[Interrelationship between staphylococcal sensitization, the protective function of leukocytes and septic complications in the burned]. The state of staphylococcus sensitization and the index of completeness of staphylococcus phagocytosis was studied in 42 persons with severe burns. Development of staphylococcus complications was connected with marked specific microbial sensitization and disturbance of intracellular digestion of staphylococci by the patients' blood leukocytes. Detection of unfavourable interraltions of the antistaphylococcus immunity and allergy in the course of the disease can be of diagnostic and prognostic significance.


[Immunologic properties of soluble shigella antigens]. Of the live Sh. Flexner 2a and Sonne soluble antigens containing glucide-lipoid-protein complex, characterized by low toxicity, a high yield of dry substances, and the capacity to induce immunity production in mice after subcutaneous and oral immunization, were obtained by salt extraction and physical disintegration. Local antigen application into eye mucosa of guinea pigs produced local resistance against homologous causative agents and also stimulated production of the highest level of specific antibodies at the site of administration in oral and conjunctival vaccination. A marked antigenic-immunological activity of soluble shigella antigens in local administration permits to refer them to the group of protective ones and to recommend their further study in the capacity of preparations for enteral vaccination against dysentery.


[Methods of using the antibody neutralization test in intestinal coli-infections]. Specificity and sensitivity of the antibody neutralization test intended for detection of the O-antigen of enteropathogenic escherichia were checked under experimental conditions. Only 3 strains of the Klebsiella genus proved to neutralize the antibodies to the enteropathogenic escherichia of the serological group O20:K84. In the rest of the cases a positive result was obtained only in homologous combinations. In comparative study of the microbial cultures of the infected feces on hard nutrient media by means of bacteriological and serological methods the latter was found to be more sensitive, capable of detecting the homologous O-antigen with the bacterial concentration of not less than 5-10(5) microbial cells per 1 ml.


[Study of the role of conditionally pathogenic enterobacteria in acute intestinal diseases]. Conditionally pathogenic enterobacteria were isolated in 34.2% of the patients with acute intestinal diseases (1559 cases examined in all). Such representatives of enterobacteria as Klebsiella, Hafnia, Citrobacter of 4, 8, and 22 serological groups. Proteus mirabilis of 6, 10, 13, 26, and 28 serological groups, and Proteus morganii mostly played the etiological role. In some of the patients conditionally pathogenic microbes only aggravated the main disease, taking part in the development of dysbacteriosis. In healthy individuals these microbes were much more rare and were encountered inconstantly.


[Study of the immunological effectiveness of the enteral vaccination of volunteers with detergent Sonne dysentery monovaccine]. The authors evaluated the immunological results of enteral and subcutaneous injection of detergent Sonne dysentery vaccine to volunteers (changes in homo- and heterologous antibodies in the blood and saliva recorded by means of common indirect hemagglutination test and that modified according to Coombs' test, and IgG, IgM, and IgA concentration recording. Both immunization methods induced specific antibody formation: enteral vaccination caused chiefly the accumulation of secretory antibodies of IgA class, and subcutaneous -- of serum antibodies belonging to IgG class. The supposed mechanisms determining the capacity of enteral administration of the antigen to provoke an immune response different from that caused by its subcutaneous injection are discussed.


[Use of hybrid strains of S, typhi and S. typhimurium for characterizing the biological activity of individual Salmonella antigens by the alternative recording of the experimental results]. Intraperitoneal infection of mice, subcutaneously immunized with acetone vaccines of various antigenic composition, with the microbes of hybrid salmonellae strains of murine and typhoid fever caused development of infectious process approaching natural infection. A significant elevation of the intensity of immunity was provided by preparations containing serologically identical O-antigen in infection with O-strains, or Vi-antigen in infection with Vi-strains. For the formation of animal resistance to infection it was necessary to immunize the mice with vaccines containing homologous H- and O-antigens (in infection with O-strains) and H-, O- and Vi-antigens (in infection with Vi-strains). Immunization with killed vaccines with a full-value antigenic structure provided effective protection of mice from doses approaching LD50.


[Effect of lactic bacteria metabolic products on the transmission of R-plasmids in enterobacteria in vitro]. The authors present data on the study of lactobacteria used in the production of dry lactobacterin (lactobacterinum siccum). Metabolic products (lactocidin) were extracted with lactic and acetic acid after Vincent et al. Two donor strains (E. coli K12 J5-3 R1-19 and E. coli K12 W1845 R26) were crossed in the conjugation process in various conbinations with six recipient strains (E. coli K12S, E. coli Su 3912/41, Sh. sonnei 263B, Sh. sonnel 3470, S. heidelberg, A161, and S. typhimurium SH3 his-). The frequency of R-plasmide transmission in enterobacteria was decreased in vitro under the effect of L. plantarum 8R-A3 and L. fermentum 90T-S4 metabolites.


[Effect of the formation of spheroplasts and the subsequent reversions on the virulence and other biological traits of E. coli 0124:K72(B17)]. The authors present experimental data indicating that revertants with a manifest mucous capsule formed in the spheroplasts of E. coli O124 : K72 culture. The appearance of the latter depended on the presence of glucose, lactose, maltose, or glycerine in the medium. Mucous culture could be regarded as a prolonged modification induced with penicillin. Mucous substance aided preservation or partial restoration of the virulent properties by the given bacteria.


[Population of B-lymphocytes in the peripheral blood of schizophrenic patients]. With the aid of a direct immunofluorescent method the per cent of the B-lymphocytes in the peripheral blood of schizophrenic patients and normals was determined. It was demonstrated that in the preparation of blood cells the portion of cells, possessing superficial immunoglobulins (B-lymphocytes) significantly exceeds the portion of cells in normal donors. On the basis of achieved data it can be assumed that in the blood of schizophrenic patients there is a higher % of B-lymphocytes than in normals and most likely lesser of T-lymphocytes.


Urinary excretion of ten plasma proteins in patients with extrarenal epithelial carcinoma. Urinary and serum proteins were studied in 55 patients with extrarenal epithelial carcinoma, using an automated immunopreciptin reaction. The 24 h excretion and renal clearance of 6 high molecular weight proteins: albumin, transferrin, haptoglobin, IgG, IgA, and IgM were significantly increased compared with a control group, implying a glomerular injury. The 24 h excretion of 4 low molecular weight proteins: free lambda and kappa light chains of immunoglobulin, lysozyme, and beta2-microglobulin was significantly increased in patients with disseminated carcinoma compared with patients with localized carcinoma. The serum concentrations of albumin and transferrin were significantly decreased and the serum concentration of haptoglobin significantly increased in patients with disseminated carcinoma compared with patients with localized tumours.


[Surgical treatment of deep burns in children (author's transl)]. The clinical material is described and the principles of burn wound treatment are indicated: --excision and grafting of third degree burns: early whenever possible, delayed if the diagnosis or the limits are difficult to appreciate;--local treatment with Silver-Sulfadiazine of second degree burns, and those of undetermined depth. The difficulty of diagnosing the exact depth of the burn as well as the problem of the sequelae are stressed. The treatment of the complications is mentioned, particularly of the large hypertrophic scars. More than ever, prevention seems to be essential, but also possible.


[Grafts for surgery of the anus (author's transl)]. In surgery of the anus, grafts should be used as a complement to the extensive resections of lesions such as: skin tumors, radiotherapic lesions, resistant itching, chronic infection, pilonidal cysts, multiple fistulae. Such grafts are useful in many instances because they shorten the period of healing and insure a better skin cover. Grafts used in anal surgery are: the Davis-patch type, the free skin type and the pedicle-flap type. Each has its own indications. They are immediate or delayed. The author's experience indicates that indications for grafts are frequent, that their effects are always favorable and that the rate of failure is very low despite the risk of contamination from the proximity with the anus.


Bromocriptine treatment in acromegaly: clinical and biochemical effects. Eight selected patients with active acromegaly and elevated GH levels without other endocrine disturbances were submitted to long-term treatment and acute dose-response trials with bromocriptine. Seven patients showed clinical improvement and lowering of GH levels in response to long-term treatment, however, two of these showed only minor changes in GH levels during the acute dose-response trial. Glucose tolerance and heel pad thickness remained unchanged, while urinary hydroxyproline excretion and blood, plasma and erythrocyte volumes decreased. Using daily doses of 20 mg bromocriptine, side effects were generally minor. Severe vasovagal reactions were, however, observed in two patients, in one at the start of treatment, in the other after ingestion of 25 mg bromocriptine. Bromocriptine represents a valuable treatment alternative in acromegaly, but only long-term treatment will separate responders from nonresponders.


[Operative wounds of the main biliary tract: immediate repair (author's transl)]. The authors report a series of eleven surgical wounds, all immediately repaired. They consider the frequency of these biliary accidents to be 2% in cholecystectomies and 4% in gastrectomies. In such instances end-to-end suture seems the first choice procedure with the best longterm results. They stress the importance of prevention methods that will help to limit the risks of such operative accidents and not to overlook them, should they occur.


Microchemical assays of glutathione, zinc, cobalt and manganese in micro-dissected areas of the endocrine pancreas in the hagfish, Myxine glutinosa. In hagfish islet parenchyma, consisting practically only of insulin-producing B-cells and agranular B-cell precursors, the contents of glutathione (GSH) and total protein-free thiols (NPSH) were determined on micro-dissected islet lobules. GSH was found to be of the same order of magnitude (22-25 mg/100 g wet weight) as in the islet parenchyma of a previously studied teleost fish and of some mammals, including man. However, the NPSH was found to be considerably higher in the islet lobules of the hagfish than in the teleostean islet parachyma. As in both teleost fish and mammals, GSH made up most of the NPSH in the hagfish erythrocytes, myocardium, and skeletal musculature. This discrepancy between hagfish islet parenchyma and other tissues indicates that the non-GSH portion of NPSH may be of particular significance for the insulin-producing B-cells. By means of flameless atomic absorption spectrophotometry the contents of zinc, cobalt, and manganese were determined in micro-dissected hagfish islet lobules. Neither zinc, nor cobalt, occurred in significantly higher concentrations in the islet parenchyma than in the liver or the skeletal musculature. Only manganese was found in somewhat higher amounts in the islet lobules than in the other tissues, but the contents were still low. The results indicate that none of the three heavy metals play any important role in the synthesis, storage, or release of insulin in the hagfish. The significance of this in relation to the prevailing hypotheses regarding the pathogenesis of alloxan diabetes is discussed.


Zinc and manganese contents of micro-dissected pancreatic islets of some rodents. A microchemical study in adult and newborn guinea pigs, rats, Chinese hamsters and spiny mice. By a flameless atomic absorption spectrophotometry procedure, using a graphite furnace, it was possible to assay the contents of zinc and managanese in micro-dissected pancreatic islets of several rodents. Interest was focused upon the islets of guinea-pigs, due to the fact that guinea-pig insulin lacks a histidine residue in the B10 position of the molecule which normally binds zinc (or other heavy metals) in the hexamer formation, probably involved in the storage of insulin. Both the zinc and manganese contents were too low in the guinea-pig islet parenchyma to be reasonably involved in the storage of insulin in the beta-granules. Instead, it was suggested that guinea-pig insulin, like hagfish insulin, might crystallize without access to zinc or other heavy metals. Low zinc and manganese contents were also observed in newborn and diabetic guinea-pigs. The islet zinc content was high in the Wistar rat, the Chinese hamster, and the spiny mouse. No significant amounts of manganese were found in any of these kinds of islet parenchyma.


Hyperprolactinaemia in amenorrhoea - incidence and clinical significance. Prolactin concentrations in serum were determined in 287 women with amenorrhoea. The incidence of hyperprolactinaemia was 14.6 per cent. All but 4 of the 31 women with persistent hyperprolactinaemia had galactorrhoea. Radiological signs suggestive of a pituitary tumour were seen in 48 per cent of the hyperprolactinaemic women, while only 4.5 per cent of the 245 normoprolactinaemic women had abnormal sellar X-rays. All the patients with prolactin concentrations above 100 microgram/1 had radiologically abnormal sellae, but lower prolactin levels did not rule out the existence of even large pituitary tumours. The hyperprolactinaemic women with normal and abnormal sellae and a control group of healthy women in the early follicular phase all had similar mean basal FSH and LH levels with one exception, the group with abnormal sellae had lower basal LH levels than the control group. There was no difference in the mean FSH and LH responses to LH-RH between the hyperprolactinaemic women with pathological sellae and the control group while the hyperprolactinaemic women with normal sellae had higher responses than the other two groups. Prolactin determinations were found to be superior to other pituitary hormone estimations for identifying patients who are at risk of having pituitary tumours.


The effects of testosterone and its 5alpha-reduced metabolites on pituitary responsiveness to gonadotrophin-releasing hormone (Gn-RH). The aim of this study was to investigate effects of androgens on gonadotrophin release in response to gonadotrophin-releasing hormone (Gn-RH) stimulation in vitro. Hemipituitaries of mature male rats were pre-incubated for 90 min with T, DHT, 3alpha- or 3beta-diol (4 ng or 4 microgram/ml medium), and the incubation continued for 240 min after adding Gn-RH (1 ng/ml medium). Gn-RH caused a 4-5-fold rise in the secretion of LH and a 2-fold rise in FSH secretion. The effect of the androgens was dose-dependent. At low levels, T and DHT exerted no effect on Gn-RH-stimulated gonadotrophin release, whereas the two androstanediols (3alpha- and 3beta-diol) augmented the Gn-RH stimulation of both gonadotrophins, though preferentially LH. With high doses of androgens, the results obtained showed: a) no effect of T; b) DHT suppression of the Gn-RH-stimulated FSH release; c) suppression of Gn-RH stimulation by 3alpha- and 3beta-diol regarding both LH and FSH. It is concluded that T exerts through its reduced metabolites a feedback effect on the pituitary gland responsiveness to Gn-RH stimulation.


Assays for antigen-stimulated lymphocyte-derived migration enhancement and inhibition factors from patients with thyroid diseases and their relatives. Cell-mediated immunity to thyroid antigens was studied by means of an assay for antigen-stimulated leukocyte migration inhibition factor (LIF) in 5 groups of subjects: patients with Graves' disease, Hashimoto's thyroiditis, their relatives and normal controls. We also sought evidence for the possibility that the hypothesized migration enhancement factor (MEF) might be produced by lymphocytes from patients with autoimmune disorders. We found little evidence of LIF production and none of MEF production by the leukocytes of patients with autoimmune thyroid diseases upon exposure to thyroid antigens. Similarly, either no or only minimal amounts of LIF were demonstrated in culture supernatants of leukocytes of their immediate relatives.


Simultaneous determination of the content of serotonin, dopamine, noradrenaline and adrenaline in pancreatic islets isolated from fed and starved mice. A highly sensitive double isotope method for the simultaneous determination of serotonin, dopamine, noradrenaline and adrenaline has been developed. Advantages and limitations of the method are discussed. The mentioned biogenic amines are all present in isolated pancreatic islet tissue from albino mice in concentrations ranging from approximately 5-30 micronmol per kg wet weight (0.8-5 X 10(-3) pmol/ng DNA). A somewhat higher content of these amines, especially dopamine, was found in pancreatic acinar tissue. The hypothesis that the impaired glucose-induced insulin secretion during starvation partly is caused by an increased content of biogenic amines in the pancreatic islets was not supported by our experiments which showed an unchanged islet content of these amines after 48 h starvation.


An in vivo model for testing inhibition of arginine-induced insulin and glucagon release by somatostatin analogs. An animal model for testing the in vivo potency of somatostatin analogs in inhibiting the release of insulin and glucagon is described. The secretion of these pancreatic hormones was stimulated in rat by infusion of arginine. The plasma insulin level increased almost to a maximum after an infusion of 10 min, while plasma glucagon rose more slowly, reaching its maximum only after a 30 min infusion. Concomitant infusion of graded doses of somatostatin (2.5, 10, 40 and 160 microgram/100 g BW) for 30 min inhibited both insulin and glucagon release in a dose-dependent manner, enabling us to test somatostatin analogs for insulin and glucagon-suppressive activity in a semi-quantitative manner. Using this animal model, 3 analogs of somatostatin [D-Cys14]-, [Ala2, D-Cys14]- and [D-Trp8, D-Cys14]somatostatin were tested in a 4-point assay. They all showed dissociated activity in inhibiting the secretion of glucagon more than that of insulin.


Induction of ovulation with cyclophenyl. The results of 495 cycles of treatment with Cyclophenyl given to 286 women suffering from amenorrhea, oligomenorrhea or persistent anovulation are reported. In 61 cases the drug solved the problems of infertility, with a success rate of 43%. The over-all success rate was 58% (288 ovulatory cycles produced in 495 treatment cycles). In detail:--in cases of prolonged amenorrhea, with plasma estradiol levels lower than 50 pg/ml, the positive results were only 15%;--in cases of short-term amenorrhea, with plasma estradiol levels lower than 50 pg/ml, the success rate was only 18%;--in cases with prolonged amenorrhea but with plasma estradiol levels higher than 50 pg/ml, the success rate was 43%;--in cases of short-term amenorrhea with plasma estradiol levels higher than 50 pg/ml, the success rate was 68%;--in cases of oligomenorrhea and of persistent anovulation, the success rate was 72%.


Correlation between pituitary gonadotropin response to GnRH and testicular histology in subjects suffering from dyspermia. No significant changes of LH in basal conditions and in response to GnRH stimulation were found in any of the subjects studied; the same applies to basal testosterone and testosterone after HCG stimulation. On the other hand, the pituitary response for FSH gonadotropin showed significant variations in the different groups of subjects examined. These variations were closely correlated to the stages at which spermatogenesis was arrested. The earlier the stage of spermatogenetic arrest, the more strongly enhanced the FSH response to GnRH stimulation. Further, the most significant change, and the one most liable to be suited for purposes of diagnosis, was the one observed when passing from the 1st to the 2nd degree arrest (spermatids-spermatocytes). This FSH pattern is a constant finding; so much so that in the view of some authors testicular biopsy can now be avoided in cases with strongly increased pituitary FSH reserve since in these conditions the seminal line has been shown not to go beyond the stage of the spermatocyte.


A clinical comparison of tilidine hydrochloride and pentazocine, given orally for the treatment of postoperative pain. A controlled, double-blind study involving 250 women was carried out ot assess the efficacy of oral tilidine 25, 50 and 100 mg in treating postepisiotomy pain, and to offer a comparison with oral pentazocine 50 mg. All the analgesics produced significant pain relief. At peak effect tilidine 50 mg produced very similar results to pentazocine 50 mg with tilidine 25 mg producing less, and tilidine 100 mg more pain relief. These results were not, however, statistically significant. In these postdelivery ambulant patients pentazocine 50 mg and tilidine 100 mg produced at 25% incidence of side-effects, mainly dizziness and drowsiness, but tilidine 25 mg produced significant analgesia with virtually no side-effects.


A comparison of the plaque-inhibiting effect of stannous fluoride and chlorhexidine. A double blind clinical trial was undertaken in order to compare the plaque inhibiting effect of SnF2 (0.2% and 0.3%) with chlorhexidine (0.1%) applied as mouthrinses in a test panel of 12 dental hygienist students. The experimental series were performed in periods of four days. The mean Plaque Index values were 0.35 and 0.2 when employing SnF2 and 0.1 when chlorhexidine was used, whereas distilled water resulted in a mean value close to 1.0. The long-term effect of a 0.3% SnF2 solution was tested in another group of five students for a period of three weeks. The two trials confirmed previous reports claiming that SnF2 is effective as a plaque inhibitor and, furthermore, that this effect could be maintained for a period of at least three weeks. The staining problem was less than in similar studies using chlorhexidine.


Rupture of the distal biceps tendon. Report of five cases. Five cases of rupture of the distal biceps tendon are described. Three were operated on--two in the acute stage and one after 3 months--and the other two were managed conservatively. The literature on this condition is reviewed and alternative forms of treatment are discussed.


[Richter's syndrome and cervical cancer in the course of a rheumatoid arthritis]. The authors describe a rare case of Richter's syndrome (transition of chronic lymphatic leukaemia into reticulosarcoma) developing during rheumatoid arthritis in a women aged 53 years. Chronic antigenic stimulation and disturbances of interaction between lymphocytes T and B are suggested as a cause of Richter's syndrome.


Some aspects of bone grafting for non-union of the carpal navicular. Analysis of 41 cases. Forty-one patients with established non-union of the carpal navicular are presented. Forty patients were treated by bone grafting, using the same operative technique in all of them. All operated fractures healed and were free of pain at the time of union. Vascularization did not seem to interfere with union in the different types of fractures. Radial styloidectomy, performed in addition to bone grafting in 26 of the patients, who had arthritic changes, improved their wrist mobility.


Prophylactic antibiotics against early and late deep infections after total hip replacements. A review with a longer observation period is performed of a previously published double-blind investigation of the prophylatic value of cloxacillin against late infections after total hip replacements; In addition, a retrospective patient material is examined. The total material consisted of 1065 total hips. 15.4 per cent deep, late infections were found in the group without prophylaxis and 20 per cent in the one with prophylaxis. The frequency of haematogenous deep infection was estimated to be less than 1 per cent.


Preliminary report of a compression technique to apply tension to sliding bone grafts in tibial shaft fractures. A new compression device is described that applies tension to sliding bone grafts on the medial aspect of the tibia in tibial shaft fractures. The mechanical aspects of the operation are outlined and the advantages and disadvantages of the system discussed. There have been no complications and rigidity has been obtained in two clinical cases. Mechanical tests in bending and torsion show that rigidity can be obtained without breaking the graft.


The trachea and cuff-induced tracheal injury. An experimental study on causative factors and prevention. The effect of a large tracheal tube cuff on the rabbit tracheal mucosa was investigated by phase contrast microscopy and scanning (SEM) and transmission (TEM) electron microscopy. The tube was left in the trachea for 15 min. The cuff was either uninflated or inflated to a cuff-to-tracheal wall pressure (C-T pressure) of up to 100 mmHg. The uninflated cuff caused superficial damage to the epithelial lamina over regions where a cartilage was situated. When the cuff was inflated, it resulted in an increase of the mucosal damage, the extent of which was directly related to the pressure in the cuff. This took the form of both widening of the injured areas and penetration of the damage to deeper regions. At a C-T pressure of 100 mmHg the damage involved almost the entire mucosa and only small unaffected mucosal regions remained. At this stage it appeared as if the basement membrane had also begun to disintegrate. It is well known that a small cuff easily causes deep ulceration in the mucosa overlying the cartilages. From this investigation it was concluded that a large cuff causes the same type of ulceration if 1) the cuff wall is not sufficiently thin and pliable, and 2) if the cuff is overinflated enough to dilate the trachea to a diameter exceeding the cuff-diameter. At that moment there will be circumferential tension in the cuff and the sealing physics of the large cuff will become the sealing physics of a small (high pressure) cuff. A large cuff, properly handled, is more benign to the trachea than a small cuff. In order to avoid overinflation of the large cuff, the intracuff pressure (= C-T pressure) should always be measured by means of a four-way stopcock and an aneroid manometer. In the case of extended periods of mechanical ventilation with a high airway pressure, the resulting tracheal diameter at the cuff site should be checked radiographically.


Antibody production by the mammary gland in mothers after artificial oral colonisation of their infants with a non-pathogenic strain E. coli 083. Twenty five breast-fed and 25 formula-fed infants were colonised by oral administration of a living suspension of E. coli 083. Twenty breast-fed and 13 formula-fed infants were followed as controls. Specific antibody titres in serum, stool filtrates and milk, and secretory IgA levels in stool filtrates and milk were determined in samples taken fortnightly from birth until 20 weeks of age. The haemagglutinating antibody in serum and milk increased in the colonised groups, but in stool filtrates an inhibitory effect of breast-milk was demonstrated. Secretory IgA levels in stool filtrates were significantly higher in colonised infants and breast-fed controls than in bottle-fed infants during the period of breast feeding. Then levels in the colonised groups remained high, but in breast-fed controls they decreased to values found in bottle-fed controls. Artificial colonisation evoked local antibody and secretory IgA responses in the intestine, as well as an antibody response in the mother's mammary gland. The possible protective effect of those responses is discussed.