Long-term neuropsychological outcome of closed head injury. Long-term recovery from severe closed head injury was investigated in predominantly young adults whose Glasgow Coma score was 8 or less at the time of admission. Of the 27 patients studied (median follow-up interval of 1 year), 10 attained a good recovery, 12 were moderately disabled, and five were severely disabled. In contrast to previous studies suggesting that intellectual ability after severe closed head injury eventually recovers to a normal level, our findings showed that residual intellectual level, memory storage and retrieval, linguistic deficit, and personal social adjustment corresponded to overall outcome. All severely disabled patients and several moderately disabled patients exhibited unequivocal cognitive and emotional sequelae after long follow-up intervals. Analysis of persistent neuropsychological deficit in relation to neurological indices of acute injury severity demonstrated the prognostic significance of oculovestibular deficit.


High-pressure liquid chromatographic assay of folic acid: a collaborative study. A collaborative study of the USP high-pressure liquid chromatographic assay for folic acid was performed. Two samples were analyzed in duplicate by 14 participating laboratories. Relative standard deviations for a single determination (RSDS) ranged from +/-0.40 to +/-2.39%. Based on an analysis of variance, it was concluded that the method of peak measurement was a major determinant of reproducibility and that graphical measurement was associated with a high standard deviation. Adequate resolution was obtained using a variety of columns and operating conditions. The interlaboratory RSDS was +/-1.8%.


Force-velocity relation in normal and nitrate-treated frog single muscle fibres during rise of tension in an isometric tetanus. 1. The force-velocity (P-V) relation for normal or NO-3 treated single fibres isolated from the semitendinosus muscle of the frog was determined at given times during the rise of tension and the plateau of isometric tetani. Experiments were made at about 2.25 micron sarcomere length and at constant temperatures, from 3 to 4.5 degrees C and from 19 to 21 degrees C. The controlled-velocity release method was used. 2. During the rise of tension, at any initial tension higher than about 0.2 P0, the lowest release velocity required to drop the tension to zero was the same as at the tetanic plateau, independent of the temperature and the presence of NO-3 ions in the bathing solution. 3. The degree of activation (measured by the steady force exerted at a given velocity of shortening lower than V0) increased with time, but attained its steady-state level before isometric tension. 4. At about 20 degrees C, frog muscle fibres at about 2.2 micron sarcomere length were only partially activated after a single stimulus. 5. NO-3 ions did not affect the steady-state P-V relation. At about 20 degrees C, NO-3 ions increased the rate of development of activation. Potentiation of the twitch contraction was due at least in part to this mechanism. 6. The 'relative' P-V relation appears to be independent of both the time after start of stimulation and the presence of NO-3 ions in the bathing solution. 7. The results are discussed in terms of the sliding filament model of Huxley (1957), assuming that either the number of actin sites available for cross-bridge formation, or the value of the rate constant for making of cross-bridges, is time dependent.


[The transjugular approach to the hepatic region for the differential diagnosis of jaundice and exploration of the portal system (author's transl)]. The results obtained in a series of 200 patients, using the transjugular approach to the common bile duct for the differential diagnosis of cholestasis, are presented and discussed. 1. The advantages of the method are: --the simplicity of the technique and the rapidity with which it can be mastered, the negligeable investment required; --the safety in use if the only contra-indication is respected: recent acute infection of the biliary tract; --the possibility of obtaining a cholangiography and a liver needle-biopsy at the same time, even in cases with disorders of the blood. 2. The limitation of the method is the failure to visualize the CBD, which is seen in 30% of cases when the latter is not dilated by an obstruction. 3. The respective indications for either transjugular cholangiography or retrograde catheterization of the papilla can be defined. 4. A preliminary series of 37 explorations of the portal system by the transjugular approach with embolization of bleeding oesophageal varices is reported.


Preparation of the enantiomeric forms of 9-(5-deoxy-alpha-threo-pent-4-enofuranosyl)adenine and 9-(3,5-dideoxy-beta-D-glycero-pent-4-enofuranosyl)adenine and in vitro antileukemic screening. The preparation and use of 5-deoxy-5-iodo-1,2-O-isopropylidene-alpha-D-xylofuranose and 5-deoxy-5-iodo-1,2-O-isopropylidene-alpha-D-arabinofuranose in the synthesis of the L and D forms of 9-(5-deoxy-alpha-threo-pent-4-enofuranosyl)adenine, respectively, are described. The preparation of 9-(3,5-dideoxy-beta-D-glycero-pent-4-enofuranosyl)adenine (19) was accomplished from either 3,5-dideoxy-5-iodo-1,2-O-isopropylidene-alpha-D-erythro-pentofuranose or 3,5-dideoxy-5-iodo-1,2-O-isopropylidene-beta-L-threo-pentofuranose. In each case, acetolysis was performed to obtain the acetates which were condensed with 6-(benzamidochloromercuri)purine by the titanium tetrachloride method. Treatment with 1,5-diazabicyclo[5.4.0]undec-5-ene and removal of the blocking groups produced the desired nucleosides. Only 19 showed inhibitory activity toward leukemia L1210 in vitro.


A new nonsteroidal analgesic-antiinflammatory agent. Synthesis and activity of 4-ethoxy-2-methyl-5-morpholino-3(2H)-pyridazinone and related compounds. In order to examine analgesic and antinflammatory activities, various 2-alkyl- or 2-alkenyl-4-alkoxy-5-(substituted amino)-3(2H)-pyridazinones were prepared. Among the compounds prepared, 4-ethoxy-2-methyl-5-morpholino-3(2H)-pyridazinone (8) was evaluated to be the most attractive compound as an analgesic-antiinflammatory agent. Compound 8 was shown to be more potent in analgesic and antiinflammatory activities and less potent in toxicity than aminopyrine and phenylbutazone. Some pyridazinone derivatives in which possible active sites of 8 are eliminated and altered were prepared, and their activities were evaluated by means of analogous assays. On the basis of available data, the structure-activity relationship in a series of 4-alkoxy-2-substituted-5-(substituted amino)-3(2H)-pyridazinones was also discussed.


Constant-pressure aortic root perfusion versus cardioplegia and hypothermia. Comparison of methods of myocardial protection. Both coronary perfusion and hypothermic cardioplegia are widely used methods of myocardial protection during aortic valve replacement. A theoretical objection to coronary perfusion is that it is not synchronized with cardiac contractions. Accordingly, a special pump was designed to provide perfusion at a constant range of pressure. Twenty dogs were studied during 4 hours of bypass. In six dogs no manipulations were carried out and hearts were allowed to beat in a nonworking state. Seven dogs underwent 2 hours of aortic cross-clamping and constant-pressure aortic root perfusion. Seven dogs underwent 2 hours of uninterrupted aortic occlusion with myocardial protection being maintained by cold potassium-induced arrest, Contractility did not change significantly in any of the three groups. All animals demonstrated significant hyperemia after bypass but normal endocardial/epicardial flow ratios. Although compliance deteriorated in all groups, the most striking changes were seen following 4 hours of bypass alone or constant-pressure aortic root perfusion. Hypothermic potassium arrest, in contrast, provided a slightly greater degree of myocardial protection, perhaps both by limiting the degree of ischemic injury directly and by excluding the heart from the circulating blood and the pump oxygenator system.


Coronary bypass in a patient with hemophilia B, or Christmas disease. Case report. A 40-year-old patient with moderate factor IX deficiency (Christmas disease) underwent quadruple saphenous vein coronary bypass grafts for angina and severe coronary atherosclerosis involving the left and right main, left anterior descending, and circumflex coronary arteries. Excessive bleeding was prevented by infusion of factor IX concentrates during and after the operation. The surgical procedure and total body perfusion were carried out in the same manner as in patients without a hemorrhagic disorder. The patient was discharged after 13 days of hospitalization. He is doing well at the time of this publication and has returned to work.


[Audiogram-analogue representation of the vestibular reaction to caloric stimulation (author's transl)]. A new diagram with audiogram-like presentation of the vestibular reaction to caloric stimulation is proposed, which facilitates the identification of typical vestibular disorders. Spontaneous nystagmus with the relevant parameters is entered in the chart. The diagram can be used for any parameter of the reaction, such as frequency, slow phase velocity or total amplitude in a defined period of time, e.g. 30 sec of maximal reaction.


Combination chemotherapy in histiocytosis X. Twenty-five children with generalized histiocytosis X were treated with a combination of cyclophosphamide, vinblastine, and prednisone: 8 patients experienced complete response, 8 partial response, 2 imporvement, and 7 no response. Response rates for children over 1 year of age were higher than those reported for single agents. Twelve children are now off therapy with no evidence of disease for 10--50 months. Very poor response rates and high toxicity were seen in children less than 1 year of age. The two infants who eventually achieved CR did so by other therapies. Further trials in combination chemotherapy must weight possible long-term effects of such therapy against the prospect of more rapid disease control.


Oral anticandidal prophylaxis in patients undergoing chemotherapy for acut- leukemia. Fifty-six untreated patients with acute leukemia (38 acute myelogenous leukemia, 16 acute lymphoblastic leukemia, and 2 blast crisis of chronic granulocytic leukemia) were randomized on admission to one of three groups--one to receive oral anticandidal prophylaxis through the period of remission induction chemotherapy with nystatin, another to receive natamycin, and the third to receive no anticandidal prophylaxis. Neither of the first two groups show any advantage over the last and it is concluded that provided gut sterilization regimes are not employed, prophylactic oral anticandidal treatment is of no value in these patients and should be reserved until there is clinical evidence of infection.


Lymphocyte function in the blood of patients with untreated non-Hodgkin lymphoma: influence of stage and pathology. Lymphocytotoxicity of T, non-T and K cells was found to be diminished in a proportion of 30 patients with untreated non-Hodgkin lymphoma; T cell number as enumerated by E sheep cell rosettes was also reduced. The reduction was greatest in patients with disease of unfavorable pathology; the effect of stage on these tests was not marked. Decreased skin reactivity was found in the same group of patients with unfavorable pathology. The reduction of direct and antibody dependent lymphocytotoxicity was not related to an obvious reduction in non-T cell numbers, as assessed by rosetting tests. There was, however, a decrease in phytohemagglutinin cytotoxicity in those groups with reduced T cell number. The influence of unfavorable pathology on lymphocyte effector function is emphasized by this study.


Cytokinetic studies in children with untreated acute lymphocytic leukaemia (ALL): relationship to "T" cell markers. "The labelling index (LI), mitotic index (MI) of marrow lymphoblasts and the percent of peripheral blood lymphocytes and lymphoblasts that form rosettes with sheep red cells at 4 degrees C ("T4"), were measured at presentation in 33 children with ALL. There was a significant correlation between LI and MI, but no significant correlations between them and the total white cell count at diagnosis or the "T4" percent. Three patients had greater than 55% "T4" rosettes and showed increased LI and MI, and 2 have relapsed; 12 had less than 20% "T4" rosettes, showed an increased LI (LI greater than 8% in 8 of 12) but not MI, and 5 have relapsed; 18 had 20--55% "T4" rosettes and generally had the lowest LI (LI less than 8% in 11 of 18), and only 3 have relapsed. Our findings suggest that patients with high and low percentage of "T4" rosettes in the peripheral blood have an increased fraction of leukaemic cells in DNA synthesis and have a diminished chance of prolonged remission.


The power to reduce the cost of technology. Technology has been made the scapegoat for the increasing cost of health care. Government action in the form of congressional legislation, administrative regulations, funded research, health care payments, etc., has been an important contributing factor in this increasing cost. Microcomputer/microprocessor-based systems such as MUMPS, PROMIS, COSTAR, GeMSAEC, and ASPECT have underutilized potential for producing economies of scale. Quantitative comparative cost data should be developed by every government-sponsored study or project to forcefully prove that more technology results in lowered costs.


[Bessel Hagen's deformity, Madelung's deformity: cosmopolitan diseases (author's transl)]. These two deformities are rare and the 8 reported cases give evidence of the cosmopolitan feature of these malformations (Madagascar, Ivory Coast, Central African Empire, Djibouti).


Use of L-asparaginase and cytosine arabinoside for refractory acute lymphocytic leukemia with particular reference to T-cell leukemia. Ten patients with late-stage acute lymphocytic leukemia were treated with L-asparaginase and cytosine arabinoside. Complete remission was achieved in 8 patients including 5 of 5 patients with T-cell leukemia. Major toxicity included anaphylactic reactions in 3 of the 10 patients.


The effects of antidepressants on serotonin turnover in discrete regions of rat brain. Serotonin (5-HT) turnover was measured in hypothalamus, hippocampus, cortex, septum and nucleus caudatus of rats after acute or chronic treatment with antidepressants. Acute chlorimipramine (1.8 -- 16.2 mg/kg i.p.) decreased 5-HT turnover in all the areas tested as measured by the rate of accumulation of 5-hydroxyindoleacetic acid after probenecid, or the rate of accumulation of 5-hydroxytryptophan after decarboxylase inhibition. However, chlorimipramine failed to reduce the rate of 5-HT accumulation after monoamine oxidase inhibition. Chronic chlorimipramine treatment (3 times daily for 2 weeks) did not change the 5-HT turnover. Fluoxetine, which like chlorimipramine specifically blocks 5-HT uptake also decreased 5-HT synthesis. In contrast, no change in 5-HT turnover was observed after desmethylimipramine, amitriptyline, iprindole or amphetamine which affect the catecholaminergic, but not serotoninergic systems.


Site of action of a uremic serum fraction inhibiting sodium transport in frog skin. The rate coefficients and fluxes of sodium across the outside and inside barriers of an in vitro, short-circuited frog skin preparation were determined in the presence of a uremic serum fraction to localize the site of action of an inhibitor of sodium transport. In unpaired studies, the mean depression of short-circuit current (SCC) resulting from the addition of the uremic serum fraction (21.9+/-2.2%) was significantly greater than the decrease in SCC resulting from either frog Ringer's wash or normal serum fractions. Paired studies comparing active and inactive uremic serum fractions indicated that the reduction in net sodium transport, whether calculated from changes in SCC(-0.55+/-0.12muEq/h) or changes in unidirectional Na fluxes (-0.56+/-0.15 muEq/h) was significantly greater in hemi-skins treated with the active fraction. The depression in sodium transport was associated with a significant decrease of sodium movement from the skin to the inside compartment, phi22 (-0.62+/-0.2 muEq/h). The results of these studies suggest that the inhibition of sodium transport ascribed to the uremic serum fraction is due to an inhibition of the active transport mechanism located at the serosal barrier.


Comparison of CT and conventional neuroradiological procedures in lesions in the proximity of the tentorial hiatus. Seventeen cases with (obstructive) lesions in the region of the tentorial hiatus were examined with an EMI CT 1010 brain scanner, of which 8 had additional intrathecal metrizamide. Findings were compared with information received from angiographic studies and conventional contrast examinations of the intracranial CSF spaces and with CT scans of patients presenting with herniation at the tentorial hiatus. CT, including enhancement and intrathecal metrizamide, did not yield optimal information about exact localisation or infiltrative growth of lesions. A combination with conventional procedures was needed in order to obtain essential information.


Comparative study of computed tomography and ventriculography with water-soluble contrast media. From material of over 10,000 CTs a comparative study of computed tomography and ventriculography with contrast media was carried out. We examined 18 patients with suspected expansive lesions localized in the 3rd ventricle, aqueduct of Sylvius, and 4th ventricle. We have found that CT is the method of choice in these cases and that ventriculography should be reserved for those cases which have clear clinical indications.


p,p'-DDT-induced neurotoxic syndrome: experimental myoclonus. p,p'-DDT (100 to 600 mg per kilogram orally) produced spontaneous and stimulus-sensitive myoclonus in mice and rats. Drugs that enhance brain serotonergic activity reduced p,p'-DDT-induced myoclonus, and serotonin antagonists invariably aggravated this syndrome. p,p'-DDT-treated rats had increased concentrations of 5-hydroxyindoleacetic acid (5-HIAA) in seven regional areas, but serotonin was increased only in the midbrain and cerebellum. We postulate that p,p'-DDT-induced myoclonus may be causally related to blockage of serotonin receptors or inhibition of serotonin release into the synapse, resulting in functional deficiency of this neurotransmiter at the receptor site.


Mitogen responsiveness and suppressor cell function in multiple sclerosis. Influence of age and disease activity. Mitogen responsiveness and suppressor cell function were determined in patients with multiple sclerosis. Mitogen response to concanavalin A, expressed as stimulation index, decreased with age in both patients and controls. Although responses in the overall group of young patients did not differ from controls, the stimulation index was reduced in clinically inactive patients. Patients with recent flare-ups showed responses comparable to controls. Suppressor cell activity increased with age in both disease and control groups. Among young patients, suppressor activity was borderline low in inactive patients but increased significantly in those with recent exacerbations.


Myasthenia gravis treated with purified antithymocyte antiserum. The therapeutic effect of goat anti-human thymocyte antiserum globulin (ATG) was assessed in 10 patients with myasthenia gravis. All subjects had far-advanced, debilitating disease poorly responsive to anticholinesterase therapy. Prolonged, low-dose ATG therapy was used, with 1.0 to 2.6 gm ATG protein administered intramuscularly over a 28- to 73-day period. Therapeutic responses of varying degrees were noted in 8 of 10 patients. Completion of a course of ATG treatment and discontinuation of the drug did not lead to acute relapse. Follow-up examinations for over 5 years have been maintained. A mean remission period of approximately 2 years was observed. This therapy deserves further evaluation; subjects with progressive myasthenia gravis despite prior thymectomy may represent ideal candidates.


Visual-vestibular interaction and cerebellar atrophy. The vestibular and optokinetic ocular control systems were studied in 10 patients with cerebellar atrophy and in 10 normal subjects using (1) constant velocity optokinetic stimulation, (2) sinusoidal rotation in the dark, and (3) sinusoidal rotation in the light with a surrounding fixed optokinetic drum. The gain (maximum slow component velocity/maximum head or drum velocity) of induced nystagmus was calculated from electro-oculographic recordings. Optokinetic nystagmus was abnormal in seven patients and the average optokinetic gain in the patients was significantly (p less than 0.01) less than that of the normal group. Three patients with "clinically pure" cerebellar atrophy had increased vestibular responses, and one patient with clinical signs of peripheral neuropathy had decreased responses, probably due to associated vestibular nerve disease. The average vestibulo-ocular reflex gain in patients did not differ significantly from controls (p greater than 0.05). Three patients had normal vestibular and optokinetic responses when tested independently, but had abnormal visual-vestibular interaction. These patients probably had selective disorders of the midline cerebellar pathways that mediate visual-vestibular interaction. By studying each system, both independently and during interaction, all patients were identified as abnormal, and a more precise anatomic localization of the atrophy was obtained.


The development of the parachute reaction: a visuo-vestibular response. The development of the parachute reaction as a postural response has been tested under various optic stimuli in normal and statomotorically retarded infants. Complete reaction consists in symmetric extension of the arms with extension and spreading of the fingers on quick approach to visual surface. Using a glass plate with three different sized stimulus patterns the parachute response is scored as complete or incomplete. The complete reaction to large visual surface develops significantly earlier than to small visual surface. The response also requires simultaneously a visual and a vestibular sensory input. The developmental course of the parachute reaction is statistically significant linear correlated in double logarithmic transformation to the stimulus pattern and to the age indicating a complex biological maturating process. When the whole retinal area was stimulated by moving visual scenes similar to normal environmental conditions the reaction starts with about 4 months of age and is fully developed from 9 months onwards. The time of quickest development is around 6.3 months of age, a period where locomotor abilities shift from horizontal postiion to active verticalisation of the body. In statomotorically retarded infants the response develops significantly later according to their active motor behaviour. Brain integration and computing centers of sensory afferent input could be multilevel from reticular formation to cerebral cortex, wherein the latter, probable the parietal lobe should play the major role. It is concluded that the parachute reaction results from a combined visuovestibular mechanism of interaction in connection with sufficient kinesthetic experience in visuo-motor behaviour.


Intellectual development and brain size in 13 shunted hydrocephalic children. A group of 13 successfully treated hydrocephalic children living a normal social life according to their ages has been examined to evaluate the possible correlation between their brain size, intellectual development and physical disability. The brain size was assesed by ventriculography prior to initial surgery and by computer tomography (CT-scanning) at the time of investigation 6--11 years after operation. The intellectural development was evaluated by psychological investigation of the children and by evaluation of their social adaptation. The physical disability was investigated by neurological examination. Significant improvement in ventricular size was demonstrated from pneumoencephalographic examinations prior to surgery and to the CT investigations. No prediction of the intellectual development could be based on the ventriculographies prior to initial surgery. In spite of positive trends, correlation trends, correlation between the ventricular size as determined by CT-scans and the IQ was not significant, possibly due to the small number of cases available for study.


Ear disease in rural New Zealand school children. Surveys of children aged 5--17 in a predominantly rural area showed a high prevalence of inflamed ears and perforated drums in younger subjects and of perforated and scarred drums in older subjects. Abnormal drums were associated wtih lower socioeconomic status, ethnicity and low altitude and low rainfall. Maori children had both higher incidence and lower recovery rates than non-Maori children. The wider use of trained nurses for case detection and follow up is advocated, at an estimated cost of 53 cents per child examination. Further parent education and co-ordination of nurse/audiometrist surveys are necessary.


The management of patients with intraocular lenses. Guidelines for those who do not perform this operation. The management of patients with intraocular lenses can be done quite well by any knowledgeable ophthalmologist. Every examination must include the measurement of intraocular pressure and a thorough slit-lamp examination, specifically noting: Corneal edema, local or diffuse; Increasing corneal guttata; Touch of lens or iris suture to the cornea; Aqueous ray or cells, KP, LP (lens precipitates); Lens displacement; Iris suture problems; Pupil margin erosion; Secondary cataract; Vitreous face: loss or thickening; Retrolenticular membrane formation; Vitreous cells. Ophthalmoscopy should include examination of the peripheral retina for detachment, but visual fields should be done whenever detachment is suspected. Contact lens--slit-lamp examination of the macula for cystoid edema should be supplemented by Flourescein angioscopy when needed. Lens removal should be done only after careful consideration. The damage induced by such surgery must be weighed against the problems of leaving the lens in place. Consultation is mandatory. When in doubt, refer.


Intravitreal antimycotic therapy and the cure of mycotic endophthalmitis caused by a Paecilomyces lilacinus contaminated pseudophakos. A salvaged eye in a case of mycotic endophthalmitis is reported. The case was one of eleven in the United States resulting from Luminex lens implants contaminated with amphotericin B resistant Paecilomyces lilacinus, and one of two eyes salvaged in this series of cases. The fungus, recognized 28 days after the lens was inserted, was in the anterior chamber, on the psuedophakos, and in the vitreous. The therapeutic procedures included removal of the pseudophakos, radical vitrectomy and iridectomy, and the intraocular and combined topical and systemic use of antimycotic compounds, including miconazole and thiabendazole.


Changes in gastric EMG resulting from differences in direction of linear acceleration in rabbits. The role of direction of linear acceleration in stimulation of the otolith organ, which leads to alteration of autonomic activities in the form of inhibition of gastric motility, has not been fully studied. With a view to elucidating this problem, we placed healthy adult rabbits unanesthetized and unrestrained in individual cages, and subjected them to the three different linear acclerations to study changes in gastric EMG. As a result, the forward-and-backward movement was found to inhibit the EMG activity most potently, and was followed in decreasing order by side-to-side movement and up-and-down movement. These findings, when viewed from the standpoint of the accepted concept that optimum stimulation to the otolith organ constitutes the shearing force, account well for the supposition that forward-and-backward movement stimulates both the sacculi and utriculi, while up-and-down movement stimulates the sacculi alone.


Flunarizine and cinnarizine as vestibular depressants. A statistical study. The authors analysed the vestibular depressant activity of flunarizine and cinnarizine, as compared to a placebo, in 58 patients with peripheral labyrinthine disorders. The activity of the medications was judged by the reduction of the average velocity of the slow phase of the post-caloric nystagmus, before and after treatment. In spite of being administered in a smaller dosis, flunarizine appeared to have a more intense vestibular supressant activity, as judged by different statistical tests.


Quantification of vestibular nystagmus by an interactive computer program. An interactive program for the analysis of nystagmus is presented, and some results obtained by processing postrotational responses are reported. The program is provided with a special subroutine which gives a quantification of the rhythm and regularity of the response through the histograms of the ratios between the duration of successive intersaccadic intervals and between the amplitudes of successive fast components. The consideration of these histograms has been proved to be highly significant in discriminating between normal and pathological responses.


Description of age-depending cellular changes in the human tonsil. The growth and ageing of tonsils is described by means of the behaviour of the cell count, T cell count, DNA, and organ weight. Proliferation of cells and the influx of recirculating T lymphocytes cause hyperplasia up to the age of 17 approximately, later on the cell count and organ weight decrease again. The number of T cells in cell suspensions from the tonsil is lower than that of blood. Due to the proliferation decrease of B cells and the accumulation of recirculating T lymphocytes, the T cell count in the tonsil increases with advancing years. The tonsil function decrease as a result of this population shift. No influence of the differentiation of T cells by the tonsil can be detected.


Pain-induced alterations in the individual non-esterified fatty acids in serum. Changes of individual non-esterified fatty acids in serum were studied in 7 metabolically healthy patients, suffering from idiopathic trigeminal neuralgia, who underwent electrocoagulation of gasserian ganglion under neurolepthypalgesia. The mean concentration of fatty acids increased by about 40% during the strong surgical pain stimulus. The increased lipolysis affected all individual fatty acids in proportion to the ratio of their presence in adipose tissue. The mechanism of pain-induced activation of lipase and possible consequences of alterations in individual non-esterified fatty acids are discussed.


[Re-operation for myocardial revascularisation. 15 cases (author's transl)]. Among 1110 patients undergoing aorto-coronary bypass procedures, 15 required late re-operation (average interval 28 months) for myocardial revascularisation. This was performed following the recurrence of anginal symptoms, on average 15 months after the first operation. Six resections of localised stenosis of the vein graft and eleven "new" aorto-coronary bypass were performed. One patient died early, 12 hours after surgery, while 2 died 3 and 26 months later. Nine of the 12 survivors had no symptoms 4 to 63 months after the re-operation. Thus in the presence of angina recurring after aorto-coronary bypass, a new follow-up coronary arteriogram should be performed in order to seek lesions which might benefit from further attempted surgical treatment.


[Lung biopsy by thoracotomy. 23 cases (author's transl)]. This series of surgical lung biopsies performed for diffuse lung disease indicates the excellent tolerance of the procedure and the high diagnostic rate. It is indicated above all in the presence of bilateral reticulo-nodular radiological appearances, suggestive of focal lesions not identified by the usual means. The surgical procedure was felt to be justified on the one hand because of the time gained in reaching a precise diagnosis whilst the results of usual laboratory investigations, even the most sophisticated, remain uncertain, and secondly in view of the discovery by the method of malignant lesions which are still curable and which it would have been impossible to identify otherwise, except by awaiting the development of more accessible lesions. Whilst percutaneous needle biopsy found favour amongst many, it would now seem to have been virtually abandoned, particular in France, in view of its risks and it's poor diagnostic rate. By contrast, open surgical biopsy provides in all cases not only lung but also pleural and mediastinal tissue. Its risks are confined to those of any surgical procedure under general anaesthesia, but appear to be sufficiently slight (mortality of 0,5 to 2%) that the technique may be used successfully in intensive care units to obtain a diagnosis in cases of certain types of respiratory distress.


Evidence for tetradecanal as the natural aldehyde in bacterial bioluminescence. Dim aldehyde mutants of the luminous bacterium Beneckea harveyi emit light with exogenously added long-chain aliphatic aldehyde. In one class of these mutants, luminescence is also stimulated by myristic (tetradecanoic) acid. In such mutants the amount of light obtained by the addition of a small (limiting) amount of either tetradecanal or myristic acid may be increased 60-fold by cyanide and other agents that block respiration. This indicates that the fatty acid product of the luminescent reaction is recycled. The effect, like the stimulation by exogenous fatty acid, exhibits specificity for the 14-carbon compound, suggesting that tetradecanal is the natural aldehyde. In those aldehyde mutants that are not stimulated to emit light by fatty acids, and thus presumably lack the recycling system, the chain-length-specific stimulation by cyanide does not occur.


Interaction of peanut agglutinin with normal human lymphocytes and with leukemic cells. The interaction of peanut agglutinin (PNA) with human thymocytes, peripheral blood lymphocytes, and peripheral blood cells of various types of leukemia was investigated by using fluorescein isothiocyanate-conjugated PNA. The majority of human thymocytes (60-80%) bind the lectin. The major subpopulation of thymocytes that is PNA-positive was separated from the PNA-negative cells by differential agglutination with the lectin. The two thymocyte subpopulations were tested in the mixed lymphocyte reaction and with the phytohemagglutinin of Phaseolus vulgaris. The poor response of the PNA-positive thymocytes to these stimuli indicates that these thymocytes are functionally immature. The fluorescein isothiocyanate-PNA-binding test with peripheral blood lymphocytes of leukemic patients revealed that in most acute leukemias the PNA receptor is exposed on the blastic cells, whereas in most cases of chronic leukemia the peripheral blood lymphocytes are PNA-negative. The validity of PNA as a marker of immature blood cells and its potential clinical application are discussed.


Impairment of cell-mediated immunity functions by dietary zinc deficiency in mice. Several immunologic features were analyzed in mice on a zinc-deficient diet [Zn(-)], in mice pair-fed a diet containing zinc [Zn(+)], in mice fed a Zn(+) diet ad lib, and in mice fed laboratory chow ad lib. When placed on a Zn(-) diet, 6- to 8-week-old A/Jax, C57BL/Ks, and CBA/H mice showed loss of body weight, low lymphoid tissue weight, and profound involution of the thymus within 4-8 weeks after initiation of the regimen. Approximately 50% of the mice on the Zn(-) diet developed severe acrodermatitis enteropathica (lesions on tail and paws) and diarrhea. Pair-fed mice on the Zn(+) diet did not show any of these symptoms. Mice on the Zn(-) diet showed the following immune deficiencies: (i) depressed plaque-forming cells against sheep erythrocytes after in vivo immunization; (ii) depressed T killer cell activity against EL-4 tumor cells after in vivo immunization; and (iii) low natural killer cell activity. However, antibody-dependent cell-mediated cytotoxicity against chicken erythrocytes was normal in the mice on the Zn(-) diet. Deficiency of T killer cell activity was not observed when immunization with EL-4 allogeneic lymphoma cells was carried out in vitro. Progressive loss of relative and absolute number of Thy 1.2+ cells and a proportionate relative increase in cells bearing Fc receptors was seen in spleen and lymph nodes of Zn(-) animals. It appears that zinc is an essential element for maintenance of normal T cell and other immune functions in vivo.


Absence of virus-induced lymphocyte suppression and interferon production in multiple sclerosis. Lymphocytes from normal adult donors exposed in vitro to inactivated measles virus were found to exert significant suppression (33.9%) of the concanavalin A responses of cryopreserved, autochthonous responder cells. In marked contrast, lymphocytes from multiple sclerosis patients exhibited significantly reduced suppression (1.5%), and in 80% of cases failed to suppress at all. The degree of suppression increased slightly with age of the patient but did not vary with the clinical stage of disease. There was no apparent genetic restriction of suppressor activity. Although specificity of this phenomenon for measles virus has not been established, no differences in the responses of lymphocytes from normal or multiple sclerosis patient donors were found with subacute sclerosing panencephalitis, Sendai, canine distemper, mumps, or influenza viruses. Supernates of measles-treated lymphocytes from normal donors possessed both suppressive and antiviral activities. Both activities were resistant to pH 2 treatment and were neutralized by an anti-human leukocyte interferon antiserum, strongly suggesting that interferon (probably type I) was the mediator of suppression. Consistent with their inability to suppress concanavalin A responses, lymphocytes from multiple sclerosis patients failed to produce significant amounts of interferon in response to measles challenge in vitro. These results extend previous observations that multiple sclerosis patients are unable to respond appropriately to measles virus antigen in vitro.


Induction of amplified synthesis and secretion of IgM by fusion of murine 'b lymphoma with myeloma cells. Murine B lymphoma cultured cell lines bearing membrane IgM and lacking the ability to secrete measurable amounts of IgM were fused with drug-resistant cell lines derived from the IgG2b-producing MPC-11 myeloma. Many of the hybrid clones synthesized and secreted large amounts of IgM, as judged by radial and double immunodiffusion in agar of culture supernatants and by polyacrylamide gel electrophoresis of biosynthetically labeled IgM. When fused with an IgG2b-producing myeloma, many of the hybrids also produced IgG2b, indicating that there was no suppression of the parental IgG synthesis in the hybrids. The amount of IgM or IgG2b secreted by the hybrids was higher than that secreted by myeloma cell lines. The synthesis of the gamma2b heavy chain of the MPC-11 myeloma was not reexpressed by fusion of a gamma2b nonproducer myeloma cell variant with B lymphoma. No other classes of Ig heavy chains, besides the gamma2b and the mu chains, were found to be secreted by any of more than 100 B lymphoma--myeloma hybrids examined. The results of the present work suggest that myeloma cells may fuse not only with normal plasma cells but also with less-mature normal B lymphocytes and that this fusion "induces" the maturation of B lymphocytes into IgM-secreting cells.


Purine excretion by mouse peritoneal macrophages lacking adenosine deaminase activity. Deoxyadenosine, a cytotoxic purine nucleoside, is excreted in large amounts by patients with severe combined immunodeficiency disease associated with deficiency of adenosine deaminase (adenosine aminohydrolase, EC 3.5.4.4). To identify the source of the purine nucleoside, purine excretion by macrophages was studied by using mouse peritoneal macrophages as an experimental model system. Normally, macrophages excrete a large quantity of uric acid into the culture medium. However, in the presence of deoxycoformycin, a potent inhibitor of adenosine deaminase, these macrophages also excreted deoxyadenosine. Furthermore, phagocytosis of nucleated erythrocytes augmented the excretion of deoxyadenosine. Macrophages are involved in the phagocytosis of nuclei that are extruded from normoblasts during erythropoiesis and also of senescent cells in lymphoid organs. A hypothesis is proposed that macrophages of the reticuloendothelial system are a source of deoxyadenosine, which is one of the two cytotoxic purine nucleosides (the other is adenosine) apparently responsible for the suppression of immune functions in patients with adenosine deaminase deficiency.


Sequence-specific DNA uptake in Haemophilus transformation. Haemophilus cells efficiently take up Haemophilus DNA from the medium during transformation but do not take up other DNAs. To study the mechanism of this specificity we have cloned an 8.1-kilobase (kb) fragment of H. parainfluenzae DNA in the escherichia coli--pBR322 host--vector system and reisolated the DNA fragment for use as a defined probe. The 5'32P end-labeled 8.1-kb DNA is efficiently absorbed by competent Haemophilus cells whereas vector DNA present in the mixture is not, implying that the 8.1-kb DNA contains sequence-specific recognition sites that are needed for DNA uptake. Absorbed DNA can be recovered from cells as a 32P-labeled duplex of unaltered size for several minutes after uptake. We have determined the number and location of uptake sites in the 8.1-kb DNA by constructing a restriction endonuclease cleavage map and assaying fragments for uptake. Only two small fragments retain the ability to be absorbed. These fragments, 120 and 140 base pairs long, are 3.8 kb apart on the 8.1-kb fragment. We assume that each of these fragments contains a short common sequence, perhaps 8--12 base pairs long, that is the actual recognition site. We have shown by DNA competition assays, with the 8.1-kb DNA as a standard, that about 600 copies of the uptake sites are present in the Haemophilus genome.


Action of black widow spider venom on quantized release of acetylcholine at the frog neuromuscular junction: dependence upon external Mg2+. Black widow spider (Latrodectus tredecimguttatus) venom (BWSV) increases several hundredfold the frequency of occurrance of minature end-plate potentials (Fmepp) at frog neuromuscular junctions bathed in Ringer's solutions containing either Ca2+ of Mg2+, but it has little effect on Fmepp at junctions bathed in modified Ringer's solution containing 1--2 mM ethylene glycol bis(beta-aminoethyl ether)-N,N'-tetraacetic acid (EGTA) but no Ca2+ or Mg2+. When Mg2+ is added to preparations that have been treated with BWSV in the modified solution, Fmepp increases exponentially with time. Fmepp falls again to low values when the Mg2+ is removed. The rate constant of the exponential rise is proportional to [Mg2+]o in the range 1--4 mM, and the threshold [Mg2+]o is 0.1--0.5 mM. Increasing the K+ concentration of the bathing solution decreases the ability of Mg2+ to increase Fmepp. Addition of Ca2+, Co2+, Mn2+, or Zn2+ also leads to a large increase in Fmepp. These results are consistent with the possibility that BWSV increases the permeability of the nerve terminal to divalent cations. BWSV can, however, increase Fmepp in hypertonic solutions in the absence of external divalent cations. This result suggests that the effects of BWSV on the nerve terminal may not be confined to increasing the permeability of the plasma-lemma.


Computed tomography profiles of periventricular hypodensity in hydrocephalus and leukoencephalopathy. Profiles of hypodense periventricular white matter, drawn from the interior of the frontal horns through the surrounding white matter to the peripheral gray matter, were analyzed in 65 patients. Abnormal curves were grouped into four patterns: linear, double-slope, plateau, and bimodal. The first two, found primarily in hydrocephalic patients, appear to be due to transependymal passage of cerebrospinal fluid (CSF). The linear pattern was found more frequently in acute cases and indicates breakdown of the ventricular wall as a barrier. The double-slope pattern probably indicates a persistent or restored barrier effect at the wall, with residual CSF infiltration of the parenchyma. Most of the other patients' curves showed either a plateau pattern or (especially in primary leukoencephalopathy) a bimodal ("bumpy") pattern which is believed to correspond to the nonuniform nature of the pathological process.


[The effect of proteinase inhibitor aprotinin on RNA-synthesis rate after partial hepatectomy in rats (author's transl)]. The effect of Aprotinin has been investigated on RNA-synthesis rate--measured by the incorporation of 3H-uridine--after partial hepatectomy in rats. In the control group two maxima of the incorporation of 3H-uridine into the regenerating liver were obtained after hepatectomy. On the other hand no increase of the 3H-uridine incorporation was detectable after Aprotinin pretreatment. The results indicate that Aprotinin inhibits the early events of liver regeneration by inhibition of proteinase enzymes.


Facial nerve palsy in acute leukaemia.

Facial nerve palsy in acute leukaemia. During a three year period, of 62 children and adults seen with lymphoblastic leukaemia 6 developed unilateral facial paralysis during the course of their disease, compared to none of 54 adults and children with acute non-lymphatic leukaemia seen during the same period. In all cases the problem arose in patients with refractory disease and was associated with the development of resistant bone marrow infiltration. The neuropathy showed no obvious response to intrathecal therapy and whilst meningeal infiltration was present at some stage in all but one of the 6, this waxed and waned independently of the facial palsy. Four of the 6 cases described had stigmata of the T-cell variety of lymphoblastic leukaemia, which is a significantly higher proportion than would be expected by chance. This apparent association with T-cell disease has not been previously recognised.


Macrophage requirement for the in vitro response to an insolubilized T-independent antigen. The role of macrophages in the in vitro response of mouse spleen cells to the insolubilized, T-independent antigen trinitrophenylated polyacrylamide (TNP-PAA) is demonstrated by the following points. The response is abolished by filtration on Sephadex G-10 and can be restored by the addition of splenic adherent cells, deficient in either B or T cells, or by 2-mercaptoethanol (2ME). It is suppressed upon elimination of phagocytic cells by silica, and restored by 2-ME. 2-ME can restore a normal response from zero, in cultures depleted of both adherent and phagocytic cells, and is efficient in the absence of mature T cells. Experiments in microcultures show that large numbers of macrophages can stimulate a supra-optimal response from B cells. This response is only obtained in the presence of the antigen, and is specific for TNP. These results show that microphages, probably by their polyclonal B-cell activator (PBA) property, play a role in the specific response to TNP-PAA. This prompts us to discuss the respective roles in the B-cell response of this PBA activity and of the interaction of the antigen with the specific B-cell receptors.


Severe suppression of the B-cell system has no impact on the maturation of natural killer cells in mice. Mice were treated with a heterologous anti-IgM serum to obtain B-cell-deprived mice. Spleen cells from normal and B-cell-deprived mice were tested in three different cytolytic systems: natural killer cells (NK); antibody-dependent cell-mediated cytolysis (ADCC) against an NK-sensitive tumour, P815; and ADCC against chicken erythrocytes. The impact of administration of an interferon-inducing NK enhancing agent, Tilorone, was also investigated. Whereas the cell population from B-cell-deprived mice was significantly suppressed in antibody-producing cells, the capacity to function in NK or ADCC was largely unimpaired both before and after administration of Tilorone. Our results would imply that mature B cells play no significant role in either the maturation of the NK cells or the expression of their cytolytic ability. Furthermore, effector cells for both NK and ADCC against antibody-coated tumour target cells were found to be distinct from those functioning in ADCC against chicken erythrocytes.


Alpha-naphthyl acetate esterase activity in human lymphocytes: distribution in lymphocyte subpopulations and in mitogen-activated cells. The cytochemical demonstration of nonspecific alpha-naphthyl acetate esterase (ANAE) activity in human peripheral blood mononuclear cells was studied. Different staining patterns were found, allowing differentiation of mononuclear cells into macrophages (strong granular cytoplasmic activity), B lymphocytes (negative reaction), Tgamma lymphocytes, i.e. bearing IgG Fc receptors (granular scattered reaction), and T non-gamma lymphocytes, i.e. devoid of IgG Fc receptors (single cytoplasmic ANAE spot). During the early phases of phytohaemagglutinin (PHA)- and concanavalin A (Con A)-induced activation, the reactivity of most lymphocytes became granular and scattered, similar to that found in Tgamma cells. Blast cells generating in successive phases appeared devoid of detectable enzymatic activity. The hypothesis is put forth that T cells showing granular, scattered reactivity represent a population of activated cells and that the redistribution of enzymatic activity could represent a preliminary step leading to secretion (lymphokine-like?) of enzyme from cytoplasm in the course of cell activation.


The prognosis of schizophrenia: rationale for a multidimensional concept. Three main ways of viewing schizophrenia exist that have different prognostic, practical, and conceptual implications. The mixed cross-sectional/longitudinal view of Kraepelin and others states essentially that there is a disease, schizophrenia, that can be identified by considering both characteristic symptoms and course. Prognosis in the disorder so defined is guarded, but because of the composite diagnostic criteria used, the characteristics most important for relating to outcome remain unknown. The second view defines schizophrenia primarily in terms of the cross-sectional symptom picture alone. It has been shown empirically that defining a disorder in this way has relatively limited prognostic implications. The third approach identifies schizophrenia in terms of several "axes," such as type of schizophrenic symptoms, their duration, the person's social relations, and his work function. These axes are viewed as relatively independent processes with somewhat different determinants, implying the need for different specific treatments. The authors believe this last view is the one most supported by currently available data.


[Immune profile in patients with Hodgkin's disease in long-term remission after cytostatic chemotherapy]. 13 patients in complete and prolonged remission after treatment with cytostatic chemotherapy for disseminated Hodgkin's disease have been investigated for immune competence by a total of 27 immunological parameters. 11 patients had abnormal values for lymphocyte populations, lymphocyte function and skin tests. The immune profile described is suitable for long-term evaluation of patients under immunosuppressive therapy.


[The effect of coronary surgery on the prognosis of angina pectoris]. The literature on the influence of aortocoronary bypass surgery is reviewed with respect to life expectancy and symptoms. Preliminary results of the European prospective randomized coronary study are also presented. There was no significant difference in clinical or angiographic criteria as between the medically and surgically treated patient groups. For the total cohorts, survival did not significantly differ, though in patients with 3-vessel disease, mortality was significantly higher in the medically treated group. This observation requires confirmation before it is allowed to influence our decisions. In the same prospective trial, surgery improved symptoms in 4/5 of the patients and eliminated angina in half. With medical treatment, fewer than half of the patients experienced further improvement during the same time period and only 15% became symptom-free.


[Thallium 201 myocardial scintigraphy. Clinical use and value]. Thallium-201 exercise myocardial perfusion scintigraphy, a new, non-invasive screening method, serves to visualize stress-induced ischemic regions and scarred tissue. As compared to the exercise electrocardiogram, the method shows higher sensitivity and specificity in detecting coronary artery disease. Moreover, it makes it possible to localize the predominant defects. Even though myocardial scintigraphy cannot replace coronary arteriography in establishing the precise morphologic situation of the coronary arteries, it is of help in deciding whether an arteriogram should be carried out or not. Thus, important indications for myocardial stress scintigraphy are atypical chest pain and an abnormal electrocardiogram without pain. Furthermore, the method is useful for evaluating patients with uninterpretable electrocardiograms during exercise, and in assessing the outcome of coronary artery bypass surgery.


The effect of oral isoniazid on human lymphocyte subpopulations. After oral administration of isoniazid (INH) to volunteers, a significant reduction in circulating T lymphocytes and a significant increase in B lymphocytes was found. These findings suggest that INH may be useful as an immunosuppressive agent.


A prospective evaluation of injection sclerotherapy in the treatment of acute bleeding from esophageal varices. In a 25 month study of massive upper-gastrointestinal hemorrhage, 64 patients were shown to have esophageal varices on emergency endoscopy. Twenty-four patients were actively bleeding from varices and were treated with a Sengstaken tube, and in 22 this was followed by emergency injection sclerotherapy using a rigid esophagoscope and general anesthesia. These 22 patients were followed prospectively and had 51 episodes of endoscopically proven active bleeding from esophageal varices which required Sengstaken tube control of hemorrhage during 36 separate admissions. This group included our total experience of injection sclerotherapy in acute variceal bleeding. The majority (14 of 22 patients) had alcoholic cirrhosis. Definitive control of variceal bleeding during the period of hospitalization was achieved in 33 hospital admissions (92%), usually with a single injection (27 hospital admissions: 75%). The results were satisfactory in 26 hospital admissions (72%). There were nine deaths (41% overall patient mortality rate), but no patient died primarily of variceal bleeding, and exsanguinating variceal bleeding was no longer a problem. The mortality rate per injection was 18%, and the mortality rate per hospital admission was 25%. Injection sclerotherapy is proposed as the emergency treatment of choice for patients with proven bleeding esophageal varices who do not stop bleeding on initial conservative treatment.


Mesocaval shunts for the control of bleeding esophageal varices. Results in 44 patients with esophageal bleeding who underwent a mesocaval shunt utilizing a prosthetic graft are presented. Portal hypertension was secondary to alcoholic cirrhosis in 30 patients, to chronic active hepatitis in eight, to primary biliary cirrhosis in four, to cirrhosis secondary to inflammatory bowel disease in one, and to portal vein thrombosis following splenectomy in one. Thirty-six shunts were performed during the emergent or semiemergent time period, and only eight were performed electively. Sixteen of the patients were Child's class A, 16 were class B, and 12 were class C. There were no hospital deaths in the emergency shunt group (of eight patients); there was a 12% mortality rate for patients undergoing semiemergency shunts (two of 17 patients) and a 42% mortality rate for patients who had emergency shunts (eight of 19 patients). Death was related more closely to hepatic reserve, however, than to timing of the shunt. Among the 32 class A and B patients, there were only three deaths in hospital (9%), as compared with seven deaths among the 12 class C patients (58%). Portal-systemic encephalopathy was high in the period immediately after operation (13 of 34 patients, 38%), but it was a chronic problem following discharge from the hospital in only three of 34 patients (9%). The mesocaval shunt is a safe, effective procedure for the control of variceal bleeding in class A and class B patients in any time period, but it carries a high operative mortality risk in the class C patient when it is performed as an emergency operation.


Satellite and invasive cells in frog sartorius muscle. The occurrence and distribution of two cell types associated with normal and denervated frog skeletal muscle fibers are described. The first is the satellite cell. The general appearance and the number of satellite cells are not affected by long-term denervation. The second type of cell is the invasive cell. Invasive cells penetrate across the basal lamina and up to the core of the muscle fiber, without fusing with it. It is suggested that the origin of invasive cells is extramuscular, probably circulatory. Although invasive cells are more numerous in some denervated muscle, it is established that this is not a direct effect of denervation.


Effects of electrical intravaginal stimulation on bladder volume: an experimental and clinical study. Clinical observations have indicated that not only stress incontinence due to defective urethral closure but also urge incontinence due to bladder hyperactivity can be successfully treated by electrical stimulation of the pelvic floor. Clinical investigations revealed that intravaginal electrical stimulation caused bladder inhibition registered as a volume increase. This inhibition was most marked at a low stimulation frequency (10 Hz). Animal experiments indicated that the bladder inhibition was achieved by autonomic spinal reflex mechanisms activated by stimulation of pudendal afferents.


[Effect of aflatoxin on the serum profile and antibody formation in chickens]. Experiments were carried out to follow up the effect of aflatoxin on the production of hemagglutinating antibodies in birds vaccinated against Newcastle disease and the changes in the serum profile. Birds that had been given a feed mixture with 560 and 640 mcg per kg for 20 days showed a lower titer of hemagglutinating antibodies and a drop of the alpha1, alpha2, beta1, gamma2-globulin fractions as well as a rise of the albumin and gamma1-globulin fractions. The liver and kidneys of the treated birds showed dystrophic changes.


[Changes in the amount of sialic acids during B-lymphocyte blast transformation]. Albino mice were immunized with a suspension of sheep erythrocytes. On the fifth day the animals were killed and B-lymphocytes were isolated from the spleen tissue. Aminoff's method was employed to determine the amount of sialic acids. Normal lymphocytes, obtained from unimmunized animals, were used as controls. It was found that stimulation raised the level of sialic acids by about 26 per cent as against their amount in normal limphocytes. The biologic character of the phenomenon observed is briefly discused, stating that it corroborates the concept that the binding of immunogenic agents with the cell occurs in a "stimulated" status.


[Control of the immunological reactivity in cervical cancer in the process of radiation therapy]. The author reports the results of studying 311 reactions of lymphocyte blasttransformation, 74 reactions of spontaneous rosette-formation and 186 reactions of plaque-formation in 184 patients with different stages of cervical cancer. It was found that in the tumor progression cell immunity indices are lowered and the degree of the lowering is dependent on the form of tumor growth. Radiotherapy results in the enhancement of autoantibody-formation processes and suppresses the response of lymphocytes to PHA found to be mostly pronounced in patients with advanced cancer. The blasttransformation reaction correlates well with the number of peripheral blood lymphocytes, and during radiotherapy the former slows down before the routinely revealed lymphopenia, that allows using this reaction to prognosticate lymphopenia. The most large amounts of plaque-forming blood cells were detected in patients with radiation injuries of the adjacent to the uterus organs of the small pelvis. Use of lymphocyte blasttrasformation reaction and quantitation of plaque-forming blood cells may provide the grounds for the individual application of radiotherapy for cervical cancer to increase its effectiveness.


[The influence of TNS (transcutaneous nerve stimulation) on placental flow (author's transl)]. A report about 12. gravid patients with a diminished uteroplacental flow is given. To increase their placental perfusion a transcutaneus lumbo-sacral electric nerve stimulation was performed. In all 12 cases a distinet increase war measured by the method of radioisotope placenta-perfusion. The mean values showed a high significant difference (p less than 0,001). The reasons for this results and the possibilities of this findings for the therapy of funcitonal placental insufficiency are discussed.


[Chronic, nonpathogen-related orchitis]. Chronic non-infectious orchitis was found in 8.1% of fertility-patients, who underwent testicular biopsy because of severe disturbances in spermatogenesis. The histopathological findings were characterized by a membraneous and interstitial orchitis. In these cases, the cause of the disease was unknown; but immunological abnormalities were found suggesting an imbalance of cell-mediated immune responses: all cases of chronic non-infectious orchitis showed a significant T-cell-deficiency.


The comparison of different rosette assay systems for the determination of T-lymphocytes in patients with solid malignant tumors. The number of T-lymphocytes in the peripheral blood of 51 patients with different type of solid malignancies, 33 normal controls and 10 patients with rheumatoid arthritis was determined using different variations of the sheep red blood cell (SRBC) rosetting-technique (test temperature of 4 or 29 degrees C, medium substituted with or without fetal calf serum [FCS], SRBC treated or untreated with neuraminidase). No significant differences between cancer patients and normal controls were observed in the percentages of T-lymphocytes with the 4 degrees C incubation under any of the conditions tested. In absolute counts, however, a significantly decreased number of T-cells was observed in cancer patients, most likely due to the observed significant lymphopenia in this group. When the test temperature was raised to 29 degrees C, a significantly lower rosette formation was obtained in both percentages and absolute counts of peripheral T-cells in the group of cancer patients as compared to normal individuals only when both neuraminidase treated SRBC and FCS substituted medium were used. The question of whether the observed differences in the percentages and absolute counts of peripheral T-lymphocytes between cancer patients and normal controls using this rosette assay are due to a loss of a T-cell subpopulation or to an alteration in the metabolic state of T-cells in cancer patients remains open.


Bronchial carcinoma and its regional lymph nodes in relation to immunological functions. Two hundred and fifty lymph nodes from 100 patients with lung carcinoma and the same number of regional nodes from 119 patients with gastric ulcer were histologically evaluated by the standardized reporting system of COTTIER et al. Special attention was focused on the immunological reactions in these lymph nodes. Histologic features suggesting actively functioning humoral and cell-mediated immune reactions were encountered more frequently in the nodes of the control series. The significance of the histologic findings is discussed and it is concluded that there is some degree of derangement of both humoral and cell-mediated immune responses in the lymph nodes draining lung carcinoma. The applicability of the reporting system used is emphasized.


Antibodies against purified pigeon IgA in pigeon breeders' disease. It is demonstrated that previously described PDF1-A antigens from pigeon dropping extract contain pigeon IgA. The sera of patients with pigeon breeders' disease contain precipitating antibodies against pigeon IgA, in contrast to the sera of pigeon breeders suffering from unrelated forms of pulmonary dysfunction. The degree of complement consumption by PDF1A antigens, pigeon serum, and pigeon IgA turned out to be correlated. No correlation was found between precipitating anti-pigeon IgA antibodies and complement consumption by pigeon IgA in patients' sera.


[Physiology and pathology of the epiphyseal cartilage (author's transl)]. Knowledge of the physiology of the epiphyseal cartilage, respectively epiphyseal plate, is essential for an understanding of defective growth and abnormal modeling of the long bones. The epiphyseal cartilage develops from the embryonal, cartilaginous long bone structure. The histology of the epiphyseal cartilage is characterised by definable zones representing the individual differentiation steps from the reformation of cartilage to chondrolysis. Modeling of the ends of the long bones is also influenced by a transversal and longitudinal direction of growth in the epiphyseal cartilage. The intercellular substance mainly contains collagin, proteoglycanes and non-collagenic proteins. These macromolecules are compounded by means of physicochemical bonds and are responsible for the special mechanical qualities of the hyaline cartilage. The process of mineralisation at the base of the epiphyseal cartilage is an essential differentiating step for the ossification processes which take place in the metaphysis. Two pathogenetic principles at the epiphyseal cartilage appear to be important for the defective growth of the long bones. On the one hand, the flowing equilibrium between the differentiation steps of cartilage reformation, transformation of the hyaline cartilage into a mineralised cartilaginous tissue and chondrolysis is changed, whereas on the other hand the turnover of these differentiation steps is retarded or accelerated.


[Activity of a number of enzymes in the splenic T- and B-lymphocytes of CBA strain mice]. The activity of some enzymes in T- and B-lymphocytes from the spleen of CBA mice was investigated. T-cell suspension was obtained by using a modified Kedar et al. method based on immunosorption. EAC-rosette forming cells were studied in the capacity of B-cells. The activity of all the enzymes examined proved to be higher in T-lymphocytes than in B lymphocytes; the greatest difference was noted in the activity of NADP.H2-diaphorase, and the least--in the activity of NAD.H2-diaphorase.


[Detection of penicillinase and bacteriocinogenicity plasmids in Staphylococcus aureus strain No. 580]. Staphylococcus aureus No. 580 strain contains simultaneously two plasmids: bacteriocinogenicity plasmid and penicillinase plasmid. Both plasmids are lost spontaneously with a high frequency, and also under the effect of acridine orange at temperatures of 37 degrees C and 44 degrees C, and in cultivation at a temperature of 44 degrees C for 5 days. Loss of one of the plasmids failed to lead to stabilization of another plasmid, and it was eliminated spontaneously with the same frequency as in the population of the initial strain. Plasmid loss did not lead to the changes in biochemical and pathogenic properties and also of the phagovar and bacteriogenovar. At the same time in elimination of one or both plasmids lag-phase diminished from 220 to 120 min.


[Characteristics of individual lymphocyte populations in the blood of virtually healthy persons]. The number of individual lymphocyte populations in the blood of apparently healthy persons was determined by spontaneous rosette-formation with SRBC (T cells) and mouse red blood cells (B cells). In the majority of persons examined the percentage of T-lymphocytes constituted 47.3 +/- 1,6, of B--16.8 +/- 1, and of "zero" cells--33.5 +/- 3.4.  There was less T- and B-lymphocytes in the blood of elderly persons (over 50 years of age) than in the young ones. It was also shown that the T-lymphocyte population forming "active" rosettes could be assessed by the number of SRBC sorbed on their surface.


Demonstration of nuclear antigen binding lymphocytes by the resette method in SLE-patients. A rosette method suitable for the demonstration of deoxyribonucleic acid and deoxyribonucleoprotein-binding peripheral lymphocytes is described. The results confirmed the existance of a human peripheral lymphocyte subpopulation capable of binding nuclear antigen specifically. The subpopulation was demonstrated in 63 out of 75 SLE-patients; 57 out of 59 SLE-patients being in the active period of the disease revealed nuclear antigenbinding lymphocytes, as against 6 our of 16 patients being in remission.


Cholinesterase activity in rat liver and serum during experimentally induced inflammation. Cholinesterase activity of albino rats with acute local oedematous inflammation induced by turpentine, croton oil or Freund's adjuvant was elevated in the liver homogenate but decreased in the serum. Aprotinin administration prevented the decrease of serum activity. In the oedema fluid of rats treated with croton oil an enzyme with cholinester splitting activity was detected and it was shown to be identical with serum cholinesterase (EC 3. 1. 1. 8.).


Trans-reservoiral ventriculography (TRV). We report here the usefulness of ventriculography by means of percutaneous injection of a recently developed water-soluble contrast medium of great safety through a shunt flushing reservoir; the method is called trans-reservoiral ventriculography (TRV), and is presented here in twelve clinical cases. The TRV is especially useful in observing the course of brain tumour after either surgical or non-surgical treatment.


Increase of IgA-bearing lymphocytes in peripheral blood from patients with IgA nephropathy. Aberration of IgA-bearing B lymphocytes in patients with IgA nephropathy has been investigated. Twelve patients with IgA nephropathy demonstrated a marked increase of IgA-bearing lymphocytes in peripheral blood, while ten patients with chronic proliferative glomerulonephritis without mesangial deposition of IgA showed normal amounts of IgA-bearing lymphocytes. The increase of IgA-bearing lymphocytes reflected that of IgA-producing lymphocytes, since lymphocytes obtained from patients with IgA nephropathy restored a high percentage of IgA-bearing cells in vitro after treatment with trypsin. Quantitation of IgA-bearing lymphocytes in peripheral blood is a useful method for screening of patients with IgA nephropathy.


Aplastic anemia associated with bone marrow suppressor T-cell hyperactivity: successful treatment with antithymocyte globulin. In five patients with idiopathic aplastic anemia, the colony-forming unit (CFU-c) assay was used to quantitate stem cells and test the possible presence of suppressor cells inhibiting bone marrow differentiation. All five marrows failed to form CFU-c. In one out of the five cases tested, coculture of the patient's marrow with normal marrow suppressed the latter to form CFU-c. Removal of T-cells from the patient's bone marrow freed the aplastic marrow to produce more colonies and, in the coculture study, abrogated its inhibitory activity on the normal bone marrow. Treatment of the patient with horse antihuman thymocyte globulin (ATG), improved the peripheral blood count and myelopoiesis. Furthermore, the aplastic marrow increased its colony forming capacity from less than 1% pre-ATG to 46% post-ATG of the normal control, and its inhibitory activity on the normal marrow was ablated. In selected cases of aplastic anemia, with evidence of T-suppressor cell hyperactivity, treatment with ATG may offer an alternative approach to bone-marrow transplantation.


A new allele of human alpha1-antitrypsin: PiNhampton. A new allele of alpha1AT is described. By isoelectric focusing, the microheterogeneous pattern of the variant was similar to but more cathodal than that of Pi N. This allele has therefore been tentatively designated PiNhampton(Nham). Further examination revealed that the minor bands of Nham are indistinguishable from the major bands of Z by isoelectric focusing, and a careful family study was necessary to clearly define the proband's phenotype. Pi Nham was found in association with M1, S, and Z, but to date its possession is not apparently related to clinical disorders or reduced serum levels of alpha1AT.


Increased factor VIII/von Willebrand factor antigen and von Willebrand factor activity in renal failure. Factor VIII/von Willebrand factor antigen and von Willebrand factor activity (ristocetin assay) were studied in 12 patients in renal failure. A dramatic increase in both activities was observed (antigen 315 +/- 30 per cent in patients verus 104 +/- 9 per cent in control subjects; activity 402 +/- 48 per cent in patients versus 111 +/- 5 per cent in control subjects; p less than 0.001 for both). Since von Willebrand factor is thought to play at least a facilitative role in the development of arteriosclerosis, these increased activities may contribute to the premature arteriosclerosis reported in patients with chronic renal failure undergoing dialysis.


Analysis of complement receptors on B-lymphocytes in human milk. Experiments were performed on human B-lymphocytes in paired samples of milk and blood from the same patient to determine the numbers and percentages of lymphocytes with complement receptors, utilizing the erythrocyte-antibody-complement (EAC) rosette assay. Studies on nine paired samples show the numbers, as well as the percentages, of complement-reactive cells (CRCs) in milk are significantly lower than in blood. Milk lymphocytes were cultured in media containing serum for a 24 hour period to determine if the observed lower numbers of CRCs in milk were due to saturation of the lymphocyte receptors with free complement, as well as to determine if the culture of the cells in nutrient media might result in the reformation of shed complement receptors. Similarly, peripheral blood lymphocytes were incubated in milk supernatant to determine if free complement or other factors in milk might interfere with the EAC assay. These studies support previous findings from this laboratory that B-lymphocytes in milk represent a subpopulation of cells different from those in peripheral blood. The paucity of B-lymphocytes bearing complement receptors in milk may be due to the following: (1) B-lymphocytes in milk may be plasmablasts and/or antibody-producing plasma cells--both known to lack complement receptors; (2) selective processes operating at the mammary alveolar epithelium allowing transit of certain subclasses of maternal immunoglobulins may also allow transepithelial passage of B-lymphocytes with surface immunoglobulins, but no complement receptors. These possibilities are currently being studied.


Lymphotoxin-induced loss of plasma-membrane protein. Lymphotoxin-sensitive L cells were prelabeled with isotopically marked leucine and exposed either to human alpha-lymphotoxin (alpha-LT) or control buffer. Plasma membranes were then isolated from these cells, and TCA-precipitable leucine was determined as a measure of membrane protein. Human alpha-LT caused a marked reduction of plasmalemmal protein in LT-sensitive target cells. This loss of protein was general, not restricted to specific fractions, as assessed by sodium dodecyl sulfate (SDS)--polyacrylamide gel electrophoresis. Since purified alpha-LT had no detectable proteolytic activity, the effect of the lymphokine is not readily explained by direct enzymatic action on plasma-membrane protein. In contrast, there was no plasma--membrane protein loss in LT-resistant target cells on exposure to alpha-lymphotoxin.


Characterization of non-Hodgkin's lymphomas using multiple cell markers. Immunologic, morphologic, and cytochemical studies of 72 cases. Tissues from 72 cases (87 specimens) of various non-Hodgkin's lymphomas were analyzed for cell markers using multiple techniques. Cell suspensions were evaluated for E, EAC, and IgGEA rosette forming cells; Fc receptor cells; and surface immunoglobulin bearing cells. Cryostat section studies topographically defined EAC binding cells. Cytochemical determinations and immunoperoxidase methods for detection of intracellular immunoglobulin and lysozyme complemented other techniques in evaluating infiltrates containing large neoplastic cells. B-cell malignancies comprised 58 cases (80%) of this series and included well and moderately well differentiated lymphocytic lymphomas (10/10); nodular (23/23) and diffuse (10/18) poorly differentiated lymphocytic lymphomas; and lymphomas of mixed lymphocytic-"histiocytic" (3/3), "undifferentiated" (3/3), and "histiocytic" (9/13) types. Nodular lymphomas were characterized as B-cell neoplasms but also revealed a prominent population of T lymphocytes (39 +/- 12%). Alkaline phosphatase activity, a cytochemical marker for lymphoid cells of follicular cuffs, was most consistently observed in B-cell lymphomas of moderately well differentiated lymphocytic type (4/6 cases). In some diffuse lymphomas, cryostat section studies (EAC rosettes) suggested a pre-existing nodular proliferation. One unusual B-cell lymphoma of large cell type exhibited IgGEA rosette formation and a strong receptor for the Fc portion of IgG. Ten lymphomas (14%) were of T-cell type and were represented by cases of diffuse poorly differentiated lymphocytic lymphoma (5/18, including 3 lymphoblastic lymphomas), Sézary syndrome (1), mycosis fungoides (1), and a cytologically distinctive large cell ("histiocytic") lymphoma (3/13). Acid phosphatase activity was a consistent marker for the T-cell malignancies, some of which also revealed alpha-naphthyl butyrate esterase activity. No true histiocytic lymphomas were detected. Three cases of diffuse poorly differentiated lymphocytic lymphoma and one "histiocytic" lymphoma were null.


Computerized Transaxial Tomographic and Neuropsychological Evaluations in Chronic Alcoholics and Heroin Abusers. Computerized transaxial tomographic (CTT) scans and the Halstead-Reitan Neuropsychological Battery were administered to 42 paid male volunteers (15 chronic alcoholics, 15 heroin abusers, and 12 matched control subjects). CTT scans revealed that only 1 of the chronic alcoholics had a ventricle/brain (V/B) index larger than normal. One unexpected finding was that the heroin abusers had significantly smaller sulci and V/B indices. Neuropsychological assessments of the alcoholics and heroin abusers revealed functional impairment in a majority of cases; the alcoholics were twice as likely as opiate abusers to show impairment.


[Studies on fibrous and fibro-glial surface wrinkling retinopathy by scanning electron microscopy (author's transl)]. The scanning electron microscope was used to examine 16 cases of epiretinal membrane formation and retinal puckers which occurred in a variety of primary retinal disorders. In this first section the authors describe three types of epiretinal membranes: (1) Fibrous acellular membranes with and without vitreous adhesions. Retinal puckering was caused by vitreous traction with collagen strands binding the residual folds. (2) Fibrous membranes containing isolated glial cells. (3) Fibrous membranes partly covered by sheets of glial cells. In all three forms the acellular fibrous component is believed to represent vitreous cortex remnants. The invariable presence of these fibrous membranes at sites of retinal pucker and their relationship to wrinkled internal limiting membrane suggests that contraction of these membranes is responsible for retinal puckering. Morphological evidence of glial membrane contraction and collagen production by glial cells was not found.


[The electroretinogram and the visual evoked potential in normal and glaucomatous eyes (author's transl)]. The functional changes of the intraocular nerve structures caused by glaucoma were examined electro-ophthalmologically. The OPs, the photopic and scotopic ERG to examine the receptor and bipolar layers, as well as the EPs, elicited by luminance and pattern-reversal stimuli, for evaluation of the signal conduction in the optic nerve, were recorded. The problem was approached by way of three investigations: first was the question of which nerve structures are affected by glaucoma and exactly how the loss of visual field due to glaucoma can be determined. For this reason, 55 glaucomatous eyes with regulated intraocular pressure and different visual field losses were examined. The results show a functional diminution of all intraocular nerve structures in which the prelaminary part of the optic nerve is most affected. Differences in the visual field loss of both eyes can be well determined by the EPs. Second, the electro-ophthalmologic behavior in seven normal and eight pressure-regulated glaucomatous eyes was studied by gradually elevated intraocular pressure in order to obtain better insight into the functional pathology of glaucoma. The elevation of intraocular pressure was performed with a Müller spring dynamometer in five steps, depending on the ophthalmic blood pressure. The pressure behavior of the ERG components and the EPs is different. The amplitudes of the ERG components show a gradual decrease in normal as well as in glaucomatous eyes when intraocular pressure is increased, and are maintained when intraocular pressure reaches ophthalmic blood pressure. On the other hand, the EPs show a strong decrease in amplitude when intraocular pressure exceeds the mean ophthalmic blood pressure, particularly in the case of glaucomatous eyes. This behavior can be explained by a high pressure sensitivity of the preliminary part of the optic nerve, even greater in glaucomatous eyes. Third, the influence of pressure decrease on the electrical response was examined in glaucomatous eyes with chronic and acute pressure increase before and after pressure regulation. A mean pressure decrease of 37-13.6 mm Hg in ten eyes with chronic pressure increase led to no change in electrical responses other than a phase shift on the pattern-reversal EPs. In five cases with acute pressure increase, an amplitude increase on the luminance EPs was noticed after pressure regulation, with unchanged systemic blood pressure and almost unchanged ERG components. However, in one case an amplitude decrease on luminance EPs and ERG components was found with simultaneous blood pressure decrease. The increase of the amplitudes of the luminance EPs and the phase shifts of the pattern-reversal EPs can be explained as the functional improvement of the prelaminary part of the optic nerve caused by pressure decrease due to improved blood circulation in the prelaminary part of the optic nerve...


Destructive ophthalmic procedures, a comparison between a developed and a developing country. The causes for enucleation, evisceration, and exenteration were compared between Malawi and Israel. Differences in etiology, age, and sex were found due to the medical facilities, standard of living, and cultural background of each country.


Ultrasonic findings in the vitreous body at various ages. A total of 444 healthy eyes in 290 subjects of varying age were examined ultrasonically with a frequency of 6 MHz. In subjects under 20 years the structure of the vitreous body was acoustically homogeneous, and in those between 21 and 40 there was slight degeneration in 5% of the eyes. In the age group 41-50 the incidence of degeneration was 19%, in the group 51-60 63% and in that over 60 more than 80%. There was a clear increase in acoustically observable degeneration after the 40th year; nevertheless, in about 10% of those over 60 years an acoustically homogeneous vitreous body was observed. Ultrasonic observation can be used to supplement optical observations, and in the case of elderly patients is often the only way of obtaining information on the structure of the vitreous body.


Immunoglobulin E in human aqueous humor and corresponding serum. A physiopathological and clinical study. The analysis of IgE in aqueous humor yielded an average concentration of 3.4 +/- 0.97 U/ml for 22 cataract patients and 5.5 +/- 3.42 U/ml for five uveitis patients. The IgE level in aqueous humor (IgEa.h.) of the cases examined is most probably, beside hematoocular diffusion of serum IgEs, the result of intra-ocular IgE production. In comparison with (mostly normal) IgEs levels, the IgEa.h. concentration appears relatively elevated, not only with uveitis patients, but also with cataract patients, above all when lenticular opacity is accompanied by other ophthalmic diseases (glaucoma, high myopia, diabetes). This "increase" of IgEa.h. concentration in very probably due to the radioimmunosorbent (RIST) technique employed, the most sensitive method available at the time of the present study. Thus, the calculated IgEa.h. value in the cataractous eyes should be regarded simply as approximate to the normal IgEa.h. concentration. These values are of clinical significance however, since a reference IgEa.h. mean-value is indispensable to the interpretation of pathologically high IgEa.h. levels and ethics do not permit of IgEa.h. determination in healthy eyes. The mean IgEa.h. levels of the delayed-type uveitis and cataract patients examined reveal no significant differences. IgEa.h. determination could make a contribution to the etiological clarification of, for example, immediate-type uveitis cases and intra-ocular parasitosis and serve as an appropriate model to study intra-ocular immunomechanisms.


HLA antigens-risk factors for primary open-angle glaucoma? The comparison of the HLA A, B, and C phenotypes of 70 patients with primary open-angle glaucoma (POAG) with the phenotypes of 450 healthy control individuals and the rather discordant data published by other investigators show that there is no genetical influence of HLA A, HLA B, or HLA C genes on POAG and on the clinical complications associated with this disease.


Pattern reversal visually evoked potentials in general anesthesia. Various authors have tried to determine visual acuity both electrophysiologically (Sokol, 1976 and 1978; Marg et al., 1976; Maffei and Fiorentini, 1977) and with psychophysical methods (Teller et al., 1974; Banks and Salapatek, 1976; Atkinson et al., 1976) in awake children. Our experiments try to verify the possibility of assessing visual acuity in children under Ethrane anesthesia. We conclude that under Ethrane anesthesia VEPs produced by phase-alternating square-wave gratings do not allow a fine assessment of visual acuity. Gross indications of visual acuity can however be obtained.


Histopathology and histochemistry of the superficial corneal epithelium in experimental herpes simplex keratitis. Three days after herpes simplex virus inoculation, an increased amount of DNA and RNA was observed in the superficial epithelium cells of rabbit cornea. Histochemical staining demonstrated the development of acid mucopolysaccharides and the destruction of reticulin. In the early stages, on rare occasions, giant polykaryocytes with multiple micronuclei were seen. From 1 week after infection, more and more cells became rounded and shrunken. Cytoplasm of these cells might contain DNA diffusely interspersed with RNA. This DNA is probably viral in nature. The nuclei of these cells varied in shape, size, and staining intensity. Nuclear fragments were often observed in the cytoplasm. Stainings for acid mucopolysaccharides were strongly positive in the rounded cells. These cells fused to form syncytia Variable-sized pseudopodialike processes containing DNA and RNA extend from some of the rounded and liquefied cells toward other cells. In the later stages, development of ghost cells was seen. Histochemical methods demonstrated the deposition of acid mucopolysaccharides on their cell membranes. Necrosis was more often present in the late stages. Nuclear debris and deformed cells were encountered in such areas. On the healing of the keratitis, 3 months after inoculation, the cell cytology and staining reactions reverted to normal.


[In vivo-measurements of the latitude of Schlemm's canal in buphthalmos (author's transl]. In 9 cases of buphthalmos 'in vivo-measurements of the latitude of Schlemm's canal gave us a mean value of 678 micron. The extreme values ranged between 600 micron and 800 micron. Therefore these values differ significantly from those measured 'in vivo' in chronic simple glaucoma (x:542 micron, extreme values 425 micron and 625 micron). The latitude of Schlemm's canal correlates with the diameter of cornea and the rise of intra-oculare pressure. In cases of buphtha-mos the success of trabeculotomy seems to be better, if the latitude of Schlemm's canal is less than l50 micron. Trabeculotomy should therefore be performed as soon as possible.


Ultrasonic vitrectomy - an alternative technique to presently used mechanical procedures. Experimental results. The liquification of the corpus vitreum by ultrasound is a promising new alternative to presently used mechanical methods of vitrectomy. With regard to the duration time of insonation, as well as to the ultrasonic intensity, there exist thresholds, the exceeding of which causes a discontinuous breakdown of the vitreous frame in a spherical zone around the transducer tip which can be verified by ultrasonic pulse echo methods. Viscosity measurements showed that the vitreous isonified in this area has almost the same viscosity as water whereas its optical transparency remains unchanged. The dependence of the diameter of the liquified zone on insonation time was measured.


Clinical and statistical aspects on standardization of tonometers. Using the applanation tonometry of Goldmann (mechanical-optical applanation principle with constant diameter of the applanation circle) as a reference system, a test plan inclusive of the necessary conditions for the clinical control measurements of new tonometer types and guiding values for judging the usefulness of these new developments are described. For calculation of the statistical values a computer program in BASIC system is specified.


In vitro IgE biosynthesis in asthmatic children. Forty-seven asthmatic children and eight non-allergic adults were studied by the co-culture technique of Wadman et al to test the postulated deficiency of IgE suppressor T-cell function in allergic patients. The results showed that (1) lymphocytes from asthmatic children synthesize more IgE than those from normal adults, (2) there was no correlation between serum IgE and in vitro IgE biosynthesis, (3) co-culture of lymphocytes from normal adults and patients often resulted in deviation, both enhancing and inhibiting, from expected values; therefore, no consistent suppressor T-cell defect could be demonstrated in patients; and (4) after hyposensitization, while there was a tendency for the serum IgE to decline, the capability of IgE biosynthesis tended to increase.


Colitis cystica profunda: an unusual surgical problem. Colitis cystica profunda is a rare, benign, non-neoplastic condition which usually presents as a mass in the rectum associated with bloody, mucoid diarrhea. This clinical presentation associated with the microscopic finding of mucus cysts in the submucosa has led to the mistaken diagnosis of adenocarcinoma of the rectum and unnecessarily radical operative procedures. Attention to the completely normal cellular architecture provides the key to the correct diagnosis. Local excision is curative, and there is no propensity to develop malignancy in these patients. Experience with one case is reported, and the medical literature on the subject is reviewed.


Novel beta-lactamase from Branhamella catarrhalis. A strain of Branhamella catarrhalis isolated from sputum was shown to be resistant to penicillin and ampicillin. This strain produced a beta-lactamase which has been judged to be a novel enzyme, on the basis of substrat profil, isoelectric point and location of genetic determinant.


[Study on the nature of tonic ocular movement produced during pendular vestibular stimulation (author's transl)]. During vestibular function tests using the pendulum chair, electronystagmography has repeatedly shown that a tonic ocular deviation precedes the change in nystagmus. This tonic movement may be anticipated in respect to the change in the sinusoidal movement of the chair. Greiner, Conraux, Collard and more recently J.B. Causse, have proposed a hypothesis based on the own periodicity of the vestibular system. J. Max explained this phenomenon in terms of a difference in phase with the electronic system. Our investigation suggests another explanation of this phenomenon. Each half-period consists of a acceleration phase and a decelaration phase. Thus within half-period alone there are two successive forms of nystagmus induced. The succession of half-periods gives the usual systagmus response. We consider that the tonic response of the eyes is not an anticipated one in respect to the change in sinusoidal movement of the chair, but rather a delayed one in respect to the reversal in the direction of acceleration.


Optokinetic suppression of aberrant vestibular reactions: an observation. It has long been known that optokinetic nystagmus may be modified by vestibular inputs. We have suppressed an aberrant vestibular response and associated gastrointestinal sensations by use of an optokinetic stimulus simultaneous to the positional stimulus in a patient with paroxysmal positional vertigo. This single subject study utilized several optokinetic conditions, and patterned its stimulus presentations to control for visual fixation and vestibular habituation. Objective recordings of eye movements (ENG) were made simultaneously with subjective evaluation of "dizziness" on a simple magnitude estimation scale.


Computerized tomography in the diagnostic evaluation of multiple sclerosis. Sixty-six patients with a tentative or certain diagnosis of multiple sclerosis (MS) were examined with cranial computerized tomography (CT). Abnormalities found in 19 (29%) included discrete areas of decreased white matter density, enlarged ventricles, cortical atrophy, and focal areas of contrast enhancement. The presence of white matter lucencies and ventricular dilatation correlated with an increased incidence of diffuse hyperreflexia and mental impairment. Since half the patients with contrast-enhancing lesions were clinically stable, their lesions may represent acute asymptomatic plaques. Abnormalities on CT scan were observed more often in older patients whose disease had lasted longer and was clinically more definite. Since findings were sparse in early, less definite disease, the use of CT as a purely diagnostic tool is limited.


Gentamicin vestibulotoxicity. Long term disability. Vestibular toxicity is known to occur from gentamicin. Over a five-year period seven patients with severe and prolonged ataxia from gentamicin vestibular toxicity were seen. Two of these patients were not in renal failure. Case reports of five of these are presented. The possible explanations for prolonged disability are discussed.


Production of beta-lactamase by non-streptomyces Actinomycetales. Supernatants and whole cells from fermentation broths of Micromonospora, Nocardia, Oerskovia, and other genera of the Actinomycetales were examined for the presence of beta-lactamase activity by using the chromogenic cephalosporin 87/312. Nearly 60% of the 250 isolates examined produced detectable levels of beta-lactamase. All enzyme preparations were active over a range of pH values from 6.5 to 8.2, with maximum activity occurring between 7.0 and 7.8. The preparations varied in their stability at 60 degrees C. An examination of selected enzyme preparations revealed a similarity between substrate specificities of the non-Streptomyces Actinomycetales and gram-negative-bacterial beta-lactamases.


[Heterophile haemagglutinogens on pig, canine and human thymocytes (author's transl)]. Immunization of sheep or horse with pig, canin or horse thymocytes produces heteroagglutinating antibodies, which allow to define two heterophile antigens:--the first one, HC, immunogen for sheep, is localized on pig, human and canin thymocytes, as well as on red blood cells of the two latter species;--the other, HCP, immunogen for horses, is situated on the red blood cells and thymocytes of the same three species. HC is distributed on various cells and in similar fashion in pig and human, except for the pig red blood cells.


Lack of correlation between beta-lactamase production and susceptibility to cefamandole or cefoxitin among spontaneous mutants of Enterobacteriaceae. A large number of cultures of gram-negative bacteria were examined for their susceptibility to various concentrations of cefamandole, cefoxitin, carbenicillin, and nalidixic acid. Heterogeneity of susceptibility was demonstrated in individual cultures to all of these antibiotics. Resistant clones isolated from cefamandole or cefoxitin plates were examined for beta-lactamase production. Approximately 13% of 262 resistant clones acquired the ability to produce a beta-lactamase. Examination of the substrate profile of the beta-lactamases from some of these clones revealed no change in the specific activity of these enzymes for cefamandole, cephaloridine, or compound 87/312 as compared with their parental enzymes. This study clearly shows that some resistant clones do not produce beta-lactamases, whereas some susceptible strains produced significant amounts of these enzymes. We conclude from these findings that little correlation exists between beta-lactamase production and decreased susceptibility to cefamandole or cefoxitin. The results suggest the possibility that characteristics other than beta-lactamase production may be responsible for resistance in Enterobacteriaceae.