relapse in the treatment of acute leukemia. The introduction of high-dose Methotrexate (HDM) in a consolidation phase is based on theoretical considerations and the use of HDM in malignant tumors. Three courses of Methotrexate, 500 mg/sq.m. at 3-weekly intervals, has been used as part of a consolidation therapy in Norway during the last two years to 59 children with ALL and one with AML. One child died following HDM. Postmortem examination showed that she was not in complete remission at the time. Among 154 courses of HDM in the 60 patients were eight severe reactions, including six cases of allergic-toxic skin reactions. Two patients developed a Stevens-Johnson's like syndrome. Stomatitis was common in those with toxic reactions. The risk of HDM in patients who are not in complete remission is stressed and the use of rescue therapy with two doses of Leukovorin instead of one is recommended. Forty of forty-two children in 1st complete remission have been in sustained primary remission for 4 to 28 months. Two of these 40 children died after about a year from infections. Only two patients so far have relapsed.


Swelling and replicative DNA synthesis of detergent-treated mouse ascites sarcoma cells. Previous investigation showed that mouse ascites sarcoma cells permeabilized with appropriate concentrations of detergents (Triton X-100, Nonidet P-40 and Brij 58) had high replicative DNA synthesis in the presence of the four deoxyribonucleoside triphosphates, ATP, Mg2+ and proper ionic environment. The present study showed the optimum detergent concentration for DNA synthesis coincided closely with the minimum detergent concentration for inducing cell swelling. Phase contrast microscopy and electron microscopy of Triton-permeabilized cells showed the characteristic swollen cytoplasms and nucleus. Autoradiographic study showed that the DNA synthesis in permeable cells was confined to the nucleus. Cell viability and [3H] deoxythymidine uptake were impaired at much lower concentrations of Triton X-100 than the optimum concentration for in vitro DNA synthesis. In Triton-permeabilized cells, the minimum Triton concentration that produced cell swelling also seemed to produce high repliative DNA synthesis, which reflects the in vivo state of DNA synthesis.


[Effect of noradrenaline on transport adenosine triphosphatase in the cerebral synaptosomes of Citellus erythrogenus susliks]. The effect of noradrenalin (0.5 mM) on the activity of Na, K-ATPase and Mg-ATPase has been investigated in active and hibernating ground squirrels. ATPase activities were determined in vitro at 37 and 17 degrees. The inhibitory effect of noradrenalin was found on Na, K-ATPase in non-hibernating summer animals. It was most significant at the beginning of summer, i. e. at the period of highest physiological activity of animals, and lowered to the end of summer. No significant influence of noradrenalin on the activity of Mg-ATPase was found. In hibernating ground squirrels, noradrenalin inhibited Na, K-ATPase and activated Mg-ATPase of synaptosomes incubated at 37 degrees, but produced no effect at 17 degrees, i.e. at the temperature closer to that during hibernation.


Cerebral aterial spasm. I. Adrenergic mechanism in experimental cerebral vasospasm. This study demonstrates that an adrenergic mechanism plays an important role in producing the delayed cerebral vasospasm which follows subarachnoid hemorrhage. Results were as follows: 1. Experimental subarachnoid hemorrhage (SAH) was produced by injection of fresh arterial blood into the cisterna magna in cats. The cerebral vasospasm was shown angiographically to be biphasic in nature: immediate constriction lasting 1 h and marked prolonged spasm occurring between the 3rd and 5th day after SAH. The amount of noradrenaline (NA) and dopamine-beta-hydroxylase (DBH) activity decreased over a period of 24 h both within the wall of the basilar artery and in the locus ceruleus and then gradually increased, reaching a maximum on the 3rd day after SAH. 2. Topical application of spasmogenic substances (NA and blood) produced a marked constriction of the hypersensitive basilar artery on the 3rd day after SAH. 3. 6-Hydroxydopamine (6-OHDA) injection into the cisterna magna produced prolonged vasocilatation. The dilated vessel responded with mild transient constriction after the topical application of NA or fresh blood. DBH activity and NA concentration in the vessels, locus ceruleus and medial hypothalamus decreased markedly on the 3rd day after the cisternal injection of 6-OHDA. 4. Various spasmogenic substances (i.e. serotonin, NA, prostaglandins and methemoglobin) were measured in a mixture of equal volume of CSF and blood in cats. ONly the serotonin in the mixed fluid produced vasoconstriction. Spasmogenic substances decreased markedly in the mixed fluid incubated for 3 days at 37 degrees C, and none of these substances apart from methemoglobin was present in a concentration sufficient to produce constriction of vessels. 5. These results suggest that early spasm is induced by serotonin around the arteries of the cranial base, and delayed spasm might be caused by hyperreaction of cerebral vessels to spasmogenic substances such as methemoglobin, during the accumulation of excess NA in the cerebral vessel wall.


Effect of myocardial ischemia and nitroglycerin on systolic time intervals in the segmental myocardium. Effects of ischemia and nitroglycerin on systolic time intervals in the segmental myocardial length were studied in anesthetized open-chest dogs. Two strain-gauges were sutured on the surface of the left ventricular wall; one was in the central area perfused by the left circumflex coronary artery (LCX) and the other was in the area perfused by the left anterior descending coronary artery. LCX was partially occluded with a screw type constrictor to the degree at which reactive hyperemia after the transient total coronary occlusion almost disappeared. After the hemodynamics stabilized nitroglycerin (20 microgram/kg) was injected into the femoral vein. In the ischemic area, contraction time was shortened and precontraction time was prolonged in association with an elongation of end-systolic and early systolic segment-length, respectively. The systolic time intervals in the ischemic segment were improved as a result of the recovery in the segment-length toward the control. The results suggest the usefulness of analyzing the segmental myocardial systolic time intervals for verifying the asynchronous contraction of the ventricle and the favourable effects of nitroglycerin on segmental myocardial function in the ischemic area.


A case of giant cavernous hemangioma of the liver complicated by intravascular coagulopathy. A case of liver hemangioma complicated by intravascular coagulopathy is presented because of the rarity of the association. Hemangioma of the liver was suspected by palpation of the liver tumor, scintigraphy and x-ray examination, and confirmed by selective hepatic arteriography in combination with exploratory laparotomy. Intravascular coagulopathy was established by demonstrating secondary fibrinolysis and consumption of platelets and coagulation factors. Unconjugated hyperbilirubinemia due to micro-angiopathic hemolytic anemia was also present. The clinical course of the clotting abnormalities was basically a chronic one with an occasional acute or subacute defibrination process associated with further enlargement of the hepatic tumor. These provide sufficient evidence that the intravascular coagulopathy was closely related with the hemangioma in the liver. Neither ligation of a presumed nutritional artery of the hemangioma nor radiation therapy caused any demonstrable reduction in the tumor size.


Influence of fibrinogen degradation products (FDP) on the ATPase activity in the rat heart. Influence of fibrinogen degradation products (FDP) on the ATPase activity in the rat heart. Acta Physiol. Pol., 1978, 29 (2): 185--187. The influence of dialysable fibrinogen degradation products (FDP) on the ATPase activity was studied. It was found that FDP augment the Mg(2+)-- dependent ATPase and slightly decrease the (Na+--K+) dependent ATPase in the rat heart. It is concluded that biological activity of examined peptides depend on other mechanisms than the direct effect on ATPase in the heart.


Farber's disease (disseminated lipogranulomatosis): the first case reported in Japan. We report the first case in Japan, i.e., the first case among oriental subject of Farber's disease. This is a rare disorder of lipid metabolism in infancy subsequent to a genetically-determined defect in ceramide degradation. Main features are characterized clinically by hoarseness, joint swelling, subcutaneous nodules and retarded psychomotor development. Lipid analysis and pathological investigation on the material obtained from a subcutaneous nodule confirmed clearly the presence of ceramide and intracytoplasmic inclusion bodies characteristic for Farber's disease. In this case, we experienced also corneal opacity and striking abnormalities in electroencephalogram, which have apparently not been noticed in the 17 cases hitherto reported.


Coagulation factor deficiency apparently related to the Fitzgerald trait: the first cases in Japan. A blood coagulation deficiency was found at the contact phase in identical Japanese female twins. Of the four possible factors involved, Factor XI or XII can be ruled out according to cross-correction studies. The problem factor was probably not Fletcher factor, because the abnormal partial thromboplastin time was not significantly shortened by increasing the incubation period of plasma with kaolin. The deficiency is most likely due to the lack of Fitzgerald factor.


Significance of a terminal R wave in lead V1 of the electrocardiogram. A terminal r wave in Lead V1 lower than 0.6 mV. was studied in the ECGs of four groups: (1) 104 healthy children, (2) 207 healthy young adults, (3) 171 patients with no autopsy evidence of a cardiopulmonary disease, and (4) 1,078 autopsy patients with a cardiopulmonary disease. Cases with a complete right bundle branch block were excluded. A terminal r wave occurred in 2.9 per cent healthy children, 1.4 per cent of healthy young adults, 0.6 per cent of patients without and in 5.9 per cent of patients with autopsy evidence of a cardiopulmonary disease. The occurrence of a terminal r wave was most common in pulmonary patients (10 per cent). But it was also found in patients with an anterior or a posterior myocardial infarction and in some cases of left ventricular hypertrophy. In the autopsy series RVH occurred in 57 per cent of patients with a Qr pattern, in 30 per cent of patients with a terminal r wave higher than the initial one, and in none of the patients with a terminal r wave lower than the initial one. It is concluded that the height of the terminal r wave has clinical significance. A terminal r wave higher than the initial one in Lead V1 is associated with a cardiopulmonary disease in subjects over 30 years of age, while an r wave lower than the initial one seems to be an innocent finding.


Hereditary atrial septal defect. Update of a large kindred. A large pedigree wherein members are predisposed to atrial septal defect (ASD) and associated cardiovascular anomalies has been studied. There were ten direct line relatives with ASD verified by cardiac catheterization and/or surgery and in one case by reliable medical history. The pedigree shows vertical transmission of ASD through four generations. Estimates of the genetic segregation ratio were near 50%, indicating that predisposition to ASD among family members was due to a deleterious autosomal dominant gene. Family members have also manifested other congenital heart anomalies, consistent with pleiotropic effects of the putative gene. Electrocardiograms in six ASD patients revealed an absence of prolonged P-R interval. In the light of prior studies showing prolonged P-R interval in familial ASD, we suggest the existence of at least two distinct hereditary varieties of ASD, one with and one without a prolonged P-R interval.


Effects of cannabinoids on synaptic membrane enzymes. I. In vitro studies on synaptic membranes isolated from rat brain. The understanding of the effects of cannabinoids in human subjects has been obscured by a lack of knowledge about how the various active principles from marijuana act at the cellular level in the brain. For this reason the present study was undertaken to determine the effects of cannabinoids on the enzymes associated with the synaptic membranes. Electron micrographic analysis was performed to determine the purity of synaptic membrane preparations from rat brain, and subsequently such preparations were subjected to additions of ethanol, Tween-80, 80% glycerol, and either delta-tetrahydrocannabinol, 11-hydroxy-delta-tetrahydrocannabinol, or cannabinol. Both sodium and potassium activated ATPase (Na, K-ATPase), and Mg-ATPase were measured as the micrometer orthophosphate (P) released per minute per microgram membrane protein and these specific activities of the enzymes expressed as absolute values and as the percentage depression brought about by the cannabinoids. The ATPase spcific activities are taken from the rate curve over a 30-min incubation time. Additionally, synaptic membrane acetylcholineesterase specific activity was measured by continuous rate enzyme assay. While as low as 10 M delta-tetrahydrocannabinol showed appreciable decrements in both the membrane-bound ATPases, the other cannabinoids did not show such a great depression in enzyme activity. The specific activity of acetylcholinesterase, which is weakly bound to the membrane, showed only slight or no changes in activity with the various cannabinoids. It was additionally shown that the cannabinoids, delta-tetrahydrocannabinol in particular, bound to the synaptic membranes almost irreversibly in the in vitro system, and that the vehicle for dissolving the cannabinoids, while used as background control values when calculating the percentage decrements in enzyme specific activity, did vary the effects on the ATPase enzymes in particular. These data are discussed in relation to psychotomimetic activity of the cannabinoids.


Immune complex glomerulonephritis in sicca syndrome. In three patients with the sicca syndrome (Sjögren's syndrome), who were followed for one to seven years, glomerulonephritis developed. None of these patients fulfilled the diagnostic criteria for systemic lupus erythematosus. All of these patients had circulating immune complexes as detected by the Clq binding assay. Glomerular histology by light and electron microscopy revealed changes compatible with membranoproliferative glomerulonephritis in two of the patients and membranous glomerulonephritis in the third. All patients showed rapid improvement in renal function following moderate doses of corticosteroids. In addition, the treatment decreased the level of circulating immune complexes in two patients who were followed for a sufficient period of time.


Pulmonary vascular changes in scleroderma. To determine the incidence and significance of pulmonary vascular changes in scleroderma, all necropsy reports of patients with scleroderma who died at the Massachusetts General Hospital were analyzed and correlated with clinical data. The records of 30 such patients were available. Fourteen had moderate or marked abnormalities in the pulmonary arterial tree. Nine of these 14 patients had predominantly respiratory symptoms. The arterial changes consisted pathologically of intimal and medial hyperplasia affecting pulmonary arteries of all sizes. Of the eight patients with the most severe pathologic changes in the pulmonary arteries, five had slight or no interstitial fibrosis. Three of these five patients had rapidly progressive respiratory failure and severe pulmonary hypertension leading to death. Such cases form a distinct clinicopathologic entity of malignant pulmonary hypertension in scleroderma, comparable to the better recognized entity of malignant renal hypertension in scleroderma.


Down's syndrome and leukemia: mechanism of additional chromosomal abnormalities. There is an increased incidence of acute leukemia in patients with Down's syndrome patients have a trisomy-21 chromosomal pattern, and chromosomal abnormalities can be seen in acute leukemia. It is possible that the increased incidence of acute leukemia in Down's syndrome persons may be due in part to their chromosomal abnormalities. Such abnormalities, some appearing in a stepwise clonal evolution, were found in five Down's syndrome patients, four with acute leukemia and one with abnormal regulation of leukopoiesis. Morphological abnormal chromosomes were also found in three patients. These chromosomal abnormalities are similar to those seen in non-Down's syndrome leukemic patients. There is suggestive evidence for clonal evolution hypothesis of luekemogenesis in non-Down's syndrome patients. The abnormal chromosomal pattern reported in our Down's syndrome patients could be the result of nondisjunction in mitosis, and leukemia may be the phenotypical expression of this nondisjunction.


Etiological differences in patterns of psycholinguistic development of children of IQ 30 to 60. We compared the psycholinguistic abilities of 131 mentally retarded children (IQs 30 to 60) of different etiological classifications (Down's syndrome, biologically brain damaged, environmentally caused retardation, unknown cause) and characterized each etiology according to the different patterns of psycholinguistic skills exhibited by the children. Level of skills was determined by the Illinois Test of Psycholinguistic Abilities, which was administered to each subject. Down's syndrome children exhibited significantly lower verbal-auditory skills than visual-motor skills. The environmentally caused retardation group showed no significant differences in development of psycholinguistic channels. Down's syndrome children had significantly lower verbal-auditory abilities than did the other etiological groups of severely retarded children. Etiological differences in the visual-motor channel were less marked.


Furazolidone-induced cardiomyopathy in turkeys. Association with a relative alpha1-antitrypsin deficiency. A naturally occurring cardiomyopathy (round heart disease) which is potentiated by inbreeding and a cardiomyopathy produced by furazolidone, a nitrofuran derivative, were studied for an associated alpha1-antitrypsin deficiency in two flocks of turkeys (one inbred for round heart disease and a commercial flock). At 4 weeks of age, the furazolidone-fed birds of both flocks demonstrated a marked increase in mortality and cardiac dilatation associated with disordered hepatic metabolism when compared with controls. Although PAS-positive, diastase-resistant globules were observed in the livers of both strains of turkeys fed furazolidone, these globules were present in lysosomes and not in the rough endoplasmic reticulum as in alpha1-antitrypsin deficiency. The control inbred birds with round heart disease did not demonstrate histologic or biochemical evidence of an alpha1-antitrypsin deficiency. It is proposed that furazolidone in the turkey produces primary hepatic damage that is reflected in lowered total serum proteins, including trypsin inhibitory capacity, and that the alterations produced by furazolidone are superimposed on round heart disease in the inbred flock.


Amyloid tumor. A clinicopathologic study of four cases. Four examples of amyloid tumors were studied to determine whether there was an association with myelomatosis. Three patients had follow-up examinations of 12 years, 9 years, and 2 1/2 years, respectively. A local recurrence developed in one patient and a second lesion developed in this patient and in one other who also had a transient monoclonal 7S globulin peak. In spite of these findings, none of our patients developed myelomatosis. A study of the scanty literature on amyloid tumors reveals that only patients with lesions of the lung and urinary bladder have had long-term follow-up. They have invariably remained free of disease. Several reports of bone lesions have inferred that amyloid tumors occurring here signify solitary myeloma despite a lack of follow-up confirmation. Our longest surviving patient developed two bone lesions over a 12-year period without developing myelomatosis. Our findings lead us to conclude that there is little evidence to regard the presence of an amyloid tumor at any site as a manifestation of solitary myeloma or myelomatosis.


Course of denervation atrophy in type I and type II fibres of rat extensor digitorum longus muscle. In the denervated extensor digitorum longus muscle of the rat type I and type II muscle fibres were differentiated histochemically and their course of atrophy was studied. Until 42 days after denervation type I and type II fibres could be identified by means of the myofibrillar ATPase reaction. Up to that time an exclusive atrophy of type II fibres was found. Type I fibres, the smallest of the normal muscle, did not change their diameters and therefore represented the largest fibres 42 days after denervation. Type II fibres of the "white" muscle portion, in which the larger IIB fibres are predominant, showed a higher rate of atrophy than those of the "red" muscle portion, in which the smaller IIA fibres are predominant: by 42 days the diameters of all type II fibres had gone down to equal values. Combined with a further progress of atrophy at later stages, there was a dedifferentiation of the histochemical properties, and the type I fibres exhibited atrophy as well. 120 days after denervation all muscle fibres were found to be highly atrophied.


[Congenital brain arteriovenous shunt. cardiological aspects (author's transl)]. An infant with a congenital brain arteriovenous shunt and secondary aneurism of Galen vein is related. Abnormal electrocardiogram without physical signs of primary cardiopathy is observed. Complete description of the case is done and the problems originated from a cardiological point of view are discussed.


[Chloracne due to tetrachloro-2,3,7,8-dibenzo-p-dioxin in children (author's transl)]. Several cases of chloric acne have been observed in children after the accidental Seveso TCDD intoxication. The lesions consist in an inflammatory hyperkeratotic erythema of exposed areas, with numerous horny cysts, sometimes associated with granuloma annulare aspects of the hands. All lesions have the same histological pattern and atrophoderma vermiculata is often their ultimate evolution. These cases are similar to the epidemic follicular keratosis observed in 1946 around Bâle in Switzerland; thus the clinical and genetic evolution of these patients may be foreseen.