Evoked cisterna cerebellomedullaris potentials in the clinically normal dog. Cisterna cerebellomedullaris potentials (ECMP), evoked by percutaneous electrical stimulation of the ulnar and sciatic nerves, were recorded and averaged in each of 38 anesthetized, clinically normal dogs. The amplitude, latency, duration, and form of the recordings were characterized and compared with results obtained when the recording needle was positioned laterally, rostrad, caudad, and superficially to the cisterna cerebellomedullaris and in the brainstem. Recordings were compared with averaged evoked cerebrocortical potentials (ECP). The ECMP and ECP recordings were compared in dogs maintained at light planes of anesthesia, following cardiac arrest, and following severance of the spinal cord at L1 (in 14 dogs). The ECMP recordings were found to have greater amplitude and to be more consistent, complex waveforms than the ECP. The method of recording the ECMP was found to be straightforward. Thus this method of ECMP recording appeared suitable for clinical application.


Comparison of the averaged evoked cisterna cerebellomedullaris potential, cortical potential, and neurologic examination in the diagnosis of spinal cord injury of the dog. Average cerebrocortical potentials (ECP) and cisterna cerebellomedullaris potentials (ECMP), evoked by ulnar and sciatic nerve stimulation, were compared with neurologic examination to evaluate their accuracy in the diagnosis of the degree of experimental spinal injury in 24 Beagles. The dogs were divided into 2 equal groups. Various impact forces were applied to the spinal cord at L1 of 1 group of dogs and various degrees of compression forces were applied to the spinal cord at L1 of the other group of dogs. The degrees of functional loss in both groups of dogs extended from mild to complete. The dogs were untreated and monitored for 30 days after injury. A short-acting barbiturate was compared with a long-acting barbiturate as the means of anesthesia; both were found to permit similar production of ECP and ECMP. The ECMP was found to be a more sensitive, more easily interpreted, and more consistent means of evaluating the degree of spinal injury than the ECP or the neurologic examination.


Pathogenesis of experimental pulmonary paragonimiasis in cats. Specific-pathogen-free cats (n = 20) were inoculated orally with metacercariae of Paragonimus kellicotti and necropsied between 1 and 263 days later. The immature Paragonimus flukes excysted in the intestine, penetrated the intestinal wall, and migrated from the peritoneal cavity through the diaphragm to the pleural surface of lungs by postinoculation days (PID) 5 to 23. This migration resulted in multifocal eosinophilic peritonitis and myositis. The flukes entered the lung by penetration of the pleura, which resulted in multifocal pleural hemorrhage and eosinophilic pleuritis. Immature flukes developed in the subpleural alveolar tissue surrounded by intense eosinophilic and neutrophilic inflammation. Communications developed between the fluke-containing subpleural cavities and adjacent bronchioles by PID 39, and ova from the sexually mature flukes entered the bronchioles. From PID 55 to 263, other prominent pulmonary lesions were peribronchiolar infiltration of lymphocytes and plasma cells, hyperplasia of bronchioles and peribronchiolar glands, and chronic active eosinophilic granulomatous pneumonia associated with degenerating Paragonimus ova in the alveolar tissue adjacent to cysts. The interior surface of the fluke-containing cysts became partially epithelialized by cells from communicating bronchioles.


Cellular and humoral immune response in pigs given vaccinal and chronic hog cholera viruses. Humoral immune response (seroneutralization) and cellular immune response (lymphocyte-stimulation test) were analyzed in pigs inoculated with low virulent strains of hog cholera virus or vaccinated with a live-virus vaccine. Vaccinated animals exhibited an intense neutralizing antibody production, but cellular immune response was not detected. Neutralizing antibodies were not found in infected pigs, but a brief cellular immune response (18 days after inoculation) was observed.


Ovine nasal adenopapilloma: incidence and clinicopathologic studies. Nasal adenopapillomas were observed in 9 Y'anKasa and 1 Y'anKasa-Suffolk crossbred sheep (8 females and 2 males) over a 20-month period. The neoplasms originated from the epithelium of the lateral mass of the ethmoid bone. Gross and histologic features and clinical signs were similar in all cases. Influence of sex, age, or genetics was not established.


Evaluation of niridazole as a suppressant of cellular immunity in chickens. Niridazole was administered by gavage to 5-week-old chickens at dosage levels of 50, 100, and 200 mg/kg of body weight. The 2 larger dosage levels were toxic and resulted in the death of many of the recipients. The 50 mg/kg dosage level was not lethal, but depressed weight gain. Cellular immune functions were measured by responses of lymphocytes in whole blood to T-cell mitogens and by delayed hypersensitivity reactions to tuberculin. Blastogenic responses to phytohemagglutinin and concanavalin A were reduced in niridazole-treated chickens with responses of controls. Wattle tests measuring delayed hypersensitivity were positive only in control chickens; reactions in niridazole-treated chickens did not differ from nonimmunized controls.


Efficacy of injectable and tablet formulations of praziquantel against mature Echinococcus granulosus. The efficacy of an injectable formulation of praziquantel (given either intramuscularly or subcutaneously at dose levels of 5 or 8 mg/kg of body weight) and a tablet formulation (5 mg/kg) against mature Echinococcus granulosus tapeworms was studied in experimentally infected dogs. The compound was efficacious (100% clearance) if injected via either route or if administered orally.


Preliminary report of the distribution of [14C]penicillic acid in rats: autoradiographic technique. The distribution of [14C]penicillic acid in rats was determined by autoradiographic technique. Adult male rats were given [14C]penicillic acid orally and IV. According to autoradiographic analyses 24 hours later, high levels of radioactivity were in liver, heart, kidneys, lungs, and caudal part of the intestine. The significance of bile as an excretory route for penicillic acid was confirmed by the results from IV administration of the compound.


Effect of dexamethasone on Mycobacterium paratuberculosis infection in hamsters. Sixty hamsters were randomly divided into 4 equal groups: group 1--given only dexamethasone, group 2--given dexamethasone and exposed to Mycobacterium paratuberculosis, group 3--exposed to M paratuberculosis but not treated, and group 4--used as normal controls. Group 2 hamsters (treated with dexamethasone and exposed to the bacterium) had significantly higher bacterial counts in spleen and aggregated lymphatic nodules (Peyser's patches) than did those in group 3. None of the hamsters exposed to M paratuberculosis (groups 2 and 3) developed clinical signs of disease. All hamsters treated with the drug (groups 1 and 2) grew more slowly than did the hamsters not treated.


Baylisascaris procyonis for testing anthelmintics against migratory ascarids. Oral inoculation of mice with 340 embryonated eggs of the nematode, Baylisascaris procyonis, proved uniformly fatal as early as 13 days after inoculation and as late as 48 days. Mice given either 0.5% or 0.25% of pyrantel tartrate in dry feed were protected from cerebral migrations of the worm for 55 days. Treatment with pyrantel pamoate in the feed at the concentration of 0.2% given 7 days before inoculation and 5 days after inoculation also protected mice from migrations throughout the 55-day experiment. Embryonated eggs stored in 0.5% formalin in a 4-C refrigerator for 9 years have proved fatal to mice given doses of 340 eggs each.


Treatment and prognosis of lobar and segmental atelectasis in cystic fibrosis. Lobar atelectasis occurred in 30 (4.1 per cent) and segmental atelectasis occurred in 6 (0.8 per cent) of 728 patients with cystic fibrosis. The right lung was involved in all 11 patients less than 5 years of age and in 18 of 26 episodes in 19 older patients. Five of the younger patients died within 5 years of the initial episode. Bronchoscopy (with or without local lavage) performed in addition to intensified medical therapy did not appear to improve the outcome. Future studies of therapeutic measures (including bronchoscopy) for treatment of atelectasis complicating cystic fibrosis must include appropriate control patients who receive only medical therapy.


Cell-mediated immunity in anergic patients with pulmonary tuberculosis. Twelve adults with confirmed pulmonary tuberculosis who failed to respond to repeated skin tests with 250 TU of second-strength purified protein derivative of tuberculin were studied using in vivo and in vitro tests of cell-mediated immunity. All but 2 of the patients failed to respond to skin tests with candidin and histoplasmin, and only one could be sensitized with topical applications of dinitrochlorobenzene. The blastogenic response of peripheral blood lymphocytes from these anergic patients, when cultured in the presence of phytohemagglutinin, pokeweed mitogen, and purified protein derivative, was significantly less than that of lymphocytes from tuberculin-positive control patients. During the course of therapy with isoniazid and streptomycin, 6 of the anergic patients converted spontaneously and reacted positively to purified protein derivative. This skin-test conversion was accompanied by a significant increase in the blastogenic response of lymphocytes from the converted patients when cultured with purified protein derivate. Tuberculin anergy in these 12 patients was not associated with progessive, disseminated disease. All patients responded successfully to the primary chemotherapeutic regimen.


A study of co-positivity of three multipuncture techniques with intradermal PPD tuberculin. One hundred thirty-five patients with a reaction of 10 mm or more of induration to 5 TU of intradermal PPD were simultaneously tested with 3 multipuncture techniques to determine the copositivity of the multiple puncture methods with the Mantoux method. Of the 3 multipuncture preparations used (Tine Test, Aplitest, and Mono-Vacc), the Mono-Vacc had 2 (1.5 per cent) false-negative result after 48 hours with only one remaining negative result after 72 hours; whereas the Tine-Test had 21 (15.5 per cent), and the Aplitest had 13 (9.6 per cent) false-negative reactions after 48 hours. Vesicular eruptions were not a commonly noted reaction to the multipuncture preparations. Of the 3 multipuncture preparations commercially available, Mono-Vacc is the preferred reagent because of its significantly lower incidence of false-negative reactions.


Responses to isoproterenol in a general population sample. The response of forced expiratory flow to inhalation of isoproterenol was evaluated in a general population sample of 1,063 subjects. Percentage changes in the forced expiratory volume in 1 sec and in the maximal flow measured at 50 percent of the initial expired forced vital capacity appeared to be the best indicators of responsiveness to bronchodilator. Subjects with a history of asthma more often showed responsiveness than did the remainder of the population, even when their initial function was within normal limits. Over-all, a high proportion of subjects with abnormalities in baseline forced expiratory volume in 1 sec or maximal flow after exhalation of 50 per cent of the forced vital capacity showed sufficient improvement after bronchodilator to cause their values after isoproterenol to fall within the normal range. The data suggest that responsiveness to bronchodilator aerosol may be a useful guide to the presence of bronchial reactivity in epidemiologic studies of obstructive airway diseases.


The role of hyperventilation in exercise-induced bronchoconstriction. Significant bronchoconstriction, comparable in severity to that observed after moderate treadmill exercise, was induced in asthmatic children by voluntary isocapnic hyperventilation of 3-min and 10-min duration. In both hyperventilation and exercise, nasal breathing inhibited the bronchoconstrictive responses, whereas mouth breathing potentiated the bronchoconstrictive response. In the asthmatic children, 10 min of voluntary isocapnic hyperventilation did not represent a greater  bronchoconstrictive stimulus than did 10 min of exercise or 3 min of isocapnic hyperventilation. This study also showed that in normal children there was no measurable airway response after either voluntary isocapnic hyperventilation or moderate exercise. Finally, this study indicates that it is the stimulation of upper airway receptors by relatively cold and dry air, rather than hyperventilation per se, that provokes exercise-induced bronchoconstriction.


Primary alveolar hypoventilation treated by nocturnal administration of O2. A case of idiopathic alveolar hypoventilation is described. Although lung function was normal, the alveolar-arterial O2 tension difference was abnormally large for reasons which were unclear. Despite this, the patient's pulmonary hypertension and polycythemia were out of proportion to the relatively mild hypoxemia that he demonstrated while awake. Sleep was associated with severe hypoxemia, and administration of O2 during sleep produced CO2 retention. The patient did well on no treatment for 5 years, until respiratory infection precipitated severe hypoxemia and pulmonary hypertension. He was treated with O2, at first continuously then nocturnally (12 hours per day), with reversal of polycythemia and pulmonary hypertension. He was then treated with nocturnal O2 as an outpatient for 7 months and maintained his improvement. Nocturnal administration of O2 may be an effective treatment of some forms of primary hypoventilation.


Lactic acidosis presenting as acute respiratory failure. Two patients with chronic obstructive pulmonary disease and chronic respiratory failure who developed acute lactic acidosis are described. The initial arterial blood gas values in both patients had the pattern of acute respiratory failure with no metabolic disturbance. It was the calculation of the "anion gap" that provided the clue to the presence of metabolic acidosis, which was then confirmed with the measurement of serum lactate. We emphasize that complete laboratory data and clinical information may be essential for accurate diagnosis and understanding of mixed acid-base disturbances and, hence, for initiation of appropriate treatment.


Simultaneous canine tracheal transport of different particles. We describe a method to study simultaneously the transport of 2 different markers in the canine trachea. In our studies, we found that choice of radioisotopic label and variation in marker size from 3 to 180 micrometer did not affect the transport rate of basic anion exchange resin particles. Furthermore, anion exchange and acidic cation exchange particles of the same size had similar tracheal transport rates. This method may help to determine the influence of the physicochemical properties of markers on mucous transport.


Indications for choledochoduodenostomy.

Indications for choledochoduodenostomy. In summmary, at University Hospital of Jacksonville, we have performed 36 side-to-side choledochoduodenostomies over the past five years. We have repeatedly demonstrated that choledochoduodenostomy is the procedure of choice for obstructing or partially obstructing lesions of the distal or mid common bile duct, and our extensions of the original indications have not affected the morbidity or mortality as previously reported.


Complications associated with the Baker tube jejunostomy. 1. The jejunostomy route for the intraoperative insertion of a Baker tube carries significant and probably excessive risks. 2. Such risks can be greatly reduced by introducing the Baker tube through a cecostomy or a gastrostomy. When possible, introduction through an ileal stoma or through the rectum when an ileoproctostomy has been performed, is probably even better. 3. For most patients, the cecostomy approach, if performed with great care, will prove to be safe, convenient, and effective.


Routine exteriorization in the treatment of civilian colon injuries: a reappraisal. 1. We have reviewed our experiences with colon injuries from 1972-76. 2. Mortality increases when there are more than four associated organ injuries, the principal cause of death being sepsis. 3. Primary closure in our institution has a mortality and morbidity comparable to most other series, but exteriorization of the colon wound has given the best results of any treatment. 4. We feel that solitary wounds of the colon, with only one or two associated injuries, with little fecal contamination, should be treated by closure plus exteriorization, with return to the peritoneal cavity (interiorization) at five to ten days.


Details of technique and results of staging laparotomy in the diagnosis of Hodgkin's disease. The operative procedure for staging laparotomy in Hodgkin's disease is described in detail. Of 18 patients undergoing this procedure, staging laparotomy changed the stage of disease and subsequent therapy in 38%. Complications of the operation were minor, occurring in only two patients. Abnormal lymphangiography and splenomegaly proved unreliable clinical diagnostic findings. Most disturbing was the 100% incidence of amenorrhea in the women receiving pelvic irradiation following oophoropexy.


Surgical implications of ovarian vein thrombosis. Ovarian vein thrombosis, with rare exceptions, is a puerperal process that often mimicks appendicitis but may be recognized only in retrospect as a source of continued pulmonary embolization. Ovarian vein thrombosis may also accompany septic pelvic thrombophlebitis and constitute a life-threatening problem. Ovarian vein thrombosis probably exists in a subclinical form as well, and the relative infrequency of reports of this entity attest to the lack of clinical recognition rather than to its clinical rarity. Most instances of ovarian vein thrombosis will respond to antibiotics, anticoagulation, hydration and bed rest but, when septic in etiology, interruption of the vena cava and ovarian veins may be required. Acute appendicitis, the most frequent misdiagnosis, often leads to exploration, and careful resection of the affected vein in such patients generally results in cure.


Spontaneous (nontraumatic) perforation of the common bile duct: report of three cases. Three cases of non-traumatic perforation of the common bile duct are reported. Severe inflammatory reaction of the perforated site was a common and only histologic finding in those three patients. Timely diagnosis of the resulting choloperitoneum and prompt surgical treatment of the primary cause of biliary inflammation afforded long-term uncomplicated cure; the site of perforation healed spontaneously after simple external drainage of the newly formed bile cavity.


Acute intestinal ischemia.

Acute intestinal ischemia. The present mortality rate of more than 80% for patients with superior mesenteric arterial thrombosis or embolism will remain unacceptable until earlier diagnosis is achieved. Although leukocytosis is often an early feature and may seem elevated out of proportion to the severity of the illness, the later developments of abdominal rigidity, intestinal paralysis, and vascular collapse indicate transmural gangrene and peritonitis. At this stage, the eventual high mortality of acute ischemia is established whatever the urgency of the operation or the skill with which it is performed. The syndrome must be suspected immediately when a patient in an older age group complains of sudden abdominal pain in the presence of associated cardiac arrhythmia, valvular disease or congestive heart failure, particularly if other sites of peripheral embolization are identified.


Effect of limiting post-shock pulmonary edema on mortality from bacterial pneumonia. Dogs were subjected to hemorrhagic shock and then resuscitated according to physiological parameters. Randomly selected dogs received a sublethal dose of intratracheal microorganisms. In comparing the results with those previously reported from our laboratory, in which animals received an 85% greater resuscitation of Ringer's lactate, it appears that pulmonary edema in the post-shock contaminated state can be limited. Furthermore, through minimization of pulmonary edema, pulmonary defenses appear to be improved and mortality from infection reduced.


Vena caval interruption in pulmonary hypertensive canines. Massive pulmonary embolism regularly causes a reduction in systemic arterial pressure. This is accompanied by an increase in pulmonary arterial pressure. If right heart strain is sufficient, peripheral venous pressures also rise. Initial cardiac output and heart rate responses are variable, but with the progression of time, cardiac output almost uniformly falls. When either vena caval clipping or vena caval ligation are performed in the face ot these altered hemodynamics, there is a further reduction of systemic arterial pressure and cardiac output. After a period of 90 to 120 minutes, the effects of the two procedures appear to be equivalent. This is thought to be on the basis of opening of venous collateral pathways in the case of vena caval ligation. Therefore, when sufficient venous collaterals are present, the major determinant of the ultimate outcome is the impact of the embolus itself rather than the type of procedure used to interrupt the inferior vena cava.


Chemoneurolysis of the canine gastric submucosa. Effects on Heidenhain pouch secretion. Double denervated gastric pouches were constructed in dogs. One gastric pouch served as a control, and the other gastric pouch had its submucosa infiltrated with 25% ethyl alcohol (submucosal chemoneurolysis). Neurolysis of these gastric pouches did not alter their histological appearance but did eliminate their gastric secretory responses to histamine, meat and pentagastrin. The dogs exhibited elevated serum gastrin levels after feeding.


Chemoneurolysis of the canine gastric submucosa. Effects on surgically-induced gastric hypersecretion on the Heidenhain pouch. Double denervated gastric pouches were constructed in dogs. One gastric pouch served as a control, and the other gastric pouch had its submucosa infiltrated with 25% ethyl alcohol, (submucosal chemoneurolysis). Neurolysis of these gastric pouches eliminated their gastric secretory responses to histamine, meat and pentagastrin without altering their histological appearance. Transplantation of 75% of the gastric antrum into the colon caused a hypergastrinemia and increased the sensitivity of the control gastric pouches to the various stimuli but had no such effect on those gastric pouches infiltrated with ethyl alcohol.


[Inhibition of calcium absorption and conditions of its prolongation in the presence of carbohydrate]. Experiments were performed on adult rats. In situ ligatured ileal loops were injected with a solution 10 mM CaCl2 containing 45Ca either with or without L-xylose in concentrations of 25, 50 or 100 mM L-xylose. The rats were sacrified at either 0.5, 1.0, 1.5 or 2.0 hours after injection; the entire loop including the wall and content was removed. After ashing, the radioactivity of the loop was measured and the absorption coefficient of 45Ca was calculated. After half an hour, the absorption coefficient of the four solutions had about the same value. At this time, the 45Ca absorption was completed with the solution containing only calcium. With the solution containing pentose, the 45Ca absorption continued for a longer period of time. The maximal values of absorption coefficient were obtained after one hour with 25 and 50 mM L-xylose and after one and a half hour with 100 mM L-xylose; similarly, the maximal values increased in proportion to the concentration of pentose in the solution. The contents of the loops were fractionated successively by centrifugation, ultracentrifugation and two membrane ultrafiltration. No differences were observed between the repartition of 40Ca or 45Ca, either with or without 50 mM L-xylose. The stop or the lengthening of the absorption could be attributed to a possible influence of carbohydrate upon the mechanism of calcium transfer. This question is discussed from the point of relationship between the carbohydrate and the intestinal alkaline phosphatase.


[Tissue thiamine, riboflavin and vitamin B6 in the aged rat. II. Effects of vitamin supplementation in the diet on the excretion of vitamins and its tissue levels]. Nine and twenty-one months old rats fed a balanced diet were given for 5 weeks an extra supplementation in thiamine, riboflavin and vitamin B6. Control animals were given the same diet but without vitamin extra supplementation. Fecal and urinary vitamin excretions were determined during this 5 weeks period. They were shown to be less important in older rats than in younger ones. Influence of aging and vitamin supplementation on the vitamin contents of organs and tissues were studied on these animals: previous results were confirmed [see LECLERC, Ann. nutrit, Aliment., 1976, 30, 10--25]. From these results and others published elsewhere, it is conclused that in older animals there could be an increased intestinal destruction of the above mentionned vitamin although changes in vitamin metabolism can be involved too.


[Survey of contamination of food by 3, 4-benzopyrene. I. Demonstration of a universal method of determination. Application to the determination in complete meals in food emporia]. A versatile spectrofluorimetric method is proposed for the determination of 3,4-benzopyrene in foods and biological material. Recording the emission spectrum allows a reliable identification, and determination at a 0,2 ppb level, with 85 p. 100 recovery and good reproductibility. The time required for analysis is decreased, if compared to existing methods. As a test of its reliability, results of a survey on 3,4-benzopyrene content in canteen meals are presented. The values obtain are very low, generally below 1 ppb; their significance is discussed.


[Nutritional value of fish flours made in laboratory from fishes of the Nosy-Bé area]. Several types of fish meals (principally from no commercializable Carangues) are made in a laboratory. They are tested for general composition, amino-acid composition, vitamin and mineral compositions. Two fish meals from Carangues are very interesting: they are white muscle meal (rich in proteins of good quality, poor in lipids and slightly rich in minerals) and the meal from fish without head and guts (not so rich in proteins but slightly richer in minerals). These fish meals have a variable interest regarding mineral and vitamin contents. All of them have a lack of methionin and cystin which is comparable to the defficiency mentioned in other fish meals by various authors.


[Data on the quantity and quality of lipolytic bacteria in products with a meat base]. The numbers of lipolytic bacteria and their proportion, relatively to total mesophilic aerobic bacteria, were determined in 65 samples. Other analyses: psychrotrophic bacteria, coliform bacteria, Escherichia coli, fecal streptococci, and enterotoxinogenic staphylococci were also made. The less modified products generally contained a low number of lipolytic bacteria. 101 isolates very lipolytic were obtained, 81 of which were Gram + bacteria and 20 were Gram --. It is hypothesized that in pork-meat preparations, Gram + bacteria, especially Bacillus and fecal steptococci, have a lipolytic action of greater importance than it is generally assumed.


Application of intraocular pressure reduction and regulation system. In some patients undergoing intraocular procedures, the intraocular pressure may remain dangerously high immediately before surgical penetration of the anterior chamber despite all available measures. A mechanical device, called an "Intraocular Pressure Reduction and Regulation System," has been devised as a means of reducing and regulating intraocular pressure immediately before and during intraocular procedures. The system has been used in selected glaucoma patients with satisfactory results.


Retinal embolization from endocarditis.

Retinal embolization from endocarditis. Arterial emboli, fragmentation of both the arterial and venous blood columns, and bilateral cherry red spot were seen in the fundus of a patient with progressive onset of visual loss. Initially, the patient, a 56-year-old housewife, was thought to have temporal arteritis. Her clinical condition worsened on steroids which was subsequently discontinued when 5 out of 6 blood cultures were reported positive. Showers of microemboli were responsible for her unusual fundus findings.


Image magnification, contact lenses, and visual acuity. The optics of image magnification are derived. Necessary criteria for contact lens dispensing are explained and well-known approximations are demonstrated, along with their inherent limitations. The image size with spectacle lenses is contrasted with that of the corresponding contact lens, and the simple relationship between the two is demonstrated. Thus, no tables of contact lens image magnification are necessary for the clinical practitioner. Visual acuity as commonly expressed is not an exact measurement, but rather indicates that the patient has visual acuity equal to or better than the line read, but poorer than the next smaller line on the chart. It is shown how contact lens/spectacle interchange may be of significant social and legal benefit to selected groups of patients.


Spontaneous luxation of the eyeball associated with branch thrombosis of the central retinal vein. A report of a patient with spontaneous luxation of the globe and a branch thrombosis of the central retinal vein is presented. The causal relationship of the two phenomena is discussed.


Use of the argon aiming beam in visual function testing. The aiming beam of the argon laser photocoagulator can be a useful tool in visual function testing. Applied with the slit lamp delivery system and fundus contact lens, it clearly documents the size of the blind spot surrounding the optic nerve head and the normal area of nonfunctional retina in the periphery. The size of pathologic field defects can be recorded on fundus photographs or retinal drawings by an observer. Safety precautions must be taken to protect all patients from excessive laser energy.


Vertical pendular nystagmus in chronic myositis of medial and lateral rectus. A 38-year-old white woman developed left medical rectus myositis possibly due to an immune response to mepivacaine (Carbocaine) injected around her upper left first molar. Ten months after resolution, a recurrence of left medial restus myositis and also left lateral rectus myositis occured after the injection of chemically related lidocaine (Xylocaine) in the same area. At this time, with gaze to the left, there appeared vertical pendular nystagmus of greater amplitude in the involved eye, in the absence of systemic neurologic or posterior fossa disease. This association of vertical pendular nystagmus with chronic myositis of the medial and lateral rectus, to my knowledge, has not been previously reported.


Vitelliform lesions associated with retinal pigment epithelial detachment. Two patients with bilateral vitelliform macular lesions had normal electro-oculogram findings. The fluorescein angiograms showed retinal pigment epithelial detachment. Detachment of the retinal pigment epithelium associated with lipid and/or protein accumulation within the subpigment epithelial space represents another mechanism by which a lesion ophthalmoscopically similar to that seen in classical Best's disease can be produced.


Vitreous loss during intracapsular cataract extraction. Among 448 patients operated upon for bilateral cataracts (896 eyes), vitreous was lost in 96 eyes, an incidence of 10.7%. The most striking difference between the whole group of eyes without vitreous loss (800 eyes) and those with vitreous loss is in the percentage of eyes able to perform a very good visual acuity postoperatively. An analysis of 50 cases losing vitreous unilaterally shows the following: (a) more than 80% of eyes with vitreous loss achieved a vision comparable to their fellow eyes; (b) 12% of eyes with vitreous loss achieved a poorer vision than their fellow eyes; and (c) fewer eyes with vitreous loss achieved a very good visual acuity as compared to their fellow eyes (8.7% to 11.1% in eyes with vitreous loss as compared to 21.5% to 22.2% of fellow eyes). The combination of vitreous loss with an accidental extracapsular cataract extraction had a worsening effect on the expected postoperative visual performance.


Review of surgical results using bilateral lateral rectus recession for the correction of exodeviations. The results of bilateral lateral rectus recession as the first procedure for the correction of exodeviations were reviewed. Thirty-six charts met the criteria used in this study. There was an overall success rate of 83% by judging satisfactory surgical results as no more than a 10 diopter esodeviation or exodeviation in the primary position at distance. The success rate for patients with an exodeviation of 40 diopters or less was 93% using our criteria. For exodeviations 45 diopters and greater the success rate was 50%. The factor of basic or divergence excess exodeviations did not seem significant in its correlation to satisfactory surgical results.


Management of large angle exotropia.

Management of large angle exotropia. Four cases of large angle exotropia secondary to third nerve palsy are presented. An effective technique involving recession of the lateral rectus and splitting and advancement of the medial rectus is presented.


Tolosa-Hunt syndrome.

Tolosa-Hunt syndrome. Ten cases of painful ophthalmoplegia are reported. In all cases pain marked the onset of the disease; the condition was mostly unilateral. Recurrence and dramatic response to steroid therapy were more constant features than angiographic findings which may be completely normal. CAT permitted us to eliminate a tumor of the cavernous sinus in 7 cases, but in one case, which was operated, an aggravation followed surgery. Despite complete investigations of all patients, some questions remain unanswered. Is it an inflammatory or an allergic inflammatory process? (And the presence of antinuclear factor in an only case does not permit it to respond.) Why is the process confined to the superior orbital fissure? Mathew and Chandy tried to find a similarity between this syndrome and Bell's palsy although the 2 syndromes have not been shown to coexist. Is the Tolosa-Hunt syndrome comparable to the pseudotumor of the orbit? Although the dura mater is inserted on the border of the sphenoidal cleft, some patients may altern the 2 syndromes.


Keratoconus following contact lens wear. While it can be stated that cases such as ours are examples of simultaneous development of keratoconus are otherwise predisposed individual rather than direct results of contact lens wear, it is still a disturbing development. Although inheritance patterns are vague if existent in keratoconus patients, it might fall on the ophthalmologist to prove that lens wear was not associated with the problem in a legal forum. With increasing attention to medicolegal problems, the burden of careful and reasonably close follow-up cannot be ignored in contact lens patients.


Raeder's paratrigeminal syndrome.

Raeder's paratrigeminal syndrome. Three middle-aged patients, 2 of whom are females, with unilateral trigeminal pain and associated isolated oculosympathetic paralysis are presented as characteristic of the benign form of Raeder's paratrigeminal syndrome. Their nonprogressive course is representative of the fact that this syndrome is not likely to be caused by aneurysms or mass lesions, and suggests that neuroradiologic contrast studies are generally not initially required in the investigation of such patients. If atypical features are present, or the pain is protracted, further investigation may be warranted.


Metastatic tumor of the iris: case report. The iris involvement in generalized carcinomatosis is less frequent than that of the ciliary body and choroid; its point of interest is that it might constitute the presenting sign of the general disease. The case of a 43-year-old man who had a metastasis of an anaplastic bronchus carcinoma in the iris and died of metastases 3 months after the appearance of the iris tumor, despite adequate chemotherapy, is reported.


The prognosis of retinal detachment due to lattice degeneration. In a series of 553 consecutive retinal detachments, 29% (120) were due to lattice degeneration. Forty-five percent of these were due to atrophic holes in the lattice degeneration and 55% were due to tears caused by traction posterior to or at the end of a patch of lattice. In phakic patients, retinal detachments due to atrophic holes were most common in young myopes. Detachments due to traction tears were seen in older, less myopic patients. The incidence of massive periretinal proliferation was less (5%) in detachments due to lattice degeneration than in detachments not due to lattice degeneration (6.5%).


Limbal immunopathology of Mooren's ulcer. A patient with a progressive Mooren's ulcer of the cornea was successfully treated utilizing a peritomy with limbal conjunctival excision and cryotherapy. The limbal conjunctiva contained a band of IgG beneath the epithelium as well as complement and fibrin in the wall of small blood vessels. This implies Mooren's ulcer is an immune mediated process.


A successful treatment for aphakic cystoid macular edema. Twenty-eight consecutive cases of aphakic cystoid macular edema in 16 patients were treated with corticosteroid drops. Enough medication was used in each occurrence to achieve intraocular pressure elevation. This increases the hydrostatic pressure on the retina thereby decreasing retinal swelling pressure and reversing the cystoid macular edema. Visual acuity improved in each instance after resolution of the cystoid macular edema.


Ophthalmoscopic changes in a patient with Wilson's disease during long-term penicillamine therapy. The development of retinal pigment epithelial defects in a young patient with Wilson's disease after long-term penicillamine therapy is described. It is hypothesized that decreased copper availability secondary to penicillamine therapy may result in defective elastin within the lamina of Bruch with resultant defects in the overlying retinal pigment epithelium.


Epiphora following rhinoplasty.

Epiphora following rhinoplasty. Damage to the lacrimal drainage apparatus is probably a frequent occurrence during rhinoplasty and this may lead to a permanent occlusion of the drainage system with tearing. This fact is not well documented in the plastic surgery or ophthalmic literature. Four cases of epiphora following rhinoplasty are presented. The possible mechanism of the obstruction and the treatment are discussed.


The penetration of antistaphylococcal antibiotics into the aqueous humor of rabbits. A multiple dose schedule of antibiotic administration parallels the clinical therapeutic situation. However, most reported studies on the aqueous humor concentration of antibiotics have been carried out following single doses of drug. We administered 2 penicillinase-resistant penicillins, 2 cephalosporins, and gentamicin to rabbits over a 24 hour period. Samples of serum and aqueous humor were obtained after the first and after the fifth dose of antibiotic. Of the agents studied, only methicillin in multiple doses gave therapeutic concentrations in the aqueous humor of normal rabbits. It is proposed that any future studies of intraocular penetration of antimicrobials be designed to include single and multiple doses in normal and infected eyes.


A new technique for the surgical repair of cyclodialysis induced hypotony. A new technique for the treatment of cyclodialysis induced hypotony is presented along with the results achieved in 4 cases. The technique is best suited to large clefts, or those in which conservative therapy has failed. No serious sequelae resulting from the procedure were noted in any of our cases.


Expulsive hemorrhage: report of five cases. Five cases of expulsive hemorrhage occurring over a period of one year were reviewed. Two cases occurred during a trabeculectomy procedure. There appear to be multiple factors playing a role in the etiology of expulsive hemorrhage. There was not a single common factor among these 5 cases, except for the conjectural presence of some kind of vascular disease. However, there were some important factors that may have played a role such as glaucoma, hypertension, vascular disease, and general anesthesia (and sudden decompression of the globe).


Keratoconjunctivitis sicca following excision of a dermolipoma of the lacrimal gland. A 20-year-old woman with subconjunctival mass of the superotemporal region of the globe was operated upon. The mass was found to be a dermolipoma of the lacrimal gland. The removal of the mass caused severe keratoconjunctivitis sicca, which could only be helped with frequent applications of artificial tears.


Ketamine anesthesia and intraocular pressure. We studied the influence of intramuscular ketamine-narcosis on the intraocular pressure of rabbits. Tonography and indirect arterial pressure measurements were performed 5 to 10 minutes after the administration of the agent. The systolic arterial pressure did not change significantly, whereas the intraocular pressure significantly increased. The intraocular pressure increase was 7% on the average with a maximal increase of 20%. In more than half of the cases the arterial and intraocular pressures changed in the opposite directions which speaks for the role of other factors in enhancing these pressure alterations.


Sudden or fluctuating hearing loss and vertigo in children due to perilymph fistula. Five cases are presented of children with rapid onset of sensorineural hearing loss, disequilibrium, or both, who were found at exploratory tympanotomy to have a perilymph fistula. Four of the children had histories suggesting that antecedent barotrauma or physical exertion contributed to the development of the fistula. One child with congenital unilateral craniosynostosis had a residual temporal bone abnormality on the same side as the perilymph fistula. Two children had identifiable anatomic abnormalities in the middle ear. A classification of perilymph fistula is proposed that describes a congenital, an acquired, and a combined type of fistula. Inner ear fluid dynamics and patency of the cochlear aqueduct appear to be important factors in pathogenesis. Children with unexplained fluctuating or sudden onset of sensorineural hearing loss, and children with unexplained disequilibrium or vertigo should be suspected of having a perilymph fistula. The history can be singularly important in raising the suspicion that a perilymph fistula may be present. Although audiometric, vestibular, and radiographic studies can be helpful, there is no way to prove the presence or absence of a fistula without directly viewing the middle ear. Tympanotomy with repair of the fistula does not assure improvement in hearing.


Delayed endolymphatic hydrops.

Delayed endolymphatic hydrops. Delayed endolymphatic hydrops is a disease entity that can be differentiated from Ménière's disease. Typically it occurs in patients who have sustained a profound hearing loss in one ear, usually from infection or trauma, and then after a prolonged period of time develop either episodic vertigo from the same ear (ipsilateral delayed endolymphatic hydrops) or fluctuating hearing loss, also sometimes with episodic vertigo, in the opposite ear (contralateral delayed endolymphatic hydrops). The ipsilateral form of the disease may be treated by labyrinthectomy but no satisfactory therapy is available for the contralateral form of the disease.


Hypercholesterolemia and auditory dysfunction. Experimental studies. Rabbits were used for the long-term study of auditory function associated with experimental hypertension and hypercholesterolemia. Auditory dysfunction (threshold changes of sound evoked responses) was monitored with an electrode, chronically implanted into the contralateral inferior colliculus. Hypertension was created using the renal encapsulation technique. Auditory function in the hypertension trial demonstrated a dip at higher frequencies as well as improvement at lower frequencies. One gram of cholesterol fed daily for three months was capable of making rabbits atherosclerotic. Cholesterol-fed rabbits showed increasing auditory dysfunction over time at all frequencies. When experimental hypertension was combined with hypercholesterolemia, the auditory changes appeared additive. This work, although in preliminary stages, seems to provide experimental evidence that auditory dysfunction is associated with cholesterol diet.


Noise-induced hearing loss. A human temporal bone case report. The histopathology of a case of profound hearing loss which seemed to be induced by noise exposure (explosions and drillings in a gold mine) is reported. The patient's only residual hearing was 250 Hz at 90 dB SPL in the right ear. The major histopathological findings were as follows: Bilateral absence or collapse of Corti's organ was observed in the middle and basal turns of the cochlea; however, in the remaining area (approximately 6.0 mm in range in the apical portion of the cochlea) Corti's organ was well-preserved with a moderate loss in number or atrophy of the hair cells. Bilateral marked decrease of the cochlear nerve was noted in the middle and basal turns; however, the nerve was well-preserved in the remaining apical portion (approximately 6.0 mm in range) of the cochlea. These pathological findings were somewhat less severe in the right cochlea than in the left. In general, there was good correlation between the profound hearing loss and the extensive pathological findings in Corti's organ. The residual hearing in the right ear would seem to be explained by the less severe pathological changes found in the apical portion of the right cochlea than in the left cochlea. In addition to noise exposure, other possible etiological factors contributing to this hearing loss are discussed. These include diabetes mellitus and presbycusis.


Selected hearing impairment associated with pinealoma. A 23-year-old Caucasian male entered the audiology clinic with a complaint of difficulty understanding speech, although speech sounds could be heard. Conventional clinical audiometry showed normal sensitivity bilaterally. The speech discrimination tests confirmed his inability to comprehend speech adequately. Békésy audiometer tests revealed dramatically rapid temporary threshold shifts bilaterally. Subsequent physical examinations revealed a massive pinealoma. Thirteen days after completion of Torkildsen's procedure, all the auditory tests indicated normal auditory function in each ear.


Auditory prostheses research with multiple channel intracochlear stimulation in man. Although single-channel electrode arrays implanted in the scala tympani of deaf patients are useful as an aid to lip reading and for distinguishing some environmental sounds, they do not transmit intelligible speech. However, multichannel electrode arrays, which take advantage of the cochlea's tonotopic organization, may be capable of generating the complex patterns of neural activity necessary for speech discrimination. In this study, multichannel electrodes were implanted in the cochleas of four volunteers, with access to the connecting wires made through the skin via a percutaneous connector. The major portion of the data presented is from two of these subjects: one has been bilaterally deaf since birth and the other has been unilaterally deaf for 15 years. Preliminary results of experiments with two more recently implanted subjects are described as well as experiments with a fifth volunteer who was implanted with five electrodes by House in 1969. Data on pitch and loudness discrimination as well as the effects of stimulation parameters on threshold, impedance, and electrode interaction are presented. Place pitch and periodicity pitch were observed in all five volunteers. The results of pitch-matching experiments with the unilaterally deaf volunteer were consistent with tonotopic maps of the cochlea, and experiments indicated that a pitch continuum may be achieved by combining place and periodicity pitch modulation. Preliminary experiments in tune recognition with one subject demonstrate his ability to recognize simple melodies based on periodicity pitch cues. These results, coupled with the finding that subjective sensations remain stable over the long-term, support the feasibility of providing artificial hearing with a multichannel cochlear stimulation system.


[Two cases of superficial pemphigus induced by pyritinol (author's transl)]. Pyritinol is presently prescribed in rhumatoid polyarthritis because of its structural analogy to D-penicillamin. Only benign cutaneous side effects had been mentioned up to now. We report two cases of pemphigus occurring during pyritinol therapy given in one case for rhumatoid polyarthritis, in the other case for memory deficiency. Clinical aspect was that of a superficial pemphigus. The histologic picture was in some instances that of a superficial acantholysis, and in other instances, that of an eosinophilic spongiosis. Definite proof of pemphigus was shown by presence of anti-intercellular substance antibodies in the serum and in the skin of both patients.


[Transient acantholytic dermatosis (Grover) (author's transl)]. In this report, we wish to demonstrate histological and ultrastructural characteristics of transient acantholytic dermatosis, first described in 1970 by Grover. Papules on the upper part of the body and on the arms and thighs are noted in our two patients. They are small in size (2-4 mm) and encircled by an erythematous border; pruritus and vesicles with serous content are often present. The vesicles are follicular and tend to group. Biological and immunological studies are normal. Histological examination shows acantholysis and intraepidermal vesicles above which is hyperkeratosis with parakeratosis. In the dermis, inflammatory infiltrates are noted. Ultrastructural study reveals rarefaction of desmosomes and widening of intercellular spaces. Fragments of tonofibrils are also noted. Karyolysis is sometimes present. The dermis contains  A. Civatte's bodies. It is likely that this recently identified disease is less unfrequent than it appears to be.


Surgical anatomy of the temporal bone in the chinchilla. The chinchilla is of value in otological research for many reasons, including the surgical accessibility of the majority of structures within its temporal bone. This paper describes the anatomy of the chinchilla's temporal bone, and four surgical approaches to the labyrinth and ossicular chain, three through the bulla and the other via the external canal. No one approach reveals all the temporal bone structures, and each route is therefore more suited to some surgical procedures than others. The cochlea is particularly accessible for microsurgical procedures because it projects into the labyrinthine part of the bulla and because its bony capsule is thin. Surgery in the posterior cranial fossae is both hazardous and difficult; the hazard is bleeding from the venous sinuses which run within the occipital and temporal bones, and the difficulty is the limited access due to the intervening cerebellum and the closeness of the brain stem.


[Peri-navel intestinal patch-like choristia (author's transl)]. The authors describe an umbilical anomaly marked by confluent erythematous and crusted plaques, spreading beyond the navel limits and histologically regarded as a choristia that is to say a displacement of intestinal tissue within the epidermis. The ultrastructural study investigated the relationship between intestinal cells and keratinocytes. The authors believe that behaviour analogies exist between ectopic intestinal cells and Paget's cells.


[Allergy to betalactamins. Diagnosis in vivo and correlations with tests in vitro (lymphocyte transformation and specific IgE) (author's transl)]. A comparative study of the results of skin tests and tests in vitro (lymphocyte transformation L.T. and R.A.S.T. for specific IgE) in 21 patients allergic to penicillin or penicillin-derivates revealed that tests in vivo are more sensitive and reliable than L.T. and R.A.S.T. This discordance needs future research for more valuable tests in vitro, such as specific histamine-release by leucocytes or determination of IgG4 reagins by R.A.S.T. procedure. A method of diagnosis of betalactamin hypersensitivity by skin tests, including penicilloylpolylysine, benzyl-penicillin, ampicillin and cephalosporin, is suggested; this method was experienced in 21 patients and 23 control subjects and proved to be safe and reproducible.


[Oral photochemotherapy in vitiligo (author's transl)]. 33 patients with vitiligo were treated with total body artificial U.V.A. irradiations and systemic 8-MOP. Hexagonal upstanding light boxes containing 84 fluorescent bulbs were used as sources of U.V.A. Patients were treated for 2 months. Response to psoralen photochemotherapy was evaluated as follows: --excellent: greater than 90 p. 100 repigmentation; --good: 50 p. 100 to 90 p. 100 repigmentation; --fair: less than 50 p. 100 repigmentation; --no repigmentation. Excellent results were obtained in 5 patients (15 p. 100), good results in 9 patients (27 p. 100). 6 of the patients (18 p. 100) showed no response. There was no correlation between: --the age of the patients, --the extent of involvement, --the duration of vitiligo and response to therapy. Artificial U.V.A. sources and systemically administrated 8-MOP is at least as effective as 8-MOP + sunlight exposure.


[Uncombable hair syndrome. Pili trianguli et canaliculi (author's transl)]. We present a general review of a new syndrome that we described in 1973, under the title "cheveux incoiffables" (uncombable half syndrome). The scanning electron microscopy shows two specific alterations of the hair: a triangular section and a longitudinal groove.


[Congenital or acquired unilateral nevoid stellar telangiectasias. About 5 cases (author's transl)]. Based on five personal cases (one neo-natal case, one in childhood, and three cases in pregnant women) and sixteen published cases, this study remind us of the essential caracteristics of unilateral nevoid telangiectasis. Prevalence in women is noticeable appearance during pregnancy, with complete regression during post-partum, is quasi constant. If their nosological place is not clear among the essential telangiectasias, they seem to be quite different from Hutchinson's serpiginious angioma (verrucous telangiectasis), from Osler-Rendu's disease, from Brocq's telangiectasias and from generalizated telangiectasias. The true signification of all these diseases is still completely unknown.


[Pyoderma gangrenosum associated with seronegative polyarthritis. Report of a case. Review of the literature (author's transl)]. Pyoderma gangrenosum developed in a 45-year-old caucasian woman who had an 18 year past history of seronegative polyarthritis without any visceral or haematologic associated abnormalities. A literature review revealed only 12 reported cases. Extensive laboratory evaluation failed to detect alterations of the immune functions. The presence of a vasculitis with C3 deposits suggested that levamisole may have played a role in eliciting the lesion. Clofazimine, administered for a period of one month, was a relative failure.


Surgical experience with acute arterial occlusion in the upper extremities. 34 episodes of acute arterial occlusion in the upper limbs were treated surgically in 30 patients. In 32 cases the embolus was considered to have originated in the heart. In 27 cases the radial pulse was reestablished after the primary operative procedure and in 2 cases after an additional operative procedure. In 3 cases the pulse remained inpalpable and 2 amputations were needed. The earlier after the onset of the symptoms the operation was performed the better were the results. Two patients expired in the hospital during the first week after operation and there were 11 late deaths during the follow up period. The remaining 17 patients were followed for an average of 4.1 yrs. 15 of these patients have not shown any evidence of re-occlusion during the follow up period.


Gastroscopic reduction of afferent loop intragastric intussusception. A case is presented of afferent loop intragastric intussusception diagnosed by gastroscopy 18 years after partial gastrectomy with retrocolic gastrojejunostomy. The intussusception was successfully reduced by means of the gastroscope. The symptoms were instantly relieved, with a symptom-free follow-up of 1/2 year. Provided that the intussuscepted segment appears viable it seems justified to aim initially to reduce jejuno-gastric intussusception with the aid of the gastroscope.


Acute appendicitis complicating pregnancy. Seventeen cases of acute appendicitis complicating pregnancy were analysed. The presenting symptoms were abdominal pain, nausea and anorexia. The usual physical findings were direct abdominal tenderness and rectal tenderness. Correct diagnosis was more difficult when gestation was advanced. This was reflected both by the severity of the disease process found at operation and by the increasing foetal mortality rate. Delay in diagnosis and treatment is the main factor causing high maternal and foetal death rates, especially when pregnancy is advanced.


Precipitate labour.

Precipitate labour. In Turku University Central Hospital there were 4976 deliveries in the years 1974--75. Among them there were 106 spontaneous, nonaugmented labours with a duration of two hours or less, giving an incidence of 2.1% precipitate labour. The most important aetiological factor was multiparity. 35% of precipitate labours commenced with spontaneous rupture of the membranes. The incidence of prematurity after precipitate labour was 8.5% and thus significantly (p less than 0.05) higher than in a control group, where mothers were matched according to age and parity. After precipitate labour the newborn fared as well as those in the control groups. It is our conclusion therefore, that precipitate labour need not be considered as an intrapartum risk factor, when neonatal well-being is considered.


Intravenous cholangiography and cholescintigraphy in the diagnosis of hepatobiliary disease. The diagnostic yields of intravenous cholangiography (IVC) and 99mTc-diethyl-IDA cholescintigraphy (CS) were compared in 50 patients; 19 had acute cholecystitis, 5 pancreatitis, 4 obstructive disease of the common bile duct, 5 chronic gallbladder disease, 6 parenchymal liver disease and 11 had other intra-abdominal diseases. The comparison of IVC and CS covered three aspects: the definition of the biliary tract structures, their morphologic changes and an assessment of bile flow through the cystic duct and the common bile duct. The definition of the main intrahepatic bile ducts was better with IVC; that of the common bile duct and the gallbladder was better with CS. Morphologic details such as calculi or local changes in duct calibre were detected only in IVC. Measurements of common bile duct calibre obtained from operative cholangiograms correlated better with those from the IVCs than with those from the CSs. CS was more sensitive in the diagnosis of cystic duct obstruction. Bile flow in the common bile duct was estimated in the cases where the gallbladder did not fill. Delayed emptying of the common bile duct was revealed in IVC in 1 and in CS in 3 out of 6 cases with disturbed bile flow. The morphologic findings in IVC gave indication of the obstructive condition in the 1 case with retarded flow and in 2 additional cases. CS provided functional information for which the concentration of the tracer was sufficient except in one case. IVC provided morphologic and functional information, but the excretion of the contrast medium was insufficient for a morphologic assessment of the common bile duct in 16 cases and for a functional assessment in 11 cases.


Blood pressure changes in the marginal artery of the colon following occlusion of the inferior mesenteric artery. The perfusion pressure in the marginal artery of the descending colon was measured continuously at laparotomy in eight patients and the effect of sudden occlusion of the inferior mesenteric artery recorded. Three patients with ulcerative colitis, all in their early 30s, and five elderly patients with colonic or rectal carcinoma were studied. In all patients occlusion caused an initial and marked pressure drop, which remained reduced at a critically low level in two of the elderly patients. Such a reduction in perfusion pressure is probably still insufficient to interfere with the nourishment of the terminal part of the colon provided that the systemic pressure is kept at a normal level. However, since in many patients there is a sharp drop in systemic blood pressure during the recovery phase after surgery, it appears likely that the perfusion pressure in the marginal artery may in those cases be insufficient to maintain an adequate blood flow to the colon despite the inherent tendency of "auto-regulation" in this vascular bed. The results of the present study indicate that, contrary to previous belief, ligation of the inferior mesenteric artery may increase the risk of ischaemia in the terminal part of the descending colon, leading to anastomotic dehiscence after anterior resection, or sloughing after a "pull-through" operation. This complication could probably be prevented by a more generous resection of the sigmoid and descending colon, thus reducing the length of the anastomosis formed by the arc of Riolan and by careful maintenance of an adequate blood pressure during the recovery phase.


Caeruloplasmin: a plasma protein, enzyme, and antioxidant. Multifunctional roles of the plasma protein, caeruloplasmin, have been briefly reviewed under three main headings. These are protein functions, enzymic activity, and antioxidant protection. As a plasma protein it is said to play a role in the transport of copper. Since some 95% of serum copper is associated with caeruloplasmin, measurement of the protein provides a useful guide to copper levels. Enzymic functions are related to its oxidase activity. Substrates commonly used for laboratory assay include non-biologically occurring aromatic amines and polyphenols. More recently, a physiological function has been proposed in which the enzyme oxidases iron from the ferrous to ferric state for binding to apotransferrin. This enzymic function of caeruloplasmin has been designated 'ferroxidase'. In vitro studies have shown that caeruloplasmin can inhibit the peroxidation of polyunsaturated fatty-acids. This function is in part related to its ferroxidase activity. No antioxidant activity has yet been demonstrated in vivo but this possibility is speculatively discussed.


Serum deoxycytidylate deaminase activity after myocardial infarction. The activity of serum deoxycytidylate deaminase, not hitherto reported to increase after myocardial infarction, has been investigated and the results have been related to other cardiac enzymes, including the MB fraction of creatine phosphokinase. Deoxycytidylate deaminase was found to increase to maximum activity on the third day after infarction. It may therefore be added to the list of 'cardiac enzymes.


Plasma 25-hydroxyvitamin D and alkaline phosphatase isoenzymes in hyperthyroidism. Plasma 25-hydroxyvitamin D (25-OHD) values in 22 hyperthyroid patients did not differ significantly from those of controls matched for age, sex, and the time of year that plasma samples were taken. In the hyperthyroid group, plasma alkaline phosphatase was significantly higher than in controls, and an increase in bone type alkaline phosphatase occurred in 50%. In the 18 female hyperthyroid patients the plasma gamma-glutamyl transferase was significantly increased compared with controls. Mean values for plasma albumin, alanine transferase, and calcium showed no significant difference between hyperthyroid and control patients.


Radioimmunoassay of methotrexate: use of 75Se-labelled methotrexate. 75Se-labelled methotrexate has been used as the radiolabel in a radioimmunoassay for methotrexate and its use compared with that of 3H-methotrexate. The gamma-labelled drug has proved to be extremely reliable and easier to use than 3H-methotrexate. Results obtained with it compare well with those obtained with tritiated drug. There are practical advantages in using a gamma emitter, and it is suggested that the modified radioimmunoassay is invaluable for routine monitoring of methotrexate in patients undergoing chemotherapy with the drug.


Total urine oestriol by a modification of a commercial plasma oestriol kit. An adaptation of a radioimmunoassay for plasma oestriol for assaying urine oestriol is presented. The method has been shown to be precise, reliable, and directly comparable with the manual spectrophotometric technique for urine oestriol.


Antibiotics in acute cholecystitis.

Antibiotics in acute cholecystitis. In 460 cholecystectomies performed for acute cholecystitis 215 (47%) positive gallbladder bile cultures were obtained. In 73% of emergency operations bacteria were recovered, in 48% of early operations (p less than 0.001) and in 29% of late operations (p less than 0.001). In vitro concentrations of 8-16 mcg/ml of ampicillin or cephalothin inhibited in most cases the growth of E. coli, Klebsiella and Enterococci, which comprised 75% of all strains isolated. One hour after intravenous infusion of 1 g ampicillin the mean serum level was 21 mcg/ml, the mean common duct level 16 mcg/ml and the mean gallbladder bile level 4.4 mcg/ml. In acute cholecystitis 2 g cephalothin gave mean concentrations of 14, 8, and 1.2 mcg/ml. Most of these patients had cystic duct obstruction both on intravenous cholegraphy and during operation. Control patients with patent cystic ducts who received ampicillin had mean gallbladder and common duct bile levels of 47 and 56 mcg/ml, and those receiving cephalothin 23 and 28 mcg/ml. It appears that adequate gallbladder bile concentrations of antibiotics are not attainable in acute cholecystitis because of the obstruction to the bile flow. The favourable results of prophylactic antibiotic treatment in reducing septic complications seem to depend more on adequate serum and tissue concentrations than on the concentration of antibiotics in the bile.


Human atrial noradrenaline content, hypothermic ischaemic arrest and parameters of left ventricular function. The noradrenaline (NA) content in tissue excised from the right atrium before and after hypothermic ischaemic arrest and subsequent coronary reperfusion was estimated biochemically and histochemically. The series consisted of 22 patients suffering from aortic valve disease. The NA concentration in the preoperative and postoperative samples was similar in all instances and it was clear that the right atrial myocardial NA content remained unchanged under conditions typical of an aortic valve replacement operation. The mean NA contents (microgram/g +/- SD) of the whole series before and after procedure were 2.0 +/- 1.1 and 2.2 +/- 1.5, respectively (p greater than 0.1 NS). Additionally, left heart catheterization was performed preoperatively in 11 patients with aortic valve disease, and certain left ventricular cardiocirculatory variables of contractility and failure were recorded. No statistically significant correlation could be found between the right atrial myocardial NA content and the left ventricular contractile state. However, left ventricular end-diastolic pressure presented a significant positive correlation with the NA content of right atrial myocardium (r = 0.65, p less than 0.02, n = 11). The problems encountered in weaning the heart off perfusion after aortic surgery can hardly be explained in terms of altered myocardial NA stores.


Ergospirometry and coronary arteriography in young patients with angina pectoris or atypical chest pain. A bicycle ergospirometric test was performed on 57 women and 26 men of age 40 or less in combination with coronary arteriography for angina pectoris or chest pain atypical for ischaemia severe enough to affect their working capacity. Nine men and 14 women had angina pectoris with coronary artery narrowings of 50% or more (Group I) and 5 men and 22 women had angina pectoris without obvious coronary artery narrowings (Group II). This means an incidence for coronary changes of 64% for men and 38% for women for angina pectoris. Group III consisted of 12 men and 21 women with a chest pain atypical for ischaemia and without coronary artery narrowings. Minor changes were found on angiographic examination in some patients. Four men and 11 women could not do the ergospirometry adequately. The patients with coronary artery narrowings had a lower maximal oxygen consumption than the others, even though only the mean values for the women showed a statistically significant difference. They also had lower maximal heart rates and their total work and maximum load were lower. The highest proportion of ST segment depressions of 0.5 mm or more was also found in the same patients. The pressure rate product did not show any clear difference with regard to the patient groups or the ST segment changes. As a purely diagnostic tool ergospirometry does not give more information about possible ischaemia in cases of chest pain than a routine upright bicycle test, but for following up patients with angina pectoris and evaluating treatment it gives valuable data about working capacity.


Myocardial complications of immunisations. Immunisation may induce myocardial complications. In this pilot study clinical, electrocardiographic, chemical and immunological findings have been studied during a six weeks' follow-up after routine immunisation (mumps, polio, tetanus, smallpox, diphtheria and type A meningococcal disease) among 234 Finnish conscripts at the beginning of their military service. Serial pattern of ECG changes suggestive of myocarditis was recorded in eight of the 234 conscripts one to two weeks after vaccination against smallpox and diphtheria. Changes were mainly minor ST segment elevations and T wave inversions and usually they disappeared in a few weeks. The ECG positives more often had a history of atopy, and their mean body temperatures and heart rates after the vaccinations were higher than among the other subjects (p less than 0.01). However, clinical myocarditis was never noted, nor were immunological or enzymological changes different among the ECG positives. Thus in 3% of the study population, evidence of postvaccinal myocarditis was noted, based on serial ECG patterns, but without any other evidence of cardiac disease.


The response of human platelets to hypotonic stress: direct measurement of volume change. Human platelets stored at 22 degrees C were subjected to standard hypotonic stress at intervals up to five days after collection. Changes in light absorbance were recorded during the reaction, and size distribution was measured directly using a Coulter Model ZBI Counter and Channelyzer. Recovery following osmotic stress was measured by change in absorbance, as well as by change in platelet size distribution. Significant correlation was demonstrated between the two methods. By both measures, fresh platelets demonstrated substantial recovery following hypotonic stress, but platelets stored for five days had lost this ability. The requirements for intact sulphydryl groups and the lack of effect of colchicine were confirmed.


Platelet and granulocyte pheresis.

Platelet and granulocyte pheresis. The need for sophisticated component therapy has resulted in improved techniques for obtaining concentrates of platelets and granulocytes. The use of single donors as a source for these products is advisable to avoid multiple sensitizations. A method for obtaining large quantities of platelets has been established rather easily. Obtaining concentrated granulocytes represents a greater problem owing to the difficulty in separating granulocytes from red cells by differential centrifugation or sedimentation since the specific gravities are similar. Separation is easier by the use of hydroxyethyl starch. A modified solution of hydroxyethyl starch and sodium citrate was used with good results.


Monoclonal gammopathy associated with multiple sclerosis. A 52-year-old white male with a 26 year history of multiple sclerosis developed a monoclonal gammopathy of the IgA class, with reciprocal depression of normal immunoglobulins. A bone marrow aspirate and biopsy showed a marked increase in plasma cells, many of which appeared immature. These findings fulfilled the diagnostic criteria for multiple myeloma. The association of multiple myeloma with multiple sclerosis may not be coincidental. Mechanisms regarding this association are discussed.


Effects of nickel chloride and nickel carbonyl upon glucose metabolism in rats. Hyperglycemia, hyperglucagonemia and hyperinsulinemia were observed in fasting rats at 0.5 hr after ip injection of NiCl2 (68 mumole per kg). Infusion of somatostatin iv (0.5 mg per rat) did not prevent Ni(II)-mediated hyperglycemia, hyperglucagonemia or hyperinsulinemia. Exposure of rats to inhalation of Ni(CO)4 (1.2 to 6.4 mumole per liter of air per 15 min) caused acute hyperglycemia, similar to that observed after ip injection of NiCl2. Hyperglycemia induced by NiCl2 and Ni(CO)4 was not associated with inhibition of erythrocyte glycolysis measured in vitro by erythrocyte uptake of 1-14C-glucose and release of 14CO2. These findings indicate that Ni-induced hyperglycemia may be mediated by increased pancreatic release of glucagon, but that Ni stimulation of glucagon release differs from stimulation of glucagon release by arginine or epinephrine, since the Ni effect is not antagonized by somatostatin.


Theoretical analysis of ligand-binder complex formation: partial equilibrium and incubation time. This report presents a theoretical model of the rate at which complex formation approaches equilibrium in competitive binding systems while ligand concentration varies. Three commonly encountered systems are examined in which binder concentrations (q) are fixed at 0.5/K, 3/K and 50/K, respectively. Our analysis of the incubation time for any particular fraction of reaction completeness shows that longest incubation times occur with the lowest ligand concentrations when q = 0.5/K. However, in systems where q = 3/K and q = 50/K, the longest incubation times correspond not to lowest ligand concentrations but to those approximating the concentration of binder. It is concluded that empirical determination of minimal incubation times for these latter two assay systems should be performed with ligand and binder in approximately equal concentrations.


[Histofluorometric study of catecholamines of the external layer of median eminence in the rabbit (author's transl)]. In order to study the role of the Biogenic Amines of the Median Eminence (M. E.) in the ovulatory neuroendocrinological reflex in the female rabbit, we analysed by semi-quantitative histofluorometry (Zeiss) the post-coïtum variations in formaldehyde induced fluorescence (Falck and Hillarp's technique) in the dopaminergic layer of the M. E. 116 female rabbits (62 control, 54 post-coïtum) were examined. In all the animals the dopaminergic layer of the M.E. displayed variations in fluorescence, both in thickness and intensity, along the antero-posterior axis and lateraly. In this respect, these results partly recovered those reported in the Rat (Lofstrom, 1976). Moreover, in half of the post-coïtum animals, from the 5 th min. up to the 30 th min, the intensity of the fluorescence was increased in the whole external layer. These results provide some evidence for a correlation between the variations in the Dopamine content of the M.E. and the involvement of the nervous mechanisms implied in the ovulatory neuroendocrinological reflex.


[Low triiodothyronine syndrome in non thyroidal diseases. Distribution and serum TSH concentration studies (author's transl)]. Thyroid explorations were made in 57 patients complaining of serious illnesses in order to identify "low T3 syndrome". All these patients were clinically euthyroid as assessed by normal values of T4 concentration, RT3U ratio and FT4I. However, all the patients included in this study had significantly low serum T3 (42 +/- 29 ng/100 ml) and FT3I (0,44 +/- 0,30). Low T3 syndrome was particularly frequently seen in patients with cancer (8/10), hepatic cirrhosis (5/6), renal failure (6/7), old age (5/8) and in serious systemic diseases (6/12). Nevertheless, at adverse with other authors, we have observed less frequently the low T3 syndrome in anorexia nervosa (4/6) as well as during fasting (1/8). In 31 out of 35 patients with low or normal low T3 concentrations, the serum TSH values observed were within the normal limits in 28 cases. The etiologies of isolated decreased T3, mainly the deviation of peripheral conversion of T4 to reverse T3, are discussed. Normal metabolic state and normal TSH concentration encountered in the low T3 syndrome are equally commented.


[The neurophysins (author's transl)].

[The neurophysins (author's transl)]. The neurophysins are the carriers of oxytocin and antidiuretic hormone (ADH) along the hypothalamo-neurohypophyseal tract. They are liberated when the hormones are released; their radioimmunoassay which are methodologically more simple than that of the active nonapeptides can be used in clinical practice. Moreover, the separate assay of each major neurophysins bring a specific index of the release of each hormone. The radioimmunoassay for circulating neurophysins appears to be useful for the differential diagnosis of polyuria, water retention and hypothalamic disease. The neurophysins are however devoided of any antidiuretic or oxytocic properties and their half-lives differ slightly from that of circulating hormones: therefore a basal level or values obtained in the course of an inhibitory test must be cautiously interpreted.


Paired helical filaments in neurovisceral lipidosis (juvenile dystonic lipidosis). Paired helical filaments, the ultrastructural substrate of Alzheimer neurofibrillary change, were found in great number in a 29-year-old patient with neurovisceral lipidosis. The abnormal filaments were frequently present in the distended neurons and axons. The clinical, pathological, and ultrastructural findings were consistent with juvenile dystonic lipidosis, which is considered to be a variant of type C Niemann-Pick disease. The association of Alzheimer neurofibrillary change and central nervous system lipidosis is reviewed.


The long-term prognosis in untreated cerebral aneurysms: II. Late morbidity and mortality. Three hundred sixty-four patients who suffered a subarachnoid hemorrhage from an aneurysm at either the anterior (ACA) or posterior (PCA) communicating artery location and who were not surgically treated have been followed for up to 21 years in order to study the late morbidity and mortality. For patients surviving six months: (1) little improvement in morbidity was noted during the many years of subsequent follow-up; (2) in general, ACA patients fared better than PCA patients; (3) the neurological state on original admission was strongly correlated with the degree of morbidity; (4) other factors measured at time of original hemorrhage which adversely affected morbidity included the level of blood pressure or the presence of clot or spasm; (5) if deaths from late hemorrhage are excluded, cardiovascular causes account for the majority of subsequent deaths; and (6) the risk of dying from all causes is increased when compared to a population matched by age and sex.


Bihemispheric decreases of regional cerebral blood flow in dementia: correlation with age-matched normal controls. Regional cerebral blood flow (rCBF) was measured by the xenon 133 inhalation method in 20 patients with senile and presenile dementia, and values were compared with flow data obtained in a series of 44 age-matched normal controls. The rCBF was reduced in patients with both presenile and senile dementia, and the degree of decrease exceeded the age-related rCBF decline in normal subjects. Similar rCBF reductions were observed in the left and right cerebral hemispheres and in general were homogeneously distributed in the various areas. The rCBF reductions in normal aging and in dementia may be associated with similar underlying cerebral morphological changes. Our findings suggest that the greater rCBF decreases in dementia compared with the values in age-matched controls may quantitatively reflect more severe pathological alterations in the brains of patients with intellectual deterioration.


Lymphocyte activation in penicillin allergy: modification of the response to phytohaemagglutinin by benzylpenicilloylated human albumin. Lymphocytes from twenty-six subjects, allergic or non-allergic to penicillin, were cultured together with phytohaemagglutinin (PHA) and penicillin. The antigen, benzylpenicilloylated human serum albumin (BPO-HSA), induced an enhanced proliferation with PHA in the allergic subjects, but a decreased proliferation with PHA in the non-allergic subjects treated by penicillin (p less than 0.01). The results are interpreted in terms of B- and T-cell regulations in the immune response of man to penicillin.


The role of judges in life/death decisions for the neurologically impaired. The Massachusetts supreme court has recently ruled that decisions about withholding care from hopelessly ill, legally incapacitated patients must be made by judges. It clearly rejected the view that families and attending physicians should be empowered to make such decisions. In this respect, the ruling contrasts with that of the Quinlan case and highlights the issue of whether judges or physicians and families are better able to make medically and morally sound decisions respecting this class of patients.


Modification of murine lupus by sex hormones. The effects of pre- and post-pubertal castration and testosterone administration on the course of murine lupus were studied in NZB/W F1 mice. Castration of males worsened their disease, whereas testosterone treatment of females ameliorated their autoimmune syndrome. Pre-pubertal treatment with testosterone caused a significant reduction in anti-DNA antibodies; in contrast, post-pubertal treatment had no effect, suggesting an age-dependent maturational event which is hormone-dependent. Finally, intact females were found to respond to testosterone treatment with prolonged survival, even when treatment was initiated after the onset of clinical disease.


Muscle carnitine palmityltransferase deficiency: a case with enzyme deficiency in cultured fibroblasts. A further case of carnitine palmityltransferase (CPT) deficiency in a young man is described, the defect being documented by direct enzyme assays of muscle biopsies. The finding of markedly reduced enzyme activity in the patient's cultured fibroblasts supports the concept that CPT deficiency is a systemic rather than an exclusively muscular condition.


Tissue carnitine in Reye syndrome.

Tissue carnitine in Reye syndrome. Skeletal muscle carnitine palmityltransferase and muscle or liver carnitine content were determined in biopsies from children during and after attacks of Reye syndrome. No consistent abnormality of enzyme or cofactor was found. Reye syndrome is biochemically distinct from the clinically similar syndrome of systemic carnitine deficiency.


Venous angioma of the optic chiasm.

Venous angioma of the optic chiasm. A 30-year-old man presented with decreased vision in the right eye of three weeks' duration. Examination indicated a chiasmal syndrome and evidence of subarachnoid hemorrhage. CAT scan showed a large suprasellar mass. Surgical intervention confirmed the presence of a globular lesion filled with blood clots involving mainly the right side of the optic chiasm. Following removal of the clots, the chiasm regained its shape and anatomical landmarks. Biopsy of the mass demonstrated a venous angioma located within the optic chiasm as well as recent and old bleeding. Following surgery the patient did well and recovered vision in the right eye, though a left homonymous hemianopia persisted.


Downbeat nystagmus due to anticonvulsant toxicity. Isolated downbeat nystagmus was observed in 2 patients on multiple anticonvulsant regimens. The nystagmus disappeared when phenytoin dosage was reduced. Electrooculographic analysis revealed impaired downward tracking, supporting the concept of "pursuit" nystagmus.


Destruction of the internal sagittal stratum and normal smooth pursuit. Analysis of smooth pursuit by infrared oculography showed normal horizontal smooth eye movement gain in a patient with a unilateral parietooccipital hematoma that involved the internal sagittal stratum and the adjacent tapetum and visual radiation. Normal pursuit toward the lesion is attributed to commissural transfer of visual information from the normal cerebral hemisphere to the intact extrastriate cortex of the visually deprived hemisphere. This pathophysiological correlation indicates that the occiptiomesencephalic projections of the internal sagittal stratum and the peristriate interhemispheric connections of the tapetum are not necessary for smooth pursuit system function.


Serological studies of a host range mutant of a lactic streptococcal bacteriophage. A host range mutant was isolated from a bacteriophage that attacked Streptococcus cremoris 114. The mutant was able to adsorb and grow on S. cremoris 266, where the parent phage could not. The mutant phage was unable to adsorb to the original bacterial host, S. cremoris 114. The change in host range was accompanied by an alteration in the neutralization antigen as shown by a change in neutralization rate by an anti-phage serum. Serum-blocking experiments confirmed the difference in neutralization antigen between parent and mutant phages. The two phages nevertheless had similar complement fixation antigens, confirming that one was a mutant derived from the other. A distinction between complement fixation and neutralization antigens, similar to that found for the coliphages and staphylococcal phages, has therefore been demonstrated for two lactic streptococcal phages.


Occurrence of nitric and nitrous oxides in a coastal marine sediment. The distribution of denitrification activity in a coastal marine sediment was determined by the acetylene inhibition technique and compared to concentration profiles of NO3-, NO2-, NO, and N2O. The bulk of the denitrification activity was associated with the accumulation of NO3- in the oxidized surface zone of the sediment, but a secondary denitrification zone was occasionally found in the deeper layers where oxidized patches had been introduced by the burrowing activity of the macrofauna. Maxima of NO and N2O were not associated with the peak activity of denitrification in the surface zone but were located at the lower edge of the activity profile. Significant accumulation of NO was found at the redox transition zone towards the deeper, sulfide-rich layers.


Nodule infection by bean yellow mosaic virus in Phaseolus vulgaris. Infection of root nodules of beans, Phaseolus vulgaris L., by bean yellow mosaic virus (BYMV) and the effect of the disease on the specific activity of the nodule are reported. Infectivity and serological microprecipitin assays with two sources of BYMV antiserum demonstrated that nodules from bean plants whose leaves had been inoculated with BYMV contain BYMV antigen. The disease reduced the fresh weights of tops, roots, and root nodules and induced premature nodule decay and/or nodule drop. The disease also reduced leghemoglobin content, on a plant weight basis, and N2 fixation rate, on an individual plant basis, as measured by the acetylene reduction assay. The increased leghemoglobin content per gram-nodule in BYMV-infected nodules relative to healthy nodules might be associated with multiplication of the virus in the nodule and/or unknown cellular effects derived from the BYMV-Rhizobium interaction.


Production of xanthomegnin and viomellein by species of Aspergillus correlated with mycotoxicosis produced in mice. By using thin-layer chromatography and infrared spectroscopy, xanthomegnin and viomellein have been isolated and identified from species of the Aspergillus ochraceus group. A correlation was established between the occurrence of these fungal quinones in the fungal cultural products and the ability of these products to induce mycotoxicosis in mice. In addition, a method was employed to estimate the amount of xanthomegnin and viomellein produced by the fungi.


Distribution of ice nucleation-active bacteria on plants in nature. A replica plating method for rapid quantitation of ice nucleation-active (INA) bacteria was developed. Leaf washings of plant samples from California, Colorado, Florida, Louisiana, and Wisconsin were tested for the presence of INA bacteria. Of the 95 plant species sampled, 74 were found to harbor INA bacteria. Only the conifers were, as a group, unlikely to harbor INA bacteria. All of the INA bacteria isolated resembled either Pseudomonas syringae or Erwinia herbicola. Sufficient numbers of INA bacteria were present on the samples to account for the ice nuclei associated with leaves that are necessary for freezing injury to occur. Numbers of INA bacteria were large enough to suggest that plant surfaces may constitute a significant source of atmospheric ice nuclei.


Microbial succession and mineral leaching in an artificial coal spoil. An artificial pyritic coal spoil was prepared and examined over a period of 1.5 years for changes in the population of various physiological varieties of bacteria and also for mineral leaching. Heterotrophic bacteria were the first to dominate the spoil, acquiring a population of 10(7) cells per g within 2 weeks. Bacteria capable of utilizing choline sulfate as the sole source of energy comprised approximately 1% of the total heterotrophic bacteria. Sulfur-oxidizing autotrophic bacteria (Thiobacillus) and finally iron-oxidizing bacteria (Thiobacillus ferrooxidans) increased in the population, the latter becoming the dominant species where acidity was greatest. Partition of species paralleled partition of acidity in the spoil. Maximum acidity (pH 2.6) and maximum population of T. ferrooxidans (greater than 10(7) cells per g) occurred at the summit. Molds (notably, Aspergillus), algae (Chlorococcales, Oscillatoria, Navicula), cilliated and flagellated protozoa, an arthropod (Podura aquatica), and a moss (aberrant Physcomitrium pyriforme) were observed. The mineral salts leached from the spoil, in decreasing order, were the sulfates of magnesium (predominantly hexahydrite), calcium (gypsum), sodium, aluminum (alunogenite), and iron.


Survey of 1977 crop year preharvest corn for vomitoxin. Fifty-two preharvest corn samples were collected in mid-October 1977 from 26 farms in a four-county area of northwest Ohio. Vomitoxin ranging from 0.5 to 10 microgram/g was found in 24 of the samples. Analysis for vomitoxin was by gas-liquid chromatography. Preceding harvest in northwest Ohio, unusual wet conditions prevailed, making it favorable for Fusarium growth. Gibberella zeae-infected kernels ranged from 2 to 50% of the kernels analyzed for 44 corn samples, and 8 corn samples showed no infection.


Toxicity of zinc to fungi, bacteria, and coliphages: influence of chloride ions. A 10 mM concentration of Zn2+ decreased the survival of Escherichia coli; enhanced the survival of Bacillus cereus; did not significantly affect the survival of Pseudomonas aeruginosa, Norcardia corallina, and T1, T7, P1, and phi80 coliphages; completely inhibited mycelial growth of Rhizoctonia solani; and reduced mycelial growth of Fusarium solani, Cunninghamella echinulata, Aspergillus niger, and Trichoderma viride. The toxicity of zinc to the fungi, bacteria, and coliphages was unaffected, lessened, or increased by the addition of high concentrations of NaCl. The increased toxicity of zinc in the presence of high concentrations of NaCl was not a result of a synergistic interaction between Zn2+ and elevated osmotic pressures but of the formation of complex anionic ZnCl species that exerted greater toxicities than did cationic Zn2+. Conversely, the decrease in zinc toxicity with increasing concentrations of NaCl probably reflected the decrease in the levels of Zn2+ due to the formation of Zn-Cl species, which was less inhibitory to these microbes than was Zn2+. A. niger tolerated higher concentrations of zinc in the presence of NaCl at 37 than at 25 degrees C.


Ochratoxin A as the cause of spontaneous nephropathy in fattening pigs. At a number of slaughters nephropathy and high ochratoxin A contents in kidneys have been observed in fattening pigs from two Swedish farms. In one herd the source of contamination was barley grown on the home farm and stored under such conditions that the growth of fungal species (Penicillium verrucosum var. verrucosum) producing ochratoxin A occurred, with the subsequent formation of the toxin. In this case high ochratoxin A levels in fattening pigs were found during a period of about 18 months. In the second herd, where compounded feed was used, it was impossible to locate the source of contamination. It was presumed that a consignment of feed was damaged by rain during storage at the farm. Ochratoxin A was found in fattening pigs from this herd for a period of about 2 months. Ochratoxin A appeared in the kidneys of all investigated pigs. In some animals the livers, whole blood, and plasma were analyzed, too. The livers contained somewhat lower amounts of ochratoxin A than the kidneys, whereas the content in whole blood and plasma, respectively, was 5 and 13 times greater. Kidneys spontaneously contaminated with ochratoxin A, when stored for 10 months at -70 degrees C, showed no systematic decrease in toxin content.


Isolation and characterization of plasmid DNA in Streptococcus cremoris. Nine industrially important strains of Streptococcus cremoris (HP, AM(2), ML(1), WC, C(3), R(1), E(8), KH, and Wg(2)) were shown to possess a diversity of plasmid molecules. Molecular weights of plasmids were determined from their relative mobilities after agarose gel electrophoresis and via electron microscopy. To illustrate the varied plasmid sizes, strain HP contained plasmids of 26, 18, 8.5, 3.3, and 2 megadaltons (Mdal); strain ML(1) contained plasmids of 29, 18, 9, 4, 2.2, and 1.8 Mdal; and strain AM(2) had plasmids of 42, 27, 16, and 8.4 Mdal. The numbers of plasmids observed in the other strains were 6, 5, 5, 7, 5, and 4 for C(3), E(8), KH, R(1), WC, and Wg(2), respectively. A spontaneous proteinase-negative (Prt(-)) mutant of HP was missing the 8.5-Mdal plasmid, which suggests that in this strain proteinase activity could be linked to this particular plasmid. A lactose-negative (Lac(-)) Prt(-) mutant of ML(1) lacked the 2.2-Mdal plasmid. Under the conditions employed, antibiotic sensitivity and heavy-metal susceptibility did not correlate with the missing plasmid in Prt(-) HP or in the Lac(-) Prt(-) ML(1). Curing experiments with AM(2), using acridine dyes and elevated temperatures, did not yield Lac(-) variants. AM(2) was also cultured at high dilution rates in a chemostat for 168 h by using a buffered milk or lactic broth at 18 or 32 degrees C with no selection of Lac(-) derivatives. The inability to obtain Lac(-) variants under conditions known to facilitate plasmid elimination suggests that lactose metabolism is not plasmid-mediated in AM(2).


New monitoring system for proteolysis in soil as influenced by selected herbicidal applications. Proteolysis in soil (Regina heavy clay) was monitored by the gelatinolytic etching of developed color film emulsion, using a film immersion-slide carrier technique. Etching followed a sigmoid curve to completion. A total of 11 herbicides were tested for their potential influence on this proteolytic function. Eight caused some inhibition, and two were stimulative at 200 microliter of applied herbicide per liter. Eptam was found to stimulate at low concentrations and inhibit at higher concentrations (greater than 1,000 microliter of applied Eptam per liter).


D-Lyxose as a substrate for Streptomyces D-xylose isomerase. Results are presented which show that the D-xylose isomerases present in Streptomyces olivaceus and Streptomyces phaeochromogenes NRRL B-3559 are incapable of utilizing D-lyxose as a substrate. The implications of these findings as related to the use of D-lyxose in the selection of constitutive mutants are discussed.


Isolation of a unique marine bacterium capable of growth on a wide variety of polysaccharides from macroalgae. A unique marine bacterium has been isolated which can be cultured on a variety of polysaccharides and cell wall preparations from red and brown algae.


Successful management of postoperative hemorrhage of the kidney by selective transcatheter embolization. A case is reported where postoperative hemorrhage from the kidney was successfully managed by selective transcatheter embolization of the bleeding vessel. A review of the literature reveals that only three papers have been published dealing with selective embolization for controlling hemorrhage from the kidney. Our case is another illustration of the possibilities and usefulness of this method of treatment in the management of persistent postoperative hemorrhage.


The relationship between carcinoma of the rectum and hemorrhoids. The suspected positive correlation between rectal carcinoma and hemorrhoids was examined in a retrospective study. In patients older than 50 a significant positive correlation could be demonstrated between rectal carcinoma and hemorrhoids. In the group of hemorrhoid patients described it could not be shown that rectal carcinoma was more frequent than in the normal population. In patients older than 40 with hemorrhoids a rectoscopy is always recommended. In this material the colonic enema did not contribute any diagnostic information from which therapeutic consequences could be inferred.