Influence  of body temperature during cardiopulmonary bypass on the haemodynamics early after aorto-coronary bypass surgery. The haemodynamic adaptation early after aorto-coronary bypass surgery, with special reference to the influence of body temperature on postoperative vasoconstriction, was studied in 20 patients. Cardioplegia arrest was used in all cases. Eleven patients were cooled to 30 degrees C during cardiopulmonary bypass, and nine were normothermic (37.5 degrees C) while the heart was cooled selectively. The normothermic patients had significantly higher oesophageal and skin temperatures in the immediate postoperative period, indicating better heat preservation. However, the systemic vascular resistance was similar in the two groups; i.e. it was moderately elevated initially and subsequently decreased. There was no significant difference regarding postoperative myocardial function. The normothermic patients woke up earlier after the operation than the hypothermic patients, and since they also had a relatively low oxygen uptake index (0.10--0.12 mmol. s-1. m-2), the possibility of earlier extubation in these patients is suggested.


Intrarenal distribution of renal blood flow in the rat. Intrarenal blood flow distribution was studied with the simultaneous use of the 99Tc labelled frog erythrocyte (microsphere) and the radioactive 86Rb fractionation method in the rat. The amount of blood entering the outer cortex (99Tc labelled erythrocytes method) proved to be higher than one perfusing the outer cortex (86Rb method), whereas the amount of blood entering the inner cortex (99Tc method) was less than the amount perfusing the inner cortex and medulla (86Rb method). Hence a group of the preglomerular arterioles in the outer cortex contributes to the blood supply of the inner cortex, on the other hand a group of preglomerular arteries in the inner cortex participates in the postglomerular blood supply of the medulla. Changes in the renal circulation are, however, associated with altered distribution of postglomerular vascular segments supplied by some groups of preglomerular arterioles. From this it is concluded that the postglomerular vessels of the deeper cortical layers constitute a system which is not parallelly coupled but comprises both series- and parallel-coupled sections. The contribution of these sections appears to vary depending on the actual haemodynamic conditions.


The optokinetic head nystagmogram of the frog. An electronic device for recording optokinetic head nystagmus is described. By feeding a point-like mass (radiator) with an alternating current generator, alternating voltage can be measured on a large flat plate (receptor), which depends on the distance of the radiator from the receptor. The radiator was fixed on the head of the frog, and could move between a pair of receptors. Voltage changes during head motions can be recorded in the form of nystagmogram. The head nystagmogram of the frog proved to be similar to that of mammals. Rotation of the optokinetic drum to one direction for several minutes resulted in habituation (decrease of frequency or stopping of head motions). Based on the frequency and amplitude pattern several types of optokinetic head nystagmus could be identified.


Mitigation of experimental allergic encephalomyelitis by cathepsin D inhibition. Intraperitoneal treatment with the enzyme inhibitor, pepstatin, of BSVS mice, guinea pigs and Lewis rats which were sensitized with guinea pig spinal cord and pertussis vaccine resulted in complete or partial suppression of paralysis dependent on the species studied and alterations of histological signs of experimental allergic encephalomyelitis (EAE). The effect was dose-dependent but had no relationship to the age of the experimental animal at the time of the experiment.


Enhancement of tumor growth by peritoneal macrophages of normal and tumor-bearing mice. The effect of peritoneal macrophages on tumor growth was investigated in an in vivo transfer assay (Winn test). A significant acceleration of tumor appearance was observed in animals injected with tumor cells together with peritoneal exudate cells (PEC) from normal mice, as compared to animals injected with tumor cells alone. Macrophages were shown to be the cells responsible for tumor enhancement. PEC from tumor-bearing mice also caused a strong tumor-enhancing effect in the Winn test. These results indicate that non-activated macrophages can enhance tumor growth in in vivo transfers and raise the question of whether a similar effect takes place in the primary host of a tumor.


B and T lymphocyte activation by murine leukemia virus infection. FLV is suppressive both in vivo and in vitro in terms of the specific sheep RBC induced antibody response. FLV-containing extracts from infected spleens were found to be markedly immunosuppressive. However, these extracts stimulated the background PFC response to SRBC in vitro, whereas similar background responses were depressed in infected animals. Furthermore the virus-containing extracts were mitogenic for normal spleen cells in vitro. Thus, FLV infection may cause immunocyte division (i.e., transformation) as an early event followed later by marked impairment of the function of the cells as evinced by their failure to respond normally to challenge immunization.


The antipyretic effect of UP 517-03 in the rabbit. The antipyretic effect of UP 517-03 was studied in rabbits, provided with a cannula in the lateral cerebral ventricle. Given orally as a curative treatment, UP 517-03 can abolish hyperthermic reactions induced by intracerebroventricular injection of sodium arachidonate or bacterial endotoxin. A comparison with acetylsalicylic acid and indomethacin is given. UP 517-03 does not modify the temperature of normothermic rabbits. These results suggests that the antipyretic action of UP 517-03 can be explained by an effect of this substance on the metabolism of arachidonic acid in brain.


Bleeding oesophageal varices caused by the Budd-Chiari syndrome treated by the Warren shunt. A previously healthy nonalcoholic 21-year old man was admitted to the hospital for further investigation because of previous severe haematemesis. Oesophageal varices proved to be the origin of the bleeding. The underlying cause for portal hypertension was total obstruction of the left and 70% obstruction of the right hepatic veins (chronic Budd-Chiari syndrome). Portal flow to the liver was almost normal due to well developed collaterals to the azygos vein and the patient's liver function was good. Distal splenorenal shunt (Warren shunt) was performed to decompress the varices. Postoperative recovery was uneventful and 10 months later the patient's general condition was excellent. Varices had disappeared and there was also improvement in his haematological status.


Serotonin receptors on astrocytes in primary cultures: effects of methysergide and fluoxetine. A specific binding of serotonin (at least 50 fmol/mg protein) was demonstrated in mouse astrocytes in primary cultures. This binding was inhibited by methysergide and by fluoxetine.


Myocardial protection during aortocoronary bypass. The authors analyze the results of 220 applications of internal cold cardioplegia in 136 patients with ischaemic heart disease, treated surgically by aortocoronary bypass. The operation was performed under neuroleptanalgesia and artificial circulation with hypothermia (27.9 +/- 0.2 degrees C) and haemodilution (24.9 +/- 0.3%). On the basis of clinical examination, electron microscopy of the myocardial ultrastructure, and investigation of the myocardial metabolism (contents of glucose, lactate, pyruvate, free fatty acids, catecholamines, and oxygen in arterial and venous blood flowing out of the myocardium), they come to the conclusion that internal cold cardioplegia efficiently protects the myocardium during aortocoronary bypass and secures favourable conditions for the development of anastomoses between coronary arteries and venous shunts.


Serotypes and biotypes and antibiotic susceptibility of Haemophilus influenzae encountered in a clinical laboratory in Taiwan. Forty-four serologically and biochemically typable Haemophilus influenzae isolates from clinical specimens in Taiwan were subjected to analysis in their relationship with source of isolation and age distribution. It was found that all isolates from blood and cerebrospinal fluid were serotype b, biotype I, and all were in children less than 4 years of age. Serotypes b and e, biotypes I and III were encountered to have the highest incidence of infection caused by H. influenzae in this area. All H. influenzae isolates were further tested for susceptibility to several selected antibiotics. All strains of this organism were susceptible to erythromycin and chloramphenicol. All but two strains were susceptible to tetracycline, whereas more strains were resistant to carbenicillin, gentamycin, keflin, and penicillin. Thirty-four percent strains were found to be resistant to ampicillin and all were beta-lactamase producer. No direct correlation between ampicillin resistance and serotypes or biotypes was recognized.


Histochemical localization of T-cells in tissue sections. Utilizing the acid alpha-naphthyl acetate esterase histochemical staining technique, cells with established T-cell (thymus-derived) staining characteristics could be consistently demonstrated in the periarteriolar lymphatic sheaths of the spleen and the diffusely infiltrated area of the cloacal bursa. The same areas failed to stain positively in significant numbers following a preincubation period with a specific inhibitor for carboxyl esterase. Lymphoid cells in the thymus, the splenic follicles, and bursal follicles were mostly negative.


Chemical composition and biological activities of a phenol-water extract from Haemophilus influenzae type a. Ribonucleic acid was removed from a phenol-water extract of Haemophilus influenzae type a by streptomycin sulfate. This preparation was called purified preparation or PP. It contained neutral sugars (glucose, galactose, mannose, pentose), glucosamine, amino acids, and fatty acids. Heptose and 2-keto-3-deoxyoctonic acid were not present. The biological properties and immunogenicity were compared with the activities of lipopolysaccharide of Escherichia coli or Salmonella typhimurium. Higher doses were necessary to obtain lethality in mice and Sanarelli and Shwartzman reactions with our preparations than were necessary with lipopolysaccharide. The Limulus test and pyrogen assay in rabbits gave the same results with purified preparation and lipopolysaccharide, but pyrogenicity of purified preparation was not destroyed by NaOH treatment. Purified preparation was not as immunogenic at low doeses for rabbits as lipopolysaccharide. The results were different from those obtained with lipopolysaccharide but similar to those known from peptidoglycan studies. The contamination of purified preparation with peptidoglycan was negligible and cannot explain the biological activities of purified preparation. We suggest that the phenol-water extract from H. influenzae is not a classical endotoxin, but rather an endotoxin-like substance.


Relationships between adjuvant, immunosuppressive, and mitogenic activities of staphylococcal peptidoglycan. Staphylococcal peptidoglycan (PG) possesses in vivo immunodulating activity and is a B-cell mitogen in mice. The effect of PG on in vitro immune response of mouse splenocytes to sheep erythrocytes (SRBC) was studied, as well as the relationships between in vivo and in vitro adjuvant, immunosuppressive, and mitogenic activities of PG in terms of dose response, time kinetics, and physical state. Particulate PG suppressed in vivo anti-SRBC response when injected in a large dose before or simultaneously with SRBC. A small dose of particulate PG given before or along with the antigen was immunostimulatory. Soluble PG was adjuvant active in both high and low doses when injected before or along with the antigen. Both PG preparations were adjuvant active for mouse splenocytes in vitro immunized with SRBC, but particulate PG was more active. Even high doses of particulate PG were not directly suppressive for the in vitro immune response. Particulate PG was also mitogenic for mouse splenocytes, and the maximum increase in [3H]thymidine incorporation was observed after 2 days of culture. Soluble PG was not mitogenic during the 5-day incubation period. These results indicate that the physical state of PG, its dose, and its time of application are important factors determining its immunomodulating and mitogenic activities, and that by changing them it is possible to dissociate the adjuvant, immunosuppressive, and mitogenic properties of PG.


Immunity to coccidiosis: T-lymphocyte- or B-lymphocyte-deficient animals. Comparisons were made between infections with Eimeria spp. in normal animals and in animals with functional deficiencies in either T-lymphocytes (athymic nude rats) or B-lymphocytes (bursectomized chickens). Approximately three times more oocysts of E. nieschulzi were passed during a primary infection in the nu/nu rats, and in contrast to the nu/+ rats, they were completely susceptible to reinfection. Nu/nu rats did not produce agglutinating antibodies to sporozoites, and injections of serum from immunized nu/+ rats caused a reduction of oocyst production during a primary infection in both nu/nu and nu/+ rats. In chickens, oocyst production in primary infections with E. maxima or with E. acervulina was increased 1.5 to 2-fold in the bursectomised (BX) groups, and the clinical effects of infection with E. maxima were greater than in controls. The BX birds were slightly more susceptible than the controls to challenge inoculations of oocysts, but nevertheless, they were very substantially immune. Tests for the functioning of B- and T-lymphocytes indicated that in the BX birds there was a severe deficiency of B-cell function, but near-normal T-cell function. The results show that T-lymphocytes are essential for immunity and that, although they may function partly as helper cells for immunoglobulin production, their major effect is exerted via some other mechanism.


Inhibition of host resistance by nutritional hypercholesteremia. Previous experiments showed that nutritionally induced hypercholesteremia in mice caused an increase in susceptibility to coxsackievirus B, with a marked suppression of cellular infiltrates in infected tissues and an increased mortality. The present studies demonstrated that a hypercholesteremic diet was associated with an inhibition in host resistance as measured by susceptibility to Listeria monocytogenes infection and the growth of two transplanted syngeneic murine tumors. Moreover, the ability of Corynebacterium parvum to induce regression of a transplanted methylcholanthrene-induced fibrosarcoma was inhibited in hypercholesteremic hosts, as was the histiocytic infiltration normally accompanying C. parvum inoculation. In contrast, the peritoneal macrophages from C. parvum-treated hypercholesteremic mice were indistinguishable from similarly treated macrophages from normal mice with respect to their in vitro tumoricidal activity and the presence of a cell surface antigen associated with activated macrophages. Hypercholesteremia was also associated with a decreased antibody response to sheep erythrocytes in vivo, but dit not appear to exert a detrimental effect on B- or T-cell blastogenesis when tested in vitro. The findings that the hypercholesteremic diet was associated with an impairment in the host immune response and increased susceptibility to viral, bacterial, and tumor cell challenge are discussed with respect to virus-lipid interactions in the pathogenesis of atherogenesis and diabetes mellitus.


Fixation of potentially lethal radiation damage by post-irradiation exposure of Chinese hamster cells to 0.5 M or 1.5 M NaCl solutions. The effect of 0.05 M and 1.5 M NaCl treatments on CHO cells during and after irradiation has been examined. Treatment with either hypotonic or hypertonic salt solutions during and after irradiation resulted in the fixation of radiation damage which would otherwise not be expressed. The half time for fixation was 4 to 5 min, and the increased expression of the potentially lethal damage by anisotonic solutions was mainly characterized by large decreases in the shoulder of the survival curve, as well as by decreases in DO. Fixation of radiation damage at 37 degrees C occurred to a much greater extent for the hypertonic treatment than for the hypotonic treatment and was greater at 37 degrees C than at 20 degrees C. Although both the hypotonic and hypertonic treatments during and after irradiation reduced or eliminated the repair of sublethal and potentially lethal damage, treatment during irradiation only, radiosensitized the cells when the treatment was hypotonic, and radioprotected the cells when the treatment was hypertonic. These observations are discussed in relation to salt treatments and different temperatures altering competition between repair and fixation of potentially lethal lesions, the number of which depends on the particular salt treatment at the time of irradiation.


Dominance of a repair function for X-ray-, U.V.- and alkylating agent-induced damage in hybrids between mouse lymphoma cells of different sensitivity. Cell lines resistant to IUdR and 6-thioguanine were isolated from a radiosensitive mouse lymphoma line LS and its radioresistant derivative AII respectively. Their biological and biochemical characteristics, as measured by plating in HAT medium IUdR and TG and by (14C) hypoxanthine and (3H) thymidine uptake were measured and found to be consistent with those expected for drug resistant cell lines. Two hybrid cell lines were isolated from crosses between the LS IUdRr line and AII TGr line and their radiosensitivity measured relative to that of the parental lines. Radioresistance was found to be dominant in both the hybrid lines as was resistance to EMS and U.V. to which the parental lines also show differential sensitivity. The ability to recover from sublethal damage after X-irradiation was found to be temperature sensitive in radiosensitive cells, an inverse effect being seen when LS cells were irradiated at 20 degrees C and held at 20 degrees C between dose fractions. Hybrid cells showed a normal amount of recovery from sub-lethal damage when compared with that in AII cells but this occurred at t slightly slower rate at 20 degrees "c than at 37 degrees C. Recovery from sub-lethal damage in AII cells was unaffected by lowering the temperature. These findings suggest that the radiosensitive cells may be temperature sensitive, in some step or steps in the ligation process.


Radiolysis of chromatin extracted from cultured mammalian cells: formation of DNA-protein cross links. Chromatin extracted from Chinese hamster lung fibroblasts has been examined for the formation of radiation-induced DNA-protein cross links, using a membrane filter assay. The relative efficiencies of the aqueous radical intermediates, OH., eaq- and O2-, were investigated. Cross links were found in gamma-irradiated isolated chromatin and in chromatin irradiated in the cell before isolation. When isolated chromatin was irradiated under conditions in which the chromosomal proteins were dissociated from the DNA, no cross links were detectable. The most efficient radical for the production of cross links in irradiated, isolated chromatin was found to be the hydroxyl radical, whereas, the superoxide radical was essentially ineffective. For chromatin irradiated in the cell before isolation, the greatest effect was seen for cells irradiated in an atmosphere of nitrous oxide, suggesting the hydroxyl radical may be involved in the formation of cross links in intact cells also. The formation of cross links in chromatin irradiated in cells before isolation was considerable less efficient than in irradiated, isolated chromatin.


Sparing of bone marrow stem cells by long-term administration of Na-alginate to 226Ra contaminated mice. 226Ra toxicity studies form the experimental basis for the estimation of radiation risk from internal emitters in man. We investigated whether treatment with Na-alginate is able to protect haemopoietic bone marrow cells against alpha-irradiation from 226Ra contamination. Doses from 4 to 14 micronCi/kg were injected intraperitoneally in mice 12 days before the start of the treatment. Damage to marrow stem cells was assessed by the exogene clonal spleen technique. Collection of marrow cells by two methods was compared. In the lower dose groups no influence on stem cell survival is noticed. but from 9.0 micronCi/kg a decrease in the number of surviving stem cells is observable in non treated animals. while in animals treated with Na-alginate fewer stem cells are damaged. These preliminary data agree with the hypothesis that Na-alginate stimulates removal of 226Ra mainly from the endosteal bone surfaces, reducing the local 226 Ra dose which accounts for damage to marrow stem cells within the range of alpha-rays at the endosteal surfaces.


Effect of ionizing radiation on 15-hydroxy prostaglandin dehydrogenase (PGDH) activity in tissues. Whole body irradiation of mice with 200-1000 R of unfiltered X-radiation (230 kV, 15 mA, 140 R/min) produced extensive falls of 15-hydroxy prostaglandin dehydrogenase (PGDH) activity in the spleen within 4 hours. A transient recovery between 4 and 72 hours was followed by a second reduction in PGDH levels which was still evident 7 days after exposure. In the jejunum and kidney, the falls were smaller. High doses (1000 R) increased PGDH activity in the lung. Effects of radiation on the other cellular enzymes, including other dehydrogenases in the cytosol, were less pronounced, and in some cases the opposite of the effects on PGDH. The loss of PGDH may contribute to the increase in prostaglandin concentrations in the spleen and jejumun, and thereby to some features in radiation sickness.


[Is total pancreatectomy still responsible treatment for chronic pancreatitis? (author's transl)]. A total of 61 pancreatectomies for chronic pancreatitis are reported. The operative mortality rate was 21% and the later mortality rate 29%, although caused by diabetes. The results are so poor that this method should only be performed in extreme situations. Left or right resection of the main inflammation site is proposed as an alternative. To prevent recurrence of the pancreatitis, the in situ remaining part of the pancreas should be sclerosed by occlusion of the pancreatic duct system.


[Preoperative diagnosis of posterior fossa tumors (author's transl)]. The wide-scale use of the CT Scanner has completely modified the radiological approach in the diagnosis of infratorial tumors. In the cerebello pontine angle tumors, computerized tomography offers enough information for surgery (at least in those cases where enlargement of porus is noticeable on the skull film). On the other hand, if clinical picture is incomplete or CT scann atypical (spontaneous hyperdensity), a vertebral angiography is necessary to recognize a meningioma or a neurinoma of the firth nerve. A low density suggesting a cyst (epidermoid or other) is a good indication for pneumoencephalography. In cerebellar tumors of the hemispheres, vertebral angiography should be performed in the case of multiple tumors (except if there is a good chance of metastases) and also with a single tumor showing a high enhancement with contrast; in a solitary cyst, angiography is recommanded when clinical signs suggest hemangioblastoma. Isotopic scanning is only indicated when there is a suspicion of metastases. In midline tumors, one has to consider the relationship with the 4th ventricle; no other radiological exams are necessary if tumor is likely located in the cerebellar vermis; on the contrary, if the ventricular cavity is barely visible positive ventriculography is helpful. In the anteriorly located neoplasms, pneumoencephalography with tomography may precise the exact situation in relation with the brain stem. Regardless of the anteroposterior location, a highly contrasted tumor should be explored by angiography.


[Iatrogenic damage to the nervous system]. A survey is given of the most important findings in respect of iatrogenic damage to the nervous system on the basis of published reports and the author's own findings, taking special account of lumbar puncture and suboccipital puncture, myelography, contrast-medium encephalography, ventriculography and cerebral angiography. The possibility of damage such as the danger of embolism in diagnostic and therapeutic vascular puncture is referred to. Among the lesions caused in the course of therapy, the side-effects of treatment with drugs, effects of radiation, effects resulting from anesthesia, sequelae of neural therapy and of manual manipulations, sequelae of operations, and postvaccinal encephalopathies are discussed. The necessity of systematic morphological examinations for exact assessment of ioatrogenic lesions is stressed. Iatrogenic damage due to neglect of diagnostic and therapeutic measures is also considered.


Differential diagnosis between normal pressure hydrocephalus and cerebral atrophy on computed tomography. A brain computed tomography--cisternographic correlation of 48 cases suspected of having normal pressure hydrocephalus (NPH) was undertaken, observing that the enlargement of temporal horns correlates with abnormal cisternograms compatible with NPH, and appears to be a reliable differential feature from cases of cerebral atrophy with "ex-vacuo hydrocephalus". The results of this correlation and typical images are presented.


Morphology of motor end-plate and its size relation to the muscle fibre size in the amphibian submandibular muscle. The morphology of neuromuscular junction in the amphibian submandibular muscle has been examined both light and electron microscopically. Despite the differentiation of muscle fibres into types, both the structure and ultrastructure of the motor end plates was found fairly uniform in the examined species. The strongly positive correlation between the motor end plate surface area and muscle fibre diameter was found in Triturus and Rana. Some aspects of the motor end plate morphology are discussed in connection with the results of the author's physiological and morphological observations obtained formerly.


[Effect of direct current on bone regeneration]. The data on bone biocurrent and on the bone regenerating effect of low intensity direct current are discussed. The stimulator constructed by the authors is described. With its help an improved callus formation could be achieved on the osteotanised femur of the rabbit.


Afterload reduction by enflurane.

Afterload reduction by enflurane. In 12 patients with coronary artery disease, hypertensive period during aortocoronary bypass grafting were treated with enflurane. The effects of enflurane on the general hemodynamic and the major determinants of myocardial oxygen consumption were studied. Heart rate and systolic arterial pressure were significant reduced, cardiac index and pulmonary capillary wedge pressure remained unchanged. The calculated determinants of myocardial oxygen consumption decreased, as well as the measured arterial-coronary venous oxygen content difference. The authors conclude, that enflurane can reduce the afterload in patients with coronary heart disease.


[Observations on the mode of distribution of cholesterol in cholesterolosis bulbi (author's transl)]. Clinical and histological findings are described together with the mode of distribution of the cholesterol crystals that could be traced in the anterior chamber, iris, corpus ciliare, vitreous body, retina and choroid. No crystals were found in the cornea, sclera or lens. In the patient's medical history was a trauma that had occurred 37 years before. Histologically, macrophages were visible in the iron reaction. Since these macrophages contained siderous pigment, an intraocular haemorrhage probably played an important role in the development of the crystals.


[Length measurements by rocking-plate micrometry at the fundus of the human eye (author's transl)]. An additional unit which can be used for length measurements at the fundus of the human eye is described for the ophthalmoscope. The principle of measurement is based on optical displacement of the measuring object to itself. The optical displacement of picture points is made possible by the use of a tilting flat glass plate in the intermediate image plane of the eyepiece. The relation between the optical displacement of picture points and the measuring movement is sufficiently linear for the described device.


[Timolol and acetazolamide in the treatment of increased intraocular pressure (author's transl)]. Twenty-four patients with open-angle glaucoma were tested to see if, and to what extent, timolol and acetazolamide produced a supplementary reduction of intraocular pressure. Twelve patients were treated with timolol eye drops, 0.5% b.d over a period of one week and then received one dose i.v. acetazolamide 250 mg which produced a statistically significant drop in intraocular pressure. Twelve patients with open-angle glaucoma who had been treated with acetazolamide 500 mg t.d.s. orally over a period of one week, received one drop of timolol 0.25% which produced a statistically significant additional effect. These results are discussed on the basis of the mode of action of the applied medications.


[Comparative measurements of the ophthalmic arterial pressure using the Mikuni dynamometer and the Stepanik-arteriotonograph (author's transl)]. Comparative measurements of the ophthalmic arterial pressure have been performed in 102 eyes using the Mikuni dynamometer and the Stepanik-Arteriotonograph. There was a linear correlation between the results obtained with both methods (P less than 0.001). Ophthalmic arterial blood pressures taken with the Stepanik-Arteriotonograph (SAT) were on the average 23 mmHg higher than with the Mikuni suction cup dynamometer. The mean ophthalmic blood pressure using the SAT was 88% of the mean brachial arterial pressure, whereas it was 70% with the Mikuni instrument. Differences between duplicate readings in the same eye were higher with the SAT than with the Mikuni dynamometer (P less than 0.001). Differences between both eyes in one individual were on the average greater using the SAT than the Mikuni instrument (P less than 0.001) and suction cup dynamometry was tolerated better subjectively than ophthalmic arteriotonography. A different reference point for taking arterial blood pressure with both methods is discussed. In arteriotonography the point of pressure measurement is more central than in suction cup dynamometry, because of the different method of increasing intraocular pressure in each procedure. The pros and cons of both methods are critically discussed.


[Echoculometry of the scleral buckle after retinal detachment surgery with and without subretinal drainage (author's transl)]. In a series of 32 eyes, the elevation of the scleral buckle was measured by means of A-scan echo-oculometry at the end of retinal detachment surgery, 6 and 10 h later, and 2, 3, 4, 8, 14, and 21 days after cryopexy and plombage with a 5 mm diameter silicon sponge. Subretinal drainage was applied in 50% of the cases. In more than 50% maximal indentation was found 2 days postoperatively; in less than 50%, 3 days postoperatively. Statistically significant, this maximum appeared earlier in cases with subretinal drainage than in cases without drainage. The highest elevation of the buckle persisted from one to two weeks and decreased during the third week.


[Action of 5-hydroxytryptophan on serum thyreostimulin and prolactin in primary hypothyroidism (author's transl)]. Orally 5 HTP has significantly decreased serum TSH level in eight patients with primary non treated hypothyroidism, but not in five normal subjects. Serum T4 et T3 levels did not change and serum PRL did not increase in the two groups. These results indicate a possible inhibitory action of 5 HT on TSH regulation. Action of 5 HT on PRL has not been defined here.


[Calcium and phosphrous evaluation during cortisone treatment of nephrotic syndrome in relapse]. Metabolic balances were used to study the intestinal absorption of calcium, magnesium and phosphate in children with steroid sensitive nephrotic syndrome in relapse. Magnesium balance was unaffected by the illness, steroid therapy, or by the addition of vitamin D. In contrast, the absorption of calcium and phosphorus was reduced by the illness and was still furthur diminished by the steroid therapy. The addition of vitamin D was totally ineffective in the doses used. The causes of these changes are discussed.


Synthetic antigens: IV. Antigen-binding cells to interpolymer of styrene and maleic acid (PSM) in rats immunized with sheep red blood cells. The results of studies on the effect of a new synthetic antigens: interpolymer of styrene and maleic acid (PSM) on the immunological response in rats to sheep red blood cells, and vice versa are presented. It was found that in rats, in contrast to mice, PSM did not generate antigen-binding cells for sheep red blood cells. However, an opposite effect was observed: sheep red blood cells generated in rats antigen-binding cells to PSM.


T and B lymphocytes in patients with steroid-dependent bronchial asthma during long-term treatment. Since corticosteroids are known to be a potent factor redistributing the peripheral blood lymphocytes to other body compartments, we estimated the sub-populations of T and B lymphocytes in peripheral blood of steroid dependent asthma patients. In twenty steroid-treated asthma patients and eighteen healthy blood donors the percentage and absolute number of lymphocytes forming spontaneous rosettes with sheep red blood cells ("early" and "late" T lymphocyte marker) and mouse red blood cells (B lymphocyte marker) were determined. The asthma patients were treated with 40 or 60 mg of triamcinolone acetonide (Kenalog) i.m. for at least one year or more prior to the study. No statistically significant differences were observed in lymphocyte subpopulations between steroid-treated asthma patients and healthy blood donors.


Immune responsiveness of irradiated mice reconstituted with complement receptor positive CLR+ or negative CLR--lymphocytes from spleen or bone marrow. Spleen and bone marrow cells depleted of CRL cannot restore immune reactivity of irradiated mice to sheep red blood cells SRBC. The response to anti-SIII, a T-independent antigen does not change when irradiated animals are repopulated with spleen cells or spleen cells depleted of CRL. Spleen cells of 6-day-old mice having low number of CRL, in contrast to spleen cells of adult animals, could not reconstitute irradiated recipients.


The peripheral T and B lymphocytes in uremic patients. By employing the rosette technique the peripheral T and B lymphocytes were determined in 24 patients with terminal renal failure treated by diet and 17 subjects treated by program of repeated hemodialysis. The decreased percentage of B-cells was found in both groups of patients in comparison with the control group. The more distinct decrease of B-cells was observed in patients treated by hemodialysis in comparison with undialized patients but the difference was statistically nonsignificant. The degree of immunity disturbance in chronic renal failure does not depend on dialysis but on the duration of the renal insufficiency.


The role of autoaggressive reactions in recurrent uveitis. An experimental study in rabbits and clinical study in patients with uveitis was carried out. Experimental uveitis was induced in rabbits sensitized with albumin and antigen was injected intravenously or into the vitrous body of their eyes. Blastic transformation of lymphocytes stimulated with PHA, albumin and extracts of the uvea and cytotoxicity of the serum against normal white blood cells in presence of antigen were determined. In recurrent uveitis blastic transformation induced with uvea antigens, hemagglutinin titers against these antigens and serum cytotoxicity increased. The results indicate a significant role of autoaggression in the pathogenesis of some recurrent eye uveitis cases.


[Function returning without and with recovery nystagmus after sudden unilateral isolated vestibular loss (author's transl)]. The restoration of peripher labyrinthine excitability after sudden unilateral isolated vestibular loss shows a different behaviour: It can happen with or without recovery nystagmus with a numerical nearly equal frequency. In a follow-up of 44 patients with unilateral vestibular loss of vascular genetics the objective and subjective characteristics of both states are described. In explanation of it a lesion of variable etiology in the region of the vestibular artery and a supposition of a not yet or already occured compensation of the disturbed tonus balance in the nuclear area are not sufficient. Rather the origin of the different clinical states of recovery phenomenon must be presumed in all probability as the result of a primary and secondary retrograde degeneration of the vestibular neurons. Thereby the distance of the lesion from the Scarpa ganglion is presumably of decisive importance.


The effects of major and minor trauma on lymphocyte kinetics in mice. The effects of major and minor trauma on the circulating white blood cell populations of C57BL mice were followed. The results showed that not only major trauma (nephrectomy) but minor injury and stress (e.g. injection, bleeding) triggered a highly significant fall (50-70%) in the number of lymphocytes circulating in the blood. The fall was a gradual one, with the maximal drop 2 h after the operation or handling procedure. Major trauma resulted in a fall in both B and T lymphocytes. Minor trauma produced a fall in B lymphocytes only. A 3-4 fold increase in circulating polymorph numbers also accompanied major trauma, but no increase was observed after minor trauma. The blood picture returned to normal generally within 24 h of both minor and major trauma. Repetition of the trauma stimulus after recovery led to a renewed trauma response. Bilateral adrenalectomy abolished the lymphocyte response to major and minor trauma and decreased the polymorph response to major trauma by more than 50%, indicating that stress hormones played a role in these changes. Studies with 51chromium-labelled lymphocytes, transferred into traumatized and adrenalectomized animals, suggested that decreased entry of lymphocytes into the blood (rather than increased exit from the blood into the tissues, or cell death) was the most likely mechanism of the lymphopenia following trauma.


Bovine granulocyte/macrophage and erythroid colony culture: characteristics of the colonies and the assay systems. Bovine bone marrow granulocyte/macrophage colonies were cultured in vitro in methyl cellulose and in plasma clots using bovine endotoxin-stimulated serum as a source of colony stimulating activity. The endotoxin-stimulated serum was four times as potent as the control serum in the methyl cellulose cultures. No significant increase in the number of colony forming units was observed when bovine marrow cells were maintained in suspension cultures for various periods prior to plating in methyl cellulose. The percentage of glass/plastic adherent cells in bovine marrow cells was observed to be 43% +/- 12 (SD). Benzidine positive erythroid colonies appeared in plasma clot cultures on day 4 and disappeared by day 9. No second population of erythroid colonies appeared either as a function of time or as a function of erythropoietin concentration. The optimum erythropoietin concentration for bovine erythroid cultures was found to be 1.0 unit/mL. A significant difference was observed between animals in their marrow capacity to produce erythroid colonies in culture but no significant difference was observed within individual animals over a period of three months.


Clinical, physiological and philosophical implications of innovative brain surgery in humans. Abnormal states of motor behaviour can be reversed by interruption of facilitating mechanisms and augmentation of inhibitory mechanisms. Similarly, psychological and emotional behaviours which were abnormal due to disinhibition, such as screaming, repetitive speech and aggressive violent behaviour, have been favourably affected from a clinical and sociological standpoint. The mechanisms of the facilitatory and inhibitory systems which modulate motor behaviour also modify psychological and emotional behaviour. The findings of our studies in experimental neurosurgery may help to provide new insights into mechanisms of mental capacity and behaviour.


[The epidemiological approach to depression (author's transl)]. The epidemiological method is indispensable to the clinical investigator, the practising clinician and the public health worker. In the field of mood disorders epidemiological inquiry has been hampered by the subjective nature of the phenomena under study, the problems of assessment and diagnosis, observer bias and the unrepresentative nature of small population samples. Nontheless, it is argued that the difficulties are similar to those encountered elsewhere in medicine and examples are given of epidemiological contributions to an understanding of depression.


Endoscopy in the upper G.I. bleedings.

Endoscopy in the upper G.I. bleedings. From 388 patients with upper G.I. bleeding investigated by endoscopy, radiology or emergent surgery, one third bled from duodenal ulcer, one third oesophageal varices, and from the remain the most frequent were gastric ulcer (14%) and gastric cancer (9%). From a sample of 53 patients with liver cirrhosis, 66% bled from varices and 34% from other lesions. The proportion of patients who bled from oesophageal varices is higher under 60 yrs. The mortality was higher after 60 yrs, except when there was associated chronic liver disease or renal or cardio-respiratory failure. In this group of patients, near half in our series, the mortality is the same under and above 60 years.


Isolation of pluripotent hemopoietic stem cells and clonable precursor cells of erythrocytes, granulocytes, macrophages and megakaryocytes from mouse bone marrow. Murine pluripotent hematopoietic stem cells and precursor cells with restricted commitment to erythrocytes, granulocytes and macrophages as well as megakaryocytes have been purified 30- to 50-fold from mouse bone marrow cells. Purification was achieved by a three-step procedure. Bone marrow cell populations free of erythroid cells and lymphocytes were obtained by culturing the cells for several weeks. Macrophages and adherent polymorphic neutrophils (PMN) were removed by adherence to plastic. The remainder of the PMN along with more primitive granulocytes (but not promyelocytes and some monocytoid cells) were removed either by neutral density centrifugation or by differential centrifugation after rosette formation with sheep erythrocytes coated with immunoglobulin (EA rosettes). The remaining population of marrow-derived cells contained 40-66% blast cells, 20-35% promyelocytes and 5-10% other cells (usually PMNs and monocytes). Using cloning techniques to detect immature hemopoietic cells, this population contained 15-35% granulocyte-macrophage progenitor cells, approximately 0.2% erythroid burst-forming cells, approximately 0.1% megakaryocyte progenitor cells and 1-3% pluripotent stem cells (based on seeding efficiency 0.06).


The physical separation of three subpopulations of granulocyte/macrophage progenitor cells from mouse bone marrow. The heterogeneity among progenitor cells of granulocytes and macrophages capable of forming colonies in vitro (CFU-c) is analysed. If specific culture conditions and stimuli are used, it is possible to discriminate among three subpopulations of CFU-c. CFU-c directly responding to CSF prepared from pregnant mouse uteri are characterized by a density of 1.075 g.cm-3. The G1-phase cells of this CFU-c subpopulation have a sedimentation rate of 4.8 mm.h-1. CFU-c of two additional subpopulations are induced to proliferate by enhancing factors present in serum of mice injected with endotoxin 18 hours earlier and in lysate of rat erythrocytes. CFU-c responding to postendotoxin serum have a density of 1.070 g.cm-3 and a sedimentation rate of 4.3 mm.h-1 (G1 cells). The CFU-c responding to erythrocyte lysate have a density of 1.080 g.cm-3 and a sedimentation rate of 5.3 mm.h-1 (G1 cells). The calculated diameters of G1-phase cells of these three CFU-c subpopulations range from 7.4 to 7.6 micron and are not significantly different. It is proposed that the three CFU-c detected represent three sequential maturation stages of granulocyte/macrophage progenitor cells. These cells are similar in size but increase in density (1.070 g.cm-3 to 1.080 g.cm-3) as they mature.


[Diagnosis of lupus erythematosus].

[Diagnosis of lupus erythematosus]. For the exact classification of lupus erythematosus, morphological criteria alone (clinical picture, histopathology, immunopathology from involved skin, immunoelectron microscopy) are not sufficient. It is the aim of this paper to discuss briefly the known criteria for the diagnosis of systemic lupus erythematosus with particular reference to the interpretation of more recent deagnostic methods (determination of certain antinuclear antibodies; lupus band test; C1q-binding assay.


[Immunotherapeutic possibilities for treatment of malignant melanomas]. Principles, possibilities and limits of an immunotherapy of malignant melanoma are discussed. On account of the results of immunological investigations in melanoma patients and in animal models the immunogenicity of melanoma cells and the stage dependent immune reactivity of tumor bears seem to be certain. These facts have been the rational basis for the evaluation of an immunotherapy in malignant melanoma. Netherless these therapy trials are still in the state of clinical testing. Controlled long term studies of immunotherapy schedules under observation of the immune profile of the patients in vivo and in vitro are necessary in order to determine the place of immunotherapy within the range of oncological therapeutic possibilities.


[Immunocytomas and immunoblastic lymphomas of the skin]. Evaluation and classification of malignant lymphomas have changed decisevely in recent years. It was especially through immunology that these new discoveries were made. Some namely the immunocytoma and immunoblastic lymphoma. These lymphoma-entities of the non-Hodgkin-group are in the majority of cases neoplastic analogues of transformed B-lymphocytes. Clinico-pathologic correlations and the enzymecytochemical characterisation of the tumor cells are also described in this paper.


[Problems in the emergency surgical treatment of bleeding esophageal varices]. An examination is made of a series of emergency operations carried out in the period 1974-78 to arrest haemorrhage due to the rupture of oesophageal varices. An account is given of the personal criteria employed in the choice of candidates and the type of surgical management. Stress is laid on the need for greater aggressivity. In addition, support is expressed for the porto-systemic shunts, especially shunts of the porto-cava and meso-cava type. These are superior to other forms on account of their easy and rapid execution.


[Proteins in human tears (author's transl)]. Levels of lacrimal proteins, 90% of which are synthetised by the lacrimal gland, normally vary between 2.5 and 6 g/litre. Three fractions migrating towards the anode may be isolated by electrophoresis: 2 prealbumins corresponding to approximately 30% of the proteins, a poorly known group (4 to 12%) and lactotransferrin (40 to 50%). One fraction migrates towards the cathode: lysosyme (25 to 35%). It is also possible to demonstrate a protein profile of tears (albumin less than 200 mg/l, transferrin less than 20 mg, IgA 100 to 200 mg/l, IgG less than 10 mg/l, bacteriolytic activity equivalent to a concentration of lysosome of 4 to 6 g/litre). In pathology, electrophoresis is valuable in the study of dry syndromes and for identification of fluid from a palpebral cyst. The protein profile is of interest above all when the tears are inflammatory.


Cystoid macular oedema and ocular inflammation. The corneo-retinal inflammatory syndrome. Intraocular lens implantation may be associated with an inflammatory syndrome which leads to corneal decompensation and cystoid macular oedema. The inflammatory aspects often do not appear striking but manifest as mild ciliary flush, mild flare, moderate cells in the anterior chamber, and moderate vitritis. The cornea will decompensate in the presence of endothelial cell counts which are sufficient to maintain corneal clarity in the non-inflamed eye. Metal-looped lenses and poorly polished lenses cause iris chafing and capillary leakage which increase the severity of this syndrome. It is postulated that intraocular surgery initiates an inflammatory response which is augmented by certain components of intraocular lenses. The mediation for this increased inflammatory response may be inhibited by both steroidal and non-steroidal anti-inflammatory agents. The presence of white blood cells and their products, such as lysosomal enzymes, may be sufficient to perpetuate the inflammatory response and cause damage to abnormal and normal cells. The presence of protein and its immune components, as well as complement, may be involved in this syndrome.


Prekallikrein activation by Hageman factor: potentiation by proteins in the absence of high molecular weight kininogen. Proteins which potentiate the conversion of prekallikrein to kallikrein by Hageman factor fragments are present in cryoprecipitate prepared from the plasma of an individual lacking HMW kininogen as well as in purified von Willebrand's factor preparations. However, the potentiator activity could be separated from the von Willebrand's antigen and ristocetin cofactor activity by chromatography on QAE-Sephadex. Moreover, it was present in plasma from an individual lacking von Willebrand's factor. These observations indicate that von Willebrand's factor is not responsible for the potentiator activity in cryoprecipitate.


Aortic stenosis--angiodysplasia of the caecum. A 73-year-old female patient developed beside aortic stenosis angiodysplasia in the caecum, which gave rise to serious, repeated intestinal bleedings. As a result, the patient was admitted to hospital 32 times. Over a period of 8 years she was given 178 litres of blood. The vascular disorder which was the source of bleeding, was detected by mesenterial angiography. After resection of the colonic section concerned, the bleeding stopped. The diagnosis of angiodysplasia of the caecum was confirmed by pathological examination.


[Associated myasthenia and disseminated lupus erythematosus. A report on two cases and complete review of the published literature (author's transl)]. Two patients aged 47 and 48 years respectively were found to have associated immunity disorders: myasthenia and DLE in the first case, and erythroblastic anemia, myasthenia, a lupus syndrome, and a thymoma in the second case. The association of myasthenia and DLE has been reported 39 times in the published literature (20 times only if stricter biological criteria are applied). The association does not increase the severity of the patient's condition and a thymoma is not present more frequently. Studies on the major histocompatibility complex and lymphocyte levels are still insufficient in this context: the haplotype was HLA A1 B8 in three cases out of seven. The physiopathological data available cannot confirm the possibility of a common pathogenesis in which the thymus and lymphocytes could play a determining role.


[Effect of transfer factor on the immunity state of patients with bronchopulmonary cancer. A report on 12 cases (author's transl)]. The dialysate of an extract of leucocytes having transfer factor (TF) activity was administered, at a daily dose of 1 mg/ml of orcinol-sulphuric positive material, by intramuscular injection to 12 patients with bronchopulmonary cancer for 6 days. An increase in the percentage of E-rosettes and the absolute number of T lymphocytes was observed in 7 cases out of 10. Rapid healing of a widespread intercurrent zona and a regin of B.C.G. scarification reaction was also noted. The TF was well tolerated in most cases.


L-cysteine hydrazide--its pharmacological and immunosuppressive activity. The authors investigated the immunological and pharmacological activity of l-cysteine hydrazide. It was found, that the preparation exhibited an interesting immunosuppressive and anti-inflammatory effect, which was evoked by the interference of the drug in nucleic acids and by stabilization of the cell membranes. Moreover it diminished the number of T lymphocytes. L-cysteine hydrazide showed no significant side effects. The authors discussed the possibility of its application in clinical therapy.


Serum prolactin and brain and pituitary monoamine responses to chronic monoamine oxidase inhibition in the rat. The acute administration of the monoamine oxidase inhibitor iproniazid to rats causes a highly significant suppression of serum prolactin levels at 2 h. At the same time there is a significant rise in the hypothalamic-median eminence concentrations of the biogenic monoamines dopamine, noradrenaline and serotonin. When iproniazid is administered daily to rats for 4 days and the animals are examined on the fifth day brain noradrenaline and serotonin levels are elevated similarly to those seen after acute administration but dopamine concentration is near normal while serum prolactin is significantly elevated. This study thus demonstrates that a quite specific and unexpected change occurs in the regulation of hypothalamic-median eminence dopamine when iproniazid is administered chronically and provides an explanation of previous observations in human subjects where raised serum prolactin levels are observed after chronic therapy with monoamine oxidase inhibitors.


Induction of the hepatic microsomal and nuclear cytochrome P-450 system by hexachlorobenzene, pentachlorophenol and trichlorophenol. The application of hexachlorobenzene (HCB), pentachlorophenol (PCP) and 2,4,5-trichlorophenol (TCP) to female rats led to an induction of both the microsomal and the nuclear cytochrome P-450 system in the liver. The increase of th mixed-function hydroxylase activities examined (7-ethoxycoumarin deethylase, 7-ethoxyresorufin deethylase, NADPH-dependent cytochrome c reductase, aminopyrine demethylase, benzpyrene hydroxylase) did not correlate strictly with the cytochrome P-450 content. Depending on the inducers and the substrates used, the content and the activity of the cytochrome P-450 were essentially smaller in the nuclei than in the microsomes. It was striking that in the nuclei those activities (benzpyrene hydroxylase, 7-ethoxyresorufin deethylase, 7-ethoxycoumarin deethylase) were preferably induced which can be attributed to the methyl-cholanthrene-induced form of the cytochrome P-450 (cytochrome P-448). These results suggest, also in the light of findings of other authors, the induction of different species of cytochrome P-450 in the nuclei and microsomes.


Vestibular nystagmus under hyperbaric conditions. Sixty subjects participated in 454 experiments, 94 of which involved a centrifuge and an overload of 2 units. The studies showed that otolithic stimulation (the 2 unit overload) either activated nystagmus or had no substantial effect on the magnitude of this property. The paper advances a new, supplementary method for individual evaluation of the functional state of the vestibular analyzer of a pilot, in complicated cases of vestibulometry in clinical examinations, by comparative evaluation of the intensity of the nystagmic response under normal and hyperbaric conditions. Patients in whom the nystagmic slow phase speed (SPS) during hyperbaria (2 units) exceeds its usual value are designated as vestibulo-resistant; persons in whom the SPS of the nystagmus does not change substantially during hyperbaria are designated as vestibulo-susceptible.


Identification of TL+ thymocytes with different Lyt phenotypes. The surface antigenic phenotype of BALB/c thymocytes has been analyzed by sequential cytotoxic treatment with Lyt-1.2, Lyt-2.2 and TL.2 antisera plus complement. Two new minor subpopulations with TL+Lyt-1+2- and TL+Lyt-1-2+ phenotypes have been identified providing direct evidence for the heterogeneity of the Lyt phenotype among the TL-positive supopulation of thymocytes. This finding suggests that differentiation pathways of Lyt subsets of T cells are more complex than originally proposed and that commitment to separate lines of differentiation may occur already at the level of immature, cortical thymocytes.


Surface markers on natural killer cells of the mouse. Rabbit antiserum against mouse brain tissue (anti-brain-associated T cell antigen, anti-BAT) was capable of killing splenic natural killer (NK) cells of CBA/J, BALB/c, C 57 Bl/6J, C 3 H/He and nude mice, which were detected with Molony virus-induced lymphoma (YAC-1) and radiation-induced leukemia (RL male 1) cells as targets. The same antiserum abolished T cell functions, e.g. carrier-specific helper function and the responsiveness to concanavalin A, but not B cell functions, e.g. immunological memory for the secondary antibody response and the responsiveness to lipopolysaccharide. After absorption of the anti-BAT with thymocytes, the ability to kill T cells was completely abrogated, leaving the activity to kill NK cells intact. No other heterologous and isologous antisera, i.e. rabbit anti-mouse thymocyte antiserum, goat antiserum against antigens shared by thymus and B cells, anti-Thy-1.2 and anti-Ia antisera, could eliminate NK function regardless of their definite reactivity against T or B cells. The results indicate that the absorbed anti-BAT can distinguish NK cells from other known subsets of T and B cells.


[Genetic regulation of T-lymphocyte responsiveness to PHA is independent of culture conditions (author's transl)]. A maximal interline separation has been obtained after 10 consecutive generations of selective breeding for the character "quantitative in vitro response of lymph node lymphocytes to the mitogenic effect of phytohaemagglutinin". At the selection limit the difference between high and low responder lines was about 20-fold. A similar interline separation has been demonstrated for the T-mitogen effect of concanavalin A. The identical response to PPD (purified protein derivative of tuberculin), a B mitogen, proved that the genetic selection has only modified the potentialities of T lymphocytes. During the selective breeding, responsiveness to PHA stimulation has been always measured under identical culture conditions. To demonstrate that the interline difference in responsiveness was due essentially to genetic factors independent of environmental effects, a systematic study of various culture conditions has been undertaken. The optimal stimulation was found after two days of culture for high line cells and after three days for low line cells. The difference between maximal responses was only slightly lower than that obtained after a two-day culture as used for the selection test. Increase in cell concentrations produced higher thymidine incorporation. In the two lines, a linear correlation was established between the cell concentration and the response produced. The maximal response given by the highest number of low line lymphocytes was equivalent to that given by a number, 11-fold smaller, of high line cells. Within certain limits, changes in the amount of tritiated thymidine added to the culture did not affect the interline separation. With a thymidine of high specific activity, a sub-evaluation of uptake by high line cells decreased the interline difference. Results in mixed culture of lymph node cells from high and low lines indicated that the low response was not due to the release of inhibiting factors or to the presence of suppressive cells in low responder mice. In conclusion, separation of these two lines was due to genetic factors acting independently of the cell culture conditions.


A mature T lymphocyte subpopulation marker closely linked to the Ig-1 allotype Ch locus. An antiserum raised in BALB/c AnN mice against selected CAL.20 T cells reacts with a cell surface antigen in virgin animals that is found on 25% of mature thymocytes and Lyt-2-bearing T cells, but not on prothymocytes, Lyt-1 T cells or B cells. The antigen is restricted to strains carrying the Ig-1d or Ig-1e heavy chain allotype haplotypes. It is expressed in F1 mice. The antiserum blocks the binding of suppressor T cells to the cross-reacting idiotype for arsonate while reagents specific for Fab, Fc or Ig were ineffective. We suggest that the antigen described represents a determinant on the product of a new locus coding for a heavy chain-linked polypeptide found on a subpopulation of T cells.


[Aneurysmectomy and aortocoronary bypass. Immediate and long-term results of 56 patients]. 56 pts. who underwent left ventricular aneurismectomy were studied. Clinical improvement and lat post-operatory mortality rate have been evaluated. 39 pts. (II group) also had aortocoronary bypass and other surgical procedures performed at the time of the aneurismectomy. Group I (no other surgery beside the aneurismectomy) and group II did not significant differences in the pre-operatory period and were, therefore, comparable. The total operatory mortality has been of 14% (17.6% in group I and 12.8% in group II). By using myocardial protection the mortality dropped to 5.8%. A significant difference between deceased and survived pts. was noted in the following parameters: cardiac index, A-V oxygen difference, extracorporeal circulation time and the number of diseased coronary arteries (P < 0.001-0.005). Only 2 pts., both in group II, had a late death. After the operation 32 pts. became asymptomatic. Five pts. remained symptomatic: 3 continued to complain of angina and 2 to show signs of left ventricular failure; ventricular arrhythmias were still present in 6 pts. post-operatively (compared to 16 pts. pre-op.). The data suggested that aneurismectomy, associated with aorto-coronary bypass and myocardial protection, has an acceptable operatory risk, particulary in pts. with a good residual ventricular function. Except for ventricular arrhythmias clinical results are very good and late mortality rate is low


[The pronator teres syndrome. Clinical aspects, pathogenesis and therapy of a non-traumatic median nerve compression syndrome in the space of the elbow joint]. The proximal compression neuropathy of the median nerve is described by 11 personal cases and a review of literature. The most reliable diagnostic sign is "pronation-pain", discomfort in the forearm localised under the pronator teres, produced by passive supination of the wrist, by active pronation from this position against resistance, okr by local pressure. A nearly constant finding is weakness of grip and paraesthesia or hypaesthesia of the fingers, not always following the normal median nerve distribution. Three different anatomic points of possible compression are described: 1. The supracondylar process of the humerus, or Struthers' ligament, a rare compression mechanism. 2. The passing of the nerve through the two variable heads of the pronator teres muscle. 3. The sharp edged superficialis bridge. Apart from compression of the entire median nerve single branches of the median nerve can be entrapped seperately (the anterior interosseus nerve, the Martin-Gruber-anastomosis to the ulnar nerve) Conservative treatment with immobilisation and local electric interference current application may be satisfactory. If clinical improvement is insufficient, surgical decompression is indicated.


Rhodopsin phosphorylation suggests biochemical heterogeneities of retinal rod disks. Frogs (Rana pipiens) were injected subcutaneously with (3H)-leucine and allowed to incorporate the radioactive amino acid into newly assembled disks in the retinal rod outer segment. The labeled disks served as a temporal marker for following the turnover of rod outer segments. Animals were killed at different times after injection and outer segments were isolated and phosphorylated with ATP in the light. The visual pigment (as isorhodopsin) was regenerated with 9-cis retinal, extracted, and chromatographed on epichlorohydrin triethanolamine cellulose so that phosphorylated pigment could be separated from unphosphorylated pigment. The ratio of (3H)-radioactivity of phosphorylated pigment to that of unphosphorylated pigment was then plotted against the time after injection. The ratio was high when (3H)-labeled disks were largely associated with the basal region of the rod and decreased as the labeled disks moved toward the rod apical region. The results were interpreted as suggesting that newer disks are phosphorylated preferentially to older disks. Papain digestion of (3H)-labeled disks indicated that rhodopsin in newer disks is more susceptible to proteolysis than that in older disks.


Mitogenic effects of murine serum and fibroblast growth factor on EGF nonproliferative variants of 3T3. The enhanced ability of murine serum to support growth of 3T3 cells, when compared with fetal calf serum, is also evident on variants of 3T3 cells lacking the ability to bind epidermal growth factor (EGF). Variant 3T3 cell lines unable to bind EGF also retain a mitogenic response to fibroblast growth factor.


[The use of cimetidine in the prevention and therapy of gastroduodenal hemorrhage in resuscitation. Preliminary results]. The Authors report on 85 patients hospitalized in the resuscitation department, suffering from serious acute conditions and treated prophylactically with cimetidine. In comparison with analogous group of not treated patients, a marked diminution of digestive bleeding complications, typical in these patients, was noted.


[An unusual case of digestive hemorrhage caused by gastric lipoma]. Gastric lipoma responsible for repeated haemorrhage was observed in a 50-yr-old woman. The relevant literature is reviewed and reference is made to the rarity of this form. Its main clinical signs include a latent course, haemorrhage, and invagination of the tumour in the duodenum. It is stated that surgical management is necessary, owing to the high percentage of diagnostic uncertainty, and the serious haemorrhagic and occlusive complications mentioned.


The effect of L-DOPA and L-5-hydroxytryptophan on the pentetrazole seizures in rats after lesions of the median raphe nucleus and substantia nigra. Electrolytic lesions of the median raphe nucleus and substantia nigra markedly increased susceptibility to pentetrazole seizures in rats. L-5-hydroxytryptophan, considerably increasing the serotonin (5-HT) level in the brain, markedly inhibited the seizures and abolished the seizure-enhanced effect of lesion of the substantia nigra. L-DOPA tended to potentiate the seizures-enhancing effect produced by lesions of the median raphe nucleus. The changes in the brain 5-HT level and the intensity of pentetrazole seizures were correlated. The results indicate that the balance between neurotransmitter systems in the brain is of importance to the susceptibility to pentetrazole convulsions.


Local experience with granulocyte-macrophage progenitor cells in human leukaemia and aplastic anaemia. Haemopoietic cells from patients with leukaemia and aplastic anaemia were studied in vitro with a standard soft agar tissue culture method. In the leukaemic patients a range of growth patterns was observed, but in most cases the results indicated that leukaemic cells retain the capacity to proliferate in response to the normal physiological neutropoieic regulator, colony-stimulating factor. In some patients, cells were apparently also capable of normal morphological maturation. These findings support the work of others in suggesting that leukaemic cells may be induced to behave normally in vitro, at least in some cases, raising possibilities of radically altered approaches to further therapy. In aplastic anaemia granulocyte-macrophage progenitor cells are greatly diminished.


Hepatitis in the Haemodialysis Unit, Baragwanath Hospital, 1973-1977. A cross-sectional and longitudinal survey. All patients considered for regular haemodialysis, as well as all nurses recruited to work in the haemodialysis unit of Baragwanath Hospital, were tested for the presence of hepatitis-associated antigen (HBAg) and for antibody to hepatitis-associated antigen (HBAb). Thereafter they were tested at intervals as long as they remained in the unit. The prevalence of HBAg was 1,7% in nurses and 5,1% in patients. HBAb was present in 27,2% of nurses and 35,1% of patients. HBAg is found less frequently among Black haemodialysis patients than is reported from Europe or the USA, but the prevalence is similar to that among healthy Blacks in South Africa. The prevalence of HBAb is similar to that in Europe or the USA. Follow-up studies showed no instance of hepatitis or seroconversions of HBAg, but there was a small number of conversions of HBAb from negative to positive.


[Lymphocyte subpopulations in non-Hodgkin's lymphoma during cytostatic therapy]. 1. In non-Hodgkin-lymphomas with leucaemic form of the course a significant percental decrease of the number of T-lymphocytes and an also significant increase of the number of B-lymphocytes was to be proved. The increase of the B-lymphocytes concerned among others cells which carry the ME-receptor. 2. In non-Hodgkin-lymphomas with aleucaemic form of the course in decrease of the absolute number of lymphocytes a relative and absolute increase of the subpopulation of lymphocytes carrying the ME-receptor was provable. 3. In the course control of 7 patients with non-Hodgkin-lymphoma under polychemotherapy in 5 cases a discrepancy between the number of rosette-forming cells and the total number of lymphocytes appeared. 4. In the monotherapy of patients with CLL in favourable clinical development a percental increase of the T-cells is objectifiable after one year. A similar development was to be found in 3 patients after the first cycle with CVP.


Elimination of cobalt from the frog brain introduced into the optic centres through the optic nerve. One optic nerve in several frogs was filled with cobaltous-lysine complex, and the animals were left to survive from 1 day to 52 days. Degenerated cobalt-filled retinal fibres were phagocytosed by ependymo-glial, and microglial cells. The cobalt appeared in the ependymo-glial cells in the 4th postoperative day, and its amount was greatly reduced by the 52nd day. Within 12 days the labelled axons were replaced by cobalt-loaded microglial cells in the termination sites of optic fibres. By the end of the experimental period, the number of labelled cells increased in the periventricular layers, and decreased in places where retinal fibres had terminated. These processes were accompanied by the appearance of cobalt in the choroid plexus. It is supposed that glial cells dischargd the cobalt into brain ventricles, and the metal left the nervous tissue via the cerebrospinal fluid.


[Value of endoscopy in the diagnosis of upper digestive tract hemorrhage]. In 11 years experience (67-78) we studied the importance of endoscopy in HDA. Were carried out 8300 esophagogastroduodenal endoscopies of which 2837 were HDA. The main reasons to follow these studies were: 1) Diagnostic of the HDA location; 2) Diagnostic of type of injury; 3) Injury intensity. Referring to the findings 30% were duodenal ulcer; 27% hemorrhagic gastritis; 17% gastric ulcer and 10% were due to VE. From the remaining 10% the most frequent were the esophagitis and gastric cancer. It is most important to show that aspiring added to alcohol in the most common cause of hemorrhagic gastritis. We have to point out that in 42 endoscopies performed in Intensive Care Service 10 of them were due to non-digestive causes. Through this method of diagnosis the Endoscopist has an important role to play in defining the prognosis and conduct to be followed.


Vulval eosinophilic granuloma.

Vulval eosinophilic granuloma. A case of Eosinophilic Granuloma of the vulva, associated with Diabetes Insipidus, is presented. There is neither specific nor adequate treatment for the vulval lesions. Treatment with local steroids should first be tried, if this does not help Roentgen-ray irradiation should be given. Simple vulvectomy is a last resort with poor results.


[Sex linked mental deficiency, unusual facies, macroorchidism and fragile site on chromosome X (author's transl)]. The association of mental deficiency, macroorchidism, and a fragile site on chromosome X [fra (X)(q28) is reported in a 13-year-old boy who also exhibits a peculiar facies reminescent of trisomy 8. This particular facies is considered part of the clinical syndrome associated with the fra(X)(q28). The fra(X)(q28) was not found in the mother nor in two normal sibs of the propositus. The significance of the marker is discussed in view of two hypotheses, close linkage between pathological gene(s) and the fra(X)(q28) and faulty transcription of the gene(s) beyond the tra(X)(q28).


[A jumping translocation (5p;15q), (8q;15q), and (12q;15q) (author's transl)]. Three balanced karyotypes (5p;15q), (8q;15q), and (12q;15q) were found simultaneously in a child with the Willi-Prader syndrome. The hypothesis is presented of a "jumping# translocation by affinity of telomeric and interstitial palindromes. The relationship between the Willi-Prader syndrome and a juxtacentric anomaly of the long arm of chromosome 15 is discussed.


[De novo monosomy 4q32.1 leads to 4qter in a newborn with multiple malformations (author's transl)]. In a newborn with multiple malformations, deletion 4q32.1 leads to 4qter was observed after BrdU incorporation and staining with acridine orange. The patient's phenotype and that of five children monosomic for 4qter reported in the literature define a syndrome with a high rate of mortality due to major respiratory difficulties, laryngeal hypotonia and oedema, and complex congenital heart malformations.


Trisomy 3q : two clinically similar but cytogenetically different cases. The clinical and cytogenetic findings in two unrelated infants both trisomic for differing amounts of the long arm of chromosome 3 are described and discussed in relation to previously reported cases and the existence of a distinct syndrome of trisomy 3q is confirmed. Assignment of the gene for human red blood cell galactose-1-uridyltransferase is discussed.


Some clinical and cytogenetic observations on a ring chromosome 13 (p11 q34). A girl of 9-10/12 years of age with 46,XX,r(13)(p11q34) karyotypes was studied. She presented some clinical and radiological features, such as pectus excavatum, scalp alopecic area, 12th rib agenesis, hypoplastic pelvis, small gluteal pits and hypoplasia of the external genitalia in a female, which have never been previously described in other cases with ring 13 chromosomes. Cytogenetically, in vivo and in vitro viability of complete monosomic and partially trisomic and tetrasomic cells was found. The presence of nucleolus organizer regions and association of the ring 13 with other acrocentrics question the exclusivity of these attributes to acrocentrics p12.


Malformed genitalia in the 47,XYY genotype. A 5 10/12 year-old boy with a 47,XYY karyotype, micropenis, scrotal hypospadias and right testicular regression is described. Normal for age basal plasma testosterone levels which increased after hCG stimulation were interpreted as an adequate response of the left testicular Leydig cells. The review of similar cases did not permit definite conclusions concerning the relationship between the abnormal genitalia and the XYY karyotype.


On the deletion 4p16 Wolf-Hirschhorn syndrome. Two girls (aged 46 and 5 months) and one boy aged 5 months) were studied and found to have the Wolf-Hirschhorn syndrome. Chromosomal complement in all three cases implicated the deletion of the 4p16 band ; in two of them an extra segment of autosomal material was found to be translocated to 4p. Parents' karyotypes were normal. It is concluded that the expression of the 4p16 monosomy is stronger than that of some simultaneous partial trisomies.


[Ring chromosome 13 (author's transl)].

[Ring chromosome 13 (author's transl)]. A ring for chromosome 13 with loss of the bands p12 and q34, is reported in a person with clinical features characteristic of the loss of these specific segments.


[Monosomy 7qter (author's transl)].

[Monosomy 7qter (author's transl)]. A de novo terminal del (7)(q35) was found in a 3-month-old girl referred because of a peculiar cry. This observation, with seven others from the literature permit the delineation of a syndrome characterized by severe microcephaly with a flattened occiput, a bulbous nose, a "double chin", and a broad thorax with widely spaced nipples, without internal organ malformations. Assays of Hageman factor (XII) revealed normal values. The proposita is heterozygous Jk (a + b +). The parents and the proposita are iny-1.


Hereditary lens dislocation with angle closure glaucoma. Eight patients in one family showed dislocation of the lens and secondary angle-closure glaucoma coming on in the 50's. They all displayed the sequence of myopia, angle shallowing, followed by angle-closure glaucoma. This sequence should alert the clinician to the possibility of a hereditary disease. The cause of the disease is unknown. It is suggested that treatment should be an iridectomy in the early stages and a lens extraction if glaucoma develops.


Infectious disease management with oral antibiotics. This paper has reviewed the bacterial etiologies and therapeis for commonly seen infections in the out-patient clinic or physician's office. The use of oral antibiotics for the treatment of pharyngitis, otitis media, sinusitis, bronchitis, certain pneumonias, cellulitis, urinary tract infections and as follow-up therapy to systemic administration is discussed. Emphasis on the decreasing bacterial spectra of the tetracyclines is noted as well as a discussion of therapy of infections due to beta-lactamase-producing Staphylococcus aureus and Haemophilus influenzae.


Cefaclor in the treatment of susceptible infections in infants and children. Fifjty-two outpatients, aged from six months to 17 years, and suffering from Group A streptococcal pharyngitis, skin and soft tissue infection, urinary tract infection, or otitis media were enrolled in the study. The dosage of cefaclor was 20 to 40 mg/kg/day in three or four divided doses for ten days. In 43 children given either cefaclor suspension or capsules, plasma level estimations were performed. Cefaclor readily produces therapeutic plasma levels in children. Cefaclor appears to be a safe, well tolerated and effective antimicrobial agent in children. It has a distinct advantage over other antibiotics in children with Haemophilus influenzae otitis media and should be considered as a primary drug in treatment of otitis media.


[In vitro activity of cefaclor against Haemophilus influenzae in comparison to various oral chemotherapeutic agents (author's transl)]. The antibacterial activity of cefaclor against 100 non-beta-lactamase producing and 11 beta-lactamase producing isolates of Haemophilus influenzae was compared with that of cephalexin, ampicillin, chloramphenicol, tetracycline and co-trimoxazole. A new standardized microtiter dilution technique was used. Cefaclor showed greater activity than did cephalexin and inhibited beta-lactamase producing H. influenzae isolates. Ampicillin was the most active compound against non-beta-lactamase producing isolates. One of our strains was resistant to chloramphenicol and one resistant to tetracycline.


Presence of thymosin-like factors in human thymic epithelium conditioned medium. The objective of the present study was to determine whether or not thymosin and conditioned medium from human thymus epithelial cultures (HTECM) contain similar fractions, capable of inducing T-cell differentiation. Therefore we tested the ability of rabbit antisera to different thymosin fractions (thymosin fractions 5, 6 and alpha 1) of both bovine and human origin to block the stimulatory effect of HTECM on Con A and PHA response of mouse thymocytes. We also looked for reactivity of the antisera toward tissues of man, mouse and calf, and to tissue cultures of man and mouse. Anti-thymosin fraction 5 and 6, but not anti-thymosin-alpha 1, were found to inhibit the stimulatory effect of HTECM on both Con A and PHA responses. This cannot be attributed to cytostatic or cytotoxic effects of the antisera on thymocytes. No effect was seen when using antiserum to kidney fraction 5 or normal rabbit serum. In both tissue sections and tissue cultures of the different species tested, anti-thymosin reacts only with thymus epithelial cells. The reactivity is blocked by neutralizing the antisera with thymosin fraction 5 but not by kidney fraction 5. The reactivity is also strongly diminished by neutralizing the antisera with HTECM but not with supernatants of conditioned media from non-thymic tissues. The observations are highly suggestive for the presence of similar fractions in HTECM and thymosin, and that both are secreted by thymus epithelial cells.


Adverse effects of endotoxin following massive distal bowel resection. Sepsis is a frequent cause of morbidity following extensive bowel resection. It has been suggested that the lymphoid tissues of the gut may be essential to normal humoral immunity. This study evaluates: (1) the effect of endotoxin on mortality following selective massive bowel resection and jejunoileal bypass; (2) cellular immunity by skin allograft rejection and bypass, and (3) T and B cell lymphocyte subpopulations is mesenteric lymph nodes, intestine and appendix. Endotoxin increased mortality in rats with more distal bowel resection but not following bypass. Skin allograft rejection was similar in each group. Peyer's patches, mesenteric lymph nodes and appendices were evaluated for T & B cell subpopulations. These tissues had a greater percentage of B cells (53% lymph nodes, 63% appendix) with IgM the predominant immunoglobulin. Cellular immunity was not a factor. Lymphoid tissues of the distal bowel and mesentery contain abundant B cells and IgM that may contribute to humoral immunity. Massive bowel resection may increase the risk of morbidity from gram negative sepsis and/or endotoxin presumably due to decreased humoral immunity.


The effect of neonatal thymectomy on the induction of autoimmune orchitis in rats. The objective of these experiments was to determine the effects of neonatal thymectomy on the induction of experimental autoimmune orchitis in inbred rats of the Fischer 344 and Lewis strains. It was found that thymectomy alone in Lewis rats, and thymectomy followed by immunization with testicular extract in both Lewis and Fischer 344 rats, led to the development of autoimmune orchitis, as indicated by decreased testes weights, increased serum spermagglutinating antibody titers and histopathological changes in the testes. These data indicate that rats of the Lewis strain are genetically predisposed to the development of autoimmune orchitis, and thymectomy alone leads to active manifestations of the disease, which are further enhanced by subsequent immunization with testicular extract. In Fischer 344 rats, thymectomy followed by immunization leads to indications of early signs of experimental autoimmune orchitis. This is in contrast to experimentally induced autoimmune diseases in other model systems, where previous investigators have reported that thymectomy lessens or prevents induction of autoimmune disease. It is suggested that these differences may be related to the timing of thymectomy with regard to differences in the time of appearance of sperm antigens (at puberty) as compared to pre-natal and early neonatal appearances of other autoantigens.


Cord blood lymphocyte subpopulations and mitogenic activity in whole blood microculture. Comparative studies on cord and adult blood showed that cord blood contained at least twice as many lymphocytes as adult blood. Relatively, the percentage of T cells (E-RFC) was significantly lower in cord blood lymphocytes. The percentage of B cells (EAC-RFC and SmIg bearing cells), as well as the total number of T and B cells (mm(-3)), was significantly higher in cord blood. In vitro mitogen transformation of cord and adult lymphocytes in while blood, cultured for different times and diluted to contain equivalent numbers of lymphocytes per culture, showed significant qualitative and quantitative differences. Responses to the T cell mitogens phytohaemagglutinin (PHA) and concanavalin A (Con A) were examined from 3 to 6 days in culture. Cord blood lymphocytes were significantly more responsive when cultured for 3 to 4 days, similar to adult cells after 5 days, but significantly less responsive after 6 days in culture. The optimal levels of T cell mitogen responsiveness in cord cells (Day 4) were similar to adut cells (Day 6). Spontaneous transformation of unstimulated lymphocytes and B cell mitogen transformation with pokeweed mitogen (PWM) and staphylococcal protein A (SpA) were all significantly higher in cord blood than in adult whole blood cultured for 5 days.


Pneumocystosis: a chronic respiratory distress syndrome in the dog. Pneumonia caused by Pneumocystis carinii in two unrelated Miniature Dachshunds is reported. The clinical findings, gross- and histopathology and some diagnostic transmission and scanning electron microscopic features of the condition are described. Although pneumocystosis has been reported from a human and a domestic goat in the Republic of South Africa, these are probably the first reported cases of the canine disease in this country.


Canine pneumocystis pneumonia.

Canine pneumocystis pneumonia. This is a case report of pneumocytosis of an eight month old Dachschund from the Cape Province. Clinically it was an afebrile disease with signs limited primarily to the lower respiratory tract. The report consists of a short history, the histopathologic findings, evidence of the electron microscopic confirmation of the diagnosis and a brief discussion. It is believed to represent the first case of canine pneumocystosis in the Republic of South Africa.


Cellular interactions in haematopoiesis. In vitro culture of haematopoietic cells has provided some surprising insights into critical interactions of blood-forming cells. Subpopulations of lymphoid cells have been shown to produce colony-stimulating activity, to interact with macrophages, and to have important effects on the very early stages of erythropoiesis. Macrophages have multiple influences on the proliferation and differentiation of other haematopoietic cells.


Resistance of mice suppressed for IgM production to Babesia microti infection. The immunological mechanisms responsible for overcoming infections with Babesia, an intra-erythrocytic protozoan, are not fully understood. Although high titres of specific anti-babesial antibodies have been observed in several species of animals, and protection has been obtained by transfer of large volumes of recovery serum, the role of antibody in the immune response to an infection is uncertain. The present study investigates the nature of B-cell participation during Babesia microti infections by observing the course of the disease in mice in which IgM production has been suppressed from birth and which contain no B cells. The results show that, in contrast to control mice, which develop and subsequently clear circulating parasitaemias, suppressed mice show an unexpected resistance to infection as reflected by a virtual absence of parasites in the peripheral circulation.


Strongyloides stercoralis infection and small intestinal lymphoma. A West Indian man who was infected with Strongyloides stercoralis developed small intestinal obstruction. Treatment with thiabendazole did not relieve the obstruction which was found at laparotomy to be due to a poorly differentiated small intestinal lymphoma. There was no blood eosinophilia or accumulation of eosinopohils in the sites of infection. There was no reaction in the skin to delayed hypersensitivity antigens and the blood T lymphocyte count and serum C3 levels were low. From these findings and a review of the literature it was concluded that the immune response in man to Strongyloides stercoralis may depend on T lymphocyte mediated reactions including granuloma formation, and mast cell and eosinophil responses in tissues. We suggest that the association of strongyloides hyperinfection and small bowel lymphoma in this patient may not have been fortuitous. The lymphoma may have led to a reduction in cellular immunity, with the subsequent development of strongyloides hyperinfection.


Differential diagnosis of cartilage tumors. A total of 1187 cartilage tumors have been diagnosed at the Reference Center for Bone Tumors of the University of Freiburg; 67 of these were chondrosarcomas. All tumors were coded in terms of their frequency, age distribution, and localization. The typical radiographic, macroscopic, and histologic architecture is described for each tumor, and differential diagnostic aspects are described. Special attention is devoted to the distinction between proliferating chondromas and well-differentiated chondrosarcomas. which are often very difficult or even impossible to distinguish histologically. A grading system for chondrosarcomas is described. Cytophotometric DNA measurements may be applied to cartilage tumor cells in an effort to objectify the radiologic and histologic findings, and to make possible a decision between "benign" and "malignant". With the help of these modern histochemical methods it should be possible to solve differential diagnostic problems in cartilage tumors.


Diagnostic and differential diagnostic aspects in histiocytosis X diseases. Diagnostic and differential diagnostic aspects of the known manifestations of histiocytosis X are discussed with respect to our own findings. It is our considered opinion that the term "histiocytosis X" should not be employed in isolation for diagnostic purposes. Rather, one should make an effort to designate the disease exactly in stating the prognosis for a particular patient. Both clinical and morphologic parameters must be considered in making this exact diagnosis.


Brain distribution and kinetics of 11C-chlorpromazine in schizophrenics: positron emission tomography studies. The positron emitter 11C (20 minutes half-life) permits the labeling of chlorpromazine (CPZ) and the study of its distribution in humans by external counting. Trace amounts of 11C-CPZ were injected intravenously into 22 schizophrenic patients all untreated for several months with neuroleptics. The brain uptake was 6.04 +/- 1.6% of the injected dose 15 minutes after the injection, and it remained constant for 45 minutes. By positron emission tomography, the drug distribution was shown to be in the gray matter, and such structures as the cortex, caudate nucleus, thalamus and putamen could be identified. This new methodology will be helpful in studying specific receptors in humans in a noninvasive way.


Computed tomography in tuberous sclerosis--with special reference to relation between clinical manifestations and CT findings. Concerning the clinical signs and symptoms, we noticed skin white macula in 87%, adenoma sebaceum in 53%, mental retardation in 75%, retinal phacoma in 54% and seizure in 92%. Numbers of nodules ranged from zero to 11, and showed no correlation with aging. Half of the cases showed slight ventricular dilatation, one quarter showed moderate dilatation and the remainder were normal. There was no definite correspondence between size of the ventricle and number of nodules. There were relatively many cases with normal mental state in the group with normal ventricles. In adult cases a large ventricle does not always mean poor prognosis in mental state. Almost all of the cases with cortical atrophy had mental retardation. In the group with moderate dilatation infantile spasms were the most frequent type of seizure. On the contrary, grand mal was most frequent in the normal group. As for the position of nodules there was no difference between the normal and dilated groups. Nodules were predominantly seen in the lateral aspect of the body, trigone of the lateral ventricle and adjacent to the foramen of Monro. Asymmetrical lateral ventricles were noticed in 18%. Incidence of laterality increased as dilatation proceeded. It was larger on the left side in 9 out of 11 cases. We have no reasonable explanation of this tendency. There was one case with a tumor which was verified by enhanced CT. There were five cases with brain anomalies.


Thermographic visualisation of coronary artery blood flow during by-pass surgery. A technique is described for visualising coronary artery blood flow and assessing myocardial perfusion during aorta to coronary artery bypass surgery. The technique involves an injection of cold fluid into the graft which is then viewed thermographically using an infra-red camera.


Presidential address. Coronary bypass surgery: status 1979. Coronary bypass surgery is highly effective in relieving angina pectoris. Early results of several well controlled studies show a small, but definite positive effect of surgery on life expectancy. The effect on prognosis is greatest in patients with the most severe arterial and myocardial disease. The discrepancy between the large effect on symptoms and the small effect on survival is best explained by postulating more than one mechanism of action for the operation.


The processing of T-lymphocytes by the but of the suckling neonate. The suggestion that intact effector lymphocytes can pass from maternal milk through the gut wall of the suckling neonate has been tested directly by labelling alloantigen-stimulated T cells in vitro with [125I]iododeoxyuridine and following their fate after intraoral administration to newborn mice by whole body gamma counting. The cells were rapidly lost from the animal when compared to cells injected intraperitoneally, and at a rate indistinguishable from cells deliberately killed and given intraorally. If the alloantigen used to stimulate the T cells in vitro was shared by the neonate, the T cells were lost even faster. It was also found that highly lethal labelled leukemia cells behaved in a similar fashion and did not cause excess mortality if given intraorally. These results suggest that few, if any, lymphocytes traverse the neonatal gut wall and indicate that subcellular fractions may be responsible for maternal to neonatal transfer of immunological effector functions.


Factors influencing the inactivation of aminoglycosides by beta-lactams. Aminoglycosides and beta-lactam antibiotics were tested alone and in combination, via bioassay, in the presence of pH buffers at 6.5, 7.5 and 8.5; human serum; MgCl2 and CaCl2; clavulanic acid and beta-lactamase. Results show: inactivation of gentamicin, tobramycin, sisomicin and netilmicin is influenced by pH; clavulanic acid can inactivate gentamicin and tobramycin; and inactivation is influenced by salt concentration and constituents.


Markers of activated T cells on synovial fluid lymphocytes in rheumatoid arthritis. Membrane markers of activated T lymphocytes of synovial fluid of two groups of patients with various forms of arthritis were studied. The first group (group A) concerns patients affected by rheumatoid arthritis (RA), and the other (group B) includes those affected by not immunologically-mediated arthropathies as osteoarthrosis, crystal synovitis, post-traumatic arthritis. Some other arthropathies included in a third group (group C) have been considered separately. Both the receptor for human group O Rh negative erythrocytes (H rosettes forming cells) and the receptor able to bind at 37 degrees C sheep red blood cells (stable-E-rosette forming cells) respectively were used as markers for the identification of activated T lymphocytes. The results show a marked increase of activated T cells in group A in comparison to group B. So the possible causes of this lymphocyte activation in rheumatoid patients are suggested.


Bone-marrow T-lymphoid cells: a simple method for enriched specimen. A simple method for immunological characterization of lymphoblasts from hypoplastic or fibrotic bone marrow aspirates is described. The method is quite suitable for immunological diagnostic purposes in classifying acute lymphoblastic leukemias (ALL) at onset of the disease. In fact, T-, common and classified ALL appear to have a different prognosis with consequent different patient management.


An apparent relationship between responsiveness to folinic acid protection from methotrexate cytotoxicity and uptake of 5-methyltetrahydrofolate in a series of murine cell lines. The ability of CF to protect cells from methotrexate toxicity was measured in a series of murine lymphoma cells of varying degrees of sensitivity to methotrexate. The cells that were the most resistant to methotrexate showed the least degree of protection from methotrexate cytotoxicity. The extent of protection afforded by CF was found to correlate with the capacity of the cells to take up C14-5-methyltetrahydrofolate. That is, the cells with the lowest extent of uptake of reduced folate were afforded the least degree of protection from methotrexate by CF.


Response of lympho-hemopoietic tissue to Corynebacterium parvum by study of DNA enzymes and H3-TdR metabolism. The effects of Corynebacterium parvum on the lymphohemopoietic tissues of mice was investigated by H3-TdR metabolism, organ weights, DNA-polymerase-alpha activity and terminal deoxynucleotidyl transferase (TdT) activity. Marked increase in spleen size occurred. The increase in size was accompanied by increases in DNA-P-alpha activity and H3TdR uptake. This indicated that the spleen was a major site of cell proliferation and of increase in population size after C. parvum stimulation. Thymus and bone marrow changes are also described. The thymus showed a marked decrease in size which was maximal in 10 days and showed recovery thereafter. Thymus TdT activity fell immediately and may reflect either a release or lysis of thymocytes which contain TdT activity. However, no change in TdT activity was measurable in the bone marrow or spleen. The principal cell population increase had phagocytic activity and was presumably monocytes-macrophages, and an increase in such cells was found in the spleen.