Note on the relationship between introversion-extraversion, field-dependence-independence and accuracy of visual target detection. 49 soldier-observers viewed 40 slides in which a stimulus soldier was identically posed in a constant background [corrected] but a different viewing distance (175, 200, 225, 2508 and 275 ft.) and viewing angles (14 degrees and 21 degrees, left and right) from the observer. Accuracy of target detection was compared with viewers' scores on the Hidden Shapes Test and the Maudsley Personality Inventory. Field-dependence-independence and extraversion-introversion were determined to be separately and jointly related to accuracy of target detection. The major effects were attributable to the notably poorer perfromance of Ss characterized of field-dependent extraverts.


Effects of race and sex on field dependence-independence in children. Field dependence-independence is a possible social-psychological variable which contributes to inter-ethnic group differences. 40 Grade 6 children equally divided by race (Negro and white) and by sex were administered the Embedded-figures Test. High scores, indicating field dependence, of the black girls accounted for most of the significant differences due to race and sex.


Formal operations and field independence in a heterogeneous sample. 25 sixth grade students from diverse socioeconomic backgrounds were administered two Piagetian formal operational tasks (bending rods and balance beam) and a test of field independence. A Pearson product-moment correlation coefficient of .92 (p less than .001) was found between the two formal operational tasks. Correlation between the formal operational tasks and field independence were .81 and .77 (p less than .001) respectively. These values support the hypothesis of a unified stage of formal reasoning and also support the hypothesis that a degree of field independence is required for the development of formal stage reasoning.


[Occurrence and distribution of drug resistant enterobacteria in extra enteral habitats (author's transl)]. In the period 1971-73 various extra enteral habitats have been examined for the occurrence of resistant E. coli. Of 172 isolates of E. coli from retail butcher's meat products 9.9% were resistant and 3.5% R+ E. coli. Of 203 isolates of E. coli from bakery products 7.9% were resistant and 3.5% R+ E. coli. Of 52 isolates of E. coli from freshly killed carcases of chickens 40.4% contained weak non-transferable monoresistance against sulphonamides (Table I). Of 92 isolates of E. coli from seawater receiving human sewage 15.2% were resistant and 4.4% R+ E. coli (Table III). All but one samples of sewage and crude sludge contained resistant E. coli of which 11% harboured R factors (Table II). Of 117 Salmonella isolates from human sewage 11.1% were resistant and in 4.2% resistance were transferable (Table VI). Quantitative examinations of untreated and treated sewage did not indicate any selective reduction of resistant E. coli compared to sensitive (Table IV). However, more di- and multiresistant E. coli were found in sewage than in seawater (Fig. 1). The food hygienic implications of resistant E. coli are discussed.


[The association of myasthenia and disseminated lupus erythematosus. 2 cases]. Two cases of the association myasthenia/systemic lupus erythematosus are described. This association is rare but of particular interest from a pathogenic point of view. The discussion includes the suggestion of an immunological disturbance which might be the common denominator of the two disorders. Recent data concerning the role of the thymus and of "suppressor" T cells support such a hypothesis.


Role of modified nucleosides in tRNA: effect of modification of the 2-thiouridine derivative located at the 5'-end of the anticodon of yeast transfer RNA Lys2. Yeast tRNA Lys2 codes preferentially for AAA and contains a 2-thiouridine derivative (U) at the 5'-position of the anticodon. Removal of the 2-thio group from U by treatment with CNBr did not affect the amino acid accepting activity of the modified tRNA Lys2. CNBr treated tRNA Lys2 was active in protein synthesis but with a much reduced efficiency. Although the modified tRNA Lys2 was recognized by elongation factor (EF) T, the EFT dependent binding to ribosomes to tRNA Lys2 (CNBr) was markedly decreased.


Synthesis of DNA complementary to the mRNAs for milk proteins by E. coli DNA polymerase I. E.Coli DNA polymerase I (Klenow subfragment) was used for the synthesis of complementary DNA with the mRNAs for rabbit milk proteins as templates. The cDNA formed, contained 200 nucleotides and represented about 20% of the mRNA template. The cDNA was hybridized specifically to the mRNA templates. The Klenow subfragment of the E.Coli DNA polymerase I was as efficient as the avian myeloblastosis virus reverse transcriptase in the synthesis of cDNA. The mean size of the cDNA fragments obtained with the Klenow enzyme proved to be 70% of the value obtained with the AMV reverse transcriptase and at least twice the value generally obtained with the complete E.Coli DNA polymerase I. The cDNA was used for the detection and the quantification of the mRNA template in various RNA fractions.


Studies of DNA bound RNA molecules isolated from nucleoids of Escherichia coli. Methods are developed for studying RNA molecules bound directly to DNA in bacterial nucleoids. It is found that among the 1000-3000 nascent RNA chains that normally are attached to the DNA via their associated RNA polymerase molecules, 74 +/- 14 chains per nucleoid can be bound differently. These chains unlike the other nascent RNAs remained bound to the DNA after the chromosome was deproteinized and sheared. Sensitive assays using radioactive labels detected no RNA polymerase involved in the RNA-DNA linkage. The linkage was stable at low temperatures, but the RNA separated from the DNA at high temperature. The bound RNA molecules were heterodisperse (weight average length 1200 bases). Pulse-chase experiments and studies of the fate of these RNA molecules in rifampicin treated cells demonstrated that they are nascent RNAs, degraded or released from the DNA in vivo with kinetics similar to that of the total nascent RNA. Hybridization analyses showed that the chains are composed at least in part of nascent rRNA and known mRNA molecules. Some, but not more than 5% of the bound chains, contained sequences of about 300 nucleotides in length, bound to the DNA in an RNase resistant form.


Enzymatic synthesis of duplex circular phiX174 DNA containing phosphoramidate bonds in the (-) strand. Duplex circular phiX174 DNA (RF I) containing some phosphoramidate links in the backbone chain of the (-) strand was synthesized by reaction of 5'-amino-5'-deoxythymidine 5'-triphosphate, dCTP, dGTP, and 3H-dATP with DNA polymerase I and DNA ligase (T4) on a (+) strand phiX174 amber 3 DNA template. The yield of duplex DNA was higher when dTTP was included along with the amino analog in the initial reaction system or was added late in the synthesis. RF I DNA was observed as a rapidly sedimenting species in an alkaline sucrose gradient, and the presence of phosphoramidate linkages was demonstrated by the unusual lability of the duplex DNA in a weakly acidic solution.


Atomic coordinates and molecular conformation of yeast phenylalanyl tRNA. An independent investigation. The atomic coordinates of yeast tRNA(Phe) in the monoclinic crystal form have been determined by an independent analysis from a model built into a 3 A MIR map. The overall molecular structure is found to be in agreement with those reported for the same crystal form by Ladner et al. (1975) and for the orthorhombic form by Quigley et al. (1975) and Kim et al. (1975). However, significant differences between any two of the four models are found in certain local regions of the molecule. The structure is analyzed in terms of the nucleotide stereochemistry and internucleotide phosphodiesters. A striking observation is that the majority of the nucleotide moieties occur in the conformation preferred by the constituent mononucleotides themselves. The internucleotide P-O bonds afford the primary source of flexibility for the folding of the polynucleotide backbone while the sugar pucker and C(4')-C(5') torsions provide the secondary source of flexibility.


Terminal labeling and addition of homopolymer tracts to duplex DNA fragments by terminal deoxynucleotidyl transferase. Terminal deoxynucleotidyl transferase, which requires a single-stranded DNA primer under the usual assay conditions, can be made to accept double-stranded DNA as primer for the addition of either rNMP or dNMP, if Mg+2 ion is replaced by Co+2 ion. The priming efficiency in the presence of Co+2 ion with respect to initial rate tested with 2 single-stranded primer, is 5-6 fold higher than that observed with Mg+2 ion. In the presence of Co+2 ion, the primer specificity is altered so that all forms of duplex DNA molecules can be labeled at their unique 3'-ends regardless of whether such ends are staggered or even. Thus, using ribonucleotide incorporation, we have for the first time employed this reaction for sequence analysis of duplex DNA fragments generated by restriction endonuclease cleavages. Furthermore, by using Co+2 ion, it is possible to add a long homopolymer tract of deoxyribonucleotides to the 3'-terminus of double-stranded DNA. Therefore, without prior treatment with lambda exonuclease to expose the 3' terminus as single-stranded primer, this reaction now permits insertion of homopolymer tails at the 3'-ends of all types of DNA molecules for the purpose of in vitro construction of recombinant DNA.


Patterns of E. coli leucine tRNA isoacceptors following bacteriophage MS2 infection. The RNA extracted from MS2 phage particles can accept radioactive leucine and serine in the presence of tRNA activating enzymes. Leucine acceptance is due to the presence of E. coli leucine tRNA that binds very tightly to the virus particle. RPC-5 column chromatography shows that the pattern of virus associated leucyl-tRNA isoacceptors is different from that of normal E. coli leucyl-tRNA. It is also different from the pattern of host leucyl-tRNA isoacceptors found in E. coli lysate following MS2 phage infection. The RPC-5 pattern of the latter tRNA shows several new peaks of leucine tRNA isoacceptors. The possibility that these tRNAs are some modified forms of normal leucine tRNA isoacceptors is suggested.


Anticodon conformation and accessibility in wild-type and suppressor tryptophan tRNA from E. coli. The association between Trp-tRNA and Pro-tRNA, which have complementary anticodon sequences, has been used as a probe of anticodon conformation. It is unaffected, however, by the base change in the D-stem present in UGA-suppressor Trp-tRNA. This does not support the hypothesis that UGA suppression depends upon a conformational change induced in the anticodon. The stable denatured form of wild-type Trp-tRNA no longer interacts with Pro-tRNA; the structure of the anticodon region must therefore be quite different in the denatured form.


[Function of the pancreatic insular apparatus in growth retardation]. Function of the insular apparatus of the pancreas was studied in 12 healthy children and in 86 patients with growth retardation. The content of immunoreactive insulin (IRI) in the blood serum was examined with the aid of sets for radioimmunological determination on fasting stomach and in dynamics during the standard glucose-tolerance test. Investigations carried out showed the changes in insulin secretion in the patients with growth retardation to be in different direction; these changes were independent of the form of nanism. Normal IRI curves were revealed in 36.1%, and pathological ones--in 63.9% of the patients with growth retardation. Four types were distinguished among the pathological curves; they were hyposecretory (10.5%), torpid (15.1%), hypersecretory (30.2%), paradoxic (8.1%). The established disturbances in the function of the insular apparatus of the pancreas could serve as one of the pathogenetic moments causing or aggravating the growth retardation.


[Changes in carbohydrate and lipid metabolism and in the structure of the fatty tissue and pancreatic insular apparatus of rats under conditions of prolonged overeating]. Prolonged overfeeding of rats with a highly caloric mixed food led in the majority of the animals to a more intensive increase in body weight and of fat depôt than in control animals given conventional laboratory diet. Rats with adiposity caused by prolonged overfeeding displayed disturbances of carbohydrate and lipid metabolism expressed in elevation of blood sugar level on fasting stomach, a fall of glucose tolerance and of insulin sensitivity, and also in increase of blood insulin activity and of free fatty acids and blood triglycerides on fasting stomach. The number of fat cells in the adipose tissue remained unchanged, but their volume increased. In the animals with adiposity the relative area of the islar tissue of the pancreas and the mass of beta-cells increased significantly; the count of the islar cells in the glandular parenchyma increased as well.


[Method for the intavital of the isolated pancreatic islands of Langerhans in rats]. The authors describe a method of vital detection and isolation of individual islands of Langerhans in rats. This method is based on the capacity of the beta-cells of the islands to accumulate the stain during life. Since the stain (0.05% neutral red solution) is harmless and it is rapidly eliminated by the cells this method permits vital marking on the surface of the pancreas of individual islands and their distinguishment under steroscopic microscope; these islands can be isolated from the surrounding parenchyma of the pancreas with the aid of a microknife. Thus obtained islands of the pancreas could be used as material for experiments with implantation and for other experimental studies.


Membrane penicillinase of Bacillus licheniformis 749/C:sequence and possible repeated tetrapeptide structure of the phospholipopeptide region. The membrane penicillinase (EC 3.5.2.6; penicillin amido-beta-lactamhydrolase) of Bacillus licheniforis 749/C, which appears to be an intermediate in the formation of the exoenzyme, is a phospholipoprotein that carries an NH2-terminal chain of 24 amino acids (only serine, glycine, aspartic acid, asparagine, glutamic acid, and glutamine) and a phosphatidylserine that is not present in the exoenzyme.


Functional genetic expression of eukaryotic DNA in Escherichia coli. We have isolated a segment of DNA from the eukaryote Saccharomyces cerevisiae (baker's yeast) as a viable molecular hybrid of bacteriophage lambda DNA which, when integrated into the chromosome of an E. coli histidine auxotroph, allows this bacterium to grow in the absence of histidine. The nonrevertable, histidine auxotroph lacks the enzymatic activity of imidazole glycerol phosphate (IGP) dehydratase (EC 4.2.1.19). From genetic experiments, we conclude that expression of the segment of yeast DNA results in the production of a diffusible substance and that transcription necessary for the complementation is most likely initiated from the segment of eukaryotic DNA.


Synthesis of an R plasmid protein associated with tetracycline resistance is negatively regulated. Synthesis of proteins encoded by the R222 plasmid was observed in a DNA-directed cell-free system and the products were compared to those plasmid proteins synthesized in Escherichia coli minicells. A greater number of plasmid-specified proteins was detected in the in vitro system than in the minicell, suggesting the presence of control factors for plasmid gene expression in the minicell. Synthesis of a newly detected plasmid protein (TET protein) is induced by tetracycline in minicells containing tetracycline-resistant plasmids, including R222, and this induced synthesis correlates with induced host resistance to the drug. This TET protein was synthesized in vitro from R222 DNA in the absence of tetracycline, indicating that no positive regulatory role for tetracycline is required for the protein's synthesis. TET proteon synthesis was inhibited in vitro when cell-free extracts prepared from cells containing the R222 plasmid were used.


Electron microscopy of gene regulation: the L-arabinose operon. Unlike normal cells, malignant rat and two simian virus 40-transformed human cell lines can neither grow nor survive in B12- and folate-supplemented media in which methionine is replaced by homocysteine. Yet three lines of evidence indicate that the malignant and transformed cells synthesize large amounts of methionine endogenously through the reaction catalyzed by 5-methyltetrahydropterolyl-L-glutamate: L-homocysteine S-methyltransferase (EC 2.1.1.13). (1) The activities of this methyltransferase were comparable in extracts of malignant and normal cells. (2) The uptake of radioactive label from [5-14C]methyltetrahydropteroyl-L-glutamic acid (5-Me-H4PteGlu) was at least as great in the malignant cells as in the normals and was nearly totally dependent on the addition of homocysteine, the methyl acceptor; furthermore, 59-84% of the label incorporated by cells was recovered as methionine.


Coordinate regulation of the synthesis of eukaryotic ribosomal proteins. We have developed a method of r the direct measurement, in eukaryotic cells, of the synthesis of ribosomal proteins, irrespective of the synthesis of ribosomes. In this way the synthesis of ribosomal proteins has been examined in mutant strains of Saccharomyces cerevisiae, which are unable to synthesize ribosomes under nonpermissive conditions. The results suggest that the synthesis of more than 40 ribosomal proteins is under coordinate control. Under nonpermissive conditions,the synthesis of each h protein declines exponentially to a basal level which is 10-20% fo normal. The kinetics of that decline suggest that an early, if not primary, result of the nonpermissive conditions is the cessation of production of new mRNA for eac of the ribosomal proteins. The coordinate regulation appears not to be influenced directly by the rate of transcription of ribosomal precursor RNA.


Control of cell division in Saccharomyces cerevisiae by methionyl-tRNA. We suggest that two events are necessary for an asynchronous population of cells to undergo arrest in the GI phase of the cell cycle upon nutrient starvation. First, passage through GI must be prevented by a deficiency of some metabolic intermediate. Since this intermediate may act indirectly to arrest division, we designate it the "signal". We have found three conditions under which Saccharomyces cerevisiae cells arrest division in GI: sulfate starvation of a prototroph, methionine starvation of an auxotroph, or a shift of a conditional methionyl-tRNA synthetase mutant [L-methionine: tRNA Met ligase (AMP-forming), EC 6.1.1.10] to a restrictive condition. We interpret these results to indicate that the signal for sulfate starvation in S. cerevisiae is generated near the end of the sulfate assimilation pathway (at or beyond the formation of mehtionyl-tRNA). As a unifying hypothesis, we propose that the signal for all nutrients is generated at the level of protein biosynthesis.


A mutant of Escherichia coli with an altered elongation factor Tu. A previously isolated mutant of E. coli K12 HAK 88 [Kuwano, M., Endo, h & yamamoto, M. (1972) J. Bacteriol, 112, 1150-1156], contains a new protein that in two-dimensional gel electropherorgrams has the same molecular weight as normal elongation factor Tu, but whose isoelectric point is altered approximately 0.1 pH unit in the acidic direction. Peptide mapping, purification properties and the ratio of leucyl plus isoleucyl to methionyl plus cysteinyl residues of the normal elongation factor Tu protein and the new protein show a close similarity between the two. The mutation causing the altered electrophoretic mobility is located between argH and rif (79 min on the E. coli genetic map). These biochemical and genetic data indicate that strain HAK 88 has a mutationally altered tufB gene.


Central factors in the control of insulin and glucagon secretion. A complete system for neural regulation of insulin and glucagon secretion from the ventral hypothalamus to the autonomic cholinergic and adrenergic nerves of the endocrine pancreas is described. Both physiologic and pathophysiologic states of altered metabolism can be partly explained by activation of this neural system. Direct hypothalamic humoral control of the endocrine pancreas has been evaluated by studies of the hypothalamic hormone somatostatin, or somatotrophin release inhibiting factor (SRIF). Somatostatin has been shown to inhibit pancreatic glucagon and insulin secretion when infused into the pancreatic artery of intact dogs in vivo in the absence of a change of systemic glucose concentration. Although less inhibition is observed when the same amount of hormone is infused intraportally, the potency of somatostatin when given directly into the liver suggests extrapancreatic effects as well as direct pancreatic effects on insulin and glucagon secretion.


Developing physical therapy fee schedules based on Social Security Amendments of 1972. Implications of the requirements related to the documentation and justification of the cost of physical therapy services are considered. These implications include 1) the cost components of physical therapy services, 2) the development of fee schedules, and 3) reimbursement requirements of third-party payers. The development of a fee schedule based on a sampling of the prevailing rates in two San Francisco Bay area counties is presented. The relationship between cost accounting, community standards, and the "prevailing rate" as defined by Medicare is documented. Public Law 92-603 and its ramifications for physical therapy fees and salaries are discussed.


The bridge flap for reconstruction of a full-thickness defect of the upper lip. We describe a repair that preserves the vermilion border of the upper lip, after a full-thickness excision of a tumor of the upper lip which did not require excision of this structure. A bridge flap technique was employed, similar to the Cutler-Beard technique of eyelid reconstruction.


Laryngeal reconstruction by free flap transfer. In the two cases reported herein, a laryngeal cavity was successfully reconstructed with a free flap, using microvascular anastomoses. The revascularized free flap contributed significantly to the maintenance of a patent airway and to the reproduction of an appreciable voice. Our experiences with these laryngeal reconstructions encourage us to try to expand the application of free flaps for reconstructions after head and neck cancer surgery.


Defining the malignant potential of the giant pigmented nevus. An unusual giant pigmented nevus, containing lymphocytic infiltrates and apparent muscle invasion, but without the presence of melanoma, is described in detail--including its related immunological parameters. The controversy concerning the malignant potential of giant pigmented nevi, and the paradoxes that are encountered clinically, are discussed.


Long-term study of reactions to various silicone breast implants in rabbits. A long-term study of the fixation and the encapsulation of soft alloplastic implants in rabbits was done-with examination of the capsules at one, 6, 12, and 18 months. No evidence of hematoma, infection, or carcinogenesis was observed. The type of filling in the prosthesis had no demonstrable effect on the encapsulation. The mobility of the prostheses correlated directly with the capsules evoked by plain silicone, perforated silicone-backed, Dacron-backed, and polyurethane-covered prostheses (in order of decreasing mobility). A patch on the base of a given prosthesis did not influence the amount or character of the capsule formed around the remainder of that prosthesis. The results of this study are discussed in the light of past information, to point out the need for further basic research on these problems.


Lack of effect of skin cycle on survival of experimental skin flaps in rats. Skin flaps were raised in 83 rats. In 58 of them the skin cycle was determined before the flap was raised, and in 25 of them the flap was raised without regard to cycle. There was no significant difference in the surviving length of flaps raised in early anagen, midanagen, telogen, or in randomly selected animals.


A migrating cervical mass. Case report.

A migrating cervical mass. Case report. An asymptomatic migration of a foreign body from the axilla to the neck was diagnosed mistakenly as an infected thyroglossal duct sinus. Cure was effected by removal.


Repair of nostril defect with a contralateral nasolabial flap. Two consecutive cases of nasal reconstruction, using a contralateral nasolabial flap for lining and a scalping forehead flap for cover, are reported. The procedure has been useful in repairing defects from large nasal lesions extending to the cheek, ones which preclude the use of a flap from the homolateral nasolabial fold. We have used this technique in two patients, without loss of any portion of such a flap and without the persistence of any hole in the nasal septum.


Fourteen free groin flap transfers.

Fourteen free groin flap transfers. We present 14 free flap transfers, 9 of which were completely successful (74 percent), two of which were partial successes (14 percent), and 3 of which were failures (22 percent). All the 5 cases involving free flaps to the head and neck region were successful. In the 9 cases involving free flap transfer to an extremity, 4 were completely successful (44 percent), two were partially successful (22 percent), and 3 were failures (34 percent). Many factors determine the success or failure of free flap transfer, but two that seem most significant are (1) the technical expertise and experience of the surgeon, and (2) the quality of the vasculaturein the recipient bed.


Ten free flap transfers: use of intra-arterial dye injection to outline a flap exactly. Ten free skin flap transfers, with microvascular anastomose, were performed by our service since July 4, 1973. The donor site most frequently used for this purpose was the groin flap. In one case a free auxillary flap based on the external mammary artery was used. We discuss the advantages of using an intra-arterial injection of patent-blue dye to outline the maximal area supplied by the donor site vessels.


Reconstructive rhinoplasty for the lower two-thirds of the nose. A general format has been developed and used for reconstruction of the lower two-thirds of the nose in patients retaining some septum who have a low forehead. The lining above the  alae comes from strategic local flaps, while the alar lining and most of the columella are produced by a pair of nasolabial flaps. Support is provided by the residual septum (sometimes advance), and by a later costal chondroperichondrial hinge graft. The cover comes from a "headless" gull-shaped, forehead flap.


Peripheral circulation in arterial hypertension. The underlying causes of hypertensive disease remain unclear. This article has attempted to highlight potential dysfunctions in arterial pressure regulation which could either initiate or sustain the hypertensive process. As has been suggested innumerable times hypertension must certainly be a multifactorial abnormality. The current state of knowledge about control of the peripheral circulation in high arterial pressure reinforces the view that interactions between neurogenic, myogenic, humoral, and structural factors are probably disrupted when hypertension appears.


Evaluation of myocardial infarction with enzymatic indices. The severity of myocardial damage appears to be a common denominator contributing to electrophysiologic derangements, impaired ventricular function, and prognosis after myocardial infarction. Physiologically based models of processes affecting appearance and disappearance of CPK from the circulation may improve predictions and estimates of infarct size. Elevation of serum MB CPK isoenzyme activity appears to be a highly sensitive and specific indicator of myocardial injury. Despite the limitations discussed, recently developed enzymatic methods for detection, projection, and quantification of infarct dize have demonstrated that the extent of myocardial injury may be limited in selected patients by appropriate therapeutic measures. Further investigation may help to define the intervals between the onset of infarction and implementation of therapeutic maneuvers during which myocardial protection is possible, and may help to identify and differentiate inter ventions which salvage myocardium, those which improve cardiac performance without altering infarct size, and those which augment cardiac injury despite improving hemodynamics. Thus, in conjunction with electrophysiologic, radioisotopic, and hemodynamic techniques, enzymatic estimates and projection of infarct size should facilitate increased understanding of factors influencing the evolution of infarction and hasten development of effective therapeutic interventions designed to reduce myocardial damage.


Animal inhalation studies with tobacco smoke. An outline is given of the techniques that have been used for exposure of small and large experimental animals to tobacco smoke. The effects of tabacco smoke inhalation on a wide range of biological systems have been investigated, and some important published studies have been noted. Much early work on tobacco smoke was equivocal because of the unsatisfactory exposure techniques, and the poor quality of animals used. Exposure techniques, particularly for small animals, are improving and more recent publications indicate an increased awareness of the special problems of working with tobacco smoke. At this time, however, exposure techniques anty of different tobacco smokes are essentially at the mid-development stage.


[Early isotopic synoviorthesis during rheumatoid polyarthritis (RP)]. The authors report the results of 1258 chemical synovectomies carried out in subjects with rheumatoid polyarthritis on joints at Steinbrocker stage I and of 470 chemical synovectomies carried out during the first year of evolution of rheumatoid polyarthritis. Comparison with the results of chemical synovectomy carried out later demonstrate the superiority of early chemical synovectomy.


Serum amylase activity and renal amylase activity clearance in patients with severely impaired renal function and in patients treated with renal allotransplantation. Serum amylase activity was measured in 29 nondialysed patients with severe renal failure, in 24 uraemic patients treated with chronic haemodialysis, and in 29 patients treated with renal allotransplantation. Simultaneous measurement of renal amylase activity clearance (CAm) and creatinine clearance (CCr) was performed in 25 patients with severe renal failure and in 19 transplanted patients. Serum amylase activity was elevated in all three groups. CAm was significantly correlated to CCr both in the group with severe renal failure and in the transplanted group. Unlike in the group of transplanted patients, the ratio CAm/CCr was significantly increased in patients with severe impaired renal function. It is concluded that the elevation of serum amylase activity in patients with impaired renal function is primarily due to decreased glomerular filtration rate. The value of CAm/CCr for diagnosing acute pancreatitis is doubtful in patients with severe renal disease.


Oxypurine excretion during kidney preservation: an indicator of ischaemic damage. The loss of 5'-adenine nucleotides in ischaemic kidney tissue is related to the postischaemic survival of the organ. It has previously been demonstrated that the catabolism of 5'-adenine nucleotides in ischaemic tissue can be evaluated indirectly by the washout of the final products: hypoxanthine, xanthine, and inosine. The present study indicates a relationship between postischaemic renal function and the duration of normothermic ischaemia. It further demonstrates a linear correlation between the duration of normothermic ischaemia and the quantity of hypoxanthine/xanthine recovered from the perfusate. Thus the method may be used for the evaluation of possible renal grafts.


Susceptibility of the liver and biliary tract to anaerobic infection in extrahepatic biliary tract obstruction. III. Possible synergistic effect between anaerobic and aerobic bacteria. An experimental study in rabbits. The pathogenicity of single anaerobic, single aerobic, and mixed anaerobic and aerobic bacterial inocula was studied in 3 groups of 12 rabbits with biliary tract obstruction. B. fragilis, ss. fragilis and E. coli serotype 01: K1: H7 were used. The investigation was made 7 days after bacterial inoculation and included bacteriological studies of the liver and bile as well as studies of liver function and morphology of the liver and biliary tract. Inoculation of 10(5)-10(6) E. coli did not cause biliary tract infection, liver abscesses or death. Inoculation of 10(9) B. fragilis caused biliary tract infection in 83% and liver abscesses in 17% of the animals inoculated, without any mortality. Combined inoculation with B. fragilis and E. coli in reduced doses significantly increased mortality (42%) and frequency of liver abscesses in surviving animals (86%). All abscesses, however, yielded pure culture of B. fragilis only. 84% of the animals inoculated with B. fragilis alone or with B. fragilis in combination with E. coli developed biliary tract infection with B. fragilis, the bile yielding from 10(7)-10(9) B. fragilis per ml, gallbladder bile yielding significantly higher bacterial counts than common duct bile. E coli was never recovered from bile in surviving animals but from both bile and blood in animals not surviving the experimental period.


Colon perforation in renal transplant patients. Six patients with spontaneous colonic perforation after cadaveric kidney transplantation are described. Five perforations occurred in a diverticulum of the sigmoid colon, while one was at the suture line after a colotomy performed 5 months previously. Four patients died. Clinical diagnosis was difficult, but on x-ray examination free air in the abdominal cavity  was found in 3 patients. Explorative laparotomy should be performed promptly when the diagnosis is suspected. All patients above the age of 4o should be screened with a barium enema prior to transplantation.


Alcoholic hepatitis superimposed on cirrhosis. Clinical significance and effect of long-term prednisone treatment. Of 483 patients with biopsy-verified cirrhosis who entered the controlled trial of prednisone treatment conducted by the Copenhagen Study Group for Liver Diseases, 99 had alcoholic hepatitis as defined by morphological criteria in the initial biopsy. The maximum period of observation varied from 5 to 12 years. The survival of prednisone-treated patients (median survival time 38 months) and placebo-treated patients (median survival time 34 months) with alcoholic hepatitis did not differ significantly. This was also true for each of the two subgroups comprising mild and severe cases respectively. The presence of morphologically defined alcoholic hepatitis was postively correlated with the daily consumption of alcohol but poorly correlated with the clinical syndrome usually attributed to alcoholic hepatitis.


Bacterial density in laparotomy wounds during gastro-instestinal operations. Operation wounds were sampled quantitatively for aerobic bacteria in 56 patients by the velvet pad rinse technique in a prospective, randomised study of abdominal operations (1) truncal vagotomy and pyloroplasty, (2) gastric or (3) colo-rectal operations, and (4) exploratory laparotomy. On entering the peritoneal cavity and prior to incision of the gastro-intestinal tract the bacterial density in the wounds did not differ significantly between these four types of operations, the median being 5.4X10(-1) viable counts/cm2 (range 0.7-135.8). In all series of operations the median bacterial density was increased prior to closure of the wounds, significantly so after colo-retal operations, being 21.3X10(-1) viable counts/cm2 (range 1.1-144.4), caused by a rise in density of aerobic intestinal species, especially Escherichia coli. Regardless of type of operation, all wounds were contaminated during operation by aerobic commensals of the skin and mucous membranes of the upper respiratory tract, in particular by Staphylococcus epidermidis, this species not differing significiantly in density from the beginning to the end of operation. This same study revealed that within the operation wound, sites of low or even zero bacterial density were close to sites with a high density. It is suggested that postoperative wound infection is closely related to the density of the different species of bacteria present in the operation wound at closure.


The effect of experimental heterotopic pancreatic allotransplantation on the insulin response to oral glucose administration. Oral glucose tolerance tests (OGTT) were performed in 6 healthly, unimmunosuppressed pigs before and after heterotopic pancreatic transplantation and total pancreatectomy. Mean survival time after grafting was 55 days. Mean basal concentrations of glucose and insulin in serum were significantly higher after grafting and total pancreatectomy (p less than 0.01), but the insulin-to-glucose ratio was unaffected. The tolerance to oral glucose decreased after grafting and total pancreatectomy (p less than 0.01), even though the insulin levels in serum during OGTT were higher tp less than 0.01). This finding was also reflected in the insulinogenic index, which was almost twice as large after transplantation (p less than 0.01) as before. The decreased oral glucose tolerance might be explained by drainage of the transplanted pancreas into the systemic circulation instead of the portal vein.


Transferable and non-transferable drug resistance in enteric bacteria from hospital and from general practice. Drug resistance to 8 different antibiotics in Enterobacteriaceae isolated from different hospitals and two groups of general practitioners was studied. Escherichia coli dominated among the 632 strains investigated. Drug resistance was found in 62% of the 512 hospital strains and in 38% of the 120 strains from general practice. Multiple resistance was common especially in strains from hospital. R factors was found in 23% of the 317 drug-resistant strains from hospital and in 11% of the 46 drug-resistant strains from general practice. Resistance to streptomycin, sulphonamide and tetracycline either alone or in combinations were the most common traits transferred.


Determination of varicella immunity by the indirect immunofluorescence test in urgent clinical situations. Certain categories of patients run an increased medical risk when exposed to varicella. Newborns lacking maternal immunity, immunosuppressed leukemic children or children with other immunodeficient disorders may gain a decisive benefit by administration of e.g. interferon or of specific immunoglobulin against varicella. An indirect immunofluorescence (IF) method has been used to estimate varicella. An indirect immunofluorescence (IF) method has been used to estimate varicella immunity. Of 51 heavily exposed women denying earlier varicella, 39 were found to be immune by the test and none of those contracted varicella, whereas 9 out of the 12 non-immune women fell ill. 14/48 immunosuppressed children were found to be seropositive and none of these contracted varicella, whereas 13 mild or subclinical cases occurred among the 34 seronegative children. The same test revealed that 175/182 (96%) young adults in Sweden were immune. The indirect IF test is considered a rapid, simple and reliable method for estimating varicella immunity.


The persistence of group B streptococci in families. Four years ago the relative occurrence of group B streptococci was studied in a group of 118 term pregnant women of which 17 were B-streptococcal carriers. Of these, 15 were investigated in connection with the delivery. 11 of these women were reexamined 45-50 months after delivery together with their families. A high frequency of positive cultures without symptoms (50%) was found in this small group of women and their husbands compared with male and female control groups. Persistence seems to be common, a fact to be remembered in subsequent pregnancies.


A retrospective study of the occurrence of beta-haemolytic streptococci of various Lancefield groups in routine cultures from the County of Uppsala. During the months October to December of the years 1971-1974 the incidence of beta-haemolytic streptococci of the Lancefield groups, A, B, C and G from patients in the County of Uppsala was studied. The proportion of culture positive patients increased during the period studied from 7.2% to 13.7%. The increase was not only due to group A. In cultures from the respiratory tract the finding of group A streptococci increased from 4.1% to 10.7% and group C from 0.1% to 1.6%, while group B and G streptococci remained constant. In cultures from wound infections the percentage of patients culture positive for group A streptococci increased from 6.2% to 8.7%, group B from 0.8% to 1.9%, and group G from 0.5% to 0.9%, while group C remained constant. During the same months of the years 1972 to 1974 the frequency of sera with an antistreptolysin O titre of more than 1 000 U/ml increased from 0.6% t0 2.3% in the same region. A clinical study of scarlet fever and pharyngotonsillitis at the Department of Infectious Diseases showed a similar trend concerning group A streptococcal infections. These results stress the great importance of group A beta-haemolytic streptocci in human infections and indicate that the recent interest in non-group A infections should be continued.


The determination of fibrinolytic degradation products in concentrated urine after renal transplantation. Fibrin/fibrinogen degradation products (FDP) were determined in concentrated as well as unconcentrated urine in 29 patients undergoing renal transplantation. When determined in unconcentrated urine, FDP was found for 3-4 weeks after an uneventful transplantation, compared with 12 weeks when determined in concentrated urine. After acute rejection episodes FDP was found in unconcentrated urine, but remained in the concentrated urine for 8 weeks longer when concentrated urine was used for determination. In early chronic rejection and glomerulonephritis, FDP appeared as a sign of glomerular lesion in concentrated urine before it was found in unconcentrated urine. It was concljded that the presence of FDP in concentrated urine is a diagnostic tool of value particular in detecting early glomerular lesions caused by chronic rejection or glomerulonephritis.


Lymphocele: an important post-transplantation complication. Four cases of perirenal lymphocele after transplantation are reported. The possible aetiology, symptoms, and diagnosis of this uncommon complication are discussed. Careful dissection and ligation of perivascular lymph vessels during transplantation are recommended.


Pulmonary vein flow pattern in man during thoracotomy. Pulmonary vein flow (PVF) pattern was traced with an electromagnetic flowmeter in 10 patients with normal hearts undergoing operations for pulmonary diseases. Instantaneous pulmonary artery flow, ECG, pulmonary artery pressure and left atrial pressure were recorded simultaneously. The pulsatile flow patterns obtained ocrresponded well to those previously found in dogs, and were remarkably similar to caval flow pattern. A constant and inverse relationship between the contour of the right atrial pressure andthe PVF pattern was found. In 3 patients, PVF was reversed by atrial systole; otherwise the flow was forward throughout the cardiac cycle. The influence of positive pressure ventilation was small, consisting of a slight initial inspiratory increase followed by a decrease during the latter half of inspiration.


Donor-circulation as cardiopulmonary bypass in experimental heart transplantation. Heart transplantation was performed on 21 mongrel dogs using donor-circulation of another, bigger dog, instead of the heart-lung machine. All the dogs survived the operation. They showed a moderate metabolic acidosis, which was more related to a reduced blood flow of the recipient than to inadequate oxygenation capacity of the pump dog during transplantation, and which was corrected by administration of bicarbonate after the procedure. The technique was superior to disposable oxygenators in reducing the expense of the operation and providing a more gentle perfusion.


Peroperative measurements of blood flow and pressure in occlusion and/or stenosis of the subclavian artery and the brachiocephalic trunk. Preoperative haemodynamic studies were performed in 60 out of 64 patients operated upon for occlusive disease of the subclavian artery. The pressure differences over the occlusive lesion were recorded in 53 patients. Blood flow was studied in 56 patients with the aid of electromagnetic flowmetry. The average mean pressure difference was 30 mmHg in 6 patients with occlusion of the brachiocephalic trunk and 20 mmHg in 20 patients with left subclavian artery occlusion. In 3 patients with right subclavian occlusion it was 17 mmHg. The highest individual mean pressure differences were found in patients with multiple occlusive lesions in extracranial cephalic arteries. Stenoses of the brachiocephalic trunk and the subclavian arteries in general caused a lower average mean pressure difference than the occlusions. Vertebral blood flow in cases of occlusion of the proximal part of the subclavian artery was usually reversed.


[Studies on the retention capability of push-button attachments]. Of nine pushbutton attachments the force was determined which is necessary for separating the elements from each other, from unused state and in regular intervals up to 44000 times. The initial forces were between 3150 p and 775 p. It appears that forces between 400 and 1000 p should be sufficient for the anchorage of partial dentures. It is suggested that the retentive forces of such retentive elements be standardized. In extracoronal attachments, the use of two abutments soldered together is recommended.


Human pancreatic islets in culture: effects of supplementing the medium with homologous and heterologous serum. Islets of Langerhans, isolated from the human fetal pancreas and cultured in media supplemented with serums from human umbilical cord or adult donors, remained intact, free-floating, and functional for 2 to 5 months. Substitution of fetal calf serum for the human serum usually resulted in attachment of islets, monolayer formation, and relatively early (3 weeks) functional arrest.


Direct evidence for a bone marrow origin of the alveolar macrophage in man. Alveolar macrophages were obtained from 23 patients who had received marrow transplants for hematologic disorders. The presence of a Y body in macrophages of male origin was demonstrated by fluorescence microscopy. In those patients with a marrow donor of opposite sex the alveolar macrophages were shown to be of donor origin. The disappearance with time of host macrophages indicates a life-span, under the conditions, of approximately 81 days.


Evaluation of transcendental meditation as a method of reducing stress. Transcendental meditation is said to induce in its practitioners an altered state of consciousness resulting in relief of stress, an increased sense of awareness, and a sense of well-being. Release of catecholamines has been associated widely with stress and lends itself to quantitation. Plasma epinephrine and norephinephrine, as well as lactate, were measured in 12 volunteers before, during, and after meditation. Values were compared with those obtained from controls matched for sex and age who rested instead of meditating. Essentially the same results were obtained for the two groups, which suggests that meditation does not induce a unique metabolic state but is seen biochemically as a resting state.


Leeuwenkoek's observation of bacteria.

Leeuwenkoek's observation of bacteria. A form of dark-field illumination was produced that allows bacteria in aqueous suspension to be observed with both a Leeuwenhoek microsocope and a compound microscope without a condenser. Possibly, this illumination was Leeuwenhoek's "particular method of observing" bacteria.


Estimation of blood flow with radioactive tracers. The techniques of tracer dilution in the circulation, and of tracer uptake by and washout from an orgen, may be described using expressions that are general and are not dependent on specific models such as exponentials. The expressions have been applied to the measurement of cardiac output using impulse and constant rate injection techniques. Further expressions have been given for estimating organ blood flow from inflow/outflow concentration-time curves, and from the distribution of deposited tracer. Some problems with respect to the use of deposition techniques as they are ordinarily applied to the estimation of regional blood flow must be considered, particularly when there are capillary beds in series or where there is countercurrent diffusional shunting of diffusible tracers between inflow and outflow. This review deals with these various aspects of tracer theory as they relate to the measurement of blood flow.


Evaluation of perfusion with the 81Rb-81mKr generator. The development of the 81Rb-81mKr generator-delivery system has made available an ultrashort (13-sec) half-life radionuclide for continuous, constant-rate delivery as a gas, or as an isotonic, nonionic solution in 5% dextrose and water. This system has been evaluated and applied to the scintigraphic imaging of various organs and anatomic regions by intravenous and intraarterial infusion and by inhalation and deglutition. This diffusible, noble gas is inert chemically and biologically. When the gas is administered intraarterially, the volume of tissue being perfused may be defined with the scintillation camera. The 13-sec half-life is of a similar magnitude to the rate of capillary exchange, producing a heterogeneous image with steady-state administration in which the intensity of detectable radioactivity is proprotional to the time of diffusion into the tissue. This system appears capable of defining the rate of capillary exchange and the moment-to-moment changes brought about by vasoactive stimuli in specific organs.


Radionuclide angiography.

Radionuclide angiography. Radionuclide angiography is an established, widely used diagnostic tool. It is safe, easy to perform, and the low patient radiation dose makes frequent follow-up studies feasible. High-quality scintiscans have contributed to the widespread clinical acceptance of the procedure. The areas of application include virtually every organ of the body. In the brain, abnormalities in cerebral perfusion may be detected with this technique. Hepatic and renal tumors can be differentiated from cysts with radionuclide angiography. Its application to cardiology is achieving rapid growth and acceptance in both congenital and acquired heart disease.


Eikenella corrodens osteomyelitis, arthritis, and cellulitis of the hand. Eikenella corrodens was isolated from an orally contaminated hand wound which resulted in cellulitis, osteomyelitis, and arthritis. E corrodens is a gram-negative, microaerophilic bacillus which only lately has received attention as a possible pathogen. The organism grows characteristically as small, corroding, or pitting colonies on blood agar. It typically requires hemin or blood for reliable aerobic growth. Oral contamination of wounds predisposes to infection with E. corrodens. The management of these infections includes treatment with an effective antibiotic and surgical debridement. Because it is gram-negative, microaerophilic, and often difficult to isolate, infections caused by E corrodens may mimic those caused by gram-negative obligate anaerobes. However, E corrodens is resistant to clindamycin and lincomycin and sensitive to most other commonly used antimicrobial agents.


Naloxone in the parturient and her infant. Eighteen women in labor received analgesia with moderately large total doses of meperidien. Various doses of naloxone (8, 12, 18, 27, 40, or 60mug/kg of body weight) were given intravenously to the mothers before delivery in an attempt to find the dose that would prevent neonatal narcotic depression. Maternal and neonatal blood gas values, Apgar scores, and postnatal neurobehavioral examinations were used to assess the effects. Infants born of mothers who had received neither meperidine, promethazine, nor naloxone served as controls. After the naloxone injection, the mothers showed an improvement in consciousness and blood gas values. When the study infants, as a group, were compared with control infants, there was very little difference in blood gas values or neurobehavioral examination. Infants in the groups receiving naloxone in doses of 18, 27, and 40mug/kg compared most favorably with the control infants, indicating that naloxone may be effective in preventing neonatal narcotic depression.


Increased frequency of chloroquine resistant P. falciparum on a rubber estate in Peninsular Malaysia during two years of systematic chloroquine treatment. Chloroquine pressure was applied over a 22 month period on a somewhat isolated, malarious rubber estate by examination of residents at 4-week intervals and treatment of parasitaemias with chloroquine. During this time the monthly attack rate for P. falciparum rose four-fold to an average of nearly 18% per month, while that of P. vivax remained relatively constant at about 8%. Eight in vivo chloroquine resistance studies, which allowed both detection of late recrudescing R-I resistance and estimation of the risk of reinfection, showed an apparent rise in the drug resistance rate, from 12% to 20% prior to the study to the range of 40-50%. Virtually all resistance encountered was R-I in nature. There was no convincing evidence of chloroquine resistance among 148 tested P. vivax infections.


The differentiation of brugia malayi, B. pahangi, B. tupaiae and Wuchereria bancrofti. During studies on filariasis in Thailand, attempts were made to differentiate Wuchereria bancrofti and Brugia spp. by morphological characteristics, as well as by vector species.


Circumcision and 'uncircumcision'.

Circumcision and 'uncircumcision'. The origin of circumcision is shrouded in antiquity. Mummies, 6 000 years old, have been reported to show evidence of circumcision but the first definite account appears in Genesis, chapter 17. Many nations practise it as a rite, the time of its performance varying from soon after birth to early manhood. Antiochus Epiphanes prohibited it in Palestine and the introduction of Greek gymnasia where nudity was the practice, led to many seeking to become uncircumcised. Celsus has described such an operation which appears to have been successful. In Rome under Hadrian and in 16th century Spain a heavy funnel-shaped copper tube fitting was used as another method of restoring the prepuce. The debate concerning the value of circumcision has continued up until the present day.


Lipomata of the central nervous system.

Lipomata of the central nervous system. The radiological features and some clinical aspects of lipomata of the central nervous system are discussed, with examples of the different sites of involvement.


Herpes gestationis.

Herpes gestationis. A case report of herpes gestationis is presented. The incidence, classification, aetiology, natural history, diagnosis, prognosis and therapy of the disease are briefly discussed. The picture presented by the patient is classical of the disease, and her obstetric history of repeated abortion and stillbirths belies the modern concept of favourable fetal prognosis.


Reconstruction of defects of the mandible. A series of 14 mandibular reconstruction in 13 patients with chips of autogenous, cancellous bone and marrow supported by a titanium mesh tray is presented. The mandibular defects were the results either of operation for carcinoma of the tongue and the floor of the mouth or trauma. Satisfactory rehabilitation was accomplished in 11 patients. The advantages of this technique are ease of accomplishment, ability to replace long and awkardly shaped segments, less shrinkage due to bone resorption, and shorter intermaxillary fixation.


Immunological enhancement of renal allografts by antireceptor antibody. Lewis (L) rats treated with donor antigen [Lewis Brown-Norway (LBN) spleen cells] and antidonor antibody (L anti-BN serum) produce L anti-(L anti-BN) antibody that reaches peak titers 10 days later. The antiantibody functions as an antibody against cell-surface receptor molecules on Lewis recognition lymphocytes for BN antigen. LBN kidneys grafted at the time of peak antireceptor titer are not rejected and function indefinitely. Homeostasis of enhanced kidneys in long-term graft recipients was evaluted by four sets of experiments with the following results: (1) adoptive transfer of spleen cells from long-term recipients causes fatal graft-vs.-host disease in LBN and LDA hosts; (2) adoptive transfer of spleen cells from long-term recipients to new, otherwise untreated Lewis recipients of LBN kidneys delays rejection and prolongs recipient survival; (3) adoptive transfer of sensitized spleen cells to long-term recipients causes no apparent injury to enhanced LBN kidneys; (4) splenectomy in long-term recipients did not lead to deterioration of enhanced kidneys. It appears that long-term recipients maintain a delicate balance of effector and suppressor cells with respect to donor antigens.


A heterophile system in human renal transplantation. VI. Biologic effect of heterophile (HT-A) and nonheterophile (HL-A) compatibility on allograft survival. A series of 79 selected renal allografts has been studied to determine the biologic importance of the heterophile (HT-A) locus and the relative effects of HT-A and nonheterophile (HL-A) loci on allograft survival. The results demonstrate that HT-A and HL-A compatibility together yield poor results, whereas HT-A and HL-A incompatibility together yield poor results. HT-A incompatibility with any serologically determined HL-A incompatibilities give a one year allograft survival of 34%, and with two or more HL-A incompatibilities the one year survival rate is only 22%. Compatibility at one locus with incompatibility at the other yields intermediate results. Thus incompatibilities at both loci seem cumulative. The chief difference in the effect of incompatibility of the two loci is that HT-A incompatibility is decisive early, whereas HL-A effects are seen later. The HT-A system appears to be a major determinant of renal allografts success which needs to be taken into account in compatibility testing.


The detection and evaluation of migration stimulatory factor in renal allograft recipients. Seventy-one recipients of related donor renal allografts were tested for cellular immunity with the direct migration inhibition factor assay. Patients were divided into three groups on the basis of their responses in the assay. It was shown that all patients whose lymphocytes stimulated macrophage migration in vitro experienced more benign clinical courses than did those patients whose lymphocytes inhibited macrophage migration in vitro. The significance of a correlation between in vitro macrophage stimulation and clinical course is discussed.


[Epidemiological studies on salmonella in a certain area ("Walcheren project"). II. Presence of salmonella in the mesenteric lymph nodes and rectal contents of normal pigs slaughtered in Walcheren (author's transl]. During a period of twelve months, all pigs slaughtered on the former Isle of Walcheren were examined for the presence of Salmonella in the mesenteric lymph nodes and rectal contents. Salmonella was detected in 22.3% of 7,756 animals studied. Fifty different serotypes were isolated, two of these (S. menhaden and S. mikawasima) being isolated for the first time in the Netherlands. Data on the farms was collected, a differentiation being made between the type of farm (breeding, breeding and fattening, and fattening farms), the type of feed (pellets, pellets plus meal and meal) and the number of fattening pigs on each farm. The results show that there is a slight difference in the proportion of pigs responding positively to pellet rather than meal feeding, viz. 20.9% against 23.7%. A striking feature consists in the fact that this difference is much larger in favour of pellet feeding on the smaller farms (up to one hundred fattening pigs), viz. 12.9% against 21.0%. Another finding was that the average number of serotypes isolated on farms on which pellets were fed was smaller than that on farms on which meal was fed.


[Annual review of serotypes of E. coli isolated from various lesions in poultry and their sensitivity to drugs in vitro (author's transl)]. 550 Strains of E. coli, isolated from poultry, were typed. In addition, their sensitivity to various drugs was tested. A wide variety of serotypes was found to be present. Approximately 50% of the isolated strains of E. coli were found to be resistant to the tetracyclines, streptomycin and sulphafurazole. Chloramphenicol, neomycin and furazolidone usually were effective.


[Determination of intravascular and extravascular lung water after open heart surgery (author's transl)]. Total lung water (169 measurements) and intravascular lung volume (72 measurements) were determined postoperatively on 11 patients with aortic or mitral valve prostheses, by means of thermodilution (diffusable) and cardiogreen (non-diffusable). No loss of heat from the lungs occurred after injection into the trunk of the pulmonary artery and recordings in the left atrium. The admixture of the tracers was satisfactory. The extravascular volume was found to be higher than that measured by other authors, presumably owing to the greater efficacy of the thermodilution technique as compared to the use of tritiated water.


Production of specific antisera to human B lymphocytes. Antisera have been prepared, in mice and rabbits, to membrane and sub-membrane fractions of human B lymphocyte derived lymphoid lines. Antisera to a protein subfraction were, after only minimal absorption, specific for human peripheral B lymphocytes, monocytes and B cell derived lymphoid lines. The antigen(s) recognised by these antisera were not the same as the previously described B-cell markers; immunoglobulin, Fc receptor, complement receptor and Ia antigens. The antigen(s) could not be removed from cells by lysostrip with anti- beta2 microglobulin.


Cost comparison haemodialysis and renal transplantation. It is generally accepted that renal transplantation as a routine therapy for terminal stage renal patients has various medical advantages over chronic haemodialysis. A comparison of costs of both types of treatment clearly demonstrates a considerable difference also in favour of the former. This comparison is based on patient data from the Leyden University Hospital and on the tarrifs agreed upon by the Dutch Public Health Insurance Companies for haemodialysis treatment in 1973. (In this article only cost of center dialysis has been compared with cost of transplantation. In Holland, so far, no comparable data on the cost of home dialysis are available.) Renal transplantation, including 12 months of post-operative care, requires some Dfl. 45,000 (or + 18,000) whereas one year of chronic center haemodialysis cost Dfl. 65,000 (or + 26,000). The cost of treatment of a patient with a well-functioning graft in the second and following years normally does not exceed Dfl. 8,000 (or + 3,200) per year. These figures demonstrate the enormous economic advantage of transplantation as compared to chronic center haemodialysis, and that together with the medical advantages of transplantation should be sufficient reason to promote transplantation.


[A forty-year survey of radiation therapy of the nasopharyngeal carcinoma]. Dueing the last forty years, 295 patients with carcinoma of the nasopharynx were admitted to our department. Dur to retarded discovery, the total five-year survival rate amounts to only 15.5% of all patients admitted. In 48.5%, the first symptom was a swelling of the lymphatic ganglions at the neck. Squamous cell carcinoma with 44.2% ranges at the first place followed by retotheliosarcoma with 11% and lympho-epithelioma with 6.4%. Three periods of therapy are confronted. During the first one, brachyradium and teleradium were used; during the second, brachyradium and telecobalt; during the third period, telecobalt and high-energy electrons were employed. Most important, after all, is not the ionization technique but the stage with a 47.1% five-year survival rate in T1N0 as compared to T2N0 with 28.6% and T1N1 with 19.4%. Lympho-epitheliomas with a five-year survival rate of 38.6% offer the best prognosis in contradistinction to sarcomas with 25% and squamous cell carcinomas with 15.04%. At the moment, investigations are going on to verify if afterloading techniques using 60Co are preferable to conventional irradiation techniques.


Stimulation of the estrogen synthesizing system of the immature rat ovary by exogenous and endogenous gonadotropins. Immature rat ovaries increase their secretion of estradiol (E2) when stimulated by gonadotropins but only after a lag period of several hours. Once established, estrogen secretion can be maintained, or increased, by the continued presence of gonadotropin. A combination of ovine FSH+LH given at 2 hr intervals stimulated the estrogen synthesizing system (ESS) of the ovary and serum E2 showed a pronounced rise between 16 and 20 hrs after the initial injection. When given every 2 hrs for 5 doses (0-8 hrs) serum E2 was undetectable. However, it was increased if 20 IU PMS was injected at the time of the last dose of FSH+LH. Endogenous FSH+LH, increased by hourly injections of LH-releasing hormone for a period of 8 hrs, stimulated the ESS: serum E2 increased at the expected when this treatment was followed by an injection of PMS. Anti-PMS antiserum given 12 hrs after PMS, prevented the expected rise in serum E2 at 24 hrs. However, FSH, LH or a combination of the two given every 2 hrs beginning at the time of the anti-PMS produced an increase in E2 secretion; the combination was more effective than either hormone alone. These results are consistent with the interpretation that a combined FSH-LH action is responsible for induction fo the ESS in the immature rat ovary. The combination of homones is also very effective in maintaining estrogen secretion but some function appears possible with FSH or LH alone.


The United States National Family Planning Program, 1968-74. In the United States, there are currently an estimated 30 million women at risk of unwanted pregnancy; of these, more than 12 million low-and marginal-income women aged 20-44 and adolescents of all incomes appear to be in need of subsidized family planning services. A family planning delivery system capable of serving approximately one-half of these women has been rapidly organized: the clinic program has grown from 900,000 clients in 1968 to 3.4 million in 1974, and the private sector is assumed to be providing care for 3 million more. The allocation of federal funds, the enactment of supportive policies and laws, and the organization of a specialized and centralized agency in the federal government have been factors in the initiation and expansion of family planning services.


The Arruga suture for retinal detachment 17 years on. A brief description is given of the experience gained in the use of the 'Arruga suture' method in 64 eyes out of a total of 356 operated on for retinal detachment. The encouraging results in those eyes in which the method was used as a primary procedure and the absence of complications suggest that the 'Arruga suture' should be considered in selected cases of retinal detachment--particularly in cases of aphakic detachment.


Out-patient cataract surgery.

Out-patient cataract surgery. A randomized prospective study of 100 consecutive cataract operations was designed to ascertain the need for hospitalization for this procedure. The results clearly indicate that immediate ambulation and discharge of the cataract patient do not detract from the very high success rate of this operation. The random nature of this study adds strong support to those surveys that have similarly concluded that hospitalization and postoperative restrictions are not necessary for the great majority of cataract patients.


Herpes simplex keratitis and keratoconus in the atopic patient. A clinical and immunological study. Selected case histories indicate that there is good evidence that atopic disease is associated with severe primary and recurrent ocular herpes. The salient features of the syndrome are that the disease is often bilateral, that recurrences are more frequent, and that the corneal epithelium is often slow to regenerate after disease. Therapeutic difficulties may be encountered because atopic eye disease requires anti-inflammatory therapy which is contraindicated in epithelial herpes. Keratoplasty in herpetic disease in the presence of vascularization or atopic eye disease should be avoided, as an augmented homograft reaction is also an occasional complication. Screening of patients for serum immunoglobulins and cellular immunity using in vitro lymphocyte transformation and macrophage migration inhibition tests, failed to reveal any group evidence of immune deficit, but there was evidence of this in some individuals. The most serious management problems occurred in the presence of raised IgE levels. In a group of patients with keratoconus, IgE was raised in 17 per cent, and there was a depression of IgA in 8 per cent. A knowledge of the serum innumoglobulin levels can be of help in the management of the keratoconus patient in the postoperative period after keratoplasty.


Humoral antibody and cell-mediated cytotoxicity responses of mice to rat skin xenografts. Aspects of both the humoral and cell-mediated immune responses of mice to rat skin xenografts were studied sequentially and quantitated. Antirat lymphocytotoxic and hemagglutinating antibodies were first detectable at 7 and 6 days, respectively, after primary grafting and their appearance in serum corresponded to the time of graft rejection. Lymphocytotoxic titers were low after primary grafting but increased greater than 4-fold after secondary grafting. Cytotoxicity of mouse spleen and axillary lymph node cells for 51Cr-labeled rat lymphocyte target cells was first detectable 5 days after primary grafting but was quite low showing a peak of only 7% specific 51Cr release 6 days after grafting. In contrast, the cytotoxicity of mouse spleen and lymph node cells for allogeneic target cells after primary skin allografting was significantly greater. It is suggested that the magnitude of the cell-mediated immune response to skin xenografts is less than the response to allografts and that the quicker and more vigorous rejection of skin xenografts is due to a larger participation of humoral antibody in the rejection process.


Lymphocytotoxic antibody detection and crossmatching for renal transplantation. Sera of 134 recipients awaiting first renal transplants have been tested for cytotoxic antibody by three methods in order to assess the different techniques, and various factors in the techniques have been investigated. The use of only one technique would have failed to detect some of the antibodies found in the sera of 35 patients and it was necessary to use both a 37 C test and the NIH 20 C technique in order to demonstrate them. Results on 402 serial samples from 108 patients indicate the importance, because of fluctuation in antibody levels. of using more than one sample, i.e., previous sample in addition to a fresh specimen from any patient when crossmatching prior to renal transplantation. Lymphocyte suspensions from 44 of 118 cadaver donors were found to be unsatisfactory for accurate cytotoxic crossmatching due to a high background of dead cells. DNase renders such suspensions suitable for use and should be used in such cases. It is felt that if more than one technique were generally used, improved detection of cytotoxic activity would result and would help to resolve present conflicting opinions about the effects of cytotoxic antibody on graft survival. Results are given of 19 patients who had formed cytotoxic antibody prior to renal transplantation in the Unit. Eighteen of these have surviving grafts.


Successful kidney trasnplant in patient with positive crossmatch due to autoantibodies. Prior to kidney transplantation a young woman was found to have lymphocytotoxic antibodies to an HLA/mixed lymphocyte culture identical sib donor. The serum killed 75% of the lymphocytes at 22 C but was unreactive at 37 C. At room temperature it was cytotoxic for many lymphocytes of a random panel and also reacted with the recipient's own cells. Complement was required for cytotoxicity. Absorption with lymphocytes but not with platelets abolished the reaction. The antibodies disappeared spontaneously and the transplant was performed. There was no evidence of rejection and at 6 months the kidney is in excellent condition. Cold-reactive lymphocyte specific autoantibodies causing a positive crossmatch could be distinguished from anti-HLA antibodies and did not preclude a successful kidney transplant.


Differential survivals of F1 hybrid allografts in parental recipients. Differential survival times of various organ allografts in the rat across the same histocompatiblity barrier were studied by transplanting the kidney, heart, intestine, pancreas, and skin from (BN X Le)F1 hybrid donors to Lewis recipients. Some (one-third) of the kidney grafted rats survived for a prolonged period of time (32-72 days, plus one rat surviving over 9 months), whereas all other organs and skin were promptly rejected between 7 and 21 days. Possible factors responsible for the prolonged kidney survival are discussed; the reason for this was not clear but was not related to the period of operative ischemia or postoperative blood-urea-nitrogen, nor were animals tolerant to donor antigen as evidenced by the popliteal lymph node weight assay and signs of mild rejection on histology of grafted kidneys. A hypothesis of autoenhancing mechanism is presented.


Prolongation of rat heart allograft survival by a synthetic progestogen (melengestrol acetate) and ara-cytidine acylates. Immunosuppressive effects of newly developed synthetic progestins, melengestrol acetate (MGA), and three pyrimidine analogs, ara-cytidine (Ara-C), Ara-C 5'-benzoate and octanoate, were investigated on the heart allograft survival in the rat. MGA at the dose of 25 mg/kg given every 3rd day starting 1 day before the grafting through day 20 prolonged the graft survival significantly without toxic effects (80.2 +/- 40.2 days versus control 7.0 +/- 0.1 days). The high dose (50 mg/kg/day) was more effective (137.4 +/- 26.6 days) but a high incidence of multiple abscesses (37%) was also noted. The other three agents were either highly toxic or not immunosuppressive.


A comparison of the survival of H-Y incompatible ear, tail, and body skin grafts. In the H-Y incompatible C57BL/6 male to female system, both tail and ear skin grafts were found to persist longer than body (thorax) skin grafts of the same size and shape. Ear skin grafts of long standing did not affect the survival of subsequent body skin grafts but, in one case, a long-term tail skin graft prolonged the survival of a subsequent body skin gratf, both transplants persisting throughout the life of the host. Whereas ear skin grafts from which cartilage was removed were invariably rejected, several ear skin grafts with cartilage intact survived permanently.


[Use of the ORIM-1 microscope for determining the thickness of paraffin sections]. On measuring the thickness of paraffin sections with the help of the "OPIM-1" microscope the error for sections of optimal thickness 5--10 mkm was no more than 3%.


[Use of aluminum foil baths for embedding biological materials in epoxide resins]. The baths intended for embedding the biological material into epoxide resins are made of aluminium foil, 0.1 mm thick, cut in the form of rectangles (13 X 18 mm). The rectangular foil plates are placed on a soft microporous rubber separator 30--40 mm thick and by means of a form with the base equal to 5 X 10 mm the baths are pressed down by 4 mm deep. The baths are stuck to the paper stripes by rubber cement to ensure easy handling and numeration. In the process of embedding and polymerization the paper stripes having the baths are placed in the exsiccator with P2O5 and thermostate on special aluminium stands.


Embryologic basis for lower ureteral anomalies: a hypothesis. A hypothesis for the embryogenesis of lower ureteral anomalies invokes variations in location and number of ureteral buds on the mesonephric duct. Such vagaries determine the length of the common nephric duct and the time of meeting of the ureteral bud (or buds) with the urogenital sinus. These factors in turn affect the density of the mesenchymal tissue and its mass in relation to the adjoining structures and, ultimately, the musculature of the trigone as well as the level of the ureteral hiatus and the musculature of the bladder base. Primary reflux, ureteral ectopy, ureteral duplication, ureterocele, functional ureteral obstruction, and congenital strictures are viewed and possibly explained in the light of the embryonal variations mentioned.


Internal marsupialization of lymphoceles after renal transplantation. A technique of internal marsupialization of lymphoceles after renal transplantation in selected cases is described. This technique allows complete marsupialization of retrorenal lymphoceles not amenable to external marsupialization. It also can be carried out during concomitant intraperitoneal surgical procedures.


[Further trial of clinical diagnostic index for the malignancy diagnosis of mammary nodules. (author's transl)]. The results of a further trial of a clinical dianostic index (CDI) for ill-defined mammary nodules, based on the algebrical results of positive numerical values (for a suspect feature), or negative numerical values (for non suspect feature), attributed to 10 characteristic semeiological features, previously described, are reported. 222 nodules were clinically examined, all subsequently subjected to mammography and 188 of them to thermography; they were then operated and examined histologically. Of 106 malignant nodules the accuracy of the CDI was 88.6% with 4.7% false negatives; for mammography 65% with 21.7% false negatives; for termography (out of 87 cases) 66.6 with 21% false negatives. The accuracy in 116 benign nodules was 45.6% for the CDI, 32.7% for mammography and 29.7% for termography (out of 101 cases). In three cases of malignant nodules in women below 35 years of age, all three examinations gave negative results. The relations between the diagnostic errors of the three examinations, as well as the dimensions and histo-type of the nodules are also considered. It may be concluded, that the CDI is a simple rapid and highly accurate clinical investigation for early diagnosis of mammary carcinoma.


[Replacement of the bladder with isolated intestinal loop]. Based on the experience with 98 operations performed for replacement of the urinary bladder with an isolated intestinal segment, it was demonstrated that the most frequent complications were peritonitis, inflammation of the lung that develop mainly with the postoperative paresis of the digestive tract in the background. Therefore, a complex of prophylactic and therapeutic measures for the postoperative intestinal paresis is recommended, the technic of surgical intervention being described in detail. A comparison of the results of surgery, taking into account the mode of the urine outflow in cystectomy, enabled to consider cystectomy with replacement of the bladder with an intestinal graft as the method of choice.


[Incompetence of duodenal stump sutures after stomach resection in ulcer disease]. Among 356 gastric resections of the Billroth 11 type performed for ulcerous disease there were 11 cases of suture incompetency of the duodenal stump (3.1%). This complication was mainly caused by technical difficulties arising in operations under complicated anatomical conditions and tactical errors of a surgeon in selection of the technic of the stump suturing. The treatment of the duodenal stump suture incompetency consisted in urgent relaparotomy with a tramponade and drainage at the site of incompetency and application of a complex of conservative measures. During the first days after relaparotomy a drainage is connected into a pump-aspirator. In case of complicated duodenal ulcers resection with the aim of "ulcer exclusion" seems to be rational.


[Results of hetero-osteosynthesis in treatment of injuries of the crural bones]. The early and late results of secure heteroosteosynthesis in patients with fresh open and closed fractures and pseudarthrosis of crural bones are discussed. The most favourable results were gained in treatment of closed injuries of crural bones-80.25% of good and excellent issues. Observations for up to 6 years period over patients have demonstrated persistant functional issues with restoration of the anatomical form of the injured extremity and complete rehabilitation of the capacity for work in patients operated upon.


[Surgical treatment of injuries of large blood vessels of the limbs]. In treatment of 50 patients with injuries of large vessels of limbs the authors have employed all kinds of vascular plasty, including lateral and circular sutures, putting of a patch on the vascular wall, replacement of an arterial defect with an autovenous graft. Autovenous plasty employed in various modifications in 21 cases is felt to be the method of choice in operations on injured arteries in cases of an extensive damage of soft tissues of limbs and open fractures. The results of the treatment are described.


[Treatment of injuries of the tendons of digital flexors]. An experience with functional and physical and physical therapy employed postoperatively in 525 patients with injuries of 752 digital flexor tendons is reported. A primary suture on flexor tendons after the V.I. Rozov technic within the boundaries of the synovial-aponeurotic sheath was put on 252 fingers in 183 patients. Homoplasty of digital flexor tendons was performed in 342 patients (500 fingers), terms of the injury being from 2 months to 15 years. Studies of late results in 382 patients on 535 fingers enabled to conclude that along with an operative procedure one should provide the conditions for an early functioning of the muscle and operated tendon per se. Therapeutic exercises associated with massage, physical and labour therapy seem to be a decisive factor in the complex of postoperative measures.


[One-row suture in construction of biliodigestive anastomoses]. An experience with the construction of 138 anastomoses between the external bile ducts and the duodenum is analysed. The anastomoses were constructed in 47 patients with two-raw and in 91--with one-raw sutures. A partial nonhermeticity of the suture line was observed as seldom both in cases with one-raw and two-raw sutures. In constructing anastomoses one-raw suture is felt to be more preferable, since the formation of stoma with a one-raw suture is felt to be more preferable, since the formation of stoma with a one-raw suture simplifies the procedure.


[Method of treatment of pancreatic stump after its resection]. Based on anatomical studies and clinical observations the authors concluded that a mechanic suture and subsequent closure of the pancreatic stump with an absominal graft covering the gland, or that procured from the transverse colon mesentery seemed to be an optimum procedure in pancreatic resection.


[Primary plastic surgery of skin defects with delto-pectoral flap after resection of disseminated neck tumors]. In the paper, the authors report their experience with the use of deltopectoral fat-cutaneous grafts for primary reconstruction of jugular skin defects after the combined therapy for malignant tumors. The technic of procurement of such grafts is described. The results of the plasty performed in 20 patients are reported. Favourable results were noted in 19 patients.


[Dermatoplasty in treatment of late radiation injuries of the skin]. An account should be taken of regional blood and lymph circulation in selecting the method of cutiplasty in surgical therapy of advanced radiation injuries of skin. A well-grounded choice of cutiplasty enables one to improve the results of the treatment and to shorten its duration.


[Evaluation of survival of the pedicle flap by polarographic method]. The data obtained by the authors allowed the use of a polarographic study of pO2 in the pedicled graft tissue as an adjunct method of determining the graft patency. This method may be especially valuable in cases of a complicated period after suturing the graft to a defect, when considerable difficulties arise as to finding the optimum terms for a safe incision of the feeding pedicle.


The role of vasoactive agents in shock therapy. Vasoactive agents may have vasoconstrictor, vasodilator, cardiac stimulatory, or combined effects on the cardiovascular system. The intensity or degree of therapeutic effect differs with each agent. Table 1 provides a relative ranking of each discussed compound's effect regarding its ability to produce one or more of the listed effects. The effects of vasoconstrictor drugs such as methoxamine, phenylephrine, and norepinephrine have been generally unfavorable in shock because of the inhibition of tissue perfusion which results from their use. Debate still exists, however, and these agents have been shown to provide some benefit in selected cases. The rationale that shock results at least in part because of intense vasoconstriction has led to the usage of vasodilators in therapy. Currently isoproterenol, a beta adrenergic stimulating agent, is being used to elicit vasodilation in lieu of alpha blockage because the alpha blocking drugs phenoxybenzamine and chlorpromazine have longer, more irreversible effects. The merit of isoproterenol has to be evaluated in light light of its cardiac stimulatory effect. With the current antishock drugs, those which possess cardiac stimulatory effects seem to be most effective with the exception of those with alpha stimulatory properties. The importance of cardiac stimulation in treating shock is related to the fact that in many forms of shock a decrease in cardiac function is evident. Drugs which effect increases in cardiac performance will increase cardiac output and tissue perfusion. The increased excitability of the heart caused by many of the drugs is a drawback, but compounds such as dopamine seem to have less excitatory effect than does isoproterenol. It may be that vasoconstriction, vasodilation, and cardiac stimulation are all contributory to the alleviation of shock. However, it is important to remember that the use of vasoactive agents must be reserved for those deteriorating shock states in which primary and secondary factors responsible for the initial state have been adequately controlled and only when appropriate methods for judging hemodynamic performance have been instituted.


Salmonellosis in calves due to lactose fermenting Salmonella typhimurium. A lactose fermenting strain of Salmonella typhimurium was isolated from two calves which died during an outbreak of acute enteritis. The organism was biochemically typical in all other respects. In one calf, uncomplicated by treatment before death, the autopsy findings were those of a severe fibrinous enteritis which was reproduced in another calf dosed orally with culture. Attention is drawn to scattered reports of lactose fermenting salmonelle causing morbidity and mortality in calves and man.


Nutrition and bone disease in the dog and cat. The most commonly encountered nutritional bone disease is nutritional secondary hyperparathyroidism. This is primarily of importance in the dog but is occasionally seen in kittens, particularly of the Siamese breed, and is often associated with the feeding of owner compiled, meat-rich diets. Classic rickets is now a rare clinical entity. Hypertrophic osteodystrophy is regularly seen in the larger breeds of dog and the aetiology remains obscure. Hypervitaminosis A associated with liver-rich diets is often encountered in the cat. Hypovitaminosis A has been described but its true clinical significance is unknown.


[Comparative study of the protective qualities of some protease inhibitors in the drying of Cl. oedematiens type B toxin]. A comparative study was carried out on the lethal properties of dry toxins of Clostridium oedematiens Type B obtained by means of salting cultural Seitz-filtrates, containing or lacking protease inhibitors, being dried for 24 and 48 hours at 37 degrees C. It was found that when ammonium sulfate was used for salting, the dry toxins from such filtrates, containing 0.0001 gram% specific soya inhibitor, showed 2 to 300 times higher toxicity than those containing no inhibitor. The addition of 3 per cent normal horse serum to the cultural filtrates of Clostridium oedematiens Type B favoured the production of dry toxins of higher lethal properties. The decrease in the lethal properties of a dry toxin without inhibitor was found to be in a positive correlation with the drying term and the residual moisture of the toxin. When a protease inhibitor was employed the drying term had no effect on the activity of the dry toxins.


[Hypoglycemic mediastinal tumor].

[Hypoglycemic mediastinal tumor]. A very rarely met case of extrapancreatic hypoglycemic tumor is described, localized in the anterior mediastinum, histologically- a reticulosarcoma. The tumor advanced very rapidly till the exitus. The frequent hypoglycemic crises and comae, when the blood sugar reached to 50 mg% mere overcome by glucose solutions.


[131-I capture by the thyroid gland during and after stopping thyrostatic treatment in thyrotoxicosis]. The accumulation of 131J in the thyroid gland was investigate in dynamics in 31 patients with thyrotoxicosis, treated with mercaptoimidazol (timidazol) for an average of 16 months. The patients were clinically euthyroid, with normal values of the basal metabolism, PBI, PBI131 AND TOTAL THYROXIN IN SERUM. The 131J captation, investigated in the course of a maintaining treatment without discontinuation of thyrostatics, show elevated percentages (55.4 per cent by the 6th hour, 61.3 per cent by the 24th hour), being within the norm only in eight patients. Its average values are significantly lower up to the 6th month post treatment discontinuation and closrm, with only 13 above the norm. Only three of them (10 per cent) developed recidivations till the end of the 9th month after e treatment. The authors concluded that thyrostatics, in maintaining doses, do not block thyroid gland 131J cumulation which in the majority of the cases persisted to be elevated a long time after the discontinuation. Its complete normalization in the later stages speak, most probably, for the development of a lasting remission of thyrotoxicosis.


[Possibility of determining the species of cultured cells by the method of membrane immunofluorescence]. Different cell cultures were studied in order to determine their species appurtenance by the method of indirect membrane immunofluorescence. A continuous line of rat fibroblast cells previously regarled to be a line of rat derivation was found to belong to primate species. The experimental results show that this method may be used not only for determination of the species appurtenance of in vitro propagated cells but also for detection of additional antigens not associated with their species-specificity.


Treatment of trichomonal vaginitis with single dose tinidazole (Fasigyn). A new trichomonacidal agent, Tinidazole, (Fasigyn) has been used in a single oral dose of 2 g in 24 patients with very good results. An over-all cure rate of 100% (6 patients) was achieved in in-patients and of 94% 23 out of 24 patients in out-patients. The failures may be attributed to recurrence due to concomitant bacterial infection or to re-infection by a male partner. This regime is therefore strongly recommended as the treatment of choice for Trichomonal vaginalis infection.


Toxigenic Escherichia coli and childhood diarrhea. Stool specimens were examined from 40 children with diarrhea who were under three years of age to determine the incidence of enterotoxigenic Escherichia coli in endemic diarrhea. Heat-labile E. coli enterotoxin was assayed in the very sensitive and reproducible cultured adrenal tumor cell system. Toxigenic E. coli were isolated from only one stool specimen and in this case infection with Shigella dysenteriae was also present. None of the eight classic enteropathogenic E. coli isolates were positive in the adrenal assay. This study suggests that heat-labile enterotoxin-producing E. coli are not an important cause of endemic childhood diarrhea in Southern California.


[Local therapy of extensive severe burns: an illustrative review (author's transl)]. Apart from improvements in general management, the implementation of modern local therapy of burns, including topical chemotherapy and early surgical coverage of the burned surface, has significantly reduced the morbidity and mortality of severely burned patients. Furthermore, the average time of hospitalization has decreased (for example: 3rd degree burn, 60% of body surface involved, hospitalization in 1953: 11 months; in 1974: 5 1/2 months) and the rehabilitation period has also been shortened. This paper deals with current management at this department in respect to the local treatment of extensive 3rd degree burns. Special consideration is given to the different possibilities of wound closure and their indications, to therapeutic problems inherent in the special localization of certain burns and to the importance of physical therapy for early rehabilitation. In severe burns additional injuries should be considered and excluded by careful examination.


[The isoenzyme pattern of serum alkaline phosphatase in patients on intermittent haemodialysis and kidney transplant recipients (author's transl)]. The total activity and the isoenzyme fractions of alkaline phosphatase were determined in the serum of 15 patients on intermittent haemodialysis and 32 kidney transplant recipients. The isoenzymes of alkaline phosphatase were separated by polyacrylamide gel disc electrophoresis. It was apparent that the increased activity of serum alkaline phosphatase in these patients was not limited to a distinct isoenzyme fraction. 5 of the 15 dialysis patients and 19 (59%) of the 32 kidney transplant patients showed a bone-type isoenzyme pattern. The possible causes for the presence of a bone-type alkaline phosphatase pattern are discussed. The fractionation of alkaline phosphatase gives a valuable indication as to the organ of origin of the particular fraction and is also of diagnostic value when the total activity of alkaline phosphatase lies within the normal range.


[Disturbances of lipid metabolism following renal transplantation (author's transl)]. The serum cholesterol and triglyceride levels and the lipoprotein electrophoretic pattern were investigated in 33 kidney transplant recipients. These patients showed elevated serum cholesterol and triglyceride levels in comparison with a group of healthy control subjects. Lipoprotein electrophoresis showed a predomination of types II a, II b and IV, according to Frederickson. The causes of the disturbances in lipid metabolism are discussed. There is a definite risk of cardiovascular disease in kidney transplant patients as a consequence of the altered lipid metabolism.


[Some aspects of biological membranes: concepts and techniques (author's transl)]. Some of the abundant data on the structure of biological membranes are compiled in this short review, with particular emphasis on morphological techniques. The "fluid mosaic" model of biological membranes has rapidly gained importance as the fundamental concept. According to this model, protein particles swim in a lipid bilayer, whose molecules are ordered with their hydrophilic end outside and their hydrophobic tail inside the membrane. Proteins are spatially stabilized and actively moved by a submembranous net of fibrillar proteins. Information about the orientation of protein molecules within the bilayer is obtained by protein labelling with membrane impermeable compounds and subsequent gel-electrophoretic separation of the solubilized components. Freeze etching brings to light intramembranous particles which are probably segments of the membrane proteins that stand out from the plane of the split hydrophobic membrane interface. By this method the morphology of cell contacts, for example, can be analyzed and comprehended at a supramolecular level. Special techniques such as observation of both matching sites of the split membrane halves or deep etching (whereby the actual surface of membrane is exposed) may provide further valuable contributions to the rapidly expanding field of membranology.


[New methods in cytogenetic diagnosis (author's transl)]. Several different methods for identifying human chromosomes were developed over the past years. These methods include fluorescence techniques using quinacrine mustard, acridine orange or Hoechst 33 258 and special methods using Giemsa staining. Studies on replication of chromosomes were greatly improved by using BUdR labelling.


[Heterologous fibrinogen for tissue adhesion. immunological and histological investigations (author's transl)]. The immunological reactions of heterologous fibrin were investigated in a sensitive experimental system. In 10 rabbits autologous full-thickness skin grafts were glued with bovine fibrinogen cryoprecipitate. 5 of these animals had been immunized against this adhesive before transplantation. In a control group the graft was fixed with homologous fibrinogen cryoprecipitate. Examination of the sera of the animals for antibodies against fibrinogen was performed before immunization, 1 day prior to and 14 days after skin grafting. 14 days after skin adhesion all grafted areas were examined by histological methods. In the group without preoperative immunization antibodies were found against fibrinogen. The skin graft healed in this series in the same manner as in the sham group. In the series with preoperative immunization the glued skin graft was discharged early and the healing procedure of the defect was retarded.