[Stereotaxic combined dentate-thalamotomy in the treatment of spastic-hyperkinetic forms of subcortical dyskinesias]. The work is based on the results of operations on the cerebellar dentate nuclei in 92 patients. In 42 of them, combined manipulations were carried out on the cerebellar dentate nuclei and the diencephalic structures (relay nuclei, median centre, pulvinar and subthalamus). Analysis of the results showed that stereotaxic destruction of the ventrooral parts of the cerebellar dentate nucleus is a very effective surgical manipulation in various forms of spastic dyskinesia. A natural decrease in the spastic component of the muscular hypertonia is the principal clinical effect of dentatotomy. Its effect on the rigid component of muscular hypertension is negligible. Combined manipulations on the cerebellar dentate nuclei and diencephalic structures are indicated in cases with combined spastic conditions and hyperkinesia which cannot be corrected by dentatotomy. The analysis of the results of combined interventions on the nuclear structures of the thalamus shows that pulvinarotomy is most effective, it reduces or corrects hyperkinesia in infantile cerebral paralysis and, in addition, causes diminution of the general hypertonia, of the upper extremities before all else. Proper rehabilitation treatment is the decisive factor in the final outcomes of stereotaxic intervention on the cerebellar motor systems and on those of the diencephalon in spastic forms of hyperkinesia.


Effect of preoperative administration of oxytetracycline and neomycin on the development of local tumour recurrences in cases of cancer coli-recti. In the available literature some evidence has been shown, implying that antibiotic prophylaxis in connection with colorectal surgery might increase the frequency of local recurrences of the carcinoma. 134 patients undergoing elective curative surgery of the large bowel have been followed for 20-52 months. 66 patients had been pretreated with Enterobiotic; 68 patients were controls. In our study, we found no difference between the pretreated and non-pretreated group concerning the frequency of anastomotic suture line recurrences or other types of local recurrences in the operation field.


[Repeated perforations of the small intestine in muscular agenesis in a newborn infant. Apropos of a case. Review of literature]. A rare case of intestinal muscular layers agenesis is described. Ten other cases were founded in the literature and are briefly reported. Association of ischemia and congenital abnormality of the muscular layers is probably the cause of the perforation. Prognosis is very bad: all the children with clinical symptoms (occlusion or perforation) died.


Striae cutis atrophicae. Morphokinetic examinations in vitro. The in vitro behaviour of fibroblasts and epidermis cells taken from recently developed striae distensae was studied in morphokinetic examinations in the cell culture and the results were discussed. The findings give rise to the assumption that the antianabolous effects of the adrenocorticotrophic hormones do not only indirectly cause the atrophia of the epidermis by decrease of the elasticity of the connective tissue, but it appears that primarily epidermis and corium are simultaneously involved in the pathomechanisms of these alterations by irreversible cellular damage.


Pagetoid reticulosis. A further case report with a review of the literature. A further case of pagetoid reticulosis (PR) was studied, and the findings were compared with 18 previous case reports in the literature. There seem to be two variants: The generalized type (Ketron-Goodman) with disseminated lesions and a poor prognosis, and the localized type (Woringer-Kolopp), with a single lesion usually located on the extremities with a good prognosis (if the lesion can be totally cleared by excision or highdose-radiation). The basic criterion of diagnosis is a very strong cellular infiltrate within the epidermis, but usually weak in the upper dermis. The etiology of PR remains unclear: In some cases a T-cell lymphoma seems a likely interpretation. In others, epidermal infiltrating cells are not typically lymphoid, but remain morphologically unclassifiable.


Oral retinoid for psoriasis. A report of a double blind study. Oral administration of an aromatic retinoid has a marked beneficial effect on psoriasis and does not produce significant changes in liver function or the blood count when given at a dose of 25 mgm three times a day for six weeks. This effect does not occur unless the drug has produced dermatological side-effects and this may inhibit its future acceptance but the present findings indicate that, at least in the less developed parts of the world where many Western treatments are unacceptable for various reasons, oral retinoids are a useful and relatively safe addition to the present range of medications available for psoriasis.


Percutaneous transperitoneal aspiration of pancreas guided by ultrasound: morphologic and cytochemical appearance of normal and malignant cells. A pancreatic aspirate was obtained by fine needle biopsy guided by ultrasound in a patient clinically suspected of having a pancreatic malignancy. The cytomorphologic features of well-differentiated adenocarcinoma are described and illustrated. Comparison is made between the carcinoma and normal pancreatic cells. PAS-Trichrome stain is described as a useful cytochemical technique to properly identify normal acinar and islet cells.


Topical methoxsalen photochemotherapy in the treatment of palmoplantar pustulosis and psoriasis. Topical methoxsalen photochemotherapy has been assessed in 22 patients suffering from recalcitrant palmoplantar pustulosis or psoriasis predominantly involving the hands and feet. Although 20 out of 22 patients improved and good results were obtained in exactly half of those treated, only 4 patients were classified as being "clear" or "minimally involved" at the end of 12 weeks. Two patients have shown no improvement at all. Minor local side effects were relatively common and included symptomatic erythema, blistering and local pigmentation. The histological findings in post PUVA treated skin are discussed and the pros and cons of topical photochemotherapy in this group of diseases is reviewed.


Pre-pin-point papules. Changes preceding pin-point lesions of psoriasis. Skin areas of 10X10 cm were marked out and closely observed during 14 days in 22 patients with active and 18 cases with less active psoriasis. The first changes - minute papules, slightly erythematous, almost flush with the skin (pre-pin-point papules) appeared within this period and transformed after several days into pin-point lesions. Histological examinations performed in 25 pre-pin-point and 10 pin-point papules, as well as cytochemical studies have shown significant differences. In the pre-pin-point papules inflammatory infiltrates were in a great part polymorphonuclear, and the epidermis had no features characteristic of psoriasis. The performed studies have shown that the earliest changes preceding the appearance of spontaneous psoriatic papules are very much like those of provoked Koebner phenomenon.


[Mechanical suture during resection of the rectum through the abdomen (author's transl)]. A mechanical suture using the URSS PKZ 28 or SPTU stapler was used in 30 low colo-rectal anastomoses. There were two deaths related to anastomotic complications. It is safe to establish a colostomy when the colon is not well prepared. Fistulae are frequent after palliative operations: this is a poor indication. Local recurrences are no more frequent with stapling than with manual suture.


Lichen planus and bullous pemphigoid.

Lichen planus and bullous pemphigoid. A patient is described who had clinical and histopathological features of lichen planus and bullous pemphigoid; deposits of in vivo bound C3 at the basement membrane zone, which, at the electron microscopy level, were deposited in the lamina lucida; and with circulating IgG antibasement membrane zone antibodies which exhibited a pronounced C3 binding capacity. The similarity of our case to others described in the literature suggests that bullous lichen planus in fact represents the coexistence of two distinct diseases, namely lichen planus and bullous pemphigoid.


Binding sites for endotoxic lipopolysaccharide on the plasma membrane of isolated rabbit hepatocytes. The in vitro fixation of bacterial lipopolysaccharide (LPS) on the plasma membrane of mechanically or enzymatically isolated hepatocytes from rabbits was studied by immunofluorescence technique. Antisera against LPS from E. coli 026:B6 and 0111:B4 were induced in rabbits. Antibody titers up to 1:1024 were determined by the passive hemagglutination test. There was no immunologic cross reactivity between the two antisera. IgG and IgM were prepared from anti-LPS as well as from normal rabbit serum and conjugated with fluorescein-isothiocyanate. The antibody activity against LPS was localized in the IgM fraction. Hepatocytes were isolated by a perfusion technique without enzymes and with collagenase. LPS binding to the hepatocellular plasma membrane increased proportionally with the LPS concentration in a range between 0.01 and 1.0 mg per ml. The fluorescence pattern of the membrane fixed IgM anti-LPS-antibody at the surface of LPS coated hepatocytes was coarse granular. The in vitro reaction of LPS with hepatocytes was not influenced by the presence of complement. The demonstration of binding sites for LPS on the hepatocellular plasma membrane supports the hypothesis that not only Kupffer cells but also parenchymal liver cells are involved in the hepatic clearance activity for endotoxin.


The effect of salbutamol and propranolol on pentagastrin, histamine and meal-stimulated acid and pepsin secretion in the dog. The beta 2 adrenergic agonist Salbutamol was infused intravenously in doses of 0.05, 0.1 and 0.2 microgram/kg-min in conscious dogs with gastric fistulae. Salbutamol inhibited meal-stimulated acid (measured with intragastric titration) by up to 82%. Salbutamol produced dose-related inhibition of acid stimulated by pentagastrin (up to 88%) and by histamine (up to 52%). Pepsin secretion in response to histamine (but not pentagastrin) was also inhibited by salbutamol. The salbutamol infusion caused a marked tachycardia, an increase in pulse pressure, slight hyperkalaemia and hyperglycaemia. The beta-adrenergic antagonist propranolol augmented pentagastrin-stimulated acid and inhibited meal-stimulated secretion. Propranolol abolished salbutamol - induced tachycardia, and blocked the inhibition by salbutamol of pentagastrin-stimulated acid. Salbutamol inhibition of acid in the dog provides further support for the hypothesis that there are beta 2-adrenergic receptors in the stomach.


Nepresol in the treatment of hypertension of major severity. Fifty patients with arterial hypertension of various causes were treated with a combination consisting of Nepresol, a beta-adrenergic receptor-blocking agent and a diuretic. Duration of treatment ranged between 3 months and 5 years. A significant reduction of blood pressure was attained in all of the cases, with a return of the values to the normal range in a high proportion of the patients. The renal function did not deteriorate during therapy, but owing to potassium loss regular potassium replacement was required in the majority of the cases. Allergic reactions appeared in two cases. Neither SLE nor rheumatoid arthritis was encountered. Positive ANF reaction and a significant elevation of the Rose-Waaler titre were demonstrated in a number of cases. The benefits as well as the hazards of the therapeutic use of hydrazine derivatives are pointed out.


Problems of body structure and size of the hypophysis. The size of the hypophysis, especially of the anterior lobe, is related to body size while the nervous lobe is related to the brain weight. The anterior lobe of the hypophysis in domestic animals is smaller than that of their ancestors in the wild. The proportions of the body, the distribution of bulk, as they appear in different races--whippets and bulldogs--are related to the size of the anterior lobe. Same body weight implies that the anterior lobe is nearly twice as large in animals with a compact body structure. These intraspecific results can also be shown interspecificly by comparing the species of African Bovidae. Independent of the influence of body size, the subfamilies Alcelaphinae and Hippotraginae possess a larger anterior lobe. A tendency can be shown for a relation to body structure as short-legged species living on marshy grounds (Kobus) or soft sands (Addax) have larger anterior lobes.


Clonidine in prophylaxis of migraine.

Clonidine in prophylaxis of migraine. Various drugs have been used in migraine to bring down the frequency of attacks. Recently clonidine hydrochloride, an antihypertensive agent, has been reported to be effective. The mechanism of action of this drug is not clear, but it is thought to act through its effect on tyramine metabolism. A double-blind cross-over trial using clonidine and identical-looking placebo tablets was carried out in 20 patients of migraine. There was no statistically significant difference between clonidine and the placebo in reducing the frequency of attacks, as evaluated by the non-parameteric test of Wilcoxon. No side effects of clonidine were observed.


Pituitary responsiveness to luteinizing hormone-releasing hormone during treatment with subdermal D-norgestrel implants in women. It has previously been reported that subdermal implants containing d-norgestrel inhibit ovulation through blockage of the positive feedback action of estrogen on luteinizing hormone (LH) release. In this study 100 micrograms of LH-releasing hormone (LRH) were injected intravenously to test the pituitary reserve capacity for gonadotrophin secretion in three women with three 40 mg d-norgestrel rods implanted subdermally for more than one year. The gonadotrophin release to LRH varied and seemed related to the ovarian steroid concentrations at the time of the LRH infusion in a manner similar to that seen during the normal menstrual cycle. It is concluded that low plasma levels of d-norgestreol do not inhibit the pituitary responsiveness to LRH. The results indicate that the blocking action of the gestagen on the positive feedback of estradiol on LH release occurs at the hypothalamus or higher CNS centers.


Bacteria beneath composite restorations--a culturing and histobacteriological study. The occurrence, viability and identification of the microbial flora under composite fillings using an anaerobic technique were studied. Class V cavities were prepared on clinically healthy buccal surfaces of 7 contralateral pairs of premolars in children 11--15 years of age. After preparation, rubber dam was applied and one cavity in each pair of teeth was washed with water blasted dry with air and filled with Adaptic. The other cavity was washed with a cavity cleaner (Tubulicid) and a cavity liner (Tubulitec) was applicated prior to filling with Adaptic. The teeth were extracted after 4--6 weeks. Under anerobic conditions the tooth crown was split. From one half samples were taken from the pulpal wall under the filling and cultured on blood agar and in broth medium. The other half was examined with histobacteriological technique. No growth occurred in cultures from lined cavities but in 6 of the 7 unlined cavities. Full agreement was observed between the findings from the culturing and histobacteriological examinations concerning presence or absence of microorganisms at the pulpal wall in all 14 teeth. The flora was mixed. Gram-positive bacteria, mainly Streptococcus and Actinomyces, dominated over gram-negative bacteria including Veillonella, Fusobacterium, Campylobacter and Selenomonas. The composition of the flora was more similar to that observed in dental plaque than that found in carious dentin or in saliva in other studies.


The protrusions from the cervical canal at the scar of a previous cesarean section. By comparing the condition of the cervix at the time of a cesarean section with the findings at subsequent hysterography in 68 patients, it is considered likely that the thickness of the scar depends primarily on the thickness of the lower uterine segment at the time of the section and on the site of the incision. The prognostic significance of these findings is discussed on the basis of a theoretical approach to the development at or near the scar of previous cesarean section.


Bromocriptine treatment of the premenstrual syndrome. Bromocriptine, 2.5 mg twice a day was tested for its effect on premenstrual tension in a random double-blind cross-over trial. 1. The compound tended to lessen the symptoms, especially mastodynia. 2. Serum prolactin levels around the upper limit of the normal range were significantly lowered. Patients with the highest starting prolaction levels had the most severe symptoms and in these patients the fall in the levels was greatest. 3. Serum FSH and LH levels were significantly reciprocally influenced compared with serum prolactin. Serum estradiol-17-beta and progesterone did not change during treatment. 4. The bromocriptine-treated cycles were all ovulatory according to basal temperature levels. The luteal phase was prolonged when serum FSH was raised.


Mixed wife-husband leukocyte migration inhibition test after normal pregnancy. The leukocyte migration inhibition test was performed in mixed wife-husband leukocyte suspensions in 11 cases of normal pregancy. Migration of leukocytes was significantly inhibited in the presence of paternal, as compared to maternal serum.


Corneal transplantation and HLA histocompatibility. A preliminary communication. A series of 222 cases of 7 mm penetrating corneal grafts were analysed with respect to the influence of HLA compatibility. The degree of compatibility was random as no matching was done (HLA types unknown at time of operation). Consequently, most of the cases showed 3 or 4 incompatibilities. The series was divided into seven diagnostic groups (keratoconus, herpetic keratitis, non-herpetic keratitis, stromal dystrophy, endothelial dystrophy, mechanical lesion and corrosion). In all groups there was a tendency towards better results among the compatible transplantation, but only when considering the entire series could statistical significance be demonstrated. The groups of 0--2 incompatibilities showed fewer rejection episodes or opaque grafts than the groups of 3 or 4 incompatibilities (chi 2 = 9.20, P less than 0.005). Comparing only the frequency of opaque grafts among the two groups the correlation was less significant (chi 2 = 3.66, P similar to 0.05).


Anterior segment fluorescein angiography in inflammatory diseases of the cornea. To study the vascular changes in inflammatory diseases of the cornea 22 patients with various corneal inflammations were examined by means of anterior segment fluorescein angiography. Simple avascular central and marginal corneal ulcers stained with fluorescein in the late phase of angiography. An inflamed limbus and an early microscopic pannus adjacent to the ulcer were seeen in simple corneal ulcers. Progressive pannus with pronounced fluorescein leakage was observed in chronic corneal ulcer, disciform keratitis, Mooren's ulcer, and complicated acute keratoconus. In sclerokeratouveitis and in gutter associated with rheumatoid arthritis the corneal vessels showed less leakage. The iris vessels showed fluorescein leakage as a sign of irritative iritis during the active stage of simple and chronic corneal ulcers, in disciform keratitis, Mooren's ulcer, and in graft rejection. It is concluded that anterior segment fluorescein angiography gives valuable information of the vascular architecture, flow and leakage in inflammatory diseases of the cornea.


Effects of corneal preservation, donor age, cadaver time and postoperative period on the graft endothelium. A specular microscopic study. The endothelia of 102 clear human corneal grafts in 95 patients were photographed in vivo with a specular microscope. The endothelial cell densities of the grafts were counted from a area of 0.01 mm2. The follow-up period averaged three years. The patients' ages ranged from 16 to 77 years and that of the donors from 8 to 89 years. The average endothelial cell density for all 102 transplants was 1169 +/- 478 cells/mm2. Corneal transplants stored in MK medium (N = 19) have more cells than cryopreserved grafts (N = 42) or grafts stored in the moist chamber (N = 41); this last group was used as control material. The differences in cell densities were statistically significant. The cell density of cryopreserved grafts was significantly higher than in grafts stored in moist chamber. Only in those grafts in which moist chamber storage had been used was endothelial cell density dependent on time of storage. With an increase in cadaver time (time from death to enucleation), the endothelial cell density of the graft decreased. An inverse correlation was found between the cell density of the graft and donor age. Good results were still found with healthy donors over 60 years. The endothelial cell density of the grafts showed a steady decrease during the long-term post-operative period, the rate of cell loss being much higher in graft endothelium than in normal endothelium during ageing.


The specular microscopic appearance of corneal graft endothelium during an acute rejection episode. A case report. The specular microscopic appearance of a graft endothelium during a successfully treated acute endothelial rejection episode is reported. Coinciding with the increased thickness of the graft great disturbance in cellular morphology was observed. Individual cells were seen to appear swollen or to show bright intracellular areas. Also abnormalities with respect to cellular intersections were seen with the occurrence of junctional complexes at which more than three cells met. The significance of these abnormalities is discussed. The morphological changes subsided gradually as the graft cleared and the thickness decreased. This study examplifies the value of the non-contact specular microscopic technique which enables a thorough study of the diseased corneal endothelium without traumatizing the cornea and interfering with subsequent specular microscopic examinations.


The osteogenic capacity of free periosteal and osteoperiosteal grafts. A comparative study in growing rabbits. The behaviour of free periosteal and 200 micron thick osteoperiosteal grafts was studied histologically in 40 six-week-old rabbits. The grafts were taken from the tibia and fixed on either side of the same lumbar vertebra between the spinous and mamillary processes. The free stripped periosteum had better osteogenic activity than the 200 micron thick osteoperiosteum. The new bone was formed by the osteogenic cells of the cambium layer in both types of graft.


Ketotic hypoglycemia of childhood--a clinical trial of several unifying etiological hypotheses. We have studied 15 children referred to St. Göran's Children's Hospital because of suspected ketotic hypoglycemia. The patients were investigated according to a program designed to test several hypotheses--old and new--postulated to explain the etiology of ketotic hypoglycemia. We have used the classical ketogenic provocation with a low calorie, high fat diet and measured the blood levels of several substrates and hormones as well as the urinary excretion of certain metabolites and hormones. Out of the 15 children, 6 will fill the criteria of ketotic hypoglycemia at the time of study. The most remarkable finding in these 6 children in contrast to the other children studied was that they did not decrease their peripheral glucose utilization (measured as Kg) during starvation. These 6 children seemed to be more "advanced" in their adaptation to ketogenic diet in all other parameters studied. The children with ketotic hypoglycemia did not differ from the other children in plasma level of cortisol or urinary excretion of nitrogen, urea, 3-methylstidine and catecholamines. We favour the concept that the children with ketotic hypoglycemia represent the tail of the gaussian curve in the normal age-dependent development of the adaptation to starvation.


A prospective study of urinary proteins in early infancy. Urinary concentrations of protein, albumin, beta 2-microglobulin, alpha-amino nitrogen, and creatinine were determined in forty-one full-term infants on seven occasions up to six months of age. Except for beta 2-microglobulin the concentrations were highest on the first day, followed by a rapid decrease to a constant level within two weeks. Protein diminished approximately seven-fold, albumin twenty-fold, alpha-amino nitrogen three-fold and creatinine five-fold. By contrast, beta 2-microglobulin, a low molecular weight protein, first increased three-fold between day 1 and day 5, thereafter decreasing slowly 17-fold during the first three months of age. The data indicate that different kidney functions mature asynchronously.


Umbilical artery catheterization in newborns. II. Infections in relation to catheterization. Infections, as a complication of umbilical artery catheterization, were studied in 65 sick newborn infants. Every second day during the catheterization period peripheral blood cultures as well as blood samples for white cell count and platelets were taken. Cultures were taken from the catheter tips and from the umbilicus at the time of withdrawal of the catheter. Local or systemic antibiotics were not used prophylactically, but on rather broad clinical indications. No case of septicemia was found, but 8 infants had positive blood cultures and 16 had positive catheter tip cultures. Positive catheter tip culture occurred more often in infants who were born before 32 weeks of gestational age. Neither the duration of the catheterization nor the treatment with antibiotics influenced significantly the frequency of positive cultures.


Gastric emptying in preterm infants.

Gastric emptying in preterm infants. The gastric emptying of meals of human milk and infant formula was studied in 11 healthy preterm (AGA) infants at a postnatal age of 1-9 weeks corresponding to 33-38 weeks of gestational age. A total of 30 studies were performing using a marker dilution technique. Gastric emptying of meals of human milk followed a biphasic emptying pattern with an initial fast phase. In about 25 min half of the meal had left the stomach. The emptying of meals of adapted infant formula usually followed a linear pattern and half the meal had left the stomach after 51 min. After one hour an average of 24.8 ml of human milk and 19.2 ml of infant formula had left the stomach.


Glomerular immune deposits in kidneys from patients with no clinical or light microscopic evidence of glomerulonephritis. Assessment of the influence of autolysis on identification of immunoglobulins and complement. Using a direct fluorescent staining technique, immunofluorescent microscopy (IFM) demonstrated glomerular deposits of IgG and IgM and/or fractions of complement in kidney tissue from 24% of 33 patients examined post mortem and in 39% of kidney biopsies obtained from 23 patients on lithium treatment. All the patients investigated had a normal blood pressure. There was no evidence of glomerulonephritis (GN) neither clinically, at light microscopy, nor on laboratory investigation. These "spontaneously" deposited immunoglobulins and complement fractions in glomeruli will obviously by demonstrated in kidney biopsies from patients with GN, even though they bear no relation to the disease. This will therefore preclude an immunopathological classification which relates to histological and clinical findings. A control study of the IFM findings in glomeruli on 13 surgically removed kidneys showed optimal identification and no further glomerular deposition of immunoglobulins during the 72 hours following nephrectomy, at temperatures below 10 degrees C. Clq and C3 were less stable and were only demonstrated with certainty up to 24 hours after nephrectomy.


Immune deposits in human glomerulopathy. Fluorescent microscopy findings in 366 kidney biopsies correlated to symptoms, clinical course and immunosuppressive therapy. 366 kidney biopsies from 339 patients, 290 of which were classified on combined light microscopy (LM) and clinical criteria as glomerulonephritis (GN) and 49 as non-glomerulonephritis nephropathy, were examined by immunofluorescent microscopy (IFM) without knowledge of the clinical or LM findings at the time of examination. The IFM findings in the glomeruli were correlated to (l) the LM diagnosis, (2) the clinical symptoms, (3) the clinical course, and (4) the effect of immunosuppressive treatment. A few IFM results were found to correlate significantly with the LM diagnosis and clinical symptoms, but not to the effect of immunosuppressive treatment. It was impossible using IFM alone to group patients into any specific categories with uniform symptomatology and prognosis. Defined by IFM "immune complex nephritis" was demonstrated in 72%, and linear nephritis was found in 2% of the patients with GN. IgA occurred more frequently in GN secondary to systemic disease, particularly in SLE (60%) and HSP (88%). IgA was demonstrated in only 10% of patients with nonglomerulonephritic nephropathy. Demonstration of IgA is therefore a good indicator for corroborating the LM diagnoses of GN. Demonstration of IgG and/or IgM in GN was not found to be sufficient evidence for GN because these deposits also appeared in 40% of patients with non-glomerulonephritic nephropathy. An immunopathological classification based solely on glomerular deposits of immunoglobulin/C3 appears to have no practical importance. The demonstration of glomerular deposits of immunoglobulin/C3, however, showed to be a necessary supplement to clinical and morphological findings in some instances, in order to attain practical diagnostic boundaries within the very ill-defined concept which today constitutes GN.


Hepatic changes in late canine endotoxin shock. A light and electron microscopic investigation. The patho-morphological lesions in the liver in late stages of canine endotoxin shock were studied by light and electron microscopy. Light microscopic lesions included sinusoidal dilatations, with accumulation of red cells and leucocytes, varying damage of the sinusoidal lining, microthrombi and widening of the space of Disse. Necrotic foci were in some cases recognized within a varying number of lobuli, at times in the centrilobular areas. Electron microscopy revealed severe hepatocytic damage. These lesions included formation of blebs and other surface protrusions corresponding to cytoplasmic ecdysis. The resulting cytoplasmic fragments seemed frequently to enter the sinusoids. It is suggested that the severe disturbances observed in the proteolytic enzyme systems of plasma during endotoxin shock are influenced by the hepatic parenchymal changes observed.


Mitotic activity and delay in fixation of tumour tissue. The influence of delay in fixation on mitotic activity of a human osteogenic sarcoma grown in athymic nude mice. The purpose of the present investigation was to study the effect of delay in fixation on the mitotic activity in tumour tissue. A human osteogenic sarcoma, especially suitable for counting of mitoses, grown in athymic nude mice, was fixed with varying delay and the mitotic, prophase, metaphase and ana-telophase indices were determined. An almost exponential decline of the mitotic index was observed with a reduction to 49.4% and 15.0% after respectively 60 and 180 minutes. The proportional incidence of prophases, metaphases and ana-telophases changed so that a relative accummulation of advanced phases occured during the 180 minutes of observation. It is concluded that delay in fixation of a magnitude, which is not uncommon in routine surgical pathology, may allow the majority of mitoses to terminate, resulting in unreliable assessments of mitotic activity.


Rapid identification of Enterobacteriaceae. II. Use of a beta-glucuronidase detecting agar medium (PGUA agar) for the identification of E. coli in primary cultures of urine samples. beta-glucuronidase activity is an exclusive characteristic of E. Coli and some shigellae among Enterobacteriaceae and Vibrionaceae. An agar medium (PGUA agar) which permits the detection of bacteria with beta-glucuronidase activity in mixed cultures was evaluated as a primary culture medium for clinical samples of urine. The medium was selective for enterobacteria and yielded significantly higher recoveries than MacConkey agar. Based on the examination of 3,460 urine samples, it was found that the use of the PGUA agar has several advantages over conventional methods: 1) 94% of all E. coli cultures could be identified on the basis of their appearance on the primary plates; 2) The use of the PGUA method did not result in any misidentidications as compared to 1% of cultured misidentified by the conventional procedure; 3) Approximately one-half of the urine samples which contained E. coli as the sole organism could be reported following the reading of primary culture plates; 4) The application of the PGUA medium resulted in a 46% reduction in the cost of media employed and a 67% reduction in the time required for the processing of urine samples.


Group L streptococci as the cause of bacteraemia and endocarditis. A case report. A beta-haemolytic streptococcus was isolated from multiple blood cultures in a 56-year-old woman suffering from thrombophlebitis in a leg and from a 42-year-old man with endocarditis. Both strains were identified as group L streptococci by precipitation testing. Initially they were identified as group A streptococci on the basis of cultural characteristics, bacitracin sensitivity and fluorescent staining with an anti-group A conjugate. The two cases are an addition to the few existing reports on proved infection in humans by group L streptococci.


Acute and subacute effects of diazepam on psychomotor skills: interaction with alcohol. Effects of diazepam and alcohol on psychomotor skills were measured in two trials. In the first one, 200 healthy students volunteered for a double-blind single-dose study. Three doses of diazepam (5, 10 and 20 mg) and alcohol (0.5, 0.8 and 1.2 g/kg) were used alone and combined to construct dose-response graphs. All doses of alcohol impaired divided attention while co-ordinative skills were impaired by the 1.2 g/kg dose. Diazepam alone did not impair reactive or co-ordinative skills whereas the combinations of diazepam and alcohol did so. To further elucidate the subactue effects, a double-blind randomized study was conducted administering 2 and 10 mg of diazepam t.i.d. for two weeks to 18 healthy volunteers. The psychomotor tests were performed on the 7th and 14th days of drug administration, and 0.5 g/kg of alcohol was given on either day. Diazepam 2 mg, alone or with alcohol, did not differ from placebo. 10 mg of diazepam slightly increased reaction times but not reaction mistakes, and impaired both co-ordination and attention. Alcohol did not enhance diazepam effects. We suggest that a development of tolerance to diazepam may compensate the deleterious interaction of the agents found in acute studies.


Postoperative deep vein thrombosis of the lower limb and prophylactic value of heparin evaluated by phlebography. The incidence of postoperative thrombosis of the leg at phlebography, and the prophylactic effect of low-dose heparin, was assessed in a double-blind investigation comprising 50 patients. Thrombosis occurred in 17 per cent in the heparin group and in 23 per cent in the placebo group. This difference is not significant. No prophylactic effect of low-dose heparin was demonstrated.


Early effects in kidney enzyme activities after irradiation. Brush border enzymes of proximal tubules, lysosomal activities and protein content of rat kidney were analysed after whole-body irradiation using two different experimental schedules. Maltase, alkaline phosphatase and beta-glucuronidase activities increased moderately during the first days after irradiation, whereas LAP, cathespsin D activities and protein content were not modified. No evident morphologic alterations were observed.


Effect of plasma free fatty acid lowering on exercise tolerance and ST segment depression in patients with angina pectoris. The effect of a single oral dose of a plasma FFA-lowering drug (5-(3-pyridyl) tetrazole), which does not act by conversion into nicotinic acid, on exercise tolerance and ECG reaction was studied on a double-blind basis in 15 men with stable angina pectoris. Exercise was performed on a bicycle ergometer in the sitting position with a load increase of 10 W/min. In addition to ECG, time to onset of chest pains and to termination of exercise because of strong chest pains was recorded. 5-(3-pyridyl) tetrazole decreased plasma FFA during exercise from 523 to 299 mumol/l. It reduced significantly the ST depression at corresponding work loads and permitted the patients to exercise 0.6 min longer, corresponding to a 7% higher work load, before the onset of chest pain. However, absolute exercise time was not significantly increased. The most probable explanation of the improved performance is a decreased lipid and increased carbohydrate oxidation by the ischemic heart, although a contribution may have come from hemodynamic effects of the drug, unrelated to effects on myocardial metabolism but perhaps involving heart rate and BP. The lack of a significant effect on performance time may have been due to general fatigue.


Miliary tuberculosis.

Miliary tuberculosis. Twenty-six cases of miliary tuberculosis were studied in retrospect. The mean age of the patients was 62 years. Eighteen patients suffered from another underlying chronic disease. Nine had been treated with corticosteroids or cytotoxic agents. A limited manifestation of tuberculosis had been previously verified or suspected in ten cases. Fever was present in 85% of the patients, frequently combined with fatigue or abdominal pain. Serum alkaline phosphatase was elevated in 81% of the cases. Minor haematological abnormalities (anaemia, etc.) were found in 16 cases and pancytopenia, stimulated lymphocytes or chronic myeloid leucaemia in six. Miliary mottling was found in the chest radiographs of 13 patients. Other findings were pleural effusion, mediastinal node enlargement, opacities suggesting pneumonia or old, possibly tuberculous lesions. Antituberculosis therapy was initiated in 12 patients, two of whom died within a few days. There was a high frequency of liver or system involvements. It is concluded that laparoscopy or liver needle biopsy are valuable diagnostic procedures in patients with fever and elevated alkaline phosphatases of unknown aetiology. A therapeutic test with antituberculous drugs should be undertaken in suspected cases.


Penicillamine in rheumatoid arthritis.

Penicillamine in rheumatoid arthritis. Perhaps the most important conclusion is that much remains to be learnt about how to use penicillamine in clinical practice. The results described have been obtained by observing groups of patients on various fixed schedules of dosage. There may be a case for using a more flexible system but this makes comparisons difficult and at this stage predetermined fixed schedules have been preferred. A total daily dose of 1500 mg is clearly excessive and probably unnecessary. There is some suggestion that administration between meals produces better and perhaps more predictable absorption. If used in this way the total daily dose should be lower than the one found most suitable when the drug is given with food. Experience to date favours a daily total of 375 mg given between meals. The late onset of some adverse reactions in patients on low doses suggest that the total cumulative dose may be relevant and that some toxic reactions are liable to occur when a certain total intake has been reached. No mention has been made in this survey of comparisons with other drugs. The main task has been seen to be the exploration of various dosage schedules in the hope of finding an effective dose which does not produce a high incidence of adverse effect. Only when this information has been obtained will it once again become relevant to test the drug under control conditions either against an inactive placebo or some other anti-rheumatoid drug.


Drug therapy reviews: evaluation of butorphanol tartrate. The chemistry, pharmacology, uses, side effects, pharmacokinetics and dosage of butorphanol tartrate, a narcotic analgesic with antagonist properties, are reviewed. When administered intramuscularly or intravenously, butorphanol tartrate appears to be as effective for relieving moderate to severe pain as are pentazocine, meperidine and morphine. Butorphanol produces sedation more commonly and, at therapeutic dosages, depresses respiration as much as these other narcotic analgesics. A limited number of long-term clinical studies suggest a lower physical dependence liability with butorphanol than with other narcotic analgesics. Butorphanol is more expensive than morphine and, for most patients, offers no significant advantages over morphine for short-term use. Because butorphanol's cardiovascular effects are not completely understood, morphine also remains the drug of choice for pain associated with myocardial infarction.


Multiple-baseline design in instructional research: pitfalls of measurement and procedural advantages. The multiple-baseline design has utility for evaluating the instructional programs used with mentally retarded persons; however, there are several pitfalls of measurement that may be encountered in using this design. Subjects' performance may be inadvertently altered by (a) repeated testing during baseline, (b) a procedural contrast between training and testing, and (c) inaccurate generalization during testing. Procedures to mitigate the effects of these problems were recommended. The pitfalls may arise in part because of the direct interpersonal nature of measuring the dependent variable in instructional research. Also, the pitfalls are not inherent in the multiple-baseline design per se but are issues of measurement that may occur in other designs as well. Finally, the advantage of using the multiple-baseline design to study covariation of responding was highlighted.


Additional comments on multiple-baseline designs in instructional research. A number of measurement and design issues that are critical to the use of multiple-baseline procedures in evaluating instructional interventions were highlighted. First, issues related to the interaction between length of baseline assessment and the following outcomes were presented: (a) deceleration in behavior across baseline, (b) prediction of behavior change, (c) error analyses performance on instructional stimuli, and (d) reactivity of observation. Finally, an attempt was made to match the variety of multiple-baseline designs to specific questions often asked by instructional researchers.


Early and Periodic Screening, Diagnosis, and Treatment Program. Preventive health care for children can have a significant impact on detecting and treating potential health problems. The Early and periodic screening, diagnosis, and Treatment Program (EPSDT) is a preventive health program under Medicaid designed to improve the health of indigent children. Since this program is the only federal Medicaid program which requires vision screening and treatment services, the opportunity exists for enormous benefits for detecting and treating an indigent child's vision problems, as well as general health problems. Even though the program has been slow in evolving, it is taking an expanding role in all phases of indigent child health care, including vision care.


The application of the sepharose bead immunofluorescence test for the detection of allergen-specific IgE and IgG antibodies in pollinosis. A new application of the Sepharose bead immunofluorescence test for detection of allergen-specific IgE and IgG antibodies is described. Allergen extracts of four different grass pollens were coupled to CNBr-activated Sepharose 4B. Twenty normal and allergic sera were incubated with the allergen-coupled beads, washed and incubated with fluorescence-conjugated anti-gamma E and G globulins. After washing and staining with 0.5% trypan blue, the percentage of fluorescent beads was detected by fluorescence microscopy. In the IgG/anti IgG system, the smallest amount of IgG demonstrated was 20ng/ml; in the IgE/anti-IgE system it was 40ng/ml. Independent examination of tests gave a mean difference between observations of 4.1%. Reproducibility was also very good (var. coeff = 18%). The number of beads stained with IgE correlated well with intensity of skin reactions to the same extracts (r = 0.64; p = 5 x 10-7), the percentage of IgG stained beads being independent of skin reactivity. The Sepharose-IgE test allowed clear distinction between allergic and normal sera (p = 4 x 10-7), while the Sepharose IgG test did not distinguish between them at the time of diagnosis. However, the number of beads stained with IgG significantly increased in patients undergoing immunotherapy (p = 3.8 x 10-3). The Sepharose bead immunofluorescence test requires a very small amount of materials, is highly sensitive and easy to handle. It may be valuable in the "in vitro" diagnosis of grass pollen allergy and useful in evaluating immunotherapy.


Premalignant tumors and conditions of bone. Most bone sarcomas arise in apparently normal bone. However, some sarcomas arise in preexisting benign bone tumors or in nonneoplastic conditions. Some of the lesions, such as multiple exostoses and Ollier's disease, have a propensity to develop chondrosarcoma. Rarely does a benign giant cell tumor become malignant without prior irradiation, malignant transformation of other benign tumors, such as osteoblastoma and chondroblastoma, is a medical curiosity. Among nonneoplastic conditions, radiation changes, long-standing chronic osteomyelitis, and Paget's disease have definite premalignant connotations. However, the risk of developing cancer in these conditions is still low.


Laryngeal paraganglioma. Case report with ultrastructural analysis and literature review. Laryngeal paraganglioma is an infrequently reported tumor; only 16 examples have been recorded in the English literature. All but one laryngeal paraganglioma originated superiorly in the larynx; involvement of the ipsilateral aryepiglottic fold is common. Male patients predominate (11:5). The average age of patients at the time of diagnosis was 47 years, and symptoms had been present for an average duration of 5.8 years (range 6 months to 27 years). Attempted biopsy has resulted in significant hemorrhage in three cases. As illustrated by the present case, the Grimelius argyrophil stain is a useful diagnostic procedure. Electron microscopy confirmed the presence of neurosecretory granules with core diameters ranging from 110 to 140 nm. Surgical resection is the preferred treatment and has been possible in 14 cases; nine patients are alive and free of tumor for an average of 3 years. Compared to other head and neck paragangliomas, these have a more malignant course with a 25% mortality; tender subcutaneous metastases are commonly observed in these patients.


Syphilitic lymphadenitis: immunofluorescent identification of spirochetes from imprints. We are reporting two cases of early syphilis with inguinal buboes which were surgically excised. Th clinical impression was lymphoma in one case and inguinal hernia in the other. The correct and specific diagnosis was quickly established by the application of fluorescent antibody technique to imprints of the enlarged lymph node.


The Oxford Training Scheme in Anaesthesia and other matters. The Faculty of Anaesthetists of the Royal College of Surgeons of England has made proposals on the training of anaesthetists. These proposals have been implemented by the Nuffield Department of Anaesthetics of the University of Oxford. The General Professional Training scheme was established in 1972 and is briefly described. Some of the results and the fate of those who joined as trainees are presented. Some conclusions are drawn.


[Perfluorochemical-emulsion (fluorocarbon-43) as blood gas carrier--fate of the substance after intravenous injection in rat (author's transl)]. The present paper concerns light and electron microscopic studies on cellular uptake and deposition of the oxygen and carbondioxide carrying substance "Fluorocarbon-43" after intravenous injection in rats. Phagocytosis of "Fluorocarbon-43" by blood monocytes, histiocytes, endothelial macrophages (i.e.v. Kupffersche cells) and hepatocytes as well, could be demonstrated. In our experiments cellular storage of the substance was detectable even six month after injection. In the lumina and walls of alveoli migrating macrophages with storage vacuoles were found indicating pulmonary excretion of the substance. Maximum storage of "Fluorocarbon-43" caused cellular alterations and may induce interstitial fibrosis. The question whether long term incorporation of "Fluorocarbon-43" causes irreversible alteration of organs is still a matter of conjecture because of the prolonged half-live value of storage of this substance.


[Plasma catecholamines in open heart surgery and abdominal operations using a combined electrical stimulation analgesia (author's transl)]. Changes of plasma catecholamines during surgery performed in the presence of a combined electrical stimulation analgesia were studied in 11 patients undergoing open heart surgery and in 5 patients undergoing abdominal operations. Stimulation was applied through 2 needles attached subcutaneously to each ear. In 8 of the 11 patients undergoing open heart surgery an up to 20 fold increase in the level of adrenaline in plasma was observed intraoperatively indicating a massive activation of the adrenal medulla. Adrenaline remained elevated also in the postoperative period. The level of noradrenaline did not increase either during the intra- or during the postoperative period. In contrast no changes in adrenaline or noradrenaline could be demonstrated in the remaining 3 patients in whom the concentration of the catecholamines was in the lower normal range. In 5 patients with abdominal surgery noradrenaline was elevated additionally to the increase of adrenaline in the intra- and postoperative period. The increase in the activity of the sympathetic nervous system was associated in these patients with an increase in heart rate and systolic as well as diastolic blood pressure. On the basis of these results the use of a combined electrical stimulation analgesia for abdominal surgery in patients at risk and for open heart surgery is questioned.


Neonatal tetanus.

Neonatal tetanus. Forty-eight babies were treated for neonatal tetanus and there were ten deaths. Twenty-seven patients were treated with neuromuscular blockade, nasotracheal intubation and intermittent positive pressure ventilation. In this group there were five deaths and three of these were the direct or indirect result of respiratory complications. A management regime for neonatal tetanus is outlined and the complications are discussed.


Hormones and the lung. II. Immunohistochemical localization of thyroid hormone binding in type II pulmonary epithelial cells clonally-derived from adult rat lung. The type II pulmonary epithelial cell is the recognized state of surfactant synthesis and storage. Results of recent studies indicate that the thyroid hormones, triiodothyronine (T3) and thyroxine (T4), may be important regulators of surfactant production and/or release. Direct and indirect immunofluorescence techniques were used in an attempt to demonstrate binding of T3 and T4 in monolayer cultures of isolated type II cells. These cultured epithelial cells are clonally-derived from adult rat lung, retain a diploid karyotype through 35 population doublings in vitro, contain granular inclusions (lamellar bodies) in the perinuclear cytoplasm, and synthesize phosphatidylcholine via the CDP-choline pathway. In isolated type II cells, either of two fluorescent patterns was observed: (a) nuclear fluorescence accompanied by a reticular perinuclear network; or (b) diffuse cytoplasmic accumulations with concentrations around perinculear cytoplasmic inclusions. Ultrastructurally these inclusions had the typical appearance of lamellar bodies. Histochemical studies demonstrated that these inclusions contained surfactant-associated nonspecific esterases and stained with Nile blized markers for pulmonary surfactant indicate that these inclusions are indeed lamellar bodies, the putative sites of surfactant synthesis and/or storage. These findings suggest that the type II pulmonary epithelial cell contains specific binding sites for thyroid hormones, and support the hypothesis that thyroid hormones are regulators of surfactant metabolism.


Morphology of the atrioventricular node, bundle and proximal bundle branches: a study employing computerized reconstruction. The morphology of the human atrioventricular node, atrioventricular bundle and bundle branches is described. A block of tissue bounded by the ostium of the coronary sinus, the pars membranacea, the septal leaflet of the tricuspid valve and the atrial and ventricular septa is removed. The block is then sectioned serially from the right endocardial surface in the frontal plane of the heart. Sectioning in this way produces fewer sections than from techniques previously described. Outlines of the atrioventricular node, atrioventricular bundle and proximal bundle branches are digitally registered and stored in a computer. Three dimensional reconstructions of the structures are then generated by computer and displayed on an oscilloscope so that the entire three dimensional image can be rotated in any plane. Stereoscopic image pairs are produced to assist perception of the shape of the atrioventricular node, bundle and branching patterns of the bundles. This technique is unique in that it describes a method from which a relatively small number of histologic sections are generated permitting not only a complete histologic examination, but also a study of the morphology of the area.


[Leukocyte migration. Clinical study (author's transl)]. The authors present a new method to study leukocyte migration with a skin window. The method uses a new leukocyte migration P. L. chamber. The technical is applied on witness population to release a reference scale of values.


[Hemostatic effects of the argon laser on the gastric wall of the dog. II. Effects of the laser on 53 hemorrhagic ulcers of the gastric mucosa]. The authors made a histopathological study of 53 haemorrhagic ulcers of the gastric mucosa of the dog, photocoagulated using an Argon laser apparatus (delivering a power of 6 watts at the tip of the fibre). Haemostasis was obtained in less than 10 sec. in all cases where photocoagulation was performed by small applications of 1.5 sec. to the edges of the ulcer. There were no cases of perforation or muscularis damage. Healing of the lesions was complete or well under way at 15 days.


[Practical immunocytochemistry of the endocrine pancreas]. Complementing cytochemical and ultrastructural studies, immunocytochemistry may be used to define, in terms of immunoreactivity, the nature of the polypeptide(s) made and stored in the cells of the endocrine pancreas, islet or otherwise. Immunoserums are applied to histological sections after fixation of the material in Bouin's fluid, and in accordance with four protocols: indirect immunofluorescence, immuno-enzymatic technique, variants in prolonged primary incubation and the method of soluble peroxidase-antiperoxidase complexes. Certain precautions are essential for correct interpretation. In the adult, four essential immunoreactions, corresponding to hormones or "local hormones" are regularly detected:insulin, pancreatic glucagon, somatostatin, pancreatic polypeptide. The cytochemical and ultrastructural characteristics of the cells involved are known (B, A and D cells for the first three specificities). C-peptide immunoreactivity is easily identified, but other immunoreactivities are more irregular or contested: gastrin, cholecystokinin, vasoactive intestinal peptide, ACTH, met-enkephalin.


[Interest of stimultaneous determination of antistreptolysins and antideoxyribonuclease B in streptococcal infections (author's transl)]. The determination of antistreptolysin O (ASLO) and antideoxyribonuclease B (ADNase B) was carried out on a sample of 199 sera from normal subjects and on a sample of 4019 sera from patients admitted to the Strasbourg University Hospital Center. The sera of hospital origin were divided into two groups. The first group (n = 3889) consisted of sera taken at random, the second group (n = 130) corresponded to patients in whom we isolated a streptococcus of group A. The results obtained show that the distribution of ADNase B and ASLO of normal subjects follow a logarithmic distribution. The geometric averages of the titres DNAase B and ASLO of normal sera and of the first group of hospital origin are scarcely different, whereas the geometrical means of the titres of the second group of sera of hospital origin are quite different and two or three dilutions higher. We noted that the titres of DNAase B and ASLO were in agreement in 84% of cases in the whole group of hospital sera. Among the cases of discrepancy, the negative ASLO and the positive DNAase B corresponded mainly to streptococcal infections.


Enterotoxigenic colibacillosis in colostrum-fed calves: pathologic changes. Enterotoxigenic colibacillosis was experimentally produced in 8 of 9 colostrum-fed calves orally given 10(11) Escherichia coli. The eight calves developed profuse diarrhea accompanied by dehydration and depression. At 12 hours after exposure, all calves were euthanatized for necropsy and for collection of tissues for microscopic examination. Histopathologic changes included stunted villi in the jejunum and ileum, focal degeneration and exfoliation of absorptive epithelial cells at the tips of jejunal and ileal villi, and focal emigration of neutrophils which was especially prominent above the dome area of aggregated lymphatic follicles (Peyer's patches). A layer of E coli adhered to the epithelial surface of the jejunum and ileum. In the duodenum, lesions were minimal or absent and bacteria were not adhering to the mucosa. Histopathologic changes were not observed in other tissues. In two calves examined 24 hours after they were inoculated and in two calves euthanatized 24 to 36 hours after spontaneously developing enteric colibacillosis, lesions were similar to those observed in the calves at 12 hours after exposure.


Exposure of rabbits to spores of Aspergillus fumigatus or Penicillium sp: survival of fungi and microscopic changes in the respiratory and gastrointestinal tracts. Rabbits were exposed to spores of Aspergillus fumigatus by 1 of 2 routes: exposure to aerosols of dry spores or introduction of liquid suspensions of spores directly into the stomach. Rabbits also were exposed to aerosols containing spores of a Penicillium sp. Cultural and microscopic examinations of tissues from the respiratory and gastrointestinal tracts indicated fungi were distributed throughout the gastrointestinal tract of the rabbits within 1 hour after exposure to aerosols of A fumigatus or Penicillum spores. Viable A fumigatus and Penicillium were detected in lung tissues of rabbits for 2 or 3 weeks after inhalation of spores. Aspergillus fumigatus was isolated from the gastrointestinal tract no more than 1 week after aerosol exposure, and Penicillium, not beyond 48 hours. However, when large numbers of A fumigatus spores were introduced directly into the stomach, fungi were isolated from tissues for as long as 16 days after exposure even though the intestinal contents were negative 4 to 7 days after introduction of spores. Tests for precipitating antibody were negative, with one exception, among 26 rabbits surviving for 2 weeks or more. Microscopic changes were more pronounced in rabbits exposed to spores of A fumigatus than in rabbits exposed to Penicillium spores.


Effect of long-term tetracycline exposure (drinking water additive) on antibiotic-resistance of aerobic gram-negative intestinal flora of rats. A study was undertaken to determine the effect of 2 years of intermittent administration of tetracycline in drinking water on antibiotic resistance in the aerobic gram-negative enterobacteria of rats in a closed colony. The bacterial isolates examined were resistant to tetracycline and streptomycin. Minimal inhibitory concentrations of tetracycline and streptomycin for intestinal organisms were similar in all of the animals, regardless of whether the animals were sampled while they were given drinking water with added tetracycline or at intervals of 3, 8, and 9 months after the antibiotic was no longer added to the drinking water. Biochemical examination of the isolates from each principal showed that Escherichia coli was the predominant enteric organism. In conjugation experiments, all E coli and Klebsiella pneumoniae isolated transferred tetracycline and streptomycin resistance to an E coli K-12 recipient. Four different strains of rats that had not been treated with tetracycline (controls) were examined for tetracycline resistance. Tetracycline-resistant Proteus mirabilis was isolated from the intestines of these animals. Plasmid-mediated resistance could not be demonstrated. The E coli and P vulgaris isolates from these control animals were susceptible to tetracycline.


Bovine salmonellosis: experimental production and characterization of the disease in calves, using oral challenge with Salmonella typhimurium. A highly virulent strain of Salmonella tyhimurium was given orally to produce disease experimentally in 21 normal colostrum-fed calves 3 to 9 weeks old. The challenge inoculum varied from 10(4) to 10(11) organisms. The disease was characterized by fever, depressed attitude, and decreased appetite. Many calves given larger challenge dose levels also had diarrheic feces containing mucus, fibrin, and blood. Fecal cultures were positive for salmonella. Septicemia occurred in some calves (9 of 15 calves cultured were positive). Eleven calves died and 10 calves survived challenge exposure. Survival was inversely related to the size of the challenge inoculum and directly related (although to a lesser degree) to age of the calf. White blood cell total and differential counts were variable. Both neutropenia and neutrophilia were observed. Plasma proteins decreased markedly in calves with diarrhea, probably indicating fecal protein loss. Fibrinogen increased during the acute stages of diarrhea.


A study of Klebsiella pneumoniae infection in the uterus of the mare. Two experiments incorporating 13 mares were conducted for the purpose of producing and monitoring intrauterine infection with Klebsiella pneumoniae. In the pilot study, the infection was produced with strains of K pneumoniae type 68 and type 10 isolated from the genital tract of stallions with a history of breeding problems. In the principal study, K pneumoniae type 68 was used to produce the infection. Tampons and guarded culture swabs were used to obtain uterine samples in the pilot study. In comparing the efficacies of isolation of K pneumoniae with the tampons and isolation with standard guarded culture swab, the tampon proved to be a more reliable means with which to isolate K pneumoniae and was used in the principal study. In both studies, inoculated mares became infected and remained infected at least until the postinoculation estrous cycle was initiated or was completed. Some of the inoculated mares remained infected through more than one estrous cycle. The numbers of K pneumoniae decreased in the uterus of mares after completing the estrous cycle after inoculation. Klebsiella pneumoniae was not demonstrable in frozen tissue sections of uterine biopsy specimens stained by fluorescent antibody technique. Postinoculation sera antibody titers to K pneumoniae, as determined, using the capsule swelling technique, were no higher than 1:8.


In vivo and in vitro responses of cats sensitized with viable Mycobacterium bovis (BCG). Cats were injected subcutaneously with viable Mycobacterium bovis (BCG), and immune responses were evaluated at various times after injection. The BCG injection produced fever, leukocytosis, neutrophilia, and lymphadenopathy of regional lymph nodes. Intradermal tuberculin injection produced responses consistent with delayed type hypersensitivity reaction in the treated cats at postinoculation day 21. Skin responses to tuberculin were not significant at postinoculation day 49. The cellular infiltrate at the tuberculin injection site at 48 hours after injection was an admixture of polymorphonuclear cells and mononuclear cells. The BCG produces strong intradermal skin responses in the cat, but the response was not long-lived as in cattle and guinea pigs. The BCG injection did not produce significant changes in the absolute total lymphocyte and absolute T-lymphocyte numbers in peripheral blood. The percentage of T-lymphocytes was significantly higher in the BCG-treated group. Differences were not observed in lymphocyte blastogenesis with tuberculin and non-specific mitogens between BCG-treated and control cats.


Studies on the pathogenesis of Escherichia coli in the bursa of Fabricius (cloacal bursa) of the turkey. Turkey poults were inoculated with avirulent or virulent strains of Escherichia coli by direct application to anal lips and were killed at postinoculation hours (PIH) 0.1, 2, 5, 10, 24, 48, 72, and 96. Bursae of Fabricius (cloacal bursae) were collected, cultured, and examined by light, fluorescent, and electron microscopy. The virulent strain of E coli was not recovered from the bursae after PIH 24, although the avirulent strain was recovered up to PIH 96. The E coli strains neither localized at nor associated with the bursal fold epithelium, passed through the follicular pad epithelium, nor caused cytopathologic changes in the lymphoid follicle. A mild catarrhal bursitis was observed at PIH 48 with the avirulent strain of E coli.


Vaccination of the dam by the intramuscular or deep subcutaneous route to prevent neonatal calf enteric colibacillosis. Comparison of colostrum-induced immunities in calves was made by challenge exposure with Escherichia coli. These calves were delivered of cows which were vaccinated intramuscularly or deep subcutaneously (in the region of the mammary lymph nodes) with strain B44 E coli bacterin during the last trimester of pregnancy. The calf of each cow was allowed to nurse colostrum naturally after birth. Cows vaccinated by either route of administration were capable of providing increased resistance to their calves, via the colostrum, when compared with nonvaccinated cows.


[Repair after circular pharyngo-laryngectomy with deltopectoral flap (author's transl)]. Eleven patients with advanced tumors of eso-pharyngeal area were treated by circular eso-pharyngo-laryngectomy with repair of pharyngo-esophageal continuity by deltopectoral flap (V. Y. Bakamjian). Surgical procedures are described and results presented. Advantages and failures, compared with others techniques, have allowed us to recommend the use of deltopectoral flap, especially when the tumor remains located in hypopharyngeal region and doesn't exceed one cm below the eso-pharyngeal ring.


[Aberrant course of the intrapetrous internal carotid in the eardrum. Analysis of a personal case. Review of the literature (author's transl)]. A new case of aberrant course of the internal carotid artery in the eardrum described, with the particular features of being associated with progressive chronic otitis and a picture of multiple malformations. Diagnosis of the abnormality of the course and its topographical limits, using tomography and angiography, led to a successful antroatticotomy. On the basis of a review of the literature, the authors describe the main criteria of the clinical and radiological diagnosis and present the current pathogenic theories of the mechanism of this congenital abnormality.


The influence of BCG vaccination on murine leprosy in C57BL/6 and C3H mice. Cross-reactivity between Mycobacterium lepraemurium (MLM) and BCG vaccine was found and evaluated in vivo, in C57BL/6 mice, in terms of delayed-type hypersensitivity, local granulomatous response at the injected site and limitation of growth of the challenge inoculum in the draining node. Cross-reactive specific protection and local reactivities were transferred in syngeneic normal recipients by means of non-adherent lymphoid cells from immune donors. When BCG vaccine was injected either intravenously or subcutaneously in C57BL/6 and in C3H mice, it was able to induce resistance to local infection with living MLM in both strains, but no alteration of the local granulomatous reaction (equivalent to local specific immune response) was observed in C3H mice, as compared to the control. When mice were immunized with one or two injections of heat-killed MLM after the immunomodulating effect of BCG vaccination, better immunization was not achieved. In order to test the presence of strain-related immunosuppressive mechanisms, mice were cyclophosphamide-treated during the immunization process. As expected, higher specific DTH reactions were obtained in both strains, but with only a slight increase of the protective mechanism. Protection was always higher in C57BL/6 than in C3H mice. The specific and non-specific immune responses to BCG vaccine were then evaluated in both strains with different parameters: in vivo lymphoproliferative response in the draining node, delayed local granulomatous reaction at the injected site after a subcutaneous injection, increase in spleen index, kinetics of the immunopotentiation to a thymus-dependent antigen (sheep red blood cells) after a single intravenous injection of BCG. A striking interstrain difference was observed; C57BL/6 mice were able to mount a more rapid and marked immune response as compared to C3H mice (which only developed a delayed and slight response). Moreover, these differences were associated with the fact that BCG did not seem to multiply properly in C3H mice during the first two weeks after inoculation. Thus, it was concluded that higher natural resistance to pathogens and cross-reactive preimmunization with related microorganisms can interfere with the artificial immunization when living microorganisms are used. Implication for vaccination to mycobacterial infection (tuberculosis and leprosy) are discussed.


Role of macrophage activation in allograft immunity: in vivo studies. Macrophage-rich adherent peritoneal cells from mice sensitized by two i.p. injections of allogeneic cells at days -- 12 and --2, were found non-specifically cytotoxic against (a) tumoral target cells, as evaluated by the chromium release test, and (b) normal target cells, as evaluated by a functional test based on the insulin secretion response to glucose stimulation of isolated pancreatic islet cells. This non-specific cytotoxicity was identical to that of macrophages "activated" by an in vitro incubation with supernatants of MLC between allograft donor and recipient as reported elsewhere. Moreover this cytotoxicity was not abolished by anti-theta serum treatment of adherent peritoneal cells before contact with target cells. It is concluded that an in vivo macrophage activation was obtained in our experiment. Using this same model, we found that the survival time of skin grafts from male C57BL/6 to female C57BL/6 mice was shortened if the graft was performed at the time when the recipient macrophages were found non-specifically cytotoxic (two days after the second allogeneic cell injection). The role  of macrophage cytotoxicity in this accelerated allograft rejection is suggested by (a) the lack of any detectable cross-histocompatibility antigens between the immunizing cells and the skin graft, and (b) the absence of any alteration of the graft survival if the second immunizing injection two days prior to grafting is omitted (in that case only lymphocytes are found specifically cytotoxic against the strain of injected cells, while the non-specific cytotoxicity of macrophages is lacking).


Classification of polyene antibiotics according to chemical structure and biological effects. Fourteen polyene antibiotics and six of their semisynthetic derivatives were compared for their effects on potassium (K(+)) leakage and lethality or hemolysis of either Saccharomyces cerevisiae or mouse erythrocytes. These polyene antibiotics fell into two groups. Group I antibiotics caused K(+) leakage and cell death or hemolysis at the same concentrations of added polyene. In this group fungistatic and fungicidal levels were indistinguishable. Group I drugs included one triene (trienin); tetraenes (pimaricin and etruscomycin); pentaenes (filipin and chainin); one hexaene (dermostatin); and one polyene antibiotic with unknown chemical structure (lymphosarcin). Group II antibiotics caused considerable K(+) leakage at low concentrations and cell death or hemolysis at high concentrations. The fungistatic levels were clearly separable from fungicidal. This group included the heptaenes (amphotericin B, candicidin, aureofungin A and B, hamycin A and B), and five of their semisynthetic derivatives (amphotericin B methyl ester, N-acetyl-amphotericin B, hamycin A and B methyl esters, and N-acetyl-candicidin). Nystatin, classified as a tetraene, and its derivative, N-acetyl nystatin, also were in this group.


Affinities of penicillins and cephalosporins for the penicillin-binding proteins of Escherichia coli K-12 and their antibacterial activity. The affinities of a range of penicillins and cephalosporins for ther penicillin-binding proteins of Escherichia coli K-12 have been studied, and the results were compared with the antibacterial activity of the compounds against E. coli K-12 and an isogenic permeability mutant. Different penicillins and cephalosporins exhibited different affinities for the "essential" penicillin-binding proteins of E. coli K-12, in a manner which directly correlated with their observed effects upon bacterial morphology. Furthermore, the affinities of the compounds for their "primary" lethal penicillin-binding protein targets showed close agreement with their antibacterial activities against the permeability mutant.


[Inflammation and host resistance against bacteria. I.--Increased resistance against Listeria monocytogenes and Salmonella typhimurium in mice, following their treatment with bradykinin, kallidin and methionyl-lysyl-bradykinin (author's transl)]. Mice pretreated with kinins are more resistant to a lethal challenge of Listeria monocytogenes. The multiplication of Listeria is decreased in the liver and spleen and the blood clearance of Salmonella typhi-murium is increased.


Amikacin resistance associated with a plasmid-borne aminoglycoside phosphotransferase in Escherichia coli. Enzymatic phosphorylation of amikacin has not been reported previously in gram-negative bacteria. We found that extracts of MP1, a mutant of Escherichia coli JR66/W677 that is resistant to amikacin, were able to phosphorylate this aminoglycoside more rapidly than were extracts of the parental strain. Conjugal transfer of resistance from MP1 to a recipient strain was accompanied by acquisition in the transconjugants of amikacin phosphotransferase activity and of a 57-megadalton plasmid present in the donor. Partial purification of the phosphotransferase activity on amikacin-Sepharose 4B yielded an enzyme with a substrate spectrum similar to that of the 3'-neomycin-kanamycin phosphotransferase II found E. coli, except that it was also active against amikacin. A mutant of MP1, MP5, had increased susceptibility to amikacin and reduced phosphotransferase activity. MP9, a mutant MP5, was more resistant to amikacin and had increased phosphotransferase activity. The mutations leading to these alterations of amikacin susceptibility and amikacin phosphotransferase activity were transferable with the same plasmid that was associated with amikacin resistance and phosphotransferase activity in MP1. These studies demonstrate that resistance to amikacin in a laboratory strain of E. coli is due to an aminoglycoside phosphotransferase coded by a transferable plasmid-borne gene.


Effect of free fatty acids on liposome susceptibility to imidazole antifungals. The presence of free fatty acids in liposome model membranes sensitizes these membranes to the action of the imidazole antifungals, clotrimazole, micronazole, and sulconazole. Unsaturation of the fatty acids is an important variable; the effect of linoleic and oleic acids is much greater than that of stearic acid. The imidazoles differ somewhat in action, with clotrimazole potency greatest both on membranes with and without fatty acids. Sulconazole has very little activity on membranes without fatty acids even at the highest concentrations tested. The data are discussed with reference to the susceptibility of various cells to the imidazoles and the specificity of imidazole action. A modification of the enzymatic method generally used for assay of marker glucose with liposome systems is also presented.


Transductional construction of a threonine-producing strain of Serratia marcescens. A threonine-producing strain of Serratia marcescens Sr41 was constructed according to the following process. Thr- strain E-60 was derived from strain HNr59 having constitutive levels of threonine-sensitive aspartokinase and homoserine dehydrogenase. Thr+ transductant T-570 was constructed from strain E-60 and phage grown on strain HNr21 having feedback-resistant threonine-sensitive aspartokinase and homoserine dehydrogenase. This transductant lacked both feedback inhibition and repression for the two enzymes. Thr- strain N-11 was derived from strain AECr174 lacking feedback inhibition and repression of lysine-sensitive aspartokinase. Subsequently, the threonine region of strain T-570 was transduced into strain N-11. One of the THR+ transductants, strain T-693, produced markedly high levels of the two aspartokinases and homoserine dehydrogenase, which were insensitive to feedback inhibition. This strain produced about 25 mg of threonine per ml in the medium containing sucrose and urea.


Separation of botulinum-positive and -negative fish samples by means of a pattern recognition method applied to headspace gas chromatograms. A gas chromatographic headspace technique was used to analyze the gas produced during putrefaction of pond-raised, degutted trout, incubated in evacuated plastic pouches. The following samples were analyzed; 10 samples which, due to natural contamination with Clostridium botulinum, were toxic when injected into mice, 10 samples which were nontoxic when injected, and 9 samples inoculated with one strain of C. botulinum type E. The gas chromatograms showed the presence of 118 compounds in most samples. Quantitative differences among most chromatograms could be observed, but no compound was unique to any of the three groups. By means of a specific pattern recognition method, all negative samples were shown to fall into one group and were distinctly separated from the toxic samples. No differences could be observed between the two groups of inoculated and naturally contaminated trout samples. The results suggest that headspace analysis combined with pattern recognition analysis might prove to be a valuable method for screening studies of foods containing living cells of C. botulinum.


Differentiation of selected Enterobacteriaceae by pyrolysis-gas-liquid chromatography. Pyrolysis-gas-liquid chromatography was used to differentiate selected species of Enterobacteriaceae. Individual cultures of Salmonella typhi, Hafnia alvei, and Proteus vulgaris, and 12 strains of Yersinia enterocolitica were grown in nutrient broth. After harvest and lyophilization, the bacterial samples were pyrolyzed at 900 degrees C, and their volatile fractions were separated on a 50-m capillary column coated with Carbowax 20M. The resulting pyrolysis elution patterns (pyrograms) of the four species were monitored on an integrating console, which was coupled with the chromatographic detector. The pyrograms were divided into 312 30-s time interval areas, and each interval area was normalized in relation to the area of the entire curve. The normalized areas were evaluated by stepwise linear discriminant analysis, and the discriminating component coordinates were used to generate a plot of the canonical variables. Distinct clustering patterns allowed discrimination among the four genera of Enterobacteriaceae studied. The tight clustering of the 12 Y. enterocolitica strains suggests the advantage of pyrolysis-gas-liquid chromatography over traditional approaches for species identification.


Plate diffusion assay as a rapid method for dosimetry of mutagens. This paper presents a method for determining mutagenic concentrations of chemicals by using an agar diffusion assay. The method is based on the linear relationship between the amount of chemical placed at the center of the dish and the radius of the mutagenic zone. A brief theoretical discussion and experimental data confirming this relationship are given. Alkylating agents and mycotoxins were used to test the system. This method can be used to follow up decreased mutagenic potencies of solutions of unstable mutagens and to follow the production of mutagenic substances throughout fermentation.


Adherence of bacteria, yeast, blood cells, and latex spheres to large-porosity membrane filters. Strong adherence of bacteria, yeast, erythrocytes, leukocytes, platelets, spores, and polystyrene spheres to membrane filter materials was noted during filtration through membranes with pore size diameters much larger than the particles themselves. Quantitative recovery on the membrane filters of these particles from low-concentration suspensions was achieved during gravity- or vacuum-assisted filtration through membranes with pore diameters as much as 30 times that of the filtered particles. Mechanical sieving was not responsible. The phenomenon was judged to be electrostatic. It could be partially blocked by pretreating the filter with a nonionic surfactant (Tween 20), and elution of adherent particles was achieved with 0.05% Tween 20. Gram-positive cocci were removed from suspension more efficiently than gram-negative rods. The commonly used cellulose membranes adsorbed more bacteria, blood cells, and other particles than did polycarbonate filters. Of lesser adsorptive capacity were vinyl acetate, nylon, acrylic, and Teflon membranes. Backwashing with saline, serum, 6% NaCl, dextran solutions, or phosphate buffers of varying molality and pH removed only a fraction of adherent particles. Tween 20 (0.05%) eluted up to 45% of adherent particles in a single back-filtration. Selected filters quantitatively removed the particles tested, which then could be washed and subjected to reagents for a variety of purposes. It is important to anticipate the removal of particles during membrane filtration, since it is not a simple mechanical event.


Early Dutch contributions on Peyronie's disease. Long before De la Peyronie's description of three cases of plastic induration and curvature of the penis (1743) the disorder was already known. The Ephemerides (1687) and the rather scabrous booklet, Venus minzieke gasthuis (Venus Hospital for the lovesick)(1688), contain short remarks on this condition. Two extensive Dutch contributions -- not mentioned in the literature on this subject -- were written by Nicolaas Tulp (1593--1674) and Fredrik Ruysch (1638--1731). The first one is a case history, the second one is more general discussion with a fine engraving added. Treatment varied according to the various early authors. The therapeutic successes claimed must be seen in the light of the natural history of this disease: spontaneous improvement occurs not infrequently. To change the eponym 'Peyronie's disease', however, seems unjustified. It is an homage to François Gigot de la Peyronie (1678-1747) surgeon to King Louis XV and founder of the French Académie de Chirurgie.


Facial paralysis - 100 years of treatment. After surveying the literature on the treatment of unilateral facial paralysis, a classification of the various measures is offered. Several methods and their values are discussed, and the treatments we prefer indicated.


Urinary-tract infections due to inflammation around nonabsorbable suture material in the bladder. Three patients are reported with urinary-tract infections around wire granulomas caused by nonabsorbable suture material in the bladder. On the basis of reports in the literature and of personal findings use of this material in operations in and around the urinary tract should be considered inadvisable. Use of absorbable material, such as catgut, chromic catgut, Dexon or Vicryl is to be preferred.


Ethnic differences in the Goodenough-Harris draw-a-man and draw-a-woman tests. The draw-a-man (DAM) and draw-a-woman (DAW) tests were given to 307 schoolchildren in Petaling Jaya, Malaysia. The children were ethnically Malay, Chinese, or Indian (Tamil), and all came from lower socioeconomic groups. The standard scores of the Chinese children averaged 118 in the DAM and 112 in the DAW tests. These scores were significantly better than the American standards. Malay children scored significantly lower than Chinese, and Tamil children scored lower again. The nutritional status of the children had no influence on the scores. Chinese and Tamil children scored better in the DAM than the DAW, while in Malay boys the reverse was true. Malay children tended to emphasise clothing in the DAM, but Chinese and Tamil children scored better on items relating to facial features and body proportions. The Goodenough-Harris draw-a-person tests are obviously not culture-free, but the causes of ethnic differences have not been elucidated.


The efficacy of histamine antagonists as antipruritics in experimentally induced pruritus. 1. The antipruritic ability of histamine (H1 and H2) antagonists alone and in combination in experimentally induced pruritus has been investigated in 12 normal human volunteers. 2. A combination of cimetidine (H2 anatagonist) and chlorpheniramine (H1 antagonist) proved effective in suppressing itch that was artificially induced by the application of papain and histamine. 3. The combination was more effective than chlorpheniramine or cimetidine alone or placebo. 4. The results suggest that both H1 and H2 receptors are involved in the mediation of pruritus.


Immunoelectron-microscopical localization of in vivo-bound complement C3 in bullous pemphigoid with the use of the peroxidase-antiperoxidase multistep technique. In vivo-bound complement C3 in bullous pemphigoid was precisely localized by means of the peroxidase-antiperoxidase multistep technique. In the nonbullous lesions peroxidase deposits filled the lamina lucida completely, i.e., the space between lamina densa and the cell membranes of the basal cells. In developed bullae, the reaction product was located both on the lamina densa and on the surface of separated keratinocytes. These findings may indicate that antigen components in bullous pemphigoid are localized almost exclusively within the ground substance which fills the lamina lucida and covers the surface of the basal cells.


Fibronectin distribution in epithelial and associated tissues of the rat. Specific antiserum was used to investigate the distribution of the extracellular glycoprotein, fibronectin, in rat skin and tongue tissue by light and electron microscopy with immunofluorescence and immunoperoxidase techniques. We conclude that fibronectin is absent from stable, differentiated parts of tissues, such as the sebaceous glands or the matrix, medulla, cortex, and cuticles of the hair and the inner and outer root sheaths, or even in tissues in which there is some cell movement, such as the epidermis. It is, however, characteristic of sites at which cell division is occurring in contact with an extracellular scaffolding, such as basement membrane or loose connective tissue. Conspicuous examples were in the glassy membrane and connective tissue sheath associated with the follicular epithelium, the basement membrane underlying vascular endothelial cells, the connective tissues surrounding and investing nerve and muscle fibre bundles, and the dermal connective tissue where fibronectin was often associated closely with collagen fibres. At the basement membrane of the dermal/epidermal junction, fibronectin occurred at the plasma membrane of the basal cells and in the lamina lucida area. There was no correlation with specific areas of cell-substrate adhesion, such as the hemidesmosomes. The endoplasmic reticulum of fibroblasts stained strongly suggesting that these cells represent a major site of synthesis.


The concentration of chloroquine in serum during short and long term malaria prophylaxis with standard and 'double' dosage in non-immunes: clinical implications. The concentration of chloroquine in serum was analysed after one week, six weeks and one year on standard dose prophylaxis (300 mg chloroquine base once a week) and after six months on the double dose. After six weeks, the standard dose gave adequate protection against malaria. During the first weeks of prophylaxis insufficient protection might be achieved by the customary standard dose. In a double-dose group many values reached the point above which a higher incidence of side-reactions have been observed.


Schistosomiasis: assessment of the sensitivity, specificity and reproducibility of serological methods for the diagnosis of schistosomiasis in Nigeria. Three groups of sera were tested by indirect fluorescent antibody (IFA), complement fixation (CF) and counter-current immunoelectrophoresis (CCIE) techniques; 56 (10.1%) of 554 sera from Nigerians were anticomplementary and so could not be tested by the CF. Crude antigen extract of adult Schistosoma mansoni was used in the CF and CCIE tests and cercarial antigen in the IFA test. IFA was the most sensitive test and CF the most specific. The reproducibility of both these tests was good. The CCIE was the least sensitive and specific, and its reproducibility was poor. The IFA test was the most suitable for Nigerian conditions. Cross-reactions to S. haematobium antibodies were consistently present in all three tests and it was not possible to differentiate serologically S. mansoni from S. haemotobium. The interpretations of the results presented some difficulties because of the frequency of cross-reactions and false-positives, but the data fell within the infection prevalence rate of 50% reported earlier from south-western Nigeria. The IFA test was more specific and is considered ideal for serodiagnosis.


Bancroftian filariasis: a comparison of microfilariae counting techniques using counting chamber, standard slide and membrane (nuclepore) filtration. Three techniques were compared for counting microfilariae of Wuchereria bancrofti in blood specimens--a standard slide method, the counting chamber technique (CCT) and a membrane filtration technique (MFCT). The CCT was much more sensitive than the slide method, the difference in sensitivity between these two methods probably being due mainly to the loss of microfilariae during the dehaemoglobinizing process prior to staining in the standard slide method. There was good correlation between the techniques when 0.1 ml of finger-prick blood was examined by the CCT and 1 ml of venous blood by the MFCT. The number of additional positives revealed by the MFCT was ten of 275 (3.6%) subjects examined. The use of venepuncture for MFCT is impractical for field surveys in East Africa whereas a microfilarial count on 0.1 ml of finger-prick blood meets most of the criteria required of a field technique. The method is simple, quantitative and acceptable to the population. The results are reproducible, can be readily checked, the technique provides a useful and practical method for obtaining prevalence information following control schemes. The finding of a relatively low prevalence of microfilariae seen by both MFCT and CCT in children aged five to nine years from a highly endemic filariasis area agrees with the results of previous East African surveys carried out by blood smear and CCT.


Preliminary screening of antifilarial activity of levamisole and amodiaquine on Wuchereria bancrofti. A single dose of levamisole of 3 mg/kg had a marked microfilaricidal effect in some persons harbouring Wuchereria bancrofti, but there was considerable variation in the response. In some cases blood examinations for microfilariae remained negative or at a low level for several months. Persons with high pretreatment microfilaraemias responded less to therapy than did those with low counts. The main side-reaction to levamisole was fever, which began six to eight hours after treatment. Combined DEC-levamisole therapy appears to have no advantage over the use of DEC alone. Amodiaquine in a total dose of 40 mg/kg appears to be macrofilaricidal, but because of the slight possibility of blood dyscrasias, mass chemotherapy with this dosage could not be recommended. Some amodiaquine congeners shown to be effective in experimental infections against adult filarial worms may prove to have a higher chemotherapeutic index than amodiaquine against W. bancrofti in man.


Cardiovascular actions of prostacyclin (PGI2) in the cat. The cardiovascular actions of the newly discovered bicyclic prostaglandin, prostacyclin, or PGI2, were compared with those of PGE1 in the anesthetized cat. PGI2 decreased systemic arterial pressure, increased cardiac output and decreased systemic vascular resistance. The decreases in systemic vascular resistance were similar when PGI2 was injected into the left or right atrium, suggesting that prostacyclin is not inactivated in the feline pulmonary vascular bed. PGE1 also decreased systemic arterial pressure and increased cardiac output; however, left atrial administration of this substance produced greater reductions in systemic vascular resistance than right atrial injections, suggesting that PGE1 is inactivated in the feline lung. PGI2 also caused dose-related decreases in perfusion pressure in the renal, hindquarters and mesenteric vascular beds and had the greatest vasodilator activity in the mesenteric vascular bed. PGE1 decreased perfusion pressure in the 3 regional beds, and the overall dilator effects of PGI2 and PGE1 in the peripheral circulation were quite smiliar. The present data show that PGI2 is a potent peripheral vasodilator in the cat and since this substance is not inactivated in the lung, it could serve as a circulating hormone in this species.


Inhibition of vasoconstrictor responses by prostacyclin (PGI2) in the feline mesenteric vascular bed. The effects of infusion of prostacyclin, PGI2, on vasoconstrictor responses to sympathetic nerve stimulation, norepinephrine and angiotensin II were investigated in the mesenteric vascular bed of the cat. Stimulation of the sympathetic nerves and intra-arterial injections of norepinephrine and angiotensin increased mesenteric perfusion pressure in a frequency and dose-dependent manner. Responses to nerve stimulation and pressor hormones were reproducible and not altered by infusions of the Tris vehicle for PGI2 or the PGI2 breakdown product, 6-keto-PGF1 alpha. Infusions of PGI2, 1 and 0.3 micrograms/min, decreased mesenteric arterial perfusion pressure and, at the higher infusion rate, markedly reduced responses to nerve stimulation, norepinephrine and angiotensin. At the lower infusion rate PGI2 caused small but significant reductions in responses to norepinephrine and nerve stimulation but did not alter responses to angiotensin. Results of these studies demonstrate that PGI2 possesses the ability to inhibit vasoconstrictor responses in the feline intestinal vascular bed and suggest that this effect is postjunctional.


[Cytochemical and ultrastructural studies of the cell wall of Candida albicans (author's transl)]. The ultrastructural localization of polysaccharides in the cell wall of Candida albicans was carried out by means of Concanavalin A on glycol methacrylate ultrathin sections. The sections were incubated successively with horseradish peroxydase, 3-3' diaminobenzidine and H2O2, for revealing the binding sites of the lectin. This method allowed us to localize mannan, since Concanavalin A does not react with other polysaccharides of the C. albicans cell wall. In these conditions mannan was found to be located in two continuous reactive layers at the periphery of blastospores cell wall. The results are discussed in relation with those obtained by another method using the polysaccharide detection technique described by Thiery (PATAg).


Temperature control of nitrogen fixation in Klebsiella pneumoniae. At growth temperatures above 37 degrees C, Klebsiella pneumoniae does not grow in a medium containing N2 or NO3- as nitrogen sources. However, both the growth in the presence of other nitrogen sources as well as the in vitro nitrogenase activity are not affected at this temperature. The inability to fix N2 at high temperature is due to the failure of the cells to synthesize nitrogenase and other nitrogen fixation (nif) gene encoded proteins. When cells grown under nitrogen fixing conditions at 30 degrees C were shifted to 39 degrees C, there was a rapid decrease of the rate of de novo biosynthesis of nitrogenase (component 1), nitrogenase reductase (component 2), and the nifJ gene product. There was no degradation of nitrogenase at the elevated temperature since preformed enzyme remained stable over a period of at least 3 h at 39 degrees C. Thus, temperature seems to represent a third control system, besides NH4+ and O2, governing the expression of nif genes of K. pneumoniae.


Spontaneous fascial necrosis of the upper thigh by beta-hemolytic streptococci. This is a case-report of a gangrene involving muscle and fascia of the left femur due to group A of beta-hemolytic streptococci without visible injury of the skin. The diagnosis was derived from germ-evidence and by course of anti-desoxyribonuclease-B titer.