Bilateral sudden deafness following combined insecticide poisoning. A case of combined poisoning due to exposure to an aerosol containing both malathion and methoxychlor (sold under the trade name Ortho TM Orchard Spray in the United States) ps presented. The following unusual features occurred in the course and outcome of the poisoning: slow onset of symptoms and signs, bilateral profound and permanent sensorineural hearing loss, and residual peripheral neuropathies in the extremites. The possible potentiation of the usually low toxicity of malathion is suggest and discussed.


Facial palsy: interpretation of neurologic findings. A review of the otoneurologic findings in 500 patients with facial paralysis revealed their importance for diagnosis, prognosis, and understanding the pathophysiology of Bell's palsy. Diagnosis. The presence of simultaneous bilateral palsy, facial paralysis associated with lateral rectus palsy, slowly progressive facial weakness with or without hyperkinesis, and facial paralysis that showed no recovery after six months excluded Bell's palsy from the diagnosis. Ipsilateral recurrent palsies were another indication to suspect an underlying cause, since a tumor of the facial nerve caused the paralysis in 30% of the patients with this finding. Signs such as intact forehead movement, alterations in facial sensation, and corneal hypesthesia--although often associated with lesions in the cerebral cortex, cerebellopontine angle, or internal auditory canal--were also found in patients with Bell's palsy. Prognosis. A spontaneous complete recovery following Bell's palsy occurs in about 70% of the patients; but in the presence of a dry eye or dysacousis, the prognosis for a complete recovery drops 10 and 25%, respectively. Pathophysiology. It is proposed that the wide range of neurologic findings associated with Bell's palsy is due to a viral polyneuropathy. This is a disorder that primarily involves sensory nerves, and the facial motor deficit results from involvement of the sensory fibers carried with the facial nerve within the fallopian canal.


Tympanoplasty using homograft tympanic membranes and ossicles. The use of homograft materials in reconstructive, mastoid, and middle ear surgery is increasing. Not only are they useful and practical, but they also do the job well in both anatomical and functional restoration. Many encouraging reports have been written to support their use. Their advantages, in the opinion of the author, outweigh their cost since they can offer a more efficient, versatile, and better method of restoration of hearing in tympanoplasty surgery.


Repair of anterior floor of mouth defects: the island pedicle tongue flap. The island pedicle tongue flap has been utilized for situations where split-thickness skin or dermis had been used previously. It has been found to provide rapid, reliable healing, without excess scarring or problems of desquamation. No functional deficit of the tongue is produced, so swallowing and speech remain unaffected. This method is recommended for those anterior floor of mouth lesions amenable to wide local excision, but too large for primary closure.


[Behçet's disease and the gastrointestinal tract (author's transl)]. Behçet's disease is characterized by the triad of aphteous stomatitis, genital ulcerations and uveitis. This syndrome is thought to be a systemic disease with various unspecific manifestations, which may arise in other organs as well in a considerable number of cases. More than 50% of all patients do have gastrointestinal symptoms; erosive and ulcerative lesions are found primarily in the jejunum and colon. Case reports are given of 3 patients with Behçet's disease and gastrointestinal involvement; one of these patients died. All patients did have unspecific changes of esophageal motility.


[Gastroscopy and rinsing of the gastric wall under sight in drug intoxication (author's transl)]. Gastric rinsing during gastroscopy is presented as a new, effective, uncomplicated method of primary elimination of poison, as a part of a new diagnostic and therapeutic concept for patients intoxicated with hypnotics. The advantage of this active therapy is a fast elimination of the toxic substance and prevention of secondary complications. The diagnostic value of gastroscopy and radiological examination in patients with unexplained comatous states is emphasized.


[Differential diagnosis of emphysema of the gastric wall: emphysematous gastritis (author's transl)]. A case report is given of a female patient with infectious emphysematous gastritis; clinical, radiological and histological findings are described as well as--for the first time--endoscopic findings. This serious disease is compared to nonbacterial interstitial gastric emphysema. Etiology and therapy are discussed.


[Chronic gastritis in patients with unexplained upper abdominal symptoms (author's transl)]. In 439 patients biopsies were taken from antral and corpus mucosa, except from the lesser curvature, and histological examinations were done. Superficial inflammatory changes were found in 52.2% of all speciments taken from the corpus and in 64.9% taken from the antrum; atrophic gastritis was found in 2.6% of corpus biopsies and in 10.0% of antral biopsies. Normal findings were obtained in 47.3% of corpus specimens and in 25.7% of antral specimens. It is evident, that inflammatory changes are far more frequent in the antral than in the corpus mucosa. Changes in both areas increase with age. Our findings in regard to atrophic gastritis are different from those obtained by Siurala; this difference needs further explanation.


[Emptying of the stomach after selective proximal vagotomy (author's transl)]. Cream cheese containing 14C-labelled glutaminic acid was given to patients after proximal selective vagotomy and 14CO2 measured in the expired air in order to test the gastric emptying process. Results do not allow exact quantitative evaluation, however definite changes of gastric emptying for up to 6 month after surgery could be demonstrated.


[Neurinoma of the stomach (author's transl)]. Case reports are given of 4 patients suffering from gastric neurinoma. Signs, symptoms and clinical findings are unrevealing. X-ray examination and gastroscopy may help to make a diagnosis, surgery however is necessary to establish a diagnosis definitely. Surgery is indicated in addition, since neurinoma may become malignant. Prognosis is good, recurrence is unusual.


[Subjective tolerance of pentagastrin test (author's transl)]. Side effects of pentagastrin were registered in 50 patients before application of a gastric suction drainage tube, during the basal secretion period as well as after injection of 6 microgram/kg pentagastrin resp. 1 ml of physiological saline. Discrete symptoms occurred significantly more frequently after pentagastrin application: 28% of patients complained about nausea, 24% about tremor, 22% about hot feeling. These sensations occurred immediately after injection and continued for several minutes. In 4 persons the test had to be stopped because of collapse. There was no correlation between the frequency of symptoms, age of the patient, sex or gastric acidity. Causal relationships to lowering of blood pressure or changes of gastrointestinal motility are discussed.


Lipid composition and biosynthesis of human omental tissue. Two groups of five males each were selected for total lipid analyses of their omental tissue. One of these groups had been subjected to a severe caloric restriction and had undergone total weight reduction of about 20%. The other group served as control. Both of these groups of patients required elective surgical procedures during which it was possible to obtain small samples of omental tissue, adipose pad, and/or mesenteric tissue. Total lipid analyses were performed on all of the materials. A distinctive positional distribution of the acyl groups was maintained in the triglycerides of omental tissue for all the patients regardless of dietary state. Patients under caloric restriction showed a reduction in their total triglyceride content, a reduction in their content of unsaturated fatty acyl groups, and a relative increase in phospholipid content. The de novo lipid biosynthetic capacity of omental tissues, as determined by 1-[14C]-acetate incorporation, showed an inverse proportionality to the lipid content of the samples. Omental tissue is biosynthetically a very versatile material capable of yielding rapidly many types of fatty acids. This ability, among others, could account for the usefulness of omental tissue as a supporting base in many types of restorative surgery.


Alkaloids of Thalictrum XXVI. New hypotensive and other alkaloids from Thalictrum minus race B. The roots of T. minus race B have yielded 9 alkaloids, thalirabine (1), thaliracebine (13), thalfine (19), thalfinine (20), thalrugosaminine (22), thalidasine (13), obaberine (24), thaliglucinone (25) and (S)-reticuline (26). The first two, possessing marked hypotensive activity, were assigned complete structures by physical and chemical methods. Thalfine (19) was given S-configuration at its one asymmetric center and was converted to thalfinine (20) and epithalfinine (21), thus the stereochemistry was established at one of the two optically active positions. The other alkaloids were identified by direct comparison with known samples. Antimicrobial testing showed thalirabine, thaliracebine, thalfine, and thalfinine to be active against Mycobacterium smegmatis.


Alkaloids of Thalictrum XXVII. New hypotensive aporphine-benzylisoquinoline derived dimeric alkaloids from Thalictrum minus race B. The roots of T. minus race B have yielded, in addition to adiantifoline (1) previously isolated from this source, two new related alkaloids, thaliadine (2) and thaliadanine (5). Both were assigned complete structures by spectral methods and by chemical interconversion to adiantifoline or its product. O-Desmethyladiantifoline should have structure 14, rather than the previously reported 5. All three isolated alkaloids show hypotensive activity in rabbits, and thaliadanine (5) has antimicrobial activity against Mycobacterium smegmatis.


Plasma membrane phospholipid, cholesterol and fatty acyl composition of differentiated and undifferentiated L6 myoblasts. The lipid composition of plasma membranes isolated from differentialted and undifferentiated L6 myoblasts have been compared. In general, the plasma membranes of differentiated L6 myoblasts have a higher cholesterol to phospholipid molar ratio than plasma membranes of undifferentiated cells. Differentiated L6 myoblasts have increased relative amounts of phosphatidylethanolamine and phosphatidylcholine ine in their plasma membrane and a decreased relative amount of sphingomyelin when compared with the plasma membranes  of undifferentiated myoblasts. In addition, preliminary results show that differentiated L6 myoblasts plasma membrane phospholipid shows differences in the fatty acyl composition, specifically there appears to be relatively more 17:0 and 24:1 and less 16:1 and 18:1 than in plasma membrane phospholipids of undifferentiated L6 myoblasts. These observations indicate that significant changes in plasma membrane lipid composition occur during myoblast differentiation. The role that changes in lipid composition play in control of cellular differentiation, however, remains to be elucidated.


The effects of selected fungicides and insecticides on growth and thebaine production of Papaver bracteatum. The fungicides benlate, maneb, and captan depressed plant growth, thebaine concentration, and thebaine yield per plant when administered chronically to Papaver bracteatum. The chronic administration of dicofol inhibited plant growth and thebaine yield per plant, but did not affect thebaine concentration. Malathion and pyrethrins had no adverse effects on either plant growth or thebaine content.


Behavioral and toxicological studies of cyclopentanoid monoterpenes from Nepeta cataria. Two samples of catnip oil were analyzed by tic, gc, and hplc; the results indicated the presence of 23 components. Fractionation of the commercial sample of catnip oil by either distillation or gc yielded 40% nepetalactone and 43% nepetalic acid. Catnip oil, nepetalic acid, and a nepetalactone-enriched fraction were evaluated for toxicological and behavioral effects in mice and rats. The LD50 of catnip oil, the nepetalactone-enriched fraction, and nepetalic acid were found in mice to be: 1300 mg/kg, 1550 mg/kg and 1050 mg/kg, respectively. Catnip oil (500 mg/kg) and nepetalic acid (62.5 mg/kg) were found to significantly increase hexobarbital sleeping time in mice. Rats trained on a Sidman avoidance schedule showed a significant decrease in performance following intraperitoneal injections of catnip oil (500--750 mg/kg), nepetalic acid (125--250 mg/kg), and the nepetalactone-enriched fraction (500--750 mg/kg). Rats trained on the same avoidance schedule developed behavioral tolerance after daily injections of 750 mg/kg catnip oil.


Absorption of synthetic, stereochemically defined acylglycerols in the rat. The stereochemistry of fat digestion and absorption was investigated in rats with thoracic duct fistulas, after feeding synthetic triacylglycerol or alkyldiacylglycerol. After feeding 1,2-dilauroyl-3-oleoyl-sn-glycerol, dilauroyloleoylglycerol and lauroyldioleoylglycerol were the most abundant chyle triacylglycerols. Positional analysis of the fatty acid distribution and the absence of optical activity indicated that the following structures dominated: rac-1,2-dilauroyl-3-oleoylglycerol and rac-1,3-dioleoyl-2-lauroylglycerol. Therefore, the triacylglycerol resynthesized from 2-lauroylglycerol (pre-cursor to 60% of chyle triacylglycerol) and other precursors was essentially racemic. Chyle phospholipids contained largely endogenous fatty acids, and the proportion of lauric acid was very low. A racemic mixture of 1,2-di[3H] oleoyl-3-tetradecyl-sn-glycerol and 1-tetradecyl-2,3-di[12C] oleoyl-sn-glycerol was absorbed to a lower degree than triacylglycerol. The appearace of oleic acid with different labels in chyle and intestinal lipids did not differ, indicating the absence of stereospecificity in fat digestion. Possible explanations for the low absorption are discussed.


Phytochemical screening of Nigerian medicinal plants II. A total of 47 plant extracts representing 132 genera and 172 species of plants distributed over 59 families were collected from various parts of Nigeria. The plant extracts were screened for the presence of alkaloids, saponins, tannins, phlobatannins and anthraquinones. The number of positive tests obtained was 176 (32.18%) for alkaloids, 242 (44.24%) for saponins, and 435 (79.52) for tannins. A few were positive for phlobatannins and anthraquinones.


Effect of pentadecan-2-one on lipid metabolism in HeLa cells. HeLa cells exposed to trace amounts of pentadecan-2-one showed changes in metabolism of 1(-14)C-palmitate. These changes consisted of an increased incorporation of radioactivity into the triglycerides and free fatty acids and a decreased 14C incorporation into the ether moiety of alk-1-enyl acyl phosphoglycerides. Chemical analysis of the several lipid fractions showed a threefold increase in triglyceride content but no change in the amount of alk-1-enyl acyl or diacyl phosphoglycerides in the treated cells. Pentadecan-2-one added to the culture medium apparently gains entrance to the cell since both pentadecan-2-one and pentadecan-2-ol were detected in the ketone-treated cells and their culture medium.


Reduction in medium chain acids and monoenoic acids in livers and plasma of rats fed eicosa-5,8,11, 14-tetraynoic acid. Male Sprague-Dawley rats were fed for 8 weeks a corn oil (CO) diet or a hydrogenated coconut oil (HCNO) diet. These diets were fed in the absence or presence of eicosa-5,8,11,14-tetraynoic acid (TYA). The inclusion of TYA in the HCNO diet reduced the levels of 12:0 and 14:0 in the total fatty acids of livers and plasma. With either diet, the presence of TYA caused an alteration in the fatty acid composition of these tissues so as to reduce the values of the ratios: 16:1/16:0, 18:1/18:0. and 20:4/18:2. These results suggest that dietary TYA can influence the hepatic metabolism of medium chain fatty acids and that it may inhibit the desaturase enzyme involved in the synthesis of not only 20:4 but also of monoenoic fatty acids.


Fiber, hypercholesteremia, and atherosclerosis. Epidemiological data suggest that populations subsisting on high fiber diets are free of a number of the diseases of Western civilization, among them coronary heart disease. Studies in animals and man show that each type of fiber exerts its own specific influence. Thus, in man bran has no effect on serum lipids, but pectin lowers cholesterol levels. In animals fed atherogenic diets, alfalfa and pectin exert some measure of protection, but cellulose does not. To fully understand the mode of action of dietary fiber, it is necessary to ascertain the mechanism(s) of action of each chemical component of that fiber.


Dietary factors in arteriosclerosis: sucrose. Epidemiological studies show that coronary heart disease is more common in wealthier countries than in poorer. Such studies cannot, however, isolate which of the dietary or nondietary characteristics of affluence help to cause the disease; they provide only clues that need to be subjected to experimental study. Experiments should be designed on the basis of their ability to produce the multiple abnormalties associated with coronary heart disease (CHD) and not only hypercholesterolemia. They should also explain the association of CHD with obesity, diabetes mellitus, cigarette smoking, and physical inactivity. These considerations suggest that the underlying abnormality that produces CHD is a disturbed hormonal balance. Experiments have shown that a high consumption of sucrose produces not only the wide range of abnormalities seen in CHD but also an increased blood concentration of insulin and cortisol. Since a low intake of sucrose confers many other health benefits, it is a more logical dietary recommendation than that of substituting polyunsaturated fat for saturated fat.


Cholesterol and repair processes in arteriosclerosis. The high cholesterol content of the atheroma and the correlation between elevation of the serum cholesterol and myocardial infractions gave rise to the lipid theory of arteriosclerosis, which assumes that cholesterol induces arteriosclerotic lesions and that its reduction counteracts their development. However, many facts contradict this theory. Therefore, a new hypothesis has been based on the high cholesterol content of old pathological lesions of granulomatous nature and the similarity of atheromata to granulomas. In the latter, a complicated tissue containing a high percentage of cholesterol is deposited in response to the injurious agent, which becomes walled off by this tissue. Thus, cholesterol forms part of a protective mechanism, a hypothesis compatible with the known facts about the relationship of cholesterol to arteriosclerosis.


Hyperlipidemia and premature arteriosclerosis. In the last decade, understanding of the relationship between plasma lipoprotein concentrations and arteriosclerosis has advanced considerably. Prospective and case-control epidemiologic studies in the general population have established a direct correlation between low density lipoprotein and an inverse correlation between high density lipoprotein concentrations and the risk of coronary disease. Detailed studies of patients and families with genetic hypercholesterolemia, hypertriglyceridemia, and combined hypercholesterolemia hypertriglyceridemia have identified subpopulations at particular risk. Skin fibroblast lines from patients with genetic hyperlipidemias have been used to provide important new information on the regulation by plasma lipoproteins of cellular cholesterol metabolism. We are entering a phase of investigation where epidemiological and biochemical data supplement each other in such a way that the old hypothesis linking plasma lipids to atherosclerosis has new life.


The development of coronary thrombosis following myocardial infarction. One hundred twenty-one patients who died from myocardial infarction were studied. Occlusive coronary artery thrombosis was present in 32%. In 68% of these, the infarct developed first. Factors inducing thrombus formation include fall in systemic blood pressure, alteration of blood flow, shock, and size of infarct. Factors inducing infarction, apart from hypoxia, may be stress, altered cell membrane permeability, and increased catecholamines.


Antioxidants in neoplastic cells: I. Changes in the antioxidative capacity of mouse neuroblastoma cells measured by a single-phase assay. Cultured mouse neuroblastoma cells exhibit a striking increase in antioxidative capacity during the transition from logarithmically dividing cells to nondividing, neurite-bearing cells. Two physically separable phenomena are involved: (a) the membrane pellet of neurite-bearing cells is highly resistant to lipid peroxidation, and (b) the postmicrosomal supernatant of these cells inhibits peroxidation in rat liver mitochondria and other biological membranes. A precise, single-phase assay has been developed for assessing antioxidant levels in lipid extracts. By means of this assay, the increase in membrane resistance to lipid peroxidation has been correlated with a threefold increase in the antioxidant activity of the neuroblastoma neutral lipid fraction. This finding implies that generations of a neutral lipid antioxidant (or antioxidants) is involved in the profound increase in antioxidative capacity which occurs in differentiating neuroblastoma cells.


Antioxidants in neoplastic cells: II. Isolation and partial characterization of a phenolic antioxidant from differentiated mouse neuroblastoma cells. The generation of an antioxidant has been shown to be associated with the dramatic increase in resistance to lipid peroxidation which occurs during the differentiation of mouse neuroblastoma cells in culture. The antioxidant has been isolated from the neuroblastoma neutral lipid fraction and partially characterized by means of low-resolution and high-resolution mass spectrometry and other lines of evidence. All presently available information suggests that this antioxidant is a highly aromatic, monosubstituted phenol having the molecular formula C19H14O2.


Effects of dietary vitamin E, selenium, and polyunsaturated fats on in vivo lipid peroxidation in the rat as measured by pentane production. Starting at 21 days of age, groups of six rats each were fed a basal Torula yeast diet supplemented with 0.4% L-methionine and varying amounts of vitamin E as dl-alpha tocopherol acetate, selenium as sodium selenite, and with either 10% stripped corn oil, stripped lard, or coconut oil. By 7 wk, pentane production by rats fed a corn oil diet deficient in both vitamin E and selenium was twice that by rats fed 0.1 or 1 mg of selenium per kg of the same basal diet. Blood glutathione peroxidase activity after 7 wk was proportional to the logarithm of dietary selenium. Groups of rats fed the vitamin E- and selenium-deficient diets with lard or coconut oil had one-half the pentane production of rats fed the vitamin E- and selenium-deficient corn oil diets. The plasma level of linoleic plus arachidonic acid was 1.8 time greater on a wt % basis in rats fed corn oil than in rats fed lard or coconut oil as the fat source. Pentane production by rats fed 40 i.u. dl-alpha tocopherol acetate per kg of the selenium-deficient corn oil diet was one-sixth of that by rats fed the same diet without vitamin E; the plasma of the rats fed the vitamin E-supplemented corn oil diet had a level of vitamin E that was about six times greater than that of the rats fed the vitamin E-deficient corn oil diet.


Synthesis of acyl-S-pantetheine by rat liver microsomes. The synthesis of acyl-S-pantetheine was found to occur in rat liver microsomal preparations. The reaction required ATP and a metal ion as cofactors, a fatty acid and the reduced form of pantetheine for optimal activity. The Km for pantetheine was 0.8 mM, for ATP 0.8 mM, and for oleic acid 0.3 mM. Mg2+ (20mM), Mn2+ (5 mM), Ca2+ (5mM), and Fe2+ (5 mM) produced approximately equal activity when all other conditions were optimal. The characterization of the product and other properties of the enzyme are described. The acyl-S-pantetheine formed does not act as an acyl donor in the acylation of sn-glycerol-3-phosphate, 1,2-diacylglycerol, or lysolecithin.


Effects of ethanol intake on lipoprotein lipase activity in adipose tissue of fasting subjects. Ethanol (ca. 1 g/kg body weight) was given alone or together with glucose or lipid (mixed triglycerides) perorally to young, fasting subjects. The changes with time (0-6 hr) of lipoprotein lipase activity (LLA) in adipose tissue, plasma glycerol, triglyceride, insulin, blood glucose, and alcohol concentrations were followed. A maximal mean blood alcohol concentration of 0.09% (w/v) was obtained 1 hr after ingestion with no apparent intoxicating effects. Ethanol intake prevented the previously observed [Nilsson-Ehle, P., S. Carlström, and P. Belfrage, Scand, J. Clin. Lab. Invest. 35:373 (1975)] glucose-induced rapid elevation of adipose tissue LLA but had small effects on this enzymatic activity when given alone or together with lipid. Confirming results by others, ethanol intake decreased plasma glycerol concentration and increased plasma triglycerides, especially after intake of lipid. It is suggested that ethanol intake interferes with the normal carbohydrate-induced elevation of adipose tissue LLA after a mixed meal, thereby decreasing the removal capacity for circulating dietary lipid and causing enhanced and prolonged alimentary hyperlipemia.


The effect of protein deficiency on some rat liver lipid metabolic enzymes and CoA. Two groups of male Wistar rats were fed normal (i.e., 18%) and protein-free diets, respectively, for 7 weeks. In vivo incorporation of [1-14C] acetate into palmitic, stearic, oleic, and arachidonic acids by the liver was reduced in the protein-deficient rats. In vitro incubation of liver microsomes with labeled palmitate or linoleate revealed no change in the specific activities of chain elongating or desaturating enzymes. Protein deficiency resulted in a decrease in specific activity of short chain acyl-CoA synthetase and in total CoA, accompanied by the virtual disappearance of acyl-CoA and an increase in free CoA. Furthermore, there was less microsomal fatty acid synthetase and mitochondrial beta-hydroxybutyrate dehydrogenase activity. These results are discussed in relation to fatty acid synthesis and the changes in liver fatty acid composition.


1,2-Propanediol-induced changes in plasma and tissue lipids of rats. Oral administration of 1,2-propanediol to rats in a daily dose of 1 ml of 28.4% aqueous solution per 100 g body weight for 30 days caused a significant decrease in the total lipids, fatty acids, phospholipids, and triglycerides of plasma, liver, and heart. The cholesterol content in plasma decreased while that in the tissues increased significantly. The accumulation of cholesterol in tissues tends to discourage long term use of 1,2-propanediol even by the oral route.


Hormonal and metabolic responses to exercise in subject of high and low work capacities. Hormonal and metabolic responses to submaximal were studied in eight normal subjects. Four subjects had high maximal oxygen uptakes (455 +/- 0.49/min) and were classified as "fit" and four had low maximal oxygen uptakes (2.13 +/- 0.32 1/min) and were classified as "unfit". All subjects exercised for 20 minutes at 750 kpm/min on a cycle ergometer, which represented 35% and 85% of the maximal oxygen uptake for the fit and the unfit subjects respectively. The unfit subjects had a higher heart rate and CO2 output at the same oxygen uptake when compared with the fit group. There was a high blood lactate in the unfit subjects and also a greater rise in blood glucose, plasma cortisol and serum growth hormone during exercise in these subjects. Free fatty acids increased in the fit subjects, but not in the unfit and serum insulin was depressed in both groups. Thus, the cardiorespiratory fitness is an important determinant of the hormonal and metabolic response to submaximal exercise, which differed considerably when fit and unfit subjects exercised at identical absolute levels of power output. These differences have implications for the control of energy substrates used during exercise.


The effect of weight lifting exercise on heart rate and metabolism in experienced weight lifters. Fifteen experienced weight lifters were investigated to examine the effects of weight exercise with variable intensity on heart rate and changes in arterial glucose, lactate and pyruvate, as well as serum total lipids, beta-lipoproteins, triglycerides, glycerol and free fatty acids. The highest value of heart rate were reached during repetitions (ca. 150 beats/min), during single maximal contraction only 120--130 beats/min. No important changes were found in lipid substrates or glucose, while lactate (x max: 4 mmol/l) and urivate (x max: 0.11 mmol/l) increases were moderate. This type of training may be useful in the clinical rehabilitation of the locomotor system but it lacks importance for preventive or rehabilitation therapy of the cardiovascular system.


Specificity of run training on VO2 max and heart rate cganges during running and swimming. To further evaluate the specificity of aerobic training, maximum physiologic measures (VO2, VE, HR, and R) and submaximal exercise heart rate were determined in control (N = 8) and experimental (N = 11) subjects prior to and following 10-week interval run training. Experimental subjects significantly increased (P less than 0.01) treadmill VO2 max by 252 ml O2 or 6.3%. This was siginificantly larger (P less than 0.01) than the 87 ml O2 or 2.6% increase (P less than 0.05) observed during swimming. Max HR decreased significantly in both forms of exercise. In addition, heart rate at two submaximal work levels during running and swimming was significantly lower after training. No changes in metabolic and physiologic measures were demonstrated for the controls after the 10-wk period. These results further support the concept of the specificity of the metabolic adaptation to aerobic training and strongly suggest that local adaptations in skeletal muscle significantly contribute to improvement in VO2 max. However, running may produce a general training adaptation in maximal and submaximal heart rate.


Lower extremity forces and torques during systematic variation of non-weight bearing motion. Component and resultant external forces and torques at ankle, knee, and hip joints of unrestrained lower extremity motion were computed as resultant limb velocities were systematically changed. Cinematographic and modeling techniques were used to analyze 45 trials of five skilled soccer players who performed slow, medium and fast velocity kicks. A model of the lower extremity was incorporated, with kinematic data and segment mass estimates, into computer programs to quantify the mechanical variables. Monotonic increases in magnitudes of all kinetic elements occurred as the velocity of kicking was increased. Significant differences were also observed in the maximum values of the net parallel and perpendicular external force actions, and resultant torques at the joints with changes in limb velocity.


Effects of pedalling rate changes on maximal oxygen uptake and perceived effort during bicycle ergometer work. The present investigation determined the efficacy of progressively increased pedalling rate (P) or resistance (R) during assessment of maximal oxygen uptake (VO2max) on the bicycle ergometer. Twenty male and nine female university students performed randomly assigned discontinuous P and R maximal stress tests. Male subjects immedicately repeated each test within the same experimental session. Regardless of test protocol, VO2max was quite similar. Magnitude estimates of perceived effort were significantly lower for male subjects during P testing (P less than .05) and 80% of male subjects preferred P testing. Conversely, magnitude estimates were significantly lower for female subjects for R testing (P LESS THAN .05). P testing could be reliably repeated within the same experimental session whereas with R testing VO2max was significantly reduced (P LESS THAN .05). It was concluded that progressively increased pedalling rate offers a physiologically acceptable means to VO2max assessment on the bicycle ergometer for males and females. In addition, progressively increased pedalling rate offers a perceptually preferable means to VO2max assessment for males but not for females.


A comparison of continuous and intermittent progressive multistage exercise testing. Twelve male subjects were compared on continuous and intermittent treadmill test of identical exercise stages. Each stage was three minutes in duration. Oxygen uptake during minutes one and two was significantly lower in the intermittent test. Heart rate VE and R were lower and oxygen pulse greater during all three minutes at moderate and strenuous workloads and throughout recovery of the intermittent protocol. There were no significant differences in exercise minute three or recovery VO2 and blood pressure. Regression equations for the relationship between VO2 oxygen pulse heart rate, VE systolic blood pressure and workload during the third minute of exercise included curvilinear functions whereas the regression equations between VO2 and heart rate, and between R and workload were linear. Slopes of percent maximal heart rate vs.  percent percent maximal VO2 of the third minute were not different. Heart rate responded more rapidly to onset and cessation of exercise than did VO2. A near steady state was obtained during low and moderate workloads prior to minute three supporting the feasibility of reducing test time. Result suggest a slight advantage in intermittent testing compared to continuous testing for evaluating cardiovascular function and for exercise prescription.


Triglyceride turnover in severe chronic non-nephrotic renal failure. In 12 patients with chronic non-nephrotic renal failure (creatinine clearance 3.5-11 ml/min) and 8 control subjects, plasma triglyceride turnover was studied. The patients showed significantly increased fasting triglyceride concentrations and absolute plasma triglyceride turnover rates, while the fractional turnover rate was significantly decreased. The finding of an elevated triglyceride turnover rate with a near normal fractional removal rate in the patients with the highest creatinine clearance suggests the involvement of an increased triglyceride synthesis rate in these patients. However, most patients showed an impaired removal mechanism as the major cause of the hypertriglyceridemia.


Palmitate and glucose oxidation by diaphragm of rats with fructose-induced hypertriglyceridemia. Palmitate and glucose oxidation were investigated in isolated hemidiaphragm of rats in which hypertriglyceridemia was induced by dietary fructose. Palmitate oxidation was increased, and glucose oxidation was reduced, in fructose-fed rats, as compared with glucose-fed controls. Glucose incorporation into muscle glycogen was similar in both dietary groups.


Effect of dopaminergic blockade on the secretion of growth hormone and prolactin in man. Serum growth hormone (GH) response to insulin and glucagon administration was studied in 12 male and 12 female volunteers under control conditions, and under treatment with pimozide and metoclopramide. In addition, serum prolactin levels were measured during the treatment period. Pimozide and metoclopramide administration had no effect on the GH response to insulin and glucagon. In contrast, serum prolactin levels increased markedly during the treatment period. Dopaminergic blockade is unable to affect GH secretion in response to insulin and glucagon administration in man.


Sex differences in the size of bile acid pools. In view of the excess prevalence of gallstones among women and the association of gallstones with diminished bile acid pool size, we measured bile acid pools in 27 male and 25 female healthy human volunteers. The average bile acid pool in the women was significantly smaller than in the men (2.25 +/- .12 g versus 2.88 +/- .16 g; p = 0.003). Chenodeoxycholic acid pool size, computed from bile acid composition data available in 43 of these subjects, was also smaller in women than men (0.94 +/- 0.06 versus 1.22 +/- 0.07 g; p = 0.004). Age, race, and body size bore no statistically significant relationship to bile acid pool size. Biliary cholesterol saturation was positively correlated with weight and obesity and showed a significant inverse correlation with chenodeoxycholic acid pool size, but not with total bile acid pool size. These findings suggest a possible mechanism for the higher prevalence of gallstones among women.


Effect of concurrent calcium ingestion on intestinal absorption of fluoride. It has been suggested that calcium interferes with absorption of fluoride and that it diminishes the effect this ion has of increasing the bone mass when taken orally. Normal volunteers were given a combination of fluoride and calcium carbonate or fluoride alone, and serum levels of fluoride were measured to determine the effect, if any, of the concomitant administration of calcium on absorption of fluoride. The results indicate that 1.3 g of calcium, as the carbonate, decreases the integrated blood fluoride values by 22%.


The transport and metabolism of L-proline-14C in the rat in vivo. The physiologic disposition, metabolic fate, and renal clearance of intravenously injected 14C-L-proline was determined in the rat. The disappearance of radioactivity from plasma occurred with a biphasic curve, the initial high levels reaching a nadir about 30 min after injection with subsequent increasing amounts of radioactivity. Examination of the 14C components in plasma revealed that 14C-proline disappeared rapidly during the first 30 min. At this time, the labeling of circulating plasma proteins ensued and continued to increase during the following 45 min of observations. Plasma glucose became labeled 10 min after injection and, thereafter, increased its 14C content. The extensive labeling of plasma proteins and glucose accounted for the increasing 14C found in plasma 30 min after injection. The course of radioactive labeling of brain, kidney, diaphragm, and liver was assessed. The greatest number of cpm/mg of tissue was found in the kidney. Determination of the distribution ratio, the ratio of cpm/ml intracellular nonprotein 14C to that in plasma in kidney revealed a peak of 3.9 within 15 min, a value comparable to that found in vitro. Twelve percent of the administered radioactivity was excreted as 14CO2 within 180 min. The oxidation was inhibited by known transport and metabolic inhibitors, the greatest effect observed with hydroxyproline, followed in order by thioproline, 3,4-dihydroproline, and glycine. The fractional urinary excretion of proline, Cproline/Cinulin, was determined and found to be 1% or less. This was increased by inhibitors, the greatest effect due to hydroxyproline followed in order by dehydroproline and glycine, a result similar to the observed extent of inhibition of proline oxidation to 14C O2. The physiologic disposition of proline was not altered by ligation of the renal vasculature.


Inhibitory effect of calcitonin on growth hormone and insulin secretion in man. The effect of calcitonin administration on basal and arginine-stimulated growth hormone and insulin plasma levels was investigated. The intramuscular injection of synthetic salmon calcitonin (100 U MRC) in five normal subjects produced a significant decrease (p less than 0.05) in insulin concentration. The same amount of calcitonin given 15 min before an arginine infusion test in seven normal subjects significantly reduced the response of growth hormone (p less than 0.025) and insulin (p less than 0.005) to the stimulus.


Parathyroid hormone clearance in man.

Parathyroid hormone clearance in man. The role of the kidney, liver, and bone and/or muscle, in the metabolic clearance of parathyroid hormone (PTH), has been examined in man. Serum was obtained from the femoral artery and the renal, hepatic, and femoral veins of nine hyperparathyroid patients undergoing selective venous catheterization. The concentration of immunoreactive parathyroid hormone (IPTH) was measured in the samples by radioimmunoassay using an antiserum predominantly specific for the aminoterminal (N-terminal) portion of the PTH molecule. Gel filtration of hyperparathyroid sera demonstrated this antiserum to measure essentially only intact PTH. The mean arteriovenous (AV) difference measured across the liver was 44%; across the kidney, 34%; and across the leg, 16%. These arteriovenous differences were all statistically significant (p less than 0.005). A significant positive correlation was found between the AV difference in IPTH across the kidney and the serum calcium concentration (r = 0.50, p less than 0.05). These studies suggest that both the liver and the kidney play major roles in the clearance of PTH in man and indicate that PTH is cleared by bone and/or muscle as well. The correlation observed between the serum calcium concentrations and the AV differences in IPTH across the kidney suggest that the rate of clearance of PTH in man may be modulated by changes in the concentration of serum calcium.


Biological functions of hydroxylamine inactivated influenza virus. Hydroxylamine inactivates members of the orthomyxovirus group. Studies with inactivated influenza virus indicate that the genome of such virus does not serve for the production of functional viral proteins. Additional evidence indicated that the genome may, however, undergo limited replication. These observations are correlated with the inactivation of influenza virus and the known mechanism of action of hydroxylamine.


[Microkymography--a method to measure the flow velocity in the microvascular bed after endotoxin administration (author's transl)]. In this paper the application of intravital microkymography on studies of the microcirculation of the hamster cheek pouch is presented. Flow velocity reduction which is one of the characteristic initial alterations in small blood vessels after injection of endotoxin is recorded in a direct way by the strip microkymography. The method of the recording system is described and some examples of the effects of endotoxin as well as of serotonin, one of the mediators of endotoxin, are given. The advantage of microkymography in quantitative and functional studies of endotoxic actions, e.g. flow velocity decreases and vessel diameter changes, is discussed.


Demonstration of the physiological role of autolysis by a comparative study with a wild-type and its non-autolytic mutant of Micrococcus lysodeikticus (luteus) cultivated with externally added proteolytic enzymes. The log phase cells of autolytic Microccus lysodeikticus (luteus) IFO 3333 did not autolyze when grown in the presence of trypsin although the growth curve and morphology of the cells were not influenced. A non-autolytic mutant was obtained by subculture of the wild-type strain IFO 3333 on an agar slant containing 1% glucose. The mutant (strain MT) was wild-type IFO 3333 which occurred singly or in irregular masses. The mutant MT grown in a culture medium containing trypsin caused remarkable alteration in cell morphology: large cell packets consisting of a number of "unit tetrads" arranged regularly in three dimensions were formed by the addition of trypsin to the medium. The findings suggest that inhibition of the separation of divided cells is brought about by inactivation or suppression of a cell wall autolytic enzyme which plays an important role in the separation step and is accessible to externally added trypsin in the mutant cells but not in the wild-type cells. The possibility that there are two kinds or phases of autolytic enzymes "a physiological autolytic enzyme" and "a  useless autolytic enzyme", is discussed.


Thymidine metabolism in cells treated with DNA-suppressing factor (DSF). Inhibition of thymidine incorporation into DNA in cells treated with DNA-suppressing factor (DSF) has been studied. After 16 hr treatment with DSF, transport of labeled thymidine across the cell membrane was not inhibited, since equilibrium of labeled thymidine with the acid-soluble pool occurred at the same rate and the radioactivity was at the same level as in untreated cells. The values of Vmax and Km in the kinetics of transport of exogenous thymidine were not changed by DSF. Phosphorylation of labeled thymidine to deoxythymidine triphosphate (dTTP) was not inhibited by DSF. After a chase of labeled thymidine, radioactivity of the acid-soluble fraction in DSF-treated cells decreased more rapidly but that of the acid-insoluble fraction remained at a lower level than in untreated cells. It was assumed that DSF might block the entry of dTTP into DNA.


Complement-dependent cytotoxicity of sera obtained from subacute sclerosing panencephalitis patients. Human lymphoid cells (NC-37) persistently infected with either measles virus (Schwarz and TYCSA strains) or subacute sclerosing panencephalitis (SSPE) virus (Halle and Mantooth strains) were destroyed in the presence of complement by anti-measles sera as well as by sera from SSPE patients. The cytotoxic activity was demonstrated in both IgG and IgM fractions of measles convalescent sera, but only in IgG fraction of SSPE sera. Measles convalescent sera completely lost the cytotoxic activity to all the cell lines, when absorbed with any one of the cell lines, indicating that the viral surface antigens of these cell lines infected with measles or SSPE virus are identical. On the other hand, the cytotoxic activity of SSPE sera could not be readily absorbed with these cells. Thus, the affinity of SSPE sera for the viral surface antigens might be lower than that of measles convalescent sera.


Kinetics and mechanisms of macrophage activation by Corynebacterium anaerobium. Kinetics and mechanisms of macrophage activation by heat-killed Corynebacterium anaerobium (CA) in mice were investigated. The carbon clearance test revealed that the function of the reticuloendothelial system rose markedly on the 4th day after a single intravenous injection of CA and continued in a highly enhanced state until the 14th day. This activity declined gradually and dropped to a normal level around the 21st day. On the other hand, both lysosomal enzymes, beta-glucuronidase and acic phosphatase, of peritoneal macrophages decreased after the CA injection and then recovered, taking an almost inverse course to the function of the reticuloendothelial system. These results might be attributable to possible extracellular secretion of the lysosomal enzymes in accordance with macrophage activation by CA. A remarkable cytotoxicity of peritoneal macrophages, examined in vitro against L 929 cells, was detected on the 4th day following intraperitoneal administration of CA. It was maintained up to the 14th day and then declined rapidly. The mechanisms of macrophage activation by CA were also examined in vitro. CA-homogenate, heat-killed CA disrupted with an ultrasonicator, directly activated thioglycollate-induced macrophages. The macrophages were aslo activated by simultaneous treatment with both CA-homogenate and CA-sensitized spleen cells. Furthermore, the supernatant obtained from the culture of CA-sensitized spleen cells with CA-homogenate was capable of inducing activation of the macrophages. Conversely, the culture supernatant of spleen cells from CA-immunized athymic nude mice with CA-homogenate was unable to activate them. It was ascertained from the above-mentioned results that macrophages are activated initially by direct action of CA in a nonspecific way and subsequently by a soluble factor elaborated by CA-sensitized lymphocytes in an immunological way.


[Autotrophic growth of Microcyclus aquaticus in hydrogen]. Microcyclus aquaticus Z-238 which had been isolated as a methanol oxidizing culture was found to be capable of growth in the atmosphere of hydrogen, oxygen and carbon dioxide in the presence of yeast extract. Autotrophic growth of the culture in the atmosphere of hydrogen required biotin or casaminic acids.


[Development of a pure Methanosarcina biotype 2 culture on acetate]. A pure culture of the obligate anaerobe methanosarcina, biotype 2, was isolated using an original technique of dilution in agar and inoculation into a preliminarily reduced medium. Additional organic substances, in particular yeast extract, are necessary for germination of a small number of packets in the course of isolation. The methanosarcina can use, during several inoculations, acetate as a sole source of carbon and energy, and does not require hydrogen as the main substrate of catabolism. The organic substances being tested (with an exception of pyruvate, hemin and cysteine which somewhat increased the lag phase) had no significant effect on growth and production of methane. Apparently, the mechanosarcina, biotype 2, should be referred to as an individual species.


[Dependence of the rate of ferrous oxide oxidation by a Thiobacillus ferrooxidans culture on its concentration]. The effect of the concentration of ferrous iron on the rate of its oxidation was studied with Thiobacillus ferrooxidans. The specific rate of oxidation of ferrous iron was found to increase with its concentration and to decrease with a rise of the total iron content. Cultivation of bacteria with electrochemical reduction of Fe3+ produced high cell concentrations at a low content of total iron (4--6 g/litre), e. g. upto 4.5 g/litre (dry biomass weight).


[L-glutaminase-asparaginase biosynthesis by a Pseudomonas boreopolis culture dependent on cultivation conditions]. The activity of deamidases of L-glutamine and L-asparagine of Pseudomonas boreopolis 526 was found to depend on the conditions of cultivation. The activity of L-glutaminase-asparaginase II (EC 3.5.1.38) decreased with an increase of the specific growth rate in the conditions of periodic cultivation and increased in the conditions of continuous cultivation. The activity of this enzyme was manifested mainly in the conditions of continuous cultivation at a rate of 0.1--0.2 hr-1 and a final nitrogen concentration of 0.006--0.025 g per litre of the medium. If the concentration of nitrogen was increased in these conditions, biosynthesis of L-glutaminase-asparaginase I was stimulated while the activity of L-glutaminase-asparaginase II was not detected at all.


[Effect of exogenous factors on extracellular alkaline ribonuclease synthesis in Bacillus mesentericus]. Bacillus mesentericus was found to assimilate nucleic acids as a source of nitrogen and phosphorus. Nucleic acids added to the medium as a source of nitrogen or phosphorus stimulated synthesis of ribonuclease. When washed bacterial cells were incubated for a short period of time in a fresh nutrient medium containing RNA, synthesis of RNAase was also induced. Synthesis of the enzyme was inhibited by high concentrations of chloramphenicol and actinomycin D, and stimulated by low concentrations of actinomycin D. Therefore, alkaline RNAase is an inducible enzyme which participates in the nutrition processes of bacteria.


[Flavin pool in Propionibacterium shermanii and the formation of corrinoids by bacterial cultures]. The content of flavins and vitamin B12 was studied in the cultures of Propionibacterium shermanii. The limited ability of propionic bacteria to synthesize 5,6-dimethylbenzimidazole, the nucleotide base in the true forms of vitamin B12, was found to be caused by a deficiency of the biogenetic precursor (riboflavin). Exogenous 5,6-dimethylbenzimidazole had no effect on the processes of flavinogenesis. In the absence of the nucleotide base, the yield of the true forms of vitamin B12 increased upon aeration of cultures which were grown for four days on an iron-deficient medium in the anaerobic conditions.


[Effect of amino acids as sole nitrogen sources on exoprotease biosynthesis in Aspergillus candidus]. Aspergillus candidus produced an exocellular protease at a high rate in the absence of nitrogen sources. Nineteen amino acids were added separately as sole nitrogen sources to the medium to study their effect on biosynthesis of exoproteases. All the amino acids were found to repress the biosynthesis, arginine, histidine, lysine and ornithine being most effective among them. Repression of the biosynthesis of exoproteases in the presence of amino acids added as sole nitrogen sources is presumed to be accomplished by ammonium ions which are formed in the course of utilization of amino acids. The level of repression is proportional to the concentration of an amino acid in the medium. Amino acids have no effect on the activity of exocellular proteases synthesized by Aspergillus candidus.


[Fatty acid and fractional makeup of the lipids of osmotolerant yeasts]. Osmotolerant yeast cultures differ in their fatty acid and fraction composition of total lipids from yeast cultures of the same or related species from other habitat. Their lipid fatty acids are represented by C14--C18 acids. Their fraction composition of lipids is characterized by a low content of free fatty acids and diglycerides and an elevated content of esters of sterines and wax. The fatty acid and fraction composition of lipids depend on the concentration of NaCl and the C/N ratio in the medium.


[Aqueous petroleum-oxidizing Arthrobacter]. Water petroleum oxidizing bacteria of Arthrobacter ceroformans as well as their lipid composition are described. On a medium containing hexadecane, all the strains produce wax in large amounts (upto 70% of total free lipids) consisting by 95% of cetyl palmitate. Fatty acids are represented mainly by palmitic acid but comprise also unsaturated C16:1 and C18:1 acids. Mycolic acids have not been detected. The significance of lipid composition for the identification of arthrobacteria is discussed.


[Microflora of the low-mineralized waters of the Truskavets deposit]. Waters of the Truskavetz deposit with a low content of mineral substances were found to contain considerable amounts of microorganisms; upto millions of cells per 1 ml. Sulphate-reducing, dentrifying and iron bacteria were detected in the waters. The following genera were represented and isolated: Pseudomonas, Bacillus, Nocardia, Arthrobacter, Brevibacterium, Corynebacterium, Micrococcus, Candida, Cryptococcus, Rhodotorula, Hansenula, Torulopsis, Trichosporon. Many of the studied strains assimilated C6--C10 and C12--C22 mixtures, industrial paraffins, naphthenic acids and their salts. The isolated bacterial and yeast strains were much more carbooligotrophic as compared to the museum strains of the same species; many of them were oligotrophic. The cells continued to grow in the course of storage of isolated water samples. The majority of isolated pure cultures grew upon inoculation into sterilized mineral water and caused a decrease in the content of organic substances.


[Lipid fatty acid makeup of actinomycetes]. The composition of fatty acids was studied in ten species of the Actinomyces genus. All the cultures contained C12--C18 acids. Saturated branched acids prevailed. The fatty acid composition of the cultures Act. olivaceus and Act. violaceoruber changed in the course of their growth in the conditions of submerged cultivation. In the stationary phase of growth, the coefficient of branching increased upto three times as compared to the period of active growth. The content of saturated branched fatty acids increased upon addition of CoCl2.6H2O.


[Seasonal fluctuations in the potential soil capacity for nitrogen fixation]. The nitrogenase activity of soils to which no energy-rich substances were added is low. This can be attributed to a low content of easily available organic substances. The potential activity of nitrogen fixation of the soils under study is different and changes with seasons. The highest ability for potential nitrogen fixation is displayed by soddy-calcareous and continuous-cultivated grey forest soils. The potential activity of nitrogen fixation in these soils correlates with the bacterial number on agar. Such a correlation is not observed in grey forest soils.


[Base composition and DNA content in single-cell Cyanobacteria]. The base composition and DNA content were determined in 19 strains of cyanobacteria. The content of GC varied within the range of 33.6 to 70.7 mol%, and the content of DNA, from 1.05 X 10(-14) to 28.7 X 10(-14) g per cell. The latter parameter almost directly depended on the cell volume. The cultures were subdivided into six groups according to the results obtained.


[Isolation, fractionation and comparative analysis of the cell membranes of the cyanobacterium, Anabaena variabilis]. A homogenate prepared from the protoplasts of Anabaena variabilis was fractionated by differential centrifugation and zonal electrophoresis. Four subcellular fractions were isolated and characterized with respect to their composition and morphology, two of them being of the membranous nature. Membrane visicles from the light, chlorophyll-containing fraction were identified as small fragments of thylakoids while the pigment-deficient, heavy membrane fraction seemed to be represented by fragments of the cytoplasmic membrane.


The quality and educational value of medical records--a survey of student opinion. In July 1975 clinical students at the Royal Free Hospital School of Medicine were asked to complete a questionnaire, including questions on medical records. Full and accurate recording of clinical information was considered an important characteristic of the good physician, but less important for success as a medical student. Students felt they should be given more instruction on the writing of medical records and that teachers should pay more attention to students' notes. Review of students' notes is a valuable method of teaching clinical medicine; teachers can ensure that patients are the focus of learning and can encourage students to simulate real clinical practice.


Introducing instructional objectives in Indonesian medical schools. This paper reports on the responses of nearly 600 Indonesian medical academics, from ten different medical schools, to a series of 2 week workshops in educational science. These workshops set out to help participants: (a) to acquire skills in constructing educational objectives, at all levels, from those of the institution to those connected with a particular course; and (b) to develop positive attitudes towards the use of these skills in curriculum design and planning. The results demonstrate that the workshops helped most participants to meet the above objectives. The instructional model chosen and the reasons for its effectiveness have been discussed. It has been concluded that the development of basic educational skills can be acquired in a relatively short, condensed workshop, by a large number of participants: that is, the approach is feasible and economical for large numbers. It has also been shown that concepts of 'modern educational technology' are acceptable in a socio-cultural context with very different practices and traditions from those within which most applications of educational technology in medicine have been achieved. The results have general implications for the training of health workers in developing countries.


A trial of multiple choice examination in pharmacology. An account is given of the introduction of MCQ in an Indian Medical institution in 1974/75. Preliminary results suggest that the reliability coefficient of MCQs rises with their difficulty, and that Pearson-type coefficient indicates a higher degree of correlation with essay marks than do Spearman coefficients. A 'student assessment response' taken with standard item analysis technique may be of value in assessing questions for future use.


A comparison of student performance in two parallel physiology tests in multiple choice and short answer forms. Two parallel tests in physiology, one in multiple choice answer form and one in short answer form, were administered consecutively to a group of 104 students. The construction of the questions in the two papers and marking schedules were such that if the form of examination did not influence the students' performance, the scores obtained in the two papers could be expected to be closely similar. The results indicate that the form of the question influences the students' performance significantly. The short answer format offers certain advantages over the multiple choice format and it would appear that greater use should be made of this type of question in testing at medical schools.


[Natural variability of saprophytic mycobacteria]. The ratio of S, R and M variants was studied in 20 strains of six saprophytic mycobacterial species. The process of splitting of mycobacteria into variants by the shape of colonies was found to be different not only among species but also among strains of the same species. Such a heterogeneity of mycobacterial populations should be taken into account while working with these microorganisms.


[Thermophilic bacteria, Thermus ruber, that produce a bright orange pigment]. A non-sporeforming gram-negative bacterium isolated from soils of Africa was shown to belong to the species Thermus ruber in its morphologo-cytological and physiologobiochemical properties. It differed from the Thermus ruber species described elsewhere (Loginova et al., 1975; Loginova and Egorova, 1975) only on colour: the former contained a bright-red pigment while the latter produced bright-orange pigments.


Medical and social work student perceptions of deviant conditions: descriptive label, cause and help source. The focus of this paper is on medical and social work student perceptions of the descriptive label, cause and treatment source for seven conditions; mental illness, mental subnormality, alcoholism, drug addiction, homosexuality, unmarried pregnancy and venereal disease. Responses to questionnaire items were examined to ascertain whether there were differentials by career choice (medicine and social work) and by class year (first and final year). The students indicated that the seven deviancies should be described as sick or handicapping conditions, that causes are social and psychological, and that treatment should be given by private and social sources. When reference to medical aspects of the conditions is made, the students select psychiatric rather than general medical options. Both medical and social work students tended to choose neutral, rather than negative and stigmatizing terms of reference for the conditions. While students in the different school years made similar response overall, multiple responses were much more frequent among those preparing for social work rather than medical careers and among students in their final year of schooling.


[Isolated water in desiccated microorganisms]. The presence of isolated mobile water in dehydrated eukaryotic microorganisms established earlier by NMR has been confirmed by direct chemical registration of this water in the yeast Cryptococcus albidus. This water constitutes several per cent of the dry biomass weight. Apparently, its preservation should be attributed to changes in the permeability of intracellular membranes upon dehydration. The water is released by the cells when they are heated to 150--200 degrees C and the cellular structures containing water are destroyed.


Utilization of feedback from student evaluation of teachers. Students who had completed a part of the medical course rated their teachers on a multiple choice-type questionnaire. Each teacher was provided with data from his own rating, and also the mean rating for all teachers, on each item. Six of these teachers were re-rated after a year by the next group of students who followed the same course. Positive change, often significant, was observed in the majority of instances. Such change was not, however, confined to behaviours previously hypothesized to be easily amenable to improvement on feedback. There was evidence of a tendency to unidirectional change within each teacher across most behaviours, some showing predominantly positive and others predominantly negative change at the second evaluation. These results are discussed in relation to the need for counselling following such evaluations. The second evaluation lent itself to determining the possibile existence of a 'halo effect' arising from students of one ethnic group evaluating teachers of the same ethnic group. Such an effect was found to be absent. The reliability of the measurements was tested in serveral ways.


The St Andrews MD (1935-1972).

The St Andrews MD (1935-1972). The St Andrews MD, 1935--1972, has been investigated. The number of awards has declined and the porportion of doctors proceeding to MD has also declined. The average time between the award of the MD ChB degree and the MD degree was 11 years. About one third of the awards were at the Honours or Commendation grade. Only two doctors gained Honours in both the MB ChB and the MD. A smaller proportion of women gianed an MD degree, but of those that did a similar proportion received Honours or Commendation as in the male group. Laboratory-based studies are more likely to attract the higher grades of award compared with clinically based studies. Subsequent achievement areas show almost half the graduates to be in clinical or laboratory hospital work, 15% in administrative posts, 27% in academic posts but only 5% in general practice. Even less are in industry or the services.


Do the peptide hormones common to intestine and brain participate in the genesis of epilepsy? It is suggested that the peptide hormones common to the brain and intestine provide a physiological basis to the hypothesis that acute gastroenteritis during the first postnatal month may be associated with spontaneous epileptogenic activity in EEG and lowered seizure threshold in adult age.


A new concept of renal hemodynamics.

A new concept of renal hemodynamics. Observations which show that urine output can vary with changes in the contour of the pulse cure, that it can even increase while the mean blood pressure falls during counterpulsation, that the well known hypertensive effect of a renal artery stenosis can also be produced by an aneurysm of the renal artery, cannot be explained by orthodox concepts of renal hemodynamics. The anatomical fact that the afferent glomerular arteriole is about twice as large as the efferent has so far not been adequately explained. The hypothesis that the combination of pulsatile flow and the unique anatomical configuration of the glomerulus permit a hydraulic switching mechanism which modifies profoundly its perfusion explains these questions.


Cancer as a systemic disease.

Cancer as a systemic disease. Theories on the nature of cancer may be classified into two categories. One regards cancer strictly as a local phenomenon while the second looks at cancer as a local manifestation of a systemic process or disease. Although the first dominates current medical thought, the theories of immunological surveillance and of protovirus-oncogene implicitly assume cancer to represent a local manifestation of a systemic process or disease. This is supported also by epidemiological data forwarded in the present paper. In order to clarify the exact meaning of a systemic disease, cancer and its manifestation are compared with arteriosclerosis and its sequelae. Arteriosclerosis could be regarded as a prototype of a systemic disease. It presents itself clinically solely by its local manifestations, like myocardial infarction or stroke. These local manifestations may be followed by secondary systemic sequelae like congestive heart failure. In the same context, it is proposed to regard cancer as one systemic disease which presents itself clinically by local phenomena like carcinoma, lymphoma and sarcoma. These local manifestations may lead further to secondary systemic sequelae like metastasis.


Self and non-sense: an organism-centered approach to immunology. This paper provides a conceptual framework to accommodate important recent developments in immunology (genetic determination, cellular interactions, suppression). The basic idea is to look at the immune system as a closed network of interactions which self-determines its ongoing pattern of stability and its capacities of interaction with its environment. Thus, all immune events are understood as a form of self-recognition, and whatever falls outside this domain, shaped by genetics and ontogeny, is simply nonsensical. This paradigm, stemming from the ideas of Jerne, represents almost a logical inversion of the Burnetian idea of self-discrimination. A detailed discussion of the immunological evidence that substantiates this view is presented, together with some new concepts (eigenbehavior, cognitive domains). Although the paper is addressed to biologists and immunologists, we make extensive use of system-theoretic notions in a non-mathematical form (recursion, nets and trees, self-organization).


Combined chemotherapy and radiotherapy for the treatment of small cell carcinoma of the lung. Twenty-nine (88%) of 33 patients who were treated with multiple drug chemotherapy and radiotherapy for small cell carcinoma of the lung showed significant improvement in their clinical condition and quality of life. Treatment was well tolerated and toxicity was acceptable.


Nutrient consumption patterns of families in Busselton, Western Australia. Nutrient consumption data were obtained from 211 members of 41 families living in the coastal town of Busselton, Western Australia. It was found that food consumption patterns were similar in boys and girls up to the age of 11 years. After that, as expected, males consumed more food than females. There was a general tendency for daily kilojoule intakes to be considerably less than the Australian Dietary Allowances for all age groups with the exception of males aged from 35 to 55 years. There was a significant prevalence of obesity in the subjects who were studied, particularly in the older groups of both sexes. The results suggest that, in the older adult groups, failure to make concessions to decreased levels of physical activity by modifying appetite and customary eating practices is a major factor which contributes to obesity.


Whale strandings: hypothesis.

Whale strandings: hypothesis. The hypothesis is presented that whales become stranded inadvertently as a consequence of seeking stimulation. The animals enter shallow water in order to roll over, bask, and rub themselves in the sand, and are trapped by the receding tide. It suggested that stimulation-seeking behavior (and stranding) reflects a general sympathetic nervous system response which may be due to a number of factors such as pain, discomfort, reproductive state, and other biorhythmic changes.


Recurrent extreme breast involution following pregnancy and susceptibility to breast cancer: a hypothesis. Nine multiparous women were found to have breast development resembling the prepubertal "flat-chested" state. During their pregnancies, the breasts of all nine women had developed and enlarged, and five had successfully nursed for two or more months. The remaining four women did not attempt to breastfeed. Following cessation of lactation in the women who had breastfed, and after delivery in those who had not suckled, the breasts of all nine women completely regressed to their prepregnant "flat-chested" physical state. Based on the findings of normal health and regular menses in these women, we hypothesize that the breast epithelium of these and other flat-chested women may have an elevated threshold of estrogen sensitivity in the nonpregnant state which may reduce susceptibility to mechanisms of carcinogenesis.


On the definition, cause and nomenclature of cancer. Definitions and terms currently employed in the nomenclature of cancer are examined and found inadequate or misleading. It is suggested that the two entirely different processes involved in cancer, namely, neoplastic transformation and neoplastic disease, be clearly distinguished and rigorously defined. It is also suggested that proper terms and expressions to describe these processes be adopted and clearly defined.


Will elevated levels of lead exposure precipitate clinical symptoms of porphyria in individuals with the latent condition? Individuals with excessive activity of the enzyme ALA-S due to either inherited disorder (i.e. porphyrias) or endogenous (i.e. steroids) or exogenous (e.g. barbituates) chemical agents and who are exposed to elevated levels of lead are predicted to have a significantly enhanced likelihood of experiencing either enhanced or precipitated clinical symptoms (e.g. photosensitivity) associated with elevated levels of porphyrins or their precursors in body tissues. In light of the widespread societal use of ALA-S inducing agents and the ubiquitous nature of lead in the environment, a more precise assessment of the health risks associated with their interaction is warranted.


The effect of labetalol in the treatment of severe drug-resistant hypertension. Twenty-two hypertensive patients from a large clinic, who were resistant to conventional therapy, were entered into this study. Most patients previously had received beta-blocking drugs, thiazide diuretics, alpha-methyl-dopa, or vasodilator drugs (hydrallazine or prazosin) which failed to control their blood pressure. The therapy with vasodilator drugs was discontinued, and the therapy with labetalol (a drug with both alpha-blocking and beta-blocking effect) was commenced. Subsequently, as the blood pressure came under control, other drugs that the patients were taking were also withdrawn. In 13 of the 22 patients, labetalol enabled the blood pressure to be controlled at acceptable levels. In six patients, the response was not considered to be sufficient to justify continuation of labetalol therapy. In three patients, the drug was withdrawn because of postural hypotension in one patient, intractable diarrhoea in another, and an allergic-type skin rash in the third. In certain patients, postural changes in blood pressure were observed, but this rarely produced symptoms. It is suggested that, if blood pressure control is not achieved with a thiazide diuretic and a beta-blocking drug, then labetalol should be introduced and the beta-blocking drug should be withdrawn.


The treatment of paracetamol overdose with charcoal haemoperfusion and cysteamine. A 53-year-old female was admitted to hospital one hour after taking an overdose of 60 g of paracetamol and 960 mg of codeine. Two hours after ingestion of the drug, the plasma concentration of paracetamol was 3040 mumol/l. In view of the enormous, and potentially fatal, plasma concentration of the drug, charcoal haemoperfusion was undertaken as well as cysteamine therapy. Charcoal haemoperfusion and cysteamine therapy led to the rapid removal of the paracetamol from the body and consequently prevented the development of severe hepatic necrosis. It is suggested that charcoal haemoperfusion as well as cysteamine has a role in the management of severe overdosage with paracetamol. This is the first report on the use of charcoal haemoperfusion for acute poisoning in Australia.


Labetalol in hypertensive emergencies.

Labetalol in hypertensive emergencies. Labetalol, a combined alpha-blocking and beta-blocking agents, was administered by intravenous bolus to six severely hypertensive patients. The blood pressure response was unsatisfactory in every case. It is concluded that intravenous administration of labetalol is not useful in hypertensive emergencies which occur in patients who are already receiving other antihypertensive agents.


A study of 208 patients in premature labour treated with orally administered salbutamol. Orally administered salbutamol (8 mg every six hours) is a simple, acceptable and effective method of inhibiting labour. Of 208 patients, 89.4% had pregnancy prolonged for longer than two days. The pregnancy was prolonged for one week in 77.5%, and for two weeks in 66.8% of patients. Tremor and anxiety occurred in 68.3% of patients, and tachycardia greater than 110 beats per minute in 21.2%, but these proved tolerable if the patient was forwarned. Haemorrhages, both ante partum, and post partum, were apparently reduced. Glycosuria and pre-eclampsia were uncommon. Urinary oestriol levels were not significantly altered. Perinatal mortality was 58 per 1000 live and still births. The babies were active at delivery, but prone to hypothermia. The incidence of respiratory distress syndrome (4.1%) was low, particularly in babies born within four hours of the last salbutamol administration. Low Apgar scores were also uncommon in this group.


Treatment of intestinal amoebiasis and giardiasis; efficacy of metronidazole and tinidazole compared. Aboriginal children who were aged from six to nine years and living in Cherbourg Community were treated for Giardia Lamblia and Entamoeba histolytica infection with either the manufacturer's recommended dose of metronidazole (Flagyl) or with tinidazole (Fasigyn), at two-dose levels. Tinidazole successfully cleared both protozoans from stools, a single dose being as effective as the longer regimens which were studied. The obvious advantage of single-dose administration is that it should permit more effective treatment of these intestinal parasites, especially in Aboriginal populations.


The Mallory-Weiss lesion: a five-year experience. A retrospective survey has been made of patients with the Mallory-Weiss lesion who presented with upper gastrointestinal tract bleeding during the period 1972 to 1976. The lesion was diagnosed endoscopically in 78 cases, representing 7.7% of the total number of patients admitted with upper gastrointestinal tract bleeding. Patients ranged in age from 18 to 86 years (mean 43 years). The male-female ratio was 3:1. A history of retching and vomiting clearly preceded the bleeding in 60 patients. Significant alcohol intake within 48 hours of bleeding was reported in 53% of patients. Other upper gastrointestinal tract conditions, or migraine, may have induced vomiting in some instances. Previously known Mallory-Weiss lesions were rare (two patients), but 21% of patients had well documented past upper gastrointestinal tract bleeding from other causes. The tears were situated at the cardio-oesophageal junction in 47% of patients and were entirely gastric in 30%; 23% were oesophageal. Blood replacement was required in 31 patients (40%), and 16 of these were transfused with five or more units. Of those patients requiring transfusion, half had other significant pathological lesions. The mean hospital stay was four days and prolonged stay in hospital was usually necessary only in the presence of other disease. In no instance was surgery required primarily to control bleeding from mucosal tears. This study suggests that the Mallory-Weiss lesion is a relatively common cause of upper gastrointestinal tract bleeding, but that it is usually a benign condition, unless it complicates some other disorder.


Training medical students to empathize: an experimental study. Research has indicated that patients are greatly concerned about the poor quality of doctors' interpersonal communication skills, but such training is infrequently incorporated into medical education. An experimental study, which used a commercially available training programme, is described. Undergraduate medical students were the subjects of the study, and their ability to empathize was assessed in the actual interview. Results indicated that training was effective in increasing the students' levels of empathy.


Studies of intravenous cefoxitin (MK306). The pharmacokinetics of cefoxitin, a new cephamycin antibiotic, were studied in six patients who were undergoing total hip replacement, and who were given cefoxitin to provide prophylactic cover at the time of operation. Later, the efficacy of cefoxitin was studied in nine patients with severe acute infections. The mean elimination phase half-life of cefoxitin which was obtained in this study (83 to 87 minutes) was significantly longer than that obtained in other studies. Cefoxitin was also found to be effective in lung and urinary tract infections against sensitive organisms. It was well tolerated, and the only side effect was that of phlebitis in long-term therapy. Cefoxitin may be valuable for prophylactic use in bowel and orthopaedic surgery.


Gardner's syndrome: a report of two Western Australian families. Patients from two families are reported who exhibited features of Gardner's syndrome: familial polyposis coli; epidermoid cysts; and osteomata. The difficulty in defining this syndrome, its clinical features and suggested management are discussed. Follow up has been difficult in one family because of the late age at which lesions developed, and because family members have moved interstate. The premalignant potential of Gardner's syndrome is emphasized.


Concurrent exptraperitoneal and intracaval rupture of an abdominal aneurysm. A case is reported in which concurrent intracaval and extraperitoneal rupture of an abdominal aortic aneurysm was found. While intracaval rupture is uncommon, but well documented, leakage at two different sites is very rare. The presentation and management is briefly discussed.


Diagnosis of parasitic infections of the small intestine by the Enterotest duodenal capsule. A method for the diagnosis of giardiasis and strongyloidiasis by the Enterotest duodenal capsule is described. The method has a greater reliability than does the examination of stool specimens. Results of a study of 36 patients are reported.


[Myocardial infarction "with angiographically normal coronary arteries (author's transl)]. Within a cohort of 121 patients with clinical picture and electrocardiographic pattern of myocardial infarction four cases (3%) had normal coronary arteried demonstrated by selective coronary angiography. Two patients revealed no risk factors, two patients were heavy cigarette smokers. Mean age of patients was 34 years. Exact analysis of clinical, hemodynamic and angiographis data confirmed assumption of regional myoaggressive myocarditis as the underlying disease in one patient and suggested regional myocarditis with high probability in another case. The two other patients however could not be classified as having coronary or primary myocardial disease. The investigation suggests that some cases with the clinical and electrocardiographic pattern of "myocardial infarction" with normal coronary arteries may be due to regional myoagressive myocarditis.


[The normalizing effect of ECG in exercise tolerance tests under molsidomine in different dosages (author's transl]. In 15 patients with coronary heart disease and typical ST-segment depression during and/or after increasing physical effort in supine cycloergometry the normalizing effect of different dosages of Molsidomine on the electrocardiogram under effort was investigated in 74 exercise tolerance tests. Already after application of 0,5 mg Molsidomine there was observed a significant positive effect in comparison to an identical workload without drug. The normalizing effect was further increased by raising the dosage ot 1 mg or 2 mg respectively. To the administration of 3 mg only 1 out of 10 patients in the trial responded with an additional normalizing effect on the ECG since the rest of the patients showed already normal ECGs on 2 mg. This dose relationship also was observed in the pressure-rate-product. There was a dose-dependent decrease from which we can conclude a relief of the working myocardium. Under effort without drug 13 of 15 patients complained about stenocardia. Under the same effort and under Molsidomine however there were no more of these complaints. Because of these results it is recommended to use 2 mg of Molsidomine as a dosage in daily routine. It is needed 2 or 3 times dialy since in previous investigations there was shown a long-lasting effect over more than 5 hours. 3 out of 15 patients showed side effects which were only weak headache or weak congestion in the head.


[Lethal course of myocarditis successive to polymyositis]. The clinical course and post mortem findings of a 57 year old woman stuffering from polymyositis are reported. Besides the symptoms of the inflammatory musculoskeletal process the myocardial involvement finally gaines importance leading to the fatal outcome. Therefore the indication to early preventive pacemaker implantation is recommended in all cases of myocardial involvement with symptoms of conduction defects.


[The significance of the evocative test in the diagnosis of chronic pancreatitis (author's transl)]. To evaluate the predictive value of the evocative test (E.T.) in the diagnosis of pancreatitis, the E.T. was performed in 35 healthy subjects (group I), 65 patients with a presumptive clinical of chronic pancreatitis (group II), and 52 patients with proved chronic pancreatitis (group III). In group I, false positive results were obtained in 11,4% of the patients, the increase in lipase above the upper limit of normal was relatively small. The patients of group II gave abnormal E.T.'s in 63%, reduced faecal chymotrypsin activities being found in 40%, and steatorrhea in 28% of the cases. Positive E.T.'s were associated with abnormal chymotrypsin and faecal fat determinations in 51% and 27%, respectively. In group III,, a positive E.T. was obtained in 60%, the test results show a signifikant negative correlation with the extent of pancreatic exocrine insufficiency. In group of patients with confirmed chronic pancreatitis but without steatorhea, the E.T. was positive in 72%. The E.T. has a limited value in the diagnosis of early stages of chronic pancreatitis.


[Clinical experiences with a disposable biopsy set according to Menghini for percutaneous liver biopsy (author's transl)]. The handling and reliability of a new disposable biopsy set (Hepafix) have been evaluated in 170 percutaneous liver biopsies according to the technique of Menghini. In comparison with the conventional multiple biopsy set the new set provides several advantages discussed in the paper. The wider use of the disposable liver biopsy set may contribute to the prevention of transmission of hepatitis.


[Clinical experience with the cardiac glycoside Gitoformat (author's transl)]. Gitoformat, a new derivate of Gitoxin, was tested with 50, mainly geriatic patients with a manifested cardiac insufficiency. The initial treatment as well as a changeover from the usual glycosid-treatment after a renewed decompensation was without any problems. With a rate of success of 95 per cent the efficiency of this new glycosid can be classified as excellent. Side effects or incompatibility were consequences of overdosage. It is remarkable that also patients with a reduced renal function did not need a reduction in dose. At 10 patients the recompensation with Gitoformat continued after discharge over an observation period of 6 months. The maintenance dose had not to be changed, incompatibility or overdosage reactions didn't appear.


[The influence of quinidine on serum digoxin concentrations (author's transl)]. We were able to demonstrate a significant rise of serum digoxin concentrations (SDC) under simultaneous quinidine-glycoside therapy. The reason for this elevation is not yet known. In vitro studies under addition of quinidine showed no influence on the SDC-values measured by a tritium-labelled radioimmunoassay. The mean SDC of 18 patients under simultaneous quinidine therapy was 2.39 +/- 0.84 ng/ml (3.06 +/- 1.08 nmol/l) compared to a mean SDC of 1.23 +/- 0.74 ng/ml (1.57 +/- 0.95 nmol/l) of 11 patients without quinidine therapy (p less than 0.001). Both groups of patients received the same maintenance dose and showed no obvious impairment of renal function and no significant difference in mean body weight. Our results suggest that part of the great number of adverse reactions seen under a combined glycoside-quinidine therapy might be due to the elevated SDC-values. For these patients a low-normal glycoside maintenance dose and an early reduction of the quinidine dose is recommended.


[Autopsy findings in a case of fatal dextran reaction (author's transl)]. A report of fatal dextran reaction is presented. A patient who had had a stable circulatory status developed massive systemic venous congestion and irreversible cardiac arrest after receiving an infusion of approximately 50 ml of dextran solution. Autopsy showed total occlusion of the pulmonary circulation as a result of precipitation of the dextran-blood mixture. Similar occlusion was demonstrated in capillaries in the kidneys, spleen and cardiac musculature. Death occurred during acute, right-sided heart failure. Pathogenetically a type III allergic reaction with precipitation of antigen antibody complexes in the presence of excess antibody is suspected. In cases such as this one, with no history of prior exposure to dextran, sensitization may have occured with a substance sharing antigenic properties with dextran.


[Effect of estrogen upon thyroid metabolism (author's transl)]. During enhanced endogen estrogen production (pregnancy) as well as during exogen estrogen application a rise occurs in TBG concentration in serum, which seems to be dose related. Simultaneously with the TBG there is an increase in total T4 and T3; the concentrations of the free T4 and T3 however decrease. Towards the end of pregnancy AFT4 is significantly decreased, compared to the controls, AFT3 being in the lower normal range. The lower concentrations of the free hormones are also documented by a decline in the T4/TBG and T3/TBG ratios. Normal basal TSH concentration in serum suggest a metabolic state which is still compensated. Oral contraceptives with low estrogen content have no influence on TBG, T4 and T3 concentrations.


[Dose-effect relationship of orally administered Pyritinol in the chronic organic brain syndrome (author's transl)]. 161 patients with the chronic organic brain syndrome (average age 64 years) were treated with various oral doses of Pyritinol for various periods of time. Statistical analysis of the data by means of "Konfigurationsfrequenzanalyse" showed that the success rate of treatment increases significantly with increasing dose and duration of the treatment. This means that the recommended daily dose should be exceeded if - for example at the start of treatment and in severe cases or in hospitalized patients - there is no immediate clear improvement in the condition. From the point of view of method this study shows that a retrospective analysis of a group of patients treated in a clinic can also provide interesting results and appropriately supplement controlled studies.


Protection induced by inactivated influenza virus vaccines with polymethylmethacrylate adjuvants. Nanocapsules from a copolymer of polymethylmethacrylate and polyacrylamide were tested for adjuvant activity in mouse protection experiments with inactivated influenza virus as antigen. Viruses were either adsorbed on the capsules after polymerization or added to the monomers and incorporated by copolymerization after X-ray initiation. Both preparations showed enhanced immunity as compared to fluid vaccine, if the adjuvant content was 1%. The adjuvant effect was comparable to that caused by the mineral adjuvant Al(OH)3. After dilution of the polymer the adjuvant effect was lost. Such synthetic polymers at suitable concentrations could serve as alternatives to mineral adjuvants.


Holographically stored x-ray images: gray-tone reproduction. Storage of radiographs by holographic means is analyzed with emphasis on its gray-tone reproduction characteristics. The density range and number of gray-tone levels is found to be limited by random scattering in the holographic medium. The behavior is described quantitatively and is in satisfactory agreement with experimental data. Gray-tone resolution is shown to be reduced by speckle noise. It is shown that there exists a trade-off between speckle reduction and reproduced density range.


Establishment of a beam line at the Fermi National Accelerator Laboratory for proton radiography. A proton beam is extracted from the 200-MeV linear accelerator at the Fermi National Accelerator Laboratory to investigate the efficacy of proton radiography in medical diagnosis. Fluence rates from 2 X 10(3) to 2 X 10(5) protons/cm2s over a 28-cm diameter field are obtained with a full width at half-maximum beam-energy spread of less than 3.61 MeV. The system is designed to radiography most parts of the human body, including the head, with high-speed screen-film as the imaging medium. Beam extraction and test results along with the medical implications of the beam quality are reported.


Plastic scintillation filament detector system for 14CO2 breath-analysis tests. A 14CO2-measuring system for breath-analysis tests is described which utilizes plastic-scintillator filaments as radiation-detector elements. The 14C radioactivity in expired breath is measured directly, thus eliminating the need for trapping and counting of liquid scintillation-counting solutions. Total CO2 concentration in expired breath is measured by an infrared detector, making no assumption of endogenous CO2 output and enabling results to be expressed as either a concentration (percentage of administered dose per unit of CO2) or total expired 14CO2. Advantages of this system over an ionization chamber are: significantly lower background variation and shorter breathing time to fill completely the detecting chamber with expired air. The system is easy to operate, transportable on a small cart to the patient's bed if necessary, and applicable for continuous monitoring of 14CO2 in experimental animal studies.


An empirical equation for screen MTFs.

An empirical equation for screen MTFs. An empirical equation is described which accurately fits intensifying-screen MFT data within the accuracy of the MTF measurements. The equation is S (u) = 0.5 erfc[alpha1n(u/u0)]. The equation was fitted to data for 27 intensifying screens. Graphical and numerical results are presented. The maximum standard error was 0.02 and typical standard error was 0.01. Comparisons between results for three experimenters are also presented.


The relationship between resolution and speed of x-ray intensifying screens. Two important physical characteristics of x-ray intensifying screens, speed and resolution, are inversely related. However, the exact mathematical relationship, if any, between them is not known. To investigate this matter, a simple model is considered, which predicts that the product of the equivalent passband Ne and the square root of the speed is constant for a given phosphor material and given film. This relationship is found to be in excellent agreement with experimental data. The papper concludes with a discussion of the generalized validity of this relationship.


Image analysis of the heart action recorded with a high speed multicrystal gamma camera. The use of a high speed scintillation gamma camera for recording and an adequate bolus injection technique during first pass of a radionuclide tracer provides significant information about the function of the heart chambers. The computer-stored information can be processed to get easy interpretable images and parameters for detailed diagnosis. With special procedures the statistical noise of the zones of the images with low count rates can be suppressed, allowing use of smaller quantities of radionuclide, thereby reducing radiation for the patient.


Correction for beam hardening in computed tomography. Corrections for beam-hardening artifacts in computed tomography can be made by using a model which assumes that water and bone mineral are the only constituents of tissue. With this model, a correction factor for the measured transmission values can be calculated such that the reconstructed attenuation coefficients have values corresponding to a monoenergetic source of known energy. Systematic errors in the uncorrected attenuation coefficients, which may be 5%, can be reduced to less than 1% if corrected transmission values are used.


Surface investigations of oxide layers on cobalt-chromium-alloyed orthopedic implants using ESCA technique. The uppermost monolayers of a metal implant are far more important for the corrosion resistance than the alloy itself. Using electron spectroscopy for chemical analysis (ESCA) technique these oxide layers on Vitallium specimens were investigated regarding thickness, elemental composition, and valence state of the elements. The oxide layers on metal implants are not very strong, as they can be easily damaged mechanically. According to environmental conditions, oxide layers of different elemental composition can be grown on the same specimen.


Hazards to the eye lens and gonads from hard beta rays. Considerable attention has been paid to the protection against x and gamma radiation but comparatively less stress has been given to the possible hazard due to external radiation from high-energy beta rays. In order to evaluate the magnitude of this hazard, central-axis depth doses at different source-to-skin distances for 90Sr-90Y and 32P sources were measured. Isodose curves in a testicular phantom for a 90Sr-90Y source were measured. The data of Haybittle for 144Ce for 10 cm SSD has been included. From the measured data, the eye-lens epithelium dose may be as high as 51%, 21.5%, and 82%, respectively, for the three sources instead of 15% as has been conventionally assumed. The isodose curves obtained in the testicular phantom indicate that an appreciable amount of testicular tissue can be subjected to radiation exposures. The radiation hazards due to high-energy beta rays are not negligible and considerable care should be exercised while using these sources.