Double-contrast artifacts.

Double-contrast artifacts. With the increasing use of double-contrast technique in radiological evaluation of the gastrointestinal tract, certain artifacts peculiar to this mode of examination need to be identified. These artifacts arise because of: (a) the characteristics of the barium suspensions used for double-contrast studies; (b) the see-through effect obtained on double-contrast studies whereby opacities lying in front of or behind the organ being examined may simulate pathologic lesions; (c) infolding of the mucosa which may simulate pathology; (d) extraneous or foreign material which is frequently detected and must be differentiated from intrinsic disease; (e) certain anatomical structures such as the cardia, pylorus, and retrogastric structures which are seen with unusual clarity and detail and which, in some cases, may simulate pathology. In general, these artifacts may simulate diffuse superficial ulceration, discrete ulceration, or polypoid lesions. Familiarity with the double-contrast technique and an understanding of these artifacts will help to avoid diagnostic errors.


Antral and esophageal rimple: a normal variation. The occurrence of fine antral and esophageal rimpling appears to be the result of contractions of the muscularis mucosa. The lack of persistence during distention is compatible with this conclusion. The folds have no pathologic significance.


The radiologic manifestations of diabetic gastric neuropathy and its differential diagnosis. The radiologic signs of diabetic gastric neuropathy consist of ineffectual peristalsis, solid gastric residue, elongated sausage-shaped stomach, gastric barium retention, and duodenal bulb atony. This entity is seen in patients with long-term diabetes mellitus under relatively inadequate control with the likelihood of other complications of this disease. The radiologic differential diagnoses include surgical and autovagotomy as well as drug-induced gastric motility disorders. Theories advanced to explain the pathophysiology of this entity are discussed.


Value of the compressive technique associated with pharmacological hypotonia in the diagnosis of erosive gastritis. The double-contrast method and the compressive technique associated with pharmacological hypotonia of the stomach were compared in 13 cases and found to be equally valuable in the diagnosis of erosive gastritis.


Hypotonic duodenography--too often performed but of too little value? A comparison with conventional spot films. Hypotonic duodenography was compared with conventional barium examination in 68 patients (70 examinations) with clinically suggested or verified disease of the pancreas or duodenum. In 13 cases (18.5%) conventional examination demonstrated the duodenal anatomy better than hypotonic duodenography. In nine cases (13%) hypotonic duodenography was superior and in 48 cases (68.5%) both techniques were diagnostically equal. It is concluded that, in only a few cases, does hypotonic duodenography add any diagnostic information to that which can be obtained with properly performed conventional examination of the duodenum.


Calcifications within the duct of Wirsung in calcific pancreatitis. A review of abdominal radiographs of 50 patients with the clinical diagnosis of chronic pancreatitis showed calcific pancreatitis in 27 patients. Ten patients had severe pain associated with weight loss. Five had obstruction of the duct of Wirsung:  one by a pseudocyst and four by large stones near the ampulla of Vater. The radiologic workup presented emphasizes the need to study the duct of Wirsung in patients with chronic pancreatitis to guide the surgical approach for relief of intractavle pain. Theories regarding the pathophysiology of calcium deposition and stone formation and migration are reviewed.


Detection of hepatic amebic abscesses by infusion tomography. The liver represents a major challenge for radiologic imaging. A simple method of diagnosing acute inflammatory lesions of the liver by infusion tomography is presented. Results of this technique in 48 consecutive patients with amebic abscesses of the liver are described, and their typical appearance is presented. The test also appears to aid in defining the acuteness of the lesion.


Use of the C-terminal octapeptide of cholecystokinin in clinical radiology. I. The gallbladder. Two 30-min. infusion doses of the octapeptide of chloecystokinin (C8-CCK) (1 and 4 ng/kg/min) produced equal and consistent gallbladder contractions (75 +/- 8% mean and SEM decrease in size) in 24 human volunteers. The long 30-min infusion method of C8-CCK administration appears better than bolus injection (30 to 180 s) for cholecystokinetic cholecystography.


Use of the C-terminal octapeptide of cholecystokinin in clinical radiology: II. The small bowel. The octapeptide of cholecystokinin (C8-CCK) administered by bolus (20 ng/kg) and by infusion (4 ng/kg/min for 30 minutes) doses produced significant shortening of small bowel transit time. Significantly, fewer side effects occurred with the infusion method. The problems encountered in studies of small bowel motility are discussed.


A modified technique for the double-contrast small bowel enema. A small bowel enema technique is described which makes it possible to achieve double-contrast images comparable to those routinely obtained in the stomach or colon. It is a biphasic procedure, requiring the transtubal injection of barium sulfate, followed by 0.5% methylcellulose. Adjustment of relative injection quantities and injection speeds can adapt each examination to a patient's individual diagnostic problem. Indications for the examination are discussed.


Radiological detection of colonic dysplasia (precarcinoma) in chronic ulcerative colitis. Epithelial dysplasia occurring in long-standing ulcerative colitis is a precancerous lesion. Macroscopically it has a nodular or villous appearance or may be indistinguishable from the surrounding mucosa. An investigation into the radiological diagnosis of dysplasia, using in vivo and in vitro double-contrast examinations with magnification radiographic studies, correlated with the histological analysis, has been made in four patients. Characteristic radiological abnormalities have been identified in the areas of the mucosa associated with histologically proven dysplasia. These appearances include nodularity and irregular areas with sharply angulated edges which may represent enlarged areae colonicae. The demonstration of these changes is an indication for endoscopic examination and biopsy of the suspicious area.


Dermoid perforation of the colon.

Dermoid perforation of the colon. A case report of an ovarian dermoid tumor perforation the sigmoid colon in a pregnant woman is presentd. Various complications of dermoid perforation are discussed.


Radiologic findings in anorectal gonorrhea. Gonorrhea is the most prevalent communicable disease in the United States and the incidence of anorectal involvement is high. Anorectal gonorrhea may be clinically elusive making the radiologic findings crucial in suggesting the diagnosis. Edematous rectal mucosa with limited distensibility and small ulcerations are the prominent radiologic findings.


Plasmacytoma of the large bowel: a review of the literature and a case report of multiple myeloma involving the rectosigmoid. Large bowel involvement is a rare manifestation of plasma cell tumors, especially in association with multiple myeloma. A review of the world literature reveals only 21 reported cases, the majority of which are classified as the solitary form of the disease. A case of multiple myeloma with rectosigmoid involvement is herein presented, and the radiological findings of reported cases are summarized.


Gas-filled appendix with meniscus: outline of the appendicolith. A meniscus was produced in a gas-filled appendix by the outline of the obstructing appendicolith. This meniscus appearance should be specific for appendicitis since it represents the obstructing stone. This sign can be elicited by oblique or other projections, perhaps with fluoroscopic control.


A new approach to absorptive function of gallbladder. To investigate the mechanism of concentration of bile, the normal canine gallbladders were cannulated through the cystic duct into the gallbladder neck with polyethylene tube, and hypotonic, isotonic and hypertonic salines as well as hepatic and gallbladder biles were placed in the gallbladder. Low molecular electrolytes such as Na+ and Cl- were transported across the epithelial membrane against water flux. The hepatic bile was decreased markedly in volume and each level of electrolytes including bile acids approached that in the gallbladder bile. The different results were obtained by concentration of the hepatic bile in the gallbladder with chemically induced cholecystitis.


Therapeutic effect of histidine decarboxylase inhibitor on chronic active hepatitis. The effect of orally administered histidine decarboxylase inhibitor on liver function tests and histological appearance as well as on plasma histamine level were evaluated in biopsy proven 13 patients with chronic active hepatitis, whose liver function tests were refractory to other measures. Tritoqualine was used as histidine decarboxylase inhibitor and was administered in dose levels of 600 to 1,600 mg per day. Before treatment the average value of SGOT, SGPT and plasma histamine showed 252 +/- 24U, 318 +/- 152U and 15.2 +/- 5.5 microgram/L, respectively. Results obtained at six weeks' treatment, however, gave significantly improved values, indicating SGOP 57 +/- 24 (p less than 0.001), SGOP 40 +/- 28 (p less  than 0.001) and plasma histamine 8.6 +/- 0.4 (p less than 0.001). Serum gammaglobulin also tended to fall (p less than 0.1). Marked improvement was noted in reexamined biopsied specimen, representing disappearance of fibrogenesis as well as round cell infiltration in and around the portal tract, together with pericellular fibrosis. Four cases have been proven to be healed. Despite long-term administration, no obvious side effect was observed. Investigation for HBsAg revealed to be positive in 4, however, no conspicuous difference was seen from that of negative cases in the improvement.


Change of glucagon reacting to 30 K antibody in totally depancreatized dogs. Total pancreatectomy was performed in dogs; and arginine test was conducted at the first, second and third weeks after surgery, and measurement was made of blood glucose, glucagon and insulin on a time-course basis for a comparative study with normal dogs. 1) After total pancreatectomy, glucagon reacting to 30 K antibody decreased once but increased with the lapse of time when no insulin was administered. 2) In the arginine test, glucagon showed a biphasic reaction in normal dogs, but a monophasic reaction in totally depancreatized dogs. This reaction declined three weeks after surgery. 3) When blood samples were taken from the pancreaticoduodenal vein, the left-gastroepiploic and mesenteric veins, during and after arginine was infused for 30 minutes. Glucagon in the pancreaticoduodenal vein increased markedly, but there were no such prominent changes in the left-gastroepiploic or mesenteric veins, Meanwhile, the level of glucagon in the left-gastroepiploic vein increased remarkably in dogs one week after total pancreatectomy.


A clinical investigation of chronic pancreatitis--comparative study between alcoholic pancreatitis and non-alcoholic pancreatitis--. An analysis of 89 cases with chronic pancreatitis revealed 56% of chronic alcoholic pancreatitis (AP). The sex ratio was 47 males to 3 females and the mean age at onset was 42.4 years in AP and 49.3 years in chronic non-alcoholic pancreatitis (NAP). The 'total amount' of alcohol consumption was correlated to the onset. In AP, the abdominal pain was apt to relapse and severe in nature, furthermore painless pancreatitis was seen in 6%. The association with diabetes or calcification (38%) were more frequently seen in AP. The calcifications in AP appeared to be smaller in size and distributed diffusely or localized in cephalic portion. A striking frequency of liver dysfunctions (39 cases) were demonstrated, however, cirrhosis was rare in AP. The P-S test dysunctions in NAP were frequently reversible in the follow up study, while even some of chronic asymptomatic alcoholics developed clinical signs of pancreatitis during the observed period and proceeded to definite AP, of whom pancreatic dysfunctions showed fluctuation and eventual progression. In other words, even pain free intervals the pancreatic inflammation in susceptible persons may proceed to ultimated destruction of the pancreas. The fatality from chronic pancreatitis was rare (12.3%), which was related diabetes mellitus.


Primary adenosquamous carcinoma of the stomach: experience of 11 cases and its clinical analysis. 1) During the last 10 years, 11 cases of primary adenosquamous carcinoma of the stomach were operated on. 2) Histologically, the specimens from the stomach showed adenocarcinoma with squamous differentiation in all the cases. 3) All the patients but 1 were males and their average age was 61.2 years. 4) The duration of illness prior to treatment was relatively long period of time and the chief complaints in over half of the patients were abdominal pain. 5) Eight cases showed metastases at the time of operation. Metastasis to the regional lymph nodes was observed in 8 cases and the squamous element was present in 5 of these cases. 6) There was no operative death. Followup study was made in 9 cases. Only 2 are still alive and the remaining 7 died of recurrence. The length of survival averaged 10.7 months.


Diagnostic and therapeutic considerations of myogenic tumors of the duodenum. Three cases of duodenal myogenic tumor are described in detail. All the three were surgically treated and the final diagnoses were histologically established. The three consisted of two leiomyomas and one leiomyosarcoma. To make clinical diagnosis, roentgenologic, endoscopic, and angiographic examinations were empolyed. The selective angiography was more reliable than endoscopic biopsy to make a differential diagnosis whether a tumor was benign or malignant. Surgical procedures were required not only for malignant myomatous lesions but also for benign lesions because the latter also produce a high incidence of hemorrhage from ulceration of the tumor. Out of the three cases, one was successfully treated by enucleation but the other two were undergone more extensive surgery such as a Whipple's procedure or wide resection of the duodenal wall with side-to-side duodenojejunostomy. Operative techniques are discussed in detail basing on the biological characteristics, location, and size of the tumor.


Endoscopic studies on the minute structures of colonic mucosa in the follow-up observation of ulcerative colitis. Thirty cases of ulcerative colitis were examined endoscopically by means of magnifying colonoscope with dye spraying method (the combined method), and their minute mucosal structures were classified into four categories endoscopically, which correlated well with the histological findings. By this procedure, it was easy to detect the subsidence of inflammation of the mucosa in the quiescent phase or to reveal the active inflammatory involvement of the bowel. Moreover, inspecting the minute changes of the colonic mucosa detected by the combined method, remission was more correctly decided and rigid control is contributing to the decrease in the recent rate of recurrence of ulcerative colitis.


Nodular regenerative hyperplasia of the liver. Report of six cases and review of the literature. The authors report the cases of 6 adult patients suffering from nodular regenerative hyperplasia of the liver, an uncommon lesion characterized by small-sized hepatocytic nodules scattered throughout the liver, with no or slight fibrosis. The histological recognition of nodular regenerative hyperplasia of the liver was easy on large specimens taken intraoperatively, but was difficult or impossible on small specimens such as those provided by needle biopsy. In all of the patients of this series, the main consequence of nodular regenerative hyperplasia of the liver was portal hypertension. In this series, nodular regenerative hyperplasia of the liver was not associated with rheumatoid arthritis, whereas such an association has been noted in most of the cases previously reported. The etiology and pathogenesis of nodular regenerative hyperplasia of the liver is unknown.


Contents and implications of ammonia human and canine bile. The quantification and physiological significance of ammonia in human and canine bile has not been clearly documented or analyzed previously. Bile from the gallbladder, common hepatic duct, and from T-tubes obtained from patients undergoing cholecystectomy and choledochotomy. Similar samples were obtained in 6 dogs by cannulation of their hepatic duct and various blood vessels. Simultaneous blood and bile samples were obtained at 15-min intervals before during, and after an exogenous load of ammonia, given intravenously. Ammonia levels were measured in all samples. Ammonia was measurable by conventional methods in human and canine bile. In both species the gallbladder bile contained at least twice as much ammonia as bile from the common hepatic duct. After an exogenous ammonia load, the levels of ammonia in canine bile increased in similar patterns, but in lesser magnitude than the ammonia levels measured at several sites in the circulation. The findings document that the bile contains ammonia in different quantities and suggest that bile could be an additional pathway for the removal of ammonia by the liver, in addition to the urea cycle. The loss of the biliary pathway for ammonia excretion could contribute to the pathophysiology of the signs and symptoms attributed to hyperammoniemia occurring in human beings and dogs with decreased hepatic function.


Acinar distribution of liver cell regeneration after selective zonal injury in the rat. Liver cell regeneration after selective zonal injury induced by bromobenzene (acinar zone III damage) and allyl alcohol (acinar zone I damage) was examined in the context of the simple liver acinus. The zonal distribution of necrosis and inflammation was assessed by light microscopy and the volume fraction of necrosis was quantitated at the times of maximal damage. The acinar distribution of hepatocytic [6-3H]thymidine incorporation was determined autoradiographically at 24, 36, 48, 60, 72, and 96 hr after the administration of the toxicants. The mitotic index for each acinar zone was calculated at the time of peak thymidine incorporation after each drug and then at 12-hr intervals for the next 24 hr. Autoradiographic data indicated that the relative contributions of acinar zones II and III to [6-3H]thymidine incorporation were greater after zone III damage (bromobenze), whereas the relative contribution of acinar zone I was greater after allyl alcohol (zone I) damage. This was observed despite the greater degree of damage seem after bromobenzene than after allyl alcohol (volume fractions of necrosis were 26.4 and 10.1%, respectively). Moreover, the acinar distribution of mitosis indicated an increased centrizonal mitosis after centrizonal damage, and an increased periportal mitosis after periportal damage. Thus, the contribution of each acinar zone to liver cell regeneration depends on the acinar location of damage.


Portal pressure reduction induced by partial mechanical obstruction of the superior mesenteric artery in the anesthetized dog. In an effort to avoid the potentially dangerous side effects of vasopressin infusions, we attempted to reproduce mechanically the splanchnic hemodynamic changes induced by vasopressin without its systemic effects. Superior mesenteric arterial pressure was reduced to 50 to 70 mm Hg for 30 to 60 min in 10 normal dogs by partial balloon obstruction of the superior mesenteric artery. Balloon inflation caused a decrease in portal venous pressure (5.6 +/- 0.6 versus 2.8 +/- 0.7 mm Hg), hepatic vein wedge pressure (4.8 +/- 0.4 versus 2.3 +/- 0.5 mm Hg), and portal vein flow 424 +/- 53 versus 275 +/- 52 ml per min), and an increase in hepatic arterial blood flow (172 +/- 19 versus 217 +/- 29 ml per min). Total hepatic blood flow and oxygen delivery to the liver were unchanged. Partial balloon obstruction caused an increase in cardiac output (1950 +/- 203 versus 2317 +/- 376 ml per min) and mean arterial pressure 138 +/- 6 versus 151 +/- 7 mm Hg), whereas heart rate did not change. Partial balloon obstruction of the superior mesenteric artery caused  similar changes in splanchnic hemodynamics to those of vasopressin infusions into the superior mesenteric artery, but without the potential deleterious effects of vasopressin  on systemic hemodynamics.


Portal hypertension in vinyl chloride monomer workers. A hemodynamic study. Hemodynamic studies were performed in 5 vinyl chloride monomer workers in whom splenomegaly or thrombocytopenia was detected during a screening program at major chemical plant. Three patients had portal hypertension and collateral venous circulations, with intrasplenic pressures between 20 and 29 mm Hg and normal wedged hepatic venous pressures, but the gradient between the wedged and free hepatic vein pressures was also increased. Splenic blood flows were increased in both hypertensive and normotensive patients. There was no correlation between the splenic blood flow and the portal pressure or the presence of portal fibrosis. The portal hypertension associated with vinyl chloride exposure is mainly presinusoidal in type, and may be attributed to an abnormality of the portal vein radicles, or hepatic sinusoids.


Appearance of killer (K) cells in the mesenteric lymph nodes in Crohn's disease. The local lymph node in Crohn's disease contains killer (K) cells which are able to lyse antibody-coated heterologous target cells. K cells are not found in mesenteric lymph nodes from control patients not suffering from Crohn's disease, whereas they are regularly found in similar amounts in the peripheral blood of both control and patients with Crohn's disease. Even mesenteric lymph node cells from areas not macroscopically affected by inflammatory disease show increased K cell activity as compared to control lymph node lymphocytes, suggesting a generalized mesenteric lymph node involvement with regard to K activity in Crohn's disease.


An occupational group with a high risk of large bowel cancer. Over a 1 1/2-year period a cluster of 5 patients demonstrated similar characteristics of large bowel cancer, in terms of histological type, occupation in the same manufacturing unit of a carpet factory, sex, young age (less than 50), and a negative familial history of cancer. Therefore, the lifetime occupational familial history of all known cases of colorectal cancer, occurring between 1965 and 1975 in the geographic region where the factory was situated, were reviewed to compare the incidence, histopathological type, and the site distribution of colorectal cancer in the exposed and in a control group. Of 1000 subjects with large bowel cancer so far analyzed 30 have had a positive occupational exposure. A detailed analysis of 12 cases occurring from 1971 to 1975 indicates that the observed age and sex-adjusted relative risk ratio was 10 timer higher among workers in the carpet factory than among other industrial workers. The observed morbidity in the studied group was 11.4 times higher than the expected one.


Identification of the dietary lectin, wheat germ agglutinin, in human intestinal contents. Plant lectins are known to have potent biological actions of normal and malignant cells. High concentrations of these lectins are present in many types of high residue diets. The specific binding of wheat germ agglutinin, a dietary plant lectin, to N-acetylglucosamine was used as the basis for purification of this lectin by biospecific chitin affinity chromatography. Subsequently, methods were developed for the extraction, purification, and identification of wheat germ agglutinin from fecal samples. Biologically intact wheat germ agglutinin was detected in ileostomy effluent and fecal collections from human subjects consuming a diet containing wheat germ. These studies demonstrate that wheat germ agglutinin can traverse the human small intestine intact. It is feasible that orally ingested wheat germ agglutinin and other plant lectins which interact with a wide variety of cell membranes may alter intestinal epithelial or bacterial cell function in the human bowel.


Pancreatic secretory activity of secretin5-27 and substituted analogues. The effect of secretin5-27 and four substituted analogues (9 Gln-secretin5-27, 15-Asn-secretin5-27, 9-Gln-15-Asn-secretin5-27, and 15-Lys-secretin5-27) on pancreatic secretion in the rat and guinea pig was examined. Secretin5-27 retained significant pancreatic secretory activity in both species. Its efficacy (intrinsic activity) relative to secretin was much higher in the rat (0.2) than in the guinea pig (0.03). The activity of secretin5-27 was not affected by a single or dual substitution of carboxylic acid residues by the corresponding carboxamides or by lysine despite a substantial decrease in the helical character of the peptide.


Humoral stimulation of cell proliferation in small bowel after transection and resection in rats. Possible humoral involvement in the control of postresectional intestinal adaptation was tested in individual rats and in pairs of rats connected in vascular parabiosis for 48 hr. In individual rats, transection of the jejunum produced transient mucosal hyperplasia in the mid and distal small intestine, independent of the effect of laparotomy and of handling the bowel. Jejunal resection caused more intense and sustained distal hyperplasia, with increases in midbowel RNA content (38%), DNA content (16%), and DNA specific activity (68%) over values 48 hr after transection. In parabiotic rats, both transection and resection of the jejunum in one partner stimulated mucosal uptake of [H]TdR in the intact parabiont; increments of 59 to 128% in total radioactivity and in specific activity of DNA were found in the mid and distal small intestine of the intact parabiont. Because only rats actually undergoing abdominal operations had higher mucosal nucleic acid contents than their parabiotic partners, the transmitted response was weaker than the direct response. Systemic factors as well as local (topical) stimulators appear to be involved in adaptation of the shortened gut.


Effect of substance P on the lower esophageal sphincter of the opossum. Since the original observations by Von Euler and Gaddum, considerable interest has developed regarding the role of substance P in smooth muscle function. The purpose of the present investigation was to evaluate the effect of intravenously administered substance P on the vivo motor function of the lower esophageal sphincter (LES). Intraesophageal pressures were monitored by an assembly of polyvinyl catheters attached to pressure transducers and a recorder. The catheters were continuously perfused with bubble-free water. Administration of 5, 10, 25, 50, and 100 ng per kg of substance P stimulated the LES, respectively, 16, 32, 57, 147, and 169% above control values. Tetrodotoxin, phentolamine, hexamethonium, methysergide, and bilateral cervical vagotomy did not alter the response of the LES to substance P. Atropine in 40-, 250-, and 500-microgram per kg doses significantly but partially inhibited the response of the LES to substance P. It is concluded that subtance P is a potent stimulant of the LES. The stimulatory effect of substance P may involve both cholinergic muscarinic and noncholinergic mechanisms. It is conceivable that substance P may be a modulator of LES pressure, although the exact physiological significance is not clear at the present time.


Effect of intraduodenal peptone on the lower esophageal sphincter pressure in the dog. The role of the duodenum in the regulation of the lower esophageal sphincter pressure (LESP) was investigated in 4 unrestrained dogs equipped with a chronic Komarov type esophagostomy, a cutaneous duodenal fistula, a gastrojejunostomy, and a Y anastomosis between the distal end of the duodenum and the midjejunum. Installation of NaCl solution into the duodenum or into the stomach did not effect LESP during the following 60-min observation period. Peptone instillation into the duodenum or into the stomach produced a sustained elevation LESP. The rise of LESP was significantly greater after duodenal than after gastric instillation. Duodenal peptone did not raise serum gastrin. It is concluded that the duodenum may be an important regulator of LESP in the dog and that this effect is not mediated by circulating gastrin.


Transmural electrical potential difference in the mammalian esophagus in vivo. A simple, safe, accurate, and reproducible technique for measuring the transmural electrical potential difference (PD) of the esophagus has been developed. This technique, a modification of those previously used, allows simultaneous correlation of the PD profile with the pressure profile obtained during routine manometry. With this technique, a subcutaneous reference bridge was shown to detect accurately a lumen-negative electrical orientation for the esophageal PD in three species: rabbit, opossum, and man. A characteristic and reproducible PD profile was present for each species. In the rabbit the gastric PD was low,--12 mv, relative to the body of the esophagus,--26 to -29 mv. In contrast, both opossum and man had relatively high gastric PD's ( -36 to -43 mv) when compared to esophageal PD's ( -12 to -25 mv). In the rabbit and opossum, the PD in the lower esophageal sphincter ( -5 to -6 mv) was less than both gastric or esophageal PD's, whereas in human beings the lower esophageal sphincter PD ( -22 mv) was between gastric and esophageal values. In vitro PD measurements and histological studies of opossum esophagus revealed differences in the epithelium which correlated with the different in vivo PD's.


Immunological studies in acute pseudomembranous esophageal candidiasis. Immunological studies in 3 patients with acute pseudomembranous esophageal candidiasis are presented. None of the patients had history or clinical signs of chronic mucocutaneous candidiasis. All 3 patients had an intact humoral response as measured by the presence of elevated candida agglutinating antibody titers. However, further investigations revealed a cell-mediated immune defect characterized by in vivo and in vitro anergy to candida antigen in these patients. Response to the other antigens was found to be intact in 2 of 3 patients. Successful medical therapy was associated with return of skin and lymphocyte reactivity to candida antigen in two cases.


Genetic and immunological aspects of familial chronic active hepatitis (type B). Thirteen family members of a patient with chronic active hepatitis type B were investigated. The family included both parents, 6 sons, and 5 daughters. The parents were second cousins. HBsAg, liver tests, immunological evaluation, and HLA typing were performed on all subjects. Percutaneous liver biopsies were done on the mother and 5 of the 6 sons. The mother and all 6 sons had HBs antigenemia. The mother was free from any evidence of liver disease whereas all 6 sons had abnormal liver and immunological tests. The liver biopsies of 5 sons showed chronic active hepatitis with variable degrees of progression toward cirrhosis. The 6th son could not be biopsied in view of his prolonged prothrombin time. The father and the 5 daughters were HBsAg negative and had no evidence of liver disease. Immunological abnormalities were present in all of the effected children and in the mother and 3 daughters. This is the second report in the English literature on the familial occurrence of chronic active hepatitis type B. It emphasizes the predominance of this entity in the male offspring and confirms the presence of immunological abnormalities in the relatives of such patients. There was no evidence to link the inheritance of an immunological abnormality to clear the HBsAg to the histocompatibility complex.


[Comparison of cytological features in keratinizing dysplasia and keratinizing squamous carcinoma (author's transl)]. By means of the literature pathological aspects of the keratinizing dysplasia and the keratinizing squamous cell carcinoma are discussed. It has been tried to point out cytological criterias by means of which a differential diagnosis can be performed between the two lesions. The difficulties of this task are mentioned. To give examples for the diagnostic criterias pictures of our own material are demonstrated. Criterias for differential diagnosis of the two lesions are summarized in a table. By the use of all criterias mentioned above a differential diagnosis can be performed cytologically in most cases. Cytological findings should be described as precisely as possible. It is only in this way that the best information can be given to the clinician referring to diagnostical or therapeutical procedures that should be performed further on.


[Secondary invasive and preinvasive carcinomas of the vagina following hysterectomy for treatment of analogous lesions of the cervix (author's transl)]. Seven patients with carcinoma in situ respectively epidermoid carcinoma of the vagina after treatment of analogous lesions of the cervix are presented. The seven case reports are shortly discussed. All these cases of carcinoma occurred after treatment of primary lesions with abdominal hysterectomy. As the main reason for the occurrence of secondary carcinoma of the vagina the author considers the following facts: The insufficient removal of the primary lesions, the multicentric development of carcinoma and the missed detection of a yet invasive neoplastic change at the occasion of the first disease. The results are compared to those of other authors. The observations lead the author to the following consequences: The in situ lesion of the cervix should be treated with a vaginal hysterectomy in combination with a removal of a vaginal cuff after a Schiller test. Patients with carcinoma in situ of the cervix should be followed by cytologic controls. Preinvasive lesions of the vagina should be treated surgically whereas invasive vaginal carcinoma demands radiotherapy.


[Recommendation for an intensified treatment of advanced carcinomas of the cervix in the histologic stage 1 b and for the establishment of a stage 1 c (author's transl)]. Publications from the department of women of the University of Rostock suggested the establishment of a histologic stage 1 c for advanced carcinoma of the cervix confined to the cervix itself. The cases from 1960 to 1971 of the first department for women of the University of Vienna were reviewed. In all operable cases radical abdominal hysterectomies and lymphadenectomies were performed. Contrary to our earlier practice, cases in stage 1 c received post-operative radio-therapy for the past year. The authors agree with the establishment of a stage 1 c and a necessity for more intensive treatment of these cases.


[On the use of fenoterolhydrobromide in the treatment of imminent abortion (author's transl)]. A report was made about the retrospective comparison of a purely hormonal and a hormonal-tocolytic therapy of abortus imminens in 153 patients. The statistical comparison of the two groups was later specified. As a successful criterion, the successful childbirth was based upon. In this case it was found out, that an additional tocolytic medication of the final result was insignificantly affected, rather the hospital admittance under the tocolysis was significantly lengthened and the number of pregnancies which ended through abortion was reduced. Through this clear indication, it could be said, that pregnancies with delicate prognosis through tocolytic therapy are possibly unnecessarily lengthened and the final result is not better.


[The early cytological diagnosis of carcinoma of the uterine body with the Gravlee jet-washer (author's transl)]. A group of 108 patients who had a curettage for post-menopausal bleeding had a cytologic investigation with the Gravlee jet-washer prior to the curettage. 79 jet-washes (73.1%) were cytologically negative, nine (8.3%) were positive, two (1.8%) were false negative. False positive cytology did not occur. In 18 cases (16.6%) the material was insufficient for cytology. The accuracy of the jet-washings was 82%.


[Prenatal diagnosis of a double fissure malformation (author's transl)]. By Sonography changes of the non-osseous parts of the fetal body are just as recognizable as any malformation of the skull and skeleton. We report about a severe case of double cleft formation. The prenatal diagnosis pre-determined our intranatal care and method of delivery.


[Combined intra-uterine and ectopic pregnancy following the treatment with clomiphen (author's transl)]. Report on a case of combined pregnancy in a 25 year old patient who was treated with Clomiphen for anovulatory cycles. The left tubal pregnancy was removed at 12 weeks gestation. The intra-uterine pregnancy resulted in a term delivery of a 3 kg. 670 g. normal infant. Combined pregnancies rarely occur without treatment with ovulation inducing agents by superfecundation and superfetation. Ovulation inducing agents increase the theoretical possibility of combined pregnancy. Obstetricians should be alert to the possibility of combined pregnancy following induction of ovulation.


[A case of spontaneous rupture of the uterus (author's transl)]. A 22 year old primigravida at 40+ weeks gestation had an i.v. induction of labour with 5-10 mU/min oxytocin for 3 h which resulted in fetal distress without bleeding at 5 cm dilatation at station -3, vertex transverse. At emergency Caesarean section an occult rupture of the uterus was found. Maternal height 168 cm, weight 71.0 kg. Fetal length 53 cm, weight 4080 g. The problems of spontaneous rupture of the uterus without detectable prior damage of the uterine wall are discussed.


[Consideration of modern demographic questions (author's transl)]. It is assumed that the decrease in the birth rate can be checked or that an increase in births can be stimulated by models or value judgements. On the basis of articles reflecting the official demographic opinion published by the Federal Office for Statistics, an attempt was made to reflect the intellectual foundation for such views. With the help of population statistics and model computations as well as vaguely intimated ideologies, changes in procreative activity considered necessary could be induced. The investigation concluded with the question of whether the detachment of procreative activity in highly industrialized, capitalistic countries with their specialized instruments, technologies, and institutions can be attributed to economic factors.


[Sarcoma botryoides of the cervix uteri as cause for haemorrhages in childbed (author's transl)]. A case of a 21-year-old woman with a botryoid sarcoma of the cervix uteri, who consulted a specialist for women's diseases because of non stopping haemorrhages in childbed, is reported. Neither radical operation nor radiation nor treatment with cytostatica could arrest the extreme impetuous growth of this tumor.


[The psychological situation in a childless marriage (author's transl)]. In addition to the investigation of organic causes by gynaecological and andrological diagnostic tests the psychological problems of the infertile couples require close attention. Results of the investigation of 200 infertile couples elucidate the psychosomatic problems of infertility. There were organic cause in 72% of the cases, psychosomatic causes in 5% of the cases, probable psychologic causes in 11% of the cases and an unknown cause in 12% of the cases. The psychological problems of artificial husband and donor insemination are discussed. The importance of early psychological diagnosis in addition to organic diagnosis is emphasized.


[The value of an exploration of the mesogastric and epigastric regions in laparotomies (author's transl)]. The records of 4765 laparotmies including 1422 Caesarean sections were reviewed regarding additional surgical or medical findings. In 13.79% of the cases additional pathological findings were present which required additional general surgery or urologic surgery, or intra-operative or post-operative diagnostic steps. The exploration of the general abdominal cavity by inspection and/or palpation during the gynaecological or obstetric laparotomies was therefore very valuable. This simple preventive step requires very little time and maybe of considerable importance for the patient.


[Transvaginal surgical removal of a sacrococcygeal teratoma (author's transl)]. For the operative treatment of presacral sacrococcygeal teratomas perineal, abdominal, and combined abdominal-perineal routes are described. In this paper the transvaginal surgical removal of a benign teratoma after partial abdominal resection of the tumor in a 19-year-old woman is reported. No recurrence was observed within 5 years.


[Premature rupture of the membranes and RDS incidence in prematures (author's transl)]. In the years 1974, 1975 and 1976 495 children were born alive with a birthweight less than 2500 g in the Ist Department of Gynecology and Obstetrics of the University of Vienna. We selected all cases with dystrophy or factors, which were a disposal for RDS, so we got a rest of 188 prematures with a weight from 1000 g to 2500 g. For these children we checked the influence of time of rupture of the membranes (ROM) before delivery to the incidence of RDS. We found a lower incidence of RDS of the newborns when duration of ROM exceeded the time of 12 hours. This fact was statistically significant in the class of premature newborns with a weight of 1500 g to 2000 g. The similar trend was found in 119 dystrophic newborns with a weight between 1000 g to 2500 g, although there was no statistical significance. No influence of duration of labor on the incidence of RDS neither in selected premature nor dystrophic newborns was found.


[Comparison of nipple care in the Puerperium with powder and ointment (author's transl)]. Recommendations for the care of the nipple postpartum are numerous and variable. Cracks and fissures in the nipple must be prevented to prevent mastitis. A randomized prospective study shows that it does not matter whether powder or ointments or nothing is placed on the nipples after nursing. The incidence of cracked nipples is not significantly changed by theses measures. For the prevention of mastitis the general measures for the prevention of hospital acquired infections are necessary and more important than modifications of the nipple care.


Indirect suppression in Caenorhabditis elegans. Two cases of indirect suppression have been characterized. One case involves suppressors compensating for defects in muscle structure. Nine independent suppressor mutations were judged to lie in a single suppressor gene, sup-3. Suppression is dominant, but dose dependent, and results in improved locomotion, as well as in an increase in the ability of mutant animals to lay eggs. Mutations in six genes known to affect muscle structure were tested for suppression by representative sup-3 mutations. Alleles of three of the six genes are suppressed, two of which are known to code for thick filament proteins. One suppressor allele was identified as a deletion by genetic criteria. A second case of indirect suppression is not associated with muscle defects, but involves two mutant genes producing uncoordinated phenotypes very similar to one another. As in the first case, suppression is dominant but dose dependent and is not allele specific.


Genetics of hemoglobin in the deer mouse, Peromyscus maniculatus. I. Multiple alpha- and beta-globin structural loci. Genetic data, together with molecular structure studies, have demonstrated that the complex hemoglobin phenotypes in four subspecies of P. maniculatus are generated by at least four, and probably five, globin structural loci. The Hba and Hbc loci apparently arose by duplication of an ancestral alpha-type locus, while Hbb, Hbd, and Hbe apparently were derived from a beta-type locus. The Hba and Hbb structural loci are electrophoretically monomorphic, while Hbc, Hbd, and Hbe are each polymorphic for at least two electrophoretic alleles. Alleles at Hbc and Hbd segregate independently. The globin products of Hbc and Hbd are electrophoretically indistinguishable; therefore, it is impossible to enumerate true gene frequencies in population surveys. Combined evidence from Peromyscus, Mus and Rattus indicates a remarkable similarity in the numbers of duplicated globin structural loci and in their linkage relationships to coat color loci.


Genetic variation in activity of the enzymes of glycolysis and gluconeogenesis between inbred strains of mice. Variation in the activity of 21 liver and 15 erythrocyte enzymes between seven inbred strains of mice has been studied in a single area of metabolism, glycolysis and gluconeogenesis. Most of the variation between the strains is genetic. From the variation within and between inbred strains heritabilities (H2) were determined. Out of 35, 26 showed significant values above 0.4. A comparison with previously published work suggests that enzyme activities have mainly dominance and interaction components of variance, and this is discussed in relation to the variation in quantitative characters such as growth. In nine of the pairwise comparisons of the strains, the activity of the enzyme varied more than two-fold. In these cases the genetics and biochemistry of the enzyme was studied; F2 progeny were produced and assessed for segregation, and the heat stability of the enzyme was determined. No unequivocal segregation was observed, although in one case we found a considerable difference in heat stability. The variations found were not considered to be great enough to be useful as models of human inborn errors of metabolism or to study metabolic control. If such variants are to be found, sources of variation other than inbred strains must be used.


Genetics of hemoglobin in the deer mouse, Peromyscus maniculatus. II. Multiple alleles at regulatory loci. Deer mice are polymorphic for electrophoretic hemoglobin phenotypes showing one, two, or three bands. Within the multibanded phenotypes, there is considerable variation in the hemoglobin partitioning, defined as the fraction of total hemoglobin made up by the secondary and tertiary bands. In subspecies sonoriensis, for example, hemoglobin partitionings range from 0.03 to 0.38. The inheritance of partitioning values is under remarkably strict genetic control. The genetic variation is additive and the narrow heritability is close to 1.0. The inheritance data can be modeled in precise detail by postulating multiple-allele polymorphisms at globin regulatory loci. Comparison of simulated versus actual inheritance data demonstrates that the so-called null structural alleles actually produce functional globins.--The genetic controls in Peromyscus may be analogous to those in primates. Unfortunately, the molecular mechanisms effecting the regulation are unknown. Different subspecies of P. maniculatus show strikingly different arrays of partitioning values, but the role of natural selection in maintaining the quantitative polymorphisms remains obscure.


[Dynamics of dominant lethal mutations in male mice exposed to cyclophosphamide in drinking water for different periods of time]. The dependence of induction of dominant lethal mutations in male mice on the duration of exposure (from 1 to 12 weeks) to 0.01% aqueous solution of cyclophosphamide was studied. The maximal frequency of dominant lethal mutations was observed when males treated were crossed during the first week after the end of exposure. The yield of dominant lethal mutations did not depend on the duration of the exposure of cyclophosphamide.


[Genetic study of bacteriophage phi81. II. Gene localization in the right arm of the phage chromosome and a comparison of phage phi81 with phages lambda and phi80 in regard to gene functions]. Data on genetic investigation on lambdoid bacteriophage phi81 made possible to localize the cos site on the prophage genetic map. Four essential genes and the gene c1 are located in the right arm of the phage genetic map. Regulatory genes of phage phi81 are found to be uncapable of functional substitution of lambda phages regulatory genes N and Q. It is discovered that some late genes of phage phi80 can be substituted with respective phage phi81 genes. No substitution possibility was observed for a number of early genes of phage phi80.


[Gene regulation of the lactate dehydrogenase isoenzyme spectrum in the mouse liver]. The isozyme pattern of lactate dehydrogenase (LDH) was studied by means of electrophoretic and immunochemical methods in liver of inbred mouse strains: CBA/Lac, DBA/1J, DBA/2J, AKR/J, C57BL/6J, C3H/He. Interstrain polymorphism for the activity of LDH isozymes in mouse liver is found to take place, which is due to the presence of the regulatory gene Ldr-2. Based on the breeding data of DBA/2J and CBA/Lac mice, which show different liver LDH patterns, and judging by the results of the immunochemical analysis, it is suggested that the low activity of LDH isozymes containing subunit B and controlled by the gene Ldr-2 is inherited codominantly. It is found that the effect of the gene Ldr-2 is independent on that of the gene Ldr-1, which modifies the phenotypic expression of the gene B of erythrocyte LDH in mice. The gene Ldr-2 is in the same linkage group as the gene Ldr-1, at a distance of 19.6 map units from it. The data of immunochemical analysis suggest that the effect of the gene Ldr-2a is related with the decreased content of the subunit B, and possibly of the subunit A of LDH. The study of LDH pattern throughout mouse development has demonstrated, that the differences in liver KDH patterns between CBA/Lac and DBA/2J mice, controlled by the gene Ldr-2, express phenotypically on 6-8 dyas and are finally formed in the middle of the first month of the life.


[Problems in the genetics of bovine leukemia. II. The effect of fathers and mothers on the leukemia disease frequency in the progeny]. Geneology of 14,000 animals which are the progeny of 554 bulls are studied, 2060 of them having leucosis. Differences between bulls in the frequency of the disease in daughters are observed. The morbidity of daughters of bulls having leucosis is higher than for the population in the average. The morbidity of the animals depends on the linear relation animals. "Leucosis" families having a high concentration of ill animals for several generations, and families resistant to leucosis are revealed. Daughters of leucosis mothers got ill more often than those of healthy animals. The coefficient of heritability of leucosis ranges from 0.07 to 0.50. Concordancy for leucosis in unisexual twins is 74.1%. Insignificant increase in leucosis is found for the last three generations. Predisposition for leucosis is characterized by a complex hereditary condition. The portion of genetic factors is quite enought to conduct the animal selection for leucosis resistance.


[Role of the genetic-physiological interrelationships of mother-progeny in establishing the viability and fertility of mammals. II. The weight of the embryos of BALB, CBA and DBA strain mice developing from transplanted blastocysts]. The weights of embryos and their placentas obtained by blastocysts of CBA/LacY and DBA/2 mouse strains transfer in recipient females of BALB/c strain and also by blastocysts of BALB/c mouse strain transfer in recipient females of CBA/LacY strain were analysed on the 16th gestation day. It is shown that placental weights are determined by genotypic peculiarities of embryos, although comparative placental weights of different strain embryos could also depend on females fertility. The weight of allogenic embryos (developed from transferred blastocysts) significantly excessed the weight of singenic embryos, and most significant differences were noted in females with small number of embryos. The possibilities to solve some applied and fundamental problems of mammalian reproduction given by the method of interstrain and interbreed early stage embryos transfer are discussed.


An alternative to radical surgery for cancer of the prostate. We have used the technique of retropubic implantation of 125I seeds, as introduced by Whitmore and associates in 1972, in 12 selected patients with prostatic cancer. Morbidity has been minimal, and the tumor has been effectively controlled. This technique delivers more radiation and has fewer side effects than external cobalt irradiation, and it should be offered to the patient as an effective alternative to radical prostatectomy. It is best suited for patients with stage A, stage B, or small stage C lesions who have negative bone scans. Edema of the penis follows the lymphadenectomy but gradually subsides.


Alaskan Malamute chondrodysplasia. V. Decreased gut zinc absorption. Experiements were conducted to determine if zinc absorption was impaired in Alaskan Malamutes which had a genetic chondrodysplasia or dwarfism. When the uptake of an oral dose of 65Zn from the gut in blood was measured in whole dogs it was found that the chondrodysplastic animals absorbed only 25 per cent the amount absorbed by their controls. In vitro studies suggested that 65Zn was initially bound to a protein fraction in all cases but it was later released to a non-protein fraction in the case of normal dogs. This transfer did not occur in the case of the chondrodysplastic dog and it suggests that the transfer of zinc from a protein to a non-protein fraction in the mucosal cell may be the missing step in the dog with chondrodysplasia.


The effect of a single injection of papain on growth of the limb bones of the mouse. The chondrodystrophic mouse mutant stumpy (stm) shortens proximal limb bones more than distal ones and acts late in development (circa 14 days post partum). It was thought that a late disturbance in bone growth might cause more damage to epiphyses of proximal than distal bones. This was investigated using a single injection of papain on days 8, 10 and 12: shortening of proximal and distal bones was demonstrated, but was similar in all three experimental groups.


A short term study on the growth of garden lizards in the laboratory. Male garden lizards weighing between 2 to 17.5 g and having a snout to vent length range of 4.5 to 8.7 cm were collected from nature during the breeding season and reared in the laboratory at 28 +/- 2 degrees C for a period of 6 months. There was a high mortality rate but those which survived showed excellent positive correlation between bodyweight and time (r = 0.97, P is less than 0.001) and between S-V length and time (r=0.98, P is less than 0.001). The length and body weight relationship during the period of study was also highly significant (r=0.99, P is less than 0.001).


Secular change in sitting height and lower limb height of children, youths, and young adults of Afro-black, European, and Japanese ancestry. During a large part of the last 100 years many human populations in Asia, Australia, Europe, and North America have increased in standing height. The amount of increase has risen with age from infancy to mid-adolescence, and diminished with age from mid-adolescence to early adulthood. In the present paper standing height is broken into two components and-for American black, American white, and Japanese groups-each component is found to (1) show substantial secular increase, and (2) yield a trend of quantitative difference similar to that of standing height. Average sitting height of Japanese males increased during the 33 years between 1937 and 1970 by 2.5 cm at age 8 years, 4.1 cm at age 14 years, and 2.9 cm at age 16 years; corresponding values for lower limb height were 3.7 cm, 5.3 cm, and 3.9 cm. During the 80 years following 1881, American white females ages 9 years and 13 years living in the Midwest increased in average sitting height by 4.6 cm and 5.4 cm, and in average lower limb height by 4.9 cm and 5.2 cm. For both dimensions of each racial group, secular change is greater at mid-adolescence than in early adulthood.


Socioeconimoc influences on the weight-height relationship in pre-school children. Ehrenberg has found a relation between heights and weights of children which was hypothesized to hold throughout the period of growth and under different environmental conditions. Early work showed that in developing countries the children were lighter than would be expected from their weights on the basis of that relationship, and more recently it was shown that in Western children the relationship requires modification over the first eighteen months of life. It is hypothesized that the decay of the modifying term (a negative exponential) is in some way an index of maturation. This suggested that its decay might well be affected socio-economic factors, and the analysis of three studies from developing countries, each involving different socio-economic groups of similar genetic background, showed that the rate of decay was indeed related to the socio-economic levels, with the better-off children exhibiting faster maturation.


The effect of various dietary restricted regimes on biochemical variables in the mouse. Twenty-one day old and seventeen month old female mice were fed the following three dietary regimes for one or six months: 1) 24% protein ad libitum; 2) 4% protein ad libitum; or 3) 24% protein intermittently fed (diet offered for twenty-four hours on Monday and Wednesday, and for eight hours on Friday). The activities of succinoxidase, malic dehydrogenase and cholinesterase as well as the concentrations of protein and DNA were determined in livers and kidneys. Calculated on the basis of DNA, the activities of these three enzymes as well as protein content were decreased in the 4% and intermittent-fasted animals and increased in the intermittent-fed animals. The mean values of the enzymes as well as the protein content per mg. of DNA of the intermittent-fed and intermittent-fasted animals were essentially the same as that of the 24% ad libitum controls. These findings were obtained on both young-growing and adult animals. INDEX WORDS: Dietary restriction, enzymes, age, mouse, protein synthesis, genetic code use.


[Pharmacological studies on supersensitization. V. Augmentation of pressor response to catecholamine induced by N, N-dimethylethylenediamines (author's transl)]. Effects of N,N-dimethylethylenediamines on epinephrine-induced pressor response in pentobarbital-anesthetized rats were examined and 3 out of 12 compounds, i.e., tripelennamine, N,N-dibenzyl-N', N'-dimethylethylenediamine (I) and N1, N1-dibenzyl-N2, N2-dimethyl-1,2-propanediamine (II), were found to be more potent as potentiators to epinephrine. In pithed rats, tripelennamine, I, II and cocaine also augmented pressor response induced by epinephrine. In pentobarbital-anesthetized rats or in perfused hind paw of rats, the potentiation induced by cocaine and tripelennamine was more marked to norepinephrine than to epinephrine, but an inverse relation between norepinephrine and epinephrine was observed in the potentiation by I and II. In pentobarbital-anesthetized rats, tyramine-induced pressor responses were decreased or abolished by cocaine and tripelennamine, but these responses were increased by I and II. In pentobarbital-anesthetized rats, isoproterenol-, acetylcholine- and histamine-induced depressor responses were not influenced by cocaine, tripelennamine, I and II. Sensitivity of reserpinized rats to epinephrine was increased about eight times that seen in pentobarbital-anesthetized rats. In reserpinized rats, epinephrine-induced pressor responses were slightly increased by cocaine, tripelennamine and II, but these potentiations were not dose-dependent. These results indicate that one of the sites of action of cocaine, tripelennamine, I and II is localized in the peripheral portion of cardiovascular system. The principal mode of action of cocaine and tripelennamine appears to be the inhibition of amine-uptake mechanism at sympathetic nerve endings. The mode of action of I and II is apparently different from the actions of cocaine and tripelennamine.


[Pharmacological studies on the cough-like reflex induced by chemical stimulation (author's transl)]. To investigate the mechanism of the cough-like reflex (CLR), we employed 1.1-dimethyl-4-phenylpiperazinium iodide (DMPP). In dogs anesthetized with alpha-chloralose, CLR was induced by administration of DMPP (i.v. and intracarotid arterial), lobeline and nicotine. Repeated administration of DMPP did not cause a tachphylaxis, however, lobeline and nicotine did induce a tachphylaxis. DMPP (i.a.), lobeline, nicotine and histamine caused an increase in respiratory resistance as measured by a Respiratory Resistance Meter, while DMPP (i.v.) did not. The ED50 of morphine, codeine, oxymethebanol, picoperidamine and piclobetol on CLR with DMPP was higher than that of those drugs employed for the peripherally-induced cough. CLR with DMPP was not affected by isoproterenol, ephedrine, atropine and propranolol. CLR was markedly depressed by hexamethonium and slightly depressed by benzonate. CLR was abolished after bilateral vagotomy or bilateral denervation of the carotid sinus nerves. These results indicate that the mechanism of CLR with DMPP is different from that of peripherally-induced cough and the carotid body chemoreceptor plays an important role in CLR with DMPP. This CLR may be useful for demonstrating the site of action and the mechanism of antitussive drugs.


[Biological activity of 1alpha-hydroxycholecalciferol (II). Effect on the metabolism of calcium and phosphorus in rats (author's transl)]. Effect of 1alpha-hydroxycholecalciferol on the metabolism of calcium and phosphorus was studied using Ca-labelled and non-labelled rats. With an oral daily dose of 2.5 or 12.5 microgram/kg of 1alpha-hydroxycholecalciferol, serum calcium, urine volume, urinary calcium excretion, urinary calcium concentration and water consumption increased, while fecal concentration, urinary phosphorus concentration and food consumption decreased. There was a lag time (1 or 2 days) between the increase of serum calcium and that of specific activity of serum calcium, and bone resorption was stimulated later than was intestinal calcium transport. After 10 days treatment, calcium concentration in the femur decreased, while a remarkable calcification was noted in soft tissues such as kidney, intestine, aorta, heart and muscle, although these effects were reduced with lower doses of the drug. With a smaller oral daily dose (0.1 or 0.5 microgram/kg), for 6 months, bone calcium and phosphorus concentration increased without soft tissue calcification. Thus, 1alpha-hydroxycholecalciferol may be an effective drug for patients with metabolic bone diseases.


[Effect of clonidine on plasma insulin level in mice (author's transl)]. The influence of adrenergic agents, epinephrine and clonidine, on plasma immunoreactive insulin and plasma glucose concentrations was studied in mice. Subcutaneous injection of epinephrine in fasted mice did not alter the plasma glucose concentration (PG), while plasma immunoreactive insulin concentration (IRI) tended to increase gradually. Intravenous injection of glucose markedly increased IRI. Glucose-induced IRI increase was inhibited by a subcutaneous injection of epinephrine in spite of high elevation of PG. This inhibition of glucose-induced IRI increase by epinephrine was reversed after treatment with an alpha-adrenergic blocking agent, phentolamine. Propranolol, an beta-adrenergic blocking agent suppressed IRI to a greater extent as compared with IRI induced by simultaneous injection of glucose and epinephrine. These results indicate that beta-adrenoceptor stimulating action accelerates the insulin release induced by glucose while alpha-adrenoceptor stimulating action inhibits it. Subcutaneous injection of clonidine in fasted mice slightly decreased IRI and increased PG. The response of PG to clonidine was dose-dependent. Glucose-induced IRI increase was inhibited by an intravenous injection of clonidine, and PG was elevated under the same conditions. The inhibition of glucose-induced IRI increase by clonidine was reversed when phentolamine was given, and under these conditions, PG showed no change. Propranolol treatment did not result in a recovery of the inhibition of glucose-induced IRI increase by clonidine. When compared with the results of epinephrine treatment, it may be concluded that clonidine shows alpha-adrenoceptor stimulating action in the secretion of insulin from beta-cells of the endocrine pancreas.


[Influence of indapamide on isolated rabbit arteries (author's transl)]. The effect of indapamide, a high ceiling diuretic, antihypertensive drug, was investigated in helically-cut strips of rabbit cerebral, coronary, renal, mesenteric and femoral arteries and aortae. The addition of indapamide in concentrations higher than 3 X 10(-5)M relaxed those arterial strips contracted with prostaglandin F2alpha; the relaxation being greater in cerebral, coronary and renal arteries. Atropine propranolol and aminophylline did not reduce the relaxing effect. Hydrochlorothiazide produced fewer incidences of relaxation. Treatment for 20 min with indapamide (3 X 10(-5) or higher) significantly attenuated the contractile response of mesentric arteries to nicotine and tyramine. Contractile responses to transmural electrical stimulation were not reduced but rather potentiated. The dose-response curve of norepinephrine was not significantly affected by indapamide. The contractile response of nictitating membranes of anesthetized cats to stimulation of preganglionic sympathetic nerves was not influenced by indapamide but was abolished by hexamethonium. It may be concluded that arterial relaxations induced by indapamide are due to a direct action on smooth muscles. Indapamide appears to attenuate the response to nicotine and tyramine by interfering with the mechanism of neuronal amine uptake. However, such does not involve a ganglionic blockade nor a reduction of the release of norepinephrine from adrenergic nerve terminals.


[Effect of selective application of sodium picrate to the hypogastric ganglion in the hypogastric nerve-vas deferens preparation of the guinea pig (author's transl)]. Effect of sodium picrate (picric acid-Na; PA) on the hypogastric ganglion in the hypogastric nerve-vas deferens preparation of the guinea pig was studied and the results are as follows: PA or acetylcholine (ACh) at doses (g/ml) of 10(-5) approximately 10(-4) applied to the ganglion increased the height of the response (R-NS) of the vas deferens to the hypogastric nerve stimulation. Neither drug restored R-NS blocked by hexamethonium 3 X 10(-5). Effects of PA and ACh on R-NS were potentiated by neostigmine 10(-7) and the potentiation was considerably greater for ACh than for PA. Effects of PA on R-NS were not influenced by pretreatment with atropine. Both PA and ACh recovered R-NS which was partially reduced by hemicholinium-3 (HC-3), although the recovery of R-NS by PA was rapidly abolished more than that by ACh when these drugs were repeatedly applied in the presence of HC-3 3 X 10(-5). PA markedly recovered the R-NS reduced by morphine 10(-4) and ACh slightly restored that R-NS. These results suggest that the site of action of PA on the hypogastric ganglion of the guinea pig is different from that of ACh and the effect of PA on R-NS may be due to the acceleration of ACh-release from preganglionic nerve endings.


[Application of a response duration schedule in rats to evaluate drug-induced auditory impairment (author's transl)]. Determination of auditory threshold was carried out under a response duration schedule of tone and/or light-dipper presentation. This schedule enabled an exact assessment of auditory sensitivity, since the direction and distance from rat to sound source were constant and the rat could thus acquire the conditioned behavior in a short time. The rat has to press the lever and hold it until a CS(tone and/or light) was presented. The animal could get water-reinforcement with release of the lever during the period of CS. The intensity of 3 KHz pure tone was reduced, from 110 dB (starting point), by 2 dB steps in each trial, until the subject made 3 non-response trials (i.e., no dipper approach within 0.7 sec after the tone onset) among 5 trials. The highest tone intensity among non-response trials was taken as the threshold. The auditory sensitivity of the rats with cotton-stuffed ears and the pierced eardrums decreased about 10 and 20 dB, respectively. The auditory sensitivity in rats was decreased by administration of streptomycin sulfate(SM), 300 mg/kg/day, i.m., in combination with ethacrynic acid(EA), 50 mg/kg/day, p.o., for forty days and in combination with EA, 100 mg/kg/day, p.o. for ten days. The auditory sensitivity was not influenced by administration of SM, 300 mg/kg/day, i.m., for forty days.


Development mutants of Streptomyces coeruleorubidus, a producer of anthracyclines: isolation and preliminary characterization. The wild strain Streptomyces coeruleorubidus JA 10092 was found to segregate into two spontaneous morphological variants (spo-1 and bld-1) with a different ability to form aerial mycelium in media with glucose as the main carbon source. Six new types of developmental mutants were obtained from the bald variant bld-1 after treatment with mutagens (UV light, gamma radiation, nitrous acid) and after natural selection. Formation of the aerial mycelium was fully suppressed in the bld-2 type growing on media both with glucose and with starch. The other types were bald only on starch media, forming the aerial mycelium on media with glucose; types spo-2, spo-3, spo-4 and spo-5 differed in size, shape and surface structure of spores, the type whi formed asporogenous aerial hyphae.


Effects of cyanein and ramihyphin A on the dimorphism of Paracoccidioides brasiliensis. As a preliminary step in the study of dimorphism in Paracoccidioides brasiliensis, the effects of cyanein and ramihyphin A were studied. These antibiotics have been reported to induce morphological changes in fungi. The results obtained suggest that ramihyphin A induce swelling of hyphae while partially inhibiting Y leads to M transformation with the production of an incipient and swollen mycelium. Cyanein did not affect the mycelial morphology as did ramihyphin A. However, the Y leads to M transformation was inhibited and, also, the M leads to Y transformation was blocked with the production of a few yeast cells which were not released from the mycelium.


Contribution to the taxonomy of haemolytic corynebacteria. In an attempt to assess the taxonomic relationships among human (Corynebacterium haemolyticum), animal (Corynebacterium pyogenes bovis) haemolytic corynebacteria, typical corynebacteria (Corynebacterium diphteriae mitis, C. ovis, C. ulcerans) and group A and G streptococci, a number of biochemical parameters were established: the DNA content of G + C, the presence of the cytochrome system, composition of fatty acids in free lipids and production of carboxylic acids as end products of fermentation. It was found that according to the above criteria, streptococci differed significantly from the corynebacteria studied. In addition, it was possible to differentiate a subgroup of typically aerobic haemolytic corynebacteria (different from both human and animal corynebacteria), possessing a complete cytochrome system, producing propionic acid and having a different composition of fatty acids.


Antimicrobial effects of some benzthiazol derivatives. Substitution with NO2, Cl, Br and I into position 6 of 2-benzthiazolthiol derivatives increased their antimicrobial efficiency while the SH group is preserved. This increase affected both G+ and G--bacteria, mycobacteria and some fungi. The degree of efficiency of the benzthiazol derivatives is also influenced by the substituent in position 2.


Microbial changes in clover rhizosphere after foliar and soil application of cobalt. Application of cobalt(II) nitrate to the leaves of red clover (Trifolium pratense L.) resulted in a pronounced increase of dry weight and the number of root nodules. Counts of bacteria in the rhizosphere, content of ammonia and production of carbon dioxide in rhizosphere soil were also higher, whereas the content of nitrates decreased. Differences in the counts of bacteria, actinomycetes, Azotobacter, anaerobic bacteria and cellulose decomposing bacteria in the rhizosphere of control and treated plants were not directly related to the way of application of cobalt. Genera Penicillium, Fusarium and Trichoderma predominated among fungi. The relative occurrence of penicillia was higher after the application of cobalt, the incidence of fusaria was lower. The effects of foliar and soil application of cobalt on rhizosphere microflora were not identical.


7-Deoxy-13-dihydrodaunomycinone in cultures of Streptomyces coeruleorubidus. 7-Deoxy-13-dihydrodaunomycinone was isolated from three strains of Streptomyces coeruleorubidus. Its production was found to rise at the end of cultivation and to be stimulated by lowered aeration intensity.


Map reading by chimpanzees.

Map reading by chimpanzees. Infant chimpanzees, after watching a small black-and-white closed-circuit television picture of a familiar caretaker walking out into an outdoor field and disappearing from sight, were more successful in finding the person than if they had been given no such cue; and their performance approximated that which obtained after they had seen the same scene normally, via direct perception.


Clinical experience with Org GB94 (mianserin hydrochloride), a new tetracyclic antidepressant. (1) Org GB94 (Mianserin hydrochloride), a new tetracyclic antidepressant, was administered to 21 patients with depression or with depressive states. (2) Remarkable antidepressive response was obtained with Org GB94 in moderate and mild forms of endogenous, involutional and senile depression. (3) The onset of action of Org GB94 was rapid. (4) Anticholinergic side effects were extremely rare and other untoward effects were mild in nature.


On psychiatric symptoms of neuro-Behçet's syndrome. Studies were made on the groups of psychiatric symptoms of Neuro-Behçet's syndrome in six cases considered to be brain stem encephalitis, including one case of autopsy. Psychiatric symptoms appeared from one to eight years after neurological symptoms first occurred. This group of psychiatric symptoms can be divided roughly into the early-stage, middle-stage, terminal-stage and episodic groups. The initias-stage symptom group concerns mainly a change in, and regression of, personality, consisting of being childish, shallow, indifferent, careless, rude, slow in action, euphoric, or depressive. The middle-stage symptom group is made up of indifference, forced smiling, forced crying, amnesia, recent memory impairment, and disorder of sleep rhythm. The terminal-stage symptom group comprises the "lock-in" syndrome, which if advanced, will become Apallisches Syndrome. The episodic symptom group is made up of pathologically abnormal experiences such as hallucinations and delusions and symptoms due to a decline in the level of consciousness such as confusion, delirium and twilight state. Dementia hitherto mentioned in Neuro-Behçet's syndrome should be classified as subcortical dementia.


Time-dependency of serum carbamazepine concentration. Serum CBZ concentration was determined by gas liquid chromatographic method in 14 epileptic patients (32 samples) treated initially with CBZ alone, and the following results were obtained: 1. The relationship between serum CBZ concentration and CBZ dose was expressed by a regression line that sloped sharply upwards at first: high serum concentration was obtained from small dose up to the end of three weeks after initiation of CBZ administration. After the 3rd--4th treatment week, regression coefficient was reduced by half, and the regression line had a gentler slope. 2. As the treatment was continued longer, serum CBZ concentration and serum concentration/dose ratio became lower. The relationship between duration of CBZ treatment and serum concentration/dose ratio was expressed by a regression curve representing a quadratic function with negative coefficient, the ratio being high in early stage of the treatment. This regression curve shows that the ratio reached its maximum value at the 10.5 days after initiation of the treatment. The ratio was stabilized at a low level about 3--4 weeks after that. 3. From the results, serum CBZ concentration was confirmed to be more dependent on duration of the treatment than on dose. This was inferred, on the basis of documentary research, to be attributable to the autoinduction of CBZ metabolism, the inference of which seemed to be supported by the results of measurement of time-course change in serum concentration in five cases of the present series. The results in one of the said five cases suggest that serum CBZ concentration varies greatly within 12 hr. 4. On the basis of these results, it is proposed that spontaneous decrease in serum CBZ concentration must be countered not merely by increase in CBZ dose, but by increase in the number of dosages/day for suppression of excessive diurnal change in serum concentration as well.


Induction of the six c/sec spike and wave by diphenhydramine hydrochloride in healthy male adults. Diphenhydramine hydrochloride (DPHm) solution 1.5% was given intravenously to 375 healthy males (mean age; 23.8 years) at a rate of 30 mg/min. The dosages injected were 2 mg/kg (N=157); 1.5 mg/kg (N=94); 10 mg/kg (N=72); 0.5 mg/kg (N=52). As a result, the 6 c/sec spike and wave discharges (WSP) was found in 19.7%, 9.6%, 20.8%, and 15.4% of cases, respectively. Comparisons were made between the WSP incidence versus past histories and Cornell Medical Index results, and between WSP positive and WSP negative subjects. No significant differences were observed in any of these parameters.


On the distribution of senile changes in the spinal cord. Using serially sectioned spinal cords, studies were made on the number of Alzheimer's neurofibrillary tangles, and the distribution of lipofuscin in five cases of clinically and histopathologically confirmed Alzheimer's disease, 10 cases of similarly confirmed senile dementia and 10 cases of mentally normal people. Alzheimer's neurofibrillary tangles were not observed at all in Alzheimer's disease and in the conrol group. A very small number of them were found in the intermediolateral cell, posterior column cell, anterolateral cell, and anteromedian cell groups in three cases of senile dementia. The deposition of lipofuscin was high in the anterolateral and posterolateral cell groups and nucl. dorsalis in all of the cases of Alzheimer's diseases, senile dementia and the control group. It is worthy of note that the Alzheimer's group, for its age, showed a relatively greater amount of lipofuscin.


The effect of motor-response-deprivation on contingent negative variation (CNV): the morphology. Eighty-four healthy subjects (47 males and 37 females) ranging in age between 9 and 76 years were employed in a study of the relations of the CNV morphology with the CNV amplitude, the reaction time and the MPI score. The results were as follows: 1. We classified a new type of Plateau (P) in the negative-going limb (NGL) types. 2. There was no sex difference in the NGL types, but the positive-going limb (PGL) types were influenced by age, and the type II tended to increase between the ages of 40--59 years old. 3. As a whole, the type B in the NGL and the type I in the PGL were most prominent regardless of age, session or paradigm. The type FD was very rare and appeared only in the session N. The types III and IV failed to be found in any healthy subjects. 4. Using the matched control study, the relations of the morphology with the CNV amplitude, the reaction time and the MPI score were analyzed. The conventional CNV amplitude in the sessions C and R increased in the sequences of the types B-A-P and the types I-II, and the CNV amplitudes in the session N increased in the sequences of the types A-B-P and II-I. The reaction time in the sessions C and R tended to prolong in the sequences of the types P-B-A and II-I. With the MPI, as the N-score increased with a decrease of the E-score, the NGL types changed from the type P to A through B in the conventional CNV and from the type A to B or P in the session N, while the PGL types changed from the type I to II in the conventional CNV and from the type II to I in the session N. 5. We suggest that there is a twofold arousal process, specific (task-relevant) and general, behind these types and that the dynamic balance of this process may influence psychological manifestations.


A morphologic study of central nervous system aging in Hiroshima, Japan. The presence of intraparenchymal small vessel arteriosclerosis, senile plaques, neurofibrillary tangles and granulovacuolar degeneration was quantified in the brains of autopsided patients from three age groups: 1) 90--99 years old 2) 70--79 years old and 3) 50--59 years old. Neurofibrillary tangles particularly in the hippocampus were the best indicator of chronologic aging, but senile plaques and granulovacuolar degeneration were also age related. Intraparenchymal small vessel sclerosis, cerebral infarction and hemorrhage, cause of death and radiation exposure at the time of the atomic bomb explosion in Hiroshima apparently had little or no effect on the development of these aging changes. Each type of aging change appeared to be independent of the others, to progress to a different combination of physiologic processes.


Electron microscopic X-ray microanalysis of the nervous system after mercury intoxication. The nervous system of the rats with methyl mercury intoxication was studied by a recently developed electron microscopic X-ray microanalytical technique. A mercury element was detected at the lysosome-like dense bodies of the peripheral nerves and of the cerebellum, especially prominent at the dense bodies of the collapsing cells. Mercury was also suggested at the dilated endoplasmic reticulum of Schwann cells. It may be apparent that mercury itself practically penetrates into the cells of the nervous system and directly destructs them. Except for the lysosome-like dense bodies and occasional endoplasmic reticulum, however, the precise localization and distribution of minimal amounts of mercury element within the cells were difficult to evaluate by this method, because a peak for mercury was overlapped occasionally with that of sulphur when they were so scanty in quantity.


An autopsy case of atypical senile dementia with atrophy of the temporal lobes--a clinical and histopathological report. A man aged 70, descendant of an apparently healthy family, showed disorientation, delusional ideas and rages at 66. Later there was slowly advancing deterioration with muteness, disorientation and dysphagia. He died of cardiac failure. There was the diffuse atrophy of the cerebrum, which was remarkably accentuated on both temporal lobes (poles, T2 and T3), where the loss of nerve cells and proliferation of astrocytes were found in the cortex and pallor and conspicuous fibrillary gliosis were noted in the white matter. These findings fundamentally suggest Pick's disease. On the one hand, numerous senile plaques and Alzheimer's neurofibrillary changes, suggestive of Alzheimer's disease (senile dementia), were observed throughout the cerebral cortex. On the other hand, a few inflated cells were also seen in the cingulate, superior frontal gyri and temporal lobes. Basilar artery was moderately atherosclerotic and cerebrovascular disorders were distributed throughout the cerebral cortex and basal ganglia, especially in the field of supply of middle cerebral artery. This case is similar to rare cases reported by Berlin (1949), Neumann (1949) and Oyanagi et al. (1975). The nosological situation as a disease entity remains to be determined.


[Study report on the lack of interaction between mianserine and noradrenaline in man]. Tricyclic antidepressants are known to potentiate the increase in blood pressure caused by noradrenaline. Five depressive patients were given intravenous noradrenaline before and after 2--4 weeks of treatment with Org GB 94 (Tolvin). The dose of noradrenaline was increased until a rise of 30 mmHg in systolic blood pressure occurred. No evidence of interaction between Org GB94 and noradrenaline was found. The implications of this are discussed.


[Imprint cytology of axillary lymph nodes in breast neoplasms for intraoperative rapid diagnosis]. A total of 385 lymph nodes of patients suffering from breast cancer were examined intraoperatively for the presence of metastases. We applied imprint cytology and stained using the "Diff-Quick" set (3 times 30 seconds). The percentage of correct identifications following instant cytological examination amounted to 94.5 if compared with subsequent paraffin histology. The 21 diagnostic failures were composed of 3 false negative and 18 false positive results. These data make the advantages for routine clinical application quite obvious.


[Scintigraphy and fine needle biopsy in nodular goiter. Results in 548 patients]. The results of scintigraphic and cytological investigations in 548 patients with goiter are presented: In 402 goiters 470 nodes were detected, 385 of which were scintigraphically "cold". 276 solitary nodules were found, 109 in cases of multinodular goiter. Solitary nodules were preferentially located in the right lobe. The cytological diagnosis was confirmed histologically in 88 cases. Out of 24 malignant tumors, 21 were diagnosed correctly by means of cytology. The positive smears and the histological findings were in agreement in 14 of 15 cases. The accuracy of cytological diagnosis in the detection of thyroid malignancies was 87.5%. 12.5% of the smears were false negatives, 1.6% false positives and 10.9% false suspicious. The relative high percentage of false suspicious smears is caused by difficulties in cytologic differentiation of thyroid lesions due to microfollicular structures which are usually only classified as "follicular neoplasia". This cytologic term necessitates an obligatory histologic examination since cytology does not allow to differentiate between follicular adenomas and carcinomas. 5.5% of the histologically ascertained cold nodules were malignant, in 19% of the cases with cold nodes thyroid punction revealed cystic lesions.


[Functional effects of micro-oil embolization following lymphography]. Lymphography, if performed correctly, has few clinically relevant complications. Nevertheless, the passage of oily contrast medium into the pulmonary vascular bed along physiological pathways can usually be verified radiographically and functionally. Since that part of the contrast medium filtered in the lungs is of no diagnostic value we think that a total amount of 14--16 ml Lipiodol Ultrafluid should normally suffice for outlining the retroperitoneal lymph passageways from the legs. With smaller amounts one may misinterpret an incomplete filling of the cranial paraaortic lymph nodes as filling defects. We agree with most authors that in patients with abnormal lung function, especially those with restrictive disorders, and in patients with pre-existing right heart strain lymphography should only be considered when truly indicated and only after testing of pulmonary function.


[Video technic in the hospital--play or progress?]. Many surgical departments indlcuding the ENT field have installed video recording systems or simple b/w or color TV camera and monitors. Using a TV color system has been quite successful for ENT purposes in the operating room. The camera is used in microsurgical work (tympanoplasty etc.) and is connected to the microscope so that the picture can be controlled, corrected, analysed and explained by the teacher. Recording systems are presented and the "utopic" question of compatibility is discussed.


[Conservative treatment of lumbar intervertebral disc displacement and its limits]. Non-surgical therapy of lumbar disc protrusions is based on complete differential diagnosis. Drug therapy means mainly muscle relaxants partly combined with analgetics. Physiotherapy is important, especially gymnastics and swimming. Chirotherapy is in most cases useful, but if 3 or 4 therapeutic sessions are without success, operation will be necessary. Indication ofr an operation can be (relatively) persisting disturbances, absolute indication is any kind of weakness or paresis.


[Rubella vaccination during puerperium? Effect of rubella vaccination during puerperium on the titer of HAH]. The rubella-HI-titer of 142 women vaccinated against rubella during childbed and 126 women not vaccinated during childbed were tested at the time of delivery and again 10-12 weeks later. The results show booster effects if prevaccinal titer were low. In the case of higher prevaccinal titer a titer reduction due to vaccination results.


[Organic acids including alpha-keto acids. Their importance and gaschromatographic-mass spectrometric analysis in serum and urine of infants]. Alpha-ketoacids are of some importance as intermediary metabolic products of aminoacids. Analysis of alpha-ketoacids has been difficult due to their ketogroups. A newly applied method is described by which these ketogroups are transformed to oximes. Linearity, massspectrometric verification, stability, sensitivity, and extractability allow the application to physiologic fluids: 1. when challenged with oral 1-leucine, children with maple syrup urine disease show an increase in all three branched-chain alpha-ketoacids; 2. apparently branched-chain alpha-ketoacids play a major role in the pathogenesis of the so-called ketotic hypoglycemia; 3. infants, newborns, and prematures have higher serum concentrations and higher urinary excretion of organic acids including the alpha-ketoacids than oder children; 4. even when humanized milk is fed there appears to be a higher metabolic load in newborns and prematures than under human milk; 5. tyrosine and its organic acids pHPPA, pHPLA, and pHPAA are significantly increased in newborns and prematures when humanized milk versus real human milk is fed. These are further reasons, among many others, to prefer human milk in infant feeding over all artificial products.


[Tuberculosis of the peripheral lymph nodes]. In Germans as well as in "foreign workers" acute tuberculous lymphnode disease is most often seen in the drainage areas of old sometimes even calcified tuberculous processes. The infective agent is almost always mycobacterium tuberculosis. Resistant strains are rarely found even in recurrent disease. Differential diagnosis includes tulareaemia, cat scratch syndrome, lues, and foreign body reaction. In those cases in which the histopathologic findings are similar to productive tuberculosis, sarcoidosis and epitheloid cell reaction in the drainage area of malignant tumors have to be taken into account. Knowing the usual good-response to tuberculostatic drugs there is no need to perform risky operations or to utilize rather dangerous agents such as streptomycine.


[The value of galactography in the secreting breast]. At the Institutes for Diagnostic Radiology of the Universities of Athens (Greece) and Freiburg/Br. (West Germany) the mammographic examination had to be supplemented in 4 res. 2 per cent by injection of contrast medium into the milk ducts (galactography). This procedure is indicated in cases with secreting of the mammary glands. Technic and results are presented. Recognition of small, non-palpable tumors which might not be detected by mammography alone is emphasized.


[Possibilities for pain reduction by the prevention of edemas and elimination of endogenous pain producing substances]. The contemporary view of the cause of pain in case of histological lesions is discussed, i.e. the mechanisms of the formation of local high-protein oedemas in connexion with disorders of lymphatic drainage. 295 patients of an oral-surgical department were subjected to a systematic therapeutic study for investigating the possibilities of medicamentously influencing oedema and pain. Tested by way of comparison were a benzopyrone preparation (Venalot) and oxyphenbutazone. A group of control patients could only make use of an analgetic. The assessment of the reduction of oedema was done by means of anthropometric measurements. The analgetic action was judged by the need of analgetics. The result of it was that the benzopyrone preparation possesses a strong analgetic and antioedematous action which also exceeds that of the comparative therapy. The benzopyrones' clinical mechanisms of action are discussed in the light of experimental results.


[Ambulatory blood sugar control of diabetics on insulin therapy during pregnancy by means of the Eyetone reflectometer]. The data obtained in this study show that sufficiently accurate blood glucose values can be obtained by the pregnant diabetic with the Eyetone reflectometer. It is possible to lower the blood glucose value of the pregnant diabetic to the normal range as soon as pregnancy is confirmed. Prolonged hospital confinement can be avoided by using this outpatient blood glucose measurement procedure.


[Fetomaternal immune reaction in normal and pathologic pregnancies]. Pregnancy-specific diseases such as pre-eclampsia/eclampsia and intrauterine growth retardation do certainly influence the feto-maternal immunological links; this effect may be primary or secondary. In vitro methods to measure quantitatively the maternal cellular immune response and its sensitivity to humeral serum factors are discussed. Trophoblast cells grown in macro- and microcultures under standardized conditions were exposed to the cytotoxic effect of a suspension of maternal lymphocytes derived from peripheral venous blood; the concentration of lymphocytes was titrated. In a second titration series we tested the influence of maternal serum on the lymphocytotoxic effect; trophoblast and lymphocyte cell numbers were kept constant. The results give some evidence that in the absence of maternal serum the lymphocytotoxicity is diminished in cases with poor fetal growth or with pre-eclampsia/eclampsia, if compared with the conditions found in cases of normal term pregnancies. If, however, maternal serum was present, the known anticytotoxic effect of the serum became only evident in the normal term controls, whereas the cytotoxicity increased with rising serum concentrations in cultures derived from cases with intrauterine growth retardation or pre-eclampsia/eclampsia. One possible explanation would be the presence of cytotoxic serum factors in those cases. In the discussion the different aspects of feto-maternal immune relationship in healthy subjects are analysed and an attempt is made to correlate the findings of different authors. It is most likely that the maternal immune responses (directed specifically and non-specifically against fetal antigens) do vary continuously in pregnancy.


[Microbiological evaluation of cefoxitin, a new beta-lactamase resistant cephamycin antibiotic, compared to cephalothin, cephaloridine and cefazolin]. Cefoxitin (Mefoxitin), Cephaloridin, Cephalothin and Cefazolin were tested in vitro against 380 clinical isolates of Staph. aureus and Enterobacteriaceae using the tube dilution procedure. Of the gramnegative microorganisms a selection of 150 strains was examined regarding susceptibility to the antibiotic combinations cefoxitin/gentamicin and cefoxitin/sisomicin in comparison to cephalothin/gentamicin and cephalothin/sisomicin. Cefoxitin has a broad antimicrobial spectrum and a high beta-lactamase-resistance. Cefoxitin was more active than the other antibiotics tested against E. coli, Klebsiella, Serratia, Enterobacter, indole-negative and -positive Proteus species. The high effectiveness of cefoxitin against anaerobic bacteria such as Bacteroides fragilis and Clostridium perfringens is discussed. Cefoxitin has an excellent bactericidal potency. Among the combinations tested cefoxitin/sisomicin was most active and obtained synergistic effects in most species. The resistance rate of cefoxitin of 8.7% was reduced to 0.7% with cefoxitin/sisomicin.


[Depressive syndromes during schizophrenic psychoses]. Depressive syndromes are often seen in schizophrenics. Three forms have to be distinguished: 1. Depressive reactions of acute psychotic symptoms. Primary therapy should be done with neuroleptics. 2. Psychodynamically understandable depressed mood after psychosis and/or hospitalization. Psycho- and sociotherapy is necessary. 3. Very often and most heavy are pharmacogenic depressions following recovery from schizophrenic symptoms (under fluphenazine-decanoate up to about three quarters of the patients). A controlled study showed that they are caused by neuroleptic drugs. First and best therapy is to reduce or even discontinue the application of the neuroleptic. Antiparkinsonian drugs intravenously applied help within one minute. The recovery from depressive syndromes can also be accelerated if reduction of neuroleptic dosage is sometime assisted by antidepressants.