Mild stimulation of serum immunoreactive insulin (IRI) release following large doses of intravenously given glycine to children of normal pituitary function. In healthy, sexually immature children of both sexes serum IRI levels rose more than expected from random inter-individual variation (i.e. more than 3 standard deviations of the basal level) in 10 out of 21 subjects loaded by glycine. The IRI release by glycine though moderate and not constant is, however, unquestionable. The growth hormone (GH) secretory response to glycine did not change according to the occurrence and/or magnitude of IRI release. It was concluded that GH and IRI stimulatory properties of glycine given intravenously in large doses are completely unrelated.


Nonsecretory myelomatosis without intracellular immunoglobulin. Immunofluorescent and ultramicroscopic studies. A patient with multiple myeloma is reported with severe hypogammaglobulinaemia but without monoclonal immunoglobulin (M-component) in the serum or Bence Jones protein in the urine. In May-Grünwald-Giemsa stained bone marrow film 45% of the cells resembled plasma cells. Marrow immunofluorescent studies showed no increase of immunoglobulin containing cells. Ultrastructural studies showed a large number of cells with a well developed rough endoplasmic reticulum and other morphological features characteristic for plasma cells.


Microbiological aspects on peritonsillar abscesses. In 37 patients with unilateral quinsy put was collected with a syringe technique and bacteriologically examined. Beta-hemolytic streptococci were isolated from 17 abscesses; in 8 of these, however, together with other bacteria, mainly anaerobes. Anaerobic bacteria, often more than one species, were found in 28 abscesses. Streptococcal serology including AST-O, Streptozyme and separate ADNAse test showed high titres or titre rises in 22 out of 30 examined cases. There was one case with beta-hemolytic streptococci in the abscess but negative serology. In the remaining cases a possible primary etiological role of anaerobes is suggested. The effect of combined surgical drainage and treatment with antibiotics (ampicillin or penicillin V) was good.


Streptococcal types in impetigo and acute glomerulonephritis among children in Addis Ababa. Studies on the streptococcal epidemiology  of impetigo in children below 12 years of age in Addis Ababa indicated that most streptococci isolated belonged to the classic serological impetigo strains. Streptococcal type 9 seemed to be a new impetigo strain. Several cases of severe acute glomerulonephritis on impetigo basis were observed during the study.


Vaccination against meningococcal group A disease in Finland 1974-75. Meningococcal group A polysaccharide vaccine was used in children 3 months to 5 years of age in the winter 1974-75 during an epidemic caused by sulphanamide-resistant group A meningococci. In 3 provinces, the vaccine was offered on a double-blind basis, using Haemophilus influenzae type b polysaccaride vaccine as control. Approximately 100 000 children were vaccinated with either one of the vaccines. In the Kymi province, approximately 22 000 children representing 90% of the child population of this age received the meningococcus vacine. Infants below 18 months received a booster dose of vaccine 3 months after the first dose. The meningococcus vaccine caused local symptoms in 71%, mild systemic reactions in 37%, and high fever (38.5 degrees C or more) in 1.8% The haemophilus vaccine produced fewer side effects. No clinical infections caused by group A meningococci were reported in the first 6 months after vaccination among those who had received the meningococcal vaccine. At the same time, group A cases continued to appear in other age groups and other areas of the country.


Yersinia enterocolitica infection in patients with acute surgical abdominal disease. A prospective study. The rate of yersiniosis in patients with acute abdominal disease was studied in a 16-month prospective investigation in 1972-1973 of 205 acutely ill patients referred to a surgical clinic of a Copenhagen City hospital with complaints of abdominal pain suggestive of appendicitis. Yersinia enterocolitica, biotype 4, was isolated from 11 patients (5.4%), 8 of whom were children. Yersinia was grown from faeces in 8 cases and from appendix of all 9 patients operated upon. Rising or falling agglutinin titres larger than or equal to 100, indicative of yersiniosis, were found in 22 patients (10.7%) including all bacteriologically verified cases. Eight additional patients (3.9%) had less significant titres larger than or equal to 100, suggestive of recent or present infection. 28 patients (13.7%) had insignificant titres, including 3 with antibodies against serotype 9. In all cases except these 3, antibodies were against Y. enterocolitica, serotype 3. A differential diagnosis between Y. enterocolitica infection and other types of appendicitis could not be made within this highly selected group of patients using available clinical data. All cases were rather mild and self-limiting. It is suggested that in future epidemiological and other studies of yersiniosis, early bacteriological and serological examinations be carried out.


A NEW Escherichia coli O-group, O159, associated with outbreaks of enteritis in infants. An outbreak of enteritis occurred amongst babies in a nursery unit. 25 babies were affected and 5 required intravenous therapy; there were not fatalities. From 24 of the 25 babies affected, an Escherichia coli with a previously undescribed O-antigen was isolated. An outbreak of diarrhoea had taken place in the same hospital a year before and re-examiniation of cultures of E. coli isolated at that time showed that 5 of the 15 babies affected had been excreting E. coli with the same O-antigen. Isolates from 10 of the babies were tested for enterotoxin production in the infant mouse model and 4 gave a positive response. The new O-antigen has been accepted into the international serotyping scheme and has been designated E. coli O159.


Streptococcus zooepidemicus (group C streptococci) as a cause of human infection. Cervical lymphadenitis with high fever and respiratory distress in a 3-year-old boy is reported. Group C streptococci were isolated from the boy's throat and these were identified as Streptococcus zooepidemicus. The patient recovered after treatment with penicillin. Strep. zooepidemicus is extremely rare as a causative organism of human infections. Even symptomless carriers are very rare. Group C streptococci isolated from humans normally belong to the species Strep. equisimilis.


Neonatal osteomyelitis caused by group B streptococci. A 3-week-old infant with a group B streptococcal osteomyelitis is described. On admission swelling and fluctuation were combined with local erythema in the right ankle joint region. Group B streptococci, type Ib, were isolated both from blood and from the local focus in the ankle. The diagnosis was further confirmed by X-ray examination showing a lytic lesion in the talus. The child was successfully treated with penicillin, initially in combination with kanamycin.


A study on the mutagenic activity of styrene and styrene oxide. Styrene oxide is multagenic, without metabolic activation, to S. typhimurium strains TA 1535 and TA 100, which have been devised to detect mutagens causing base-pair substitutions. Styrene seems to be mutagenic toward the same strains, but only after metabolic activation. The toxicity of both styrene and styrene oxide make the construction of reliable dose-response curves rather difficult. Diethylmaleate and 3,3,3-trichloropropene oxide enhanced the mutagenicity of styrene oxide in the presence of homogenate; this result indicates the participation of epoxide hydratase and glutathione S-oxide transferase in the metabolism of styrene oxide. These two chemicals did not influence the mutagenic activity of styrene. Styrene glycol and 4-tert-butyl-brenzcatechin were not mutagenic to any of the strains studied. Results show that further, more detailed experimental and, possibly, epidemiologic studies are warranted.


Effect of a short, heavy exposure to lead dust upon blood lead level, erythrocyte delta-aminolevulinic acid dehydratase activity and urinary excretion of lead delta-aminolevulinic acid coproporphyrin. Results of a 6-month follow-up of two male subjects. During 1 h two healthy volunteers, not earlier exposed occupationally to lead, inhaled about 100 mg of lead as a mixture of lead oxides and lead sulfate. Maximum blood lead (PbB) concentrations of about 0.5 mg/1 and minimum blood cell delta-aminolevulinic acid dehydratase activities (ALAD) (6% of the preexposure values) were observed within 38 h after exposure. PbB and ALAD returned to preexposure levels after about 300 and 150 days. A highly significant correlation between ALAD and PbB was seen even at lead levels in the range 0.1-0.2 mg/1. Delta-aminolevulinic acid, coproporphyrin and lead in the urine (ALAU, CPU, and PbU, respectively) increased. The peak levels occurred after about 15 h for ALAU and CPU and after about 24 h for PbU. There was a very good correlation between log PbU and lin PbB. ALAU increased already at PbB levels of about 0.3 mg/1.


Antibacterial synergism: a proposal for chemotherapeutic potentiation between trimethoprim and sulfamethoxazole. Sulfamethoxazole and other sulfa drugs are moderately potent inhibitors of Escherichia coli dihydrofolate reductase. They also significantly potentiate the inhibition of this enzyme by trimethoprim. The molecular basis for inhibition potentiation is the simultaneous binding of trimethoprim and sulfa by the enzyme. This potentiation may explain the synergism observed when these drugs are used in antibacterial chemotherapy.


Structural studies on des-pentapeptide (B26-30)-insulin. I. The preparation and properties of des-pentapeptide-insulin. It has been suggested in our previous reports that the B-chain C-terminal peptide sequence of the insulin molecule plays an important role in the primary biological activity of this hormone. It is interesting, therefore, to study the structure-function relationship of a series of related insulin analogues. An improved method has been used in this paper for the preparation of des-pentapeptide (B26-30)-insulin (DPI) suitable for the growth of single crystals. These crystals possess 88% of the receptor binding activity of insulin and exhibit hormonal activity of 20 I.U. per milligramme in the mouse convulsion test. In the presence of zinc ions, DPI cross-reacts immunologically with insulin antibody.


Anaerobic infections: diagnosis and treatment. Anaerobic bacteria outnumber aerobic bacteria in normal flora in the oropharynx and gastrointestinal tract. They are important and frequent causes of infection, although they often go unrecognized except in the classic and very distincitve clostridial infections and intoxications-gas gangrene, botulism, and tetanus. Although anaerobic infections often originate close to a muscosal surface where anaerobes are part of the normal flora, they may occur anywhere in the body via direct of hematogenous spread. Clues to diagnosis include a foul-smelling discharge, gas, necrotic tissue, abscess formation, the unique morphology of certain anaerobes on Gram's Stain, and failure to obtain growth on aerobic culture despite the presence of organisms on Gram-stained direct smear. Predisposing conditions include aspiration, vascular insufficiency, trauma, malignancy, and previous antimicrobial therapy. Clinical suspicion requires confirmation of diagnosis by appropriate collecting, transport and culturing of specimens while excluding contamination with anaerobes from the normal flora. Treatment usually requires a combination of surgical and medical measures. Penicillin G is the drug of choice for virtually all anaerobic infections except those caused by Bacteroides fragilis, which require chloramphenicol or clindamycin. Investigational agents also appear promising in the treatment of anaerobic infections.


Serologic diagnosis of syphilis: an update. Tests used in the serologic diagnosis of syphilis can be divided into two main groups: nontreponemal (reagin) tests and treponemal tests. The most widely used nontreponemal test is the Venereal Disease Research Laboratory (VDRL) slide test, and the standard treponemal test is the manual fluorescent treponemal antibody-absorption (FTA-ABS) test. These tests and other newer tests available for the serologic diagnosis of syphilis are reviewed, with emphasis placed on their current clinical usefulness.


Renal failure in infectious mononucleosis. An 18-year-old man developed generalized lymphadenopathy and interstitial renal disease which progressed to irreversible renal failure. Serologic studies evidenced the recent onset of infectious mononucleosis, and prior exposure to Epstein-Barr virus was demonstrated. Lymph node, liver, and renal biopsies showed mononuclear cell infiltration consistent with infectious mononucleosis. Although renal involvement in infectious mononucleosis rarely is severe, an association between infectious mononucleosis and renal failure is suggested in this patient.


Fournier's gangrene of the penis.

Fournier's gangrene of the penis. Fournier's gangrene is a rare, fulminant, though generally localizaed disease of the scrotum and penis. Three cases are presented in which the sexual practices of the patients may have played a role in the etiology. Hospitalization, parenteral antibiotics, and appropriate surgical treatment are required.


Free groin flap to the hand with end-to-side vessel anastomosis. A single case of successful free groin flap transfer to the hand is presented. Its use demonstrates a distinct advantage of free flap transfer, preventing dependent edema and enforced immobilization of the hand necessitated by conventional technics. It also demonstrates a successful end-to-side microarterial anastomosis, thus allowing a continued normal blood supply to the hand.


History of mental health services in South Africa. Part XIII. The National Council for Mental Health. The National Council for Mental Health was born out of the coming together of the Society for the Care of the Feebleminded in Cape Town and a society with similar aims in Johannesburg in 1920. The Council's headquarters were in Cape Town until 1926 and were then moved to Johannesburg. The Council's work has always been essentially informative with the aim of enlightening the public on mental health and of urging the Government to provide better facilities. It has encouraged the establishment of local mental health societies in the main centres, and has subsidised them. It has had a great share in removing the stigma attached to mental illness.


A medical paradox: curative versus preventive medicine. A familiar medical contrast is presented as part of a modern medical problem. The problem it reflects is the relative importance of preventive and curative services for medical practitioners, which is already, or will shortly resolve itself into, a dilemma of whether medical men should stress preventive medicine to the possible detriment of curative medicine. It is submitted that the solution to both problem and dilemma should be sought against the background of history and philosophy, where they are seen to be expressions of an eternal paradox--that of the relative value of the individual in relation to the family, group, or community. If the submission is valid, then the answer to the problem is not a purely medical exercise, nor is the dilemma purely a 'doctor's dilemma'. The paradox, being eternal, is not soluble in our time, but the community must, on the urging of the medical profession, find a general solution to the problem--'a public consensus for out time'. This must be followed by public demand for a parliamentary solution--'decision-making ex consensus'. It is argued that although the latter programme does not come easily to democracy, it can be achieved through public consensus if action is taken by the leaders of thought in appropriate categories. Initiative must be exercised by the medical profession, but public consensus can only be achieved in consultation with the leaders of all learned professions, civil servants and legislators. It must then be presented fairly and without bias to the public. In the meantime, the medical profession must formulate its own 'medical consensus' and the doctor must resolve his personal dilemma according to formulated law, public or medical consensus or, in the last resort, according to his conviction and conscience. This method of solving a problem will almost certainly be applicable to other and more recent medical problems such as the population explosion, selective abortion and euthanasia.


The role of diagnositc ultrasound in the assessment of masses in the left upper quadrant of the abdomen. The usefulness and advantages of diagnostic ultrasound (sonar) scanning as an aid in the investigation of soft-tissue masses, are illustrated in a number of patients with such masses in the left upper quadrant of the abdomen. These illustrative cases show that sonar scanning can reveal the size, shape, anatomical relations, and consistency of intraperitoneal and retroperitoneal masses. Sonar scanning is particularly valuable in differentiating cystic from solid masses. Furthermore, clinically unsuspected masses can be detected. Sonar scanning is harmless, relatively quick, non-invasive and causes no pain or discomfort. These factors are of particular importance in postoperative and acutely ill patients.


Philo on circumcision.

Philo on circumcision. Circumcision has been regarded through the ages from many points of view, lay and religious, and the reasons advanced for its practice are diverse and often rationalised to counter assertions of its irrationality. This article includes an argumentum ad circumcisionem centred in the scholarly opinions of Philo Judaeus of Alexandria.


Geographical boundaries of facial reconstruction. The principle of considering defined areas of the face as separate entities when planning reconstructive procedures is explained. The resurfacing of these individual areas is discussed, and the priorities in the order of reconstruction are defined.


Closure of abdominal incisions with subcutaneous catheters. Five hundred patients who underwent a variety of major abdominal operations had primary closure of their abdominal incisions. The technique of closure included the use of catheters in the subcutaneous space with suction, except when an antibiotic solution was being instilled every 8 hours of the first 9 days after operation. The rate of postoperative wound infection in these 500 patients, a group which included 140 patients who had contaminated or dirty wounds, was 0.8 percent. Infection developed in only one (0.47 percent) of the 211 patients who underwent major colon procedures. No significant side-effects of treatment were observed.


Aspergillus prosthetic valve endocarditis. The clinical, laboratory, and histopathological features of seven cases of Aspergillus fumigatus prosthetic valve endocarditis are presented. The exact nature of the lesion, a combination of infective fungal endocarditis and thrombosis on the prosthetic valve, is discussed and the difficulties in clinical diagnosis are emphasized. Helpful indications were sudden unexplained heart failure with the appearance of new murmurs, and emboli to large or medium-sized systemic arteries. Fever and anaemia were inconstant, and in no case was blood culture or precipitin investigation helpful. Spore contamination of operating theatre air was the likely source of infection, and measures taken to overcome this and other predisposing factors are discussed. Since medical diagnosis is usually late and the few reported cures in this condition have included replacement of the prosthesis, early surgical intervention combined with antifungal chemotherapy is advised.


[Use of radio-immuno-assay of gonadotropic hormones in farm animals (author's transl)]. The determination of the concentration of gonadotropic hormones in the peripheral plasma of farm animals by radio-immuno-assay is described. Particular attention was paid to the determination of ovine, bovine and porcine LH using an anti-ovine-LH serum. This serum was found to be specific for LH, and there was no cross-reaction with FSH. Cross-reactions with TSH cannot be ruled out. The usefulness of this antiserum was tested in studying the release of LH during oestrus (in sheep), after injection of LH-RH (in cattle and pigs) and after weaning (in pigs). The results are in accordance with those reported in the literature.


Prolonged survival of rat leg allografts due to immunological enhancement. Attempts were made to induce a prolonged survival of leg allografts in rats by means of immunological enhancement. AS rats injected with AS anti-August antiserum accepted (AS X August)F1 kidney allografts for longer than 50 days, but rejected F1 leg allografts within 12-16 days. However, AS rats bearing established, enhanced (AS X August)F1 kidneys accepted F1 leg allografts for periods of 21-207 days. The possibility is discussed that composite tissue allografts can manifest prolonged survival provided that their recipients have passed through the "induction phase" of enhancement and reached the "steady-state" or maintenance phase.


Preparation and characterization of antithymocyte serum and globulin without stem cell activity. Immunosuppressive antimouse and antihuman thymocyte sera and antihuman T lymphocyte sera, raised in rabbits, inhibited colony formation in vitro by bone marrow stem cells. Absorption of the antisera with fetal liver, or isolation of the gamma-globulin from the antisera, removed the inhibitory effect on bone marrow stem cells but left the anti T lymphocyte activity unimpaired. Absorption with cultured lymphoblasts (B cell lines) failed to remove the affinity of the globulins for B lymphocytes.


The fate of experimental organ-cultured corneal xenografts. Human, chicken, and guineapig corneas organ cultured (O.C.) from 1 to 4 weeks were transplanted intralamellarly into rabbits. Chicken and guinea pid corneal xenografts O.C 3 to 4 weeks had statistically significant delayed rejection times reject. Histologically, O.C. xenografts with delayed rejection or nonrejection were hypocellular. Chicken xenografts O.C. 4 weeks in which recipient (autochthonous) rabbit serum replaced the calf serum routinely used in the media also had a significant delay in rejection time when compared to fresh controls or chicken xenografts stored in pooled (allogeneic) rabbit serum. The rejection time of human corneal xenografts O.C. FOR PERIODS UP TO 4 WEEKS WAS NOt delayed. These data suggest that in this model, prolonged survival of xenografts after O.C. is species specific and represents a form of immunological modification, possibly reduced antigenicity sedondary to donor hypocellularity.


Ischemic versus cytotoxic damage in the white graft reaction. Its relationship to hyperacute kidney rejection. "White" skin grafts on appropriately sensitized allografted mice are ischemic and necrotic. The ischemia occurs because of failure to form anastomoses between host and graft vessels. This failure is not due to altered host vascular function but correlated with obliterative (nonthrombotic, non-necrotizing) changes of graft vessels at the interface. It appears that the ischemia of white grafts, in contrast to that observed in hyperacutely rejected renal allografts, is not the cause of the necrosis, but vice versa. The necrosis of white grafts, which begins during the first 24 hr after their placement, is probably related to a very early immune assault on the graft as a whole. The nature and the pathways of this immune assault are not the subject of this study.


Hair growth cycles and wave patterns in "nude" mice. Hair growth cycles and waves were studied through five generations of hair growth in C57BL/6Icr "nude" mice. One group of nudes received thymus grafts, a second group was composed of athymid nudes and a third consisted of heterozygous (nu/&) haired littermates. The results showed that hair growth cycles and wave patterns were essentially the same in thymus-restored nudes and athymic nudes which indicated that thymus did not play a role in these phenomena. The time interval between hair cycles was considerably shorter in both groups of nude mice as compared to heterozygotes (nu/&). Finally, the hair growth wave pattern in nude mice did not change throughout the generation of hair growth whereas profound changes in wave patterns were observed in heterozygous (nu/&) littermates.


Rentran. An on-line computer-based regional kidney transplant matching system. An interactive on-line computerized renal transplant matching system called RENTRAN which serves the Southwest Kidney Transplant Region is described. The region consists of one transplant center in Arkansas, two in Oklahoma, and six in Texas. The computer used is the DECsystem-10 located in the Medical Computing Resources Center at Dallas. RENTRAN participants have remotely located standard interactive computer terminals and gain access to the computer by dialing over normal telephone lines. Functions provided by RENTRAN include obtaining instructions, performing a donor-recipient match, obtaining a list of potential recipients, making a user comment or adding, updating or deleting a potential recipient record. Either long or short formats for dialog with the computer system are available for inexperienced and experienced and users, respectively. In the time period from August 1,1973, when the system went into production on February 1, 1976, there have been in excess of 232 matches attempted and approximately 142 kidneys have been transplanted according to RENTRAN results. There are about 361 recipients currently on the data base. The system was developed with funds provided by the Texas Regional Medical Program. Expenses of maintaining the system as well as occasional programmed improvements as deemed appropriate by the Southwest Kidney Transplant Region Registry Committee on the basis of user comments are provided through a $25 per year  charge to patients for being listed on the data base.


Prolongation of allograft survival by combination therapy with anti-thymocyte serum and anti-immunoglobulin. Heterologous anti-immunoglobulin (AI) is a potent immunosuppressive agent which compares favorably to anti-thymocyte serum (ATS) in inhibiting E and EAC-rosette formation and diminishing the secondary antibody response to sheep erythrocytes and E. coli lipopolysaccharide. AI prolongs H-2 incompatible skin allograft survival than either antiserum used alone, without evidence of toxicity to recipient mice. AI does not cause significant immune complex glomerular or renovascular deposition and may act by interference with antigen binding.


A technique for liver transplantation in the inbred mouse. The technique of liver grafting to the kidney of inbred mice was used to characterise ultrastructurally liver rejection under controlled conditions. Electron microscopy showed that liver rejection was initiated by intimate contract between the hepatocytes and the infiltrating large lymphoid cells and brought about by means of narrow cytoplasmic processes extended from the latter. This was prevented by ATS-immunosuppressive treatment.


Histocompatibility in the rabbit. The effect of imbreeding on skin graft survival time. Skin grafts were exchanged between siblings from 16 inbreeding lines of rabbits. Progressive inbreeding and genome fixation through 12 generations of brother X sister matings does not produce a concomitant increase in graft survival time but instead produces a heterogenous response reflecting the residual segregation of individual histocompatibility loci. Grafts exchanged between RL-A incompatible siblings were not maintained for more than 12 days, regardless of the degree of inbreeding. The frequency distributions of the survival times of grafts exchanged between animals from all inbreeding lines from each generation, F5 through F8, agree best with the expected values calculated by assuming that 17 independent histocompatibility loci, with 95% confidence limits of 11 and 28 loci, must be matched to assure acceptance of skin grafts for 60 days or more. However, in animals from line Sh5b, only 3 significant histocompatibility loci appear to be segregating. Two of the significant histocompatibility loci segregating in line Sh5b have not geen identified;the third significant locus is either the Hg blood group locus or is linked to the Hg locus. Established loci that remain polymorphic during intensive inbreeding may be important in the development of a model transplantation system; as inbreeding progresses these established loci may be maekers for histocompatiblity loci thathave a significant effect on allograft survival time.


The liver and immune responses. I. Regional lymph node response in rats to injection of semi-allogeneic adult liver cells. Regional lymph node response in F1 hybrid rats in injection of parental adult liver cells was investigated. More than a 10-fold increase in node weight over the uninjected control node was observed on day 11 following injection of 60 X10(6) parental liver cells. The node weight gain was both dose and time dependent although 10 times more liver cells were required than the lymphocyte. Injection of either irradiated (600 rads) or cultured (30 days) liver cells did not reduce the reactivity. The liver cells prepared from 18-day-old fetuses, 70% hepatectomized or portacaval shunted rats were all shown to be reactive, the latter being far superior. This phenomenon is immunological since only parental (semi-allogeneic) but not syngeneic liver cells gave the reaction although a hybrid resistance cannot be denied. Possible mechanisms underlying this phenomenon are discussed.


The fate of serially transplanted bone marrow cell populations from young and old donors. Two bone marrow cell populations, separately identifiable by means of chromosome markers, were serially transferred at 8-10 week intervals through lethally irradiated syngeneic recipients. This system allowed a precise comparison of populations derived from young and old donors; no consistent differences were observed. Both donor populations ceased to replicate after 4-5 transfers. Although more than 10(3) spleen colony-forming units were transferred, the number of colones proliferating in the bone marrow fell sharply between the second and third transfer-generations. Regenerating host cells accounted for an increasing proportion of the miroses scord in the third and subsequent transfer generations. It is concluded that many of the stem cells of bone marrow subjected to two or more transfers have decreased powers of self renewal. The results suggest that stem cells of adult mouse bone marrow are capable of undergoing, at most, between 80 and 200 mitoses. This limitation is very possibly innate, but the possibility that it is an artifact of the serial transfer system cannot be entirely ruled out.


Immunological studies in onchocerciasis in Cameroon. Immunological studies were undertaken in a group of twenty patients with varying clinical manifestations of onchocerciasis. Significantly higher levels of immunoconglutinin, IgG and IgM, and alterations in C3 levels were found in the patient group than in controls. IgG and IgM complement-fixing antibodies to microfilariae of O.volvulus were detected in the sera of these patients. The lymphocyte transformation rate following PHA stimulation was high in patients with localised skin lesions in which the microfilariae were difficult to demonstrate in contrast to the low transformation rate obtained in those with diffuse lesions and in whom microfilariae were readily detected in skin biopsies. The significance of these findings is discussed.


Parasitic infections in humans in West Kalimantan (Borneo), Indonesia. A survey was carried out among inhabitants of eight villages in West Kalimantan Province (Borneo), whereby blood smears were examined for malaria, stools examined for intestinal parasites and sera tested by the indirect hemagglutination test for antibodies to Entamoeba histolytica and toxoplasma gondii. The prevalence of malaria among 3017 people examined was 5.6% (Plasmodium vivax 2.8%, Plasmodium falciparum 2.8%). Brugia malayi microfilariae were found in 3.6% and Wuchereria bancrofti in 0.3%. Ninety-seven percent of 2101 stool specimens examined contained evidence of intestinal parasites. Trichuris trichiura (90%) was most common followed by Ascaris lumbricoides (76%), hookworm, (60%), Etamoeba coli (23%), Entamoeba histolytica (6%), Endolimax nana (6%), Iodamoeba butschlii (4%), Giardia lamblia (3%), Chilomastix mesnili (1%) and Strongyloides stercoralis (1%). Other parasites found were Entamoeba hartmanni, Trichomonas hominis, Balantidium coli, Enterobius vermicularis, Hymenolepis nana, Echinostoma sp. and Physalopterid, Dicrocoeliid, and Heterophyid type-eggs. The amoeba prevalence rate was 30%. Indirect hemagglutination antibody titers equal to or greater than 1:128 for Entamoeba histolytica and 1:256 for Toxoplasma gondii were detected in 7% and 3%, respectively, of 1511 sera tested.


Counter immunoelectrophoresis technique in laboratory diagnosis of bacterial meningitis. Fifty cerebrospinal fluid specimens were studied by counter-immunoelectrophoresis (CIE), Gram's staining and culture techniques. Out of 33 test cases of pneumococcal, meningococcal and Haemophilus influenzae meningitides, 31 cases, were CIE positive, 24 were detected by Gram's staining while 27 were positive by culture. The 17 cases which served as controls did not give false positive results. The CIE is recommeded as an adjunct to bacterial culture in laboratory diagnosis of bacterial meningitis especially in areas where there is poor control of drug usage by people with resultant self antibiotic medication which makes definite bacterial meningitis specimens "sterile" on culture.


Bacterial enteropathogens in Malaysian shellfish. Three species of commonly eaten shellfish found in Malaysian coastal waters were examined for the presence of common bacterial enteropathogens. Vibrio parahaemolyticus, non-agglutinating vibrios, and various serotypes of enteropathogenic E. coli were isolated from a large proportion of them. Salmonella were isolated in two instances. High colony counts with evidence of faecal contamination indicated the strong possibility of pulltion being the cause for the presence of these enteropathogens. Methods of cooking and eating these shellfish enhance their likelihood of acting as vehicles of diarrhoeal disease.


Caprine pneumonia. II. Biochemical characterisation and serological identification of mycoplasmas. Thirty strains Mycoplasma isolated from pneumonic lungs of goats were chracterised biochemically and serologically. On the basis of biochemical characteristics, the strains were divided into three groups. (A) Eighteen strains which fermented glucose and mannose, digested serum and reduced tetrazolium, (B) 10 strains which reduced tetrazolium, formed "film and spots" and possessed phosphatase activity and (C) two strains which catabolised arginine only. Serologically group A strains were identified as M. mycoides subspecies, group B strains could not be fully identified but on the basis of immunofluorescence and biochemical reactions were put in the M. agalactiae subspecies; there are to be further investigated. Group C strains were identified as M. arginini.


[Urological complications following renal transplantation (author's transl)]. Between December 1964 and April 1974, 216 renal transplants were performed on 200 recipients at the University Clinic of the Cantonal Hospital at Zürich. The ureteroneocystostomy was performed in most cases, a pyeloureterostomy being done only five times. 12% of all recipients (24 patients) developed serious urological postoperative complications involving 27 (14.3%) of the transplants, with four cases being fatal. Not considered as a serious complication were urinary infections and retention due to clotting, both of which could be treated conservatively with success. Of the more serious cases, 8 involved stenosis of the ureter, 4 compression of the ureter, 2 obstruction of the ureter, and 4 bladder fistulation. In 10 of these cases the complication can be related to imperfect operative technique in respect to transplanting the donor kidney. Preserving sufficient ureter vascularization is of paramount importance, and consideration must be given to increased vulnerability to infection as a result of the immunosuppressive therapy. Extreme stripping of the pyelon and ureter can result in stenosis and necrosis of the ureter. The treatment of urinary passage complications has not been standardized. However, fistula closure and operative correction of ureter obstruction must be carried out quickly.


[Contribution on the surgical correction of penile and penoscrotal hypospadias (author's transl)]. The authors present a modification of the penoscrotal method of operation for the treatment of penile and penoscrotal hypospadias. The operating technique employed by the authors differs from the original method in that the urethra is formed from a strip of skin from the penis and scrotum. The so far good results are shown, and the importance of careful pre- and postoperative treatment for the success of the operation is pointed out.


[Obstructive uropathy by perirenal lymphocele, a rare complication after renal transplantation (author's transl)]. One lymphocele was observed in 151 renal transplants. Ureteral compression led to obstructive uropathy with decreased renal function. The clinical symptomatology, diagnostic procedures and management of lymphoceles is described and discussed. Lymphoceles can mimic the clinical pattern of rejection. The most important data of 21 lymphoceles reported in the literature are reviewed. The formation of lymphoceles may be prevented by careful ligation of all lymphatics transected during dissection of the recipient vessels. Intraperitoneal marsupialization is the therapy of choice in case of persistent lymph leakage and recurrency.


Manifestations of renal cell carcinoma.

Manifestations of renal cell carcinoma. Patients with renal cell carcinoma often have no specific localizing symptoms or signs, and their presentation will often involve many organ systems. Since 40 per cent of these patients do not have genitourinary symptoms, care must be taken to avoid being misled by normal findings on urinalysis. More than 50 per cent of patients with renal cell carcinoma have vague symptoms suggesting a gastrointestinal origin; thus if primary gastrointestinal studies do not disclose a cause for these symptoms, excretory urography must be included as a screening procedure.


Plasma insulin and glucose levels after renal transplantation. Plasma insulin and glucose levels were measured before and for twenty-four hours after operation in 13 patients who had undergone renal transplantation, 4 who had undergone bilateral nephrectomy, and 5 who had undergone donor nephrectomy. Postoperative hyperglycemia was noted in all patients, but the hyperglycemia was much greater after renal transplantation. Peripheral insulin antagonism rather than decreased insulin secretion appeared to account for the hyperglycemia. The peripheral insulin antagonism was largely due to surgical stress, but intravenous immunosuppressive medications contributed to the exaggerated hyperglycemia, hyperinsulinemia, and insulin antagonism observed in the transplant patient.


Comparison of flutamide (SCH-13521) and diethylstilbestrol in untreated advanced prostatic cancer. A double-blind study comparing the efficacy of flutamide (SH-13521) and diethylstilbestrol in 15 patients with advanced, previously untreated adenocarcinoma in the prostate in herein presented. Patients receiving diethylstilbestrol, 1 mg. daily, remained stable without evidence of progression of their disease for an average of 25.6 weeks while those receiving either high-or low-dose flutamide showed no objective progression for an average of thirty weeks. There were no complete remissions, and no signficant side effects were seen with either of these agents. In this small series of hormonally untreated Stage D prostatic cancer patients, neither agent displayed significant superiority.


Room temperature incubation of dipslide urine cultures. Two hundred and fifty urine specimens selected at random were cultured simultaneously by routine methods and on dipslides containing MacConkey agar and cystine-lactose electrolyte deficient agar with colistin (CLED-colistin agar) at room temperature incubation. There were six major and five minor differences between the two methods in interpretation of results. Many of these differences were due to the fact that CLED-colistin agar fails to support the growth of many gram-positive species, and that the dipslide tended to overestimate the colony count. Nevertheless there was sufficient agreement between the two methods to suggest that dipslides can be used effectively in office or clinic without the need for an incubator.


Arteriovenous fistula complicating renal transplantation. A case of arteriovenous fistula of the major transplant vessels contributing to posttransplant hypertension hypertension and severe microangiopathic hemolytic anemia is reported. Improvement in blood pressure and correction of anemia followed ligation of the fistula. This case reinforces the need for diagnostic evaluation of all patients with sustained post-transplant hypertension.


Review of erythroplasia of Queyrat and its treatment. EQ (erythroplasia of Queyrat) manifests itself by single or multiple asymptomatic papules or plaques on the glans penis, or periurethrally, predominantly in uncircumcised men, age range from twenty to eighty years of age.  The bright red lesions may be ulcerated. The disease progresses slowly, and the interval between onset and diagnosis may be years. The cause is unknown. Diagnosis is confirmed only by histologic examination. A therapeutic regimen of 5 per cent 5-fluorouracil cream applied to lesion(s) twice daily for four to five weeks has produced a high cure rate and maintained penile integrity and function.


Reticulum cell sarcoma of testes.

Reticulum cell sarcoma of testes. Seven cases of primary reticulum cell sarcoma of the testes have been added to the world literature, bringing the total to 83 cases. Primary reticulum cell sarcoma should be suspected in all patients over the age of fifty years who have a testicular mass. There is a marked tendency of bilateral involvement of this tumor, as well as an association with cutaneous and pharyngeal lesions. Although there have been a few long-term survivors, over-all prognosis is poor.


Transcervical thymectomy in renal transplant recipients: surgical complications and possible effect on long-term allograft survival. Between January 1963 and December 1967, 59 renal transplant recipients underwent thymectomy with or without splenectomy as an adjuvant to standard immunosuppression. All thymectomies were performed transcervically. By internal comparison long-term renal allograft survival was better in recipients who had thymectomy, when compared to those who did not. There were no significant surgical complications associated with transcervical thymectomy and the completeness of thymectomy was judged satisfactory. The role of thymectomy as an adjuvant operation in human renal transplant recipients should be re-examined.


The use of the omental pedicle graft in urinary tract reconstruction. The omentum is unique in that it is the only body tissue specifically developed for the resolution of infected process; it also regains its suppleness once healing has taken place. These characteristics are not shared by the peri-ureteral and per-vesical tissues so that a properly mobilized pedicle graft is a valuable adjunct to the more difficult repairs and reconstructions of the urinary tract.


Transcanal tympanoplasty: a 15-year report. The data presented would seem to support the following conclusions: 1. Transcanal tympanoplasty employing connective tissue underlay grafts, ossicular bone prostheses, and avoidance of mastoid exposure, unless irreversible disease is present, seems to meet contemporary standards of efficacy, safety, and long-term stability when performed on patients with either chronic suppurative otitis or atelectatic otitis. 2. Although chronic suppurative otitis and atelectatic otitis have differing characteristics and are of seemingly different pathogenesis, no statistical differences were found in the pattern of ossicular destruction or in their response to surgical intervation. Hearing results, long-term stability of results, and pattern of complications had no significant differences. 3. Hearing results in those patients with destruction of the malleus handle in whom an L-shaped prosthesis was used were significantly different and poorer than when the malleus was present. A different approach, perhaps employing homograft tympanic membrane with incorporated malleus and staging, may be indicated for these patients. 4. The use of polymeric silicone film and homograft nasal cartilage was associated with a significant number of complications and has been abandoned, substituting instead absorbable gelatin film and ossicular bone transplants. 5. Since no significant changes were seen following one year's observation, this period would seem to be statistically suitable for analysis of results. This conclusion can only be applied to those patients with either chronic suppurative otitis or atelectatic otitis and in whom the surgical procedures herein described were applied.


The era of home urine cultures.

The era of home urine cultures. The parents of 289 children performed bacteriuria screening with a self-administered dip-strip culture, which was inoculated, incubated and interpreted in the home. Simultaneous pour-plate quantitative cultures and laboratory tested dip-strip cultures were done on the same urine specimen that had been tested at home. The dip-strip culture was reliable (89 percent) in detecting significant bacteriuria with home administration and interpretation. Only 1.6 percent falsely positive results occurred in the home testing. The dip-strip home cultures are an effective way to screen or followup patients with bacteriuria.


Influence of rejection on graft survival after renal transplantation. The clinical course was reviewed of 102 renal allograft recipients between December 1967 and December 1973. Only 4 of 21 patients (19 per cent) who had 2 or more episodes of rejection during the first 2 months had a functioning graft at the end of 1 year, compared to 24 of 30 patients (83 per cent) who had no rejection episodes. A similar trend was seen 2 to 6 months after transplantation. During the first 2 years  vigorous immunosuppressive therapy for rejection in the first few months resulted in 12 deaths (44 per cent) of 27 patients. Subsequent to this immunosuppressive therapy was modified and grafts were removed if there was not a prompt recovery of function after treatment, which resulted in a significant decrease in mortality rate to 16 per cent. There also was improvement in the over-all survival of patients with functioning grafts from 37 to 56 per cent. Serious complications and mortality could be related to high dosage of steroids and severe leukopenia. A white blood count of less than 1,000 m m.3 on 3 successive days was associated with a mortality rate of 52 per cent, compared to 15 per cent in those without leukopenia. Serious consideration should be given to early graft removal in patients who have 2 or more episodes of rejection in the first few months after transplantation, particularly when there is not a prompt improvement in renal function after immunosuppressive therapy. High doses of steroids (greater than 1 mg. per kg. for more than 26 days during the first 60 days) should be avoided to decrease morbidity and mortality rates from serious infections. The results of histocompatibility (HL-A) matching in 72 donor-recipient pairs indicated an improved graft survival when there was a match of 2 or more antigens, which is supported by the results recently reported by the Transplant Registry. The results of mixed lymphocyte reactions in 20 live donor-recipient pairs showed a marked improvement in graft survival when there was less than 20 per cent stimulation and it appeared that this reaction was of more important prognostic significance than the results of histocompatibility (HL-A) matching in these patients.


[Edematous form of acute pancreatitis].

[Edematous form of acute pancreatitis]. Among a numerous contingent of patients with acute edematous peritonitis a group of 135 subjects with a pure form of acute edematous peritonitis was singled out. A sharp differentiation between proper acute pancreatitis and associated one and the fact, that these patients are singled out as a separate group are of certain clinical importance. Proper acute pancreatitis is characterized by primary affection of pancreatic vessels but not by the mechanic obstruction of the ducts.


[Osteocartilaginous homoplasty in surgery of focal lesions of the femur head]. The present communication is concerned with the problem of using osteocartilaginous homoplasty for diseases of the coxa of a nontuberculous origin. The data of observations over 53 operated patients (aseptic necrosis of the femoral head, gigantic cell tumor, deformating arthrosis, etc.) are reported. The procedure was a failure in 4 patients.


[Free dermatoplasty in melanoblastomas treated by perfusion chemotherapy]. In the paper, the data on the immediate and late results of skin tranplantation in the complex treatment of limb melanoblastomas are reported. The latter consisted in a one-moment massive regional chemotherapy by perfusion of the extremity (iliac, femoral, brachial) with antitumor drugs, against which background melanoblastoma was excised electrosurgically, and lymphadenectomy was performed. The defect of the limb tissues, which was located on the foot or leg in 61 cases, was replaced by a free skin graft. The results of the plastic repair were followed up within the terms from 1 to 10 years.


[Treatment of Mallory-Weiss syndrome].

[Treatment of Mallory-Weiss syndrome]. The author has observed Mallory-Weiss syndrome in 13 patients. In 3 patients bleeding was arrested by conservative measures, 10 patients were operated upon. The operative procedures employed are described. The author reports one case of necrosis of the left hepatic lobe due to ligation of the left hepatic artery abnormally running from the left gastric artery with lethal issue. It is concluded that conservative therapy is to be used only in cases of rapid arresting of bleeding.


[Use of Kiel bone in plastic surgery of jaw defects]. A 5-year clinical experience with the use of Kiel bone in different osteoplastic operations on jaws in 67 patients is described. The implants proved to be effective in replacement of defects not associated with an impairment of the jaw bone integrity. Infection of the bed tissues was considered to be contraindication to implantation.


Anaemia and veal calf production.

Anaemia and veal calf production. Calves have been raised for veal on liquid diets containing different amounts of iron. A concentration of 25-30 mg soluble iron/kg dietary dry matter provided sufficient haemaglobin for normal appetite, growth and oxygen transport, and also produced carcases light coloured enough for the veal trade. When anaemia was induced in calves or sheep the first measurable response from the animals was a fall in appetite which provided a more sensitive indicator than more complicated physiological or biochemical measurements.


Suspected botulism in foxhounds.

Suspected botulism in foxhounds. An outbreak of acute paralysis in a pack of foxhounds, which followed the ingestion of raw and partially cooked meat, was almost certainly due to botulism. Botulinal toxin was detected in the serum of one of three hounds which recovered, and Clostridium botulinum type C was present in a sample of meat remaining from a batch fed to the hounds.


Diagnosis and treatment of Amanita phalloides-type mushroom poisoning: use of thioctic acid. The number of cases of mushroom poisoning is increasing as a result of the increasing popularity of "wild" mushroom consumption. Amanitin and phalloidin cytotoxins found in some Amanita and Galerina species produce the most severe and frequent life-threatening symptoms of Amanita phalloidestype poisoning. Delay in onset of symptoms, individual susceptibility variation and lack of rapid and reliable identification have contributed to the significant morbidity and mortality of this type of poisoning.A rapid chromatographic assay for identifying the potent cytotoxins and apparently successful management using thioctic acid of two cases of A. phalloides-type mushroom poisoning are reported. All known cases of A. phalloides-type mushroom poisoning treated with thioctic acid in the United States are summarized.


[Therapeutic problems in status epilepticus (author's transl)]. A review is given of the present state of knowledge and current concepts of the causative factors involved in, and the pathological mechanisms underlying status epilepticus. A synopsis of the commonly-applied therapeutic methods is presented. A step-wise therapeutic procedure is advised for the different stages of status epilepticus. Treatment is directed towards a lowering of cerebral excitability (hydantoin, diazepam), the prevention of brain oedema (osmotherapy, positive pressure respiration) and the avoidance of the development of secondary complications (antibiotics, intensive care). In every case the requisite investigations should be undertaken in order to clarify the aetiology.


[Neuropathology of renal transplantation (author's transl)]. The neuropathological features are presented of an autopsy series of 43 renal transplant recipients. Inflammatory CNS lesions were found in 18 cases and were attributable to secondary CNS involvement in bacterial or fungal septicaemia (8 cases) or in localized extraneural infections (5 cases). Mixed bacterial-fungal infection and bacterial-fungal-viral triple infection were seen in one case each. Isolated toxoplasmic granulomas were observed in two cases. No tissue changes typical of CNS viral infections, including cytomegaly, were found except for small glial nodules in the brain stem in 7 cases. Massive intracerebral haemorrhages were seen in 2 cases after haemodialysis; subdural haematoma occurred once. Non-specific changes including brain oedema and diffuse glial poliodystrophy were found in many cases; vascular lesions and purpura occurred only seldom. A meningocerebellar malignant lymphoma, probably of metastatic origin was found in one case. Clinico-pathological correlation was poor in 5 cases; this is considered to be due to immunosuppressive therapy, which may mask either clinical expression of severe CNS lesions or morphological expression of viral encephalitis.


[Splenectomy for traumatic rupture of the spleen in childhood and its sequaelae]. This study was undertaken in order to assess the clinical and immunological consequences of splenectomy for traumatic reasons in childhood. Immunological testing of 22 persons 1 to 20 years subsequent to removal of the spleen for traumatic rupture between the ages of 3 and 6 revealed diminished or absent agglutinins in 10 cases and diminished or absent opsonins to E. coli in 16 cases. All patients were in good health and no clinical evidence of increased susceptibility to severe infections was found postoperatively. It is, therefore, assumed that the diagnosed defects had been compensated for by other immunological mechanisms. In contrast to the opinions of other authors, it is concluded that splenectomy in childhood between the ages of 3 and 6 does not appear to carry greater risks than in later years.


Bacterial leaching of waste uranium materials. The effect of ferrobacteria and thiobacteria on the leaching of waste uranium materials from which 70-80% of uranium was previously leached by classical chemical hydrometallurgical procedure has been investigated. The bacteria used are found in the ore and the mine water of Zletovska River locality, Yugoslavia. Parameters of biological leaching were examined in the laboratory. Leaching conditions were changed with the aim of increasing the amount of uranium leached. The effect of pyrite added to the waste materials before the beginning of leaching has also been examined. Uranium leaching is directly proportional to the composition and number of ferrobacteria and thiobacteria, and increased by almost twice the value obtained from the same starting materials without using bacteria. Increased sulphuric acid concentrations stimulate considerably the rate of leaching. Uranium leaching is increased up to 20% while sulphuric acid consumption is simultaneously decreased by the addition of pyrite. Uranium concentrations in starting waste materials used for leaching were extremely low (0.0278 and 0.372% U) but about 60% recovery of uranium was obtained, with relatively low consumption of sulphuric acid.


[The anodically moving thermolabile antigen (ATA) of gram-negative bacteria: its molecular heterogeneity and its chemical composition]. The anodically-moving thermolabile antigen (ATA) of gram-negative bacteria represents a glycolipoprote in. In aqueous solution ATA exhibits heterogeneity of the molecular size, the range varying between 2.10(4) and 8.10(5) Daltons. In the molecular range between 5.10(4) and 8.10(5) all the molecular states give precipitation lines with the corresponding antisera. It could be shown that all the molecular states of ATA are formed by different aggregation of the same subunit with a molecular weight of approximatively 22000.


[Health hazards: asbestos--a review (author's transl)]. The health hazards caused by asbestos are reviewed and some conclusions are drawn. Asbestos and the materials containing a high percentage of asbestos cannot completely be substituted by other materials without dangerous health effects. It is to be expected that the use of asbestos will still increase. An important health hazard has become evident among asbestos insulation workers. But also in other branches the application of asbestos is widespread. It seems to be difficult to find substitutes meeting the same requirements for using like asbestos. Rock-wool and glass fibres are used more and more in exchange for asbestos. Registers for asbestos workers and asbestos working places are established in several countries. The main causes of death induced by asbestos among asbestos workers are asbestosis. mesothelioma and cancer. For the evaluation and assessment of cancer risk due to asbestos epidemiological studies have to be conducted. Even a short period of exposure to low quantities of asbestos fibres proves to be a health hazard causing certain diseases (diffuse pulmonary fibrosis, pleural hyalinosis, pleural calcifications, mesothelioma) after more than 20 years. For avoiding occupational disease hazards among asbestos workers the dust level on the working place has to be lowered to acceptable concentrations (maximal allowable concentrations). The identification of dust sources of asbestos, the application of practice codes for handling of asbestos, the substitution of asbestos by materials without dangerous health effects, and dust control at source are the most effective directions of hygienic practice. The health protection requires annual medical examinations of all persons exposed to airborne concentrations of asbestos.


[Organ diseases treated as neuroses--a psychotherapeutic task]. On the basis of experiences with haemophilics is reported on the significance and possible neurotic digestion of organic diseases. In 60 outpatients the reasons of the verbal causes evoking the false treatment are described. Insufficient and exaggerated informations can be maldigested in the same way. In the drawing test examples are given, the therapeutic demands are discussed.


[Microbiological diagnosis of pyelonephritis]. Microbiological methods occupy an important place in the diagnosis of pyelonephritis. Taking into consideration still open problems, the principles of the bacteriological and serological diagnosis of infections of the urinary tract are discussed.


[Histological diagnosis of glomerulonephritis]. The morphological diagnosis of glomerulonephritis is a descriptive one. On the basis of the classification after Kettler and co-workers several forms are discussed in short and certain interrelations of these forms are indicated. Data concerning floridity are mostly expected, sometimes, however, they are possible only with reservation. Only with the help of the usual paraffin histology in a part of the biopsy cylinders no clear diagnoses can be made. Above all often the exclusion of minimal glomerular changes is not possible. Newer morphological investigation methods are an essential diag-microscopy; the question of the floridity of nostic enrichment, i.e. the semi-microsection technique, the immunohistology and the electron glomerulonephritis is best to be answered immunohistologically.


[Segmental wall movement of the left ventricle in healthy persons and myocardial infarct patients studied by a catheter-less nuclear medical method (camera-cinematography of the heart)]. Camera-Kinematography is a nearly noninvasive method to investigate regional motion of the myocard, and allows evaluation of the function of the heart. About 20 min after injection of 15-20 mCi of 99mTC-Human-Serum-Albumin, when the tracer is distributed homogenously within the bloodpool, data acquisition starts. Myocardial wall motion is represented in an appropriate quasi three-dimensional form. In this representation scars can be revealed as "silent" (akinetic) regions, aneurysms by asynchronic motion. Time activity curves for arbitrarily chosen regions can be calculated and give an equivalent for regional volume changes. 16 patients with an old infarction have been investigated. In fourteen cases the location and extent of regions with abnormal motion could be evaluated. Only two cases of a small posterior wall infarction did not show deviations from normal contraction pattern.


[Posttraumatic pyogenic and granulomatous encephalitis. An animal experimental contribution on inflammation (author's transl)]. The present studies were performed to elucidate the factors responsible for the relative resistance of the brain to bacterial infections. As a model, group A streptococci were used to produce an experimental brain infection in mice. Attention was focussed on the activity of brain macrophages, the function of which to date is poorly understood. The primary purpose of the experiments was to compare the types of inflammation elicited in the brain by the injection of either killed or living group A streptococci. As a result, two fundamentally different types of encephalitis were observed histologically. A granulomatous inflammation was induced by killed streptococci; when deposited in the brain by intracerebral injection, these were phagocytosed by invading mononuclear macrophages and polymorphonuclear granulocytes during the first day p.i. There was no necrosis of brain tissue excepting the stab wound at the site of injection. The number of granulocytes in the inflammatory infiltrates decreased during the first week p.i. whereas, during the same period, the number of macrophages forming granuloma-like cell accummulations increased. At the beginning of the third week a fading of the granulomatous encephalitis was observed. In contrast, living streptococci produced a pyogenic inflammation of the meninges as well as of the grey and white matter in the region of the stab wound combined with extended tissue necrosis surrounding deposits of bacteria. This pyogenic infection progressed until the end of the first week, forming a brain abscess. A phlegmonous spreading of the pyogenic inflammation predominantly in the white matter and pyocephalus internus was also observed. In contrast to the increase of mononuclear macrophages in the border zone of the abscesses, the granulocytic inflammation decreased. During the second and third weeks p.i. granulation tissue consisting of proliferating connective tissue cells, macrophages and lymphocytes replaced pyogenic necrosis. A secondary purpose was to determine the fate of living and killed streptococci within the pyogenic and granulomatous encephalitis. In these studies immunohistologic, electron microscopic, bacteriologic and serologic methods were employed in addition to the techniques already mentioned. In the majority of the experimental animals streptococci were killed by granulocytes within the first week after injection of the living bacteria. At this time, most of the streptococci were contained within granulocytes and macrophages located to the periphery of the brain abscesses. Corresponding to the granulomatous encephalitis produced by injection of killed streptococci it was possible to detect persistent cell wall material in macrophages by immunohistology. By electronmicroscopy streptococci and their cell walls were found within the phagocytic vacuoles of macrophages. During the course of degradation the group-specific cell wall carbohydrate was enzymatically converted into the group A-variant specific structure...


[Modification of glycylglycine dipeptidase activity in the human ovary using follicle stimulating hormone. I]. The glycyl glycine dipeptidase activity under the in vitro influence of two follicle-stimulating hormone preparations of different concentration was investigated in 36 ovaries. A significant impediment was observed under Folistiman, whereas under Anthrogon the impediment could only be detected with higher concentrations. The FSH/ICSH relation evidently plays an important role in this respect. The results are in support of the statement that the glycyl glycine activity in vivo also depends on the gonadotrophin production. At the same time they affirm the fact that not only endopeptidases play a role in the hormone metabolism of the ovary.


[Treatment of functional sterility using a clomiphene-Sterolibrin combination]. Out of 252 women with primary or secondary sterility, 107 women with functional sterility with anovulation cycles were selected for hormonal therapy. These women received Clomifen citrate after menstruation, and a push dose of an oestroprogestative combination, Sterolibirin, before menstruation. After this therapy, in 71 women (66%) ovulation cycles were produced; of this number, 49 women (46%) became pregnant to date. No statistically significant correlations could be revealed with respect to the ages of the women treated, duration of sterility, duration of medication, nor between the respective results achieved in women with primary and secondary sterility.


[The detection of aeromonads of the "hydrophila-punctata-group" within the hygienic control of drinking water (author's transl)]. The first part brings a retrospective analysis of bacteriological water examinations at single wells at which within a new one year examination period E. coli, coliforms and colony count determinations were performed and in addition the water samples were examined regarding Aeromonas of the "Hydrophila-Punctata-Group". The single wells have been divided in five groups because of the pre-testing and reexamination results and because of the local circumstances. They are summarized in the tables 1-5. The second part reports about the findings of the examination regarding the relation of aerogenic to anaerogenic Aeromonads in wells close to the shore in the direction of infiltration. It also reports about flat wells without influence of surface water in ground-water areas with relatively porous surface layer. Whilst in river water loaded with sewage the anaerogenic Aeromonads dominate the population up to about 80% their proportion diminishes in the shore filtrate so that within a certain distance, in groundwater filtered through the shore, only aerogenic Aeromonads are found. Also, from the water of flat wells with relatively porous surface layer exclusively aerogenic Aeromonads colonies have been isolated. Proceeding from these results the findings of the single wells divided in the groups 1-5 have been discussed. Because the aerogenic Aeromonads have not been found in deep wells but more or less frequently in flat wells the proof of anaerogenic Aeromonas obviously demonstrates a pollution of surface water loaded with sewage.


[Microbial invasion of the intestine in colonising agamas (Agama agama) from the aspect of hygienic water control in tropical areas of West Africa (author's transl)]. Agamae are regularly found in great numbers in the neighbourhood of water supply plants and excrements of these animals can be traced to the plants proper. In order to ascertain the cause of drinking water infections, 37 Agamae were cought, immediately killed and the bowel contents examined. It was found that the Agamae have no uniform microbial population and that none of the aerobically cultivated bacterial species is present in all animals (Tablet 1 indicates the species for each animal). With regard to the hygienic inspection of drinking water it is important to know that only some of the Agamae discharge E. coli or coliform bacteria with the excrements and that 7 out of 12 animals which excrete large quantities of salmonellae were not found to harbour E. coli or coliform bacteria in their bowels. Under these circumstances the prerequisite to be met by the indicator function for E. coli and coliform bacteria no longer exists for water infections brought about by reptile excrements. The detection of salmonellae in water must be given priority over the detection of E. coli and coliform bacteria if - as happens in West Africa - the spread of salmonellae by reptiles or other animals, which do not excrete E. coli or coliform bacteria regularly, must be considered.


[A rapid technique for isolation of Escherichia coli type I in food (author's transl)]. A rapid isolation method for E. coli Type I is being presented: A 4-6 hours resuscitation period at 24 +/- 3 degrees C is immediately followed by the 44 +/- 0.1 degrees C incubation period. Using this method the result can be read off after 24 hours, in exceptional cases after 48 hours. This technique enables the demonstration of an hygienic parameter important for food microbiology within a short time. Examinations will now be started in the Federal Health Office with the aim for defining E. coli-standards for various foods. It is planed to recommend these standards to the federal health authorities for including them in appropriate food regulations.


Activity of methoxyamine-modified f2 RNA in initiation and elongation steps of protein synthesis. 1. Messenger activity of phage f2 RNA modified with methoxyamine under non-denaturing conditions was studied in E. coli-free system. The incorporation of amino acids into phage polypeptides was decreased, and the synthesis of phage-specific proteins was diminished. The RNA replicase synthesis was more affected than synthesis of coat protein. The impaired messenger activity of the methoxyamine-modified f2 RNA was due to the blocking of elongation process by modified cytosines present in RNA chain. 2. Specificity of f2 RNA to stimulate ribosomal binding predominantly at the coat protein initiation site was not affected by methoxyamine-treatment, as demonstrated by unchanged binding of f[3H]Met-tRNA and [14C]alanyl-tRNA to ribosomes. 3. Unfolding of f2 RNA molecule on treatment with methoxyamine in the presence of guanidine-HCl resulted in a significant increase of RNA capacity to direct fMet-tRNA binding to ribosomes. Sucrose-density gradient profiles revealed the formation of polysome-like initiation complexes indicating that ribosomes were able to bind at many hitherto inaccessible initiation codons in RNA molecules. fMet-tRNA bound to ribosomes in the presence of unfolded RNA was found to be fully reactive with puromycin.


[RNA and protein biosynthesis in toluene treated E. coli B]. The conditions for RNA- and protein synthesis in toluenized E. coli B are investigated. The kinetics of RNA- and protein synthesis indicate that a coupled synthesis of both macromolecules takes place in these preparations. Treatment with 1% Brij 58 alters the permeability of toluenized E. coli in such a way that the protein synthesis depends on the addition of supernatant proteins (chromotographed S100 from E. coli) and tRNA.


Serum phospholipids in bilharzial hepatic fibrosis and chronic active hepatitis. The various serum phospholipid fractions were quantitated by thin layer chromatography in 33 patients with bilharzial hepatic fibrosis, 11 patients with chronic active hepatitis and 25 normal human subjects. In bilharzial hepatic fibrosis, the total serum phospholipid level showed a significant drop, while in chronic active hepatitis it was significantly elevated above the normal level of the controls. In both groups of patients, the percentage of phospholipids analyzed as lecithin was significantly elevated. The percentage of total phospholipids analyzed as sphingomyelin tended to be within the normal range of controls while the percentages of lysolecithin and cephalin fractions were significantly decreased. The increase in the relative percentage of lecithin with the simultaneous decrease of the relative percentage of lysolecithin was referred to the decrease of the lecithin-cholesterol acyl transferase enzyme activity in the plasma of these patients.


Bood glucose level in pregnancy.

Bood glucose level in pregnancy. Oral glucose tolerance curves were constructed for 50 normal pregnant women, 25 pre-diabetics and 25 cases of diabetic pregnant women of different degrees of disturbance in carbohydrate metabolism. The mean rise in blood glucose level after the intake of 50 g glucose, was 53% in normal cases, and only 41% in the prediabetic cases, due to increased insulin secretion in the prediabetic group. This group of pregnants gave flat-topped curves in 60% of the cases studied, as compared to 10% of the normal pregnant cases in the same study. This was attributed to delayed insulin secretion in the prediabetic group. On the other hand, all diabetic cases gave peaked glucose tolerance curves during the first hour after glucose intake. The results of insulin-glucose tolerance test, effect of fasting for four hours and tolbutamide sensitivity test suggested that the prediabetic pregnants showed hyperinsulinemia which became evident during fasting. The pancreas of the prediabetic responds more readily, by the release of insulin, to the stimulus of oral hypoglycemic agents, such as sodium tolbutamide, than in the case of normal pregnants. Measurements of serum inorganic phosphorus, serum potassium and serum alkaline phosphatase of these 3 groups of pregnants, showed a definite disturbance in the liver function of the prediabetics which became more obvious in the diabetic group.


[Macrophage membrane potential test: an electrophysiological modification of the Field-Caspary test in melanoma patients]. In modification of the cytopherometric test according to FIELD and CASPARY [3] were studied the influence of the cell-free supernatant (lymphokine) of the lymphocyte antigen reaction on the transmembrane potential of macrophages obtained from guinea pigs (peritoneal exsudate cells PEC). Macrophage membrane potential (MMP) was determined by glass microelectrode technique. In agreement with histological and clinical findings in malignant melanoma and Dubreuilh's disease with malignatization we observed a depolarization of the macrophage membrane up to 40% as compared with controls. A depolarization up to 60% was obtained in patients having undergone BCG vaccination, if the antigen used was PPD. In control persons and in non-malignant pigmentary tumors (such as foreign body granuloma) we found no variation of MMP. The results indicate that cell mediated immunity is closely correlated with membrane permeabilities, ion gradients and cell metabolism.


Urinary catecholamines and their metabolites in diabetes. Total, free, and conjugated urinary catecholamines and their metabolites are studied in diabetes before and after treatment. There are abnormalities in catecholamines metabolism and their metabolites caused by the diabetic condition. The 24 hour urinary excretion of the total catecholamines is significantly increased in diabetics. Epinephrine, as a free fraction, conjugated fraction, and, consequently, as a total metabolite, is significantly increased. No change in dopamine concentration is observed in diabetes although dopamine is known to inhibit insuline release. No sex difference is, however, observed in the diabetic patients with regards to the catecholamines excretion. After controlling the diabetic state, abnormalities in catecholamine metabolism and their metabolites are normalized.


[Histidine tolerance in low skin histidase activity]. An oral histidine loading test (100 mg L-His/kg body weight) was performed in 8 deaf patients with low histidase activity in the str. corneum of the skin. Beside an elevated plasma phenylalanine level resulting in a Phe/Tyr-quotient of 1,09 +/- 0,15 the basal level of histidine was slightly enhanced in patients with deafness, but without statistical significance. After histidine loading no differences of the histidine tolerance curves could be observed suggesting the heterozygosity state for histidinaemia. Thin-layer chromatographic investigation of imidazole compounds revealed some abnormal findings after loading. The results are discussed with regard to the clinical and biochemical heterogeneity of histidinaemia.


[Structural and immunochemical studies on the immunoglobulin of carp (Cyprinus carpio L.). III. Valence and affinity of antidinitrophenyl-antibodies]. Carps were immunized with DNP conjugated to human serum albumin, bovine gamma globulin and Brucella abortus. The antibodies were isolated by immunoadsorption. The intrinsic average association constant (Ko) of the antibodies was determined by equilibrium dialysis and ammonium sulphate precipitation employing the monovalent hapten tritiated epsilon-DNP-L-lysine. The tetrameric carp IgM possesses four measurable combining sites per molecule. The affinity (Ko) of the isolated antibodies varied from less than 10(4) M-1 to 2,5-10(5) M-1. The highest determined affinity in the whole serum was 4,4-10(5) M-1. The affinity of antibodies, which was determined in the whole serum was 1,1--1,45 times higher than the affinity of specifically purified antibodies. The selective influence of the antibody isolation procedure was unimportant. The affinity of these IgM antibodies increased twice during the first stage following immunization and did not change significantly over a 25-month period.


Modulation of the hexose induced suppression of glucagon secretion by somatostatin on isolated pancreatic rat islets. Somatostatin inhibits in a dose-dependent manner the glucagon secretion in the presence of up to 5 mM glucose, whereas the suppressed glucagon release in the presence of greater than or equal to 10 mM glucose, 10 mM glyceraldehyde, 30 mM fructose or 30 mM mannose is characterized by an increase of hormone release under the influence of somatostatin.


The effect of surgery on carbohydrate metabolism. II. Insulin response during surgery. Serum-immunoreactive insulin response on glucose load was observed during the operation of 13 patients. The tests were performed on the same patients also 5 days prior to operation. The patients were divided into two groups according to the performed operation which was either intra- or extraperitoneal. Glucose tolerance during operation remained unchanged, but the serum insulin level was considerably lower. A certain difference was detected between intraperitoneal and extraperitoneal operations in this respect, though the trend of the changes was the same. The probable pathomechanism of the lacking insulin secretion on glucose is discussed.


[Securing of intestinal sutures].

[Securing of intestinal sutures]. End-to-end small intestinal anastomoses were performed in 20 dogs. In four dogs, the anastomosis was secured by distant single line stitches. These animals died of peritonitis. In the other animals the suture was covered with Surgicel and fixed by means of Histoacryl-N-Blau adhesive. In these cases, no insufficiency developed and in two cases were only adhesions and intestinal obstruction, respectively, observed. All the animals survived the operation. The method is recommended for securing intestinal anastomoses and stumps in patients.


The insulin tolerance test after pre-treatment with dexamethasone. The plasma 11-hydroxycorticosteroid and serum GH responses to insulin-induced hypoglycaemia were studied in 25 healthy volunteers. The results of a control insulin tolerance test were compared with those of 2 similar tests which were performed after pre-treatment with dexamethasone 0.5 and 1.0 mg, respectively. The GH response to hypoglycaemia was significantly lower in women than in men in all 3 tests. In men, but not in women, the GH response was lower after pre-treatment with 1 mg dexamethasone than in the other 2 tests. The plasma 11-hydroxycorticosteroid response was significantly greater after pre-treatment with 0.5 mg dexamethasone than in the control test, and was at least as good after 1 mg dexamethasone. After pre-treatment with dexamethasone the subjects experienced less discomfort and a shorter duration of sweating than in the control insulin tolerance test. Pre-treatment with 1 mg dexamethasone also has other advantages. Thus, the basal plasma cortisol level is low and stable, which facilitates estimation of the magnitude of the cortisol response. Furthermore, information is obtained about the dexamethasone suppression response.


Biological effects of a new and potent progestagen. A clinical study. The biological effects of a new synthetic progestagen, Org 2969 (13-ethyl-11-methylene-18,19-dinor-17 alpha-pregn-4-en-20-yn-17-ol) were studied in healthy normally menstruating women. Two of them were given 0.125 mg, five 0.060 mg and two 0.030 mg of Org 2969 daily on days 1-20 during one menstrual cycle. Serum levels of follicle stimulating hormone, luteinizing hormone, progesterone and oestradiol were analyzed on days 8-23 in order to evaluate the function of the hypophyseal-ovarian axis. The serum concentrations of aspartate amino transferase, alanine amino transferase, alkaline phosphatase, gamma glutamyl transpeptidase and bilirubin were determined to evaluate possible side effects on live function on days 8, 15 and 23. Serum cortisol was measured on days 8 and 23. The basal body temperature was recorded daily during the whole cycle, and endometrium biopsies were taken on days 21 or 22 of the cycle. All samples were taken similaryl during the treatment cycle and the preceding control cycle. According to the hormone determinations, all the treatment cycles were anovulatory except in one woman receiving the lowest dose. The treatment led to decreased spinnbarkeit, arborization and sperum penetration in the cervical mucus. Liver function tests and serum cortisol remained unchanged during the treatment.


Ontogeny of four cell types in fetal rat islets using histochemical techniques. The pancreas of the fetal rat was collected from the first appearance of the pancreatic bud at 11 days of gestation, and every day thereafter until birth. After birth the neonatal pancreas was collected every day for one week, and at intervals thereafter. Fetal B-cells were stained with Gomori's aldehyde fuchsin at 16 1/2 days, and with the immunofluorescent technique for insulin at 14 days. The A-cells were stained as early as 13 days using the fluorescent antibody technique for glucagon. The D-cells first stained at 17 days with pseudoisocyanin. A 4th cell type was found which stained black with silver nitrate, using a method derived from the Grimelius technique for A-cells. This 4th cell type appeared at 15 days in the fetus, reaching its greatest abundance around 19 days, and then declined in numbers after birth until adulthood, when occasionally one or two cells were found.


Studies on the mechanism of centpiperalone-induced hypoglycemia. The effect of centpiperalone [2-piperazino-4(3H)-quinazolinone monoacetate], a potent hypoglycemic compound on glucose and oxygen uptake, and lactic acid formation by rat hemidiaphragms suspended in glucose-phosphate buffer in Warburg bath at 37 degrees C and 80 shakes/min was studied in vitro. Although centpiperalone enhanced glucose and oxygen uptake by itself, no increment in the above parameters was seen when insulin was added simultaneously along with centpiperalone. Preincubation of hemidiaphragms with centpiperalone and their subsequent incubation with insulin did not indicate any potentiation of insulin action as indicated by uptake of oxygen and glucose. However when 16 times diluted serum from centpiperalone-treated rats was added to hemidiaphragms suspended in glucose-phosphate buffer, significant increase in glycogen content was observed compared to that seen in hemidiaphragms after addition of serum from normal untreated and alloxanized centpiperalone-fed rats. Definite degranulation of B-cells was seen in centpiperalone-fed rats using the aldehyde fuchsin staining technique. These data strongly suggest that centpiperalone induces hypoglycemia through liberation of insulin from B-cells.


[Dynamic tests with GN-RH L-dopa, clomiphene, HCG and HMG in normal adult men]. The plasma levels of gonadotrophins, androgens (expressed as testosterone) and 17beta-oestradiol in response to GnRH, L-dopa, clomiphene, HCG and HMG administration have been assayed by radioimmunological mehtods in 70 normal adult males. In keeping wih findings reported in the literature, the results obtained confirm the usefulness of dynamic stimulation with GnRH, clomiphene, and HCG in andrology for the purpose of evaluating the efficiency and integrity of the hypothalamic-pituitary-testicular system and of its individual glandular components. On the other hand, the administration of L-dopa and HMG does not appear to yield clinically useful findings.


Mast cell sensitizing antibodies in experimental myositis. Mast cell sensitizing antibodies, direct mast cell degranulation and positive delayed skin tests were detected in guinea pigs and rats during experimental paralysis provoked by inoculation with acetylcholine receptors from the Electrophorus electricus. The animals also developed fluorescent antibodies to the sarcolemma, and massive myositis with histological changes in muscles similar to those characterizing clinical polymyositis.


[Development of the pancreas of the urodele amphibian, Pleurodeles waltlii (Michah). A morphologic and ultrastructural study in vivo]. The study of the pancreas development in Pleurodeles waltlii Michah (amphibian urodele) shows the following characteristics: 1) The dorsal rudiment is formed the first, even before the irrigation of the tree producing branchial buds (end of stage 30). This rudiment is formed by isolation of cells rich in vitellus from the dorsal wall of the archenteron. The ventral rudiment, which is massive and more developed on the right side than on the left, appears only a few hours later. The two rudiments fuse at the eclosion time (after stage 35). (2) The elements of the exocrine pancreas, which are the first formed, take place little before the eclosion (stage 33b). They come from the transformation of the cells rich in vitellus, with embryonic character. Solid masses of these cells are first formed and then hollowed in tubules which secondarily join the central pancreatic canal of rudiments. (3) The endocrine elements, which are as rare in the larva as in the adult, appear only after the eclosion. The B cells are formed first (stage 35).


Effects of synthetic secretin on gastric secretion in man. Five healthy subjects received on one occasion 2 mug/kg-hour of pentagastrin alone and on another occasion in combination with synthetic secretin (Schwarz/Mann) in the dose of 2 U/kg-hour. The gastric and duodenal contents were collected continuously through a gastroduodenal Lagerlöf tube. Polyethylene glycol and 57Co labelled vitamin B12 were used as non absorbable markers in the duodenum and in the stomach, respectively. In each subject synthetic secretin inhibited acid (mean inhibition 17 percent) and stimulated pepsin secretin (mean stimulation 49 percent). The findings indicate that these actions are properties of secretin itself.


[Pharmacokinetic study of sodium di-n-propylacetate (usual tablet and enteric coated tablet with delayed absorption) (author's transl)]. The authors study the blood levels of DPA after ingestion of the drug in the usual tablet form and after ingestion of an enteric coated tablet with delayed intestinal absorption. They emphasize the fast and very variable absorption of the drug in the usual tablet form which makes necessary the administration of several doses each day. They find a slower absorption from the enteric coated tablet resulting incumulative effects. This form allows an easier administration schedule (one dose in the morning and one dose in the evening). Moreover, the blood levels show less variation during a twenty-four-hour period. Undoubtedly, this new form is an improvement in comparison with the usual tablet.


[Primary reticulosarcoma of the central nervous system (author's transl)]. Among the last 7000 consecutive autopsies from our department, nine cases of primary reticulum cell sarcoma (non hodgkinian malignant lymphoma) of the central nervous system were discovered. Another case was found by cerebral biopsy. There were six males and four females (mean age 43.5 years). Mean duration of illness to time of death was 4.6 months. Gross examination revealed a wide range of neuropathological lesions (multifocal or diffusely infiltrating the parenchyma) and predominant in the cerebral hemispheres. Review of this materal underlines the difficulty of clinical diagnosis and the need to search for a more specific tratement.


Analysis of a multicentre trial of a new low-dose oral contraceptive in Great Britain. An oral contraceptive containing D-norgestrel 150 mug. and ethinol oestradiol 30 mug. (Neovletta) was tested in 682 British women during more than 6,000 cycles. The pregnancy rate was 0.2 per 100 woman-years with the exclusion of pregnancies that followed admitted errors of tablet-taking, and 0.8 per 100 woman-years when they were included. 92.2 per cent of cycles were within 28 +/- 3 days. withdrawal-bleeding was missed in 3.3 per cent of cycles. Spotting occurred in 9.3 per cent of cycles and breakthrough bleeding in 5.8 per cent. Total bleeding averaged 4.71 days per cycle. Concurrent symptoms likely to be attributable to the pill were few and only 10.3 per cent of subjects withdrew because of them. It can be concluded that this formulation is extremely well tolerated and highly effective.


Four years overall experience with a new low estrogen -- low progestogen oral contraceptive. The reliability and the overall clinical acceptance of a new combined oral contraceptive, containing 30 mcg of ethinyl estradiol and 0.15 mg of D-norgestrel, was studied in 102 patients over 1,731 cycles. The results have been accumulated over a period of four years, some of the subjects still using the presented formulation. No pregnancy occurred during the observation period. Out of the totally observed cycles, 94.3 per cent had a duration of 28 +/- 2 days. In only 1.7 per cent of the cycles did withdrawal bleeding fail to appear. Spotting and breakthrough bleeding occurred 3.6 and 3.8 per cent of the cycles respectively. The incidence of side-effects reported by the users and commonly associated with oral contraceptive use was relatively low.


Preliminary results from a swedish multicenter trial of a new low dose combined oral contraceptive. Neovletta, a new combined low estrogen -- low progestogen oral contraceptive was investigated in 226 women over 1921 cycles at three different clinics. This report constitutes a preliminary evaluation of a large scale multicenter study being conducted in Sweden. No pregnancy was reported during the observation period. The length of menstrual cycle was generally 28 days and withdrawal bleeding during the tablet free period was missed in only 0.9 per cent of the cycles. The duration of menstruation was shortened by about one day. The amount of menstrual flow, as registered by the women, showed a reduction during treatment. Spotting and breakthrough bleeding were increased during the first three treatment cycles, whereas from the fourth to 12th cycles the incidence of these bleeding irregularities was not much different from pretreatment values. A total of 46 women (20 per cent) discontinued treatment due to side-effects of which bleeding irregularities constituted the major problem.


Chromatographic separation of human salivary peroxidases. A series of rapid and simple chromatographic purification procedures for peroxidase-like enzymes occurring in the human oral cavity is presented. Samples of whole saliva, parotid saliva, gingival exudate and various bacterial preparations contain peroxidases which were purified using molecular exclusion and ion exchange chromatography, and isoelectric focusing. Salivary lactoperoxidase can be easily separated from bacterial and leucocyte peroxidase activity by the methods presented.


The use of isoxsuprine in essential dysmenorrhea. A controlled clinical study. The "uterus-specific" beta-adrenoceptor stimulator isoxsuprine was used for the treatment of primary dysmenorrhea in a double-blind controlled clinical study. No significant beneficial effect of the drug was evident.


Cervical bacterial flora in women fitted with a copper-releasing intra-uterine contraceptive device (IUD). A bacterial culture was taken from the cervix in 85 sexually active women before, and 3 and 6 months after, insertion of either a copper-releasing or an inert intra-uterine contraceptive device (IUD). Sixty had a Copper-T (TCu-200) and 25 a Lippes loop D. Although in more than a quarter of the patients the bacterial flora increased slightly in diversity and abundance after IUD insertion, there was no difference in effect between the TCu-200 and Lippes loop D.


The use of salbutamol in obstetrics.

The use of salbutamol in obstetrics. Sympathomimetic amines have been used with the aim of abolishing uterine contractions. On the basis of results from an in vivo technique for testing the specificity and affinity of the beta2-receptor stimulating agents, salbutamol was used for a clinical trial. Five case histories were selected in order to illustrate the possibility of utilizing salbutamol in emergency cases with the aim of achieving uterine relaxation during the period of time between the admission of the patient and the commencement of delivery by, for example, caesarean section.


[Measure of nasal permeability in expertestimony]. After guoting the different origins of the post-traumatic ventilatory disorder, the author describes the working of the two valves, liminal and turbinal, which adjust, among normal man, the intranasal flow of the respiratory currents. Then, he describes anterior and posterior rhinomanometry, used furniture and measured parameters. Finally, the author gives the methodology of according to the nature of the ventilatory disorder, and the normal values of rhinomanometric parameters.


The influence of infection on the content of lysosomal enzymes in rat Kupffer cells and hepatocytes. The activities of beta-glucuronidase, arylsulphatase A and acid DNAase were measured in homogenates from Kupffer cells and hepatocytes prepared from germ-free, monocontaminated and conventional rats. The cells were prepared from a liver cell suspension obtained by treating the perfused liver with collagenase. Kupffer cells from germ-free rats were found to have lower lysosomal enzyme activities than cells obtained from conventional rats. Monocontaminated animals (E. coli or Streptococcus pyogenes) showed intermediate activities. Our data indicate that the level of lysosomal enzymes in macrophages is a function of the endocytic activity of these cells.


The bactericidal action of benzoic acid and sodium acetate on the gram-negative flora of dialysis fluid. Benzoic acid in concentrations from 0.18 per cent and upwards exerted a bactericidal action on the gram-negative flora of dialysis fluid at pH 4.75 in vitro. At a concentration of 0.32 per cent, a reduction of 10(5) was obtained with 24 hours. Sulphonamide resistance did not affect the bactericidal action. The killing effect was hardly more than directly proportional to the concentration of benzoic acid. Increasing inoculum decreased the bactericidal effect. Therefore, benbzoic acid should not be used as an artificial kidney disinfectant when the concentration of microorganisms exceeded 10(5.5)/0.1 ml.


[Personality of the dyslexic child. Clinical data and contribution of projective technics]. The present paper focuses its attention on the personality disorders among relatively old dyslexic children whose symptom persists beyong logopedic reeducations of a long duration. The degree of disorientation of our subjects runs parallel to the degree of fragmentation of personality. In the Rorschach and TAT tests, the image of the Self is ill-differenciated from a poorly structured maternal image and pleads for a primary defect of the mother-child relation at a preobjectal level. The paternal function is obvious but ill-invested, therefore the relationship between severe and persisting dyslexia on the one hand, and psychosis on the other.


[Double-blind comparison between amitriptyline Diffucaps and ordinary amitriptyline in sleep disorders of depressive origin]. Within the conditions of the double-blind trial, it appears that long-acting amitriptyline (Diffucaps), given at the dosage of 25 mg at the evening meal, is more active and better tolerated than a dosage of 40 mg of ordinary amitriptyline at bedtime in depressive sleep disorders.