Fading of malaria immunity in mice.

Fading of malaria immunity in mice. Fading of immunity in Swiss and C3H/StZ mice was progressive, and related to both, the interval elapsed since the last challenge infection and survival of parasites. In both mouse strains the proportion of mice that remained immune to challenge decreased with increasing fading periods. Moreover, a shift from delayed mortality to a normal course of infection as seen in non-immune controls was observed in C3H/StZ mice. Early parameters of fading were increasing peak parasitaemias after challenge in an increasing proportion of mice, and lethal infections instead of transient parasitaemias. Fading was also reflected by changes in the host cells preferentially infected early after reinfection: with increasing fading periods host cell preference shifted from predominantly polychromatophilic erythrocytes to mixed infections and finally to predominantly oxyphilic cells, especially in Swiss mice. The results of isodiagnosis indicated a positive correlation between persistence of parasites and immunity; whereas the absence of parasites was related to various phases of a fading immune response.


Comparison of the dried blood on filter paper and serum techniques for the diagnosis of bovine babesiosis utilizing the indirect fluorescent antibody (IFA) test. A comparison between the techniques of dried blood on filter paper and serum for the diagnosis of babesiosis utilizing the indirect fluorescent antibody (IFA) test was evaluated. Dried blood on filter paper was used as a method to detect B. bigemina and B. argentina antibodies of Colombian cattle under laboratory and field conditions and the technique was compared with the serum of the same animals. A high relationship was found between the results of the dried blood and the serum from calves experimentally infected with Babesia spp. and calves from enzootic hemoparasites-free zones in Colombia. There were no significant differences in the sensitivity and specificity of both techniques. The samples on filter paper could be practical for field use due to their easy management and storage at different temperatures. This indicates that the use of dried blood may be a valuable aid for the epizootiologic studies of Babesia spp. infections in bovines.


Vaginal abnormalities.

Vaginal abnormalities. The embryologic development of the vagina is still disputed. The urogenital sinus and the mesonephric (wolffian) and paramesonephric (müllerian) ducts probably all play a role in the development of the vagina. Duplication, agenesis, mesonephric duct remnants, and hymen abnormalities are among the more common congenital anomalies of the vagina.


Embryology of the lower genitourinary tract. The urinary and genital systems are closely related in their development so that dividing them into separate divisions is often artificial. The lower urinary system begins as a cloaca. The urorectal septum then divides the cloaca into a ventral urogenital sinus and a dorsal hindgut. The ureteral bud forms off the mesonephric duct. The male and female genital systems are the same until the gonad assumes characteristics of the testis or ovary in the eighth week of gestation. It is not until the eleventh or twelfth week that the external genitalia assume specific sexual characteristics. Anomalies of the urethra and bladder can vary from a severe epispadias-exstrophy complex to a minimal Type I urethral valve. Ureteral anomalies include duplications, ectopia, and ureteroceles. An undescended testis is probably the most common anomaly in the male genital tract. Female genital anomalies can include a variety of uterine duplication anomalies. Gonadal abnormalities are often created by a chromosomal defect and are ultimately reflected by abnormal sexual differentiation.


Hypospadias.

Hypospadias. The principles involved in the two techniques illustrated in this article are safe and effective. Complications can occur, as with any surgical procedure, but they can be minimized with careful attention to detail. In this, as in most discussions of technique, many small details are not included. Therefore, the reader is warned against embarking on repairs with the book in front of him in the operating room. The illustrations serve only as a guide and offer various degrees of assistance, depending upon the amount of the surgeon's experience. The list of references that follows is a fascinating tour of the development of hypospadias surgery, and is recommended reading.


The efficacy of urinary cytology in the detection of urothelial tumours. Sensitivity and specificity of urinary cytology. The sensitivity and specificity of urinary cytology in the detection of urothelial tumours using voided urine and applying simple smear preparation and staining techniques have been assessed. Of the 2704 patients under investigation 207 had urothelial tumours. The first urine analysis was positive in 66% of the patients with urothelial carcinoma; an additional 23% of the patients showed positive cytology in repeat smears, resulting in a sensitivity of 89%. The efficacy of urinary cytology depends on the tumour type: for grade 2 tumours, 79% were cytologically positive, 92% of grade 3 and 98% of the grade 4 tumours. The diagnostic efficacy in cases of carcinoma-in-situ, squamous cell carcinoma and adenocarcinoma was comparable with that of grade 4 carcinomas. Grade 0-1 tumours did not result in positive cytology. In eleven cases of lithiasis and in two cases of cyclophosphamide therapy the cytological diagnosis was positive but no neoplasm could be established histologically; these represent true false positive diagnoses. Thus, the false positive rate, 13 out of 165, was 7.88% and the false negative rate, 61 out of 207, was 29.4% when grades 0-1 were included, but 8.75% (14 our of 160) when grades 0-1 were excluded.


[Treatment of post-burn perineal deformities in children]. The classification of scar injuries of the perineum, peculiarities of their clinical course and characteristics of functional disorders in 12 children are presented in this work. The treatment depended upon the character of pathology. In case of a "scar sail" the plasty with local tissues grafts was performed. The Filatov's graft was used for the plasty of the defect formed after the excision of the scars in an injury to the anus. The Filatov's graft was also used for the plastic reconstruction of the large pudendal lips in girls. In case of the rectum prolapse and extensive perineal scar changes the Filatov's graft and feeding pedicle graft, formed, in the vicinity, were used for the replacement of the large defect. The results of the treatment are described.


[Restrictive artificial mechanisms in prevention of late complications after small intestine-colon anastomosis]. The experiments on 30 dogs proved that reduplication and semi-invagination serve as restrictive mechanisms before small intestine-colon anastomosis. These procedures slow dowm the evacuation of intestinal contents, interfere with small intestine-colonic outflow, improve digestion and absorption, contribute to the shortening of the time needed for compensation, provide better late results of the right hemicolonectomy.


Brain abscess associated with a penetrating foreign body. Oropharyngeal foreign bodies are not infrequently encountered in dogs and are usually associated with dysphagia. In this case an oropharyngeal foreign body resulted in nervous signs as a result of penetration of the cranial cavity and the development of a brain abscess.


Detection of Salmonella typhimurium infection of chickens. The serological response of two groups of chickens was followed by three techniques after experimental infection of one group with Salmonella typhimurium. Results obtained illustrate the greater sensitivity of the microantiglobulin (Coombs) test over more conventional methods for detecting salmonella agglutinins. The possibilities of the diagnostic use of the microantiglobulin test in the field are discussed.


[Metastasis to the lymph nodes as an index of the effectiveness of preoperative endolymphatic polychemotherapy of cervix cancer]. Ninety eight patients with cervical cancer were subjected to endolymphatic chemotherapy with multiple cytostatic drugs to affect metastatic lymph nodes. A comcentrated mixture of chemotherapeutic drugs (total amount about 20 ml) was injected into plantar lymph vessels, an interval being 10-14 days. The combinations and dosage of the drugs were as follows: thio-TEPA (100-150 mg) or cyclophosphamid (1000-2000 mg)+methotrexate (100 mg)+5-fluorouracil (1000-1500 mg). Subsequently, 76 patients underwent an extended extirpation of the uterus with adnexa, and their lymph-nodes were studied morphologically. It was found that the number of metastases into the lymphnodes was considerably less than it had been expected. Of 45 patients with the disease stage II metastases have been found only in 3 cases (7%). Of 24 patients with cancer stage III the lymphnodes were involved in 4 cases (16.6%). According to the literature data metastatic involvement of the lymphnodes is on an average encountered in 36% for stage II and in 51% - for stage III.


[Exercise haemodynamics and ECG in the evaluation of the severity of coronary heart disease (author's transl)]. Myocardial scarring and coronary insufficiency give rise to regional changes in left ventricular function, often leading to generalized left ventricular dysfunction during physical activity only. The main purpose of this study was to evaluate the relations between left ventricular function determined by ECG and measurements of pulmonary artery pressure during exercise and the severity of coronary artery disease. Simultaneous measurements in the pulmonary artery and in the left ventricle in 76 patients revealed that the enddiastolic pulmonary pressure (PAEDP) was lower than the enddiastolic pressure in the left ventricle (LVEDP) by a mean value of 10.5 mm Hg in the presence of ventricular dysfunction. This difference was smaller in congestive heart failure than in cases of acute myocardial ischaemia. Correlation coefficients of mean pulmonary wedge pressure (PCm), PAEDP, mean pulmonary pressure (PAPm), and LVEDP were 0.90, 0.86, and 0.81, respectively, thus allowing only an approximate estimate of the left ventricular filling pressure. In 150 angiographically documented cases of coronary heart disease, haemodynamic measurements were performed during stepwise-increased, symptom-limited supine exercise on a bicycle ergometer. All patients limited at 25 watts had either triple vessel disease or stenosis of the trunk of the left coronary artery or of the proximal section of the left anterior descending artery (RIVA). In comparison with subjects with single vessel disease, patients with triple vessel involvement tolerated only a smaller exercise load and reached higher values of PAEDP (30.4 +/- 9.0 versus 24.0 +/- 7.7 mm Hg, p less than 0.001). Analysis of data of patients with a single coronary stenosis showed the exercise-PAEDP to be largely independent of the myocardial condition, but to depend upon the location of the stenosis, the highest pressure values being observed with stenoses of the main left coronary artery or the proximal segment of the RIVA. Based on these findings a simple coronary score system was delineated to determine the severity of the disease, taking into account the location of an obstruction, in particular, and, to a lesser amount, the degree of the stenosis and the type of coronary artery distribution. The score yielded essentially better correlations to work load and filling pressures during exercise than did the number of obstructed vessels. The regression line of the PAEDP versus the coronary score was flatter in patients with angiographically documented collaterals than in cases without, indicating the functional significance of these vessels. In patients with stenoses confined to the arteries supplying infarcted areas and, consequently, without signs of ischaemia during exercise a close relation was obtained between the left ventricular ejection fraction (EF) and the maximum PAEDP, best expressed by a third order regression equation (r = 0.79), p less than 0.001, SEE +/- 6.1). A PAEDP exceeding 25 mm Hg is, thus, a reliable sign of an EF of less than 40%...


Bunolol metabolism by dogs: urinary excretion of 5-hydroxytetralone. 1. Anion exchange and t.l.c. were used to collect the polar drug metabolites present in urine of dogs treated orally with [14C]bunolol. 2. A new metabolite, 5-hydroxytetralone, was isolated, purified, and identified by u.v.,i.r. and mass spectroscopy. 3. 5-Hydroxytetralone represented 1.7% dose excreted in urine collected for 24 h after bunolol administration. 4. Properties of the metabolite are discussed in relation to the question of whether 5-hydroxytetralone was excreted as a conjugate.


Taurine conjugates as metabolites of arylacetic acids in the ferret. 1. The pattern of conjugation in the ferret of 8 arylacetic acids and, for comparison, benzoic acid and 4-nitrobenzoic acid was examined. 2. The arylacetic acids, phenylacetic, 4-chloro- and 4-nitro phenylacetic, alpha-methylphenylacetic (hydratropic), 1- and 2-naphthylacetic and indol-3-ylacetic acids, were excreted in the urine as taurine and glycine conjugates. Diphenylacetic acid did not form an amino acid conjugate and was excreted as a glucuronide. 3. The taurine conjugate was the major metabolite of 4-nitrophenylacetic, alpha-methylphenylacetic, 1- and 2-naphthylacetic and indol-3-ylacetic acids, whereas the glycine conjugate was the major metabolite of phenylacetic and 4-chlorophenylacetic acids. Taurine conjugation did not occur with benzoic and 4-nitrobenzoic acids which were excreted as glycine and glucuronic acid conjugates. 4. Phenacetylglutamine and 4-hydroxyphenylacetic acid were minor urinary metabolites of phenylacetic in the ferret. 5. A number of taurine conjugates of aliphatic and aromatic acids were synthesized and their characterization and properties were studied. The role of taurine as an alternative to glycine in the metabolic conjugation of arylacetic acids is discussed.


[Study of the effect of rimantadine on the course of mixed viral-bacterial infection in albino mice]. The results of the study of rimantadine effectiveness in a viral-bacterial infection in white mice caused by a mixture of influenza A2 virus (10 LD50) and hemolytic streptococcus group A (350 million bacteria). The drug showed no prophylactic or therapeutic effect in the mixed infection, whereas in influenza infection in the animals which served as a positive control rimantadine had marked antiviral activity (P less than 0.001). It is assumed that the lack of the drug effectiveness against the mixed infection is due to the formation in the animals of virus-microbe complexes which are conducive to an increase of infectious virus titers and virus resistance to various treatments.


[Disorders of hemostasis in shock].

[Disorders of hemostasis in shock]. Shock and disturbance of haemostasis are described as the cause of a common severe basic disease evoking them. Haemodynamically rheological changes with disturbances of the perfusion of high degree which in the extreme case via formations of microcoagulations may lead to organ necroses with irreversible deleterius loss of organs are common to both. Bodily dysregulations may also lead to an increase of the potential of fibrinolysis with dramatic haemorrhagic complications. A coarsely orienting stage division of the consumption coagulopathy allows aimed therapeutic measures after differentiated indication, such as the application of antifibrinolytics and aimed haemosubstitution under heparin protection.


[Contractile connective tissue cells and wound healing. Function of myoid fibroblasts in reparative regeneration of mesenchymal tissue]. The present survey deals with processes of wound healing with special regard to fibroblast proliferation. Comparative experimental studies on reparative and regenerative fibroblastic proliferates and findings from the literature point to the importance of a fibroblast modification with myoid structure in certain phases of the reparative regeneration of the connective tissues. The ultrastructural picture of the myoid fibroblasts and their functional significance are discussed with regard to wound healing in man.


[Experimental studies on the antimicrobial effect of several butylcyanoacrylate tissue adhesives]. It is dealt with the effects of various butycyano-acrylate type surgical adhesives on gram-positive and gram-negative bacterial species. The experimental results show a growth-inhibiting effect on gram-positive germs. Gram-negative germs are not affected. The growth inhibition produced by SO2-containing adhesives is greater than that caused by SO2-free ones. As compared to Histoacryl blue, the Fimomed variants showed a broader spectrum. Furthermore, it was stated that the adhesive exerts its growth-inhibiting effect not only in the monomeric, but also in the polymeric state. A relationship between the gram-behaviour and the antimicrobic effect of the adhesive is taken into consideration.


[The problem of anti-lung basal membrane immunity in the framework of allogenic lung transplant rejection]. This study is concerned with the significance of autoimmune processes caused by the damage of lung tissue after lungallo- and autotransplantation. In 15 mongrel dogs a left side lung-allotranplantation was performed, 5 of them were treated with immunsuppressive therapy in the posttransplantation period. A group of 5 dogs with autotransplantation of the left lung served as a control-group. In the posttransplantation period the development of humoral antibodies responding with lung basal membrane antigens was examined by daily taken sera as well as by elution of immuneglobulins from the rejected grafts in the passive hemagglutination and compared with the development of alloantibodies against donor-lung's tissue. Besides of regularly traceable humoral alloantibodies of lung allograft recipients in the posttransplantation period, in no group antilung basal membrane antibodies could be found.


[Animal experiment studies on vascular wall injuries causing early vein-transplant thrombosis]. Veno-venous autotransplantations of the jugular veins of dogs were performed. The grafts remained patent if an endothelium preserving technique was applied for the dissection of the veins as well as for the anastomotic procedure. The endothelium preserving surgical technique consists in avoiding touching the veins by the hand of the surgeon, by instruments and by swabs. Also the retraction of the severed ends of the vein and of the graft should be avoided as well as the conglutination of the lumina. For this purpose the ends of the veins are kept in extension by atraumatic holding sutures. A progressive shrinking of the anastomotic region was never observed. Moderate stenoses, sometimes seen the first days after the transplantation, regularly disappeared a few weeks later. Ten autografts remained patent without systemic anticoagulation and without creating an arterio-venous fistula.


[Current status of lung preservation for organ transplantation]. This paper gives a survey of the development and the present state of the preservation of isolated lungs intended for transplantation. Hypothermal perfusion with a colloid-containing electrolyte solution, supplemented with certain additives, without ventilation of the preserved lung is obviously a technique that is ready to be used in practice. The present priorities in experimental research are: elaboration of a standardized preservation technique, of which the expenditure can be justified in a clinical transplantation program, and establishment of parameters for the control of its efficiency.


[Morphology of the placenta in premanifest maternal diabetes mellitus (author's transl)]. 66 placentas of mothers with protodiabetes or of the White-classes A/a, respectively, are investigated morphologically. The results are correlated with the clinical findings. Complications during pregnancy as well as the perinatal mortality (5.7 per cent) are less frequent in early stages before the diabetes become manifest. Severe diabetic disturbances of placental maturation we have found in protodiabetics in 15.4 per cent, in the White-classes A/a in 18.9%. In the White-classe D the frequency is 49.5 per cent. Accordingly, the diagnostic possibilities are smaller than in cases with manifest diabetes mellitus. Diabetic disturbances of placental maturation can be demonstrated already in few cases of the material in protodiabetics and in patients with glucosuria during pregnancy and with suspicion of diabetes mellitus, but without diabetic fetopathy. Therefore in our opinion diagnosis of diabetic metabolic disorder may be possible by some morphologic criterias of the placenta in very early stages of diabetes before clinical manifestation.


Response of the blood glucose and the pancreatic islets of the lizard, Uromastix hardwicki (Gray) to exogenous insulin. Uromastix hardwicki was found more resistant to insulin as compared to other poikilotherms and this insulin resistance appears to be related to the preponderance of glucagon secreting alpha-cells in this species. The magnitude and the persistence of hypolgycemia caused by insulin are directly dependent upon the quantity of the dose. The higher doses (2000 and 3000 U/kg) resulted into shocks, but the lack of correlation between hypoglycemia and shocks has been attributed to the direct effect of insulin on the nervous system. Histologically, insulin induced degranulation of both the beta- and alpha-cells. The physiological action of insulin is apparently greater at higher ambient temperature. The ability of insulin to damage beta- and alpha-cells in Uromastix hardwicki further gathers evidence for the similarity of these cell types with those of mammals and other vertebrates in being the source of insulin and glucagon respectively, and in controlling the blood glucose homeostasis in this lizard.


Electron microscope studies of human spermatozoa. Semen of 40 healthy fertile men aged between 22--44 years was investigated. A triple morphological investigation of the semen was performed in each person. For the ultramicroscopic evaluation the semen specimens were selected according to the quantative criterion of normospermic. The ultrastructure of spermatozoon was described in comphiance with its division into head, neck and tail. The substructure of the axial fibre was separately analyzed. The physiological role of individual organelles of normal spermatozoon in fertilization was discussed.


A study on the bronchial innvervation of the male Perdicula asiatica (Uungle Bush quail) by cholinesterase technique. Ganglia of various shapes (rounded and oval) and sizes (large, medium and smaller) either arranged in chain like fashion or in free form, lying on the wall of the bronchi and their branches, were recorded. The preganglionic and postganglionic nerve fibres formed the meshwork on the bronchi. The postganglionic fibres of the bronchial ganglia and the fibres of the peribronchial plexus, were either connected with the fibres of the plexus on air cavities or with the myelinated fibres of the plexus of muscles in the intraparenchyma. Groups of AChE-positive nerve cells were recorded in the lung lobule.


[P. L. Friedrich and the problem of wound infection (author's transl)]. For the first time P. L. Friedrich proved wound infection to be a local process for 6 to 8 hours. After total excision such wound can be treated like a sterile one. For the first time Friedrich also realised the importance of this time-limit which however was often misinterpreted. He never excised wounds in his patients totally, but always practised wound débridement after von Bergmann-Lexer.


[Immunobiological fundamentals of primary graft rejection (author's transl)]. Graft rejection caused by genetic differences between donor and recipient is an immunological reaction of transplantation antigens with mechanisms of primarily cellular immunity, and later on even of humoral immunity. For initiating the immune response of the recipient three stages have to be distinguished: 1. Recognition of determinant groups of transplantation antigens by menbrame receptors at the surface of immunologically competent lymphocytes. 2. Differentiation and proliferation of immunologically activated lymphoid cells into cellular antibodies and plasma cells, the receptor molecules of which could be identified as immunoglobulins and which are sent into the blood as circulating humoral antibodies, , partially as complement fixing ones. 3. Effector phase, in the course of which the lysis of the graft is caused by target cell destruction. Many problems still remain unsolved, but now as ever, the basis of most experimental studies is still formed by Burnet's clonal selection theory.


[Indication for vascular reconstruction in ischaemic diseases of the legs (author's transl)]. The indication for vascular reconstruction in ischaemic diseases of the legs should be considered as early as possible and individually. Only by strict selection of patients it is possible to reach favourable late results.


[Prediction of spontaneous abortion by vaginal cytologic smears (author's transl)i1]. Vaginal smears were obtained from 175 women during the first four months of pregnancy weekly and the Karyopycnotic Index and the Eosinophilic Index encountered by phase contrast microscopy. The normal values were listed our by percentils. The development of KPI and Eo I during early pregnancy were compaired in three groups of patients: 1, 120 women with normal early pregnancy, 2.20 women with threatened abortion but good following up of later pregnancy, and 3. 35 women with spontaneous abortion. Even 4 weeks before abortion vaginal smears changed to pathological values in about 40% of all patients with spontaneous abortion. Women with threatened abortion but good outcome of pregnancy used to have normal KPI and Eo I.


Isolation of salmonella from minced meat by the use of a new procedure of enrichment. In the examination of 526 samples of minced meat for the presence of salmonellae, a preliminary pre-enrichment in buffered peptone water was made. From this medium enrichments were made, for each sample of meat, in the usual Rappaport's medium (R25), incubated at 37 degrees C, and in Muller-Kauffmanns tetrathionate broth, incubated at 43 degrees C. Moreover, an enrichment was also made in a strongly modified Rappaport's medium, containing much less malachite green (R10), incubated at 43 degrees C. The two Rappaport's media proved to be equally effective in the isolation of salmonellae and clearly more efficient, in this respect, than the Muller-Kauffmann's broth. The new Rappaport's medium (R10), incubated at 43 degrees C, has the advantage over the usuals Rappaport's and Muller-Kauffmann's enrichment media to inhibit much more considerably the growth of competing organisms than the two other enrichment media.


[Variants of transitory myeloradiculoischemic disorders]. The authors studied the development of transient disorders of blood supply in the spinal cord and radicles. Besides the well known clinical forms which are described as syndromes of intermittent claudication of the spinal cord and cauda equina, there are some other variants of this disorder. Transient ischemia of this localization as a rule is either connected with atherosclerosis of the abdominal aorta, either with degenerative-dystrophic or congenital changes in the sacral part of the spine. The authors underline the role of individual differences in the vascularization of the spinal cord in the development of disorders in spinal circulation. The prognosis of transient ischemia, its correlation with stable disturbances is assessed. A differential diagnosis is also made between different transient vascular spinal disorders and radicle disturbances.


[Role of arterio-arterial embolisms in the pathogenesis of cerebral circulatory disorders]. The authors studied 52 patients with brain infarctions and transient disorders of cerebral circulation, which in the opinion of the authors developed as a result of arterio-arterial embolism. Besides, 16 post-mortem cases with arterio-arterial embolism were studied as well. On the basis of clinico-angiographical, clinico-laboratory and clinico-anatomical correlations, the authors come to the conclusion that this mechanism is frequently the main link in the pathogenesis of distrubed cerebral circulation. Embologenic materials in the development of brain infarctions are most often particles of parietal or obturating thrombi in the magistral cerebral vessels. In patients with transient disorders of cerebral circulation most likely embolism of the minor cerebral vessels by thrombocytic aggregates. The authors discuss the functional properties of thrombocytes in the pathogenesis of transient disorders of cerebral circulation and the feasibility of the use of antiaggregates for preventive purposes.


[Typology of depressions in endogenous psychoses]. The results of a clinico-statistical study of 483 patients with depressive syndromes in the framework of affective and schizoaffective psychoses demonstrated a wide range of depressive conditions. In the absence of specific nosological types of depression there was, however, a certain predilection of the syndromal distribution in the nosological framework, in some clinical, psychopathological features, even in structural similar depressions, depending upon the character of the development of the pathological process and its dynamics.


[Action of respiratory inhibitors on the electron transport system of Escherichia coli]. Bacteria of two strains of Escherichia coli (Q13 and MRE 600) were disintegrated by aluminium oxide. The influence of the respiratory inhibitors RF (a protein from reticulocytes), carboxin, Dexon (fungicides), thenoylftrifluoroacetone (TTFA), rotenone, antimycin A, myristic acid and monolaurin was tested on the succinate oxidase and the NADH oxidase system, respectively, of the membrane preparation obtained in this way as well as on the NADH oxidase activity of the cytosol. Among the inhibitors listed, only TTFA (5mM) inhibited the succinate oxidase system and Dexon (10 miconr), monolaurin (100 micron) and myristic acid (100 micron) inhibited the NADH oxidase system of the membranes. KCN (10 micron) inhibited both NADH oxidase systems. The inhibitory effects by monolaurin and myristic acid were prevent by human serum albumin and were markedly weaker than those on beef heart mitochondrial particles under similar conditions. The results argue for a divergent structure of the iron-sulphur proteins in the dehydrogenase regions of the electron transport system in comparison with animal and plant mitochondria and, moreover, confirm the specificity of RF and carboxin as well as the nature of Dexon as a group reagent on pyridine nucleotide dependent flavin enzymes.


[Immobilization of proteins on macroporous glasses involving maleinimide as the anchoring group]. Macroporous glasses with pore sizes from 400-1000 A appropriate for protein binding were produced and characterized by a thermal demixing procedure and alkaline after treatment. To achieve a covalent binding capacity relative to proteins, the gamma-aminopropyl derivative was allowed to react with 4-maleinimido benzoylic chloride to give preparations containing, in addition to maleinimide residues, acid chloride structures for the protein binding. A preparation of 400 A pore size was tested for its protein binding capacity relative to bovine serum albumin and trypsin. Furthermore, the capacity of binding glucoamylase from Endomycopsis bispora in active form was studied.


Suprasellar extension of tumour associated with increased cerebrospinal fluid activity of LH and FSH. A 65 year old man with pituitary adenoma, partial hypopituitarism and normal serum FSH and LH concentration is described. LH (but not FSH) partially increased following the administration of LH-RH. Subsequent FSH and LH assays of the cerebrospinal fluid, however, showed a high and correctly predicted suprasellar extension of the tumour.


Qualitative and semiquantitative calcium cytochemistry in B cells of mice treated with cyproheptadine and mannoheptulose. The effect of cyproheptadine (CPH) and D-mannoheptulose (MH) on the function and the histo- (GBHA-method) and ultracytochemical (pyroantimonate method) calcium handling by pancreatic B cell were studied in mice. Intraperitoneal injection of CPH (45 mg/kg) or MH (1500 mg/kg) produced a hyperglycaemic syndrome, which was accompanied by decreased plasma insulin levels. CPH and MH also abolished glucose-induced insulin release. CPH led to a decrease of about 30 to 40% in the histochemical calcium content of islets as revealed by semi-quantitative microdensitometry, while MH did not change the calcium content of the islets. The ultracytochemical distribution pattern of calcium-rich precipitates were identical in CPH and MH treated B cells. The subcellular calcium deposits were predominantly located in the cytoplasmic matrix, but were rarely seen in granule halos and along the cell membranes. In contrast, glucose stimulation of the B cells resulted in an accumulation of the precipitates along the cell membranes and in the secretory granules. The results suggest that CPH and MH inhibit insulin release by either directly or indirectly interfering with the normal calcium handling by the B cell.


Effects of valinomycin on Rb+ fluxes, ATP content and insulin release in pancreatic islets. Valinomycin, 0.5-500 nM, was tested for its effects on pancreatic islets microdissected fron non-inbred ob/ob-mice. Valinomycin decreased the islet accumulation Rb+ and the content of ATP in a dose-dependent manner; efflux of Rb+ from pre-loaded islets was not noticeably changed. Rb+ accumulation and ATP content correlated markedly; on the model of linear regression, less than 10% of the change Rb+ accumulation in valinomycin-treated islets was statistically attributable to factors other than ATP. Valinomycin did not cause a prompt inhibition of glucose-stimulated insulin release that could reflect hyperpolarization due to increased K+ permeability. The following conclusions are drawn: 1) The plasma membranes of beta-cells resemble those of neurons in having such a high ion permeability as to be relatively little influenced by valinomycin; 2) Islet accumulation of Rb+ is due to a vectorial catalyst in theplasma membrane rather than to uptake by mitochondria; 3) Rb+ accumulation in islets is ATP-dependent.


Inhibition of puerperal lactation by bromocriptine. Puerperal lactation is regulated by a complex of hormones, including in particular prolactin. In a few instances prevention of lactation is desirable on medical grounds. However, most Western-European women who do not nurse their babies choose not to do so for personal reasons. In two double-blind studies the effect of bromocriptine was compared with that of placebo and an oestrogen/androgen compound. Bromocriptine prevented both milk secretion and engorgement of the breasts very effectively. It is clearly a better and more specific inhibitor of lactation than the combined oestrogen/androgen compound. Its effect is through the blockade of pituitary prolactin release. As normoprolactinaemia is reached, normal ovarian function is restored in bromocriptine treated women. To prevent the occurrence of a rebound lactation phenomenon, the drug has to be administered continuously for at least a fortnight.


Bromocriptine treatment of hyperprolactinaemic hypogonadism. Results of bromocriptine therapy of 70 women and 25 men with hyperprolactinaemia are reported together with those of 8 normoprolactinaemic and 3 post menopausal women. Galactorrhoea was present in 79% and 28% of the hyperprolactinaemic women and men respectively. 34 of the hyperprolactinaemic women had suspected pituitary tumours. Bromocriptine therapy resulted in lowering of prolactin levels to normal in 85 of the 95 patients, and in the remainder prolactin levels were lowered in all but one patient. Gonadal function was restored in all but seven of the hyperprolactinaemic women, and potency in all but 4 of the men. Normal cyclical function was restored or pregnancy was achieved in 5 of 6 normoprolactinaemic women with irregular cycles or amenorrhoea. Basal circulating LH and FSH levels and their responses to GnRH were normal or exaggerated in the majority of the women, but the LH responses to GnRH were impaired in 12 of 21 men. The results of 37 pregnancies in 31 women, 11 of whom had suspected pituitary tumours, are discussed together with the problems of possible tumour growth during pregnancy.


Acromegaly--results of long term treatment with bromocriptine. Bromocriptine, a long acting dopamine agonist, has been used to treat 73 patients with active acromegaly for between 3 and 25 months. Clear clinical improvement occurred in 71 patients (97%). This included improvement in facial appearance, reduction in hand and foot size and sweating, relief of headaches and increased energy and libido. Abnormal visual fields became normal in two patients, but one of these was given concomitant radiotherapy. A significant reduction in growth hormone occurred in 58 patients (79%), but only 15 patients had levels persistently below 5microgram/l. Carbohydrate tolerance improved with the reduction in growth hormone and of 23 patients with diabetes mellitus before treatment, glucose tolerance became normal in 15 and improved in a further 5. Administration of bromocriptine should begin slowly in order to minimise early side effects. Long term side effects have been minor to date and the deaths of two patients whilst taking the drug were not considered to have been caused by it. Bromocriptine offers a major advance in the management of acromegaly, but further careful follow-up is required to determine whether serious side effects will be a problem with the long term use of high doses.


Bromocriptine therapy in patients with acromegaly: effects on growth hormone, somatomedin A and prolactin. Six of ten patients were subjectively improved by bromocriptine treatment as illustrated by diminished sweating, reduction of soft tissue swelling and restoration of sexual potency and menstruations. These six patients had elevated or normal blood levels of prolactin, which could be stimulated by TRH and inhibited by bromocriptine. During medication two clinical responders normalized and one lowered plasma GH concentrations. Three clinical responders with initially increase somatomedin A levels normalized these levels during treatment, in one case despite lack of effect on GH levels. The four nonresponders had undetectable or notably depressed levels of prolactin, which could not be stimulated by TRH. It is suggested that the presence of prolactin, per se or as an indication of a certain dopaminergic situation, is a prerequisite for successful bromocriptine treatment of patients with acromegaly.


Bromocriptine therapy in eleven patients with acromegaly. Eleven patients with active acromegaly were treated with bromocriptine for one year or more. Nine showed significant reduction in plasma growth hormone levels and eight improvement with respect to clinical symptoms. No serious side effects were observed.


Factors affecting the excretion of common neutral steroids in urine. After a brief summary of the biosynthesis, production rates, metabolism and elimination of the pertinent adrenocortical and gonadal precursors for the common urinary neutral steroids, a survey is presented of the general, disease related and hormonal factors that can affect the excretion of neutral steroids in urine.


Fatal air embolism after subclavian vein catheterization. Case report. The authors describe a case of fatal air embolism in a patient with an endovenous catheter introduced into the subclavian vein through a supraclavicular way. The opening of pleura caused by the needle during the thrusting of the needle caused a subcutaneous supraclavicular and laterocervical emphysema during ventilation with intermittent positive pressure (IPPV). The authors suggest that IPPV, in the postoperative period following kidney removal, was the main ancillary reason of the air embolism since opening of pleura, in a patient who breathes spontaneously, only induces pneumothorax according to the majority of the authors.


Long-term treatment of Parkinson's disease with L-Dopa and Dopa-decarboxylase inhibitor: therapeutic results and side effects. The authors present a review of their clinical experience in the treatment of 127 Parkinsonian patients with L-Dopa alone and in association with a Dopa-decarboxylase inhibitor; the follow-up lasted more than 7 years. In all cases the dosages of L-Dopa, either alone or associated with the decarboxylase inhibitor, were fairly low; the strategy was to reach in each case the minimal effective dose instead of the maximal tolerable one. After 7 years of treatment about 60-65% of the patients had shown improvement, even though to a lesser degree than during the first and second year of therapy; the remaining 35-40% were unchanged or worse. The authors conclude that, despite the decreased efficacy of the therapy with time, the L-Dopa treatment remains of great significance in lengthening and in improving the quality of life of Parkinsonian patients.


Flow cytometry in tumours of the brain.

Flow cytometry in tumours of the brain. Flow cytometry was used for studying the distribution of single cell DNA content in biopsy material from 85 patients with benign and malignant lesions of the brain and spinal cord. In inflammatory lesions and in most benign tumours, cells with diploid DNA values were observed, sometimes with additional smaller amounts of tetraploid DNA. Cells from malignant tumours were characterized by marked hyperploid DNA values. Flow cytometry is found a rapid and valuable method adding important information to the biological nature of tumours of the central nervous system.


Chlorhexidine gel and Steradent employed in cleaning dentures. It was the purpose of the study to test the efficacy of brushing with a 1% chlorhexidine gel or a commercial solution cleanser (Steradent) in preventing formation of plaque on the fitting surface of new dentures. The study group consisted of 74 denture wearers with denture stomatitis who were assigned randomly to one of four treatment groups, testing either the chlorhexidine gel, a placebo gel, Steradent, or a placebo solution. The experiment was started immediately after denture treatment was completed. The experimental period was 1 month. The amount of denture plaque, the clinical condition of the palatal mucosa, and the concentration of yeasts in mucosal and denture smears were recorded while the patients used their original dentures and after the experimental period. Plaque had formed on all new dentures but to a smaller extent in the groups testing the chlorhexidine gel or the placebo gel. The study does not provide any obvious evidence of a chemical effect of chlorhexidine gel or Steradent as a means to prevent formation of microbial plaque on the mucosal surface of maxillary complete dentures.


Experimental method of producing total cerebral ischaemia in dogs. Experimental method of producing total cerebral ischaemia in dogs. Acta Physiol. Pol., 1977, 28 (6): 585-588. It is very difficult to produce complete cerebral ischaemia in dogs in view of very abudant anastomoses between branches of carotid and vertebral arteries and muscle arteries. The methods applied for this purpose are technnically difficult and lead frequently to spinal cord injury or major metabolic distrubances in the whole organism. The reported investigations were carried out for elaboration of a method which would not have these disadvantages. Cerebral ischaemia was produced in dogs occluding the brachiocenhalic trunk and the left subclavian artery. The blood flow to the intercostal arteries and through them to the spinal artery was interrupted by means of a bypass between the aortic arch and the abdominal aorta. Isoelectric EEG line and lack of blood flow from the punctured carotid arteries were the criteria of complete ischaemia.


Results of a clinical trial with bromperidol C-C 2489/21. A controlled clinical study--phase III--with bromperidol was conducted on 30 male patients with a diagnosis of schizophrenia of different subtypes, realized by psychiatric assessments and by laboratory measures over an eight-week investigational period. A global improvement (from very much up to moderately) was achieved in 76% of the patients; two patients dropped out. The optimal dosage of bromperidol seemed to lie between 4 and 6 mg/day. The adverse effects were confined to moderate extrapyramidal symptoms in the extent of a higher dosage. Bromperidol appears to be a potent longacting neuroleptic drug without essential psychomotor damping, anxiolytic and hypnosedating properties, but with a strong antipsychotic potential against the basic schizophrenic disintegration. It is mainly indicated in paranoia, depressive-paranoia and simple forms of schizophrenia.


Treatment of female schizophrenic patients with bromperidol, a new neuroleptic drug of the butyrophenone group with medium duration of action. Bromperidol has a safe antipsychotic effect. The latency is short, the effect is definite on the seventh treatment day and is already seen in particular symptoms on the third treatment day. Beside the antipsychotic effect, the substance has slight sedative properties, an anxiolytic effect and an evident influence on the complex phenomenon of social re-integration. The sedative effect is not sufficient in severe psychomotor agitation; here it is necessary to combine it with a sedative neuroleptic or other sedating substance. The clinical effect is safe for 24 hours. Due to the small doses (3-12 mg daily), bromperidol belongs to the neuroleptics of high potency. The high potency, the 24 hour efficiency and the low sedation qualify the substance for the long-term treatment of schizophrenic psychoses. Extrapyramidal effects occur in relation to the high potency and are easily corrected by an anticholinergic drug.


Use of bormperidol in psychotic outpatients. An ambulatory population of 18 men and 4 women, aged 17 to 61 years (mean 30.3), were treated with bromperidol oral drops for an eight-week study period. investigation of tolerability, side effects and psychopharmacological effects; determination of the optimal dose. The Wirtschafts Mathematik AG Zurich case report form was used. Various medical, neurological and psychic parameters were recorded before the study and after the first, second, fourth, sixth and eighth weeks of treatment. Bromperidol is a potent and safe neuroleptic agent of polyvalent action, which can be administered in one single daily dose and is very well tolerated in ambulatory conditions, without antiparkinsonians in the doses used.


The initial US clinical experience in the management of schizophrenic patients with bromperidol. Observations and conclusions from initial acute and maintenance bromperidol clinical trials conducted in the USA are presented along with an overview of the clinical development program. Thirty diagnosed schizophrenic patients, recruited from private practice, were admitted to either study. Patients were controlled with bromperidol administered only once daily. The acute patients received an average dose of 14-23 mg day during the month-long inpatient stay. The average maintenance dose was calculated to be approximately 8 mg. Overall, patients received from 3-39 mg for up to four months. Pre-treatment vs. 4 week treatment BPRS scores showed highly significant decreases in the five NCDEU (New Clinical Drug Evaluation Unit, which developed the accepted US psychiatric rating scales) behavioral symptom clusters analyzed. Two thirds of the patients were much to very much improved over this same interval based on clinical global ratings. Minimal side effects were noted. In particular, fewer acute neuromuscular reactions and less weight gain were noted. Based on the experience to date, bromperidol will be a significant addition to the therapeutic armamentarium for the management of schizophrenia in both acute and chronic cases.


Double-blind- evaluation of bromperidol versus haloperidol treatment in chronic psychotic patients. Twenty four chronic psychotic patients were assigned at random to bromperidol or haloperidol. The mean dose for bromperidol was 4 to 8 mg in one intake in the morning and for haloperidol 4 mg given twice a day. Regular evaluation was performed by BPRS, global clinical impression, side-effects scale, hematological and biochemical screening. It appears that bromperidol is a potent antipsychotic drug with a duration of 24 h. Compared to haloperidol, it favours social integration by a mild but definite activating property. No major side-effects were observed.


Effects and side-effects of bromperidol in comparison with other antipsychotic drugs. In 1975 we performed an open trial with bromperidol in 25 hospitalized schizophrenic patients. Effects and side-effects were registered by means of the AMP system. Patients were treated up to 30 days and the dosage of bromperidol was increased depending on effects and side-effects up to 5 mg per day. Bromperidol showed a good effect on productive schizophrenic symtpoms and caused a significant reduction of accompanying depressive symptoms. Data of this open trial were compared with data of two open trials with clozapine and haloperidol which were performed using the same methods. We compared the three open trials and found similar effects on psychotic symptomatology, but a different severity of extrapyramidal side-effects. A double-blind comparison between bromperidol and perphenazine in 40 schizophrenic patients showed a strong antipsychotic efficacy of bromperidol and an earlier onset of its effects.


Preliminary note on the antipsychotic efficacy of bromperidol. Bromperidol was administered to 20 acute and chronic psychotic inpatients during six to eight weeks at a mean daily dose of 18 to 10 mg. The neuroleptic was given orally or intramuscularly once a day (in the morning in order to evaluate its therapeutic and side effects). In 13 patients, bromperidol was substituted for haloperidol; in 7 cases, it was given immediately after the washout period. Descriptive psychopathology was complemented with quantitative psychopathology (ad hoc 29-item scale, AMDP Psychopathology Scale, Bf/Bf' Mood Scales). According to a preliminary analysis of data, both descriptive and psychometric, bromperidol seems to be a potent antipsychotic drug without disturbing adrenolytic side-effects or sedation, with classical extrapyramidal effects of the hypertonia type.


Maprotiline and doxepin in the treatment of depression. A double-glind multicentre comparison. Maprotiline (Ludiomil) and doxepin were compared in the treatment of depression in a double-blind multicentre trial. Four centres and 95 in- and out-patients took part in the trial. The severity of depression was evaluated with the aid of a visual analogue scale and nine target symptoms. Both maprotiline and doxepin diminished neurotic as well as psychotic depression significantly. The mean time of onset of action was 7.0 days in the maprotiline group and 7.7 days in the doxepin group. No statistically significant differences in antidepressive effect were found between the treatments. Two patients in the maprotiline group and four patients in the doxepin group discontinued the treatment because of unwanted effects, one patient in each group because of lack of efficacy and nine patients due to reasons not related to the treatment.


L-tryptophan and 5-hydroxytryptophan in the treatment of depression. A review. Trials performed do not provide evidence for an antidepressant effect of 5-HTP. L-TP, without interacting pharmaca, does not appear to be a well-documented antidepressant. The only convincing evidence for L-TP as an antidepressant is that L-TP enhances the effect of MAOI.


Interim report: high dosage bromperidol therapy of delirium tremens. The high dosage of bromperidol as used in this investigation was a safe and effective agent in the treatment of alcohol-induced delirium tremens. All of the 10 patients survived without having complications of the illness or side effects of the therapy. The high doses of bromperidol had a gradual effect against the ten target symptoms of delirium tremens. Particularly effective was the action of bromperidol in controlling hallucinatory phenomena. Against excitement and restlessness, it was rather less effective; no patients were oversedated. Supplementary sedative medication was only rarely needed.


Postmortem radiography of the subarachnoid cisterns. A technique has been developed for stereotactic postmortem cisternography using water-soluble contrast medium and plastic material with enhanced attenuation by the addition of red lead. The latter technique can be used for the preparation of plastic casts of the cisterns, accessible for analysis by radiologic means as well as by direct inspection.


Neuroleptic potency of bromperidol.

Neuroleptic potency of bromperidol. The following statements can be made on the basis of our study. 1. The butyrophenone bromperidol is an absolutely effective drug of the series of very high-potency neuroleptics, with a mean neuroleptic threshold dose of 5.6 mg/day. The mean optimum dose is 6 mg/day, and the mean maximum dose reaches 11 mg/day, i.e. twice the neuroleptic threshold dose. 2. The substance is generally well tolerated; when it was administered to one third of all cases in one single dose in the evening, it not only had the same beneficial neuroleptic-antipsychotic effect as on administration t.i.d., but also positively influenced sleep, so that sleep-inducing drugs could be reduced and, in some cases, even dispensed with. This relatively long-lasting effect confirms the finding made in animal experiments.


Open study with bromperidol in hospitalized chronic schizophrenic patients. A one-year treatment with bromperidol in a group of 30 patients (schizophrenic) has given us the impression that the product is a valuable antipsychotic drug which in most cases can successfully be substituted for haloperidol. The sedating effect of bromperidol seems to be somewhat lower than that of haloperidol. This could explain the fact that patients, who had periods of serious agitation in their anamnesis, are not sufficiently sedated by bromperidol alone. On the other hand, there are reasons for supposing that the less sedating or possible more stimulating effect of bromperidol can be beneficial in the treatment of particularly autistic or inhibited schizophrenics.


Distribution of immunoglobulin-containing cells in bone marrow and lymphoid tissues in patients with monoclonal gammapathy. Cell suspensions of bone marrow and lymphoid tissue from 85 patients with monoclonal gammapathy were investigated by a direct immunofluorescence procedure for the detection of intracellular immunoglobulin alpha, mu, gamma, kappa and lambda chains. Serum Ig levels were determined and daily syntheric rates estimated. In all cases the majority of Ig-containing bone marrow cells contained the same Ig class as that of the M-component in serum or urine indicating a diffuse distriubtion of these clones in the bone marrow. This was observed not only in myeloma but also in benign monoclonal gammapathy (BMG) and lymphoma with an M-component. The M-component producing clone could be traced to extramedullary lymphoid tissue in myeloma but usually not in BMG. A positive correlation was found between the calculated synthetic rate of the M-component and the number of Ig-containing cells in the bone marrow and some indication was found that the synthetic rate per cell might be lower in IgM and IgG than in IgA monoclonal gammapathy. The depressed level of polyclonal Ig in myeloma and to some extent in BMG was parallelled by a diminished number of Ig-containing cells in the bone marrow.


Clinical experiences in an open and a double-blind trial. A total of sixty patients were trated with bromperidol first in open conditions (20 patients), then on a double blind basis (40 patients) with haloperidol as the reference substance. The open study lasted for four weeks; the drug was administrated in the form of 1 mg tablets. The daily dose (initial dose: 1 mg; mean dose at the end of the trial: 4.47 mg) was always administered in one single dose. Nineteen patients finished the trial, and in 18 cases the therapeutic result was considered very good to good. These results were confirmed by statistical analysis. Nine patients exhibited mild to moderate extrapyramidal concomitant symptoms; no other side effects were observed. The results of detailed laboratory tests and evaluations of various quantitative and qualitative tolerability parameters were not indicative of toxic effects. In the double blind study with haloperidol, both substances were found to be highly effective in the treatment of psychotic syndromes belonging predominantly to the schizophrenia group. Certain clues, including the onset of action, seem to be indicative of the superiority of bromperidol. No differences were observed with respect to side effects and general tolerability.


Postmortem diagnostics of renal diseases from semithin sections. For  the light microscopic postmortem study of mostly glomerular renal diseases, in addition to the paraffin technique, 0.5 mu thick (semithin) sections from material fixed in buffered formaldehyde and embedded in methacrylate or Durcupan ACM were used. The method allows for eventual electron microscopic examinations. The semithin sections were stained with methylene blue combined with basic fuchsin, as well as with periodic acid-silver methamine. The method is not a substitution, but the supplementation of the paraffin technique and is suited for the clarification of numerous fine details: in some cases the exact diagnosis was made in this way.


Use of prostaglandin E1 for maintaining the patency of the ductus arteriosus. Prostaglandin E1 was utilized for maintaining the patency of the ductus arteriosus in 19 infants with congenital lesions whose survival depended on ist patency. Fourteen of the patients had lesions which required blood flow from the aorta to the pulmonary artery (cyanotic group); 11 of these were considered successful. Two of the failures were in older infants aged 13 days and 1 month. The remaining five trials were in patients who required a flow of blood from pulmonary artery to aorta (left heart and aortic defect group), two of whom were considered to have responded successfully to the prostaglandin E1 administration. Based on this experience, it is suggested that this method of treatment is of benefit in the cyanotic group in providing emergency medical care while awaiting surgical palliation. A similar benefit in the aortic arch defect group would seem to be less well demonstrated at this time.


Localization of four polypeptide hormones in the saurian pancreas. Glucagon, insulin, somatostatin, and pancreatic polypeptide have been localized in the anolian pancreas using peroxidase-antiperoxidase immunocytochemistry. The most abundant endocrine cell type contains glucagon. Insulin-containing cells are the next most numerous. Somatostatin-immunoreactive cells tend to be localized at the periphery of the islet cords. Pancreatic polypeptide-containing cells are a minor endocrine component scattered throughout the exocrine pancreas and occasionally within the islet areas. No staining was observed after application of antigastrin serum.


Antithrombin III. Theory and clinical applications. H. P. Smith Memorial Lecture. Antithrombin III is one of the main inhibitors in the blood coagulation mechanisms. Thrombin and factor Xa are slowly inactivated by it, as well as other serine proteinases of the coagulation mechanisms. Heparin tremendously accelerates the inhibitory function of antithrombin III. In the process antithrombin III activity is also reduced. Heparin retards the thrombin-fibrinogen reaction, but otherwise the effectiveness of heparin as an anticoagulant depends on antithrombin III in laboratory experiments, as well as in therapeutics. The activation of prothrombin is inhibited, and any thrombin or other vulnerable protease that might generate becomes inactivated. The measurement of antithrombin III concentration in blood is now achieved by research methods, as well as by methods that are practical for routine use. The tests require either thrombin or factor Xa as substrate, and could be specific for antithrombin III. There are congenital as well as acquired deficiencies of antithrombin III. The inhibitor is also found in tissues.


Death in an adolescent following an overdose of acetaminophen and phenobarbital. A 13-year-old epileptic girl took an overdose of acetaminophen (Tylenol) and phenobarbital. Hepatic encephalopathy developed and the patient died eight days later. Necropsy revealed extensive centrilobular necrosis of the liver, degeneration of the renal distal tubules, and infarcted and demyelinated foci throughout the white matter of the cerebral cortex. Electron microscopy of intact hepatocytes showed a proliferation of both smooth and rough endoplasmic reticulum consistent with enzyme induction from phenobarbital. To our knowledge, this is the first reported death in a child in the United States as a result of acetaminophen and should alert physicians to an expected increase in acetaminophen toxicity as the drug becomes more widely available.


Nebulized racemic epinephrine by IPPB for the treatment of croup: a double-blind study. Racemic epinephrine has been advocated for the treatment of croup, but controlled studies have not proved it more effective than saline. Twenty patients (aged 4 months to 5 years) hospitalized with acute croup and persistent inspiratory stridor at rest were randomly assigned to one of two treatment groups: saline or racemic epinephrine, both nebulized and delivered by intermittent positive pressure breathing. Clinical scores were significantly improved (P less than .01) at ten and 30 minutes following the treatment with racemic epinephrine but not at 120 minutes. Racemic epinephrine was significantly more effective than saline at 10 (P less than .01) and 30 minutes (P less than .05) but not at 120 minutes after the treatment. We conclude that nebulized racemic epinephrine is effective treatment for the acute signs of croup.


Neonatal shock in the first postnatal day. Advances in neonatal medicine have markedly reduced mortality in preterm infants. Current emphasis should be placed on early detection and treatment of neonatal hypotension and shock. Ideal clinical management includes perinatal recognition of low birth weight infants at risk for hypotension. All critically ill preterm infants should be closely monitored for tachycardia, hypotension, and/or decreased urinary output. By use of noninvasive blood pressure screening techniques, hypotensive infants may be identified in the first hours of life. Judicious use of whole blood or balanced salt solutions will result in reduction of mortality from 50% to 10%.


The solution to narcotic addiction in the People's Republic of China. The People's Republic of China dealt with addiction as a political problem, offering the new society hope, food, shelter, work, and land instead of opium. Addiction no longer had its appeal. Opium producing poppies were replaced by food corps. Large opium distributors were imprisoned. Addicts were "clean". A mass campaign against addiction mobilized the entire nation. Before Liberation in 1949, the Chinese Communist Party had kept opium out of their areas. However, it took until 1953 to rid China completely of opium. Twenty million Chinese outside the People's Republic of China continue to have serious narcotic addiction problems.


Alcohol by drug-dependent persons: a literature review and evaluation. The literature review very clearly indicated that the majority of drug-dependent persons abused alcohol before becoming addicted to other drugs such as heroin. A conservative estimate of this form of sequential multiple substance abuse would include 80% of all drug-dependent persons. The literature also indicated that substantial numbers of drug-dependent persons used alcohol as a substitute for their preferred drug(s) of abuse, as well as a means of boosting, balancing, counteracting, or sustaining the effects of the other drug(s). Based on the literature, this form of concurrent multiple substance abuse would be evident in the substance abuse histories of at least 30% of all drug-dependent persons. The pernicious effects of alcohol abuse among methadone maintenance patients is documented and discussed, including the medical hazards associated with alcohol-drug abuse. Data from the DARP and CODAP national data systems are also reviewed and discussed. Recommendations for future treatment, prevention, and research on this subject are provided.


Drug abuse by alcoholics and problem drinkers: a literature review and evaluation. The estimate of drug abuse by alcoholics and problem drinkers in the literature varies from a low of 1% to a high of 90%. These studies, coupled with data from the National Drug/Alcohol Collaborative Project (NDACP), led us to estimate the figure to lie somewhere between 60 and 80%, being somewhat higher for individuals under 40 than over 40. Some explanations for the increased occurrence of this form of multiple substance abuse are provided. Problems associated with investigating this phenomenon are discussed and illustrated. Physiological and medical complications associated with drug and alcohol abuse are also cited.


Combined treatment of alcohol- and drug-dependent persons: a literature review and evaluation. A review of the substance abuse field literature concerning combined treatment of alcoholic and drug-dependent persons indicates a moderately favorable, albeit cautious degree of support for doing combined treatment. With only one exception, all of the published reports of clinical experience with combined treatment were positive. Research evidence comparing substance-specific treatment and combined treatment, however, was conspicuous by its absence. Social forces contributing to the creation of an atmosphere conductive to experimenting with combined treatment are discussed. Finally, a series of questions is raised which will likely determine the speed by which the substance abuse field as a whole will move toward adopting a combined treatment approach.


Low cost, manual drug use review of Medicaid recipients to screen prescriber and pharmacist performance. A manual drug use review (DUR) methodology to screen outpatient prescribing which would meet the needs of large third-party programs that cannot afford elaborate computerized DUR was developed and pilot tested. A Medicaid drugs data base was used for the pilot test. A probability sample of 100 recipients over a three-month period was selected for the DUR. The drugs for each recipient, listed by their generic composition and amount, were recorded. Then a priori, explicit, screening criteria were developed for these generics. These criteria delineated drugs of choice, daily dose and refill patterns and, as appropriate, therapy length, drug holidays, and disease-drug and drug-drug interactions. Only 11% of recipients had prescribing patterns which passed all the screens. The most frequent screening failure was due to the prescribing of a drug which was not a drug of choice. In nearly all of the cases which failed the other screens, an alert pharmacist with patient records should have noticed these problems. An analysis showed that the initial start-up cost for the manual DUR was estimated at $1053 (not including personnel fringe benefits); for subsequent quarterly review, the cost was estimated to be about $530. The project showed that manual DUR can effectively and efficiently screen prescribing in a large third-party program.


Sinus node dysfunction. An overview with emphasis on autonomic and pharmacologic consideration. Sinus node dysfunction is a disorder of impulse generation and impulse conduction. Previous works have emphasized that the dysfunction occurs not only within the sinus node but also within the escape pacemaker. Adrenergic and cholinergic mechanisms, as well as pulsations and pressure within the sinus node artery, play an important role in normal sinus node activity. Although perinodal fibers act as a buffer zone for sinoatrial conduction, their role in man is yet to be clarified. During normal sinus node activity, pacemaker shifts from the sinus node to the crista terminalis have been shown to occur. Following sinus node destruction, similar shifts do occur. Clinical methods of determining sinus node function, such as the sinus node recovery time and sinus atrial conduction time, are useful but have limitations. Dynamic electrocardiographic monitoring provides the best clinical method available for detecting sinus node dysfunction. Digitalis appears to improve the parameters of sinus node function by increasing the automaticity of latent atrial pacemakers. The atrial arrhythmia of sinus node dysfunction appears to be related to the characteristics of latent atrial pacemaker and "enhanced" cholinergic tone.


Terminal deoxynucleotidyl transferase in the diagnosis of leukemia and malignant lymphoma. Neoplastic cells from 253 patients with leukemia and 46 patients with malignant lymphoma were studied for the presence of terminal deoxynucleotidyl transferase (TdT) by biochemical and fluorescent antibody technics. TdT was detected in circulating blast cells from 73 of 77 patients with acute lymphoblastic leukemia, 24 of 72 patients with chronic myelogenous leukemia examined during the blastic phase of the disorder and in cell suspensions of lymph nodes from nine of nine patients with diffuse lymphoblastic lymphoma. Blast cells from six of 10 patients with acute undifferentiated leukemia were TdT positive, but the enzyme was found in only two of 55 patients with acute myeloblastic leukemia. TdT was not detected in other lymphocytic or granulocytic leukemias or in other types of malignant lymphomas. The fluorescent antibody assay for TdT permits rapid and specific identification of the enzyme in single cells. The TdT assay is clinically useful in confirming the diagnosis of acute lymphoblastic leukemia, evaluating patients with blastic chronic myelogenous leukemia, and distinguishing patients with lymphoblastic lymphoma, whose natural history includes rapid extranodal dissemination, from patients with other poorly differentiated malignant lymphomas.


Painful crises following renal transplantation in sickle cell anemia. A 34 year old woman with sickle cell (SS) anemia and chronic renal failure of unknown etiology was maintained on dialysis for 11 months before she received a cadaveric renal transplant. After 24 months, transplant function is excellent although a mild urinary concentrating defect (Umax = 532 mOsm/liter) is present. Renal biopsies five and 11 months after transplant revealed mild focal interstitial infiltrates and mesangial thickening. A major complication has been the reemergence of numerous severe painful crises, inferred to be caused by an increased blood viscosity consequent to a rising hematocrit value, after a hiatus of many years. The succession of crises was stopped with a prophylactic partial exchange transfusion program, reemerged when the program was discontinued, and was stopped again when the transfusion program was reinstituted. We conclude that renal transplantation may be successfully performed in patients with sickle cell disease. Complications of the hemoglobinopathy may develop, but painful crises can be successfully managed with judicious transfusion therapy.


The fundamentals of color perception. Charles F. Prentice Award Lecture--1977. The author raises the question, "Suppose a newly qualified optometrist announced that he wanted to undertake research on the perception of color; what fundamental elements of the subject should he attempt to master before setting out on his research program?" In answering this question, the author traces his own development in the subject of color vision.


Recovery of hair coat color in Gray Collie (cyclic neutropenia)-normal bone marrow transplant chimeras. Gray Collie-normal bone marrow transplantation chimeras showed normal coloration of the hair coat on tails and several other areas 2 years after successful transplantation of bone marrow to correct cyclic neutropenia of the Gray Collie syndrome.


Damage to hyphal forms of fungi by human leukocytes in vitro. A possible host defense mechanism in aspergillosis and mucormycosis. Evidence suggests that neutrophils are important in host defenses against invasive aspergillosis and mucormycosis, although hyphae in these lesions are too large to be phagocytized. Interactions of neutrophils with hyphae of Aspergillus fumigatus and Rhizopus oryzae were studed in vitro. Light and electron microscopic observations indicated that neutrophils attached to and spread over the surfaces of hyphae, even in the absence of serum. This was followed by dramatic morphologic changes which suggested severe damage and probably death of hyphae. An assay of neutrophil-induced reduction of uptake of radioisotopes was used to quantitate damage to the fungi by neutrophils from normal subjects. Damage to hyphae was inhibited by a variety of compounds which are known to affect neutrophil surface functions, motility, and metabolism. Use of inhibitors of oxidative microbicidal mechanisms of neutrophils indicated the central importance of these mechanisms in damage to hyphae. Inhibitors of neutrophil cationic proteins altered damage only to Rhizopus. Damage to hyphae by lysozyme suggested that it may play a secondary role in the neutrophil, primarily against Aspergillus. This new nonphagocytic mechanism may play an important role in host defenses against these and other hyphal forms of fungi.


Computer analysis in clinical electromyography. Electromyographic findings are traditionally evaluated in terms of the duration, amplitude and shape of the myoelectric potentials as well as the pattern of discharge. Unfortunately, the evaluation is frequently dependent on the examiner's subjective observations with the result that mild, early cases or variations in the typical symptoms of the disease may be missed. To overcome these deficiencies, various approaches employing either analog or digital computer techniques have been explored. Programs have ranged from recognition and measurement of motor unit potentials to quantification of the interference pattern. Studies have also compared completely automatic analysis with operator-computer interaction and measurements performed manually. It is evident that the general format is still in the developmental stage. The prime need at the present time, however, is not only for quantification of the electromyogram but for innovative approaches which will expand our knowledge and increase diagnostic accuracy.


Insulin secretion during acid-base alterations. Insulin secretion under extracellular acid-base alterations (metabolic acidosis or alkalosis) was studied, by challenging in vitro perfused sodium pentobarbital-anesthetized-rat pancreases with glucose, arginine, and tolbutamide. Under our experimental conditions, the amount of insulin released was lower at pH 7.8 than the amount corresponding to the pH 7.4 control, in spite of the agent used to stimulate the pancreas. The effect of pH 7.0 on insulin secretion, however, depends on the type and concentration of the stimulus used. It enhances the secretion elicited by glucose (6.6 mM) and glucose plus arginine (6.6 and 10 mM, respectively). On the other hand, it reduces the beta cell response to glucose plus tolbutamide (3.3 mM and 400 microgram/ml, respectively), whereas the response to high glucose (16.6 mM) is reduced in the first phase and not affected in the second. According to these results, modifications of the extracellular pH, mainly at high levels, may interfere with a common process involved in insulin secretion, namely beta cell emiocytosis.


Intracellular activities of sodium and potassium. The intracellular contents of Na+ and K+ appear to modulate a variety of cellular and tissue functions, including transepithelial transport. However these total ionic contents appear to consist of heterogeneous populations of Na+ and K+. No more than a few percent of intracellular Na+ and K+ appear bound. Thus, the heterogeneity of the intracellular ionic contents must reflect subcellular compartmentalization. Recent technical advances in the preparation and use of ion-selective microelectrodes have permitted progress in defining the possible sites of such intracellular compartmentalization. Furthermore, intracellular recording with microelectrodes and micropipettes now provides a technique with which to directly monitor the chemical activities of Na+ and K+ within the cytoplasm as a function of the state of transepithelial transport. This approach has already provided information necessitating a reexamination of certain classical concepts of transport physiology.


Selective effects of bumetanide on chloride transport in bullfrog cornea. Frog corneas were mounted in a modified Ussing chamber and short-circuit current (SCC) and unidirectional Cl fluxes were measured. Bumetanide, a loop diuretic, at concentrations as low as 10(-7) M, reduced the SCC 29%. At 10(-5) M, bumetanide reduced the SCC 96% and increased transcorneal electrical resistance 20-51%. The forward Cl flux declined from 0.71 +/- 0.04 to 0.20 +/- 0.03 mueq/h.cm2 (n, 7), while, in separate experiments, the backward Cl flux did not change significantly (from 0.22 +/- 0.03 to 0.23 +/- 0.04; n, 7). When corneas were mounted in Cl-free Ringer and the net Na transport was stimulated with amphotericin B, 10(-5) M bumetanide had no effect on the SCC. In separate experiments the effect of 10(-5) M bumetanide on the O2 consumption was measured in a stirrer bath assembly. Bumetanide decreased the O2 consumption from 352 +/- 14 to 297 +/- 19 microliter/h.cm2 (significantly different from sham-treated controls). This decrease was similar to that obtained with furosemide or when Cl was removed from the bathing medium. We infer from these results that bumetanide is a selective inhibitor of active Cl transport in the bullfrog cornea.


Comparison of SA nodal and subsidiary atrial pacemaker function and location in the dog. A 3-4 cm length of sulcus terminalis tissue including the sinoatrial node (SAN) was excised from 14 dogs. After an initial junctional rhythm with SAN excision a P wave emerged within days to weeks in 12 animals. Maximum heart rates of the SAN (preoperative) in response to exercise (276 +/- 15 beats/min), isoproterenol infusion in conscious animals (272 +/- 11 beats/min), and stellate stimulation during anesthesia (273 +/- 9 beats/min) were significantly greater than subsidiary pacemakers (postoperatively) for exercise (219 +/- 9 beats/min), isoproterenol (226 +/- 8 beats/min), and stellate stimulation (197 +/- 9 beats/min). During a final experiment, electrophysiological mapping of the area of earliest epicardial activation (pacemaker location) was carried out. By use of a suction electrode in reference to plunge electrodes located in the anterior interatrial band (AIB), eustachian ridge of the coronary sinus, and limbus of the fossa ovalis, the pacemaker was located at the inferior vena cava-inferior right atrial junction in 80% of the animals mapped. During isoproterenol infusion the foci shifted to regions of the AIB in 70% of the animals mapped. The concept of pacemaker hierarchy is discussed.


Immunofluorescent localization of renin in mouse submaxillary gland and kidney. An antibody prepared against purified submaxillary renin was used to determine the site of renin concentration in male mice using immunofluorescent localization. The results provide direct evidence that the granular tubules of the submaxillary glands are the source of submaxillary renin. The antibody against submaxillary renin cross-reacts with kidney renin as evidenced by immunofluorescent localization in the juxtaglomerular apparatus of mouse kidney.


Renal autoregulation: perspectives from whole kidney and single nephron studies. The phenomenon of renal autoregulation is often thought to relate only to the manner in which the kidney responds to changes in arterial pressure. This review presents a more comprehensive description of the process based on the intrinsic renal vascular responses to changes in arterial pressure, venous pressure, ureteral pressure, and plasma colloid osmotic pressure. Regulation of glomerular filtration rate (GFR), or some function thereof, is the feature most consistently observed. More specifically, in response to external manipulations that change GFR, autonomous changes in renal vascular resistance tend to return GFR back towards normal. The bulk of the evidence suggests that the requisite renal vascular resistance alterations occur predominately at preglomerular segments. Most of the whole kidney autoregulatory responses can be explained on the basis of the distal tubule-glomerular feedback hypothesis, thought to be mediated by the macula densa-juxtaglomerular complex, which states that increases in distal volume delivery lead to increases in afferent arteriolar resistance while reduced distal delivery leads to afferent arteriolar dilation. Micropuncture data have demonstrated that interruption of distal volume delivery prevents single nephrons from autoregulating GFR and glomerular pressure. Also, single nephron glomerular filtration rate (SNGFR) based on proximal collections is higher than SNGFR measured by distal collections or with an indicator-dilution technique. Studies utilized direct microperfusion of the distal nephron from a late proximal tubule site have demonstrated that SNGFR and glomerular pressure decrease in response to increases in distal nephron perfusion rate. Although experiments in rats have been interpreted as indicating that distal chloride concentration and/or reabsorption most likely mediate the feedback responses, recent studies in dogs have demonstrated that feedback responses can be consistently obtained with nonelectrolyte perfusion solutions. These latter studies suggest that the feedback response may be sensitive to some function of total solute delivery or concentration. At present, there is no clear understanding of the intracellular events that link the compositional alterations occurring within the early distal tubule to the final effector system.


Contributions of the communication sciences to physiology. This paper reviews the impact on physiology of the revolutions in the communication sciences and technology that have occurred in the last 35 years. Particular attention is given to the significance of the cybernetic suggestions of Norbert Wiener--specifically, the ideas of negative feedback, of the computer as a brain metaphor, and of signal-and-noise considerations in information processing. It is argued that the first two of these have not in fact made much lasting contribution to physiology beyond providing loose analogies. On the other hand, the ready availability of a wide variety of electronic measuring and signal-processing devices from communication technology has clearly had a substantial impact. And it is proposed that the kind of models and concepts that are necessary for the characterization of the nervous system as an information-processing device play now, and will continue to play in the future, a major role in physiology.


Plasma and erythrocyte levels of tricyclic antidepressants in depressed patients. Plasma and red blood cells (RBCs), amitriptyline, nortriptyline, imipramine, desipramine, doxepin, and desmethyl doxepin levels were measured in depressed inpatients during steady-state kinetics. A strong positive correlation between the drug levels in plasma and RBCs was found for amitriptyline, nortriptyline, desipramine, and desmethyl doxepin. However, at a given plasma level, up to a 6-fold interindividual variation in the RBC drug levels was found. The correlations between plasma and RBC imipramine and doxepin levels were low. The interindividual variation in the RBC-plasma tricyclic level ratios was large enough to warrant further clinical studies on the relationship between efficacy and pharmacokinetics of tricyclic antidepressants.


Prophylactic effect of lithium and imipramine in unipolar and bipolar II patients: a preliminary report. Relapse rates of the first 35 unipolar and bipolar II manic-depressive patients who entered the controlled phase of a continuing evaluation of the prophylactic value of lithium alone or in combination with imipramine were analyzed. Lithium had a prophylactic effect in unipolar patients and possibly in bipolar II patients. Imipramine did not have a prophylactic effect in either group of patients.


A comparison of pimozide and haloperidol in the treatment of Gilles de la Tourette's syndrome. In a double-blind placebo-controlled study, both pimozide and haloperidol significantly decreased tic frequency in nine patients with Gilles de la Tourette's syndrome. These findings are consistent with the catecholamine hypothesis of tic generation. Pimozide was associated with significantly fewer complaints of lethargy. Follow-up 4-20 months later showed that six of seven patients receiving pimozide and one of two receiving haloperidol had had greater than 75% improvement in symptoms.


Quantitative care norms for a psychiatric ambulatory population in a county medical assistance program. An approach for developing quantitative care norms for outpatient acute psychiatric patients is presented. Both the methodological concept of the norming procedure and its application to the needs of Medicaid in Rockland County, New York are given. The methodology is totally general in that it could be applied to concerns related to characterization of services rendered in a wide variety of applications ranging from planning to utilization review. The norms developed relate both to monthly quantity of services rendered and length of active treatment period. Further, the impact of a review rule is discussed in terms of its implication to number of cases reviewed.


Educational benefits of the United States school feeding program: a critical review of the literature. In the Child Nutrition Act of 1966 it was stated that educational progress was an objective of the United States School Feeding programs. In spite of this fact no serious attempt has ever been made to evaluate whether this objective has been met; the few evaluations that have been conducted lack scientific rigor. As a whole the studies fail to provide a strong basis from which to make valid inferences regarding the long-term effects of the feeding program on school achievement and adaptation. Studies that have focused on the short-term effects of hunger or morning feeding suggest that the provision of breakfast may both benefit the student emotionally and enhance his capacity to work on school type tasks.


The influence of acetylator phenotype on the response to sulfalene in individuals with chloroquine-resistant falciparum malaria. The disposition of sulfalene was studied in eight individuals before and during an infection with a chloroquine-resistant strain of Plasmodium falciparum. Isoniazid acetylator phenotype was determined in each individual prior to the administration of sulfalene. Following the administration of sulfalene before infection with malaria, a significant difference in half-life of non-acetylated sulfalene and percent acetylation of sulfalene in plasma was observed between rapid and slow acetylators. When sulfalene was administered during malaria, this difference was no longer apparent. Individuals who did not respond to the therapeutic administration of sulfalene alone were treated with a combination of sulfalene and pyrimethamine. Three individuals were cured by sulfalene without pyrimethamine and one was cured by the drug combination. Three of the four individuals who were not cured by any dose of sulfalene or the drug combination were slow acetylators. There was no distinct correlation between clinical response and maximum levels or half-life of nonacetylated sulfalene. These findings suggest that acetylator phenotype does not influence the therapeutic response of individuals infected with falciparum malaria to sulfalene or to the combination of sulfalene and pyrimethamine. Further information is presented, however, to confirm the importance of an as yet unidentified host factor(s) in determining therapeutic response to these agents.


Comparison of IgG and IgM contents in serum and filter paper blood eluates. By the indirect immunoperoxidase radial immunodiffusion technique the IgG and IgM contents in serum and filter paper eluates were found to remain essentially at equivalent levels for at least 2.5 months after collection.


Single-layer anastomosis of the colon. A review of 165 cases. One hundred sixty-five patients undergoing elective colorectal or colonic anastomoses with a one-layer technic are presented. One death from suture line dehiscence was noted, and the overall mortality was 2.4 per cent. The usual technic for esophagogastrointestinal suturing in French surgical centers is described and the importance of suture technic in the etiology of anastomotic leaks is discussed.


Hepatic abscesses: improvement in mortality with early diagnosis and treatment. This study demonstrates that hepatic abscesses are highly lethal when untreated. There was an overall mortality of 29 per cent; however, if autopsy cases are excluded the mortality was only 13 per cent. Positive blood cultures (especially if multiple or anaerobic organisms), significant anemia, elevated bilirubin levels, multiple abscesses, and being Caucasian were identified as factors associated with increased mortality. Early diagnosis coupled with aggressive surgical and antibiotic therapy is needed.


Chemoimmunotherapy of head and neck cancer. The present review aims at developing a perspective for surgeons of the role of chemoimmunotherapy in the management of head and neck cancer. The biochemical pharmacology of high dose methotrexate with leucovorin "rescue" is also discussed. The need for a combined modality approach in the treatment of patients with this cancer is emphasized.


Evaluation of a method for transportation and preservation of anaerobic microorganisms. Fecal samples from sixty patients were utilized to evaluate a method for the preservation of anaerobic organisms. Comparison was made with a method commonly employed in the collection of specimens from the operating room and bedside. Analysis of the numbers ae preservation of anaerobic fecal flora in a reliable manner during a 24 hour delay between specimen collection and plating.


Simple mandatory minute volume.

Simple mandatory minute volume. An easily constructed system for mandatory minute volume is described, using a Brompton Manley ventilator, a thin polyvinylchloride bag in a glass jar, and an Ambu "E" valve.


Alternative methods of treating pain.

Alternative methods of treating pain. The range of non-invasive methods of treatment of chronic pain which are currently available has been discussed. They fall into three categories; those dependent on counter stimulation, those which influence the higher centres and those, like acupuncture, which possibly combine both mechanisms. The empirical, but frequently successful nature of such treatments has been emphasised.


Fluoride-induced mineralization within vacuoles in maturative ameloblasts of the rat. Dense crystalline deposits appeared within vacuoles in rat maturative ameloblasts as a result of repeated injections of sodium fluoride. The crystals assumed varied arrangements but were always observed within intracellular vacuoles. The crystals resemble those of normal enamel and resist microincineration. They are readily dissolved by decalcification and leave behind an organic framework which matches the outline of the crystals. An experimental model is presented which may be useful in further studies of calcium transport, enamel matrix absorption or digestion of cellular debris.


Effect of triamcinolone acetonide aerosol upon exercise-induced asthma. The effect of triamcinolone acetonide aerosol upon exercise-induced asthma was compared with that of placebo in a double-blind, crossover study in 11 asthmatic children. Measurement of pulmonary function before and after treatment and before and after exercise disclosed inhibition of exercise-induced asthma in only three of nine children in whom exercise after inhalation of placebo caused bronchospasm.


A clinical trial of the bronchodilator effect of Sch 1000 aerosol in asthmatic children. In a double-blind study in 23 asthmatic patients Sch 1000 was found to be an effective bronchodilator with an onset of effect within 15 minutes and a duration of four hours. It was effective on both small and large airways.


Specific adaptation.

Specific adaptation. In this paper the key to the diagnosis, treatment and prophylaxis of chronic illnesses based on individual susceptibility to foods, drugs, food-drug combinations and environmental chemicals is discussed thoroughly.


Beclomethasone dipropionate in pediatric perennial extrinsic rhinitis. A double-blind, crossover trial of beclomethasone dipropionate intranasal aerosol was undertaken in 30 children suffering from long-term perennial extrinsic rhinitis refractive to conventional therapy with a success rate of 83%. There were no side effects. Maximum improvement was a seen a week after initiation of the active drug. Nasal blockage and rhinorrhoea were most responsive. It is suggested the beclomethasone dipropionate is an effective and safe treatment of children suffering from extrinsic perennial rhinitis.


Evaluation of reconstitution of immunodeficient mice by partially purified thymic extracts. Partially purified thymus products were used to evaluate the maturation of T lymphocytes in immunodeficient mice. Three different bovine thymic extracts, designated thymic extracts A, B, and C, were successful in increasing the longevity of conventionally raised nude mice. Daily injection of bovine thymic extracts A, B, and C and mouse thymus extracts failed to mature a population of T lymphocytes and restore the capacity to reject heart allografts. Preincubation of normal syngeneic bone marrow with thymic extract B in vitro before injection into nude mice also failed to reconstitute the host's ability to reject heart grafts. The number of antibody plaque-forming cells of sheep red blood cells in lethally irradiated, bone marrow-reconstituted mice could be increased by preincubating the bone marrow cells with bovine thymic extract fraction B before injection followed by daily injections. A similar but less marked increase in plaque-forming cells was obtained by the daily injection of bovine thymic extract fraction C. Complete functional maturation of T lymphocytes in immunodeficient animals appears to require more than thymic extract stimulation of bone marrow cells or pre-T lymphocytes.


Salmonella serotypes isolated from the aquatic environment (Wabash River, Indiana, 1973-1976). During 1973-1976, 833 isolations of salmonellae were made from the aquatic biosphere of the Wabash River, Lafayette, Ind. Of the isolants, 643 were definitively serotyped. Salmonella typhimurium represented 34.4% of the cultures. Salmonella eimsbuettel previously had not been recognized in Indiana. A total of 35 serotypes and 1 untypable group C1 was obtained from the aquatic samples, ie, river water, river bottom sediment, fish, and mussels. Most of the isolants were presumed to be of human origin, because many samplings were made in close proximity to sewage treatment plant outfalls. During the survey period, epidemic salmonellosis had not been reported for the Lafayette-West Lafayette metropolitan area.


[Cutaneous microbiol flora in 206 children with diaper dermatitis and pyodermitis]. Staphylococcus aureus (60 p. 100) and Candida albicans (50 p. 100) were mostly found in 73 cases of diaper dermatitis. They were present together in 16 out of these 73 cases. This study enables us to think this is a matter of opportunistic infection. Staphylococcus aureus (75 p. 100) and beta-hémol. Streptococcus A (28 p. 100) were found in 40 children with impetigo contagiosa. They were present together in 7 out of the 40 cases. Nephritis was never found either in those cases or in other 93 cases of pyodermitis.


[Generalized lymph node sarcoma during course of an actinic reticuloid (author's transl)]. A 50 year old man with actinic reticuloid developed a diffuse malignant lymphoma 7 years after the beginning of the dermatosis. Biopsy of lymph node showed a polymorphic proliferation with lymphocytes, numerous reticular cells and several Sternberg-like cells. An ultrastructural study showed an indifferentiate lymphocyte proliferation and numerous malignant reticular cells without the Sternberg cell picture. In this patient we discuss the role of immunosuppressive therapy, chronic herpes virus infection and chronic antigenic photostimulation. Up to now, this is the third case of an association between actinic reticuloid and malignant lymphoma.


[Comel's linear circumflex ichthyosis and Netherton's syndrome. General conceptions based on study of 4 cases (author's transl)]. We have recently observed 4 new particularly demonstrative cases and we think it is adequate to give a general conception in order to bring together in one and a single syndrom the ichthyosis linearis circumflexa Comel and the Netherton's syndrom. We also emphasize some features:--the possible association of ichthyosis linearis circumflexa with family epileptogenous encephalopathy;--a particular type of trichorrhexis which we named "frayed pili torti";--the usual lethality in males, with possible serious viral and pyococcic superinfection;--the characteristics of ichtyosiform erythroderma in the Netherton's syndrom. At the end of this study we confirm that a unicist theory which would consider Netherton's syndrom and ichthyosis linearis circumflexa as one and a single disease should be adopted.


[Study of lichen planus by direct immunofluorescence (author's transl)]. The results of direct immunofluorescent staining from patients with different types of lichen planus are reported. Total antiserum, IgA, IgG, IgM, C1B/C1A and Fg antiserums were used. Immunoglobulin deposits were noted on colloid bodies, on the epidermal basement ,nd the walls of the papillary vessels.