Purulent pericarditis in children.

Purulent pericarditis in children. Acute purulent pericarditis was treated successfully in five children between the ages of 27 months and 11 1/2 years during the past 5 years. The responsible organism was Hemophilus influenzae, type b, in two cases and Meningococcus, Pneumococcus, and coagulase-positive Staphylococcus aureus in one case each. No primary source of infection could be identified in two patients. A high index of suspicion, combined with immediate echocardiograms and pericardiocentesis, led to the diagnosis. Immediate antibiotic therapy was instituted on the basis of the gram stain of the pericardial fluid. All five patients had a pericardial window established--four through subxyphoid approach and the fifth, because of a left pleural effusion, through a left thoracotomy. When the subxyphoid approach was used, sump drains were left for postoperative suction and irrigation. All five patients survived without sequalae during follow-up periods of from 18 months to 5 years. We advocate an aggressive approach to the diagnosis and treatment of this problem. This report documents the safety, ease, and effectiveness of the subxyphoid approach as a means of drainage.


Effective antitumor immunity following elimination of suppressor T cell function. An increased resistance to a transplantable tumor was demonstrable in Fischer (F344) strain rats after thymectomy and high doses of total body irradiation, followed by bone marrow cell repopulation if the animals were allowed to recover for 6 to 8 weeks. Further experiments demonstrated that removal of a subpopulation of T cells by lower doses of radiation plus thymectomy could (1) reduce recurrences after surgical excision, and (2) prolong survival of animals with established pulmonary metastases. It was found that thymectomy + 50 leads to 100 R total body irradiation could eliminate a T cell-mediated suppression of effective antitumor immunity. The removal of the suppressor cell component by lower doses of irradiation was dependent on pre-exposure of the animals to tumor antigen. These experiments indicate the specificity of suppressor T cells to tumor antigen and their exquisite sensitivity to radiation in appropriate circumstances.


Control of acute gastroduodenal hemorrhage with cimetidine. Thirty-four patients with acute gastroduodenal hemorrhage were treated with intravenous Cimetidine. Preliminary endoscopy was done at the onset of bleeding to determine the source of bleeding and to rule out the presence of a brisk arterial bleeding site that would require immediate operation for control. Sixteen of the patients had primary peptic ulcer disease and 18 patients had "stress ulcer" syndrome. The bleeding stopped following Cimetidine administration in 14 of the 16 peptic ulcer patients (88%) and in 13 of 18 stress ulcer patients (72%). There was no subsequent rebleeding. The data suggest that Cimetidine is of value in the immediate nonoperative management of acute gastroduodenal hemorrhage. Further, the availability of Cimetidine for postoperative use may modify the surgical approach to stress ulcer bleeding.


Direct myocardial revascularisation: experience with 9364 operations. Between July 1968 and December 1976, 9364 consecutive patients with coronary insufficiency underwent direct myocardial revascularisation using aortocoronary bypass (ACB). Among these patients 8017 had ACB alone, and the remaining 1347 had ACB in addition to correction of other cardiac and vascular lesions. In the series of patients having ACB alone the hospital (early) mortality was 3.9%, but for 2383 surgical patients in 1976 this figure was 2.2%. Operative mortality was higher for women (6.85%) than for men (3.5%), but late survival was about the same for both sexes. Among surviving patients 88% were improved or symptom-free after undergoing ACB. According to our data, at the end of eight years 80% of the patients will be survivors. These results, when compared with other series of patients treated medically, indicate the superiority of surgical treatment both in terms of symptomatic relief and also in increased life expectancy.


[Results of endarterectomy in coronary artery surgery (author's transl)]. In a series of 432 aortocoronary bypass procedures endarterectomies were performed in 58 patients (13.4%) on 60 coronary arteries. Except of two vein patch grafts all endarterectomized arteries were bypassed with a saphenous vein graft. The majority of the patients had an endarterectomy of the right coronary artery. Clinical control investigations were performed in 43 out of 47 survivors including 30 with coronary angiograms 5.2 months (mean) after surgery. 26 out of 31 endarterectomized arteries (83.9%) were open angiographically whereas the patency rate to non-endarterectomized arteries of the same patients was 86.4%. The hospital mortality was high; 11 out of 58 patients (19%) deceased. All patients who died postoperatively had a three vessel disease with diffuse coronary sclerosis. Only three had no myodardial infarction prior to surgery, seven had one to four infarctions before surgery. The relatively high mortality intends for the future a more strict revision of the indications for coronary surgical procedures. But not in all cases the preoperative coronary angiograms and ventriculograms allow a clear estimation of the local arterial conditions.


Serological characterization of human monocytes for HLA, B-lymphocyte, granulocyte, and monocyte-associated antigens by cytotoxicity testing. Highly enriched preparations of monocytes, B and T lymphocytes, and granulocytes from 18 normal donors were serotyped in parallel in a complement-dependent cytotoxicity assay using allogeneic and heterologous antisera defining three independent tissue antigen systems. HLA and B-lymphocyte tissue antigens were detected on human monocytes although granulocyte antigens were absent. By cytotoxicity testing the presence of Ia-like antigens on monocytes was significantly diminished compared to the autologous B-lymphocyte population and has important implications in B-lymphocyte serology. The study indentified a number of human antisera obtained from multitransfused subjects and pre- and post-transplant organ recipients that were non-HLA and appeared to define monocyte-associated antigens. The serological implications of surface antigen expression on human monocytes compared with other peripheral blood cells are discussed.


Fluctuated changes in the rat hypothalamic content of corticotropin releasing factor around the peak of the circadian rhythm. It is well known that hypothalamic corticotropin releasing factor (CRF) activity shows a marked circadian rhythm with the peak around 16 o'clock and the minimal level around 8 o'clock, followed by almost parallel changes of plasma corticosterone. But the circadian variations of CRF activity at short intervals (22 or 23 min) around 16 o'clock has not been obvious. In this experiment, we demonstrated fluctuated changes of CRF content in the non-stressed rat hypothalamus with 22 or 23 min intervals around the peak at a quarter past 16 o'clock.


[Rhodopsin regeneration: role of interaction between the photoreceptors and pigment epithelium cells]. Regeneration of rhodopsin has been studied in the eyecup, isolated retina and retinal homogenate of frog Rana temporaia as well as in the eyecup and isolated retina of fish-flounder Limanda aspera (Pallas). Rhodopsin has been found to regenerate only in the eyecup of frog, while isorhodopsin appeared to be the final product in the frog retinal homogenate. Decrease in rhodopsin regeneration level has been resulted from addition of inhibitors--theophyllin (2.10-2 M), papaverine (10-4--10-3 M) and strophantin (2.10-4 M) To the eyecup preparations (60, 20, 23%, consequently). A conclusion is made that structural connection between pigment epithelium cells and photoreceptors is necessary to provide regeneration of native rhodopsin.


[Effect of phytohemagglutinin on T-lymphocytes isolated from human blood]. T--enriched lymphocyte fraction from normal donors was isolated from heparinized peripheral blood on Ficoll-Urotrast gradients. The mitogenic response of T-lymphocytes in culture was 3 times as high as that of unseparated mononuclear cells. The intensity of blast transformation to PHA did not correlate with the increase of T-lymphocytes in culture. These data suggest that cells of not T-origin may be the limiting factor during mitogenic response of T-lymphocytes to PHA.


[Quantitative interrelationships between the T- and B-cell populations of mouse lymphoid organs]. The number of thymocytes and splenic T-lymphocytes correlate negatively. After the treatment of mice with cortisol, this negative correlation changes for a positive one. It is proposed that the negative correlation between cortisone-sensitive thymocytes and splenic T cells is mediated by cortisone-resistant thymocytes. The negative correlations were also found between amounts of T-cells in mesenteric lymph nodes and in Peyer's patches, the positive correlations being seen between numbers of splenic and lymph nodes T-lymphocytes. No correlations between B-cell populations in different organs were revealed. Apparently, correlations between lymphocyte populations reflect some aspect of hierachic structure of the lymphoid system.


[Regulation of alpha-amylase biosynthesis in Pichia burtonii B]. The synthesis of amylolytic enzymes by Pichia burtonii strain CBS 6141 requires the presence of etarch, maltose, and saccharose. Glucose exerts a strong repression which completely inhibited snzyme induction.


[Indices of cellular immunity in patients with influenza A1]. The content of T-lymphocytes was determined by the method of spontaneous rosette formation according to Bach et al. and of B-lympocytes by the method of complementary rosette formation according to Mendes et al. in patients with uncomplicated and complicated influenza A1. In the acute period the values of T-lymphocytes were low and of B-lymphocytes and "O" cells high. During the convalescent period the amount of T-lymphocytes became normal in most patients. In patients with concurrent chronic diseases and in elderly patients the amount of T-lymphocytes remained low for a longer period and did not become normal in most of them during convalescence. The amount of B-lymphocytes at the time of recovery remained high, but in patients with complicated forms of the diseases the values were higher.


[Morphological and physiological characterization of fiber types in the iliofibular muscle of Rana esculenta]. In both longitudinal and cross sections of the M. iliofibularis of Rana esculenta three types of muscle fibres are identified by means of light and electron microscopy. These fibretypes called A-, B- and C-fibres are according to the fibres of m. rectus abdominis of the frog. They can be compared with the fibres of the m. rectus abdominis of rat and mouse. But there is another distribution of the fibretypes A, B and C in the m. iliofibularis and in the m. rectus abdominis. The m. iliofibularis is divided into two parts called "Tonusbündel" and "nichttonischer Teil" by means of their reaction to acetylcholine. The surface of the "Tonusbündel" consists of A-, B- and C-fibres while its inside is onlyformed by A- and B-fibres. They continue the "Tonusbündel" in the "nichttonischer Teil". This part chiefly consists of A-fibres. In cross sections their myofibrils are larger in their extent than the A-fibres known before. Therefore the A-fibretype has to be distinguished into two A-fibres: A1 and A2. The new one is called A2-fibre. A1-fibre is described in the "Tonusbündel" and in further investigations. The difference between the two fibres can be understood as a greater manifestation of power of the A1-fibre. The surface of the "nichttonischer Teil" of the m. iliofibularis consists of A2-fibres which easily could be found opposite the "Tonusbündel". At this point in contrary to the "Tonusbündel" could be found a defined morphological substrate for physiological investigations. The different reactions of "Tonusbündel" and "nichttonischer Teil" to acetylcholine could only be explained by the sum of reactions of all fibretypes in each bundle in correspondence with the reaction of the fibres in the neighbour bundle. But their different behaviour by summer- and winterfrogs is unknown. Therefore it is to discuss whether it is allowed to refer generally the results to "muscle" or "musclefibre" got from frogs living in cooled rooms. It is known in literature that not all results of physiological investigations can be interpreted with the two fibre- theorie ("twitch" and "slow") of muscle. Those not interpretable physiological results could be associated to the B-fibre can not be explained by morphological methods but must be proofed by physiological investigations. In tables are summerised morphological criteria of the three types and it is tried to associate the physiological qualities known from literature. Besides there is summerised the usual nomenclature with the first citations.


[Regulatory role of the bone marrow in immunogenesis. 1. Bone marrow suppressor cells in the in vitro culture]. Bone marrow cells added to the spleen cell culture (after Mishell and Dutton) stimulated with sheep red blood cells suppressed the production of plaque-forming cells. Bone marrow supressors-cells bear surface immunoglobulins and MBLA, they are referred to the actively prolferating cells, and, apparently, represent immature cells-precursors of B-lymphocytic series.


[Methods of determination of toxicity of pertussis vaccine. 1. Change in the weight of the thymus gland and the spleen in mice after administration of pertussis vaccine]. Experiments were conducted on mice, strain NIH, line HSFS/N, immunized with pertussis vaccine. Determination of thymocyte pool proved to be a more sensitive method of detection of the stress effect of the vaccine than determination of the thymus weight. The test can be used for the elaboration of the method of assessment of the toxicity of pertussis preparations.


[Thrombocytosis in progressive generalized sclerosis (scleroderma) and in other rheumatic diseases]. A platelet count was made in 37 patients with Progressive Systemic Sclerosis (PSS), 6 with Sjögren's Syndrome, 11 with Rheumatic Polymyalgia with or without Horton's Arteritis (PMR-AH), 26 with Ankylosing Spondylitis (A.Sp.), 29 with Psoriatic Arthritis, 15 with Gout and in 65 healthy subjects. In this last group the mean platelet count was 215.692/mm3, S.E. 4.167. In the various groups of patients the following mean platelet counts were determined: PSS 242.108 +/- 11.766; Sjögren 245.000 +/- 22.620; PMR-AH 276.818 +/- 25.577; A.Sp. 272.846 +/- 14.124; Psoriatic Arthritis 245.833 +/- 9.374; Gout 265.333 +/- 24.628. Statistical analysis showed a significant difference (P less than 0.05), (P less than 0.01) or (P less than 0.001) between each group of patients and the controls. However, the platelet count in the majority of patients in each group was not higher than 300.000/mm3. Statistically significant correlations were found between platelet count and some biolgoical inflammation parameters. All patients with platelets higher than 300.000/mm3 showed a high disease activity. Yet some patients with marked inflammation did not present thrombocytosis. According to literature data thrombocytosis in Rheumatoid Arthritis is considered to be correlated to disease activity. The results of this study indicate that even in other rheumatic diseases thrombocytosis is often present, apparently correlated to the inflammation. Therefore thrombocytosis is an inflammation parameter; but it is less sensitive than other ones.


[Protein synthesis in lymphocytes of patients with various stages of chronic polyarthritis]. Protein synthesis in lymphocytes of patients suffering from rheumatoid arthritis shows various levels according to the stage of the disease. Incorporation of 3H-isoleucine is markedly increased in progredient cases (compared to normal subjects + 75%). Additional treatment of these patients with corticosteroids has no effect on the protein synthesis in the lymphocytes. This seems to be in contrast to investigations using in vitro incubation of lymphocytes in media containing steroids. Because of completely different conditions in these investigations exact comparison of the results is not possible. Protein synthesis in lymphocytes from patients with early stages of rheumatoid arthritis or ankylosing spondylitis shows no statistically significant difference to normal controls.


[Effect of the low molecular weight thymus factor on T-cells in human blood]. Lowmolecular factor of polypeptide nature (thymarin) was extracted from calf thymus. This factor differed by physical and chemical characteristics from thymosin. The percentage content of "active" T-lymphocytes increased under the effect of thymarin in the cultures of lymphoid cells obtained from healthy individuals. The total T-cell count remained unchanged. Thymarin favoured increase of the total T-lymphocyte and "active" T-lymphocyte count in the cultures of cells from patients with chronic inflammatory processes. Cellular immunity reactions were restored and the course of the main disease improved under the effect of parenteral administration of thymarin. It is supposed that T-immunity system incompetence was associated with the inadequate production of the thymus factor capable of restoring the activity of the thymus-dependent lymphocyte population.


Changes in the activity of the ependyma in the infundibular recess of the brain of Rana esculenta L. in the annual cycle. Volume of the cell nuclei of the ependyma of the infundibular recess was measured in 30 female and 30 male water frogs (Rana esculenta L.) obtained from their natural environment, taking into account the phase of the annual cycle. Karyometry of the ependymal cell nuclei in the infundibular recess in males and females showed statistically significant differences of volume (activity) in the annual cycle. The largest volume of nuclei of the ependymal cells in females and males was observed in the first decade of April (end of hibernation), and the smallest in the first decade of September (end of the period of active life). Activity of nuclei of cells from the infundibular recess clearly correlated with gonadal development.


The dorsomedial nuclear group of cranial nerves in the frog. The dorsomedial motor nuclei were demonstrated by the cobalt-labeling technique applied to the so-called somatic motor cranial nerves. The motoneurons constituting these nuclei are oval-shaped and smaller than the motoneurons in the ventrolateral motor nuclei. They give rise to ventral and dorsal dendrite groups which have extensive arborization areas. A dorsolateral cell group in the rostral three quarters of the oculomotorius nucleus innervates ipsilateral eye muscles (m.obl.inf., m.rect.inf., m.rect.med.) and a ventromedial cell group innervates the contralateral m. rectus superior. Ipsilateral axons originate from ventral dendrites, contralateral axons emerge from the medial aspect of cell bodies, or from dorsal dendrites, and form a "knee" as they turn around the nucleus on their way to join the ipsilateral axons. A few labeled small cells found dorsal and lateral to the main nucleus in the central gray matter are regarded as representing the nucleus of Edinger-Westphal. The trochlearis nucleus is continuous with the ventromedial cell group of the oculomotorius nucleus. The axons originate in dorsal dendrites, run dorsally along the border of the gray matter and pierce the velum medullare on the contralateral side. A compact dendritic bundle of oculomotorius neurons traverse the nucleus, and side branches appear to be in close apposition to the trochlearis neurons. A dorsomedial and a ventrolateral cell group becomes labeled via the abducens nerve. The former supplies the m. rectus lateralis, while the latter corresponds to the accessorius abducens nucleus which innervates the mm. rectractores. Neurons in this latter nucleus are large and multipolar, resembling the neurons in the ventrolateral motor nuclei. Their axons originate from dorsal dendrites and form a "knee" around the dorsomedial aspect of the abducens nucleus. Cobalt applied to the hypoglossus nerve reaches a dorsomedial cell group (the nucleus proper), spinal motoneurons and sympathetic preganglionic neurons. Of the dorsomedial motor cells, the hypoglossus neurons are the largest, and a branch of their ventral dendrites terminates on the contralateral side. Some functional and developmental biological aspects of the morphological findings, such as the crossing axons and the peculiar morphology of the accessory abducens nucleus, are discussed.


Chronic bleeding from a primary non-specific small intestinal ulceration localized by angiography. An idiopathic non-specific small intestinal ulceration in a young man is described. The lesion, which caused chronic anemia, was localized by angiography. Immediately prior to operation an angiography catheter was placed with the tip in the mesenteric artery supplying the abnormality. The catheter was easily palpated peroperatively and the lesion found.


[Diagnosis of neurinomas of the Gasserian ganglion]. The article analyses the findings of clinical and X-ray examination in 39 patients in two types of growth of neurinoma of the gasserian ganglion: with localization within the boundaries of the middle cranial fossa (22) and with the formation of tumor nodes in the middle and posterior cranial fossae (17). The first symptoms of the disease were paresthesia or numbness and continuous pain mostly in the zone innervated by the 1st--2nd pair of the trigeminal nerve, absence of corneal reflexes, high lumbar cerebrospinal fluid pressure, and protein-cellular dissociation in the cerebrospinal fluid. The craniograms revealed destruction of the floor of the middle cranial fossa with involvement of the walls of the f. ovale, spinosum et lacerum and the apex of the pyramid of the temporal bone. Carotid angiography demonstrated typical displacement of the carotid siphon to the midline, to the front, or to the back. The middle cerebral artery was moderately displaced upward and an arched art. chorioidea, anterior was noted. Growth of the neurinoma into the posterior cranial fossa was attended with displacement and deformity of a. basilaris et cerebellaris superior and the veins of the posterior cranial fossa. The ventriculograms showed compression of the inferior horn of the lateral ventricle and moderate compression of the caudal parts of the fourth ventricle and aqueduct of Sylvius. Comprehensive generalization of all the findings gained from examination of the patient is necessary in determining the topics and type of the growth of a neurinoma of the gasserian ganglion.


Congenital achromatopsia in a Finnish family. A family with two achromatic members, a sister and brother, is described. Their parents were first cousins. Eye examination of the 34 relatives examined revealed no abnormalities in 32. The son of their youngest brother was deuteranomalous. However, since this recessive trait is X chromosome linked, this failure was not related to the achromatopsia gene. The granddaughter of their eldest brother had difficulties in colour vision tests and was interpreted as an anomalous trichromat of unclassified nature. This might be a slight intermediate heterozygotic manifestation of the gene. The information of those relatives not examined revealed only a deceased paternal aunt who had had poor vision of an unknown cause. Congenital achromatopsia is rare but nevertheless should be kept in mind in cases of unexplained amblyopia. The nature of this disorder justifies the opthalamologist to inform these patients of the hereditary character of this disease and to give advice on educational guidance to them.


Spontaneous lymphokine production by human B lymphocytes. When human blood lymphocytes are cultured in vitro without any intended stimulus, they produce activities in the supernatant resembling lymphokine. This phenomenon was further investigated in the present study, where it has been demonstrated by physicochemical characterization and inhibition experiments that leukocyte migration inhibitory activity in the supernatants is due to leukocyte inhibitory factor (LIF). When T and B lymphocytes were purified by carbonyl iron and SRBC-rosette sedimentation, only B cells produced LIF and leukocyte chemotactic lymphokine(s) in subsequent cultures. B cells elaborated lymphokines without the help of T cells. the need for co-operation of monocytes was also unlikely. T cells were inactive even when reconstituted with monocytes and platelets.


Freezing of rat lymphocytes. V. The effect of suppressor cells in phytohaemagglutinin-stimulated spleen cell cultures before and after freeze-thawing. Spleen lymphocyte proliferation, as measured by 3H-thymidine incorporation induced by phytohaemagglutinin (PHA), was increased after freeze-thawing with 10% dimethyl sulphoxide. Depletion or intoxication of macrophages in fresh spleen cell preparations also increased lymphocyte proliferation in response to PHA. On the other hand, freezing of macrophage-depleted spleen cell suspensions lowered 3H-thymidine uptake of stimulated cultures. At concntrations above 3%, macrophages added to cultures of fresh purified lymphocytes showed a dose-dependent inhibitory effect on the PHA response, and fresh macrophages were more inhibitory than frozen-thawed macrophages. Purified lymphocytes mixed with 10% macrophages showed a higher response after freeze-thawing. It is concluded that macrophages suppress the lymphoproliferative response to PHA in rat spleen cell cultures, and that these macrophages are more sensitive than lymphocytes to the present freeze-thaw process.


Triton detergents and the frog neuromuscular end-plate: an electrophysiological and ultrastructural study. The effects of the nonionic detergents Triton X-45 and Triton X-100 were studied in the frog muscle end-plate, by intracellular recordings of spontaneous miniature end-plate potentials (m.e.p.p.'s) and the potential changes produced by iontophoretic application of acetylcholine (ACh-potentials). In addition, the ultrastructural changes produced by Triton X-100 were studied by transmission electron microscopic and freeze-fracture techniques. It was found that Triton X-45 and Triton X-100 caused a rapidly developing reduction of the amplitude of the m.e.p.p.'s. The response to iontophoretic application of acetylcholine was reduced by Triton X-100. Following return to normal Ringer solution the ACh-potentials recovered, although not completely. The dissociation constant calculated from the rate constants for onset and offset of the reaction (Kp=k2/k1) was 5--50 micron depending on the type of stoichiometric reaction presumed to occur between Triton X-100 and the cholinergic receptor. The ultrastructural changes observed indicate that the nerve terminal plasma membrane and mitochondria are affected by Triton X-100. Leakage of Ca2+ from the latter may therefore be the cause of the increase in m.e.p.p. frequency. It is concluded that the influence on the amplitude of the m.e.p.p.'s and the ACh-potentials can be attributed to a direct effect of the detergent upon the acetylcholine receptor protein.


Histiocytosis X. II. Histologic appearance correlated to prognosis and extent of disease. Specimens from 27 bone lesions of histiocytosis X were analysed semiquantitatively before treatment. Eosinophilic granulocytes seemed to be the only significant prognostic cell type. Absence of eosionphils or only slight eosinophilia in the initial bone lesions were found predominantly in widespread disease with fatal outcome. A moderate or severe degree of eosinophilia dominated in solitary bone lesions with good prognosis.


Needle aspiration biopsy in the diagnosis of lytic bone lesions in histiocytosis X, Ewing's sarcoma and neuroblastoma. Cytologic smears obtained by needle aspiration biopsy of lytic bone lesions in 15 patients with histiocytosis X, Ewing's sarcoma and neuroblastoma were reviewed. After conventional staining, histiocytosis X could be diagnosed and differentiated from small cell tumours such as Ewing's sarcoma and neuroblastoma. The need for sampling material for cytochemical and ultrastructural analysis of these small cell tumours by needle aspiration is emphasized.


Differentiation between process and reactive schizophrenia based on vestibular reactivity, grasp strength, and posture. The sensory-integrative treatment approach for the adult schizophrenic was indirectly examined by focusing on the differences between process and reactive subtypes of schizophrenia. Differences between the process and reactive schizophrenic were evaluated on the basis of three variables; grasp strength, posture, and vestibular reactivity. Results of the study indicated a significant difference between the process subtype schizophrenic subjects and normal subjects on all three variables, and a significant difference in vestibular reactivity between the process and reactive schizophrenic groups. Vestibular reactivity appears to be a variable by which to distinguish between reactive and process schizophrenic patients.


The effects of vestibular stimulation on verbalization in chronic schizophrenics. An experimental group of seven nonparanoid schizophrenic adults was given eight weeks of sensory-stimulating treatment, while a control group of seven similar subjects was given eight weeks of sedentary activities. Three components of language, in response to 16 questions, were measured pre- and post-treatment: number of words used, speed of response, and relevance of response. Analysis of covariance showed that the post-test scores of the experimental group were better than the post-test scores of the experimental group in relevance of response at the .01 level. These results suggest that eight weeks of sensory-stimulating activities can improve the quality of nonparanoid schizophrenic language, but does not appear to have an effect on the quantity or rate of that language.


Sensorimotor treatment of chronic schizophrenics. A pilot study, a sensorimotor treatment program, was conducted that involved five subjects. The subjects ranged in age from 23 to 49 and all carried a diagnosis of schizophrenia. Length of hospitalization ranged from 3 years to 30 years with only brief interruptions. Patients were evaluated before treatment, after six weeks of treatment, and six weeks after termination of treatment. Evaluation procedures used were: DRAW-A-PERSON Test; NOSIE; Posture Evaluation; and the Step Test. Results showed a decrease in overt psychotic behavior that did not last after sensorimotor treatment was discontinued; improved posture and gait in most patients; and improved body concept. There were no significant changes in pulse, blood pressure, or respiration rates.


Electrocardiographic pseudo-infarction pattern: appearance with a large posterior pericardial effusion after cardiac surgery. Two patients with a large posterior pericardial effusion after cardiac surgery presented with electrocardiographic precordial Q waves without evidence of myocardial infarction. Resolution of the pericardial fluid resulted in the disappearance of the Q waves. Changes in conductivity and orientation of the heart within the pericardial space, along with a decrease in QRS voltage, could lead to the loss of initial R waves in the precordial leads, eventually resulting in a QS complex. Care should be taken in interpreting the electrocardiogram after cardiac surgery in patients with a large posterior pericardial effusion. The clinical course along with serial electrocardiographic and echocardiographic tracings should be helpful in identifying this false infarction pattern.


A "problem-oriented" optometric record?

A "problem-oriented" optometric record? The concept of the problem-oriented record is presented. The system of record-keeping is described in detail and its advantages and disadvantages are discussed. A recommendation is made to incorporate the system in optometric practice.


Applied pressures and net water flux across in vitro frog gastric mucosa. The effects of hydrostatic pressure differences up to 0.4 atm/413 cmH2O were studied on frog gastric mucosa in vitro. Net water flux, transmucosal electrical potential difference, and acid secretion were measured.  A significant correlation between hydrostatistic pressure difference and net water flow (r=0.77) was obtained. The intercept of the regression line, at zero hydrostatic pressure difference, is 9.3 +/- 0.5 microliter/cm2.h, and the slope 42.9 +/- 3.2 microliter/cm2.atm.h. No significant correlation was obtained between the hydrostatic pressure difference and the transmucosal potential difference (P greater than 0.20), the acid secretion (P greater than 0.20), or the nonacidic chloride transport, measured as short-circuit current (P greater than 0.20). Hydrostatic water flux is compared to osmotically induced flux previously reported. It is proposed that the difference between hydrostatic and osmotic induced water fluxes is due to the area of cells exposed to the pressures. Only part of surface cells are directly exposed to the osmotic pressure due to the presence of restricted extracellular compartments.


Use of platelet-fibrinogen-thrombin mixture to seal experimental penetrating corneal wounds. A platelet-fibrinogen-thrombin mixture utilizing autologous platelets was studied for its potential to seal perforating corneal wounds. In rabbits, the mixture demonstrated sufficient adhesive properties to permit 75% of penetrating keratoplasties to remain in place without the use of sutures. All 12 grafts held initially; after 48 h three grafts extruded. In control eyes only two out of 12 (16%) of the corneal grafts remained in place. The material is simple to prepare and apply and is not toxic to the cornea. It does not cause inflammation or lid irritation. Intraocular complications observed with its use were transient anterior synechiae and retrocorneal membrane formation.


Anterior chamber angle recession in uveal melanomas. Sixteen uveal melanomas in celloidin sections and eight other fresh cases of melanoma were examined using different clinical and histological methods. A recession of the lateral border of the anterior chamber angle was found in most of them. The grade of this distortion varied from very deep to insignificant, but was apparent in most cases. Seven fresh cases were gonioscopically examined and some recession was seen in five of them.


[Perimetry during monocular and binocular fixation with the phase-difference haploscope of Aulhorn]. For the first time it was possible to compare perimetry during monocular and binocualr fixation under homogeneous conditions by the aid of phase-difference haploscopy. A binocular perimetry was not practicable using common perimeters. The examination was based on the anatomical fixed papilla nervi optici, which appears in the visual field as the blind spot. Its extension corresponds more to the anatomical size during binocular examination than during monocular examination. The difference is highly significant. Likewise the binocular perimetry refers to the quality of reproduction of paracentral retinal diseases significantly improved compared with the monocular examination. Supposing that the use of a larger fixation target during monocular perimetry contributes to the stabilization of normal eye movements, all examinations were additionally made with two fixation targets of different sizes. We have shown that there is no significant difference between the measurement either concerning the extension of the blind spot or the paracentral retinal diseases, which means a larger fixation target represents no fixation aid.


The blood-aqueous barrier and its permeability for proteins of different molecular weight. In aqueous humors and sera from 44 patients with cataracts, albumin, IgG, and alpha-1-antitrypsin were measured using radial immunodiffusion. The mean concentrations of the three proteins were significantly smaller than values found in aqueous humors taken post mortem, but corresponded well to values found in cerebrospinal fluid. No statistically significant difference was found between men and women, normotensives and hypertensives, and patients with or without myopia of high degree (greater than 6 diopters). A slight increase in protein concentrations in older patients and a relative decrease of alpha-1-antitrypsin is described. The aqueous humor-serum quotients of the different proteins showed a higher correlation than did the concentration of the proteins in aqueous humors.


Vitreous fluorophotometry and retinal blood flow studies in proliferative retinopathy. The permeability of the blood-retinal barrier and retinal blood flow were evaluated by two new fluorophotometric methods in a series of patients with proliferative retinopathy, due either to retinal vein occlusion or to diabetes. A breakdown of the blood-retinal barrier and a decrease in retinal blood flow were observed in these patients. The breakdown of the blood-retinal barrier could be quantitated by vitreous fluorophotometry, which revealed very high concentrations of fluorescein in the vitreous after intravenous administration. The decrease in retinal blood flow appeared to be due mainly to appreciable narrowing of the retinal arteriolar vessels.


Role of debridement and interferon in the treatment of dendritic keratitis. In a controlled clinical study, 42 patients with dendritic keratitis were treated either with thermocautery plus human leukocyte interferon (HLI) or with minimal wiping debridement plus HLI. The results show that the efficiency with which primary debridement was carried out, determined the success of further therapy using interferon. We conclude that interferon works basically as a prophylactic agent and needs the support of further antiviral measures to be effective against dendritic keratitis.


Phagocytic activity in the ischemic retinal pigment epithelial cells. An electronmicroscopic histochemical study of acid phosphatase. The role of lysosomal enzymes in ischemic retinal pigment epithelial cells (RPE) of albino rabbits was examined with the modified Gomori technique for acid phosphatase. Ischemia was produced by cutting the lateral posterior ciliary artery and short posterior ciliary arteries (PCA). Five days after PCA-cut RPE in the ischemic region were disorganized by increased enzymatic digestion. In RPE of the border between the ischemic and normal region a lot of fragmented outer segments were phagocytosed 24 h to 7 days after PCA-cut. At this time phagosomes appeared much more frequently than in the normal retina, showing several variations in their shape, localization, and histochemical reaction. However, after 10 and 14 days, RPE in the border had a tendency to reduce the phagocytic activity. A strong acid phosphatase activity was encountered in the phagosomes of macrophages, which was considered to be derived from RPE, and seemed to play the major role in scavenging destructed retinal elements.


Amiodarone-induced lipidosis-like alterations in ocular tissues of rats. The antianginal drug amiodarone (an amphiphilic cationic compound) causes a keratopathy in humans. In the present investigation the cytologic effects of amiodarone on ocular tissues of rats were studied. Ultrastructural alterations, which are typical of human keratopathy and characteristic of drug-induced lipidosis, could be experimentally reproduced in rats by local application of amiodarone. Repeated oral administration of high drug doses induced lipidosis-like alterations in many ocular cell types, particularly in retinal pigment epithelium. It is concluded that amiodarone has the potency to induce generalized lipidosis in rats, as do several other previously investigated amphiphilic cationic drugs. It is tentatively suggested that amiodarone-induced corneal alterations in humans might equally be interpreted as part of a generalized lipidosis.


Exogenous mycotic infections of the eye and adnexia. Three cases of exogenous mycotic infections of the eye are presented. The first is a case of keratitis in a patient suffering from glaucoma simplex who removed a foreign body from the cornea, caused by Fusarium solani, generally known as a saprophytic soil and plant inhabitant. As factors predisposing the patient to infection, trauma to the cornea like injury by a foreign body, as well as the preexisting disease of the eye, are discussed. The other case illustrates the change in the pathogenicity of an otherwise innocent fungus like Penicillium, which penetrated the sclera after injury of the eye by a broken airpiece of a drill and caused a severe endophathalmitis. The infection responded well to treatment with 5-fluorocytosine. The last case represents a rather mild well-known mycotic infection by Streptomyces somaliensis causing canaliculitis in a patient admitted for cataract surgery. Curettage of the infected canaliculus followed by iodine washout proved to be effective. The importance of the early clinical and laboratory diagnosis in order to avoid mistreatment with antibiotics and steroids and to ensure the right antimycotic treatment is stressed.


Intravenous chloramphenicol to prevent postoperative endophthalmitis in cataract surgery--520 consecutive cases. In 520 consecutive cataract extractions, 1 gm chloramphenicol has been given intravenously immediately before entering the anterior chamber of the eye with no known resultant blood dyscrasias and no bacterial endophthalmitis.


Heterotypic protective immune reactions in mice infected with distinct serotypes of human influenza virus. Infection of mice with subtype A0 OR A2 human influenza viruses, by a non-respiratory route causing no lethality, renders the animals markedly resistant to subsequent respiratory challenge with a strain differing from the first one through its haemagglutinin and neuraminidase antigens. This state of heterotypic immunity which appears rapidly (5 days) after the first infection, manifests itself during the second infection by a much reduced mortality, by less extensive lung lesions than in the control mice and by a final drop in lung virus titre (while in controls this titre stays at a high level until death) associated with a rapid rise of serum antibody levels against the haemagglutinin of the challenge virus and the "soluble" antigen common to type A strains. The development of this state of heterotypic immunity is dependent on the capacity of the first virus inoculated to replicate actively in the mouse. The role played by cell-mediated immunity in this phenomenon is evidenced by the fact that both the induction and the expression of this state of heterotypic resistance may be abolished by treatment of the mice with anti-thymocyte serum, while they are not affected by cyclophosphamide. Furthermore, in the mouse infected with an influenza A0 or A2 virus, it has been possible to demonstrate completely cross-reactive delayed type hypersensitivity reactions against the virions or their products. The fact that heterotypic immunity is not demonstrable between influenza viruses of type A and B favors the hypothesis that an antigen (matrix or nucleoprotein) common to all A subtypes--but different in B type strains--plays a role in these reactions of cross-protection.


Combined activitiy of clavulanic acid and ticarcillin against ticarcillin-resistant, gram-negative bacilli. Fifty-one clinical isolates of ticarcillin-resistant, gram-negative bacilli were tested for susceptibility to combinations of ticarcillin and clavulanic acid (BRL 14151), a potent beta-lactamase inhibitor. Minimal inhibitory concentrations (MICs) were measured by a microdilution method, and minimal bactericidal concentrations for selected strains were measured by the broth dilution method. Ticarcillin MICs were >/=128 mug/ml for all and >/=512 mug/ml for 38 (75%) of the strains. Thirty-nine strains of Enterobacteriaceae tested included Escherichia coli (14), Klebsiella pneumoniae (16), Citrobacter sp. (3), Enterobacter sp. (3), Salmonella enteritidis (1), Serratia marcescens (1), and Proteus mirabilis (1). Ticarcillin MICs for 34 strains (88%) were lowered at least threefold by the addition of 1.0 mug of clavulanic acid per ml. Against 33 strains (85%), the MICs were 64 mug or less per ml in the presence of 5 mug of clavulanic acid per ml. In contrast, the MICs for seven of eight strains of Pseudomonas aeruginosa were unaffected by the addition of up to 10 mug of clavulanic acid per ml. Ticarcillin with 5 mug of clavulanic acid per ml was bactericidal against ticarcillin-resistant (MIC >/= 2,048 mug/ml) E. coli, K. pneumoniae, Enterobacter, and P. mirabilis.


Specificity of pig T lymphocyte antiserum: cytotoxicity and inhibiting properties onto E-rosette-forming lymphocytes. The immunoglobulins obtained from a sheep anti-pig thymocyte serum were made specific for a subpopulation of porcine lymphocytes by adsorptions with pig red blood cells and bone marrow cells. In the presence of rabbit complement, these immunoglobulins killed a porcine lymphocyte subpopulation similar to the subpopulation of lymphocytes forming rosettes with sheep red blood cell (E-rosettes) when enhanced by dextran. Without complement, these immunoglobulins inhibited the E-rosette phenomenon at a dilution near to the cytotoxicity titre of the serum, but did not inhibit the rosettes formed with activated zymosan (ZC rosettes). These two different tests revealed the presence of antibodies directed against pig T-lymphocyte specific antigens and allowed the quantitication of T lymphocytes in different organs.


[Serological diagnosis of the antigenic markers of acute lymphatic leukaemias and non-Hodgkin lymphomas in childhood (author's transl)]. Leukaemia cells of 11 children with acute lymphatic leukaemias (ALL) and lymphoma cells of 4 children with lymphosarcoma (LS) were studied for the presence of T- and B-lymphocyte markers on their cell membranes. Spontaneous rosette formation (E-rosettes) of the malignant cells after adding sheep erythrocytes and the reaction with antithymocyteserum in cytotoxic test served as T-cell-markers and the surface immunoglobulins as B-cell-markers. The leukaemia cells of 5 ALL-patients with mediastinal tumours formed E-rosettes and reacted with the anti-thymocyte-serum. Six ALL-patients did not show these reactions. None of the ALL-patients had surface-immunoglobulins. Two of the 4 LS-children were E-rosette-positive, the cells of the other two LS-children contained surface immunoglobulins. There was a good correlation between the formation of E-rosettes and the reaction with the anti-thymocyte-serum. After absorption of the anti-thymocyte-serum with peripheral leukocytes it reacted with some of the E-positive lymphoblasts and thymocytes but not with normal peripheral T-lymphocytes. Anti-leukaemia-sera against the ALL-cells with T-cell markers of two patients after absorption with spleen cells did not react with peripheral lymphocytes but did effect lysis of thymocytes. Consequently, leukaemia cells which are E-rosette-positive possess a T-lymphocyte-associated antigen and a Thymus-associated antigen.


[Role of the ballon of intraaortic contrapulsation in a patient with stenosis of the main left branch and renovascular hypertension]. A 34 year old patient with prolonged unstable angina pectoris who did not respond to medical treatment is presented. In the course of three days he developed acute subendocardial infarction complicated by severe ventricular arrhythmias and cardiac arrest. Previously renovascular arterial hypertension due to important stenosis of the right renal artery had been diagnosed by renal arteriography. The precordial pain did not disappear with acute myocardial infarction. He presented acute postinfarction angina which required the use of vasodilator and beta-adrenergic blocking agents which did not alleviate his symptoms completely. Coronary arteriography performed a month after acute myocardial infarction demonstrated 99% stenosis of the left main coronary artery and 70% stenosis of the left anterior descending artery. During three days before surgery intraaortic ballon pumping was employed and the patient did not present precordial pain. The patient became asymptomatic after placing two aortocoronary vein grafts to the left anterior descending and circumflex arteries, and three months later blood pressure fell to normal after placing a right aorto renal graft. The poor prognosis of critical stenosis of the main left branch, its medical treatment and better evolution after surgery is discussed. The indications for intra-aortic ballon pumping in this type of patients and its use before surgery so as to be able to suspend beta-adrenergic blocking agents without risks are specified. Finally the surgical indications for renovascular hypertension are discussed.


Histopathology of cornea and iris in Chandler's syndrome. Corneal and iris tissue were examined from a 72-year-old woman with Chandler's syndrome. Light and electron microscopy showed posterior, corneal, collagenous-layer production by metaplastic corneal endothelium. In areas of iridocorneal contact, there were several layers of metaplastic endothelial cells that covered iris stroma and melanocytes, which were directly subjacent to Descemet's membrane. Cells similar to the metaplastic endothelium covered the anterior surface of the iris specimen. Similar corneal endothelial metaplasia has been described in posterior polymorphous corneal dystrophy. Presumptive growth of corneal endothelium on the anterior iris surface has been observed in typical essential iris atrophy and in Cogan-Reese syndrome, both of which share several features with Chandler's syndrome. Proliferation of endothelium over the anterior chamber angle and the iris may play a role in glaucoma and in the iris abnormalities that occur in these disorders.


[Situs inversus and long-term bronchopneumopathies, existing since the neonatal period]. Four boys are described who developed respiratory difficulties and broncho-pulmonary disease in the neonatal period. Three had situs inversus, and one situs ambiguus (Ivemark's syndrome). The symptoms continued for several months or years and in three children progressed to bronchiectasis. The other child is recovered. Two the children were brothers and a third sib. presented with bronchopulmonary disease at birth that continued for 17 months. He did not have situs inversus.


Multi-system immunologically mediated disease: T lymphocyte deficiency and thyroid immunologic disease--a report of four cases. Four cases are described of multi-system immunologically-mediated disease (systemic lupus erythematosus (two cases), polymyositis, and sarcoidosis) in association with thyroid autoimmunity. In all patients there was evidence of T lymphocyte deficiency, namely poor response of peripheral blood lymphocytes (PBL) to T cell mitogens (four cases) and failure or decreased ability to become sensitized to dinitrochlorobenzene (three cases), although two patients were ill and two were being treated with steroids. There was also evidence of B lymphocyte deficiency since PBL of no patient responded normally to pokeweed mitogen, a B and T lymphocyte mitogen. In two patients there was evidence of cell-mediated immunity to human thyroid antigens. Although thyroid stimulating antibody was not detected in the one patient with Graves' disease tested, significant titres of thyroid antibodies were detected in all cases. Possible relationships between T lymphocyte deficiency, organ-specific autoimmune disease and immunologically-mediated multi-system disorders are discussed.


[Hypogammaglobulinemia of variable expression, Addison's disease, Dubin-Johnson's disease]. A girl aged 12  with hypogammaglobulinaemia is described who developed Addison's disease with adrenal antibodies at the age of eight. This unusual finding is rarely seen in childhood except in the syndrome of juvenile familial polyendocrinopathy and mucocutaneous moniliasis. By chance the child also had Dubin-Johnson syndrome which could alter the metabolism of therapeutically administered drugs and steroids.


Hypertension due to 17alpha-hydroxylase deficiency. A female patient with hypertension, hypogonadism and hypokalaemia due to 17alpha-hydroxylase deficiency is described, in whom the diagnosis was initially based on the finding of low urinary 17-ketosteroids and 17-hydroxycorticosteroids, in the presence of high plasma fluorometric 11-hydroxycorticoids. Later studies confirmed the diagnosis by demonstrating low circulating levels of 17alpha-hydroxyprogesterone and the steroids derived from this precursor: 11-deoxycortisol, cortisol, oestradiol and testosterone. Plasma progesterone, corticosterone and deoxycorticosterone (DOC) were greatly increased, but plasma and urine aldosterone were very low. The initial subnormal cortisol and 11-deoxycortisol levels responded to tetracosactrin administration, suggesting that the adrenal was not maximally stimulated by endogenous ACTH and indicating that the 17alpha-hydroxylase deficiency was incomplete. Plasma and urinary aldosterone levels were still suppressed after 12 months treatment with prednisone despite normalization of the previously suppressed renin levels. The findings indicate that this uncommon cause of medically-controllable juvenile hypertension can be identified without specific steroid assays.


Localization of ferrochelatase and of newly synthesized haem in membrane fractions from Rhodopseudomonas spheroides. Cells of Rhodopseudomonas spheroides, strains R-26 or GVP, were grown photosynthetically, disrupted and two particulate fractions separated by sucrose-density-gradient centrifugation. The upper particulate fraction, enriched in bacteriochlorophyll, was identified as containing the chromatophores; the lower particulate fraction had the characteristics of the cell envelope. The two fractions differed in cytochrome content and cytochrome spectra. Ferrochelatase was found almost exclusively in the chromatophore fraction and was located on the outer face of the chromatophores, i.e. in contact with the cytosol in intact cells. The addition of 59FeCl3 to cells growing in low-iron media resulted in labelling of the protohaem fraction (probably arising from cytochrome b) of the membranes. The specific radioactivity of the haem of the chromatophores rose more rapidly than that of the envelope fraction and then after 2 h declined to approximately the same value, suggesting that haems of the chromatophore may act as precursors of haem of the envelope.


Immunological abnormalities in bronchiectasis with chronic bronchial suppuration. Fifty-three patients with bronchiectasis (chronic bronchial suppuration) of unknown cause, in whom the chronic production of purulent sputum was the prominent clinical feature, were investigated for possible immunological abnormalities. They were compared with two control groups comprising 50 patients with chronic bronchitis and emphysema and 33 patients with bronchial asthma. Forty-two patients with bronchiectasis(79%) had at least one abnormality of immunoglobulin, usually elevation of IgA, IgG or IgM. Eight patients had all three immunoglobulin levels raised and this was related to severity of disease. Similar increases in immunoglobulin levels were observed in the control groups, but the frequency and severity of these changes were significantly greater in the bronchiectasis patients. Two patients had IgA deficiency. There was a very high prevalence of rheumatoid factor (52%) and an increased prevalence of antinuclear factor (10%) in the bronchiectasis patients compared with the control groups. The presence of these autoantibodies did not correlate closely with severity of disease. Ten patients with bronchiectasis (19%) had one or more autoimmune disorders, and the association of severe bronchiectasis, Hashimoto's thyroiditis and pernicious anaemia in one patient is described in detail. The immunoglobulin changes, high incidence of autoantibodies and association with autoimmune disorders raises the possibility that in some patients with bronchiectasis (chronic bronchial suppuration) of apparent unknown cause abnormal immune mechanisms may be important in causing or perpetuating the condition.


Gastrointestinal systemic sclerosis in serologic mixed connective tissue disease. Mixed connective tissue disease is a clinical entity defined by overlapping features of progressive systemic sclerosis, systemic lupus erythematosus, polymyositis, rheumatoid arthritis, and distinct serologic findings. Esophageal dilatation and dysmotility have been the only gastrointestinal manifestations reported. Three patients with serologic findings of mixed connective tissue disease and extensive gastrointestinal involvement compatible with the changes found in progressive systemic sclerosis are presented. Gastrointestinal manifestations of progressive systemic sclerosis are reviewed and were found to be indistinguishable from the findings in these patients.


Circulating Sézary cells in hospitalized dermatology patients. Sézary cells in the circulation were counted daily in 14 hospitalized dermatology patients: six with contact dermatitis, five with atopic dermatitis, and three with exfoliative psoriasis. All had circulating Sézary cells, but absolute counts of Sézary cells of more than 1000/mm3 appeared to correlate with a severe refractory course in two patients. It is probable that low, intermittent levels of circulating Sézary cells accompany many inflammatory dermatoses, and it is reasonable that monitoring this cell population may aid in anticipating more consequential skin disease.


Role of ultraviolet light and UV DNA in the induction of skin lesions in experimental animals. In vivo and in vitro animal experiments have been performed to clarify the role of ultraviolet light denatured DNA (UV DNA) and ultraviolet light (UVL) in the pathogenesis of the dermal lesions of human SLE. Rabbits immunized with UV DNA show deposition of immunoglobulin at the dermal-epidermal junction following exposure to UVL. We have also shown that UV DNA appears concomitantly with the antibody at the dermal-epidermal junction subsequent to the UVL exposure. Both n DNA and UV DNA have been shown to bind to the dermal-epidermal junction in vitro which could result in the persistence of these antigens at this site. These studies lend further support to the hypothesis that the release of UV DNA and its subsequent deposition at the dermal-epidermal junction may result in binding of both immunoglobulin and complement, leading to the development of histological lesions of SLE.


Circulating inhibitors of granulopoiesis in patients with aplastic anaemia. An inhibitor of granulopoiesis has been detected in the serum of aplastic patients by its ability to reduce colony formation by normal human marrow cells in culture. The inhibitory activity in the serum was abolished when a patient was treated with azathioprine and exposure of aplastic marrow to antithymocyte globulin (ATG) in vitro released the colony forming cells from suppression. The clinical findings in three of the patients studied support the idea that the inhibitory activity detected in vitro is associated with normal marrow suppression in vivo.


Use of an antiserum specific for human T lymphocytes as a diagnostic reagent: comparison with E rosette formation and mitogenic response to PHA. An antiserum with specificity for human T lymphocytes was evaluated as a diagnostic reagent in the clinical immunology laboratory. The antiserum was used in indirect immunofluorescence to detect T cells in blood samples from normal controls and patients with various disorders involving the immune system. The same samples were also examined using two established tests for T cells, the rosette reaction with sheep red blood cells (E rosette assay) and the proliferative response to phytohaemagglutinin (PHA). The antiserum and the rosette assay detected approximately the same numbers of T cells in controls, but the antiserum indicated T cell deficiency in several patients who appeared normal by rosetting or PHA reactivity. PHA stimulation in autologous plasma was depressed in a further group of patients who had normal T cell numbers by the other two tests. In vitro experiments with normal lymphocytes indicated that the E-rosette receptor was distinct from determinants detected by the T-cell specific antiserum. The immunofluorescence test with the anti-T serum provides an additional assay which appears to be more sensitive than the other two tests in detecting certain cases of T lymphocyte deficiency.


Purification and characterization of a colony stimulating factor from human lung. Conditioned medium prepared from human autopsy lung tissue contains high level activity of colony stimulating factor which stimulates granulocytes and macrophage colony formation in both mouse and human bone marrow. The lung colony stimulating factor has been purified about 2250-fold by methods including hydroxylapatite chromatography, preparative gel electrophoresis, preparative isoelectric focusing, and gel filtration chromatography. The final specific activity was 2.7 X 10(6) units/mg. The purified factor has a molecular weight of 41 000 as determined by gel filtration. It is stable at the pH range of 6.5--10 and 56 degrees C for 30 min but sensitive to protease digestion and periodate oxidation. On polyacrylamide gel electrophoresis, it migrates in the alpha-globulin post-albumin region. Upon isoelectrofocusing lung colony stimulating factor appears heterogeneous with isoelectric points of 3.7--4.3. Treatment with neuraminidase did not affect its activity, but caused a change in electrophoretic mobility and isoelectric point. Antibody produced by immunizing rabbits with partially purified lung colony stimulating factor exerted strong inhibitory activity on the factor from lung as well as on colony stimulating factor from other human sources including serum, urine, and placenta.


Amylase transport across ileal epithelium in vitro. Amylase transport was measured across the rabbit ileum in vitro employing a modified Ussing chamber. Amylase was moved preferentially in the mucosal to serosal direction. Its rate of transfer was 2--3 orders of magnitude greater than that for inulin. Mucosal to serosal transport of exogenous amylase was completely inhibited in the absence of oxygen. There was also a constant release of endogenous amylase from intestinal tissue into both mucosal and serosal compartments in the absence of an exogenous source. An estimate of the rate of amylase absorption indicates that it may be of sufficient magnitude to account for the enteropancreatic circulation of amylase secreted by the pancreas during augmented secretion.


Non-enzymatic DNA strand breaks induced in mammalian cells by fluorescent light. Fluorescent light (5.4 J . m-2 . s-1) induces 0.041 single-strand breaks per 10(8) daltons per h in the DNA of cultured Chinese hamster cells (4.8 . 10(-6) breaks per 10(8) daltons per J . m-2). The breaks are induced at 1 degrees C and hence are not likely to be the result of endonuclease incision. When the cells are incubated at 37 degrees C, the breaks are rejoined within 2 h. At least two lesions are responsible for the observed effects. One lesion has the ability to break DNA subsequently treated with alkali but is neither toxic nor mutagenic. This lesion is produced by light of wavelength greater than approx. 350 nm. The other lesion(s) produce mutagenicity and/or toxicity, but do not necessarily produce strand breaks. These lesion(s) are produced by light of wavelength less than 350 nm.


[Detection of isoimmune antibodies against a population of human B-lymphocytes]. Rosette-forming ability of human lymphocytes was tested before and after their sensitization with isoimmune sera against histocompatibility antigens. Anti-HLA sera inhibited the ability of T- and B- lymphocyteè to form rosettes. Some sera inhibited rosette formation mostly of B-lymphocytes; they also possessed marked capacity to react with B-lymphocytes population in prolonged lymphotoxic tests.


[Cortical tissue from syngenous brain as a stimulator of immunogenesis in thymectomized mice]. Experiments on CBA mice showed that the gray matter homogenate of the syngeneic brain contained components reconstituting the T-cell population in the spleen of thymectomized animals and possessing a stimulating effect on the immune response to sheep red blood cells. The white matter homogenate was much less active, it is not excluded that the trace activity is due to the gray matter admixture in the preparation. Syngeneic muscle tissue homogenate possessed no biological activity.


[Mechanism of the stimulating effect of an electric current on reparative regeneration of bone tissue]. Experiments were conducted on rabbits. Changes in ATP in the regenerating bone tissue after incomplete osteotomy and removal of a bone section, and also in cases of reparative osteogenesis stimulation in the region of the bone defect by means of pulse electric current were studied. ATP content in the bone callus after incomplete osteotomy and electrostimulation proved to exceed such in the regenerating bone tissue following removal of the bone fragment when no stimulation was applied. On the basis of the data obtained it is suggested that improvement of energy provision of the fracture consolidation process was one of the important links in the mechanism of stimulating influence of the electric current on the reparative regeneration of the bone tissue.


Purification and some properties of colony-stimulating factor from normal human urine. A colony-stimulating factor (CSF) that stimulated human and mouse bone marrow cells to proliferate in vitro and form pure granuloid colonies was purified about 4000-fold from normal human urine. Purification procedures included concentration with polyethyleneglycol, ammonium sulfate precipitation, two chromatographic separations on DEAE-cellulose columns, gel filtration, and polyacrylamide gel electrophoresis. The molecular weight of the purified factor was estimated to be about 85,000 daltons by gel filtration, and the specific activity was found to be 10(6) or 6.7 X 10(5) colonies/mg protein using mouse or human bone marrow cells, respectively. A urinary colony-inhibiting factor was separated from the CSF on the first DEAE-cellulose column. This inhibitor suppressed the formation of pure granuloid colonies of human and mouse bone marrow cells when employed in conjunction with the purified urinary CSF.


Human T lymphocyte cell line producing colony-stimulating activity. We derived a permanent human T lymphocyte cell line that elaborates a potent colony-stimulating activity (CSA). The line was established with spleen cells from a patient with a T lymphocyte variant of hairy-cell leukemia. These cells form rosettes with sheep erythrocytes, show a proliferative response to phytohemagglutinin, and are lysed by antithymocyte globulin. They do not synthesize immunoglobulin, nor do they contain Epstein-Barr virus. CSA is regularly detected in the supernatant medium after 3 days culture. In the presence of PHA there is augmented elaboration of CSA; maximal activity is reached by 2 days and is 20% greater than that produced by a feeder layer of 1 X 10(6) peripheral blood leukocytes. One microliter of the supernatant material stimulated colony formation from the light-density nonadherent fraction of human bone marrow; there was maximal activity between 10 and 50 microliter/ml. Conditioned medium from these cells has little effect in stimulating CFU-C from murine bone marrow. The availability of a human T lymphocyte line producing CSA will provide a source for large quantities of the lymphocyte-derived hormone and permit a definition of factors modulating the interaction of T lymphocytes with granulocyte and monocyte stem cells.


Production of stem cell proliferation stimulators and inhibitors by haemopoietic cell suspensions. In mice treated with phenylhydrazine haemopoietic spleen colony forming cells (CFU-S) are proliferating rapidly in the bone marrow but not in the spleen. Using such mice we have investigated the production of factors responsible for the control of CFU-S proliferation. When irradiated spleen cells are incubated with non-irradiated bone marrow cells there is a marked fall in the proportion of femoral CFU-S in DNA synthesis. In the converse experiments, rapid triggering of splenic CFU-S is achieved. Both these effects can be eliminated by washing the irradiated cells prior to incubation; they are, however, retained in the supernatant media "conditioned" by these cells. When the washed cells are incubated in fresh medium at 37 degrees C both stimulatory and inhibitory activities reappear but after different incubation periods. The data demonstrate that both proliferation stimulatory and inhibitory factors acting on CFU-S can be produced by the same haemopoietic cell suspension.


Ventricular tachycardia due to cardiac ischaemia: assessment by exercise electrocardiography. Although ventricular tachycardia is a well-known complication of myocardial ischaemia and may be provoked by exercise, many patients may appreciate only the angina and be unaware of the unduly rapid heart rate that precipitates it. Exercise testing is needed to show this arrhythmia and to enable treatment to be started.Twenty-three patients were found to have chronic ischaemic heart disease complicated by ventricular tachycardia. Six patients with old myocardial infarction had ventricular tachycardia at rest which required conversion to sinus rhythm; 17 patients developed ventricular tachycardia only when they exercised. In 12 of these 17 patients coronary angiography showed disease of the anterior descending branch of the left coronary artery; other vessels were usually also affected. Although beta-adrenergic blocking drugs increased exercise tolerance, ventricular tachycardia still occurred when the heart rate on exercise reached a level similar to that before treatment. In five patients coronary artery bypass surgery was performed because of angina and exercise-induced ventricular tachycardia. Exercise tolerance was increased in all three patients who underwent exercise tests after operation, and in two of these patients, both of whom were known to have patent grafts, ventricular tachycardia was abolished.If part of the beneficial effect of coronary bypass surgery is preventing life-threatening ventricular arrhythmias it is essential to detect these, and ambulatory monitoring and stress testing have a complementary role.


Diagnosis and management of obscure gastrointestinal bleeding. Twelve consecutive patients presenting with unexplained recurrent gastrointestinal bleeding were investigated by selective visceral angiography. A cause for the bleeding was shown in all 12 cases, and in eight the lesion responsible was diagnosed radiologically as an area of angiodysplasia. Abnormal areas were pinpointed by fluoroscopy and examination of the resected bowel with a dissecting microscope after injecting the vessels with barium. Histologically these areas had various microvascular abnormalities. Angiodysplasia is a useful descriptive radiological term, but does not seem to represent a single pathological entity.


Ultrastructural studies on cerebellar histogenesis in the frog: the external granular layer and the molecular layer. Maturational changes of the cerebellum of frog tadpoles were studied with the electron miscroscope. In the premetamorphic tadpole, parallel fiber-like processes (PFP) were present in the incipient molecular layer, long before the appearance of the external granular layer (EGL). These PFP showed synaptic contacts with the precociously developed Purkinje cell dendrites. It appears that these PFP may be responsible for inducing the precocious elaboration of the Purkinje cell dendritic arborization. In the metamorphosing tadpoles, the EGL cells migrating into the internal granular layer were frequently seen in close association with the ependymoglial cell processes, which extend from the pia down toward the ependymal surface. This observation lends support to the hypothesis that glial processes guide the migrating EGL cells.


The topographical distribution of serotoninergic terminals in the spinal cord of the cat: quantitative radioautographic studies. In vitro uptake of labeled serotonin (5-HT) has allowed the radioautographic detection of serotoninergic fibers in the cat spinal cord at thoracic and lumbar levels. The specificity of labeling was ensured by the conditions of incubation ([3H]5-HT was 10(-7) M) and by test control experiments with concomitant 10(-6) M NA or 2 X 10(-6) M fluoxetine which led respectively to an unmodified or a negative radioautographic pattern. Macroscopic radioautography with [14C]5-HT gave the framework for analysis of 5-HT innervation at this level which appeared dense in the grey matter and more scattered in white matter except in the periphery. In the grey matter labeled structures appeared at histological level as randomly oriented fibers. They displayed enlargements which were identified by electron microscopy as varicosities (mean diameter 0.7 micrometer) containing clear and large granular vesicles. To estimate the density of 5-HT varicosities in grey matter, semi-automatic counting was performed on histological radioautographs, using an image analyzer. Maximal concentrations of boutons were found in the periependymal region, the sympathetic lateral column, the whole dorsal horn and the motor neuron area of ventral horn. In a densely innervated region, the number of boutons was estimated to be at least 2.65 X 10(6)/cu.mm. In white matter, labeled fibers were longitudinally oriented in the periphery and obliquely in other regions, except in the dorsal funiculus, where they were nearly absent. Previous histofluorescence and biochemical data are confirmed and completed by the results of this approach which displays several advantages in resolution, sensitivity and possibilities of automated quantification. Moreover owing to the dynamic abilities of the radioautographic method, the spinal cord provides a good model for the study of the properties (namely the axonal flow) and the functions of the serotoninergic neurons.


Hypothalamic-pituitary responses to intracranial self-stimulation in the rat. The effects on pituitary and adrenal hormones of intracranial self-stimulation (ISS) and forced stimulation in rewarding (PS) and non-rewarding (NSS) sites were investigated in adult male rats. Growth hormone (GH) was suppressed during periods of ISS and PS and rose sharply to a peak within 15 min of cessation. The interval between GH secretory episodes was significantly shortened during all 3 types of stimulation when compared to the normal rhythmic discharge observed in freely behaving baseline (BL) sampled rats. ISS, PS and NSS resulted in a rapid rise in prolactin (Prl), which returned to normal by the end of each hourly period of stimulation. There was a significant reduction of Prl elevation in the second and third periods of stimulation, suggesting that the first exposure to ISS had a greater stimulatory effect than subsequent stimulations. There was a rapid and sustained release of corticosterone (CS) during ISS and PS. As with Prl, the initial period of either ISS or PS caused a greater effect that subsequent periods. These studies provide data to compare the relationship between ISS and neuroendocrine responses. The hormonal responses, with minor exceptions, were similar under all experimental conditions, and could not be clearly dissociated from previously described stress responses. Neural pathways and substrates involved in GH, Prl and CS secretion are discussed in relation to pathways activated by LH-MFB stimulation. Potential differential functions of monoamines and hypothalamic neuropeptides in behavioral and neuroendocrine regulation are hypothesized.


Trigeminal neuralgia in aqueduct stenosis. Trigeminal neuralgia was the presenting symptom in two patients with aqueduct stenosis, hydrocephalus, and raised intracranial pressure. Treatment of the hydrocephalus resulted in the remission of pain in both patients.


Hodgkin's disease terminating in a T-cell immunoblastic leukemia. A patient who developed an immunoblastic leukemia of T-cell type two and one half years after initial diagnosis of mixed cellularity Hodgkin's disease, stage IIIB, is described. The patient's course was characterized by an initial 15-months remission following radiation therapy. A relapse of Hodgkin's disease was treated with intensive chemotherapy. Thirteen months later the patient entered a rapid terminal course with multiple organ infiltrates and a leukemic peripheral blood. The leukemic phase was characterized by a 55,000 WGC with 48% immunoblasts, greater than 90% of which marked as T-cells. Although acute myelogenous leukemia, acute lymphocytic leukemia, lymphosarcoma cell leukemia and other tumors have been described in Hodgkin's disease after intensive therapy, this is the first report of the unusual association of a T-cell immunoblastic leukemia with Hodgkin's disease.


Establishment and characterization of a human cancer cell line that produces human colony-stimulating factor. A human colony-stimulating factor (CSF) producing cell line, T3M-1, has been established from explant cultures of a human squamous cell carcinoma of the oral cavity that secretes human CSF. It has been continously propagated during the past 15 months. The cells grew in a monolayered sheet with about 17 hr of population-doubling time and showed a colony-forming capacity with about 5% plating efficiency. The cells exhibited an epithelioid morphology resembling the structure of the original tumor, and they showed "tumor takes" when inoculated into nude mice. Karyotypic analysis revealed the cell line to be a human aneuploid one with a hypotriploid mode, including the Y-chromosome(s) and at least 10 common markers. T3M-1 cells possess the characteristic function of human CSF production in vitro, and a marked neutrophilia was observed in nude mice bearing the tumors produced by inoculation with the T3M-1 represents a new human cell line that secretes human CSF.


Clinical implications of glucocorticoid receptors in human leukemia. Glucorticoid receptors were studied in various populations of normal human peripheral blood lymphocytes and leukemic lymphoblasts. Normal lymphocytes contain low levels of glucocorticoid receptor (approximately 2,500 sites/cell) which are identical in T- and non-T-fractions. Phytohemagglutinin treatment increases levels about 3-fold. Leukemic lymphoblasts contain larger numbers of receptor sites. Presence of receptor is correlated with in vitro sensitivitiy to glucocorticoids and in vivo response to therapy. Quantity of receptor is also correlated with complete remission duration independently of leukemic cell type (T or null), initial WBC, or age of patient. Quantitative determination of glucocorticoid receptor levels in acute lymphoblastic leukemia may be of value both as an independent prognostic variable and in suggesting which patients should receive glucocorticoid therapy.


Structural examination of antitumour, water-soluble glucans from Grifora umbellata by use of four types of glucanase. Antitumour glucans (GU) from the fungus Grifora umbellata have been subjected to periodate oxidation, Smith degradation, methylation analysis, and treatment with endo-(1 leads to 6)-beta-D-, endo-(1 leads to 3)-beta-D-, and exo-(1 leads to 3)-beta-D-glucanases, and alpha-amylase; the following structural features were revealed. GU-2 contains a backbone involving (1 leads to 6)-beta- and () leads to 3)-beta linkages, and two kinds of branches involving (1 leads to 6)-beta and (1 leads to 4)-alpha linkages. GU-3 has a (1 leads to 3)-beta-linked backbone and branches involving (1 leads to 6)-beta linkages or (1 leads to 4)-alpha and (1 leads to 6)-beta linkages. GU-4 also contains a (1 leads to 3) beta-D-glucan backbone and a small number of (1 leads to 6)-beta-linked branches. Probable structural units of these glucans are proposed.


[Trichocellular leukemia--ultrastructural study of tumor cells and various functional parameters]. In two cases of trichocellular leukaemia, specimens of blood, bone marrow and the spleen were evaluated not only by means of SEM and TEM but also with a view to their phagocytic and immunological properties. While immunological investigation rather suggested a B lymphocytic aetiology of the process, phagocytosis of Ferrocide (not, however, of latex) seemed to justify, in one case, also histoendothelial aetiology.


Cancer, pancreatitis, and the detection of the isoenzymes of DNAase, RNAase and amylase. Substrate films of starch, RNA, and DNA were used to identify the isoenzymes of amylase, RNAase, and DNAase found in human ductal pancreatic juice subjected to isoelectric focusing. The pancreatic secretions from 15 patients were shown to contain as many as four isoenzymes of RNAase; the two major forms had isoelectric points of 7.87 and 7.52, and the two minor forms, of 7.25 and 6.90. Six DNAase bands were detected; the major bands had pI values of 4.86 and 4.79, and sometimes appeared as one band. The minor bands had pI values of 5.08, 5.00, 4.68, and 4.58. Purified bovine DNAase I, analyzed similarly, showed four bands (5.29, 5.19, 5.04 and 4.96). Nine isoenzymes of alpha-amylase were observed in the secretions from 15 patients. The major alpha-amylase isoenzyme had a pI value of 6.84 in 14 patients and of 7.04 in 1 patient. Secondary bands were seen with pI values of 6.23, 6.53 and 6.69. Additional isoenzymes were found with pI values of 7.16, 6.39, 6.00 and 5.78. The amylase isoenzyme with a pI value of 6.39 was found in 7 of the 8 patients with a normal pancreas or carcinoma of the pancreas, and in only 1 of 7 patients with acute or chronic pancreatitis.


[Hyposensitisation treatment with pure bee venom (author's transl)]. Hyposensitisation with pure bee venom was undertaken in eleven persons with proven allergy to bee stings. Rapid hyposensitisation led to side effects in seven of them during dosage increase. Serial determination of total IgA, IgG, IgM and alpha1-antitrypsin revealed no changes, while allergen-specific IgG and IgE and total IgE increased maximally after 30 days. All persons were exposed to one bee sting during the treatment: all tolerated it well without the allergic reactions which had previously been noted.


Transglycosylic reactions of deoxysugars. Biosynthesis of deoxy analogues of starch. The biosynthesis of starch was investigated in the reaction catalyzed by plant alpha(1 leads to 4)-glucan phosphorylase using alpha-D-glucopyranosyl phosphate and its deoxy analogues as substrates. It was found that the hydroxyl groups at the positions C-2, C-3, C-4 and C-6 in the glucose moiety of the molecule of alpha-D-glucopyranosyl phosphate are not essential for its substrate properties in the transglycosylic reaction. The affinity of plant (alpha(1 leads to 4)-glucan phosphorylase and the rate of hexose incorporation into alpha(1 leads to 4)-glucan decreases in the following sequence: alpha-D-glucopyranosyl phos-phosphate, 2-deoxy-, 6-deoxy, 4-deoxy, and 3-deoxy-alpha-D-glucopyranosyl phosphate. The deoxyglucosyl analogues of alpha-D-glucosylpyranosyl phosphate act as competitive inhibitors on the elongation reaction of the alpha(1 leads to 4) chains of starch. It was found that more than one residue of 2-deoxy-D-glucose or 6-deoxy-D-glucose can be incorporated into the nonreducing terminus of alpha(1 leads to 4)-glucan chains of starch.


Angina following aortocoronary bypass surgery. 43 patients (group A) who had a recurrence of angina after aortocoronary bypass surgery were compared with 93 (group AF) who remained symptom free for at least 1 yr in order to assess the effects of pre- and intraoperative factors on the outcome of surgery. Age and sex distribution, severity and duration of preoperative angina, incidence of preoperative infarction, known coronary risk factors and severity of coronary artery disease assessed angiographically, were similar in the 2 groups. Group A had a lower preoperative exercise tolerance (434 V, 517 ppm/min; P less than 0.05) and a greater proportion of patients with cardiac enlargement (33% V, 14%; P less than 0.05). Fewer grafts were implanted in this group (1.65 V, 2.05; P less than 0.01) which consequently had a higher postoperative coronary score (2.47 V, 1.69; P less than 0.05). It appears that the extent of myocardial revascularization may influence the symptomatic result of aortocoronary bypass surgery.


Prevention of immunoglobulin production by allotype-dependent T cells. Adoptive lymphocyte transfers between Iga, Igb and Igd allotype-congenic mouse strains revealed host barriers against the production of certain donor allotypes. First, as recipients of Igb cells, Iga and Igd mice permitted the production of donor Ig-4b but not that of Ig-1 b. The apparent mediators of this Ig-1 b barrier were T cells specific for Ig- 1 b determinants on B cells. Additional cell transfers showed Iga mice to have a second barrier against allotype production by Igd donor cells. Reciprocal cell transfers showed Igb and Igd mice to have comparatively weak barriers against Iga-producing cells. As host barriers were absent in mice deficient for T cells (athymic nude mice), it appears that they are T cell-mediated. Further, the allotype-dependence of such barriers means that the antigens responsible must be under the control of allotype-linked genes. The regulatory implications of this for the immune system are discussed.


A time study of the requirement for carrier-specific helper cells in the response of mice to dinitrophenylated keyhole limpet hemocyanin. The anti-hapten response of spleen cells from mice primed with hapten-carrier (dinitrophenylated keyhole limpet hemocyanin) was decreased by depletion of T cells during the first four days after secondary antigenic stimulation, but was unaffected when the T cells were depleted on day 5. The response of cultures that were depleted of T cells prior to secondary antigenic stimulation was restored by addition of carrier-primed cells during the first two days of culture, partially restored on day 3, but not at later times. Thus, T cells were required only at about day 4 of a secondary response to a T-dependent antigen that peaked on day 8. Autoradiography experiments showed that the frequency of antigen-binding cells increased with time regardless of the presence of T cells in the cultures. We conclude that helper T cells are not required for B cell proliferation, but are required for the differentiation of B cells to antibody-secreting cells.


Colony formation of cytolytic T cells in semisolid medium. Addition of supernatant from concanavalin A-stimulated spleen cells to in vitro primed cytolytic T lymphocytes in semisolid medium stimulated the growth of colonies of cytolytic lymphocytes. Optimal results were obtained using a peritoneal adherent cell underlayer where a 10% plating efficiency (greater than or equal to 4 cells per colony) was achieved when between 5000 and 100 000 cells were plated per dish. Individual colonies were harvested and tested in a short term (5h) 51Cr release microassay, employing 200 target cells. The frequency of lytic colonies varied from 46--67%. The observed lytic activities were specific for the relevant allogeneic target cells.


Idiotype-specific T helper cells are required to induce idiotype-positive B memory cells to secrete antibody. We have tested the proposition that induction of certain sets of B cell clones to produce antibody requires a signal from T helper cells that recognize idiotypic determinants expressed on Ig receptors of the relevant B cell clones. The approach is based on the analysis of T cell populations required to induce B cells to secrete anti-arsonate antibodies that are marked by a cross-reactive idiotype (CRId). crid+ anti-azophenyl arsonate (Ar) antibodies are produced in A/J strain mice after immunization with Ar keyhole limpet hemocyanin and represent 20--70% of the total anti-Ar antibody response. These studies indicate that antibody secretion by idiotype+ B memory cells requires two signals: one provided by "carrier"-specific Ly-1 cells, and a second delivered by idiotype-specific Ly-1 cells. Both signals are required for optimal induction of idiotype+ B memory clones.


Effects of the antituberculous agent ethambutol on myelinated nerve. The action of the antituberculous agent ethambutol on the myelinated nerve was studied in two ways: (1) Resting and compound action potentials of the desheathed sciatic nerve were measured; (2) Na+ and K+ currents through the node of Ranvier were investigated by means of the voltage clamp. Reversible dose-dependent decreases of the compound action potential and of the conduction velocity were observed when ethambutol was applied in concentrations of 1--7 mM for 15 min; prolongation up to 60 min caused irreversible changes in membrane function and a decrease in Ca content. Ethambutol induced a hyperpolarizing change of the resting potential. When the nerve was depolarized in Ca2+-free solutions, ethambutol repolarized the nerve membrane. Ethambutol instantly reduced sodium and potassium currents through the nodal membrane. Presumably ethambutol acts primarily as a Ca2+ chelating cation on negative charges at the nerve membrane.


Seasonal variations in fat body metabolism of the green frog Rana esculenta (L.). Rana esculenta (L.), kept under natural conditions, show almost constant body weights in the annual cycle. Fat body weight, however, has a distinct maximum in October decreasing continuously to a May minimum which is also evident in the fat body index. The triglyceride and protein contents show the same course. Suprisingly high amounts of glycogen are found, which reach a maximum in August.


Kinetics of antibody response in unprimed recipients after transfer of immune lymphocytes. Spleen cells from mice immunized with SRBC were transferred, at various times after immunization, to non-irradiated and lethally irradiated syngeneic recipients. The PFC kinetics and anti-SRBC antibody titres were followed in various groups of mice. Similar results were obtained both in non-irradiated and lethally irradiated recipients, showing that after the transfer: a) PFC proliferation was blocked, b) PFC blocking was unrelated to their maturation stage, c) resting PFC were still able to synthesize antibodies, d) blocking activity was radio-resistant.


Effect of piperazine on central and peripheral cholinergic synapses of the frog. The anthelmintic agent piperazine did not antagonize carbachol-induced depolarizations of the frog sartorius muscle but depressed root potentials and acetylcholine release from the frog spinal cord. We suggest that piperazine has a presynaptic site of action at central cholinergic nerve-terminals.


The role of the radiologist in acute gastrointestinal bleeding. Angiography is valuable in the diagnostic and therapeutic management of the patient with acute gastrointestinal bleeding. It should be preceded by endoscopy in acute upper gastrointestinal bleeding, but in acute lower gastrointestinal bleeding, angiography is firmly established as the primary diagnostic modality. Although angiography is less useful in chronic gastrointestinal bleeding, it may show the underlying pathologic lesion. Vasonconstrictive and embolic therapeutic angiographic procedures are particularly valuable in the patient with multiple system disease.


Production of alpha-amylase by yeasts and yeast-like organisms. Of a total of 177 strains of yeasts and yeast-like organisms only 8 were capable of producing alpha-amylase; most strains were able to utilize 1,4-alpha-glucans by means of enzymes acting on the non-reducing ends of the outer glucan chains.


[Determination of blood coagulation in acute obstetrical and gynecologic hemorrhages by means of the Hellige direct writing thrombelastograph]. Thrombelastography, as a method of rapid registration, is an important addition to the present screening tests of coagulation status. With this method we are able to quickly obtain exact values for clotting and fibrinolysis with more precision than those which can be obtained from the clot observation test. The TEG monitor must however be available in the immediate vicinity of the labour ward and must be ready for use around the clock. Specific therapy for the elimination of failures in hemostasis may then be started without delay, due to prompt determination of coagulation status and early detection of fibrinolysis.


[T-lymphocytes and their function in Hodgkin's disease]. In untreated patients with Hodgkin's disease the percentage of T-lymphocytes was significantly reduced in comparison to healthy controls independent of the stage of the disease. The absolute number of T-lymphocytes was also reduced in most patients. The response of lymphocytes after PHA-stimulation was diminished parallel with the skin reactivity: Normal results were obtained in early stages and with favorable histological types whilst low values were found in stages III and IV and in unfavourable histological types. A correlation between the percentage of T-lymphocytes and the PHA-stimulation was found in early stages, but not in stages III and IV. There was also a correlation between the absolute number of T-lymphocytes and skin reactivity. The percentage of DNA-synthesizing lymphocytes was significantly higher than in normal blood. The highest values were found in stages III and IV and in unfavourable histological types. After radiation therapy the T-lymphopenia, the diminished PHA-stimulation as well as anergy was more pronounced than after chemotherapy.


[Immunosuppression by means of cytostatic chemotherapy. Inhibition of antibody formation and induction of tolerance in animal experiments]. Two different experimental models are presented for the induction of immunosuppression and immunological tolerance in mice with antineoplastic drugs: a) an unspecific T cell activation with a phytomitogen (phytohemagglutinin), or b) a partial synchronization of antigen-induced proliferation by mitotic blockade with vincristinsulfate prepare lymphoid tissue for an increased sensitivity to cyclophosphamide. With the first model a complete (antigen-nonspecific) inhibition of antibody production--mediated by an inactivation of T cells which act synergistically with antibody-forming cell precursors during the induction of the humoral immune response ("helper cells") -- has been demonstrated. The second model was shown to be suitable for the induction of immunotolerance, indicating a rather selective suppression of a clone of antigen-specific cells.


Characterization and mitogenic activity of Haemophilus influenzae type B capsular polysaccharide. Studies were conducted on the characterization of Haemophilus influenzae type b polysaccharide (HITB-PS) and its mitogenic activity upon peripheral lymphocytes. This capsular polysaccharide was found to contain hexosamines and hexoses in addition to the main components of ribose and ribitol phosphate. The molecular weight of HITB-PS was determined as 585,000. The affinity constant of HITB-PS to unfractionated lymphocytes was 3.13 X 10(3) M-1 with 1.11 X 10(4) binding sites per cell. HITB-PS was found to be mitogenic for both human T and B lymphocytes. At optimum doses, a three to five fold increase in 3H-thymidine incorporation into T and B cells was observed. Higher than optimum doses resulted in suppression of this mitogenicity. The effect of concanavalin A (Con A) mitogenicity was detected in T and B cells treated with effective as well as suppressive doses of HITB-PS; the mitogenic activities of Con A and HITB-PS were found to be independent of each other.


Mitogenic factor from chronically infected guinea pigs. A lymphokine produced by antigen stimulated lymphocytes, induces blastogenesis in cultures of lymphocytes which are not sensitive to the specific antigen. The in vitro production of this factor (MF) was accomplished utilizing peritoneal exudate (PE) cells from Coccidioides immitis infected guinea pigs. Production of MF by lymphoid cultures paralleled skin test reactivity of the donor animal. Removal of adherent cells from the PE population did not decrease the production of MF; conversely, a more significant production of MF was effected by the adherent cell depleted populations. Maximal production of MF was achieved at non-adherent cell concentrations from 4 X 10(6) to 8 X 10(6) cells/ml. Cell concentrations below 4 X 10(6)/ml produced material which inhibited DNA synthesis in test cultures. MF was separated from the inhibitory substance(s) by column chromatography of the crude preparations on Sephadex G-75. Inhibitor(s) eluted in the void volume (VO), and the MF eluted in an effluent volume (Ve) which was greater than the total bed volume (Vt) suggesting that MF is adsorbed by Sephadex beads.


Different mitogenic activity of soluble and insoluble staphylococcal protein A (SPA). The response to SPA and Staphylococcus strain Cowan I (StaCw) of highly purified populations of peripheral blood and tonsil human lymphocytes was investigated. Purified T lymphocytes isolated from perpheral blood by E-rosetting were unable to respond in vitro to StaCw. Highly purified B-cell populations from tonsils did not show any proliferative response in the presence of soluble SPA. The addition to highly purified B-cell suspensions from human tonsils of increasing concentrations of autologous T lymphocytes did not induce any increase of thymidine uptake in the presence of StaCw. However, it was able to restore a marked proliferative response of the B-cell cultures to soluble SPA, even though mitomycin-treated T lymphocytes were added. The low response of highly purified peripheral blood T lymphocytes to soluble SPA could be potentiated by the addition of autologous mitomycin-treated B cells, whereas the unresponsiveness of purified T lymphocytes to StaCw was not affected. Mitogenic activity of SPA coupled to Sepharose beads was different from that of soluble SPA and paralleled that of StaCw. These data strongly suggest that insoluble SPA is a T-cell-independent B-cell mitogen in man, whereas soluble SPA, like PWM, exerts its activity on B cells only in the presence of T cells.