Placental steroid synthesis from DHEAS during dexamethasone therapy. Maternal glucocorticoid treatment affects estrogen synthesis by decreasing estrogen precursors. Whether glucocorticoid has any effect on the placental conversion of estrogen precursors to estrogen is not known. A study was therefore undertaken to investigate the effect of 100 mg of intravenously administered dehydroepiandrosterone sulfate (DHEAS) on estradiol (E2), estriol (E3), and testosterone (T) serum levels. The test was conducted for 5 hours in 10 women treated with intramuscular dexamethasone and in 8 controls during the last trimester of pregnancy. The initial E2 and E3 serum concentrations were lower in women treated with dexamethasone than in controls, while T serum levels did not display any difference. Following the injection of DHEAS there was a significant increase in E2, with maximal levels reached between 1 and 3 hours after injection in both groups. Maximal levels of E2 were equal for both groups. There was no change in E3 levels after DHEAS administration in the nontreated group, while the increase in the dexamethasone group was significant. A significant rise in T, with maximal levels reached at 1 hour after infusion, was similar in both groups. It is concluded that maternal dexamethasone does not inhibit the conversion of DHEAS either to E2 in the placenta or to E3 and T.


Complications of laparoscopic sterilization. Comparison of 2 methods. A retrospective study of 5346 cases of laparoscopic sterilization with special reference to early and late complications was undertaken. In the 6-year period from 1972 to 1978, 846 patients were sterilized by the elasticized silicone-ring technique and 4500 patients were sterilized by the electrocautery method. The electrocautery method was complicated by electrical burns in 13 cases (0.29%); 3 of these patients required bowel resections. Mechanical complications occurred in 1.6% of the Silastic-ring cases, but none of the patients required additional surgery. The Silastic-ring patients had greater postoperative abdominal pain than the electrocautery patients, but it usually abated within 48 hours. There were 15 cases of postoperative pelvic infection in the electrocautery group, and none in the Silastic-ring group. Bleeding from the mesosalpinx occurred in both groups and occurred more often with coincident suction D&C. Technical failure to perform the sterilization procedure was principally related to previous abdominal surgery. A substantial number of patients complained of menstrual irregularity and/or dysmenorrhea following these sterilization procedures. The majority of women reported unchanged or improved sexual relations. Improvement in sexual relations was reported by significantly more patients in the Silastic-ring group than in the electrocautery group.


Steroid rosacea in children.

Steroid rosacea in children. Steroid rosacea is a facial dermatitis clinically resembling acne rosacea. Fluorinated topical steroids have been implicated as the cause or precipitating factor in previous case reports mainly involving an adult population. Four cases of pediatric acne rosacea associated with the use of topical fluorinated glucocorticosteroids are described. The process worsened during the two weeks following steroid cessation. We recommend that fluorinated glucocorticosteroids should not be used on the face of infants and children.


Communication patterns in pedodontics.

Communication patterns in pedodontics. This investigation examined communication patterns between 16 randomly selected senior dental students and their child patients. Interactions were videotaped during a regular treatment appointment and analyzed according to four Practitioner Communication categories and four Child Cooperation categories. Communication categories included Directive Guidance Behavior, Permissive Behavior, Coercive Behavior, and Other Behavior. Child behavior categories included Cooperation, Resistance, Noncooperation, and Other. The probability that a given category of child's behavior would follow a given category of practitioner's behavior was calculated. Results indicated a .85 probability that Directive Guidance would be followed by Cooperation; a .67 probability that Permissiveness would lead to Noncooperation; and a .97 likelihood that Coerciveness would lead to either Noncooperation or Resistance. Practitioners' confidence was also considered; less confident operators account for 95% of the Coercive behaviors, 86% of Permissive behaviors and 87% of Uncooperative behaviors.


DNA polymerase alpha, beta and gamma activities in ultraviolet irradiated CV-1 monkey cells. To determine the possible role of DNA polymerase alpha, beta and gamma during the repair period following ultraviolet (lambda max : 254 nm) irradiation of monkey CV-1 cells, we measured the three enzymatic activities by using specific tests, either in crude extracts or after fractionation by sucrose gradient (5--20%) centrifugation at high salt concentration. When compared to the unirradiated control, we could not detect any significant variation in the levels of activity of DNA polymerases alpha, beta and gamma at any time (0, 12 to 48 h) after ultraviolet irradiation of the cells with doses ranging from 9 to 52.5 J.m-2.


Synthesis and coding properties of dinucleoside diphosphates containing alky pyrimidines which are formed by the action of carcinogens on nucleic acids. Dinucleoside diphosphates of the general type pGpN have been prepared enzymatically using ribonuclease N1. Alkylated uridines or cytidines, which are products of carcinogens acting on nucleic acids, were tested in dinucleoside diphosphates for their ability to stimulate the binding of Ala- or Val-tRNA to ribosomes. O2-Ethyl C and 3-methyl C functioned as U, but not as C. In contrast, 3-methyl U behaved as C, but not as U. Both O2 and O4-ethyl U could be recognized as C or U, although binding in both cases was weak. Thus, modifications of the hydrogen-bonding sites of U or C causes miscoding and could be considered to represent mutagenic reactions.


Laboratory of Physiological Chemistry, State University Groningen, Netherlands. To obtain more information about the arrangement of Hind III restriction fragments in the tRNA-rRNA region of the Neurospora crassa mitochondrial (mt) DNA we have cleaved the mtDNA with Hpa I and Hind II. We could construct additional cleavage maps for these enzymes. Hybridization of rRNAs to Hind II fragments confirmed the existence of an intervening region of about 2,300 basepairs in the 24S rRNA (Hahn et al., Cell, in press). About seven tRNA genes, among which the genes for tRNA1Ser and tRNAMetM, are located in a segment of about 5,000 bp separating the 24S and 17S rRNA genes. Another cluster of 14 tRNA genes is found adjacent to the other end of the 24S gene. The genes for tRNALeu1 and tRNAMetF are located in this cluster.


Termination of transcription by Escherichia coli RNA polymerase: influence of secondary structure of RNA transcripts on rho-independent and rho-dependent termination. The effect of RNA secondary structure on rho-independent and rho-dependent termination of transcription of T3 DNA by Escherichia coli RNA polymerase has been studied by incorporating, into nascent transcripts, base analogs that lead to altered base-pairing properties. A guanine --> hypoxanthine substitution, with attendant weakening of secondary structure, abolished the rho-independent termination at 20% of the genome; in contrast, replacement of cytosine with 5-bromocytosine, which forms stronger pairs with guanine, enhanced termination at this site. rho-Independent termination was not altered by replacing uracil with 5-bromouracil. There are two major rho-dependent termination sites on the T3 DNA-at 8 and 15%. The termination activity of rho in this system also depended on RNA secondary structure. The incorporation of 5-bromouracil instead of uracil into RNA did not alter the site specificity of rho action but rho was rendered inactive when cytosine was replaced by 5-bromocytosine. In contrast, replacement of GTP with ITP in the reaction increased rho-dependent inhibition of RNA synthesis, caused production of heterogeneous-sized transcripts, and stimulated rho-mediated ATP hydrolysis. The rho-associated ATPase activity, in the presence of isolated T3 RNA, was also stimulated by inosine substitution. Furthermore, the temperature-sensitive rho isolated from rho 15 mutant of E. coli, which does not terminate transcription in the presence of the common rNTPs, was active when GTP was replaced with ITP. These results suggest that strongly paired G.C-rich regions in RNA stem-loop structures or RNA.DNA hybrids are essential for rho-independent termination, whereas rho-dependent termination requires weakly paired cytosine residues for its action.


Purified Escherichia coli recA protein catalyzes homologous pairing of superhelical DNA and single-stranded fragments. Purified Escherichia coli recA protein catalyzed ATP-dependent pairing of superhelical DNA and homologous single-stranded fragments. The product of the reaction: (i) was retained by nitrocellulose filters in 1.5 M NaCl/0.15 M Na citrate at pH 7, (ii) was dissociated at pH 12.3 but was not dissociated by heating at 55 degrees C for 4 min or by treatment with 0.2% sodium dodecyl sulfate and proteinase K, (iii) contained covalently closed circular double-stranded DNA (form I DNA), (iv) contained single-stranded fragments associated with replicative form (RF) DNA, and (v) contained a significant fraction of D-loops as judged by electron microscopy. Linear and nicked circular double-stranded DNA did not substitute well for superhelical DNA; intact circular single-stranded DNA did not substitute well for single-stranded fragments. Homologous combinations of single-stranded fragments and superhelical DNA from phages phiX174 and fd reacted, whereas heterologous combinations did not. The reaction required high concentrations of protein and MgCl2. The ATPase activity of purified recA protein was more than 98% dependent on the addition of single-stranded DNA. In 1 mM MgCl2, the ability of superhelical DNA to support the ATPase activity was two-thirds as good as that of single-stranded DNA.


Human platelet myosin light chain kinase requires the calcium-binding protein calmodulin for activity. In an actomyosin fraction isolated from human platelets, phosphorylation of the 20,000-dalton light chain of myosin is stimulated by calcium and the calcium-binding protein calmodulin. The enzyme catalyzing this phosphorylation has been isolated by using calmodulin-affinity chromatography. Platelet myosin light chain kinase activity was monitored throughout the isolation procedures by using the 20,000-dalton smooth muscle myosin light chain purified from turkey gizzards as substrate. The partially purified myosin kinase requires both calcium and calmodulin for activity and has a specific activity of 3.1 mumol of phosphate transferred to the 20,000-dalton light chain per mg of kinase per min under optimal assay conditions. Km values determined for ATP and myosin light chains are 121 microM and 18 microM, respectively. Of several substrates surveyed as phosphate acceptors (alpha-casein, histone II-A, phosphorylase b, protamine, histone V-S, and phosvitin), only the 20,000-dalton myosin light chain is phosphorylated at a significant rate. These results suggest that platelet myosin light chain kinase is a calcium-dependent enzyme and that the requirement for calcium is mediated by the calcium-binding protein calmodulin.


Nucleotide sequence of the mitochondrial structural gene for subunit 9 of yeast ATPase complex. We have determined the nucleotide sequence of a segment of Saccharomyces mtDNA that contains the structural gene for one of the subunits (the dicyclohexylcarbodiimide-binding protein) of the mitochondrial ATPase complex. The sequence fits the known amino acid sequence of this protein with the exception of one amino acid. Codon usage is biased in favor of A + T-rich codons. On both sides of the gene, the nucleotide sequence contains less than 4% (mol/mol) G + C for at least 180 nucleotides; these A + T sequences show no evidence of internal repetition. The gene and all the A + T-rich sequence preceding the gene are present in a 12S RNA that is the major transcript of this segment of mtDNA. The nature of the sequences responsible for binding ribosomes to mitochondrial mRNA and for termination of RNA synthesis is considered.


Inhibitory spectrum of alpha 2-plasmin inhibitor. alpha 2-Plasmin inhibitor (alpha 2PI) has been recently characterized as a fast-reacting inhibitor of plasmin in human plasma and appears to play an important role in the regulation of fibrinolysis in vivo. We have studied the effect of purified alpha 2PI upon various proteases participating in human blood coagulation and kinin generation. At physiological concentration (50 microgram/ml), alpha 2PI inhibited the clot-promoting and prekallikrein-activating activity of Hageman factor fragments, the amidolytic, kininogenase, and clot-promoting activities of plasma kallikrein, and the clot-promoting properties of activated plasma thromboplastin antecedent (PTA, Factor XIa) and thrombin. alpha 2PI had minimal inhibitory effect on surface-bound activated PTA and activated Stuart factor (Factor Xa). alpha 2PI did not inhibit the activity of activated Christmas factor (Factor IXa) or urinary kallikrein. Heparin (1.5-2.0 units/ml) did not enhance the inhibitory function of alpha 2PI. These results suggest that, like other plasma protease inhibitors, alpha 2PI possesses a broad in vitro spectrum of inhibitory properties.


Plasmin-mediated proteolysis of casein in bovine milk. Plasminogen was found to be present in bovine milk by crossreactivity between rabbit antiserum to plasminogen and casein prepared from milk by acid precipitation. This result was further supported by recovery of intact 125I-labeled plasminogen from rabbit milk after its intravenous injection. Freshly isolated whole bovine casein was observed to undergo slow autoproteolysis at 37 degrees C. Polyacrylamide gel electrophoresis revealed gradual disappearance of major caseins accompanied by appearance and increase in intensity of numerous electrophoretic bands. This autoproteolysis was inhibited by low concentrations of epsilon-aminocaproic acid (0.1 mM) and diisopropyl fluorophosphate (1 mM); catalytic amounts of urokinase accelerated the process. Autoproteolysis of isolated bovine beta-casein was shown by both urea and sodium dodecyl sulfate gel electrophoresis to result in formation of gamma 1- and gamma 2-caseins. Similar electrophoretic bands were formed when beta-casein was degraded by plasmin prepared from bovine blood serum. These results support the hypothesis that bovine plasmin occurs in milk and is identical to alkaline milk protease.


Down syndrome: gene dosage at the transcriptional level in skin fibroblasts. Chromosome imbalance (aneusomy) is the leading known cause of both spontaneous abortion and mental retardation in human beings. The primary abnormality is thought to result from quantitative changes of transcription products from the unbalanced genetic material. To document this point, I compared chromosome 21-specific transcription in skin fibroblasts from subjects with monosomy 21, disomy 21 (normal), and trisomy 21 (Down syndrome). Polyadenylylated RNA [poly(A)-RNA], which is enriched in messenger and messenger-precursor RNA sequences, was isolated from the above fibroblast lines. Radioactive DNA (cDNA) complementary to these RNAs was synthesized with reverse transcriptase (RNA-dependent DNA polymerase). These cDNAs were hybridized with (i) DNA from a cell line with a mouse genome plus human chromosome 21 and (ii) mouse DNA. Subtraction of the amount of hybridization in experiment ii from that in experiment i yielded a measure of human chromosome 21-specific RNA sequences. The results were consistent with gene dosage at the transcriptional level; for monosomy 21-derived cDNA, 0.6% (of the total cDNA) hybridized specifically to human chromosome 21; for disomy 21-derived cDNA, 2% hybridized; and for trisomy 21-derived cDNA, 3% hybridized. Thus, for DNA sequences on chromosome 21 in human skin fibroblasts, transcription depends on DNA dosage. Characterization of the chromosome 21-specific RNA sequences quantitated in these experiments could help to elucidate the mechanisms by which abnormal karyotypes result in abnormal phenotypes.


Molecular signals for initiating protein synthesis in organ hypertrophy. When chronically provoked to increased physiologic activity, organs increase in mass through augmented protein protein synthesis. This process of compensatory hypertrophy can involve cell division as well as cell growth. To test for molecules that might regulate organ size, by inducing hypertrophy, we performed a series of experiments using isolated, perfused, canine hearts in which the left ventricle was beating but performed no work. Hypertrophying hearts and kidneys as well as normal control organs were extracted and the extracts were perfused through isolated heart preparations. Before and after perfusion, RNA was extracted from fragments of the isolated hearts and translated in cell-free media containing [35S]methionine. Incorporation of methionine into protein was measured by liquid scintillation spectrometry. When perfused through normal hearts, extracts from hypertrophying heart and kidney were able to increase greatly the translational ability of RNA extracted from the normal hearts; corresponding perfusates from nonhypertrophying hearts and kidneys had no effect. Our results indicate that molecules that initiate hypertrophic organ growth are extractable, are generated by the cells of the organ under stress, and are probably similar in heart and kidney and perhaps in many other organs as well.


Effect of alpha-methyltryptamine on spontaneous activity in mice. A standard dose of 10 mg/kg (48 mu mole/kg) of (+/-)-alpha-methyltryptamine (AMT) induced a significant and long lasting increase in spontaneous activity in mice. Pretreatment of mice with either pimozide or alpha-methyl-para-tyrosine methyl ester HCl (AMPT) prevented the activity increase induced by AMT. In similar trials, methysergide or para-chlorophenylalanine (PCPA) were also found to antagonize the development of hyperactivity following a standard dose of AMT. The results suggest that both endogenous dopamine and serotonin many participate in the hyperactivity induced by AMT.


Mediation of footshock sensitivity by serotonergic projection to hippocampus. The present experiments assessed the effects of changes in serotonergic function on footshock sensitivity, as determined by a quantified version of the flinch-jump assessment method. In Experiment 1, depletion of telencephalic serotonin by PCPA injection, medial forebrain bundle lesion, or septal lesion, produced increases in reactivity which were correlated with reductions in telencephalic serotonin levels. In all cases, this increased sensitivity was reversed by injections of d, 1-5-hydroxytryptophan (5-HTP) which restored telencephalic serotonin levels to normal. This effect of 5-HTP had not previously been demonstrated in septal lesioned animals, and overall levels of reactivity of septal animals to other stimuli were also reduced by 5-HTP. Experiment 2 tested the effects of hippocampal lesion on the 5-HTP effect in animals when serotonin depletion produced by either PCPA or septal lesion. Hippocampal lesion, while not increasing footshock sensitivity further, significantly attenuated the effectiveness of 5-HTP in restoring sensitivity to normal. The results suggest that hippocampus may be an important site of action of serotonin in modulating reactivity to footshock, and that failure of raphe lesions to increase reactivity may be due to failure to adequately deplete hippocampal serotonin.


[Synthetic inhibitors of serine proteinases. Part 19: On the inhibitory effect of amidinobenzylidene derivatives of benzo-condensed cycloalkanones on trypsin, plasmin and thrombin (author's transl)]. Amidinobenzylidene derivatives of benzo-condensed cycloalkanones proved to be potent competitive inhibitors of thrombin and trypsin. On the contrary, the antiplasmin effect of these derivatives is considerably less marked. The conversion of 3-amidinochalcone to derivatives in which the carbonyl group is incorporated into a ring, does not lead to fundamental changes in the inhibitory effect on trypsin and thrombin, whereas the antiplasmin effect decreases. Compared to 4-amidinochalcone, the 2-(4-amidinobenzylidene) derivatives of indanone-(1) and tetralone-(1) exert a stronger inhibitory effect on trypsin and thrombin. The introduction of a hetero-atom to the cycloalkanone component affected the inhibitory effect on trypsin and thrombin but insignificantly. From these results it is concluded that also in amidinobenzylidene derivatives of benzo-condensed cycloalkanone derivatives, the carbonyl function shares in enzyme-inhibitor binding.


Effects of brain serotonin alterations on hypothermia produced by chlorpromazine in rats. Depressing functional serotonin or depleting serotonin levels in rat brains with either p-chlorophenylalanine, 5,6-dihydroxytryptamine or raphe lesions greatly enhanced hypothermia induced by chloropromazine (CPZ). Depressing the firing of raphe units or decreasing serotonin turnover in the brain with either a serotonin precursor (tryptophan) or the inhibitors of serotonin re-uptake (Lilly 1 10140 and chlorimipramine) also greatly enhanced the CPZ-induced hypothermia. The data indicate that serotonergic activity in the brain plays a role in the elaboration or modulation of CPZ hypothermia.


The "fakeability" of the attitudes toward disabled persons scale: form B. The purpose of this study was to provide evidence for or against the "fakeability" of the Attitudes Toward Disabled Persons Scale: Form B. Form B of the Scale was administered to 25 women, between the ages of 19 and 24, studying at a midwestern university. Seven days later, the subjects retook the test and were instructed to fake their answers so that they would receive a higher score. The difference between the true scores and the fake scores were not found to be significant, and it was concluded that the Attitudes Toward Disabled Persons Scale: Form B is not "fakeable."


Two unusual umbilicoplasties.

Two unusual umbilicoplasties. We describe the creation of an umbilicus where none previously existed, during an abdominoplasty, and the cosmetic shaping of a stretched umbilicus after an umbilical hernia repair.


Interactions among the cannabinoids in the antagonism of the abdominal constriction response in the mouse. The ability of delta 9-tetrahydrocannabinol (THC), cannabinol (CBN), cannabidiol (CBD), 11-OH THC and 8 alpha, 11-diOH THC to antagonise the abdominal constriction response in the mouse induced by formic acid, phenylquinone, 5-hydroxytryptamine, prostaglandin E1 (PGE1) and bradykinin was tested. THC was an effective antagonist against all nociceptive agents with an ED50 in all cases between 1.0 and 2.6 mg/kg. CBN, while also effective against all nociceptive agents, was less potent than THC, with an ED50 range between 46.2 and 112.5 mg/kg. CBD in doses as high as 200 mg/kg was without effect. Using PGE1 as the nociceptive agent, 11-OH THC was equipotent to THC while 8 alpha, 11-diOH THC was inactive. Naloxone, while able to antagonise the antinociceptive effect of morphine against formic acid-induced writhing, did not reverse the antinociceptive effects of THC. There were no pharmacological interactions between THC, CBD and CBN.


Hepatitis-B surface antigen and antibody: prevalence and persistence in institutionalized and noninstitutionalized persons. A total of 426 persons were studied in an attempt to more clearly define the high prevalence of hepatitis-B surface antigen (HBsAg) seen among institutionalized persons. HBsAg was found in 63.4 percent of the children and young adults with Down's syndrome (DS) at the Central Wisconsin Center (CWC) and in 45.5 percent of those at the Northern Wisconsin Center (NWC). Significantly more subjects with DS had hepatitis-B antigenemia than age- and sex-matched non-DS institutionalized subjects. Antibody (anti-HBs) to HBsAg was found in 19.5 percent of the DS subjects at CWC and in 38.6 percent of those at NWC. The prevalence of anti-HBs was similar among DS and non-DS institutionalized subjects. None of the noninstitutionalized subjects had HBsAg in their serums and their anti-HBs prevalence was low (2.1 percent). HBsAg was found to persist for at least 10 years in both DS and non-DS institutionalized subjects. However, persistence occurred more frequently among DS subjects. Anti-HBs persisted at least 10 years among non-DS subjects, but DS subjects tended to lose antibody sooner. The study findings indicated that the high prevalence of HBsAg seen in institutionalized DS subjects at CWC and NWC were not related to the age of the subject at admission nor to the duration of institutionalization.


[Severe fractures of the lower end of the humerus in adults (author's transl)]. The authors have treated sixty six cases of severe comminuted fracture of the lower end of the humerus. Five main types have been distinguished: 1. Supracondylar fractures. 2. T-shaped fractures. 3. Trans-condylar fractures in which the fracture line is distal, detaching only the articular surfaces. 4. Diaphyso-epiphysial fractures. 5. Trans-columnar fractures similar to transcondylar fractures but with additional fractures detaching a fragment of lateral or medial epicondyle and a fracture through the trochlea separating the articular surface into two parts. Fifty-four patients were operated on to apply internal fixation. Analysis of the results based on critical criteria shows 53 p. 100 of satisfactory results. The authors emphasise the frequency and severity of damage to the ulnar nerve. They conclude that the results are better after surgical treatment than with conservative treatment which should be reserved for distal and comminuted fractures. A new type of plate has been designed to be applied and fixed to the lateral aspect of the bone.


[The patello-femoral joint in osteoarthritis of the knee with genu varum (author's transl)]. The authors have treated 63 knees with osteoarthritis associated with varus deformity by valgus osteotomies. The clinical and radiological state of the patello-femoral joints has been studied before and after correction of varus deformity. No correlation was found between the severity of tibio-femoral osteoarthritis and patello-femoral osteoarthritis. Medial patello-femoral discordance was found in 12 p. 100 of the cases. Clinical evidence of pain arising from the patello-femoral joint was more often found than evidence of radiological abnormality. It is concluded that pain arising from the medial compartment may be confused with patellofemoral pain. A five-year follow-up showed that the patello-femoral joint was not influenced radiologically by the valgus osteotomy but patellar pain was improved in most of the cases. Procedures to re-align the patella should not normally be associated with valgus osteotomy in cases in which patellar pain exists in association with osteoarthritis of the knee with varus deformity.


Cimetidine fails to block functional antagonism of carbachol by histamine in rat trachea. Histamine and dimaprit functionally antagonised the ability of carbachol to constrict the rat trachea in the presence of mepyramine. Cimetidine did not block the functional antagonism of histamine or dimaprit for carbachol.


A prospective study of low back pain.

A prospective study of low back pain. Consecutive patients attending hospital for the first time with backache were entered into a prospective study, provided that certain defined causes (infective, neoplastic, metabolic and inflammatory etc.) were not apparent at the first visit. Amongst 188 available for analysis, 65% were discharged and 28% defaulted, together making a total of 93% who 'recovered uneventfully' (in the sense that they were no longer attending hospital) on average in about three months, 4% came to 'myelography' (radiculography using Dimer-X or Amipaque) including 2% to discectomy, 1.5% proved to have treatable underlying diseases accounting for their backache while 1.5% became 'chronic attenders'. Information available at the first visit (patient characteristics, history, examination, radiographs and psychological questionnaire) provided few pointers to what the outcome would be or how long the patient would attend hospital. In particular, routine X-ray examination did not provide clues to any important conditions not already suspected by the clinicians. A case is made for reserving routine radiography for patients who have not recovered within about three months.


[Bacteriophage therapy of septic complications of orthopaedic surgery (author's transl]. Seven septic cases have been treated by bacteriophage; two infections after insertion of  a hip prosthesis, two septic arthritis of the knee, one osteomyelitis of the tibia, one septic non-union of the femur and one septic complication following Harrington rodding. Only specific phages were used in association with several types of surgical procedure. The technique of treatment is described. All cases were long-term infections with resistant organisms. Results were good in five, fair in one and one case was a failure. It is concluded that phage therapy may be helpful in the treatment of long-term infections.


[Mycobacterium fortuitum infection after total hip prosthesis. A report of 3 cases (author's transl)]. The authors have observed three instances of sepsis due to Mycobacterium fortuitum complicating total hip replacement for osteoarthritis. The case histories are fully described. The requirements are given for recognition of the organism which grows on special culture media and which may be mistaken for Mycobacterium tuberculosis. This feature explains why, in some cases, the organism may not be discovered. Antibiotics were ineffective but the general condition of the patient was not greatly affected.


Incidence of post burn hypertensive crisis in patients admitted to two burn centers and a community hospital in the United States. Fortynine patients of 193 admitted (25%) with second and third degree burns to 3 hospitals in different geographical areas of the United States developed a hypertensive crisis within three to four days after admission. The crisis usually lasted from 5 days to about two weeks. Serum sodium levels decreased significantly in hypertensive patients one or two days before the peak of the hypertensive crisis and, in the Center where it was measured, plasma renin activity increased in an opposite trend to the fall of sodium. BUN and creatinine reached their highest levels in hypertensive patients two days after the peak of the crisis. Autopsies were performed on 23 patients who succumbed to the injury: eleven of them (48%) were hypertensive and had marked hypertrophy of left and right heart ventricles and of the adrenal glands when compared to the normotensive burn subjects. The cells of the zona fasciculata and the zona glomerulosa of the adrenal glands were very compact at histologic examination thus suggesting hyperactivity. This data shows that the incidence of hypertension in burn subjects is twice as high as that of the US population. Further studies of the renin-angiotensin-aldosterone system and the adrenal cortical function are indicated by the changes in plasma renin activity and the glandular weight and morphology seen at autopsy.


[Humerus varus congenitus (author's transl)]. Two cases of humerus varus congenitus have been treated by lengthening of the humerus using an external distraction device. The first was lengthened by about 6 centimetres and the second by about four centimetres. In one case, primary bone union was obtained and in the second, secondary grafting had to be done. The clinical results were satisfactory.


Penicillamine in rheumatoid arthritis: adverse effects. The use of penicillamine in rheumatoid arthritis (RA) is limited by the incidence of adverse effects, some of which are potentially hazardous. However, adverse effects are dose-related and the advantages and disadvantages of different fixed and flexible dose regimes are discussed. The incidence of adverse effects is significantly greater in patients previously treated with gold who developed toxicity to that drug--no such increase being found in gold treated patients whose only reason for stopping gold was ineffectiveness. Rashes which develop after several months of treatment are variants of pemphigus and their various presentations are described. Fatal reactions, fortunately rare, are predominantly associated with aplasia of the bone marrow. Monthly haematological checks coupled with meticulous charting of the results may reveal trends as well as numerical changes and serve as an early warning of marrow damage.


[Ununited fractures of the femoral neck treated by cervicocephalic impaction. A report of two cases (author's transl)]. The cases of ununited fracture of the femoral neck, treated by a technique described by Brackett (1927) and modified by Merle d'Aubigné (1968) are reported. The femoral head was partly evacuated, care being taken to preserve its blood supply and then impacted onto the femoral neck. The results were found to be satisfactory.


Hypothesis for the pathogenesis of sodium aurothiomalate (Myocrisin) induced immune complex nephritis. Renal complications associated with gold salt treatment in rheumatoid arthritis occur in fewer than 5% of treated patients. Recent investigations have shown that the renal lesion manifested clinically as membranous glomerulonephritis is caused by immune complexes. This paper presents a hypothesis for the mechanism by which gold causes this lesion: autoimmunization due to released tubular antigen(s). This hypothetical mechanism is strikingly similar to that responsible for autologous autoimmune nephrosis in the rat (Heymann's nephritis).


[Targeted heart fluoroscopy in radiologic and internistic practice]. Fluoroscopic examination of the heart requires a special technique if it is to provide useful diagnostic information. Information can be obtained regarding coronary calcifications, slight enlargement of a heart chamber or great vessel, localization and extension of abnormal contours within the heart shadow, pulsatory phenomena at the heart border or the great vessels, and functional changes of lung structures during respiration. This information may be decisive for the further evaluation or treatment of the patient.


Non-inactivation of an x-chromosome locus in man. Cloned fibroblasts from women heterozygous for X-linked ichthyosis (steroid sulfatase deficiency) were examined to see whether or not this locus is subject to X-inactivation. Of 103 clones examined, all had normal levels of steroid sulfatase activity. Two of the women studied were also heterozygous for glucose-6-phosphate dehydrogenase deficiency. This allowed the demonstration that both X chromosomes were represented as the active X in various clones and that selection did not account for these findings. Thus, the steroid sulfatase locus, like the Xga locus to which it is linked, appears to escape X-inactivation in man.


Chemotherapy of parasitic worms: new biochemical strategies. Many chemotherapeutic agents that are effective against parasitic helminths affect cellular regulatory sites that control motility, metabolism, chemotaxis, and egg formation. Serotonin receptors are present in several species of parasitic flatworms and appear to participate in the regulation of motility and carbohydrate metabolism. In Fasciola hepatica these receptors are coupled to an adenylate cyclase through a cellular component that requires guanosine triphosphate. Serotonin is the most potent indoleamine agonist, while lysergic acid diethylamide and its 2-bromo derivative are the most potent antagonists. These studies are revealing additional sites in trematodes that may be important for the development of new and more selective chemotherapeutic agents.


Exfoliative dermatitis: presenting sign of internal malignancy. Exfoliative dermatitis is most commonly associated with antecedent cutaneous disorders, medications, and lymphoreticular malignancies. Three patients with exfoliative dermatitis associated with internal carcinoma are described. The importance of thorough evaluation of all patients who present with exfoliative dermatitis is stressed.


Complications and follow-up of gastroschisis. Twenty-seven patients with gastroschisis were seen at the Red Cross War Memorial Children's Hospital between 1960 and 1977. Twenty-five children were operated on either by primary closure, by skin closure alone, or by the insertion of a reinforced Silastic pouch or patch. The mortality rate has been reduced from 62% to 33% over the past 6 years. Despite better metabolic and respiratory care and intravenous alimentation, serious complications still occur, particularly when prematurity and associated anomalies such as atresia or meconium ileus exist. Other problems were respiratory complications, ileus, perforation, gangrene, intestinal obstruction, enterocolitis and disaccharide intolerance. The long-term follow-up of some of these patients is described.


[Clinical aspects of the anti-androgens]. The ongoing development and gradual availability of the new anti-androgens hold exciting clinical implications for the future. The biosynthesis and interchangeability of the sex steroids, the roles of the ovaries and adrenals and the value and interpretation of biochemical assays in clinical practice are briefly discussed. Because the anti-androgens are used primarily for seborrhoea/acne/hirsutism/oligomenorrhoea, the pathophysiological basis of this socially debilitating syndrome is discussed. The classification of the anti-androgens, their indications, side-effects, dosage schemes and results of treatment are reviewed. Finally, a summary of a possible clinical management regimen is presented.


Laparoscopy for the general surgeon.

Laparoscopy for the general surgeon. A group of three general surgeons in a small community hospital found laparoscopy and laparascopic tuball ligations to be a valuable addition to their practice. Equipment costs and training costs are not prohibitive for a small hospital. The procedures result in minimal morbidity, and have enhanced treatment of gynecologic problems.


Evaluation of hysterectomized women seen at a clinic for treatment of sexually transmitted diseases. Thirty-one women who had had total hysterectomies, seen in a venereal disease clinic, were interviewed and examined. Thirteen (31%) of the 31 women had acquired one or more venereal infections after hysterectomy. The diseases, listed in order of decreasing frequency, were trichomoniasis (four cases), gonorrhea (three), early latent syphilis (three), vaginal candidiasis (three), secondary syphilis (two), late latent syphilis (two), and condyloma acuminatum (one). These results indicate that clinicians working in venereal disease clinics must maintain as high an index of suspicion of sexually transmissible diseases for women with hysterectomies as for all other women.


Prune belly syndrome and fetal ascites.

Prune belly syndrome and fetal ascites. A case of prune belly syndrome (PBS) in a 22 week male fetus is described. All the features characteristic of the syndrome were present: absence of abdominal muscle; dilatation of the bladder, ureters, and renal pelves; and undescended testes. In addition, there was marked ascites. The rectus abdominis muscles were entirely absent whereas other abdominal muscles were only absent centrally. Between regions of normal and absent musculature muscle fibers were sparse, enlarged, frequently disrupted, and mostly in the myotubule stage. The prostate was thin-walled and its urethra greatly expanded. The testes lay close to the corresponding ureters and each ductus deferens was only partially present. It is considered that prostatic dysgenesis and fetal ascites are key factors in the causation of PBS.


Transplantation in miniature swine. VI. Factors influencing survival of renal allografts. Renal allografts were performed between and among animals from three herds of miniature swine that were selectively inbred to homozygosity at the major histocompatibility complex, MSLA. The results suggest several genetic factors which influence the survival of renal allografts in these animals. As expected, the major histocompatibility complex (MHC) was of dominant importance, and all MSLA-mismatched grafts were rejected promptly (12 +/- 3.7 days). Some MSLA-matched grafts were also rejected (30 +/- 15.0 days), indicating that non-MSLA loci also determine antigens which can lead to kidney rejection. Other MSLA-matched grafts were accepted indefinitely. At least one immune response gene that determined ability to reject kidneys across non-MSLA differences seemed to be segregating in our swine population. Animals that had accepted MSLA-matched renal grafts for extended periods demonstrated markedly prolonged survival of subsequent donor skin grafts compared to skin graft survival across the same non-MSLA difference in normal animals. This finding suggests that failure to reject kidneys across non-MSLA differences indicates systemic tolerance, and that there may be a relationship between the induction of such tolerance and the proposed immune response gene controlling rejection.


Transplantation in miniature swine. VII. Evidence for cellular immune mechanisms in hyperacute rejection of renal alografts. Renal allografts were performed in miniature swine that were identical at their major histocompatibility locus and were presensitized by skin grafts from their prospective renal donors. All of these renal grafts were rejected in a hyperacute or markedly accelerated manner compared to the survival of comparable grafts in nonsensitized animals. Studies directed at the mechanism of this rejection revealed no circulating recipient antidonor antibodies by several serological assays. In contrast, mixed lymphocyte cultures (MLCs) and cell-mediated lympholysis (CML) assays demonstrated marked recipient antidonor lymphocyte reactivity that appeared after skin grafts, diminished during the tenure of the renal graft in the host circulation, and reappeared after removal of the rejected kidney. These results suggest that cellular immune mechanisms may plan a role in the accelerated rejection of major histocompatibility complex (MHC)-identical renal allografts.


Removal of anticomplementary activity from human immune serum globulins by treatment with purified human plasmin. Human immune serum globulin preparations were treated with highly purified human plasmin to remove their anticomplementary activity. The extent of anticomplementary activity removed and the amount of fragmentation obtained from immune serum globulin preparation depended upon the amount of plasmin added and the length of incubation time. The enzymatic reaction was stopped by removing plasmin with bentonite adsorption. Two types of plasmin-treated immune serum globulin that may be used for intravenous injection were obtained. One was a more fragmented product (35 to 45%) with lower anticomplementary activity, the other was a less degraded product (15 to 20%) with slightly higher anticomplementary activity. Antibody content of the former preparation was somewhat reduced while that of the latter preparation was virtually unchanged from the untreated immune serum globulin.


Delayed extrusion of testicular prosthesis. A case of migration and extrusion of a testicular prosthesis with erosion of the fixation tab through the skin is reported. Predisposing factors are discussed. Trimming the corners of the tab prior to fixation is recommended as well as anchoring it firmly to the most dependent portion of the scrotum, using nonabsorbable sutures.


[Surgical tactics in postoperative eventration in children]. As a result of a clinical analysis of 66 observations on eventrations in children, the surgical tactics in this condition is founded. 38 experiments on dogs have shown that the maximal disorders of protein metabolism and transport occur on the 6th to 12th days, that is during the period of formation and maturation of the connective scar. On the grounds of the obtained findings the authors suggest to use wider albumins, plasma and erithrocytic mass for weak patients in preoperative and postoperative management.


Back muscle necrosis of pigs.

Back muscle necrosis of pigs. The clinical signs and pathological features of back muscle necrosis (BMN) in four pigs from three English pig herds were similar to those recorded in pigs from mainland Europe. The observations made support the view that BMN is a special manifestation of the porcine stress syndrome. Diagnosis of acute BMN can be made clinically supported by the analysis of plasma creatine phosphokinase activity and can be confirmed post mortem by macroscopic and microscopic observation on the back muscles.


[Molecular organization of Mg2+, Ca2+-ATPase of sarcoplasmic reticulum]. The article deals with the results of studies on the structure and properties of discrete sites in a molecule of sarcoplasmic reticulum Mg2+, Ca2+-ATPase obtained during its fragmentation in the process of its limited hydrolysis by trypsin. It is established to contain three fragments with the molecular mass of 45 000, 30 000 and 20 000 Daltons. Some properties of these fragments are determined by the amino acid analysis, inhibitory analysis with application of radiactive labels and also of immunochemical analysis. The properties show that the first fragment is hydrophobic and the others are hydrophilic; these properties show that the first fragment is hydrophobic and the others are hydrophilic; these properties determine the location of the fragments in the sarcoplasmic reticulum membrane. The fragment with the molecular mass of 45 000 Daltons forms in it a nonspecific channel as if "sewing" it, two other fragments of the Mg2+, Ca2+-ATPase are located at the outer side of the membrane, the fragment with the molecular weight of 20 000 occupying a middle position between the fragments with molecular weight of 45 000 and 30 000, thus creating a selective respect to calcium "valve" to the nonspecific channel. This discrete part of Mg2+, Ca2+-ATPase possesses the ionophoric activity. The fragment with molecular weight of 30 000 is the energy converter. The site hydrolyzing AMP is located in it. The models (hypothetic) are presented for the Ca2+ active transpprt through biological membranes with Mg2+, Ca2+-ATPase participation.


[Characteristics of human plasminogen activator and of a fraction of fibrinolytically active plasma enriched with this enzyme]. An activator of plasminogen with specific activity 203 AU/mg was isolated from blood plasma with fibrinolytic activity, obtained from blood of suddenly decreased patients. Specific activity of the plasminogen activator exceeded 88-fold the activity of the initial blood plasma. The protein was identified with a glycoprotein, similar to beta-globulin; its molecular weight was 70,000 as shown by gel filtration; the isoelectric point was at pH 6.2. The plasminogen activator remained stable after heating up to 50 degrees. Effects of pH in an incubation media and of cations on the activity of the plasminogen activator were studied. A fraction containing the fibrinolytic activity and enriched with plasminogen activator was obtained from the blood plasma after fractionation at low temperature with ethanol at definite pH value. The specific fibrinolytic activity in the fraction exceeded 17.6-fold the activity of blood plasma. The fraction exhibited high thrombolytic and antithrombin activities in vitro. It was similar to streptase and streptokinase preparations in its throm-bolytic effect. Relative species specificity was found in studies of the fibrinolytic and antithrombin effects of the fraction containing fibrinolytic activity.


[Structural investigations on lipopolysaccharides of mutants S SF 1111 and R 595 SF 1167 of Salmonella minnesota (author's transl)]. The lipolysaccharides of two mutants of Salmonella minnesota with known chemical structure were investigated by X-ray methods. Both thickness of the lipopolysaccharide layer and arrangement of the molecular components could be estimated. Using these informations a space-filling model of the structure was built.


On the dynamic model of tRNA: recent experimental findings. Recent experimental findings are shown to support various aspects of the dynamic model of tRNA proposed earlier and the interaction between tRNA, mRNA and the ribosomal RNA's. Extra loop of tRNA molecule is suggested to play a role in recognizing the corresponding amino acids and a correlation is presented between the tRNA molecules and the corresponding amino acids as tabulated by the genetic tableau.


Electron microscopy of synaptonemal complexes in semithin sections. The technique of osmium tetroxide fixation followed by a treatment with p-phenylenediamine was applied to mouse testes in order to analyze pachytene nuclei. Observation of Epon semithin sections (0.25--0.5 micrometer) in conventional electron microscopy revealed the presence of positively stained synaptonemal complexes surrounded by unstained chromatin. The present results show that by using this method a suitable contrast and resolution can be achieved for semithin sections, which facilitates the topographical study of synaptonemal complexes.


A new mutant affecting aldehyde oxidase in Drosophila melanogaster. A new locus, Aldox-2, which affects the activity and heat stability of aldehyde oxidase in D. melanogaster is described. The Aldox-2 locus is localized to map position 86 on chromosome 2, between c and px. Aldehyde oxidase activity in aldox-2 homozygotes is approximately 25--30% that of the Oregon-R wild-type control strain. The enzyme from the mutant stock is much more heat labile than is the enzyme from the wild-type strain. Both the activity and heat phenotypes are completely recessive.


The molecular weight of rRNA precursor molecules and their processing in higher plant cells. Actively dividing callus cells of higher plants (Petroselinum crispum, Daucus carota, Acer pseudoplatanus) were used to detect the primary gene product of rDNA in vivo. Parsley and carrot cells were labelled with [32P]orthophosphate. Under non-denaturing conditions, in both cases only one high molecular weight rRNA precursor was present on polyacrylamide gels. Its molecular weight did not exceed 2.5 x 10(6) dalton. Under denaturing conditions, 2.0--2.1 x 10(6) dalton were determined on formamide gels. This rRNA precursor was already present after a labelling period of 5--10 min. In parsley cells labelled mature rRNA (25S and 18S) arrived in the cytoplasm 45 min after onset of incubation. In Acer pseudoplatanus incubated with [3H]uridine two rapidly labelled components did emerge from polyacrylamide gels without formamide; their molecular weights were 2.3 and 3.2--3.4 x 10(6) dalton. After electrophoresis in formamide, the larger component disappeared, thus indicating that it would be an intermolecular aggregate of different RNAs. From these results we have no evidence for the existence of rRNA precursors exceeding the molecular weight of 2.5 x 10(6) dalton.


[The inbred mouse strain STU. Development and properties (author's transl)]. The highly inbred STU mouse strain (up to 100 inbred generations) was developed from a German white mouse colony. Its properties are described with special emphasis on the occurrence of tumors, occurrence of C-type oncornaviruses and on its immunological reactivity. The predominant tumor is a fibrosarcoma (approximately 23% incidence).


[Q fever in the Mordvinian ASSR].

[Q fever in the Mordvinian ASSR]. In the serological (CFT) examination of patients with elevated temperature for Q fever positive results were obtained in 8.2--14% of cases. The number of positive results of the CFT in rural districts was higher (16%) than in urban districts (10.2%). A considerable percentage of positive results was observed among the workers of a meat-packing plant (25%) and among persons who regularly received milk at their work as a special diet (25--39.2%). In the Mordovian ASSR the infection seemed to be transmitted mainly by the alimentary and contact ways.


[Social and work rehabilitation of schizophrenics under the shop conditions of an industrial enterprise]. The paper is concerned with the results and effectivity of rehabilitation of 219 schizophrenic patients with unfavourable variants of development, who worked for 1--3 years in shops of an enterprise, intended for promoting the rehabilitative treatment and employment of mental patients. with the use of special rating scales, the efficacy of rehabilitation attained in therapeutic-occupational shops (TOS) and in industrial shops. The study demonstrated that the results of rehabilitation in conditions of a shop are significantly higher than the corresponding indices in conditions of TOS.


The fine structure of denervated and reinnervated muscle spindles: morphometric study of intrafusal muscle fibers. The fine structure of normal, denervated, and reinnervated muscle spindles in lower lumbrical muscles of rats was studied morphometrically at time intervals ranging from 3-14 months. In control spindles, the mean transverse area of mitochondria was estimated to be more than twice as large in nuclear chain than in typical nuclear bag fibers. Following denervation, there was a severe decrease of the mean number and transverse area of mitochondria, and a moderate, but statistically significant decrease of the mean transverse area of intrafusal muscle fibers (IMFs) despite an increase of the number of IMFs. At 12-14 months of reinnervation, changes of the transverse areas of IMFs were statistically insignificant, but the mean values for the mitochondria were incompletely restored. At 4 x 3 months, after fourfold repeated crush injuries to the nerve, most of the values estimated (transverse area of mitochondria; number, shape, and transverse area of IMFs and nuclei) tended to approach those in denervated rather than in reinnervated IMFs. The differences of the reactions of intra- and extrafusal muscle fibers following complete motor and sensory denervation appeared to be in accordance with their normal dimensional dissimilarities.


Serum levels of total dehydroepiandrosterone and total estrone in postmenopausal women with special regard to carcinoma of the uterine corpus. Serum levels of total dehydroepiandrosterone and total estrone were determined in 18 postmenopausal women with carcinoma of the uterine corpus (stage I, grade 1-3) and in 40 healthy postmenopausal women. Elevated levels of both steroids were found in the carcinoma group, for dehydroepiandrosterone 2010+/-195 vs. 1299+/-117 nM, p less than 0.01, and for estrone 2,38+/-0.24 vs. 1.36+/-0.11 nM, p less than 0.001. Dehydroepiandrosterone as well as the precursors of estrone are almost exclusively of adrenal origin in the postmenopausal woman. Thus these findings indicate a role of the adrenal cortex in the etiology of corpus carcinoma, either by providing increased levels of substrate for the peripheral synthesis of estrone or a direct action of adrenal androgens on the endometrial tissue.


Kartagener's syndrome--a reappraisal.

Kartagener's syndrome--a reappraisal. Congenital lack of dynein arms in cilia has recently been associated with Kartagener's syndrome. Ultrastructural findings from six patients with chronic stagnant secretion in the respiratory tract are briefly reported. Only one of the patients had the complete syndrome. The term Immotile-cilia syndrome has been coined, and it is suggested that Kartagener's syndrome should be included in this entity.


Effect of splenic nerve stimulation on the contents of noradrenaline, ATP and sulphomucopolysaccharides in noradrenergic vesicle fractions from the cat spleen. In order to assess the effect of splenic nerve stimulation on the contents of noradrenaline, ATP and 35S-labelled compounds in noradrenergic vesicles from the spleen, experiments were carried out on the cat spleen in situ, its frontal portion being used as control. Particulate fractions containing noradrenergic vesicles were isolated on Ficoll gradient centrifugation of homogenates from both portions of the spleen. The cats received phenoxybenzamine (10 mg/kg) and imipramine (5 mg/kg) to inhibit the contractive response of the spleen to nerve stimulation and the reuptake of noradrenaline (NA) into nerve terminals. Administration of the drugs did not significantly affect the levels of NA, ATP and 35S (presumably in sulphomucopolysaccarides, SMPSs). In response to prolonged stimulation of the splenic nerve a significant loss of NA from noradrenergic vesicles occurred, whereas levels of ATP and 35S-labelled compounds remained unchanged. The results indicate that a discharge of NA in response to nerve stimulation is not accompanied by simultaneous discharge of ATP and SMPSs.


Massive congenital tricuspid insufficiency in the newborn. Three cases of massive congenital tricuspid incompetence in the newborn are reported and discussed from diagnostic, pathologic and etiologic points of view. The diagnosis is important as cases have been reported with spontaneous resolution.


Incarcerated Spigelian hernia: ultrasonic differential diagnosis. The gray scale ultrasonic findings in a case of incarcerated Spigelian hernia are presented. This hernia is uncommon, and the clinical diagnosis can be difficult. The appearance of the lesion is compared with others in and about the abdominal wall, including rectus sheath hematoma, seroma, abscess, peritoneal tumor implants, and pseudocyst at the end of a ventriculoperitoneal shunt. Clinical and sonographic differentiation is emphasized.


Complete occlusion of the left main coronary artery. In this report, we describe the clinical, hemodynamic, and angiographic findings in three patients with atherosclerotic complete occlusion of the left main coronary artery. This rare entity was only seen in three out of 7,000 coronary angiograms. The three patients had extensive right-to-left collateralization. Two patients underwent saphenous vein bypass surgery and are asymptomatic, while the third patient died awaiting surgery. We suggest that patients with complete left main occlusion must undergo surgery as soon as possible.


Noninvasive evaluation of the athletic heart: sprinters versus endurance runners. To evaluate possible differences in the cardiac effects of different types of running training, 22 competing male runners--10 sprinters and 12 endurance runners--were studied with a physical examination, electrocardiography, chest X-ray film and echocardiography. Thirteen sedentary men served as control subjects. There were no differences between the athletic groups in physical findings. However, left ventricular hypertrophy in the electrocardiogram was more apparent in the endurance runners (P less than 0.05), whose relative heart size on chest X-ray examination was also greater than in the sprinters (P less than 0.02). On echocardiography the left ventricular end-diastolic volume was equally greater than normal in both groups of athletes (P less than 0.005), but in the endurance runners the percent chance of the minor axis diameter in systole was greater than in the sprinters or control subjects (P less than 0.02). Values for left ventricular wall thickness and mass were greater than normal in both groups of athletes but were higher in the endurance runners than in the sprinters (P less than 0.001). The left atrial diameter was apparently greater in the endurance runners than in the sprinters or control subjects (P less than 0.001), whereas that of the sprinters did not differ from normal. Thus, intensive sprinter training seems to dilate the left ventricle but causes less increase in wall thickness and mass than training for endurance running and no change in left ventricular function or left atrial size. Endurance running causes left ventricular dilatation equal to that of sprinter training, greater wall hypertrophy and improved systolic emptying of the left ventricle, and it also dilates the left atrium perhaps because of decreased left ventricular compliance.


Abnormal cellular immune responses during acquired zinc deficiency. The cellular immune response of a 17-year-old decerebrate male with acquired zinc deficiency was studied. He had been fed a commercial formula which contained 7.6 mg zinc per kilogram. His caloric intake had been inadequate as judged by his cachexia. A detailed pretreatment nutritional assessment (five separate observations) which included total serum protein and globulins, albumin, folate, vitamins A, B2, C, ceruloplasmin, and plasma zinc, copper, iron, and total iron binding capacity revealed that the patient was deficient only in zinc and calories. His plasma zinc was 41 +/- 5 microgram/d1 compared with our laboratory norm of 89 +/- 9 microgram/d1 for young adult males. Cellular immunity was assessed by delayed skin reactivity to dinitrochlorobenzene and by in vitro lymphocyte transformation studies. Before zinc therapy the patient rendered a negative skin reaction to dinitrochlorobenzene, and the ability of his lymphocytes to undergo blast transformation in response to mitogen stimulation was significantly depressed with a stimulation index of 4.7 +/- 0.8 as compared with 139.1 +/- 77.3  for controls. Within 3 weeks after zinc therapy (22.7 mg zinc per day) he demonstrated a positive delayed skin reaction to dinitrochlorobenzene and a normal lymphocyte response stimulation index = 205.5 +/- 42.6 versus 199.3 +/- 58.2 for control). In addition, a pretreatment facial seborrhea and a decubitus ulcer rapidly healed.


A method for cloning T-lymphocytic precursors in agar. A new technique for the culture of T-lymphocytic colonies is reported. The method may be regarded as a human lymphocyte precursor cell assay, as is the myeloid colony culture for granulocyte-macrophage progenitors. The colonies arise under the simultaneous stimulation of phytohemagglutin and a leukocyte feeder. A linear relationship is found between colony numbers and cell numbers plated. The colonies represent aggregates of lymphoblast-like cells, the majority of which are capable of E-rosette formation, are responsive in mixed lymphocyte cultures, and do not exhibit surface immunoglobulins. Their density distribution profile is very similar to that of myeloid colony-forming cells. The finding that most of these colony-forming cells are recovered in the so-called lymphocyte-free stem cell fraction following density fractionation suggests that they originate from a lymphocytic precursor.


The immune complex pathogenesis of glomerulonephritis and pulmonary vasculitis in Behçet's disease. A kidney and lung biopsy were performed on a patient with active Behçet's disease with renal and pulmonary involvement. Histologic, immunohistochemical and electron microscopic studies of the kidney biopsy specimen revealed a focal segmental necrotizing glomerulonephritis characterized by the presence of numerous subendothelial and occasional intramembranous deposits containing immunoglobulin G (IgG), the third component of complement (C3), the fourth component of complement (C4) and fibrin(ogen). Histologic and immunohistochemical studies of the lung biopsy specimen showed an acute venulitis and septal capillaritis associated with the presence of identical deposits within the walls of affected vessels. Circulating immune complexes were detected in the patient's serum by Raji cell assay. The findings indicate that the glomerulonephritis and pulmonary vasculitis occasionally occurring in Behçet's disease are due to the deposition of circulating antigen-antibody complexes. In addition, they strongly suggest that the majority of the major and minor manifestations of the disease, such as uveitis, cutaneous vasculitis, synovitis and meningoencephalitis, are a result of vascular immune complex deposition.


Calcification of the mitral annulus: etiology, clinical associations, complications and therapy. This report reviews the clinical features of 80 patients with roentgenographically proved mitral annular calcification. The mean age of the group was 73 years, and there was a 2.5 to 1 female to male ratio. Evaluation for underlying cardiovascular disease revealed six patients with severe calcific valvular aortic stenosis; five patients with hypertrophic cardiomyopathy, 11 with mitral prolapse and 33 with significant arterial hypertension (blood pressure greater or equal to 150/96 mm Hg). Eighty-five per cent of the group (68 of 80 patients) had an underlying cardiac disorder associated with either chronically increased left ventricular systolic pressure or abnormal leaflet motion. Other cardiovascular abnormalities occurring as complications secondary to the mitral ring calcification included subacute bacterial endocarditis (three cases), arterial emboli (five episodes) and high grade atrioventricular block (16 cases). Twelve patients had severe mitral regurgitation; successful mitral valve replacement was carried out in four patients (all with myxomatous mitral tissue). Evidence of diffuse conduction system disease, not limited to the area of the cardiac fibrous skeleton, was found frequently (44 patients). Nine patients had sinus node dysfunction and 35 patients had electrocardiographic evidence of distal intraventricular (fascicular) block. Twenty-one patients eventually required pacemakers for management of symptomatic bradyarrhythmias. Atrial fibrillation was present in 23 patients. In this review it was found that calcification of the mitral annulus is frequently associated with or induces serious cardiovascular disease. Since some of these disorders may be modified by appropriate therapy, calcification of the mitral annulus should no longer be ignored as a benign marker of the elderly heart.


Suppression of mixed lymphocyte reaction by progesterone and estradiol-17beta. The effects of estrone, estradiol-17beta, estriol, testosterone, progesterone, and 20alpha-dihydroprogesterone on incorporation of 3H-thymidine into cultured lymphocytes from normal men and nonpregnant women in response to allogeneic stimulation was investigated with two-way MLR. A dose-dependent reduction in the mean percent incorporation was observed in the range of progesterone concentration between 2 x 10(3) and 10(4) ng/ml with statistically significant differences from the control cultures. Estradiol-17 beta at 10(4) ng/ml produced a slight but significant inhibition of incorporation. No significant change in incorporation occurred with the other steroids tested. Since the suppressive property of progesterone in phytohemagglutinin-induced lymphocyte culture reported in our previous communication was reproduced by the present investigation in MLR, the possible role of progesterone in immunoregulation during pregnancy is emphasized as has been postulated previously.


The dehydroepiandrosterone loading test. III. A possible placental function test. The dehydroepiandrosterone loading test (DLT) has been used in a small population of normal and high-risk obstetric patients, to date, in an attempt to develop a dynamic test of placental function. In spite of its limited applications, it has shown reliability in discriminating, with statistical significance, between high-risk pregnancies that result in normally grown, undistressed infants, and high-risk pregnancies that result in infants showing signs of placental insufficiency. The present report expands the study population by presenting our data on 40 loading tests performed in 37 high-risk and normal obstetric patients. Results of 19 of these DLT's have been previously reported and are included herein for statistical analysis. The DLT utilizes an excess substrate load of dehydroepiandrosterone to assess the maximum capability of the placenta to convert it to estrogen. Although our previous report did not show false positive or negative results in the conversion rates, the present results (40 DLT's) found two (2 out of 17) false positives (12%) and two (2 out of 19) false negatives (11%). The highly significant correlation between DLT result and pregnancy outcome seen previously was preserved. In addition, the data of another five DLT's in four patients are presented. This group includes a pregnancy with a fetus with multiple congenital malformations, two patients with intrauterine fetal death, and a nonpregnant woman. The results are not included in the statistical analysis, but discussion of these results has interesting pathophysiologic implications.


Delay in growth and the development of nephritis in rats treated with interferon preparations in the neonatal period. Suckling rats were injected for 14 to 17 days with potent rat-cell-culture interferon preparations or various heterologous interferon or control preparations. Only treatment with rat interferon resulted in a delay in growth and maturation of different organs and the subsequent development of an "immune complex" type nephritis. Thus, 38 of 43 rats treated with rat interferon developed a severe glomerulonephritis. Thus, 38 of 43 rats treated with rat interferon developed a severe glomerulonephritis, whereas only 3 of 99 rats in the various control groups had minimal renal lesions. Deposits of IgG and C3 along the glomerular basement membrane were only seen in interferon-treated rats.


Patterns of neuromuscular disease. As related to stages of normal embryogenesis in voluntary muscle. Skeletal muscle samples from the upper and lower extremities of 38 human fetuses (6 to 18 weeks' gestation) of both sexes were studied by histologic, histochemical, and electron microscopic methods. Ultrastructural morphometry was applied. In the different stages of normal development are found regressive changes, ranging from reversible dystrophic to irreversible necrotic alterations, which are characteristic of either primary myogenic myopathies or primary neurogenic muscle atrophies in older age. Several pathologic patterns of so-called congenital myopathies also presented. On the basis of their findings, the authors conclude that in a certain group of congenital myopathies full normal development of muscle is hindered or blocked and that groups of muscles or the whole voluntary musculature is arrested at certain stages of maturation. For example, insufficient or absent innervation of the fetal muscle may be a factor in Werdnig-Hoffmann or Kugelberg-Welander syndromes. The authors' findings suggest that pathologic patterns in muscle diseases have been used physiologically in fetal development to eliminate unnecessary overproduction of muscle fibers.


Character disorders in traumatized and handicapped children. Character disorders in children may arise from abuse or neglect by the family or from stresses of the broader social environment. Physically handicapped and mentally retarded children have innate disabilities that predispose them to problematic interaction with their surroundings. Early professional multidisciplinary intervention can often avert future psychopathy.


Diocytophymatid larval nematode in a subcutaneous nodule from man in California. A nematode in a subcutaneous nodule excised from the chest of a man in central California is described and identified as a third-stage larval dioctophymatid, probably Dioctophyma renale, though a Eustrongylides species could not be excluded. In all well-documented previously reported cases of D. renale infection in man, none of which was from North America, adult worms were discovered in the kidney at autopsy (5 cases), or were observed migrating or being expelled through the urethra (6 cases), discharged through the skin over an abscessed kidney (1 case), or detected by finding eggs in the urine (1 case).


Laparoscopy in routine and emergency surgery: experience with 1,720 cases. Experience with laparoscopy in 1,720 cases performed for surgical diseases with elective or emergency indications is reported. It is hoped that laparoscopy, a simple and harmless technic of great diagnostic value, will be employed more frequently in routine and emergency surgery.


Daily activity of Tabanidae in the Caucasus. The daily activity of Tabanidae (Diptera) was studied in the submountain region of the East Caucasus, district Ismailly, NE Azerbaijan SSR at an altitude 900--1000 m. Tabanidae were collected by the unbaited canopy trap on 8 and 12 July 1976. Females were active from 9 a. m. to 7 p. m., the diurnal biting activity is characterized by a one peak curve with a conspicuous peak of activity between 4 p. m. and 6 p. m. It is suggested that the temperature, relative humidity and the thermic mountain wind are the decisive factors influencing the late afternoon peak of activity. Mating activity of Tabanus unifasciatus at sunrise and of Philipomyia aprica at sunset were observed.


Corneal manifestations of the systemic mucopolysaccharidoses. Newer biochemical understanding of the mucopolysaccharidoses now allows a better classification of these diseases. The dermatan and keratan sulfate-storing diseases have corneal clouding. The heparan sulfate-storing diseases have retinal changes and usually central nervous system manifestations.


Evidence for the subcellular localization and specificity of chlordane inhibition in the marine bacterium Aeromonas proteolytica. Sublethal levels (10 to 100 micrograms/ml) of the chlorinated insecticide chlordane (1,2,4,5,6,7,8,8-octachloro-3a,4,7,7a-tetrahydro-4,7-methanoindan) were introduced into the growth medium of the marine bacterium, Aeromonas proteolytica. Chlordane inhibited the synthesis of an extracellular endopeptidase by almost 40% but exhibited no such inhibition of the extracellular aminopeptidase also produced during the growth cycle. Studied with 14C-labeled chlordane demonstrated that the insecticide was not biologically degraded under the test conditions used and that up to 75% of the recoverable chlordane was cell associated within 48 h. Studied with uniformly labeled L[14C]valine and [2-14C]uracil established that neither the transport nor the incorporation of these protein and ribonucleic acid precursors was inhibited by chlordane. Separation of the membrane fractions using isopycnic centrifugation localized 14C-labeled chlordane in the cytoplasmic membrane. Also, chlordane inhibited the membrane-bound adenosine 5'-triphosphatase while the soluble (released) form of this enzyme remained unaffected. These data indicate that chlordane resides in the cytoplasmic membrane and may cause specific alterations in membrane-associated activities.


Extended clinical use of the argon laser for cutaneous lesions. A safe, easy, and effective outpatient modality for the treatment of various cutaneous lesions such as hemangiomas and decorative tattoos has long been sought. The argon laser has proved satisfactory for such treatment of port-wine hemangiomas, capillary/cavernous hemangiomas, telangiectasia, and decorative tattoos as well as a variety of cutaneous pigmented lesions. The intense laser light is attracted and absorbed by pigmented skin lesions producing heat that selectively destroys the intradermal pathologic condition and spares overlying skin. Hemangiomas and tattoos have undergone satisfactory subtotal blanching in the majority of cases with a low incidence of hypertrophic scarring. Thus, the argon laser has proved useful in the outpatient treatment of a variety of pigmented cutaneous lesions.


Hypopigmentation in alopecia mucinosa.

Hypopigmentation in alopecia mucinosa. Alopecia mucinosa was found in the hypopigmented skin of two black patients. Alopecia mucinosa should be included in the differential diagnosis of hypopigmented papular skin lesions.


Erythema multiforme and urticaria. Eruptions induced by chemically related ophthalmic anticholinergic agents. Erythema multiforme developed in an 80-year-old man following the use of scopolamine hydrobromide ophthalmic drops. The erythema multiforme cleared when the medication was discontinued and recurred on challenge. Later, he was given tropicamide, an anticholinergic ophthalmic preparation that, like scopolamine, has a tropic acid residue. Within 15 minutes an immediate hypersensitivity reaction with generalized urticaria developed in the patient.


Acropustulosis of infancy.

Acropustulosis of infancy. Acropustulosis of infancy (Al) is a syndrome consisting of pruritic pustules that are found primarily on the extremities of infants. It is uncommon, but not rare, and persists about two years. In two infants in whom Al began at birth, there was a striking response to sulfones. There was no response to other therapy. Laboratory findings are not diagnostic for Al. Similar histopathologic changes (subcorneal pustules) can be found in other eruptions of infancy.


Postoperative alterations in size of Dacron aortic grafts: an ultrasonic evaluation. Reports of aneurysmal dilatation involving Dacron aortic prostheses have raised questions concerning the incidence, degree and significance of postoperative alterations in graft size. Consequently, a study was undertaken to evaluate Dacron graft size by ultrasooud in 95 asymptomatic patients selected at random after aortic surgery. A Vidison Real Time ultrasound unit was used to determine the internal diameter of the aortic portion of the various grafts utilized: 41 Cooley knitted, 25 Vasculour-D; 13 U.S.C.I. ultralightweight; nine Wesolowski Weavenit; and seven DeBakey standard weight knitted. Patients were studied at from two weeks to 138 months postoperatively (average of 33 months). Hypertension was present in 64% of patients. In the total series, the degree of mean dilatation was 17.6%. Average dilatation in patients with normotension was 15% compared to 21% in hypertensive patients. Graphic analysis of the data collected indicated that dilatation of a significant degree occurs in the immediate postoperative period and slowly increases with time; the time regression period and slowly increases with time; the time regression lines for normotensive and hypertensive patients were almost parallel. Results of this clinical study appear to corroborate the results of in vitro quality control tests performed by two graft manufacturers (Meadox and U.S.C.I.).


Myocardial hypertrophy: the distribution of cell growth within the layers of the myocardium. The spatial distribution of radioactively labeled microspheres was studied in normal and in experimentally hypertrophied hearts of adult pigs. The hearts had been "tagged" with microspheres when the pigs were young. When the adult animal was killed, the spatial distribution of the microspheres was identical in the normal and in the hypertrophied hearts. This demonstrates that hypertrophic growth had occurred evenly throughout all layers of the myocardium.


Graft hemostasis: an alternative to preclotting. An alternative to preclotting prosthetic grafts has proved to be simple, safe, and effective in the already heparinized patient. The prosthetic graft or patch is soaked in the patient's blood obtained after systemic heparinization, autoclaved for three minutes at 131 degrees C (270 degrees F), and then inserted.


Pulsatile perfusion: its effects on blood flow distribution in hypertrophied hearts. Left ventricular hypertrophy was created in 15 pigs by banding the ascending aorta when they were young. The adult animals were placed on normothermic cardiopulmonary bypass and perfused with either nonpulsatile (two groups of pigs) or pulsatile (one group) flows. As long as the perfusion rate was maintained at 70 ml/kg/min, myocardial blood flow distribution as determined by radioactive microspheres, was identical in the hearts with normal sinus rhythm and those with ventricular fibrillation irrespective of the type of perfusion. At low flow rates, however, subendocardial ischemia developed in all three groups, but was most severe in the fibrillating hearts, and was not reversed by pulsatile perfusion.


Predetermined time standards: their application in workshop settings. There is a need for a simple, quickly applied tool which can correlate performance of the handicapped individual with that of the able-bodied worker and be easily utilized by nontechnical personnel. Efforts at both the Cerebral Palsy Center and the Rehabilitation Center in Atlanta demonstrated that the third generation of Methods-Time-Measurement (MTM-3) satisfies these criteria. As every motion involved in an operation is detailed and a corresponding time value applied, the over-all result reflects a normal rate of accomplishment more accurately than the usual methods and is especially useful in bidding jobs for the workshop. MTM-3 also has a place in the evaluation section to verify or correct existing standards on bench-type work samples and to develop more meaningful time distribution charts relating to a specific population at a center. In studies of disabled individuals, MTM-3 yields a more accurate determination of the actual degree of disability than the American Medical Association's existing estimated percentages in regard to motor skills.


Attitudes of college students toward sexual behavior of disabled persons. Empirical data on attitudes toward sexual behavior of disabled persons were gathered from a written, sentence-completion task in which 110 college students engaged. The task consisted of 36 sentence stubs, 18 of which probed attitudes toward sex. To facilitate expression of attitudes rather than values, respondents were instructed to respond rapidly with the first thoughts that came to mind. Responses were scored as positive or negative. Negative responders took significantly less time to complete the sentences than did positive responders. The X2 comparisons of negative responses to 5 pairs of parallel sentence stubs concerned with aspects of sex in general and the same aspects of sex in disabled women yielded statistically significant differences. Four of those differences showed more disapproval of sex for the disabled than for the able-bodied. The 5th difference indicated greater tolerance of homosexual play among disabled girls. On 9 of the 13 sentence stubs concerned with sex and disability, at least 43% of all participants gave negative responses. Similarly, order analysis disclosed that 9 of 10 aspects of sex viewed most negatively were related to sexual behavior by the disabled. It was concluded that attitudes in the sexual revolution have not as yet embraced the disabled even among college students.


A driver training program for the disabled. This is a report of results of a driver training program for a selected group of disabled individuals at the Long Beach Veterans Administration Medical Center. A total of 167 eligible candidates elected to enter our driver training program, of whom 154 (92%) were successful. Dropouts were the result of educational deficiencies, physical inability, and/or stress in performance ability.


Seeding endothelium onto canine arterial prostheses. The effects of graft design. To identify prosthetic characteristics that support the proliferation of an endothelial lining, 14 different graft designs were studied in dogs. The grafts were prepared by the use of a technique of endothelial seeding that we described previously. They were studied two and four weeks after their implantation. Weft-knit Dacron grafts (water porosity from 1,400 to 1,650 mL/min/sq cm) were the most successful. A velour index (velour stitch frequency times velour loop height) was computed. When the internal velour index (IVI) was greater than 60,000 loop-mu/sq cm, the percentage of clot-free surface was 17.2 +/- 14.5%, compared with 62.0 +/- 26.9% when the IVI less than 60,000 loop-mu/sq cm. Endothelium could be detected on 61.5% of the grafts when the IVI less than 60,00 loop-mu/sq cm, compared with 0% when the IVI greater than 60,000 loop-mu/sq cm. The cells that formed the outer capsule were better organized and more adherent to the graft when an external velour was present, but external velour did not affect the inner lining. We conclude that weft-knit Dacron grafts with water porosities from 1,400 to 1,650 mL/min/sq cm and with limited internal velour (IVI less than 60,000 loop-mu/sq cm) are suitable substrates for single-staged endothelial-cell seeding.


Current arterial prostheses. Experimental evaluation by implantation in the carotid and circumflex coronary arteries of the dog. Five types of 4-mm diameter arterial prostheses (three Dacron, one expanded Teflon, one preserved umbilical vein) were studied in the dog to assess graft thrombogenicity. Separate experiments involving six hours of controlled blood flow, one-week carotid implantation, and aortocoronary implantation were performed. In general, graft thrombogenicity derived from controlled flow study was more predictive of a graft's long-term implantation success than were one-week implantation results. In order of increasing thrombogenicity, we ranked grafts studied as follows: noncrimped Dacron, expanded Teflon, crimped Dacron, umbilical vein. Results of 19 experimental left coronary artery implantations using Dacron or Teflon prostheses are reported that indicate grafts with low measured thrombogenicity are most likely to succeed in this site. Data presented in this report suggest there is reason to evaluate noncrimped, kink-resistant, porous Dacron grafts for use both in the left coronary artery and below the knee when there is compelling clinical indication and no autogenous vessels are available.


Ureteral obstruction secondary to bifurcated aortic grafts. We report three cases of ureteral obstruction producing hydronephrosis following aortofemoral bypass graft. In each case, the obstruction occurred in the area where in the ureter crossed over the limb of a Dacron graft. Ureterolysis relieved the obstruction. Most of the previously reported cases of this complication of bypass surgery occurred when the ureter was situated between the limb of a graft and the patient's own iliac artery. Various methods of surgical appraoch are listed. In some cases, ureterolysis is a suitable alternative to division and reanastomosis of the ureter to relieve obstruction.


Sedative effects of apomorphine in an animal model of Huntington's disease. The sedative effectiveness of apomorphine in a newly developed animal model of Huntington's disease was examined. The motor responses of rats with kainic acid lesions of the neostriatum to a sedative dose of apomorphine (50 micrograms/kg) was similar to that observed in intact controls. In contrast, compared to controls, a marked potentiation of the motor stimulant effects of dextroamphetamine was confirmed in the kainic acid-lesioned group. We suggest that the pathological changes underlying the symptoms observed in this animal model and in Huntington's disease do not include abnormalities in presynaptic dopamine receptors in the neostriatum.


Changes in the immunoglobulin levels of the mouse gut and serum during conventionalisation and following administration of Salmonella typhimurium. Increasess in all immunoglobulin classes, except IgM, were observed in the sera of specific pathogen-free (SPF) mice beginning 10 days after their removal from barrier conditions. Concentrations of serum immunoglobulins, comparable with those of conventional mice, were obtained in these animals between 21 and 35 days. Following the removal of germ-free mice from their sterile isolaters, their intestinal IgA levels increased over 35 days to attain levels found in conventional animals. A marked increase in serum immunoglobulin occurred within one day following intravenous administration of live Salmonella typhimurium organisms to SPF animals, and this persisted for longer than 7 weeks (the duration of the study), This rapid elevation in serum immunoglobulin was not elicited by nonbacterial antigens, killed Salmonellae, or viable Vibrio cholerae. Negligible amounts of this immunoglobulin increase could be attributed to specific antibody.


Serum immune complexes and disease.

Serum immune complexes and disease. The solid phase Clq radioimmunoassay was used to detect immune complexes in sera from patients with systemic lupus erythematosus (14/25), rheumatoid arthritis (4/5), vasculitis (5/15), infective endocarditis (2/2), acute rheumatic fever (2/3), pre-eclamptic toxaemia (0/14), lung cancer (3/7), glomerulonephritis (26/98) and renal transplant patients (0/5). The best correlation with disease activity was seen in systemic lupus erythematosus and infective endocarditis where serial immune complex determinations were clearly of value in monitoring therapy. The findings in primary glomerulonephritis indicate only a limited usefulness of the assay in that serum immune complexes were detected in a minority (22/73) of patients with glomerular immune deposits. In particular the data do not support a role for Clq fixing immune complexes in the pathogenesis of membranous glomerulonephritis or in pre-eclamptic toxaemia.


Studies of immune functions of patients with systemic lupus erythematosus. In normal individuals T cells are stimulated to proliferate by autologous non-T cells; this is called the autologous mixed lymphocyte reaction (MLR). Previous studies demonstrated that such an autologous MLR was markedly impaired in patients with active systemic lupus erythematosus (SLE). To determine whether the defect resided in the responding cell or the stimulating cell, mixing experiments were performed using cells from identical twins. We identified two sets of identical twins discordant for SLE activity and correspondingly discordant in their degree of responsiveness in the autologous MLR. Reciprocal mixing experiments were performed in which T cells from one twin of each pair were mixed with non-T cells from the other twin of that pair. These studies indicated that patients with active SLE have a defect in the ability of non-T cells to stimulate as well as a defect in the ability of both Tgamma and Tnongamma cells to respond in the autologous MLR. Patients with inactive SLE have a defect only in responsiveness of Tgamma cells.


Hair casts.

Hair casts. The literature on hair casts suggests they are rare even though Kligman intimated in 1957 that in some scalp diseases they might well be common. In this study, casts have been looked for in a group of orthokeratotic and parakeratotic scalp conditions. Hair casts are indeed common in psoriasis, pityriasis amiantacea, pityriasis capitis and seborrhoeic dermatitis. No casts were seen in women with traction hair styles or in those regularly using hair sprays.


Contact dermatitis and gastrointestinal symptoms from hydroxyethylmethacrylate. A laboratory technician developed allergic contact dermatitis to hydroxyethylmethacrylate associated with nausea, diarrhoea and persistent paresthesiae of the fingertips. The gastrointestinal symptoms were reproduced by patch testing. Hydroxyethylmethacrylate was demonstrated to pass through vinyl gloves. Cross reactions occurred to methyl-, ethyl-, propyl- and isopropylmethacrylate but not to butyl- or isobutylmethacrylate.


Properties of ATP-induced chlorophyll luminescence in chloroplasts. 1. The recently described reaction of ATP-induced luminescence is analyzed for its relation to other ATP-induced reactions such as ATP-driven transmembrane proton gradient formation and ATP-driven reverse electron flow. 2. In the absence of phenazine methosulfate ATP-induced luminescence is optimal while the main phase of ATP-driven reverse electron flow is eliminated. 3. DCMU which by itself causes a much smaller luminescence, inhibits the ATP-induced luminescence. 4. Nigericin plus valinomycin, but not each by itself, fully inhibit the ATP-induced luminescence. 5. The observations are interpreted as indicating that ATP stimulates luminescence by a 2-fold mechanism: (a) increasing the amount of the reducing primary electron acceptor of Photosystem II, Q, and (b) creating a transmembrane electrochemical potential which serves to decrease the activation energy required for the charge recombination reaction which leads to luminescence.


Solubility characteristics of Micrococcus lysodeikticus membrane components in detergents and chaotropic salts analyzed by immunoelectrophoresis. In order to evalute the effectiveness and selectivity of various reagents in the solubilization of bacterial membranes, membranes of Micrococcus lysodeikticus were treated with detergents and chaotropic agents. The composition of the extracts so obtained was analyzed by rocket and two-dimensional immunoelectrophoretic techniques. Recoveery of succinate-, malate-, and reduced nicotinamide adenine dinucleotide- (NADH) dehydrogenases, ATPase, succinylated lipomannan and cytochromes in the extracts was measured. Treatment with a variety of non-denaturing detergents produced extracts that were generally qualitatively uniform although quantitative differences were observed. The degree of extraction of various components was correlated with the hydrophile-lipophile balance. Several chaotropic agents were also evaluated as reagents for membrane solubilization. These agents were less effective in extraction of bulk protein, but produced extracts enriched in some membrane components.


Ca2+-dependent ATPase activity of alveolar macrophage plasma membrane. A plasma membrane fraction was isolated from lysates of Bacillus Calmette-Guérin-induced alveolar macrophages of rabbit. On the basis of morphological and biochemical criteria this fraction appeared to be minimally contaminated by other subcellular organelles. Concentrations of Ca2+, but not of Mg2+, from 6.10(-8) to 1.10(-5) M markedly stimulated the basal ATPase (EC 3.6.1.3) activity of the plasma membrane, with an apparent Km (Ca2+) of 1.10(-6) M. The specific activity of the Ca2+-ATPase assayed at pCa = 5.5 was enriched about 8-fold in the plasma membrane fraction over the macrophage lysate. In contrast, the specific activity of the K+, EDTA-activated ATPase, associated to macrophage myosin, increased only 1.3-fold. Oligomycin and -SH group reagents exerted no influence on the Ca2+-ATPase activity, which was on the contrary inhibited by detergents such as Triton X-100 and deoxycholate. The activity of the Ca2+-ATPase was maximal at pH 7, and was decreased by 50 mM Na+ and 5 mM K+. On the contrary, the activity of Mg2+-ATPase, also present in the plasma membrane fraction, had a peak at about pH 7.8, and was stimulated by Na+ plus K+. On account of its properties, it is suggested that the Ca2+-ATPase is a component of the plasma membrane of the alveolar macrophage, and that its function may be that of participating in the maintenance of low free Ca2+ concentrations in the macrophage cytosol.


Purification of the arom multienzyme aggregate from Euglena gracilis. The arom multienzyme complex that catalyzes steps two through six in the prechorismate polyaromatic amino acid biosynthetic pathway has been purified up to 2000-fold from Euglena gracilis. The native arom aggregate has a molecular weight of approx. 249 000 based on a sedimentation coefficient of 9.5 and Stokes radius of 60 angstrom. A comparison between the arom aggregates of Neurospora crassa and Euglena gracilis and the possible phylogenetic relationships between the organisms are discussed.


Enzymatic activities and ATP-induced fluorescence enhancement of myosin from fast and slow skeletal and cardiac muscles. The maximal ATP-induced enhancement of fluorescence and the dependence of this enhancement on ATP concentration were determined for myosins from fast and slow skeletal and cardiac muscle of the rabbit. With myosins from slow and cardiac muscle modifications in the preparative procedure and chromatography on DEAE-Sephadex were required to obtain preprations which were free of actin, which exhibited the maximal fluorescence enhancement and which bound two moles of ATP per mole of myosin. Since the fluorescence enhancement of cardiac and slow muscle myosins is labile at slightly alkaline pH, it was also necessary to minimize incubation at pH greater than 7 in order to attain the maximal enhancement. With fast muscle myosin the changes in preparative procedure, together with chromatography, led to a 50 to 100% increase in the steady-state rate of ATP hydrolysis and fluorescence enhancement, without changing the maximal binding of ATP. From a comparison of the rate of steady-state hydrolysis of ATP with the rate of decay of the enhanced fluorescence, it appears that for all three myosins, both ATP binding sites have the same enzymatic activity, the steady-state rate per site being slower for cardiac and slow muscle myosins than for fast muscle myosin.


Protein-protein interactions of proteolytic fragments of actin. Proteolytic fragments of actin, prepared by removal of up to sixty-eight residues from the N-terminal end of the molecule, can form filamentous structures after denaturation in urea solution. The filaments have a diameter similar to F-actin filaments and interact with myosin and tropomyosin. A fragment comprising residues 1 to 207 of the actin sequence did not form filaments or interact with myosin after the urea treatment.


Studies of dynein from Tetrahymena cilia using agarose polyacrylamide gel electrophoresis. Described in this report is an application of agarose-polyacrylamide gel electrophoresis, which separates protein components of crude dynein fraction (Fraction I by Gibbons) derived from Tetrahymena cilia. By this method, the fraction was separated into three protein components (designated as bands I, II and III) on the gel. When the gel was actively stained for dynein ATPase, a single band appeared, which coincided with the position of band I. A purified dynein prepared by controlled pore glass (CPG-10) column chromatography and followed by Biogel A-15m filtration showed one band on the gel at the same position as band I. These results suggest that among these three protein components, band I represents dynein and bands II and III are derived form non-ATPase protein. 'Burstic phenomenon' was also observed on their ATPase activity when axoneme or crude dynein fractions were used for ATPase assay, while the phenomenon was almost extinguished when partially purified dynein after controlled pore glass column chromatography was used as sample.