Induction of cleavage in nucleated and enucleated frog eggs by injection of isolated sea-urchin mitotic apparatus. Mitotic apparatus (MA) were isolated in glycerol-dimethylsulphoxide solution (MTME) from zygotes of sea urchins (Stronglyocentrotus purpuratus). Freshly isolated MA were stored in 1/10 strength MTME for varying periods of time and were then injected into unfertilized frog (Rana pipiens) eggs. These injections induced 40-60% of the recipient frog eggs to initiate cleavage, resulting in the formation of blastula cell clusters. The cleavage-inducing activity of MA stored in 1/10 MTME at room temperature decreased with time of storage in 1/10 strength MTME, and disappeared by about 6 h. There was no change in the ultrastructure of MA during storage. MA isolated and stored in MTME at room temperature had a constant level of cleavage-inducing activity during the first 48 h of storage, but this activity slowly declined upon further storage; almost no activity was left after 3 weeks. MA isolated in hexylene glycol (HG) and immediately transferred into MTME were compared with MA isolated in MTME; both MA had the same cleavage-inducing activity on the day of isolation, after which the MA isolated in HG quickly lost activity. On the other hand, MA isolated and stored in HG had little cleavage-inducing activity when tested 3 h following isolation. Cleavage-inducing agent (CIA) isolated from frog brains induced cleavage and blastula formation when injected into nucleated frog eggs, but had no such activity when injected into enucleated frog eggs. MA isolated in MTME induced cleavage and blastula formation in enucleated frog eggs as well as in nucleated frog eggs. Cytological examination revealed that blastula cells which developed from MA-injected enucleated eggs contained Feulgennegative nuclei, whereas cells which developed from CIA-injected nucleated eggs contained Feulgen-positive nuclei. These results suggest that sea-urchin nuclear materials participate in mitosis in frog eggs. Isolated MA which had been stored in MTME for 3 weeks and which exhibited little cleavage-inducing activity were injected together with frog brain CIA into either normal or enucleated eggs; normal recipient eggs cleaved with significantly higher frequencies (70%) than those injected with CIA alone (40%). Furthermore, enucleated eggs injected with CIA alone failed to cleave, while those injected with MA and CIA together cleaved with significant frequencies (overall 29%). This result suggests a cooperative interaction between CIA and the inactivated MA to restore the cleavage-inducing activity of MA.


Biochemical characteristics of Haemophilus influenzae in relationship to source of isolation and antibiotic resistance. Based on a limited number of biochemical properties, a system for biotyping Haemophilus influenzae (M. Kilian, Acta Pathol. Microbiol, Scand. Sect. B82:835-842, 1976) was used to analyze the relationship of biotype to source of infection and antibiotic resistance for 600 clinical strains. The distribution of biotypes from bacteremic patients was significantly different (P less than 0.001) from the distribution of biotypes from nonbacteremic patients. Although there appeared to be a correlation between biotype and source of isolation, no single biotype correlated with a specific clinical syndrome in bacteremic patients. The frequency of resistance to antibiotics (ampicillin, tetracycline, chloramphenicol, and kanamycin), which was known to be at least in part plasmid mediated, was determined. Of the 600 isolates, 43 were resistant to at least one antibiotic (30 were ampicillin resistant, 11 were tetracycline resistant, 1 was ampicillin-tetracycline resistant, and 1 was tetracycline-chloramphenicol resistant). Of these 43 resistant isolates, 42 were either biotype I or II. This distribution of biotypes among antibiotic-resustant isolates was significantly different from the overall distribution of biotypes (P is less than 0.001).


Factor VIII/von Willebrand factor protein. Galactose a cryptic determinant of von Willebrand factor activity. The normal Factor VIII/von Willebrand factor protein has the ability to agglutinate or aggregate normal platelets in the presence of ristocetin (von Willebrand factor activity). Removal of greater than 95% of the sialic acid from this protein by neuraminidase did not affect the von Willebrand factor or procoagulant activity. However, oxidation of the penultimate galactose of the asialo Factor VIII/von Willebrand factor protein with galactose oxidase resulted in a progressive loss of von Willebrand factor activity with no effect on procoagulant activity. Reduction of the 6-aldehydo intermediate by potassium borohydride caused full regeneration of von Willebrand factor activity. These studies confirm the identification of the intact penultimate galactose moiety as a critical determinant of von Willebrand factor activity.


The ventricular size on computed tomography. Deriving a ventriculocranial index for the evaluation of ventricular size from a standard transverse plane image can lead to an erroneously small estimate of ventricular size due to partial volume averaging. Coronal plane imaging largely eliminates this problem. The index can then be derived either from the video image or the digital printout. There appears to be less error in measurements derived from the image than in measurements derived from the 64 X 64 printout, provided the image is photographed at large window widths of 2,000 Delta units or more.


Enhancement by oleandomycin of the inhibitory effect of methylprednisolone on phytohemagglutinin-stimulated lymphocytes. Triacetyloleandomycin (TAO) and its parent compound oleandomycin have a "steroid-sparing" effect in asthmatic patients. This study was designed to determine whether oleandomycin would enhance the inhibitory action of glucocorticosteroids in suppressing the blast transformation of phytohemagglutinin-stimulated human lymphocytes. Although oleandomycin could not be shown to inhibit the phytohemagglutinin stimulation of lymphocytes, there was a significant potentiation of steroid suppression at each concentration of methylprednisolone examined. This augmentation of glucocorticosteroid suppression of lymphocyte proliferation in vitro appears to support the clinically observed "steroid-sparing" effect of TAO and therefore its usefulness may not be limited to asthma and bronchitis.


Fc-receptor heterogeneity of human suppressor T cells. Concanavalin A (Con A) stimulated the IgM-binding subpopulation of human T cells (TM) to suppress the pokeweed mitogen-induced differentiation of B lymphocytes to plasma cells. Control TM cells that had not been Con A activated did not suppress. The degree of suppression was related to the number of Con A-TM cells added to the cultures and it was abolished by irradiation of the T lymphocytes either before or after the 24-hr culture period with Con A. Suppression did not require the presence of TG cells, whose suppressor potential has been previously established. These findings indicate that suppressor activity is not confined to the TG subpopulation but may be expressed by TM cells also.


Development of B cell subsets: effect of priming on in vitro TNP-LPS responsiveness. Mice were injected with DNP-derivatives of thymus dependent (DNP-OA) and thymus-independent (DNP-Ficoll and TNP-LPS) antigens, and the response to TNP-LPS in vitro was studied after several priming periods. DNP-OA priming decreases the amount of cells responding to TNP-LPS in vitro. In the case of DNP-Ficoll and TNP-LPS-primed cells, there is an initial burst of responsiveness to TNP-LPS, which progressively decreases until an abolishment of TNP-LPS responsiveness is found at day 40 after immunization. The sensitivity to TNP-LPS reappears as new precursor cells differentiate into mature cells. We suggest that B cells progressively gain the capacity to respond to thymus-independent and thymus-dependent antigens (B1-B2 differentiation) and that challenge with a particle antigen increases the ratio of maturation throughout the pathway.


Subpopulations of splenic T cells regulating an anti-hapten antibody response. II. Distinct functions of, and sequential requirement for, helper and amplifier cells. In adoptive transfer experiments, two classes of peripheral T lymphocytes, carrier-primed helper (TH) and carrier-primed amplifier (TA) cells, synergized in the induction of a primary anti-hapten IgG response by virgin B cells. Purified TH and TA had separate functions and were required at different times during the antigen-driven development of the response. TH were required early, and provided an initiating signal to B cells in the presence of the specific hapten-carrier conjugate. The differentiative nature of this signal was inferred from the threshold dose-response relationship and the insensitivity of the TH-directed event to the antimitotic agent vinblastine. TA were required 4 days later and provided an amplifying signal to B cells in the presence of the same hapten-carrier conjugate. The proliferative nature of this second signal was inferred from the exponential dose-response relationship and the exquisite sensitivity of the TA-directed event to vinblastine. Virgin B cells became susceptible to the TA signal only after having received the TH signal. TH and TA did not synergize, however, in true secondary responses since hapten-primed B cells depended only on the TH signal to generate large numbers of IgG antibody-forming cells.


The control of autoreactivity. I. Lack of autoreactivity in murine spleens is due to concomitant presence of suppressor and autocytotoxic lymphocytes. To determine if autocytotoxic lymphocytes were naturally occurring in murine spleens, C57BL/6 spleen cells were fractionated on discontinuous BSA gradients. Autocytotoxicity was assessed in vitro (cytotoxicity of C57BL/6 fibroblasts) and in vivo (splenomegaly and popliteal node enlargement in C57BL/6 mice). A medium density subpopulation of lymphocytes was shown to be autocytotoxic and to be similar to autoreactive lymphocytes produced by the in vitro "sensitization" of splenic lymphocytes on syngeneic fibroblasts monolayers. The naturally occurring autocytotoxic lymphocytes express no detectable theta antigen, did not adhere to nylon, but did have an Fc receptor. In recombination experiments, BSA-fractionated lymphocytes were incubated with autocytotoxic and "sensitized" lymphocytes. A light density subpopulation was shown to suppress both autoreactive lymphocyte subpopulations at a 1:50 ratio. The suppressor cells were nylon nonadherent T lymphocytes. The lack of autoreactivity of unfractionated murine spleen cells is due to the concomitant presence of autocytotoxic and suppressor lymphocytes. If suppressor lymphocytes are selectively removed in vitro, the reactivity of autocytotoxic lymphocytes can be detected.


Suppressor T cell mechanisms in contact sensitivity. II. Afferent blockade by alloinduced suppressor T cells. We investigated the mechanism(s) by which MHC-restricted suppressor T cells (Ts) induced by i.v. injection of allogeneic DNP-modified lymphoid cells (alloinduced Ts) suppress the DNFB contact sensitivity response. It was shown that alloinduced Ts acted only during the early phases (afferent limb) of sensitization. They were incapable of suppressing previously sensitized recipients or of inhibiting the expression of DNFB-immune LN cells when co-transferred into normal recipients. The target of alloinduced Ts seems to be cell proliferation, i.e., inhibition of antigen-induced cell proliferation (DNA synthesis) in Ts recipient mice. The failure of recipients of alloinduced Ts to generate DNFB-immune LN cells capable of transferring contact sensitivity to normal recipients also suggests that these Ts act by preventing the development of an expanded clone of mature immune T cells. The suppressive effects of alloinduced Ts also were inhibited by prior in vitro treatment with anti-TNP serum. The data are discussed in terms of current models of suppression, and are compared to mechanisms of suppression in other contact sensitivity models.


Low density of Thy 1 antigen on mouse effector cells mediating natural cytotoxicity against tumor cells. Mouse effector cells mediating natural cell-mediated cytotoxicity against tumor cells were found to contain a low density of Thy 1 antigen. Treatment of nude spleen cells, or spleen cells from mice in which natural reactivity was boosted, with anti-Thy 1.2 plus complement resulted in a substantial decrease in cytotoxicity. The spontaneous cytotoxic reactivity of young, thymus-bearing mice was resistant to such treatment, but repeated exposure to anti-Thy 1.2 plus complement did cause a decrease in lytic activity. By use of congenic anti-Thy 1.2 and effector cells from mice congenic for Thy 1, the effects of the treatment were shown to be specific for Thy 1.2 antigen.


The role of antibody in recovery from experimental rabies. I. Effect of depletion of B and T cells. The avirulent high egg passage (HEP) strain of rabies virus produces an inapparent infection limited to the central nervous system (CNS) in intracerebrally inoculated adult mice. Heavy chain isotype (anti-mu antiserum) immunosuppression potentiates the infection, with a mortality of about 60% and with elevated virus titers in the brain. Anti-mu-treated mice fail to raise antibody responses to rabies virus although their T cell function is normal when measured by the concanavalin A response of splenic lymphocytes. This indicates that the B cell response plays an important role in clearance of rabies virus from the neuroparenchyma. Treatment with cyclophosphamide or by adult thymectomy, x-irradiation, and bone marrow reconstitution potentiates HEP infection to a greater extent than does isotype suppression. Since these suppressive techniques impair both T and B lymphocyte responses, the data suggest that cellular immune mechanisms may also contribute to host defenses against this central nervous system (CNS) virus infection.


Characteristics of BALB/C T cell lymphomas grown as continuous in vitro lines. Transplanted lymphomas (Thy 1.2+, Ig-) of BALB/c mice, induced by the injection of 1-ethyl-1-nitrosourea, were adapted for growth as in vitro lines to provide potential tools for investigation of T lymphocyte differentiation and functions. All these tissue culture lines maintained the same pattern of surface differentiation antigens (Ly, TL, and Thy-1 antigens) as they had expressed during in vivo passages: BALENTL 13 was Thy 1.2+, TL.2-, and Ly 1+2-. BALENTL 3, 4, 5, 6, 7, 8, and 14 were Thy 1.2+, TL.2+, and Ly 1-2+. P1798 and BALENTL 9 were Thy 1.2+, TL.2+, and Ly 1-2+. There were various levels of terminal transferase activity present among these T cell tumor lines. The range of variation was from 4.6 units/10(8) cells to 29.3 units/10(8) cells (normal thymocytes, 5.0 units/10(8) cells). This 6-fold variation in TdT activity was present even among those cell lines which were Ly 1-2+, TL+. Most cultures lines had chromosome numbers near 40 and generation times of 11 to 22 hr. There were no significant morphologic changes after the adaptation of these tumors in culture except an increase in cytoplasmic C-type virus particles.


Anti-tumor immunity in B lymphocyte-deprived mice. I. Immunity to a chemically induced tumor. Immunity to a syngeneic methylcholanthrene-induced tumor was studied in (C57BL/6 X C3H)F1 males, treated continuously from birth with a rabbit anti-mouse IgM serum. Such mice have been shown to be selectively depleted of Ig-bearing lymphocytes and incapable of synthesizing antibodies. In the experiments reported, a heightened resistance of these mice to the syngeneic fibrosarcoma was demonstrated. This resistance was manifest in significantly slower tumor growth at the site of injection, as well as a lower incidence of spontaneous pulmonary metastasis.


Effect of a synthetic adjuvant on the induction of primary immune responses in T cell-depleted spleen cultures. N-acetylmuramyl-L-alanyl-D-isoglutamine (muramyl dipeptide) stimulates in vitro primary immune responses to SRBC in T cell-depleted (nude) spleen cultures. The stimulation of immune responses by muramyl peptide was antigen dependent. A microculture system was used to compare the T cell-replacing activities of several structural analogues of muramyl dipeptide and to compare the activity of muramyl dipeptide to helper T cells. In a limiting dilution analysis with excess helper T cells or muramyl dipeptide, the frequency of B cell precursors that respond to SRBC was similar, ranging from 1.5 to 5 X 10(-5). Decreasing the cell density in microcultures did not affect the efficiency of B cell precursor responses in the presence of muramyl dipeptide. Muramyl dipeptide was examined for mitogenic activity in spleen cell cultures. In serum-free medium, muramyl dipeptide stimulates slight (3-fold) increases in DNA synthetic activity. In medium supplemented with 5 to 20% fetal calf serum, muramyl dipeptide showed no significant mitogenic activity. There are a number of possible explanations for the T cell-replacing activity of muramyl dipeptide. The most likely is that muramyl dipeptide interacts directly with B cells to mimic the helper T cell signal in the inductive stimulus.


Influence of specificity of reagents and of behaviour of cell surface Ig on the detection and enumeration of immunoglobulin-bearing lymphocytes in humans. Some parameters likely to influence detection and classification of human B-lymphocytes using anti-immunoglobulin (Ig) sera have been investigated. Of 20 separate mono- and polyspecific native or conjugated anti-Ig sera analysed by a passive haemagglutination technique, 13 exhibited non-specific reactivity. This technique showed no consistent correlation between the titre of individual sera against Fab2 and whole IgG respectively. The indirect immunofluorescence (IF) method applied to detect surface Ig on blood lymphocytes seemed to detect Fc-bearing rather than Ig-bearing cells. The direct method generally yielded fewer reacting cells (5%) than the indirect (10-25%), suggesting that Fc-bearing cells are more numerous than Ig-bearing cells. The Ig-bearing blood lymphocytes seemed to belong preferentially to the IgM class. Passively adsorbed Ig did not appear to contribute significantly to the number of Ig-bearing cells detected. Anti-Ig sera induced redistribution and some endocytosis of surface Ig but this did not markedly affect detection of Ig-bearing cells.


Mitogenic analysis of murine B-cell heterogeneity. The B-cell mitogens lipopolysaccharide (LPS), Nocardia water-soluble mitogen (NWSM), and dextran sulfate (DxS) react with different subpopulations of B lymphocytes. Selective in vitro killing of cells responding to either LPS or NWSM has little effect on the in vitro response to the other mitogen, although the response to DxS is reduced in both cases. If, after selective in vitro killing, cells are injected into irradiated mice for 2-3 wk before measuring their in vitro mitogen responses, the same specificity pattern is seen. Thus, one is dealing with different B-cell subpopulations rather than different stages of maturation of a single population. Treatment with various alloantisera and complement before measuring the mitogen response to LPS and NWSM shows that (a) whereas all LPS response cells carry surface Ig, a subpopulation of NWSM responsive cells does not; (b) both LPS- and NWSM-responsive cells carry I-A antigens but might not I-E or I-J antigens; (c) all LPS-responsive cells carry I-C antigens, whereas approximately 25% of NWSM responsive cells do not: (d) there is a subpopulation of NWSM-responsive cells carrying neither surface Ig nor I-C antigens and resistant to anti-theta treatment.


Cytotoxic cells induced during lymphocytic choriomeningitis virus infection of mice. I. Characterization of natural killer cell induction. Lymphocytic choriomeningitis virus (LCMV) infection of C3H/St, nude (BALB/c background), and other mice induced high levels of natural killer (NK) cell activity in the spleen and peritoneum. L-929 cells were used as targetsand were not lysed by spleen or peritoneal cells from uninfected mice. The cytotoxic cells were characterized as NK cells because they were nonadherent, nonphagocytic lymphocytes lacking theta and immunoglobulin antigens on their plasma membranes. Their activity was sensitive to 6 mM EDTA and to heating for 5 h at 37 degrees C, but resisted treatment with 0.5 percent trypsin. No role for antibody could be demonstrated in these assays. Relative to cytotoxic T-cell activity, the induction of NK cell activity was resistant to X-irradiation of mice with 1,000 rads but was sensitive if mice were first treated with Strontium-89, a bone-seeking isotope. NK cells were induced by LCMV in all tested strains of mice. In C3H/St mice NK cell activity was detected as early as 1 day and peaked at 3 days postinfection. Maximum activity in C3H/St mice was observed in mice 5-10 wk of age, but significant NK activity was also induced in newborns, which subsequently carried virus in their tissues for the duration of their lives. Older LCMV-carriers did not have detectable spleen NK cell activity. No memory oranamnestic response could be demonstrated for NK cell induction. NK cell activity was not induced by LCMV challenge of LCMV-immune mice, but was induced in those mice by infection with Pichinde virus, a closely related virus. The advent of NK cell activity correlated with the synthesis of interferon in LCMV-infected mice. Culture fluids lacking virus infectivity but containing interferon induced cytotoxic cell activity in nude and C3H/St mice. These experiments suggest that LCMV induced NK cells via an interferon-dependent mechanism. When studied in several strains of mice, the continued expression of NK cell activity did not seem to directly correlate with spleen interferon levels, suggesting that additional factors may play a role as well in maintaining the activity of the NK cell in vivo.


Effect of idiotype-specific suppressor T cells on primary and secondary responses. Previous reports have shown that suppression of idiotype can be adoptively transferred by T cells, or by rosettes containing T cells with anti-idiotypic receptors, from an idiotypically suppressed, syngeneic mouse. The present data indicate that secondary B cells are highly resistant to such suppression. Priming recipients to the relevant hapten, p-azophenylarsonate, 6 days or 4 mo before the adoptive transfer prevented suppression. This was independent of the carrier used for the hapten group during priming or subsequent immunization, suggesting that resistance to suppression is attributable to secondary cells with specificity for the hapten. The effect of suppressor T cells could also be overcome by mixing them with specifically purified B cells having receptors for the hapten group before the adoptive transfer. Adoptive transfer of the suppressed state by specifically purified B cells from suppressed, hyperimmunized animals confirmed our previous finding that the suppression of idiotype can also be caused by B cells lacking idiotypic receptors, evidently through a mechanism involving clonal dominance. Possible mechanisms of idiotypic suppression by T cells are discussed.


Site of action of serum factors that block delayed-type hypersensitivity in mice. When mice have been rendered anergic by a large intravenous dose of sheep erythrocytes, their inability to mount a delayed-type hypersensitivity (DTH) reaction is not due to an absence of mediator cells, for these can be detected in the spleen by cell transfer. Nor is it due to disappearance of accessory cells (monocytes) from circulation. The serum of anergic mice contains blocking factors which are more abundant after absorption with antigen. Such factors are unable to inactivate the mediators of DTH in vitro, nor do they suppress a DTH reaction when introduced locally into the reaction site. They are active, however, when given intravenously to systemically sensitized mice, provided that the sensitized animal has an intact spleen. If the spleen has been removed or the recipients of sensitized cells have been treated with cyclophosphamide before cell transfer, blocking factors are no longer able to suppress a DTH reaction. Reasons are given for the belief that suppression of DTH in animals undergoing a vigorous antibody response is due to the diversion of reactive cells from circulation to undertake an alternative role in antibody formation in the spleen.


The frequency of clones of cytotoxic lymphocytes generated by H-2 antigens. By using a culture system that allows the segregation of individual precursors of cytotoxic lymphocytes, the number of clones generated by cells from different combinations of congenic mice have been measured. It has been found that 0.3% of the total anti-H2d clones are generated by stimulators which differ predominantly at the H-2 locus. The contribution of non-H-2 antigens to anti-H-2 responses is discussed.


Problems in family practice. Rectal bleeding. The diagnosis and management of rectal bleeding problems varies with the urgency of the situation, the age of the patient, and the applicability of available diagnostic methods. Every instance of rectal bleeding is a problem that demands investigation by endoscopic, radiographic, and laboratory means. A physician can be misled by the patient's understatement or underobservance of bleeding. A good history obtained as quickly as possible in urgent circumstances and in great detail under more relaxed circumstances is of immeasurable diagnostic value.


Distal splenorenal shunt in children.

Distal splenorenal shunt in children. The distal splenorenal end-to-side anastomosis (Warren shunt) decompresses esophageal varices while maintaining high portal hypertension and avoiding reduction of portal venous blood inflow to the liver. The Warren shunt was performed in seven consecutive patients with portal hypertension, including post-necrotic cirrhosis, portal thrombosis, and schistosomiasis, all with recurrent esophageal bleeding. Five shunts remained patent and two thrombosed. There was no mortality. If long-term follow-up evaluations indicate its effectiveness in preventing esophageal hemorrhage, the distal selective splenorenal shunt would be the more physiologic and safer procedure in children with portal hypertension.


GLC assay of fenclorac in human plasma.

GLC assay of fenclorac in human plasma. A simple, sensitive GLC assay for fenclorac is described. Plasma proteins were precipitated with methanol, and the methanolic extract was refluxed with hydrochloric acid to form the methyl esters of fenclorac and the internal standard. The esters were purified by partitioning into benzene. Aliquots of 1 microliter of the concentrated benzene phase were injected into the gas chromatograph and quantitated by a 63Ni-electron-capture detector. Recovery of fenclorac from plasma averaged 82 +/- 1.6%.


A time-resolved X-ray diffraction study of muscle during twitch. 1. A position sensitive X-ray counter was connected to a data-collection system which registered the outputs of the counter as a function of time. This enabled us to study time-dependent changes in the intensities of the equatorial reflexions from frog sartorius muscle during an isometric twitch. 2. The intensity ratio of the 1.0 and 1.1 equatorial reflexions (I1,0/I1,1) decreased during a twitch. The time at which the intensity ratio started to decrease coinsided approximately with the onset of tension development. No detectable change in the intensity ratio occurred during the latency relaxation. 3. The intensity ratio reached a minimum level approximately 90 msec before the peak of tension, and stayed at that level until the peak tension. 4. The intensity ratio returned to the 'resting' value 0.7--1.1 sec after the twitch tension had fallen to zero. 5. The observed decrease in the intensity ratio was interpreted as being caused by radial movements of the myosin projections from the vicinity of thick filaments to that of thin filaments. This leads us to conclude that, early in the rising phase of twitch tension, the number of myosin projections in the vicinity of thin filaments reaches the value obtained during a maximum isometric tetanus.


Reactivation of membrane charge movement and delayed potassium conductance in skeletal muscle fibres. 1. Intramembrane charge movement has been measured in striated muscle subjected to prolonged depolarization but repolarized to -100 mV for up to 100 sec. The method of measurement allows identification of charge or charges which are 'reprimed' by repolarization. 2. Charge 'reprimed' by repolarization appears to differ in its voltage distribution from charge detected in a permanently polarized fibre. The difference is probably due to the different pulse sequences used in the two measurements and to the fact that there appear to be several species of intramembrane charges with different transition potentials and different steepness of voltage distribution (V and k in eqn. (14): see below). 3. Potassium conductance is reprimed by repolarization following inactivation by depolarization. When the repriming potential is -100 mV the process appears to be in two stages; repriming to a value rather less than half the final value takes place exponentially with a time constant of approximately 40 sec; subsequently repriming to the final value is very slow. At a repriming potential of -140 mV repriming to the final value )1--2 mmho/microF) takes place exponentially with a time constant of approximately 17 sec.


Distribution of acetylcholine receptors at frog neuromuscular junctions with a discussion of some physiological implications. 1. The distribution of acetylcholine receptors (AChR) at frog cutaneous pectoris neuromuscular junctions was studied quantitatively using [1125]alpha-bungarotoxin (alpha-BTX) labelling and EM autoradiography. 2. We found that, as in mouse end-plates, the AChR is localized uniformly along the thickened post-junctional membrane. In the frog muscle this specialized membrane constitutes approximately the top 50% of the junctional folds. 3. The receptor site density is approximately 26,000 +/- 6000 sites/micrometer2 on the thickened post-junctional membrane and falls sharply to approximately 50 sites/micrometer2 within 15 micrometer from the axon terminal. 4. alpha-BTX site density on the presynaptic axonal membrane was directly determined to be at most 5% of the value on the thickened post-junctional membrane. 5. The high post junctional AChR site density leads us to conclude that: (a) each quantum of ACh needs to spread only over a very small post-junctional area (to be called the 'critical area') before it encounters as many AChR (plus AchE) sites as there are ACh molecules in the quantum (for a packet of 10(4) ACh molecules this critical area is approximately 0.3 micrometer2), (b) the average concentration of ACh prevailing in the cleft over this critical area during a quantal response will be approximately 10(-3)M (independent of the size of the quantal packet), and (c) since 10(-3)M-ACh is large compared to any estimates of the dissociation constant Kd for ACh binding to the AChR, the ACh will essentially saturate the AChR within the critical area (provided the ACh binding rate is sufficiently faster than the ACh spreading rate). 6. The total receptive surface for a frog end-plate is calculated to be approximately 1500 micrometer2, and therefore an end-plate potential resulting from 300 quanta will be due to the activation of less than 10% of the total receptive area. 7. Free diffusion would allow each small post-junctional critical area to be reached in less than 15 musec. Therefore, either the recorded rise time of the miniature end-plate is not predominantly a function of ACh diffusion time, or, as suggested by Gage & McBurney (1975), the net rate of movement of ACh in the cleft is much slower than indicated by the free diffusion constant.


Responses and pharmacological properties of preoptic/anterior hypothalamic neurones following medial forebrain bundle stimulation. 1. The responses of neurones in the anterior hypothalamic and preoptic areas (POA/AHA) to stimulation of the medial forebrain bundle (MFB) have been studied in urethane anaesthetized female rats. Extracellular unit recordings have been made from 150 neurones which were responsive to a single stimulus applied to the MFB at the level of the mammillary nucleus. 2. Forty-five per cent of these cells were orthodromically activated with latencies ranging from 7.5 to 100 msec. However, the majority of cells responded with latencies of less than 40 msec. 3. Marked inhibition of spontaneous activity was observed in 41.5% of the units. Response latencies of up to 40 msec were observed in these cells, the inhibitory periods lasting up to 150 msec. 4. A small proportion of cells (13.5%) were antidromically activated and the average conduction velocity of these neurones in the POA/AHA with axons passing down to the mid-brain was estimated to be 0.3 m sec-1. It is suggested that they represent part of the descending MFB. 5. The experiments did not show any discrete topographical organization of cells in the POA/AHA which could be driven by MFB stimulation although the units tended to be located in more lateral rather than medial areas. 6. The responses to iontophoretically applied dopamine (DA) or noradrenaline (NA) was tested on sixty-one cells. These amines suppressed the activity of the majority of both orthodromically activated and inhibited units; the remaining cells were unresponsive. 7. These results provide electrophysiological evidence for both a direct and indirect input of MFB fibres to cells in the POA/AHA and that these inputs can be either excitatory or inhibitory. The data also indicate that a small number of fibres in the descending MFB originate from cells in the POA/AHA. 8. The sensitivity of these units to NA and DA suggests an inhibitory aminergic input, although this evidence is as yet indirect. 9. These connexions of the MFB, with neurones in the POA/AHA may be part of the neural circuits important for extra-hypothalamic modulation of gonadotrophin secretion.


Water response of the frog olfactory epithelium as observed from the olfactory bulb. The water response elicited by application of distilled water on the olfactory epithelium was recorded extracellularly from single olfactory bulb neurones. Characteristics of the water response in the frog olfactory epithelium were examined in comparison with those of the water response in the gustatory and palatal organs. 1. Effects of various electrolyte solutions on the generation of the water response were studied by dripping distilled water on the olfactory epithelium after adaptation to each of these electrolyte solutions. Number of the olfactory bulb cells responding to distilled water increased with increasing the charge of the adapting cations and also with decreasing the size of the cations with a few exceptions. 2. Magnitude of the 'water response' increased with decreasing concentration of salt in the solution which was dripped after adaptation to the isotonic solution of the same salt. 3. The water response was effectively depressed by an electrolyte solution but not by a non-electrolyte solution. An electrolyte also depressed effectively the water response which was produced after adaptation to an organic salt solution. 4. The water response was blocked by treatment of the olfactory epithelium with the uranyl ions which had high affinity for phospholipids. A tentative hypothesis on the generating mechanism of the water response in the frog olfactory epithelium is presented on the basis of the present experimental results and the water responses of the gustatory and palatal organs so far reported.


The equilibrium between metarhodopsin I and metarhodopsin II in the isolated frog retina. 1. Rapid and slow changes in the absorbance of isolated frog retinae produced by exposure to brief flashes were studied at temperatures between 5 and 30 degrees C.2. Rapid changes observed at 475 nm consist of a transient increase of absorbance followed by an exponential decay to a new level of absorbance which is lower than before the flash exposure.3. The new level of absorbance determines the initial conditions of slow changes following the rapid ones. At higher temperatures, the loss of absorbance during the rapid changes is greater than at lower temperatures. Accordingly, the slow reactions start at lower levels of absorbance when the temperature is high.4. Quantitative analysis showed that the rapid reactions can be described in terms of two consecutive reactions followed by an equilibrium reaction: the light-controlled formation of lumirhodopsin, decay of lumirhodopsin to metarhodopsin I, and the equilibrium reaction between the metarhodopsins I and II.5. The slow absorbance changes observed in the visible (lambda = 480 nm) are due to metarhodopsin I and to metarhodopsin III. Metarhodopsin I decays during the early phase of slow reactions but can noticeably influence the kinetics at lower temperatures.6. The activation energy of the lumirhodopsin decay is 22.5 kcal/mole, that of the conversion of metarhodopsin I into metarhodopsin II is 30.1 kcal/mole. The entropy change associated with the metarhodopsin I-II equilibrium amounts to +34 cal/mole. K.


[Nature of the erythroid colony stimulating extract obtained from spleen of irradiated rats (author's transl)]. Non-adherent bone marrow cells of a bled rabbit were cultured in plasma clot media containing auto-serum, alpha-medium, erythropoietin (Ep) and spleen extract from irradiated rats. The preparations were cloted on a cover glass, fixed and stained by Giemsa or hemoglobin staining method after 3 or 5 days in culture, and the number of erythroid colony was counted as reported elsewhere. In the present study, first, it was elucidated that the optimal numbers of innoculating cells were among 0.6 approximately 1.2 x 10(4) cells per well for the erythroid colony formation. Second, this colony formation was slightly stimulated by the experimental media which contained heat treated extract at 40 degree or 50 degree C for 30 minutes. Contrary this, the extract treated at 70 degree C for 30 minutes lost completely its stimulating activity of the colony formation, suggesting that the effective substances might be protein in the extract. Third, an inhibitory factory might be present in the dialysate of the crude spleen extract, because the number of erythroid colonies decreased in a dose response manner by the dialysate. The residue of inner dialysate, however, certainly contained the colony stimulating factors (s). The crude extract was separated into five fractions (F1 approximately F5) by ammonium sulfate. F1, which was precipitated with 40% ammonium sulfate, had the highest activity for the colony formation. Fetuin also showed appreciable effect on the erythroid colony formation.


Similarities in resorption patterns of maxillary and mandibular ridges. The differences in the posterior arch widths between opposing maxillae and mandibles were studied in 100 edentulous denture-wearing patients. Panoramic radiographs of 67 of these patients were used to assess the percentage of mandibular height reduction from that considered present before extractions. Comparisons between posterior maxillary and mandibular arch widths, reductions in mandibular height, and edentulous age accompanied by denture wearing were made. The following conclusions emerged: 1. The mandible does not progressively widen as its opposing maxillae becomes narrower, nor does a progressive incremental increase occur in posterior maxillomandibular width relations with increased resorption or resorptive age. 2. The arch width of the mandible exceeds the arch width of the maxillae in the molar region by an average of 6 to 7 mm after sufficient resorption establisheds a definitive alveolar crest. This difference remains the same regardless of the amount of resorption or resorptive age. 3. The progressive and irreversible mandibular alveolar resorption rate is greatest in the earlier stages of edentulism and slows with loss of bone, longevity of edentulism, and attendant wearing of dentures.


Effect of ultraviolet light on disease characteristics of NZB/W mice. The development of antinuclear antiboides, proteinuria and cumulative mortality has been studied in four groups of NZB/W mice. Two groups were exposed to different amounts of ultraviolet light [UVL] and one group were bred and raised in total darkness. The fourth group served as a control. No significant difference was noted bwtween the groups in the development of antinuclear antibodies, proteinuria or in cumulative mortality. This study failed to show any major role of UVL as an environmental factor in the development of this disease.


Effect of external sodium and calcium on calcium efflux in frog striated muscle. The effect of media with different ionic composition on calcium efflux from the dorsal head of semitendinosus muscles of Rana pipiens was studied. The reduction in the fractional loss of 45Ca, when going from normal Ringer's solution to an ONa--OCa medium, was 60%. Withdrawal of only Na or Ca from the external medium also caused a significant drop in the fractional loss (33% and 34%, respectively). The effect of different concentrations of Ca (studied on the absence of the external Na) was also studied. It was found that a linear function could describe the relationship between the calcium-dependent calcium efflux and the external calcium concentration. These results indicate that calcium efflux from frog muscle fibers consists of three major components: one that is dependent on the presence of calcium in the external medium, one that is dependent on the presence of sodium in the external medium, and one that persists in the absence of these two cations.


Traumatic rupture of a left-sided liver and postoperative acute respiratory failure in a patient with Kartagener's syndrome. A case is described of abdominal trauma and rupture of a left-sided liver in a patient with Kartagener's syndrome (situs inversus, bronchiectasis, sinusits). Exploratory laparotomy, left thoractomy, cholecystectomy and hepatic artery ligation were necessary to control hemorrhage. Special attention was paid to the patient's respiratory condition postoperatively via physiotherapy and analgesia. The importance of identifying this three-part syndrome and especially the bronchiectasis is emphasized.


[Spiroergometry in assessing the late results of the aortocoronary shunting operation]. The remote results of aorticocoronary shunting were studied in 105 patients (follow-up periods of 1 to 5 years and more). The values of bicycle ergometry and spiroergometry (rehabilitation coefficient, oxygen expenditure per 1 kgm of work, maximum oxygen consumption per 1 kg body mass during muscular exertion, effectiveness of work) were studied before and after operation. The data obtained were compared with the results of spiroergometry in 175 patients with various lesions of the coronary arteries identified by coronarography and in 50 healthy individuals. Spiroergometry is an effective method for diagnosing coronary atherosclerosis before performing coronarography. Patients with good postoperative results showed values which were close to normal; in poor results of surgery and in thrombosis of the coronary shunts initial values characteristic of atherosclertoic involvement of the coronary arteries are encountered. Increase of the effectiveness of work to normal, decrease in oxygen expediture per 1 kgm of work, diminution of maximum oxygen consumption per 1 kg body mass during muscular exertion in the remote postoperative period make it possible to presume, before performing coronarography, that the shunts are functioning. The study conducted allow bicycle ergometry and spiroergometry to be considered demonstrative functional methods for appraising the remote results of operation.


[Results of lens extractions in defective light projection (author's transl)]. It is demonstrated by means of a series of 84 lens extractions in 80 patients that cataract extraction can be meaningful and successful even with defective light projection. Indications discussed are those which are considered urgent (Cataracta hypermatura or primary and secondary glaucoma with concomitant cataract), purely functionally urgent (desire on the part of the patient to have his vision restored) and relative.


Precursors of B-lymphocytes with surface IgM and their possible migration from bone marrow to peripheral lymphatic tissues. The lymphocytes with surface immunoglobulins (sIg) represent precursors of B-lymphocytes and were studied in ontogeny of pigs by autoradiography using iodinated monospecific anti-mu, anti-gamma or anti-alpha antibodies. The earliest detection of sIgM+ small lymphocytes was at 44 days of gestation in liver, followed at 51 days in spleen and at 60 days in bone marrow, the thymocytes being sIg-negative. The first circulating small lymphocytes were detected at 38--40 days and are most probably thymus-derived.


Medical record objectives in relation to clinical problems and user needs. The difficulties met when clinical record systems are implemented using a computer have many causes. Some difficulties must be first solved by determining user requirements and then a technical solution found. The general considerations involved in setting up medical record objectives, which relate to medical activities, accounting procedures and technical solutions, are discussed. These factors are at the base of many system failures in the past decade.


A problem orientated information system. It has been suggested several times that care of patients with medical problems is not carried out in a consistent manner. Emergency medical care is most usually given by junior medical staff. It seems possible that their inexperience may further increase the inconsistency of care given. An information system HOISS (House Officer Information and Scheduling System) is described. It consists principally of a data-base of 80 clinical problems and a suite of programs to access the data-base. There is also a scheduling program which prints-out a worksheet of tests needed to be done that day. A review of the care of 86 patients is given. It is seen that there is considerable variation in the investigations done for a particular clinical problem. Also routine tests are not asked for and many investigations are done which cannot be justified from the patients condition. The results of five months experience with the system are presented. It is shown for the one problem considered that management was more consistent, the routine tests were done more regularly and there were less spurious tests performed.


[Complications after severe corrosive lesion due to acid in the upper gastrointestinal tract (author's transl)]. Case reports of 3 patients are given with severe corrosive lesions of the esophagus and stomach due to acid ingestion. All of them survived the initial phase and seemed to be expecting a favourable clinical course. In all of these cases however massive upper gastrointestinal bleeding, perforation, and death occurred in a later phase after an interval free of symptoms. Treatment of severe corrosions of the upper gastrointestinal tract differs significantly from treatment of less serious cases. In less severe cases care has to be taken to avoid later complications in the first place. If there are serious corrosions however vital indications are predominant in determining the course of treatment during the initial phase. An interval with no or rather few clinical symptoms of 3 weeks duration after severe corrosive lesions should not be considered to exclude the danger of later lethal complications, especially bleeding and perforation. In order to avoid such complications endoscopic and eventually surgical exploration after the acute initial phase is recommended.


Alteration of the erythrocyte membrane during Newcastle disease virus-induced hemolysis. In attempting to explain the mechanism whereby hemoglobin is released during NDV-induced hemolysis it was found that marker substances like albumin or myoglobin with diameters larger than 30 A are retained in the erythrocyte membrane, whereas low molecular weight material is released. This indicates that NDV-induced hemolysis does not result in the formation of membrane lesions but rather in the alteration of membrane permeability. A prerequisite for this process is the insertion of viral envelope components into the cell membrane. NDV-induced hemolysis can be enhanced by virus-specific antibodies and complement. In this case the release of marker substances is due to membrane lesions since large molecules also are released from the erythrocytes.


[Trampoline jumping--a dangerous sport? Analyses of injuries and preventive measures]. Trampoline Jumping--A Dangerous Sport? Injury Analyses and Prophylactic Measure: Trampoline jumping enjoys an increasing popularity yet it is not without its dangers. More than 7000 schoolchildren are reputedly injured at this sport annually. The numerous distortions, fractures and luxations of the extremities are relatively harmless injuries. However, severe traumata with tetraplegia appear with increasing frequency. We have seen 25 cases in 10 years. The causes and exact mechanism of injury became apparent from thorough analysis of the accidents. Improvement of the safety measures is urgently necessary. The mini-trampoline should be abolished from school lessons.


[Local reaction and neutralization test in smallpox vaccination after previous inoculation with MVA. Stickl's graduated vaccination (author's transl)]. Of 200 first inoculations and 8 revaccinations, the sera were examined for content of neutralizing vaccine antibodies 3 weeks after the MVA graduated inoculation. In spite of imponderables which affect the failure rate in the "clinical trial", a positive result was obtained on first vaccination in 85%. In vaccinated children with a negative neutralization test a distinct booster effect was obtained with a "main vaccination" after about six months. The same effect was seen with revaccinations. For the time being inadequately controlled cerebral convulsive diseases, severe endogenous eczema, neurodermatitis, acute allergies, malignancies, immunosuppressive therapy, cortisole and intensive antirheumatic therapy and acute and purulent diseases must be considered as contraindications.


On the mode of action of diazepam on brain catecholamine metabolism. Intraperitoneal injection of diazepam in moderate dosage (1--10mg/kg) to rats caused a decrease in dopa and 5-hydroxytryptophan (5-HTP) formation, measured as the accumulation of these intermediates induced by inhibition of the aromatic L-aminoacid decarboxylase by means of NSD 1015 (3-hydroxybenzylhydrazine (HCl), in limbic forebrain, striatum and the remaining hemisphere portion. These effects are opposite to those induced by gamma-aminobutyric acid (gaba) and gamma-butyrolactone (100 and 750 mg/kg i.p. respectively), and the effects of the latter agents were significantly counteracted by diazepam. The effect of diazepam on dopa formation persisted after the acute transection of dopaminergic axons (transverse cerebral hemisection at the level of the caudal hypothalamus). The elevation of dopamine following hemisection was also significantly counteracted on the hemisected side of the brain, the intact side remaining unchanged. The data do not support the hypothesis that benzodiazepines act by enhancing gabaergic transmission. They rather suggest that these agents exert an inhibitory action on transmitter synthesis and utilization at the synaptic level, i.e. an action not necessarily bearing any direct relationship to gaba.


[Tumoral forms of tuberous sclerosis. The clinical and therapeutic importance of concomitant hydrocephalus (author's transl)]. In a young man and a pregnant young woman presenting since childhood of tuberous sclerosis without epilepsy or mental disorders severe intracranial hypertension developped secondary to obstructive hydrocephalus. Ventriculo-peritoneal shunting unilateral in the first case, bilateral in the second, releaved the patients of all their symptoms. Angiographic studies in both cases showed the existence of extracerebral visceral lesions. After a short review of similar published cases and the proposed treatments the authors suggest as only treatment a shunting procedure without attempt of removal of intracerebral nodules.


Treatment of experimental allergic encephalomyelitis with an inhibitor of cathepsin D (pepstatin). Intraperitoneal administration of pepstatin (2 mg/day for 5 weeks) to Lewis rats subjected to experimental allergic encephalomyelitis (EAE) (induced by guinea pig spinal cord and pertussis vaccine) suppressed the appearance of clinical signs of disease, and reduced the severity and incidence of CNS lesions normally associated with this disease. Administration of pepstatin for shorter periods to Lewis rats, or BSVS mice, or guinea pigs challenged with myelin basic protein delayed, but did not prevent clinical signs of EAE, but was accompanied in all cases by a less severe histopathology.


Aortocoronary bypass surgery and chronic renal failure: case report. A successful case of aortocoronary bypass operation in a patient with chronic renal failure managed by home haemodialysis and being considered for renal transplantation is described.


[Clinical experiences with a new method of laser coagulation in gastrointestinal hemorrhages]. Endoscopic laser-coagulation was used 94 times in 14 patients to stop gastro-intestinal bleeding or coagulate potential bleeding sources during non-bleeding intervals. Lasting haemostasis was achieved in three cases of incomplete gastric erosion, one of gastric ulcer, one of duodenal ulcer and one of bleeding after antral rugectomy. It failed to stop severe arterial bleeding in a case of gastric carcinoma. Lasting haemostasis was achieved in six haemangiomas of the colon, one case of angiomatosis of the antrum with 62 individual sites, two of angiodysplasia of the colon, 17 lesions in Osler's disease of the oesophagus (2 cases), stomach (10) and duodenum (5). The procedure was performed in the course of diagnostic endoscopy with an argon-ion laser developed by the authors, which has a density of 0.7-1.3 W/mm2. No complications have been observed so far.


[A case of aneurysm of the celiac trunk ruptured into the duodenum]. A case of repeated, exsanguinating gastrointestinal haemorrhage in a 36-yr-old man, due to rupture in the duoedenum of an arteriosclerotic aneurysm of the coeliac artery, is described. Selective arteriography enabled the cause of bleeding to be established. The pictures for the coeliac and superior mesenteric arteries showed good hepatic arterial vascularisation via the vessels issuing from the right hand side of the superior mesenteric, immediately after its point of origin. Successful aneurysmectomy was not performed until the fifth operation, when the cause of bleeding had thus been made clear.


Optokinetic training and vestribular habituation. The present study deals with the interaction of the visual and vestibular system with special reference to habituation. The results indicate that vestibular responses are modified by repeated uni- and bidirectional optokinetic stimulation. This transfer mechanism is more evident in test subjects after wide angle (foveo-peripheral) than after narrow angle (foveal) optokinetic stimulation. The modification of vestibular responses by means of repetitive optokinetic stimuli is characterized by an enhancement on the one side and a decline of the responses on the other, depending entirely on the nature of the  optokinetic stimulus (uni- or bidirectional, foveal or foveo-peripheral). There is some evidence to suggest that these phenonomena are habituation transfer mechanisms. They seem to subserve the improvement of the gain of the vestibulo-ocular reflex. They help the vestibular system to improve the assessment of self-rotation within the environment and to impede the development of visual-vestibular conflicts.


Plasma tryptophan and musculoskeletal pain in non-articular rheumatism ("fibrositis syndrome"). Plasma-free tryptophan is inversely related to the severity of subjective pain in 8 patients who fulfilled criteria for a variety of non-articular rheumatism, the "fibrositis syndrome". The observation is consistent with animal and human studies suggesting a relationship between reduced brain serotonin metabolism and pain reactivity.


Neurodiagnostic tests in children with brain tumors: changing patterns of use and impact on cost. The utilization of neurodiagnostic tests in the initial work-up in children with brain tumors was relatively stable during the three years before computed tomography (CT) became available. After this test became available there was a significant (P less than .05) reduction in the utilization of cerebral angiography, echoencephalography, electroencephalography, and ventriculography in children with tumors below the tentorium. In children with tumors above the tentorium, only a reduction in the use of cerebral angiography and radioisotopic scanning was demonstrated. These changes have resulted in a significant (P less than .05) reduction in cost to the patient (or third party) for the initial neurodiagnostic work-up. Since CT became available, children with brain tumors undergo fewer tests, and the greatest reduction has been in tests that have the greatest cost.


Modified K-channel gating by exhaustion and the block by internally applied TEA+ and 4-aminopyridine in muscle. Voltage clamp experiments on frog sartorius muscle fibres suggest that the large increase in resting potassium conductance during metabolic exhaustion is due to a change in the gating of activated potassium channels to a permanently open state. gK in exhausted fibres is less sensitive to externally applied blockers as Zn2+ and 4-aminopyridine (4-AP) while TEA+, Rb+ and Ba2+ act similarly, both in normal and exhausted fibres. In addition, injection experiments provide evidence that TEA+ and 4-AP applied internally to normal fibres effectively block potassium outward current, whereas in exhausted fibres the block seems to be smaller. These results suggest modifications in the structure of the potassium channels during metabolic exhaustion.


[The action of vitamin D2 and of 25-hydroxy-cholecalciferol on calcemia and urinary calcium excretion in the alcoholic cirrhotic (author's transl)]. In 2 similar groups of alcoholic cirrhotics with definite hepatic failure, the results of the oral administration of 25-hydroxycholecalciferol and of vitamin d2 on calcemia and urinary calcium excretion were studied. 25-hydroxycholecalciferol definitely increases calcemia and urinary calcium excretion, this action being superior to that of vitamin D2. This action which occurs, at least in part, by an increase in intestinal calcium absorption, deomonstrated the true nature of the "hepatic block" of vitamin D2 in alcoholic cirrhosis and the value of the administration of 25-hydroxycholecalciferol.


[Gastrointestinal haemorrhage in the cirrhotic. The value of injectable posterior pituitary extract (author's transl)]. The authors report the experience which the have acquired since 1970 in the use of posterior pituitary extract as part of the treatment of gastrointestinal bleeding in cirrhotics. 100 cases have been collected, in 73 patients. These may be divided into two groups: one of 32 patients, who did not receive posterior pituitary extract, with 31 deaths, and one of 41 patients who did receive the extract, with 6 deaths. These figures should be viewed in parallel with the results obtained by other techniques, and it would seem that comparison with other statistics is feasible. In addition, emphasis must be placed upon the simplicity of the administration and surveillance of treatment. Attention is also drawn to the absence of any inherent complication associated with the use of the drug, despite the administration, in certain cases, of high doses.


[The clinical significance of soluble nuclear antigen specific antibodies (author's transl)]. Anti-ENA antibodies have been found in 176 sera which nearly all contained antinuclear antibodies giving a speckled pattern of nuclear fluorescence. The charts of 134 of these 176 patients were available for a thorough clinical study. Among these 134 patients, 59 had a well defined Connective Tissue Disease including 40 SLE, 31 had a limited clinical syndrome made of Raynaud's phenomenon, inflammatory polyarthritis, swollen fingers and hyperglobulinemia and 34 had a complex clinical picture associating signs of more than one connective tissue disease. Some of the patients in this third group could be considered as-having the Mixed Connective Tissue Disease (MCTD) described by Sharp et al. Anti-RNP antibodies were more common in this series than the other anti-ENA antibodies. However, no narrow specificity could be assigned to any of these antibodies. This is true of the non anti-RNP antibodies, the anti-Sm in particular, which were found in 49 patients of whom 32 had SLE existing alone or in association with features of other connective tissue diseases and 17 had another connective tissue disease or the afore-mentioned limited clinical syndrome. In any case, the anti-ECT antibodies never reach the diagnostic value of the anti-DNA antibodies.


[Iatrogenic medullary deficiencies after gold salt therapy (author's transl)]. A 63 year-old patient with pancytopenia aplastic bone marrow of several years duration and incomplete response to anabolic steroids is reported. The bone marrow biopsy reveals within lymphoid areas, a refringent pigment proved by microanalysis to be a gold salt.


[Gastrointestinal haemorrhage related to portal hypertension. The pathologist's viewpoint (author's transl)]. Study of as homogeneous series as possible of 72 cases of gastrointestinal haemorrhage in patients with portal hypertension showed that the major cause of bleeding, accounting for almost 70% of cases, was ulceration of oesophageal varices. The presence at autopsy of haemorrhagic or necrotic lesions of the gastric mucosa is not felt to be a definite argument in favour of a gastric origin of the bleeding. Ulceration of gastric varices is considered to be an uncommon possibility, by virtue of the absence of dystrophic changes in the overlying mucosa, in contrast to the state of affairs seen in the oesophagus. Finally, the authors noted the relatively common presence of an associated malignant tumour (more than 8% of cases). This should perhaps lead to more profound investigations in order to seek a malignant intra- or extrahepatic malignant tumour before any bypass procedure to correct portal hypertension is undertaken.


[Gastrointestinal haemorrhage related to portal hypertension. The clinician's and the endoscopist's viewpoint (author's transl)]. The origin of bleeding in 54 patients was determined by fibroscopy in 36 cases. In 29 (80%) it was due to oesophageal varices. Such ulceration of oesophageal varices is the chief cause of bleeding (80% of cases). It is most grave when there is abundant and persistent haemorrhage in an individual aged less than 55, in particular male, and with signs of severe hepatic insufficiency.


Heterogeneity of locomotion in human T cell subsets. Locomotor activity of T cells with receptors for IgM and IgG, T cells without receptors for IgM or IgG, and T and non-T cells from human peripheral blood and human tonsils towards the chemoattractant casein was examined in modified Boyden chambers. T cells with receptors for IgG both from human tonsils and peripheral blood did not move in response to casein. T cells with receptors for IgM and those without receptors for IgM or IgG, on the other hand, moved very well toward casein and the distances were comparable to those achieved by T cells before separation. This difference in the locomotor activity of T cell subsets might explain their differential distribution in various lymphoid compartments. Separated T cells, cultured in medium supplemented with fetal calf serum, moved into the filters in response to casein. Prior culture of T cells in medium alone or in medium supplemented with human AB serum resulted in a reduction in the distance traveled in response to casein; however, the effect of AB serum was variable. Non-T cells from peripheral blood and B cells from tonsils responded poorly to casein.


Natural species-restricted attachment of human and murine T lymphocytes to various cells. Murine and human T lymphocytes bear on their surface a receptor that confers on them the ability to attach to a variety of target cells from the same species, derived in vivo and in vitro. Thymocytes and activated T cells attached readily to target cells, while blood T lymphocytes were able to do so only after the removal of sialic acid from either their cell membrane or that of the target cell. The natural attachment (NA) receptor and the corresponding site on the target cells are trypsin sensitive and the conjugation between them is temperature dependent. The phenomenon may be a manifestation of self recognition in a broader sense--recognizing the species--which is also reflected in the reactivity of mitogen-activated T cells and specific immune responses against allo- or other antigens expressed on target cell surfaces.


Control of proliferation and differentiation in B lymphocytes by anti-Ig antibodies and a serum-derived cofactor. The effects of various anti-Ig antibodies on different B lymphocyte functions were investigated. With the proper accessory cofactor(s) derived from serum, anti-IgM antibodies induced a vigorous proliferative response in normal adult murine B cells, while polyspecific anti-Ig and anti-IgD had no effect. Without the required cofactor, all three anti-Ig antibodies were inhibitory for mitogenic responses. All three anti-Ig antibodies were also inhibitory for mitogen-induced antibody responses with or without the cofactor. Even with the required cofactor, neonatal B cells as well as adult C3H/HeJ B cells were not triggered into proliferation by anti-IgM. Finally, the cofactor required for anti-IgM-triggered mitogenesis was shown to be generated from serum by 2-mercaptoethanol and to be approximately 65,000 in molecular weight. These results indicate that, for at least some responses, B lymphocyte surface IgM molecules are involved in both triggering and suppression, depending both on the developmental state of the B cell and the presence or absence of accessory influences. In these experiments, IgD gave evidence only of being suppressive.


Participation of histocompatibility antigens in capping of molecularly independent cell surface components by their specific antibodies. The antibody-induced capping of several cell surface components has been investigated by immunofluorescence methods using two mouse cell lines, a parental C58 thymoma line and a mutant derived from it lacking TL and H-2 antigens. Other cell surface components were present in approximately equal amounts on the two cells. Parental cells treated with rabbit antibodies to T200, a major surface glycoprotein, rapidly formed caps containing T200, but the mutant cells similarly treated showed a uniform surface distribution of T200. On the other hand, with a secondary antibody treatment, the T200 on both cells capped equally well. When the indirect T200 caps were examined using a second immunofluorescent stain for H-2, TL, or Thy-1 antigens, it was found that on parental cells all three of these antigens were co-capped with T200; on mutant cells no staining was found for H-2 or TL, as expected, and essentially uniform distribution of Thy-1 was observed. The co-capping of H-2, TL, and Thy-1 antigens with T200 on the parent cell is remarkable, because the first three components are known to be molecularly independent in lymphocyte cell surfaces. The indirect capping of the viral glycoprotein gp 69/71 similarly induced a co-capping of H-2 and TL antigens on the parent cell. These results demonstrate that H-2 and related molecules may co-cap with a variety of independent cell surface antigens. Such co-capping of histocompatibility components could play an important role in a proposed dual recognition mechanism for cell-mediated cytotoxicity reactions and other immunologically important cell-cell interactions.


Major histocompatibility complex-linked immune-responsiveness is acquired by lymphocytes of low-responder mice differentiating in thymus of high-responder mice. Female murine T cells can respond to the Y antigen of male cells by generating cytotoxic T-killer lymphocytes. Responsiveness is linked to several H-2 genes. Two types of low responders can be distinguished: the B10.A(5R) (H-2i5) strain, a low responder because it lacks Y-specific precursor T cells able to differentiate into cytotoxic T-killer cells; and the CBA/J (H-2k) strain, a low responder because it lacks Y-specific T-helper cells able to support differentiation of T-killer cell precursors. B10.A(5R) stem cells differentiating in an x-irradiated (CBA/J X C57BL/6) (H-2k X H-2b)F1 host respond to Y antigen by generating T-killer cells whereas CBA/J stem cells do not. The results are consistent with the hypothesis that diversity of T-cell receptors is generated by somatic mutation of germ-line genes encoding specificity for self-H-2. A detailed account of this hypothesis is presented.


Use of anti-idiotypic antibodies as cell-surface receptor probes. Anti-idiotypic antibodies have been raised against antibodies to retinol-binding protein (RBP) and to insulin. After absorption the anti-idiotypic antibodies recognized the antigen-combining sites of the antibodies used as the immunogen but of no other antibodies. Some of the anti-idiotypic antibodies raised against antibodies to RBP bound specifically to rat intestine epithelial cells, which have a physiological cell-surface receptor for RBP. The RBP receptor mediates the uptake of retinol from RBP to the cells. This uptake was abolished in a concentration-dependent manner by the anti-idiotypic antibodies, which obviously competed with RBP for binding to the receptor.Anti-idiotypic antibodies against antibodies to insulin inhibited the binding of (125)I-labeled insulin to isolated rat epididymal fat cells, whereas anti-idiotypic antibodies raised against antibodies to RBP had no effect. Furthermore, on interacting with young rat thymocytes, anti-idiotypic antibodies against antibodies to insulin stimulated the uptake by the cells of alpha-aminoisobutyric acid, thereby mimicking the effect of insulin. These results suggest that in some cases anti-idiotypic antibodies may be useful tools in elucidating structure-function relationships for cell-membrane receptors.


Cocaine: acute effects on reinforcement thresholds for self-stimulation behavior to the medial forebrain bundle. Reinforcing thresholds for self-stimulation behavior to the medial forebrain bundle were determined in rats by means of rate-free psychophysical method. The acute administration of cocaine lowered the reinforcing thresholds independent of motor stimulatory effects. These results indicate that cocaine affects the sensitivity of the reward pathways in the brain, and further demonstrate the utility of rate-independent methods in the assessment of drug effects on self-stimulation behavior.


Radiologic evaluation of the treatment of nonunion of fractures by electrical stimulation. A procedure is described in which nonunion of fractures is treated by implantation of electrodes with direct electric current at the site of fracture. Of 107 patients treated with electrode stimulation, 71 (66%) healed. If one eliminates 9 cases of congenital pseudoarthrosis and 11 patients treated with only 10 microamperes of current, 70 of 87 patients (8095%) healed. Severe osteoporosis and sclerosis were common radiologic findings, but had no value in predicting which patients would respond to therapy.


Ventricular opacification after intravascular injections of contrast material. The cerebral ventricles of two neonates were demonstrated on CT scans and plain radiographs after the intra-arterial injection of contrast material. Leakage of contrast material into the ventricles after intravenous injection probably indicates damage of the blood-brain barrier. Breakdown of this barrier results only from severe and prolonged anoxia because cerebral vessels are much more resistant to anoxia than neuronal tissues. The authors have not observed ventricular opacification in adults.


Metabolism of para-aminobenzoate over time. Potassium para-aminobenzoate incorporated into rat chow was fed ad libitum for 14 days to adult female Buffalo rats. Determination of the principal urinary metabolites, namely, p-aminobenzolyacetylester and p-aminobenzoylglucuronide, namely, p-aminobenzoylacetylester and p-aminobenzoylglucuronide, as well as p-aminobenzoylglycine and p-hydroxybenzoylglycine (hippurates), showed significantly greater amounts of the metabolites at the 14th day compared to day 1. There was no significant change in free p-aminobenzoate excretion during this interval. The results suggest that para-aminobenzoate stimulates its own metabolism during chronic administration.


Respiratory control and CO2 conductance: temperature effects in a turtle and a frog. The respiratory control systems of the predominantly lung-breathing turtle. Pseudemys scripta, and the bimodal breathing frog, Rana catesbeiana, are compared. At constant temperature, control is effected in both species primarily by pulmonary ventilation, and appears to be similar in basic organization to the mammalian system. The skin CO2 exchange of the frog is largely passive and apparently under little adaptive control. CO2 exchange at different temperature is analyzed by means of the conductance equations: convective conductance [MCO2 = (VA/RT).pACO2] for lung exchange, and diffusive conductance (MCO2 = GCO2.transcutaneous deltaPCO2) for skin exchange. Predictions of conductance values, based on data for PaCO2 and MO2, agree well with measured values of both the turtle's ventilation and the frog's skin CO2 conductance at different temperatures. In each case the conductances increase only moderately, if at all, with temperature, a result that can be attributed to the similar Q10 values of PaCO2 and MO2. Because the conductances exhibit this blunted temperature dependence, both lung and skin breathers are provided with the respiratory effector mechanisms necessary to regulate PaCO2 and pHa at their characteristic values over the ectothermic temperature range.


[The esophagogastral transitional region--localization of acute and chronic hemorrhages (author's transl)]. Various diseases which can be associated with hemorrhages are located in the esophagogastral transitional region. Emergency endoscopy can contribute significantly to the detection of an acute source of hemorrhage. Roentgenologic examination can make significant contributions toward the further clarification of acute and especially chronic hemorrhages, by assessment of the topographic, morphologic, functional and angiologic conditions. The relevant diseases in this respect are discussed with regard to clinical pattern and significance of the roentgenologic and endoscopic methods of examination, namely, reflux disease, hiatal hernia, cardial tumors, esophageal varices and Mallory-Weiss syndrome. Differential diagnostic problems are demonstrated by means of relevant cases. Brief reference is also made to "operated cardia" and the associated possibility of hemorrhage.


[Roentgenological morphology and clinical signs for the differential diagnosis of pulmonary fibroses (author's transl)]. The clinician usually determines the measures to be taken on the basis of clear symptomatics represented by more or less pronounced cyanosis. The author is able to show that the negative roentgenogram is not a reliable means of excluding pulmonary fibrosis, in contrast to functional pulmonary studies. If breathing physiology is normal and the roentgenogram does not reveal any abnormal findings, further invasive procedure will not be required. However, if functional investigations are positive and indicate a diffuse pulmonary disease, then our criteria point to open pulmonary biopsy, since prognosis and possible causal treatment largely depend on the histology.


[HLA DRw in ankylosing spondylitis].

[HLA DRw in ankylosing spondylitis]. The association of ankylosing spondylarthritis with the B locus and more specifically with the B 27 antigen, is the closet known for any illness. The absence of linkage with the DRw antigens studied during this project, in 50 patients, can give rise to the hypothesis that spondylarthritis is associated with determinants situated on the B lymphocytes, linked to the HLA-B locus.


Immune function in patients with multiple myeloma (delayed cutaneous reactivity and lymphocytes bearing receptors for sheep, human and mouse erythrocytes). Immunologic function was evaluated in 27 patients with multiple myleoma (MM). When tested for their ability to develop delayed hypersensitivity to panel of skin test antigens, 2 out of 15 such patients were found to be anergic. The property of human peripheral blood T lymphocytes to form rosettes with sheep [total E and active or early rosette-formimg cells (RFC)] and human erythrocytes (H-RFC) was also studied. In addition, rosette formation with mouse erythrocytes (M-RFC) was investigated as a B cell marker. Decreased proportions of total E-RFC were found in one third of the patients with MM when compared to normal volunteers. By contrast, both mean percentages and ranges of active E-RFC, H-RFC, and M-RFC in the MM patients overlapped those revealed in healthy controls. The rosette-forming ability of peripheral blood lymphocytes was tested before and after treatment with levamisole, thymosin, and transfer factor in healthy controls, as well as in some groups of patients with MM active systemic lupus erythematosus and Hodgkin's disease. A positive effect of all three immunomodulating agents could only be demonstrated on cells from T cell-deficient patients. It is suggested that the immunodeficiency syndrome associated with MM and related malignancies may reflect quantitative and possibly selective defects of lymphocyte subpopulations.


Diagnosis of Haemophilus influenzae type b pericarditis by counterimmunoelectrophoresis. A 6-year-old girl developed pericardial tamponade because of pericarditis caused by Haemophilus influenzae type b. Bacteriological cultures of the pericardial exudate were negative. The etiological diagnosis was established by counterimmunoelectrophoresis (CIE).


The effect of transcutaneous electrical nerve stimulation (TNS) on joint pain in patients with rheumatoid arthritis. The effect of transcutaneous nerve stimulation (TNS) on joint pain was studied in patients with rheumatoid arthritis. Three different forms of TNS were used in an attempt to evaluate the influence of placebo effects. The results were evaluated by means of loading tests and from the patients' own assessments of pain relief. High intensity TNS near the painful joint gave pain relief of varying degree in 95% of the patients, while TNS of low intensity and TNS applied at a remote site gave an improvement in 75% and 5% respectively. It seems quite clear that TNS is effective in reducing joint pain. There are a number of factors which intimate that this improvement is not merely a placebo effect.


HLA-B8 in caucasian patients with systemic lupus erythematosus. HLA antigen frequencies were determined in 27 Caucasians with systemic lupus erythematosus (SLE). A statistically significant association between HLA-B8 and SLE was found. HLA-B8 occurred in 48% of patients and in 18% of controls (P corr approximately equal to 0.005). The relative risk of SLE for HLA-B8 carriers is 4.23. In addition, SLE patients with later onset of disease more frequently had HLA-A1 and/or HLA-B8. There was no association between any HLA antigen and clinical (renal, central nervous system, and lung involvement) or serological (antinuclear and anti-nDNA antibodies) parameters.


Electrical stimulation: new methods for therapy and rehabilitation. Electrical stimulation is emerging as a new therapeutic and rehabilitative agent. Reviewed are pain control, restoration of lost functions and alteration of abnormal movement and other functions using electrical stimulation. Reported for acute and chronic pain control use are transcutaneous, dorsal column, spinal cord, peripheral nerve, and direct brain stimulation methods and results. Overall success ranges up to 50% for chronic pain problems and up to 80% for acute pain; e.g., postoperative incisional pain, sports medicine, and trauma. Restoration of lost function has broad implications for the future. These include phrenic nerve pacing for respiration, foot drop control, restoration of bladder function, and grasp control in the spinal cord-injured patient. Amelioration of abnormal function includes stimulation for epilepsy and cerebral palsy, certain symptoms of multiple sclerosis and scoliosis. The effects of electrostimulation are completely reversible and nondestructive. Technical details of devices and stimulus waveforms are also briefly considered.


[Effect of vasopressin on the lower esophageal sphincter. Study on the action mechanism of vasopressin in bleeding esophageal varices]. The effect of vasopressin on the lower esophageal sphincter has been investigated in 12 healthy volunteers. Peripheral infusion of 0.2 U/min resulted in a significant (p less than 0.05) decrease in sphincter pressure. Accordingly, vasopressin-induced myogenic compression of bleeding varices has been ruled out as a potential additional hemostatic mechanism of vasopressin.


[Immunology and immunotherapy of malignant tumors: balance and prospects 1978]. The immunology and immunotherapy of malignant tumours in man are still at the experimental stages. Practical use is now made of immunodiagnosis as well as immunological evaluation of tumour patients. Current research is focused on the interrelationship between immunological and neuroendocrinological mechanisms. Illustrations are provided to show how cancer chemotherapeutic agents may act by interfering with tumour-specific immune reactions.


The Mallory-Weiss syndrome. A prospective study in 130 patients. The clinical features of the Mallory-Weiss syndrome were prospectively documented in 130 of 1 667 patients submitted to endoscopy for gastro-intestinal haemorrhage, an incidence of 7,8%. The important clinical features found in these patients were: alcohol abuse (21%); retching or vomiting (38%); salicylate ingestion (36%); dyspepsia (39%). The correct clinical diagnosis was therefore often difficult to make. Additional lesions were found in 40% of patients at endoscopy. Blood loss was relatively small, and surgery was not required in any patient. The 2 deaths that occurred were not attributable to haemorrhage. A high index of suspicion and early endoscopy are required to establish the diagnosis.


Colonic hemorrhage.

Colonic hemorrhage. We have briefly presented our concepts of the investigation and management of lower intestinal bleeding. Such bleeding was divided into massive and nonmassive colonic hemorrhage, and the differences in the investigative techniques were discussed for each of these circumstances. An algorithm of our diagnostic and management protocol for massive large bowel hemorrhage may be followed in a somewhat varied fashion in the investigation of those patients having nonmassive large bowel bleeding.


The collapsed ventricle: management and prevention. Acute obstruction of a shunt may occur when the ventricular space becomes slitlike. Four patients with collapsed ventricles were treated by adding a higher pressure valve to the system. The ventricles enlarged and the patients became asymptomatic. Twelve children who had been shunted in the neonatal period had a higher pressure valve added as an elective procedure to prevent ventricular collapse. There were no episodes of shunt obstruction in the subsequent seven to 38 months.


The von Willebrand pig as a model for atherosclerosis research. In order to evaluate a possible role played by platelets in the development of atherosclerosis, the aortas of 11 control pigs and 11 homozygous von Willebrand (vWd) pigs were examined for spontaneous atherosclerosis. Of the 11 normal pigs, 6 showed multiple atherosclerotic plaques with an intimal thickening of 63 to 130 micrometer. In contrast, none of the von Willebrand pigs had multiple plaques and only one showed a single lesion of more than 2 mm in diameter. In a prospective study 5 control pigs and 5 vWd pigs were given a high (2%) cholesterol diet from the age of 3 to 9 months. All of the controls developed atherosclerotic plaques. In 4 of the pigs the plaques exceeded 13% of the aortic surface with an intimal thickening of 50 to 390 micrometer. In contrast, only one of the vWd pigs developed atherosclerotic plaques which only involved 7% of the aortic surface. Most of the vWd pigs, however, developed non-atherosclerotic flat fatty lesions. These findings may be related to the impaired platelet arterial wall interaction in vWd. The vWd pigs seem to be an ideal model for atherosclerosis research.


[Efficiency of sequential aorta-coronary vein-bypass (author's transl)]. From 1976 to 1977 308 patients were treated with multiple aorto-coronary vein-bypass. Fiftytwo patients receiving sequential bypasses were compared with 256 patients in whom conventional multiple anastomoses were performed. The rate of postoperative bypass failure did not differ significantly in the two types of anastomoses: 16 per cent in sequential as compared to 18 per cent in conventional bypass. In both cases the circumflex-system was afflicted by bypass failure more frequently (20 per cent each). The practical and theoretical advantages and disadvantages of the two procedures are discussed. Sequential aortocoronary vein-bypass is considered the method of choice for certain combinations of coronary stenoses and also if an adequate length of vein can not be obtained.


Visualization of layers lining the lung of the South American lungfish (Lepidosiren paradoxa) and a comparison with the frog and rat. Comarisons have been made of the structure of layers lining the lungs of lungfish, frog and rat using material fixed by perfusion of the pulmonary circulation of physiological pressures and at normal air pressures within the lung. The lining consists of a thin densely osmiophilic surface layer which covers a much thicker hypophase of generally floccular appearance. Tubular myelin, present in the frog and rat lung lining, was not observed in the layers lining the lung of Lepidosiren.


The effects of enzyme concentration on the kinetic behavior of adrenal 21-hydroxylase and 11beta-hydroxylase in the pregnant rat. Experiments were designed to study the kinetic behavior of 21-hydroxylase and 11beta-hydroxylase as a function of enzyme concentration (Et) during proestrus, dasy 5 (D5), 12 (D12), and 22 (D22) of pregnancy, and within 24 h post-partum. The enzymes were prepared from rat adrenal microsomes and mitochondria, respectively. The experiments consisted of measuring the initial velocity of each reaction for a series of substrate concentrations at three fixed Et. Double reciprocal plots were constructed and the slope (Km/Vmax) of each line estimated. Variation in the value of the slope as a function of enzyme dilution would predict the presence of an endogenous effector. The kinetic behavior of 21-hydroxylase was not altered throughout the range of Et (10-100 microgram protein) at any of the reproductive stages. In contrast, kinetic behavior of 11beta-hydroxylase was clearly dependent upon Et. Dilution of the enzyme preparation (25-200 microgram of protein) increased the slope of the double reciprocal plot at all reproductive stages, thus suggesting that an activator substance may be present within the mitochondrial preparation. A secondary plot of the slope (Km/Vmax) versus Et described a power function (Km/Vmax = a [Et]b) with the greatest rate of change in Km/Vmax occurring at low values of Et. The rate of change in Km/Vmax per mg rise in mitochondrial protein at all dilutions of enzyme was greatest for proestrus and post-partum, followed by D22 greater than D12  greater than D5. In addition, repeated washing of the enzyme preparation at 4 degrees C increased Km/Vmax to a greater extent at all Et than did the control preparation. These findings suggest the presence of a diffusible endogenous activator of 11beta-hydroxylase whose influence decreases markedly at D5 and D12. On the other hand, there is no evidence to suggest the presence of a diffusible endogenous effector for 21-hydroxylase.


[Etiology and prevention of hemorrhages after stomato-surgical interventions]. Haemorrhages may occur as complications after tooth extractions or other oral surgical procedures. Therapeutical difficulties will happen especially in patients with haemorrhagic diathesis of unknown aetiology. A survey of rare congenital and acquired forms of disturbance of clot formation is given in tabular form. The local particularities of the course of intra-oral blood clotting are pointed to. On the basis of six years of clinical experience, a drug combination for local application is recommended for the prevention of postoperative bleeding.


[Acute-phase proteins in women with a copper IUD (author's transl)]. Acute-phase (AP) proteins haptoglobin, alpha1-antitrypsin and C-reactive protein were measured in 50 women before and 10 to 30 weeks after insertion of a copper T-200. No statistically significant increase in AP proteins was found. Since these proteins are synthesized in the liver, the results indicate the lack of a systemic humoral reaction of the organism in women with a copper-containing IUD.


[Disorders of phagocytic and fungicide function of granulocytes in chronic muco-cutaneous candidiasis]. The granulocytes which are distributed by blood circulation close to the extern and intern body surfaces as well as in all organs protect the organism from microbial perils by phagocytosis and intracellular killing of bacteria and fungi so constituting a very important component of the granulocytic functions seriously impairs the host resistance and may entail a state of persisting infectious disease. As chronic mucocutaneous candidosis (CMCC) represents such a persistent generalized infection, we studied in vitro several functional activities of the granulocytes of 5 patients suffering from CMCC. 2 of them presented a non-familiar type of CMCC, the remaining 3 patients (father and 2 daughters) were subject to the hereditary type of CMCC. For comparison, by the same way we investigated the granulocytic functions of 51 clinically and immunologically healthy adult persons. Each of our 5 patients exhibited a reduced ability of the granulocytes to phagocytize and kill Candida albicans. In the CMCC family, the father had a marked deficiency of the oxidase activity of the granulocytes whereas in his daughters, the oxidase deficiency proved to be of a minor grade. In the sera of both daughters a phagocytosis inhibiting factor could be assumed to exist in addition to the granulocytic abnormalities. When heat-inactivated Candida albicans cells, however, were used for experiments, the granulocytes of each patient were able to phagocytize the germs at the same rate as did the granulocytes taken from the controls. With regard to alterations of the T cell function previously reported in CMCC, in all patients we also could demonstrate various symptoms of a T cell-dependent immunodeficiency. The results of the present in vitro-experiments furnish good evidence of a state of fundamental deficiency of the microphages in patients with CMCC, which may be the dominating cellular factor in the aetiopathogenesis of CMCC.


Surface carbohydrate composition of murine thymocytes and of lymph node cells from normal and athymic (nude) mice. Surface glycoproteins (papain digests) have been isolated from lymph node cells of normal mice which contain mainly T cells, and from lymph node cells of nude (athymic) mice, which essentially represent B cells. Gaschromatographic analysis revealed that the glycoproteins from the lymph node cells of the euthymic mice contain less galactose than the glycoproteins from lymph node cells of the athymic mice, but contain still more galactose than glycoproteins from thymocytes. Lymph node cells from both sources contain about equal amounts of neuraminic acid, while thymocytes contain slightly less sialic acid. The observed differences provide a molecular explanation for the different reactivity of murine B cells and T cells towards soybean agglutinine and other galactose-binding plant lectins.


Predictors of operative mortality for coronary bypass grafting in patients with ischemic heart disease. Predictors for operative mortality (OM) were studied in 172 consecutive patients (pts) undergoing coronary artery grafts (CAG) for angina pectoris.Seventy eight pts had Class IV angina; of the 147 patients given propranolol, 41 were gradually withdrawn from propranolol and finally discontinued 24 hours before surgery, and 106 were abruptly withdrawn from propranolol 24 hours before CAG; 20 pts had left main coronary disease; 156 pts had cardiopulmonary bypass (CPB) time shorter than 20 minutes, and 16 pts had a CPB longer than 120 minutes.The operative mortality was 5.2% (9/172) for the entire group. Class IV angina (OM 7%), abrupt propranolol withdrawal (OM 6.6%), left main coronary artery disease (OM 25%), and CPB longer than 120 minutes (OM 50%), all significantly increased OM. These variables were interdependent, however, as many pts belonged to several predictor categories, combinations of predictors were examined, in order to more accurately predict the risk of individual pts. The combination of left main coronary artery disease and CPB longer than 120 minutes; and Class IV angina and CPB longer than 120 minutes were significantly associated with higher operative mortality.We conclude that Class IV angina, abrupt propranolol withdrawal, left main coronary artery disease and prolonged CPB are potent, interdependent predictors of OM in pts undergoing CAG. Consideration of these predictors, alone and in combination, allows effective prediction of OM for CAG in patients with stable angina pectoris.


[Immunologic examination after posttraumatic splenectomy in childhood (author's transl)]. Immunologic examination was done in 26 patients on to 20 years after posttraumatic splenectomy at the age of 3 to 6 years of life. Immunologic parameters used were: concentration of IgG, IgA, IgM, isoagglutinins, heterophila antibodies, agglutinins against staphylococci E. coli and pertussis, serum opsonins for E. coli and pneumococci, serum haemolytic complement activity, C3C4, B- and T- subpopulations of lymphocytes, inhibition migration of mononnuclear cells with E. coli. Pathologic susceptibility to infections was not observed clinically. IgM, E. coli agglutinins and E. coli opsonins were significantly lower in the postsplenectomy group than in controls.


[Regulatory role of bone marrow in immunogenesis. II. Analysis of various mechanisms of antibody genesis suppression by the bone marrow B cells in vitro]. The suppressive effect of the cells on the bone marrow of the B-lymphocytic series on the production of antibody-forming cells to sheep red blood cells, observed on their addition into the culture of the spleen cells after Mishell and Dutton, was mediated only by the live cells capable of proliferation, and was independent of the histocompatible differences between the bone marrow and the spleen cells and of the preliminary immunization of the bone marrow donors.


[Positive ventriculographic signs of cerebral hemisphere glioma extension into the ventricular system]. A positive ventriculography with fatty and water soluble contrast substances (myodil, conray, dinner - x, amipaque) was performed in 87 patients with gliomas of the frontal lobe 36 cases), temporal (22 cases) and parietal (29 cases) lobes. Gliomas of the frontal and temporal lobes penetrating into the cavity of the lateral ventricles from an "amputation" of  the anterior or inferior horn. Gliomas of the parietal lobe penetrated into the upper--outer wall of the triangle of the lateral ventricle and creates a defect of filling around which a certain "plication" develops. A common symptom of glioma penetration into the brain ventricles is its tuberous polycyclicity, an uneveness of the edges of the ventricles. The author describes some diagnostical signs of a penetrating glioma into the corpus callosum and subcortical nodes.


[Proliferative response of schizophrenic patient's peripheral blood lymphocytes]. The author studied the proliferative abilities of lymphocytes in the peripheral blood of schizophrenic patients and normals in cultures not containing autologous plasma. The reactivity of lymphocytes in schizophrenic patients to PHA and rabbit serum to human thymocytes (ATS) appeared to be decreased. The level of their proliferative response to concavaline A was significantly the same as in normals. The assumption is made that in schizophrenic patients there is a blocking of lymphocyte receptors, binding PHA and ATS. The possibility of a deficit of a subpopulation of T lymphocytes in the organism of patients highly sensitive to stimulation by PHA and ATS is not excluded.


Comparison of the prevalence of hypertension in the rural and urban areas of Guilan Province, Northern Iran. Blood pressure levels of three groups of people 35 years and older in the Guilan province, Northern Iran are compared. One group in the city of Bandar Pahlavi (550) another group in the coastal villages near the city (510) and the third in the mountain villages, less than 100 km far from the city (272). This study shows that in both sexes, both systolic and diastolic blood pressure are lowest in the mountain villages, highest in the city and intermediate in the coastal villages. The possible causes of the observed differences are discussed.