The effects of an antipsychotic medication on the classroom behavior of four schizophrenic male children. An analysis of attention to task, deviant classroom behavior, and academic productivity data was conducted on four schizophrenic male children to whom an antipsychotic medication was administered. Although the results indicated varying degrees of success as a function of this psychotropic treatment, the medication appeared to have little influence on classroom behavior for three of the children. It was concluded that empirical strategies must be developed for objectively assessing the influence of medications administered for the purpose of controlling the classroom behavior of disturbed children.


Formation of ribothymidine from thymine and ribonucleosides by the cell-free extract of tumors and rat tissues. Formation of ribothymidine by the ribose exchange reaction between thymine and uridine with the cell-free extract of mouse Ehrlich ascites tumor cells was demonstrated. Since phosphate ions appear to be not required for this reaction, perhaps it proceeds by the mechnism of direct exchange of nucleoside N-ribosyltransferase. The transfer activity was found in the precipitates when the crude extract was fractionated with 30-60% saturated ammonium sulfate. Ribothymidine formation was also demonstrated between thymine and ribonucleosides other than uridine with this tumor extract. Production of ribothymidine from thymine and uridine was detected also by the use of extracts from lung, brain, and regenerating liver of normal rats, and from newborn rats (whole body). An extract of Rhodamine sarcoma exhibited the ribose exchange activity, while that of human gastric cancer did not.


Purification and amino acid sequence of mating factor from Saccharomyces cerevisiae. Mating factor is a peptide excreted into the culture fluid by alpha-mating type cells of Saccharomyces cerevisiae X-2180 1B. The purification of the mating factor was carried out by ion exchange chromatography on phosphocellulose and Amberlite IRC 50 columns, followed by gel filtration on a Sephadex LH 20 column. The factor thus prepared was a peptide composed of Lys1, His1, Trp2, Gln2, Pro2, Gly1, Met1, Leu2 and Tyr1, and was able to induce morphological changes on alpha-mating type cells at a concentration of 5 pg/ml. The amino acid sequence of the mating factor was determined by the manual Edman degradation method using intact mating factor and its thermolytic peptides. The C-terminal amino acid residue was determined by digesting the factor with carboxypeptidase A. The complete amino acid sequence of the mating factor was established to be as follows: Trp-His-Trp-Leu-Gln-Leu-Lys-Pro-Gly-Gln-Pro-Met-Tyr.


Degradation of mating factor by alpha-mating type cells of Saccharomyces cerevisiae. The change of the mating factor activity during the culture of Saccharomyces cerevisiae X-2180 1B, an alpha-mating type haploid strain, were followed. The activity increased rapidly during the exponential phase of growth, reached a maximum during the early stationary phase and then decreased. Oligopeptides comprising partial sequences of the mating factor were isolated from the culture fluids at various phases of cell growth. We concluded that the mating factor, a tridecapeptide, was degraded during culture into two peptides, Trp-His-Trp-Leu-Gln-Leu and Lys-Pro-Gly-Gln-Pro-Met-Tyr, by cleavage of the peptide bond between Leu-6 and Lys-7 of the mating factor. A dodecapeptide lacking the N-terminal Trp residue was not detected at any stage of cell growth examined.


DNA polymerase I-mediated ultraviolet repair synthesis in toluene-treated Escherichia coli. DNA synthesis after ultraviolet irradiation is low in wild type toluene-treated cells. The level of repair incorporation is greater in strains deficient in DNA polymerase I. The low level of repair synthesis is attributable to the concerted action of DNA polymerase I and polynucleotide ligase. Repair synthesis is stimulated by blocking ligase activity with the addition of nicotinamide mononucleotide (NMN) or the use of a ligase temperature-sensitive mutant. NMN stimulation is specific for DNA polymerase I-mediated repair synthesis, as it is absent in isogenic strains deficient in the polymerase function or the 5' leads to 3' exonuclease function associated with DNA polymerase I. DNA synthesis that is stimulated by NMN is proportional to the ultraviolet exposure at low doses, nonconservative in nature, and is dependent on the uvrA gene product but is independent of the recA gene product. These criteria place this synthesis in the excision repair pathway. The NMN-stimulated repair synthesis requires ATP and is N-ethylmaleimide-resistant. The use of NMN provides a direct means for evaluating the involvement of DNA polymerase I in excision repair.


Primase, the dnaG protein of Escherichia coli. An enzyme which starts DNA chains. Conversion of the viral DNA of phage G4 to the duplex form provided an opportunity to isolate and determine the function of the dnaG protein, the product of a gene known to be essential for replication of the Escherichia coli chromosome. This stage of G4 DNA replication requires action of three proteins: the E. coli DNA-binding protein, the dnaG protein, and the DNA polymerase III holoenzyme. The dnaG protein has been purified approximately 25,000-fold to near-homogeneity. The native protein contains a single polypeptide of 60,000 daltons. It has been assayed for its activity on G4 DNA in three ways: (a) RNA synthesis, (b) complementation for replication of an extract of a temperature-sensitive dnaG mutant, and (c) priming of DNA replication by DNA polymerase III holoenzyme. The dnaG protein is highly specific for G4 DNA and synthesizes a unique 29-residue RNA primer to be described in the suceeding paper. Other single-stranded and duplex DNA templates are inactive. RNA primer synthesis by the dnaG protein has an apparent Km for ribonucleoside triphosphates near 10 micrometer, and a narrow optimum for Mg2+. The sharp specificity of the dnaG protein in choice of template and the utilization of either deoxyribonucleotides or ribonucleotides to produce a hybrid piece only a few residues long (as described in a succeeding paper) suggests that the dnaG protein previously named RNA polymerase by renamed primase.


The RNA primer synthesized by primase to initiate phage G4 DNA replication. With phage G4 DNA as template, primase (the dnaG protein) synthesizes a 26- to 29-residue RNA transcript at the origin of replication. The sequence starts with ATP and contains a hairpin region of one A-U and seven G-C base pairs. Covalent linkage between the RNA and the newly synthesized complementary DNA chain indicates that the RNA transcript serves as a primer.


A ribo-deoxyribonucleotide primer synthesized by primase. The 29-residue ribonucleotide primer formed by primase at the origin of phage G4 DNA replication (Bouché, J.-P, Rowen, L., and Kornberg, A. (1978) J. Biol. Chem. 253, 765-769) was shorter in the presence of deoxynucleoside triphosphates (dNTPs). At 50 micrometer dNTPs and 20 micrometer rNTPs, RNA trancripts no longer than 6 residues were synthesized and these were still effective in priming replication by the DNA polymerase III holoenzyme. Primer synthesis was initiated with ATP; adenosine 5'-O-(3-thiotriphosphate) (Appp(S)), adenosine 5'-tetraphosphate, adenylyl imidodiphosphate (App(NH)p), and ADP were able to substitute for ATP. dATP and GTP were ineffective in initiating replication. DNA replication was stimulated by GTP, suggesting that incorporation of this nucleotide into the second position of the primer trancript by primase produces a more efficient primer. Each of the dNTPs can be incorporated into a hybrid ribonucleotide-deoxyribonucleotide transcript, indicating that primase is able to add either a ribonucleotide or deoxyribonucleotide to the 3'-OH of either of ribo residue or a deoxy residue of the primer terminus. Incorporation of an individual dNTP was less efficient than that of the corresponding rNTP, and the presence of all four dNTPs profoundly depressed RNA synthesis by primase.


Chemical and functional properties of the native and reconstituted forms of the membrane-bound, aerobic glycerol-3-phosphate dehydrogenase of Escherichia coli. A simple purification for the membrane-associated, flavin-linked, glycerol-3-phosphate dehydrogenase of Escherichia coli has been developed which yields homogeneous enzyme in a detergent-solubilized state. 1. The dissociated form of the enzyme has a molecular weight of 58,000 and contains 0.5 mol of FAD/mol of protein monomer. 2. The solubilized enzyme-catalyzed reaction has a pH profile and temperature dependence similar to that observed for the membrane-bound enzyme. 3. The most efficient electron acceptor is potassium ferricyanide but phenazine methosulfate, methylene blue, menadione, and dichlorophenolindophenol can also be utilized. 4. The reaction is competitively inhibited by dihydroxyacetone phosphate, phosphoenolpyruvate, phosphoglycolic acid, glyceraldehyde-3-phosphate, and D-2- and D-3-phosphoglyceric acid. 5. The activity of the enzyme is regulated in a complex manner by ATP and GTP. 6. Detergent-depleted enzyme can be functionally reconstituted with Escherichia coli membrane vesicles to support glycerol-3-phosphate-dependent active transport of L-proline. 7. Detergent-depleted enzyme requires exogenous phospholipid or nondenaturing detergent for electron transfer activity.


Covalent structural analysis of yeast inorganic pyrophosphatase. The present paper describes the amino acid sequence analysis of the internal and COOH-terminal cyanogen bromide fragments of yeast inorganic pyrophosphatase (Sterner, R., Noyes, C., and Heinrikson, R.L. (1974) Biochemistry 13, 91-99). This information coupled with that derived from earlier structural studies of the enzyme (Sterner, R., AND Heinrikson, R.L. (1975) Arch. Biochem. Biophys. 165, 693-703) provides the complete covalent structure of the pyrophosphatase subunit. The majority of the sequence data was derived from automated Edman degradation of the intact cyanogen bromide fragments and the large tryptic peptides obtained from citraconylated derivates in which cleavages were restricted to arginyl residues. The structural determination was completed by analysis of tryptic and chymotryptic peptides from the decitraconylated fragments. The monomer peptide chain contains 285 amino acid residues and the molecular weight calculated from the sequence analysis is 32,042.


Colicins and bacterial membranes: structures and functions. I. Effects of colicins on the protein composition of the membranes of sensitive and tolerant Escherichia coli. Treatment of Escherichia coli K12 C600 with colicin K or E1, but not E3, caused changes in the protein composition of the bacterial cytoplasmic membrane and an impairment of the membrane-associated ATP-linked transhydrogenase activity. The major compositional changes were loss and/or reduction in the levels of protein bands 4, 8, 9, 10, 13, and 18 with approximate molecular weights of 122,000, 81,000, 75,000, 73,000, 62,000, and 44,000, respectively. Colicin K or E1 treatment had no significant effect on the protein composition or the ATP-linked transhydrogenase activity of the cytoplasmic membranes of the isogenic tolerant strain E. coli K12 C600 TolII (A592). The cytoplasmic membranes of the untreated tolerant mutant were characteristically devoid of protein bands 4 and 13. It is proposed that protein bands 4 and/or 13 participate in colicin action by acting as receptors for colicins at the cytoplasmic membrane level. Some observations on the structural and functional heterogeneity of the cytoplasmic membrane preparations were made.


Determination of N-desmethyldiazepam in plasma by gas chromatography with an internal standard. N-Desmethyldiazepam in plasma has been determined by gas chromatography with electron capture detection, using N-desmethyltetrazepam as internal standard and a column filled Poly-A 103 on Gas-Chrom Q. No prior transformation of benzodiazepines is necessary. The sensitivity is ca.1 ng/ml and the recovery is greater than or equal to 70%. The method is particularly suitable for the pharmacokinetic study of dipotassium clorazepate: the amount of unchanged clorazepate may be estimated from the difference between the amount of N-desmethyldiazepam present initially and the total amount of N-desmethyldiazepam obtained after acidic treatment of the sample; the method is also useful for therapeutic control and for analytical toxicology.


Immune response in the mutant diabetic C57BL/Ks-dt+ mouse. Discrepancies between in vitro and in vivo immunological assays. Cell-mediated and humoral immune responses of mutant diabetic db+/db+ mice were evaluated using in vivo and in vitro immunological assays. When compared to lean, nondiabetic db+/m+ or m+/m+ mice, db+/db+ mice demonstrated markedly altered in vivo immune responses characterized by a significantly diminished ability to reject allogeneic skin grafts, a markedly diminished capacity to generate cytotoxic cells after sensitization with allogeneic EL-4 lymphoma cells and a significantly enhanced plaque-forming cell response to sheep erythrocytes. In contrast, spleen cells from db+/db+ mice demonstrated only minimal alterations in in vitro responses to mitogens and allogeneic cells and no alteration in their capacity to generate an in vitro plaque-forming cell response. The spleens and thymuses of db+/db+ mice weighed significantly less than organs from db+/db+ mice. In addition, thymuses from db+/db+ mice demonstrated a marked deficiency in in vivo [125I]UdR uptake. These data suggest that the altered metabolic status of the diabetic host influences immune function in vivo possibly due to abnormal function of lymphocyte subpopulations.


Recognition of right-to-left shunts following closure of low atrial septal defects. Intraoperative dye curves are routinely employed following closure of all types of intracardiac defects. The technique has been quite helpful in a variety of problems. With atrial defects which are low in the septum or when arterial desaturation occurs immediately postoperatively, it is important that inferior vena caval, as well as superior vena caval injection of dye be obtained. In the past two years, intraoperative dye curves have been employed in approximately 75 patients following ASD repair without evidence of iatrogenic diversion of blood flow from the inferior vena cava to the left atrium in any patient. It is a simple technique which can detect this error at the time of surgery and thus permit its immediate correction and can be strongly recommended as a routine procedure.


Late results of Linton flap operation.

Late results of Linton flap operation. Linton flap operation was performed in 202 patients with postphlebitic syndrome complicated by evident ulceration 64% of patients were followed up for 1-14 years. Complete cure was obtained in 87.7%.


Absence of intercellular antigens in the deep layers of the epidermis in pemphigus foliaceus. 12 patients with pemphigus foliaceus, a form of pemphigus with lesions that arise in the intercellular substance in the superficial layers of the epidermis, and 7 patients with pemphigus vulgaris, where lesions are in the deep layers, were studied by immunofluorescence. Circulating antibodies to intercellular antigens (IC antibodies) were found in 11 pemphigus foliaceus and 5 pemphigus vulgaris patients. On direct immunofluorescence of skin lesions 75% (9 of 12), pemphigus foliaceus patients had intercellular deposits of IgG localized solely or predominantly in the superficial epidermal layers, whereas this was not the case in any of the patients with pemphigus vulgaris. Over 70% of the pemphigus foliaceus patients with predominantly superficial IgG deposits lacked in their lesions normal intercellular antigens usually expressed in the deep layers of the epidermis. This was shown by the inability of IC antibodies in autologous or allogeneic sera to bind to intercellular antigens in the lower epidermis of patient's skin, even though the same sera could bind to intercellular antigens in all layers of normal allogeneic skin. Lack of normal intercellular antigens deep in the epidermis may result in circulating IC antibodies binding to the superficial layers, a site which corresponds to, and thus in some patients may account for, the anatomical location of lesions in pemphigus foliaceus.


Damage to pseudohyphal forms of Candida albicans by neutrophils in the absence of serum in vitro. Large forms of Candida are characteristically present in invasive lesions and are often cleared by host defenses. Therefore, an in vitro system was developed to study interactions between leukocytes and pseudohyphae. By light, phase contrast, and electron microscopic observations, in the absence of serum, neutrophils attached to and spread over the surfaces of partially ingested pseudohyphae, which then appeared damaged. Using a new assay which measured neutrophil-induced inhibition of uptake of [(14)C]cytosine by Candida, damage to Candida in the absence of serum was 53.04+/-2.96% by neutrophils from 27 normal subjects. With serum, damage to Candida increased because of opsonization by low levels of anti-Candida immunoglobulin G in normal sera. Damage to Candida was inhibited by colchicine, cytochalasin B, and 2-deoxyglucose, which interfered with spreading of neutrophils over the surfaces of Candida. Dibutyryl cyclic AMP, theophylline, and isoproterenol also inhibited damage to Candida. Hydrocortisone was inhibitory in levels (10 muM) achievable with pharmacologic doses in man. Light, fluorescence, and electron microscopy indicated that neutrophils degranulated after contact with Candida. Quantitative studies revealed only a minimal increase in specific release of lysosomal enzymes from azurophil granules, but much greater release of lysozyme from specific granules. Candida activated neutrophil oxidative microbicidal mechanisms, as shown by iodination of Candida by neutrophils, and chemiluminescence from neutrophils interacting with Candida. Unlike live Candida, killed Candida did not induce chemiluminescence, were not iodinated, and did not attach to neutrophils by microscopy. Like Candida pseudohyphae, contact between neutrophils and hyphal forms of Aspergillus and Rhizopus occurred in the absence of serum. This did not occur with Cryptococcus neoformans, an encapsulated yeast, and was low with Candida yeasts. These findings indicate that neutrophils can recognize and attach to Candida pseudohyphae, then damage the Candida. This may represent a general reaction between neutrophils and large forms of fungi. Though the size of the organisms precludes complete ingestion, neutrophil oxidative microbicidal mechanisms are activated, and preferential release of contents of specific granules appears to occur.


Mechanisms of attachment of neutrophils to Candida albicans pseudohyphae in the absence of serum, and of subsequent damage to pseudohyphae by microbicidal processes of neutrophils in vitro. Mechanisms were studied that might explain the attachment and damage to Candida albicans pseudohyphae by neutrophils in the absence of serum. Attachment of neutrophils to pseudo hyphae was inhibited by Candida mannans (1-10 mg/ml), but not by mannose, dextran, chitin, conconavalin A, or highly charged polyamino acids. Contact was also inhibited by pretreatment of Candida before incubation with neutrophils with chymotrypsin, but not trypsin or several inhibitors of proteases. Similar results were obtained with pretreatment of neutrophils, except that trypsin was inhibitory. When pseudohyphae were killed with ultraviolet light, proteinpolysaccharide complexes of mol wt <10,000 were released which appeared to bind to the surfaces of neutrophils and inhibit contact between neutrophils and Candida, as well as other fungi. Damage to Candida by neutrophils was inhibited by agents known to act on neutrophil oxidative microbicidal mechanisms, including sodium cyanide, sodium azide, catalase, superoxide dismutase, and 1, 4 diazobicyclo (2, 2, 2) octane, a singlet oxygen quencher. Neutrophils from a patient with chronic granulomatous disease did not damage Candida at all. However, the hydroxyl radical scavengers mannitol and benzoate were not inhibitory. Cationic proteins and lactoferrin also did not appear to play a major role in this system. Low concentrations of lysozyme which did not damage Candida in isotonic buffer solutions damaged pseudohyphae in distilled water. Isolated neutrophil granules damaged pseudohyphae only with added hydrogen peroxide and halide, and damage occurred only with granule fractions known to contain myeloperoxidase. These findings suggest that neutrophils recognized a molecule on the Candida surface which has a chymotrypsin sensitive protein component, and which may be liberated from the cell surface upon death of organism. The neutrophil receptors for Candida appear to be sensitive to trypsin and chymotrypsin. Damage to Candida by neutrophils occurred primarily by oxidative mechanisms, including the production of superoxide and hydrogen peroxide interacting with myeloperoxidase and halide, as well as singlet oxygen, but did not appear to involve hydroxyl radical. Lysozyme might have an accessory role, under some conditions.


An enzyme-linked immunosorbent-assay test for hepatitis B surface antigen. A new commercial test for hepatis B surface antigen based on an enzyme-linked immunosorbent-assay system was evaluated and compared with other tests already available. It was of comparable sensitivity to the radioimmunoassay test but required less expensive equipment (in terms of both outlay and upkeep) and did not use radioisotopes; the reagents were more stable.


Iodothyronine metabolism in rat liver homogenates. To investigate mechanisms of extrathyroidal thyroid hormone metabolism, conversion of thyroxine (T(4)) to 3,5,3'-triiodothyronine (T(3)) and degradation of 3,3',5'-triiodothyronine (rT(3)) were studied in rat liver homogenates. Both reactions were enzymatic. For conversion of T(4) to T(3), the K(m) of T(4) was 7.7 muM, and the V(max) was 0.13 pmol T(3)/min per mg protein. For rT(3) degradation, the K(m) of rT(3) was 7.5 nM, and the V(max) was 0.36 pmol rT(3)/min per mg protein. Production of rT(3) or degradation of T(4) or T(3) was not detected under the conditions employed. rT(3) was a potent competitive inhibitor of T(4) to T(3) conversion with a K(i) of 4.5 nM; 3,3'-diiodothyronine was a less potent inhibitor of this reaction. T(4) was a competitive inhibitor of rT(3) degradation with a K(i) of 10.2 muM. Agents which inhibited both reactions included propylthiouracil, which appeared to be an allosteric inhibitor, 2,4-dinitrophenol, and iopanoic acid. Sodium diatrizoate had a weak inhibitory effect. No inhibition was found with alpha-methylparatyrosine, Fe(+2), Fe(+3), reduced glutathione, beta-hydroxybutyrate, or oleic acid. Fasting resulted in inhibition of T(4) to T(3) conversion and of rT(3) degradation by rat liver homogenates which was reversible after refeeding. Serum T(4), T(3), and thyrotropin concentrations fell during fasting, with no decrease in serum protein binding as assessed by a T(3)-charcoal uptake. There was no consistent change in serum rT(3) concentrations. Dexamethasone had no effect in vitro. In vivo dexamethasone administration resulted in elevated serum rT(3) concentrations after 1 day, and after 5 days, in inhibition of T(4) to T(3) conversion and rT(3) degradation without altering serum T(4), T(3), or thyrotropin concentrations. Endotoxin treatment had no effect of iodothyronine metabolism in liver homogenates. In kidney homogenates the reaction rates and response to propylthiouracil in vitro were similar to those in liver. No significant T(4) to T(3) conversion or rT(3) production or degradation could be detected in other tissues. These data suggest that one iodothyronine 5'-deiodinase is responsible for both T(4) to T(3) conversion and rT(3) degradation in liver and, perhaps, in kidney. Alterations in serum T(3) and rT(3) concentrations induced by drugs and disease states may result from decreases in both T(3) production and rT(3) degradation consequent to inhibition of a single reaction in the pathways of iodothyronine metabolism.


Microbial flora of the vagina and cervix. The microbial flora of the vagina and cervix was assessed qualitatively and semiquantitatively in 40 women attending an intrauterine contraceptive device clinic. Both sites harboured many types of macroorganism, the mean number of microbial types isolated being five from the vagina and four from the cervix. Typical lactobacilli were detected in 61% of vaginal and in 53% of cervical specimens; faecal bacteria, including anaerobes, were even more frequently found at both sites. No differences in the microbial populations at either the vagina or the cervix were detected after fitting of the devices, in the different weeks of the menstrual cycle, or with various previously used contraceptive methods.


Periodontal surgery in plaque-infected dentitions. A clinical trial was performed to study the result of periodontal treatment following different modes of periodontal surgery in patients not recalled for maintenance care. The material consisted of 25 patients distributed into 5 groups. Following an initial examination, all patients underwent presurgical treatment including case presentation and instruction in oral hygiene measures. This instruction was given once. The various patient groups were then subjected to one of the following surgical procedures: 1) the apically repositioned flap operation including elimination of bony defects 2) the apically repositioned flap operation including curettage of bony defects but without removal of bone 3) the "Widman flap" technique including elimination of bony defects 4) the "Widman flap" technique including curettage of bony defects but without removal of bone 5) gingivectomy including curettage of bony defects but without removal of bone. Six, 12 and 24 months after completion of the treatment, the patients were recalled for assessment of their oral hygiene standard and periodontal conditions. The results showed that case presentation and oral hygiene instruction given once, only temporarily improved the patient's oral hygiene habits. Renewed accumulation of plaque in the operated areas resulted in recurrence of periodontal disease including a significant further loss of attachment. All five different techniques for surgical pocket elimination were equally ineffective in preventing recurrence of destructive periodontitis.


Comparison of traditional and experimental expanded function dental hygiene students in hand scaling. The purpose of this investigation was to determine whether an expanded function dental hygiene curriculum prepared students to perform traditional dental hygiene clinical procedures at the same level of competency as a traditional dental hygiene curriculum. Hand scaling was selected as the most appropriate procedure to evaluate. Fourth-year dental hygiene students enrolled in a special expanded function curriculum were compared to fourth-year students enrolled in the traditional dental hygiene curriculum during a controlled one-day experiment. Results indicated no statistically significant differences between the two student groups in the performance of scaling procedures as measured by number of tooth surfaces on which calculus remained. It was concluded that the University of Iowa expanded function dental hygiene curriculum prepared students to perform hand scaling procedures at a competency level comparable to that of the traditional curriculum.


Human figure drawings as a measure of the child's response to dental visits. The HFD as obtained in this study was a measure of the child's response at the beginning of the dental visit. HFD scores correlate with the five other measures of the child's response as well as those measures correlate with each other. The subscore of six items was an acceptable substitute for the twenty items scoring index and was superior to any single item. The data, with respect to age, suggest that children suppress signs of overt fear and anxiety with increasing age, giving a misleading impression of older children's feelings toward their dental experience.


Haemodynamic effects of dopamine, epinephrine and orciprenaline (Alupent) in patients early after cardiac surgery. The haemodynamic effects of Dopamine (100, 250 and 500 mcg/min), Epinephrine (4 and 8 mcg/min), Orciprenaline (4 and 8 mcg/min) and two combinations of Dopamine 250 mcg/min with Epinephrine and Orciprenaline 4 mcg/min respectively at constant infusion rates were studied in 21 patients after cardiac surgery. Special attention was payed to four types of catecholamine infusions during which the highest cardiac index (CI), 161-168% of control, was seen: Dopamine 500 mcg/min (D 500), Epinephrine 8 mcg/min (E 8), Dopamine 250 mcg/min combined with Epinephrine 4 mcg/min (D 250 + E4) and Dopamine 250 mcg/min combined with Orciprenaline 4 mcg/min (D 250 + Or 4). At the same time mean arterial pressure (MAP) was highest with D 500 (137%) and lowest during both combined infusions (120 and 125%). Total peripheral resistance (TPR) was lowest during the combined infusions (80 and 81% of control) and highest during D 500 (89%). The relative increase of stroke index (SVI) and heart rate (HR) in favor of SVI, given as a quotient SVI/HR, was highest with D 250 + E4(3.7), followed by E 8 (1.9), D 500 (1.6) and D 250 + Or 4 (1.3). It was concluded that a combined infusion of Dopamine and Epinephrine, both in low doses, is preferable to a high dose of Dopamine, or Epinephrine alone, producing the same increase of cardiac output with less afterload and less chronotropic effect than high doses of either drug alone.


Clinical comparison of sealant and bonding systems in the restoration of fractured anterior teeth. This study compared the clinical performance of the ultraviolet light-initiated fissure sealant and composite system (Nuva-Seal/Nuva-Fil) with a chemically activated system (Adaptic Bonding Agent/Adaptic). A total of 63 fractured permanent anterior teeth involving only enamel and dentin were restored. All teeth were isolated with rubber dams, and the acid etch technique was used. The degree of success was determined from an assessment of retention, marginal integrity, marginal staining, and color change. The restorations were evaluated at 3, 6, 12, 18, and 24 months postoperatively. Of the restorations, 93% were retained in both groups of patients after two years. Varying degrees of marginal problems (lack of marginal integrity or marginal staining) were directly attributable to the extension of the bonding medium and the composite in relation to the conditioned enamel and to each other. Repolishing of the margins should be considered at the time of the recall appointments to improve the quality of restoration.


Skin test conversion following transfer factor. A double-blinded study of normal individuals. The use of skin test conversion as a measure of change in cellular immune status is a fairly routine procedure despite considerable potential for variation in testing. This study is a double-blinded and randomized reassessment of this assay in the context of transfer factor (TF) activity. Thirty-three normal people with negative tuberculin skin tests received either dialyzable TF, column purified TF, hypoxanthine, or saline in a randomized and double-blinded fashion. Skin test reactivity to tuberculin and keyhole limpet hemocyanin (KLH) was read by three of the investigators. Nine of 20 recipients of TF and 7 of 13 controls demonstrated an increase in tuberculin reactivity after "transfer." Four reactions were greater than 10 mm. Fourteen of 20 recipients of TF and 7 of 13 controls demonstrated some reactivity to KLH on initial testing post-transfer. Control solutions were as effective as TF preparations in "causing" skin test conversion. These observations stress the importance of controlled and and blinded studies when serial skin test reactivity is used to evaluate cellular immune status in humans.


The use of porcine xenografts on nail beds following total nail avulsion and phenol chemomatrixectomy. The success of applying split-thickness porcine xenografts to nail beds after nail avulsion with matrix chemocauterization depends on the adherence of the graft to the underlying tissue. When this was obtained, the authors found that porcine xenografts contribute markedly toward reducing postoperative pain and drainage. Further investigation is being undertaken to determine whether total healing time following chemomatrixectomy has been reduced by utilizing xenografts.


Rectus femoris muscle and composite skin transplantation by microneurovascular anastomoses for avulsion of forearm muscles: a case report. The first clinical use in man of the rectus femoris muscle, with overlying composite skin, as a free transplant by microneurovascular anastomoses to the upper extremity was done for traumatic loss of all digital and forearm flexors, which had been treated with primary flap coverage, and later, sural nerve grafts for the avulsed portions of the median and ulnar nerves.


Studies on the mechanism of lysis of Echinococcus granulosus protoscoleces incubated in normal serum. Brood capsules were obtained from freshly collected cysts of equine and ovine strains of Echinococcus granulosus. Protoscoleces were freed from brood capsules either by mechanical disruption or pepsin-HCI digestion. Preparations of protoscoleces studied included: mechanically released protoscoleces without further treatment, or incubated either in HCI pH 2.0 or in evaginating solution (containing Na taurocholate) for 24 h; pepsin-HCI released protoscoleces without further treatment or incubated in evaginating solution for 24 h or 7 days. Half of each preparation of ovine protoscoleces was fixed in absolute methanol. All fresh preparations of protoscoleces lysed rapidly when incubated in normal human serum. Studies with a fluorescein isothiocyanate (FITC) labelled sheep anti-human C3 antiserum revealed the presence of C3 on the surface of lysing protoscoleces. Antibody could not be detected on the surface of any of the preparations of fresh or methanol-fixed protoscoleces using direct or indirect fluorescent antibody tests suggesting that the classical pathway of complement activation was not involved in the lytic process. Strong evidence for lysis by the alternate pathway of complement activation was the lysis of protoscoleces which had been treated with pepsin-HCI and lysis of protoscoleces in guinea-pig serum deficient in C4 component of complement.


Immunohistological localisation of two hydatid antigens (antigen 5 and antigen b) in the cyst wall, brood capsules and protoscoleces of Echinococcus granulosus (ovine and equine) and E. multilocularis using immunoperoxidase methods. Cyst wall, brood capsules and evaginated protoscoleces of E. granulosus (ovine and equine) and E. multilocularis were fixed in 10% formol-saline, embedded in paraffin and cut at 8 micrometer. Specific rabbit antisera to antigen 5 and antigen B of hydatid cyst fluid were used with immunoperoxidase methods to localise the antigens in the histological sections. Antigen 5 was found in all parasites and was associated with cells of the subtegumental area of the protoscolex, the brood capsule wall and the germinal membrane. The labelled antigen appeared as distinct granules in all areas. It is suggested that antigen 5 may be synthesised in all of these sites and that a source of the antigen in cyst fluid may be the germinal and brood capsule membranes. The laminated membranes of E. granulosus (ovine and equine) were, except for the superficial layers, free from antigen 5. Antigen B was present in all parasites. It was distributed diffusely throughout the laminated membrane, germinal membrane and brood capsule wall. There were areas of densely labelled antigen B on the surface of the distal cytoplasm of the protoscolex tegument and the surface of calcareous corpuscles. The distribution of antigen B in relation to PAS positive material and possible complement activating substances is discussed. The laminated membrane of E. granulosus was apparently more permeable to antigen B than to antigen 5. It is suggested that differences in the diffusion of these antigens through the laminated membranes of hydatid cysts in the same or different host species may account for variable serological responses during infection.


A hospital epidemic caused by gentamicin-resistant Klebsiella aerogenes. In the 15 months, February 1976 to April 1977, more than 241 patients became colonized with a strain of Klebsiella aerogenes, capsular serotype K2, resistant to most antibiotics. Urinary tract infection was the most common clinical manifestation but bacteraemia and, occasionally, infections of other sites were encountered. The main reservoir of the epidemic klebsiella was the gut, urine and skin of colonized patients. Gut carriage among staff was very uncommon. The most susceptible patients were elderly males, with debilitating illnesses and urinary tract abnormalities, especially if they were catheterized or receiving antibiotics. Likely vehicles for spread were the hands of staff, and contaminated bedpans and urinals. Control measures were directed at these factors. At the end of April 1977 no new cases had occurred for 3 months in the ward in which the outbreak began, and which had been the main focus of infection, and only 5 patients in the affected hospitals were known to be colonized by the epidemic klebsiella.


The hygienic quality of vegetables grown in or imported into the Netherlands: a tentative survey. Samples of 61 home grown and 199 imported vegetables of different varieties were examined for Escherichia coli, faecal streptococci and, when E. coli was present, for salmonellas. Eleven per cent of samples contained greater than 10(4) E. coli per 100 g, and 14% greater than 10(6) faecal streptococci per 100 g. Salmonellas were isolated from 23 out of 103 samples examined. Salmonellas were isolated from 8% of 76 samples with E. coli less than 10(4)/100 g, but from 63% of 27 samples with E. coli exceeding 10(4)/100 g; from 6% of 65 samples containing less than 10(6) faecal streptococci/100 g but from 51% of 37 samples containing more than 10(6)/100 g. S. typhi was isolated from one sample of vegetables imported from the tropics. To our knowledge this is the first isolation of S. typhi from food in the Netherlands. Products from tropical countries were found to present the highest level of contamination. The hygienic quality of Dutch products is sometimes inferior to that of similar imported products, although the different seasons of sampling may have influenced the result. For the prevention of risk to the consumer of vegetables, good kitchen hygiene would appear to be the most important factor.


The use of a fluorescence typing method in an epidemiological study of Klebsiella infection in a London hospital. The fluorescent antibody technique was used to investigate an epidemic of Klebsiella infection in a urological ward and to trace the probable source to a contaminated sink in the treatment room. It was also shown that cross infections by particular capsular types were very common within each ward. Certain types of Klebsiella occurred in cut flower water but could not be associated with the types infecting the patients. Antibiotic resistance patterns within one capsular type were found to vary whether the type was from different sources in one patient or from different patients in the same ward. One capsular type was observed to develop resistance to increasing numbers of antibiotics over a 3-year period. This was probably due to the acquisition of R-plasmids. There also appeared to be a relation between capsular type and the site of infection. The frequency of Klebsiella infections in the urological wards dropped significantly after up-grading the treatment room, improving catheter storage and reducing ampicillin use.


Heritability in retrospect.

Heritability in retrospect. The origin of the word heritability remains unknown. Its usage has evolved through three stages, becoming more restrictive in its meaning along the way. In the initial stage, 1832 and possibly earlier, heritability was used to denote the hereditary transmission of characteristics or material things, simply having the capability (legally or biologically) of being inherited. The second stage, beginning around the turn of this century, followed Johannsen's classical definition of nongenetic or environmental fluctuations distinct from genotypic differences, and usage closely approximated "broad sense heritability" and Johannsen's Erblichkeit. Finally, in 1936, we come to the modern day usage of narrow sense heritability, the ratio of additive genetic variance to the total phenotypic variance within a population, and credit Dr. J.L. Lush with its origin.


The sources of "OH" serotypes of Escherichia coli. The sources from which different "OH" serotypes of Escherichia coli have been isolated are listed in a series of tables. It is considered that these tables should provide a basis for obtaining a greater understanding of the ecology of E. coli.


Mechanism of nonspecific macrophage-mediated cytotoxicity: evidence for lack of dependence upon oxygen. Peritoneal macrophages elicited in C3H/HJ mice by the i.p. injection of Corynebacterium parvum were cytotoxic to allogeneic virus-transformed fibroblasts in vitro. Cytotoxicity was demonstrated in a morphologic (plaque) assay, and quantitated by measuring macrophage-mediated inhibition of incorporation of 3H-thymidine by the target cells. The cytotoxic effect was well established by 6 hr of macrophage-fibroblast interaction, and was retained in cultures from which the supernatant was removed before the addition of 3H-thymidine. Cytotoxic activity of macrophages diminished rapidly after 22 hr of cultivation in vitro. Maximal cytotoxic effect could be prolonged by addition of C. parvum, 50 microgram/ml to macrophage monolayers preincubated in vitro for 22 hr. It could neither be retained nor regenerated when C. parvum was added to monolayers greater than 22-hr old. C. parvum-activated macrophages, grown under anaerobic conditions for 8 hr, retained the ability to phagocytize heat-killed Candida albicans and to exclude trypan blue dye. There was a small but significant reduction in the ability of macrophages to inhibit 3H-thymidine incorporation by target fibroblasts under anaerobic conditions. The cytotoxic effect of activated macrophages in air was not altered by the presence of catalase and was enhanced by enzymatically active superoxide dismutase. We conclude that the processes involved in macrophage-mediated cytotoxicity against allogeneic fibroblasts in this system are largely independent of oxygen.


Cell surface immunoglobulin XXI. appearance of IgD on murine lymphocytes during differentiation. The differentiation of Ig-bearing lymphocytes in adult mice was studied by monitoring the appearance of IgD relative to IgM on the surface of splenocytes obtained from lethally irradiated animals reconstituted for various periods of time with adult bone marrow cells, neonatal splenocytes, or Ig- adult splenocytes. It was found that IgM appears before IgD on differentiating lymphocytes. Furthermore, the rate of appearance of IgD during differentiation of adult cells is similar to that observed with neonatal cells.


Human cell membrane components bound to beta2-microglobulin in T cell-type cell lines. Cell membrane components bound to beta2-microglobulin were isolated from Renex 30 (a nonionic detergent)-solubilized membrane materials of two human T cell-type cell lines, MOLT-4 and CCRF-CEM, by gel filtration and lectin affinity chromatography. The isolation was carried out by following the beta2-microglobulin activity by radioimmune inhibition assay. The T cell membrane components bound to beta2-microblogulin had a uniform molecular size of about 200,000 daltons and most of them showed an affinity to lentil lectin. The isolated membrane components were radioiodinated and examined for identity to HLA antigens by sequential precipitation with rabbit anti-HLA antiserum (specific to HLA large components) and with rabbit anti-beta2-microblogulin antiserum. In addition to HLA antigens, the beta2-microglobulin-bound components obtained from the MOLT-4 cells were found to contain certain membrane components that are the same in molecular size as the HLA large components but that are different antigenically from the HLA large components. On the other hand, the beta2-microglobulin-bound membrane components obtained from the CCRF-CEM cells were all HLA antigens. No other membrane components were involved in the binding.


The reaction of SLE antibodies with native, single stranded RNA: radioassay and binding specificities. Escherichia coli 3H-tRNA and MS2 phage 125I-RNA were prepared and used in a sensitive nitrocellulose filter assay. Antibodies that bound these RNA ligands occurred in the sera of several patients with SLE, but not in sera of patients with other connective tissue diseases. The antibody populations that bound polyribonucleotides (largely IgG) were distinct from antibody populations that bound polydeoxyribonucleotides. Competition experiments showed that the anti-RNA antibodies preferentially bound native ssRNA as compared with synthetic single and double stranded polyribonucleotides. There was increasing affinity with increasing m.w. of the ssRNA. The anti-tRNA population was of restricted heterogeneity (Sips index 0.83) and bound tRNA with an average association constant (Ko) of 9 x 10(6) l/mole at 4 degrees C. The anti-MS2 RNA population was much more heterogeneous (Sips index 0.67) and bound MS2 RNA with a Ko of about 3 x 10(9) l/mole at 4 degrees C. Whereas NZB/NZW mice spontaneously produce RNA reactive antibodies with conformation specificity for native tRNA, human SLE anti-RNA antibodies appear to have very little of this type of conformation specificity.


Comparison of haplotypes of the major histocompatibility complex in the rat. I. The Ag-B7 (H-1g) and Ag-B8 (H-1k) haplotypes. Two haplotypes of the major histocompatibility complex of the rat, Ag-B7 and Ag-B8, have been compared with known H-1 haplotypes using the F1 skin-graft test and the dextran haemagglutination test. Both of these Ag-B haplotypes were different from the known H-1 haplotypes and determined different private specificities. The Ag-B7 haplotype was denoted as H-1g and the Ag-B8 haplotype as H-1k. The complex structure of the serologically detected antigenic products of these haplotypes was determined by means of H-1 congenic lines.


Comparison of haplotypes of the major histocompatibility complex in the rat. II. Serological analysis of the haplotypes H-1a (Ag-B4), H-1d (Ag-B9) and H-1f (Ag-B10). The strongly cross-reacting haplotypes of the inbred strains DA, ACI, ACP, MR, BD V and AS2, and of the congenic lines LEW.1A, LEW.1D and LEW.1F, were explored. All of these inbred strains and these congenic lines type with anti-Ag-B4 antisera raised against the DA strain, which behaved as operationally mono-specific in previously reported studies of the eight currently defined Ag-B haplotypes. Serological analyses showed that this cross-reactivity was due to antibodies against public antigenic specificities which were not previously recognized as being in the anti-Ag-B4 antisera, due to the fact that the LEW.1D and LEW.1F animals were not available for testing. With the use of appropriate antisera and of absorption studies, two haplotypes in the H-1 system were found not to have been previously identified in the Ag-B system. The animals carrying the H-1d haplotype (MR, BD V and LEW.1D) have been designated as Ag-B9, and those carrying the H-1f haplotype (AS2 and LEW.1F) have been designated as Ag-B10. With the proper absorptions, an anti-Ag-B4 antiserum can be prepared which reacts only with the DA, ACI and ACP strains, and it will henceforth be used as the operationally mono-specific Ag-B4 typing reagent. A variety of typing experiments showed that the results using antisera raised in Pittsburgh and in Prague and using the Ficoll and dextran haemagglutination methods were the same.


The ultrastructural localization of IgA in skin of a patient with mixed form of dermatitis herpetiformis and bullous pemphigoid. A case with mixed features of dermatitis herpetiformis and bullous pemphigoid was investigated by immuno-electron microscopy. There were clinical, histological, and ultrastructural characteristics of both diseases, the response to sulfapyridine was dramatic at the beginning, but intestinal lesions were absent. Direct immunofluorescence tests were made 6 times in the 4 year period and demonstrated in all biopsies exclusively linear IgA deposits. The IgA deposits were shown to occupy the entire lamina lucida and to adhere to the basal cell membranes and lamina densa, very much like IgG deposits in bullous pemphigoid. Antibodies against the basement membrane zone could not be demonstrated in the serum.


Myoglobin turnover--influence of renal and extrarenal factors. The serum level of myoglobin, an LMW constituent of striated and myocardial muscle, has been studied in various clinical situations in order to obtain information about factors influencing myoglobin turnover. The myoglobin level was significantly correlated to different variables of GFR such as serum beta2-microglobulin, serum creatinine, and 51Cr-EDTA clearance. Following a successful renal transplantation rapid decrease in serum myoglobin was found parallel to increase in GFR's. In patients with advanced long-standing uremia, comparatively small elevations of serum myoglobin were seen when correlated to the degree of GFR reduction, demonstrating an influence of extrarenal factors on the myoglobin levels. The importance of extrarenal factors on the actual serum level of LMW proteins was also illustrated by serial studies on SLE patients receiving corticosteroid therapy. In these patients, elevations of serum myoglobin levels were found, but serum beta2-microglobulin levels gradually decreased during therapy. Finally, calculations based on curves of serum disappearance of myoglobin in patients with acute myocardial infarction indicate that only about 0.3 mg of myoglobin per day is released from the muscle pool during normal conditions, which suggests that myoglobin catabolism mainly occurs within the muscle tissue.


Electrocardiographic mapping of the precordium in the coronary care unit. Precordial electrocardiographic mapping systems comprising a large number of recording sites have been utilized in the Coronary Care Unit for following the natural course of ischemic injury and detecting extension of acute myocardial infarction in patients. These electrocardiographic techniques have also been found useful in evaluating the effects of a number of metabolic, hemodynamic and pharmacologic interventions currently proposed as effective means of reducing the extent of ischemic damage. However, these methods have not been found useful in the study of patients with inferior transmural or nontransmural myocardial infarctions. Bundle branch blocks and pericarditis complicating acute myocardial infarction invalidate the mapping technique. To assess effectiveness of therapeutic interventions, ST-segment changes taken as an index of ischemic injury are correlated with alterations of the QRS complex, used as a parameter of ischemic necrosis.


Removal of inhibitors of bacterial growth by dialysis culture. Dialysis culture was used to investigate the extent to which growth inhibition in bacterial cultures may be caused by accumulation of metabolites. Escherichia coli B was grown in a glucose/salts medium. A concentrated nutrient solution was pumped at a constant rate into the growing culture to ensure that growth was not limited by exhaustion of nutrients. In this way the only difference between growth conditions in dialysis and non-dialysis cultures was the transfer of dialysable metabolites from the culture vessel to the reservoir in the dialysis culture system. By adjusting the glucose concentration in the feed and maintaining a constant rate of feeding, glucose-limited growth could be achieved. Under these conditions, with oxygen in excess, bacterial yields of 140 to 150 g dry wt l-1 were obtained in dialysis culture compared with 30 to 40 g l-1 in non-dialysis culture. The high yields in dialysis culture depended on the removal of end-products of glucose metabolism. Growth inhibition was demonstrated to be the result of the combined influence of acetate, lactate, pyruvate, succinate, propionate and isobutyrate in concentrations found at the end of growth in non-dialysis cultures of Escherichia coli B.


Influence of glucose and dissolved oxygen concentrations on yields of Escherichia coli B in dialysis culture. Yields of Escherichia coli B grown on glucose were determined in dialysis and non-dialysis culture. The molar growth yields were compared under conditions of excess glucose and oxygen as well as glucose- and oxygen-limiting conditions. The molar growth yields on glucose (YG) were determined for different periods during growth in non-dialysis cultures. A rapid decrease of YG was observed and growth ceased even in the presence of high concentrations of glucose and dissolved oxygen in the culture liquid. The decrease in YG was delayed in dialysis cultures where a high YG could be maintained at very high cell concentrations. The inhibition of growth depended on the accumulation of end-products of fermentative degradation of glucose. These products interfered with the oxidative phosphorylation. A large proportion of the glucose was fermented even in the presence of high concentrations of dissolved oxygen in the culture liquid. A decrease in the growth yield per g glucose was also observed.


The growth of virulent African swine fever virus in pig monocytes and macrophages. The replication of virulent African swine fever virus (ASFV) in cultures of monocytes and macrophages derived from pig bone marrow (PBM) and pig leukocyte (PL) cells was investigated by light microscopy, immunofluorescence, haemadsorption and infective virus release. Monocytes showed a high rate of infection and complete destruction within 2 to 3 days, whereas macrophages had only a very low level of infection and survived to form persistently infected cultures. These observations may explain the decrease in sensitivity of PBM and PL cells for ASFV assay after extended periods of incubation and suggest that the macrophage may be one of the cell types concerned with virus persistence in the pig.


Role of tissue typing on preserved nerve allografts in dogs. Histocompatibility seems to play an important role in the regeneration of nerve allografts. Compatible tissue typed nerve allografts behave more like autografts and are, therefore, more readily accepted by the host tissue without producing evident tissue rejection. The influence of histocompatibility difference becomes more marked if the graft is longer than 30-40 mm. Irradiation as a means of reducing the immune reaction of the nerve allografts does not seem to have any beneficial effect along with tissue typing. Preservation of nerve grafts at - 70°C does not have any untoward effect.


Studies on gallium accumulation in inflammatory lesions: I. Gallium uptake by human polymorphonuclear leukocytes. The mechanism of ionic gallium-67 localization in inflammatory lesions was studied. Human polymorphonuclear leukocytes (PMN) had higher Ga-67 uptake than lymphocytes, whereas red blood cells had no affinity for Ga-67. Uptake by PMN showed temperature dependence, was independent of Ga-67 concentrations, and was not inhibited by metabolic inhibitors. However, its binding to PMN could be removed by trypsin but not by neuraminidase. These results are consistent with the hypothesis that the plasma membrane serves as a diffusion barrier and Ga-67 only binds to the surface of the PMN plasma membrane. When this membrane's permeability barrier was disrupted, as in heat-killed PMN, Ga-67 uptake increased markedly. Experimental abscesses were induced with E. coli or turpentine in rabbits. Twenty-four hours after i.v. injection, only 20% of Ga-67 in abscesses was in fractions containing intact PMN, cell debris or bacteria; the remainder was in a soluble, non-cellular fraction (2,500-g supernatant).


Reconstruction of mandibular defects by autogenous bone grafts: a review of 37 cases. Thirty-seven cases of autogenous bone grafted to the mandible at the maxillofacial unit, Kaduna, Nigeria, were reviewed. The ilium was used in the majority of cases. In four cases where the recipient beds were vascular, the rib was used. The various techniques for restoring the central arch defects of the mandible are discussed and the methods we used are described. The superiority of autogenous bone grafts over homografts and heterografts is emphasized.


Asymptomatic bacteriuria in schoolgirls. VIII. Clinical course during a 3-year follow-up. A 3-year follow-up of 116 schoolgirls with asymptomatic bacteriuria, treated or untreated is reported. It is concluded that bacteria isolated from girls with asymptomatic bacteriuria do not commonly cause symptomatic pyelonephritis and that the risk of developing renal damage as a result of asymptomatic bacteriuria in a schoolgirl with a roentgenographically normal urinary tract seems to be small. It is also suggested that for the majority of these patients therapy is not necessary.


McCune-Albright syndrome in a male child: a clinical and endocrinologic enigma. A 6 5/12-year-old boy with polyostotic fibrous dysplasia, café-au-lait pigmentation of the skin, and precocious pubertal development was studied for two years. Parathormone, calcium, phosphorus, testosterone, cortisol, and growth hormone levels were within normal limits. Urinary 17-ketosteroids, 17-ketogenic steroids, and estrogens were at the upper limits of normal. After GnRH stimulation, there was only a very slight increase in LH and no increase in FSH. There was no increase in TSH after TRH, and plasma levels of T4 and T3 were normal. The plasma prolactin level was within normal limits, and increased after TRH stimulation (with a second, delayed upsurge). Abnormal distribution of 131I in the thyroid was evident, without clearcut evidence of hyperfunctioning areas after TSH stimulation and T3 suppression tests followed by conventional scanning and gamma camera scintiphotography. Our findings do not support the claimed, single, hypothalamic origin of the disease that is presumed to result in overproduction of releasing hormones; they are more in keeping with a pleiotropic, scattered peripheral lesion, possibly of embryonal origin.


The necessity for monitoring chloramphenicol levels when treating neonatal meningitis. Chloramphenicol can be an effective agent in the treatment of ampicillin-resistant E. coli meningitis due to susceptible organisms in the premature or term infant. However, it can be used safely and effectively only if careful monitoring of serum levels is undertaken.


The status at two years of low-birth-weight infants born in 1974 with birth weights of less than 1,001 gm. A two-year follow-up study of 43 infants of birth weight less than or equal to 1,000 gm born during 1974 revealed the following: average height at two years was between the tenth and twenty-fifth percentiles; average weight between the third and tenth percentiles. Fifteen (35%) developed lower respiratory tract infections during the first two years. Seven (16%) had retrolental fibroplasia. Major neurologic defects occurred in four (9%); severe developmental delay (mean developmental quotient less than 80) was found in nine others (21%). Defects of the central nervous system were closely associated with a neonatal history of intracranial hemorrhage or seizures or both.


Tropical acute rheumatic fever and associated streptococcal infections compared with concurrent acute glomerulonephritis. Ninety-three patients with acute rheumatic fever and 195 patients with acute glomerulonephritis were observed in Trinidad during an outbreak of scabies with a high incidence of secondary streptococcal infections. Clinical and laboratory manifestations of ARF were the same as those seen in temperate zones, except that antistreptolysin O titers were less markedly increased. The patients with ARF were similar to those with AGN in respect to sex, race, location of residence, and living conditions, but were older and had markedly fewer skin infections. Currently prevalent nephritogenic streptococcal strains never were isolated from patients with ARF even when M55 streptococci appeared and led to an epidemic of AGN.


Desquamative gingivitis: immunologic findings. A case of desquamative gingivitis is presented that was a gingival manifestation of cicatricial pemphigoid. Immunologic studies of serum and biopsies were of diagnostic significance. The application of immunofluorescence for the diagnosis of desquamative gingival lesions was discussed. If a definite diagnosis can not be made on the basis of light microscopy, immunofluorescence studies should be performed.


The submucosal implantation of human allogeneic decalcified dentin. Decalcified human dentin was implanted into the buccal oral mucosa of 10 human volunteers and was later recovered for histologic examination. Extensive resorption took place. Bone did not form. Human dentinal matrix is not a bone inducer. Differences between the two methods of decalcification were not relevant.


Clinical evaluation of freeze-dried bone allografts in periodontal osseous defects--part II. Freeze-dried crushed cortical bone allografts were implanted into widemouthed three-wall, two-wall, one-wall, combination, and furcation defects. One hundred eighty-nine sites were reentered in 97 patients and of these 60% had osseous regeneration of greater than 50%. A total of 231 sites were evaluated for pocket elimination, of which 63% demonstrated greater than 50% pocket reduction. This study presented additional evidence indicating that freeze-dried bone allografts have definite potential as grafting material in certain periodontal osseous defects. Information from additional cases is being tabulated as it becomes available and will supplement the current data.


Physiologically active substances from marine sponges V: Isolation of physiologically active compounds from the sponge Verongia archeri. Methanolic extracts of hard and soft varieties of the sponge Verongia archeri were found to contain similar compounds. An isolation procedure and the structures of 2-(3',5'-dibromo-4'-hydroxyphenyl)-acetamide, 1-(3',5'-dibromo-1',6'-dihydroxy-4'-methoxycyclohexa-2',4'-diene)acetonitrile, and 2-oxo-5,7-dibromo-6-methoxy-9-hydroxy-8,9-dihydrocoumarin from one variety are described.


Serum protein binding and pharmacokinetics of valproate in man, dog, rat and mouse. The serum protein binding of valproate (di-n-propylacetate) has been determined at therapeutic concentrations by equilibrium dialysis in man (94.8%), dog (78.5%), rat (63.4%) and mouse (11.9%). In dog serum, the binding was found to be independent of the valproate concentration in the range of 5 to about 70 microgram/ml, but fell with higher concentrations. In addition, the kinetics of valproate has been determined in dogs and rats. After intravenous administration, serum concentrations declined biexponentially in both species, the half-life of elimination (T 0.5 (beta)) being 1.7 hours in dogs and 4.6 hours in rats. In comparison with the pharmacokinetics of valproate in man and mouse, it can be assumed that the protein binding of valproate is rate-limiting for its clearance by the liver and may be responsible for the striking differences in the half-lives of the drug in different species. Increased drug binding was associated with a decrease in the total clearance and in all species examined, the calculated hepatic extraction ratios (0.009-0,17) were smaller that the free fraction, indicating that valproate fits into the group of drugs with restrictive and liver blood flow independent elimination, i.e., only the unbound drug can be cleared.


Effect of lung transit on systemic depressor responses to arachidonic acid and prostacyclin in dogs. Arachidonic acid (AA) (100 and 200 microgram/kg) and prostacyclin (PGI2) (0.25, 0.5, 1,2 and 3 microgram/kg) were administered by bolus injection into the inferior vena cava (i.v.) and left ventricle (i.a.) in spontaneously breathing anesthesized dogs (25). PGI2 like its precursor AA, decreased arterial diastolic pressure in a dose-dependent manner. The depressor responses after i.a. administration of a given dose of either AA or PGI2 did not differ significantly when the same dose was given i.v.; the i.v./i.a. ratio was 1. In comparison, the vasodepressor response to PGE2 (1, 2 and 3 microgram/kg i.v.) was reduced 12- to 40-fold by passage through the dog lung. The vasopressor response to PGF2alpha (1, 2, 3 and 5 microgram/kg i.v.) was diminished 5- to 8-fold by lung transit. Similarly, the pressor response to norepinephrine was also reduced by pulmonary transit. These studies support the view that (1) the lung plays a minor role in the systemic depressor response to AA and PGI2 and (2) the lack of an i.v./i.a. difference for AA and PGI2 indicates that the depressor response to AA may be due to generation of PGI2 by the vessel wall.


The effect of the combination of quinidine and propranolol upon atrial and ventricular automatically in dogs. The effects of quinidine, propranolol and their combination on atrial and ventricular automaticity were studied in pentobarbital-anesthetized dogs with complete heart block produced by injection of 40% formalin. The indices of atrial and ventricular automaticity were the intrinsic rate and the asystole interval, 10-beat period, and beats per 30 seconds after cessation of a 2-minute overdrive. Potentiation was considered to be a response produced by the combination of a half-dose of quinidine plus a half-dose of propranolol significantly greater than that produced by the full dose of either drug. Two combinations were studied: combination I consisted of 1.0 mg/kg of quinidine and 0.04 mg/kg of propranolol while combination II consisted of 2.0 mg/kg of quinidine and 0.08 mg/kg of propranolol. Neither combination potentiated the action of the individual drugs on the ventricle. Both combinations produced a potentiation of the individual drug effects on atrial intrinsic rate, asystole interval, and 10-beat period while only combination II potentiated the individual drug effects on atrial beats per 30 seconds. These studies indicate that the enhanced effect of the quinidine-propranolol combination in conversion of atrial tachyarrhythmias to sinus rhythm may be a function of its potentiation of the ability of the individual drug to depress atrial automaticity.


A comparison of the analgesic effect of intramuscular nalbuphine and morphine in patients with postoperative pain. In a double-study, using patients' subjective reports as indices of analgesia, the relative analgesic potency of intramuscular nalbuphine and morphine was determined in 56 postoperative patients. A total of 28 crossover comparisons (utilizing the twin passover, balanced four-point incomplete block design) were performed in two sequentially related experiments, each assay comparing 4 and 8 mg of morphine with either 3 and 6 or 6 and 12 mg of nalbuphine. When both intensity and duration of analgesia are considered (i.e., total analgesic effect), nalbuphine was 0.8 to 0.9 times as potent as morphine. In terms of peak analgesic effect, nalbuphine was 0.7 to 0.8 times as potent. Both the time-effect curves and the relative potency estimates suggest that nalbuphine has a slightly longer duration of action than morphine at doses that are equianalgesic in terms of peak effect. Side effects of the type usually noted after the administration of potent injectable analgesics to postoperative patients were observed after both morphine and nalbuphine. Although nalbuphine is a potent narcotic antagonist, no psychotomimetic reactions were observed.


Lingualized occlusion for removable prosthodontics. Lingualized occlusion provides a useful combination of several occlusal concepts. Many advantages of anatomic and nonanatomic occlusions are retained. Adjustment to compensate for minor changes in vertical and centric relation is readily accomplished. Satisfactory occlusion is easily obtained, and balanced occlusion can be accomplished. The lingualized occlusal concept is not a panacea, and all other procedures still must be carefully executed.


Management of patients with myasthenia gravis who require maxillary dentures. Some signs of myasthenia gravis can be clearly identified in the oral cavity. The patient with progressive neuromuscular impairment may seek consultation because of dysphagia, impaired mastication, and dysarthia. The dentist should understand the pathophysiology of the symptoms and treat the myasthenic patient accordingly.


The collarless metal-ceramic crown.

The collarless metal-ceramic crown. A technique has been developed whereby collarless metal-ceramic crowns can be fabricated by spot-welding the platinum-foil matrix to the casting after it has been contoured for porcelain application. The main advantage of this procedure over previously reported techniques is that it produces well fitted restorations while requiring a lesser degree of technical skill.


The acid-etch class III composite resin restoration. The acid-etch systems have become a familiar part of the dentist's armamentarium for achieving retention in the treatment of major esthetic problems in anterior teeth. They have another advantage, however, that has not been fully utilized. By combining the acid-etch technique with conventional cavity preparations such as the Class III, the common problems associated with microleakage can be greatly reduced and composite resin restorations can be placed with better esthetic results and greater longevity.


Semiprecious alloys for cast restorations: a preliminary report. A previous clinical evaluation indicated that semiprecious metals had a definite place in the construction of dowels and cores in endodontically treated teeth. 2 The results from the present in vitro study suggest that those alloys do have a place in the fabrication of single castings as type III and IV gold alloy substitutes. Although when compared with a type III gold alloy the behavior of the semiprecious alloys tested was less like that of a noble alloy, the semiprecious alloys appeared less active than the base-metal alloy. This suggests that the semiprecious alloys should be acceptably resistant to corrosion in the oral environment.


Occlusally oriented impressions for large maxillary stomas. A stable record base is critical to the making of an accurate centric jaw relation record. This is attained by meeting three criteria: (1) a well adapted, adequately extended record base, (2) adequate support of the alveolar bone to prevent excessive movement of the record bases, and (3) accurate tissue integrity to allow good base adaption, maximum tissue contact, and minimum movement. If these criteria cannot be met--and they cannot in the bilateral subtotal maxillectomy patient--then an alternative method must be used. The combination jaw relation record-impression technique using the patient's pre-existing occlusion is an alternate method for the fabrication of a stable prosthesis. This method has been tested in several maxillofacial prosthodontic centers and has proved to constitute a realistic approach to the management of the subtotal maxillectomy patient.


Hollow silicone abturators for patients after total maxillectomy. One technical approach for the treatment of a patient after complete removal of the hard palate and other supportive structures has been presented. This technique offers a means of obtaining a detailed impression of the defect and promptly provides the patient with a lightweight and flexible tissue-tolerant obturator. The patient can ultimately be provided with a hollow dental prosthesis attached to a removable hollow obturator.


Composite resin repair of porcelain denture teeth. An effective temporary repair of fractured poreclain denture teeth involves abrasive treatment of the fractured tooth surface followed by a composite resin buildup. This study has demonstrated that the best potential retention of the composite buildup can be obtained through abrasive treatment by a course diamond stone.


Impression technique for complete maxillary immediate denture. A technique for making complete maxillary immediate denture impressions has been described. With this procedure impressions of the edentulous area and remaining dentition can be made in sections and they can be removed from the mouth joined together.


Attachment fixation of the overdenture: part II. Many attachment systems of the bar or stud type increase the stability of an overdenture. When selecting an attachment it is essential to consider the skill of the dentist-laboratory team as well as the dexterity of the patient and to use the easiest system that will still improve stabilization. Generally simplicity in design, ease of maintenance, and minimum leverage should be paramount considerations in selection. Use of a guide such as the EM Gauge and of the EM Attachment Selector significantly reduces the confusion in selecting attachments and increases the working armamentarium for stabilizing an overdenture.


Extracoronal removable partial denture service in Canada. Remarkable uniformity exists in the teaching of removable partial denture prosthodont,cs in Canadian dental schools. The removable partial denture services requested by dentists and those provided by commercial dental laboratories do not appear to be as similar. A greater emphasis on continuing education for the dentist is needed, along with better and more detailed communication between the dentist and the dental laboratory. An educational program for dental laboratory technicians is also needed to further this goal.


The strength of multilayer and repaired composite resin. Composite resin surfaces that formed against a plastic matrix or that polymerized while exposed to air were excellent substrates for the adhesion of new resin. Samples formed by the addition of composite resin to a cut surface had a tensile strength of one half of the cohesive strength of the resin. Coating the cut surface with a thin layer of unfilled resin enhanced bonding of the second composite resin layer. The use of a thin layer of unfilled catalyst resin as a bonding agent caused the most rapid development of strength and the greatest strength in samples tested after 7 days.


Evaluation of a rubber-base impression material. A laboratory experiment has been described that utilized materials found in most dental offices and that was designed to evaluate a distinctly different polysulfide impression material. In this experiment the largest duplicating errors were produced with use of the stock tray and single-mix technique recommended by the manufacturer. This study therefore supports the use of the custom tray and double-mix technique for dental duplication procedures utilizing Neo-Plex impression material. Further investigation is necessary before stock trays and single-mix techniques can be recommended for routine use in fixed prosthodontics.


Combining final impressions with maxillomandibular relation records in stabilized record bases. The postinsertion problems of complete denture prostheses are closely related to accurate recording of maxillomandibular relationships. It is essential that these recordings be made with stable record bases; making the final impressions within the record bases prevents movement and tilting. Face-bow and centric relation records properly orient the casts in the articulator. A method to obtain all of these records in one dental appointments has been described.


Anterior rests for maxillary removable partial dentures. Positive anterior rests were shown to be an essential element of design when considering stress distribution with a removable partial denture involving anterior teeth. Proximal plates often added stability and reduced stress accumulation in any one region. Distobuccal forces on the extension base adversely affected the primary canine abutment. Forces in the regions of the anterior base and central incisor abutment produced the most widespread transmission of stress throughout the arch. Greater stress throughout the arch was observed when forces were applied to the central incisor rather than to the right canine abutment. There is a need for established criteria of rest form and placement. Guidelines for using the natural crown as opposed to a positive rest seat in a restoration are needed. Continuing studies of other anterior rest forms should increasingly clarify this phase of treatment planning. The dentist should recognize the need for structural integrity in the anterior maxillary segment when designing removable partial dentures. A practical, defensible rationale for the routine use of maxillary anterior teeth as removable partial denture abutments must be established.


Failure of removable partial denture castings during service. The fracture of removable partial denture castings does not occur in a random manner but rather at characteristic sites that are determined by the designs of the castings. These sites will be located where elastic stresses resulting either from handling or from normal function are likely to be concentrated. Regions of abrupt change in cross-sectional areas and internal voids also have been shown to cause stress concentration. In many instances the regions of stress concentration that are present may act as sites for crack initiation, with fatigue as the ultimate mode of failure.


Accurate arcylic resin temporary restorations. A technique for making temporary restorations has been described. The temporary restoration is diagnostic, protective, and stabilizes prepared teeth.


The retentive ability of acid-etched dentin. 1. The retentive quality of dentin to Sevriton, Restodent, and Nuva-Seal was not enhanced by acid etching in this investigation. 2. Acid etching smooths and cleans the dentinal surface. 3. Acid etching clears tubule orifices slightly. 4. Sevriton was the most adhesive material tested. Nuva-Seal was the least retentive of the three materials studied.


A combination impression and occlusal registration technique for extension-base removable partial dentures. The ultimate goal of a prosthodontic service is the placement and maintenance of prostheses which are in biologic and functional harmony with the supporting tissues and remaining teeth. The combination impression and occlusal registration technique minimizes clinical and technical procedures which might introduce errors. If accurately managed, this technique will provide optimum occlusion and mucosal support for extension-base removable partial dentures.


A method of verifying parallelism of preparations for Zest anchor attachments. In overdenture therapy using attachments, near-perfect alignment is mandatory for the success of the procedure. A good example of failure due to mis-alignment is seen in Fig. 5. This resulted in the eventual breakdown of the periodontium and the extraction of the root remnant upon removal of the denture. The application of semiprecision attachments in overdenture therapy may greatly enhance the success of the denture. However, care must be taken to adhere to the principles and philosophies of complete denture therapy.


Completed bases for removable dentures.

Completed bases for removable dentures. A technique for the fabrication of completed bases for removable dentures has been described. The artificial stone mounting casts and completed bases must be kept free of debris at all times to allow for accurate seating of the bases on the casts. The completed bases must be kept in water when not in use between patient appointments.


Growth-inhibition drug test with Trypanosoma cruzi culture forms. A 48-hr drug screening test is described which evaluates inhibition of exponential growth of T. cruzi culture forms by electronic cell count. About 80% of drugs active in vivo produced a greater than 50% growth inhibition, whereas among compounds inactive in vivo, only 19.6% induced such inhibition. Advantages of this test are low cost, rapid results, small amounts of drugs needed, and feasibility without animal facilities. Comparative studies showed that culture forms are not suitable for screening additives to prevent transmission of T. cruzi by banked blood.


Proteolytic activites in cell extracts of Trypanosoma cruzi. Cell extracts of culture forms of Trypanosoma cruzi are capable of hydrolysing substances belonging to 4 different groups of protease substrates: (a) substrates for trypsin-like enzymes: benzoyl-arginine-p-nitroanilide and benzoylarginine-naphtylamide; (b) substrates for aminopeptidases: leucyl, lysl and glutamyl-beta-naphtylamide; (c) a substrate fochymotrypsin-like enzymes: carbobenzoxy-L-tyrosine-p-nitorphenylester, and (d) a nonspecific substrate for a broad range of proteases: azocasein. Some physico-chemical characteristics of each enzymic reaction were studied. They were found to be distint enought to allow attributing each hydrolytic activity to a separate enzyme.


Immunofluorescence localization of ovine placental lactogen. Immunoreaction to ovine placental lactogen was found in binucleate and uninucleate cells of the fetal trophoblast.


Fluorescence histochemical demonstration of a relationship between adrenergic nerves and cells containing actin and myosin in the rat ovary, with special reference to the follicle wall. Contractile proteins (actin and myosin detected by immunohistochemistry) were present in elongated cells forming concentric layers in the theca externa of Graafian follicles and around corpora lutea. Immunofluorescent cells were also found in the ovarian stroma. Study of adrenergic nerve fibres by the glyoxylic acid technique showed numerous branches in between and in close association with the contractile cells.


Effect of sparsomycin analogues on the puromycin-peptidyl transferase reaction on ribosomes. Sparsomycin analogues in which the unique -S(O)CH2SCH3 moiety was replaced by a variety of more easily accessible side chains were evaluated as inhibitors of the peptidyl transferase reaction with bacterial ribosomes. Competitive inhibition of acetyl[14C]phenylalanylpuromycin formation revealed that the sulfur-containing side chain of sparsomycin could be replaced with hydrophobic moieties, whereas complete removal of the -S(O)CH2SCH3 side chain eliminated the ribosomal binding affinity of sparsomycin. The specificity for the D isomer of S-deoxo-S-propylsparsomycin has established that the chiral carbon of sparsomycin analogues must be identical with the chirality of D-cysteinol for ribosomal binding.


Hetacillin (R)- and (S)-sulfoxides. Synthesis and structure-activity relationships. Hetacillin was oxidized with m-chloroperbenzoic acid to give the corresponding (R)- and (S)-sulfoxides. Ozonization of hetacillin not only oxidized the sulfide but caused unexpected oxidation of the imidazolidine ring to a 2H-imidazoline. The biological spectrum showed the (R)-sulfoxide to be appreciably more active than the (S)-sulfoxide.


Spontaneous alterations in the pancreas of the aging Syrian golden hamster. The systematic histologic examination of the pancreas of aging Syrian golden hamsters revealed distinct alterations that affected the exocrine, endocrine, and supporting tissues. Some of these lesions showed a significant relationship to age and/or sex of the animal. Specific alterations that affected the ductules and islets represented a characteristic, probably genetically linked, process of the hamster pancreas and may have been the decisive factors for the unique carcinogenic response of this species to specific carcinogens.


Quinoline: conversion to a mutagen by human and rodent liver. Quinoline, a hepatocarcinogen in rats, and 23 quinoline derivatives were tested for mutagenic activity with the Ames Salmonella typhimurium assay. Quinoline, 5-hydroxyquinoline, and 8-hydroxyquinoline were mutagenic in strain TA 100 when Aroclor 1254-induced rat (male outbred Sprague-Dawley) liver homogenate was present in the incubation mixture. Enzyme preparations from rats pretreated with P-448-dependent aryl hydrocarbon hydroxylase inducers [3-methylcholanthrene (MCA) and beta-naphthoflavone] and MCA-treated "responsive" C57BL mice also metabolized quinoline to a mutagen, but phenobarbital and pregnenolone-16alpha-carbonitrile pretreatment did not yield active preparations. The mutagenicity of quinoline was blocked by the in vitro addition of menadione, butylated hydroxytoluene, alpha-naphthoflavone, vitamin A acetate, and glutathione to the test system. Depletion of glutathione by diethyl maleate pretreatment in vivo enhanced the mutagenic potential of the liver enzyme preparation. Mutagenic activity was correlated to the formation of water-soluble quinoline metabolites, and we suggested that the reactive quinoline intermediate is quinoline-2,3-epoxide. Microsomal enzymes isolated from human liver tissue, but not lung tissue, also converted quinoline to a mutagen.


The treatment of electrical injury compared to burn injury: a review of pathophysiology and comparison of patient management protocols. Because of basic differences in pathophysiology, patients with electrical injury require therapeutic measures quite separate and distinct from patients with flame burns. Fluid requirements are much greater for the electrical-injured patient due to the depth of the injury and frequent occurrence of pigment in the urine. Fasciotomy with surgical exploration for determination of tissue viability is usually required in areas of obvious or questionable viability in patients with electrical injury. Sulfamylon is preferred for topical antibacterial therapy in electrical injury, because of its excellent penetration into deeper tissues. With this regimen of conservative surgical debridement of necrotic tissue, in many patients we have been able to salvage limbs and, in particular, preserve function.


Ultrastructural studies of H-1 parvovirus replication. VI. simultaneous autoradiographic and immunochemical intranuclear localization of viral DNA synthesis and protein accumulation. The localization of H-1 viral replicative-form double-stranded DNA and progeny single-stranded DNA replication in parasynchronously infected, simian virus 40-transformed newborn human kidney cells was studied with high-resolution electron microscope autoradiography (80-nm silver grains). We analyzed wild-type H-1 and ts1 H-1 (a conditional mutant defective in progeny single-stranded DNA synthesis). The proportion of the total DNA synthesis that was viral was estimated to be >90% by comparing the amount of [(3)H]thymidine uptake in cultures infected with wild-type H-1 versus ts14 (an H-1 mutant defective in DNA replication). Simultaneous staining with cytochrome c-conjugated anti-H-1 immunoglobulin G was performed to ensure that cells incorporating [(3)H]thymidine (2- to 60-min pulses) were H-1 infected. The sites of H-1 replicative-form (in ts1-infected cells) and progeny (in wild-type-infected cells) DNA synthesis were identical. Immunospecifically labeled nuclei at the earliest stages of infection exhibited dense clusters of silver grains over material extruded from nucleolar fibrillar centers. These foci became larger with increasing cellular damage, forming a limited number of H-1 DNA synthetic centers in the euchromatin. Each island-like focus was surrounded by tufts of heterochromatin containing high concentrations of unassembled H-1 capsid proteins. In late phases of infection, the heterochromatin became completely marginated, and the nucleoplasm contained only euchromatin that exhibited randomly distributed sites of H-1 DNA replication. This indicates that H-1 DNA synthesis begins at localized euchromatic or nucleolar sites and then spreads outward. Immunostained heterochromatin and nucleolar chromatin never incorporated [(3)H]thymidine. Our results suggest that H-1 proteins and cellular cofactors associated with the fibrillar component of the nucleolus and the euchromatin may play a role in the regulation of H-1 DNA synthesis.


Escherichia coli mutant temperature sensitive for group I RNA bacteriophages. The temperature-sensitive conjugational transfer-deficient mutant Escherichia coli JCFL39, carrying a traD(Ts) mutation, is herein described as also being temperature sensitive for group I RNA phages (MS2, f2, and R17) but not for Q beta. Temperature shift experiments showed that the growth of group I phage MS2 in the mutant could be inhibited by a post-penetration event at high temperature. A possible role for the traD cistron of sex factor F in the intracellular development of MS2 is suggested.


Delayed recurrence of reflux after initial success of antireflux operation. Delayed recurrence of reflux was discovered in 4 children among 103 who were followed at least 5 years after ureteral reimplantation for treatment of vesicoureteral reflux. In each of the 103 children initial success in correction of reflux was proved by 2 cystographic series performed 3 months apart after the initial ureteral reimplantation. Reoperation was successful in correction of the recurrent reflux in 2 children, failed in 1 and has been attempted in 1. Prolonged postoperative followup (to at least 5 years) is recommended after ureteral reimplantation for treatment of vesicoureteral reflux.


Gram-negative endocarditis following cystoscopy. Patients with bacteriuria are at risk for local and distant infectious complications at the time of urologic procedures. The American Heart Association recommends that penicillin and streptomycin be given prophylactically to patients with rheumatic or congenital heart disease without reference to the presence or absence of bacteriuria. A patient with unrecognized calcification of the mitral annulus who underwent cystoscopy for evaluation of urinary retention is reported. Although bacteriuria was present preoperatively antibiotics were not given. Subsequently, Serratia marcescens and possibly Proteus morgani mitral valve infection developed and the patient died. Calcification of the mitral valve annulus and an extensive urinary tract infection were identified at autopsy. This case suggests that calcification of the mitral annulus may be an endocarditis risk factor. The spectrum of prophylactic antibiotic coverage given at the time of urologic procedures to patients with congenital or aquired heart disease, including calcification of the mitral annulus, should include whatever organisms are present in the urine.


Sporadic Legionnaires' disease.

Sporadic Legionnaires' disease. The first case of Legionnaires' disease recognized in Pennsylvania since the Philadelphia epidemic of 1976 was that of a 53-year-old emphysematous man who had extensive unilateral pneumonia accompanied by high fever, hypoxemia, and disorientation. His illness progressed despite treatment with cephalothin, but he recovered coincident with the administration of gentamicin and erythromycin. The diagnosis was established serologically by a 32-fold rise in antibody titer to the agent of Legionnaires' disease. Similar illness did not affect others in his community, and infection in four family members was excluded clinically and serologically.


Antitumor activity of protoplast membrane from group A streptococcus. Cytoplasmic membrane of Group A streptococcus has been obtained by treatment of the cells with a phage-associated lytic enzyme to dissolve the streptococcal cell wall, followed by shocking osmotically. The protoplast membrane fraction (PMF) remained as a distinct homogeneous structure in the electron micrograph and analysis showed a low rhamnose content. Febrile response produced by PMF was very slightly exhibited or not at all. PMF showed weak suppression against the growth of rat Yoshida sarcoma cells in culture and inhibition of [3H]-uridine incorporation into the sarcoma cells in vitro. In vivo antitumor experiments demonstrated that PMF has a mild inhibiting effect against mouse Ehrlich ascites carcinoma, though there was not observed a definite correlation between survival rate and dose level. Antitumor activity of PMF was thermo-labile and was strikingly abolished by treatment with a bacterial enzyme, Nagarse, but not so much by alpha-chymotrypsin.


The agglutination reactions of cholera vibrios. The present study with 11 strains of vibrio using single-dose and hyperimmune antisera confirmed earlier observations on the cross-reactivity of the flagellar (H) agglutinating antigens of cholera and NAG vibrios. The effect of several variables on the agglutinating sensitivity of cell suspensions was determined by measuring the reaction rate in the presence of constant O- or H-antibody. The variables investigated were culture conditions, antigen dilution, reaction temperature, formalin fixation and heat-treatment; all were found to affect cholera and NAG serovars similarly. The optimal conditions for the O- and H-tests were markedly different. Dilute, young living broth cultures were highly sensitive to O- but not H-antibody. Conditions favoring the H-reaction were 48-hr culture on firm dry agar, high suspension opacity, a reaction temperature of 45 C and formalin fixation. The inverse relationship of O- and H-sensitivity under these conditions indicated that the flagellar antigen in the growing vibrio is masked by an O-sensitive layer. The temperature of denaturation of the unfixed H-antigen before or after reaction with antiserum was 64 +/- 0.5 C and could be used as a criterion of the H-reaction.


[Surgical treatment of arteriosclerosis]. Experience gained in the surgical management of 21 patients with atherosclerotic lesions of the aorta and arteries of the lower extremities treated by open endarterectomy extending for a distance of 20 to 70 cm is summarized. Only the outer coat of the artery and the external elastic membrane were preserved during open endarterectomy. A graft of autologous or allogenic vein was stitched into the incision made in the anterior wall of the aorta to repair it completely. In the distal portions open endarterectomy was supplemented by closed endarterectomy. In 2 patients with a follow-up period of 18 months thrombosis occurred at the site of the operation. In all the other patients patency of the reconstructed vessels was preserved. The author believes that the arterial bed should be expanded in such a way that no stenosed parts reducing the volume of the blood flow in the reconstructed artery should remain proximal to the zone of the reconstruction. The universal extraperitoneal approach to the aorta including thoractomy in the ninth intercostal space with the diaphragm cut off at the site of its attachment was used in 2 patients (with aneurysm of the abdominal aorta and Leriche's syndrome in conjunction with vasorenal hypertension). The conditions for and possibilities of applying allogenic veins in reconstructive operations on the arteries are discussed.


[Hemodynamics and the heart volumes of patients before and after mitral valve prosthesis]. The article deals with a complex study of parameters of the hemodynamics and volume of the cardiac cavities in comparison with a clinical state of patients suffering from mitral defect before and in different periods following prosthesis of the mitral valve. On the basis of the results obtained during examination of 54 patients there was revealed a complete conformity between their clinical state, data of the hemodynamics, the volume of the heart and left auricle. A reverse development of many signs characteristic of the defect was established. The absence of an absolute improvement of some clinical and hemodynamic indices in remote periods following the operation in a number of patients was connected with a marked increase of the cardiac volumes before the operation, an unsatisfactory contractile capacity of the myocardium, the remaining of cardiac fibrillation after the operation.


[Experience in using integral rheography for evaluating the hemodynamic indices in emergency states in cardiology]. The work deals with the comparative assessment of integral rheography, a modern method for studying hemodynamic indices. As compared to the method of dye dilution and radiocardiography, integral rheography has proved to be sufficiently precise and at the same time has definite advantages as a method of express diagnosis in patients with acute cardiovascular diseases. As compared with the other method of indirect determination of the cardiac output, tetrapolar rheography, integral rheography is more suitable for being used in emergencies, particularly in cases with disorders of the rhythm of the cardiac activity.


[Pyridoxylate treatment of athletes with chronic myocardial overexertion]. Twenty-five highly skilled athletes with chronic stage I or II myocardial overexertion were examined. It was established that pyridoxilate produced a good therapeutic effect despite the fact that the athletes went on with their sport activities. On the background of the treatment the ECG and the indices of cardio- and hemodynamics and gas exchange improved and the physical efficiency grew. No essential difference was found in the effectiveness of pyridoxilate when it was administered by different routes. Side-effects of treatment were not observed.


[Effect of isoptin on the central and peripheral hemodynamics in hypokinesia in healthy persons]. Central and peripheral hemodynamics was studied by the radioisotope method employing 131I-labelled albumin, the blood flow in the muscles was investigated (using 133Xe) and the longitudinal rheovasogram of the leg and forearm recorded in 10 healthy male volunteers before, during, and after 45-day antiorthostatic hypokinesia. Five of the examines received isoptin, while the remaining 5 formed the control group. Due to the effect of hypokinesia a tendency towards a a decrease in the circulation volume, a reduced stroke index, an increase in the central venous pressure and peripheral resistance, and a decrease in the muscular blood flow were observed. With the prescription of isoptin the changes in the cardiac index and peripheral resistance were corrected, but there was no esstential effect on the level of the venous pressure and the muscular blood flow.