[Long-term graft survival in the xenogeneic system wolf-dog (author's transl)]. In contrast to the zoological definition that wolf and dog belong to different species, it is shown by this study that in terms of immunology both species appear to be even closer related than DL-A compatible and MLC negative unrelated dogs. However, this close relationship is not expressed in DL-A or MLC tissue typing. Wolf skin-graft survival time in untreated dogs was 12,5, in ALG-treated dogs 85,6 days. The survival time in this system may be less dpendent on DL-A or MLC histocompatibility than on other genetic systems, which are hitherto not sufficiently defined. An accidental, speciesspecific accordance in these systems may explain the obviously weak histocompatbility barrier between wolf and dog. It is concluded that in certain species-combinations xenotransplantation could be more successful than random allotransplantation. The availability of a xenogeneic species related to man similar as wolf to dog would markedly facilitate clinical xenotransplantation.


[Renal blood flow investigations with 133xenon and the Anger scintillation camera in the hyperacute xenograft rejection of the rabbit kidney (author's transl)]. The aim of this study was to demonstrate the advantage and validity of 133Xe-washout externally monitored by the scintillation camera. Until now there were no reports on quantitative blood flow studies in Hyperacute rejection of transplanted kidneys using a scintillation camera. Within 35 minutes after e-vivo hemoperfusion of rabbit kidneys by cats we found a simultaneous progressive decrease of renal blood flow, renal cortical blood flow as well as of the intrarenal distribution of renal cortical blood flow in all cases. The hyperacute rejection of xenografts could be verified in every case histologically. Using the scintillation camera we were able to detect regional perfusion defects caused by artifical air embolism as well as by preexisting cortical infarction.


Effects of L-thyroxine in acute renal failure. Eight pediatric patients presenting with acute renal failure (shock kidney, anuria continuing for three to five days) were treated with L-thyroxine (p.o. 5-6 mug per kg per day). Dialysis was not used. Diuresis started within 34 to 46 hours. Serum levels of urea and creatinine normalized within a very short time. The results are discussed on the basis of a new hypothesis concerning the RPF- and GFR-raising action of thyroid hormone in the normal situation and in acute renal failure.


[Trial routine dections of malaria. Experimentation of 1,500 blood donors]. The aim of our research was to look for specific malaria antibodies in a randomized sample of 1.500 blood donors. We used the indirect immunofluorescence technique. During this project we have noticed the lack of validity of the "the five years rule" usually followed in France to prevent transfusion malaria. We have also evaluated the help brought by an "oriented investigation" allowing firstly a selection of potentially dangerous donors, secondly, the use of their blood bottles according to serology results. This work finally shows that total security can only be achieved by systematic research on all blood donors.


[Comparison of angiographic and bioptic findings in transplanted kidneys (author's transl)]. Comparison of angiographic, clinical and bioptic findings after kidney transplantation permits the following statements: Angiography is indicated with the appearance of a hypertony after transplantation and in clinically unclear reduction of function; it is the method of choice for proof or exclusion of a vascular complication. Recognizable vascular alterations and an extended arterial wash-out time during previous crises tend to indicate severe damage which affects the whole organ. On the other hand, the same alterations in chronic rejection do not permit a conclusive evaluation of the ability of the transplant to function. Isolated cortical ischemia in regard to rejection occurs relatively early and is prognostically an unfavourable sign. Differentiation of low grade rejection: tubular necrosis is hardly possible on the basis of the angiogram. As a result, the value of angiography for the diagnosis of rejection in the clinically important, but less pronounced, stages is limited. The most important of the informative diagnostic measures is renal sequence scintigraphy. This technique not only makes an early diagnosis possible but also an observation of the course of the reaction.


[Introduction to x-ray diagnosis of primary malignant bone tumor (author's transl)]. Diagnosis of primary malignant bone tumors is based on a synopsis of X-ray findings, clinical symptoms, gross pathology and histology. Osteosarcoma, chondrosarcoma, fibrosarcoma and myelogenic sarcomas have a typical symptomatology and can be diagnosed in the radiograph by localisation, mode of extension, alterations of bone and periosteum.


[Dietotherapy in the diseases of the gastrointestinal tract in infancy (author's transl)]. The AA are proposing a dietotherapy in the diseases of the gastrointestinal tract in infancy, characterized from acute diarrhoea. A slow hydrolysis product of casein is used for this purpose. The AA after description of the very good results obtained, are calling the attention on the fact that the advantage was realized only with a food product and not with drugs.


[Fatty acids with an odd number of carbon atoms: metabolic and nutritional aspects]. Odd-numbered fatty acids are present in natural sources of animal or vegetable origin. Their concentration is generally not higher than 5% of the total fatty acids. In some cases, however, like in the mullet or Euglena gracilis, the value reaches 20% of the total fatty acids. Higher concentrations, up to 80%, have been found in some hydrocarbon-grown microorganisms. In the animal organisms metabolic pathways for the synthesis or degradation of the odd-numbered fatty acids are present, but the adaptive capacity and the regulation of the different pathways are not known. The consequences of feeding animals or human beings on these unusual fatty acids in large amount are uncertain, because the composition of the fat depots, of the lipid structures and the circulating lipids can be affected, possibily influencing the membrane functions and, particularly the nervous system functions. The literature sighted shows the scarcity of specific studies in this field and indicates the need for further and more detailed researches.


[Post-salmonellosis rheumatism].

[Post-salmonellosis rheumatism]. Reports of forty-six cases of aseptic polyarthritis following intestinal Salmonlla infections have been published. The organism involved is always a "minor" Salmonella either typhimurium or enteritidis. The interval separating the diarrhoea from the joint manifestations is usually one or two weeks. Post-salmonellosis rheumatism is most frequently polyarthritis involving the large joints accompanied by fever that is sometimes high. The sedimentation rate is increased and hyperleucytosis and discrete anaemia may also be present. Salmonella infection is established by the presence of the organism in the stools and a positive sero-diagnosis. In all cases the polyarthritis is cured by anti-inflammatory treatment in 1-6 months. HLA W27 antigen is present in the majority of the patients although spondylarthritis is not seen during the evolution. Although the number of cases of post-salmonellosis rheumatism is very small and the connection between the salmonellosis and the rheumatism has not been demonstrated, it is valuable, in cases of acute polyarthritis following enteritis, to carry out coproculture and serodiagnosis of salmonellosis.


Respiratory sinus arrhythmia in man: relation to right ventricular output. The respiratory effects on heart rate (HR), right ventricular stroke volume (SVRV), and the pulmonary arterial flow (PAF) have been studied beat-by-beat in 7 conscious, healthy subjects. Tidal volumes (VT) of 1.0 and 2.0 liters at a breathing rate of 6 cXmin-1 were used as controls. With identical VT and respiratory rate intrathoracic pressure was affected by (A) negative inspiratory pressure (NIP) of 5 cm of water and (B) with intermittent positive pressure ventilation (IPPV). In the control experiments all subjects exhibited an inspiratory increase in HR (respiratory sinus arrhythmia) as well as in SVRV. With VT of 1.0 liter, NIP augmented the inspiratory increase in SVRV and the respiratory oscillations of PAF. IPPV decreased SVRV and HR during inspiration. It is concluded that NIP and IPPV affect the SVRV and the right heart blood flow. The similar effects on HR and SVRV suggest a relationship which might be explained by heart-rate-regulating reflexes from the heart.


Determination of urinary fibrin/fibrinogen degradation products by radioimmunoassay. Glomerular fibrin/fibrinogen related material is often found in the early stage of especially proliferative types of glomerulonephritis and during rejection of renal grafts after transplantation. The presence and concentration of urinary fibrin/fibrinogen degradation products (FDP) have been found to be correlated to the extent of glomerular fibrin deposits. Most methods for FDP determination hitherto available are not sensitive enough to detect such small amounts of the fibrin/fibrinogen related material in the urine as are found in early glomerulonephritis. A radioimmunoassay for determining urinary FDP is described, in which the high molecular weight degradation products (HMWDP) are first converted into end degradation products (D and E) by addition of plasminogen and streptokinase to the urine sample. In the test an antiserum against purified D-products is used, which avoids the influence of varying binding properties and therefore makes the method more specific.


Effect of toothbrushing with chlorhexidine gel on salivary microflora, oral hygiene, and caries. The effect of daily toothbrushing with 0.5% chlorhexidine-containing gel for 12 months was evaluated in a double-blind study in 37 dental students. The active gel did not markedly influence plaque formation, gingival conditions, or caries as compared with placebo gel treatment. Salivary bacterial counts were performed on subgroups of six subjects using chlorhexidine gel and on six using placebo gel. No differences in the effect of treatment on the microorganisms studied in the two subgroups could be detected except for S. sanguis. The percentage of this species decrease in the placebo group and increased in the chlorhexidine group. The difference became significant after 2 weeks. A tendency to a greater reduction of S. mutans noted in the chlorhexidine group was most marked in individuals who had high initial counts of this species. The proportion of S. sanguis, which could grow on chlorhexidinei-containing mitis salivarius medium, increased and after 12 months of chlorhexidine treatment averaged 34% of cultivable S. sanguis compared with 0.002% prior to treatment. The number of less sensitive S. sanguis decreased in the 12 months following termination of treatment. There was no observed tendency for the selection or proliferation of other streptococci, gram-negative rods, yeasts, or staphylococci.


Clinical evaluation of amalgam restorations. The good reproducibility of a clinical evaluation system for restorations was confirmed, but the system was not considered suitable for detection of minor differences between amalgam restorations. A modified system for evaluation was therefore developed. It was based on the same principles but included more characteristics. The modified system was evaluated in practice on 246 amalgam restorations. The level of agreement between two examiners reached about 70% after an initial training period. The results demonstrate the need for calibration of examiners and the importance of a detailed definition of criteria.


Short-term tissue culture of two nonsecretory human myelomas. A morphological and functional study. Bone marrow cells from two patients without detectable monoclonal immunoglobulin (Ig) in serum and urine but with the clinical picture of plasma cell myeloma were cultivated in vitro. Immunofluorescence studies of cultured living and fixed bone marrow cells showed no signs of Ig production in one of the cases, whereas in the other case cytoplasmic kappa chains were detected, which, however, were not expressed at the surface of living cells. Cells from the later patient were also subjected to kinetic, ultrastructural, and functional studies in vitro. The fraction of myeloma cells incorporating tritiated thymidine in vitro decreased gradually during prolonged culture, indicating a continuous cell death. The morphological characterization revealed many similarities between this nonsecretory myeloma and classical myeloma, although the frequency of cells with cisternae of endoplasmic reticulum distended by a granular material was unusually high, as was the frequency of "flaming" myeloma cells. "Flaming" cells were not labeled by tritiated thymidine, suggesting that they are nonproliferative end cells. Studies of the Ig synthesis by gel diffusion analyses of supernatant and cell lysates from [14C]leucine-labeled cultures agreed with the immunofluorescence studies that the myeloma cells were nonsecretory.


Characterization of anti-lymphocyte antibodies in inflammatory bowel disease. Sera from patients with inflammatory bowel disease (IBD) showing broad lymphocytotoxic or lymphocyte-binding activity were subjected to additional analysis to further characterize their properties. Lymphocytotoxins appear to be antibodies predominantly of IgM class as determined by [1] 2-mercaptoethanol sensitivity, [2] serum fractionation by sucrose density gradient sedimentation, Sephadex G-200 filtration, and DEAE ion exchange chromatography, and [3] absorption by anti-Ig immunoadsorbent columns. Lymphocyte-binding antibody was found to be IgG, IgA, and IgM, as determined by indirect immunofluorescent staining of acetone-fixed lymphocytes. Individual IBD sera showed marked variability in occurrence of cytotoxic and binding antibodies when tested against the same donor panel of lymphocytes. These studies emphasize the marked heterogeneity of anti-lymphocyte antibodies occurring in IBD.


Production of monospecific antisera against antigenic componentsof Mycobacterium bovis (BCG). Monospecific antisera against four different antigenic components of Mycobacterium bovis (BCG) were produced by immunization of rabbits with precipitates cut out of gels after crossed immunoelectrophoresis (CIE). An important feature is to use a semipurified mycobacterial antigenic preparation, or a cross-reactive antigen, to obtain a simpler pattern in CIE so that a clean precipitate, free from contaminating antigens, can be obtained for immunization. The findings with one particular antigen are shown, and the use of such antisera is discussed.


Neutralizing antibodies against Escherichia coli and Vibrio cholerae enterotoxins in human milk from a developing country. By means of the adrenal cell assay and the rabbit small-bowel loop technique enterotoxin-neutralizing antibodies were demonstrated in all investigated milk samples from severely undernourished Pakistani women but, with a single exception, not in milk from Swedish mothers. The antibodies belonged to the IgA and IgG classes as observed in an enzyme-linked immunosorbent assay, which also revealed secretory component on specific enterotoxin antibodies, showing that the IgA antibodies were primarily of the secretory type. The epidemiological stituation and experimental data strongly indicate that Escherichia coli enterotoxin rather than immunologically cross-reactive Vibrio cholerae toxin in most cases constituted the antigenic stimulus for the milk antibodies. The presence in the milk of the Pakistani mothers of secretory IgA antibodies against an important diarrheogenic agent may have practical importance for protection of the breast-fed baby and probably also illustrates the frequent intestinal exposure of these women to enterotoxinogenic bacteria. Since enterotoxin antigen is presumed not to enter deeper tissues, the demonstration of secretory antibodies in milk agrees with a proposed homing of intestinally triggered lymphocytes to the mammary gland.


Ketoprofen in the treatment of rheumatoid arthritis. Double-blind, cross-over placebo comparison. In a two week double-blind cross-over trial of ketoprofen versus placebo in twelve patients, ketoprofen was shown to have substantial anti-inflammatory activity and to be more effective than placebo. Clinical and biological tolerance were excellent.


A double-blind cross-over study of ketoprofen and phenylbutazone in rheumatoid arthritis. A double-blind cross-over trial was carried out in 50 patients with definite rheumatoid arthritis, in order to compare the effects of 300 mg/day of ketoprofen with those of 600 mg/day of phenylbutazone, e.g. the maximal clinically used doses of each drug. The treatment period on each drug was two weeks. There was no statistically significant difference between the drugs with the six parameters studied, either on subjective or objective evaluation. Both drugs were superior to the conventional treatment given before the trial. The side-effects did not differ significantly for each product, except that the central nervous symptoms were less frequent with ketoprofen. Ketoprofen thus seems to be an effective and acceptable drug for the treatment of patients with rheumatoid arthritis.


Clinical evaluation of ketoprofen (Orudis) in rheumatoid arthritis. Results of a multi-centre, double-blind, cross-over trial against phenylbutazone. In a multi-centre, double-blind, cross-over trial comprising 38 patients with rheumatoid arthritis, ketoprofen was given at a dosage of 150 mg daily and phenylbutazone at a dosage of 300 mg daily, each for 2 weeks. On the basis of patient preference, general evaluation of the disease, morning stiffness, pain on movement and need for analgesics (dextropropoxyphene), it could be concluded that there was no significant difference between phenylbutazone and ketoprofene, although a tendency to more frequent and severe side-effects was seen with pehnylbutazone.


Double-blind study of ketoprofen against a placebo in osteoarthritis of the hip. In this trial, the patients suffering from osteoarthritis of the hip received either ketoporfen or a placebo successively for 2 treatment periods, A and B, of 14 days each. The daily dosage of ketoprofen was 150 mg in 3 doses of 50 mg. In each case treated, the parameters necessary for the diagnosis and those necessary to assess progress under treatment are reported. At the end of the trial, results have been rated according to the preference of the patient for treatment period A or B. The results were analysed by the sequential method. The therapeutic results reported were obtained from various criteria stated in the protocol (subjective evaluation by the patient, pain when resting, duration of morning stiffness, distance of pain-free walking, amplitude of movements, etc.). Nine cases were sufficient to produce a significant statistical result in favour of ketoprofen. In eight observations a preference in favour of ketoprofen was apparent. In one case only, there was no preference for either one or the other of the two treatment periods (failure of ketoprofen and of the placebo). Ketoprofen was excellently tolerated.


A double-blind trial of ketoprofen in the treatment of osteoarthritis of the hip. In a double-blind study of ketoprofen versus placebo in the treatment of osteoarthritis of the hip, it was shown by a sequential technique, that ketoprofen was significantly better than placebo. Some intolerance was observed but no more than with other non-steroidal antiinflammatory drugs. No changes were observed in biological parameters.


Ketoprofen -- a new anti-rheumatic agent. Ketoprofen (100 mg/day) and indomethacin (100 mg/day) were compared in a double-blind cross-over trial of four weeks duration in 46 patients with rheumatoid arthritis. The drugs were equally effective in all parameters measured, apart from the paracetamol (rescue drug) tablet count which favoured indomethacin. In a similarly designed study the same dosages of the two drugs were compared in 44 patients with osteoarthrosis of the hip. No significant differences occured between the two groups. A further double-blind cross-over study of 4 weeks duration compared 200 mg ketoprofen/day and 300 mg phenylbutazone/day in 47 patients with osteoarthrosis of the hip. No significant differences occured between the two drugs. In all three studies, side-effects with ketoprofen were infrequent and mild. Biological monitoring throughout revealed no abnormality. These studies have shown ketoprofen to be an effective anti-inflammatory for the treatment of rheumatoid arthritis and osteoarthrosis of the hip with an efficacy comparable to those of indomethacin and phenylbutazone.


Gastroscopic evaluation of the effect of a new anti-rheumatic compound, ketoprofen (19.583 R.P.), on the human gastric mucosa. A double-blind cross-over trial against acetylsalicylic acid. The tolerance of the gastric mucosa to a new anti-inflammatory product, ketoprofen (19.583 R.P., Orudis, Profenid N.D.) was compared to the tolerance of acetylsalicylic acid in a double-blind cross-over trial using selected healthy volunteers. The effect of the medication on the gastric mucosa was examined by the use of a gastrocamera technique. The volunteers received during 2 one-week periods either acetylsalicylic acid 3 g daily or ketoprofen 100 mg daily. The sequential diagram shows that the upper barrier was crossed (preference for ketoprofen) when 10 volunteers had been analysed.


Gastrointestinal blood loss induced by ketoprofen, aspirin and placebo (preliminary report). In a 4-week double-blind multi-crossover trial 12 healthy volunteers received 1-week treatment with aspirin (3.6 g daily) and 1-week treatment with ketoprofen (200 mg daily). Before and after each active drug treatment the volunteers received 1-week of placebo treatment. The gastrointestinal blood loss was quantitatively determined by use of the radioactive chromiun (Cr51) technique. It is concluded that the gastrointestinal blood loss during the ketoprofen treatment was significantly less than during the aspirin period but significantly greater than during the placebo periods.


Ketoprofen in rheumatoid arthritis: its tolerance and therapeutic effect. Four studies on ketoprofen [2-(3 Benzoylphenyl) propionic acid, 19583 R.P., Orudis, Profenid N.D.] have been carried out to establish whether it is well tolerated and effective in the treatment of patients with rheumatoid arthritis. Firstly a comprehensive open clinical and biological monitoring study was undertakin in 11 patients who received ketoprofen for an average period of 20 months without any serious or persistent adverse clinical reaction or adverse change in standard laboratory investigations. The second study involved the same patients who were also included in an ophthalmic screening study for drug toxicity. This established that no eye abnormalities attributable to ketoprofen occurred during this period of treatment. These tolerance studies were then followed by two comparative double-blind cross-over trials of ketoprofen in 117 patients with "definite" rheumatoid arthritis. One of them confirmed the significantly superior analgesic effect compared with placebo and showed that the incidence of adverse reactions was similar. The other trial showed that comparing ketoprofen 150 mg daily and indomethacin 100 mg daily the clinical effects of the two drugs were the same in 8 out of 10 indices. Only in severity of pain and rescue drug count was there a significant difference favouring indomethacin. Adverse reactions were more frequent with indomethacin despite prior exclusion from the study of patients known to be intolerant of indomethacin. It was concluded that on this evidence ketoprofen is a clinically active and well tolerated drug which should be valuable in the management of rheumatoid arthritis.


Clinical evaluation of ketoprofen (19.583 R.P.) in rheumatoid arthritis. Double-blind cross-over comparison with indomethacin. In a double-blind cross-over trial the clinical efficacy of ketoprofen (19.583 R.P., Orudis, Profenid N.D.), in comparison with that of indomethacin was investigated in 30 patients with rheumatoid arthritis. The two drugs were each given in a dosage of 150 mg daily for a period of 14 days. The clinical effects of ketoprofen and indomethacin were equal (p less than 0.90), but several side-effects appeared less often and to a milder degree during ketoprofen treatment. The study indicates that ketoprofen may prove to be a valuable drug in the treatment of rheumatoid arthritis.


A double-blind cross-over evaluation of ketoprofen and aspirin in rheumatoid arthritis. Thirty rheumatoid patients participated in a 6-week double-blind cross-over assessment of ketoprofen (200 mg daily) and aspirin (3.6 g daily). Regular clinical and laboratory assessments were conducted and revealed that at the dosages employed, the two drugs exerted a statistically comparable therapeutic effect. Side-effects were more frequent with aspirin. Ketoprofen was preferred more often by the patients while the investigator found it acceptable as often as aspirin.


Symptomatology and diagnosis in connective tissue disease. Antibodies to extractable ribonucleoprotein in 123 patients reacting with cell nuclei in the immunofluorescence test. Sera with an antinuclear immunofluorescence titre of 1/000 were taken consecutively from the diagnostic routine flow and examined for agglutinating antibodies against desoxyribonucleic acid (DNA) and extractable nuclear antigens (ENA). Passive haemagglutination tests with antigen-coated tanned erythrocytes were used and the specificity of the reactions was corroborated by testing against enzyme-treated cells. After the exclusion of the DNA-reacting 15%, three major groups and one minor could be distinguished on a serological basis. The largest group (41%) contained cases with a speckled immunofluorescence pattern and a RNase-trypsin sensitive agglutination reaction with ENA coated cells (sRNP). Nearly all cases of mixed connective tissue disease and scleroderma fell into this group which also contained 44% of the SLE cases. Symptomatically the group was characterized by remarkably high incidences of Raynaud's syndrome and myositis. The major group next in size comprised cases with a homogeneous immunofluorescence pattern but no reaction against DNA or ENA. Half of the cases within this group had the diagnosis SLE; they also constituted 42% of all SLE cases. The only other diagnosis of significant frequency within the group was unspecified collagenosis (23%). The symptomatology of the group was rather uncharacteristic, with the exception of the low incidence of Raynaud's syndrome. The third major group comprised cases with a speckled immunofluorescence pattern but no agglutination reaction against ENA or DNA. This group had a very high incidence of rheumatoid factor and also the highest incidence of visceral lesions among the groups. Yet the group contained only a small proportion (14%) of the SLE cases and the rheumatoid arthritis cases were about equally shared between this and the first group. The most common diagnosis in the group was unspecified collagenosis (40%). A fourth, small but homogeneous group contained cases with a speckled immunofluorescence pattern and a reaction with Sm antigen, i.e. an enzyme-resistant agglutination reaction with ENA. Six cases in this group had the diagnosis SLE. No diagnosis was available in two cases.


Tracheobronchial clearance in bronchial asthma: response to beta-adrenoceptor stimulation. Tracheobronchial clearance was studied in 12 patients with bronchial asthma. They inhaled a test aerosol of 6 mum teflon particles tagged with 99mTc, after which external measurement of the radioactivity in the lungs was made for 2 h in the supine position. Clearance was determined after subcutaneous administration of 0.25 mg of the beta-adrenoceptor stimulating compound terbutaline and vehicle, respectively, in a crossover, double-blind study. The average clearance in the asthmatics did not differ significantly from that of healthy non-smokers. Terbutaline significantly enhanced clearance in the asthmatics, though considerably less than reported for healthy subjects. Alternative explanations for this weak effect of terbutaline in the asthmatics might be that the mucociliary transport system was affected by the asthma disease, or that earlier treatment with beta-adrenoceptor stimulating compounds or other drugs had produced increased tolerance and/or carry-over effects. Ventilatory function measured as FEV1.0 deteriorated significantly during the clearance measurement when vehicle was given, but not when terbutaline was given. Terbutaline thus counteracted the unfavourable effect of the supine position on ventilation.


Surface forces in respiratory bronchioles during a first breath-model experiment and some theoretical considerations. In a physical sense the terminal bronchioles are capillaries, and the air-liquid interface descending through them during the first breath will therefore have a spherical curvature with a radius identical to that of the airway. Air will reach the alveolus if the liquid-coated bronchiolar wall proximal to the air-liquid interface can withstand the pressure gradient required to push the interface towards the periphery. Otherwise, there is a risk that the bronchioles become overexpanded while the alveoli remain non-aerated.


Bilateral pulmonary aspergilloma in ankylosing spondylitis treated with transthoracic intracavitary instillations of antifungal agents. Repeated transthoracic intracavitary injections of amphotericin B, nystatin and pimaricine proved a simple and safe method in the treatment of bilateral pulmonary aspergillomas in a patient with large cavities caused by lung disease in ankylosing spondylitis. Both large mycetomas were dissolved by this treatment in combination with peroral corticosteroid medication, and the patient's general condition improved markedly.


Effects of muliple doses of metoprolol and propranolol on ventilatory function in patients with chronic obstructive lung disease. The effect of metoprolol on pulmonary function was compared with that of propranolol and placebo in twelve patients with chronic obstructive lung disease. Propranolol caused a significant reduction in FEV1 compared with metoprolol and placebo. Metoprolol gave a slight reduction compared with placebo. FVC was not significantly influenced by metoprolol, but propranolol caused a significant depression compared both with metoprolol and placebo. The isoprenaline-mediated increase in FEV1 and FVC was not significantly altered after metoprolol compared with placebo. After propranolol the isoprenaline-mediated increases in FEV1 and FVC were 40 and 24% lower respectively than after metoprolol and placebo. Unwanted effects and pulmonary symptoms were at an acceptable level in all cases except in two patients who had to be given i.v. theophyllamine therapy during propranolol treatment. It is concluded that metoprolol exhibits a selective beta1-blocking action and thus may be given to patients with chronic obstructive lung disease provided that adequate beta2-stimulator treatment is given concomitantly.


[Clarification of a Salmonella typhimurium epidemic in north-eastern Switzerland by means of bacteriological and serological methods]. An outbreak of Salmonella typhi murium caused by person-to-person contacts was observed in Kurhaus (NE Switzerland) in late 1973. In all, 18 patients with clinical symptoms and 8 asymptomatic carriers were registered. However, 1 1/2 months elapsed before the etiologic diagnosis could be established. The infection was then transmitted, probably by a visiting nurse, to the personnel of a neighbouring school. An outbreak followed thereafter including 31 clinically manifest patients and 10 asymptomatic carriers. Infected food was most probably responsible for the dissemination of the disease, since two asymptomatic carriers were detected among persons engaged in the preparation of food. The close correlation between the two epidemics was confirmed by phague typing of isolated Salmonella strains according to the method of GUINEE. A common Biotype I, Lysotype 650, was identified in all cases. Clinical findings revealed diarrhea in 77,6%, fever in 59,2% and vomiting in 18.4% of cases. Only two patients who were admitted to the hospital, were given chemotherapy. The excretion of Salmonellae in the stools was observed on average for about one month in clinical cases and for 12 days in asymptomatic carriers. All the strains, with one exception, were in vitro sensitive against tetracycline, Chloramphenicol and trimethoprim-sulfamethoxazole. In one case the tetracycline treatment resulted in homologous resistance. In this case the carrier state had been observed for 111 days. Serologic tests were made one month after the outbreak was detected using Widal reactions with antigens of homologous strain. In most patients with clinical symptoms antibody titers were at serum dilutions of more than 1:80, whereas only 4 of the 9 asymptomatic carriers investigated presented with titers in this range. Patients who were not excreting Salmonellae had uniform antibody titers of less than 1:80.


[The evolution of implantology --trends toward a new concept]. The development if implantology during the recent years, relative to the tissue tolerance of various implant materials seems to have improved the chances of success. The disastrous results of prior years have been due to improper techniques leading to unstable biostability between tissue and implant material surface. This insufficiency of biocompatibility is not only biochemical, but also biomechanical as a consequence of very differing physical properties of osseous tissue and implant material. By increasing the surface of the implant material, making it porous, a penetration of fibres and a neoformation of bone could be observed. Thus a conjunctive attachment forms thus securing a closure of tissue around the emerging abutments. At this level, the implant must be considered under the periodontal angle. Marginal irritation must at any price be avoided, thus reducing the chance of epithelial growth into depth. Materials responding to the demands of biocompatibility are certain forms of porcelain, vitrified carbon, titanium, calcium aluminate.


Nuclear and mitochondrial DNA replication during zygote formation and maturation in yeast. Nuclear and mitochondrial DNA replication were monitered during the development of synchronous yeast zygotes. Purified first zygotic buds were also analyzed. Nuclear DNA replicated discontinuously but coincidently with bud initiation, while mitochondrial DNA replicated throughout the zygotic formation and maturation period. First zygotic buds contained the diploid level of both nuclear and mitochondrial DNA.


Oldest horse brains: more advanced than previously realized. Previous interpretations of early horse brains were based on an incorrectly identified fossil endocast, now believed to be from a condylarth. Newly prepared endocasts of Hyracotherium, the oldest horse and one of the earliest perissodactyls, reveal a relatively larger brain, with a more expanded neocortex, than existed in the condylarth ancestors of perissodactyls. Fifty million years ago, horse brains had suprasylvian, ectolateral, and lateral sulci, but the frontal lobe was undeveloped.


Structural domains of transfer RNA molecules. In this article, we have described various detailed features of the conformation of yeast tRNA(Phe) revealed by recent refinement analysis of x-ray diffraction data at 2.5 A resolution. The gross features of the molecule observed in the unrefined version have been largely confirmed and a number of new features found. The unique role of the ribose 2' hydroxyl groups in maintaining a series of nonhelical conformations in this RNA molecule has become apparent. Many of these features are a direct consequence of the geometry of the ribose phosphate backbone of RNA molecules, and these may also be found in structured regions of other RNA species as well. Special attention has been directed toward two conformational motifs revealed by this analysis. These include the striking similarity between the TpsiC and anticodon hairpin turns in the polynucleotide chain, which are stabilized by the participation of uridine in the U turn. In addition, there is frequent occurrence of an arch conformation  in the polynucleotide chian which is stabilized by hydrogen bonds from 2' hydroxyl residues to phosphate groups across the base of the arch. The importance of the 2' hydroxyl interactions in defining tertiary structure is illustrated by the fact that, in the nonhelical regions, almost half of the ribose residues are involved in O2' hydrogen-bonding interactions which stabilize the conformation of the molecule.


A specific population of gonadotrophs purified from immature female rat pituitary. When dispersed pituitary cells from 14-day-old female rats were sedimented in a bovine serum albumin gradient, a fraction was isolated which consisted of almost 90 percent of large cells that stained purple in the periodic acid-Schiff (PAS) reaction. Immunostaining indicated that over 85 percent of these PAS-purple cells were gonadotrophs containing both follicle stimulating and luteinizing hormone. Reproducible cell cultures could be obtained on poly-L-lysine coated dishes. As early as the second day in culture, the secretion of both follicle stimulating and luteinizing hormone was highly stimulated by luteinizing hormone-releasing hormone. The effect of FSH was as marked as that on LH. The data suggest that the isolated gonadotrophs are a specific functional subtype.


The developmental biology of primary human malignant melanomas. We have attempted to describe virtually all forms of malignant melanoma which affect man except those arising in the eye. The vast majority of malignant melanomas clearly fall into one of three kinds: (1) malignant melanoma of the superficial-spreading type, (2) malignant melanoma of the lentigo-maligna type, and (3) malignant melanoma of the nodular type. The developmental biology of a primary neoplasm is illustrated by discussing and illustrating the evolution of these three dominant forms of melanoma. Primary malignant melanoma of the superficial-spreading type and of the lentigo-maligna type develop through a characteristic biphasic growth pattern: an initial radial-growth phase, followed by a vertical-growth phase. The radial-growth phase of these melanomas is only rarely associated with the development of metastases, while the vertical-growth phase is commonly associated with subsequent metastatic disease. The phenomenon of the vertical-growth phase is apparently, therefore, a qualitative step in the development of a primary malignant melanoma. Malignant melanoma of the nodular type is an example of a primary tumor without a precursor developmental stage such as a radial-growth phase.


Inhibitors of platelet function in the prevention of arterial thrombosis. The use of platelet inhibiting drugs in the prevention of arterial thromboembolic occlusive disease demonstrates that only a few trials have been adequately designed to provide conclusive results. Dipyridamole is effective in preventing the thromboembolic complications of prosthetic heart valves and sulfinpyrazone reduces occlusive events in A-V silastic cannulae, while clofibrate is clearly ineffective in secondary prevention of myocardial infarction. No antiplatelet agent has yet been convincingly shown to exert any antithrombotic effect in venous thromboembolism, although the results with hydroxychloroquine deserve further study. Currently, only two antiplatelet drugs, dipyridamole and sulfinpyrazone are clearly proven clinically effective in reducing arterial thromboembolism. The promising results using ASA are under active study.


Aspirin revisited.

Aspirin revisited. ASA is a safe drug to relieve pain, lessen fever, diminish the inflammatory reaction and treat arthritis. This drug can be given to people in a very safe soluble and buffered form which minimizes its major potential side effect: G.I. bleeding. The G.I. bleeding seen with ASA is due to its local effect on the gastric mucosa. The evidence that exists shows that ASA's effect upon the platelet does not contribute to the gastric bleeding. It is unclear to what extent those diseases mediated by thrombosis can be prevented by ASA and other platelet-suppressive drugs. Thrombosis is not equivalent to hemostasis, but is a distortion of the hemostatic process. Clinical trials are now underway but they will probably be inconclusive. Presently, the literature is contradictory and, therefore, the decision to use ASA as an anti-thrombotic durg remains with the individual physician.


Shigellosis transmitted by nurses.

Shigellosis transmitted by nurses. Twelve cases of Shigella sonnei infection, with two deaths, occurred at a custodial institution in Donelson, Tennessee, in April and May 1973. Nine of the cases and both deaths were in patients hospitalized at the institution's infirmary. The patients with nosocomial shigellosis were significantly younger and had been hospitalized significantly longer than controls. Epidemiologic investigation implicated staff members in the transmission of illness from one patient to another and identified the previous use of broad-spectrum antibiotics as a significant factor in placing patients at risk of acquiring shigellosis.


Experimental techniques in the determination of aetiology of acute infantile gastroenteritis. Techniques used in the research laboratory for the microbiological diagnosis of infantile gastroenteritis are described. These techniques are in essence experimental models of the three pathogenetic mechanisms of bacterial diarrhoea. From the clinical bacteriological standpoint, although there is little difficulty with the identification of enteropathic bacteria such as Salmonella and Shigella, the differentiation of enteropathic strains of Escherichia coli from commensal strains is not possible with present routine bacteriological procedures. Possible adaptations of these experimental techniques to the routine laboratory are discussed. At present, negative-staining electron microscopy is the only way in which reoviruslike particles, the most important viral pathogen in infantile gastroenteritis, may be detected. Because of its relative simplicity this examination is strongly recommended in all cases of infantile gastroenteritis.


Reconstruction of the breast and nipple after bilateral radical mastectomy. Reconstruction of the breasts after mastectomy remains controversial. The majority of patients who have undergone mastectomy can be encouraged to accept the disability with correct counselling and guidance from the surgeon. Occasionally, in the very highly selected case, however, the reconstructive procedures are required in order to restore the patient's body image.


Dynamic scintiscanning with technetium-99m as a diagnostic aid in oliguria after renal transplant. Scanning with technetium-99m was used as a diagnostic aid in renal transplant patients with post-transplant oliguria. It is a safe and dependable method of determining whether the renal vasculature is still intact and can often be used to differentiate acute tubular necrosis from acute rejection.


A history of the Durban Medical School.

A history of the Durban Medical School. The establishment and the development of the Medical Faculty of the University of Natal during its first 25 years is described. A brief description of the courses offered and the achievements of the Faculty and its students is included, and a plea is made for the Medical School to be retained in its present form.


Surgical adjuncts in radical hysterectomy and pelvic lymphadenectomy. The effectiveness of radical hysterectomy depends upon the skill and the experience of the individual surgeon. A most important requirement of this operation is that it remove all of the cancerous tissue, while causing minimal damage to other structures. The data presented indicate that the use of suprapublic cystostomy, suction drainage of the retroperitoneum and closure with retention sutures of the abdomen can cause a statistically significant reduction in major postoperative complications that occur after radical hysterectomy with pelvic lymphadenectomy.


Animal models of peritonitis.

Animal models of peritonitis. A reproducible animal model of peritonitis has been developed. It uses standard animals, standardized cultures of bacteria and simple techniques. Use of this model would facilitate comparison of data from workers in this field. The use of small rodents permits the use of comparatively large populations for statistical evaluation. The method is cheap and economic of laboratory space and does not require surgical expertise.


Post-transplantation pancreatitis.

Post-transplantation pancreatitis. Post-transplantation pancreatitis occurs with a frequency of about 3 per cent and carries a mortality of 70 per cent. An average of 216 days following transplantation elapses before the onset of pancreatitis and tends to occur most frequently in men in the fourth decade of life. A multiplicity of factors which predispose to pancreatitis are present in the post-transplant period and may be responsible for the frequency and lethality of post-transplant pancreatitis. Among these factors are immunosuppressive therapy, consisting of azathioprine and steroids, secondary hyperparathyroidism and increased susceptibility to infection.


Peripheral dissemination of bacteria in contaminated wounds; role of devitalized tissue: evaluation of therapeutic measures. The role of available therapeutic agents in the management of infection has long been a continuing source of debate. This study assessed the rapidity of lateral dissemination of three common pyogenic organisms from wounds. The Streptococcus spreads peripherally with greater speed than the Staphylococcus or E. coli. Appraisal of the role and effectiveness of jet wound irrigation, debridement, and penicillin provides firm evidence that, of these three therapeutic agents, the only one that can control bacterial proliferation in a contaminated wound is the antibiotic. The primary role of energized jet irrigation is to remove clots and wound debris. The specific function of debridement is removal of devitalized tissue, in which role it has no effective competitor. These studies demonstrate that devitalized tissue in a contaminated wound quickens the rapidity of peripheral spread of all three micro-organisms. Systemic penicillin plus saline irrigation is the most effective therapeutic measure at both the second and fourth postinoculation hours in nondevitalized contaminated wounds. Debridement proved to be the most effective therapeutic device at the second, fourth, and sixth postinoculation hours in devitalized wounds.


Infected aortic bifurcation grafts: experience with fourteen patients. The experience with 14 patients with infected aortic bifurcation grafts has been reviewed. Factors which appeared to predispose to infection in 11 patients included "re-do" operations, concomitant cholecystectomy or gastrostomy, and ruptured abdominal aneurysm. A mixture of gastrointestinal organisms was responsible for the infections. The pathogenesis, presentation, and treatment varied according to whether the proximal or distal anastomosis was involved or not. Aortoduodenal communications were present in five patients; they presented with gastrointestinal bleeding or septicemia. One patient survived as a result of early, aggressive surgical therapy. Infection presented at the distal anastomosis in nine patients, either as groin abscess or false aneurysm. Conservative therapy failed in the majority of patients but apparently was successful in three of five patients in whom infection did not involve the intra-abdominal portion of the graft. When infection does involve the intra-abdominal portion of the graft, then the graft must be excised also. Revascularization often can be accomplished with extra-anatomic bypasses of prosthesis or autogenous material, depending on the characteristics of the individual patient. Regardless of the mode of presentation or the site of infection, the early institution of judicious surgical management offers the best chance of success in these patients, and temporization usually leads to failure.


The management of ocular herpesvirus infections. The many treatment methods in current use for every known complaint only seem to aggravate the difficulty of treating ocular herpes simplex virus (HSV) infections, which are generally self-limited in the immunocompetent host. The cornea is already a somewhat immune-deficient tissue since its lack of blood vessels separates it partially from the host, and treatment with glucocorticoids, which are immunosuppressive, increases the risk of damaging complications such as scarring, prolonged morbidity, bacterial or fungal superinfection, and the occasional corenal perforation. Accepted methods of treatment of specific lesions, are discussed, as are some methods that are not yet accepted, but which seem promising. Herpes zoster may result in scarring and significant loss of vision even without the use of glucocorticoids, the disease often manifesting itself in the already compromised host. The major complication is postherpetic neuralgia. None of the available treatment methods has been fully satisfactory, and every effort should be made to prevent eye lesions in patients with early infection of the ophthalmic branch of the trigeminal nerve. Stimulation of cellular immunity by various means appears to offer some new promise for control of the disease. Management of varicella, cytomegalovirus, and infectious mononucleosis are also discussed.


131I-fibrinogen in the detection of pulmonary allograft rejection. The uptake of 131I-fibrinogen in canine pulmonary allografts was compared to that in lung autografts or lungs with papain-induced unilateral hemorrhagic pneumonia. In addition to serial lung scans and the postmortem measurement of tissue radioactivity, all dogs had serial chest roentgenograms and histologic study of their lungs. All four animals in the allografted group had increased radioactive uptake on the side of the allograft lung at the same time as or slightly before radiographic abnormalities were evident. However, increases in lung radioactivity also occurred in animals with pneumonia or autografts at the time infiltrates were present. Thus the presence of increased lung scan activity, which occurs in rejecting lung allografts after the injection of 131I-fibrinogen, is not a specific index of pulmonary rejection.


Historical observations on herpetic keratitis. The history of herpetic keratitis is presented. The similarities and differences between dendritic keratitis and herpes labialis are enumerated, with the suggestion that the similarities (in onset, pathology, and clinical course) far outweigh the differences. The principal difference seems to be that the avascalarity of the cornea retards the immunologic responses. Important points in the history of herpetic keratitis include (1) the close association of herpetic disease with malaria around the turn of the century; (2) the relatively benign nature of the disease, in contrast to herpes zoster keratitis; (3) the unfavorable response of the disease to immunosuppressive measures and diseases; (4) the failure of chemotherapy to influence favorably the natural history of the disease; and (5) the increasing visual damage caused by the disease since 1952 when corticosteroids were introduced into ocular therapy. Mention is made of the increasing problem of venereal herpes, with resultant neonatal herpetic keratitis, retinitis, and encephalitis.


Subclavian artery laceration due to migration of a Hagie pin. Injuries to subclavian artery are infrequent and usually occur due to gunshot or stab wounds and occasionally by blunt trauma to the chest. An early diagnosis and control of hemorrhage is essential to prevent death which may occur due to exsanguinating hemorrhage. A case of injury to the subclavian artery due to migration of a Hagie pin, which was used to treat the acromioclavicular separation, is reported. The subclavian artery was ligated initially, which produced an ischemic and functionless upper extremity. Revascularization of the arm was successfully accomplished by an axilloaxillary bypass grafting procedure. This simple procedure is advocated in situations requiring ligation of the subclavian artery following trauma, when direct reconstruction is not feasible.


Rejection of HLA identical related kidney transplants. Three cases are described in each of which an HLA identical kidney transplant from a brother was rejected forcefully by the recipient and only one graft survived for more than a year. Rejection of this type is most unusual with well matched grafts and may have been triggered by a system of major antigens that are unassociated with those that are currently recognised.


Morphometrical method to estimate the parameters of distribution functions assumed for spherical bodies from measurements on a random section. The general equations to correlate the distribution of the radius r of spheres randomly dispersed in the three-dimensional space with measurements on a random test plane are (see article) and (see article) for the diameter delta of circular sections of spheres; and (see article) and (see article) for the length lambda of chords delivered by intersection of a random test line. In the above expressions Nvo, Nao and Nlambdao are the numbers of spheres in a unit volume, of circles on a unit surface area and of chords per unit length of a test line, respectively; n is O or a positive integer; r the arithmetical mean of r; (deltan) and (lambdan) the means of the n-th powers of delta and lambda, respectively; and Qn a quotient defined by Qn = (rn)/rn. The ratio of measured (delta2/delta2 or (lambda2/lambda2 is used for calculating one of the parameters of assumed theoretical distribution functions. A second parameter is then estimated from delta or lambda. The method was applied to the normal pancreatic islets, and the use of chord length lambda was preferred to that of diameter delta, because the error due to the failure in identifying very small islet sections was minimized in the former.


A simple hemostatic method in suprapubic prostatectomy: extracapsular pulling sutures. To block the vessels of the prostate, extracapsular pulling sutures were placed from the 4 and 8 o'clock positions on the bladder neck to the perineum prior to enucleation in 25 cases of prostatectomy. The removable pulling sutures successfully reduced blood loss during and after prostatectomy. Besides, the average operating time was markedly shortened. Postoperative courses of the patients were uneventful on the whole and there was no remarkable complication.


Dissociation of MIF activity and in vitro lymphocyte transformation in the development of experimental allergic thyroiditis in guinea pigs. Macrophage migration inhibitory factor (MIF) activity and in vitro lymphocyte transformation to homologous thyroid antigen were compared in cultures of lymph node cells obtained from 123 guinea pigs at weekly intervals after a single injection of homologous thyroid extracts in complete Freund's adjuvant (CFA). MIF activity was not detectable at the early stage of immunization but became manifest 2 and 3 weeks after sensitization and a high level was maintained during 4-7 weeks. On the other hand, lymphocyte transformation preceded the appearance of MIF activity and attained its maximum 2 weeks after sensitization before the establishment of thyroiditis. It is indicated that MIF activity and lymphocyte transformation predominate separately in the course of immunization. There was a considerable correlation between intensity of MIF activity and severity of thyroiditis in individual animals during the advanced stage (4-6 weeks after sensitization) of the disease. Also, a lower but significant correlation was seen between lymphocyte transformation and severity of thyroiditis. However, about half of animals in the advanced stage of thyroiditis failed to exhibit antigen-stimulated lymphocyte transformation, despite a positive MIF activity.


[Comparative clinical and experimental studies of various denture cleansers. 2. Testing of antimicrobial efficiency]. Agar diffusion plate tests were performed on five strains of micro-organisms to characterize the disinfecting properties of nine denture cleaners. Furthermore, the liberation of oxygen was determined as a function of time, and the course of pH variation of the various cleaning solutions was studied. The highest oxygen concentrations and the best antimicrobic activities were achieved by the preparations Eladent G and T.


[Tasks and problems of geriatric dentistry]. The health and social policy of the German Democratic Republic as well as the programs of numerous medical specialties pay special attention to the problems of citizens advanced in years. But stomatology too must contribute to preserve or restore the well-being of citizens advanced in years. For this reason, a purpose-oriented research must realize the scientific advance which is necessary to preserve the functional performance of the masticatory organ till old age in spite of the incomplete dentitions which prevail at present. In the next few years, research should be focused on the prevention and control of diseases of the mucosa of the denture foundation and on the correction elimination of somatopsychic factors which are detrimental to the functional performance of dentures.


[Experiences with the use of the double crown system. 1. Telescoping partial denture]. Follow-up examinations revealed in general positive results with telescoping partial dentures. Corresponding to their indications, subtotal constructions are very suited as a transitional solution for the period prior to changing over to full dentures.


[Evaluation of restorative alveoloplasty]. The method of restorative alveoloplasty is often marred by complications which may cause the failure of this laborious intervention. For this reason, this procedure should remain confined to single cases. It is imperative to search for new ways to reconstruct the bony denture support.


[Certain practically important questions on the intra-osseous hemangioma of the jaw]. With special regard to the viewpoint of the general stomatologist, the authors deal with the problems related to the intraosseous haemangioma of the jaw and try to give a clearly arranged survey of the criteria of this extensive complex of questions, using schematic tables. They point above all to the risks of inconsiderate management and indicate the diagnostic and therapeutic possibilities which are available only in a special clinic. Finally, the authors present two personal cases, describing in detail (with reference to the preceding representations) the course of the disease in a 17-year-old female patient.


A review of the world epidemiology of rabies. A number of countries throughout the world have been free from rabies for many years; some are reported to have eliminated the disease and in others it has reappeared after variable periods of time. Apart from these minor variations, however, the global distribution of rabies over the last five to ten years appears unchanged and the disease continues to pose both public health and economic problems of varying severity in all continents except Australia and Antarctica. Most of the data presented here are abstracted from the most recent surveys of the World Health Organization, the Annual Rabies Summary for the United States and the Pan American Zoonoses Centre's "Rabies Surveillance for the Americas". The vagaries of international reporting, accurate in some cases and undoubtedly imprecise in others, demand a cautious interpretation of the available data and suggest that the world picture be viewed as an impression rather than as a precise record.


Wildlife rabies in Europe and the British situation. The red fox is considered to be the main reservoir of the present European rabies epizootic which began in Poland in 1939-40. Its usual rate of spread is 20 to 60 km a year. Mortality among rabies-infected fox populations is estimated variously to be 20 to 60%. The infection spreads more rapidly among foxes in the autumn and winter and its occurrence is dependent on fox populations  is estimated variously to be 20 to 60%. The infection spreads more rapidly among foxes in the autumn and winter and its occurrence is dependent on fox population densities, it being readily transmitted in populations numbering over one fox to a square kilometre. Subsequently it recurs with a periodicity of three to five years. Though it was described in continental Europe in historic times there is no evidence of dramatic outbreaks among wild carnivores in Britain at any time. Aspects of the behaviour and life history of the fox, pertinent to rabies control are described. Potentially, oral antirabies vaccination of foxes in the wild may be a useful control technique, but there are problems in achieving this. In Britain, quarantine evasion with domestic animals is a significant rabies hazard, which could worsen as the five-sixth area of France still free from rabies becomes infected.


Rabies virus and the problems of rabies vaccination in man. The structure of rabies virus and the importance of its glycoprotein in immunization are discussed. The improvement in vaccines for use in man, culminating in the production of the human diploid vaccine is described. Nevertheless problems remain, particularly with regard to post-exposure therapy. Possible disadvantages in the use of subunit vaccines are mentioned and attention is drawn to the discovery of the rabies-related viruses.


Physiological and morphological characters in two pyrimethamine-resistant lines of Plasmodium berghei SP11 after cryopreservation. The authors describe the characters in two pyrimethamine-resistant lines of Plasmodium berghei berghei SP 11-RR after long storage at very low temperatures. In one case the line had maintained its original virulence but lost its resistance to pyrimethamine. Gametocytogenesis increased and cyclical transmission was successful. Furthermore, parasites crossed the blood-brain barrier and provoked cerebral malaria. In the other case no physiological changes could be detected. The authors conclude that, after cryopreservation, biological behaviour should always be carefully observed.


Histopathology of rejection in DLA-identical canine orthotopic cardiac allografts. The process of chronic rejection is the limiting factor in long term survival after cardiac transplantation. As part of a study of this process in experimental orthotopic heart transplantation, morphological changes during the course of rejection are described in DLA-identical beagle littermates, obtained by serial percutaneous cardiac biopsy. A total of 153 biopsies were performed on 19 dogs. Mean survival time was 88.11 days (14--494 days) without the use of immunosuppressive therapy. Eight dogs, surviving only 4 weeks, showed a histological pattern that resembled delayed acute rejection, with extensive lymphocellular infiltrate, vascular damage, and myocytolysis. In the 11 dogs which survived more than 4 weeks there was a slight and sometimes transient lymphocellular infiltrate. But progressive vascular lesions could be seen from the 2nd week consisting mainly of medical proliferation involving intramural vessels as well as epicardial vessels. Capillary changes were prominant and the rate of capillary damage seems to be an indication of graft survival prognosis.


Transfusion-induced malaria from an asymptomatic carrier. An asymptomatic malaria carrier who satisfied the currently recommended standards and criteria of the American Association of Blood Banks for blood donation was the source of the transfusion-induced malaria in this study. The risk of transfusion-induced malaria remains a very real threat in the United States. Any case of unexplained fever following transfusion should be considered as possibly caused by malaria. Delay of the proper diagnosis may be due to unfamiliarity of medical personnel with diagnostic criteria for malaria. Persons who give a history of having resided for long periods in malarious regions, even though they have remained asymptomatic for many years while residing in a malaria free area may still carry the more persistent malarial species and, therefore, should be rejected as donors of whole blood.


En bloc transplantation of liver, pancreas, duodenum, and spleen in the rat. Description of technique and histological findings. En bloc transplantation involving liver, spleen, pancreas, and duodenum was successfully carried out in the rat. While operative mortality due to technical failure was 31%, of those that survived over 95% of the isografts had normal histology up to 4.5 months. Rejection reaction in the allografts first appeared in the liver and the spleen, followed by the pancreas and the duodenum, and was complete by day 14. No gross evidence of graft-versus-host reaction was observed.


Prolongation effect of blood transfusions on kidney graft survival. Transfusion data were collected during a 3-year period on 382 hemodialysis patients with the aid of a computerized followup system. Thirty-seven per cent of the patients did not receive any blood transfusions prior to transplantation. The graft survival in nontransfused patients was statistically significantly lower than that in transfused patients. These results confirm our previous findings in an independent series of patients.


Serum-blocking factors versus specific cellular tolerance in long-term survival of rat heart allografts. Long-term survival of Ag-B compatible rat heart allografts was obtained by short-term treatment of the recipients with antilymphocytic serum (ALS). Graft survival apparently was based on a specific change in the hosts rather than on persistent nonspecific effects of ALS. The hosts were not fully tolerant in that they were able to reject secondary skin allografts from the heart donor strain, although in a delayed fashion. The long-surviving heart allografts retained their immunogenicity as they were rejected when retransplanted to new hosts. The passive transfer of serum from long-term heart graft acceptors to new hosts receiving fresh allografts delayed rejection by several days. This effect was seen only with the serum from long-term acceptors suggesting that serum-blocking factors were involved in long-term survival of the heart allografts. However, the ability of adoptively transferred lymphoid cells to break tolerance to a heart allograft residing in a classically tolerant host was tested. In contrast to normal lymphoid cells, cells from the long-term acceptors were unable to break tolerance, suggesting that a specific cellular tolerance had been induced in this cell population. Moreover, a serum from the long-term acceptors failed to block the breakage of tolerance by normal lymphoid cells.


Treatment of posttransplant lymphoceles: internal versus external drainage. Six lymphoceles developed in 93 renal transplant recipients. Four were drained externally and two were drained internally. All patients with external drainage of lymphoceles experienced prolonged wound drainage with eventual contamination of the wound with pathogenic organisms. A technique of internal lymphocele drainage and its advantages was discussed.


Interaction between protective antibodies and malaria parasites (Plasmodium berghei): involvement of low avidity antibodies. Free Plasmodium parasites were incubated with a standardized amount of immune serum in a small volume of fluid or a larger one. When these parasites were tested for infectivity in and in vivo test system the parasites incubated in the larger volume of fluid were more infective. Other aliquots of free P. berghei parasites were incubated with a standaridzed amount of immune serum and then reincubated with or without dilution of the suspending fluid. Those parasites reincubated after dilution were more infective than reincubated without dilution. These results were interpreted as indicating that the malaria parasite-protective antibody interaction is readily reversible probably due to the low avidity of the protective antibodies.


[Phagocytosis during mitotic and endomitotic chromosome replication in the trophoblast of the grey vole]. Phagocytosis was studied in three populations of trophoblast cells of the grey vole: primary and secondary giant cells, and spongiotrophoblast. In the two former, the cell growth is accomplished by endomitotic polyploidization only, whereas the spongiotrophoblast cells divide mitotically for a long time. The phagocytosis of these differs from that in giant cells. No more than 1--2 erythrocytes were phagocyted by the spongioblast diploid cells, while giant cells were able to phagocyte over several dozens of erythrocytes. The spongioblast cells are haemophagous and phagocyte only anucleate blood cells -- erythrocytes; unlike, giant cells, when ingrowing within the uterus mucose, are capable of taking up and digesting, in addition to erythrocytes, leukocytes, decidual and endothelial cells.


Tuberculosis in Scotland: a national sample survey (1968-70). 2. A two-year follow-up of newly-diagnosed respiratory tuberculosis notified in 1968. The methods and results of therapy during a two-year period of follow-up have been studied in a 50% random sample of the newly notified cases of pulmonary tuberculosis in Scotland for the year 1968. Of the 770 patients, 1.9% died of active tuberculosis, 2.6% were bacteriological failures, the regimen was changed for initial drug resistance in 0.9% and for drug toxicity in 2.6%. Default from chemotherapy in the first year occurred in 8.1% of patients, 4.7% absconding permanently. The bacteriological failure rate in the 372 positive cases was 7.3%. A further 20 patients were diagnosed at necropsy, 16 having died of the disease. Eighty-seven per cent of 372 initially positive patients were in hospital for an average of 18.0 weeks and 65% of 309 initially negative patients for an average of 11.0 weeks. Eighty per cent of the positive patients received streptomycin plus PAS plus isoniazid and a further 10% PAS plus isoniazid, the porportions for the negative patients being 57% and 35%. Side effects occurred in 53% of the patients on the triple regimen and 43% of those on PAS plus isoniazid. The mean duration of chemotherapy for the bacteriologically positive patients was 22.2 months and for those negative 19.1 months, the duration of the initial streptomycin supplement being 4.4 months and 3.4 months, respectively. Corticosteroids were given to 58 (8%) of the 770 patients. Only 6 (0.8%) had surgery for their tuberculosis. Forty-one per cent of the positive patients were off work for more than 6 months and 19% of the negative patients, and 18% and 8% never returned to work. In the two-year period an average of 12.5 radiographs were taken per patient and 10.8 bacteriological specimens were examined for tubercle bacilli. The number of clinic attendances in a full out-patient year averaged 4.2. Urine tests for antituberculosis drugs (invariably PAS) were performed in only 6 of 25 Burghs and 5 of 14 Counties, and were done infrequently in them. A continuous evaluation procedure for tuberculosis therapy programmes is recommended.


A study of some effects of subculture on two BCG strains. A marked improvement in the ability to consistently distinguish between colonies cultured from BCG strain 1331 (Copenhagen), employed for the routine production of Danish freeze-dried BCG vaccine, and those cultured from BCG strain 1077 (Glaxo), employed for the routine production of British freeze-dried BCG vaccine, was obtained in our laboratory by modifying the constituents of a Dubos-type solid-medium. Several batches of British BCG vaccine had been specially prepared by the manufacturer, using strain 1331 as seed culture, and samples from these batches were cultured on this medium in our laboratory. Two of the batches produced, in place of the spreading colonies normally cultured from strain 1331, a large majority of nonspreading colonies, normally characteristic of strain 1077. To study this very rapid change, modifications of the system of serial transfers employed routinely by the manufacturer were set up in our laboratory, and the relative proportions of the two colony forms cultivated at each stage of transfer were noted. The rapid changes that had occurred during manufacture were reproduced under our experimental conditions, and it was observed that transfer through deep culture in liquid Dubos medium tended to shift the balance between the numbers of spreading and non-spreading colonies in favour of the latter, whilst the reverse was true of the transfers through deep culture in production medium. The ability to monitor changes occurring in BCG strains during serial transfer should facilitate the provision of measures to prevent such changes taking place.


Manipulation of allograft immunogenicity by pretreatment of cadaver donors. The experimental basis forming the rationale for the reduction of allograft immunogenicity prior to transplantation is described. This is based on the hypothesis that ""passenger leucocytes'' are a major immunogenic stimulus in rejection. Donor pretreatment with high doses of methylprednisolone and cyclophosphamide can be used clinically for cadaver donor pretreatment and when combined with an adequate post-transplant chemical immunosuppressive regimen results in an important in improvement in overall results as seen in a series followed for 5 1/2 years.


Controversy in organ preservation.

Controversy in organ preservation. Renal preservation has contributed to improvements in human cadaver kidney transplantation in terms of viability testing and logistics. Unfortunately, the antigenicity of a kidney has not been reduced by our present preservation methods; consequently, immunologic problems in cadaver kidney transplantation still remain. Simple cold storage is an acceptable method for kidneys subjected to minimal warm ischemia. It can be used where anticipated storage time will not exceed 10 to 15 hours. Pulsatile or nonpulsatile machine perfusion will give better results especially when kidneys have sustained up to 60 minutes warm ischemia. Where there is also a need for storage time longer than 15 hours, perfusion should be used. Cryoprecipitated millipore-filtered plasma remains the most commonly used perfusate. Preservation really begins before the harvesting. Present preservation techniques cannot revive a dying kidney. No single test will determine the degree of viability of a kidney. A systematic multidisciplinary effort is needed to augment our understanding and knowlege about the effect of hypothermia on organs. Hopefully these efforts will result in the development of an organ bank whereby many more kidneys will be available for transplantation.


New approaches to immunosuppression in renal transplantation. Although the incidence of 1 year kidney graft survival has been on a plateau for the past 7 or 8 years, the likelihood of recipient survival has increased. These observations reflect the limits of our current nonspecific immunosuppressive techniques and the acquisition of knowledge about when to discontinue their use and allow rejection of the kidney rather than death from sepsis. Yet, there are many leads from the laboratory which, when applied clinically in the next few years, should allow safe kidney transplantation to become a routine clinical event. Among these are safer, more effective antilymphocyte preparations; precise indications for splenectomy; accurate identification of presensitized states in potential recipients; methods of reducing the immunogenicity of grafts by removing donor passenger leukocytes or flushing the kidney with substances that alter surface antigens; and possibly new classes of chemical immunosuppressive drugs. In addition, it is likely that techniques will evolve for selective suppression of the immune response to donor antigens. This will be achieved by using cytotoxic agents coupled to donor antigen to destroy specific antigen recognition lymphocytes. Other forms of noncytotoxic donor antigen and antibody with or without ALS will be used to manipulate the recipient's immune response prior to and after transplantation. These manipulations will leave intact most of the potential for immune response to antigens other than those introduced with the graft. Together, these manipulations and their effect in experimental animals have been called immunologic enhancement. Intentional enhancement in man by means of antigen treatment or passive immunization has just barely begun. Clinical trials will be difficult and, initially at least, they will be confined to only a few transplantation centers. Yet, the "antigen pretreatment" of natural pregnancy, blood transfusion, prior unsuccessful organ transplantation, and bacterial infection have at times inadvertently conditioned a potential host so as to allow enhancement of a subsequent graft. It is likely that much can be done with current clinical assays of cellular and humoral immunity to detect those patients who are already conditioned to enhance a subsequent graft.


Selective renal angiography: its value in renal transplantation. To date angiography has been the most precise diagnostic modality for the evaluation of a transplanted kidney. In the immediate postoperative period angiography can clearly demonstrate the integrity of the vascular anastomoses, and in most cases helps to differentiate between acute tubular necrosis and acute rejection. It is also helpful in the evaluation of the transplant kidney later in the postoperative period, since it can provide some estimate of the vascular effects of chronic rejection and distinguish between hypertension secondary to chronic rejection or renal artery stenosis. Serial isotope techniques may play a more important role in the evaluation of the transplanted kidney in the future, but at present angiography is the diagnostic modality of choice at the Cleveland Clinic.


Septicemia in renal transplant recipients. Thirty-six renal transplant recipients with 47 episodes of septicemia were studied carefully at the bedside, in the laboratory, and, all too frequently, at autopsy. Gram-negative bacilli were the pathogens most commonly responsible, folloed in order of frequency by gram-positive cocci, polymicrobic etiologic agents, Listeria monocytogenes, and fungi. Infections of the transplant site (urinary tract or transplant wounds) caused septicemia in 51% of the cases. Other portals of entry included the lung, the abdomen, the meninges, the endocardium, and miscellaneous sites. The outcome of septicemia was fatal in 36% of the episodes. There was a significantly higher mortality for episodes of septicemia associated with pneumonia, persistent bloodstream infection, leukopenia, metastatic abscesses, clinical shock, and acute respiratory failure. The high mortality of septicemia in renal allograft recipients demands that extremely careful attention be given to subtle clinical clues denoting the onset and predicting the course of the disorder.


Nomenclature of neurogenic bladder.

Nomenclature of neurogenic bladder. Vesicourethral physiology is reviewed briefly in the light of recent developments. The effect on bladder function of central nervous system disorders is considered and attention is drawn to the desirability of diverting interest from the bladder to the urethra in neuropathic cases. It is concluded that there are only two basic types of neuropathic bladder function--in lesions of and above the sacral reflex pathways, respectively. Neurologically these are classified according to the condition of the anal and bulbocavernosus reflexes and the ice water test.


Management of neurogenic bladder dysfunction in the adult. A review of the management of neurogenic bladder dysfunction in the adult is presented. The various modes of therapy are classified according to their effects on bladder contractility and outlet resistance, providing a logical framework for discussion.


Five-day course of antibacterials for uncomplicated urinary infections. Fifty-six patients with uncomplicated urinary infections were treated with a five-day course of antimicrobials. Fifty-four patients had sterile urine two weeks after termination of the drugs. Over a two-year period 8 patients were found to become reinfected.


Oxybutynin in bladder spasm, neurogenic bladder, and enuresis. Oxybutynin chloride (Ditropan), a tertiary amine possessing anticholinergic and papaverine-like, direct muscular antispasmodic effects, has been used in controlled clinical studies in patients with neurovesical reflex activity, uninhibited bladders, enuresis, and primary muscle spasm. The cystometrically documented, synergistic, anticholinergic, and muscle relaxant activity of oxybutynin observed in these studies indicates that the drug can be highly effective in the management of reflex neurovesical dysfunction, enuresis, and bladder spasm.


Silicone-gel prosthesis in treatment of urinary incontinence secondary to neurogenic bladder dysfunction. Patients with lower neuron lesion neurogenic bladder, with normal upper urinary tracts, poor closing pressure of the urethra, and absence of vesicoureteral reflux can be considered candidates for the insertion of the silicone-gel (Kaufman) prosthesis. Our results in 10 cases indicated that there is a place for passive urethral compression in the treatment of neurogenic bladder after a careful selection of patients and using objective methods to regulate the amount of urethral compression. The use of a combined operation (silicone-gel prosthesis and a Small-Carrion prosthesis) in some of the cases is also presented.


Complications of Marshall-Marchetti-Krantz urethropexy. The course of 2 patients with ureteral obstructions created during the Marshall-Marchetti-Krantz procedure is described. The superior or most craniad stitches of the repair were placed inadvertently through the bladder wall obstructing the ureterovesical junction on each side. Awareness of the possibility of this complication should aid in avoiding this mishap.


Iatrogenic microphallus secondary to circumcision. Three cases of apparent microphallus secondary to overzealous circumcision are presented. Proper diagnosis avoids unnecessary diagnostic studies. Moreover, a good functional and cosmetic result is virtually assured with appropriate resurfacing and thick split thickness skin grafting of the penile shaft. The best treatment would appear to be prevention of the complication by adequate instruction to personnel doing routine circumcisions.


Starch granulomas after transurethral resection of bladder tumors. Starch granulomas have been observed in 3 patients in a series of 140 under treatment for bladder cancer during the period 1949 to 1969 in one hospital. The lesions were observed at the fourth or subsequent transurethral procedure, suggesting strongly that the starch had been introduced at a previous transurethral procedure. The granulomatous reaction may simulate a recurrence of the initial bladder tumor.


Animal, vegetable or cerebral: brains in agricultural production. Recent developments in brain research seem to have passed unnoticed in veterinary and agricultural circles. Yet they have transformed views on the subject and, Dr Cross argues, made study of the brain mandatory for future advance in animal health and production.


[The life of Joseph Haydn from a medical point of view (author's transl)]. Joseph Haydn (1732 to 1809) had hardly been troubled by any illness of note, apart from a chronic nasal polyp until 1799. During the composition of the oratoria "The Seasons" (1799 to 1801), the signs of cerebral arteriosclerosis with cardiac insufficiency made their appearance. Haydn's creative strength subsequently declined rapidly and he was virtually unable to compose any more after he had finished "The Seasons" until his death in 1809. The plan to compose a third oratoria "The Last Judgement" ended abortively. Haydn himself suffered acutely from the inactivity imposed on him by the illness, as documented by various sources. Hadyn remained fully conscious right up to the time of his death, which presumably resulted from cardiac failure. Haydn's grave was ransacked only a few days after the funeral and his skull was snatched. It has been finally restored to his resting place in Eisenstadt only as recently as 1954 after a protracted and devious journey.


[Diagnostic methods in the assessment of gastrointestinal function (author's transl)]. A review is presented in this paper of the available diagnostic methods for the assessment of gastrointestinal function. The techniques of gastric secretion analysis, pancreatic secretion investigation and small intestinal absorption tests are described and discussed.


[Anticholinergic treatment of Parkinson's disease (author's transl)]. Anticholinergic drugs retain their place even today in the treatment of Parkinson's disease in spite of the considerable success achieved by means of stereotactic surgery and substitution therapy with dopa or dopa derivatives. An investigation was made on 44 patients suffering from Parkinson's disease treated with the new anticholinergic drug, Sormodren (Knoll). Sormodren showed a selective action on the hyperkinetic and autonomic symptoms of this disease of the extrapyramidal system. Tolerance was good, no serious side effects being observed.


[Role of stewed fruit-berries as a factor in the transmission of dysentery toxinfectious diseases]. Experimental investigations aimed at working out methods for quantification of Sh. sonnei in experimentally infected stewed fruits and berries are described and the ways for educing the epidemiological hazards of a compote prepared by failing to comply with proper heat treatment - idicated. The presently proposed by the author procedure for bacteriological analysis of an infected compote is shown to be sensitive enough, for it enables one to count 10(2) and more Shigella cells in 1 ml of compote. The greatest epidemiological danger can be found in compote prepared through heating without subsequent boiling, since it contains intact viable Shigella cells, introduced into the compote prior to its heating.


Assimilatory nitrate reductase in a chlorate-resistant mutant of Escherichia coli. Nitrate reductase was investigated in extracts from cells of a chlorate-resistant mutant strain of E. coli which grew anaerobically on nitrate as the sole source of nitrogen. The nitrate reductase was of particulate nature and reduced chlorate like the nitrate reductase from the wild strain, but in contrast was inhibited only weakly by azide or cyanide. Nitrate reductase activity was found in extracts from the mutant cells grown on nitrate as the sole source of nitrogen, but not in extracts from cells grown in complex nutrient medium. Addition of ammonia also caused a decrease in activity. Accordingly, the nitrate reductase in the chlorate-resistant mutant is of the assimilatory type.


[Psychohygienic programmes designed to help people prepare for old age (author's transl)]. Preparation for an active old age must include geropsychohygienic measures in order to maintain and promote psychic health up to the most advanced age. The scientific basis is provided by geropsychohygienic research. The use of psychohygienic programmes should concentrate on the segment of the working population which is approaching pensionable age and which has a relatively low level of qualification. But gradually all other age brackets should also be covered. The programmes should be based on modern gerohygienic and gerontopsychological findings. Relationships between ageing, environment and psychic health must be elucidated from various aspects, questions of planning one's life playing an important role here. All means of psychic training in the creative interaction between man and his environment must be set forth and utilized. The erroneous conviction still held by many that old age poses a drawback for such training must be refute. Under socialist conditions, the preservation of the senior citizen's full integration into society is part of the process of preparing for an active old age. He should also be made consciously aware of the esteem in which he is held by society and of the significance of his position. We hold the view that the integrated socialist educational system is a medium for putting psychohygienic preparation programmes into practical use. Apart from this, the process of preparing people for old age, which is a country-wide task, calls for cooperation between state-appointed managements, public bodies and representatives of different medical specialties.


[Bronchospirometric function on homotransplanted canine lungs after long-time preservation (author's transl)]. In the present study 12 canine lungs perfused in a BELZER perfusion unit for 17 hours using Albumine solution were homotransplanted. Bronchospirometric evaluation up to the 21st postoperative day have shown sufficient function. There is no remarkable difference in minute ventilation, alveolar ventilation and oxygen uptake when compared with non-stored lung homografts.


[Further development of the program system for lung function diagnostics running on minicomputer C 8205 (author's transl)]. Starting from the level of 1972 the development is characterized in view of -- general technical, psychological and economical problems -- completion of the program library and the -- technique of semi-on-line data collection. The last point describes experiences using the system of VEB Funkwert Erfurt. Different levels of automatization in lung function labs are discussed.


[Assessment of gestational age (author's transl)]. Both the birth weight and the relation of birth weight to gestational age are relevant factors in assessing the immediate and future risks in given newborn infant. When gestational age is known the assessment is done by using an intrauterine growth chart. In cases of unknown gestational ages, in cases of discrepancies between birth weight and gestational age the gestational age of the infant has to be clinically assessed. This assessment can be done by evaluating the neurologic or the external criterias both giving an accuracy of +/- 2 to 3 weeks.


[Biparietal diameter of the fetal head during pregnancy. A comparative study]. A growth curve of the diameter of the biparietal fetal head during pregnancy was presented which was plotted with the help of a computer on the basis of 660 measurements. From this curve, an additional curve and 1 table were presented for the estimation of the age of the fetus on the basis of the measurements of the fetal biparietal diameter.


[Histological studies of the African giant snail (Achatina fulica) experimentally infected with Angiostrongylus vasorum or Angiostrongylus cantonensis (author's transl)]. African Giant Snails (Achatina fulica) about 6 weeks old were experimentally infected with each 5,000 to 20,000 first stage larvae of Angiostrongylus vasorum or A. cantonensis by exposure to a larval suspension. The snails were histologically examined after various intervals after infection: 1 hour post infectionem (p.i.) larvae were present in the foot and 2 hours p.i. in addition in the gastrointestinal tract. 12 hours p.i. larvae were seen for the first time in the lung which reached nearly half of the total number of larvae via the hemolymph system. 24 hours p.i. or later 80-90% of the total larval population were detected in the foot and the lung. In the various organs (lung, mantle, hepatopancreas, gastro-intestinal tract, foot) the larvae were found in the loose connective tissue near or within the hemolymph vessels. The cellular defense mechanism of the snail is activated 12 hours p.i. and the parasites are surrounded by large numbers of leucocytes (leucocytic encapsulation). Three days p.i. the nuclei of the cells become spindle shaped and are forming concentric layers in the outer part of the capsule (fibroblastic type of encapsulation). Later on the wall of the encapsulation becomes thinner and a karyolysis can be recognized in the centre, consequently a cavity occurs. Encapsulations in organs poor in muscle cells can histologically not be differentiated from those located in the foot, which consists mainly of muscle cells; a myofibrous type of encapsulation has to be doubted. The effects of the infection on the snail are discussed.


[On the pathogenesis of the glomerulosclerosis ultrastructural and autoradiographic investigations on the rat kidney (author's transl)]. The light- and electron microscopic changes in the glomeruli of the rat's kidney have been investigated in the course of ageing and after subtotal nephrectomy, constriction of the renal vein, and intoxication by N-nitrosomorpholine. In spite of the fact that four different experimental models have been used, identical changes were always found in the glomeruli. Morphologically they consisted of a diffuse thickening of the glomerular basement membrane and of an increase in the mesangial matrix without a proliferation of the glomerular cells. Despite this thickening of the glomerular basement membrane, functionally an increased permeability of the glomerular capillaries for macroproteins could be observed, shown by a moderate proteinuria. For these morphological changes the term "glomerulosclerosis" is suggested; they are interpreted as a non-specific, non-inflammatory reaction of the glomerulus to an impairment caused by a number of varied influences. From the study of the formal pathogenesis of the glomerulosclerosis presented here one can conclude that in the individual experimental models the same result has been achieved in different ways. One possibility in the development of glomerulosclerosis is an increased production of the components of the basement membrane and of the mesangial matrix. This is the pathway which appears to be followed after nephrectomy. Another possibility is a slowing down of the breakdown of both the matrix and the membrane. This seems to be the case in the glomerulosclerosis occuring in the course of ageing, and after hypoxic and toxic changes. It could be accounted for by a functional disturbance of, presumably, the mesangial cells responsible for the breakdown of the basement membrane and of the matrix. On the other hand, one may have to consider a primary alteration of the macromolecules of these structures, as is already known from studies of the, chemically closely related, collagen. The light- and electron microscopic studies of the normal and of the altered glomeruli have led to certain conclusions concerning the origin and the fomation of the glomerular basement membrane and the mesangial matrix. In order to widen the scope of the studies, additional autoradiographic investigations with 3H-proline and 3H-leucine have been performed in ultrathin and semithin sections of the rat's glomeruli. The results of the studies presented here suggest that of the three cell types of the glomerulus the visceral epithelial cells (podocytes, "Deckzellen") may participate on the formation of the glomerular basement membrane, whereas the mesangial cells appear to be responsible for the synthesis of the mesangial matrix.


The ethological analysis of attachment. Sociometric, motivational and sociophysiological aspects. The purpose of this progress report is to discuss the concept of attachment from the ethological and from the socio-biological point of view. Recent advances in obtaining and interpreting sociometric data are summarized. The interrelationships of proximate and ultimate causes for attachment are outlined.


[Infections in newborn infants caused to B-streptococci]. An increased morbidity by Streptococcus agalactiae (group B streptococci) during the perinatal period was to be found in some countries since 1961. Six cases of group B streptococcal meningitis were confirmed by the Central Streptococcus Laboratory of the GDR from July to December 1975. Therefore it is necessary to look for group B streptococcal infection in certain cases of diseases of the newborn. In a short review of literature the clinical signs (acute onset with respiratory distress, sepsis or late onset with meningitis), prevalence, source of infection and therapy (ampicillin or a combination of penicillin G and gentamicin) were summarized. The diagnosis is confirmed by isolation of group B streptococci.


[Immunoglobulin level in herpes gestationis]. At a patient with herpes gestationis the immunoglobulins IgG, IgA and IgM as well as the proteins albumin, transferrin and coeruloplasmin were determined in the serum. The relation of this illness of pregnancy with immunological factors is in discussion.


[2-year analysis of the results of a screening program on computer basis for the detection of pre- and early stages of cervix carcinoma (model Rostock) (II)]. Two years experiences with a computer-assisted program for early detection of prestages and early cervical cancer in Rostock-city are reported. 65% = 27028 women finally cooperated. Pathological papsmears were found in 0,52%. 9 cases of severe dysplasia, 30 carcinomata in situ, 3 cases of early invasion, 3 micro- and 5 macrocarcinomas were observed. Accessory findings were seen in 10,2%.


[Rubella virus hemagglutination inhibition IgM antibodies: the method of absorption of IgG by staphylococcal protein A as compared with density gradient ultracentrifugation (author's transl)]. The elimination of IgG by adsorption to Protein A of S. aureus was used for the demonstration of rubella virus specific IgM by hemagglutination inhibition. The validity of the method was proved by comparison with the results of density gradient centrifugation. The adsorption procedure led to false positive results in 9 of 56 cases and to false negative results in 12 of 46 cases, i.e. 20.7% of the results were discordant, when the sera were tested with short incubation time (30 min. room temperature) and the residual IgG (and IgA) were not excluded by controls with 2-ME (table 1 and table 2). By prolonged incubation time (18 hrs + 4 degrees C) and controls with 2-ME, false positive results were avoided, and the number of false negative results was reduced to 9 (table 2 and table 3). The latter occured mostly in cases where the disease had started 3 or more weeks ago and the titer in the IgM fraction of the sera was low (fig. 3). Under these conditions the absorption of IgG by staphylococcal Protein A proved to be a simple, specific and reliable procedure for the demonstration of rubella virus IgM within 2-3 weeks after the onset of the disease.