Pattern of sealant retention in children receiving a combination of caries-preventive methods: three-year results. Sealant retention varied according to site of the tooth. Figures for intact sealant were particularly low for permanent first molars among first graders and for permanent second molars among sixth graders at the end of three years. Although a large percentage of these teeth needed sealant reapplications, the percentages of teeth that were lost to caries were as low as 12.2% and 12.8%, respectively. Deciduous molars had the best rate (60.9%) of complete retention and also the highest percentage (20.2%) of loss caused by caries. However, in sixth graders, the premolars had the highest percentage (46.7%) of complete retention and, at the same time, the lowest caries rate (5.6%). The sealant retention pattern has remained the same during the three-year period.


Direct bonding of unerupted teeth for orthodontic movement. The surgical technique for exposing unerupted teeth by the use of direct bonding brackets has been described. Twenty unerupted teeth were successfully exposed and bracketed with direct bonding with a minimum of surgical trauma and postoperative complications while ensuring the preservation of tooth structure. Difficulties previously described in maintaining a dry field were obviated with a quick-setting adhesive and good suction technique.


Aerosolized terbutaline in asthmatics. Comparison of dosage strength, schedule, and method of administration. Sixteen patients with bronchial asthma participated in three studies of inhaled terbutaline. Onset of action, duration, and peak effects were compared for a dose of 0.5 mg given in one, two, or four inhalations at 1 min intervals from a freon-propelled, metered-dose aerosol. There was no significant difference in the response between the schedules. Dose-response curves were compared for terbutaline from a metered-dose aerosol, and pressure nebulized with and without intermittent positive pressure breathing (IPPB). There was no difference between the response with IPPB and simple nebulization. Improvement continued to the total dose administered of 9.0 mg. For a given bronchial response, six to eight times as much terbutaline was required by pressure nebulization as from the metered-dose aerosol.


Suppression of seasonal allergic rhinitis symptoms with daily hydroxyzine. The effectiveness of hydroxyzine in the suppression of allergic rhinitis symptoms was evaluated using a double-blind, parallel study design during the 1977 ragweed season. Forty-three subjects with positive ragweed skin tests and a history of an exacerbation of symptoms during August and September of the previous two years were randomly assigned to receive either hydroxyzine or placebo. Subjects scored the severity and duration of symptoms in a daily diary and adverse effects were evaluated from a structured interview at two-week intervals. Although drowsiness and dry mouth were frequent initially among the hydroxyzine-treated patients, these minor side effects rapidly disappeared as the dose was slowly increased, and all but one subject tolerated 150 mg/day. Subsequently, during the period of the highest ragweek pollen counts, the hydroxyzine-treated group spent significantly more days free of symptoms or with only mild sneezing, rhinorrhea, and eye symptoms than subjects who took placebo (p less than 0.05). Thus, hydroxyzine appeared to be well tolerated on a continuous daily basis and was effective in suppressing most of the symptoms of seasonal allergic rhinitis. Comparison of hydroxyzine with antihistamines more traditionally used for allergic rhinitis appears warranted.


Holistic aspects of visual style: a hemispheric model with implications for vision therapy. A model is proposed relating styles of cognition and perception, modes of consciousness, and cerebral hemispheric function to visual styles and visual problems. The implications of such a model for management of vision problems are discussed. It is recommended that training for the central, eso patient emphasize procedures which are spatial, holistic, peripheral, simultaneous, and involve the use of imagery. For the peripheral, exo patient, treatment techniques should involve sequence and rhythm, analytical processing, discrimination of fine differences, and attention to detail in central areas of the visual field.


B and T lymphocytes in man. IV. Circulating B, T and "null" lymphocytes in aging population. T, B and "Null" lymphocytes were determined in the peripheral blood of 98 adults, 26 of them were between 20 to 40 years of age and 72 between 60 to 96 years of age. The total number of lymphocytes were about the same in both groups. The percent and absolute number of T cells decreased significantly in the aged. Although the percent of B lymphocytes increased with age, the absolute number of B lymphocytes remained about the same.


Local composite neurovascular island flap for skin cover in pulp loss of the thumb. A local composite neurovascular island flap to provide stable skin cover with good soft tissue padding and sensibility for extensive pulp loss of the thumb was used in five patients. The island flap included the dorsoradial branches of the radial digital neurovascular bundle of the thumb.


The intravenous fluorescein test: use in timing of groin flap division. Successful division or delay of the arterial groin flap requires an accurate prediction of viability. The fluorescein dye test is an objective test to determine the earliest possible time a pedicle can be divided. It is an easy, quick, and comfortable test that can be repeated many times without injuring or altering the flap. It consists of an intravenous injection of fluorescein while the pedicle is temporarily and reversibly occluded. All areas with adequate revascularization fluoresce under ultraviolet light. In three groin flaps intended for hand resurfacing, interval fluorescence testing was the sole criterion for successful pedicle division. In an experimental neurovascular island skin flap in the rat, the validity of the fluorescein test was confirmed. In the clinical situation and in the experimental model, fluorescence is an accurate indicator of groin flap revascularization and a predictor for the timing of safe and early groin flap division.


Health care cost containment experiments: policy, individual rights, and the law. In a climate of increasing pressure to contain health care costs, legislators and health services researchers from time to time have proposed experiments involving reductions in benefits currently authorized under the Medicare and Medicaid programs. This paper examines three court challenges to the conduct of such experiments in California, New York, and Georgia. The rulings on the California and New York cases were in favor of continuing the experiments on the grounds that the Secretary of Health, Education, and Welfare had judged the projects to be helpful in promoting the objectives of Titles XIX and IV-A, respectively, of the Social Security Act. In the Georgia case, however, the plaintiffs contended that federal regulations protecting human subjects were applicable to the experiment at issue. While the precedent of past cases upholding the Secretary's authority to approve benefit-reducing experiments was not overturned in Georgia, the Court held that the human subjects regulations were applicable and, consequently, that such experiments must be reviewed prior to implementation by an Institutional Review Board. If the experiment places human subjects at risk, the regulations require that informed consent be obtained from participating subjects. The paper concludes by examining the implications of the Georgia ruling in terms of future efforts to contain health care costs while ensuring that the rights of individual beneficiaries are adequately safeguarded.


Ultrastructural localization of intracellular antigens by the use of protein A-gold complex. An immunocytochemical technique for the demonstration of intracellular antigens (secretory proteins) on thin sections is reported. Staphylococcal protein A which reacts with the Fc fragment of IgG molecules was labeled with colloidal gold as a marker. The antigenic sites were visualized on aldehyde-fixed and Epon-embedded tissue in a two step procedure. The specific antisera were applied to thin sections for binding to the antigens and then visualized by the protein A-gold complex. By using this technique different secretory proteins of the exocrine and endocrine pancreas were localized. The protein A-gold technique is proposed as a general method for visualization of antigenic sites on thin sections.


Ultrastructural localization of pancreatic polypeptide in the F cell of the dog pancreas. The F cell of the dog pancreas has been identified as the specific cell type containing pancreatic polypeptide. This localization of pnacreatic polypeptide was accomplished by immunocytochemical staining of ultrathin sections and direct electron microscopic identification. Verification of the specificity of the reaction was obtained by blocking experiments on serial sections of the same cell. It is proposed that the name F cell be used for defining in all species the islet cell that contains pancreatic polypeptide.


Immunohistochemical localization of thyroid hormone in rat thyroid gland. Direct and indirect immunofluorescence techniques were used to localize the thyroid hormones triidothyronine (T3) and thyroxine (T4) in adult rat thyroid gland. Optimum dilutions of the antisera were established and four tissue fixatives were investigated for usefulness in this technique. Use of antibodies specific for either T3 or T4 resulted in brilliant fluorescence in the colloid pools and apical cytoplasm of follicular cells. In all cases, the adjacent parathyroid gland was devoid of fluorescence. This report demonstrates that these dipeptide hormones can be localized by using immunofluorescence techniques.


The derivation of a minimum immune titre of rubella haemagglutination-inhibition (HI) antibody. A  Public Health Laboratory Service collaborative survey. Ten laboratories collaborated in a study of minimum immune titre (MIT) of rubella haemagglutination-inhibiting (HI) antibody with one laboratory acting as a reference laboratory to provide a uniform basis for comparison of the HI results. The international unitage equivalent to the MIT used by the ten laboratories was found to vary from 24 to 98 units. Testing of the sera by immunofluorescence and by HI after flotation centrifugation indicated that residual non-specific inhibitors may interfere with HI antibody testing to an extent equivalent to 12-15 units. An acceptable MIT would therefore be equivalent to 24-48 units of rubella HI antibody. The single radial haemolysis (SRH) results on the sera indicate that this is a sensitive and specific test for rubella antibody.


The effect of travel on faecal Escherichia coli serotypes. In a study on the serotypes of Escherichia coli which are present in the faeces of students travelling from many parts of the world to Dublin, a great variety of types was found. It was not possible to relate certain types to the various parts of the world where the students came from. There was no decrease in variety of serotypes after the students had been in Dublin for a few months and no distinctive 'Dublin' types were acquired. Serological variation of the E. coli was suggested as partially explaining some of the variety of the serotypes found. Although eight students developed diarrhoea without an aetiological agent being isolated after arrival in Dublin, no distinct pattern of E. coli could be related to this.


Changes in taste sensation and feeding behaviour in cancer patients: a review. Recent studies suggest the importance of alterations in taste sensation as a determinant of anorexia in cancer patients. These studies collectively support the conclusions that the likelihood of developing abnormalities in taste increases with increasing body burden of tumour, that taste abnormality is reversible on response of the underlying tumour to therapy, and that the abnormalities in taste can be correlated with decreased intake of energy. It is suggested that these studies, and studies currently in progress, may aid our understanding of food choices in cancer patients and may guide the use of food supplements to assist the cancer patient in maintaining adequate energy intake.


Dietary factors in the aetiology of gastrointestinal cancer. Gastrointestinal cancers, mainly oesophageal, gastric, pancreatic and large bowel cancer, account for about 40,000 deaths annually in England and Wales which is 32% of all cancer deaths. Nutritional factors have been implicated in the cause of each cancer and probably act by promoting the effect of carcinogenic substances taken in the diet or produced in the gut. Gastric cancer for example may be due to nitrosamine production in the stomach. This is enhanced by readily available sources of dietary nitrite and nitrate whilst the reaction is inhibited by vitamin C and low temperatures (2 degrees C). By contrast large bowel cancer can be related to high fat and meat intakes whilst a protective role for dietary fibre has been suggested. Dietary factors in the aetiology of oesophageal cancer differ from one high incidence area to another.


Comparison of the haplotypes of the major histocompatibility complex in the rat. III. Two difficult haplotypes: H-1h (Ag-B12) in the HW strain and Ag-B13 (H-1m) in the MNR/N strain. Two haplotypes which posed difficult problems in serological identification, those of the HW and MNR/N strains, were studied. The HW strain was originally described as a unique haplotype (H-1h), but breeding difficulties precluded its detailed serological analysis. The red blood cells of the HW strain agglutinate weakly and cross-react with antisera to the Ag-B8 group. Anti-HW antisera cross-react strongly with LEW, ACI and WKA, but absorption with these strains did not produce an adequate typing serum. By judicious selection of recipients, however, an appropriate typing reagent could be made; a particularly useful one was (BUF X MR)F1 anti-HW absorbed with WKA red blood cells. The HW haplotype segregated appropriately in a (DA X HW)F2 population. The HW strain is a low responder to poly(Glu52Lys33Tyr15). The H-1h haplotype of this strain was designated Ag-B12. The MNR/N strain had not previously been studied serologically, although its MLR type had been defined as H-1c (MLR-5). Antisera to MNR/N cross-reacted strongly with the H-1a,b,d,f haplotypes, but MNR/N red blood cells agglutinated only weakly with many antisera. An operationally monospecific reagent antiserum to the MNR/N haplotype could not be made. The uniqueness of the MNR/N haplotype was shown by F1 tests with LEW.1A, LEW.1D and LEW.1F, by various serological analyses, including production of antisera against MNR/N and in the MR strain; by segregation studies with (LEW X LEW.1D)N5 and (DA X DA.MNR)N4 segregating back-cross populations, and by grafting skin from (DA X DA.MNR)N4 homozygous and heterozygous animals to DA recipients. The MNR/N strain is a high-responder to poly(Glu52Lys33Tyr15). The MNR/N haplotype of this strain was designated Ag-B13 (H-1m). The data led to the working hypothesis that the MNR/N strain may be a recombination between the A region of H-1d and the B region of H-1c. In addition, the H-1d private specificity at the A region was probably lost by a deletion mutation which left the main complex of public specificities intact.


Failure to find H-2-associated susceptibility to LCM disease. Nine strains of mice bearing five distinct H-2 genotypes were inoculated intracerebrally with LCMV. There was no association found between particular K or D allotypes and susceptibility to acute LCM disease.


[Studies on the contract of the casting. (II) Influence of core inside the cast (author's transl)]. A alloy has its constant coefficient of casting shrinkage, but its value is changed by casting conditions. This time, we studied with effect of core which exist inside the cast. The results obtained were as follows: 1. The more the strength of core material increases, the smaller the coefficient of casting shrinkage becomes. 2. The smaller the thermal expansion coefficient of core material in solid state, the smaller the casting shrinkage. 3. In case of Silver-Palladium-Gold casting alloy, its actual casting shrinkage (y) has a multiple correlation with the compressive strength (x1) of core material in high temperature, and with the difference (x2) of the original casting shrinkage of the alloy from the casting shrinkage of core material, that is, y = -0.0023x1 + 0.0087x2 + 1.4927 4. Silver-Indium casting alloy is hard to be influenced by the quality of core material, for the alloy has a small shrinkage force.


[Origination of casting porosity on high fused dental alloys by use of Bio-X X-ray unit (MRO-10R) (author's transl)]. Experiments were carried out clarify internal defects in dental casting with high fused dental alloys, as cobalt-chromium alloy or nickel-chromium alloy by use of Bio-X X-ray unit (MRO-10R for dental castings), exploited by KAWAHARA and TSK international corporation. Satisfactory radiographic observations were obtained with the following results; 1. In any of castings, a large amount of porosity was found on X-ray clearly. 2. On the castings in this experiment, porosity, round and bubble like in shape was markedly observed in the location right below the sprue attachment and its neighborhood. But in regions far from sprue, porosity was decreased, it came gradually to be present on the surface of castings. 3. Radiographically some defects were of a clack type and a shrinkage type in castings, although castings seemed to be quite sound in appearance. These types of defects were considered to become a weak point when external force was applied. 4. In regard to the completeness of castings, especially large round shape, clack type and shrinkage porosity can be prevented by a rapid removal of the air or gas from a mold and by improving the casting system to obtain better efficiency.


[Bond strength between nonprecious metal alloy and porcelain. (Part 2) Effects of the addition of Mn, Mo, Si, Sn, Ta and Ti on bond strength of 80 Ni-20 Cr alloy (author's transl)]. Alloys added 2, 4 and 6 wt% Mn, Mo, Si, Sn, Ta and Ti to 80 wt% Ni-20 wt% Cr alloyand no-added 80 wt% Ni-20 wt% Cr alloy were prepared and casted to obtain the test specimens 3 mm in diameter 25 mm in length. Ceramco porcelain (B.F. Vacuum Porcelain) was fused to each of these specimens, and the bond strength was measured by the pull-out method which applies shear stress to the metal/porcelain interface to investigate the effect of each addition element. The test results may be summarized as presented below. 1) The bond strength between the 80 Ni-20 Cr alloy and the porcelain was 182 +/- 14 kg/cm2. 2) Of the six kinds of addition elements, it was Mo, Sn, Ta and Ti that increased the bond strength. 3) The bond strength between the alloy added 6 wt% Ti to the 80 Ni-20 Cr alloy and the porcelain was 319 +/- 8 kg/cm2, which was increased by about 75% over the strength between the 80 Ni-20 Cr alloy and the porcelain.


[X-ray diffraction at the metal-ceramic interface. (Part 1) Commercial gold alloy-porcelain interface (author's transl)]. X-ray diffraction technique is one of the most useful method in understanding the exact nature of chemical bonding between metals and ceramics. However, X-ray diffraction at the actual metal-ceramic interface has not yet been performed, though ti has many merits. In this study, the X-ray diffraction at the actual interfaces of six alloy-porcelain composites was performed using a particular method, in addition to the X-ray diffraction of three commercially available precious alloys for porcelain fusing and two commercially available opaque porcelains. The results obtained were summarized as follows: 1) Appreciable reaction layers between alloys and opaque porcelains were not detected. 2) The crystal constituents of two opaque porcelains examined were different considerably. This might affect the metal-ceramic bonding conditions. 3) As for three alloys in this experiments, remarkable differences were not observed in their surface crystal structures after the degassing process.


[X-ray diffraction at the metal-ceramic interface. (Part 2) Surface oxides of 88% Au alloys containing Fe, In, Sn for porcelain fusing (author's transl)]. Fifteen alloys were prepared by adding 0-1.00 wt% Fe, In and Sn (total amount 1.00 wt%) to 88 Au -6 Pt-5Pd-1 Ag master alloy. Before and after the degassing process, the surfaces of these alloys were examined by X-Ray diffraction technique. The crystal structure and the amount of the surface oxides which were formed after the degassing process were determined, and their influence on bond strength between alloys and porcelains was discussed. The results obtained were summarized as follows; 1) In all alloys nonprecious elements were oxidized selectively after the degassing process. 2) On the surface of the alloy to which only Fe, In or Sn was added, Fe2O3, In2O3 or SnO2 was formed respectively. 3) In most cases when two or three nonprecious elements were added together, the above mentioned oxides were formed in mixture. However, something different from them was observed in some of the alloys tested. 4) Quantity of each of the oxides formed was not always in proportion to that of the additives. 5) The lattice parameters of the oxides were depended on the concentration of the additives.


[On deffect of cobalt-chromium-nickel alloy for dental castings (author's transl)]. We studied about castability and microporosity of cobalt-chromium-nickel alloy for dental casting in various methods of fusion and casting. The combinations of fusion and casting were induction fusion and centrifugal casting, arc discharge fusion and argon gas pressure casting and oxy-acetylene flame fusion and centrifugal casting. The following results were obtained. 1. The amount of microposity was smaller, when only mold temperature was low, and as mold temperature and casting temperature were high, castability was better. 2. The arc discharge fusion and argon gas pressure casting was the best method about castability and microporosity in three methods. Second method was the induction fusion and centrifugal casting. 3. In the induction fusion and centrifugal casting, blowing arong gas of 1 l/min to molten metal to protect the metal from oxidization improved the castability the best, but amount of microporosity was large, so that it was needed to lower the mold temperature in this condition. 4. The oxyacetylene flame fusion and centrifugal casting was not suitable for the casting of Co-Cr alloy "Regalloy No. 3", for the alloy was made for the induction fusion casting.


[Influence of the thickness of metal and porcelain upon metal-ceramics (author's transl)]. This paper deals with the strength of metal-ceramics and the influence of the thickness of metal and porcelain layer. The metal-ceramic specimens, 30 mm long and 10 mm wide of various each thickness, supported at each ends, were tested by bending to obtain the transverse strength. The thickness of metal layer was changed from 0.2 mm to 1.0 mm, while that of porcelain layer was changed from 0.5 mm to 1.3 mm respectively. Interaction of the thickness of metal or porcelain layer to the fixed total thickness was also investigated comparing with the results of the experiment in which the thickness of one side was constant. From the load-deflection diagram, the maximum work before breaking was surveyed and compared. Main results were as follows. 1) In case of the same total thickness of metal-ceramics, the thicker the metal layer, the greater the transverse strength, maximum work before breaking and maximum deflection. 2) When the metal thickness exceeded one half of the porcelain layer, the transverse strength increased in comparing with value of porcelain itself. 3) The maximum deflection of metal-ceramics by bending before breaking was approximately three or four times as great as that of simple porcelain. 4) The work of the metal-ceramics by bending before breaking was approximately two or three times as that of the simple porcelain. 5) It was imagined that the total strength of the metal-ceramics would be affected by the hardness of the constituent metal and boundary bonding strength.


[Studies on dental casting ferromagnetic alloys (author's transl)]. We previously reported successful applications of rare earth-cobalt magnets to dental prostheses. In order to use magnets more effectively, ferromagnetic materials with a high magnetic permeability and a high saturation flux density should be used as prosthetic materials. This type of material will form a good magnetic path, and consequently tighten the magnetic attracting force by preventing the magnetic flux from leaking into the mouth tissue. A few alloys were newly prepared by using Pd, Co and Cr, the usual dental metals, and tested. It was found that: (1) These alloys have suitable magnetic properties. (2) The corrosion resistances of the Pd-Co and Pd-Co-Cr alloys are as good as those of dental casting Ag and Ni-Cr alloys, respectively. (3) The physical and mechanical constants of the alloys are similar to those of the usual dental casting alloys. (4) These alloys can be used as dental casting ferromagnetic alloys. (5) The Pd-Co alloy can also be used as a porcelain bonding alloy.


[Relationship between mechanical properties and amounts of casting porosities in tensile-test fracture surface of Au-Pd-Ag-Cu alloy (author's transl)]. One hundred and thirty-nine tensile-test specimens of Au-Pd-Ag-Cu alloy were cast in various casting conditions. The specimens were subjected age-hardening heat-treatment. The casting porosities and the nonmetallic inclusions in the surface of a tensile-test fracture of cast specimens were observed and analyzed by use of Electron Probe X-ray Microanalyzer (EPMA). The polosity ratio that is the area ratio of the porosities to the fracture surface was determined. Studies were quantitatively made on the effect of the porosity ratio on the tensile strength and the elongation. Furthermore, the effect of the casting conditions on the tensile strength was investigated. The main results were summarized as follows; The tensile strength decreased only slightly within about 15% of the porosity ratio and remarkably with an increase in its ratio in the range from about 15% to 50%. The elongation, however, decreased considerably in the presence of the porosities of only a few per cent. Aspects of the decrease curves on the tensile strength and the elongation were represented in the shape of an inverse S-type and hyperbolic curve with an increase in the porosity ratio, respectively. With an increase in the porosity ratio, the shapes of the tensile-test specimens at the fracture part and load-elongation curves in the tensile-tests were shown as a brittle fracture. However, the result observed by a scanning electron microscope revealed that the fracture surfaces without the porosities showed mostly "dimple pattern" suggesting a characteristic figure of a ductile fracture. The nonmetallic inclusions in the fracture surfaces were identified as SiO2 (quartz) which was derived from an ingredient of an investment by comparing the inclusion with the reference standards on the characteristic X-ray O Kalpha spectra by EPMA. The microstructures observed by a light microscope showed a coarse structure with the high temperature casting conditions. However, the results of a scanning electronmicroscopy revealed that the microstructres observed in high magnifications of about 1000 to 3000 composed of two structures; micro-lamella and Widmanstätten structure, and no difference was shown in the various casting conditions. Therefore, it is concluded in the present alloy that a coarseness of the microstructures observed by a light microscope become no reason for a decrease of the tensile strength.


[Aging properties of indium added gold alloys for metal-ceramic system (author's transl)]. Aging properties is studied on Au-10 wt% Pt and Au-10 wt% Pt-0.5 wt% Fe alloys containing 0.2, 0.4 and 2.0 wt% Indium. The results obtained are as follows: 1) In added Au-Pt alloys. From the electrical resistances in the isochronal aging curves, 0.2 and 0.4 wt% Indium added alloys are age-hardenable between 350 degrees and 640 degrees C. Heterogeneous phase in founded in 2.0 wt% Indium added alloy by meanes optical microstructures. This phase is identified fcc Pt3In by meanes X-ray diffraction. 2) In added Au-Pt-Fe alloys 0.2, 0.4 and 2.0 wt% Indium added alloys are age-hardenable between 250 degrees and 620 degrees C. Grain boundary reaction accelerated in 2.0 wt% Indium added alloy, and hardness decreased by overaging. Precipitation of nodule is inhibited in 0.2 wt% Indium added alloy, and aging properties also increase.


[Investigations of Pd-Ag alloy for porcelain fusing. (Part 1) Bond strength (author's transl)]. For the purpose of developing the Pd-Ag alloys for porcelain fusing, indium and/or tin were added to Pd-Ag alloys (70, 60 and 50 wt% Pd) and nine kinds of testing alloys for porcelain fusing were prepared. The bond strength with Ceramco porcelain was measured. The test-pieces for bond strength measured were prepared by press or condensing method. The bond strength was measured by "pull-out method" developed by Iwama. The maximum bond strength (230 kgf/cm2) was obtained 54 wt% Pd-36 wt% Ag-5 wt% In-5 wt% Sn alloy.


Immunodiagnosis of systemic aspergillosis. I. Antigenemia detected by radioimmunoassay in experimental infection. Because systemic aspergillosis is difficult to diagnose ante mortem, a study to improve immunodiagnosis was undertaken in a rabbit model of disseminated infection. We found that the predominant humoral response of infected animals was directed against four Aspergillus antigens identified by crossed immunoelectrophoresis. One of these antigens, a cell-wall carbohydrate, was purified by gel-filtration chromatography and was used to develop a radioimmunoassay. The sensitivity of this assay was increased by testing for serum-bound antigen as well as for free antigen. When the sensitivity of the RIA was evaluated in the animal model, antigenemia was detected in 78% of 51 rabbits with disseminated infection and ante morten in 85% of 42 rabbits with lethal infection. By contrast, with immunoprecipitin analysis only eight of 51 rabbits were positive for antigen, and six of 51 rabbits were positive for Aspergillus antibody. The specificity of the RIA was also tested. Negative controls for antigen included sera from 76 normal rabbits and sera from 25 rabbits with systemic candidiasis. The Candida control group is pertinent because 48% of these rabbits had specific Candida antigenemia detected by a mannan RIA. This study demonstrates that Aspergillus antigenemia occurs during the course of experimental disseminated aspergillosis and illustrates the potential of an Aspergillus antigen RIA for sensitive, specific immunodiagnosis of human infections.


Complement-fixing anti--double-stranded DNA with the Crithidia method: a better indicator of active SLE than anti-DNA with the Farr method. Twenty-seven patients with SLE of juvenile onset were studies for 2 years. Episodes of active disease and quiescence were defined and were related to levels of anti-dsDNA and C3. Two methods for the detection of anti-dsDNA--the Farr assay and Cr immunofluorescence--were compared. The latter method was also used to differentiate anti-dsDNA according to its Ig class and its CF property. Positive tests for anti-dsDNA and low C3 levels were correlated with activity of the disease. Results with the Farr assay and Cr Ig test were comparable, but both low C3 and Cr CF anti-dsDNA showed a significantly stronger association (p less than 0.001) with active SLE than did DNA binding by the Farr method or Cr Ig anti-dsDNA. Furthermore, in six patients followed during active disease and remission, a negative Cr CF test was the earliest sign of ensuing clinical remission; DNA binding and C3 levels took weeks to months longer to normalize. This predictive value of CF anti-dsDNA may be useful in monitoring therapy for SLE, especially if symptoms due to prior renal damage may be confused with active disease as in lupus nephritis.


The behaviour of the maxilla in vertical movements after Le Fort I osteotomy. In 15 cases of ordinary Le Fort I osteotomy with simultaneous vertical displacement, the behaviour of the maxilla in respect to vertical movement was examined. It was observed that out of 12 maxilla which had been tilted downwards, 10 moved upwards again. One maxilla remained stable and another one moved further downwards. Of 3 cases with upward movement, two remained stable whereas one moved further upwards. Therefore, the authors conclude that the downward displacement especially is unstable and that one has either to overcorrect or search for possibilities of stabilization other than wiring suspension. Since these movements occur during postoperative intermaxillary fixation, no occlusal changes are observed.


A de-epithelialized free groin flap for facial contour restoration. The transfer of de-epithelialized free groin flaps to restore facial contour after tumour resection and in hemifacial microsomia is described. The flap can be transferred in one stage and remodelled at a later minor operation. This provides an acceptable alternative to the other more difficult and often less successful methods of restoring soft tissue deficiencies of the face.


The effects of cell density and metabolite flux on cellular dynamics. Density-dependent regulation of cell growth in tissue culture is a well-known phenomenon but the mechanism of regulation remains obscure. Here we explore the effects of cell density and metabolite flux on the collective dynamics of a cell population. The intracellular dynamics are modelled by positive feedback kinetic mechanisms of the kind known to apply to yeast cells. Several experimental observations related to glycolytic oscillations are predicted and it is suggested that the general conclusions may be applicable in a broader context.


Can emotions precipitate seizures--a review of the question. Controversy over the emotional precipitation of seizures has existed for centuries. Large clinical studies have generally shown a significant proportion of seizures to be triggered by emotions. Laboratory studies have been reported which describe seizure activity on the electroencephalogram during periods of experimentally induced stress. However, very few pf these studies have utilized control groups and blind evaluators. The numerous reports of the emotional precipitation of seizures indicate that the phenomenon may be genuine and that further research is warranted. Research on emotional interventions such as biofeedback techniques and psychotherapy is the next step, and early work on these interventions is promising.


Succinate dehydrogenase-dependent nutritional requirement for succinate in mutants of Escherichia coli K12. Lipoic acid (lip) and 2-oxoglutarate dehydrogenase (sucA) mutants of Escherichia coli K12 exhibit a requirement for exogenous succinate during aerobic growth on glucose minimal medium. Reversion studies have shown that this requirement can be suppressed by gal-linked mutations which inactivate succinate dehydrogenase. Biochemical and genetic studies confirmed that the succinate dehydrogenase gene (sdh) is affected and that suppression is mediated by the same intergenic and indirect mechanism that generates succinate independence in partial revertants of lipoamide dehydrogenase mutants (Creaghan & Guest, 1977). A series of isogenic strains containing all combinations of mutations affecting 2-oxoglutarate dehydrogenase (sucA), succinate dehydrogenase (sdh), isocitrate lyase (aceA) and fumarate reductase (frd) in a background lacking succinate semialdehyde dehydrogenase, was constructed to assess the importance of these enzymes as sources of endogenous succinate (succinyl-CoA) during aerobic and anaerobic growth on glucose. Only strains combining a deficiency in 2-oxoglutarate dehydrogenase with the presence of an active succinate dehydrogenase required succinate for aerobic growth. In all mutants, including the triple mutant (frd sucA aceA), the succinate requirement was suppressed by inactivating succinate dehydrogenase. The aerobic growth rates of succinate-independent strains were most affected by lack of isocitrate lyase but only two mutants (sdh sucA aceA and frd sdh sucA aceA) grew faster with added succinate: the growth yields were lowered by deficiencies in isocitrate lyase and also succinate dehydrogenase. It is concluded that very little succinate is needed for biosynthesis during aerobic growth on glucose and the requirement for relatively high concentrations of succinate (2 mM) by mutants lacking 2-oxoglutarate dehydrogenase or related functions stems from the presence of active succinate dehydrogenase. Anaerobically, either isocitrate lyase or fumarate reductase is essential for succinate-independent growth on glucose.


Extension of a chromosome linkage group of Proteus mirabilis. Mating procedures for detection of mobilization of the Proteus mirabilis chromosome were re-investigated. The chromosome was mobilized by plasmid D, the previously used hybrid between plasmids P-lac and R1drd19. About a 40-fold increase in recombinant recovery correlated with the absence of swarming during mating and a lower temperature of incubation. The modification introduced was that conjugation was allowed to proceed on a non-selective supplemented minimal medium at 30 degrees C before washing and plating on selective media. Final incubation was also at 30 degrees C. This technique enabled eight additional chromosomal markers to be mapped. Polarized transfer of the chromosome was shown by gradient of transmission experiments using a previously described marker as reference, by linkage analysis with reference to proximal and distal markers and (less successfully) by interrupted mating on solid medium. Markers of plasmid D transferred at high frequency to all recombinants. The plasmid was stable in recombinants and could transfer itself and chromosomal markers of the new hosts in further matings. Resulting recombination of markers occurred at usual frequencies. The marker order, his-1, ser-2, ura-2, pyrB1, trp-3, cysA1, ade-2, ilv-2, cysG1, gly-1, cysC1, argA2, metF2, nalA1, thr-1, leuB2, did not resemble the order of these markers in Escherichia coli.


Effect of incubation media on the recovery of Escherichia coli K12 heated at 52 degrees C. The exposure of exponentially grown Escherichia coli K12 to 52 degrees C for 30 min in Tris/Mg2+ buffer resulted in a considerable loss of viability when plated on tryptone agar. When such heated bacteria were held at 37 degrees C for 2 h in tryptone broth before plating on tryptone agar, there was a significant increase in viability. Thus, heat damage was repaired in tryptone broth but not on tryptone agar. Recovery was greater in tryptone broth than in synthetic medium. In tryptone broth, recA or polA mutants also recovered but a lex mutant did not. As a result of heating, the sensitivity of bacteria to ultraviolet radiation (u.v.), to mitomycin C and to plating on high salt medium was enhanced. After incubation for 2 h in tryptone broth at 37 degrees C, the bacteria regained their resistance to u.v. and mitomycin C and tolerance to high salt medium. Recovery of viability required RNA and protein synthesis, whereas recovery of u.v. resistance did not require protein synthesis. Heating for 30 min inhibited the release of acid-soluble material from DNA in all strains of E. coli used.


Effect of morphine analogues on chemotaxis in Escherichia coli. Pretreatment of Escherichia coli w3110 with levorphanol, a morphine analogue, reduced chemotaxis to serine, aspartic acid and galactose. This decreased chemotaxis was not due to decreased viability or motility. Pretreatment with 1.1 mM-levorphanol for 1 h, followed by washing to remove the drug prior to determination of chemotaxis, inhibited chemotaxis to each of the attractants by at least 80%. Pretreatment with dextrorphan, the enantiomorph of levorphanol, or levallorphan, the N-allyl analogue of levorphanol, resulted in a similar inhibition of chemotaxis. Reversal of the inhibition produced by pretreatment with levorphanol required a period of growth of at least one generation time.


Proteases produced by a proteolytic mutant of Clostridium botulinum type E. A proteolytic mutant from Clostridium botulinum type E produced extracellular proteases after the end of exponential growth coinciding with the period of sporulation. Proteases were separated into four fractions by chromatography on a DEAE-cellulose column. One was a sulphydryl-dependent protease that also apparently required a divalent cation for enzyme activity since it was inhibited by EDTA. This enzyme hydrolysed synthetic amide and ester compounds containing an arginine residue, and showed some activity towards L-lysine methyl ester. It appeared that two of the other proteases were serine proteases and the fourth was a metal protease. These last three proteases did not require a thiol agent and did not hydrolyse any of the synthetic amides or esters examined. Only the sulphydryl-dependent protease could activate C. botulinum type B, E and F toxins. The ability of this enzyme to activate type B and E toxins was markedly lower than that of trypsin. The susceptibility of type B toxin to this protease was lower than that of type E toxin. C2 toxin was not activated by this enzyme. It is suggested that the sulphydryl-dependent protease in this proteolytic mutant of C. botulinum type E has properties similar to those of proteases from C. botulinum types B and F.


The capsules of Corynebacterium equi and Streptococcus equi. The capsules of Corynebacterium equi and Streptococcus equi were examined by electron microscopy after staining with ruthenium red. They were compared with the capsule of Klebsiella pneumoniae which had previously been examined using the same procedure (Springer & Roth, 1973). The capsule of C. equi had a laminated appearance. When S. equi was grown on solid medium, its capsule appeared as radially arranged projections capped by a thick electron dense layer. When grown in liquid medium, S. equi produced a capsule which showed as short thick projections with no layer external to them.


Lipopolysaccharide core defects in Salmonella typhimurium mutants which are resistant to Felix O phage but retain smooth character. FOR mutants of Salmonella typhimurium are resistant to Felix O phage, whose receptor includes the N-acetylglucosamine branch of the lipopolysaccharide (LPS) core, but smooth in cultural properties, antigenic character and phage sensitivity pattern (MacPhee et al., 1975). The rfa(FOR) genes determining the FOR character of nine mutants were transduced into a smooth cysE pyrE recipient: the nine FOR transductants (and a tenth FOR mutant) were then made rfb (i.e. unable to make O chains) by transduction or Hfr crosses. The rfb FOR strains were sensitive to FO phage but nearly all of them showed a somewhat reduced efficiency of plating and diminished rate of adsorption of the phage. This observation and the Ra (complete core) serological activity of their LPS (tested by haemagglutination inhibition) indicate the presence of some, but less than the normal number of, completed core chains in FOR rfb LPS. On the basis of the sensitivities of the FOR transductants and their rfb derivatives to various 'rough-specific' phages, their increased sensitivities to some antibiotics and to deoxycholate and the serological activity of the rfb FOR LPS in various incomplete core systems, the mutants were divided into three groups: (i) five mutants with probable defects in previously undetected rfa gene(s) concerned with formation of both the galactose I and the galactose II units of the LPS core; (ii) two mutants with defects inferred to affect the structure of the inner part of the core and also interfere with addition of the N-acetylglucosamine branch; (iii) three mutants in which no type of incomplete core could be detected, probably affected in formation of the inner part of the core chain. The mutation of one mutant of the last class, unlike those of the other nine mutants tested, lay outside the cysE-pyrE segment, in the 90 to 116 min region of the linkage map.


Experiences with radioimmunoassay in the detection of HBsAg in the presence of anti-HBs. Interference from anti-HBs present during hepatitis B antigenemia caused the appearance of several false negative reactions in a competition radioimmuno-precipitation procedure. The results indicate that such interference is considerably less in the solid-phase radioimmunoassay (Ausria II) and probably causes few false negative tests. The use of pepsin treatment as a means to destroy interfering antibodies is discussed.


Treatment of the on-off syndrome in Parkinsonism with low dose bromocriptine in combination with levodopa. The addition of bromocriptine, given in divided doses up to 30 mg per day, to conventional anti-Parkinsonism therapy has been studied in a double-blind placebo controlled clinical trial in 11 patients with Parkinsonism with the "on-off" syndrome. Four patients withdrew because of side effects. Of the seven remaining, three had clinical benefit from bromocriptine with reduction in severity and frequency of fluctuations. There was, however, no statistically significant benefit of bromocriptine when the group as a whole was assessed in terms of severity or frequency of fluctuations measured by three different methods. The mean frequency of major fluctuations on placebo was 2.9/day and on bromocriptine 1.8/day (P less than 0.1 greater than 0.05). There appears to be a limited role for bromocriptine as additional therapy in the management of some patients with the on-off syndrome.


Atrial myxoma: a review of the neurological complications, metastases, and recurrences. The neurological complications secondary to embolism from atrial myxoma are reviewed. A patient with intracranial and skeletal metastases is described to emphasise the malignant potentiality of this tumour. A classification of atrial myxoma metastases is presented.


Double-blind evaluation of chemonucleolysis for herniated lumbar discs. Late results. Sixty-six patients with symptomatic herniated lumbar discs refractory to the usual conservative management were allocated at random into one of two treatment groups according to a double-blind protocol: 31 received chymopapain intradiscally (chemonucleolysis) and 35 received a placebo intradiscally. Symptoms remained significantly improved 1 year or more after injection for 55% of those treated with chymopapain and for 46% of those treated with placebo. The difference is not statistically significant. However, to discard chemonucleolysis on the basis of this one small clinical trial may be premature. Since continuing controversy has re-established a climate in which another double-blind study of chemonucleolysis is ethically feasible and scientifically desirable, we favor additional clinical trials under a tightly controlled protocol to help resolve the issue.


Immunoblastic sarcoma (histiocytic lymphoma) of the brain with B cell markers. Case report. A group of central nervous system neoplasms, previously known as reticulum cell sarcoma or microglioma, and recently classified as malignant lymphoma, histiocytic type, not infrequently occur in patients with immunodeficiency, either primary or induced by immunosuppressant drugs. The authors report such a neoplasm in a patient with idiopathic thrombocytopenic purpura immunosuppressed with azathioprine and prednisone. The neoplasm was studied with several immunological techniques and by electron microscopy. The neoplasm had B lymphocyte membrane markers and showed plasmacytic differentiation. These features suggest that it was a tumor of transformed B lymphocytes (immunoblasts).


A comparison of two methods of quantifying masticatory pressures developed under dentures with variable occlusal widths. Pressures developed during mastication with removable dental prostheses have been quantified by two methods. This pilot study (1) compares the peak pressure method of pressure quantification with the integrated curve method of quantification and (2) continues the exploration of the effect of the width of the occlusal table on pressures developed under dentures. A set of specially designed experimental dentures was constructed for one individual. The mandibular experimental denture contained a series of pressure transducers by which masticatory pressures were recorded. These pressures were monitored between the denture base and the residual ridge tissues. Several interchangeable posterior occlusal segments, varying only in the width of the occlusal table, were fabricated for the opposing maxillary denture. Masticatory pressure and total ridge pressure were quantified by the integrated curve method and the peak pressure method. Both methods indicated a direct relationship between masticatory pressures produced and the width of the occlusal table. A similar direct relationship between total ridge pressure and occlusal width was suggested statistically by the integrated curve method, and graphically by both methods.


Early laminar excision: improved control of burn wound sepsis by partial dermatome debridement. The large mass of devitalized tissue that comprises the burn eschar is gradually becoming recognized as the principal source of complications in the burn patient. Clinical observations suggest that the topical agent silver sulfadiazine does not penetrate the eschar sufficiently to prevent bacterial infection from becoming established in the deeper levels of the wound but does penetrate to a depth of approximately 1.5 mm in bactericidal concentrations. A new technique that takes advantage of this fact, early laminar excision, has been developed at the Children's Hospital of Michigan Burn Center. The eschar is excised layer by layer with the electric dermatome under general anesthesia within the first 72 hr post burn, and the thickness of the devitalized tissue is reduced to a remnant of less than 1 mm. This is less than the depth to which silver sulfadiazine is capable of penetrating in bactericidal concentrations, and greatly enhanced control of burn wound sepsis is achieved. Early laminar excision of the eschar, combined with silver sulfadiazine dressings, aggressive resurfacing of the wound, and increased emphasis on nutrition, is an approach to management of the victims of thermal trauma that should significantly improve survival in patients with burn injuries greater than 60% body surface area.


The induction of new bone and cementum formation. IV. Microscopic examination of the periodontium following human bone and marrow allograft, autograft and nongraft periodontal regenerative procedures. This retrospective study based on histologic evaluations of 100 human block sections and extracted teeth taken from sites treated via bone and marrow autograft, allograft and nongraft regenerative procedures revealed the following findings: 1. Graft procedures yielded new cementum formation in 66 of 79 sites evaluated while nongraft approaches yielded new cementum formation in only 7 of 21 sites. Two of the grafted sites not yielding new cementum were only 14 days duration. 2. Block section evaluation revealed new bone formation in 33 of 39 graft sites and in 7 of 21 nongraft sites. 3. When regeneration did occur, as seen in the block sections, the nature of the new attachment was similar in all graft approaches and was comparable to healthy functioning periodontium. 4. The potential for regeneration of a functional attachment apparatus including new cementum, bone and functionally oriented periodontal ligament has been demonstrated in autograft and allograft approaches. 5. Adverse immune response to bone and marrow allografts could not be detected at a clinical, histologic or chemical level. 6. No ankylosis or root resorption was noted with fresh intra-oral donor material and with frozen iliac autografts or allografts. Root resorption was noted in two cases treated with nongraft methods and in 16 of 275 sites treated with fresh iliac autograft material.


The effect of intrasulcular toothbrushing on the amount of sulcular fluid. Nineteen young adult Caucasian males had an average Gingival Score of 0.47. Each was asked to demonstrate his present method of toothbrushing. Thirteen used a scrub method, and six combined the scrub and roll methods. Sulcular fluid measurements were taken from the facial aspect of the mandibular left second bicuspid using filter paper strips stained with ninhydrin. An average value of 0.94 mm was obtained. Intrasulcular brushing was performed in the mandibular left posterior segment, for 30 seconds daily for 40 days. The brushing was done by the investigator on 28 days and by the subjects on 12 days. The average Gingival Index score following intrasulcular brushing was 0.26. Sulcular fluid measurements were again taken from the mandibular left second bicuspid. A decreased amount of sulcular fluid was found in six subjects, while nine exhibited an increase and four showed no change. An average sulcular fluid measurement of 0.87 mm resulted following the experimental brushing period. From these data, it can be concluded that, within the limitations of this study, intrasulcular brushing had no significant effect on the amount of gingival fluid.


Gingival fluid flow after gingivectomy related to mechanical or chemical plaque control. The effects of mechanical tooth cleaning and 0.2% chlorhexidine mouthrinses on healing after gingivectomy were compared in 8 patients by means of a "split mouth" technique. The experiment began after periodontal pack removal on day 7. Gingival fluid was sampled immediately before and on days 14, 21, 28, 35 after gingivectomy. The results showed that mechanical and chemical plaque control were equally effective in promoting healing after gingivectomy as evaluated by gingival fluid measurements.


The use of extracted teeth to evaluate clinical measurements of periodontal disease. Clinical indicators of periodontal disease, Gingivitis Index, Gingival crevicular fluid and pocket depth measurements were obtained from the gingiva surfaces of 30 teeth. The gingival margins were marked on the surfaces of the teeth prior to extraction. The extracted teeth were stained with hematoxylin and air dried, and the distances from the groove to the base of the calculus, plaque, and connective tissue attachment were obtained. The plaque-free zone was also measured. Comparisons were made between clinical and tooth surface measurements. A high correlation was found between clinical pocket depth measurements and tooth surface parameters. The correlations between all tooth surface parameters and GCF were statistically significant. The G.I. was significantly correlated only with the penetration of calculus into the pocket. The clinical pocket depth was statistically the same as the distance from the gingival groove to the coronal connective tissue attachment. The plaque-free zone appeared to represent the junctional epithelium.


Immunoglobulins and complement in human periodontitis. The gingiva in human periodontitis shows IgG, IgM, and C3 suggesting an antigen-antibody response binding and activating complement. The irregular distribution of the fluorescence on the basement membrane suggests binding of antigen-antibody complexes.


The alteration of lingual mucosa with free gingival grafts. Protection of a denture bearing surface. A technique has been described which has altered the form of denture bearing alveolar mucosa. Free gingival palatal grafts were used to create an attached gingival environment upon which removal denture prosthesis may rest.


Does calcium mediate the increase in potassium permeability due to phenylephrine or angiotensin II in the liver? Two agonists, phenylephrine and angiotensin II, which have been shown to alter K+ permeability in the liver were investigated as to the possible role of Ca++ in the K+ release response (measured as 86Rb efflux) in liver slices. Both phenylephrine and angiotensin II caused transient increases in 86Rb efflux from liver slices. For both agonists, the first in a series of responses was independent of extracellular Ca++, but Ca++ was required to obtain a subsequent response. This dependence on extracellular Ca++ for a second response was not receptor-specific suggesting that activation of either receptor elicited the release of the same cellular pool of Ca++. The cationophore, A-23187, only slightly increased 45Ca++ efflux and was without effect on 86Rb efflux. In contrast to the ionophore, phenylephrine stimulated a precipitous rise in 45Ca++ efflux. It is proposed that the liver may be similar to a number of other tissues in that Ca++ mediates changes in K+ permeability, but that the source is a bound Ca++ store, rather than the extracellular space.


Topography of cutaneous mechanoreceptive neurones in dorsal root ganglia of skin-grafted frogs. 1. Topographical distribution patterns of dorsal root ganglion (d.r.g.) cutaneous neurones providing innervation to various body surfaces were examined in doublypithed Discoglossus pictus frogs.2. Using electrophysiological methods, sensory neurones innervating back skin were observed to predominate on the dorsal ganglionic surfaces, while belly skin neurones were most prevalent in the caudal half of the d.r.g. ventral surfaces. Flank neurones clustered in the medial half of d.r.g. ventral surfaces.3. Cutaneous neuronal distribution patterns within the d.r.g. of 180 degrees skin grafted animals were indistinguishable from those observed in control frogs.4. Sensory neurone distribution patterns were found to be altered in all animals with single skin type grafts. Projection patterns were always heaviest towards the autograft, which was on the opposite body surface (i.e. dorsally located d.r.g. sensory neurones projected to back skin on the frog's ventrum, while ventrally located neurones projected to belly skin on the frog's dorsum).5. The results are discussed in the light of several selective outgrowth mechanisms which have been proposed as a possible underlying basis for the development of misdirected wiping reflex behaviour in skin grafted anurans. The findings indicate that none of the proposed selective growth mechanisms can account adequately for the development of misdirected wiping reflexes, at least in the species studied.6. It is suggested that selective cell replacement, based upon competition among prespecified cutaneous neurones, might best account for the development of normal and misdirected wiping reflexes in frogs.


The effect of increasing the plasma magnesium concentration on renin release from the dog's kidney: interactions with calcium and sodium. 1. A denervated 'auto-transplanted' dog's kidney preparation was developed to study renin release into renal plasma and lymph. The function of the 'transplant' was compared with that of its partner. In the 'basal' state it had a similar rate of plasma and urine flow, Na, Ca, Mg and Cl excretion but a lower rate of glomerular filtration and K excretion and a lower urinary osmolality. In the 'basal' state the 'transplant' did not release renin into plasma, but invariably released it into lymph. 2. Infusions of MgCl2 solutions into the renal artery which raised the renal plasma Mg concentration (PMg) by 0.1-2 m-mole.1.-1 provoked a concentration-related increase in renin release into plasma. This was due to a rise in the veno-arterial renin difference and in the renal plasma flow rate. Blood pressure and Na excretion were unaltered. 3. In other experiments, an increase in PMg of 1.5-2.5 m-mole.1.-1 was also found to increase renin release into lymph. 4. When the plasma Ca concentration was doubled by infusion of CaCl2 into one renal artery, an increase in PMg of 1.5-2.5 m-mole.1.-1 no longer increased renin release into plasma or lymph. 5. When the plasma NaCl concentration was raised by 8-15 m-mole.1.-1 by infusion of hypertonic saline into the renal artery, MgCl2 infusion failed to increase renin release until PMg was raised by more than 3 m-mole.1-1. 6. The results demonstrate that hypermagnesaemia stimulates renal renin release by a mechanism that is independent of the renal nerves, or of any changes in blood pressure or sodium excretion, but which is antagonized by concurrent hypercalcaemia or hypersalaemia. The possibility is discussed that Mg is reabsorbed from the tubular into the interstitial fluid where it antagonizes the action(s) of Ca on renin release from the juxtaglomerular cells.


The maxillary complete denture opposing the mandibular bilateral distal-extension partial denture: treatment considerations. The dentist should approach the treatment of the complete maxillary denture opposing the mandibular bilateral distal extension partial denture cautiously, and the institution of correct treatment initiatives is essential. Every patient must be aware from the outset that the longest possible life of any prosthesis with the least possible harm to the remaining tissues can only be ensured by regular recall and maintenance care.


The measurement of forces transmitted to abutment teeth of removable partial dentures. Despite the limited number of patients in the study, the following conclusions may be made regarding the magnitude and direction of forces transmitted to abutment teeth of extension-base removable partial dentures. 1. A technique was presented for using strain gauges to determine the magnitude and direction of forces transmitted to abutment teeth of removable partial dentures. 2. There are variations in force magnitude with a patient and between patients from chewing cycle to chewing cycle. 3. The transmitted forces vary when different removable partial denture designs are used. 4. Improving adaptation of the extension bases to the residual ridge is an excellent means for providing maximum support, increasing patient comfort, and decreasing forces to abutment teeth. 5. Extension bases apply mesially directed forces to abutment teeth during mastication. 6. Further research is needed to elucidate the effects of the various philosophies of removable partial denture design.


The upper anterior sectional denture.

The upper anterior sectional denture. An upper anterior sectional denture is described which consists of (1) a cast cobalt-chromium framework with two passive clasps that contact undercuts on the distal surfaces of the most posterior remaining teeth and (2) a labial flange that carries the replaced tooth or teeth and engages the labiointerproximal gingival undercuts of the anterior teeth adjacent to the edentulous ridge. The cast framework is inserted occlusogingivally, and the labial flange is inserted labiolingually. Both sections are held together by the frictional resistance of the split post of the framework that fits into a tube on the labial flange and hollowed-out artificial tooth. With this type of prosthesis, certain clinical problems can be handled without abutment tooth preparation and with a minimal amount of chair time.


An interocclusal record--impression-axis frame. This method combines the separate records of (1) maxillary and mandibular impressions, (2) centric occlusion, and (3) arbitrary hinge axis determination. It is made possible by the use of a new instrument which is the combination of a full-arch interocclusal record-impression frame and a facebow.


Technique for an immediate temporary fixed tooth replacement. A clinical technique for the immediate replacement of an extracted anterior tooth was presented. The clinical crown of the patient's extracted tooth was used as a pontic by attaching it to the adjacent teeth with acid-etch bonded resin. This technique provides a practical and esthetic immediate fixed tooth replacement that requires minimum materials and time.


Retention of dowels subjected to tensile and torsional forces. This investigation measured the maximal tensile and torsional forces sustained by four different designs of dowels. 1. Under tensile force, the threaded screw-in dowels were significantly more retentive than the unthreaded dowels. 2. Under torque, both the threaded screw-in and serrated dowels were significantly more retentive than the smooth-sided dowels.


Dowel retention with glass-ionomer cement. The retentive capacity of the Whaledent Parapost system utilizing ASPA cement was compared at two lengths, three diameters, and with respect to the effect of both medication and citric acid pretreatment. The greatest single factor influencing retention was embedment depth into dentin. No significant differences were observed between the retention values for medicated and unmedicated teeth. Finally, no increase in retention was noted over previously reported values for zinc phosphate, carboxylate, and epoxy resin cements. The glass-ionomer cement tested offers no advantage for post retention.


Adherence of a nickel-chromium alloy and porcelain. 1. Surface oxide favors adherence. The results of this study do not support the hypothesis that chromium oxide has a deleterious effect on adherence as measured by the torsion test. 2. Gritblasting the surface before porcelain application improves adherence. Smooth uncoated specimens where oxide was removed before enameling developed insufficient amounts of oxide for bonding. 3. The particular coating agent used on this study indirectly promotes adherence, since additional oxide forms during its application. Also, it may be directly involved by its influence on the residual stress distribution in the interface porcelain. 4. The more extensive the reaction zone at the interface, the further away the fracture surface is from the interface.


Influence of pressure and vibration during cementation. Vibration, applied at the beginning of cementation, improves the fit of MOD inlays and cast complete crowns when they are compared to the same castings cemented without vibration. The Medart pressure applicator produced better adaptation. Orange wood blocks and Burlew disks produced similar results. They were less efficient than the Medart pressure applicator. Cotton rolls resulted in the highest fit discrepancy.


Obturator-overdentures retained by nonrigid attachments. A technique is described to attempt to predictably retain a few remaining teeth for added stability and retention of a complete maxillary denture combined with a nasopharyngeal obturator. A male nonrigid attachment is added to copings on the retained roots, and the female attachments are incorporated in the denture base.


Construction of a buccal flange obturator. There are various methods of fabricating obturators. Cleanliness and simplicity are important considerations in the construction of any intraoral prostheses. With these considerations in mind, construction of the buccal flange obturator has been described.


Restoration of removable partial denture rest seats using dental amalgam. This anatomically contoured, carefully restored tooth is now capable of continuing to serve as an abutment for the patient's existing removable partial denture, and a complex and extensive treatment has been avoided.


Effects of biofeedback on muscular tension in selected personality states. The effects of electromyographic biofeedback on three selected personality states from the MMPI and one comparison group were investigated. Forty in-patients (28 males and 12 females) ranging in age from 15 to 52 in a psychiatric hospital were classified as manic, agitated, depressed, or designated as a comparison group, according to their MMPI scores and Gilberstadt and Duker's assessment of personality. Fourteen sessions of electromyographic biofeedback were given each individual. Significant differences in EMG readings were found between the manic group and the the comparison group, the agitated group and the comparison group, and between the agitated group and the depressed group during individual sessions. No significant differences were found when comparing total group means.


Levamisole in chronic inflammatory diseases. The use of levamisole in a variety of non-rheumatoid chronic inflammatory diseases has been reviewed. Both the clinical responses and the in vivo and in vitro tests of immunological function during levamisole therapy are discussed in an attempt to correlate the immuno-stimulatory properties of the drug with any therapeutic effect. It was concluded that in many diseases there are conflicting reports on the usefulness of levamisole and that there were few correlates of the therapeutic and immunological effects of the drug. There was, however, evidence that the drug may prove clinically useful and more double-blind, multicentre controlled studies with adequate laboratory testing are needed. At present levamisole would appear to be useful in the treatment of Crohn's disease, recurrent oral ulceration, and herpes simplex infections.


International symposium on levamisole in rheumatoid arthritis. A review of short and longterm effects on articular manifestations. Reports of 28 authors with a total of nearly 1,000 enrolled patients have been reviewed regarding changes in clinical manifestations of disease in rheumatoid arthritis during short term and long term administration of levamisole. Global clinical improvement was observed in 60% of patients after three months and in 75% of patients after six months of drug treatment. There was no significant difference in response whether the drug was given in a continuous daily or intermittent weekly fashion. The longest observation times extend to 3 1/2 years. An optimal effect is usually reached between six and 12 months of treatment, after which time no further improvement is observed. After cessation of drug administration, the rate of deterioration varies with the length of previous exposure.


Effects of levamisole treatment in cancer patients. Twenty-six controlled prognostic evaluations of the adjuvant use of levamisole in cancer are reviewed. The results favor intermittent administration of levamisole in a dosage that is adapted to the patient's weight or body surface. Early treatment is indicated, but synchronous treatment with cytotoxic therapies is to be avoided. The best results have been achieved in advanced but still potentially curable patients. Major toxicity occurs very seldom and measures are suggested to further characterize the few patients who are at risk of developing allergic agranulocytosis, a potentially life-threatening side effect.


Levamisole in rheumatoid arthritis--a multivariate analysis of a multicentric study. Statistical analysis of the data from a multicentric study of six months of treatment with levamisole in rheumatoid arthritis involved two steps. In a first step, the differences between observations before and after treatment have been made independent of their initial values. Differences after treatment have been transformed into responses to treatment using a proportionality factor that is related to the initial values before treatment. The second step involved a reduction of the various responses into a single global response by means of a discriminant analysis between two classes. Class membership has been defined by the type of treatment (either placebo or drug) predicted by the investigators at the end of treatment and before breaking of the code of the double-blind study. This method of analysis allows for the combination of multiple clinical observations with a subjective evaluation. Its results can be easily represented graphically and tested for statistical significance. The use of global responses to treatment is illustrated with a comparison of placebo and drug treatments and can be extended to comparisons between investigators or between different dose and time regimens.


Degree of responsiveness to levamisole and factors influencing responsiveness and adverse reactions. The individual response to treatment, and factors influencing this response, were evaluated by means of Lewi's mathematical model in patients with rheumatoid arthritis. Patients showed a graded response to anti-inflammatory agents ranging from deterioration through moderate to marked improvement. Levamisole was superior to anti-inflammatory agents in preventing deterioration or inducing marked improvement. Patients in an early stage of disease were the best responders and had fewest idiosyncratic reactions. The responses were independent of the treatment schedule used. A threshold dose of levamisole exists, but it is not critically dependent on body weight.


Experience and recommendations for treatment schedule of levamisole in rheumatoid arthritis. A review is presented of the different treatment regimens of levamisole used in rheumatoid arthritis (RA). A large double-blind EULAR multicentre trial has shown that the beneficial effects obtained with continuous (150 mg per day) and with intermittent (3 days per week, 150 mg) treatment are comparable in RA. Unfortunately with both regimens a high frequency of agranulocytosis was observed. Recent data of another double-blind trial have shown that a treatment schedule of 150 mg one day per week gives equally good results as both previous regimens. Furthermore regular control of white blood cell counts 10 hours after intake of the drug can detect early high risk patients for agranulocytosis. Results of longterm use of levamisole in RA are also presented and the different kinds of responses are discussed. Finally the authors propose a treatment scheme. This consists of one single weekly dose of 150 mg; if no response is obtained after 6 or at most 9 months, a final trial can be performed with two intakes of 150 mg each week.


A review of the effects of levamisole on erythrocyte sedimentation rate, acute phase proteins, and anemia. A statistically significant decrease of erythrocyte sedimentation rate (ESR) is seen in levamisole-treated rheumatoid arthritis (RA) patients. While there is a correlation between ESR decrease and clinical improvement, in a few patients ESR remains unchanged in spite of a good clinical result. A decrease of acute phase proteins and an increase in hemoglobin and hematocrit have also been reported with levamisole.


A multicentre randomized double-blind study comparing two dosages of levamisole in rheumatoid arthritis. A six-centre study was conducted to evaluate the effectiveness and safety of a single weekly treatment with 50 or 150 mg levamisole in patients with rheumatoid arthritis (RA). The results were compared with those of a previous placebo-controlled study, in which 150 mg levamisole was given on 3 or 7 consecutive days each week. The efficacy/side effect ratio is better with 150 mg once weekly than with 150 mg on 3 or 7 consecutive days each week. A reduction of the dose to 50 mg reduces the incidence of idiosyncratic reactions but also reduces efficacy. A single dose of 150 mg levamisole once weekly is therefore recommended as a standard dose in patients with RA. This regimen allows for hematological controls at critical times and, hence, permits recognition in practice of agranulocytosis at the incipient stage.


Levamisole and cellular immunity in rheumatoid arthritis--a review. It has been suggested that many of the pathological changes in rheumatoid arthritis can be explained on the basis of T cell hypofunction and that the chronicity of the lesions can be maintained by abnormalities in macrophage and neutrophil function. Although there is some evidence to suggest that levamisole can correct many of these abnormalities and that its mechanism of action in this disease can therefore be explained the current, often conflicting, information does not offer proof of this suggestion and indeed some of the noted changes may merely represent secondary rather than primary events.


Levamisole and cellular immunity in rheumatoid arthritis--clinical and laboratory correlates. Studies in a number of laboratories have confirmed a deficiency in lymphocyte PHA mitogen response in patients with rheumatoid arthritis. Improvement in T cell function in these deficient patients had been noted with levamisole treatment. We have also shown clinical improvement associated with reversal of this deficiency during a double-blind controlled study with levamisole. Patients showing good clinical response showed a greater enhancement of T cell function as compared to those patients showing a poor clinical response to levamisole. Clinical responders also showed a significantly greater enhancement with in vitro levamisole added to lymphocyte culture prior to drug treatment than did poor clinical responders. Decreased B cell function, immunoglobulin and autoantibody levels have also been observed with levamisole treatment. These studies may suggest that levamisole is acting by normalizing T cell function with a presumed secondary suppressive effect on B cell autoantibody synthesis.


A critical review of the effect of levamisole in rheumatic diseases other than rheumatoid arthritis. Levamisole has been used in several rheumatic diseases other than rheumatoid arthritis (RA). These include systemic lupus erythematosus (SLE), polymyositis/dermatomyositis, scleroderma, Sjögren's syndrome, psoriatic arthritis, ankylosing spondylitis, Reiter's syndrome and juvenile rheumatoid arthritis. Most of the published data have either been case reports including very few patients or have been concerned with specific clinical or laboratory assessments. It was therefore very difficult to make any reliable evaluation of the effect of levamisole in these conditions. Levamisole might have had some beneficial effect in some of the diseases listed but properly conducted, controlled trials are necessary before any definitive assessment can be made.


The microbiology of polony.

The microbiology of polony. A survey of 25 polony samples of different brands available to the consumer in Bloemfontein showed that significant numbers of various micro-organisms were present. Aerobic micro-organisms, psychrophiles, micrococci, pseudomonads, Microbacterium thermosphactum, lactobacilli, yeasts and moulds were enumerated by the plate count technique. The mean aerobic plate count was 15,850/g and counts ranged between less than 100/g and greater than 1 million/g. Selective plate counts indicated that psychrophiles, pseudomonads and lactobacilli were the main groups present. During storage at 5 degrees C for 12 d, the mean pH of polony declined from 6,32 to 6,20 while the aerobic count increased 13 fold. Counts of all groups increased during storage at 5 degrees C especially M. thermosphactum, yeasts and moulds. No salmonellae were found and counts of Escherichia coli or Staphylococcus aureus were less than 3/g. Storage of 5 polony samples at 1.1 degrees +/- 1 degrees C until they spoilt after 8 wks resulted in the aerobic count increasing to greater than 10(8)/g. Lactobacilli and psychrophiles increased most rapidly while pH decreased from 6,20 to 5,57. Organisms isolated most frequently from spoilt polony were yeasts, micrococci, lactic acid bacteria and corynebacteria. It is concluded that standards for microbiological quality of polony are unnecessary.


Role of RNA in the action of aldosterone on Na+ transport. Recent data describing the effects of aldosterone on the induction of messenger RNA (= mRNA) and ribosomal RNA (= rRNA) are reviewed. In the urinary bladder of the toad, aldosterone induces a few specific polyadenylated mRNAs (= poly(A)(+)mRNA) during the latent period, i.e., 30 to 60 min after hormone addition. Later i.e., 90 to 240 min after aldosterone addition, 18S and 28S cytoplasmic rRNA subunits are also induced. The effect of poly(A)(+)mRNA is mineralocorticoid-specific and correlates well with the aldosterone-dependent Na+ transport. Actinomycin D which inhibits both poly(A)(+)mRNA and nonpolyadenylated mRNA (= POLY(A)(-)mRNA) totally abolishes the response to aldosterone on Na+ transport. 3'deoxyadenosine (cordycepin), which inhibits poly(A)(+)mRNA but not poly(A)(-)mRNA, only inhibits 50 to 60% of the physiological response. These differential effects suggest that an intact poly(A)(-)mRNA pathway is also an important factor in mediating the action of aldosterone. In contrast, 3'deoxycytidine, which inhibits rRNA but not mRNA, does not impair the mineralocorticoid response, at least during the first 3 hr of aldosterone action.


Effect of the polyene antibiotic filipin and the calcium ionophore A23187 on sodium transport in isolated frog skin (Rana temporaria). Addition of filipin (50 micrometer) to the inside bathing solution of the frog skin resulted in a transient increase in the active sodium transport [measured as short-circuit current (SCC)]. The filipin-induced increase in the SCC required the presence of calcium. The calcium ionophore A23187 (4 micrometer) also induced a transient increase in the SCC. After the activation of the SCC by A23187, the SCC could  not be activated by filipin. This indicates that the polyene antibiotic filipin acts as a calcium ionophore. Higher concentrations (40 micrometer) of A23187 resulted in a shrinking of the cells in the transporting cell layer. A23187 also increased the potassium-42 exchange in the isolated epithelium. It is suggested that calcium ionophores enhanced the intracellular calcium concentration; this increase in the calcium concentration resulted in an increase in the potassium permeability of the inward-facing membrane. The increase in the potassium permeability might explain the observed increase in the SCC.


Sex therapy with orthodox Jewish couples. The sexual relationship of the Orthodox Jewish couple is profoundly affected by laws and values which, among other factors, prohibit male masturbation and limit sexual activity to specific monthly periods. This paper conceptualizes the interplay of religious, cultural, psychological, and interpersonal dynamics as they are related to both the etiology and treatment of sexual dysfunctions within this group. Three clinical illustrations are presented. They attempt to show that the ubiquitous presence of these Jewish laws and values create an ambience whereby the successful treatment of dysfunctions can only occur through the simultaneous resolution of key marital difficulties and the development of more intimate relational bondings.


The fault doctrine and injury control.

The fault doctrine and injury control. An analogy is drawn between the fourteenth-century conceptualization of infectious disease and the twentieth-century conceptualization of trauma. In both cases, causality is associated with faulty human behavior which acts as a handicap to progress. It is suggested that the practice of attributing accident causality to faulty behavior restricts the development of preventive activities in three ways: it implies that allocation of culpability is synonymous with identification of cause; it inhibits countermeasure implementation directly; and it concentrates on behavior instead of environmental hazards. A more useful and more appropriate approach is outlined and discussed.


Myocardial depression in sepsis.

Myocardial depression in sepsis. Myocardial failure is uniformly fatal when associated with post-traumatic sepsis and multisystem failure. Controversy exists as to whether endotoxin has a direct effect on the myocardium. A nonanoxic isolated arterially perfused rabbit interventricular septum was used in this study to evaluate the effects of endotoxin, live E. coli, and endotoxin/septic shock plasma on myocardial function and ultrastructure. Purified E. coli endotoxin and live E. coli bacteria did not have a significant direct effect on rabbit cardiac muscle function or ultrastructure. Perfusion of the rabbit septum with plasma from rabbits exsanguinated following a 2-hour septic or endotoxin shock insult, however, caused significant (p less than 0.02) myocardial depression when compared with control septa perfused with normal rabbit plasma. Septa perfused with shock plasma demonstrated ultrastructural alterations of mitochondria that were not noted in control preparations.


A simple system for splicing strip grafts into sheets. An alternative method of joining small strips of skin graft into larger sheeets in order to achieve complete coverage of large defects is reported. Split-thickness grafts are often needed larger than the skin strip obtained by dermatome. Suturing grafts together to form a larger sheet is difficult and often results in tearing and puckering of the graft so that spots do not adhere properly. A rapid, simple method of joining sheets of skin using neurosurgical clips is described. Removal of these clips is faster and easier than suture removal. The method is most useful where "tie-over" stent dressings are used, but also has general applications.


Chronic mercuric chloride intoxication in digestive system of Channa punctatus. The effect of exposure to a sublethal concentration (0.30 mg/l) of mercuric chloride on the activities of alkaline phosphatase, acid phosphatase, amylase, trypsin, and pepsin has been examined at intervals of 7, 15, and 30 d in the digestive system of a teleost fish, Channa punctatus. Inhibition of the activities of all these enzymes was noted after the first week of treatment. Treatment of the fish for 15 d resulted in marked increases in the activities of all the enzymes. A slight fall in enzyme activity was recorded after 30 d, but the overall activity was higher than in control fish.


The prevalence of toxoplasma infection in southern Iran. To determine the prevalence of infection with Toxoplasma gondii in the Fars Province of Iran, sera from 300 patients hospitalised at the Pahlavi University Medical Centre in Shiraz were tested. There were 157 males and 143 females, with a mean age of 39 years (range 10--80 years). The indirect immunofluorescent antibody technique was used and titres of 1:16 and above were considered positive. Eighty eight patients of whom 50 were male and 38 female (mean age 41 years, range 14--80 years) had positive sera. Of these 88 patients, 35 (40%), 25 (28%), 17 (19%), 5 (6%) and 6 (7%) had antibody titres of 1:16, 1:32, 1:64, 1:128 and 1:256 respectively. One hundred and twenty three of the 212 patients with negative sera (58%) had contact with cats. A similar proportion of patients with positive sera [51 of 88 (58%)] also had contact with cats. It is concluded that a substantial proportion of our patients (29%) show serological evidence of infection with Toxoplasma gondii. A significant correlation between exposure to cats and the consumption of improperly cooked meat on the one hand and seropositivity on the other, could not be demonstrated. There was no significant increase in the incidence of seropositivity with increasing age (P = 0.35).


Toxic and genetic effects of fuel oil photoproducts and three hydroperoxides in Saccharomyces cerevisiae. Phototransformation of no. 2 fuel oil by UV irradiation at wavelengths designed to simulate sunlight resulted in the formation of products toxic to the yeast Saccharomyces cerevisiae. Increasing the time of irradiation of the fuel oil samples increased the toxicity. Fuel oil that had been irradiated for 12 or 24 h was convertagenic to the yeast strain D4. The toxicity and genetic activity of these samples could be removed by treatment with thiacyclohexane. It is thought that hydroperoxides are the primary photoproducts responsible for these biological effects. Of three hydroperoxides tested, tert-butyl was convertagenic and cumene and tetralin were not. However, all three hydroperoxides were toxic to yeast.


[Temporo-mandibular joint pain dysfunction syndrome in children]. Otalgia is a common symptom in children. Otological examination usually reveals a local pathology as the causative agent. However, it does occur that otoscopy reveals normal ear drums and canals. The otologist must then review the causes of referred otalgia. We know that the ear is a nervous crossroad: vagus, trigeminal and third cervical nerve. The most common causes of referred otalgia are the teeth, the sinus, the mouth, the pharynx, and the larynx. If none of these factors is involved, one must then think about the painful temporomandibular dysfunction syndrome.


No homology between double-stranded RNA and nuclear DNA of yeast. We investigated the possibility of sequence of homology between yeast DNA and one of the double-stranded RNAs present in many strains of Saccharomyces cerevisiae. These double-stranded RNAs are encapsidated in virus-like particles, which appear to be similar to the viruses of higher fungi. Contrary to a recent report (M. Vodkin, J. Virol. 21:516--521, 1976), we find no such homology.


Replication of bacteriophage M13. XIV. Differential inhibition of the replication of M13 and M13 miniphage in a mutant of Escherichia coli defective in the 5' leads to 3' exonuclease associated with DNA polymerase I. Previous studies have shown that M13 single-strand synthesis is inhibited at nonpermissive temperature in Escherichia coli polAexl, a temperature-sensitive mutant defective in the 5' leads to 3' exonuclease activity of polymerase I (T.-C. Chen and D. S. Ray, J. Mol. Biol. 106:589-604, 1976). Under these conditions the formation of covalently closed replicative form (RF) molecules is greatly reduced, and miniature forms of RF accumulate. We show here that the accumulation of mini-RFs is the consequence of a differential inhibition of the replication of unit-length phage and preexisting miniphage rather than a de novo production of miniphage. Mini-RFs do not accumulate even after as many as nine cycles of growth in the mutant host infected only with unit-length phage. Mixed infections of the mutant host with plaque-purified unit-length phage and a single cloned miniphage show that discontinuities in the mini-RFs are joined with higher efficiency than are those contained in unit-length RFs. After a shift to nonpermissive temperature during single-strand synthesis in cells infected with plaque-purified phage alone, M13 RFs are found largely as RFII molecules (RF form having one or more single-strand discontinuities) containing only a single discontinuity in the viral strand. The inability of the accumulated unit-length RFII molecules to actively replicate may reflect the presence of either a bound protein or RNA primer on the 5' terminus of the viral strand and provides further support for the existence of distinct initiation and termination events in the synthesis of the viral strand.


Replication of RNA bacteriophages in the presence of rifamycin. Replication of RNA bacteriophages in the presence of rifamycin was studied in different Escherichia coli strains that vary in RNase content but are not isogenic: AB259 RNase+, Q13 RNase I- PNPase-, AB105 RNase I- RNase III-. It was found that rifamycin did not affect characteristics of phage replication such as the general pattern of viral RNA synthesis and intracellular development of the phage. These characteristics are strain specific and independent of the cell growth rate, which defines only phage release. The inhibition of cell division by rifamycin interfered with the release of the phage and thus produced an apparent effect of rifamycin on phage replication.


Effect of spermidine on bacteriophage P22 infection. The effect of spermidine on phage P22 infection of Salmonella typhimurium has been found to depend on the time of addition of spermidine with respect to the time of addition of the phage and also on the composition of the growth medium. If spermidine was added prior to or within a short time after infection, the cells survived. Under this condition the invading DNA appeared to remain trapped in the cell membrane, and there was no expression of the phage genome. If spermidine was added after the initiation of the infective process, the replication of the phage was inhibited but the cells did not survive. If spermidine was added after DNA synthesis was over, there was no effect of spermidine on phage multiplication. Spermidine was found to affect phage DNA synthesis but not host DNA synthesis.


Control of replication in RNA bacteriophages. The rates of viral RNA and protein syntheses for wild-type RNA bacteriophages and their nonpolar, coat protein amber mutants were determined in amber suppressor (S26R1E, Su-1 and H12R8a, Su-3) and nonsuppressor (AB259, S26, and Q13) strains of Escherichia coli in the presence of rifamycin. It was demonstrated that the rates of synthesis of phage-specific replicase and RNA minus strands drop off concurrently in both wild-type and coat protein mutant-infected Su(-) and Su(+) cells after 10 and 15 min postinfection, respectively. The rate of synthesis of RNA plus strands started to decline 5 to 10 min later in both cases. Excessive synthesis of replicase in the coat protein mutant-infected cells was accompanied by a similar overproduction of RNA minus strands, but not of plus strands. Partial suppression of protein synthesis in wild-type phage-infected cells abolishing coat protein control over replicase accumulation led to prolongation of replicase synthesis. Such an effect was observed also in coat protein mutant-infected cells, indicating that the excess of replicase itself may be capable of suppression of replicase synthesis in the absence of coat protein. The prolongation of replicase synthesis was followed by the prolonged synthesis of RNA minus strands in both cases. Moreover, replicase and minus strands were formed in nearly equal amounts when protein synthesis was partially inhibited. Assuming functional instability of phage RNAs, the observed coupling of replicase and minus-strand RNA synthesis offers a possibility for control of viral RNA replication by means of control of replicase synthesis on the translational level. A hypothesis is put forward to explain the molecular mechanism of such coupling between the syntheses of replicase and RNA minus strands.


Close association between shape alteration and loss of immunity to superinfection in a wild-type Klebsiella pneumoniae stable lysogen which can be both immune and nonimmune to superinfection. Klebsiella pneumoniae MirM7 is a wild-type strain which grows as cocci at pH 7 and above and as rods at pH 6.5 and below. Cultures of this strain and an auxotrophic derivative, MirM7b, have been found to undergo spontaneous lysis after purification from possible contaminating viruses. Lysates always contained two phages, FR2 and AP3, most often at high titers. FR2 and AP3 plated with the same efficiency on both MirM7b and K59 (another K. pneumoniae strain sensitive to FR2 and AP3) and lysogenized 45 and 54% of the K59-infected cells, respectively. These findings raise the possibility that MirM7b is lysogenic for FR2 and AP3, although nonimmune to their superinfection. The fact that mitomycin C and N-methyl-N'-nitro-N-nitrosoguanidine can induce phages FR2 and AP3 from MirM7b confirmed this possibility. When MirM7b was infected with FR2 several strains immune to FR2 and AP3, which were all rod shaped, were obtained. Furthermore, 19 derivatives, rod shaped at all pH's have been isolated from MirM7b. They were all immune to both FR2 and AP3. From mating experiments between the MirM7b donor derivative, strain M720, and either K59 or MirCV5, a rod-shaped MirM7b derivative cured from the prophages, cysteine recombinants were obtained which were most often (80%) immune to FR2 and AP3. Nonimmune and still lysogenic recombinants were obtained by mating M720 with a rod-shaped immune MirM7b derivative; the majority of the non-immune strains maintained the rod shape. Five coccus-shaped recombinants were also isolated; they were nonimmune to superinfection. Several physiological properties of strain MirM7b and the other nonimmune coccal recombinants have been studied in comparison with those of the rod-shaped immune derivatives. All of the coccal strains have shown several alterations with respect to the rods. The role of possible derepressed prophage genes in the various physiological alterations of MirM7 is discussed, and the analogies between this system and those of vertebrate cells transformed by proviruses are stressed.


Lysogenic conversion in Klebsiella pneumoniae: system which requires active immunity regulation for expression of the conversion phenomenon. We have previously described Klebsiella pneumoniae MirM7b, which, although stably lysogenic for the inducible and nondefective phages FR2 and AP3, is not immune to superinfection by these same viruses. MirA12b, a strain which is lysogenic for FR2 and AP3 and immune to superinfection, has been derived from MirM7b. The sensitivity of this strain and that of the nonimmune parent to several bacteriophages have been compared in this work. It has been found that, whereas MirM7b is sensitive to coliphages P1, T3, T7, and phiI, MirA12b is fully resistant to all of them. It is shown that phages FR2 and AP3 convert Klebsiella strains to resistance to coliphage P1 and coliphages T3, T7, and phiI, respectively, and cause loss of surface antigens in lysogenic cells. To determine such a conversion, both FR2 and AP3 require expression of immunity to superinfection. This explains the differences that exist between MirM7b and MirA12b in both phage sensitivity and surface antigens. Hypotheses are presented to explain the peculiar need for an active superinfection repressor to express lysogenic conversion.


Treatment of ureteral colic with intravenous indomethacin. A randomized prospective double-blind study of the analgesic effect of 50 mg. intravenous indomethacin, a prostaglandin synthesis inhibitor, was done on 47 consecutive patients with acute ureteral colic. The placebo used was 5 mg. intravenous riboflavin because of the same color as indomethacin. Indomethacin provided complete relief in 78 per cent of the cases, while riboflavin provided relief in 30 per cent. The difference is statistically significant. No side effects were observed with indomethacin.


Transrectal seminal vesiculography.

Transrectal seminal vesiculography. Lesions of the seminal vesicle can be evaluated by the transrectal needle approach. Biopsy, aspiration of contents for culture and cytology, injection of contrast medium for x-ray and drainage of cysts or abscesses can be done with this approach.


Dermal graft repair of Peyronie's disease: survey of 50 patients. Peyronie's disease is characterized by localized fibrosis in the tunica albuginea of the corpus cavernosum. This inelastic segment causes bending of the erect penis and sexual incapacity in advanced cases. We reviewed 52 cases in which excision of the Peyronie's plaque and replacement of the defect with a dermal graft have been done. An operation is an acceptable method to treat patients who are anatomic and sexual cripples. More than 70 per cent of our postoperative patients have been satisfied with sexual performance. Specific aspects of the postoperative course and surgical results are reviewed.