Comparison between the automated reagin test and reagin screen test methods of VDRL screening tests for syphilis in use in a routine laboratory. A comparison is made between the automated reagin test (ART) using Technicon AutoAnalyzer equipment and the reagin screen test (RST) introduced by Lederle using a new antigen formulation. Treponemal haemagglutination tests (TPHA) were done simultaneously as second screen tests. The absorbed fluorescent treponemal antibody test (FTA-ABS) was used in all seropositive cases. Altogether 1154 sera were tested; 1028 were negative with all tests, 66 were positive with all tests, 42 were positive with TPHA and negative with ART and RST, and 16 were positive with TPHA and RST and negative with ART. It was concluded that the use of the RST and TPHA together would be the more sensitive screen test.


Reaction of human smooth muscle autoantibody with gastric parietal cells: a pitfall in the diagnosis of parietal cell autoantibody. Thirteen smooth muscle antibody (SMA) sera obtained from patients with active chronic hepatitis were examined for immunofluorescence reactivity with gastric mucosal cells. Eight out of 13 sera stained the cytoplasm of gastric parietal cells in a pattern indistinguishable from that obtained with parietal cell autoantibody (PCA). The staining reaction was localised to parietal cells by the demonstration that the same cells stained with both SMA and PCA in double immunofluorescent tests. The SMA staining intensity for parietal cells was weaker than that for smooth muscle. Specificity of the staining reaction for actin was established by the observation that parietal cell staining by SMA was inhibition by serum absorption with skeletal muscle F-actin but not by a microsomal fraction derived from gastric mucosa.


The efficacy and safety of furosemide and a combination of spironolactone and hydrochlorothiazide in congestive heart failure. The therapeutic and biochemical effects of two commonly employed diuretic preparations were compared in a double-blind fashion in 32 patients with congestive heart failure. At the doses employed, furosemide and a fixed combination of spironolactone and hydrochlothiazide maintained control of the clinical manifestations of congestive heart failure to about the same degree. However, significant biochemical changes in the renin-aldosterone system were found in patients receiving the spironolactone/thiazide combination therapy. A significant increase in plasma renin activity and a significantly greater increase in aldosterone excretion were found in the spironolactone/thiazide group compared to the furosemide group. No significant differences were observed in serum potassium levels or 24-hour potassium excretion rates in patients treated with the two diuretic preparations.


The "spastic colon" syndrome: therapeutic and pathophysiologic considerations. Low doses of d-amphetamine plus propranolol rapidly improved the abdominal pain in 165 "spastic colon" patients. Concomitantly, these drugs reduced the sigmoidal hypertonicity and the rectal inhibition found in the manometric studies performed in some of those patients. The sigmoidal tone and phasic activity were also decreased by anticholinergic drugs. These results suggest that a cholinergic-serotonergic hyperactivity of the myenteric plexus may be responsible for the "spastic colon" syndrome.


The influence of pyrithioxine on certain factors of intelligence1. A double-blind trial with pyrithioxine was made with 22 pairs of visually handicapped children who were equal in IQ scores and in chronological age. Although an improvement of abstraction ability was noticed, the overall results were not in concurrence with the general tendency in relevant literature.


Review of ADA licensure policy.

Review of ADA licensure policy. ADA policies on licensure encourage states to ease mobility restrictions while maintaining sufficient control to ensure that only qualified individuals provide dental treatment within the state. Many states have had provision to license by credentials for a long time. Licensure by credentials is rapidly replacing reciprocity as an alternate form of licensure. Only four states still participate in what can be termed purely reciprocal licensure agreements. In contrast, 21 states currently offer licensure by credentials. Another trend in licensure in recent years has been increased state participation in regional clinical examination services. Today, 32 states participate in four regional clinical examination services. With the increasing number of states offering licensure by credentials and participating in regional boards, the prospect for increased mobility for dentists appears good.


Wheat bran as an etiologic factor in certain diseases. Some second thoughts. The author questions "the bran hypothesis" that a deficiency of natural fiber--wheat bran in particular--is responsible for a number of prevalent diseases in Western societies, namely diverticular disease, cancer of the colon, gallstones, and myocardial disease. In re-examining the hypothesis, he cites reports which fail to support the theory. For instance, the incidence of diverticular disease in women has increased since 1925, yet there is no evidence that their diets have changed or are different from those of men. Also, it is a mistake to equate wheat bran with fiber in general, and it cannot be shown that dietary fiber in general has declined. In addition, clinical studies have failed to show beneficial results in treating diverticular disease and irritable colon by adding bran to the diet. Similar problems arise in testing the hypothesis that natural fiber can prevent cancer of the colon and lower serum cholesterol and triglycerides. Recent interest in dietary fiber is welcome, for it has been grossly neglected, but much research is still needed to place it in proper perspective.


Physiologic and psychotropic effects of caffeine on man. A review. Caffeine, in substantive amounts, is frequently taken by the clinical or hospitalized patient. Caffeine content of coffees, teas, cola drinks, cocoa, and drugs is summarized. Systems and organs affected by caffeine include the central nervous system, the cardiac muscle, the kidney, the gastric mucosa, and smooth muscle. Psychotropic and sleep response varies with age and degree of habituation. Symptoms of caffeinism, caffeine withdrawal, and caffeine-drug interactions are described.


Prolactin cells of the human pituitary gland in old age. Pituitary glands obtained at autopsy from 20 male and 20 female subjects, over 80 years of age, have been investigated with various staining procedures, including the immunoperoxidase technique for the cytological localization of prolactin. Prolactin cells were numerous and well developed in the anterior lobes. The incidence, distribution, granulation and immunoreactivity of prolactin cells showed no apparent difference between old male and female subjects dying of acute or chronic illnesses. It can be concluded that prolactin cells do not regress in old age. The morphologic findings are consistent with the assumption that the pituitary gland is capable of secreting prolactin in aging subjects.


[Risk of neonatal Streptococcus B infection]. 23 cases of contamination with streptococcus group B have been seen after premature rupture of the membranes. Mothers and fetuses have been affected. The systematic study of swabs or liquor or cervical discharge carried out on the mother since the time her membranes had ruptured show that in 74 per cent of cases studied contamination existed within the first 24 hours. Giving antibiotics to the mother before delivery gave very variable results. These multiple tests, before and around the time of birth, made it possible to detect the children at risk of infection and to start antibiotic therapy with a narrow spectrum antibiotic of the type Penicillin G. The clinical progress of these children, which is usually favourable, gives no reason for postponing prophylactic cover antibiotic treatment when the membranes have ruptured prematurely.


Toxocara infection in pigs. The use of indirect fluorescent antibody tests and an in vitro larval precipitate test for detecting specific antibodies. An in vitro larval precipitate test using second-stage Toxocara canis larvae and an indirect fluorescent antibody (IFA) test employing cuticles of T. canis larvae as antigen were evaluated using antisera produced in pigs experimentally infected with T. canis, T. cati, Ascaris suum, Toxascaris leonina and Parascaris equorum. The former test was both specific and sensitive and is suggested as a reliable and simple method of detecting Toxocara antibodies in pigs. The latter test was considered unsuitable because of cross-reactions that occurred when sera from pigs infected with other ascarids were tested. An IFA test for Ascaris antibodies, employing cuticles of A. suum larvae as antigen, is described. The degree of specificity of this test suggests that it may be of value in the detection of antibodies to Ascaris in pigs under natural conditions.


Limulus polyphemus lectin sites in human bronchial mucosa. The lectin from Limulus polyphemus (limulin) has an affinity for glycoproteins containing N-glycolyl or N-acetylneuraminic residues. By using a peroxidase labeled limulin on human bronchial mucosa sections, it has been possible to demonstrate selectively a diffuse staining within the apical part of the epithelial goblet cells. Whereas, in the submucosal glands serous cells, the labeling appears as small granules localized either at the apical pole or in the whole cytoplasm. In our experimental conditions the  labeled limulin has no affinity for mucous cells that are known to contain sialic acid residues.


A selective oleic acid albumin agar medium for the cultivation of Mycobacterium bovis. The modification of Middlebrook's 7H11 oleic acid albumin agar medium by the addition of fresh bovine serum and lysed sheep red cells to encourage growth of Mycobacterium bovis is described. The improved medium was made selective by the addition of antibiotics and a comparative trial of this medium and the guineapig test in the isolation of M. bovis from badger tissues is reported. A close agreement between the two tests was found; the guinea-pig test detected 95% of all isolations and culture detected 91%.


The immunization of mice and calves with gal E mutants of Salmonella typhimurium. A galactose epimeraseless (gal E) mutant of Salmonella typhimurium was investigated in mice and calves for its suitability as a live vaccine. In mice, a very highly significant difference in the mortality rates was observed when vaccinated and non-vaccinated animals were challenged with virulent strains of S. typhimurium and S. dublin. In calves, doses of 10(6) and above of gal E mutant injected subcutaneously provided highly significant protection both in terms of mortality and prevalence of symptoms when calves were challenged orally with S. typhimurium. However, there appeared to be a relation between the vaccine and the presence of renal lesions and before gal E mutants can be recommended, further work is necessary to determine the pathogenesis of these lesions.


The effect of diet on intestinal Escherichia coli. During an 8-week period all specimens of stool passed by six nurses were examined for the presence of Escherichia coli and all isolations of this organism were serotyped. During the middle 4 weeks of the period the nurses ate a sterile diet. A smaller number of serotypes was isolated during the period of sterile diet than during the period when normal food was eaten. This finding supports the view that normal food is a source of strains of E. coli present in the bowel. Some new serotypes of E. coli did appear during the period of sterile diet. The possible sources of these are discussed.


The diagnosis of salmonella abortion in cattle with particular reference to Salmonella dublin. A review. The diagnosis of abortion in cattle caused by Salmonella dublin depends upon the isolation of the organism from either the products of conception, uterine discharges, vaginal mucus or milk together with serological evidence of active infection. S. dublin may be isolated when an active or a latent carrier cow abourts but in these cases an active infection will not be demonstrable. The retrospective identification of a case of S. dublin abortion may prove difficult as excretion of the organism is usually transient and the serum agglutinating antibodies frequently fall to low titres soon after the abortion.


A comparison of typing methods for Serratia marcescens. A simple method for the bacteriocine typing of Serratia marcescens without the use of induction was sought. The results of a mutual inhibition experiment with 89 unrelated cultures indicated that a bacteriocine-susceptibility method would give more discrimination between strains than would a bacteriocine-production method. A cross-streaking technique for bacteriocine-susceptibility typing without previous induction was developed, and its performance was compared with that of another susceptibility-typing method in which cell-free lysates of the producer strains were obtained by induction with mitomycin C.Replicate typing of the same collection of cultures by both methods indicated that small variations in pattern were common and that larger variations occurred occasionally. Differences in pattern of less than two strong reactions in the mitomycin-C induction method, and of less than three strong reactions in the cross-streaking method, should therefore not be taken as evidence that strains can be distinguished.Sets of cultures of Ser. marcescens, 178 in total, from a number of supposed incidents of infection in hospitals, were used to evaluate the two bacteriocine-typing methods; all of the cultures were also O serogrouped. Comparison of the typing patterns of members of the same O serogroup from clear-cut incidents of infection confirmed that results of acceptable reliability could be obtained by either bacteriocine-typing method by the application of the appropriate ;difference' rule. When so interpreted, the cross-streaking method appeared to be slightly the more discriminatory.The greatest discrimination between strains was obtained by the use of a ;hierarchical' typing system in which the strains were first O serogrouped, and the cross-streaking method of bacteriocine typing was then used to make subdivisions within O serogroups.


A study of enteropathogenic organisms isolated in the public health laboratory, Lusaka. A total of 328 specimens of stools were examined in the Public Health Laboratory during January and February 1973. Enteropathogens were isolated from 117 of these specimens. Besides these, 12 strains of Salmonellae were isolated from blood and 8 from urine. An occasional Salmonella was isolated from the pleural fluid (S. paratyphi A) pus from the knee (S. enteritidis) and from the C.S.F. of an infant (S. paratyphi C.). Salmonella typhi and Salmonella paratyphi A are the predominant Salmonella species. No Salmonella paratyphi B has been isolated. Shigella, was isolated with slightly less frequency than Salmonella, and Shigella flexneriis was the predominant species. E. coli 0112/K66 is the most common enteropathogenic E. coli. The majority of the Shigella and Salmonella species are sensitive to the common antibiotics used. The E. coli organisms show multiple resistance to a number of antibiotics.


To Shigella sonnei phage typing.

To Shigella sonnei phage typing. The epidemiological significance of phage types changes in the course of years. In Czechoslovakia, in the years 1967-1971, the most frequent phage types were 2,6, 3, 30 and 65, and, in the Middle-Bohemian Region, 2,30, 6, 3 and 65. In the epidemiological years 1972-1973 the sequence of the most frequent S. sonnet phage types changed in the Middle-Bohemian region to: 65, 23, 6, 2 and 12. Some problems concerning the instability of phage types and the part of further auxiliary tests (biochemical differentiation according to Bojlen and drug sensitivity pattern) are discussed.


Effect of colicin V on S. sonnei in vivo and in tissue culture. The effect of the preparation of colicin V, freed from the endotoxin of the producer strain E. coli Ca-7 on Sh. sonnei was studied in the keratoconjunctival tests on guinea pigs and in the cell culture Hep-2. Colicin V was found to inhibit the development of dysenteric infection in vivo by delaying the incubation period. It has been demonstrated that the mentioned colicin blocks the process of adsorption of the causative agent on the surface of epithelial cells. Obviously, colicin V can also display bactericidal effect at the moment of intercellular migration of Shigellae, but it has no effect on bacteria which have penetrated into the cytoplasm of epithelial cells. The obtained data support the opinion of the role of colicins played in the development and course of infectious processes.


Target cell-substratum interaction. II. Complement-dependent antibody-induced inhibition of adherence. When trypsinized cells were treated with alloantibody and complement they initially adhered to their substratum, then detached. Specific cytolysis did not occur. In addition to demonstrating an immunologically mediated reaction, this phenomenon has permitted the development of a new, simple, rapid assay for alloantibody that does not require a cytolytic reaction.


Induction of unresponsiveness to bone marrow grafts. Unresponsiveness to Hh incompatible bone marrow grafts was induced in mice by single or multiple injections of various tissues from a prospective donor before irradiation and bone marrow grafting. The results show that lymph node cells and splenocytes (both adherent and nonadherent) were the most effective in inducing unresponsiveness; thymocytes showed only a marginal effect in female and no effect in male mice, and hepatocytes had no effect. There was a direct relationship between the number of cells required for unresponsiveness induction and the strength of incompatibility between donor and recipient, i.e., the stronger the donor-recipient incompatibility, the more cells were required to induce unresponsiveness. The rapidity of unresponsiveness induction and its duration were also dependent on the number of cells in the "immunizing" inoculum. In general, unresponsiveness was induced sooner and persisted longer when larger cell doses were used. The unresponsiveness was highly specific with regard to donor antigens.


Activation of human B lymphocytes. IV. Regulatory effects of corticosteroids on the triggering signal in the plaque-forming cell response of human peripheral blood B lymphocytes to polyclonal activation. In vitro hydrocortisone in physiologic and pharmacologically attainable concentrations caused a marked enhancement of the PWM-induced PFC response of normal human peripheral blood B lymphocytes. This effect was seen only when hydrocortisone was added within the first 24 hr of culture and only when hydrocortisone and PWM were present together in cultures. Only suprapharmacologic concentrations of hydrocortisone (10(-3) M) were capable of suppressing early B cell activation. Late stages of antibody production and secretion were resistant to suppression by even these extraordinarily high concentrations. Hydrocortisone did not replace the T cell requirement of PWM-induced PFC responses. A single dose of in vivo hydrocortisone (400 mg) to normal adult volunteers did not produce this enhancing effect when PFC responses were measured in vitro in the absence of hydrocortisone. The data strongly suggest that the enhancing effect of hydrocortisone was due not to elimination of naturally occurring suppressor cells, but to a modulation of the triggering signal either directly on the B cell itself or via the balance of positive and negative T cell regulation of B cell activation.


Physicochemical consequences of opsonization: perturbation of liposomal membranes by Salmonella typhimurium 395 MS opsonized with IgG antibodies. When phagocytosis-resistant Salmonella typhimurium 395 MS bacteria sensitized with anti-MS IgG antibodies were incubated with liposomes composed of phosphatidylcholine, cholesterol, and dicetylphosphate, a previously sequestered liposomal marker (4-methylumbelliferylphosphate) was released. Unsensitized or F(ab')2-sensitized bacteria had no such effect. This perturbation was neither dependent upon negatively charged dicetylphosphate nor upon cholesterol. It was further evident that palmitoyl-poly(ethyleneglycol) caused release of the trapped marker in a similar way as  sensitized bacteria. These findings demonstrate a similarity between sensitized bacteria and a hydrophobic probe and lend support to the hypothesis that the perturbation was brought about by hydrophobic interaction. The observations indicate that liposomes, like phagocytes, possess "receptor sites" for the activated part of IgG and raise the possibility that phagocytic effectors can operate in a relatively nonspecific manner.


Release of slow reacting substance (SRS) from rat basophilic leukemia (RBL-1) cells. When rat basophilic leukemia (RBL-1) cells were exposed to the ionophore A23187, a substance was released that produced a prolonged contraction of guinea pig ileum resembling that seen with slow reacting substances (SRSs) from various sources. The response was temperature, dose, and the time dependent with no activity being demonstrated in unstimulated cells. Several lines of evidence indicated that the RBL-1 product was markedly similar or identical to SRSs obtained from non-neoplastic tissues: 1) appropriate behavior in seven different chromatographic systems, 2) an appropriate profile of activity on various smooth muscle preparations, 3) an ability of low concentrations of the selective SRS inhibitor FPL 55712 to block the guinea pig ileal response, 4) failure of chymotrypsin to destroy activity, 5) loss of the activity after incubation with arylsulfatase, and 6) an ability to release activity from cells preincubated with indomethacin. Since RBL-1 cells can be grown in considerable guantity and under optimal conditions an average of 1500 SRS units/10(7) cells can be obtained, these cells should be useful as a biosynthetic source in further attempts to purify and characterize the SRS molecule.


Suppression of B cell MIF production by T cells and soluble T cell-derived factors. Purified populations of guinea pig B cells from nonimmunized animals may be stimualted by PPD or LPS to produce MIF. Unfractionated lymphocyte suspensions from these animals do not produce MIF under these conditions. Reconstitution of B cells with T cells abolishes their ability to generate detectable MIF. A soluble factor obtained from stimulated T cell cultures (MIFIF) is also capable of suppressing this B cell activity. Thus suppressor T cells can interfere with lymphokine production by B cells and this effect is mediated at least in part by a soluble factor. This previously undescribed capacity of T cells may provide an explanation for the fact that B cells do not appear to play a role in reactions of cell-mediated immunity in vivo.


Modified micromethod for detection of human Fc receptor-like material. Soluble FcR-like material can be demonstrated in the culture supernatants of activated lymphocytes. We modified as assay for its detection which was based upon inhibition of complement dependent hemolysis, an unreliable phenomenon in our hands. The micromethod presented was developed using the culture supernatants of FcR producing and FcR non-producing lymphoblastoid cell lines. Suppression of hemolysis was consistently observed providing the assay was performed below 22 degrees C. It is suggested that the classical pathway of complement activation is inhibited by this material but not the alternative pathway. By this method FcR material can be detected in small cultures where cells are limited in number.


Immunology of DNA. VI. The effect of mercaptans on IgG and IgM anti-dsDNA. Reduction of IgM antibodies to DNA with mercaptans such as dithioerythrol or 2-mercaptoethanol completely destroys DNA binding in the Farr assay and in the immunofluorescence technique by Crithidia luciliae. In contrast reduction of IgG antibodies to DNA results in a six-fold increase of DNA binding in the Farr assay while no effect on titres in the immunofluorescence technique can be observed. Our results lead to the following conclusions: 1) The Farr assay is selective for high avidity interactions; only a minor part of IgG antibodies to DNA is measured; 2) 7S IgM antibodies to DNA cannot be demonstrated in the Farr assay or the immunofluorescence technique; obviously only multivalent interactions, as obtained with the intact 19S IgM molecule are stable in these assays; 3) reduction of IgG leads to a greater flexibility of this molecule; this facilitates monogamous bivalent binding to DNA; 4) THE PRESENTATION OF DNA in the kinetoplast of Crithidia luciliae favours a monogamous bivalent binding of antibodies to DNA with high avidity; this accounts for occasionally observed discrepancies between anti-DNA activity in the Farr assay and in the immunofluorescence technique.


Parasitologic and serologic observations of infection with Pneumocystis in humans. More than 500 specimens of lung tissue were examined for Pneumocystis. Of the 38 infections detected, most were in immunodeficient patients. Samples of serum from approximately 600 healthy normal subjects and 117 children with acute lymphatic leukemia were examined by an indirect fluorescent antibody test. The age-related data from the normal children suggested that nearly 100% of children are infected with Pneumocystis during the first two years of life. Groups of patients with leukemia who had symptoms of pneumocystis pneumonia had significantly higher titers of IgG antibody than groups of patients with leukemia who did not have clinical symptoms and normal subjects. Nevertheless, the diagnostic value of the indirect fluorescent antibody test is limited, but serologic follow-up study can be useful. Groups of children with leukemia had lower mean titers of IgM antibody regardless of their clinical condition.


Clinical studies of an interferon inducer, polyriboinosinic-polyribocytidylic acid [poly (I)-poly (C)], in children. Fifteen children ranging in age from one and one-half to 14 years received intravenous polyriboinosinic-polyribocytidylic acid [poly (I)-poly (C)], an interferon inducer. The patients all had serious neurologic illness either directly or circumstatially related to viral infection. Peak titers of interferon in serum ranged from 8 to 500 units/ml in response to doses of poly (I)-poly (C) of 0.1-1.0 mg/kg. Serum interferon persisted for less than or equal to 24 hr after induction. Hyporesponsiveness to a second dose of poly (I)-poly (C) persisted for seven days after initial induction, after which time full response again occurred. The half-life of poly (I) poly (C) in plasma as measured in three patients was less than 30 min. poly (I-poly(C) appears to be safe when given intravenously, but the low titers of interferon induced may limit its clinical usefulness as an antiviral drug.


Isolation and identification of encapsulated strains of Bacteroides fragilis. One hundred three clinical isolates of Bacteroides fragilis were identified during a two-year period. Most of these isolates were strains of B. fragilis subspecies fragilis, which constitutes a minor component of the fecal flora in comparison with the other subspecies of B. fragilis. By use of several techniques for demonstration of capsules, it was found that only B. fragilis strains classified as subspecies fragilis were encapsulated. An indirect immunofluorescence assay was developed for identification of clinical isolates possessing capsular material that was immunologically similar to that found in the reference strain of B. fragilis subspecies fragilis. All strains examined that were classified as subspecies fragilis were positive in this assay for the capsular material, whereas strains of the other subspecies were negative. This tests represents a rapid and sensitive means of identifying the most prevalent anaerobic gram-negative bacillus involved in human infections. The capsular polysaccharide of B. fragilis subspecies fragilis is a unique factor associated with the predominant subspecies of B. fragilis isolated from clinical material.


Adjuvant protection against bacterial infection in granulocytopenic mice. The hypothesis that the induction of nonspecific resistance to infection by immunostimulation prior to drug-induced granulocytopenia would afford increased protection to subsequent bacterial challenge was tested in a murine model of infection with Pseudomonas aeruginosa or Staphylococcus aureus in mice rendered granulocytopenic with cyclophosphamide. Prior intraperitoneal immunostimulation of mice with complete Freund's adjuvant (CFA) or Mycobacterium bovis (Bacille Calmette-Guèrin; BCG) increased the 50% lethal dose in mice challenged subcutaneously with P. aeruginosa, but only CFA protected against challenge with S. aureus. The degree of protection was 1-2 log 10. Corynebacterium parvum provided no protection against infection with P. aeruginosa. The protective effect observed with CFA and BCG substantiates our hypothesis and indicates that nonspecific immunostimulation may be of value in protection of granulocytopenic patients from opportunistic infections.


Fungicidal components of mammalian granulocytes active against Cryptococcus neoformans. Citric acid extracts of granule-rich fractions, prepared from rabbit and guinea pig heterophils or human neutrophis, killed Cryptococcus neoformans in vitro. These extracts sere fractionated by micropreparative electrophoresis on polyacrylamide gels. In preparation of rabbit and guinea pig heterophils, cryptococcidal activity was associated predominantely with lysosomal cationic protein complex. Human neutrophils lacked strictly comparable cationic proteins but contained other components that killed C. neoformans. These components appeared to be identical to previously described proteins of the human neutrophil active against Candida parapsilosis.


Comparison of killing of bacteria by guinea pig neutrophils and monocytes. Guinea pig polymorphonuclear neutrophils (PMN's; harvested from the blood and from peritoneal exudates) and monocytes (harvested from the peritoneal cavity with and without stimulation of an exudate) were compared in their capacities to kill three pyogenic bacteria. All combinations of phagocytes and bacteria required heat-labile opsonic factors. No significant differences in killing of the three organisms were observed between blood and peritoneal PMN's or between stimulated and unstimulated monocytes. PMN's killed Staphylococcus aureus more effectively than monocytes after both 1 and 2 hr of incubation (p less than 0.05). Although PMN's appeared to have greater bactericidal activity against Escherichia coli than did monocytes, this differences was significant only after 2 hr of incubation (p less than 0.05). The killing of Bacteroides fragilis by PMN's and monocytes was identical. These data demonstrate that guinea pig exudates provide suitable models for the study of phagocytosis and killing of bacteria and suggest that the relative bactericidal capacities of phagocytes depend not only on the phagocyte but also on the species of pyogenic bacteria being studied. These observations may have important implications in host defense against serious infections.


Serious cerebral complications following unilateral ligation of the internal jugular vein. Review of the literature and a case report. Serious intracranial sequelae of unilateral internal jugular vein ligation or resection are extremely rare. 22 cases including our own, were found in the literature, eight of them with a fatal outcome. Factors involved such as abnormalities of the cerebral venous sinus system, controlled hypotension, hypovolemia, posture, and dressings are discussed, as well as safeguards and possible preoperative diagnostic measures.


[Immunofluorescent study of the distribution of adult neuro-specific antigens in the chick embryo (author's transl)]. The adult neuro-specific antigens have been localized by immunofluorescence techniques in diencephalon and mesencephalon of chick embryo. This study has been made using fresh or fixed tissues from embryos 72, 48 or 36 h old. At 72 h of incubation the wall of diencephalon shows marked fluorescence; at 48 h of incubation the fluorescent cells are localized in an outer layer and an inner one. In the 48 h-old embryo the reaction is more distinct and intensive in fresh tissues than in fixed tissues. At 36 h of incubation no fluorescence has been detected either in fresh tissues or in fixed tissues.


Reactivity of rat placental cells with alloantisera. The nature of the protection afforded the placental structure against the immunologic consequences that could result from maternal exposure to paternal alloantigens remains obscure. One problem has been difficulty in antigenically defining the individual cellular components of the intact placenta. These studies were designed to examine serologically, with specific antisera, five cell types isolated from the rat placenta. The results indicate that non-Ag-B antigens are present on the cytotrophoblast cells, while Ag-G antigens are absent on all the cells except an undefined population of fibroblasts. Of particular significance is the obvious absence of detectable surface antigens on the cells directly in contact with the maternal tissues, the trophoblast mononuclear giant cells.


Indirect immunofluorescent identification of 19S immunoglobulin-containing cells in the intestinal mucosa of Xenopus laevis. The lymphoid structures in the gastrointestinal tract of immunized and non-immunized adult Xenopus laevis were studied by light and fluorescent microscopy. Serial sections stained with May-Grunnwald Giemsa showed that lymphoid aggregations and scattered lymphoid cells are present along the whole digestive tract. The aggregations are few and rather small in the oesophagus and stomach, they are particularly voluminous in the duodenum. An indirect immunofluorescent technique using antisera against Xenopus laevis 19S and 7S immunoglobulins and their heavy polypeptide chains, revealed the presence of immunoglobulin-containing cells in the duodenal region. The oesophagus and stomach were devoid of these. It has been shown that the immunoglobulins produced in the duodenal lamina propria are formed of both heavy and light polypeptide chains, and that the heavy chains are of the 19S H-type.


A comparison between John Dewey's theory of inquiry and Jean Piaget's genetic analysis of intelligence. This article compares John Dewey's theory of inquiry with Jean Piaget's analysis of the mechanisms implied in the increase of knowledge. The sources for this paper are Dewey's studies on logic and the theory of inquiry and Piaget's historical-critical and psychogenetic investigations. Three major conclusions result from the comparison: first, there are significant convergences between the two theories; second, Piaget's developmental analysis makes explicit what is programmatic in Dewey's investigations; and, finally, Piaget is incorrect in characterizing Dewey's pragmatism as a method that does not meet the criteria of intelligent activity.


Illness behavior, social adaptation, and the management of illness. A comparison of educational and medical models. Motivational needs and coping are important aspects of illness response. Clinicians must help guide illness response by suggesting constructive adaptive opportunities and by avoiding reinforcement of maladaptive patterns. This paper examines how the patient's search for meaning, social attributions, and social comparisons shapes adaptation to illness and subsequent disability. It proposes a coping-adaptation model involving the following five resources relevant to rehabilitation: economic assets, abilities and skills, defensive techniques, social supports, and motivational impetus. It is maintained that confusion between illness and illness behavior obfuscates the alternatives available to guide patients through smoother adaptations and resumption of social roles.


On the presence of different populations of pinealocytes in the mammalian pineal gland. The different categories of cells described by many authors in the pineal gland of mammals have been critically considered. In some mammalian species, two different populations of pinealocytes have been observed. To each of these populations a specific secretory process can be attributed. One is characterized by the formation of granular vesicles originating from the Golgi apparatus, the other by the formation of material directly from the cisterns of the granular endoplasmic reticulum. Both of these secretory processes appear to be also present in the pineal of the mole, the hedgehog, and the rat, mammals in which generally only one population of pinealocytes has been described. The physiological consequences of these findings have been discussed.


Identification of glial fibrillary acidic protein by the immunoperoxidase method in human brain tumors. The immunocytochemical localization of glial fibrillary acidic portein within glioma cell bodies and their processes by the immunoperoxidase method is demonstrated to be of diagnostic value. This method has advantages over "special" stains because it is not so dependent upon color alone, and because it identifies a specific protein in the cells. The immunoperoxidase method using antiserum to glial fibrillary acidic protein is shown to be useful for the differentiation of mixed glial and mesenchymal tumors, and for the diagnosis of tumors in which a glial or mesenchymal cell origin is in doubt.


The immunopathophysiological effects of chronic serum sickness on rat choroid plexus, ciliary process and renal glomeruli. The immunopathological findings and their effects upon the vascular permeability of the ciliary process, choroid plexus and renal glomeruli to intravenously injected 125I-bovine serum albumin (BSA) have been studied in 26 rats who survived a prolonged period of bovine serum albuminemia following the experimental chronic serum sickness model of Fennell and Pardo (8). Rat IgG and C3 and BSA were demonstrated in the experimental rats by direct immunofluorescence in glomeruli, ciliary process and choroid plexus of 85, 38 and 39 percent of animals respectively. Age and sex matched control tissues were negative. Statistically significant differences in the 125I-BSA content of urine, eye and brain were observed between the experimental and control groups. This experimental model offers an approach to the understanding of ocular and central nervous system involvement in clinical situations characterized by circulating immune complexes as well as an experimental tool with which to explore further the physiological consequences of immune deposits within the choroid plexus and ciliary body.


Glycolytic, hexose monophosphate shunt and bactericidal activities of leukocytes in ascorbic acid deficient guinea pigs. It is well known that glycolytic and hexose monophosphate shunt activities of leukocytes increase during phagocytosis. The relevance of these metabolic changes to particle uptake and particle destruction is also well established. In the present study, these metabolic activities were studied to assess the phagocytic function of leukocytes isolated from ascorbic acid deficient guinea pigs. Glycolytic activity which provides the necessary energy for particle uptake was found to be decreased in both resting and phagocytizing leukocytes for ascorbic acid deficient guinea pigs. The direct oxidation of glucose through the hexose monophosphate shunt (HMS) was stimulated to a significantly lesser extent during phagocytosis in ascorbic acid deficient leukocytes. There was a progressive decline in phagocytosis induced shunt activity of leukocytes as the deficiency of ascorbic acid progressed. These findings show that particle uptake (as indicated by glycolytic activity) as well as particle destruction (as indicated by HMS activity) by leukocytes are impaired in ascorbic acid deficiency. Bactericidal capacity of leukocytes against Escherichia coli was also found to be low in ascorbic acid deficient guinea pigs as compared to those in the pair-fed control group.


Diverse effects of triamicinolone on the ocular response to circulating endotoxin. The ocular response to circulating bacterial endotoxin (E coli 055:B5, 100 microgram/kg) can be either significantly reduced or made more servere by pretreatment with the synthetic glucocorticoid triamcinolone. A single injection (25 mg/kg) 3 hr prior to endotoxin sharply curtails the response. Daily injections for 3 days preceding endotoxin produces an enhanced response. With this regimen, an enhanced alteration in ocular vascular permeability is produced 4 hr following endotoxin if 5 mg of triamcinolone is injected daily; if larger quantities of steroid are employed (25 mg), there is a slight reduction in ocular vascular permeability, but an enhanced intravascular fibrin accumulation in ocular blood vessels as well as in capillaries of renal glomeruli (generalised Shwartzman reaction). Once the enhancement of the ocular response to endotoxin has been established by prior treatment with steroids, additional triamcinolone given 2--3 hr before endotoxin is no longer effective in protecting against ocular or renal changes. These divergent effects of steroid could be produced by either subcutaneous or intra-orbital injection, and the response was equal in both eyes following intra-orbital injection, suggesting that steroids probably do not exert their effects locally in this situation. Although different mechanisms of action of corticosteroids may be responsible for these diverse effects, it is suggested that a loss of responsiveness to steroids may be important in their ability to enhance the effects of endotoxinemia.


Histological criteria for immunological rejection of mouse skin homografts. The sequence of events in homograft rejection of skin in mice was studied by light microscopy in comparison to the reactions to isografts. Male C3H mice were used as donors and Balb/c mice were the recipients. In non-infected grafts no invasion of graft tissue by inflammatory cells occurred except for the marginal areas bordering on the graft bed. The most constant feature of immunological rejection was occlusion of blood vessels at the graft-host border with ischaemia of the graft. This indicated that skin homograft rejection is mainly a vascular phenomenon which can be best diagnosed by the presence of empty venules and capillaries. Leukocytic infiltration was prominent in presumably infected grafts. Destruction and inflammatory infiltration of the epidermis was not found to be a criterion for immunological rejection. In the graft bed adjoining the graft the granulation tissue contained basophilic and small lymphocytes, and macrophages. These cell tended to concentrate nearest to the graft and were surrounded on the outside by the lymphoid cells. It is probable that the macrophages were active in digestion of breakdown products.


Malignant histiocytosis with associated "reticulum celled sarcoma". A case of malignant histiocytosis associated with a "reticulum celled sarcoma" of the stomach is described. It is considered that both neoplasms represent progressive degrees of anaplasia of the same neoplastic process.


Lymphoproliferative response during resolution and recurrence of naturally occurring gingivitis. The lymphocyte blastogenic response in humans to oral bacterial antigens was investigated during resolution and recurrence of naturally occurring gingivitis. The following conclusions were drawn: 1. Actinomyces and Fusobacterium and the host responses they evoke, are associated with gingival inflammation. 2. The magnitude of the blastogenic response to these antigens is directly related to the severity of gingival inflammation. 3. Scaling may cause a transient rise in the blastogenic response. 4. Conservative therapy not only improves the clinical state of gingival health, but also interrupts a possible pathogenic mechanism of periodontal disease.


Precocious periodontitis: a clinical entity and a treatment responsibility. This report has proposed that the term, periodontosis, be discarded and replaced with the term, precocious periodontitis. The literature review has shown that, although the exact causative agents are unknown, certain microbiological reactions do occur and the condition is a periodontitis. The term, precocious periodontitis, has been suggested because the disease entity differs from chronic periodontitis in some of its characteristic features and etiologic factors. Three important local etiologic factors are: (1) contact and eruption of the first molars, (2) occlusal traumatism, and (3) ineffective oral hygiene. The recent literature concerning possible hereditary characteristics, bacteriological findings, and immunological reactions has been cited. The reports presented showing successful results of therapy were selected to illustrate that this condition can have the same prognosis and response to therapy as other similarly involved cases of periodontitis as a clinical entity with a definitive treatment responsibilities.


Effect of fluoride on autogenous iliac cancellous bone and marrow transplants in surgically created intrabony pockets in dogs. The effect of the osteogenic capacity of fluoride on autogenous iliac cancellous bone and marrow transplants was studied in experimentally created periodontal defects. Eight dogs, 2 years old, weighing between 10 to 15 kg each, were used. The right side of the upper jaw served for creation of the experimental (fluoride-treated) pockets and the left side for the control (saline-treated) pockets. Fluoride treatment was carried out by a single topical application of a high concentration of fluoride in the periodontal defects and by application of a low concentration of fluoride to the bone marrow transplants. Intraoral periapical radiographs were taken immediately after implantation, and at time of sacrifice. Changes during bone healing were assessed histologically and by radioopacity measurements. The newly formed bone in the control and fluoride-treated areas did not differ in quality. Radioopacity in the experimental defects was significantly higher in comparison with that found in the control areas. The increase was probably due to greater bone formation in the fluoride-treated defects. The difference decreased with the duration of the healing intervals. Cementum was deposited in both control and experimental sites.


Strength determination of periodontal splints fabricated from acid-etched retained materials. Six systems (one polycarboxylate, one polymethyl methacrylate, one unfilled BIS-GMA resin, two combinations of methyl cyanoacrylate and polymethyl methacrylate, and one combination of unfilled BIS-GMA and filled composite resin) were evaluated for in vitro retention to acid-etched human enamel. Also tested were one unfilled-filled resin combination backed by perforated orthodontic band metal and another unfilled resin backed by stainless steel wire mesh. Significant differences in retention were found. Results show that retention depends pril surface and to resist subsequent chemical degradation.


Handwriting characteristics and their relationship to Eysenck's extraversion-introversion and Kagan's impulsivity-reflectivity dimensions. Examined the relationship between certain handwriting characteristics and Eysenck's Extraversion-Introversion and Kagan's Impulsivity-Reflectivity personality dimensions. Using 46 female subjects, scores on the EPQ inventory and Matching Familiar Figures test were compared by factor analysis to the handwriting characteristics of: middle zone height; middle zone breadth; upper zone height; lower zone height; space between words; right margin breadth; left margin breadth; a general size measure; handwriting time; paragraph indention; slant. The factor analysis revealed three distinct writing styles: one related to Extraversion; another related to Introversion; and a final one related to Reflectivity. These findings were discussed in relation to statements made by graphologists. Also, the significance of trait-sign and factor analysis in comparison with other methods of graphoanalysis was discussed.


A reply to "Validity and student acceptance of a graphoanalytic approach to personality" by Vestewig, Santee, and Moss. Vestewig, Santee, and Moss have interpreted their 1976 study of graphoanalysis as wholly offensive to the validity of this system of personality assessment. But re-examination of their data reveals that some findings actually support the validity of graphoanalysis in spite of the fact that their methodology stacked the cards against the handwriting experts. Suggestions are made as to how this study could have been made comparable to those studies which show validity of handwriting analysis by the "global" or "holistic" method, and it is noted that under these conditions the results might have been quite different.


Need associations and psychopathology.

Need associations and psychopathology. The 1960 Picture Identification Test (PIT) provides association scores for 210 need dyads derived from 21 Murray needs. Association scores for 16 clinical-control group pairs were analyzed for differences by t test. The clinical groups represented schizophrenic, neurotic, sex disturbance, and behavior disorder categories. Assertive needs produced the largest number od dyads which discriminated (p less than .05) clinical and control groups. Schizophrenic groups had the largest number of differences from normal controls. Schizophrenics tended to under-associate pairs of Assertive needs, as compared to normals, whereas other groups tended to over-associate these needs. Clinical groups in general over-associated 379 need dyads and under-associated 99 dyads (p less than .05). These results suggest that the frustations of maladjusted people, with regard to need association, are most generally related to insuficient conceptual differentiation of needs.


Intelligence and imagery in personality. One hundred college undergraduates were administered the Richardson revision of the Gordon Test of Visual Imagery Control, the Betts-Sheehan Questionnaire Upon Mental Imagery, and the Shipley-Hartford Institute of Living Scale. The latter provided a conceptual quotient (CQ) score of intellectual impairment based upon a ratio between vocabulary and abstraction scores. Subjects with CQs above 100 had significantly higher control scores (p less than .02). High control subjects had significantly higher total IQ scores than did low control subjects (p less than .04). Subjects with high and medium range control had higher vocabulary scores than those with low control. This suggests possible assessment of proneness toward introverted and extraverted neuroticism based upon a combination type of imagery score and the ratio between abstract or vocabulary scores. The connection of imagery with dimensions of IQ may be a start toward a more refined measure of this aspect of personality. Problems and implications are discussed.


Physiologically active substances from marine sponges IV: Heterocyclic compounds. Several guanidine compounds were synthesized by the reaction of acid chlorides of thiophene and furan with guanidines. Some of these compounds showed antibiotic and cytotoxic activities. Series of pyrrole compounds were synthesized and found to have significant antibiotic activity.


Direct evidence for the location of kallikrein in the striated ducts of the cat's submandibular gland by the use of specific antibody. Kallikrein was located in the apical portion of the striated duct cells of the cat's submandibular gland by an immunohistochemical technique. This portion only of these cells showed an intense band of specific fluorescence. There was no evidence of specific fluorescence in the acinar and demilune cells nor in the interstitial tissue or blood besells. In some sections the collecting ducts showed a very fine fluorescent luminal rim.


Hemisected molars for additional overdenture support. A preventive prosthodontic technique has been described which utilizes hemisected teeth for overdenture support. This multidiscipline procedure provides firm denture support and preserves posterior residual alveolar ridges. By retaining posterior roots, proprioceptive mechanisms are maintained, and psychologically, the patient does not seem edentulous. As Brewer and Fenton stated, "The application of this method of treatment is limited only by the imagination of the dentist."


Repair technique for porcelain-fused-to-metal restorations. A technique has been described which can be used to repair many fractured porcelain-fused-to-metal restorations. The primary advantage of this technique is that it can salvage many restorations which might otherwise require remaking to achieve a satisfactory esthetic result. The disadvantage of the technique is its lack of universal application. There are situations which, due to the nature of the fracture or the framework, are not suitable for this repair technique.


Correlation of encystment and division in Schizopyrenus russelli. Schizopyrenus russelli, a free-living soil ameba, grows and encysts in the presence of bacteria. The encystment occurs with decline in the division rate. This is accompanied by incorporation of [U-14C] glucose into cyst cellulose. The degree of multiplication (but not of encystment) is a function of bacterial concentration. Berenil, a trypanocidal drug, while allowing excystment, completely inhibited multiplication of emerged amebae and their encystment. Addition of this drug after 24 hr, when amebae had gone into a phase of active division failed to check encystment, although it still inhibited further multiplication of the amebae. The findings suggest that a phase of cell division may be a prerequisite for encystment.


Response of cyclic and post-partum suckled cows to injections of synthetic LH-RH. Doses of 125, 250 or 500 micrograms LH-RH were injected i.m. into suckled beef cows on approximately Day 11 of an oestrous cycle synchronized by prostaglandin treatment. There was a positive linear relationship between dose of LH-RH and the area under the measured LH peak. Administration of 500 micrograms LH-RH as a single injection to suckled cows 13-32 days post partum resulted in LH release but failed to induce normal ovarian activity. A small transient rise in plasma progesterone for 6--9 days occurred at the expected time after injection in 50% of animals. Administration of 500 micrograms LH-RH to suckled beef cows approximately 20--30 days post partum and a second injection approximately 10 days later at the time when the resulting transient rise in plasma progesterone had returned to basal values induced normal cyclic activity (as shown by progesterone concentrations and observed oestrus) at 35 days compared with 70 days for untreated controls. Pituitary responsiveness to LH-RH, as assessed by LH levels, was found to increase up to 20 days post partum.


Effect of neonatal testosterone and oestradiol treatment on the development of the hypothalamo-hypophysial axis in the female rat. The hypothalamic LH-RH content and the concentrations of pituitary and plasma LH were measured at various ages in female rats treated daily with 10 micrograms testosterone propionate or 10 micrograms oestradiol-17beta from birth to Day 15. Persistent vaginal oestrus was induced in all the treated rats. Both hormones significantly reduced the hypothalamic LH-RH content and pituitary and plasma LH concentrations. Hypothalamic LH-RH increased after cessation of treatment but pituitary LH did not return to normal levels. Plasma LH levels were significantly lower than those in control rats. It is concluded that testosterone propionate and oestradiol-17beta (1) have a direct negative feed-back influence on the hypothalamus in the neonatal female rat; (2) alter the normal pattern of plasma and pituitary LH in developing female rats; (3) prevent the cyclic secretion of plasma LH after maturity; and (4) probably cause a chronic impairment in the release of LH-RH.


Immunofluorescent technique for the detection of antibodies to n-DNA: comparison with radioimmunoassay. One hundred and six sera from patients with systemic lupus erythematosus (SLE), 20 from patients without SLE but with a positive FANA, and 50 controls were tested for the presence of antibodies to n-DNA, using an immunofluorescent technique with the kinetoplast of Crithidia luciliae as a substrate. A high degree of correlation existed between the results obtained with this technique and a Millipore radioimmunoassay method using a well characterized tritiated native human DNA. The result with the immunofluorescent method could be expressed semiquantitatively as a titer, if serial serum dilutions were used. Results in patients with SLE correlated well with disease activity. We conclude that the immunofluorescent technique can provide a useful alternative to a radioimmunoassay for the detection of antibodies to n-DNA. In addition, as this substrate is known to contain pure n-DNA, problems do not arise with contamination with singlestranded DNA as sometimes occurs with other test antigens. This avoids the detection of antibodies reacting only with single-stranded areas and consequently increased the specificity of the reaction.


Temporal arteriography and immunofluorescence as diagnostic tools in temporal arteritis. Nineteen patients with polymyalgia rheumatica and/or temporal arteritis were classified by degree of clinical and arteriographic abnormality, biopsy grade of arteriosclerosis, and giant cell arteritis (GCA). Temporal arteriograms were very sensitive in detecting abnormal arteries. However, the assumption of some previous studies, that certain angiographic abnormalities are synonymous with GCA, was not supported, since biopsies from distal sites in a Class I and a Class II arteriogram revealed only arteriosclerosis. Class III arteriograms correlated with proximal biopsies of GCA. Immunofluorescent staining was negative in all cases.


Double-blind, multi-centre parallel trial of ketoprofen and ibuprofen in the treatment of rheumatoid arthritis. A double-blind parallel multi-centre study of 102 patients with rheumatoid arthritis (RA) was performed, comparing ibuprofen (1200-2400 mg daily) and ketoprofen (150-300 mg daily) a new non-steroidal, anti-inflammatory agent, over a three month period. Ketoprofen was well tolerated and shown to have comparable efficacy with ibuprofen. Longterm efficacy and tolerance studies are indicated.


Increased frequency of leukocyte-reactive antinuclear antibody in patients with ankylosing spondylitis. Immunofluorescent studies were conducted for leukocyte-reactive antinuclear antibody (LR-ANA) with sera from 125 patients with ankylosing spondylitis (as), 124 with rheumatoid arthritis (RA) 74 with miscellaneous immune disorders (MID), 34 with acute inflammatory disorders (AID) and 122 non-immune controls. Positive reactions occurred with 60% of AS patients, 47% of RA, 40% of MID, 12% of AID, and 9% of non-immune controls. LR-ANA in AS sera invariably showed a homogeneous pattern of immunofluorescent staining with human granulocytes, occasionally reacted with human lymphocytes but did not react with other human and non-human substrates. Studies of 61 members of seven families with 18 cases of AS revealed a frequency of 38% LR-ANA, 30% AS and 55% HLA-B27, but no correlations were found among these parameters. These studies provide evidence of altered humoral immunity to human nucleic acids in the majority of patients with AS.


A method for handling free cells through critical point drying. A method is described in which free cells were dehydrated in suspension, put one double-coated tape attached to a specimen stub and dried from CO2. The method provides a simple, fast means of handling free cells when using the critical point method of drying.


The use of PIPES buffer in the fixation of mammalian and marine tissues for electron microscopy. PIPES, an organic based buffer, was used in the preparation of a variety of marine and mammalian tissues for electron microscopic study. The ultrastructural results demonstrate that this buffer renders superior ultrastructural details to those obtained with some of the more common inorganic buffers especially when long fixation times are required. Furthermore, this buffer system does not appear to contribute extraneous anions or cations to the tissues and thus permits accurate elemental determinations to be performed on thin sections of the plastic embedded specimens by means of energy dispersive X-ray analysis.


Use of an automated image analyser to quantitate cellular hyperplasia in urinary bladder epithelium. The feasibility of using an automated image analyser to evaluate quantitatively hyperplasia caused by N-butyl-N-(4-hydroxybutyl) nitrosamine in bladder epithelium was studied. The number of cells per unit length of epithelium was counted manually, and compared with automated measurements of: (1) the number of nuclei, (2) the number of positive tangents to the lower edge of nuclei, (3) the nuclear cross-sectional area, and (4) the epithelial cross-sectional area per unit length respectively. Regression of each of the automated measurements on the manual counts all revealed close linear relationships with correlation coefficients in excess of 0-9. Coefficients of variation for repetitive automated measurements were less than or equal to 0-06 in each of the four modes. The automated system resulted in a great saving in time over manual counting. It is concluded that the automated image analyser provides an accurate, precise, and efficient tool for estimating epithelial cell numbers in normal and hyperplastic bladder epithelia.


Metabolic activation of mycotoxins by animals and humans: an overview. Aflatoxins are associated with acute toxicoses in poultry and livestock and with liver cancer in human populations in Africa and Southeast Asia. Comparative metabolism studies indicate that aflatoxin B1, the most potent of these compounds, requires metabolic activation to the ultimate carcinogen. The mycotoxin (1) is oxidatively demethylated to form the phenolic derivative, (2) is hydroxylated directly at three sites, and (3) undergoes reduction of the carbonyl group in the cyclopentenone ring to a hydroxyl group; these five hydroxy derivatives all appear to be part of detoxication pathways. Considerable evidence is now available to support the hypothesis that activation of aflatoxin B1 to the ultimate carcinogen involves epoxidation of the double bond in the terminal furan ring. The epoxide decomposes to form a carbonium ion at C-2, which attacks nucleophilic sites in DNA, especially on the guanine moiety. Thus, like carcinogenic polycyclic hydrocarbons and N-nitroso compounds, aflatoxin B1 appears to be activated to an alkylating agent.


Benzo[a]pyrene carcinogenesis: a biochemical selection mechanism. Separation of the metabolic products of benzo[a]pyrene has been readily accomplished by high-pressure liquid chromatography. This technique is uniquely suited for compounds labile to air and light and resolving positional isomers of phenolic or other types of oxygenated metabolites of this carcinogen. This procedure has been utilized to separate and compare benzo[a]pyrene activation and detoxification products between rat, mouse, and hamster hepatic microsomes and mouse and hamster embryo cell cultures. While metabolic profiles exhibited the same types of derivatives, marked quantitative variation was observed. Microsomal preparation produced large amounts of noncarcinogenic phenols, while intact cell metabolism favored diol formation. These results are in agreement with reactivation of metabolic diols as substrates for further activation to a more proximate carcinogenic species of benzo[a]pyrene and caution against extrapolating metabolic results from any single test system to other species or tissues.


Relationships of quantum mechanical calculations, relative mutagenicity of benzo[a]anthracene diol epoxides, and "bay region" concept of aromatic hydrocarbon carcinogenicity. Evidence supporting the conclusion that 7,8-dihydroxy-9,10-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrenes are ultimate mutagenic and carcinogenic forms of benzo[a]pyrene (BP) is summarized. Qauntum mechanical calculations that predict reactivity of diol epoxides derived from BP and other polycyclic aromatic hydrocarbons are described. The calculations predict that diol epoxides in which the oxirane ring forms part of a "bay region" of a tetrahydrobenzo ring should be the most reactive for a given aromatic hydrocarbon. Experiments with dihydrodiols and diol epoxides from benzo[a]anthracene (BA) are described. The ability to metabolically activate BA 3,4-dihydrodiol to species much more mutagenic that those obtained from other BA dihydrodiols ant the much greater mutagenicity of the diastereoisomeric 3,4-diol 1,2-epoxides of 1,2,3,4-tetrahydro BA relative to other diol epoxides of BA are in accord with predictions of the quantum mechanical calculations.


N-nitroso compounds: their chemical and in vivo formation and possible importance as environmental carcinogens. Brief reviews are presented on the occurrence of N-nitroso (NNO) compounds, the chemistry and kinetics of NNO compound formation from nitrite and amines or amides, the in vivo formation of these compounds (as detected by tumor induction) on feeding nitrite with amines or amides to rodents, and the carcinogenicity for rats of some new nitrosamides. The possible human hazard caused by exposure to specific readily nitrosated compounds is reviewed. Whether NNO compounds might be causing human cancer of various organs (e.g., pancreatic, nasopharyngeal, and esophageal cancer) is discussed. Some of our results in [3H]thymidine incorporation in the rat esophageal epithelium are presented. Nitrosamines that cause esophageal cancer in rats were found to inhibit [3H]thymidine incorporation, both in vivo and in vitro, when esophagi were incubated with nitrosamines. With reference to the hypothesis that human gastric cancer is caused by nitrosamides (e.g., nitrosoureas), certain correlations were examined between gastric cancer and environmental exposure to nitrate, nitrite, and nitrosatable amides. In studies from our laboratory, dried, salted fish, which was treated with excess nitrite at pH 1 and then "denitrosated" at pH O, yielded 16 mg methylurae/kh fish, possibly derived from methylguanidine.


Sites in nucleic acids reacting with alkylating agents of differing carcinogenicity of mutagenicity. The site of alkylation of a nucleic acid, in vivo, is greatly dependent on the type of alkylating agent. Most alkylating agents of low mutagenicity or carcinogenicity (such as dimethylsulfate) react primarily with the ring nitrogens. The carcinogenic N-nitroso compounds have a great affinity for alkylating oxygens and react with all ring oxygens as well as the phosphodiesters and, in the case of RNA, with the 2'-O of ribose. Ethylating agents, though in absolute terms less reactive than the corresponding methylating agents, show even greater affinity toward oxygens. It appears that the ethyl nitroso compounds that are carcinogenic are also the most reactive with oxygens.


Some aspects of the basic mechanisms of chemical carcinogenesis. An extended summary is presented of current progress in research on the basic mechanism of chemical carcinogenesis conducted in the Division of Biophysics, School of Hygiene and Public Health, at the Johns Hopkins University. The first section concerns the involvement of free radicals in benzo[a]pyrene metabolism and carcinogenesis, the second the relationship between neoplastic transformation and somatic mutation, and the third the changes in DNA sequence organization and gene expression in neoplastic transformation.


Mutational approaches to the study of carcinogenesis. A number of circumstantial lines of evidence are consistent with the somatic mutation theory of carcinogenesis, but there has been a paucity of experimental data that either support or contradict the genetic theory. In this paper, we summarize the predictions, the recent experimental approaches, and the problems involved in testing the theory. Results are presented that define the conditions and demonstrate the existence of two-stage processes of mutagenesis and carcinogenesis in vitro. We conclude that mutagenesis is responsible for the initiation of carcinogenesis and an epigenetic mechanism is responsible for its promotion. Carcinogenic agents can induce a stable transformation of a cell by either mutation or epigenetic alteration in gene expression. This conclusion has led us to propose a new integrative theory of carcinogenesis, encompassing the tenets of four main theories: (1) the mutation and epigenetic basis for carcinogenesis, (2) the two-stage theory of carcinogenesis, (3) a general theory of carcinogenesis, and (4) the somatic deletion mutation theory of carcinogenesis.


Relationship between differentiation and carcinogenesis. Carcinomas are caricatures of the normal process of tissue renerwal. Malignant stem cells proliferate, and some of their progeny differentiati and form benign functional cells. In teratocarcinoma, it has been demonstrated that the stem cells are the target in carcinogenesis and become malignant stem cells. The normal and malignant stem cells are equally differentiated. Normal stem cells of breast and colon are no more differentiated than their counterparts. If they are the target in carcinogenesis, then the concept of dedifferentiation is bypassed as an explanation for the undifferentiated appearance of tumors. While the focus of this meeting has been on mutation as an explanation for carcinogenesis, in this paper emphasis is placed on electrophilic carcinogens acting on cytoplasmic molecules that control gene expression. A type of gene control in addition to the operon is postulated.


Adenovirus DNA-binding protein in cells infected with wild-type 5 adenovirus and two DNA-minus, temperature-sensitive mutants, H5ts125 and H5ts149. Studies have been done to characterize further H5ts125, an adenovirus type 5 conditionally lethal, temperature-sensitive (ts) mutant defective in initiation of DNA synthesis and to investigate whether the single-strand-specific DNA-binding (72,000 molecular weight) protein is coded by the mutated viral gene. When H5ts125-infected cells were labeled with [35S]methionine at 32 degrees C and then incubated without isotope at 39.5 degrees C, the mutant's nonpermissive temperature, the 72,000 molecular weight polypeptide was progressively degraded. Immunofluorescence examination of cells infected with wild-type virus, H5ts125, and H5ts149 (a second, unique DNA-minus mutant) showed that immunologically reactive DNA-binding protein was barely detectable in H5ts125-infected cells at 39.5 degrees C, whereas this protein was present in wild-type- and H5TS149-infected cells, that the protein made at 32 degrees C in H5ts125-infected cells lost its ability to bind specific DNA-binding protein antibody when the infected cells were shifted to 39.5 degrees C, and that if H5ts125-infected cells were shifted from the restrictive temperature to 32 degrees C, even in the presence of cycloheximide to stop protein synthesis, immunologically reactive DNA-binding protein reappeared.


Further studies on bacteriophage T4 DNA synthesis in sucrose-plasmolyzed cells. This paper describes several technical improvements in the sucrose-plasmolyzed cell system used in earlier experiments on DNA synthesis in situ with Escherichia coli infected by DNA-defective mutants of bacteriophage T4 (W. L. Collinsworth and C. K. Mathews, J. Virol. 13:908-915, 1974). Using this system, which is based primarily on that of M. G. Wovcha et al. (Proc. Natl. Acad. Sci. U.S.A. 70:2196-2200, 1973), we reinvestigated the properties of mutants bearing lesions in genes 1, 41, and 62, and we resolved some disagreements with data reported from that laboratory. We also asked whether the DNA-delay phenotype of T4 mutants is related to possible early leakage of DNA precursors from infected cells. Such cells display defective DNA synthesis in situ, even when ample DNA precursors are made available. Thus, the lesions associated with these mutations seem to manifest themselves at the level of macromolecular metabolism. Similarly, we examined an E. coli mutant defective in its ability to support T4 production, apparently because of a lesion affecting DNA synthesis (L. Simon et al., Nature [London] 252:451-455). In the plasmolyzed cell system, reduced nucleotide incorporation is seen, indicating also that the genetic defect does not involve DNA precursor synthesis. The plasmolyzed cell system incorporates deoxynucleotide 5'-monophosphates into DNA severalfold more rapidly than the corresponding 5'-triphosphates. This is consistent with the idea that DNA precursor-synthesizing enzymes are functionally organized to shuttle substrates to their sites of utilization.


E proteins of bacteriophage P22. I. Identification and ejection from wild-type and defective particles. Of the nine proteins found in the virion of phage P22, four are ejected into the cell after adsorption. The four ejected proteins, termed E proteins, are gp16, gp20, gp26, and gp7. This was determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of radioactively labeled phage that had been adsorbed to cells and then eluted off the surface with distilled water. Phage particles that lack gp7 (7- particles) or gp20 (20- particles) successfully eject all their E proteins. The 16- particles do not eject gp7. Analysis of phage ghosts showed that they lack gp16, gp20, and gp7, but they have gp26 in close to normal quantities. Our results suggest roles for gp16 and gp26 in DNA and E protein ejection. All four E proteins are possible candidates for roles in helping the phage DNA cross the plasma membrane.


Membrane damage in abortive infections of colicin Ib-containing Escherichia coli by bacteriophage T5. Strains of Escherichia coli K-12 containing the colicin Ib (Col Ib) factor did not produce progeny phage when infected by T5 bacteriophage. The cells were killed but did not lyse. If sodium dodecyl sulfate (SDS) was added to T5-infected E. coli (Col Ib), lysis occurred prematurely, but no phage were produced. SDS had no effect on infected cells that did not contain the Col Ib factor or on uninfected cells with or without the Col Ib factor. Cells that contained a mutant Col Ib factor that allowed phage production were not prematurely lysed after infection in the presence of SDS. When the Col Ib-containing cells were infected, protein and RNA synthesis stopped at about 10 min postinfection, and the cells released abnormal amounts of 32P-containing material, ATP, and beta-galactosidase into the medium. They also became inhibited in their ability to accumulate thiomethyl-beta-D-galactopyranoside and to utilize glycerol. Two alternative hypotheses are presented to explain these results.


Amikacin therapy. Use against infections caused by gentamicin- and tobramycin-resistant organisms. Amikacin sulfate was used in 24 treatment courses for 25 serious infections caused by aerobic or facultative anaerobic Gram-negative organisms resistant to numerous drugs. Sites of infection included urinary tract (11 cases), pleuropulmonary (6 cases), primary bacteremia (5 cases), and miscellaneous (3 cases). Serratia marcescens and Pseudomonas sp accounted for 73% of the isolates. The mean minimal inhibitory concentration (MIC) of these organisms to amikacin was 3.6 microgram/ml; to gentamicin, 39 microgram/ml; and to tobramycin, 32 microgram/ml. The mean peak serum concentration of the drug was 20.8 microgram/ml. Eleven patients were critically ill at the onset of therapy, and seven patients were bacteremic. The overall favorable response rate was 80%. The most serious side effect was ototoxicity, which occurred in three of 15 patients examined by serial audiometry.


Changes in sensitivity of mice to anticonvulsant drugs following bilateral olfactory bulb ablations. Changes in sensitivity to anticonvulsant drugs were investigated after bilateral olfactory bulb ablations in mice. The sensitivity to benzodiazepines and acetazolamide increased, whereas that to phenylacetylurea and dipropylacetic acid decreased, and sensitivity to phenobarbital, diphenylhydantoin and trimethadion was not significantly changes after olfactory bulb ablations. Increase in sensitivity to benzodiazepines was the most significant in both electroshock and pentetrazol convulsions. It was suggested that altered activities and denervation supersensitivity in the limbic system, hypothalamus and midbrain might account for these changes in sensitivity to anticonvulsant drugs after olfactory bulb ablations.


Central venous cannulation and pressure monitoring. Central venous pressure (CVP) varies directly with circulating blood volume and vascular tone and inversely with right heart competency. Indications for central cannulation include cardiorespiratory arrest. The two general approaches to cannulation of central veins are peripheral and central. The physician's skill, patient's body habitus, clinical circumstances, age and thoracic deformity all influence the choice of technique. Three of the possible complications discussed are pneumothorax, arterial puncture and air embolus. Accurate measurement of CVP depends on the patient being supine, a patent and accurately located catheter and the establishment of a baseline external zero point.


Cerebral malaria.

Cerebral malaria. Cerebral malaria is an unusual and treatable cause of stupor and coma, and it can present suddenly in a healthy person. It is diagnosed by finding parasites on a blood smear and is treated either with chloroquine or with quinine, pyrimethamine, and sulfadiazine.


Mycotic aneurysm with recurrent sepsis complicating post-transplant nephrectomy. A hypertensive 37-year-old man underwent renal transplantation. The transplanted kidney was removed 5 days later, 21 months before his death. He was maintained after transplantation by hemodialysis. His postoperative course was complicated by recurrent pseudomonal infection with bacteremia. He presented with symptoms of acute peritoneal irritation and hypovolemia followed by sudden death. Postmortem examination revealed that a saccular mycotic aneurysm of the left common iliac artery, which was the site of post-transplant nephrectomy, had ruptured into the peritoneal cavity. The case exemplifies postoperative mycotic aneurysm, the frequently obscure clinical findings of iliac artery aneurysms, and the need for a high index of suspicion of mycotic aneurysm in patients undergoing renal transplantation.


[Twenty-five years of experience with corneal grafts (author's transl)]. The progress in instrumentation and surgical techniques, as well as improvements in the knowledge of the biologic mechanisms have considerably enlarged the indications for keratoplasty. Even in unfavourable cases the prognosis has been notably improved by recent advances in medications and techniques to improve the conditions of the recipient and the operative technique, and also to limit the immunologic response. The use of impeccable instruments, meticulous selection of the graft and a refined surgical technique during the the operation are essential since neglect of any small detail may lead to failure of the operation. The graft and the recipient bed must be in perfect apposition. A very neat, smooth incision of the graft and the host window are imperative, as well as the application of a sufficient number of sutures. The sutures must be left in place for a sufficiently long period of time to ensure good cicatrization of the graft. Peripheral iridotomies or iridectomies facilitate the circulation of the aqueous humor avoiding the danger of postoperative pupillary block with all its consequences. The anterior chamber must be carefully restored, preferibly by air injection, to maintain the iris well away from the incision. It should be taken into account during the whole procedure that the endothelium is the most delicate and the most important structure of the graft as well as the host cornea. Contact with the instruments should be avoided and the sutures should provide good apposition of the endothelial edges. Early diagnosis and prompt adequate treatment of any accident or complication are essential. Undetected complications or incorrect management of the same may be responsible for failure of the operation and the final result may vary between a more or less opacified graft and the full-blown picture of phthisis bulbi. A number of illustrative cases are presented.


[A modification of Toti's operation (author's transl)]. An external dacryocystorhinostomy with simplified suture is described. This method was suggested in 1937 by Kaleff and further developed by us. The modified operation consists of the following: The nasal mucous membrane is prepared free, and from this a complete pedicle is made with the base underneath. The tear sac is split in the long axis into a broad upper and a narrower lower part. The narrow lower part is sewed to the nasal mucous membrane with 3 atraumatic catgut sutures. The broader upper lobe of the sac is fixed to the covering subcutis with 3 catgut sutures.


[Patterns of renal and haemodynamic functions in cadaver kidney donors under dopamine (author's transl)]. Haemodynamics and renal function have been examined before and during i.v. infusion of dopamine (175 microgram/min) in 11 patients admitted as potential kidney donors to an intensive care unit. The findings of the control period revealed an extreme decrease of renal tubular function which points to a cessation of central regulation. The cardiovascular system showed a slight increase of blood pressure and heart rate during dopamine. Urine flow and renal blood flow increased significantly as well as the excretion of sodium while inulin-clearance showed only a minimal rise. The functional renal impairment under conditions of brain death as well as the influence of dopamine on circulation and renal function are discussed. The results indicate that dopamine may exert a favourable effect in preparation of kidney donors for the withdrawal of the organs.


[Prostaglandins in reproductive physiology (author's transl)]. Up to the present time, the most extensive knowledge in prostaglandin research has been achieved in the field of reproductive physiology. It seems now certain that prostaglandins are involved in each phase of the reproductive process although their precise physiological functions cannot yet be completely explained. For example they are thought to play an important role in the hypothalamic -- pituitary system in the liberation of LHRH and in the ovary in steroid genesis, ovulation and luteolysis; also, in the non-pregnant uterus in the onset of menstruation while at conception both sperm and ovum transport are influenced by prostaglandins. In pregnancy, a prostaglandin function has been demonstrated in the uterus in initiating labour in cases of abortion and in birth at term. Further, they appear to be involved in regulating the blood circulation in placenta, cord and fetus. Already, because of their established physiological functions, the prostaglandins have been introduced successfully into clinical use.


[Immunofluorescence studies of experimental glomerulonephritis in formalin-fixed and paraffin-embedded material (author's transl)]. Immunofluorescence studies are an essential part of the diagnosis in glomerulonephritis. For these studies unfixed, frozen material was used only, on account of intense background staining of formalin-fixed slides. A method developed by Huang (1975) was tested on experimental glomerulonephritis. He succeeded in minimizing the background staining of formalin-fixed liver tissue with pronase-treatment. Our results show no differences in the immunofluorescence of the experimental glomerulonephritis between frozen and paraffin-embedded sections. It seems to be possible therefore to investigate a glomerulonephritis in formalin-fixed material by this method.


Immunoultrastructural study of surfactant system. Distribution of specific protein of surface active material in rabbit lung. Ducks were immunized with rabbit pulmonary surface active material that had been prepared with Sephadex chromatographic separation on lung washings. Specific antibody against a protein of surface active material was obtained after absorption of duck antisera with rabbit serum. Using the ultrastructural immunoperoxidase method, dense reaction product was recognized in alveolar lining material as granular deposits, closely associating with tubular myelin figures that were often observed in the basal layer of alveolar lining layer. In type I pneumocytes, reaction product was noted only in some pinocytotic vesicles. By contrast, in type II pneumocytes there was positivity in association with lamellar inclusion bodies, multivesicular bodies, Golgi complex, and endoplasmic reticulum. No reaction product was detected in bronchiolar and bronchial epithelial cells, including nonciliated bronchiolar and goblet cells. These findings indicate that specific protein in surfactant is synthesized in type II pneumocytes and secreted into the alveolar space to become a part of the alveolar lining layer, thus suggesting that specific protein plays an important role in surfactant system. Furthermore, reaction product could be detected in phagocytic vacuoles in alveolar macrophages and thus seems to be related to the clearance mechanism of the protein component of surfactant.


[The structure of the nucleolus during the inhibition of RNA-and protein synthesis (author's transl)]. In cells treated with antimetabolites to inhibit RNA- and protein synthesis, electron microscopic studies reveal structural alterations of the nucleolus. The morphological appearance of the nucleolus differs depending of the inhibitor used. If transcription is prevented, segregation of nucleolar components is observed. Inhibition of processing of newly synthesized RNA results in a degranulation and an increase in the amount of nucleolar fibrils. A disturbance of the release of nucleolar ribonucleoproteins into the cytoplasm leads to an enlargement and a hypergranulation of the nucleolus. On the other hand interruption of translation of mRNAs has no immediate effect on the appearance of the nucleolar structure. Only after longer treatment of the cells with the translation inhibitor the nucleolus shrinks and becomes degranulated. The use of inhibitors with clearly defined mechanisms of action in a morphological study should make it possible to interpret similar nucleolar alterations seen in cancer cells and virus-infected cells on a molecular biological basis.


Hyperacute rejection of cardiac allografts in a rat strain with a hereditary platelet function defect. Graft hypoperfusion secondary to widespread vascular occlusion by recipient-derived platelet aggregates may be a major determinant of hyperacute cardiac allograft rejection in the rat. Since a hereditary platelet aggregation defect, attributed to decreased platelet levels of serotonin and adenine nucleotides and a depressed release reaction, has been described in the fawn-hooded rat strain, the effects of this intrinsic platelet function defect on the time course and morphologic features of hyperacute rejection have been evaluated. A series of nine heterotopic ACI cardiac allografts in fawn-hooded recipients actively immunized with ACI skin grafts were studied. Functional rejection with asystole was observed in all allografts from 8 to 40 minutes posttransplantation. Widespread platelet aggregation, endothelial cell destruction, interstitial widening, and focal myocardial alterations consistent with ischemic damage characterized all allograft. This study indicates that the platelet aggregation defect described for the fawn-hooded rat strain is one that does not alter the time course of the morphologic features of hyperacute cardiac allograft rejection, and thus this platelet aggregation abnormality has no essential role in the pathogenesis of this type of tissue damage.


Abstinence and controlled drinking in the treatment of problem drinkers. Issues regarding abstinence and restricted drinking as treatment goals are discussed. It is argued that therapies oriented to both controlled drinking and abstinence are needed. Problems with differential assignment of patients to treatment modalities are considered, and tentative guidelines for the selection of treatment goals are proposed.


Trans-pulmonary arterial closure of ventricular septal defect. Fourteen patients ranging in age from 4 months to 28 years underwent closure of a ventricular septal defect (VSD) through the pulmonary valve after pulmonary arteriotomy. In 13 of these the VSD was of the supracristal type and in one patient it was of the bulboventricular type. In all patients, including two infants whose VSD was closed under circulatory arrest, the operative and postoperative courses were uneventful except in one, who needed prolonged respiratory care. Right bundle branch block (RBBB) resulted in four patients, one of whom had a bulboventricular defect. The procedure is technically feasible without difficulty when the VSD is of the supracristal type and when the patient is too small. Trans-pulmonary arterial closure is the method of choice for treating a supracristal VSD, as this procedure leaves no postoperative right ventricular scar. However, the advisability of continuing to use this procedure is to be decided after statistical analysis of the frequency of postoperative RBBB can be made with a larger series of patients.


Successful correction of a complete form of atrioventricular canal associated with tetralogy of Fallot: case report. This is the third reported case of successful correction of a complete form of atrioventricular (AV) canal associated with tetralogy of Fallot. The surgical mortality rate from this combination is high, in part due to failure to recognize the associated anomaly and to completely close the ventricular septal defect. This successful correction was accomplished by giving the ventricular portion of the patch more width and by suturing it from both the atrium and ventricle. This patient reported herein is doing well 6 months after the operation.


Correction of the univentricular heart having two atrioventricular valves. Problems associated with the early evolution of corrective operation (septation) for univentricular heart (single or common ventricle) are illustrated in a total experience of 36 such operations, 30 of which were recent. Complete heart block existed preoperatively in five of the 30 patients and developed at operation in another 10; only two of these 15 patients attained a satisfactory result. Associated pulmonary stenosis was present in 16 patients, and this seemed to influence the result favorably. An extracardiac conduit between the right-sided ventricular chamber and the distal pulmonary trunk was employed in 20 patients. The presence of associated anomalies, including function of the atrioventricular valves in seven, had a highly unfavorable influence on the result. Although all seven of the most favorable candidates attained a satisfactory result, only 13 (43 percent) in the total group of 30 attained a satisfactory result. Further evolution of this operation, as in previous operations for complex congenital heart disease, should provide more results that are satisfactory.


Pediatric esophageal perforation.

Pediatric esophageal perforation. Although esophageal perforation in children is associated with a spectrum of disease different from the one in adults, management is essentially the same for both groups. Over the past 11 years, 12 patients ranging in age from 2 days to 10 years were treated for 13 perforations. Perforation in the adult is associated with a high mortality rate. All children in this series survived. Injury was secondary to instrumentation in 10 cases and three resulted from the chronic erosion of a trapped foreign body. Of the 10 acute perforations, five occurred 12 days to 5 months after lye ingestion. Anastomotic narrowing was a factor in three other cases. Seven of the acute perforations involved the thoracic esophagus and were associated with a high morbidity rate. Management consisted of operative as well as nonoperative approaches. Consideration must be given to several clinical variables including location, cause, predisposing factors, underlying illnesses, associated injury, and promptness of medical attention.


Collection and physiological measurements of peripheral lymph and interstitial fluid in man. Methods used for collection and measurement of physiological parameters of peripheral lymph and interstitial fluid in man have been described, basing on the experience of lymphological groups from Warsaw and Oslo and on data from the relevant literature. The review consists of description of methods for chronic cannulation of leg lymphatics, collection of lymph from skin lymphatic vessels, measurement of peripheral lymph flow, lymph hydrostatic and oncotic pressures, collection of interstitial fluid with the capsular, liquid-paraffin cavity, wick and skin window methods, interstitial fluid hydrostatic and oncotic pressure measurement.


Cells and immunoglobulins in lymph.

Cells and immunoglobulins in lymph. Studies of the free-floating lymphocytes and of the immunoglobulins in lymph collected over long periods of time from ducts draining individual tissues of the body as well as from the thoracic duct of the fetus in utero have been reviewed. The findings show that stimuli within the internal milieu act on different classes of lymphocytes to alter their migration pattern, morphology, metabolic activity, and range of immunological potentialities. As the lymphoid cells migrate between the blood, tissue fluid, and lymph, a continual process of reassortment occurs leading to the establishment of heterogeneous lymphoid cell populations in different regions of the lymphatic apparatus. It seems that the biological activities of these cells are not decided only in terms of a thymus or a bone-marrow origin. The immunoglobulins, like other proteins in lymph, are mainly derived by filtration from the circulating plasma. Some of the immunoglobulins and specific antibodies are synthesized, however, by lymphoid cells and secreted directly into the lymph.


Separation of lymphocytes, lymphocyte subgroups and monocytes: a review. Several techniques are now available for isolating lymphocytes from blood and other sources, but no single technique can be considered best for all purposes. In selecting a separation procedure, it is recommended that the procedure be as simple as possible, if otherwise satisfactory. The present paper reviews the most widely used techniques, including the separation of lymphocyte subpopulations and monocytes.


Morphological and cytochemical identification of lymphoid cells. This paper reviews the contribution of light and electron microscopy, surface structure and cytochemistry (acid phosphatase, B-glucuronidase, alpha-naphthyl esterase, and PAS reactions) in the recognition and classification of normal and abnormal lymphocyte populations.


Immunological identification of human lymphoid cell populations. Lymphocytes can be subdivided into two major groups according to origin and function (1,2). T lymphocytes are thymus dependent and are responsible for cell-mediated immunity while the B lymphocytes represent precursors of immunoglobulin-producing plasma cells and give rise to humoral immunity. Considerable knowledge concerning the biological properties of T and B lymphocytes and their mutual interaction has been obtained in the last few years. Recent data also demonstrate further heterogeneity within each of the two main lymphocyte populations. Certain lymphoid cells are capable of mediating cytotoxicity against target cells coated with specific antibody. These cells are termed K cells, and although some evidence seems to suggest that they comprise a subpopulation of B lymphocytes, their nature and localization in lymphoid organ is not well known. This article will attempt to cover the methodologies involved in assays of T, B, and K cells. The methods to be discussed are used to detect the presence of different lymphoid cell populations; the markers used are not necessarily related to cell function.


Experimental results of cancellous autografts and frozen allografts transplanted into the canine frontal sinus. Autograft and frozen allograft cancellous bone were each placed into one of the canine frontal sinus cavities of eight animals and analyzed by radiographic and histologic methods after one year. Complete and equal bony obliteration was demonstrated. Thus no advantage was seen in using an autograft over a frozen allograft in obliterating the frontal sinus cavity.


Otoplasty--an eclectic technique.

Otoplasty--an eclectic technique. The authors report their experience in the surgical treatment of 78 patients with lop, prominent, or protruding ears. Four patients had a unilateral deformity. The procedure used in 110 ears consisted of a cartilage excision-incision and horizontal mattress suture technique. In 42 ears, horizontal mattress sutures only, with or without scoring of cartilage, were used. The complications and unsatisfactory cosmetic results are reported. No major complications such as perichondritis, severe infection or unsightly postoperative deformities occurred. In conclusion, 94,7% of all cases had a good cosmetic result. The techniques are easy to learn and very useful in training residents.