Resection of malignant bone tumors.

Resection of malignant bone tumors. Amputation is an unsatisfactory and depressing measure for the patient as well as for the surgeon. As long as operative removal of tumors in the extermities is indicated, the search for alternative solutions should be the most urgent task for every doctor involved in surgery. Resection would be the most equitable measure as far as demands for radicality and the best possible restoration of function are concerned. In order to warrant the radicality of the operation, meticulous preoperative planning and precise surgical techniques are essential. Sufficient restoration of function must take into consideration all the factors of the individual case, age and profession of the patient playing a large role. After partial resection of longer tubular bones, fitting of an endo-prosthesis has proved to be advantageous. Implants available at present have various drawbacks; studies directed at the elimination of these drawbacks must be set up.


Comparative pathology of bone tumors in animals, with particular emphasis on the dog. A review of bone tumors in animals, based on cases reported in the literature and on personal examination of cases from several universities in the U.S.A. and Europe, has shown that: 1. The following bone tumors occur in decreasing order of frequency in animals: osteosarcoma, chondrosarcoma, osteochondroma, hemangiosarcoma, fibrosarcoma, and liposarcoma; 2. The dog has by far the highest frequency of bone tumors; and osteosarcomas account for approximately 80 percent of bone tumors in dog, followed by chondrosarcomas and hemangiosarcomas; 3. Bone tumors occur less frequently in the cat than in the dog, and are of essentially the same types and incidence as in the dog; 4. Sheep has a unique propensity for chondrosarcoma and primary bone tumors are rare in other species; 5. Giant cell tumors, reticulum cell sarcomas, and Ewing's sarcomas are exceptional findings in animals.


Biochemical markers in cancer of the breast. Currently, one could summarize this area by saying that we appear to be in a situation where three relatively nonspecific tests detect the majority of patients with metastatic disease, as well as those post-operative patients who are at high risk of relapse. The critical test of their utility for segregating those at risk for relapse from those who are not at high risk will need to be done in a highly select subgroup, e.g., N- patients. Two of these tests, CEA and hCG, also appear to be useful indicators for predicting the probability of responding to combination chemotherapy in metastatic disease. The development and further testing of potentially more specific markers to replace or add to the current matrix is now in progress, Casein, which is a product of the milk synthesis pathway of breast tissue, represents a potentially more specific test than any of those studied to date. HENDRICK and FRANCHIMONT, 1974, have found elevated levels in 21 of 26, or 81%, of patients with metastatic disease, and 8 of 11, or 73%, of patients preoperatively. The test may also reflect the tumor burden since the proportion of patients with elevated levels dropped to 41-50% postoperatively. Further results with this marker are awaited with interest. Other tests such as ferritin, hydroxyproline, or the development of tumor antigen associated immunospecific assays could increase both the specificity and sensitivity of the tests utilized in this field of investigation. Injecting the use of both single marker tests and matrix approaches into routine clinical use in the postoperative setting now appears to be ready for more critical testing. Their use in diagnostic or screening settings, which is the ultimate goal, also needs to be evaluated. Finally, from the practising clinician's viewpoint the data in this discussion should be considered preliminary. It constitutes a status report. Although there is evidence that CEA and hCG are prognostic in metastatic disease, and that subclinical disease is detectable, larger and more tightly controlled studies will be necessary before their routine clinical use can be recommended in breast cancer patients.


Ketoprofen - clinical efficacy.

Ketoprofen - clinical efficacy. Ketoprofen has, over the last few years, undergone extensive clinical trials in many centres throughout the world and these are reviewed. Adequately controlled trials have established its undoubted clinical efficacy as an antirheumatic agent in all the major rheumatic diseases, and have demonstrated therapeutic potency, comparable with other established non-steroidal anti-inflammatory analgesic drugs.


Double-blind cross-over study of ketoprofen and phenylbutazone in patients with chronic osteoarthrosis of the hip. A double-blind cross-over study of oral ketoprofen capsules 100 mg/day and phenylbutazone capsules 400 mg/day has been carried out in 44 patients with osteoarthrosis of the hip. All patients received each drug for 4 weeks. Eight patients were withdrawn for various reasons during the trial period, leaving 36 assessable patients (20 males and 16 females), whose ages ranged from 31-88 years (mean 66 years). In this series of patients the results suggest that there is little to choose in efficacy between the two drugs at these dosages. All patients showed improvement after 4 weeks' treatment on either drug and of 12 parameters measured only two showed a statistically significant favour to phenylbutazone (intermalleolar straddle and intercondylar distance; both when pain first appeared). Side-effects were reported equally with both medications, even though of necessity the protocol called for the exclusion of patients with previous intolerance or sensitivity to phenylbutazone. The study was instituted during the early evaluation of ketoprofen when the dosage of 100 mg/day was being tried; it is felt that a more significant result may possibly have emerged if the dosage had been the now recommended one of 150 mg/day.


Ketoprofen in the treatment of rheumatoid arthritis. A double-blind cross-over trial of ketoprofen (200 mg daily) compared with placebo and aspirin (4 g daily) was carried out in 24 patients with rheumatoid arthritis. Ketoprofen was shown to be significantly more effective than placebo in terms of pain relief, degree and duration of morning stiffness, articular index and patients' assessment of improvement. No significant differences were noted between ketoprofen and aspirin, although side-effects were less with ketoprofen.


Double-blind study of ketoprofen and phenylbutazone in ankylosing spondylitis. A series of 26 patients with ankylosing spondylitis have been included in a double-blind cross-over comparison of ketoprofen 200 mg daily and phenylbutazone 300 mg daily, each drug being given for 4 weeks, with paracetamol as a 'rescue drug'. Six patients withdrew from the study: three on phenylbutazone and one on ketoprofen--two defaulted treatment. Twenty patients (17 males and 3 females) were eligible for assessment. Their ages ranged between 20 and 59 years (mean 40.2 years). Patient characteristics were comparable in both groups. The results of this series indicate no suggestion of statistically significant differences in any of the nine movements measured. The only significant differences, both in favour of phenylbutazone, were in the paracetamol consumption in the second treatment period in the group receiving ketoprofen first (0.01 greater than P greater than 0.005) and in the patients' preference for phenylbutazone (0.005 greater than P greater than 0.001). Adverse reactions were comparable in both groups.


Clinical evaluation of keto profen (Orudis) in rheumatoid arthritis: results of a multi-centre double-blind trial against phenylbutazone. In a double-blind cross-over trial in rheumatoid arthritis, no difference was found between ketoprofen and phenylbutazone with regard to clinical efficacy at the dosages used. There was a higher incidence of side-effects reported during treatment with phenylbutazone.


A double-blind trial of ketoprofen in the treatment of osteoarthritis of the hip. In a double-blind study of ketoprofen and placebo in the treatment of osteoarthritis of the hip, ketoprofen was shown to be significantly more effective. Analysis of results was made using the sequential technique. Major intolerance occurred in two cases and minor intolerance in five cases. Newly diagnosed cases were treated more easily with ketoprofen than chronic cases treated for several months with other drugs which had proved ineffective. There were no changes in biological parameters. Age and sex did not affect the result. The further study of ketoprofen in large open trials appears to be indicated.


Clinical evaluation of ketoprofen (Orudis) in rheumatoid arthritis: a double-blind cross-over comparison with indomethacin. In a double-blind cross-over trial, ketoprofen was found to be as effective as indomethacin in the treatment of rheumatoid arthritis. Side-effects, particularly headache and vertigo, were less common in patients receiving ketoprofen.


Double-blind trial of ketoprofen compared with placebo in osteoarthrosis of the hip. In this study, patients suffering from osteoarthrosis of the hip received two successive periods of treatment, A and B, each of two weeks, with either ketoprofen or a placebo. The daily dosage of ketoprofen was 150 mg in three divided doses of 50 mg. In each case the findings necessary for diagnosis and for assessment of progress during the treatment were recorded. At the end of the trial, the patient's preference for one or other of the two periods of treatment was used as the criterion. The results were analysed by the sequential method. The therapeutic effects assessed by the various criteria included in the protocol (patient's subjective assessment, pain at rest, duration of morning stiffness, distance walked without pain, range of movements, etc.) were also recorded. Nine cases were sufficient to provide a statistically significant result in favour of ketoprofen. In eight cases the preference was definitely in favour of ketoprofen. In a single case there was no preference for one or other of the two periods of treatment (failure of both ketoprofen and placebo). Tolerance to ketoprofen was excellent.


Results of the rectal administration of ketoprofen in fifty-two patients. The results of a clinical study of ketoprofen suppositories suggest that the drug is effective when given in this way. It is suggested that, in the treatment of inflammatory rheumatic disorders, advantage should be taken of the longer duration of action of ketoprofen suppositories to prescribe their administration early in the morning and before retiring. Local intolerance occurred in only 4 of 52 patients.


A clinical study of ketoprofen suppositories. Ketoprofen administered via the rectal route seemed to be valuable when given at night to patients with various rheumatic syndromes and may be particularly useful for patients who show gastric intolerance of the capsules. Anal intolerance was noted in 12% of the patients.


Clinical study of ketoprofen administered rectally in rheumatology. The effects of ketoprofen suppositories were studied in an open trial in 50 patients with various rheumatic disorders. A beneficial effect was obtained in many patients and this lasted for about 8 hours after administration. Mild local irritation was the commonest side-effect but seldom led to withdrawal of treatment.


Ketoprofen suppositories in rheumatological practice. Preliminary results are reported on 30 patients treated with suppositories of ketoprofen at a dosage of two daily (200 mg). Local side-effects, rectal burning and difficulty in retaining the suppository, were recorded in seven patients and caused treatment to be stopped from the first day, and in five others local (burning) or systemic (gastric pain) side-effects caused treatment to be abandoned at a later period. Interest in the suppository presentation may lie in its more prolonged action and this presentation, when given at night, may improve the over-all results obtained with ketoprofen capsules in inflammatory rheumatism.


A study of ketoprofen in rheumatoid arthritis. Experience with ketoprofen, using the oral and rectal routes, was reviewed. The value of ketoprofen in rheumatoid arthritis was confirmed and the drug was usually well tolerated.


A controlled trial of ketoprofen (administered rectally) in arthritis of the hip and knee. A double-blind therapeutic trial carried out by the sequential method has demonstrated clearly a significant difference in efficacy between ketoprofen (given rectally at a dosage of 200 mg daily) and a placebo in a group of patients suffering from osteoarthritis of the hip or knee. The interest in this type of study lies in the fact that it will often given the answer to a simple question using a relatively small number of patients.


Clinical trial of the injectable form of ketoprofen. Although the number of synthetic anti-inflammatory agents is ever increasing, it is apparent that most of these drugs have been administered orally or rectally. Because it can be given parenterally, ketoprofen is of additional interest. Furthermore, tolerance of the product by the intramuscular route is adequate even in patients likely to suffer side-effects when the drug is given orally.


Clinically therapeutic study of intramuscular ketoprofen in rheumatic diseases. We have studied the effect of ketoprofen (19583 R.P.) given intramuscularly in some painful rheumatic conditions, notably root pains of disc and spinal origin and inflammatory conditions, and it has proved to be an effective analgesic and anti-inflammatory product, and in our series of 30 patients was very well tolerated.


Comparative study of intravenous ketoprofen versus aspirin. In order to assess the analgesic effect of an injectable preparation of ketoprofen, a double-blind comparative study was conducted against a soluble form of acetylsalicylic acid of known efficacy, widely used in the clinic. Only one indication was considered for inclusion in the trial, namely discogenic sciatica. We found no significant statistical difference between these two products, considering the criteria used. The time of onset of effect was, on average, 30 minutes and the mean duration of activity was 4 hours. The two products were well tolerated.


[Diagnostic and therapeutic problems in dystonia musculorum deformans]. Taking as starging point three patients who unsuccessfully underwent both medical treatment and different neurosurgical interventions, the Authors discuss the problem of the dystonia musculorum deformans nosographic arrangement and its present therapeutical possibilities. They believe that the dystonia musculorum deformans must be considered, rather than as a syndrome, as a real disease, to be distinguished in particular from the various infantile dystonic syndromes and from spasmodic torticollis. In fact in these last morbid forms, at least from a neurosurgical standpoint, the therapeutical possiblities are not so uncertain as those of the dystonia musculorum deformans.


Estimation of lymphocyte subpopulations in the peripheral blood of patients with sarcoidosis. Lymphocyte subpopulations in the peripheral blood of 36 sarcoidosis patients and 36 age- and sex-matched controls were determined, using the sheep erythrocyte rosette (SRBC-R) technique and immunofluorescence staining with whole rabbit anti-human immunoglobulin antisera. In the patient group the total number of lymphocytes, SRBC-R lymphocytes, and IgM-positive lymphocytes was reduced in comparison to in the control group. In the patient group no correlation could be found between any of the lymphocyte subpopulations and disease stage, cutaneous involvement of the disease, or cutaneous reactivity to purified protein derivative and dinitrochlorobenzene.


[Measurement of the heart minute volume by means of the ether dilution method]. Ethyl ether dissolved in saline has been used as an indicator for measuring cardiac output in patients with various congenital and acquired valvular heart diseases without shunts. The solution was infused at a constant rate into the superior vena cava. By means of a simultaneous rebreathing maneuver it was possible to determine the ether concentration of the mixed venous blood and hence the dilution factor. Comparative measurements with the direct Fick method revealed a satisfactory accuracy of the ether dilution method (r = 0.94), which does not require sampling and analysis of mixed venous and arterial blood.


[Study of leukocyte enriched blood smears in suspected bacteremia]. In 132 consecutive patients with suspected bacteremic infectious diseases, Gram staining of the buffy coat of blood taken from the ear lobe was performed simultaneously with blood cultures. Out of 132 patients, 7 exhibited intraleukocytic microorganisms among 22 with concomitant positive hemocultures and 21 with concomitant sterile hemocultures. Among this latter group of patients, 8 were severely ill subjects with indwelling intravenous catheters and undergoing treatment with broad spectum antibiotics, while 4 were found to have intraleukocytic yeast forms. Eight presented with a typical history of pneumonia. It is concluded that Gram staining of the buffy coat of the ear lobe blood is a simple technique which is of value in the management of patients with suspected bacteremia and of febrile patients with indwellig catheters or under antibiotic therapy.


[Renal hypertension].

[Renal hypertension]. In about 15% of cases hypertension is caused by renal diseases, including unilateral and bilateral parenchymatous nephropathies, renal artery stenosis and renin producing tumors. Important pathogenic determinants are the sodium volume status and the renin angiotensin system. The level of the blood pressure may also depend on the duration of hypertension. An increase in peripheral resistance plays a more important role than an increase in cardiac index. Simultaneous determination of the renin activity in both renal veins is of decisive importance in the diagnosis of renal artery stenosis. Drug treatment of renal hypertension is not essentially different from that of essential hypertension. Surgical procedures include revascularization, uninephrectomy and, in uncontrollable hemodialysis patients, binephrectomy.


[Study of the linear variation in certain dental plasters and self-polymerizing resins]. Dental plasters and self-curing acrylic resins are tested. One must pay attention to the setting expansion of plasters and to the setting contraction of acrylic resins which may be very important if these materials are used without care.


[Roengenocinematographic studies on the stability of the total prosthesis during mastication]. Two upper and lower full dentures of the same individual were subjected to stability tests. One of the dentures was done in a conventional way, while the other was mounted, using the author's words: "in a multilocal and autonomous stability". Both dentures were analyzed clinically, on the articulator, radiographically, and roentgencinematographically during mastication. Particularly in the latter examination it could be shown that the multilocally and autonomously stable denture offered more stability during mastication.


[Experimental study of the value of 2 types of class III Kennedy-Applegate dentures]. This experimental research shows that a class III clasp partial dentures should present four Akers clasps. This way the occlusal rests are placed as closely as possible to the edentulous area on both sides of the arch and the abutment teeth are less stressed than if the occlusal rests are further away from saddles. On the other hand, a lingual bar of average rigidity i.e. of a thickness of 1.7-2.0 mm must be recommended. It gives sufficient resistance to the framework while allowing better distribution of force. Finally, oblique forces applied on a tooth borne unilateral prosthesis cause an increase of 65.5 per cent in abutment teeth displacement compared to forces applied to a more favorable bilateral tooth borne prosthesis.


[Experiences with the CM snap attachment]. An experience report is given on 250 CM Snap attachments. The retention of these precision attachments is due to the coil spring and cylinder. This system has proven to be exceedingly lasting. The range of indication is wide because of the many types available. The smaller types may even be used in cuspid teeth, since they are no bigger than the American precision attachments. Under certain circumstances the indication is extended to the free end saddle denture. Small tricks are shown in order to facilitate insertion for the patient. Finally, certain mistakes observed in the mounting procedure are pointed out.


[Hygiene at the treatment area in the dental office]. The state of hygiene in a dental office in the canton of Bern was examined. 22 bacteriological tests were made on the surfaces around the treatment area. Also, the water from the sprays and the most important instruments were tested. Before cleaning and disinfection the test objects showed an average of 110 microorganisms per 100 cm2. The species are enumerated. Particularly infected were polishing brushes, "slurry-water", dentures polished and cleaned with water, also the water from the dental unit. The results show that improvement is badly in need. Also a warning is given for the possible transmission of hepatitis. Female dentists and dental assistants are cautioned to get a german measles vaccination.


[Immunofluorescent demonstration of heart muscle antibodies in sudden deaths]. The method used for the demonstration of antibodies was the indirect immunofluorescent method. In 30% of patients suddenly dying from ischemic heart disease the sera contained antibodies binding on the sarcolemma and the subsarcolemmal layer of muscle fibres. The results of immunofluorescent examinations have been compared with the gross and microscopical findings in the heart.


Ophthalmic striated muscle neoplasms.

Ophthalmic striated muscle neoplasms. Rhabdomyosarcoma, the most common primary malignant childhood orbital tumor, is composed of neoplastic striated muscle cells (rhabdomyoblasts) in various stages of differentiation and in patterns suggestive of neoplastic analogs of normal muscle embryogenesis. Orbital rhabdomyosarcoma is most commonly seen in children and adolescents, the average age of onset of symptoms being 7.8 years. The tumor usually presents as a rapidly evolving exophthalmos, often associated with drooping of the upper eyelid. A mass is palapable in only 25% of cases, loss of central vision at the time of presentation is uncommon, and laboratory studies are often of little help in diagnosis. The best diagnostic aid is a high index of suspicion whenever one sees a rapidly progressive exophthalamos in a child. Orbital rhabdomyosarcoma is almost always of the embryonal type, believed to originate in the orbital soft tissues from undifferentiated pluripotential embryonic mesenchyme. In the past, orbital exenteration has been the primary therapy. Review of 162 literature cases of orbital rhabdomyosarcoma, generally treated by unassisted surgery, revealed that only 25% of the patients survived 3 or more years. Recently, it has been shown that radiation therapy, alone or combined with chemotherapy, can be successful. A multidisciplinary approach, utilizing surgery, radiation therapy and chemotherapy has also been advocated. Both approaches appear to offer greater survival than unassisted orbital exenteration. The possibility of primary radiation therapy is extremely promising; if it becomes increasingly effective, a mutilating surgical procedure may become obsolete.


Jules Gonin. Inventor of the surgical treatment for retinal detachment. Jules Gonin's former student presents a personal and historical biography of the Swiss ophthalmologist, who, between 1902 and 1921, explored and illustrated the many unknown aspects of retinal detachment, defined its pathogenesis, and developed the method of reattachment by ignipuncture and thermocautery.


T and B lymphocytes in sarcoidosis: a clinical correlation. Immunological abnormalities in sarcoidosis have been previously described. Cutaneous anergy to a wide variety of antigens first prompted the suggestion that the underlying defect may be of importance in the aetiology or pathogenesis of the disorder. The thymus derived lymphocytes appear to be particularly affected, and both quantitative and qualitative in vitro defects have been described in these cells in sarcoidosis patients. We have quantitatively investigated T and B cells in a series of 52 sarcoidosis patients, and our results indicate that, as a group, sarcoidosis patients have lower mean total lymphocyte counts and lower T cell counts than the control series in agreement and with other reports. We found no difference between B cells in the sarcoidosis and control groups. The quantitative abnormalities detected did not correlate with any of the clinical parameters which were investigated--stage of disease, duration of the disease, treatment regime, and activity of disease--and there was a considerable overlap between the results obtained in sarcoidosis patients and the controls. Our results indicate that these investigations are of little value in the management of sarcoidosis patients.


Bronchodilator effect of delta1-tetrahydrocannabinol administered by aerosol of asthmatic patients. Ten volunteer inpatient asthmatics in a steady state were given a single inhalation of an aerosol (63 mul) delivered in random order, on each of three consecutive days, in the laboratory of a respiratory unit. Before, and for one hour after treatment the pulse, blood pressure (lying and standing), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak flow rate (PFR), and self-rating mood scales (SRMS) were recorded. Treatments were placebo-ethanol only; delta1-tetrahydrocannabinol (THC) 200 mug in ethanol; or salbutamol 100 mug (Ventolin inhaler), administered double blind. Salbutamol and THC significantly improved ventilatory function. Maximal bronchodilatation was achieved more rapidly with salbutamol, but at 1 hour both drugs were equally effective. No cardiovascular or mood disturbance was detected, and plasma total cannabinoids at 15 minutes were undectable by radioimmunoassay. The mode of action of THC differs from that of sympathomimetic drugs, and it or a derivative may make a suitable adjuvant in the treatment of selected asthmatics.


Repair of traumatic aortic arch to innominate vein fistula under deep hypothermia and circulatory arrest. Penetrating injuries of the thoracic aorta are usually rapidly lethal. Few patients survive for long enough to undergo surgical treatment. When penetrating injuries of the thoracic aorta are complicated by arteriovenous fistula a correct preoperative diagnosis is important for adequate planning of the surgical repair, and so selective angiography is essential. The best approach is through a median sternotomy with the use of total cardiopulmonary bypass with or without deep hypothermia and circulatory arrest. Fistulae between aorta and innominate vein invariably lead to congestive cardiac failure. A review of the literature suggests that signs of cardiac failure rarely appear early. Congestive failure developed within 30 days of the initial trauma in only two of the 12 reported cases. In our case, the early onset of cardac failure refractory to therapy and the appearance of an expanding pulsatile mass at the base of the neck, threatening rupture, necessitated emergency surgical treatment.


[Evaluation of orthodontic cases by means of key-punch cards. 3. Data from follow-up examinations]. 484 orthodontic patients were subjected to follow-up examination. The kind of treatment, the evaluation and the factors that are of importance to continuing successes and recurrences, respectively, are described. It is pointed out that the present communication and the two previous ones aim at illustrating that the orthodontic practitioner is able to document and evaluate his cases easily with the aid of key-word cards.


[Studies on a disinfection method for dental hand and angle pieces and turbine angle pieces, using paraformaldehyde tablets]. For practical and rational consideration, the authors closely investigated a disinfecting method for dental straight and right-angle handpieces and for turbine handpieces, using paraformaldehyde, and demonstrated its efficiency under certain conditions.


[Anxiety and stress in dental practice. 3. Results of studies in adults]. By means of clinical appreciation and determination of the adrenocortical function, the stressor effects of various dental procedures were evaluated in 110 patients aged from 18 to 77 years. The stress of stomatological treatment (extraction, filling therapy, prosthodontic procedures) may vary with age, the patient's psychic condition being of particular importance. Apart from premedication, psychic conditioning seems to be beneficial in case of tooth extraction.


Reconstruction of the eyelids with cartilage and mucosa from the nasal septum. Four examples are shown of lid reconstruction using grafts from the septum mucosa and pedicle flaps. These examples provide adequate data for the use of this technique in almost any major lid reconstruction procedure. The fifth case illustrates the exception; a wide pedicle is rotated in from the temporal region to construct the lower lid and the lower lid is transferred to act as the upper lid. The posterior surface of the buccal mucosa is adequate for this last procedure.


Total lid reconstruction. A simple method for the general ophthalmic surgeon. A simple method of total or subtotal lid reconstruction is presented, which is particularly suitable for use by the ophthalmic surgeon not specializing in plastic surgery, and for use in elderly patients. The principle of the technique is discussed, and the importance of adhering to well-defined indications is stressed.


Response of proliferative diabetic retinopathy to xenon-arc photocoagulation. A multicentre randomized controlled trial. Second interim report. Patients with proliferative diabetic retinopathy had one eye chosen by a randomization procedure to have treatment by xenon-arc photocoagulation. 100 patients were followed for at least 1 year, 58 patients for 2 years, and 23 for 3 years. The patients form roughly two equal subgroups: those with new vessels on both optic discs and those without new vessels on either disc. There was a significant difference between the visual acuity of the treated and the untreated eyes in the former group, i.e. with disc new vessels, after 1, 2, and 3 years, but there was no difference in the latter group. Eleven patients were blind in one or both eyes for two consecutive yearly assessments. No treated eye became blind without concomitant blindness in the fellow eye but eight untreated eyes did so. This difference was statistically significant.


[Intracellular membrane structures of Bdellovibrio bacteriovorus during development in the bacterial host cell]. Electron microscope investigation of intracellular membrane structures of Bd. bacteriovorous during its intracellular growth and development has been carried out. Increased amount of membrane structures has been stated. Along with simply organized invaginations of plasmalemma, complicated membrane structures resembling mesosomes of grampositive bacteria are observed. Localization of these structures testifies to their involvement in the synthesis of exotoxins and exoenzymes.


A study of two twice-weekly and once-weekly continuation regimen of tuberculosis chemotherapy, including a comparison of two durations of treatment. 1. First report: the results at 18 months. The controlled clinical trial reported here was undertaken in Central Bohemia, West Slovakia and Prague. Patients in whom pulmonary tuberculosis had been newly diagnosed and confirmed bacteriologically were given standard triple chemotherapy with streptomycin, PAS and isoniazid for 6 weeks or 3 months. Continuation chemotherapy was streptomycin and isoniazid given either twice weekly or once weekly, to make a total duration of treatment of 12 or 18 months. Overall there were no significant differences in the bacteriological response at 18 months, 98 per cent of the 13 week S2H2, 99 per cent of the 6 week S2H2 and 94 per cent of the 13 week S1H1 patients having a favourable response. However, the S1H1 regimen was at a disadvantage for rapid acetylators of isoniazid but not for slow acetylators, 16 per cent of 37 rapid acetylators having an unfavourable response compared with none of 62 slow acetylators. Comparing the 12- and 18-month duration, there was no evidence in the twice- weekly regimens that 18 months of chemotherapy offered any therapeutic advantage. However, there was a suggestion that there might be some benefit in continuing to 18 months with the once-weekly regimen.


[Isolation and characteristics of fragments from the cyanogen bromide splitting of inclusion body proteins of Bombyx mori nuclear polyhedrosis virus]. The cyanogen bromide cleavage of "acetic" polyhedral protein from nuclear polyhedrosis virus of B. mori was performed. Two peptides BrCN-II and BrCN-II' which consist of 29 and 34 amino acid residue were isolated from a mixture of cyanogen bromide fragments. The amino acid composition and N-terminal amino acids were established. The tryptic proteolysis of these fragments was conducted and the tryptic peptides were separated. The amino acid composition of tryptic peptides was determined. The data obtained make it possible to consider these fragments to be internal areas of polypeptide chain of the protein under investigation.


Pindolol once daily in the treatment of hypertension. The beta-adrenergic blocking drug pindolol has been used in the treatment of hypertension, using one single dose per day, given in the morning. 16 patients with mild to moderate hypertension were treated with doses which were increased if necessary up to 20 mg, and 14 patients achieved an adequate level of blood-pressure control. The trial was carried out as a single-blind cross-over study. The study shows that pindolol, a non-selective beta-blocker of high potency, may be given once daily as a hypotensive, offering advantages both for patients and physicians. Side-effects were infrequent.


The effect of E. coli and E. coli endotoxin on peristalsis in canine ureter. The association of ureteric dilatation and urinary infection has been attributed to a direct toxic effect of E. Coli endotoxin on ureteric muscle. A specific causal relationship could not be established in this study in dogs.


The incidence of deep vein thrombosis in prostatectomised patients following the administration of the fibrinolytic inhibitor, aminocaproic acid (EACA). Forty patients undergoing prostatectomy for benign prostatic hypertrophy were included in a double blind trial of epsilon aminocaproic acid, and the incidence of postoperative deep vein thrombosis determined, using 125I-fibrinogen technique. There was no significant difference between the groups, the overall incidence of abnormal scans being 50 per cent, but of the patients undergoing enucleative prostatectomy 68 per cent developed significant scan findings compared with 33 per cent following transurethral surgery.


[Treatment of varicose veins of the lower extremities with vistarin and varicocide under ambulatory conditions]. Injection-sclerosing treatment of primary varicosity of superficial veins of the lower extremities was employed in 250 patients, 200 of them being treated with vistrin and 50-with varicocide injections. The treatment was conducted under outpatient conditions. Vistarin was found to show a greater therapeutic efficacy as compared with varicocide. Late results were studied in 152 patients treated with vistarin injections and in 150 of them a good functional and cosmetic effect was gained.


[Solution for liver preservation].

[Solution for liver preservation]. The author suggested a solution for preservation of the liver. The specific feature of the solution is that it contains special substances of carbohydrate and protein nature which, requiring no complicated metabolic transformations, can easily be involved in the liver metabolism during the period of its preservation. Observations have demonstrated that the preserving substance suggested by the author is much better than analogous solutions employed in control experiments.


[Postoperative anesthesia by the extrapulmonary administration of cycloporpane]. According to the author's data postoperatively in patients receiving cyclopropane a much more early restoration of the renal excretory function was noted, postoperative intestinal paresis is liquidated more rapidly, the number of complications on the part of the respiratory and cardiovascular systems is diminished up to a minimum. There was less degree of postoperative metabolic alkalosis under the influence of cyclopropane, and it was also more rapidly eliminated.


[Diagnosis and treatment of chondromyxoid fibroma of bones]. Under observation were 23 patients, aged from 9 to 57 years, with chondromyxoid fibroma of bones. All patients were treated surgically. In 5 cases the involved bone was resected, in 6--edge resection with homoplasty and in 7--segmental resection with automoplasty were employed, in 4--amputation, in 1--exarticulation in the coxa. 20 patients are being kept under observation for 1-7 years without any recurrence and metastases, one patients is still being treated. Two patients died as a result of lung metastases.


[Method of making a pattern of the surgical wound]. The method of making a pattern of the skin wound defects by means of polyvinylchloride film with a glue layers is described. This method allows one to make rapidly and with the utmost precision the replica of a wound defect of complex configuration located in multiprofile anatomical regions.


[Dynamics of agglutination in birds artificially infected with Salmonella gallinarum-pullorum and Salmonella typhimurium and treated with sulfaguanidine and furazolidone]. Canadian Leghorn chickens were used to study the effect of sulfaguanidine and furazolidon on the dynamics of blood agglutinin formation. The birds were artificially infected with Salmonella gallinarum-pullorum and Salmonella typhimurium. At various intervals following infection they were treated with sulfaguanidine 1% tablets and 0.04% furazolidon. The level of agglutinins was determined by the methods of Huddleson (whole blood agglutination reaction), the fast serum agglutination, the method after Wright, and the indirect hemagglutination reaction. It was found that the agglutinin level in birds treated in the course of ten days with the chemotherapeutics mentioned prior to their infection did not change. The use of these chemotherapeutics parallel to the infection of the test birds and ten days later inhibited agglutinin formation. This was more pronouncedly expressed in birds treated with furazolidon. The delayed use of these therapeutic means did not inhibit substantially the level of blood agglutinins.


[Sanitization of salmonella-contaminated forage mixtures during granulation]. Studied were a total of 52 samples of forage mixtures prior to and after pelleting from three forage plants in this country, in terms of total bacterial count and the relative share of coli bacteria and Salmonellae. Two experiments were layed out under productional conditions for peletting a forage mixture at 92-94 degrees C being contaminated with Salmonella bacteria at the rate of 10(3) and 10(2) per gram of mixture. Results showed that pelleting processes reduce both the total bacterial count and the coli and Salmonella counts, the microbial cells being in an anabiotic status. It is suggested to adopt forage pelleting as a method to render harmless Salmonella-contaminated forages provided the count of Salmonella organisms does not exceed 10(2) per gram of forage. Pelleting should be carried out at 92-94 degrees C. This is to be routinely practised until the problem of forage decontamination is solved by other means.


[Immunofluorescent test in the diagnosis of babesiasis]. The direct and the indirect immunofluorescence methods were tested in the diagnosis of babesiasis in sheep. The antigen used was material of erythrocyte smears with Babesia ovis, and the conjugate employed in the direct method was obtained from a hyperimmune anti-Babesia ovis serum labelled with fluorescein-isothiocyanate. For the indirect methods rabbit anti-sheep globulin was made of, labelled with the same fluorochrome. The specificity of the direct methods was demonstrated by the absence of fluorescence in the control smears with Th. ovis, A. ovis and E. ovis at a 1:20 dilution of the conjugate (and even in higher dilutions), while that of the indirect methods--by the absence of fluorescence with the control negative serum and the heterologous antisera at the same values of dilution. The comparative testing of the indirect immunofluorescence methods and the complement-fixation reaction in the periodic investigation of 10 lambs (experimentally infected) and 10 sheep (naturally infected) with Babesia ovis revealed that the indirect methods were of higher infected) with Babesia ovis revealed that the indirect methods were of higher sensitivity. This, and the easier production of the antigen gave grounds to assume that indirect methods are more readily applicable in the laboratory diagnostic practice. On the other hand, direct methods are more accurate in the species differentiation of the Babesia agents.


[Development of the ideas of N.N. Petrov concerning the prevention of cancer in experimental studies devoted to transplacental carcinogenesis]. The principal N.N. Petrov's idea in oncology consists in the possibility of scientific organization of anticancer struggle, based in particular, on the development of the sanitary-hygienic aspects of tumor prophylaxis. N.N. Petrov's remarks on necessity of pregnancy hygiene, made by him 50 years ago, are confirmed now in experiments and sometimes in human research. The basal regulations of transplacental carcinogenesis -- one of the modern trends in experimental oncology -- are stated. Some considerations on possible applications of the results of animal experiments of human cancer prophylaxis are expressed.


[Deontologic problems in the medical treatment of tumors]. An attempt is made to discuss deontological problems, related with pharmacological treatment of malignant tumors, according to the traditions of N.N. Petrov, who always paid great attention to the problems of morality and ethics in oncology. The stages of experimental tests of new substances and recommendations for their clinical application are described. Nonscientific approach to the estimation and practical use of new substances is critisized. It is concluded that the problems of selection of the optimum method of treatment for each particular case should be considered by three specialists together: a surgeon, a radiologist and a therapeutist.


[Stereotaxic surgery in the hyperkinetic form of infantile cerebral palsy]. The results of 67 stereotaxic operations performed in 60 patients for the hyperkinetic form of infantile cerebral paralysis are presented. The efficacy of dentatotomy is compared with that of thalamotomy. Thalamotomy is most effective in patients with hemiatetosis and choreoatetoid hyperkinesis. Dentatotomy resulted not only in a reduction of hyperkinesis, but also in a considerable alleviation of muscle spasticity. The destruction of the lateral part of nuclels dentatus caused predominantly a reduction of the muscle tone and of involuntary movements of the lower extremities, and--to a lesser degree--of the upper as well. The destruction of the medial part of the nucleus dentatus resulted in a clear reduction of muscle dystony in the trunk.


[Some modern views of the role of the eosinophils in allergic reactions and bronchial asthma and a new method of detecting eosinophils in the bronchial secretion]. A review of certain contemporary opinions of eosinophil function in allergic reactions and bronchial asthma is presented in this report. Phagocytosis and processing of the complexes antigenantibody, histamine inhibition and a histamine elimination elimination by a specific inhibitor, isolated from eosinophilis (EDI), stimulation of prostaglandines E release, which also inhibit histamine and have a bronchial dilataion effect. The new method is recommended for eosinophil detection in sputa based on the fluorescent principle as faster and more efficient.


[Functional state of the kidneys during determination of the work capacity of patients with renal diseases]. The problems of work expert examination of patients with kidney diseases are discussed. It was stressed that besides the kidney functional state the state of certain basic clinical indecision had also to be given consideration, as blood pressure values, cardiovascular system state, presence of difficult-to-be-corrected anemia as well as certain social factors. Attention is drawn to the necessity of accurate determination of the disturbed renal function with the aid of the contempprary investigation methods. The problem of the capacity for work of the patients with hemodialysis and with renal transplantation is discussed in details. Stress is laid upon the fact that the sick must be given suitable work in favourable conditions as a factor maintaining the optimism and the sense of fitness in the patients, which enhances the effectiveness of the treatment applied.


[Augmented indication field for Convulex therapy (author's transl)]. The therapeutic effect of n-dipropylacetate (DPA) is described in 20 patients with cerebral or spinal spasticity. Improvement was ween in 8 out of 11 patients with cerebral spasticity, 3 out of 5 patients with spinal spasticity and 3 out of 4 cases who had sustained perinatal damage. Satisfactory clinical amelioration and improvement in the EEG was observed in myoclonia, particularly of the Unverricht-Lundborg type.


[Mucous membrane of the mouth and prostheses in old people (author's transl)]. The majority of people of advanced age at present have either very many gaps in their dentures or they have no teeth at all. For this reason they can only wear broad-base plate-type bridged, which can lead to pathological changes of the mucous membrane. The author uses the complex etiology of prothetic stomatopathy, in which not only changes in the mucous membrane of the mouth associated with ageing but also hormonal changes (menopause), general diseases and oral candidiasis play a role, to illustrated the necessity of collaboration between stomatologists and geriatricians. Oral and prosthetic hygiene degenerates with increasing age. The average period of wearing prostheses also increases with the age and the danger of chronic mucous membrane damage also increases. But since old people seldom if ever consult a stomatologist, every geriatrician should also have a look at the mucous membrane of the mouth when examining old patients.


Biological studies on a strain of Escherichia coli B resistant to chlorpromazine. A strain of Escherichia coli B resistant to chlorpromazine was developed from the sensitive strain. Cells of the resistant strain were different from those of the sensitive strain. Thus, the permeability of the resistant cells (measured by the uptake of 14C-glutamic acid) was not interfered with by Cpz. Moreover, the resistant cells were able to cause detoxification or partial detoxification of the drug.


[General symptoms in severe burn injuries (author's transl)]. In this review the pathophysiological mechanisms of general clinical symptoms during the treatment of severe burn injuries (hypovolemia, katabolism, anemia, coagulation disorders, hyperbilirubinemia, hypoxia, cardiac insufficiency and bone disorders) are analysed with special reference to specific therapeutical measures.


[Use of "non-standard" young rabbits of the chinchilla breed for determination of the stereotaxic coordinates of brain structures]. It has been found that differences in the distances from the brain structures to orienting points on the scull of non-standard rabbits considerably exceed those in the distances between the brain structures of the same animals. In non-standard rabbits of one and the same age, the quantitative differences of the rostral or caudal location of all brain structures in relation to the bone orienting points are more significant than those in the lengths of the brain. Intravital determination of a point on the surface of the scull with horizontal coordinates of the anterior commissure is suggested for selection of young rabbits with a normal location of brain structures in regard to the zero point (bregma ) as well as for introduction of corrections in the location of the zero points. It is also suggested that this point be used directly as the zero point of reading the coordinates instead of the bregma.


[Intensive care of burns (author's transl)]. The method of long time intraaortal infusions will diminish the risk of complications following early excision of burn slough. It favours quick re-epithelisation. The method enables homeostasis of burnt patients to be normalized within a short time and wide wound surface to be covered with mesh-grafts, thus lowering the shock risk and the danger of secondary wound necrosis.


[Influence of psychological factors on the immune system. Changes in susceptibility to infection after infantile stimulation in relationship to age]. NMRI mice of both sexes and in various stages of the suckling period were handled oncea day for three minutes. They were intraperitoneally infected with E. coli O 111 on the eighteenth day of life. Handling carried out from the first to the 18th day led to a significantly higher mortality (P = 1,4%) as compared to the control animals. Differences in mortality were not observed when the stimulation occurred on the 1st to 10th or 10th to 18th day of life. Weight determination carried out just prior to infection showed no remarkable differences between the experimental groups.


[Frequency, therapy and survival time of reticulum cellsarcoma in the German Democratic Republic. An epidemiological study of 7467 cases from 1960 to 1973 (author's transl)]. 7467 Reticulum cell sarcomas have been recorded in the register of patients suffering form carcinoma (1960 to 1973). This report deals with the distribution of age, sex, size and frequency during the different years and in different districts. Moreover, problems of confirming the diagnoses and of histological findings are considered. The chances of survival of patients suffering from reticulum cell sarcoma (about 16,0% survive the five-year limit, 10,3% survive the ten-year-limit) are examined for the therapy, age and size of the tumour also being taken into account.


[Hazards in the operative treatment of Ductus Botallo (author's transl)]. Possible errors and risks in operations of the ductus Botallo are discussed by using the experience from 282 operations. In young patients and adults the operative closure has to be decided upon according to the degree of the pulmonary vascular resistance. In newborns the closure of the ductus should be performed when symptoms such as heart insufficiency, frequent pneumonias and cyanosis are present. Haemorrhage due to damage of the walls is most frequent intraoperative complication. The procedure of controlling is dealt with more in detail. At least possibilities to treat the so called recanalisation or pseudorecidive are discussed. No patient was lost by intraoperative complications. The total mortality amounted to 1.4 per cent.


[Automation in the cytodiagnostic central laboratory (to meet the high requirements of obligatory gynecologic cytodiagnosis)]. Automation in preparating slides will be necessary to satisfy cytology in mass screening programmes for early detection of cancer of the cervix. This means increase in capacity of a cytological central laboratory. -- Possibilities of automation in fixation, stainings, and findings are described.


[Robert Koch's unpublished and unfinished experiments on sheep-pox (author's transl)]. The archives of the Robert Koch Institute include a casket with preparations and handwritten notes by Robert Koch (Fig. 1). He made these preparations during his time as a rural doctor between October of 1878 and September of 1880. They refer to an outbreak of sheep-pox at Rackwitz, a place near his practice at Wollstein (Fig. 2). This work has not been published; we know of it from one of Robert Koch's private letters (11). To reconstruct his working scheme and reasoning, we consulted particularly his reports on rinderpest experiments which he began in 1896 (6). The preparations from this casket which had been stained with Bismarck brown (according to Weigert) date back to a period when Robert Koch developed the foundations of bacteriology and they are evidence of his preparedness to accept new operational procedures (1, 2, 3). Thus, we have to assume that these preparations were to serve as evidence of a bacteriological etiology of sheep-pox. A wrong conclusion as to associations between the superinfection present and etiology of the disease (7) was ruled out by maintaining his own postulate. Simultaneously with this preparation work, Robert Koch performed animal experiments (11). His experience from these studies was utilized later on in his rinderpest experiments (6). On account of his confrontation with viral disease - which had its starting point in his unpublished work on sheep-pox - Robert Koch stated his postulate to be valid in the same manner as if bacteriological etiology had been demonstrated (4,6). The importance of these preparations is also seen in the interpretation of viral tissue damage, i.e. increase of macrophages and plasma cells with subsequent necrosis (9) characteristic of vira infection (Figs. 3, 4).


Nosocomial infection of nurselings caused by multiple drug resistant strain of Salmonella typhimurium--utilization of a new typing method based on lysogeny of strains. During a period of 18 months diarrheal diseases appeared among nurselings in one region of Slovakia. Salmonella typhimurium strains were isolated from 265 cases. The diseased nurselings were kept in a nurseling-home and/or were hospitalized in two city hospitals. The isolated Salmonella typhimurium strains were resistant to ampicillin, carbenicillin, tetracyclin, chloramphenicol, neomycin, kanamycin and sulphonamides, and, carried R-plasmids. The tested strains proved identical by phage typing according to the systems of Felix-Callow and Scholtens. The were lysogenic and reacted in an identical way with indicator strains. The results of tests indicate that the nosocomial infection of nurselings was caused by long-term persistance and spread of a single polyresistant strain of Salmonella typhimurium.


Growth of Cryptococcus neoformans on uric acid agar. Effect of certain low molecular nitrogen substances, namely uric acid, eura and creatinine as sole source of nitrogen was studied on 31 strains of Cryptococcus neoformans as well as on a rough looking isolate recovered from the brain of a mouse inoculated with a mucoid strain of C. neoformans. Uric acid as a nitrogen source caused striking alterations in the morphology of C. neoformans. In view of the facts that uric acid is a common end-product of human and animal metabolism, it is abundantly present in the avian faecal matter and is capable of inducing mucoid growth and capsule formation in dry growing non-encapsulated strains or in an otherwise rough looking hypha forming isolate, its role in studying the phylogenesis of C. neoformans and its pathogenicity seems to be an important proposition.


Butandioldehydrogenase in Eikenella corrodens and related bacteria. The butandioldehydrogenase was examined in 153 strains of Eikenella, Moraxella, Acinetobacter, Agrobacterium, Haemophilus, Actinobacillus, Pasteurella, Cardiobacterium and "TM-1" of Hollis et al. This enzyme has been proved to be useful in the differentiation of this group of bacteria.


Serotypes of Escherichia coli from urinary tract infections in Hong Kong. Strains of E. coli, mainly from Chinese patients in Hong Kong with urinary tract infections, were serotyped, biotyped, and their antibiotic resistance patterns determined. The most common O groups found were O1, O2, O4, O6, O7, O8, O21, O25 AND O82. In general, they carried flagellar antigens different from those normally associated with these O groups in Europe. A variety of biotypes was observed and many strains were resistant to a number of antimicrobial drugs.


[Simple method for preservation of bacteria in small portions (author's transl)]. A method of maintaining micro-organisms in small portions is described. The microbial suspensions to be preserved are transferred into small PVC tubes, which are then heat-sealed in small segments. Care must be taken to ensure that the segments are not overfull, otherwise the seams may burst upon freezing. The segments are then transferred strainwise to small propylene test tubes for deep-frozen storage in an electric freezer at -90 degrees C or in liquid nitrogen at -195 degrees C. The viability of the micro-organisms thus treated is fully comparable with that obtained by other methods of deep-freezing. A brief account is given of how the micro-organisms can be recultured from these segments. The above method is particularly suitable when periodical subcultures of a large number of strains have to be prepared over a fairly long period of time. The suppliers of the materials used are indicated.


[Biological characteristics of enteropathogenic escherichia of serologic group 015:K]. A study was made of 239 strains of enteropathogenic escherichia 0151:K-- isolated in various regions of the USSR from patients with the clinical diagnosis of dysentery, gastroenteritis, intestinal coli-infection: a standard strain of the international collection of escherichia belonging to the given serological group was also studied. There was shown an increase in the role of these microorganisms among the enteropathogenic escherichia recorded at the territory of the USSR; they occupied the third place by the frequency of isolation after the serological group 0124:K72 and 0111:K58. There was established a common nature of the enzymatic characteristics of escherichia 0151:K--with shigellae by the absence of lactose, sucrose, inosite, adonite fermentation, the presence of gasless, immobile variants containing no lysin decarboxylase, and a possibility of rapid differentiation from shigellae in the use of acetate medium. Among the escherichia 0151:K--there was revealed the presence of 5 biotypes by the capacity to gas-formation in glucose, arabinose, sorbit, dulcit fermentation, and decarboxylation of lysin and ornithin; three biotypes are described for the first time. Industrial issue of the agglutinating serum 0151:K--is necessary to provide the diagnosis of these microorganisms at the territory of the USSR.


[Characteristics of the basic parameters of killed influenza vaccine purified and concentrated on sodium borsilicate glass]. The main parameters (reactogenicity, harmlessness, immunogenicity and prophylactic efficacy) of experimental batches of the inactivated influenza vaccine A, purified and concentrated on sodium-boron-silicate glass, were studied in strictly controlled epidemiological trial. In single subcutaneous injection in a dose of 0.5 ml (5120 hemagglutinating units) of the vaccine it was characterized by a moderate reactogenicity, marked antigenicity and prophylactic, efficacy.


[Experimental study of the stability of avirulent properties and the immunogenicity of suppressor revertants of streptomycin-dependent salmonella mutants]. The authors aimed at the experimental confirmation of avirulent properties of suppressor revertants of streptomycin-dependent salmonella mutants and also at the study of their immunogenicity. Stability of the loss of virulence by the suppressor revertants was established by studying the virulence of the subcultures isolated from them, differing by the genotype. Repeated passage of suppressor revertants of S. typhimurium Rev8, S. enteritidis Rev5, S. pullorum Rev through the biological objects highly sensitive to salmonella infection failed to lead to elevation of the virulence of the cultures under study. Live salmonella vaccines prepared from the suppressor revertants proved to be highly immunogenic in single oral and parenteral immunization of albino mice and chicks. Analogous immunization with killed vaccines was much less effective, streptomycin-dependent vaccines occupying the intermediate position.


[Indication of halprowia (chlamydia) antigens by the direct immunoperoxidase method]. The authors modified and approbated the direct immunoperoxidase method for the indication in the infected L cells of the halprowia (chlamydia) antigens--etiological agents of trachoma, ocular and urogenital forms of paratrachoma, arthritis, meningopneumonia and enzootic abortion of sheep. Different types of localization of the group-specific halprowia antigen were revealed in the cytoplasm of the affected cells by light microscopy; electron microscopy demonstrated localization of this antigen in the membrane of the cell wall of the elementary and initial bodies. Specificity of the test-system used, no lesser sensitivity than the sensitivity of direct immunofluorescent method of indication of the same microbies, with a possibility of detection of stably stained antigens by widely accessible light microscopy underly practical usefulness of direct immunoperoxidase method of the diagnosis of halprowiosis (chlamydiosis) of man and animals.


[Theory of generator mechanisms in several neuropathologic syndrome]. This report formulates a general concept of the role played by determinant structures in CNS functioning and a related theory of generator mechanism which underlines neuropathological syndromes characterized by hyperactivity of cerebral centers. The theory postulates that due to deficiency of inhibitory mechanisms some populations of neurones become generators of abnormally enhanced excitation. Such generators operate as hyperactive determinant structures (or hyperactive determinant dispatch stations, DDS) inducing pathological changes in various functional systems and determining their behaviour. Formation of hyperactive DDS generating excitation in certain parts of the CNS leads to the appearance of corresponding neuropathological syndromes. This theory was used as a basis for experiments which reproduced pain syndromes of a central origin (including the trigeminal syndrome, the thalamic syndrome and phantom pains) vestibulopathy, photogenous epilepsy, catalepsy, manifestations of parkinsonism, etc. The report describes the characteristics of the generators of abnormally enhanced excitation. Some features of their operation are correlated with the course of the syndromes. Certain problems of pathogenetically oriented therapy are also discussed.


[Use of focused ultrasound for local destruction of different brain structures]. It was demonstrated that destruction of the brain can be accomplished by different combinations of ultrasound intensity and duration of irradiation. By experimental means cavitational thresholds of brain tissues were determined and a calculation was made of increased temperature in the zone of focus in each separate regime of irradiation. The authors describe the foci of lesions where the main mechanism of destruction was only warmth, either only cavitation, either warmth and cavitation together. Irradiation of deep brain structures was not accompanied by changes of the cortical and subcortical structures, located above the focus of necrosis along the path of the ultrasound ray (light microscopy). The probability of a target hit into the given brain structure corresponded to the preciseness allowed in a stereotaxic operation.


[Theory of image discernment and resolution of classification problems using medico-psychological methods]. The report deals with questions pertaining to the use of the theory of image discernment for solving psychodiagnostical problems in clinical practice. The traditional understanding of a psychological test as a measurement instrument is being opposed to its new interpretation as an instrument of classification. On this basis the authors described the successional stages of the general procedure in the elaboration of tests. Special attention is being drawn to the selection of primary signs with the aid of informational measures and the formation of scales as discriminators. The suggested approach is being illustrated on the model of elaborating scales of a personality questionnaire and intellectual techniques.


Proteins of yeast ribosomal subunits: number and general properties. 1. Saccharomyces cerevisiae at the early stationary phase of growth accumulate 80 S ribosomes, easily dissociating into subunits, which retain full activity in phenylalanine polymerization in vitro. A simplified and efficient technique for large-scale preparation of yeast ribosomal subunits is proposed. 2. Presence of 34 proteins in 40 S subunit and 42 proteins in 60 S subunit was demonstrated by two-dimensional acrylamide-gel electrophoresis. Both ribosomal subunits contain acidic proteins: three in 60 S and six or seven in 40 S subunit. It seems that two of them correspond to prokaryotic proteins, L7 and L12. The total number of yeast ribosomal proteins is similar to those obtained for other Eukaryota.


[The case for more active prevention of deep-vein thrombosis after major surgery (author's transl)]. The frequency of deep-vein thrombosis (DVT) determined by the 125I-fibrinogen test and confirmed by phlebographic studies, is 20 to 30 % in high-risk patients over the age of forty undergoing major surgery. Comparison of this figure with the incidence of clinically detected thrombosis (5 to 10 %) shows that physical signs are unreliable in the detection of this disease. The ultimate fate of these thrombi is unknown. The majority will probably disappear spontaneously; some will be responsible for the development of a "post-phlebitic syndrome" in the extremities and some will propagate and may produce a fatal pulmonary embolus. Besides the currently used physical methods of prophylaxis, some new pharmalogical techniques for the prevention of postoperative deep-vein thrombosis have been tested and advocated in neighbouring countries. Oral anticoagulants have been used routinely for many years by most Dutch surgeons but have never become very popular in other countries. They need extensive laboratory control and, in spite of this, up to 20 % overdosage bleedings have been recorded. As both the administration of low-dose subcutaneous heparin and IV dextran have been reported to provide effective prophylaxis against deep venous thrombosis, we decided to study and compare their efficacy in a randomized clinical trial in order to assess their practical value in daily surgical practice. 119 adult patients undergoing abdominal surgery have been investigated. They have been devided at random in three groups : a dextran 40 group (n=39), a heparin group (n=39) and a control group (n=41 patients). DVT was diagnosed by the fibrinogen uptake test in 21,9 % patients in the control group in 12,8 % patients in the dextran group, and in 10,2 % patients in the heparin group. For the highrisk patients over the age of 70, the administration of low dose SC heparin, as well as the administration of IV low molecular weight dextran significantly reduced the incidence of postoperative DVT in the lower extremities (p less than 0.05). The dextran 40 and heparin groups were not significantly different. The techniques are simple and do not need laboratory control. No deleterious side effects have been noted. A large-scale multicentre international, clinical trial (4121 patients) recently showed that low-dose heparin prophylaxis not only lowered the incidence of postoperative deep-vein trombosis without severely augmenting the risk of bleeding, but also significantly reduced the frequency of fatal pulmonary embolism in the postoperative period. It is suggested that the administration of low-dose subcutaneous heparin should become a routine prophylactic measure in daily surgical practice.


[Tumors of the thymus. Importance of radiotherapy (author's transl)]. A series of 10 cases with thymic tumor treated at the Institut Bordet were reviewed to assess the effectiveness of radiotherapy. Radiotherapy associated or not to an incomplete surgical resection yielded 3 cases of 5 year survival for invasive thymomas out of 5 patients with this follow-up. A review of the literature shows that irradiation at efficient doses will control local growth and improve survival in patients with invasive thymoma.


In vitro-metabolism of 3H-progesterone in human testicular tissue: II Prepubertal and adolescent boys. Normal sexual maturation in the human male depends upon a thorough regulation of the intratesticular androgen biosynthesis at various ages. We have systematically analysed the intratesticular steriod metabolic pathways in 11 boys, and 5-15 years, by means of incubation of minor testicular biopsy specimens with 3H-progesterone as substrate. Seven boys had abnormally situated testicles, and four had normally descended testicles. For comparison, 3 rats (10, 15 and 90 days old) were also investigated. Significant steroidogenic activity could be demonstrated in all prepubertal testicular tissue specimens. The steroid metabolic products recovered were identical with those found in a previously reported series of nine adult males (Kjessler & Berg, 1976), i.e., 20a-dihydroprogesterone, 17a-hydroxyprogesterone, 20a,17a-dihydroxyprogesterone, androstenedione and testosterone. No appreciable amounts of 5a-reduced substances were found. The steroid metabolic patterns observed in the present prepubertal and adolescent testicles differed from those found in adult males especially by their dissimilar proportions of newly synthesized 20a-dihydroprogesterone and 17a-hydroxyprogesterone. In prepubertal testicular tissue below the age of 11, 20a-dihydroprogesterone accounted for 45-82 per cent, and 17a-hydroxyprogesterone for only 3-6(-17) per cent of all metabolites formed. The steroid metabolic patterns displayed by abnormally situated testicles did not differ from those of normally descended testicles. The variation in steroid metabolic patterns observed between prepubertal and adult testicular tissue may be explained by the existing difference in physiologic gonadotrophic stimulation. It It may also be the result of an age-dependent maturation in various enzyme systems. The regulation of androgen biosynthesis with increasing age in the human male gonads does not seem to involve any significant reduction by 5a-reductase of continuously produced androgens, as in the immature rat. 2nstead, it appears to be brought about by a gradual shift in the metabolic pathways preferred by means of an increased activity of 17a-hydroxylase.


In vitro-metabolism of 3H-progesterone in human testicular tissue: I Adult males. Androgen biosynthesis in the male gonads may be analysed in some detail by means of in vitro incubation of minor testicular biopsy specimens with various radiolabelled steroid precursors. We have investigated nine adult human male voluteers without apparent gonadal dysfunction with regard to their in vitro metabolism of 3H-progesterone. The following metabolic compounds were recovered: 20a-dihydroprogesterone, 17a-hydroxyprogesterone, 20a, 17a-dihydroxyprogesterone, androstenedione and testosterone. No significant amounts of 5a-reduced delta4-3-oxo-steroids or oestrogens were found. The major metabolites formed were 20a-dihydroprogesterone and 17a-hydroxyprogesterone, which accounted for 13-49 per cent and 17-47 per cent, respectively, of all newly synthesized steroid compounds. Radiolabelled delta4-3-oxo-C19-metabolites were recovered in minor amounts only, possibly due to metabolic interference with the endogenous pool of cold mass compounds. The individual steroid metabolic patterns were found to be poorly related to the individual levels of FSH, ICSH (LH) and testosterone in the peripheral circulation. Adequate knowledge of the steroid metabolic pathways generally utilized in ordinary testicular tissue in vitro is a prerequisite for the evaluation of steroid metabolism in males with various types of gonadal dysfunction.


In vitro-metabolism of 3H-progesterone in human testicular tissue: III Males with extremely high and low levels of gonadotrophic hormones in the peripheral circulation; including one "XX-male". Individual steroid metabolic patterns in testicular tissue seem to vary characteristically with increasing maturity, as previously demonstrated by means of in vitro incubation studies with 3H-progesterone as substrate (Kjessler & Berg 1976; Berg et al. 1976). In the present study, individual steroid metabolic patterns were determined in two hypergonadotrophic males, one of whom representing the first instance of an "XX-male" studied in detail with regard to intratesticular steroidogenesis, and one hypogonadotrophic, hypophysectomized male. The radiolabelled steroid metabolic products recovered in the present series of testicular incubates were identical with those earlier observed in various series of prepubertal, adolescent and adult testicular specimens, i.e., 20alpha-dihydroprogesterone, 17alpha-hydroxyprogesterone, 17alpha,20alpha-dihydroxy-progesterone, androstenedione and testosterone. Thus, again, no appreciable amounts of 5alpha-reduced compounds were found in the present hyper- and hypogonadotrophic individuals. However, the proportions of newly synthesized and recovered delta4-3-oxo-C21-steroids in this series, especially 20alpha-dihydroprogesterone and 17alpha-hydroxyprogesterone, were found to differ considerably with various gonadotrophic stimulations. Hence, the relative proportions of 17alpha-hydroxyprogesterone increased, whereas the relative proportions of 20alpha-dihydroprogesterone decreased, with increasing gonadotrophic stimulation. The present results sustain and further extend our previous assumption that the relative proportions of newly synthesized and recovered delta4-3-oxo-C21-steroids in testicular incubates in vitro, especially 20alpha-dihydroprogesterone and 17alpha-hydroxyprogesterone, are primarily related to the individual degree of physiologic gonadotrophic stimulation at the moment of testicular biopsy, and less related to an unspecific maturation of various steroid metabolic enzyme systems.


In vitro-metabolism of 3H-progesterone in human testicular tissue: IV Before and after long-term gonadotrophin treatment; including one 47, XYY-male. Certain defects in the intratesticular androgen biogenetic system may lead to a significant impairment of gonadal function in total in the human male. In the present investigation, four males with impaired reproductive performance were analysed before and after long term treatment with gonadotrophic hormones with regard to their in vitro metabolism of 3H-progesterone in testicular incubates; one of whom representing the first instance of an XYY-male studied in some detail with regard to intratesticular steroidogenesis. A steroid metabolisc pattern of an "immature" type, i.e., possibly indicating a relative understimulation of the gonads by gonadotrophic hormones, in vivo, was found in one of the four patients, i.e., the XYY-male, inspite of normal levels of gonadotrophic hormones in the peripheral circulation. Gametic output was found to increase significantly during the course of gonadotrophin substitution therapy, and the individual steroid metabolic pattern also changed drastically towards a more mature type subsequent to therapy. In a second patients, who originally presented with completely immotile sperm, a certain shift in the steroid metabolic pattern was observed after the gonadotrophin therapy in favour of increasing relative amounts of 17a-hydroxyprogesterone, concurrent with a decreasing proportion of dead sperm, and a certain, though minimal, improvement in sperm kinetics. The last two patients, with originally mature types of in vitro steroid metabolism in testicular incubates, displayed no changes in steroid metabolic patterns or spermiogram qualities subsequent to the gonadotrophin therapy. However, one of them might have been azoospermic because of anatomical reasons. The present demonstration that an individual steroid metabolic pattern in testicular incubates under certain conditions may be deliberately modified as expected, by long term gonadotrophin therapy, further supports our previous suggestion that the relative proportions of newly synthesized and recovered deltal4-3-oxo-C21-steroids in testicular incubates, especially 20a-dihydroprogesterone and 17a-hydroxyprogesterone, may well reflect the actual gonadotrophic stimulation in a particular individual at the time of testicular biopsy. Investigations of individual steroid metabolic patterns in testicular incubates may therefore contribute useful information for the adequate selection of patients with disturbed gonadal function, who may benefit from gonadotrophin substitution therapy.


Double-blind trial with standard doses of fenoterol and salbutamol in asthmatic children. The broncho-dilating effect of fenoterol in aerosol form was studied in 16 children with asthma. The drug was compared with salbutamol in standard doses in a double-blind trial. Dynamic spirometric tests (FEV1.0 and VC) were performed before and up to 8 h after inhalation. There was a significant increase in the expiratory flow 5 min after inhalation of the two drugs. Maximal values were reached in 60-120 min. After 7-8 hours the increase was no longer significant. There were no significant differences between the two drugs tested. As no cardio-vascular side-effects or subjective discomfort was noted, fenoterol will be of great value in the routine treatment of children with asthma bronchiale.


Further studies on the effect of oral doxantrazole on allergen-induced bronchospasm. The protective effect of oral doxantrazole on allergen-induced bronchoconstriction in man has been tested in two different treatment schedules. A single administration of 200 mg or 400 mg doxantrazole did not result in significant protection for a group of 10 patients. Only two patients after 200 mg, and three patients after 400 mg received meaningful protection. A 14-day period of treatment with three times 400 mg doxantrazole per day had no significant different effect compared with placebo treatment on allergen-induced broncho-constriction.


The basal ganglia. A brief review and interpretation. The data reviewed suggest that: 1. The BG are not only concerned with motor functions. 2. The BG are not directly involved in the control of neurophysiological, behavioral or homeostatic functions at a primary, elementary level. Thus, the effects of total ablation of the main component of the system, i,e. the caudate nuclei, demonstrates that the BG are not indispensable for life consciousness or the basic elementary integration of movements or sensory processes. 3. The BG operate at a high level of CNS integration and appears to be involved in two main types of, generally speaking, sensorimotor functions: a) The control of some of the organism-environment inter-relationships, both at a behavioral and neurological levels, a context of regulating the balance between approach and avoidance reactions. Some of the features of the acaudate cats suggest that this regulation might also include affective type reactions. b) The preparation or "setting up" of the organism for performance of both complex motor responses (response set), and of task requiring a high level of cognition (cognitive set). 26 High level of integration means here that, in the above functions, the BG control most probably operates upon performances not triggered reflexy, directly or indirectly, from the periphery but originated internally either "volitionally" or generated by symbolic, e.g. verbal, instructions. 4. The above functions appears to be accomplished by means of a modulatory action upon afferent signals arriving into the telencephalon and triggering efferent activities through forebrain output structures, particularly the neocortex. In normal conditions such modulation is seemingly carried on by means of a selective, flexible play of the intrinsic inhibitory mechanisms of the BG. When such control is disturbed either by pathology or by experimental manipulations, abnormal functional manifestations occur. These can be understood along the general concepts of (a) "release" from the BG inhibitory control ("compulsory approaching", hyperactivity, hyper reactivity, involuntary movements, abnormal postures, rigidity) or (b) "deficit" of the "setting up" for action postulated as a positive effect of striatal modulation (akinesia). The latter is viewed, therefore, as a permissive effect of the modulation, i.e., by selective removal of the inhibition, action is allowed to go through and to be expressed in actual performance. 5. Since lesions to individual BG structures, produced either neurosurgically in man or experimentally in animals, appear not to be capable of reproducing the complete clinical manifestations of any of the BG diseases, it follows that most of the BG syndromes in man must result from involvement of several BG components and often of other brain areas as well. More experimental work using the multiple lesions approach is needed to further ascertain this statement. 6. The literature on the effect of lesions and stimulation experiments, in particular, suggest that the BG are also involved in mental processes...


Further ultrastructural studies on reticulum cell sarcoma (microglioma) of the brain. The ultrastructure of a primary reticulum-cell sarcoma (microglioma) of the brain was studied. The main or predominant tumor cells had a relatively abundant perikaryon with peripheral pseudopods and a moderate number of organelles. The nucleus was multilobulated and contained a prominent nucleolus. A second type, or phagocytic cell, had a similar structure but exhibited some distinctive features. The cytoplasm contained numerous lysosomes, phagolysosomes, occasional phagocytized whole cells and abundant organelles, especially Golgi complex. The nucleus was ovoid and nucleoli were smaller. This cell was considered to be a neoplastic element with a higher degree of differentiation. A third group of cells included lymphocytes with various degrees of maturation and/or differentiation as well as plasma cells exhibiting active protein synthesis. It is concluded that the ultrastructural features of the neoplasm are indicative of a reticulohistiocytic nature.


Multiple sclerosis: some epidemiological clues to etiology. The diagnosis of multiple sclerosis is frequently made with undue haste and without a firm basis. A false positive diagnosis is made in about 20 to 30% of the cases originally labeled as multiple sclerosis. The proportion of false positive diagnosis is probably still higher in countries where this disease is less frequent. An exhaustive investigation (neurological, clinical, neurorradiological, isotopic, etc.) is necessary before accepting such a diagnosis. This is particularly important because many of the lesions which can masquerade as multiple sclerosis are amenable to medical or surgical treatment. The prevalence of multiple sclerosis varies widely throughout the world, with a very definite preference for the white race. This difference seems to be caused, at least in part, by dietary habits. Lack of breastfeeding and excessive consumption of cow's milk during infancy is postulated as an important factor in the appearance of multiple sclerosis later in life. A lack of essential fatty acids (and may be of certain minerals and vitamins) in such a diet during pregnancy and childhood may result in the synthesis of abnormally unstable myelin. This underlying deficiency in myelin composition may be the substrate on which immunological factors act to produce the disease. The breakdown of this unstable myelin may be initiated by a variety of factors; natural decay of abnormally weak bonds in proteolipids, viral infection, immune reactions or even trauma. Immune reactions can explain, at least in part, the onset and the course of the disease, and probably immunodeficiency is the most important factor. Demyelination, once it starts, may continue until all abnormally formed myelin is destroyed, or until the building up of immunological defenses can stop the process. It follows from this that prevention of multiple sclerosis should be based mainly on dietic measures which ensure a sufficient supply of essential fatty acids, minerals and vitamins, during pregnancy and childhood. Breast feeding is probably the most important preventive factor. Skin pigmentation, either natural or from exposition to sunshine also seems to act as a preventive factor, and its mode of action deserves further investigation. Treatment of multiple sclerosis should be based on the improvement of immunological defenses, the elimination of possible allergens and saturated fats from the diet, and on the administration of sufficient amounts of essential fatty acids and of other various elements.


Supravital diffusion of fluorescent Evans blue in brain and spinal cord tissue. The influence of the fixation method on the distribution of fluorescent Evans blue (EB) was studied in the cervical grey matter of rats treated with 6-aminonicotinamide (6-AN). 6-AN leads to selective injury to the neuroglial cells and blood brain barrier without primary neuronal damage. In this model hyperchromasia and selective fluorescence of neurons were closely related but only found in tissue fixed by immersion, indicating a supravital shift of EB to shrinking neurons. Adequate perfusion fixation with Bouin solution prevents this artifactitious neuronal staining and demonstrates that EB is primarily bound by the vessel wall and the perivascular neuropil. The supravital diffusion of EB in the CNS and its dependence from the fixation method represents relevant methodological factors in morphological studies on the blood brain barrier.


Turku sugar studies X. Occurrence of polysaccharide-forming streptococci and ability of the mixed plaque microbiota to ferment various carbohydrates. Dental plaque samples collected from the subjects during the last 20 months of the 2 year trial were subjected to quantitative and qualitative analysis of the occurrence of S. mutans, S. sanguis, S. salivarius and the total growth on phenol red agar. Lyophilized plaque samples were homogenized and incubated on a sucrose containing medium under anaerobic conditions. In addition, the pH-values were measured after incubation of the mixed plaque flora in media containing 1% respectively xylitol(X), sorbitol, sucrose (S), fructose (F) or no carbohydrates. The results show a significantly lower incidence of S. mutans in the X-group relative to the S- and F-groups. The corresponding difference could not be observed between the S- and F-groups. The logarithmic means and standard deviations of the colony counts of S. sanguis, S. salivarius and total bacteria yielded no significant differences between the 3 sugar groups during the test period. Repeated pH-measurements, carried out at the 4, 12, 18 and 24 month phases, showed that, except in the presence of X, the mean values all fell below the pH-limit of 5.5. In the course of the study, no evidence was obtained of adaption of mutation enabling acidogenic decomposition of X. These findings emphasize the importance of low acidogenic potential in dental plaque, generally paralleled by a low incidence of dental caries.


Turku  sugar studies XII. The effect of the diet on oral peroxidases, redox potential and the concentration of ionized fluorine, iodine and thiocyanate. Detailed biochemical analyses of peroxidases in saliva, plaque and gingival exudate samples were carried out in view of the preliminary findings that the peroxidase activity of centrifuged oral fluid was considerably higher in the xylitol group than in the fructose or Sucrose groups. Chromatographic experiments revealed the activity which was increased due to the intake of xylitol, to be attributed to the involvement of the salivary lactoperoxidase, and not to enzymes formed in plaque or leucocytes. There were no significant differences between the sugar groups in the concentration of thiocyanate ions (mean 92 mg/l) and ionized iodine (mean 1.6 mug/l), but the concentration of ionized fluorine in saliva was lower in the xylitol group (0.128 mg/l) than in the other groups (0.150 mg/l). There were no clear differences in the salivary redox potential between the sugar groups. It is evident that various sugars selectively affect the enzyme and other production of the salivary glands. Xylitol-induced elevation of the salivary lactoperoxidase activity and the cariostatic properties of xylitol may partly be interrelated phenomena due to the antibacterial properties of lactoperoxidase.


Septic arthritis in association with primary lymphoedema. The association between b-haemolytic streptococcal arthritis of the knee and primary lymphoedema is reported. This condition appears to resolve slowly using conventional methods of treatment, in the form of immobilisation and antibiotic therapy. However, the penetration of penicillin into the joint in these two patients was adequate, suggesting that there is no place for the intra-articular injection of antibiotic in the treatment of this condition.


Open reduction of central compression fractures of the tibial plateau. Preliminary report of a new method and device arrangement. A new method of reduction and fixation of a uniformly depressed fracture of the tibial condyle is described. A curved steel probe, introduced through a cortical window in the uninjured condyle, is used to reduce the fracture fragments as well as to compact the fracture region (TV-monitored x-ray projectioning is desired). The instruments needed for the operative procedure are as follows: a probe for reduction and compaction, a tube and a plunger for deposition of bone transplants, and a forked plate. Five cases in which the curved probe reduction method has been used are reported.


[Rhinoscleroma in an immigrant].

[Rhinoscleroma in an immigrant]. A patient with rhinoscleroma was treated in our department. As far as we know it is the first importcase published in Belgium. Rhinoscleroma is an infectious disease caused by the Klebsiella Rhinoscleromatising. It is a chronic granulomatous process with subsequent stenosis and scarring. The nose and larynx are the most frequent localisations. The therapy consists of antibiotics in an early stage and is only palliative in the latter ones.


Changes in histology of the regional lymph nodes and in the proportions of T and B cell populations by oxazolone painting or LPS injection in guinea pigs. Changes in the regional lymph nodes from guinea pigs stimulated with oxazolone painting or LPS injection were examined by light and electron microscopy at various intervals. The proportions of T and B cells  in the nodes were estimated by rosette formation technique30,34 and weights of the thymus and spleen were measured at the same time. The first event occurring in the nodes after antigenic stimulation was increase in number and activity of post-capillary venules (PCV) which resulted in augmentation of an influx of small lymphocytes from the recirculating pool. Lymphocytes which streamed into the nodes promptly flowed out through the sinus endothelium into the pool. The second event was specific accumulation of committed lymphocytes35. The proportion of T cell in the node suspension reached a peak 4 days after oxazolone painting when morphological changes became maximum and the thymus enlarged. On the other hand, in LPS group, B cells reached a peak on day 5 or 6 when relatively immature germinal centers increased in the nodes and decreased on day 7 because of their differentiation into plasma cells.


The renin-aldosterone system and renal hemodynamics in patients with posttransplant hypertension. Plasma renin concentration (PRC), plasma aldosterone concentration (PAC), renal plasma flow (RPF) and glomerular filtration rate (GFR) have been studied in 19 patients who had received a renal allotransplant. Group 1 consisted of 7 normotensive and group 2 of 12 hypertensive patients. Bilateral nephrectomy was performed in all patients; all were on a fixed daily sodium intake, and no antihypertensive agents were given. No significant differences were found between the groups in age, time after transplantation or dosages of prednisone. PRC and PAC were normal in all but one patient in group 1 and two in group 2. In these three patients a slight elevation of PRC was measured. After one hour in the erect position, a significant increase was measured in PAC, but not in PRC in both groups. After 6 days on a 10 mEq sodium diet, PRC and PAC increased significantly in both groups. After a further 6 days on the diet plus 150 mEq sodium daily, significant decreases in PRC and PAC were measured in both groups. No differences were detected in PRC or PAC between groups 1 and 2 either before or after the two dietary periods. RPF was significantly lower in the hypertensive group, whereas no significant difference was found in GFR between the groups. No significant relationship could be demonstrated between blood pressure (BP) and PRC or PAC, and PRC and PAC were not correlated to each other. RPF was significantly correlated to mean BP and PRC in the normotensive group but not in the hypertensive. It is concluded that PRC and PAC are normal in most patients with posttransplant hypertension, whereas the RPF is decreased. It is suggested that an abnormal regulation of renin secretion plays a role in the sustained elevation of BP after renal allotransplantation.


The alpha-helix as an electric macro-dipole. A polypeptide chain is found to form an electric macro-dipole in solution when it is folded to take the alpha-helical conformation. This is due to the polar peptide residues, all of which are oriented to have their moment in the axial direction in its regular helical conformation. This remarkable electric nature of the alpha-helix has extensively been examined for nearly twenty years, and the study is still in a state of development. The dielectric behavior of a solution consisting of the macrodipole is one major concern of the study, and the other is to probe with this unique property into the regular conformation and helix-coil transition of polypeptides. Historical and topical, but not comprehensive, surveys have been given here for both of these dielectric aspects of the alpha-helix.


Structure, assembly and function of mammalian alpha-keto acid dehydrogenase complexes. An attempt has been made to provide a description of the mammalian alpha-keto acid dehydrogenase multienzyme complexes, especially with respect to the structure, assembly and function of PDC and OGDC based on the investigation carried out in this laboratory over the last 14 years. Special efforts have been focused on the purification, characterization, and stoichiometric resolution into component enzymes, and the reassembling process to produce these multienzyme complexes. Studies of the macroorganization and the mechanism of regulation of these multienzyme complexes still remains a most challenging question.


Target sites for suppressing fertility in the male. The present status and perspectives in the control of fertility in the male have been reviewed. There are two potential sites in the male reproductive processes that can be used as targets for regulation of fertility in the male: (1) inhibition of spermatogenesis, and (2) interference with sperm maturation in the epididymis. A variety of compounds tested for their antispermatogenic action in laboratory animals have no future for the control of fertility in the human male because of a number of undesirable side effects (cf. Prasad, 1973). Progestational compounds inhibit spermatogenesis by affecting the hypothalamo-hypophysial system and result in impairment of libido. The possibility of adjustment of the minimal dose of progestational compounds required to induce suppression of spermatogenesis and reduction of plasma testosterone to a level compatible with the maintenance of normalcy of libido and potency needs to be studied. A new approach to contraception in the male involves the use of a combination of progestational compounds for suppression of spermatogenesis along with testosterone (administered through silastic capsule implants or as intramuscular injections) for maintenance of libido and accessory sex gland function. A number of such combinations have been tested clinically with some success. However, the limitations of side effects, such as weight gain, gynecomastia, and psychological complications preclude their long-term use for contraception in man. Short-term use of these combination regimens by the male for 1 year followed by use of a contraceptive method by the female may be desirable to encourage partnership in family planning. Although testosterone and other androgens suppress spermatogenesis in man, the feasibility of their use for contraception depends on the establishment of a dosage and mode of adminstration that provide antispermatogenic action without causing more general metabolic alterations. Inhibition of spermatogenesis by selective interference with the action of FSH on the Sertoli cells by active or passive immunization or by selective suppression of synthesis and release of FSH by administration of "Inhibin" offers exciting possibilities in the control of fertility in the male. Studies on the physiology of the rete testis highlight its importance as a post-tubular site of action of antifertility agents in conveying (to the epididymis) compounds interfering with epididymal functions and/or viability of spermatozoa. A new approach to the induction of functional sterility in the male by selective alteration of epididymal function by a local androgen deprivation effect has been successfully tested in clinical trials. Small doses of cyproterone acetate, administered orally, result in maintenance of libido and accessory sex gland function accompanied by a decrease in the motility of ejaculated spermatozoa and incomplete inhibition of spermatogenesis...


Human gonadotropins: biochemical, immunological, and clinical aspects. Methodologies for the extraction of both pituitary and urinary gonadotropins are described. The chemical composition of some of the gonadotropins is discussed, and the significance of the subunit structures is reviewed. Immunological properties of the gonadotropins are discussed from the standpoint of antisera and procedures involving radioimmunoassay. Finally, certain clinical conditions which are characterized by fluctuations in gonadotropin levels are discussed.