An analysis of factors leading to a reduction in iron deficiency in Swedish women. The prevalence of iron deficiency anaemia among Swedish women of child-bearing age has fallen markedly since the mid-1960s. At that time, population studies in Göteborg and Uppsala showed that iron deficiency anaemia was present in about 25-30% of women. Later, in population studies in Göteborg in 1968-69 and 1974-75, the prevalence in the same age group was found to have fallen to 6-7%. Several factors may explain the improved iron status. The level of iron fortification of flour was increased from 30 mg/kg of flour in 1943 to 65 mg in 1970, this increase adjusting the iron intake to compensate for the lower energy requirement and expenditure of present-day living habits. There has also been a marked increase in the intake of iron tablets and of tablets containing ascorbic acid.An analysis of various factors indicates that the 20-25% improvement in iron status can be accounted for by increased use of oral contraceptives (3-4%), the impact of increased iron fortification (7-8%), the widespread use of ascorbic acid supplements (3%), and greater prescribing of iron tablets (10%).This analysis of the factors leading to the marked reduction in the prevalence of iron deficiency anaemia among Swedish women may be useful to public health planners in other countries with similar problems. Our results indicate that several factors need to be considered when planning controlled field trials and evaluating the results obtained. The methods used to analyse the impact of different factors on the reduction in iron deficiency can also be used to predict the effects of various public health measures on the iron status of a population.


Basic method for recording occlusal traits. This article describes a basic method for the recording of malocclusion that has been developed jointly by the World Health Organization and the International Dental Federation. The method was developed and field-tested in the period 1969-78 and should provide investigators and health authorities with a common basis for assessing the prevalence of malocclusion in various parts of the world. It should also serve as a basic reference tool in the development of methods for assessing the need and demand for orthodontic treatment.


Epidemiological aspects of intraocular pressure in an onchocerciasis endemic area. A field investigation of intraocular pressure in populations in onchocerciasis endemic areas of West Africa revealed a normal pressure distribution in individuals without signs of ocular onchocerciasis or with only microfilariae or reversible lesions in the eye. Females showed a significantly higher mean ocular tension, and in both sexes tension decreased with age. Patients with irreversible onchocercal ocular lesions and signs of anterior uveitis showed a significantly lower and abnormally distributed intraocular pressure. The prevalence of glaucoma was significantly higher in this group, thus indicating that a high intensity of onchocercal infection may be associated with a risk of secondary glaucoma. The presence of microfilariae in the ocular tissues and consequent inflammatory reactions may possibly give rise to an abnormal distribution of ocular tension.


A differential filtration technique for the measurement of schistosome cercarial densities in standing waters. The technique of differential filtration allows the detection of schistosome cercariae, with a recovery greater than 80%, in natural waters with a high concentration of microorganisms. This technique makes use of a new type of monofilament polyamide filter Nytrel-TI, with a pore size of 40 mum, allowing filtration of turbid water without clogging of the filter. A three-level prefiltration column (1000, 500 and 200 mum), which retains organisms larger than cercariae, facilitates reading of the filter. The apparatus used weighs less than 3.5 kg; it requires no power supply and can easily be used in the field.


Migration of lymphoblasts to the small intestine. III. Strain differences and relationship to distribution and duration of Trichinella spiralis infection. In NIH strain mice, in which the majority of Trichinella spiralis are located in the anterior half of the small intestine early in the enteral phase of infection, enhanced localization of mesenteric lymphoblasts, nylon wool separated mesenteric T-lymphoblasts and even oxazolone sensitized peripheral lymphoblasts is most prominent in the anterior region of the small intestine. As the worms move to the posterior half of the small intestine, enahnced localization of lymphoblasts is observed in that region only. In BALB/c mice, in which most of the worms are located in the posterior half of the small intestine, enhanced localization of lymphoblasts is primarily in that region. Expulsion of the worms commences within 2--3 days of a large increase in the number of lymphoblasts localizing in the anterior region of the small intestine in NIH strain mice and likewise follows a second and larger increase in the number of lymphoblasts localizing in the posterior region of the small intestine of BALB/c mice.


Impaired T lymphocyte colony formation in infectious mononucleosis: evidence for both monocyte and lymphocyte defects. PHA-induced T lymphocyte colony formation in semi-solid agar culture was studied in mononuclear cells (MC) and non-adherent cells (NAC) from the blood of patients with infectious mononucleosis (IM). Colony formation expressed as number of colonies per 10(6) E-RFC or as number of colonies per ml of blood was depressed by about 90% during the first weeks of disease, but returned to normal levels during the convalescence period. Addition to the agar culture of conditioned medium prepared from adherent blood MC or normal donors partly restored colony formation by both MC andNAC from patients with IM in the acute stages, suggesting a subnormal production of conditioning factors by cocultured adherent cells. In line with this finding adherent cells from patients with acute disease failed to produce a conditioned medium which optimally supported the growth of T lymphocyte colonies from NAC of normal donors. When mononuclear cells from patients with IM were mixed with normal donor lymphocytes prior to agar seeding, colony formation by the normal cells was reduced by 10--65%. It is concluded that mononuclear cells from patients with IM have a reduced capacity to form T lymphocyte colonies in agar medium. This reduction possibly reflects a lack of production of colony stimulating factors from monocytes, but also increased activity of T lymphocyte colony suppressor cells.


Lymphocyte-mediated cytotoxicity in isoniazid-associated hepatitis. The release of lymphotoxin (LT) from peripheral blood lymphocytes of patients with isoniazid (INH)-induced hepatitis was studied, using L929 fibroblast target cells, as was the cytotoxic effect of these lymphocytes on murine hepatoma cells (L1469) and L929 fibroblasts, using a 3H-proline cytotoxicity assay. Evidence for LT release was found in five out of six patients, following stimulation of the peripheral blood lymphocytes with INH or isonicotinic acid (INA) conjugated to human serum albumin. In the direct cytotoxicity assay, cytotoxic effects on the hepatoma cells were enhanced by preincubation of the target cells with INH in five out of six patients tested. Although specificity with regard to the drug was demonstrable, tissue specificity was less certain in that enhanced killing of the fibroblast cell line was also found to occur following preincubation of the L929 cells with INH.


Prognostic significance of cell surface markers in childhood acute lymphoblastic leukaemia. Examination of surface markers on leukaemic blasts from 51 children with ALL revealed that ALL is a heterogeneous disease. The majority (68%) of patients with ALL lack surface markers (null leukaemia); 28% could be classed as T cell as they form rosettes with sheep RBC and 4% have been shown to possess surface immunoglobulins and hence are classed as B cells. The children with null cell leukaemia have a better prognosis than T and B cell types.


Response of neutropenia and anaemia to immunosuppressive therapy: report and bone marrow culture studies. Soft agar culture of bone marrow cells was used to investigate abnormalities of granulopoiesis in a patient with acquired anaemia and neutropenia which responded to immunosuppressive therapy. Results showed that the patient's peripheral blood leucocytes inhibited granulopoiesis in vitro. Variation in the response of different target marrows suggested that inhibition was not due to direct action on granulocyte-monocyte committed stem cells but was directed against or mediated through the cells in target marrow samples which produce granulopoietic stimulators. Cell separation showed that the inhibitory activity was associated with the patient's mononuclear cells rather than neutrophils. A tentative explanation of the mechanism of production of the anaemia is also offered.


The prognostic significance of morphological features in childhood acute lymphoblastic leukaemia. A consecutive series of 209 children with acute lymphoblastic leukaemia (ALL) presenting to a regional referral unit between 1970 and 1977 was studied. The following morphological features in the initial bone marrow were recorded: blast size, percentage periodic acid-Schiff (PAS) and oil-red-O (ORO) positivity, percentage of blasts with vacuoles, and acid phosphatase positivity. The blasts were also coded according to the FAB (L13) classification. When analysed separately, increasing blast size was significantly related to the length of first remission (P = 0.01). However, this was almost entirely due to its association with the FAB L2 type of disease which also had a highly significant influence on length of first remission (P less than 0.0001) independent of all other factors. Patients with L3 disease had blasts with heavy vacuolation, ORO positivity and displayed monoclonal surface immunoglobulin and their prognosis was very poor. The percentage of vacuolated blasts and ORO positivity otherwise showed no influence on prognosis. Fine granularity of PAS staining in lymphoblasts showed no prognostic value but the trend of longer remission duration with increase in percentage of PAS coarse granularity and blocks, was statistically significant (P = 0.006). This relationship was partly due to a correlation with the presence of mediastinal mass and L2 disease, but was still independent of all other prognostic factors. In a smaller number (39) of the series of patients on whom cell surface markers were available, we were unable to demonstrate a correlation between T-derived blasts and the L1 and L2 classification; but there was a strong correlation with polar acid phosphatase positivity in T-derived blasts.


Fracutre healing in rats exposed to extremely low-frequency electric fields. Fibular osteotomies in rats were exposed to an extremely low frequency field for 14 days. By histologic evaluation it was found that the healing rate was retarded by the field. The effect (which was replicated) occurred at much lower power levels than are presently employed in electircal osteogenesis.


The effect of low frequency magnetic fields on the healing of the osteotomized rabbit radius. The object of this experimental work was to evaluate the effect of a noninvasive method of electrical stimulation on the healing of freshly-created osteotomies of the rabbit radius. The apparatus consisted of a solid core electromagnet energized by a square wave unidirectional current. The magnetic field was pulsed transversely across the osteotomy site of the radius while the animal was confined to a restraining device 6 hours daily for 5 days per week. In one group of animals the influence of different pulse frequencies, using 0.1 Hz, 1 Hz, and 4 Hz, was evaluated, while the period of stimulation was kept constant at 2 weeks. In another group of animals, exposure was continued for 3 and 4 weeks while the pulse frequency was kept constant at 1 Hz. Histologic and radiologic comparison with control animals revealed that the initiation of the healing process can be accelerated in magnetic fields pulsed at 1 Hz, but that this effect is not maintained, and that the total period of time required for union is not significantly shortened. In view of these findings, this form of treatment is not recommended for clinical use in the treatment of recent fractures of long bones.


Absence of correlation between T-lymphocyte activity and development of carcinogen-induced skin tumor in mice. Splenic lymphocytes obtained from female ICR/JCL mice, which had received combined radiation and chemical treatment for induction of skin tumors on their back skin, were tested for their ability to undergo proliferative response to non-specific mitogens as well as to allogeneic lymphocytes in vitro during 18 months after carcinogenic treatment. The treated mice, 168 in all, were divided into three groups: (a) 53 mice with no tumor, (b) 30 mice with skin papilloma, and (c) 85 mice with malignant skin tumor. Control mice, 39 in all, received no treatment. The local carcinogenic treatments used in this study induced a relatively long-lasting suppression of T-cell activities as detected by proliferative response to mitogens. Nevertheless, there was no significant difference in T-cell activities among the three groups of mice that developed (a) no tumor, (b) skin papilloma, or (c) malignant skin tumor. The results obtained with proliferative response to allogeneic lymphocytes were essentially similar. A preliminary study on the induction of cytotoxic T cells from splenic lymphocytes against allogeneic target cells in vitro also indicated that mice which developed tumors were not necessarily the ones which manifested reduced cytotoxic T-cell activity. These results suggest that reduced T-cell function was not a direct cause or not even a prerequisite for development of skin tumors in ICR mice.


Serological characterization of rat leukemia lines, DBLA-1, -6, and -9. Three lines of rat leukemia, DBLA-1, -6, and -9, were studied serologically by complement-dependent cytotoxicity test. DBLA-1, -6, and -9 were killed by anti-lymphocyte sera, anti-Thy-1.1 sera, and rabbit anti-rat brain sera absorbed with AKR/J brain. However, anti-T and anti-B lymphocyte sera had no cytotoxic effect on DBLA-1, -6, and -9. Furthermore, DBLA-6 and -9 did not absorb the cytotoxic activity of anti-T serum on thymocytes, while DBLA-1 slightly absorbed the cytotoxic activity. These results indicate that DBLA-1, -6, and -9 are of lymphoid origin and possess rat Thy-1 antigens, but lack mature T-lymphocyte antigens. On the other hand, peroxidase-positive myelogenous leukemia L1005 failed to react with any of the antisera used.


Growth characteristics of human leukemic B-cell, T-cell, and null-cell lines serially transplanted in hamsters. Human leukemic B-cell (BALL-1), T-cell (TALL-1), and null-cell (NALL-1) lines were established from three patients with acute lymphoblastic leukemia (ALL). Intraperitoneal transplantation of these ALL cell lines into immunosuppressed newborn hamsters resulted in the development of invasive tumors in all recipients, except 4 of 10 implanted with NALL-1 line. BALL-1 and TALL-1 lines were serially transplanted for 10 and 9 passages, respectively. In addition to a common in vivo feature of mesenteric and retroperitoneal tumors, BALL-1 line was characterized by infiltration of the skin, massive ascites, and bone marrow invasion. TALL-1 cells infiltrated various organs including the lymph nodes, liver, bone marrow, central nervous system, eyes, etc. NALL-1 line grew slowly, producing the least number of tumors. Leukemic cells were detected in the blood of 24 of 25 hamsters bearing BALL-1 and in the blood of 18 of 24 hamsters bearing TALL-1. Thus, these three ALL cell lines were found to exhibit a characteristic biological behavior in hamsters.


Human lung cancer cell line (KSNY) producing colony-stimulating activity which affects both human and mouse marrow cells. A cell line (KSNY) in vitro, which produces colony-stimulating activity (CSA) for human and mouse marrow cells, has been established. A biopsy was performed on the tumor mass of a lung cancer patient who had developed extensive leucocytosis. A piece of the tumor was transplanted to a nude mouse. The seconarily transplanted mice, in turn, developed extensive leucocytosis. The mouse tumor was then removed and placed in culture bottles. To date, the KSNY cells have been maintained in vitro continuously for 15 months. By the use of a methylcellulose bone-marrow colony-formation technique, a high level of CSA in the supernatant of the tumor cell culture was recognized. Doubling time of the cell line is 46 hr. The modal chromosome number is 52, ranging from 45 to 106.


Characterization of colony-stimulating activity in medium conditioned by a human cell line (KSNY). A human lung cancer cell line (KSNY) produces a high level of human colony-stimulating activity (CSA) as shown by the dose-response relationship between the number of colonies and the concentration of conditioned medium (CM). The CM tends to induce markedly granulocytic colonies rather than other cell-type colonies. The medium conditioned by KSNY cells (KSNY-CM) is stable at 50 degrees, but is completely inactivated at 70 degrees for 30 min. There is little binding of mouse CSA and/or human CSA in the CM to concanavalin-A-Sepharose. Fractionation of the CM by Sephacryl S-200 chromatography indicated that the maximum activity of KSNY-CSA for mouse and human marrow cells is eluted at approximately 20,000 approximately 25,000 and at 45,000 approximately 48,000 daltons.


Heterologous antiserum to a subpopulation of thymocytes and lymphomas in rats. Immunization of rabbits with rat leukemia DBLA-6 resulted in the production of antisera which upon absorption with hepatoma cells were specific for rat immature T lymphocytes. The antisera showed cytotoxicity against thymocytes and killed 75 approximately 90% of them, whereas the antisera had no cytotoxic effect on peripheral lymphocytes from the spleen, lymph node, and bone marrow of rats. The antisera also showed cytotoxicity against rat lymphatic leukemia and lymphoma cells of all lines tested but not against rat myelogenous leukemia and erythroleukemia cells. The cytotoxic activity of anti-DBLA-6 serum was completely absorbed with rat brain or thymocytes.


Prevalent types of tumors developing in neonatally thymectomized mice. Tumor development was observed for 24 months in neonatally thymectomized (nTx) and normal (C3H/HeMs x 129/J)F1 mice. Thymectomy was performed at 3 days of age. Ovarian (29%, with significant difference from the control at P less than 0.001), pituitary (6%, P less than 0.08), and lymphoreticular tumors (16%, P less than 0.05) were observed in higher incidence in nTx females compared with normal controls, resulting in a significant increase in overall tumor incidence (99 tumors in 114 nTx females vs. 37 tumors in 71 normal females, P less than 0.01). No apparent difference in overall tumor incidence was observed between nTx and non-Tx males. Also, there was no higher risk for lung, liver, and mammary tumors in males and females after neonatal thymectomy. The finding that increased tumor incidence was limited to endocrine and lymphoreticular tissues does not support the concept of immune surveillance of carcinogenesis, but rather suggests the importance of tumor-prone conditioning of endocrine or immune systems as a result of neonatal thymectomy.


[Pharmacological studies of 4-ethoxy-2-methyl-5-morpholino-3(2H)-pyridazinone (M73101). (3). General pharmacological actions (author's transl)]. General pharmacological actions of M73101, a new non-steroidal analgesic anti-inflammatory drug were investigated in mice, rats, guinea pigs, rabbits, cats and dogs. Intravenous administration of M73101 produced a slight transient fall in blood pressure, an increase in heart rate and a respiratory stimulation, but no remarkable change in the electrocardiogram. The contraction induced by epinephrine in the isolated ear vessels of rabbits relaxed by M73101. In the isolated trachea of guinea pigs, M73101 relaxed the contraction induced by histamine. Furthermore, M73101 inhibited the bronchoconstriction by histamine but not by bradykinin in guinea pigs. These properties of M73101 on the tracheal smooth muscle were similar to those seen with aminopyrine but different from those seen with aspirin which inhibited only the contraction by bradykinin in vivo, suggesting that M73101 is a compound with properties similar to basic non-steroidal anti-inflammatory drugs. M73101 inhibited the intestinal propulsion in mice and also the gastrointestinal movement in rats and dogs. Moreover, M73101 showed a spasmolytic activity on the isolated ileum of guinea pigs, but such was not due to any specific antagonistic action on the chemical mediators. On the other hand, M73101 had no effect on the isolated uterus and vas deferens of rats. M73101, unlike aminopyrine and phenylbutazone, slightly increased urine volume and electrolytes excretion in rats, indicating that this compound probably does not produced edema. M73101 showed no significant pharmacological activities on the blood sugar level, blood coagulation, platelet aggregation, methemoglobin formation and local irritation.


T lymphocyte number and functions in paroxysmal nocturnal haemoglobinuria (PNH). A preliminary report. T lymphocyte counts in the peripheral blood, lymphocyte response to phytohaemagglutinin (PHA) and delayed hypersensitivity reactions were studied in ten patients with paroxysmal nocturnal haemoglobinuria (PNH). Delayed hypersensitivity was abnormal in most patients and in vitro studies revealed impaired lymphocyte transformation to PHA in 50 per cent of the cases. These tests gave evidence of a functional alteration of lymphocytes in some PNH patients. The hypothesis of a disorder originated in a pluripotent lymphohaematopoietic stem cell is suggested.


Correction by factor VIII of decreased neutrophil alkaline phosphatase activity in classic haemophilia and von Willebrand's disease. Neutrophil alkaline phosphatase (NAP) score was estimated in ten patients with hereditary disorders in which antihaemophilic factor (factor VIII) is functionally deficient. NAP scores were estimated immediately before cryoprecipitate was administered, and following correction of patients' clinical condition and factor VIII activity in their plasma. While lower than normal NAP scores were observed before the treatment has been started, normal NAP score estimates were obtained following the successful correction of decreased procoagulant factor VIII (FVIIIC) activity in plasma of patients with classic haemophilia and von Willebrand's disease (vWd).


Lymphocyte activation by Con A.

Lymphocyte activation by Con A. Con A can activate cytotoxic effector cells, helper cells and suppressor cells. In all cases Con A activates polyclonally and thus the entire T cell repertoir can be revealed by Con A activation. Nylon purified T cells cannot be activated by Con A. however, in the presence of helper cells, such as adherent cells, or in the presence of serum from several species, Con A activates purified T cells. The serum factors that are responsible for Con A activation of purified T cells are present in the albumin fraction. It is suggested that Ia molecules may be responsible for the ability of Con A to activate purified T cells and a general hypothesis for T cell activation is outlined.


Characterization of alpha-1-antitrypsin by isoelectric focusing on an ultrathin polyacrylamide gel layer. An economic high-resolution system for determining PiM subtypes. Through the use of ultrathin layer polyacrylamide gel isoelectric focusing it is possible to obtain a resolution of the bands of alpha 1AT so as to be able to easily recognize all six PiM subtypes. The optimal resolution of the PiM subtypes is obtained without deforming the pattern of the Pi phenotypes. In addition to high resolution, ultrathin layer polyacrylamide gel isoelectric focusing permits a notable reduction of fees to 1/5 of the usual.


Centralized morbidity coding: the International Classifcation of Health Problems in Primary Care. After an extensive field trial, the International Classification of Health Problems in Primary Care (ICHPPC) was published in 1975 to meet the unique coding requirements of Family (General) Practitioners. Its employment has become widespread, but some difficulties persist. ICHPPC was developed principally by and for peripheral coders. Its application in a centralized coding scheme is not entirely satisfactory because of the difficulties of coding vague or inconsistent reports. These problems are illustrated and caution is recommended in the interpretation of morbidity rates reported from such systems. Suggestions are presented for revisions to ICHPPC that, along with modifications to data management system, could help alleviate the difficulties.


Upper gastrointestinal bleeding from uncommon causes in patients with concomitant peptic ulcer: a clinical, diagnostic and therapeutic pitfall. In the majority of cases, massivm a peptic ulcer arises from the ulcer. On rare occasions, the bleeding emanates from other sites in the gastrointestinal tract. Four patients, all of whom had suffered from peptic ulceration for lengthy periods, and who were referred to hospital with severe bleeding from sources other than peptic ulcer, are presented. This group of patients poses particular diagnostic and therapeutic problems, which are discussed. The need for performing emergency gastroscopy and/or selective angiography, in an attempt to localize the source of bleeding preoperatively, is stressed. In doing so, one is taking into consideration the many difficulties sometimes encountered during operation in locating a bleeding point in a bowel filled with blood clots. In those patients in whom the source of the hemorrhage cannot be ascertained, early surgical intervention is advised, because the bleeding may possibly be coming from a tumor of the small bowel.


Infiltration and survival: the behaviour of normal, invasive cells implanted to the developing chick wing. The invasiveness of mouse lymphocytes and thymocytes, rabbit peritoneal neutrophil granulocytes (PMNs), mouse peritoneal macrophages (both activated and non-activated) and pig endothelial cells was assayed by implanting these cells to the chick wing bud. Cells of each type moved into the wing mesenchyme, although activated macrophages invaded poorly. PMNs were the most invasive cells and had moved well into the limb after only a few hours. PMNs, lymphocytes and thymocytes were ingested by wing mesenchyme cells. Endothelial cells, however, ingested chick blood cells.  The implanted cells showed differences in ability to survive in the limb: PMNs disappeared rapidly, lymphocytes and thymocytes sometimes persisted for 24 h, while grafts of macrophages and endothelial cells were present at 24 h. Mechanisms which might be involved in the invasiveness of these cells, and also in their different abilities to survive in the chick wing, are discussed with particular reference to the production of plasminogen activator.


C-reactive protein for rapid diagnosis of infection in leukaemia. C-reactive protein, measured in serum from 38 patients with leukaemia, was elevated to at least 100 mg/l at the beginning of 32 of 34 episodes of infection, and subsequently rose above 100 mg/l in all 34. Uninfected patients, whether in leukaemic remission or relapse and whether pyrexial or not, always had levels below 100 mg/l, with four exceptions out of 290 measurements. Estimation of two other acute-phase proteins, alpha 1-antitrypsin and orosomucoid, was not of additional diagnostic value. Serial measurement of C-reactive protein may be important for the early detection of infection in the leukaemic patient with neutropenia.


[A posterior dislocation of the lens in herpes zoster (author's transl)]. The authors report a case of posterior dislocation of the lens during the natural history of a clinical case of herpes zoster. An echographic B-scan study was carried out to reveal the position and the size and the shape of dislocated lens, together with its structure and that of ocular media. After a discussion on the possible aetiology of the lens dislocation it was considered due to herpes zoster disease, and are reported the possible mechanism of zonula alteration.


Occupational factors in hypertension in the Nigerian African. In cross-sectional surveys of arterial blood pressure carried out in rural and urban communities in the Bendel State of Nigeria, mean systolic and diastolic pressure was generally higher in urban than in rural subjects but the differences in particular age groups were statistically significant only in some of them. Two sample Student's t tests were carried out to compare the blood pressure of rural labourers, rural clerks, and urban clerks. It is not clear from our findings whether the differences in any particular age group between rural labourers and urban clerks should be attributed to occupation or to area of residence. However, the consistently intermediate values for rural clerks over the different age groups provides strong indirect evidence that both these factors are relevant.


Surface potentials and the control of amphibian limb regeneration. The relationship between surface potentials and amphibian limb regeneration is examined. The wound surface becomes increasingly positive for several days after amputation but then decreases again, often becoming negative for a variable period during blastemal growth. The same changes of surface potentials are observed during wound healing alone, in the absence of amputation and following amputation of irradiated or denervated limbs. Similar changes occur in non-regnerating frog arms. These observations and other cited reasons lead to the conclusion that surface potentials do not control regeneration.


Somitogenesis in amphibia. II. Origins in early embryogenesis of two factors involved in somite specification. A somite pre-pattern is established shortly before visible segmentation. The pre-pattern results from the interaction of two components: a wave of cell behavioural change that passes along the axis, and, an underlying co-ordination of the cells that is the basis for their association into large somite-sized groupings. The evidence is derived from studies of the zones of abnormal segmentation that follow temperature shocks delivered between the neurula and tail-bud stages (Pearson & Elsdale, 1979). Temperature shock given earlier at the mid-gastrula stage is however ineffective in inducing abnormalities in somitogenesis. Shocks given before the mid-gastrula stage reveal a prior period of sensitivity stretching back into the blastula. Thus early and late sensitive periods can be defined separated by a short refactory period. Quite different patterns in the distribution of somite abnormalities characterize the results of shock during the two sensitive periods, suggesting different aetiologies. It is concluded that the wave of rapid cell change is set up early in embryogenesis during the blastula stage, and each cell of the prospective paraxial mesoderm carries a determination to change after a specific length of time, i.e. a countdown is set in each cell. As a result of the movements of gastrulation, the prospective paraxial mesoderm cells become laid out along the axis of the neurula in the order (antero-posterior sequence) in which they will change. The achievement of the correct redistribution of the cells depends crucially on the conservation of the sequence in the blastula by the maintenance of topological integrity throughout gastrulation. It is suggested that early shock disturbs gastrulation movements, causing some mixing up of the cells resulting in incoherence of the wavefront. Whereas early shocks are thus assumed to affect the wave, the evidence suggests that late shock undergoes co-ordination. It is concluded therefore that co-ordination is established later, after the refractory period, around the late gastrula stage.


High density cell water in amphibian eggs? The exchange of isotopic water, 2H2O and H2(18)O has been studied in amphibian eggs. The experiments were carried out with ovarian and body cavity eggs of Rana temporaria and unfertilized eggs of Ambystoma mexicanum. The cytoplasmic diffusion coefficient for H2(18)O was found to be 4.6 x 10(-6) cm2/s, somewhat higher than that for 2H2O, 3.4 x 10(-6) cm2/s. The total change in reduced weight, delta RW, during the isotope experiments was compared with the total amount of water in the egg cell, m. The ratio delta RW/m was significantly higher than would be expected from calculations using ordinary water density values. The results are discussed in terms of different phases of structured cell water.


Influence of light and calcium on guanosine 5'-triphosphate in isolated frog rod outer segments. Frog rod outer segments contain approximately 0.25 mol of GTP and 0.25 mol of ATP per mol of rhodopsin 3 min after their isolation from the retina. UTP and CTP are present at 10-fold and 100-fold lower levels, respectively. Concentrations of GTP and ATP decline in parallel over the next 4 min to reach relatively stable levels of 0.1 mol per mol of rhodopsin. Illumination reduces the concentration of endogenous GTP but not ATP. This light-induced decrease in GTP can be as large as 70% and has a half-time of 7 s. GTP is reduced to steady intermediate levels during extended illumination of intermediate intensity, but partially returns to its dark-adapted level after brief illumination. The magnitude of the decrease increases as a linear function of the logarithm of continuous light intensity at levels which bleach between 5 X 10(2) and 5 X 10(6) rhodopsin molecules/outer segment per second. This exceeds the range of intensities over which illumination causes decreases in the cyclic GMP content and permeability of isolated outer segments (Woodruff and Bownds. 1979. J. Gen. Physiol. 73:629-653). Thus, over 4 log units of light intensity, a sensitivity control mechanism functions to make extended illumination less effective in stimulating a GTP decrease. GTP levels in dark-adapted outer segments are sensitive to changes in calcium concentration in the suspending medium. If the external calcium concentration is reduced to 10(-8) M, GTP concentration is lowered to the same level caused by saturating illumination, and the GTP remaining is no longer light-sensitive. Lowering calcium concentration to intermediate levels between 10(-6) and 10(-8) M reduces GTP to stable intermediate levels, and the GTP remaining can be reduced by light. Restoration of millimolar calcium drives synthesis of GTP, but not of ATP, and GTP lability towards illumination is again observed. These calcium-induced changes in GTP are diminished by the addition  of the divalent cation ionophore A23187. Lowering or raising magnesium levels does not influence the GTP concentration. These data raise the possibility that light activates either a calcium transport mechanism driven by the hydrolysis of GTP, or some other calcium-sensitive GTPase activity of unknown function. Known light-dependent reactions involving cyclic nucleotide transformations and rhodopsin phosphorylation appear to account for only a small fraction of the light-induced GTP decrease.


Transverse-sectional imaging with Na18F in myocardial infarction. The potential utility of Na18F for acute infarct imaging was assessed in a canine model with a positron camera. Transverse-section imaging of radiofluoride in five dogs with acute myocardial infarction, using a multicrystal positron camera, clearly demonstrated the zones of damage as areas of increased activity. The F-18 uptake in the infarct zones was found to peak at 48 to 72 hr after coronary ligation, as does Tc-99m pyrophosphate. Preliminary in vitro studies indicate that the relative F-18 uptake, 48 after ligation, is an inverse linear function of regional blood flow.


Evaluation of gastrointestinal bleeding by red blood cells labeled in vivo with technetium-99m. To determine the effectiveness of abdominal imaging with RBCs labeled in vivo with Tc-99m, for the detection of gastrointestinal (GI) bleeding, 28 control subjects and ten patients with suspected bleeding underwent scintigraphy at 0-24 hr after tracer injection. Colonic activity was noted in one of the controls within 3 hr of injection, and in five of ten controls at 24 hr, all of whom had initial gastric activity. Of the ten patients with suspected GI bleeding, eight had documented active bleeding; seven of these had positive scintigrams. Nasogastric (NG) suction markedly decreased the presence of initial gastric activity in the patients with active bleeding. With this blood-pool radiopharmaceutical, frequent imaging of the abdomen over 24 hr can be done to test active bleeding. Continuous NG suction is recommended to reduce accumulation of gastric activity. These results suggest that red blood cells labeled in vivo with Tc-99m provide a sensitive method of detecting active GI bleeding.


Cranial scintigraphy: value of adding emission computed tomographic sections to conventional pertechnetate images (512 cases). A prospective trial was carried out to assess the contribution made by a radionuclide transverse-section view to conventional radionuclide scans of the brain. Each set of scans was reported by two independent teams of observers, but only one team viewed the tomography section. An abnormality rating was used to decide whether a set of scans was positive or normal. The reports for 512 patients were analyzed and compared with the final independent diagnosis. Greater accuracy of diagnosis with the section view was significant at the 0.1% level; the results showed that failure to detect tumors was almost halved while there was a 16% improvement for the detection of infarcts. Abnormality ratings were also used to plot ROC curves and rating curves; these showed that the addition of the tomographic view increased markedly the proportion of true positives without any increase in the proportion of false-positive reports.


A review of papillomas of the third ventricle. One case report. The Authors present one case of choroid plexus papilloma localized in the third ventricle. This is in fact the only case in a series of about 4,000 patients operated on for brain tumors at the Neurosurgical Institute of the University of Rome. They consider 56 cases reported in the literature. Out of these, 43 are described and summarized in a table according to the clinical, radiological and surgical features. Twentyfive were the patients operated on, the average mortality in the cases which underwent indirect or not specified operation was 80%; that of patients submitted to a direct approach or to subtotal excision was 50%; and finally 3 patients out 13 (about 23%) who had total resection, died after surgery.


Long-chain F-18 fatty acids for the study of regional metabolism in heart and liver; odd-even effects of metabolism in mice. In view of the potential usefulness of fluorine-tagged fatty acids in the study of regional metabolism in the heart and liver, the time courses of uptake and release of 9,10-[18F]fluorostearic acid, 2-[18F]fluorostearic acid, 16-[18F]fluorohexadecanoic acid, 17-[18F]fluoroheptadecanoic acid have been investigated in several organs of NMRI mice. Whereas 2-[18F]fluorostearic acid shows very little uptake in the heart muscle but an increasing accumulation in the liver, the fatty acids with the F-18 label in the middle or at the end of the carbon chain exhibit uptake and elimination behavior similar to that of the analogous C-11-labeled compounds. After rapid concentration in the heart within 1 min, clearance takes place with fast and slow components. 16-[18F]fluorohexadecanoic acid and 17-[18F]fluoroheptadecanoic acid have different half-times of elimination. These differences are also reflected by the fact that nearly all the activity present in the heart can be recovered as fluoride(F-18) in the case of 17-[18F]fluoroheptadecanoic acid, whereas practically no fluoride was found among the metabolites of 16-[18F]fluorohexadecanoic acid. Similar differences were observed for the F-18 activity in bone. The results can be interpreted in terms of the odd-even rule: beta oxidation of even-numbered fatty acids ends up with [18F]fluoroacetic acid, whereas the odd-numbered fatty acids give rise to beta-[18F]fluoropropionic acid. Only in the latter case does dehalogenation take place leading to free fluoride, whereas fluoroacetic acid undergoes further reactions in the citric acid cycle.


Concentration of Tc-99m methylenediphosphonate in hepatic metastases from squamous cell carcinoma. A case is described in which Tc-99m methylene diphosphonate concentrated in a hepatic metastasis from esophageal squamous cell carcinoma. We observed radiopharmaceutical concentration in the hepatic metastases, which was probably related to the presence of necrosis with calcification.


A new transverse-section brain imager for single-gamma emitters. Physical and clinical data on a new emission transverse-section scanner are given. Comparative data from an earlier tomoscanner and a rotating gamma-camera system yield the following information for the three imagers. Resolution at the center of the field is 9 mm for this tomoscanner, 18 mm for the earlier tomoscanner, and 11 mm for the rotating camera; sensitivity (cps/muCi-ml) 36K, 15.4K, 1.9K; crystal area (cm2) 3096, 619, 490, respectively. The quantification of images is discussed. Clinical emission section scans of the brain, liver, chest and skull are presented and discussed. Forty brain scans were analyzed in conjunction with x-ray transmission tomography. No false positives were found. From a total of 15 lesions seen by the CT x-ray scanner, 14 were detected by the emission tomographic scanner, 12 by standard gamma-camera imaging. One false negative case (cyst) was seen by the transmission x-ray scanner but not by the emission scanner.


Carbon-11-labeled amino acids for the rectilinear and positron tomographic imaging of the human pancreas. Modification of the Bücherer-Strecker amino acid synthesis facilitated the production of DL-[11C]tryptophan and DL-[11C]valine for clinical trials in patients with proven or suspected pancreatic disease. Examples of rectilinear scans and tomographic images of the pancreas are presented in this initial paper. Positron computed tomography was done with the ORTEC ECAT system. Rapid localization of these C-11-labeled amino acids and fast clearance from the plasma permit almost immediate examination following i.v. injection. Illustrative images include the normal pancreas, pancreatitis, and pancreatic carcinoma. The use of positron tomobraphy with C-11-labeled DL-tryptophan and DL-valine appears to offer a new and promising diagnostic modality for the detection and study of pancreatic diseases.


Measurement of liver volume by emission computed tomography. In 22 volunteers without clinical or laboratory evidence of liver disease, liver volume was determined using single-photon emission computed tomography (ECT). This technique provided excellent object contrast between the liver and its surroundings and permitted calculation of liver volume without geometric assumptions about the liver's configuration. Reproducibility of results was satisfactory, with a root-mean-square error of less than 6% between duplicate measurements in 15 individuals. The volume measurements were validated by the use of phantoms.


Fourier multiaperture emission tomography (FMET). We describe a new emission tomographic technique, using an Anger scintillation camera and a new family of coded apertures, in which a noniterative computer algorithm is used to reconstruct multiplanar images. The novel feature is a set of spatial narrow band filters that allow the depth information to be separated in the frequency domain. The position of the reconstructed planes can be selected at will. Using this technique, a planar resolution of 0.75 cm and a depth resolution of 1.6 cm have been measured at a depth of 10 cm and a magnification of 1. To demonstrate the potential of this system, the results of a phantom study are reported.


Non-Hodgkin's lymphomas: an immunohistochemical and histological study. Immunohistochemical and histoogical studies have been performed on paraffin sections of 19 cases of non-Hodgkin's lymphoma (NHL). All the cases were lymphocytic in type and, on the basis of the National Lymphoma Investigation classification, 11 were follicular (six small, three mixed small and large, and two large cell types) and eight were diffuse (four intermediate, three poorly and one well-differentiated types). Marshall's metalophil method revealed a population of dendritic histiocytes in and around the follicles of follicular lymphomas. The distribution of the dendritic cells within the neoplastic follicles resembled the distribution of similar cells in reactive follicles, lending support to the concept of an origin for lymphoma follicles from their reactive counterparts. In the diffuse lesions the dendritic cells were large and more pleomorphic than in the follicular lesions, but these features were not so pronounced as those previously observed in Hodgkin's disease. The PAP sequence was used to demonstrate Ig, and as judged by the types of light and heavy chains in the lymphoma cells, the cases were divided into three groups: Group 1 (eight cases) in which the lymphoma cells contained monotypic Ig; Group 2 (six cases) in which monotypic Ig was probably present; and Group 3 (four cases) where no evidence of monotypic Ig secretion was found. Monotypic Ig was most commonly found in follicular lymphomas, mu kappa secretion being the most frequently identified combination of heavy and light chains. The majority of cases (73 per cent.) were thus clearly derived from B lymphocytes. However, the fact that monoclonality was evident in only a proportion of cases suggested that lymphomas may be polyclonal initially and proportion of cases suggested that lymphomas may be polyclonal initially and that monoclonality is a later development. In addition to the lymphoma cells, normal mature plasma cells containing a high concentration of intracellular Ig were present in all but one of the lesions. The Ig was polytypic, cells containing kappa and lambda chains being present in roughly equal numbers and gamma chains pre-dominating. Extracellular Ig (gamma, mu, kappa, lambda) was also present in many lesions. Collections of small non-lymphomatous lymphocytes were also present in all cases. In eight lesions these appeared to have polytypic surface Ig (mu, kappa, lambda). Dendritic cells mingled with these lymphocytes. Collections of small lymphocytes non-reactive for Ig were also present. These had no association with dendritic histiocytes and might have been T cells. It is concluded that in most cases immunohistochemistry alone provides an insufficient basis for the diagnosis of lymphoma and that disturbance of cellular morphology and tissue architecture remain the most useful criteria on which the diagnosis of lymphoma rests.


Differential effect of perhydrohistrionicotoxin on 'intrinsic' and 'extrinsic' end-plate responses. 1. At rat and frog neuromuscular junctions, perhydrohistrionicotoxin (H12-HTX), at concentrations below 10(-6) M, blocked end-plate currents and potentials generated by ionophoretic application of ACh (extrinsic responses) more effectively than end-plate currents and potentials generated by neurotransmitter secreted from the motor nerve (intrinsic responses). 2. In contrast, (+)-tubocurarine affected both extrinsic and intrinsic responses in a parallel manner. 3. There was no change in the time course and little or no change in the amplitude of intrinsic end-plate currents when extrinsic currents were depressed by H12-HTX nor was there any change in the conductance or lifetime of channels activated by applied ACh. 4. The depressant effect of H12-HTX on extrinsic responses persisted both when carbachol was used as the agonist and when acetylcholinesterase was inhibited with diisopropylfluorophosphate. 5. Large end-plate currents elicited by nerve stimulation that presumably activate the whole end-plate area were not depressed by H12-HTX to the same degree as extrinsic end-plate currents generated by ionophoresis of ACh at the same end-plate. 6. Brief (50 microsec) pulses of ACh produced brief end-plate potentials which were depressed by concentrations of H12-HTX that had little or no effect on miniature end-plate potentials. 7. Extrinsic responses to ACh at extrajunctional regions of denervated fibres were also depressed by low concentrations of H12-HTX. 8. It was concluded that the differential effects of H12-HTX on intrinsic and extrinsic end-plate responses could be due to the existence of two populations of receptor-channel complexes or to protection of local receptor-channel complexes from the toxin by a substance secreted from motor nerve terminals.


Chemical change, production of tension and energy following stretch of active muscle of frog. 1. Measurements were made of the tension and the heat + work produced during 6.5 s of tetanic stimulation at 0 degrees C. The muscle was stretched by 3 mm to 1.2 times rest length either 1 s before stimulation began of 1 s after it began. 2. The extent of ATP splitting during the period from 1.5 to 6.5 s after stimulation began was determined from observations of the levels of phosphocreatine, creatine and the sum of inorganic phosphate and glucose-6-phosphate and glucose-1-phosphate. (The creatine kinase reaction was taken to be in equilibrium.) 3. In agreement with earlier findings more active tension was produced following a stretch when the stretch occurred during stimulation than when it occurred before stimulation. This increase was large and statistically significant. 4. The mean splitting of ATP was greater following a stretch during stimulation, but this change was small and not statistically significant. 5. During the interval from 1.5 to 2.5 s after stimulation began, which is shortly after the stretch ended, the rate of heat production was significantly greater than in the isometric contraction. 6. From 2.5 s to the end of stimulation and during relaxation the heat + work was not significantly different in the two types of contraction.


Maintaining standards of primary care in America. The evolution of present day attitudes toward maintaining standards of medical care in the United States is described, and the main methods identified. Their influence on current practice is discussed, and application made to the promotion of high standards of care in British general practice.


N-Alkylated 2-aminotetralins: central dopamine-receptor stimulating activity. In order to define the structural requirements of N-substituents of 2-aminotetralins as central dopamine receptor agonists, a series of N-alkyl- and N,N-dialkyl-substituted 2-amino-5-hydroxy- and 2-amino-5-methoxytetralins have been synthesized and evaluated. The compounds were tested biochemically and behaviorally for dopaminergic activity. From the biochemical data it is concluded that an n-propyl group on the nitrogen is optimal for activity. The corresponding N-ethyl-substituted compounds are slightly less active, while the absence of N-ethyl or N-propyl groups give almost inactive compounds. It could be demonstrated that this is due to steric and not to lipophilic factors. It is suggested that a possible requirement for a potent agonist is that one of it N substituents must fit into a receptor cavity which, because of its size, can maximally accommodate an n-propyl but also smaller groups like ethyl or methyl. The active compounds appeared to give a similar relative pre- and postsynaptic stimulation and had also similar activities for the limbic system and for striatum. None of the compounds listed seemed to have central noradrenaline- or serotonin-receptor stimulating activity.


Evidence for the failure of IgA specific T helper activity in a patient with immunodeficiency with hyper IgM. A 28-year-old man with immunodeficiency with hyper IgM was studied. His serum immunoglobulins were characterized by the absence of IgA and low level of IgG associated with high level of IgM. The in vitro pokeweed mitogen (PWM)-induced immunoglobulin synthesis by his peripheral blood lymphocytes was depressed completely for IgA and moderately for IgG although normal numbers and proportions of IgA- and IgG-bearing lymphocytes (on the surface) were demonstrated in the peripheral blood. His T cells could not help IgA production by either normal or his own B cells, whereas they were more efficient helpers for IgM production by his own B cells than were normal T cells. In addition, his B cells produced no IgA and less IgG than normal B cells when co-cultured with normal T cells. This suggests that the failure of IgA specific T helper activity and the maturation arrest of B cells at the stage of the switchover from IgM- to IgG- and/or IgA-producing cells may be the major cause for the hypogammaglobulinaemia in this patient. It is uncertain whether the maturation arrest of B cells is secondary to the T cell defect in helper function for IgA production.


[Chronic toxicity test of 4-ethoxy-2-methyl-5-morpholino-3(2H)-pyridazinone (M73101) in beagle dogs (author's transl)]. Male and female dogs, aged 17--21 months, were administered orall M 73101 (0, 60, 120 and 240 mg/kg/day), a new analgesic and antiinflammatory drug, for 27 weeks, and following recovery test was carried out for 5 weeks. Dead animals were not found throughout the experimental period. Body weight gain, and food and water consumption were not affected due to M 73101 administration. Except for a slight increase of vomitting in the highest dose, there were no abnormal symptoms. Biochemical examination showed the slight increase in serum alkaline phosphatase activity and free cholesterol level. Pathological examination revealed a dose-dependent increase of liver weight and hypertrophy of hepatocytes due to proliferation of smooth endoplasmic reticulum. In addition, mitochondria became irregularly large in the highest dose. There were no abnormal findings in the gastro-intestinal tracts except for an erosion of gastric mucosa, which was noted in a female dog treated 240 mg/kg/day of M 73101. From these results, it was suggested that the maximum non-toxic dose was 60 mg/kg/day or less, and the greatest safety dose was 120 mg/kg/day in beagle dogs.


[Assessment of the state of the fetoplacental unit before induction of labor and its outcome]. By a prospective study the authors tried to assess the state of the fetoplacental unit in pathologic pregnancies. Depending on the given situation, the following analytical procedures were used: oxytocin test (OCT), placental beta-1-glycoprotein (SP-1), amnioscopy, and analysis of the liquor amnii ingredients (L/S relationship). By combining the above quoted procedures and taking into account obstetric factors (pelvic measures, cervical maturity), the assessment was made of the state of the fetus and the placenta, of the maturity grade and gestation age, and of the condition of the fetus for delivery by the planned induction of uterine contractions. Statistical analysis (the kappa 2 test) has shown that there is no difference in the results concerning the parameters observed, which speaks for good agreement between them. In the authors' opinion, none of the methods used is an absolutely valid test but their combination and dynamic observation along with a certain clinical experience, could lead to right conclusions about the state of the fetoplacental unit before induced labour.


Comparison of heterogeneities of antitrinitrophenyl antibodies in strains of mice immunized by various methods. Heterogeneity of antibodies directed against the trinitrophenyl (TNP) determinant in immunized mice was analyzed by investigating the band groups of antibodies formed by thin layer isoelectric focusing of serum. The degree of heterogeneity in C57BL/6 mice was markedly higher than that in CBA mice under the following conditions of immunization: immunization with TNP conjugated with bovine gamma-globulin or ovalbumin, interchange of these carrier proteins at the first and second injections, change of epitope density of the antigens, replacement of the hapten by dinitrophenyl group on the antigen for the secondary stimulation, and change of intervals of these injections from 15 days to five months. The degree of heterogeneity within a strain also varied with these immunizing conditions. Furthermore, the heterogeneity in C57BL/6 mice of any immunization group was greater than that in CBA mice in any group. This was also true when the heterogeneity was examined with the immune sera diluted to the same titer. These results indicate that the number of predominant clones of cells producing anti-TNP antibody after immunization is larger in C57BL/6 than in CBA mice.


Cell-mediated immunity in human pregnancy: Changes in lymphocyte reactivity during pregnancy and postpartum. The function of thymus-dependent lymphocytes (T lymphocytes) was studied in women during pregnancy and labor and postpartum by evaluating the blastogenesis of peripheral lymphocytes, which were stimulated with phytohemagglutin-P (PHA-P) in both whole-blood semimicroculture and purifed lymphocyte culture. Data from 353 random samples (203 women) and 50 serial specimens from 10 women revealed that PHA-P induced-lymphocyte blastogenesis was significantly (p less than 0.005) reduced during pregnancy and labor but rapidly returned to normal several days after artificial termination in the early stage of pregnancy as well as after full-term delivery. These results indicate that the T-lymphocyte function in maternal peripheral blood is depressed by causes related to pregnancy. It seems very likely that depressed T-lymphocyte function during pregnancy is caused by inhibitory factors in the blood plasma derived from the feto-placental unit. Questions relating to the inhibitory factors in maternal plasma are discussed.


Immunogenicity, parturition and the prostaglandins. Immunologists have long suspected that maintenance of pregnancy (viable placentation) is contingent upon the suppressed maternal immune response. Curiously, it has never been suggested that the termination of pregnancy at term might in some way be triggered by the un-blocking of this maternal immune suppression. It is the hypothesis of this paper that maintenance and termination of pregnancy are contravening expressions of a maternal-fetal immunologic regulatory response. The role of the prostaglandins in parturition, and the immune response, is discussed.


[Angiography in posterior fossa extra-axial arachnoid cyst (author's transl)]. The clinical and roentgenographic findings in two patients with posterior fossa extra-axial cysts are presented, a detailed analysis of the angiographic findings of this congenital retrocerebellar leptomeningeal malformations reported and their differential diagnosis discussed.


The Medallion suture lens: management of complications. In a study of 613 Medallion suture implant patients, 87% of the 613 and 96% of those under 70 years of age had a postoperative visual acuity of 20/40 or better. The most common operative complication was corneal endothelial trauma, which was graded and correlated with endothelial microscopy; however, only 0.5% of cases had permanent corneal opacification. Cystoid macular edema occurred in 32 cases (5.2%), and 56% (18) of these patients regained 20/40 vision or better. Implant loop subluxation occurred in 19 cases (3.1%), but this incidence should decrease by increasing implant loop tip-to-tip distance. The data presented put in perspective the relative importance of the various complications encountered, with primary emphasis on the management of these complications.


[Exploration of humoral immunity in man using blood lymphocytes cultures (author's transl)]. New methods allow the study of humoral immunity in man using blood lymphocyte cultures. A primary in vitro antibody response can be induced, characterized by the appearance of antibody forming cells, and its pattern is as follows: stringent culture requirements, which have been so far obtained in few laboratories; the kinetics of the response, with a peak on day 7--8; and exclusively IgM response; a T-cell requirement. Among these methods, the model we have described has the advantage of allowing a reproductible response in a given individual. The in vitro study of humoral immunity has limitations, the most apparent of which is that it addresses itself to only one lymphoid population, that in peripheral blood, easily accessible. It presents several advantages, as compared to an in vivo study after injection of an antigen: absence of ethical problem; the necessity of only one blood sample, at a given time, avoiding the interference of a treatment started after the test; the possibility of performing successive primary stimulations for a longitudinal study.


[Portal hypertension. Indications and limitations of decompression operations]. A case of haemorrhage due to oesophageal varices in a cirrhotic-portal hypertense patient successfully treated with side-to-side portocaval anastomosis is reported. Long-term follow-up showed that the surgical result was satisfactory. On the basis of this case, the problems and current tendencies towards derivative operations in the prophylaxis and treatment of portal hypertension complications are reassessed.


The delayed appearance of an antinuclear factor and the diagnosis of systemic lupus erythematosus in glomerulonephritis. In 11 patients who presented with apparently idiopathic glomerular disease the antinuclear factor (ANF) was absent initially but was eventually detected during observation extending over 6 years. In 4 patients a diagnosis of systemic lupus erythematosus (SLE) has now been made and the disease treated. Of the remaining 7, 2 had conditions known to be associated with a positive ANF, and in 4, drug therapy induced the ANF. Clinical features, complement studies and measurement of anti-DNA antibody were of value in distinguishing those patients with SLE from the others.


Modulation of thymocyte membrane potential by concanavalin A. Binding of convanavalin A, a potent mitogenic lectin, to thymocyte surface membrane causes depolarization of membrane potential. The effect is suppressed by alpha-methyl-D-glucoside, a haptenic inhibitor of this lectin, or by low temperature. Colchicine and cytochalasin B aslso suppress the change. These data indicate that perturbation of thymocyte surface membrane receptors induced by concanavalin A might be linked to change in the functional state of cellular cytoskeletal systems in turn causing depolarization of thymocyte surface membrane. The initial event generated by receptor-ligand interaction on the outer surface could be translated into cellular interior action only under highly fluid conditions of membrane lipid. Depolarization of thymocyte plasma membrane may be involved in the triggering mechanism of metabolic burst associated with blastoid transformation.


Evidence for a therapeutic effect of plasmapheresis in patients with systemic lupus erythematosus. Fourteen patients with active systemic lupus erythematosus (SLE) have been treated with plasmapheresis at a rate of two litres daily on three to four days per week, over a period of two to three weeks. Plasma was replaced isovolemically with either fresh frozen plasma or with human plasma protein fractions. Ten patients were receiving treatment with prednisone at the time of plasmapheresis, and four had received no prior treatment. Eight patients showed evidence of either clinical improvement or clinical and immunochemical improvement, at the time of plasmapheresis. In the three patients who showed high levels of circulating complexes before treatment, there was a sudden fall in the level of circulating immune complexes, which was quantitatively greater than could be explained by the amount removed. This suggests that in some patients with SLE, clearance of complexes by the mononuclear phagocytic system is initially blocked by high levels of circulating complexes and that one effect of plasmapheresis may be to relieve this blockade. Five patients showed a clinical response to plasmapheresis despite the fact that tests for immune complexes were negative. Three patients showed no response to plasmapheresis, and three were regarded as unevaluable. In a limited number of patients, who show a high level of circulating immune complexes, and whose condition is deteriorating despite treatment with corticosteroids, there may be an important therapeutic role for plasmapheresis.


Human chronic lymphocytic leukaemia. Surface markers and activation of lymphocytes. Cell surface markers and the responses of lymphocytes to T- and B-cell mitogens were studied in 10 patients with CCL. T cells were identified as cells rosetting with sheep red blood cells (SRBC), and S-Ig was used as a marker for B lymphocytes. Most cells from all patients had a detectable amounts of S-Ig, and the percentage of cells rosetting with SRBC was low in all cases. Of the lymphocytes from these patients, 3-74% (mean 33%) were positive for the acid esterase (ANAE), which has been claimed to be a T-cell marker. However, some patients had cells that were positive for both S-Ig and ANAE. Acid esterase staining is therefore not a valid T-cell marker in chronic lymphocytic leukaemia. In cultures containing the T-cell mitogen leucoagglutinin (LA) and the T- and B-cell mitogen pokeweed mitogen (PWM) the reactivity of the lymphocytes was low. The cells responded vigorously to the T- and B-cell mitogen protein A (PA); however, the response was serum-dependent, being strong in a culture medium containing foetal calf serum (FCS), but impaired in the presence of human AB serum. Only 1 patient had cells that responded to the B-cell mitogen LPS.


Composition of human granulocytic colonies as a function of the purification stage of CSF. Granulopoietic colonies grown in presence of human placental conditioned medium (HPCM), before and after partial purification, were characterized in terms of number of colonies, colony size and cellular composition. Our data demonstrate that the removal of inhibitors present in crude HPCM preparations results in a higher number of CFUC which are wider in size and with different cellular composition.


In vivo and in vitro studies of tinidazole in Trichomonas vaginalis infection. A total 787 patients with complaints of vaginal discharges were examined, of which 106 patients were found to be positive for Trichomonas vaginalis by the normal saline method, and 114 patients were positive by the culture method. In the in vivo series, 55 patients were treated with a single dose of 1.8 gm of tinidazole, and with a follow-up examination 7 days there after. For the in vitro study 55 swab specimens were cultured to study the tinidazole sensitivity of Trichomonas vaginalis. The survival of Trichomonas vaginalis at each concentration of tinidazole was presented as a cumulative frequency. At the concentration of 1 microgram/ml, none of the organisms were killed; but at the concentration of 6 micrograms/ml, the mortality rate was 100%. In the in vivo series a 100% cure rate was obtained with tinidazole with no side effects, and in vitro series the mean minimum trichomonicidal concentration (MCC) at 24 hours was 3.76 +/- 1.25 micrograms/ml, with the range of 2--6 micrograms/ml. These studies revealed the sensitivity of Trichomonas vaginalis to tinidazole in Thailand and that tinidazole at a single oral dose of 1.8 gm perferably after a meal is effective, safe and cheap for the treatment of Trichomonas vaginalis.


Enhanced T-cell rosette formation in shigellosis by the in vitro use of thymopoietin. The results from this study suggest that the large nul cell lymphocyte population seen in patients with Shigella dysentery, does contain a sub-population of cells that will respond in vitro to thymopoietin, a bovine thymic extract, by increased E-rosette formation. It is felt that this sub-population is in fact immature T-cells. A previous study has shown that an unusual leukaemoid reaction develops in a substantial number of patients with Shigella dysentery. The leukaemoid response was primarily granulocytic in nature but there was also a substantial increase in the mean number of lymphocytes. The proportion of the various populations of lymphocytes from leukaemoid and non-leukaemoid subjects were altered, B-cells remained constant, while the T-cells were depressed with a corresponding rise in the proportion of nul cells. The cumulative results of this and other studies demonstrate that the T-cell arm of immunity is compromised in shigellosis. Indeed the degree of compromise may ultimately be the decisive factor in determining the severity of this disease.


[Pathohistology of non-Hodgkin's lymphomas: recent progress]. After the recognition of the various phase of the physiologic differentiation and transformation of lymphocytes (from the stem cells over T-prolymphoblasts and lymphoblasts to the effector-T-cells and over the B-lymphoblasts, B1-lymphocytes to the lymphatic plasma cells and, respectively, over centroblasts, centrocytes, B2-lymphocytes to the Marschalko plasma cells) it became clear that the non-Hodgkin-lymphomas correspond to the individual, apparently blocked phases of the differentiation and transformation. The classification after Kiel distinguishes non-Hodgkin-lymphomas of a malignity of low degree (CLL, centrocytoma, centroblastic-centrocytic lymphoma, immunocytomas) and of high degree (T-lymphoblastoma, centroblastoma, immunoblastoma). An essential part of these tumours may be diagnosed with the help of the usual light-microscopic methods. When several supplementing cytochemical and immunocytological methods are used, nearly all non-Hodgkin-lymphomas are to be characterized, though border-line cases and non-classifiable non-Hodgkin-lymphomas rarely appear, but they appear.


[Emergency endoscopy].

[Emergency endoscopy]. The possibilities and advantages of the emergency endoscopy of the upper intestinal tract are emphasized. With the help of 475 own examinations from 1971 to 1973 and from 1973 to June 1977 the improvement of the diagnostic gain by instruments with prograde optics is proved. Ulcerous diseases of the stomach and the duodenum are found as most frequent cause of haemorrhage which appear in the oesophagus or in the oesophagogastric transition. With 20% the number of the multiple findings was significantly high, the proof of which is to be regarded as an essential advantage of the emergency endoscopy. But at the same time they also emphasize the necessity not to be satisfied with the proof of a source of haemorrhage. The coloscopic emergency endoscopy is more difficult. Endoscopico-therapeutic possiblities increase the importance of the emergency endoscopy.


[Upper gastrointestinal tract hemorrhages following heart surgery]. The clinical histories of 612 patients who underwent an operation of the heart were evaluated. Eight times a more severe haemorrhage from the upper gastrointestinal tract was described, i.e. 1.3%. One patient died under the signs of the septic shock. All patients were treated conservatively, only in one patient an ulcer existed 12 years before the heart operation.


[Concentrations of pregnancy-specific beta 1-glycoprotein from urine in gestoses (author's transl)]. Concentrations of pregnancy-specific beta 1-glycoprotein from urine of pregnant women were investigated in cases with normal pregnancy and gestosis. Mean value of cases with severe gestosis (Index 4-6) was significantly increased.


Echocardiological contrast studies with dynamically focussed multiscan. Bidimensional contrast echocardiological examinations were carried out in 120 patients with the use of dynamically focussed multiscan. Ultrasonic contrast was produced by a push injection of 10 ml of isotonic saline or of 5% glucose in water injected into an antecubital vein through an 18 gauge needle. Contrast studies were observed on a television monitor and recorded on videotape for detailed off-line analysis. All the echocardiological diagnoses presented here were confirmed during catheterization. A few typical clinical examples are illustrated, including a patient with Ebstein's anomaly, a case of tricuspid regurgitation, atrial and ventricular septal defects, and a left ventricular ultrasound angiocardiogram. Bidimesional contrast opens a new field for the assessment of remediable cardiac lesions.


Influence of moxaprindine treatment on ventricular arrhythmias occurring during maximal exercise stress testing. Moxaprindine, a new anti-arrhythmic drug, with characteristics similar to aprindine, has been demonstrated to be highly effective in suppressing ventricular arrhythmias occurring before, during and after maximal exercise stress testing. This effect was obtained both in subjects with clinically normal hearts and in a limited number of patients with ischemic heart disease. These findings demonstrate the efficacy and safety of anti-arrhythmic treatment by drugs prolonging ventricular depolarization for ventricular arrhythmias occurring during exercise.


Cardiac involvement in progressive systemic sclerosis. The case of a patient with progressive systemic sclerosis (PSS) who developed electro- and vectorcardiographic patterns of myocardial necrosis without clinical picture of myocardial infarction is reported. The coronarography showed no obstruction of coronary arteries and cineventriculography a hypodynamic enlarged left ventricle. The analysis of electrocardiograms from 43 other patients affected with PSS revealed myocardial necrosis in 5 of them. The clinical syndrome of myocardial infarction was absent in all these cases. Moreover, the hemodynamic investigation in 13 cases allowed to record a dip-plateau figure on the right ventricle pressure curve in 3 of them. In PSS, the electrocardiographic aspects of "necrosis" as well as hemodynamic restrictive findings or ventricular enlargement at ventriculography could indicate myocardial disease.


Arrhythmias in organophosphate poisonings. 168 cases of organophosphate poisonings are reviewed with special respect to frequent arrhythmias. In 134 cases toxic repolarisation with QT prolongation, ST- and T- anomalies were present. 56 patients had arrhythmias and the prevalence of ventricular arrhythmias was impressive. In five patients a transient picture of myocardial infarction was seen. The great incidence of ECG alterations and arrhythmias necessitate the permanent monitoring of patients with organophosphate poisoning in an intensive care unit.


Diagnosis of mitral valve diseases using indirect (esophageal) left atrial pulse. The diagnostic usefulness of the indirect (esophageal) left atrial pulse (ESO) has been analyzed in: 1) 25 patients (pts) with mitral insufficiency (MI), 2) 18 pts with mitral stenosis, 3) 29 pts with combined valvular disease, 4) 10 normal subjects. In addition, in 1) and 4), the ESO was recorded under the following dynamic conditions: a) during isometric exercise (handgrip), b) after inhalation of amyl nitrite, c) after intravenous infusion of methoxamine. The ESO tracing demonstrated estimates of the severity of the disease. Under dynamic conditions no modification from the resting morphology was obtained in the control group, whereas in MI the following modifications were observed: a) increased, progressive, positive elevation of the systolic phase of the ESO during the handgrip and the administration of the methoxamine; b) tendency to return to normal morphology after amyl nitrite.


Cardiac tamponade with renal failure due to hemangioma of the heart. In a 18 year-old woman, an isolated benign hemangioma of the right atrium led to cardiac tamponade and acute renal failure. After 8 days of anuria, the tumor was excised and replaced by a pericardial patch. The persistence of severe renal shutdown necessitated further hemodialysis during 22 days postoperatively. The patient was discharged on the 45th day in good hemodynamic and renal condition. Thirteen cases of benign hemangioma of the heart have been reported in the literature: 12 were found at autopsy; only 4 were complicated by hemopericardium but none of these survived.


[Effect of gelatin and dextran infusion on the reticuloendothelial system]. The purpose of this study was evaluation of the phagocytic ability of peripheral blood leucocytes and reticuloendothelial system of the lungs, liver and spleen after one infusion of plasma-substituting preparations: Fluigel and dextran 70 in volumes of 20 ml/kg of body weight. The experiments were done in rabbits. The response of the reticuloendothelial system was assessed on the basis of its ability of eliminating foreign erythrocytes labelled with 51Cr from the circulating blood and radioactivity accumulation in the liver and spleen. It was found that infusion of Fluigel and dextran produced transient changes in the function of the reticuloendothelial system with increased number of granulocytes and a fall of their radioactivity 3 and 6 hours after infusion, reduced ability of pulmonary 51Cr accumulation and increased storage in the spleen observed 24 hours after infusion.


The surface immunoglobulin receptors of human lymphocytes in pollinosis. The immunological reaction of immediate as well as delayed type is produced in patients with pollinosis by the contact with pollen allergens. The immunological disturbances partially connected with function of T and B lymphocytes can be treated as the basal mechanism of pollinosis. The presence of surface immunoglobulins (SIg) from classes IgA, IgG and IgM on the B lymphocytes in circulating blood from the patients with pollinosis in various stages of the disease were studied. The method of direct immunofluorescence was used. The decrease of B lymphocytes with SIg of IgG was found. On the basis of presence SIg (IgA, IgG, IgM) on lymphocytes the four periods of various immunological reaction in pollinosis were differentiated: I - primary immunological response, II - secondary immunological response, III - immunological exhaust, IV - immunological stabilization.


Precipitating antibodies against Haemophilus influenzae and Staphylococcus aureus in sputum and serum from patients with cystic fibrosis. Serum and sputum sol phase from 23 patients with cystic fibrosis (CF) were examined for occurrence and titres of precipitins against Haemophilus influenzae and Staphylococcus aureus by means of crossed immunoelectrophoresis with intermediate gel. The patients had from four to nine H. influenzae precipitins in serum and in most cases fewer precipitins in sputum, but, on an average, there was no difference between the titres of the antibodies in serum and sputum. Most of the antibodies were cross-reactive with other species, notably those of the Haemophilus genus. S. aureus precipitins were generally found in higher numbers in serum than in sputum, but, on an average, the titre of the precipitins in sputum was higher than in serum. Three of the precipitins were detectable only in sputum and not in serum, and one of these is a S. aureus-specific precipitin. Most of the antibodies were cross-reactive with other species, and these antibodies were often present in sputum in much higher titres than in the corresponding sera. Antibodies against teichoic acid of the S. aureus cell wall could not be demonstrated in sputum, while they were present in 22 sera. The possible role of the local pulmonary humoral immune response in protective immunity and in the pathology of the lung disease in CF is discussed.


On some relationships between dopaminergic and serotoninergic mechanisms in pentylenetetrazol convulsions in albino mice. Experiments with pentylenetetrazol convulsion model in albino mice--80 mg/kg subcutaneously--have revealed the following. The inhibitory effect of 5-HT, introduced intracerebroventricularly in a dose of 100 micrograms per mouse is eliminated by 500 mg/kg L-DOPA, 100 mg/kg amantadine, 5 mg/kg amphetamine and apomorphine, while for lower doses of the dopaminergic agent only a tendency towards antagonism is observed. The inhibitory effect of 50HTP in a dose of 200 mg/kg i. p. is eliminated by 500 mg/kg L-DOPA, 50 mg/kg amantadine and 5 mg/kg amphetamine, but it is not influenced by these drugs in doses of 250 mg/kg L-DOPA, 25 mg/kg amantadine and 5 mg/kg apomorphine, although when applied independently L-DOPA and amantadine in these lower doses potentiate convulsive reactions. The results obtained show that the dopaminergic and 5-HT-ergic systems have an antagonist effect on the convulsive reactivity in the case of pentylenetetrazol convulsion model. These results are in agreement with our views about the determining role of the balance between the various neurotransmitter systems in convulsive-seizure reactions.


Inhibition of fast axonal transport and microtubule polymerization in vitro by colchicine and colchiceine. The effects of colchicine and colchiceine on fast axonal transport in frog sciatic nerves were studied in vitro. Colchiceine inhibited the transport to about the same extent as colchicine. Preincubation at low temperature potentiated the inhibitory effect of either drug. The polymerization of purified brain tubulin was inhibited by colchiceine at 5-10 times higher concentrations than colchicine. The similarity of the effects obtained with colchicine and colchiceine indicates that both drugs arrest axonal transport by interfering with microtubule function. Colchicine and colchiceine did not affect the levels of high energy phosphates (ATP and CrP) in frog nerves indicating that a reduced energy supply was not responsible for the arrested transport.


Meckel's diverticulum. Vagaries of technetium scanning. A case of a Meckel's diverticulum is described in a young man presenting with abdominal pain and gastrointestinal bleeding. Methods of arriving at the diagnosis preoperatively are reviewed. A false-negative as well as a true-positive small bowel series and technetium scan were obtained in this case. The factors influencing technetium uptake by a Meckel's diverticulum are reviewed.


Cellular immunodeficiency with immunoglobulins: treatment with a thymus implant in millipore diffusion chambers. A 14 month old male affected by cellular immunodeficiency with immunoglobulins underwent implantation of a thymus enclosed in Millipore diffusion chambers. Five days after the implant the percentage of T lymphocytes forming spontaneous rosettes reached normal levels. One month later responsiveness to PHA was demonstrated in the patient's lymphocytes and IgG and IgM serum levels showed a marked increase. Positive skin tests were elicited 6 month's post-implant. An inguinal lymph node biopsy showed developing primary follicles and germinal centers. The patient's condition improved significantly. One year after the implant the patient died from irreversible neurological deterioration. It is suggested that partial immunological reconstitution was achieved by thymic humoral factors.


Retinoblastoma Y79 cell line: a study of membrane structures. The continuous retinoblastoma cell line Y79, grown in suspension culture, has been examined by transmission and scanning electron microscopy, including freeze-fracture replica preparations. Four classes of cells were distinguishable by their size and surface characteristics. The surface structures included blebs, filopodia, lamellipodia, microvilli, and microplicae. The possible origin of a most unusual type of cell, apparently forming natural clones, is discussed.


Experiences with a new EOG photostimulator. A new EOG photostimulator used to provoke ocular pendular and saccadic movements and to evoke optokinetic nystagmus is described. Differences between ocular movements obtained according to various techniques in relation to Arden's index are also evaluated.


Report of a case resembling the 'fleck retina of Kandori' with ectodermal peculiarities and macula degeneration. This report involves the case of a 36-year-old woman followed-up for nine years. The symptoms include unique, sharply-defined, irregular, yellow, large flecks of the retina combined with bilateral macula degeneration. The patient's rusty-red hair, enamel dysplasia, and ashen-gray skin color were also noted. It is argued that this case is very likely identical with the 'fleck retina of Kandori' and as such, the first case reported outside Japan. The literature is reviewed.


Unusual features of Hemophilus infections in adults. Infections due to species of Hemophilus, especially H influenzae type B, are usually equated with the pediatric age group. However, during the past several years the medical literature has emphasized the occurrence of such infections in adults. Four adult patients are presented who demonstrate certain unique clinical features which have not been recently or previously reported.


Perforating eye injuries caused by occupational accidents treated at Helsinki University Eye Hospital 1970--1977. This study concerns perforating eye injuries caused by occupational accidents in the years 1970--1977. These injuries represented 40% of all perforations treated during this period at Helsinki University Eye Hospital. The results were compared with the previous series from this hospital for the years 1950--1951 and 1930--1939. Of the patients 92% were males, a slight percentage decrease from the fifties. The youngest age group, 16--25 years, was also the largest (30%). Earlier the next age group, 26--35 years, was largest. The proportion of workers in building construction with eye injuries increased remarkably to 26.6%. Metal workers made up another large group affected by eye perforations (24.5%). Agricultural work lost its importance as the cause of perforations as compared with the previous decades. The commonest cause of eye accidents was still hammering. Flying objects, especially metal splinters, were important causes now as well as in the previous series. Prognosis was much better in the present series than earlier: 60% of patients achieved vision of 0.5 or better, as compared with 40% in the fifties and 20% in the thirties.


Pressure lowering effect of timolol with reference to its topical vascular action. The hemodynamic effect of timolol maleate in open angle glaucoma was studied rheo-oculographically. Increase in the ocular pulse which reaches maximal amplification 2 h after the instillation of the drug was observed. The maximal pressure lowering effect appeared 3 h after instillation, as if the hemodynamic effect were the trigger for the pressure lowering effect.


Isolation of different hydroxyproline containing proteins from bovine vitreous body collagen. From pepsin-solubilized vitreous body collagen three different precipitates were collected by differential salt precipitation. These three different protein fractions contain hydroxyproline and show different patterns in polyacrylamide gel electrophoresis suggesting different collagen types.


Comparison of contrast thresholds of large bars and checks measured by VECPs and psychophysically as a function of defocusing. The effects of defocusing the image on the contrast threshold were studied both for checkerboard and bar patterns at various low spatial frequencies, and comparison was made between psychophysical results and visually evoked cortical potentials (VECPs) results. VECP threshold was defined as the contrast necessary for obtaining a criterion amplitude of 5 muV. When increasing the degree of defocusing, the lowest contrast threshold shifted towards larger checks or bars, the contrast threshold increased more abruptly for smaller sizes, and the VECP contrast thresholds increased more than the psychophysical ones, especially for smaller sizes. No significant difference was found in the contrast thresholds between the results with bar patterns and checkerboard patterns, except that for bars, the VECP threshold as defined was approx. 0.2 log units higher than those for checkerboard.


The influence of acute and chronic cervical sympathectomy on the ocular hypotensive effect of clonidine. The influence of clonidine on intraocular pressure was studied in chloralose-anesthetized cats. The cats were subjected to unilateral cervical sympathectomy, either acute or chronic. The drug was injected either intravenously or into the left vertebral artery. With the aim of investigating the role of the sympathetic nervous system in the central IOP-lowering effect of clonidine, the fall in IOP induced by the drug in these preparations was compared to the decrease in ocular pressure caused by clonidine in intact cats. An enhanced depressor effect in both eyes of unilaterally sympathectomized cats became evident after the intravenous injection of clonidine. In contrast, the effect of central administration was similar or even smaller than in intact cats. We conclude that the central IOP-lowering effect of clonidine is diminished after cervical sympathectomy, indicating that the peripheral sympathetic nervous system is the efferent pathway of this centrally initiated effect.


The influence of clonidine on intraocular pressure after topical application to the eyes of anesthetized cats. Clonidine was topically applied to the right eye of anesthetized cats. Unilateral administration induced a fall in intraocular pressure (IOP) in both eyes. This effect is not secondary to the slight fall in arterial blood pressure. Distribution experiments with 14C-clonidine revealed that only minor or negligible amounts of clonidine could be demonstrated in the contralateral eye. The concentrations of the labeled drug determined in the brain after topical application are sufficient to explain the bilateral decrease in IOP by a central mechanism. The IOP-lowering effect of clonidine upon its topical application to the eye is probably of central nervous origin and, therefore, similar to the centrally induced effect on IOP after systemic administration of the drug.


[Comparison of principles for length measurements at the fundus of the human eye (author's transl)]. Comparison of principles is presented for length measurements at the fundus of the eye and discussed with respect to minimum measuring errors. Measurements by photography or by optical dislocation of the measuring object to itself are the methods with the least uncertainty under the conditions taken into consideration.


Antinuclear antibodies in ankylosing spondylitis, psoriatic arthritis, and psoriasis. Granulocyte-specific antinuclear antibodies (GS-ANA) were detected in the sera of 5 of 88 patients with ankylosing spondylitis (AS) and in 7 of 52 cases of psoriatic arthritis (PsA), but were not found in 91 patients with malignant or non-malignant chest disease nor in 25 cases of psoriasis. Organ non-specific ANA were present in serum from 6 cases of AS and 1 of PsA. None of the sera gave significant levels for soluble immune complexes as detected by a C1q-binding assay. The presence of antinuclear antibodies was not associated with clinical features or drug therapy in either AS or PsA.


Single and double stranded DNA binding lymphocytes in the peripheral blood of patients with systemic lupus erythematosus and normal controls. Specific double (D-DNA) and single stranded (S-DNA) deoxyribonucleic acid binding cells were demonstrated in the peripheral blood lymphocytes of patients with systemic lupus erythematosus (SLE) by rosette formation with antigen coated red blood cells. The proportion of DNA binding cells in the peripheral blood of patients with SLE was significantly higher than that found in a random population of healthy individuals. Significant numbers of D-and S-DNA binding lymphocytes were found in patients with active disease even when anti-DNA of fluorescent antinuclear antibodies disappeared. The specificity of the DNA binding cells was confirmed by  inhibition experiments with D-or S-DNA. Spleen lymphocytes were also examined on one occasion and were found to contain a much higher level of DNA binding lymphocytes than the peripheral blood lymphocytes.


Accuracy of subjective measurements made with or without previous scores: an important source of error in serial measurement of subjective states. Pain severity was assessed on visual analogue scale in 4 groups of patients receiving long-term therapy. A comparison was made between pain measurements made with and without access to initial scores. The differences between these measurements increased with the duration of treatment. Patients tended to overestimate their pain severity when previous scores were not available. It is suggested that initial scores should be made available when serial measurements of pain are made in long-term experiments.


Vertical or horizontal visual analogue scales. Vertical and horizontal visual analogue scales have been compared in the measurement of pain. There was a good correlation between the 2 scales, but the scores from horizontal scales tended to be slightly lower than those from vertical scales.


Haemophilus influenzae tenosynovitis.

Haemophilus influenzae tenosynovitis. A case is reported of polytenosynovitis in a 31-year-old male during the course of a severe bacteraemic illness caused by Haemophilus influenzae type b. The clinical presentation was similar to tenosynovitis caused by bacterial or viral agents. As the management of the H. influenzae tenosynovitis would differ from that due to other causes, the addition of H. influenzae type b to a differential of tenosynovitis should be considered. Recognition and prompt treatment by appropriate antibiotics may be important to avoid suppurative complications affecting the tendons. As the pathophysiology of the tenosynovitis is not clear, careful bacteriological and immunological assessment must be obtained.


Human T and B lymphoid cells: an electron microscopic study on thymocytes, peripheral blood lymphocytes, mitogen-stimulated cells and lymphoid cell lines. Human lymphoid cells were studied by electron microscopy to find any morphological difference between T and B cells. The T cell population generally contains a smaller amount of the rough endoplasmic reticulum than the B cell in various functional states, i.e. peripheral blood lymphocytes of normal individuals, mitogen-stimulated lymphoblasts and lymphoid cell lines. This may depend on greater need of the rough endoplasmic reticulum for immunoglobulin synthesis in B cells, even though T cells produced some soluble mediators. Other differences between T and B cells are as follows: (1) Peripheral blood T lymphocytes often have clustered dense granules, while granules containing parallel tubular structures are more frequently seen in B lymphocytes. (2) Cultured T cell lines usually exhibit a higher nuclear-cytoplasmic ratio and less prominent nucleoli than B cell lines.


[Acute lymphoblastic leukemia in children. The use of antisera specific for lymphocyte populations in a classification trial]. Mononuclear cells from 14 children with acute lymphoblastic leukaemia (ALL) were studied using several lymphocyte membrane markers: E-rosettes, "active" E-rosettes, surface immunoglobulins, EA-rosettes. The use of these techniques and of three specific heterologous antisera directed against T and B cell antigens enabled the discrimination of three different ALL types according to the stage of cell maturation at which it is likely that neoplastic differention occured: T-cell ALL, pre-thymic cell ALL, and "non-T non-B" cell ALL showing only HLA-DR antigens.


Comparison of the bile salts of frogs with those of their tadpoles. Bile-salt changes during the metamorphosis of Rana Catesbeiana Shaw. 1. The bile salts of three frog species of the genus Ptychadena and of Rana catesbeiana have been compared with those of their tadpoles. For R. catesbeiana comparison was made of the bile salts in at least ten of the recognized stages of tadpole metamorphosis. 2. In all cases, adult bile salts were more complex than those of the tadpoles. 3. In R. catesbeiana after stage 18, 26-deoxy-5 alpha-ranol was hydroxylated to form 5 alpha-ranol (27-nor-5 alpha-cholestane-3 alpha, 7 alpha, 12 alpha, 24 xi, 26-pentol) and at least two other bile alcohols appeared in solvolysed bile salts. 4. Tadpole bile salts were not found to be biochemically more primitive than those of fully metamorphosed frogs; in some, but not all, cases tadpole bile alcohols could be regarded as biochemical precursors of those in the adult frogs. 5. Detailed evidence for the structure of the bile salts from mass-spectral fragmentation patterns has been deposited as Supplementary Publication SUP 50097 (2 pages) at the British Library Lending Division, Boston Spa, Wetherby, West Yorkshire LS23 7BQ, U.K., from whom copies can be obtained on the terms indicated in Biochem. J. (1978) 169, 5.


[Evaluation of the temperature effect on contractility of frog myocardium]. Dynamics of the parameters of mechanical activity of the frog isolated myocardium was studied under conditions of temperature variations. Within the temperature range of 0-35 degrees C the temperature decrease leads to a rise in the strength of contractions. Meanwhile the velocity of contractions reaches its optimum value at 20 degrees C. The velocity of contractions proved to be a more adequate and sensitive criterion for evaluating the cold effect on contractility than the strength of contractions. From the analysis of the evidence obtained it is concluded that muscle contractility of the heart is depressed on cooling.


[Congenital syphilis, malnutrition and Pneumocystis carinii pneumonia]. A Korean child aged six months with congenital syphilis and malnutrition developed pneumocystis carinii pneumonia. He recovered after treatment with trimethoprin/sulphamethoxazole with assisted ventilation. There was no evidence of immune deficiency. The role of congenital syphilis and malnutrition predisposing the baby to this infection is discussed.