[The haemodynamic effects of dobutamine and dopamine in patients with coronary artery disease. A study performed under general anaesthesia (author's transl)]. The haemodynamic effects of dobutamine (2 microgram/kg . min and 4 microgram/kg . min) and dopamine (4 microgram/kg . min and 8 microgram/kg . min) were studied in 17 patients with coronary artery disease prior to coronary bypass surgery. The study was performed under general anaesthesia (modified neurolept analgesia) and controlled ventilation. Dopamine improved cardiac index significantly, increased mean aortic pressure slightly while heart rate and total peripheral resistance remained unchanged. Dobutamine failed to increase cardiac and stroke index significantly, but increased mean aortic pressure distinctly due to an elevated total peripheral resistance. Both catecholamines increased left ventricular filling and mean pulmonary artery pressure. The HR x ASP-product which is closely related to left ventricular oxygen consumption was found to be augmented to a greater extent during dobutamine. For the above reasons dopamine should be favoured for increasing cardiac output in patients undergoing aortocoronary bypass surgery. Our study does not confirm earlier results which have shown dobutamine to be the preferable catecholamine. The possible reasons for this discrepancy are discussed.


The lymphocyte response to influenza in humans. Enumeration of total lymphocytes and T, B, and null lymphocyte subpopulations in peripheral blood of normal volunteers was performed before and at intervals after inoculation with type A influenza virus. Volunteers who subsequently developed infection and illness had larger T-cell counts before inoculation and exhibited an increased number of B lymphocytes during the incubation period and a decrease in all subpopulations during illness, although the greatest decrease occurred in T cells. A decrease in B-cell counts occurred on day 3 in volunteers who exhibited infection, but no illness and no changes occurred in uninfected, well volunteers. Values had returned to baseline by day 21 after inoculation. Thus, the lymphopenia that accompanies influenza involves all subpopulations, but is primarily a decrease in T cells; in addition, differences in T-cell and B-cell populations before and during the incubation period may identify persons who will subsequently develop febrile influenza.


Incidence of gastric lesions in patients with rheumatic disease on chronic aspirin therapy. Endoscopy was done in 82 patients with rheumatic disease who were receiving chronic aspirin therapy. Fifty-eight patients were taking at least eight aspirin tablets daily for 3 or more months; 24 patients were taking, in addition to the aspirin, a maximum of one other antiinflammatory, nonsteroidal medication. Endoscopy in 45 normal subjects not taking aspirin showed no ulcers or erosions and a 4% incidence of gastric erythema. In the 82 patients with rheumatic disease, 14 (17%) had gastric ulcers, 33 (40%) had gastric erosions, and 62 (76%) had gastric erythema. Regular aspirin and buffered aspirin users had an ulcer incidence of 23% and 31% respectively, compared with a 6% incidence in enteric-coated aspirin users (P less than 0.05). One third of all patients with gastric ulcer had no gastrointestinal symptoms. Patients taking chronic aspirin therapy for rheumatic diseases have a higher than suspected incidence of gastric ulcer and erosions. Gastric ulcer may exist without symptoms in such patients.


The polyglandular failure syndrome: disease inheritance, HLA type, and immune function. The occurrence of disease and the inheritance of histocompatibility leukocyte antigens (HLA) were evaluated in 11 patients with the polyglandular failure syndrome and 42 of their relatives. The gene frequency of the HLA-B8 allele (seven of 22) and the HLA-A1, B8 haplotype phenotype frequency (five of 11) were increased in patients with polyglandular failure as compared with a control population. Eleven of 42 relatives had a polyglandular failure illness. Disease prevalence correlated with HLA inheritance in some families, but not all. Patients and diseased relatives had a high incidenceof immunologic dysfunction: autoantibodies, including antinuclear antibodies; elevated serum immunoglobulins (three of 16); abnormal skin tests (four of nine). Polyglandular failure appears to be an HLA-B8-associated syndrome with a high prevalence of disease in relatives. Immunologic dysfunction resulting from a gene(s) on chromosome 6, in linkage dysequilibrium with the HLA-B8 allele, may be a factor in the pathogenesis of polyglandular failure illnesses.


Lens dislocation after strabismus surgery. A case of lens dislocation complicating strabismus surgery is described. This complication following scleral perforation is extremely rare. The lens dislocation occurred in the direction of the connective tissue overlying the perforation site to which multiple cryoapplications had been made. Irrigation and aspiration of the clear lens followed by discission of the lens capsule was necessary because of progressive lens dislocation resulting in profound amblyopia. Accurate aphakic optical correction of the involved eye combined with vigorous occlusion of the fellow eye resulted in excellent visual acuity for both eyes. Cosmetic strabismus surgery was then performed. Continued intermittent occlusion of the fellow eye, combined with continued constant aphakic optical correction of the affected eye will be required. The affected eye will be carefully followed for the long-term complication of retinal detachment associated with connective tissue traction.


[Principles and elaboration of a vestibular rehabilitation technic, vestibular habituation training]. In the scope of the treatment of some vertiginous patients, the vestibular habituation training has to be considered as a valuable technique, superior to the merely medical treatment by drugs. Bsed on the fundamental principles of the vestibular physiopathology, its aim is to favour the compensatory and adaptive functions of the vestibular regulation centres in case of a peripheral dysfunction, either a unilateral hypofunction or some type of paroxysmal positional vertigo. The repeating of the provoking manoeuvres results in a habituation effect, so that the centres accept this abnormal stimulation pattern and are able to transform it in an equilibrated elaboration of the reflexes. In this way, every dizzy sensation can be abolished. So each case presenting provoked dizziness, either on the base of unilateral vestibular hypofunction, or as a typical paroxysmal positional vertigo, can be treated in this way. The patients are selected by anamnesis and thorough functional evaluation with search for positional nystagmus, caloric and rotation tests, recorded by E.N.G. Afterwards movements and positions provoking dizziness are tested in a practical way, leading to a selection of movements which are used in order to compose the treatment schedule. This test battery permits also to realize a close and precise follow-up of these patients, besides the classical clinical and E.N.G. evaluations. A preliminary report of 62 cases is presented. We found a positive result in more than 2/3 of the cases after 2 months. This technique being subject of further intensive investigations in our department, we make reservations as to future changes in the technique and procedures presented in this study. We would like to emphasize this treatment has to be integrated in a global clinical approach to the dizzy patient.


[Eosinophilic granuloma of the ear. General review apropos of 2 case reports]. The eosinophilic granuloma is part of the histiocytosis X classification, having a common histological substratum, the granuloma, which is characterized by a proliferation of histiocytes (reticulo-endothelial cells) and a cytoplasmic inclusion body (the X body) whose étiopathogenic significance is not yet established. These histiocytes are accompanied by other cells and in particular granulocytes, the majority of which are eosinophils. Histiocyte proliferation leads to a destruction of bone which is the organ preferentially affected. At first there is osteolysis (this explains the lacunar aspects seen radiologically) followed by sclerosis. The clinical classification established by Lichtenstein in 1953 outlines the tissue form (eosinophil granuloma), the acute disseminated form (Letterersive) and the chronic disseminated form (Hand-Schüller-Christian). This classification is still accepted today but it needs to be refined to include the transitionary forms, and solitary bone granulomas whose long terme evolutive nature it is impossible to measure clinically, biologically, or histologically. From our observation we note that therapy (surgery, radiotherapy, chemotherapy) is effective in controlling the acute growth spurts in a majority of the cases but does not seem to effect the potential long terme evolution.


[Nervous tension and otologic syndromes (author's transl)]. The organic causes having been eliminated, the possibility of nervous tension as a cause of otologic diseases is discussed. The interest of sedatives and anxiolytic therapy is stressed.


Antibacterial activity of a new 1-oxa cephalosporin compared with that of other beta-lactam compounds. The in vitro activity of (6R,7R)-7-{[carboxy(4-hydroxyphenyl)acetyl]amino}-7-methoxy-3-[[(1-methyl -1H-tetrazol-5-yl)thio]methyl]-8-oxo-5-oxa-1-azabicyclo-[4.2.0]oct-2-ene -2-carboxylic acid was tested against isolates of gram-positive and negative bacteria and compared with those of cephalothin, cefuroxime, cefamandole, cefoxitin, cefotaxime, and carbenicillin. The compound was less active than the other compounds when tested against Staphylococcus aureus and Staphylococcus epidermidis. It had equal or slightly less activity than did cefotaxime when tested against members of the Enterobacteriaceae, but was 8- to 32-fold more active than the other cephalosporins against the Enterobacteriaceae, inhibiting most isolates at concentrations less than 0.5 mug/ml. The compound was twofold more active than cefotaxime and cefoxitin against Bacteroides, and it was twofold more active than cefotaxime and fourfold more active than carbenicillin against Pseudomonas aeruginosa. In vitro activity did not correlate with either the presence or type of beta-lactamase in either Enterobacteriaceae or Pseudomonas. The compound showed minimal synergy when combined with aminoglycosides or carbenicillin.


[Hamartoma of the internal auditory canal and cerebropontile space in a child. Trans-temporo-extradural excision methods]. A progressive facial paralysis in a child of 14 years allowed the diagnosis of a hamartoma to be made. The discovery of such a benign lesion should always be followed by a search for other lesions elsewhere, i.e. to see if there is not a phacomatosis. Persistent sciatic pains which this child now has lead one to fear a second lesion, compressing a nerve root or trunk of the sciatic nerve. There is a strong possibility that this tumor of the auditory canal is only the first manifestation of a neurocristopathy.


Comparative activity and beta-lactamase stability of cefoperazone, a piperazine cephalosporin. The in vitro activity and beta-lactamase stability of 7-[d(-)-alpha-(4-ethyl-2,3-dioxopiperazino-carbonylamino) -p-hydroxyphenylacetamido]-3-[(1-methyl)-5-tetrazolylthiomethyl] -Delta(3)-cephem-4-carboxylic acid (cefoperazone), a cephalosporin analog of piperacillin, were compared with the activities and stabilities of other cephalosporins and cephamycins. The compound was less active than cephalothin or cefamandole in inhibiting Staphylococcus aureus; it was as active as cefamandole and cefoxitin against most of the Enterobacteriaceae but less active than cefotaxime. It was more active than carbenicillin or piperacillin against Pseudomonas aeruginosa. In general, the compound was not active against Bacteroides. It was hydrolyzed by the beta-lactamases of some Escherichia coli which hydrolyzed cefamandole, but was stable to most plasmid-mediated, chromosomally mediated, inducible beta-lactamases in the Enterobacteriaceae and Pseudomonas.


Antibiotic susceptibility of Haemophilus vaginalis (Corynebacterium vaginale) to 21 antibiotics. A total of 56 strains of Haemophilus vaginalis were tested for their in vitro susceptibility to 21 antimicrobial agents by an agar dilution method. All strains were inhibited by 1 mug or less of penicillin, ampicillin, carbenicillin, and vancomycin per ml. The cephalosporins were less active; 4 mug of cefazolin per ml, 16 mug of cephalothin per ml, or 128 mug of cephalexin per ml was required to inhibit all strains. Kanamycin, gentamicin, tobramycin, and neomycin were relatively inactive against H. vaginalis. All strains were inhibited by 4 mug of streptomycin per ml and 2 mug of chloramphenicol per ml. Only 57% of the strains were inhibited by 4 mug of tetracycline per ml, whereas 43% were inhibited by 16 to 64 mug/ml. The combination sulfamethoxazole/trimethoprim was relatively inactive against H. vaginalis. All strains tested exhibited minimal inhibitory concentrations of >/=128 mug when tested against colistin, nalidixic acid, and sulfadiazine. Erythromycin and clindamycin were the most active of the antibiotics tested; for all strains the minimal inhibitory concentrations were </=0.06 mug/ml.


Ampicillin dosage in bacterial meningitis with special reference to Haemophilus influenzae. Ampicillin remains the preferred drug for most cases of bacterial meningitis, including those due to Haemophilus influenzae type b. A prospective study was performed comparing high (400 mg/kg per day)- and low (150 mg/kg per day)-dosage regimens of ampicillin in the treatment of 172 patients with bacterial meningitis. Response to both regimens was equivalent in terms of average hospital stay, duration of ampicillin therapy, microbiological response, and death and residua. Patients with H. influenzae infections treated with low-dosage regimens had slightly prolonged febrile courses. This study suggests that high-dosage regimens of ampicillin offer no benefit over low-dosage regimens in the treatment of bacterial meningitis.


New markers for Eubacterium lentum.

New markers for Eubacterium lentum. Of 37 strains of Eubacterium lentum and phenotypically similar organisms, 26 (70%) synthesized a corticoid 21-dehydroxylase and/or a 3 alpha-hydroxysteroid dehydrogenase. It appeared that the corticoid 3 alpha-hydroxysteroid dehydrogenase was identical to the bile acid 3 alpha-hydroxysteroid dehydrogenase. Steroid-metabolizing enzymes were found both in E. lentum and in phenotypically similar organisms. E. lentum is characterized by nitrate reduction and enhanced growth in the presence of arginine. Many phenotypically similar organisms possess either one or the other of the two markers. In contrast, using the steroid-metabolizing enzymes as markers, a "steroid-active" and a "steroid-inactive" group were established with minimal overlapping of metabolic characteristics. Synthesis of the steroid enzymes was positively correlated with production of gas from H2O2 and formation of H2S. A simple method for the detection of corticoid 21-dehydroxylase and 3 alpha-hydroxysteroid dehydrogenase, one or both of which were present in 92% of the steroid-active group, is described.


Abnormal laboratory test results and their relationship to prognosis in discoid lupus erythematosus. A long-term follow-up study of 92 patients. Investigation of 92 patients with discoid lupus erythematosus, manifested initially by localized cutaneous lesions only, showed abnormal laboratory test results for 57 patients (62%) on admission and for 62 patients (67.4%) on review 16 to 20 years later. Patients with discoid lesions confined to the head and neck (DLE) showed fewer laboratory abnormalities than those patients with disseminated lesions involving trunk and limbs (disseminated discoid lupus erythematosus [DDLE]). Systemic lupus erythematosus (SLE) eventually developed in six (6.5%) of the patients, and all had shown persistent multiple abnormal laboratory findings from the beginning. Complete remission occurred in 46.7%. A persistent positive antinuclear factor of either speckled or homogeneous pattern with a titer greater than 1:50, leukopenia, thrombocytopenia, or a false-positive Wassermann reaction indicated those patients who may progress to DDLE or SLE.


Normal children with large heads--benign familial megalencephaly. Fifteen normal children with large heads (circumference greater than 0.5 cm above the 98th centile) were studied. CAT scans were pefrormed to exclude hydrocephalus, and ventricular size was compared with that of hydrocephalic children. In 11 of the 13 families in which the parents' heads were measured, one parent (10 fathers and one mother) was found to have a large head, as had 6 of 17 siblings. Head circumference at birth was large in 7 of 10 babies and rate of head growth was excessive in 8 of 13. Skull x-ray showed suture diastasis in 7 infants. These families have a benign familial megalencephaly. It is important to recognise this so as to avoid unnecessary investigation and anxiety about normal children with large heads.


Four families with immunodeficiency and chromosome abnormalities. Six children, with severe deficiency of some or all of the immunoglobulins and minor somatic abnormalities, had chromosomal abnormalities: (1) 45,XY,t(13q/18q), (2) 46,XY,21ps +, (3) two brothers 46,XY (inv. 7) (4) 45,X,t(11p/10p)/46X,iXq,t(11p/10p) and, (5) in addendum, 45,XX,-18;46,XX, r18. The chromosome abnormalities were detected in B- as well as T-lymphocytes (as evidenced by using both PHA- and PWM-stimulated cultures) in all probands, but one was mosaic in PHA culture, although all his PWM-stimulated cells were abnormal. Chromosomal variants were also detected in relatives of three and immunodeficiency in relatives of two.


Acute poststreptococcal glomerulonephritis in Maracaibo. II: Studies on the incidence, nature, and significance of circulating anti-immunoglobulins. Antiglobulins were measured in the sera of 82 patients with acute poststreptococcal glomerulonephritis and correlated with C1q binding activity, serum levels of immunoglobulins and C3, site of infection, antibody titres to streptococcal enzymes, and the duration of the nephritis and interval from infection. Raised serum antiglobulins were found in 89.2% of the patients. In addition, raised titres were detected at any time during the course of the disease and very early after streptococcal infection. The finding of antiglobulins soon after the infection suggests the possibility that they appear as a primary event in the disease.


Hemodynamic patterns in human hepatic cirrhosis: a prospective randomized study of the hemodynamic sequelae of distal splenorenal (Warren) and mesocaval shunts. Increasingly successful operative management of gastroesophageal variceal hemorrhage has been achieved by newer techniques of portal venous reconstruction. Although it is postulated that the clinical success may be due to more selectivity in portal venous shunting, direct determination of the effect of portasystemic shunt on portal vein blood flow has not been possible. Direct determinations of portal vein blood flow were performed preoperative on unanesthetized, hemodynamically stable cirrhotic patients by observation of radiopaque water-insoluble droplets. Patients were then randomized into elective distal splenorenal (Warren) or mesocaval shunt and determinations were performed postoperatively under similar conditions when clinically possible. Although portal vein blood flow was not significantly different before (929 +/- 147 ml/min) or after 899 +/- 271 ml/min) distal splenorenal shunt, there was a large change in portal vein blood flow after mesocaval shunt, decreasing from 772 +/- 177 ml/min (hepatopetal) to -1021 +/- 310 ml/min (hepatofugal) p < 0.01). After either procedure total hepatic blood flow (as determined by cardiac green clearance) was not significantly changed, nor was renal blood flow; however, cardiac output was significantly increased after mesocaval shunt. Thus the theoretical hemodynamic goals of the selective distal splenorenal shunt, i.e., preservation of the hepatopetal flow within the portal vein, is achieved as determined in the early postoperative period. The correlation between these changes and the eventual clinical outcome remains to be determined.


Does pulsatile flow influence the incidence of postoperative hypertension? Twenty patients undergoing primary elective aorta--coronary artery bypass were divided into two equal groups, both receiving identical premedication, anesthetic, and pump primes. The control patients received hypothermic nonpulsatile flow and the study patients received hypothermic pulsatile flow. Hypertension, defined as a pressure of 160/100 mm Hg or higher, was observed in 80% of the control patients and 20% of the patients receiving pulsatile flow (p less than 0.05). Serial renin measurements demonstrated maximum values in the intensive care unit and coincided with the onset of postoperative hypertension in the control patients. Those patients who had received pulsatile flow did not demonstrate notable renin stimulation. Catecholamines were markedly elevated during bypass and in the intensive care unit, but there was no significant difference between the two groups. Peripheral vascular resistance was not significantly lower with pulsatile flow, except in the first study performed in the intensive care unit. We conclude that catecholamines and the renin-angiotensin system contribute to the production of postoperative hypertension and that pulsatile flow diminishes renin stimulation. Pulsatile flow results in a decreased incidence of postoperative hypertension.


[The antiprotease alpha-1-antitrypsin, alpha-2-macroglobulin and immunoglobulin E in newborns with hyaline membrane (author's transl)]. The Authors have analyzed the serum from 26 newborn children suffering from hyaline membrane to valuate the behaviour of alpha-1-antitrypsin, of alpha-2-macroglobulin, and of immunoglobulin E. A statistically significant decrease of antiprotease seric levels has been noticed. No information has been achieved as concern IgE.


A prospective evaluation of the pulsatile assist device. Conversion of roller pump flow to pulsatile flow by the pulsatile assist device (PAD) is said to result in improved myocardial preservation and a decrease in the incidence of perioperative myocardial infarction. The clinical advantages of the PAD were evaluated in a prospective randomized study of 100 consecutive coronary artery bypass operations. Serial electrocardiograms, creatine phosphokinase isoenzyme studies, and myocardial scans with technetium-labeled pyrophosphate failed to demonstrate any signficiant difference between patients with the PAD and those receiving nonpulsatile flow. Plasma hemoglobin levels were significantly higher in the PAD group indicating increased blood trauma. Other potential disadvantages of the PAD are discussed. Based on this study, we see few advantages of the PAD in routine coronary bypass operations.


Pharmacological profile of mangostin and its derivatives. Mangostin (M), a naturally occurring xanthone in the rinds of the fruits of Garcinia mangostana Linn. (Guttiferae) and its derivatives such as 3-0-methyl mangostin (MM), 3,6-di-O-methyl mangostin (DM), 1-isomangostin (IM), mangostin triacetate (MT), mangostin 3,6-di-O-(tetra acetyl) glucoside (MTG) and mangostin-6,6-di-O-glucoside (MOG) were screened for various pharmacological effects in experimental animals. With the exception of DM all the test compounds produced CNS depression characterised by ptosis, sedation, decreased motor activity, potentiation of pentobarbital sleeping time and ether anaesthesia in mice and rats. None of the compounds exhibited analgesic, antipyretic and anticonvulsant effects. With the exception of MOG, none of the test compounds produced significant effects on the cardiovascular system of frogs and dogs. MOG produced myocardial stimulation and a rise in blood pressure which was partially blocked by propranolol. M, IM and MT produced pronounced antiinflammatory activity both by intraperitoneal and oral routes in rats as tested by carrageenininduced hind paw oedema, cotton pellet implantation and granuloma pouch techniques. Antiinflammatory activity for M, IM and MT was observed even in bilaterally adrenalectomised rats. M, IM and MT did not produce any mast cell membrane stabilising effect and the degranulation effect of polymyxin B, diazoxide and Triton X-100 on rat peritoneal mast cells in vitro was not prevented. M, IM and MT did not alter the prothrombin time of albino rats. M alone produced significant antiulcer activity in rats.


[Increase of the "null cells" in children with persistent hepatitis (author's transl)]. Some membrane and functional properties of lymphocytes have been examined in a group of children affected with persistent hepatitis. Both absolute and percentage values of B lymphocytes (cells bearing surface Ig) were normal, whereas T lymphocytes (E rosette technique) were decreased in percentage but not as absolute numbers. Only in a close range of mitogen concentration PHA responsiveness was altered, and no modification was found in the percentage of EA and EAC rosettes. A marked increase in lymphocytes lacking both T and B cell markers was observed, which may be related to an increase in precursors of mature cells or to a masking of receptors on the membrane of lymphocytes, but which is probably independent of an increase in the number of K cells, since cells bearing receptors for the Fc fragment were normal.


Upper airway obstruction as a complication of oral anticoagulation therapy. Report of three cases. While taking orally administered anticoagulants, three patients had hemorrhages into their retropharyngeal and submandibular spaces, suffering eventual acute airway obstruction. One of the patients died. Despite the life-threatening nature of this complication of anticoagulant therapy, the diagnosis was obscure and initially veiled in complaints of sore throat or hoarseness, suggesting infection. Thorough investigation of such complaints is necessary in patients receiving anticoagulation therapy. If a hematoma is discovered, the patient should be admitted to the hospital for close observation and prompt reversal of anticoagulation with plasma. Intubation or tracheostomy also may be required.


Massive lower gastrointestinal bleeding from intestinal varices. Lower gastrointestinal bleeding from intestinal varices cannot readily be detected at operation; hence, preoperative identification is important. Our experience with six patients having sudden, massive bleeding per rectum from intestinal varices suggests a group of common findings. These patients had cirrhosis, no blood in the stomach or duodenum, characteristic mucosal imprints on barium enema, or direct visualization of varices on sigmoidscopy or colonoscopy. Only two had demonstrable esophageal varices. The diagnosis was confirmed and the site of the varices localized on the venous phase of selective mesenteric angiography in five patients. Varices were located in the duodenojejunum in two, in the cecum and ascending colon in two, and in the rectum and sigmoid colon in two patients. Three patients were treated nonoperatively with transfusion and intraarterial infusion of vasopressin into the superior mesenteric artery; one died. One patient with cecal varices had a right hemicolectomy that controlled the bleeding, but progressive hepatic failure resulted in postoperative death. The remaining two patients had successful decompression of left colonic varices by portasystemic shunt.


[Problem of disease variability (pathomorphosis)]. The problem of pathomorphosis is analysed in case of infectious, infectious-allergic (rheumatism, glomerulonephritis) and neoplastic diseases. Pathomorphosis is considered as nosomorphosis in a broad (panorama of diseases) and narrow (particular disease) sense. Therefore the concepts of "general nosomorphosis" and "particular nosomorphosis" are introduced. The "specifics" of pathomorphosis of one or another disease (or a group of diseases) have been shown to be determined by epidemiologic and therapeutic factors. Pathomorphosis induced by a physician may become a process directed by him which is possible with the proper knowledge of not only epidemiological factors but also the mechanism of the drug effects, i. e. patho- and morphogenesis of pathomorphosis itself.


Orbital embryonal rhabdomyosarcoma and intracranial schwannoma. A 39-year-old woman had a large benign intracranial schwannoma of the Gasserian ganglion. Thirty-two years previously, she had an embryonal rhabdomyosarcoma of the orbit. She had been treated by enucleation, local excision, and low-dose supplemental irradiation (1,400 rads). This is the longest survival of which we are aware following any treatment modality in such tumors. No correlation between the two tumors has been established.


Cerebral contribution to the visual suppression of vestibular nystagmus. Thirty-two patients with cerebral lesions were examined to locate cerebral areas involved in visual suppression. Visual suppression was reduced or abolished when the lesions were in the parietal lobe, especially in the dorsoposterior region. This part of the parietal lobe seems to modify visual suppression of caloric nystagmus that is mediated by the flocculus and nodulus of the cerebellum as well as the pons. In patients with frontal lobe lesions including the parietal lobe, visual suppression was reduced or abolished. Thus, the parietal lobe is important for this visual suppression mechanism.


Adrenergic innervation of the eighth nerve and vestibular end organs in man. Fluorescence microscopy was used to examine the adrenergic, blood-vessel-independent innervation of the 8th nerve and inner ear specimens in patients with otoneurological diseases. Specifically fluorescent adrenergic axons were scantily seen among the myelinated nerve fibers in the 8th nerve and in the subepithelial regions of the end organs but not in the endolymphatic sac.


Generation of homogeneous populations of alloreactive T cells in vitro. The supernatant from Con A-activated spleen cells (CS) can be used to generate homogenous populations of alloreactive T cells in vitro. Subculture of activated cells in CS containing medium is required for the continued proliferation and expression of effector activity. Prolonged subculture in CS containing medium does not result in indefinite growth and proliferation of alloreactive T cells. The activity in CS required to maintain cytotoxic cell growth is not species specific, and is therefore separable from the costimulator activity in CS required for the initiation of the T cell response to alloantigen; this latter activity is species specific.


[Separation of lymphocytes into classes from peripheral human blood using centrifugation on a discontinuous gradient]. Peripheral blood lymphocytes of 20 normal volunteers were separated on a discontinuous gradient of Ficoll. The ability of lymphocytes from the fractions to from sponteneous (E) and induced (EAC) rosettes and undergo transformation in the presence of phytohaemagglutinin (PHA) was tested. T-lymphocytes were concentrated in the density of 1,067 g/ml and B-lymphocytes in the density of 1,063 g/ml.


Erythrocyte rosette inhibition as an assay for naturally occurring T lymphocytotoxic antibody in systemic lupus erythematosus. By means of a modified sheep erythrocyte rosette inhibition assay, we were able to detect naturally occurring lymphocytotoxic antibodies in sera from patients with systemic lupus erythematosus (SLE). The incidence of lymphocytotoxic antibodies was 86% in all SLE patients, and 100% in patients with active disease. Since this assay detects only the antibodies that react with the determinants on T cells or on both T and B cells, it has a great advantage of demonstrating in combination with appropriate absorptions the antibodies specific for T cells. When an appropriate panel of target cells was used, most of the antibodies in SLE sera as detected by this assay appeared to be analogous to a natural thymocytotoxic autoantibody (NTA) of New Zealand mice in its specificity and nature. The changes in the antibody titer of a patient with SLE during the course of disease correlated well with those in the total number of T cells in the blood, the antinuclear antibody titer, and some delayed skin hypersensitivities.


Biological assay of potential trichomonacides in vitro using a counter apparatus. Utilising the accuracy and speed of a Coulter Counter for cell counting and sizing, a new method of antimicrobial assay has been developed in which the potency of inhibitors is calculated on a mol/cell basis. A total of 72 potential trichomonacides were screened against Trichomonas vaginalis and the ED50 value estimated for 27 of the most interesting and potent compounds. The ED50 value for metronidazole was a mean of 5.12 fmol/cell and only 6 compounds were more potent. After the nitroimidazoles, the acridines were the most potent group of compounds. Only chlortetracycline and gramicidin caused an increase in mean cell size.


The oncogenic effect of immunosuppressive (cytotoxic) agents in (NZB X NZW) mice. I. Long-term treatment with azathioprine and ifosfamide. The increased incidence of neoplasia in the chronic use of immunosuppressive agents has been linked to a variety of factors including age, dose, agent, and frequency of administration. In this study azathioprine (az) and ifosfamide (ifo) were given both daily and weekly to female (NZB X NZW) mice over a period of 14 or 16 months in various dose regimens. Daily treatment with both agents prolonged survival time significantly but induced an apparently dose-related increase in tumor frequency. Intermittent ifo therapy produced neoplasia and survival results comparable to daily treatment, whereas intermittent az failed to extend longevity or produce malignancies. Varying the age of the mice (180 vs. 120 days) at the outset of treatment did not materially affect results in any respect. Ifo is less toxic than az in doses prolonging survival.


The general pharmacology of a novel antitussive compound RU 20201. 1,2,3,4,4a,9b-Hexahydro-8,9b-dimethyl-4[3-(4-methyl piperazin-1-yl)propionamido] dibenzofuran-3-one dihydrochloride (RU 20201) is an antitussive compound with a potency comparable to that of codeine. Unlike codeine, RU 20201 is devoid of any apparent CNS effects and does not depress the respiratory system. It has no adverse effect on the gastrointestinal tract no has it any analgesic or anti-inflammatory properties. Only at very high doses was a local anaesthetic effect observed.


[Atopy and RAST. Diagnostic, therapeutic and standardization problems. Experimental contribution (allergy to antibiotics)]. The authors outline the immunological and immunogenetic bases of atopy, as well as the radioimmunological techniques employed in the allergological diagnosis and purification as well as standardization of the allergens. The latest trends of the allergological immunotherapy are examined, covering fundamentally two wide fields: the possibility to elicit an aspecific immunological tolerance (soluble suppressor substances of IgE response; Asp-Ser-Asp-Pro-arg pentapeptide, D-GL copolimer conjugated aptens) or the specific induction of "suppressor" mechanisms (allergoids, modified allergens). The preliminary results obtained on sera of patients with a symptomatology highly indicative of penicillin allergy, employing RAST Penicilloil G and Penicilloil V, are also reported.


Postoperative immunologic monitoring of cancer patients undergoing radical surgery. Immunologic parameters of cellular immunity in vitro and circulating immunoglobulin levels were evaluated before and after radical surgery in twenty-five patients with localized primary solid tumors. Peripheral blood lymphocyte counts, T-lymphocyte counts and lymphocyte blastogenesis after optimal stimulation with phytohemagglutinin were found significantly depressed at the time of diagnosis. Sequential determinations of immunologic parameters during the postoperative period showed a slight fall of lymphocyte counts and T-lymphocyte counts; subsequently these cell counts progressively returned to preoperative values. The blastogenic response of lymphocytes sharply decreased following surgery and then slowly returned to preoperative levels in one month. No significant alterations of circulating immunoglobulins were detected at diagnosis or during the postoperative period. These findings indicate that patients with localized tumors present impairment of some parameters of cellular immunity preoperatively and that postoperative immunodepression lasts about one month.


T mediated immunity in patients undergoing periodic hemodialysis. Seventeen patients with well compensated chronic renal failure undergoing periodic hemodialysis were studied with regard to absolute number of T and B lymphocytes, spontaneous and PHA induced lymphocyte blastogenesis both with autologous and homologous compatible plasma. A normal lymphocyte count as well as a normal relative and absolute number of T and B lymphocytes was found in most cases. Spontaneous blastogenesis was normal. Lymphocyte response to PHA was reduced both with autologous and homologous plasma, but the depression was more relevant when autologous plasma was used in culture. The authors discuss these findings with respect to available data, particularly concerning inhibitory factors in uraemic plasma.


[Relation between pulmonary tuberculosis and the urinary tract]. We have studied 48 children that presented lung tuberculosis together with the effects tuberculosis has on the urinary apparatus. Clinical, laboratory and radiotherapeutic studies were made in order to confirm the diagnosis which was etiologically confirmed in only two cases. In order to make a good diagnosis it is necessary to use a good technique for urine collection with serial cultures corresponding to four consecutive days and the radiological study of the kidney and its afferent ducts. It is an illness more common than what is thought. It is necessary to know how to detect it and it is very important to have it "in mind" when dealing with any generalized tuberculosis disease: (miliary tuberculosis, meningoencephalitic tuberculosis, etc.). With this article, it has been our purpose to contribute to review and to bring up to data the clinical and pathophysiological concepts of this disease.


Terminal deoxynucleotidyl transferase activity in lymphoma. Terminal deoxynucleotidyl transferase (TdT) was estimated in the tissues of 42 patients with lymphoma, whose cells were also typed by the use of surface markers. Four of the 8 patients with T-cell lymphoma were TdT+ including patients whose lymph nodes showed an undifferentiated or poorly differentiated appearance. The TdT- T-cell lymphomas included cases with diffuse histiocytic Sezary cell, diffuse, poorly differentiated and angio-immunoblastic histology. The tissues of 31 patients with B-cell lymphoma were invariably TdT-, whether the histology was poorly differentiated, well differentiated, nodular, diffuse, histiocytic or Burkitt type, and including cases with about equal proportions of T and B cells, and those whose cells showed non-capping and capping surface immunoglobulin. Hodgkin's tissue was also invariably TdT-. We conclude that estimation of TdT in tissues of patients with malignant lymphoma may be a useful test in diagnosing the T-cell lymphoma, particularly in patients with tumours of undifferentiated or poorly differentiated histology.


Iron(III)--phosphoprotein chelates: stoichiometric equilibrium constant for interation of iron(III) and phosphorylserine residues of phosvitin and casein. Estimates of the strength of iron binding to model phosphoproteins were obtained from equilibrium dialysis experiments. Iron-free phosvitin (chicken and frog) or alpha sl-casein (cow) was dialyzed against the iron(III) chelates of nitrilotriacetate (NTA), )ethylenedinitrilo)tetraacetate (EDTA), or citrate. Protein-bound metal was measured at equilibrium; competition of chelator and phosphoprotein for iron(III) was determined by reference to comprehensive equilibrium equations presented in the Appendix. Analysis of the iron-binding data for phosvitin suggested that clusters of di-O-phosphorylserine residues (SerP.SerP) were the most probable iron-binding sites. A stoichiometric equilibrium constant of 10(18.0) was calculated for the formation of the Fe3+(SerP.SerP) chelate. When comared on the basis of phosphate content, casein bound iron more weakly than phosvitin. However, if the stoichiometric equilibrium constant for the formation of the casein Fe3+(SerP.SerP) chelate (10(17.5) was adjusted to account for the fact that a smaller percentage of casein phosphoserines occurs in di-O-phosphorylserine clusters, the affinity of casein and phosvitin for iron was very similar. A theoretical comparison showed that the "strengths" of the ferric chelates can be ranked: EDTA greater than phosphoprotein di-O-phosphorylserine greater than citrate greater than NTA.


The resonance Raman spectrum of carotenoids as an intrinsic probe for membrane potential. Oscillatory changes in the spectrum of neurosporene in the chromatophores of Rhodopseudomonas sphaeroides. The resonance Raman spectrum of the carotenoid neurosporene is shown to be a sensitive monitor of absorption shifts, and thus changes in membrane potential, in chromatophores of the GlC mutant of Rhodopseudomonas sphaeroides. For a Raman excitation wavelength at 472.7 nm, the intensities of the two most prominent resonance Raman features (v1 and v2) respond very differently to small shifts in the absorption maxima. Thus, the ratio intensity v1/intensity v2 is a sensitive probe for absorption shifts. Changes in this ratio of approximately 20% were observed during a valinomycin induced diffusion potential. At 5 degrees C changes in the average intensity ratio of +6, -4 and -14% were brought about by oligomycin, FCCP and sodium deoxycholate, respectively. The changes in intensity ratio were temperature dependent and, in addition, effects due to the laser beam acting as an actinic light could be detected. Oscillatory changes were observed in absolute Raman and Rayleigh scattering intensities for chromatophores at 5 degrees C and for intact cells under growing conditions.


Simultaneous minute by minute determination of unidirectional and net water fluxes in frog urinary bladder. A reexamination of the two barriers in series hypothesis. Unidirectional and net water fluxes were simultaneously estimated in frog urinary bladder. The minute by minute tritiated water (3HOH) transepithelial flux and the net volume of fluid traversing the tissue were employed. It was observed that: (1) the time course of the increase in the 3HOH flux induced by antidiuretic hormone had a very similar pattern to that reported for the increase in the net movement. (2) Unstirred layers strongly affected the magnitude of the antidiuretic hormone-induced increase in 3HOH fluxes while the time course of the response was almost non-affected. In non-stimulated bladders 3HOH fluxes were poorly modified by medium stirring. New steady-state conditions for 3HOH fluxes were established 1 min after stirring rate modifications. (3) The simultaneously determined net water flux was not affected by a modification in the unstirred layers, indicating that the variations in the measured net water fluxes are a good estimation of the changes in the mucosal border permeability. (4) The presence of an osmotic gradient during hormonal challenge (implying net water fluxes, cell swelling and dilation of the intracellular spaces) did not modify the time course of 3HOH movements. These results suggest that the time course of the increase in water permeability is an intrinsic characteristic of the experimental system that could result from the addition of permeability units that increase in number during the development of the hormonal action.


Calcium-induced structural changes in chemically skinned muscle fibers. Detection by optical diffractometry. The intensity of the first order diffraction line produced by chemically skinned muscle fibers was detected by a self scanning photodiode array and minicomputer system. Line intensity was observed to decrease in fibers stretched to zero filament overlap when subjected to calcium-EGTA buffers in the physiological pCa range. Calcium dependent intensity decreases were not observed for myosin extracted fibers indicating that the thick filament proteins may be the source of the calcium effect seen in non-extracted fibers. These results can be interpreted in terms of calcium dependent effects on thick filament disordering which are not dependent upon cross bridge formation.


Transpancreatic transport of digestive enzyme. When porcine alpha-amylase or bovine chymotrypsinogen A was added to the medium bathing the rabbit pancreas in short-term organ culture, the secretion of these enzymes collected via the duct system increased greatly. To determine if it was indeed the amylase added to the bath that was recovered in secretion, endogenous enzyme stores were prelabeled during a 4 h incubation with [3H]-leucine and the specific radioactivity of amylase in secretion followed. The addition of unlabeled exogenous amylase to the bathing medium reduced the specific radioactivity of secreted amylase by about 90% suggesting that the response was due to the transpancreatic transport of the added enzyme. This inhibition was maintained over time, and was a result, not only of the increased secretion of unlabeled enzyme, but also of a 72% steady-state inhibition in the secretion of endogenous (labeled) amylase. This latter observation indicates that the exogenous enzyme crosses the acinar cell and mixes with endogenous cellular stores. A cellular route is also suggested by the observation that the addition of amylase to the bath increased the amylase concentration in ductal fluid relative to that in the bath by about 20 times; it did not reduce it as would be expected if paracellular shunts were involved. In addition, a cellular pathway is suggested by the observation that a 2 h prior incubation in bovine chymotrypsinogen resulted in a greatly augmented chymotrypsinogen response to a maximal cholinergic stimulus. In all, the data support the prediction of the equilibrium theory of digestive enzyme secretion that enzyme secretion should be responsive to mass action, and the prediction of the enteropancreatic circulation hypothesis that a capacity exists for a substantial transpancreatic flux of digestive enzyme.


A model of Alexander's law of vestibular nystagmus. The observation that the amplitude of vestibular nystagmus grows as gaze is increased in the direction of the nystagmus fast phase and diminished with gaze in the opposite direction is known as "Alexander's law". We have developed an analog computer model to simulate Alexander's law in nystagmus secondary to dysfunction of a semicircular canal. The model utilizes relevant brainstem anatomy and physiology and includes gaze modulation of vestibular signals and push-pull integration to create eye position commands. When simulating normally functioning semicircular canals, the model produced no nystagmus. When simulating total impairment of the canal on one side with gaze directed maximally in the opposite direction, the model produced a large amplitude nystagmus with linear slow phases directed toward the affected side. As gaze was changed from far contralateral to ipsilateral, the nystagmus gradually diminished to zero. When simulating partial impairment of one canal, the nystagmus was smaller in amplitude and absent in ipsilateral gaze.


Regulation of human suppressor cell function by thymosin. Suppressor cells were induced in vitro by Con. A using human peripheral blood lymphocytes. Suppressor cell function was evaluated by mitogen stimulation (PHA and Con. A) and in mixed lymphocyte culture (MLC), Thymosin fraction V was able to block the effector phase more significantly than the induction phase of suppressor cell expression. This effect was additive if thymosin fraction V was present both during the induction and effector phases.


External electrical stimulation of the cochlea: clinical, psychophysical, speech-perceptual and histological findings. Our progress towards the development of a particular form of cochlear implant for the totally deaf is described. A single channel stimulation at the round window or promontory is used. This involves a minimum of surgical intervention and infective risk, preserves the possibility of remission and allows the application of later developments. The signal used for stimulation is designed to be matched both to the deaf lip-reader's needs and to his new, restricted, auditory ability. This is done by concentrating on the acoustic pattern components of speech which carry intonation and voiced-voiceless information. Surgical electrophysical, psychoacoustic and speech perceptual aspects of our work with twelve patients are described. The tests involve responses, for example, relating to: threshold for sinusoids; frequency difference limens; periodic -aperiodic discrimination; stress placement; and consonant labelling using combined visual and electrical inputs. Relatively extensive measurements were made with six patients. Significant individual differences were found and the sets of responses provide an essential basis for an appraisal of the potential usefulness of our work to the individual patient. Possible reasons for the individual differences are discussed. A brief indication is given of the techniques which we have developed for the future speech training and speech production evaluation of patients with electro-cochlear voice monitoring. The final section of our paper mentions our histological investigation of the effects of this type of stimulation in the guinea pig.


[Polarization of photosynthetic membranes and reaction centers of Rhodopseudomonas sphaeroides 1760-1 in an external electrical field]. Electric fields as high as 10(5) V/cm cause polarization of chromatophores and reaction centre films prepared from photosynthesizing bacteria. Photosynthetic pigments, carotenoids in particular, the absorption spectra of which are changed in response to electric fields, may serve as an intrinsic indicator of the development of a polarized state. Polarization occurs due to changes in orientation and spacial position of different charge groups and particles. The field-induced polarized state can be fixed up by exposure to low temperature (-120 degrees C). While heating the system relaxes to the initial state and this can be seen as a current in an electric circuit. The effects of hydration, chemical modification or heat treatment on current indicate the involvement of macromolecule components in the formation of a polarized state, In light-adapted samples the polarization effect is markedly greater and this can indicate that conformational changes occur during the primary photoact. It is supposed that polarization might be implicated in the stabilization of separated charges and in the storage of energy.


Percutaneous transhepatic occlusion for bleeding oesophageal varices. Using the technique described by Lunderquist et al. (1977), transhepatic injection of oesophageal varices has been performed under local anaesthesia in 9 patients with portal hypertension (11 procedures). On 2 occasions it was not possible to enter the left gastric vein. Bleeding resumed within 2 days of radiologically satisfactory occlusion in 2 patients and at 1, 3, 4 and 10 months after 4 procedures in 3 patients. Other complications included portal vein thrombosis, gross ascites and right pleural effusion. There were 2 hospital deaths, both in alcoholic patients with poor hepatic function. In spite of the apparently high morbidity we consider that there is a place for this technique in tiding over patients who are bleeding from oesophageal varices and are medically unsuitable for any surgical procedure.


[Lateral diffusion of the concanavalin A and immunoglobulin receptors on the surface of lymphocyte plasma membranes on exposure to antigen]. The lateral diffusion of integral glycoproteins of lymphocyte plasma membranes is not described only in terms of Brown movement. The development of immune process to the thymus-dependent antigene in vivo induces changes in physico-chemical state of ConA and immunoglobulin receptors of the surface of immuno-competent cells revealed when studying cap formation in vitro.


Modification of permeability of frog perineurium to [14C]-sucrose by stretch and hypertonicity. An in vitro method has been developed to determine quantitatively the permeability of the perineurium to radiotracers at room temperature. The permeability to [14C]sucrose of the isolated perineurium of the sciatic nerve of the frog, Rana pipiens, was measured at rest length, when the perineurium was stretched and after the perineurium had been subjected to hypertonic treatment. Mean permeability at rest length was calculated to be 5.6 +/- 0.27 (S.E.M., n = 45) X 10(-7) cm/sec, and both stretch and hypertonic treatment increased the permeability. A 10% stretch increased permeability reversibly, whereas a 20% stretch or immersion of the perineurium in a hypertonic bath increased permeability irreversibly. Altered permeability under these conditions might be related to changes in the ultrastruct of tight junctions in the perineurium.


Efferent connections of the substantia nigra and ventral tegmental area in the rat. Small injections of tritiated leucine and proline confined to the ventral tegmental area (AVT) were found to label fibers ascending: (a) to the entire ventromedial half of the striatum, but most massively to the ventral striatal zone that includes the nucleus accumbens; (b) to the thalamus: lateral habenular nucleus, nuclei reuniens and centralis medius, and the most medial zone of the mediodorsal nucleus; (c) to the posterior hypothalamic nucleus and possibly the lateral hypothalamic and preoptic region; (d) to the nuclei amygdalae centralis, lateralis and medialis; (e) to the bed nucleus of the stria terminalis, the nucleus of the diagonal band, and the medial half of the lateral septal nucleus; (f) to the anteromedial (frontocingulate) cortex; and (g) to the entorhinal area. Further AVT efferents descend to the medial half of the midbrain tegmentum including an anterior region of the median raphe nucleus, to the ventral half of the central grey substance including the dorsal raphe nucleus, to the parabrachial nuclei, and to the locus coeruleus. Similar injections centered in the pars compacta of the substantia nigra (SNC) label fibers that are distributed in the striatum in an orderly medial-to-lateral arrangement, and almost entirely avoid the nucleus accumbens and olfactory tubercle. With the exception of the lateral quarter of the substantia nigra, which apparently does not project to the extreme rostral pole of the striatum, each small SNC locus, regardless of its anteroposterior localization, distributes nigrostriatal fibers throughout the length of the striatum. Descending SNC efferents are distributed to the same general regions that receive descending AVT projections, except that no SNC fibers appear to enter the locus coeruleus. Isotope injections confined to the pars reticulata (SNR) label sparse nigrostriatal fibers, and numerous nigrothalamic fibers ascending mainly to the nucleus ventromedialis and in lesser number to the parafascicular nucleus and the paralamellar zone of the nucleus mediodorsalis. Descending SNR fibers leave the nigra as a voluminous fiber bundle that bifurcates into a large nigrotectal and a smaller nigrotegmental component, the latter terminating largely in the pedunculopontine nucleus of the pontomesencephalic tegmentum.


Aorta-coronary bypass in a patient with sickle cell trait. A triple aorto-coronary bypass was performed in a patient with sickle cell trait. Partial exchange transfusion with normal packed erythrocytes was used in preparation of the patient for extracorporeal circulation, hypothermia and cardioplegic arrest.


Incidence of psychiatric treatment of adolescents. The characteristics of adolescents aged 15-19 years who received psychiatric treatment for the first time in British Columbia in 1966 are considered. Females predominated substantially over males, as did those living in urban areas over those in rural ones. Somatic, psychological, behavioural and suicidal presenting problems were commoner in females, with delinquent and academic ones being more frequent in males. Depression, psychoneurosis and personality disorders were commoner in females. Medication was used in conjunction with psychotherapy more frequently in females. Long-term psychotherapy (more than 16 visits to a psychiatric facility) was employed in only 3% of females and 2% of males. Psychiatrists provided the greatest amount of care given. The hypothesis that females from rural areas living in the city constitute a vulnerable group of individuals more likely than their adolescent peers to seek psychiatric care requires evaluation in a further study.


Effects of cervical vagus nerve stimulation on hypothalamic neuronal activity. The effects of cervical vagus nerve stimulation on the activity of 56 neurons recorded in various parts of the rat brain were determined. Recordings were made from neurons in both the ipsilateral and contralateral hemispheres during vagus nerve stimulation. Both frequency, 10 to 100 Hz, and voltage, 1 to 20 V, of 0.5 msec pulses were applied to the nerve in a random manner over a 4 sec period while monitoring ongoing single neuronal activity. Frequency response relationships were established for 64% of the lateral preoptic-lateral hypothalamic-medial forebrain bundle (LPA-LH-MFB) neurons which were tested. Four types of LPA-LH-MFB neuronal responses were observed. Twenty percent of the neurons increased in discharge frequency as stimulation frequency was increased, 9% increased in discharge frequency as stimulation frequency was decreased, 23% decreased in discharge frequency as stimulation frequency was increased, and 14% decreased in discharge frequency as stimulation frequency was decreased. Increasing the stimulation voltage always enhanced the magnitude of the effects observed due to changing the stimulation frequency. Neurons observed in some other parts of the brain were not affected by the same stimulation. In addition, cells tested in the LPA-LH-MFB area which were previously tested and affected by gastric distension were also affected similarly by vagus nerve stimulation. Results are discussed in terms of peripheral afferent control over LPA-LH-MFB neuronal activity related to ingestive behavior.


Selection of saphenous vein bypass gradt diameter to support patency of the stenosed coronary artery. Injudicious selection of a saphenous vein graft can adversely affect the the late postoperative patency of the proximal coronary artery which it bypasses. The purpose of this investigation was to deduce an upper bound for graft diameter, at small angle of distal anastomosis, below which the stenosed artery will remain patent, from a mathematical model of aortocoronary bypass haemodynamics.


Effects of midbrain raphe stimulation and lesion on EEG activity in rats. In order to clarify whether the dorsal raphe (d-R) and medial raphe nuclei (m-R) of the midbrain play a different role in EEG activity, the effects of either electrical stimulation or lesion of each raphe nucleus were examined in rats. After m-R stimulation, EEG activity changed to a marked drowsy pattern. D-R stimulation, however, failed to produce such effects. M-R lesion elicited a significant arousal in EEG. The change in hippocampal EEG was the most characteristic, i.e., synchronized waves with an extreme increase in voltage. D-R lesion did not produce such a change. The hippocampal EEG arousal was easily abolished by L-5-hydroxytryptophan without any change in the cortical EEG or behavior. These results suggest that the m-R plays a more important role than the d-R in regulating the hippocampal EEG activity, especially in inhibiting the appearance of high voltage synchronized waves in the hippocampus.


Ruthenium-red staining of skeletal and cardiac muscles. The effects of ruthenium red (RR) on amphibian and mammalian skeletal muscles and mammalian myocardium were examined. In skeletal muscle cells, a discrete pattern of staining can be brought about within the lumina of the terminal cisternae (junctional sarcoplasmic reticulum [SR]) by sequential exposure to RR and OSO4. After prolonged immersion in RR solution, formation of pentalaminar segments ("zippering") occurs at various points along the longitudinal ("network") SR tubules. Zippering can be elicited in skeletal SR at any stage of preparation prior to postfixation with OSO4. By means of dispersive X-ray analysis, both ruthenium and osmium were seen to be deposited in skeletal muscle junctional SR, and ruthenium was detected in the myoplasm as well. In skeletal muscles whose T tubules were ruptured by exposure to glycerol, the pattern of SR staining and zippering resulting from ruthenium-osmium treatment was not affected. These findings indicate that RR is capable of passage across the sarcolemma of skeletal muscle and that this passage does not occur solely under conditions in which the plasma membrane is damaged. In contrast, RR does not opacify or modify any region of the SR of cardiac muscle. However, after this treatment, randomly distributed opaque bodies, composed of parallel lamellar structures, appear throughout the myocardial cells. A few of these bodies are associated with lipid droplets, but the rest are of unknown origin. The failure of the SR of cardiac muscle to stain after exposure to ruthenium dye (even though this material enters these cells) suggests that the chemical composition of cardiac SR is significantly different from that of skeletal muscle SR.


Ultrastructural morphometry of blastogenesis I: transformation of small lymphocytes stimulated in vivo with dinitrochlorobenzene. Changes in the volumes and surfaces of subcellular compartments of unstimulated small lymphocytes and immunoblasts in mouse axillary lymph nodes have been established using stereological techniques. Blast transformation was induced in vivo with dinitrochlorobenzene (DNCB). Cell samples were obtained by random sampling regimes applied at light and electron microscopic levels. From electron micrographs the volume densities of euchromatin, heterochromatin, nucleoli, mitochondria, Golgi apparatus and rough endoplasmic reticulum were determined. Cell surface/volume ratios were also computed. By estimating mean nuclear volumes using light microscopy, it was possible to calculate absolute compartmental volumes and to evaluate the plasma membrane surface areas of average cells. Transformation in this model was characterized by a considerable cellular hypertrophy and a substantial increase in plasmalemma surface. Hypertrophy was the consequence of increases in the volumes of all measured intracellular compartments, notably euchromatin and "residual cytoplasm" (including ground cytoplasm and free ribosomes). These changes are discussed in the context of the altered metabolic status of cells.


Recurrence of Prinzmetal angina seven years following aortocoronary bypass surgery: a clinical and angiographic follow-up. A patient with Prinzmetal angina and ST segment elevation in the anterior ECG leads became asymptomatic after a 50% left anterior descending coronary artery stenosis was bypassed. However, seven years later Prinzmetal angina recurred but with ST segment elevation in the inferior ECG leads. Although the coronary bypass graft had remained patent, the proximal and distal left anterior descending coronary artery was occluded. No significant stenosis was present in the right coronary artery. Perhexiline maleate controlled his symptoms but when the drug was stopped because of side effects an acute inferior myocardial infarction occurred.


Cerebrospinal fluid dynamics in the field of neurosurgery. Alteration in the cerebrospinal fluid (CSF) circulation was studied in 62 patients with neurosurgical diseases by CT cisternography using a water-soluble contrast medium, metrizamide, and also with radionuclide (169Yb- or 111In-DTPA) cisternography. As a rule, the patterns of both methods were in good agreement. The findings were classified into 3 types and 5 subdivisions. CT cisternography is useful for sequential observation of the CSF circulation with detailed morphological definition, and radionuclide cisternography is useful for observing the general flow of CSF. Some patients with hydrocephalus showed hypodensity around the ventricle, where migration of metrizamide was observed on CT images after its ventricular reflux. This suggests an increased transependymal resorption of CSF. The mathematical analysis of attenuation coefficients on CT cisternography provided more objective and quantitative data for study of CSF dynamics.


Image recognition and the reconstruction of cleft palate histological preparations: a new approach. Serial coronal histological sections of cleft palate and normal 12 week fetal specimens are video scanned. The digitized data in a matrix of 10(8) data points are recorded and through computer manipulation three dimensional reconstructions are produced. These can be resectioned by computer in various planes to expose any given structure for study. This is the first application of such a technique to these problems.


A method for identification and follow-up of patients with a steroid-21-hydroxylase deficiency. A method is described for the determination of 17 alpha-hydroxyprogesterone from blood samples obtained by heel prick and dried on filter paper. Discs (10 mm diameter) were cut from the filter paper and extracted in the assay tubes with 1 ml of a methanol/diethyl ether/ethyl acetate (50 :45 :5, v/v) solvent mixture. Antibody, tritium-labelled tracer and dextran-coated charcoal were added to assay tubes using a multichannel dispenser. The approach used permits one technician to analyze two series, each of 60 duplicate samples, within one working day. Thus the method is applicable for the centralized screening of suspected cases, while emergency samples may be analyzed at the same time within 4 h. Comparisons with a highly specific but more elaborate technique for the determination of blood 17 alpha-hydroxyprogesterone showed a correlation coefficient of 0.99, and the regression equation for the present method (y) against the established method (x) was y = 1.07x + 2.72. The calculated upper reference limit (mean +/- S.D.) for 17 alpha-hydroxyprogesterone in healthy infants from two days to eight years of age of 7.5 ng/ml of serum.


T-lymphocyte colonies in normal blood, bone marrow and lymphoproliferative disorders. The formation of T-lymphocyte colonies was studied in normal individuals and in different lymphoproliferative disorders, using the double layer technique of Lowenberg & de Zeeuw (1977). All normal peripheral blood and bone marrow samples formed colonies: range 102-270 (mean 177) and 55-245 (mean 138) per 1 X 10(5) cells, respectively. Bone marrows from acute leukaemias in complete remission showed normal or increased colony formation. The T cell nature of the colonies was shown by rosette formation with sheep and human red blood cells (RBC). Most lymphoproliferative disorders of T and B cell either failed to grow colonies or showed reduced colony numbers. This was of particular interest in the chronic T cell disorders in which a high proportion of T cells was plated. This technique may help in the further characterization of leukaemic cell populations and may also provide clues on the distribution of particular subsets of T-lymphocytes in peripheral blood and bone marrow.


Study of some properties of the receptor for IgM on human lymphocytes. Some properties of the receptor for IgM on human lymphocytes have been investigated. It was shown that the interaction of native IgM with the receptor present on T and B lymphocytes is not critical for its detection in the EAM-rosette assay. In fact, high values of EAM-RFC could be found on cell suspensions cultured overnight in either IgM-free or IgM-containing media. In addition, the inhibition of EAM-rosettes by human monoclonal IgM at 37 degrees C was not as effective as at 4 degrees C. Rabbit IgM showed a significantly greater ability to inhibit the binding of antigen-IgM antibody complexes than human IgM. The receptor for IgM was easily removed by handling procedures, the incubation of lymphocytes at 4 degrees C and treatment of the cells with low concentrations of trypsin or pronase. After the enzymatic treatment, a rapid resynthesis occurred, which restored the number of EAM-rosettes formed by T cells and significantly increased the number formed by B cells. The interaction between the receptor and antigen-IgM antibody complexes stopped the spontaneous shedding of the receptor at 4 degrees C. When the incubation of the cells with immune complexes was performed at 37 degrees C, a significantly different behaviour between T cells equipped with receptor for IgM and those possessing receptor for IgG was found. After the binding of EAG to the receptor for IgG, a process of rapid dissociation of rosettes occurred, whereas the incubation with EAM did not induce an irreversible loss of the receptor for IgM.


Studies of the human lymphocyte-mouse erythrocyte bond. A subpopulation of human B lymphocytes forms rosettes with mouse erythrocytes through a glycoprotein-dependent bond. Further studies of this bond show that the lymphocyte receptor is not immunoglobulin, although the binding of antisera or staphylococci to surface immunoglobulin inhibits the formation of mouse rosettes. Rosette formation could not be induced in thymocytes by enzymatic modification of the surface, or in T cells by lectin-induced transformation. The capacity to bind mouse erythrocytes was lost after incubation in a serum-free medium of lymphcytes from most patients with chronic lymphocytic leukaemia (CLL) and normal subjects. This loss could be prevented by the addition of a variety of sera and glycoprotein-containing substances to the medium, including fetuin. Conditions conductive to the subsequent restoration of rosetting capacity could not be found, indicating that the loss of this capacity was not due to the shedding of a cell-surface receptor which could be re-synthesized. It is suggested that the functional receptors in B1 lymphocytes are held in aggregates by cross-linking peripheral glycoprotein molecules; disaggregation and consequent loss of the capacity to form rosettes with mouse erythrocytes occurs during incubation in serum-free media, and during maturation of lymphocytes to the B2 stage.


In vitro testing of immunoresponsiveness in patients with inflammatory bowel disease: prevalence and relationship to disease activity immunoresponsiveness in IBD. Abnormalities in the numbers and function of thymus and function of thymus-derived and bone marrow-derived lymphocytes (T and B cells) and K cells were determined in sixty-nine consecutive patients with Crohn's disease or ulcerative colitis. Rosetting techniques to identify subpopulations of lymphocytes showed a significant decrease in E-rosettes (T cells) and significant increase in EA- and EAC-rosettes (B cells) in patients with inflammatory bowel disease when compared to normals. In vitro lymphocyte transformation responses to mitogens and antigens were depressed to a variable degree. Mean levels of K cell activity were not significantly different from normal controls. A considerable degree of individual variation was noted in all groups. When the results of each groups were considered, none of the laboratory variables correlated with the site, duration or activity of disease, therapy, presence of iron deficiency anemia, weight loss or hypoalbuminaemia. Thus, in vitro evidence of abnormal immune responses in patients with inflammatory bowel disease cannot be directly related to clinical or laboratory variables and probably reflects a multi-factorial aetiology.


Comparison of various tests for Fc receptors on different human lymphocyte sub populations. Six different immune complex test systems for the detection of IgG Fc receptors were applied to the study of various human lymphocyte populations. The extent of binding varied widely according to the system and the cell type employed. Two systems bound preferentially to a high proportion of B lymphocytes from peripheral blood or tonsils, one of which bound with only a very few T cells. In contrast, four other test systems which bound well with the Fc receptors on T lymphocytes gave weaker reactions with Fc receptors on B cells. The reactivity of Fc receptors on null or third population lymphocytes was similar to that of the Fc-positive T cells. Pronase digestion experiments showed a graded selective loss of reactivity with the different Fc reagents. No one system was optimal for all of the lymphocyte populations, although aggregated IgG exhibited the broadest spectrum of reactivity. A pronounced effect of temperature was evident on the binding reactions, and native IgG showed strong binding at 4 degrees C, particularly to the Fc receptors on T cells.


The association of autoimmune diseases and anti-IgA antibodies in patients with selective IgA deficiency. The prevalence of antibodies to immunoglobulin A (IgA) was studied in eighty-three subjects with selective IgA deficiency (SIgAD), thirty-three normal individuals, thirty-two children with juvenile rheumatoid arthritis (JRA) and normal or elevated IgA, seventeen children with systemic lupus erythematosus (SLE) and normal or elevated IgA, and thirteen patients with hypogammaglobulinaemia. Anti-IgA antibodies were detected by haemagglutination of human erythrocytes coated with one of two IgA myelomas by the chromic chloride technique. Antibodies to IgA were not found in significant titre in individuals with normal or elevated IgA or in those with hypogammaglobulinaemia. In IgA deficient patients, elevated titres were found in 25--30% of those who were healthy or who had non-rheumatic diseases, 50% of those with rheumatoid arthritis, 77% of those with JRA and 100% of those with SLE. Patients with rheumatic diseases and SIgAD may therefore be particularly at risk of developing anti-IgA-mediated reactions to blood products.


Studies on the immunopotentiating effects of a streptococcal preparation, OK-432. I. Enhancement of T cell-mediated immune responses of mice. The effects of the anti-tumour agent OK-432 on the immune response to hamster erythrocytes (HRBC) and nucleated chicken erythrocytes (CRBC) were studied in inbred SL mice. Mice were treated repeatedly with OK-432 before immunization with erythrocytes in saline. The cytotoxicity of CRBC-primed spleen cells, as demonstrated by 51Cr release from labelled CRBC, was markedly increased by treatment with OD-432. The delayed footpad reaction to CRBC was significantly augmented by treatment with OK-432. These results in mice indicate that OK-432 can enhance the cellular immune responses which require the contribution of T cells. Such an activation of T cells by OK-432 was observed in the humoral immune response to a trinitrophenyl group. Augmentation of anti-hapten antibody production, suggesting the enhancement of helper T cell activity by OK-432, was noticed after immunization with trinitrophenyl conjugated to erythrocytes. Furthermore, this enhancement of helper T cell activity by OK-432 was confirmed by utilizing an adoptive transfer system. These results support the possibility that T cell activation may be one of the important effects of OK-432 as an immunopotentiator.


Intraindividual variation in drug disposition. Large interindividual differences occur in the in vivo metabolism of drugs due to genetic and environmental factors. Our studies show that intraindividual variabilities in rates of metabolism are relatively low for antipyrine and phenylbutazone, which are drugs that are primarily metabolized by the liver and have low hepatic extractions; whereas in the case of phenacetin, a drug that undergoes extensive metabolism in the gastrointestinal tract or during its first pass through the liver, or both, intraindividual variations in plasma half-lifes and areas under the plasma concentration-time curves are of much greater magnitude. In our studies, no effort was made to control the lifestyles of our subjects. The variations in rates of drug metabolism did not result from assay procedures, since there was little variation in measured concentrations when the drugs were added to plasma and assayed on multiple occasions. Intraindividual variation occurring in subjects given the drug on 5 different occasions may be due to changes in the external environment or changes in internal physiologic parameters or both. Our studies confirm the usefulness of antipyrine as a test drug in studying drug metabolism in man and also demonstrate that the antipyrine test may be able to detect those subjects whose environments are perturbed by unidentified factors.


Facial rehabilitation: new potentials.

Facial rehabilitation: new potentials. There is some clinical evidence to support the theory that in the immediate rehabilitation of the paralyzed face some regionalization and separate movement of the eye, lips, and cheek may be produced. This is not accomplished by specific fascicular connections. It is postulated that a combination of intracranial and extracranial connections, which have not been identified to date, contribute to this phenomenon.


Diagnosis of agenesis of the corpus callosum by computer assisted tomography: report of two cases presenting with epileptic seizures. Two young patients who had intermittent epileptic seizures were referred to us for cranial computer tomography, and both turned out to be cases with agenesis of the corpus callosum. There were a few other abnormalities associated with the finding, and indeed in both cases epilepsy was not the initial symptom. CT scans showed ventricular configuration very similar to that said to be characteristic of the condition on air encephalograms. The non-invasive nature of CT, and the diagnostic accuracy it provided, are the basis of this report.


Total disappearance of cell proliferation in the lens of a hypophysectomized animal: in vivo and in vitro maintenance of inhibition with reversal by pituitary factors. Cell cycle kinetics of lens epithelium were studied in frogs following hypophysectomy, and subsequent replacement therapy with bovine growth hormone (bGH). Hypophysectomy led to a complete absence of cells in DNA synthesis and mitosis within 4 weeks. A small number of G2 nuclei was present in all preparations, but the number was much reduced with time after surgery. Occasional preparations with a significant G2 population were encountered. The major block to cycle traverse appeared to be in the G0-G1 segment. Mechanical injury to the lenses of hypophysectomized animals caused the cells to move closer to S without, however, reaching it. The in vivo block to cycle traverse persisted in organ-cultured lenses maintained in medium containing serum of hypophysectomized animals. The block to cycle traverse was reversed when the lenses were cultured in medium containing the serum of hypophysectomized animals that received replacement therapy with bGH. The serum became effective between 1 and 2 days after the star of replacement therapy. The lens epithelial cells from hypophysectomized frogs incur a deficit such that a protracted prereplicative phase is detected when favourable growth conditions are restored.


Hemosuccus pancreaticus secondary to ruptured splenic artery aneurysm. A case is presented of a ruptured splenic artery aneurysm communicating with the main pancreatic duct which resulted in obscure upper gastrointestinal bleeding. Bipolar ligation of the splenic artery and excision of the pseudoaneurysm was curative. The location of the splenic artery makes it especially vulnerable to aneurysmal formation in patients with pancreatitis. It is recommended that early arteriography be obtained in patients with obscure upper gastrointestinal bleeding. If the splenic artery aneurysm is located in the mid-portion of the vessel, partial pancreatectomy and splenectomy are not necessary to effect a cure.


[Reopening of infarct-occluded vessel by transluminal recanalisation and intracoronary streptokinase application (author's transl)]. Coronary angiography was performed 2 hours after onset of complaints in a 57-year-old patient with acute anteroseptal infarction. Using a wire spiral in the coronary catheter the acutely occluded anterior interventricular branch was reopened. With intracoronary streptokinase (120 000 units in 50 minutes) the recanalisation canal was enlarged. The clinical picture and electrocardiographic findings improved under the influence of treatment. An aorto-coronary bypass operation was performed on the following day. The post-operative angiogram showed marked improvement of left ventricular function. The results indicate that this intervention prevented widespread necrosis.


Modified electrocoagulation and its possibilities in the control of gastrointestinal bleeding. In acute experiments in the stomach of dogs electrocoagulation with simultaneous instillation of water (EHT-electrode i.e. electro-hydro-thermo-electrode) proved the most effective electrocoagulation method for controlling standardized bleeding: Optimal visibility at the bleeding site, extension of the therapeutic range as well as the avoidance of charring at the bleeding site are its major advantages. Disturbing adhesion of coagulated material on the electrode is also avoided. The electro-hydro-thermo-electrode is a cheap and portable means of controlling bleeding.


The proliferative capacity of human T lymphocyte subpopulations in a continuous culture system. The continuous growth of subpopulations of human T lymphocytes was investigated using a culture system containing conditioning factors from mitogen-stimulated lymphocytes. Cultures of purified peripheral blood lymphocytes rapidly became enriched for T lymphocytes, detected as sheep erythrocyte rosette-forming cells, and could be maintained for up to a month in an actively growing state. Subpopulations of T lymphocytes bearing Fc receptors for IgM(T.M) or IgG(T.G) could not be detected in these cultures unless the cells were first washed and cultured for 3 days in medium devoid of conditioning factors. During this second culture step, many of the cells reverted from a large, blast-like state to a small lymphocyte morphology and proportion of the T lymphocytes re-expressed Fc receptors. The proportions of T.M and T.G lymphocytes so detected remained constant throughout the continuous culture period indicating that the system permitted the proliferation of all T lymphocytes. Fractionation studies supported this conclusion by demonstrating that purified T, T.M and T.G but not B lymphocyte populations proliferated when cultured in the presence of conditioned medium. The majority of cells in cultures of purified T.M lymphocytes re-expressed IgM Fc receptors following reculture in unconditioned medium. However, the re-expression of IgG Fc receptors by cultured T.G lymphocytes could not be achieved.


"Ia-like" antigens on human T cells.

"Ia-like" antigens on human T cells. Human T lymphocytes have been tested for cell surface p. 28,33 "Ia-like" heteroantigen and DRw alloantigens. Small numbers (1--5%) of sheep (E) rosette or T antigen-positive, surface immunoglobulin-negative (E+, T+, smIg-) T cells were Ia+; these cells appeared to be restricted to the TG subset. Following activation by allogeneic lymphocytes or sperm, or by purified protein derivative of tuberculin (PPD), the proportion of positive T cells increased substantially. DRw typing indicated that Ia specificities on activated T cells were not acquired passively from the stimulator cells, suggesting therefore that either "selection" of a small DRw+ cell subset or derepression and/or exposure of DR locus gene products occurs during T cell activation.


Human T lymphocyte receptors for IgM: control by IgG-binding lymphocytes. The capacity of human peripheral blood lymphocytes to bind antigen-IgG or antigen-IgM-antibody complexes was investigated using a rosette technique with ox erythrocytes (E) coated with rabbit IgG (AG) or IgM (AM) antibodies. EAM rosette formation was achieved only in suspensions pre-incubated for 24 h at 37 degrees C. Addition of either EAM or EAG complexes to the culture medium was shown to prevent the formation of EAM rosettes. The inhibition was reversible, it was not due to trace IgM contaminants in the IgG antibody fraction. It was not observed when lymphocytes depleted of EAG-rosetting cells were incubated with EAG complexes. Inhibition of the expression of lymphocyte receptors for IgM can be regarded as a consequence of the modulation of surface receptors for IgG and involves an interaction between the two lymphocyte subsets bearing surface receptors for IgG and IgM, respectively. However, these experiments do not exclude the possibility that a few cells which bind EAG may lose their receptors by modulation and then express a receptor for IgM.


Increased survival of CBA pluripotent haemopoietic stem cells in vitro induced by a marrow stromal factor in Sl/Sld mice. Media conditioned by marrow adherent cells from anaemic Sl/Sld and W/Wv mice increased the 24-h survival of CBA CFUs in vitro compared to fresh medium to about the same extent as marrow-conditioned medium from normal Sl+/Sl+, W+/W+, and CBA mice. Sl/Sld marrow-conditioned medium also increased the percentage of CFUs in DNA synthesis to the same extent as CBA marrow-conditioned medium. These results demonstrate that Sl/Sld mice produce a marrow stromal factor that increases both survival of CFUs and the percentage of CFUs in DNA synthesis in vitro. Therefore, the defective haemopoietic microenvironment of Sl/Sld mice is not due to a deficiency in the production of this factor.


Mechanisms of compensation for vestibular deficits in the frog. II. Modification of the inhibitory Pathways. In hemilabyrinthectomized frogs inhibitory responses of central vestibular neurons to electrical stimulation of the remaining vestibular nerve were recorded extra- and intracellularly at different stages (0, 3, and 60 days) after the operation. In acute animals inhibition of vestibular neurons following stimulation of the VIIIth nerve is rarely observed. In chronic animals about 30% of the vestibular neurons on the partially deafferented side and about 15% of the vestibular neurons on the intact side are inhibited. The distribution of the latencies of these inhibitory responses is bimodal with ranges from 4 to 14 ms and 18 to 24 ms. Removal of the cerebellum reduced the number of inhibited vistibular neurons and picrotoxin abolished all inhibitory responses. The vestibular input to the cerebellar dorsal rim is bilateral. In chornic animals excitation of Purkinje cells was similar as in acute preparations but many more cells were disfacilitated. Inhibition of partially deafferented vestibular neurons by cerebellar and brain stem neurons increases in parallel with their excitatory commissural input. The balance between these plastic changes may be crucial for the functional recovery of appropriate compensatory reflexes.


Interaction between the horizontal vestibulo-ocular reflex and optokinetic response in rabbits. Dynamic characteristics of the horizontal vestibulo-ocular reflex (HVOR), the optokinetic response (OKR), and their interactions were investigated in alert albino rabbits. For stimulation of the horizontal semicircular canals, the whole rabbit was rotated sinusoidally on a motor-driven turntable at peak-to-peak amplitudes of 5 degrees to 30 degrees over a frequency range of 1/30 to 1/2 Hz. Optokinetic stimulation was provided by a narrow vertical slit light source presented in front of the eye to be tested. The evoked horizontal eye movements were observed and measured by means of a closed circuit television system adapted to provide an analog signal proportional to the eye movement. The net HVOR was obtained by rotation of the turntable in darkness and the net OKR by rotation of the light source. Combining rotation of the turntable with a stationary light source immediately increased the gain and reduced the phase shift of the HVOR. The light source moving in phase with the turntable, but at twice the angular amplitude, reduced the gain and advanced the phase of the HVOR. Eye movement curves of the HVOR modified by a fixed or moving slit light could be reconstructed approximately by a linear combination of the net HVOR and OKR.


Adaptive modification of the rabbit's horizontal vestibulo-ocular reflex during sustained vestibular and optokinetic stimulation. Adaptability of the horizontal vestibulo-ocular reflex (HVOR) and the optokinetic response (OKR) was examined in alert albino rabbits during sustained runs lasting 5--12 h under four different stimulus conditions. (1) Sinusoidal rotation of the rabbit in darkness by 5 degrees at 1/10 Hz, or (2) sinusoidal movement of a vertical slit light by 2.5 degrees of 5 degrees at 1/10 Hz around the optical axis of the stationary rabbit, affected the gain of neither the HVOR nor the OKR. (3) Combination of the stimulus as in (1) with the stationary slit light increased the gain of the HVOR gradually. A plateau at about 140% of the initial control was reached in 5 h. (4) Combination of the stimulus as in (1) with the slit light movement by 10 degrees in phase with the turntable decreased the HVOR gain gradually, a plateau being obtained at about 70% of the initial control in 5 h. Changes of the HVOR gain induced in conditions (3) and (4) were not frequency-specific and accompanied by no signficant modification of either the gain or phase of the OKR or the linear property of HVOR-OKR interaction. A small but significant change of the HVOR phase was also detected under the condition (3) but not (4).


Primary vestibular afferent projections to the ipsilateral abducens nucleus in cats. An autoradiographic study. Primary vestibular projections to the ipsilateral abducens nucleus were found in cats by injecting anterograde tracer substances (radioactive proline and fucose) into Scarpa's ganglion. Labelling was observed in the rostral and middle portion of the abducens nucleus.


Effects of monochromatic X-radiation on the membrane of nodes of Ranvier under voltage and current clamp conditions. Monochromatic Ag-Ka-radiation decreased irreversibly the peak sodium current in nodes of Ranvier. This decrease occurs only with a delay of about 1000 sec after a threshold dose of about 8 kR has been reached. Potassium current and resting potential are practically not affected.


Decrease in motor activity - an early symptom in the course of experimental allergic encephalomyelitis (EAE). Motor activity has been followed in rats during an experimental allergic encephalomyelitis (EAE). The disease was produced by transfer of lymph node cells from sensitized syngenic donors. Small and large movements were permanently registered by an electric activity meter. It could be demonstrated that a decrease of the motility is an early symptome of the disease. Therefore the measurement of the motoric activity might be a useful parameter in the classification of EAE.


Peritoneal macrophages from adjuvant arthritic rats enhance tumour cell growth in vitro. Peritoneal macrophages from rats with adjuvant arthritis enhance the incorporation of 3H-thymidine in 2 tumour cell lines in vitro. Maximal enhancement is found during the development of the secondary lesions, and it is suggested that the immunologic commitment of the macrophages could interfere with their regulation of tumour cell proliferation in vivo.


Immunological observations following vasectomy. Lymphocytotoxic antibodies (LCA) against panels of normal lymphocytes and leukemic B-cells were demonstrated in vasectomized men. Since vasectomy is known to induce antibody formation to spermatozoa, the demonstration of these lymphocytotoxic antibodies may be related to antigenic constituents of spermatozoa such as HLA or B-cell alloantigens. Long term follow-up is needed to clarify the clinical significance of these antibodies.


[Pathology of the aorto-coronary bypass by autologous saphenous vein (author's transl)]. The success of aorto-coronary bypass operations, employing an autologous saphenous vein, depends mainly upon graft patency. Fortyone grafts have been examined by light micrsocopy, 35 of which were obtained from 23 autopsy cases and 6 were recovered at reoperation. Thirtythree veins had been in place for less than 20 days (early group) and 8 from  3 to 39 months (late group). In the early group, minimal to moderate mediointimal fibrosis was always detected. Graft occlusion due to recent thrombosis was observed in 13 cases; the cause of thrombosis was severe coronary narrowing distal to the insertion of the graft and atherosclerotic plaque ulceration at the site of the veno-coronary anastomosis. Among the late group, 3 veins were occluded by an old thrombus, and 3 by intimal leiomyocellular proliferation, with Alcian positive ground substance, while 2 exhibited a severe stenosis due to intimal phlebosclerosis. One of these last disclosed a vein atherosclerosis. The multiple pathogenetic factors, which are involved in the proliferative lesions, are reviewed.


[Myocardial revascularization combined with endoarterectomy (author's transl)]. The paper summarize a personal experience in myocardial revascularization combined with endoarterectomy for diffuse coronary artery disease. From Feb. 1977 to June 1978 at Harefield Hospital 60 patients had 138 grafts. In 32 patients, 42 endoarteriectomies were performed (30% of all grafted vessels); of these 19 (45%) were to LAD; 4 (10%) to CX and 19 (45%) to RC. The overall mortality was of 1 patient. Symptomatic evaluation shows that 26 patients (84%) are asmptomatic and 5 (16%) are improved. Restudy of 24 (32 endoarterectomies) shows a patency rate of 75%.


Spontaneous peritonitis due to Hemophilus influenzae in an adult. Hemophilus influenzae, usually pathogenic in the pediatric population, caused septicemia and peritonitis in the cirrhotic adult described here. Susceptibility to this unusual adult pathogen was perhaps related to liver disease or corticosteroid treatment. This organism has not previously been associated with the syndrome of spontaneous bacterial peritonitis in an adult.


Significance of tumour mass on T-lymphocyte levels in patients with gastrointestinal cancer. The relationship between tumour load and immunity in gastrointestinal cancer has been studied by sequential comparison in patients whose tumour has been removed and those whose tumour was found to be inoperable. Total lymphocyte count, absolute and percentage T- and B-lymphocyte counts, effect of papain on E-rosetting cell levels, and inhibitory effect of cancer sera on E-rosette formation by normal lymphocytes have been studied in 30 patients with stomach or colorectal cancer, and 10 control patients with benign gastrointestinal disease. The examination was done on each patient before and at regular intervals after operation up to 24 weeks. Operable cases, with removal of tumour load, showed a temporary fall in total lymphocyte count and T cell counts, which returned to normal by four weeks postoperatively. Inoperable cases (15 patients) showed a progressive fall in total lymphocyte count and a relatively greater depression of T cell counts, in parallel with increasing tumour mass. E-receptor blocking factor was demonstrated in the sera of cancer patients. This factor was related to tumour mass and presumably was of tumour origin, as it persisted in the inoperable group but disappeared by 12 weeks after tumour removal. The factor explained the excess depresion of T cells over total lymphocytes, but does not explain the continuing depression of total lymphocyte count in the cancer patients.


Quantitative electron-microscopy analysis of cranial nerves III, IV, and VI and of the extrinsic eye muscles in fog. A comparative study of the quantitative data of the frog extraocular muscles and the cranial nerves that innervate them was performed. Oculorotatory muscles contain muscle fibres of at least 4 types which are arranged in heterogeneous layers. The zonal arrangement of the muscles does not occur on the cross-sections in the vicinity of muscle insertions. In these regions only two muscle fibre types are present and the total number of fibres is smaller by 70% than in the central region of the muscle. Most numerous are muscle fibres in the rectus inferior muscle, while the smallest number of fibres is found in rectus interior muscle. Three distinct types of nerve fibres are distinguished according to the following criteria: occurrence and thickness of myelin sheath, fibre diameter and ratio "g". The fibres with thin myelin sheaths indicate small diameters (1-5--6- mum) and their ratio "g" equals 0-82 +/- 0-08. They constitute about 30% of the myelinated fibres in the nerve supply of the oculorotatory muscles and about 14% in the supply of the retractor bulbi muscle. Both the value of the ratio "g" and a greater number of these fibres in the nerve supply of the muscles that contain slow contracting muscle fibres indicate that they are rather slow conducting nerve fibres.  The range of the diameters of the fibres with thick myelin sheaths is greater (3-5--13-5 mum) and their "g" equals 0-66 +/- 0-06. These fibres constitute about 70% of the myelinated ones in the nerve supply of the oculorotatory muscles and 86% in the supply of the retractor bulbi muscles. The value of the ratio "g" in these fibres indicates that they are fast contracting ones. The smallest diameters are found in the myelinated fibres (0-5--1-7 mum). These fibres occur frequently in all the examined nerves; they constitute 36--47% of the total number of all the nerve fibres. The frog extraocular muscles are characterized by an abundal nerve supply which is reflected in the low innervation ratio (1:4--1:5). On the distal cross-section of nerves the number of nerve fibres is greater than on the proximal ones. Ganglionic neurons occur sporadically around the nerves; in the nerve III synaptic contacts between two neurons were observed.