[Clinical studies on the therapeutic effect of tinidazole ("Fasigyn") during treatment of urogenital trichomonas infections in women and men (with comparative laboratory studies on the effect of metronidazole and tinidazole)]. Tinidazole preparations are effective agents for the therapy of genitourinary trichomoniasis in women and men. The application of these drugs is very simple and, in particular, suitable as the application time is short and the occurrence of slight side effects shows a very low incidence. Unfortunately, these medicaments cannot be used during pregnancy and lactation. In addition, definite therapeutical recommendations are lacking and the published specific experiences in the therapy of obese persons with these drugs should be verified in future.


[Technic of surgical reduction plasty of the female breast]. The surgical principles for the reduction operation of the female breast were established in numerous publications during the last decades. Improvement of results can be obtained in our opinion only by refinement of previous described techniques. We are describing the operation for mammahyperplasia designed in this institution which contains modified steps of Stroembeck, Biesenberger and McKissock technique. The cosmetic results are acceptable and the complications of slough of the nipples is greatly reduced.


[Risks and trends in geriatric gynecologic surgery]. A comparative study of the geriatric gynecological operations of the two periods from 1958 to 1967 and 1968 to 1977 in the Universitäts-Frauenklinik Jena showed an increase of the number of women aged 60 years and more from 6.8% to 8.9% and in the last four years to more than 10%. In 52% a malignant tumor was the main disease. Prolapsed uterus and vagina occured in about 23%. Abdominal hysterectomy was the mostly performed operation. The mortality decreased from 6.6% to 3.3%. Pulmonary embolie was the most frequent cause of death.


[Hemorrhage in menopause and its histological correlation]. In an evaluation of 200 histological endometrial findings of female patients having postmenopausal haemorrhage malign changes were noticed in five per cent of the cases. This figure is much smaller than that which is usually mentioned in literature. However it corresponds in its proportion with the known clinical and anamestic risk factors.


[Large rapidly growing retroperitoneal lipoma following Wertheim's operation]. Report on a rapidly growing large retroperitonally placed tumor which after fifteen months was extirpated by applying a Wertheim-radical operation and following ray-therapy. The tumor weighed 6 kg and turned out to be a good-natured lipom.


[Radioimmunologic determination of several hormones in commercial immunoglobulin preparations]. Radioimmunological method with the aid of standard sets was applied to determination of the content of chorionic gonadotropin, placental lactorgen, prolactin, folliculo-stimulating and luteinizing hormones in the immunoglobulin preparations made of abortion and placental blood serum. Serum fractionation by Cohn's method (technological variant B) led to reduction in the immunoglobulin preparations of polypeptide hormones (placental lactogen and prolactin) content, but it was not sufficiently effective in respect to glucoprotein hormones.


[Klebsiellae isolated from patients and healthy subjects. III. Biochemical types of klebsiellae]. By the difference in fermentation of glucose, lactose, saccharose, inosite, adonite, behaviour in IMViC tests, relation to urine and hydrogen sulfide formation there were revealed 10 biochemical types among 120 strains of klebsiellae. Klebsiellae of biotypes 1 and 2 were the most frequently isolated from the patients; biotypes 3--10 were less frequent. Klebsiella of biotypes 1 and 2 were revealed in healthy persons; biotypes 3--10 were never found. Biochemical reactions on whose basis klebsiellae were referred to the definite biochemical type proved to be stable.


[Farr's modified method and ways of determining the index of antibody heterogeneity and the mean assoication constant]. The modified Farr's method included mixing of the solutions of a univalent antigen and antibodies, precipitation of the antigen-antibody complexes with semisaturated ammonium sulfate solution, and determination of serological activity of the free antigen in the supernatent fluid. The mentioned modification permitted to determined the heterogeneity index and the mean association constant without resorting to labeled antigens. Besides the standard calculation method, the authors recommed simplified methods of heterogeneity index and the mean association of constant determination.


[Experimental study of the immune response to swine liver urate oxidase]. An immune response to urate oxidase--an enzyme from pig liver was studied. Peculiarities of antibody formation were investigated in three animal species. It was shown that the scheme for repeated injections of the enzyme preparation had a marked effect on the intensity of humoral immune response. In studying the process of the enzyme allergic properties it was found that urate oxidase had anaphylactogenic and skin sensitizing properties. The strength of anaphylactic reaction depened on the sensitizing dose of the antigen and correlated with the results of active skin anaphylaxis. However, there was no correlation between the strength of the immune response determined by means of the indirect hemagglutination test and the intensity of anaphylactic reaction.


[Preventive effect of several antibiotics in experimental rickettsial infections]. Dibiomycin, biomycin, and biomycin in combination with erythromycin (antibiotics with a wide range of action) used once or in interrupted courses produced a distinct prophylactic effect in experimental rickettsia infection in guinea pigs. The most pronounced prophylactic action was observed when chemoprophylaxis was combined with immunization with inactivated typhud vaccine. Formation of typhus immunity was seen when such chemoprophylaxis scheme was followed.


[1st isolation of serovar Sorex--Jalna leptospirae from humans]. Leptospira strain "Patient No. 84", identical to the international standard of sorexjalna serovar, of Javanica serogroup was for the first time isolated on the 5th day of the disease from a patient suffering from leptospirosis in seeding his blood in Vervoort-Wolf's fluid medium. Antibodies heterologous against the strain isolated were also determined in the patient's blood on the 5th day. Their titre was 1 : 200(++), and they proved to react with leptospira of Cynopteri and Pomons serogroup.


[Experimental immunologic study of a protective anthrax preparation]. Rabbits and sheep immunized with protective anthrax preparation and live anthrax vaccines were examined. Protective anthrax preparation caused changes characteristic of general immunomorphology and immunomorphological reaction of the humoral type. A marked resistance in infection with the virulent anthrax culture was revealed in the animals immunized with this preparation and in those--with live vaccines. Skin allergic reactions were more intensive in sheep immunized with live Ikhtiman's vaccine; there was no reaction in the animals immunized with the protective preparation.


[Electron microscopic study of the small intestine in experimental cholera]. Ultrastructure of the small intestine was studied in nursling rabbits infected with the El Tor 5879 vibrio culture. Cholera vibrio was localized in the intestinal lumen mostly in the crypts area, in some places adhering to the brush edge of enterocytes without penetrating them. Epithelium of the villae remained intact; it however displayed dystrophic changes of microvilli and organoids, cytoplasma vacuolization and increase in lysosome count. The mentioned changes pointed to a marked elevation of functional enterocyte activity in cholera.


Determination of prostaglandins and other products of arachidonate oxygenation in perfusates and during platelet aggregation. Some analytical aspects of prostaglandin research are discussed. We present our latest results of the determination of the various products of arachidonate oxygenation in biological fluids and during platelet aggregation. These products were determined by (GLC) in combination with electron-capture detection or mass spectrometry (multiple-ion detection). The major component released from isolated perfused heart and lung was prostacyclin, determined as its hydrolysis product 6-oxo-PGF1alpha. Spleen released much thromboxane and monohydroxy acids. Normal rat platelets formed also much hydroxy acids during aggregation but at essential fatty acid deficiency, only very small amounts of product were detected.


Biosynthesis and biological properties of prostaglandin endoperoxides and thromboxane A2. Two prostaglandin endoperoxides, i. e. PGG2 and PGH2 were detected and isolated. They were unstable in aqueous medium (t1/2 at 37 degrees C about 5 min) and were converted to PGF2alpha by mild reducing agents. Human platelets as well as guinea pig lung and spleen converted the endoperoxides into thromboxane A2, an unstable (t1/2 at 37 degrees C about 30 s) oxetane/oxane derivative. Thromboxane A2 was converted into a stable hemiacetal derivative, thromboxane B2, by addition of 1 H2O. The two prostaglandin endoperoxides as well as thromboxane A2 caused platelet aggregation and the platelet release reaction. In addition they were potent stimulators of vascular and airway smooth muscle in vitro and in vivo.


Arachidonic acid-induced platelet aggregation and thromboxane A2 generation in patients with coronary heart disease. Arachidonic acid (AA)-induced platelet aggregation was studied in platelet-rich plasma of 32 male patients who survived myocardial infarction and in 32 healthy men of similar age. Only in three healthy subjects, but in 13 patient, irreversible platelet aggregation was induced consistently with concentrations of AA below 500 micrometer. The rate of conversion of AA to thromboxane A2 (TXA2) by platelets of these patients was augmented, although less endogenous TXA2 was required to trigger aggregation of their platelets as compared to the controls. The results indicate that among patients with coronary heart disease a subgroup can be distinguished which can possibly benefit from the secondary preventive treatment with aspirin and with other anti-platelet drugs which inhibit the generation of TXA2 in platelets.


Docosahexaenoic acid in cardiac metabolism and function. The polyene fatty acid compostition of cardiac phospholipids is modified by a) dietary cod liver oil, b) norepinephrine, c) chronic administration of nicotine to animals fed a high cholesterol diet. Polyene fatty acids stimulate microsomal oxydation of epinephrine to cardiotoxic adrenochrome. Adrenochrome stimulates microsomal peroxydation or oxygenation of polyene fatty acids. There is an exponential relationship between docosahexaenoic acid of cardiac phospholipids and the heart rate.


Influence of prostaglandins, prostaglandin-precursors and of a linoleic acid rich and free diet on the cardiac effects of isoprenaline and vasodilators. In isolated auricle preparations of guinea pigs arachidonic acid diminished the increase in cardiac performance by isoprenaline in a similar way as PGE1 and propranolol. Long term pretreatment of rats with a linoleic acid (LA) supplemented diet increased in vivo the maximal systolic pressure and decreased the heart rate. In hearts in vitro the LA rich diet decreased the heart rate, increased the coronary flow and showed a tendency to enhance the contraction force. The release of cardiac prostaglandin-like substances was increased. Simultaneously the LA rich diet reduced the heart rate increase and the positive inotropic effect of isoprenaline without changing the increase in the coronary flow and without any effect on the heart performance of coronary vasodilators like oxyfedrine and prenylamine.


Comparative effects of prostaglandin F2alpha and A2 on the cardiac transmembrane potentials. PGF2alpha and PGA1 similarly to PGE1 and PGE2 exerted a dose-dependent dual effect on the maximum rate of depolarization (Vmax) of the cat and guinea-pig left auricle. Low concentrations (0.5 and 1.0 microgram/ml) of PGF2alpha caused a marked increase of Vmax which was proportional to the dose in both species, while the overshoot (OS) remained unchanged. PGF2alpha in a dose of 5 micrometer/ml significantly decreases OS but did not alter Vmax, in a dose of 10 microgram/ml, however, evoked a considerable decrease of Vmax, too. These changes were not related to those in the resting potential (RP). With respect to the repolarization phase no biphasic effect was observed. PGA1 in a dose of 0.02 microgram/ml significantly increased Vmax and RP, too. In the presence of 0.1 microgram/ml of PGA1 Vmax remained unchanged, only a significant hyperpolarizing effect could be observed. A higher concentration (1.0 microgram/ml) of PGA1 evoked a significant decrease of Vmax, without changing RP. The examined concentrations of PGA1 accelerated the initial repolarization (20 and 50% repolarization phase).


Influence of electrically and aconitine induced arrhythmias on the prostaglandin efflux in coronary sinus blood in dogs. Tachyarrhythmias and extrasystoles produced an increase of PGE and PGF2alpha in canine coronary sinus blood (CSB). After application of aconitine the PG efflux was nearly unchanged before arrhythmia occurred. However, the PG efflux increased after arrhythmia had occurred.


Definition of prostaglandin-sensitive arterial constrictor systems. The effects of a number of prostaglandins on the systemic arterial circulations of the sheep, pig, dog, cat, rabbit and rat have been investigated. It is suggested that all of the species may possess, in addition to a PGE2-sensitive dilator system, a PGD2-sensitive constrictor system, and that 13,14-dihydro-15-oxo PGD2 is a potent and selective agonist on this system. The dog and the pig also have an endoperoxide-sensitive constrictor system activated by the 11,9-(epoxymethano) analogue of PGH2 and, of particular note, ICI 79939 and its 11-oxo analogue. These latter substances also contract the rabbit aorta strip and the guinea pig tracheal chain and aggregate human platelets. A number of PGF2alpha analogues show certain other distinctive cardiovascular actions.


Prostaglandin release from perfused, isolated hind legs in normal and arteriosclerotic rats. Intraarterial injection of 10 microgram noradrenaline (NA) produced a stronger increase of prostaglandin E-like material (PGE) in the outflow of isolated perfused hind legs of normal rats than of those of arteriosclerotic rats. The vasopressor effect of NA in normal rats was stronger than in arteriosclerotic rats, which could be explained on the basis of PGE release.


Influence of linoleic acid content of the diet on arterial pressure of salt loaded rats. I. Effects on prostaglandin metabolism and sympathetic nervous system. 1. Compared with linoleic acid rich and pellet diet linoleic acid free diet causes an increase in blood pressure in salt loaded rats. The blood pressure increasing effect of linoleic acid poor diet could not be augmented by linoleic acid free diet. 2. The blood pressure was increased by indomethacin in linoleic acid rich and pellet fed rats. In linoleic acid free fed animals indomethacin shows only a brief augmentation of blood pressure. 3. Prostaglandin (PG) biosynthesis was decreased in isolated kidneys and aorta but increased in the kidney medulla homogenate after a four-week linoleic acid free diet. 4.. Chemical sympathectomy by intracerebroventricular injections of 6-hydroxydopamine abolished the blood pressure increasing effect of linoleic acid free diet. We postulate that changes in the PG metabolism and in the activity of sympathetic nervous system are causes for the elevated blood pressure of linoleic acid free fed salt loaded rats and we conclude that the function of the cardiovascular system is influenced favourably by a linoleic acid rich diet.


Influence of linoleic acid in the diet on arterial pressure of salt loaded rats. II. Effects on plasma catecholamine concentration, renin activity, and reactivity of isolated vessels. 1. A linoleic acid free diet and indomethacin treatment induce an increase in the epinephrine and norepinephrine concentrations in the plasma. 2. The renin activities in the kidney and plasma were increased by a linoleic acid free diet and decreased by indomethacin treatment. 3. The reactivity of isolated blood vessels to norepinephrine, angiotensin, PGE2 and PGA2 was intensified after linoleic acid free diet. Indomethacin treatment neutralized the differences between the different diet groups. We conclude that the increase in the sympathetic activity, in the renin activity and in the vasoreactivity after a linoleic acid free diet has promoted the elevation of blood pressure of salt loaded rats and that these prohypertensive changes have been caused by a diminished PG biosynthesis in kidneys and blood vessels.


The influence of increased dietary linoleate on essential hypertension in man. A pilot study testing the hypothesis of a blood pressure lowering effect of polyunsaturated fatty acids was conducted in Evans County, Georgia. A moderate increase of dietary linoleic acid significantly decreased diastolic blood pressure in eight borderline hypertensives who were otherwise healthy, within four weeks. The change was not due to a reduced sodium content of the diet. A significant increase in creatinine excretion and clearance was noted, indicating an improvement in kidney function which might explain the blood pressure lowering effect of the fat-modified diet.


Influence of the selective prostaglandin biosynthesis inhibitor, gold, on the arterial pressure of normotensive and spontaneously hypertensive rats. Gold salt treatment does not influence the blood pressure of normotensive rats but transiently lowers the blood pressure of spontaneously hypertensive rats. The effect is abolished by indomethacin. Prostaglandin (PG) synthesis in the kidney medulla is shifted to E-PG by gold salt. A PG-mediated action of gold salts is supposed.


Influence of counter-irritation by carrageenin on inflammatory reactions induced by prostaglandins, serotonin, histamine, compound 48/80, carrageenin and Freund's complete adjuvant. The carrageenin edema of rat paw and the primary phase of rat adjuvant arthritis were significantly inhibited by carrageenin whereas the increase of skin capillary permeability induced by prostaglandins (PGs) and further irritants as well as the secondary phase of adjuvant arthritis were mostly not significantly affected. Inhibitory effects after single carrageenin injection do not seem to be mediated by the complement system because total complement activity remained unaffected.


Application of prostaglandins in obstetrics and gynecology. It is reported on the induction of abortion in the second trimenon and the induction of labour at term with the prostaglandins PGF2alpha and PGE2 under consideration of pharmacokinetic problems as well as special indications such as secondary insufficiency of labour and certain fields of applications like softening and priming. The prostaglandin in gelform and the prostaglandin analogue 15(S)-15-methyl-PGF2alpha are discussed as well as the possible advantages and side-effects of these substances.


Postconceptional prostaglandin therapy.

Postconceptional prostaglandin therapy. 392 cases of prostaglandin abortions were analyzed for efficacy, clinical acceptability and complications. It was repeatedly emphasised that the clinical administration of PGs are not without risks and serious drawbacks. The vaginal suppositories seem to be vary promising. It is suggested that new lines of research should be pursued in order to improve our understanding of the effect of PGs and to develop better dose schedules as demanded by clinical and professional excellence.


In vitro prostaglandin biosynthesis in human pregnant uterus from arachidonic acid. Formation of prostaglandins (F2alpha, E2 and D2) in the pregnant human uterus microsomes was studied using 14C-labeled arachidonic acid. Sample of uterine pieces were removed from the lower uterine segment at the time of Caesarean section. The prostaglandin synthesis in the microsomal fraction was characterized in terms of cofactors, substrate concentration and incubation time requirements.


Investigations on prostaglandin levels in amniotic fluid and maternal blood during late pregnancy. Prostaglandin E and F equivalents have been measured during late pregnancy in amniotic fluid and maternal venous blood by radioimmunoassay after purification on silicic acid columns. In amniotic fluid levels of both prostaglandins exhibit a tendency to increase, in particular after 36 weeks of gestation, possibly most markedly 20--4 h before the onset of labour. The PG E/F-ratio in amniotic fluid may slightly decrease during the late gestational age. In maternal venous blood variable low levels of both prostaglandins were observed without any correlation to the age of gestation.


Prostaglandins and primary dysmenorrhoea. In 100 patients a total of 171 PG determinations in the menstrual blood was performed under standardized conditions. The primary PGE1 and PGF2alpha were determined by RIA. The evaluation of the analysis of the sexual hormones resulted in a group with a biphasic cycle without dysmenorrhoea and a group with a biphasic cycle with dysmenorrhoea. Highly significant differences (p less than 0.01) were found in the PGF2alpha concentration in menstrual blood between a group of healthy women and one of patients with dysmenorrhoea. In dysmenorrhoea the ratio of the PGs investigated is shifted in favour of PGF2alpha. Indomethacin can decrease the PGF2alpha levels in dysmenorrhoea up to 15% (p less than 0.01). All treated patients reported that their conditions had improved. Five out of seven women were completely without any complaints.


Investigations of hormones during early abortion induced by prostaglandin F2alpha and 15(S)-methyl-PGF2alpha. In early pregnancy up the 7th week of pregnancy PGF2alpha was infused and 15(S)-methyl-PGF2alpha was applied i. m. to induce menstruation in 20 or 19 cases, respectively. In the tested form of application 15(S)-methyl-PGF2alpha is effective in 89 per cent of the cases and in 74 per cent complete abortion was achieved. PGF2alpha produced bleeding in 80 per cent only and complete abortion in 55 per cent. The differences in these two groups were not statistically significant. The steroid hormones estradiol and progesterone decrease in a successful application of PGs for induction of abortion and reach a value of 75 per cent at the onset of bleeding. The LH concentration in plasma becomes smaller too. In some cases there is a temporary increase in hormones shortly after starting treatment. The results could indicate that the considerable decrease in hormones before the onset of bleeding might be caused by an alteration of the corpus luteum, which is effective during early pregnancy.


[Gallbladder calculi: cholesterol concentration and its radiologic correlates]. Cholesterol concentration in the gallstones of 84 patients obtained by surgery is studied and radiologic correlation of the stones (lucency and opaqueness) is established with relation to cholesterol concentration. We conclude that 70% of gallstones in our population, contain greater than or equal to 80% of cholesterol and the radiographic appearance of stones in functioning gallbladder is a good method to predict cholesterol content in gallstones.


A reappraisal of percutaneous liver biopsy in clinical practice. The diagnostic yield of 101 consecutive percutaneous liver biopsies was assessed. Adequate tissue was obtained in most specimens. Even in the presence of an adequate specimen, other procedures were often necessary to rule out other diagnostic possibilities not explained nor completely ruled out by percutaneous liver biopsy alone. With the current diagnostic procedures available to the clinician which have low morbidity and low mortality, the use of blind percutaneous liver biopsy as an initial diagnostic step in certain types of liver disease should be reassessed.


[Personal experience in colonoscopy and polypectomy]. The purpose of this presentation is to point out the importance of this new diagnosis and treatment method, recently incorporated. The studies were done with the Fibroscope F9-A with doble channel, equipped with an desection smear for polipectomies and an extracting forceps. The patients arrive with their intestine perfectly cleaned with classical methods. This detail is most important for the polipectomies. If the local conditions aren't the desired, presence of bowels or barium of an previous enema, we postpone both, examination and polipectomy, because those are causes of false diagnosis in the first case or eventual accidents in the second condition. Regarding this, we had an performing doing a biopsy in an stenosing neoplasm of the sigmoid colon. We believe it convenient to prevent this complication, to reduce the air pressure before performing the biopsy. Of the 160 patients examinated, 54 had no patology, 32 had polips and of this group 4 had multiple poliposis, 4 had association with diverticulosis and 3 associated with neoplasm. (4 were neoplasm, 10 stenosis without mucous lesions, 1 villous adenoma, 1 megacolon and 1 rectitis). We made 12 polipectomies, 10 with the conventional technique and 2 associated with surgery. We had no accidents and one of them was an early stage of colon cancer.


[A simple radiologic method for measuring physiologically the rate of intestinal transit]. A simple radiological method to measure physiologically the velocity of intestinal transit is described. As a marker, a small rubber bag containing 1 ml. of Biligrafina Fuerte was orally given, and its passage along the digestive tract followed, then, performing 2 or 3 serial plain radiographs of the abdomen. By what has been experimental until now, the method seems to be of great help for a better understanding of constipation and other intestinal disorders.


[Achalasia of the esophagus].

[Achalasia of the esophagus]. Thirty-two cases of achalasia of the esophagus are studied in retrospect. The evolution was carried on from different standpoints: clinical, radiological, endoscopic, and motility studies. Patients were treated by dilatation (either pneumatic or mercury bougies) or surgery. The result of treatment was evaluated from the clinical standpoint correlating it with the remaining studies in order to establish wether or not they were related.


[Effect of hydrochlorothiazide on acid secretion and potassium and sodium in the human gastric mucosa]. Hydrochlorotiazide induced changes of gastric acid secretion, Sodium (Na) and potassium (K) of human gastric mucosa". In ten patients with elevated acid secretion we determined maximal acid secretion after histamine stimulation, Na and K in serum and in fundic mucosa obtained by peroral gastric biopsy. These experiments were performed before and after the oral administration of hydrochlorotiazide (200 mg/day) during seven days. After diuretic treatment we observed a significant decrease of Na (P less than 0.01) and K (p less than 0.05) in gastric mucosa. Both ions also decreased significantly in plasma (p less than 0.01). In gastric juice the decrease was significant for volume and peak acid output (p less than 0.01) and for total acidity (p less than 0.05). The significance of these findings is discussed.


[Progress in the early diagnosis of cancer of the colon and rectum]. Our experience with the air contrast examination in the cancer of colon and rectum diagnoses is showed. The colaboration among radiologist, endoscopist, pathologist and surgeon is important. In the large bowel tumors diagnosis, the radiologic and endoscopic prodedures should be evaluated together. The double colonic contrast has showed in our experience, better results than with the barium enema. Over 31 patients with both studies, we obtained 13 false negatives (with barium enema, doing then the double colonic contrast became positive 12 (92.4%).


[Gastric polypoid heterotopy in the small intestine]. We present a 14 year old girl with a two years' history of colicky abdominal pain associated with the palpation of a tumor in the left upper quadrant of the abdomen. During these two years, the pain and the tumor appeared and disappeared spontaneously several times. In the operation we found a jejunojejunal intussusception, the head being a sessile polyp placed 20 cm from the ligament of Treitz. The pathological examination showed a polyp formed by mucosa similar to the gastric one with chief and parietal cells. We discuss the clinical pictures that can be associated with this pathological entity in this uncommon localization in opposition to the more common settling in Meckel's diverticulum.


[Peliosis hepatis: 2 new cases].

[Peliosis hepatis: 2 new cases]. Peliosis Hepatis is a liver disease characterized by the presence of cystic spaces fill of blood visible through the capsule and on the cutting surface. The etiology has been related to the use of anabolic steroids in cases with malignant tumors and cronic diseases. Only fifty cases have been reported in the world literature. Two anatomical patterns have been described: parenchyma tous and phlebectatic. A combinated pattern including both lesions was also observed. We presented two cases: a 83 years old patient with a cecum carcinoma who developed a phlebectatic pattern, and a 63 years old woman with eritroleucemia who presented the parenchimatous patern after long medication with anabolic steroids. The combined pattern was not present in none of the two cases.


[Benign stenosis of the esophagus].

[Benign stenosis of the esophagus]. In the present study 39 patients with benign esphageal stenosis were studied (average age 59,9 years). The most common etiology was refux esofagitis, and the most common associated pathology was esophageal hiatus hernia. Thirty one patients received medical treatment (diet. antireflux drugs and dilatations.) Twenty four were dilated with the slow continuous method, six with metalic bougies. One patient was not dilated. Seven patients were not treated since the stenosis was due to extrinsec compression. One patient was surgically treated from the onset. Seventy percent of the patients had goods results with esophageal dilatation. We propose that patients with benign esophageal stenosis should be treated by the slow continuous dilatation method.


Study of the activity of antithrombin-III in latent cholestasis. (A clinico-pharmacological study of the relationship between antithrombin-III activity and steroid cholestasis). The relationship between steroid cholestasis and antithrombin-III activity were examined in users of oral contraceptives (Infecundin or Bisecurin) and in patients receiving anabolic hormone therapy (Nerobol). The control group for the oral contraceptive users consisted of patients with spontaneous anovulation. The untreated control group consisted of healthy women in the reproductive age. The increase in antithrombin-III activity was found to be directly related to the decline of anion excretion. Latent cholestasis in itself is not associated with an increased antithrombin-III activity, nor is the activity of antithrombin-III affected by long-continued use of those anabolic steroids which produce no decrease in anion excretion.


Iron metabolism and its responses to allopurinol treatment in porphyria cutanea tarda. Iron kinetics, absorption and storage were studied by means of 59Fe and deferoxamine (Desferal-Ciba) in eight patients with porphyria cutanea tarda at the time of clinical activity and after allopurinol treatment. At the time of clinical manifestations, a significant impairment of erythrocyte-iron turnover and of radio-iron utilization was demonstrable in a half of the patients and a significant increase in iron absorption and turnover in patients out of 8. The measurements of surface activity in vivo showed a significant increase in storage iron. This was confirmed by the excessive urinary excretion of deferoxamine-iron, attaining three- to four-fold figures of the normal values (251 +/- 85 mg). The increased absorption of iron coupled with an abnormal porphyrin metabolism is suggestive of a double genetic defect. As a result of allopurinol treatment, normalization of iron kinetics and a moderate decrease in iron storage were demonstrable. The abnormal excretion of uroporphyrin and coproporphyrin were also brought under control. The success of treatment is attributed to the inhibitory effect of allopurinol on xanthine oxidase.


Apex-carotid diagram in systolic click-late systolic murmur syndrome. A new non-invasive method based on mechanographic cycles has been developed for the study of heart function. It integrates synchronously recorded indirect carotid tracing and left apex cardiogram into an apex-carotid diagram. In 25 patients with systolic click-late systolic murmur syndrome, the diagram showed an elongation with a curvature of the segment of slow ventricular ejection to the right and a decrease in the area of ventricular ejection. It is concluded that apex-carotid diagram is an additional tool in diagnosis of the mitral valve prolapse syndrome.


Steroid levels in the serum and seminal plasma during clomiphene therapy in hypofertile men. The serum and seminal plasma concentrations of androstenedione, testosterone, dihydrotestosterone and 17beta-oestradiol were investigated in hypo- and oligospermic males during clomiphene-citrate, administration. A significant increase was demonstrated in the serum testosterone, dihydrosterone and 17beta-oestradiol values, mainly in the first month of therapy. The steroid increase in the ejaculate was less pronounced. Measuring of 17beta-oestradiol in serum appears to be a useful parameter for estimating the stimulative effect of clomiphene citrate.


The ADH-reserve capacity in Brattleboro rats. The water metabolism was studied in homo- and heterozygous Brattleboro rats suffering from hereditary hypothalamic diabetes insipidus. In homozygous Brattleboro rats the spontaneous water intake and urinary output and the diuretic reactions signficantly increased after water and salt loading. No antidiuretic activity was found in the urine, posterior pituitary or hypothalamus of these animals, and this state was not affected by hyperosmosis. For the heterozygous rats the spontaneous water intake and urinary output and the diuretic reaction exceed the respective control values, the posterior pituitary, the hypothalamus and the urine are of reduced antidiuretic activity and this activity is less mobilizable by hyperosmosis. It is concluded that the ADH-reserve deficiency is total in the homozygous Brattleboro rats, and partial in the heterozygotes. As a result of hyperosmosis, the vasopressin release is of a reduced extent, yet detectable in the heterozygotes.


Abnormalities in humoral and cellular immunoactivity in pancreatitis. II. Study of the cellular immune system. The in vitro parameters of the cellular immune system were followed up during the course of, and over 1 to 8 months after recovery from acute pancreatitis and in chronic pancreatitis. In acute pancreatitis, a significant inhibition of leucocyte migration and a significant reduction of the percentage and absolute number of early and total rosette-forming (T) lymphocytes were demonstrated. These abnormalities ran parallel with the alterations of the humoral immune system described in the first paper of this series. On the evidence of the follow-up studies continued for 1 to 8 months, the abnormalities of the cellular and humoral immune system were found to persist in the majority of the cases. The same is valid for chronic pancreatitis. The possible causes of the abnormalities are discussed. Tentative interpretations are offered for the possible role of specific immune sensitization in the transition of the acute to the chronic inflammatory process and in the progression of chronic inflammation.


The hepatic tissue spaces.

The hepatic tissue spaces. In a controlled study concerned with the site of intrahepatic lymph formation, liver tissue from normal dogs, cats, rats and from cats with ligated hepatic lymph vessels, was subjected to light and electron microscopy. It was found that the periportal space named after Mall by whom it had been described, represents an interstitial gap of submicroscopic size. It is bordered on the one side by the hepatocytes of the limiting plate and on the other by the connective tissue fibres and processes of the connective tissue cells of the portal canal. The relationships between the perisinusoidal (Disse) space and the periportal tissue-gap have been clarifed and their role in the formation of hepatic lymph is discussed.


Intragastric titration of peptone-stimulated gastric acid secretion. Fourteen male patients with duodenal ulcer were stimulated by a 10% peptone meal, and acid secretion was measured by continuous intragastric titration. The results were compared to the effects of intravenous infusion of pentagastrin given in a dose of 6.0 microgram/kg-hour on gastric acid secretion in the same 14 patients. Acid secretion reached the peak in the third 15-min period after peptone instillation and it was similar to that peak acid output/15 min produced by infusion of pentagastrin. Acid secretion in response to peptone in the second hour gradually diminished towards the basal level, on the contrary, during i.v. infusions of pentagastrin the acid secretion was well sustained. The acid response to peptone solution or pentagastrin infusion did not differ significantly in the first hour, but in the second hour the difference was significant. It is concluded that the gastric acid secretion induced by peptone is comparable to the effect of the highest dose of pentagastrin infusion only in the first hour. Reproducibility of gastric response to peptone and to pentagastrin infusion was very good (r = 0.79 and 0.87, respectively).


Practical application of patterned visual evoked responses in multiple sclerosis. Pattern reversal visual evoked potentials (VEP) were studied in a control group of 72 subjects and in 60 patients with multiple sclerosis. The recording system consisted of a visual stimulator for pattern production on a commercial TV connected to an EMG machine for displaying and averaging of the response. The normal values of latency, the upper limit of normality and right-left differences in our control group were compared with those given by different authors. Likewise a comparison of the positive VEP results in MS was carried out. The reasons for the variability of results were briefly discussed and the importance of control studies for each laboratory starting VEP recording was stressed. This test can easily be carried out in every clinical neurophysiological laboratory and it provides an excellent and rapid technique for the investigation of patients with suspected multiple sclerosis.


New subcortical components of the cerebral somatosensory evoked potential in man. Two new components of the human SEP upon stimulation of the contralateral median nerve at the wrist have been identified. Such components have been called N16 and N17, according to their polarity and latency. N16 and N17, as well as the N14-P15 complex, are generated by separate subcortical dipoles. Particularly, they are supposed to be far-field reflections of the activity of the dorsal columns nuclei or the medial lemniscus (N14-P15), the thalamus (N16) and the thalamo-cortical radiation (N17). Moreover, it has been established that N14 is the very first intracranial component of the human SEP, the main peak of S wave and the preceding ones being extracranial in origin. A new classification of SEP intracranial components including early (N14 through N17), intermediate (N20 through P30) and late events is proposed.


The stretch reflex in the Eaton Lambert syndrome, myasthenia gravis and myotonic dystrophy. The stretch reflex at rest and after muscle work was studied in three cases of Eaton Lambert syndrome. After muscle work a potentiation of the stretch reflex was demonstrated clinically and electrophysiologically. The presence of muscle stretch reflexes and their potentiation after muscle work was correlated with the clinical stage of the disease. The enhancement of the stretch reflex after voluntary effort was absent in normal subjects, myasthenia gravis and myotonic dystrophy.


Hypokalaemic periodic paralysis and cardiomyopathy. The results are reported of cardiological examinations, including echocardiography, in nine members of a family suffering from hypokalaemic periodic paralysis, associated with permanent muscular weakness. The studies were performed in periods between attacks of paralysis. The slowly progressive permanent muscular weakness which is found in most of the patients with hypokalaemic periodic paralysis resembles a limb-girdle type dystrophy. Involvement of cardiac muscle is not uncommon in patients with limb-girdle dystrophy. Using a combination of echocardiography and ECG examination, nowadays the most sensitive screening method for the detection of cardiomyopathy, no evidence was obtained for cardiac involvement in hypokalaemic periodic paralysis patients with permanent muscular weakness.


Influence of clonidine upon sympathetic component of the carotid chemoreceptor reflex. The central influence of clonidine on the sympathetic component of carotid chemoreflex was verified in chloraloseurethane anaesthetised cats. The electrical stimulation of sinus nerve evoked only the excitatory responses in the sympathetic cardiac and renal nerve in the full range of stimulus strength. The excitatory response in the sympathetic renal nerve was completely depressed during the central cardiodepressor action of clonidine. Taking into account that the evoked excitatory responses in the sympathetic nerves were mainly the result of chemoreceptor carotid afferent fibre stimulation, it was concluded that clonidine depresses centrally carotid chemoreceptor reflex.


Metabolic responses to adrenaline and muscle glycogen content in dogs treated with thyroxine. Lipolytic, hyperglycaemic and lactacidaemic responses to 1h adrenaline infusion (0.1 microgram/kg/min) were compared in resting dogs before (control) and after prolonged thyroxine (T4) treatment. Besides, the effect of 2-week thyroxine administration on muscle glycogen content, and its changes following adrenaline infusion were examined. Prolonged T4-treatment of dogs resulted in considerable alterations of the metabolic actions of adrenaline. A marked difference between the control and T4-treated dogs was also found in the muscle glycogen content, which was significantly lower in the latter. Both in the control and T4-injected dogs adrenaline infusion caused similar depletion of the muscle glycogen store. However, in all the control animals examined supercompensation of muscle glycogen was noted 1 h following termination of adrenaline infusion, whereas T4-treated dogs were unable of incurring any significant muscle glycogen deposition.


Influence of long-lasting physical work upon mental and psychomotor performance in relation to the time of day. Twenty three women and 20 men (19--27 year old) were tested at different time of day using battery of psychological tests. All subjects were tested every 2 hours continuously for many hours. Between consecutive tests they worked on a bicycle ergometer (series A) or rested in sitting position (series B). The influence of three following factors upon performance level was considered: circadian fluctuations, duration of the experiment, and physical effort preceding testing. Positive influence of physical effort has been shown in psychomotor tests and negative one in mental tests which was especially pronounced at night or in the morning after night work.


Leucocyte system in spontanously hypertensive rats (SHR). Investigations were carried out on spontanously hypertensive rats (SHR) of F3 and F4 generation of Okamoto-Aoki strain and on normotensive rats (NR) of Wistar strain. Blood pressure was measured by an indirect method. The haematological determinations were carried out using classical methods. The difference between SHR and normotensive rats were found not only in the values of blood pressure and in the number of erythrocytes but also in the number of leucocytes and the haemogram. The percentage of neutrocytes was significantly higher in 5 week-old female SHR than in NR of the some age and sex. The whole number of white cells depended on sex and age of animals but it was always lower in SHR than in NR. This seems to be independent of the changes in blood pressure.


Acetylcholinesterase activity in the rat brain during nephrogenic arterial hypertension and after angiotensin administration. The activity of acetylcholinesterase was assessed in the rat brain in nephrogenic hypertension and after angiotensin administration. No significant differences were found in relation to corresponding control groups.


Effect of osmotic stimuli on the carotid baroreceptor and chemoreceptor discharges in cats. In 15 cats under chloralose-urethan anaesthesia carotid sinus area was arterially isolated and perfused with artificially pulsatile pressures. Solutions of NaCl, of various osmolality, mannitol, glucose and bicarbonate were locally perfused through the isolated carotid area and the single baroreceptor and chemoreceptor fibre activity was recorded with standard technique. An increase in the osmolality of the perfused fluid evoked an increase of the single baroreceptor discharge. Each pulse pressure produced more spikes of higher frequency in big A type baroreceptor fibres. Clear effects were observed during perfusion of 300 mM NCl solutions. Solutions of higher osmolility transformed rhythmical pulse pressure discharge into continuous baroreceptor firing. The excitatory effects of hyperosmolar solutions were reversible after switching to the perfusion fluids of normal osmolality. An increased activity was also observed in the single carotid chemoreceptor fibres. It is concluded that both baro- and chemoreceptors are sensitive to osmotic stimulation.


Isotonic capacitive transducer.

Isotonic capacitive transducer. A transducer which changes the angle or elongation into voltage was designed and built. The principle of functioning of this device and technical details were described.


Studies on the specific dynamic effect of proteins of different nutritional value. Using the respiratory method the rise of metabolic rate (specific dynamic effect SDE) was determined in laboratory rats after ingestion of gluten, peas, cottage cheese and ham. The SDE was greatest after ham ingestion, which is a product of high nutritional value, while after gluten ingestion which has a low protein value, the SDE was lowest.


Abnormality in body curvature of Cyprinus carpio after injection of anaesthetics. Abnormalities in the body curvatures were noticed in Cyprinus carpio after the injection of anaesthetics, viz. paraldehyde, tertiary butyl alcohol and butanol. These abnormalities occurred behind the dorsal fin and progressively developed over a period of four months. The abnormalities affect the locomotion and speed of swimming of the fish and appear to be due to toxic effects of the anaesthetics.


Harelip and cleft palate conditions in chick embryos following local destruction of the cephalic neural crest. A preliminary note. With the aid of micro-laser irradiation, in a total of 156 chick embryos unilaterally (a part of) the cephalic neural crest paralleling the posterior portion of the prosencephalon and mesencephalon, was eliminated. As a result of this treatment, 2 out of 22 embryos, studied 24 hours after irradiation, showed a considerable degree of underdevelopment of the mesenchyme in the homolateral first branchial arch. At the age of 7 days (6 days after irradiation) 11 of the 44 surviving embryos proved to have developed a homolateral harelip condition. In 2 of these embryos, a wide palatal cleft was observed as well. These results demonstrate that facial clefts may develop as a result of a local deficiency of neural crest cells.


[The role of the adrenal gland in sex determination of the duck embryo]. In duck embryos, a study was made of the role the suprarenal glands might play in the process of sex determination. The experiments included the transplantation of suprarenal gland taken from embryos aged from 9 to 25 days, into the coelomic cavity of embryos ranging from 71 to 139 hours of age. Out of a total of 388 transplantations, 222 succeeded in the sense that the hosts reached the age, at which the gonads have sexually differentiated. The results show that the implantation of a suprarenal gland does not influence the sex-ratio. Moreover, no disturbances in the development of the gonads were observed. Hence, the conclusion may be drawn that it is highly improbable that the suprarenal gland plays an essential role in the production of substances guiding the differentiation of the gonadal primordia into ovaries or testes.


A review of data on cell actions and cell interaction during the morphogenesis of the embryonic eye. The early morphogenesis of the chick embryo seems to be an excellent model-system for study of morphogenetic movements, usually summarized in general terms like invagination, fusion and separation. This article reviews literature data about the early morphogenesis of the eye. The formation of lens vesicle and optic cup, during which invagination, fusion and separation are very important, were seen to represent a finely balanced interplay between cell mitosis, cell differentiation, cell death, cell transformation and cell migration. Differing observations and contradictory interpretations justify a systematic approach to to these embryological questions. We will attempt this in our next study. Apart from microscopic and submicroscopic description of closely succeeding developmental stages, three-dimensional reconstruction techniques will be indispensable to understand the spatial arrangement of the structures concerned.


Morphological and histochemical studies on the foetal and postnatal ovaries of the field rat (Millardia meltada). A morphological and histochemical study has been made of the development of the field rat (Millaridia meltada) ovary with special reference to follicular and interstitial gland tissue development. On day 17 of foetal life, the developing ovary consists of surface epithelium, clusters of germ cells associated with pregranulosa cells, undifferentiated stromal cells and blood vessels. The primordial follicles first appear on foetal day 19. The primary follicles develop on postnatal days 1 and 3, small secondary follicles on days 5 and large ones on day 10; the antral follicles appear on day 17. Zona pellucida material first appears in primary follicles on postnatal day 3. The thecal layer of stromal origin begins to be formed on postnatal day 5. Some lipid bodies consisting of phospholipids are present in the granutosa cells of healthy follicles. Lipids of hypertrophied theca interna cells, which develop on postnatal days 16 and 17, consist of triglycerides and phospholipids; cholesterol and/or its esters also store later on during the postnatal period. Atresia affects follicles of all sizes. The granulosa of atretic large secondary and antral follicles stores triglycerides, cholesterol and/or its esters and some phospholipids. Their hypertrophied theca interna cells form patches of interstitial gland cells in the ovarian stroma, which develop diffuse lipoproteins and lipid bodies composed of cholesterol and/or its esters, triglycerides and phospholipids. Two types of interstitial cells are identified in the developing ovary of the field rat. The primary interstitial cells start developing from the interfollicular fibroblast-like stromal cells on postnatal day 10. The secondary interstitial cells originate by the hypertrophy of the theca interna and surrounding stroma of the atretic follicles and they start accumulating from postnatal day 17 onwards. The lipids of both types of interstitial cells consist of diffusely distributed lipoproteins and lipid droplets composed of triglycerides, phospholipids and cholesterol and/or its esters. The functional meaning of interstitial gland cells is discussed in relation to steroid hormone synthesis.


Seasonal fluctuations in the testicular asymmetry of birds. A comparative study has been made of the seasonal fluctuations in the testicular asymmetry of the house crow, the common mina, the bank mina, the house sparrow and the roseringed parakeet. Their left testis usually attains a larger size and higher weight than the right one. These differences are more pronounced during the breeding seasons.


Ultrastructural changes in the rat cerebellar cortex during methionine sulphoximine convulsions. The ultrastructure of the rat cerebellar cortex and the activity of succinic dehydrogenase were examined during methionine sulphoximine (MSO)-provoked convulsions. The animals were killed 3, 6 and 12 hours after the injection of 600 mg/kg of MSO. Convulsions appeared 4--5 hours, status epilepticus developed 8-9 hours after the injection. Progressive ischaemic changes of Purkinje cells could be observed, with condensation of the nucleus and a density of the cytoplasmic matrix. The cisternae of the Golgi complex and endoplasmic reticulum showed some degree of dilation. The basis of Purkinje cells was surrounded by distorted axons and terminals that had lost in most cases the synaptic vesicles, and by clear spaces due to the swollen glial processes. Three to six hours after MSO injection, succinic dehydrogenase activity increased in the mitochondria of Purkinje cells. After the appearance of seizures the enzyme activity decreased. Twelve hours after the injection the enzyme activity recovered to a certain extent.


The arterial and venous blood supply of the preoptic region in the rat. A study has been made of the arterial and venous circulation of the preoptic region in the rat, using the double Indian ink technique. A detailed description is offered on supply of the nucleus preopticus medialis, lateralis, suprachiasmatis and periventricularis, as well as of the nucleus interstitialis striae criminalis and of the preoptic portion of the medical forebrain bundle. The arteries of the region emerge from the anterior communicans artery and from the anterior cerebral artery. The blood of the region is collected by the anterior cerebral artery. Veins collected by the v. cerebri magna, are also running dorsalwards from the nucleus interstitialis striae terminalis. The blood supply of the organon vasculosum laminae terminalis is described with special regard to its vascular connection with the preoptic nuclei.


Tubuloreticular structures in the orbicularis oculi muscle of the human eye. Tubuloreticular structures (TRS) were observed in the orbicularis oculi muscle of two patients operated on senile inversion of the lower eyelid. The structures formed occasionally loose or solid networks similar as those observed in endothelial cells, blood lymphocytes, fibroblasts and muscle cells in association with viral infections, autoimmune diseases, tumors and other tissue destructions and muscle diseases. The tubuloreticular derive form the plasma membrane by the formation of multiple cavities. Their appearance is interpreted as a specific cellular response.


Ascending brain stem pathways to the diencephalon and limbic regions: a light and electron microscopic study in the rat. Total and partial meso-diencephalic transections and lesions of the central gray matter were performed to trace with the Fink--Heimer silver impregnation method the ascending brain stem pathways to the forebrain. Most of these pathways are located near the midline at the level of their entry into the diencephalon. Fibers directed to the hypothalamus either leave the central gray matter and proceed rostralwards in the periventricular tissue layers, or, after traversing the ventral tegmental area, join the medial forebrain bundle. It can be established on the basis of electron microscopical studies that the ascending brain stem pathways project to all hypothalamic nuclei and to the median eminence.


Cerebral glucose and energy metabolism, cerebral oxygen consumption, and blood flow in arterial hypoxaemia. The influence of moderately reduced arterial oxygen tension (aPO2 of about 45 Torr) on the metabolism and the blood flow of the brain was tested in 20 anaesthetized, artificially ventilated normotensive, normocapnic beagle dogs. It is demonstrated that the decrease in systemic oxygen delivery to the brain is countered by an appropriate increase in flow (CBF being 60.3 ml/100 g min at normoxia and 84.5 mg/100 g min in hypoxaemia) which maintained the cerebral oxygen consumption unchanged (CMRO2 3.80 versus 3.32 ml/100 g min). The cortical tissue content of energy-rich phosphates such as ATP, ADP, AMP, and phosphocreatine was also found to be unaltered. Neuropathological examinations excluded any hypoxic cell damage. This reactive vasodilatory reaction of the cerebral vessels is apparently a sensitive regulatory process which protects the brain against marked oxygen lack. However, a normal carbohydrate metabolism is not restored by this cerebrovascular mechanism. For, significantly increased CMRlactate (0.32 versus 1.46 ml/100 g min) indicated raised cerebral glycolysis, and the tissue metabolites of glucose suggested an increased glycolytic flux in the brain. It is concluded that in moderate arterial hypoxaemia, which is not uncommon in clinical practice, cerebral blood flow plays an effective homeostatic role in preventing a disturbance of the energy metabolism of the brain.


The course of intracranial pressure and volume-pressure relationships following extirpation of meningiomas and astrocytomas. Thirty-five patients with meningiomas were compared with 37 patients with astrocytomas with respect to the postoperative course of their ICP and elastance. In the case of the meningioma patients, the ICP increased on average over a longer period and achieved higher values than in the astrocytoma patients. In the first group, the elastance attained values that were three times as high as in the second group. There was no fixed relationship between pressure and elastance in the two groups of patients.


Computerized axial tomography for the diagnosis of cerebral cysticercosis. Computerized Axial Tomography (CAT) has proved extremely useful for the diagnosis of cerebral cysticercosis. The calcified small, multiple, and scattered cysts provide a typical image on CAT. The collection of non-calcified cysts in the subarachnoid spaces (racemose form) or in the ventricles may produce areas of low density similar to that of the cerebrospinal fluid. The dilatation of the ventricular system, extreme degrees of hydrocephalus, areas of cerebral atrophy, and other related changes induced by the cysts in the subarachnoid spaces are also clearly shown in the CAT. Four personal cases are reported.


Aseptic meningitis and hydrocephalus after posterior fossa surgery. In an attempt to define the tissue of origin of substances causing aseptic meningitis and secondary hydrocephalus after posterior fossa surgery, analysis of several marker substances from blood, brain, tumour and muscle in the CSF was performed early in seven postoperative patients. No clear pattern emerged which could relate the substances, CSF reaction, and meningeal scarring. The effects of various factors such as contrast studies, drainage, and steroids were also not clear. Review of the literature reveals that all four tissues can cause inflammation. Certain facts about the anatomy of the basilar cisterns and arachnoid villi probably make them logical sites for problems in CFS circulation. Children, for several reasons, are most susceptible to this complication. The complexity of factors in human cases suggests that the problem should be studied in an animal model.


A case of fatal cryptococcus meningitis with intraventricular granuloma. Differential diagnostic difficulties in a case of probably spontaneous cryptococcus meningitis in a young girl are the reason for an extensive presentation of this case. The problems of CSF examination are discussed. In the course of the disease an intraventricular mycetoma had arisen, and caused the picture of a space-occupying process. Histological examination revealed an atypical reaction of the perifocal brain tissue, the possible causes of which are evaluated.


The influence of the decompressive operation on the intracranial pressure and the pressure-volume relation in patients with severe head injuries. Measurements of intracranial pressure by ventricular catheter were performed in 47 patients with severe head injuries. Thirty-three patients with decompressive operations such as osteoclastic craniotomy and dilatation by means of duraplastic have been compared with 14 patients with closed heads with regard to volume pressure response (intracranial elasticity). This was determined either by intraventricular injection of 2ml saline or by drainage of cerebrospinal fluid. The examination clearly shows that patients with closed heads have a much higher intracranial elasticity than patients who have decompressive operations, so that in the first group minor differences of the intracranial volume cause extreme deviations of the intracranial pressure. Therefore, the decompressive operation has been advised in severe head injuries with increased intracranial pressure as a measure additional to high dose dexamethasone therapy and hyperventilation.


Chronic depth electrodes study of one case of bitemporal epilepsy due to glial tumour. Some physiopathological considerations. The authors describe a seventeen-years-old girl suffering from partial seizures with complex symptomatology. The neuroradiological studies demonstrated a slow-growing glial tumour seated deeply in the right temporo-occipital region. Scalp EEG demonstrated a bilateral asynchronous temporal focus without definite lateralization. Chronic depth electrodes recording allowed identification of a primary epileptogenic area in the right rhinencephalic structures. Radiofrequency lesions performed in the right amygdala and anterior third of right Ammon's horn abolished the seizures at ten months follow up.


Atherosclerotic occlusive disease of the vertebrobasilar system in young adults and its surgical consideration. A young diabetic man with recurrent attacks of headache, dizziness, and blurred vision who was originally thought to have episodes of hypoglycaemia, underwent investigation for the possibility of an occlusive cerebrovascular disease; and eventually was operated upon for vertebrobasilar insufficiency. The young age, the degree of occlusive disease, the clinical picture, and the surgical results in this patient on the one hand, and the scanty literature on the other prompted this report.


The influence of intravenous anaesthetic agents on primarily increased intracranial pressure. In the choice of anaesthetics and techniques the danger of a possible progressive increase of intracranial pressure (ICP) should be considered. Therefore the influence of intravenous anaesthetic agents on mean arterial pressure, ICP, and cerebral perfusion pressure (CPP) in patients with primarily increased ICP was observed under standard conditions for 20-40 minutes. Etomidate, thiopentone, propanidid, and ketamine showed remarkable effects on ICP, even in patients with disturbed cerebro-vascular reactivity. Etomidate and thiopentone cause a fall of ICP by 26%. Because of its stabilizing effects on circulation etomidate does not induce a reduction of CPP, whereas thiopentone will do so because of its depressing effect on blood pressure. Propanidid appears to be a less suitable agent when there is raised ICP, because it induces fluctuations of ICP and blood pressure up to the third minute after injection. According to our results, monoanaesthesia with ketamine cannot be recommended when there is increased ICP because it causes a prolonged increase in ICP, and reduction of blood pressure and CPP.


Intracranial tuberculomas and the CAT scan. Tuberculomas of the brain are rare in the United States. Although CAT (computerized axial tomography) scanning cannot distinguish these infections from other intracranial mass lesions, it provides a non-invasive technique with which to follow the course of presumptive lesions during medical therapy, and with which to search for clinically unsuspected infections. The necessity for and timing of surgery can be considered more easily with this technique. Two cases are presented with their CAT scans, including one example of the disappearance of a presumptive tuberculoma, during appropriate medical therapy.


Intracranial malignant cartilaginous tumours. Report of two cases and review of literature. We report two cases of basicranial chondrosarcomas. Intracranial chondrosarcomas are particularly rare, amounting to 0.15% of all intracranial tumours. Their most frequent location is the skull base (76.19%), and more precisely the middle cranial fossa, as they arise from the spheno-occipital synchondrosis. Some intracerebral chondrosarcomas have also been reported. We also refer shortly to another kind of malignant cartilaginous neoplasm that was recently identified by Lichtenstein and Bernstein (1959). This is the mesenchymal chondrosarcoma. Fifteen cases of this have been reported.


Extradural haemangiolipoma in the spinal canal. Two cases presenting during pregnancy. Extradural spinal haemangiolipomas are very rare but they account for forty per cent of all lipomas in this position. The two cases described here were middleaged women who both had a paraparesis during their pregnancy which remitted after parturition. Both tumours were in the thoracic region on the posterior surface of the dura. The histological appearances were those of a lipoma with a definite capillary component. The pathogenesis of the relapsing and remitting paraplegia and its relationship with pregnancy is probably multi-factorial. It is proposed that both blood volume and extra-cellular fluid volume changes occurring during pregnancy may be responsible for the fluctuating cord compression. Similarly the hypothesis is put forward that due to the vascularity of the tumour it exerts a "steal" phenomenon over the blood supply to the adjacent cord. Also, because of its vascularity, the tumour could have a pulsatile compressive effect on the cord.


Pressure distribution on the wall of experimental aneurysms. Since it is known that turbulent flow exists in aneurysms, we have investigated whether pressure might be distributed unevenly on the aneurysmal wall, and whether it varies with the shape and size of the aneurysm and its orifice diameter as well as with the direction of blood flow in the parent vessel. It was found that in some instances, such as with aneurysms having narrow necks and situated at 90 degrees to the parent vessel blood flow, aneurysmal pressure is relatively low.


Carotid ligation for the treatment of carotid artery aneurysms. Pre- and peroperative studies of the cerebral blood flow with an intravenous isotope technique. Carotid ligation was performed in a series of 30 consecutive cases of infraclinoid aneurysms, of which 6 had not ruptured, and 9 cases of supraclinoid aneurysms. Fifteen of the ruptured aneurysms were operated on before, and 18 after, the eleventh day after bleeding. The internal carotid artery was primarily ligated in four cases, with two deaths, and in one case lasting hemiparesis occurred. In the rest of the cases, the common carotid artery was primarily ligated without operative mortality. After varying intervals, the internal carotid artery was ligated both in the neck and intracranially in 25 cases. In three cases late complications occurred due to embolus and thrombosis, resulting in one death. In four cases there were transient symptoms caused by insufficient cerebral circulation.  The cerebral circulation was investigated in 23 cases using an intravenous isotope technique before and after ligation of the common carotid artery. In each of the cases the circulatory values were sufficient, with a slight diminishing of the flow on the ligated side. After ligation of the internal carotid artery at a later stage the flow in both hemispheres increased. This finding has been interpreted as being due to the interruption by internal carotid ligation of the retrograde internal carotid flow that occurs after common carotid ligation. In five cases aorto-cervical angiography was performed some months after ligation of the common carotid artery, and in four a retrograde flow in the internal carotid artery on the ligated side was shown. In accordance with the results obtained suggestions are made for carotid ligation in the treatment of carotid aneurysms not accessible for neck ligation.


New aspects of cerebrospinal fluid dynamics in humans investigated by sequential gamma camera cisternography, with data evaluation by the digital multichannel analyzer. Part 4: A unifying criterion of the development of hydrocephalic syndrome. Its dynamic basis. In the final part of this series we present all of the clinical material, and the patients are classified by different cisternographic syndromes on the dynamic basis offered for our method: dynamic disconnection between ventricular system and basal cisterns, brain atrophy, initial dynamic decompensation or prehydrocephalus, communicating hydrocephalus with and without epicortical fluid circulation. A nomogram method for clinical estimation of CSF production based on the mathematical properties of our analysis of the ventricular reflux is proposed. The different normal and pathological characteristics of fluid movements in the spinal canal are given, and their importance as signs of turbulence in the posterior fossa are emphasized. Different aspects of the dynamics of CSF production are shown and discussed, and an evolving conception of hydrocephalus development is presented.


Overdrainage phenomena in shunt treated hydrocephalus. In addition to the high rate of shunt complications due to obstruction and infection there is a considerable number of undesirable side effects caused by excessive drainage of CSF. Four hundred shunt treated patients are analyzed for overdrainage signs: acute decompression symptoms produced by upward shifting of the brain stem, low pressure headaches (mostly transient), and microcephaly and head deformities like scaphocephaly in infants. Skull X-ray changes reflect adjustment to reduced intracranial content. Slit ventricles and a marked intolerance to minimal pressure rises may be quite troublesome. Subdural haematomas are only exceptionally space-occupying; in most instances they are space-filling. Causes, incidence, management, and prevention are discussed.


Milieu therapy with the adolescent sociopath. This paper defines sociopathy, presents current research experimentation being conducted and findings as to its causes and treatment. Also presented is a description of a milieu therapy program for the adolescent sociopath. Both preventive and active treatment methods in this program are discussed. The value of the milieu therapy approach is shown in its attempt to keep the adolescent sociopath engaged in constructive activities and relationships in order to overcome antisocial behavior patterns. With the failure of individual therapy alone to reinforce normal living patterns and overcome lack of socialization functions in the adolescent sociopath, a more comprehensive and effective approach is required. Such an approach is described in which the following are stressed: 1) prevention of incarceration, 2) prevention of rejection by parents, peers and teachers, 3) active treatment of hyperkinesis and specific learning disabilities, 4) utilization of "sponsors," and 5) multiple therapist (family, group, individual) programs.


Body build stereotypes and self-identification in three age groups of females. Body build stereotypes of three age groups (6, 15, and 19 years old) of average weight and "heavy" female students were studied. First, the students were asked to circle one adjective from each of 28 antonym pairs, which was "most like" themselves. Concurrently, side-view figures of a female endormorph, an ectomorph, and a mesomorph were shown to each student. The figures were of the approximate age of the student. She was asked to point to one of the figures which "best fit" the adjectives in each of the 18 antonym pairs as they were read aloud. Lastly, each student was asked to choose one of the figures which "most looked" like themselves and the one which they would most want to "look like". Thus, discrepancies could be detected between one's self description and one's description of others with a very similar physique. The hypothesis that females would have similar physique preferences and aversions as those of males in a previous study (3) was confirmed. Females preferred the mesomorph figure (p less than .001) and at least favored the endomorph figure (p less than .001). The ectomorph figure was viewed less negatively than the endomorph figure (p less than .01). The youngest group showed more preference towards the endomorph and ectomorph figures then did the two older groups. "Heavy" physique students rejected the behavioral stereotypes descriptive of themselves even though they earlier had associated the very same stereotypes to the physique most like their own.


Attitudes toward death in adolescent offspring of Holocaust survivors. Introductory remarks are directed toward a brief review of the literature on the psychological problems of the survivors of the Nazi Holocaust, and the paucity of research on offspring of these survivors. A discussion of three adolescents who were in a residential treatment program in Jerusalem, Israel, is proffered. Biographical data, diagnostic categories, review of TAT responses, their ability or inability in forming relationships, and some examples of dreams are presented. A section is devoted to some general underlying assumptions--including an analysis of the concepts "survivor guilt," "repressed agression," and "isolation of affect".


Adolescents' attempted influence on parental behaviors. This study was designed to determine the extent to which adolescents attempt to influence the everyday behaviors of their parents. Questionnaires given to 84 adolescents (mean age 17.6 years) and their parents asked the respondents to indicate which of 31 parental behaviors the adolescent had attempted to influence and whether or not this influence resulted in parental behavior change. Results indicate that total attempted influence correlated significantly and positively with adolescent need for autonomy and significantly but negatively with father's need for dominance. Adolescents perceived attempted influence on more behaviors than did parents, and more influence attempts were reported directed toward mothers than fathers. Differences between the types of parental behaviors that attracted adolescent influence and those that did not are discussed.


A comparative test of the developmental, role-playing, and defensive explanations of offspring identification. Following Mussen and Distler (1959) and Bandura, Ross and Ross (1963), the developmental, defensive, and role-playing theories of identification are tested on high school seniors. Previous tests have supported the developmental and role-playing hypotheses about equally, while the defensive hypothesis lacks consistent empirical support. Questions are raised, however, about the merit of these tests. Data are presented on seniors in an Eastern suburban school and a Midwestern small town school which support the developmental (warmth) hypothesis but which are inconsistent with the defensive and role-playing hypotheses. Parental behavior is measured by the Bronfenbrenner Parent Behavior Questionnaire and identification is measured by the semantic differential.


Outpatient management of the borderline adolescent. In summary an attempt is made in this paper to describe the psychopathology of the borderline patient. Descriptive features of the syndrome in children, adults and adolescents are given based on the respective work of Pine, Masterson and Kernberg. The psychic structures of the borderline patient are discussed with their resulting treatment implications. Genetic considerations with their effects on the psychotherapy of the borderline are reviewed. Finally the outpatient treatment strategies of the borderline adolescent are presented in detail including countertransference issues frequently encountered in the course of their treatment.


Identity status in high school females.

Identity status in high school females. One hundred grade 12 high school females were classified as either Moratorium, Foreclosure, or Diffusion status based on their openness to alternatives and degree of commitment in the areas of future plans, religion, and politics. Measures of social class, intelligence, tolerance of ambiguity, cognitive complexity, ego identity, and anxiety were administered to examine aspects of these differing manners of dealing with adolescent issues. Performance on a behavioral measure of information search was also examined. Results indicated generality of identity status placement across the content areas. Moratorium status females scored significantly higher than Foreclosure and Diffusion status females for social class, intelligence, cognitive complexity, and tolerance of ambiguity: Moratorium status females also scored significantly higher than Diffusion status females for information search and recall. Foreclosure status females scored significantly higher than Diffusion status females for ego identity. Intelligence contributed to many observed status differences. It was suggested that identity status placement, reflective of manner of dealing with adolescent issues, was indicative of a general mode of dealing with developmental tasks.


Adolescent sex information sources: 1964--1974. Comparison of adolescent sex information sources for black and white males and females in a Northeast Texas community was made from 1964 and 1974 questionnaire data (N = 367 and 432 respectively). A general change from parents to friends as the stated sources of major sex information was noted over the decade. While parents are still the preferred source of sex information for most of these adolescents, friends as a preferred source increased in frequency especially for males. Overall, both stated and preferred sex information sources showed more significant changes for males than females.


Sex education and premarital sexual behavior among American college students. The relationship between participation in a sex education course in the public schools and premarital sexual behavior is studied using cross-sectional data from a national probability sample of 1177 male and female American college students interviewed in detail about their sexual behavior and sexual socialization experiences. There was no significant difference between the premarital heterosexual involvement of individuals who had attended a sex education course and those who had not. Furthermore, there were no differences between those who received information on birth control or coitus and those who did not. The implications of these findings for sex education programs are discussed and speculations about successful and unsuccessful programs are made.


Crisis induction and parental involvement: a prerequisite of successful treatment in an inpatient setting. In residential treatment programs, oftentimes the relevance of the procedures and methods utilized in situations encountered on the outside are lost sight of. The utilization of a stress induction model in conjunction with parental consultation within an inpatient setting makes it a great deal easier to conceptualize the relationship between problems the child has in the program, how they are handled and the way problems are dealt with at home. Involving the parents in dealing with program "crises" allows one to see firsthand how the family interacts under conditions of stress and permits systematic interventions into this system. If the goal is to return the child home, the parents and the child must be convinced that changes in behavior are a result of their methods of interacting with each other and not merely a result of "magic" or contact with new sympathetic adults outside the home.


Management of teenage pregnancies in three different health care settings. A retrospective study was undertaken to determine if differences existed in obstetric outcome, contraceptive usage, and repeat pregnancy rates of teenage patients cared for in three different health care settings. The sites included the Rochester Adolescent Maternity Project (RAMP), a traditional obstetric clinic, and a neighborhood health center. Comparison of the three groups revealed that RAMP patients experienced a lower incidence of anemia and preeclampsia than patients in the other programs. At one year postpartum, 25% of the hospital clinic patients were using contraception compared to 45% for the health center and 49% for RAMP patients, compared to 15.8% for the health center and 6.5% for the RAMP group.


Death education: what students want and need! Because the need for ascertaining the attitudes of young persons regarding death seemed clear, we surveyed the freshman and senior students at a comprehensive high school in Illinois. The data generated concerned the adolescent's concept of death, the affective states associated with it, the need (or lack of need) for further discussion about the subject and the identities of those with whom such discussions might be initiated.


Daydreaming in the adolescent years: instrument development, factor analysis, and sex differences. The Imaginal Processes Inventory (IPI), originally devised for college students, was revised for use with high school students. Nineteen of the original 28 IPI daydreaming scales were used and the response format was changed. The self-report instrument was completed by a racially diverse sample of 181 ninth through eleventh grade students. Reliable application of the Revised IPI to this population was demonstrated. Distinct sex differences, not previously reported, were found showing more acceptance of daydreaming for females and more guilt and fearfulness in daydreaming for males. Factor structures were similar to previous studies, but a generally higher level of daydreaming and less uncontrolled mind wandering was found for high school students than for college students. The research suggests that personality differences between men and women could be further explored by the daydreaming instrument and that sex differences must be taken into account in further research. Use of such daydreaming data is suggested in therapeutic intervention.


Evaluation of intellectual, linguistic, and achievement variables in normal, emotionally disturbed, and learning disabled children. This study addresses itself to developing an abbreviated test battery to assess children presenting learning difficulties in the classroom. Factor analyses of the WISC, ITPA and PIAT revealed that 85% of the total variance of these tests can be accounted for by an abbreviated battery utilizing 12 subtests from the 26 in the total from all three tests. Evidence is presented that the discrepancy between academic achievement and academic aptitude is not as great as expected, in children with apparent underachievement, when careful, reliable measures are used.


Induction of secretory antibodies in humans following ingestion of Streptococcus mutans. 1) Ingestion of Streptococcus mutans antigen by human volunteers induced the selective appearance of antibodies in saliva and tears but not in serum. 2) These antibodies were associated with the IgA class as determined by enhanced or blocked agglutination, immunofluorescence and gel filtration. 3) A second series of antigen ingestion resulted in a secondary response in these secretions characterized by an earlier appearance of antibodies which reached higher titers than in the primary response.


Concept of the local and common mucosal immune response. The available information concerning the origin of IgA-producing plasma cells and the spectrum of IgA-associated antibodies found in external secretions provide arguments that support two pathways of stimulation for a secretory humoral immune response. In addition to an explicitly local immune response induced by a topical antigen application, a second mechanism of induction operating through the sensitization of GALT, and possibly BALT, emerges. The latter pathway of stimulation leads to the appearance of specific IgA-associated antibodies in secretions of mammary, salivary, and lacrymal glands (and perhaps other sites), all of which suggests the existence of a common mucosal secretory system. Not yet explained are the mechanisms involved in the homing to secretory glands of cells sensitized in the remote lymphoid tissues (GALT and BALT), the differentiation patterns of these cells, and the regulation of selective IgA expression.


Molecular-cellular interactions in the secretory IgA system. 1) SC receptors were not detected on the surface of human PBL before or after PWM stimulation or on the surface of established lymphoblastoid cell lines. 2) SC binding was detected in the cytoplasm of differentiated lymphoid cells. The majority of the SC-binding cells contained intracellular IgA. 3) The binding of polymeric IgA to the surface of human epithelial cells (colonic carcinoma HT-29) was dependent on the presence of SC. 4) These findings indicate that SC is a receptor and possible transport protein for polymeric immunoglobulins, but that it is not directly involved in the homing of the IgA precursor cells to secretory tissues.


Influence of parenteral immunization in rabbits on the penetrability of oral mucosa for macromolecules. It should not be overlooked that serum-derived antibodies may normally play an important role in mucosal homeostasis conducive to health. Thus, protection against at least some bacterial components may be an antibody-mediated function during the initial phase of gingivitis (21). Nevertheless, Auer demonstrated in 1920 that mild inflammation can be severely aggravated by local accumulation of serum-derived antibodies combined with a systemic supply of the corresponding antigen (2); subsequent studies have shown that this holds true also when the antigen is topically applied (11,14). Theoretically, the initial gingival lesion is an ideal situation for the development of a so-called "Auer-phenomenon", due to continuous supply of antigens from dental plaque and food. This possible hazard of circulating antibodies must be taken into account when immunoprophylaxis is attempted by parenteral vaccines.


Role of the liver in the rat intestinal s-IgA system. Rat bile is an important source of s-IgA and FSC about 10 mg of s-IgA are poured daily in the duodenum via the bile. The normal rat liver is capable of actively transferring IgA from the circulation into bile against a strong concentration gradient. Circulating IgA transferred in bile was bound to SC. Ligature of the rat bile duct induces a large and selective increase of the IgA level in serum. All this additional IgA is s-IgA and even FSC appears in serum after bile duct obstruction. The liver appears to have an important reinforcing role in the intestinal s-IgA system of the rat.


Effective immunity to dental caries: selective induction of secretory immunity by oral administration of Streptococcus mutans in rodents. 1) The selective induction of secretory antibody is antigen dose dependent. A dose of 10(7) or 10(8) S. mutans CFU (per gram of diet) elicited a significant response, while a higher dose (10(9) CFU/gram) resulted in an apparent state of unresponsiveness. 2) A lowly virulent mutant of S. mutans 6715 (C4) induced protective s-IgA antibodies against challenge with a highly virulent species (C211). Cross protection among serotypes of S. mutans has been achieved. 3) Bovine milk with antibodies to S. mutans significantly reduced the level of caries lesions in rats fed this lyophilized milk and challenged with the homologous, virulent S. mutans strains.


Cross-protective aspects of glucosyltransferase antigens in the hamster caries model. 1) Glucosyltransferase serotypes a and g are closely related antigenically but are more distantly related to GTF of serotype c, based on assays of inhibition of total glucan synthesis. 2) Local immunization with GTF from serotype c S. mutans reduces the colonization, caries, and lesions caused by infection with the homologous strain compared with sham injected controls. 3) Local immunization with GTF of serotype c S. mutans reduces the colonization, caries, and lesions caused by infection with S. mutans of serotype g (strain 6715).


Daucus carrota (carrot)--a selective bacteriosorbent. 1) An extract of D. carrota induces agglutination of most serotypes of S. mutans but not of S. salivarius or S. mitis. 2) If added to a suspension of mixed bacteria, a piece of D. carrota may selectively sorb S. mutans while S. salivarius and S. mitis only are affected to a minor degree. 3) A saliva coat on the bacteria may reduce the uptake of S. mutans to D. carota but does not totally prevent it.


Studies of secretory IgA in caries-resistant and caries-susceptible adults. Caries resistant subjects appeared to possess a greater potential for production of secretory IgA than caries susceptible subjects, at least in stimulated parotid and submaxillary secretions. There was considerable overlap, however, among subjects in all groups examined. There are no consistent differences in s-IgA among groups in unstimulated parotid and submaxillary saliva. It would appear, therefore, that s-IgA secretion per se is not a critical determinant of caries resistance. The tendency to higher s-IgA values among resistant people, however, may indicate a greater propensity to specific antibody production. This aspect of caries protection requires independent investigation.


Antibodies reacting with Streptococcus mutans in secretions from minor salivary glands in humans. 1) Antibodies reacting with S. mutans in secretions from minor salivary glands in humans were determined by a modified Enzyme Linked Immunosorbent Assay. 2) IgA antibodies reacting with S. mutans serotype c were found in all samples examined. 3) The antibody level in the secretions of the minor salivary glands varied considerably between different subjects and was considerably higher than that of parotid saliva. 4) A variation in antibody concentration over time was observed in some individuals. 5) Topical application of a streptococcal vaccine consisting of formalin killed cells increased the level of antibodies in the secretions of one person. In two persons no effect was observed.


Development of the IgA system in the mammary gland. 1) Lymphoblasts in gut-associated lymphoid tissue, committed to the production of IgA, can home to the mammary glands of syngeneic mice and differentiate there into IgA-containing plasmablasts. The phenomenon is limited to near term and lactating recipients. 2) The ability of lymphocytes originating in gut-associated lymphoid tissue and sensitized to intestinal antigens to migrate to the mammary gland can account for the specificity of milk IgA toward intestinal microorganisms and the consequent passive protection offered to suckling infants. 3) The secretory immune system of the mammary gland is apparently under hormonal control since mammotropic hormones given to virgin females can induce morphological and functional characteristics seen naturally only during pregnancy and lactation. Examples are increased numbers of IgA plasma cells and the ability to trap their circulating precursors taken from mesenteric lymph nodes.


Salivary IgA antibodies to antigens from Streptococcus mutans in human dental caries. 1) Subjects of low caries experience (DMF 7) had significantly lower IgA antibody titers to antigens from S. mutans serotype c than subjects of high caries experience (DMF 13). 2) Subjects with carious lesions and a high DMF had significantly lower salivary antibody titers than subjects without carious lesions. 3) Sequential studies revealed that in the absence of caries salivary antibody titers decreased over a 9 month period. 4) Treatment of caries was associated with a rise in salivary IgA antibodies. No significant changes were associated with the development of caries. 5) No relationship with caries experience was found with antibodies to S. mutans BHT (serotype b), S. sanguis OMZ-9 or S. mitis CHT. 6) The results do not support the hypothesis that salivary antibodies in man play a role in protection against caries.


Antibodies against Streptococcus mutans and glucosyltransferases in caries-free and caries-active military recruits. 1) Plaque samples from caries-active recruits showed a higher incidence of S. mutans than plaque samples from caries-free recruits. The persistance of the S. mutans serotypes in the individual plaque samples attested to the consistency of S. mutans in human dental plaque. 2) S. mutans serotype d is predominantly present in approximal plaque of caries-active subjects. 3) Serum antibody titers against S. mutans are higher in caries-active individuals. 4) Sera from caries-free or caries-active individuals inhibit the insoluble glucan synthesis by the cellbound GTF to the same extent. 5) It is unlikely that antibodies against S. mutans in parotid saliva or serum play a major role in the protection against dental caries in Dutch military recruits.


Secretory immunity and immunodeficiency. 1) Certain selective IgA-deficient subjects are capable of synthesizing functional secretory antibodies (s-IgM or s-IgA class) to indigenous oral microorganisms. 2) The presence or absence of these secretory antibodies in saliva can be correlated with the extent of caries involvement. 3) Lysozyme activity is significantly increased in saliva from immune deficient subjects though no correlation can be made with caries experience.


Motility of the pathogen and intestinal immunity of the host in experimental cholera. 1) Motility seems to be required for an intimate association with the intestinal mucosa which is necessary for efficient toxin delivery in the pathogenicity of V. cholerae. 2) A vaccine of semipurified flagella (CF) afforded a high degree of active and passive immunity in the rabbit ileum to both homologous and heterologous challenge strains. 3) The nature of the immunoglobulin type involved in the active immunity elicited by CF was not clear but preliminary indications implicate both s-IgA and IgG.


A comparison of secretory component - immunoglobulin interactions amongst different species. 1) SC from many species may be isolated by affinity chromatography to human IgA-Sepharose. 2) In some species SC may exist in two molecular forms. 3) The SC-binding sites on polymeric IgA and IgM are not identical. 4) In some species SC binds to IgM with higher affinity than to polymeric IgA while in other species SC binds best to polymeric IgA. This difference may influence the relative concentrations of these two immunoglobulin classes in the secretions of different species. 5) The SC-binding site is present on high molecular weight immunoglobulin in species as primitive as the nurse shark.


Modification of in vitro adherence of Streptococcus mutans by plant lectins. 1) Several plant lectins inhibit in vitro adherence of S. mutans to smooth surfaces. 2) Initial attachment of S. mutans appears to be independent of sucrose-derived glucans. 3) Blockage of adherence is possibly due to lectin interaction with basic amino acid residues on the cell surfaces.


Streptococcus mutans dextransucrase: phosphoglycerides and the detection of inhibitory antibodies in sera. 1) Rabbit and human sera contain high concentrations of phospholipids which can interact with dextransucrase causing enhanced glucan production. 2) Antibody in sera capable of blocking glucan synthesis can be accurately detected by adding excess LPC and dextran to the enzyme prior to incubating with antiserum and assaying with sucrose.


Interaction of Streptococcus mutans glucosyltransferases with antibodies. 1) The GTF-A and GTF-B activities of serotype (c), (e), and (f) organisms are antigenically more closely related to each other than to the comparable enzymes from organisms of the other four S. mutans serotypes. 2) The adherence-inhibiting antibody in anti-GTF-A appears to be mediated against a heat sensitive cell surface antigen of S. mutans - most likely GTF activity. However, unequivocal proof of this conclusion awaits the preparations of homogeneous GTF-A preparations.


Dextran/glucan binding by Streptococcus mutans: the role of molecular size and binding site in agglutination. 1) S. mutans strains of serotypes a, d and g were strongly agglutinated with soluble glucans and dextran T2000. Homologous glucan did not in all cases produce agglutination. 2) The quantity of low molecular weight dextrans bound (T20 and T70) does not correspond to the agglutination induced by glucan or T2000. 3) The agglutination and binding of high molecular weight glucan by B13 cells was sensitive to heat, trypsin, dextranase, EDTA, SDS and urea, whereas no inhibition of binding of T20 and T70 was seen. 4) Pretreatment of B13 cells with anti-d, or anti-glucan sera, or Con A, RCA I, or RCA II completely inhibited agglutination by T2000 and caused a significant reduction of the binding of glucan. No reduction in the binding of T20 and T70 occurred. 5) An agglutination-negative mutant was agglutinated by sucrose but not by T2000 or high molecular weight glucan. It bound normal levels of T20 and T70. 6) The results indicate that B13 cells possess multiple glucan binding sites and that the site responsible for agglutination consists of both polysaccharide and protein. 7) Inhibition studies on agglutination and adherence using B13 cells indicate that the two processes involve different mechanisms.