Localization and stability of hydrogenases from aerobic hydrogen bacteria. Alcaligenes eutrophus strains H 16, B 19, G 27 and N9A contained two different hydrogenases. One enzyme catalyzed the reduction of NAD by hydrogen and was strictly localized in the soluble cell fraction. While the second enzyme was found to be particulate and unable to react with NAD. All other tested strains, Alcaligenes paradoxus SA 29, Pseudomonas facilis, P. palleronii RH 2, Pseudomonas sp. strain GA 3, Paracoccus denitrificans, Aquaspirillum autotrophicum SA 32, and Corynebacterium autotrophicum 14g and 7C contained only a single enzyme exclusively bound to membranes. This was established using fractional centrifugation, indicator enzyme systems, gently methods of cell disintegration and discontinuous sucrose density gradient centrifugation. In cell-free extracts obtained by rough disruption (sonication) of cells, hydrogenase was associated to particles of different size and sedimentation velocity. A partial solubilization of hydrogenase caused by sonication was observed with P. facilis. Without exception, the particulate hydrogenases were found (1) to be unable to reduce pyridine nucleotides, and (2) to reduce methylene blue at an extremely high activity. The eminent reaction rate of 34 micronmoles H2 oxidized per min and mg protein has been determined in particle suspensions of Pseudomonas sp. strain GA 3. All hydrogenases were stable during storage under hydrogen atmosphere, except the soluble enzyme for A. eutrophus H 16 which was shown to be more stable under aerobic conditions.


alpha-Isopropylmalate synthase from Alcaligenes eutrophus H 16. II. Substrate specificity and kinetics. The purified isopropylmalate synthase of Alcaligenes eutrophus H 16 reacted with the following alpha-keto acids and acyl-coenzyme A derivatives (in the sequence of decreasing affinities): alpha-ketoisovalerate, alpha-keto-n-valerate, alpha-ketobutyrate and pyruvate; acetyl-CoA, propionyl-CoA, butyryl-CoA, malonyl-CoA, valeryl-CoA, and crotonyl0CoA. alpha-Ketoisocaproate, however, is a strong inhibitor of the enzyme. All reactions catalyzed by isopropylmalate synthase were inhibited to the same extent by the endproduct L-leucine. The substrate saturation curves of alpha-ketoisovalerate or other alpha-keto acids and of acetyl-coenzyme A or other acyl-CoA derivatives had intermediary plateau regions; the Hill coefficient alternated between nH-values higher and lower than 1.0, indicating changes from positive to negative and from negative to positive cooperativity for the substrates. The products, isopropylmalate and free coenzyme A, showed competitive inhibition patterns against both substrates (alpha-ketoisovalerate and acetyl-CoA). Free coenzyme A (1 micronM) inactivated the enzyme irreversibly. The 3'-phosphate of coenzyme A and the free carboxyl group of alpha-ketoisovalerate were involved in optimal binding of these substrates, but 3'-dephospho-acetyl-coenzyme A and the methylester of alpha-keto-isovalerate were also converted by this enzyme. A CH3--CH2-grouping of the alpha-keto acids seemed to be necessary for binding this substrate.


The functioning of cytochrome b in the electron transport to furmarate in Propionibacterium freudenreichii and Propionibacterium pentosaceum. Fumarase-free electron particles from Propionibacterium freudenreichii and P. pentosaceum were prepared by discontinuous sucrose gradient centrifugation, and the influence of 2-n-heptyl-4-hydroxy-quinoline-N-oxide (HQNO) and ultraviolet irradiation on the reduction of menaquinone and cytochrome b with L-lactate or glycerol-3-phosphate and the reoxidation by fumarate was studied. In the presence of HQNO the steady state reduction level of menaquinone during fumarate reduction was increased whereas the steady state reduction level of cytochrome b was decreased as compared with the reduction levels measured in the absence of HQNO. The steady state reduction level of menaquinone during electron transport to fumarate was not influenced by ultraviolet irradiation and the steady state reduction level of cytochrome b was decreased at increasing irradiation times. The data indicate that cytochrome b is involved in the electron transport to fumarate.


Structure of the peptidoglycans of Moraxella glucidolytica and Moraxella lwoffi grown on hydrocarbons. The peptidoglycans of Moraxella glucidolytica and Moraxella lwoffi grown on aliphatic hydrocarbons were isolated. They contained muramic acid, glucosamine, alanine, D-glutamic acid and mesodiaminoimelic acid in a molar ratio of about 0.5:0.5:1.6:1.0:1.0 (M. glucidolytica) and 0.8:0.7:1.3:1.0:1.0 (M. lwoffi). The peptidoglycans were lysozyme-resistant. However, when treated with formanide, they could be partially degraded by lysozyme. The fragments were purified and their structure determined. In both strains, the peptide subunits consisted mainly of tripeptides (L-Ala-D-Glu-meso-DAP) and tetrapeptides (L-Ala-D-glu-meso-DAP-D-Ala), most of them being directly cross-linked. It is concluded that in both strains the primary structures of the peptidoglycans are closely related.


Carotenoid glucosides and menaquinones from the gliding bacterium Herpetosiphon giganteus Hp a2. The gliding bacterium Herpetosiphon giganteus Hp a2 was shown to contain gamma-carotene, one monoglucosyloxy and two new diglucosyloxy carotenoids with a x-O-acyldiglucosyloxy carotenoid as main component. Flexirubin-like pigments could not be detected in this organism. As in the Myxobacterales and Cytophagales (Kleinig et al., 1974) menaquinones (MK-6 and MK-7) were found to be the only isoprenoid quinones present in Herpetosiphon. The chemosystematic implications of these findings are briefly discussed.


A method for the determination of confidence limits for the P/2e- ratio for chosen values of ymaxatp form the results of continuous culture experiments. A model is described, which allows the determination of 95% confidence limits for the maintenance coefficient and the efficiency of oxidative phosphorylation for chosen values of the growth yield for ATP corrected for energy maintenace (YmaxATP). As experimental data the specific rates of substrate consumption, product formation and oxygen uptake in chemostat cultures at various growth rates are use.


Platelet monoamine oxidase in early childhood autism. Platelet monoamine oxidase (MAO) activity was studied in 31 individuals suffering from early childhood autism and was not significantly different from that found in normal children or adults. In the autistic children, MAO activity decreased with age, and there was a trend toward greater platelet MAO activity in prepubertal and pubertal male autistic children relative to normal male children. Total platelet counts were not elevated in autistic children.


Cardiovascular correlates of attention in normal and psychiatrically disturbed children. Blood pressure, peripheral blood flow, and peripheral vascular resistance. Blood pressure, peripheral blood flow, and peripheral vascular resistance were measured in normal adults and children and in children with autism and severe disturbances in personality development while the individuals were engaged in a variety of attentional tasks. The tasks were designed to elicit outward direction of attention (and intake of sensory input) or inward direction of attention (and relative rejection of external sensory input). During tasks involving sensory rejection, normal adults and normal children showed increased blood flow and decreased peripheral vascular resistance; with sensory intake, blood flow was decreased and resistance was increased. The most severely impaired children showed little alteration in their physiological response to task requirements. Autistic children had higher mean blood flow and lower peripheral vascular resistance than normal children and adults. Some autistic children characteristically may be in a state of sensory rejection associated with generally higher levels of arousal or defense against environmental bombardment.


Reduced MAO activity in first-degree relatives of individuals with bipolar affective disorders. A preliminary report. Previous reports have indicated that platelet monoamine oxidase (MAO) activity is reduced in patients with the bipolar form of major affective illness. We present evidence that platelet MAO activity is also significantly reduced in the first-degree relatives of bipolar patients. However, platelet MAO activity did not distinguish ill from well family members. It is possible that reduced platelet MAO may be an indicator of increased familial vulnerability to affective disorders.


Sampling time, dosage schedule, and nortriptyline plasma levels. Steady-state nortriptyline plasma levels were determined in eight patients at 9 AM, 12 PM, 3 PM, and 6 PM during treatment with nortriptyline hydrochloride administered as a single daily bedtime (hs) dose at 10 PM and repeated after changing the dosage schedule to three times a day (tid) with divided doses at 10 AM, 4 PM, and 10 PM. Overall, the mean levels were stable during the sampling period and comparable on the two schedules. As expected, the plasma level decreased at the later sampling times on the hs schedule and increased on the tid schedule. In seven of the eight patients, the differences on the two dosage schedules were less than 30 ng/ml, which is not considered clinically significant. One patient had a higher plasma nortriptyline level on the tid schedule, which was clinically significant. Standardization of sampling time is of importance when comparing plasma levels and therapeutic response in treatment studies.


Exercise stress test interpretation for cardiac diagnosis and functional evaluation. The physiatrist, with the assistance of the physical therapist, can be the appropriate individual to prescribe and supervise exercise training programs for cardiac patients, although exercise testing is probably best left to cardiologists. Exercise test data, as supplied by the cardiologist from a diagnostic test, are often not sufficient for exercise programming - since diagnostic and fitness type testing may be carried out on different modalities, with monitoring of different parameters, using different test patterns to different endpoints, and with the patient on medication rather than off. This article describes special test modifications which provide information useful in preparing exercise guidelines for individual patients. These include walk-through, second-effort testing, testing on medication and non-standard monitoring. Based upon results from the fitness type of test, it is possible to predict which exercise candidates will benefit most from exercise programming and which should be referred elsewhere for more intensive medical management or consideration of surgery.


Progressive ambulation and treadmill testing of patients with acute myocardial infarction during hospitalization: a feasibility study. Symptoms, signs, hemodynamic and electrocardiographic responses of 12 patients with acute myocardial infarction were studied before, during and after three activities: activity I, sitting upright; activity II, walking to the adjacent toilet; and activity III, walking on a treadmill set at 1.2 mph (1.9 km/hr) at 0, 3 and 6% successive gradients. The three activities were studied respectively at three, six and ten days (means) after infarction. Weakness was the most commonly occurring symptom. Mean systolic blood pressure fell 9 mm Hg upon assumption of the upright position (activity I) and was sustained for the five minutes of sitting. The systolic blood pressure drop was only 3.5 mm Hg with activity II. During activity III, one patient developed angina. Between rest and the 6% treadmill gradient, systolic blood pressure, heart rate and pressure-rate product rose 29 mm Hg, 26 beats/minute and 64 units, respectively. Electrocardiographic evidence of ischemia was observed in two patients during activity I, in two patients during activity II, and in one patient during activity III, but was insufficient for stopping the activities. Similarly, two patients developed minor arrhythmias, one with activity I and one with activity III. The use of this low-level treadmill test before discharging the patient from the hospital proved to be safe and feasible for obtaining objective data to assess the patients' ability to perform activities requiring equal exertion at home. Successful performance of these three activities before leaving the hospital should provide useful criteria for discharge of a patient with myocardial infarction.


Isokinetic and isometric torque force relationships. The torque forces of elbow extensor musculature of 28 men were tested with an isokinetic dynamometer to determine the relationships between maximal isokinetic torque generated at various speeds and maximal isometric forces at specified angles in the arc of elbow extension. The men were tested at constant velocities ranging from 5 to 25 rpm and at angles of elbow extension ranging from 10 degrees to 90 degrees. Product-moment correlation coefficients were calculated between the maximum isometric torque developed at each of the measured angles and the isokinetic torque generated at each of the predetermined speeds. Of the 81 correlation coefficients calculated, 13 differed significantly from zero. There were slight tendencies for the significant correlations to cluster toward the slower speeds and toward the greater angles of elbow flexion. It was suggested that the slight tendency for higher correlations to cluster toward the slower speeds may be due to slower speeds stimulating isometric effort. The slight tendency for the higher correlations to cluster toward the greater angles of elbow flexion may be due to variances in the consistency of muscular strength at different muscle lengths. Since the highest correlation attained yielded a common variability of less than 24% between the two variables tested, it was concluded that measures of isokinetic strength cannot be used to predict isometric strength capabilities.


Rehabilitation hospital patient characteristics from the Hospital Utilization Project (HUP) system. The Hospital Utilization Project (HUP), in collaboration with rehabilitation associations in California and Pennsylvania, instituted on July 1, 1974, a patient data system for rehabilitation hospitals. This is a report of the first year's aggregate of 5,427 patients from 20 hospitals in six states. Of this total, 4,662 were admitted for a full rehabilitation program, and 765 for short-term. Nearly half of the patients admitted for a full program were 65 years or older; 31% were stroke victims, by far the largest single diagnosis. Eighty percent of full program admissions were accounted for by the following six categories (reported with average lengths of stay): stroke (33.7 days), other brain injury and disease (35.9 days), amputations (30.6 days), fractures (29.6 days), arthritis (25.9 days) and spinal cord injury (59.3 days). In the total sample 74% were discharged to a private residential setting. The accumulation of patient data from a number of hospitals will give medical rehabilitation important information regarding its contribution to health care delivery as well as providing data which can be used for PSRO guidelines and for third-party payers. The HUP system is currently receiving discharge abstracts from 42 hospitals in 14 states.


Noninvasive assessment of the peripheral vascular system. Forty-five limbs varying clinically from normal through moderate to severely ischemic were studied by noninvasive measurements of both arterial blood pressure and perfusion. From the values plotted on a two-coordinate system, they arranged themselves well into three clinical categories: (1) normal, (2) intermittent claudication, and (3) ischemia or ulceration and rest pain. Good clinical responses to arterial reconstruction were corroborated by postoperative measurements. Reinforcing the results of one measurement with those of the other has provided an objective, numerical, and graphic basis for decisions regarding the advisability of angiography or arterial reconstructive procedures or both. To date, almost 400 patients have been evaluated by these techniques.


[Evaluation of the lymphocyte level in breast carcinoma]. Lymphocyte patterns were examined in patient with breast cancer. A significant difference (p=0.05) was noted between the four stages of the disease before surgery only, especially in subjects aged 60-80 yr. After surgery and also after subsequent treatment, there was a highly significant fall in levels in subjects aged 40-80 yr with 1st and 2nd stage cancers. Patients aged 60-80 yr who remained free of recurrences or metastases for 4 yr had higher lymphocyte levels (p=0.001) initially. It is therefore felt that in older patients the initial lymphocyte value is of prognostic value.


Principles of management of colorectal foreign bodies. We present a five-year experience with removal of 31 colorectal foreign bodies, with no morbidity or mortality. The following principles were used: (1) biplane abdominal roentgenograms to elucidate the location, type, and number of foreign bodies; (2) removal under appropriate anesthesia; (3) transanal extraction of the foreign bodies whenever possible; (4) laparotomy only as a last resort, after failure of all transanal manipulations; (5) proctosigmoidoscopy following removal of foreign bodies; and (6) inpatient observation to rule out bleeding or perforation with delayed symptoms. A classification based on the level of the foreign bodies in the rectum or colon is proposed that is helpful in the initial approach to the problem and the ultimate therapeutic plan.


[Normalized median velocity of circumferential fiber lengthening studied with ultrasonics. III. Comparison with the normalized protodiastolic median "velocity" of the posterior wall]. Both mitral valve closing speed (MVV) and the mean standardized circumferential lengthening of the myocardial fibrocell (MVCL), between which a good correlation exists, may be used as indirect indices of ventricular compliance. These two indices have been compared with those obtained echocardiographically from the movement of the posterior wall of the ventricle in a group of normal subjects and in a group suffering from hypertrophic subaortic stenosis (IHSS). The comparison between MVCL and mean standardized speed of protodiastolic prolapse of the posterior wall (Wpwd) was fairly significant (P=0.01); that between MVCL and mean speed of protodiastolic prolapse of the posterior wall (DEV) was only slightly significant (P=0.05) or was not significant at all; that between MVCL and the maximum speed of protodiastolic release (DEVM) was slightly significant (P=0.05). Although the correlation between MVV and the various indices obtained from the movement of the posterior wall (DEV, DEVM, Vpwd) were quite significant (P=0.01), it is considered that Vpwd is preferable as an indirect index of ventricular compliance. As it is capable of distinguishing subjects with IHSS from normal subjects inthose cases in which the movement of valvular peaks, modified or impeded by inflammatory or fibrotic processes does not a-low MVV to be measured, we think Vpwd can be usefully employed as it can in all those circumstances in which it is impossible to measure MVCL owing to alterations to normal septal synchronism (infarction and fibrosis of the septum, branch blocks, etc.).


A trial of silver-zinc-allantoinate in the treatment of leg ulcers. Three hundred thirty-nine of 400 chronic cutaneous ulcers in 264 patients (including some with multiple or bilateral ulcers of both) were healed with silver-zinc-allantoinate creamed (AZAC 1%). Some of the patients treated had failed to respond to medicated wrappings, saline dressings, and various other therapeutic agents, including antibiotics. In one week of treatment with AZAC 1%, bacterial counts were reduced on the average from approximately 2 X 10(7) to 2 X 10(5) (99%). Silver-zinc-allantoinate cream also demonstrated a wide spectrum of antimicrobial activity. It did not give rise to resistance by the infecting organisms, was nonallergenic, debrided necrotic tissue, and stimulated healthy granulation. Treatment was well tolerated, side effects being limited to a burning sensation in three patients. Most patients cared for themselves at home with minimal interference in their usual daily activities.


[Screening for anemias in 500 healthy adults]. The clinical cards of 500 healthy adults undergoing check-up have been analysed with a view to picking out clinical and laboratory parameters pointing to anemia. Statistical processing of the data led to a finding of anemia in more than 4% of the people examined. None of the clinical parameters was of assistance in highlighting anemia. Of the laboratory data, the haemochrome finding was the most selective. Further study of information arising out of the haemochrome finding made it possible to identify essentially two forms of anemia: deficiency and microcytic. The study has shown that anemia is a frequent disease and screening is justified. To set in motion a programme of this type, it is enough to carry out a complete haemochrome test; screening is thus cheap and easy to carry out within any health structure.


[The kidney and gentamicin].

[The kidney and gentamicin]. The parameters that influence the administration of drugs in patients with various degrees of renal insufficiency are described. A series of 51 patients treated with gentamycin is presented. 28 subjects displayed average and serious renal insufficiency. The drug was well tolerated and gave excellent results even in cases of advanced insufficiency.


Parapharyngeal growth of parotid tumors: report of two cases. Two patients with parapharyngeal pleomorphic adenomas of the parotid gland, one malignant and one benign lesion, were successfully treated operatively. Deep lobe parotid tumors may occasionally grow along the stylomandibular tunnel into the parapharyngeal region. Since the opening of the tunnel is narrower and less distensible than the parapharyngeal region, the tumor assumes a dumbbell shape. The patients have an intraoral mass or asymmetry of the palate, with difficulties in swallowing or phonation. The diagnosis is suspected on bimanual examination, and puncture biopsies should be done to establish a histologic diagnosis. Operative removal of the parotid gland with facial nerve preservation is recommended. External, transoral, and combined approaches can be employed. Enlargement of the opening of the stylomandibular tunnel by cutting the styloid process of the mandible is necessary for complete tumor removal. Rupture of the capsule should be avoided. Results are rewarding with proper management.


Physiopathology and control of postoperative pain. Potent systemic (narcotic) analgesics, when given in doses sufficient to produce ample pain relief, usually also produce mental and respiratory depression and, at times, circulatory impairment, that prolong postoperative morbidity. Complications due to morphine sulfate or meperidine hydrochloride can be minimized by titrating the patient's pain with small intravenous doses of narcotics (morphine sulfate, 2 to 3 mg, or meperidine hydrochloride, 15 to 25 mg) administered slowly at 15- to 20-minute intervals until the pain is relieved. On the third or fourth postoperative day, acetaminophen tablets usually suffice to provide relief of pain with little or no risk to patients. Continuous segmental epidural block or intercostal block, with or without splanchnic block, provide excellent pain relief that, in contrast to the narcotic, is complete. These are especially useful after operations on the chest or abdomen or the lower extremity. Regional analgesia is especially indicated in patients not adequately relieved from severe postoperative pain with narcotics, or when these drugs are contraindicated by advanced pulmonary, renal, or hepatic disease. Continuous caudal analgesia is also effective to completely releive severe postoperative pain in the lower limbs and perineum.


[Artistic anatomy. Introduction to a course of lectures]. The subject-matter and concepts of artistic anatomy are illustrated with reference to its philosophical and psychological aspects.


[Secretion of radioactively labeled amino acids into the digestive tract. 2. 14C labeling and amount of 14C leucine in the intestinal contents after subcutaneous injection of 14C leucine in rats]. Experimental rats received a subcutaneous injection of 14C of varying activity. The rats were then killed in groups within a period of from 2 mins to 30 mins after the injection. A certain amount of 14C activity was detected in the intestinal contents as early as 2 mins after the injection, both as free 14C leucine and in the TCE soluble portion of the intestinal contents (TCE=trichloroacetic acid). A comparison of the degree of labelling in the TCE soluble and the TCE precipitable fractions of the intestinal contents showed that the most likely way for free 14C leucine to get into the lumen of the intestine is via the pancreatic juice while that for protein-bound 14C leucine is through the proteins in the pancreatic gland. The degree of labelling in both fractions decreased very steeply from the first to the third third of the intestine. This may be caused either by absorption of the secreted 14C leucine or may be brought about by a delay in food passage through the intestine.


[The vitamin B 6 requirements of the laying hen for reproduction]. A total of 1125 hens were used in 3 feeding and 20 hatching trials. The trials were performed to investigate the influence of different vitamin B6 levels on the reproduction characteristics of the hens (fertilization of eggs, hatchability of the chicks, development of progeny). The vitamin B6 requirements of the hens were fairly low for maintaining normal fertilization and hatching rates (approximately 1.5-2 mg per kg of feed). Chicks reared on low vitamin B6 diets (0-12 days) showed definitely improved rearing characteristics (Food consumption, liveweight gains, losses) if the diet of the hens had been supplemented with graded amounts of vitamin B6. These findings were, in the first instance, due to an increased rate of vitamin B6 deposition in the liver and in the yolk sac of the newly hatched chicks (vitamin B6 reserves), apart from the fact that the overall vitamin B6 content of the egg remained largely unchanged. Variations in the vitamin B6 reserves, on the other hand, did not exert any influence on the development of progeny if the chicks received adequate amounts of vitamin B6.


[The effect of nutritional factors on the ruminal mucosa. 3. Condition of the mucosa after infusion of propionic acid, acetic acid and butyric acid]. Three non-lactating cows (Deutsches Schwarzbuntes Rind) with large ruminal fistulas were fed coarsely structured food. Within a trial period of 21 weeks infusion periods lasting 3 weeks alternated with equally long control periods (K). During the 3 infusion periods, 8.4 mMol of propionic acid (P), 14.8 mMol of acetic acid (E) and 4,5 mMol of butyric acid (B) per kg liveweight per day were administered through the fistula, the total quantity being 19 litres of solution. In the periods K1...4 the ruminal fluid contained an average of 68 Mol% E, 19 Mol% P, 13 Mol% B (maximum of 10.25 mMol free fatty acids (FFS) per 100 ml, minimum pH 6.4). In the course of the 10 hrs of infusion the Mol percentages of the particular acids infused increased to 27% P (maximum of 11.14 mMol FFS per 100 ml, minimum pH 6.4) or 79% E (maximum of 12,99 mMol FFS per 100 ml, minimum pH 6.0 (5.5)) or 25% B (maximum of 10.34 mMol FFS per 100 ml, minimum pH 6.0 (5.5)). Infusions of E and B had the most pronounced effect on the ruminal mucosa compared with the K periods. All fatty acids increased the process of keratinization and decreased the size of cell nuclei in the stratum basale. As specific effect, P infusions produced a thickening of the lamina propria; B infusions caused a thickening of the stratum germinativum (proliferative effect) while e infusions led to a drastically reduced thickness of villi (antiproliferative effect) due to reductions in the stratum germinativum and the lamina propria. According to the morphological situation high specific mucosal function is suggested during the B-period. The mucosa appeared quite normal during all periods investigated, with the exception of the E period, where hyperkeratosis, atrophy and necrosis were observed in 34% of the sample. Changes in the state of the mucosa appeared as early as 1 week after the beginning of the respective trial periods. Keratin consolidation was the primary cause for chemically induced keratosis. The development of hyperkeratosis seemed to be favoured if low pH values occurred in the rumen in combination with small amounts of metabolites inducing proliferation, both representing synergistic factors.


[Artificial rearing of double purpose calves of the beef-dairy type. 1. Effects of the length of the milk-rearing period and of the amount of milk substitutes needed for the rearing of the calf]. Reducing the period of Milk rearing of calves from 90 days (time of weaning) as practised today to 50 days or 70 days (and thus reducing the amount of regenerated milk which is needed to rear the calf from 400 litres to 200 litres or 300 litres) would limit the rate of weight gains of the calves in the first 3 months of age. This delay is, within certain limits, compensated for by the calf in the growth period up to 6 months of age. Therefore, the authors believe that with cattle of the Hungarian breed "Ungarische Fleckviehrasse" weaning after 50 days and rearing the calves with 200 litres of milk seems to be possible. The method of early weaning and then feeding stock mixtures of concentrates seems to be also applicable provided that the conditions of veterinary hygiene would allow this. This, in turn, would require supplementation of the food with minerals and vitamins. Due to the results obtained supplementation of concentrate mixtures with urea for calf rearing is also possible, even under practical conditions. Aromatization of the concentrate mixtures, as practised in the present series of trials, did not substantiate the favourable results obtained by the authors in previous trials with respect to the effect of aromatics on food consumption and the development of weight gains.


[Classification of lymphogranulomatosis]. Histological and cytological studies of preparations of peripheral lymphatic nodes in 1081 patients before treatment were carried out. In 76 patients there were also investigated morphological changes in the spleen, mesenteric lymphatic nodes and parts of the liver obtained in laparotomy. Basing on the analysis of the literature and their own findings, the authors think it reasonable to single out the following 8 histological variants of untreated lymphogranulomatosis: focal lesion; a group of variants with nodular sclerosis, with various cellular composition--lymphocytic predominance, mixed cellularity, predominance of lacunar cells; a group of variants without sclerosis consisting of lymphoid predominance and mixed cellular variant; a group of lymphatic depletion combining the reticular variant and diffuse fibrosis. The variants indicated above may be both independent and transitional stages.


[Histogenesis of stomach cancer and the role of intestinal metaplasia in the process]. The study of 854 gastrobioptic specimens and 102 stomachs resected in connection with cancer justified the assumption that intestinal metaplasia as such was not of a precancer character but indicated only the presence of a pathological process in the stomach. Malignization started in places of atypical hyperplasia of the epithelium, mostly at the level of the cervical part of the glands and gastric fossae. The investigations conducted showed that under conditions of pathology proliferation of cambial elements could occur by two ways. In some cases the typical epithelium is formed (foci of morphological precancer of the stomach) representing a source of cancerous transformation; in other cases, proliferation of the cambial elements terminates with inderect metaplasia with origination of an entirely differentiated epithelium of the intestinal type.


[Cytologic charcteristics of histologic forms of cancer of the uterine cervix]. Cytograms of various histologically established forms of cancer of cervix uteri in 114 patients were analysed. The data obtained were used in subsequent collations of cytological and histological diagnoses of cervix uteri cancer in 550 patients. It was established that in a cytological investigation it was possible to determine the histological structure of tumours in 84.2% of the cases. Squamous cell keratinizing carcinoma could be diagnosed cytologically in 97.7%, squamous cell nonkertinizing carcinoma--in 74.7%, adenocarcinoma--in 84.1%, low differentiated--in 50% of the observations.


[Analysis of the quality of clinical diagnosis from generalized findings of the pathologoanatomic service]. A statistical analysis of generalized data of the pathoanatomical service on quality of clinical diagnosis in curative-prophylactic institutions in 54 administrative territories of the RSFSR was carried out. The structure (extensive indices) and frequency (intensive indices)of erroneous clinical diagnoses referring to the most important classes of diseases were identified. As to the structure of indices and frequency of clinico-anatomic disparities the first place was occupied by oncological diseases (20.1+/-0.11 and 14.2+/-0.22%), the second--by infectious diseases (16.5+/-0.1 and 13.0+/-0.34%), the third--by diseases of the digestive system (14.6+/-0.09 and 13.0+/-0.33%), the forth--by diseases of the urogenital system (14.0+/-0.09 and 12.2+/-0.49%), the fifth--by disease of the respiratory system (12.7+/-0.09 and 10.6+/-0.24%), the sixth--by diseases of the cardiovascular system (11.1+/-0.08 and 8.0+/-0.14%). The recommendation is put forward to carry on annually a complex satistical analysis of extensive and intensive indices of erroneous clinical diagnoses demonstrating the quality of clinical diagnosis in therapeutic institutions of a given administrative territory.


Experimental cerebral infarctioneffects of pentobarbital in Mongolian gerbils. Unilateral ligation of thecarotid artery was done in 110 gerbils anesthetized with either and 78 anesthetized with pentobarbital sodium. Thirty of the ether-anesthetized animals received no tratment. Starting one hour after ligation, 38 animals from each anesthesia group were given 3 mg/50 gm of body wight of pentobarbital intraperitoneally every eight hours for 72 hours. The remaining animals received normal saline on the same treatment schedule. Morbidity and mortality were recorded for the next six days. Eighty-five animals (45.2%) developed cerebral infarction. Only ten of the 38 animals (2693%) anesthetized and treated with pentobarbital developed infarction. The percentage of infarction in the remaining groups ranged from 45% to 53%. There were no significant differences among the groups in the number of deaths or in the location or extent of the lesion.


A case of congenital hypomyelination neuropathy. Clinical, morphological, and chemical studies. Developmental failure of the peripheral nervous system to form myelin is advanced as the probable mechanism of a severe neuropathy in young child. The hypothesis evolved from evaluation of clinical, electromyographic, and muscle biopsy studies at 9 months and 51/2 years of age and electron microscopic and biochemical studies of the sural nerve at the latter age. The clinical state was characterized by loss of sensation to modalities, usually ascribed as transmitted by large myelinated axons; those carried by smaller axons being relatively preserved. Thus, at the age of 51/2 years, ataxia due to absent peripheral orientation was the chief deficit. Muscle strength was decreased but still remarkable considering the histologically confirmed absence of myelin in intramuscular nerves and extremely low conduction velocities (2 to 3 m/sec) at both ages. Histological and ultrastructural features of the intramuscular and sural nerves included almost total lack of myelin sheaths, good preservation of axons, and marked proliferation of Schwann cells and their basement membranes with onion-bulb formation. The morphological findings correlated well with the absence of cholesterol esters and the presence of the normal myelin lipids in extremely small amounts in the lipid study of the sural nerve.


Activation of partial complex seizures by hyperventilation. Hyperventilation evoked abnormal EEG discharges or discharges and clinical seizures in 11% our patients with partial complex seizures. Hyperventilation is useful in the diagnosis of this kind of epilepsy, but may need to be pursed more vigorously and for a longer duration than is usual practice. The vigorous use of hyperventilation in selected patients with partial seizures should be employed before the use of other more complicated, expensive, and potentially harmful activating procedures.


Significance of positive spike burst in Reye syndrome. We have previously reported a high incidence of 14-and 6-cps positive spike bursts in comatose patients with Reye syndrome. To further demonstrate this association, positive spike bursts were obtained in three additional cases but only in certain stages during the acute phase of illness. They varied in frequency from 7 to 13 cps, presumably reflecting the degree of slowing of the background EEG activity. A loud noise or other stimuli often precipitated the bursts, particularly when high amplitude delta waves were prominant. We believe that the presence of the positive spike bursts in comatose patients may be of diagnostic significance in Reye syndrome and that an undetermined metabolic or biochemical disturbance may be responsible for their appearance.


A combined approach for the diagnosis of orbital disease. Computed tomography and standardized A-scan echography. Twenty patients with orbital disease were studied by both computed tomography (CT scan) and standardized A-scan echography (ultrasonography). The CT scan was distinctly abnormal in 15 cases: 11/11 tumors were identified; a large wooden foreign body was identified; and nonspecific abnormal radiodensities were shown in three additional casses. Standardized A-scan echography, however, was capable of demonstrating the abnormality in all 20: in nine orbital tumors, a preoperative histologic diagnosis was attempted and proven accurate in all nine (in two no histologic disgnosis was attempted); and nontumor soft tissue abnormalities were equally readily classified. The overall diagnostic capability, therefore, in our series is 19/20 with a tissue diagnosis achieved on echographic bases in 17/20. (One case is excluded from this analysis as unexplained unilateral papilledema has been the only abnormality found and orbital abnormalities per se have not been proven.) We believe the roles of these two valuable diagnostic modalities to be complementary, not mutually exclusive, and conclude thet this combined radiologic and echographic approach to orbital abnormalities is essential to the proper evaluation of orbital disease.


Retinopathy in systemic lupus erythematosus. A 32-year-old black woman with systemic lupus erythematosus went rapidly blind due to severe bilateral retinal vasculitis. The mechanism appeared to be total arrest of the retinal circulation by thrombosis of most of the retinal vasculature including major arterioles.


Factors influencing retinal redetachment after removal of buckling elements. Scleral buckling elements were removed from 152 eyes because of infection (50 eyes), erosion (69 eyes), extrusion (25 eyes), pain (5 eyes), allergy (2 eyes), and excessive buckle height (1 eye). The overall retinal redetachment rate was 14.5%. Short duration of buckling and the presence of retinal tears, as opposed to holes, appeared to predispose to recurrence. A significantly higher redetachment rate was found when infected buckling elements were considered alone (28%). This was attributed to the short duration of buckling and the associated inflammatory reaction found in these eyes.


Endophthalmitis caused by an Erwinia species. A 14-year-old boy developed exogenous endophthalmitis presumably caused by an Erwinia species. To our knowledge, this is the firs reported case of endophthalmitis caused by an Erwinia species, which has been considered pathogenic for only the last ten years. The endophthalmitis developed after a piece of wood penetrated the patient's sclera. After removal of the foreign body, the patient received intravitreally and subconjunctivally administered gentamicin sulfate, intramuscularly administered cephaloridine, and a short course of orally administered prednisone. The patient had clinical and visual improvement.


Epithelial ingrowth.

Epithelial ingrowth. A 74-year-old woman had a radical anterior segment resection for epithelial ingrowth following cataract extraction. Light microscopy demonstrated the presence of a sheet of cells morphologically similar to conjunctival epithelium covering the superior half of the inner surface of the cornea, iris, and ciliary processes. Electron microscopy revealed that frequent hemidesmosomes and a well-developed basal lamina were consistently present along the base of the ingrowing epithelium. The tissue immediately beneath the ingrowing epithelium, lining the cornea, trabecular meshwork and iris, morphologically resembled the subepithelial zone that has been described along the human skin epidermal-dermal junction. Additionally, focal areas of necrosis were noted in the trabecular meshwork. The major structural alterations induced on the surfaces of intraocular structures by the invading epithelium and the associated necrosis probably are responsible for the glaucoma which occurs with epithelial ingrowth.


[Ultrasound diagnosis in bone and soft tissue tumors (author's transl)]. The value of ultrasound diagnosis as an additional examination to x-ray and angiography is proved in various tumors and tumor like conditions of the locomotor system. It shows that the echotomogramms are helpful in various cases. This help results mainly in a better preoperative diagnosis of tumor size and topography and in some cases in the cognition of tumor structures. Therefore, this method can be a valuable information for surgery. In some cases the finding of soft tissue tumors is possible even when the x-ray and angiography do not give any information. In the search for tumor recurrence the ultrasound can also be applied.


[Operative treatment of paratenonitis achilleae in athletes (author's transl)]. This is a report about indications, technics of operation, treatment after the operations and the results of the paratenonitis at the Achilles-tendon. Our 21 patients were top-sportsmen and the treatment conservative had no succes. All patients were able to continue their sportive activity after the excision of the paratenon.


[Muscular absorption of low frequency resonance in animal experiments (author's transl)]. For the further clarification of helicopter pilot's spinal troubles caused by vibration the muscular absorption was examined with the help of animal experiments. On a swinging-table acceleration values were measured in Pirbright cavies; at first this was done under a defence reaction of the muscles, and in second experiment under maximum muscular relaxation. In the tense animal the resonance occurring at 5 Hz was almost completely absorbed, whereas in the relaxed animal a clear resonance--curve could be developed at 5 Hz. On the other hand vibration at a higher frequency up to 15 Hz were to an increasing extent better absorbed in the relaxed animal than in animal with a muscular defence reaction. For this reason the protective function of a not fatigued musculature for the defence of especially badly tolerated resonance vibrations is being discussed.


[Additional information regarding periarticular ossifications after total hip replacement (author's transl)]. Residual monomer originating from acrylic bone cement is not the origin of periarticular calcifications after hip joint replacement. This has been demonstrated by gaschromatografic detection of monomeric methylmethacrylate in the liquid of the joint space. Up to 200 microng/ml monomeric MMA could be demonstrated in the first days after the operation only. The concentration of residual monomeric MMA in the bone cement is 1% to 4%. It is deminished time dependently by diffusion of the molecule in the surrounding tissue. All determined concentrations of monomeric MMA in the joint liquid are below the toxic range for tissue demage.


[Correction osteotomies of the knees. Factors altering the static angles on the radiographies through fault projection (author's transl)]. Comparing radiographies we have examined the degree in which the static angles of the knee are affected, because of a fault projection under the influence of some factors. We have found that an inwards or an outwards turn, even of a small degree (IQ), a bending or preexistent (pathological) anomalies, each alone or in combination, affected the right projection of the angles in a face radiography. Physiological knees possibly are presented like "varum" or "valgum" projectional. It is clear that the right position during the taking of the radiography is of a great significance in order to decide about the indication of osteotomy and to determine the degree of correction. We suggest as a criterion of the right radiographies the factor "patellacondylus".


[Experiment studies on fractures of the human calcaneus under vertical pressure (author's transl)]. In 60 cases typical compression fractures of the calcaneus were achieved by means of static compression of the test preparation. Afterwards the load bearing capacity of the fractured calcaneus was studied. In case of pure vertical compression the calcaneus does not loose much stability. The load bearing capacity of the studied bones after fracture achieved on an average still 63% of the initial value. In adequate cases of compression fractures, not only the early mobilization but the early weight bearing has to be discussed.


[The unstable knee joint--aspects in basic research, diagnosis and therapy (author's transl)]. The increase of knee lesions within the last years has provoked a generally more intensive discussion about the functional anatomy, the biomechanics and the pathophysiology of the capsule and ligaments of the knee joint. Several authors have stressed the importance of the active and passive factors, stabilizing the knee joint. The injury to a single element leads to different instabilities, as proven by meticulous clinical and radiological diagnostic procedures. The progress in the treatment of fresh and old injuries of knee ligaments is connected with the names of O'Domoghue, Slocum, Larson, Hughston, Nicholas and Trillat. For a fresh completely ruptured ligament surgery is recommended. Torn  menisci are reattached whenever possible. An initial graft can be necessary for ruptures of the anterior cruciate ligament. Complex injuries, which are found most frequently, have to be dealt with completely. Old injuries of capsule and ligaments may require a plastic reconstruction. For the reconstruction of the anterior cruciate ligament it has been proven useful to take distally attached tendons of the pes anserinus group as well as the free graft from the central 1/3 of the patellar ligament. Rotational instabilities have to be dealt with according to the type of instability. The techniques of Slocum and Larson and the "five in one" reconstruction by Nicholas have to be emphasized as treatment of the anteromedial rotational instabilities. McIntosh has shown a procedure which seems to be successful for anterolateral rotational instabilities. Several techniques have been compared with our own experiences and late results studied. The point is stressed that further progress has to be made for the treatment of injuries to ligaments of the knee.


A comparison of osteotomy and joint replacement in the surgical treatment of the arthritic knee. The relatively small numbers of knees compared in this study make it impossible to draw conclusions with great confidence. On the other hand we believe that the quality of our comparison has been improved by our effort to match the groups of knees under study. Our results lead to the controversial conclusion that, at least in RA and in elderly patients with OA, ICLH arthroplasty is preferable to osteotomy regardless of the pathology and preoperative deformity and that osteotomy should not be used as a temporizing procedure before ICLH arthroplasty. We are unable to say whether or not similar conclusions would apply to other forms of arthroplasty but we suspect that they would. Certainly joint replacement is now widely preferred to osteotomy at the hip and it is difficult to see why the knee should be different. It should not be concluded from these results that replacemnt is to be preferred to osteotomy for the mildly damaged knee. It does however appear that if osteotomy fails (for technical or other reasons), it may then be difficult to obtain a satisfactory result even by replacement. Thus if a patient with a mildly damaged knee is not to be disabled irreparably, it may be better to avoid osteotomy until the day comes when the causes of failure after this operation can be predicted preoperatively and prevented. The data presented here suggest (as do those in many  other studies) that one step in this direction is to confine osteotomy to the varus OA knee. Even in this group the surgeon should, we believe, do his utmost to avoid surgery altogether until the parents' disability is unacceptable. In summary therefore, we now advance the view that if the arthritic knee is sufficiently disabling to require major surgery, it should be replaced. If the disability is less severe, the joint should be treated conservatively.


The use and misuse of vitamin supplements. Overt vitamin deficiency in Australia is a medical curiosity. Suspected hypovitaminoses in the general population requires education in nutrition, rather than supplementation by vitamin capsules. Vitamin supplementation, however, may be needed by patients receiving long-term drug treatment, or with chronic malabsorption conditions. The receipt of specific additional vitamins may also be beneficial during pregnancy, or in persons dedicated to a totally vegan diet.


Food--fads and fallacies.

Food--fads and fallacies. The importance of food and its many connotations in our daily lives is obvious, from the first feed at the mother's breast within minutes of delivery to the condemned man's last meal. Food is a source of domestic disharmony in infancy, a symptom of rebellion in teenagers, a mode of communication amongst adults (note the scene from the film "Tom Jones"), and particularly a source of concern to most health-conscious adults.


Oestrogen replacement--a boon or a curse? The decline in oestrogen secretion at the time of the menopause may give rise to symptoms involving the genital and autonomic nervous systems. There is evidence that it may also contribute to the incidence of psychological features, such as depression, and to the development of post-menopausal osteoporosis. Oestrogen replacement therapy clearly reverses the genital changes and the hot flushes, and may prevent the development of osteoporosis and lead to improvement in depression. Recent evidence indicates an association between oestrogen replacement therapy and endometrial cancer, although the exact nature of the relationship, and the factors which might alter it, remain unknown. Current data do not permit the physician to make a decision with conviction concerning the indications for, nature of and duration of oestrogen replacement in the symptomatic post-menopausal woman, but it is recommended that she be given such therapy in effective dosage and in association with regular progestagen supplement in order to achieve medical curettage. Further research is required in order to resolve many of the relevant controversies.


Nitrogen washout studies in acute mountain sickness. We assessed the severity of Acute Mountain Sickness (A.M.S.), indices of pulmonary gas exchange and nitrogen washout curves in healthy volunteers acutely exposed to high altitude. Symptoms of A.M.S. ranged from malaise to vomiting with intractable headache. The slope of phase III of the nitrogen washout curve increased most in those subjects with the most severe A.M.S. and who were most hypoxemic. The sickest subject also had the greatest increase in (A-a)DO2 and the largest increase in the slope of phase III. These abnormalities in gas exchange and nitrogen washout curves in the subjects with the most marked A.M.S. suggest that the manifestations of cerebral and pulmonary dysfunction at altitude develop simultaneously, although not necessarily by identical mechanisms.


Correlates of maximal oxygen consumption during treadmill exercise. According to the Balke treadmill protocol, 39 healthy male USAF volunteers were subjected to maximal exercise. The subjects as a group passed the anaerobic threshold by the end of exercise since average venous lactate concentrations increased from 11.2 +/- 1.6 mg% (95% confidence limits) to 93.0 +/- 8.5 mg% (95% confidence limits), and the average gas exchange ratio (R) at the end of the exercise was greater than unity (p less than 0.0005). Tests for correlations showed weak but statistically significant (p less than 0.05) relationships between change in venous lactic acid concentrations and R (r = 0.44) and maximal heart rate (r = 0.34). Maximal oxygen consumption was correlated with time of exercise (r = 0.70) and subject weight (r = 0.33). Subject age and initial plasma lactate concentrations were not significantly correlated with any other variables. Multiple linear regression yielded an equation for prediction of maximal oxygen consumption which included terms for time of exercise and subject weight. Although the multiple correlation coefficent (r = 0.75) was statistically significant (p less than 0.05), it was considered insufficient for accurate prediction of maximal oxygen consumption.


Reversal of bedrest-induced orthostatic intolerance by lower body negative pressure and saline. Six healthy male volunteers underwent two 1-week periods of bedrest, each preceded and followed by 2-week control and recovery periods. The daily metabolic diet contained 150 mEq of sodium. Following one 7-d bedrest period, each man was subjected to LBNP at a level of --30 mm Hg for 4 h while consuming 1000 ml of beef bouillon containing 154 mEq of sodium. After the other bedrest period, each man simply consumed the bouillon without LBNP treatment during 4 h of continued bedrest. Measurements of plasma volume and orthostatic tolerance were made before and after each treatment period. After combined LBNP and saline therapy, plasma volume and response to LBNP testing, as measured by heart rate and systolic BP, showed a return to pre-bedrest levels. Saline consumption alone had a lesser effect. With continuation of bedrest in three subjects, the beneficial effects of these measures appeared to be largely gone after 18 h.


Changes in orthostatic tolerance in man at an altitude of 3500 meters. Orthostatic tolerance was measured in 20 lowlander Indian soldiers (sojourners) by recording responses of heart rate (HR), blood pressure (BP) and mean skin temperature (Tsk) to 70 degrees head-up passive tilt, initially at Delhi (260 m altitude) and thereafter at 3500 m at weekly intervals for 3 weeks. For comparison, observations were also made once on 10 acclimatized lowlanders (AL) and 10 high-altitude natives (HAN) at the same altitude. Among sojourners, the percentage of subjects showing orthostatic intolerance (OI) during tilt increased at high altitude in the first and second weeks; six subjects fainted in the first week as compared to one who fainted at sea level (SL). There was no incidence of fainting among AL or HAN and the percentage of subjects showing OI was very small. The magnitude of cardio-acceleration to tilt was higher in sojourners at high altitude (HA) and relatively less in AL and HAN. The systolic BP during tilt showed no change at SL or during the first and second weeks of stay at altitude in sojourners, but in third week showed a mild rise and was comparable to the responses of AL and HAN. The diastolic BP during tilt always showed a rise, although it was of a higher magnitude during the second and third weeks in sojourners as well as in AL and HAN. There was a fall in Tsk during tilt, which was of a lesser magnitude at HA. It has been concluded that there is a reduced orthostatic tolerance at higher altitude during the first week, due to hypocapnia, after which it is improved as a result of relative sympathetic hyperactivity and adaptation of the vasomotor centre to reduced PaCO2 level.


Efficient oxygen mask for patients undergoing hyperbaric oxygen therapy. Hyperbaric oxygen (HBO) is established therapy for various disorders, but its effectiveness depends on the efficiency of the oxygen delivery system. A mask oxygen delivery system, consisting of the standard USAF aviator's A-14 regulator and the MBU-5/P oxygen mask, is installed in all USAF hyperbaric chambers. The efficiency of the mask oxygen delivery system at the USAF Hyperbaric Center, Brooks AFB, Tx, was evaluated breath-by-breath at sea level and 2.4 ATA via two different measuring techniques. Three groups of subjects were evaluated. Four subjects in Group I and seven subjects in Group II were randomly selected to use a single instrumented mask which was improperly fitted. The result was variable inspired oxygen levels from 64% to 100%. Six subjects in Group III wore properly fitted masks and achieved end-inspired oxygen levels ranging from 96% to 99%, for a mean of 97.8 +/- 0.5 (S.E.)%. A mean end-inspired oxygen level of 88,5 +/- 3,5 (S.E.)% was achieved within 5 min of mask donning. Inspiratory gas analyses indicate that the USAF aviator MBU-5/P mask and the A-14 regulator as used at the USAF Hyperbaric Center constitute a highly efficient oxygen delivery system for HBO therapy. This view has been refleced in arterial blood gas measurements and in preliminary data from tissue oxygen measurements in a gas gangrene patient. Future improvements in patient therapy masks are recommended.


Cardiovascular responses of men and women to lower body negative pressure. Changes in blood flow and blood redistribution were measured by impedance plethysmography in the pelvic and leg regions of six male and four female subjects during three 5-min exposures to -20, -40, and -60 mm Hg lower body negative pressure (LBNP). Female subjects demonstrated significantly higher mean heart rate and lower leg blood flow indices than the male subjects during the recumbent control periods. Men had slightly higher mean resting systolic and diastolic blood pressures and higher mean control pelvic blood flow indices. Women demonstrated significantly less blood pooling in the legs and slightly less in the pelvic region than the men. All of the 18 tests with male subjects at -60 mm Hg were completed without initial signs of syncope, while only two of the tests with women were completed successfully without the subject exhibiting presyncopal conditions. The results of this study indicate that impedance plethysmography can be used to measure segmental cardiovascular responses during LBNP and that females may be less tolerant to -60 mm Hg LBNP than males.


Dietary requirements of subjects exposed to hyperbaric He-O2 conditions: effects of supplementation with major nutrient groups. A 4-week growth study was conducted to determine whether changes in the type of diet could adequately compensate for the increased demands made upon the body by the stresses associated with exposure to hyperbaric He-O2 conditions. A normal rat diet (Hegsted-Chang) was used as a standard diet. This diet was also modified by increasing the fat content 25%, mineral mixture 25%, casein 50%, or all vitamins (including cod liver oil) 50%, or by decreasing the casein portion 10% from the standard levels. The corn starch portion was adjusted appropriately to maintain isocaloric properties of the various test diets. Male Sprague-Dawley rats served as the experimental subjects and were exposed to 1 ATA room air, 11 ATA He-O2, or 21 ATA He-O2 environmental conditions. The rats fed fat-supplemented diets grew as well under 11 ATA He-O2--but not under 21 ATA He-O2 conditions--as those fed the standard diet and exposed to 1 ATA room-air conditions. The rats fed protein-supplemented diets grew as well under both hyperbaric conditions as the control rats. Although the rat growth under the hyperbaric conditions equaled that under control conditions, it was less efficient because more food was required to produce each 1 g of gain. Significant differences were also observed in the apparent digestibilities of the various diets and in the protein, fat, and mineral contents of the carcasses.


Impairment of flying efficiency in anancastic pilots. Previous work on the effects of stress upon flying efficiency has shown two types of psychological stress to exist; these are usually referred to as cognitive and affective stress, respectively. A refinement in affective stress analysis has enabled two subtypes of stress to be demonstrated--one is characterized by activity of the sympathetic nervous system (SNS) and subjective feelings of rage, fear, anxiety, or frustration; the other by excessive rumination. These two subtypes are found in differing personality configurations. Ten pilots exhibiting the former type of stress, and 6 with the latter, sought personal counseling regarding domestic problems. They underwent a regiment of 1-h weekly sessions consisting of a psychometric assessment, a psychophysiological evaluation of stress, and a complex ILS task in a specially modified type D4 Link Trainer. The performance of both groups, in terms of deviations from zero and RT to cockpit drill, was found to differ significantly from the standardized norms obtained from control groups in earlier studies, and to differ significantly from each other. The SNS-aroused group showed maximum impairment at the beginning of the 20-min flight task, but gradually improved with time. The Ruminative group showed less, but consistent, impairment throughout the task. Overcontrolling was a characteristic of the former group, while errors of omission characterized the latter. The psychology of rumination is briefly mentioned, its incidence in pilots considered, and reference made to the beneficial effects of sodium diphenylhydantoinate for this condition.


Study of PFT (parasail) in air training command. Injuries in pilots following egress from disabled aircraft can be minimized by their ability to maneuver their parachutes during descent and to execute a proper parachute landing fall. USAF pilot and navigator trainees receive extensive ground training in parachute operation and parachute landing falls. They then undergo Parachute Familiarization Training (PFT) during which they experience descents by a parasail after being towed to altitude. The value of PFT was determined by evaluating questionnaires sent to approximately 700 crewmembers, including many ex-prisoners of war, who had made an emergency egress. Areas addressed included contribution of the training to overall confidence, ability to steer the parachute to avoid hazardous obstacles, execution of a proper parachute landing fall, and the role of PFT in avoiding injury or fatality in the post-egress environment. Responses indicated that PFT played a significant role in confidence-building and in avoiding or minimizing post-egress injury.


Inexpensive technique to record respiration during flight. This paper describes the development and use of a small (19 X 11 X 18 cm) tape recording system designed to monitor respiratory patterns during flight. This lightweight system (1.85 kg) was developed for less than $200 using commerically available subassemblies. Respiratory patterns are detected via a comfortable intranasal thermometer, amplified, and converted to an FM signal for taping. The device will also convert the tape recorded signal to a graphic display on a laboratory strip chart recorder. Reliable recordings of respiratory rate and respiratory regularity have been made in ambient temperatures of up to 43 degrees C. Chart recordings of student pilots' respiratory patterns at different stages of flight are presented. With modifications to the transducer assembly and amplifier, the basic recording system may be used to monitor other biological functions such as EMG, GSR, EEG, and ECG. Environmental variables have a frequency of less than 250 Hz (wind velocity, temperature, noise, etc.) may also be recorded with proper transducers.


Effective temperature scale useful for hypo- and hyperbaric environments. Basic physics of man's heat exchange by radiation, convection, evaporation, and conduction through clothing is used to define and establish a Standard Effective Temperature Scale (SET), with which sensory and physiological responses of sedentary and active personnel can be related. The standard environment chosen is the Effective Temperature (ET) Scale, used by the American Society of Heating, Refrigerating and Air-Conditioning Engineers; namely, as the temperature of an isothermal enclosure at sea level with 50% rh and still air (0.1-0.15 m/s) in which a clothed (0.6 clo) sedentary subject would exchange the same total sensible and insensible heat as in the actual test environment. Mean skin temperature (Tsk) and skin wettedness (w) can be associated at sea level with thermal comfort and neutrality and with heat exchange. For hypo- and hyperbaric environments, thermal equivalence between SET and any test environment occurs when mean body temperature (Tb) for each is identical. Comprehensive data, developed for a 2-node model of human temperature regulation and of the associated partitional calorimetry, demonstrates the expected interaction between SET and the basic environmental and clothing factors over the barometric range 0.33 to 30 ATA.


Changes in local brain tissue Po2 and electrocortical activity of unanesthetized rabbits under high oxygen pressure. Po2 changes in the thalamus, hippocampus, reticular formation, and cortex, and cortical electrical activity, were recorded simultaneously in unanesthetized, unrestrained rabbits breathing air or hyperbaric oxygen. The average tissue Po2 of investigated brain structures during exposure to 100% oxygen at 7 ATA pressures, was two to three times greater than that during air breathing at 1 ATA. In seven out of 10 rabbits, successive myoclonic fits were observed before the appearance of the first electrical discharge or abnormal EEG. Postmortem examination of the lungs showed signs of edema and hemorrhage in all the animals. Because of the possibility that the lung damage took place before the development of brain oxygen toxicity, we concluded that the rabbits are not animals of choice for the investigation of brain oxygen toxicity. The possible interrelationship between cerebral metabolic rate-O2, cerebral blood flow, and lung pathology in determining the level of tissue Po2 and the appearance of oxygen toxicity in the brain under hyperbaric conditions are discussed.


Stress responses of pilots flying high-performance aircraft during aerial combat maneuvers. In aerial combat maneuvers (ACMs), at Luke AFB, Az, eight pilots flew their two F-15 aircraft against nine pilots in three F-106 aircraft. A total of nine flights, consisting of 23 ACMs, were accomplished in 5 successive days. The degrees of fatigue, stress, and sympathetic activity were quantified using both subjective analyses and the biochemical constituents in the urine of the pilots of the F-15 or F-106. Biochemical indicators, reported per 100 mg creatinine, included: epinephrine, norepinephrine, 17-OHCS, urea, inorganic phosphate, sodium, potassium, and sodium/potassium ratio. The F-106 pilots exerted more relative effort than did the F-15 pilots--effort which appeared to be associated with high-G experience. Both groups of pilots were equally fatigued following ACMs; however, only the fatigue of the F-106 pilots was directly correlated with the length of the ACM. Sympathetic and stress responses during the ACM--similar for both groups of pilots--showed postflight increases of 54% in epinephrine, 19% in norepinephrine, and 20% in 17-OHCS over preflight values, thus suggesting a moderate stress response. Resting levels of these same indicators, for days the pilots did not fly and for pre-ACM values, were similar but higher than control values previously reported for other stressful activities. By late afternoon, postflight values for these indicators had returned to near-preflight levels.


Asymptotic behavior of temporary threshold shift and recovery from 24- and 48-hour noise exposures. Temporary hearing loss (TTS) from long-duration noise exposure reaches an asymptote between 8 and 16 h and does not increase further during continued exposure for durations of at least 48 h. Potential auditory hazards of long-duration exposures are examined in terms of growth and recovery patterns of TTS. TTS growth and recovery patterns were compared during 24- and 48-h exposures of humans to continuous pink noise at a level of 85 dB A-weighted. Results indicate similar patterns of acquisition and relatively equal amounts of TTS for the two exposure durations. However, recovery of preexposure hearing at 4000 Hz following termination of the 48-h noise exposure differed somewhat from that which followed the 24-h exposure. The implications of these findings for long missions in noisy environments are discussed.


Motion sickness susceptibility and related behavioral characteristics in men and women. The incidence of motion sickness in a large (N = 3,618) college population was determined by means of a questionnaire. The test-retest reliability coefficient (0.84) suggested that the motion sickness questionnaire (MSQ) for this particular population yields highly consistent information. Significantly greater proportions of men than women had low susceptibility scores and, conversely, significantly greater proportions of women had high susceptibility scores. The relationships between motion sickness susceptibility scores and several behavioral characteristics in men and women were also investigated. Specifically, comparisons of MSQ scores were made with other self-assessments, age changes, motion experiences, familial susceptibility, use of motion sickness medication, muscular coordination, willingness to participate in motion experiments, flying experience, phobias, visual motion effects, and use of alcohol.


Tolerance of females to +GZ centrifugation before and after bedrest. Because women may be included as passengers in the proposed Space Shuttle System, this study was designed to investigate the +GZ tolerance of women and the possible degradation of this tolerance after a period of weightlessness as simulated by bedrest. Twelve healthy Air Force Flight Nurses served as test subjects. Over a 1-week period, each subject was exposed to +GZ levels starting at +2 GZ and increasing by 0.5 GZ increments to a gray-out point. This point was determined by peripheral vision loss with a standard lightbar and by reverse blood flow in the temporal artery. Ultimately, each woman was subjected to three runs at the +3 GZ level; each run was approximately 55 min long, separated by 5-min rest periods. Eight subjects with the best tolerance times were selected for 14 d of bedrest in a horizontal position; the other four were ambulatory controls. Tests before bedrest, immediately following, and 5 d later showed that average +GZ tolerance decreased by 67% after bedrest.


Changes in tissue glycogen stores of rats under acute and chronic hypoxia and their relationship to hypoxia tolerance. Rats were exposed to simulated altitudes of 3658 m, 4877 m, and 7620 m, for 5 h/d for 30 d at an ambient temperature of 28 degrees C. Blood sugar and tissue glycogen levels were measured--after acute exposure and chronic exposure while either fed ad lib or fasted for 24 h--in liver, kidney, brain, heart, lungs, and skeletal muscles. Glycogen levels were decreased significantly in several tissues under chronic hypoxia in fed animals. In the animals which were fasted 24 h before sacrifice after their 1 month altitude exposure, there was a significant glycogen increase in livers but no change in other tissues. In fasted, acute-exposed animals, glycogen decreased in hearts while in other tissues its levels were unchanged. Hyperglycemia invariably accompanied all conditions of altitude exposures (in fed, fasted, acute, or chronic exposed). Glucose injected i.p. to fed rats as single doses of 20 g/kg body weight 3 h before sacrifice resulted in significantly increased glycogen in all tissues except brain. These glucose injected rats had highly increased resistance to hypoxic stress.


Protective effect of hypoxia on oxygen toxicity: possible mechanisms. Previous studies demonstrated a protective effect of hypoxia on subsequent death breathing oxygen. Four groups of rats were exposed to air for 120 hours plus 99% O2 for 52 hours (A + O2); 120 hours of hypoxia plus 52 hours 99% O2 (H + O2); 172 hours of only air (A); and 120 hours of only hypoxia (H). Rats were sacrificed and lung lavage protein (gm/ 100 ml) was 0.57 +/-0.18 in A + O2 and  0.26 +/- 0.12 in H + O2. Hematocrits were increased at sacrifice. Rats with induced hematocrits of 61% did not have a protective effect breathing oxygen. Mean total phospholipid in lung lavage was: A + O2  O.94; H + O2 1.10; A 1.08; and H 1.76 (micronM/ml). Phosphatidyl choline (lecithin) was: A + O2 0.49; H + O2 0.61; A 0.59; and H 1.15 micronM/ml. Differences among the groups were significant for total phospholipids and phosphatidyl choline except between air (A) and hypoxia + O2 (H + O2). Palmitic acid was decreased in A + O2 compared to the other groups. Oxygen breathing results in decreased total phospholipids and phosphatidyl choline in lung lavage. Pretreatment with hypoxia and subsequent oxygen breathing results in amounts similar to rats breathing air only.


Medical waivers: an extension of the pilot's career. The medical examination has been conducted periodically to determine medical qualifications for the continued performance of military service and as a preventive medicine measure to reveal latent and undiagnosed disease. When an individual fails to meet the medical standards for flying duties, he may be granted a waiver. A waiver means that the individual is considered by the reviewing authority to be capable of effective performance of duty world-wide without compromising health or safety. In 1973, a total of  1218 waivers were granted to 741  rated officers in Headquarters Command. This command is responsible for medical administration of 4057 rated officers. The ages of the officers granted waivers ranged from 27 to 58 years, with a mean age of 46 years. Over 80% of the waivers granted were to pilots. The value of the medical examination schedule followed in the United States Air Force today is often debated. Those who oppose the annual physical examination because of its questionable value speak in an even louder voice because the medical crunch has reduced the availbale grass roots flight surgeons to a bare minimum. These studies, however, point up the need for a continuous, strong, preventive medicine program in Headquarters Command.


A unifying concept for the role of matrix vesicles and lysosomes in the formal pathogenesis of diseases of connective tissues and blood vessels. The cells of the connective tissues contain lysosomes with enzymes capable of degrading intercellular substances (collagen, elastin, proteoglycans) and release their enzymes in membrane-bound or in free form into their intercellular substance. In this way extracellularly located lysosomes (= matrix lysosomes) can be detected by morphological and enzymatic means as well as by their metal concentrating property. This function of such matrix-lysosomes is in connection with the two step-degradation of the connective tissue and is thought to be the main part for the fibrocytic fibrolysis, chondrocytic chondrolysis, osteocytic osteolysis and myocytic mediolyses in the vessel wall. The cells of the mesenchymal tissues thus control the turnover and transformation of their own ground substance. Inflammatory and immunologic processes are suggested to be superimposed on this lysosomal action. If the lysosomal enzyme system in the connective tissues and the vessel wall gets out of control, the consequences can be dangerous as e.g. in case of relapsing polychondritis and arterial aneurysms. In this enzyme system proteolytic activators as well as proteolytic decomposable inhibitors are present. The corresponding proteolytic processes are of lysosomal nature and are subordinated to other regulatory mechanisms.


Lymphopenia and lymph node histology following repetitive extracorporeal irradiation of blood in normal and thymectomized calves. Repetitive extracorporeal irradiation of the circulating blood (RECIB) in normal or thymectomized calves and RECIB plus Imuran were used for comparative studies on the depletion of blood and lymph node lymphocytes. Elimination of the easily mobilizable pool of lymphocytes was almost complete within approximately 6 days after commencing RECIB and was reflected by a reduction of approximately 50% in the numbers of paracortical lymphocytes. Blood lymphocyte counts were reduced to approximately 1/3 to 1/4 of the pre-irradiation values. Thymectomized calves had lower pre-irradiation blood lymphocyte counts than non-operated controls, however, the reduction in the number of blood lymphocytes was proportionally similar. Continuation of RECIB beyond one week did not result in a further depletion of blood lymphocytes. The lymphocyte counts in the follicular cortex and in the medulla of lymph nodes were not significantly changed by the various procedures. RECIB of 8-16 days duration did not alter the number of germinal centers in non-thymectomized calves, however, in thymectomized animals treated with Recib, the number of germinal centers was reduced.


The effect of preload and Ca++-ions on the time-course of the isometric force and on the force-velocity relation: is Vmax dependent on the number of activated cross-bridges? The maximum shortening velocity of the isolated, externally unloaded papillary muscle of cats, as can be obtained by quick-releases in the initial phase of isometric contractions, is clearly dependent on the Ca++-concentration of the bath solution as well as on the preload: In the range of 0.55 m-mole/1 to 4.4 m-mole/1 a doubling of the Ca++-concentration induces a mean increase of 23% in Vmax; in a range of muscle length assumed to be of physiological relevance, a rise in the extension of 10% of Lmax results in a mean augmentation of 20% in Vmax. In order to reveal possible differences in the effect of calcium and various degrees of filament overlap, firstly, isometric mechanograms were measured under low Ca++-concentration at the muscle length of Lmax. By correspondingly lowering the muscle extension under increased Ca++-concentration the reproduction of almost the entire rising phase of these isometric mechanograms was obtained. Both these experimental conditions result in congruent force-velocity relations and consequently in identical values for Vmax. It must therefore be concluded that there exists an inner relationship between the initial time-course of the isometric force and the force-velocity relations measured during this period. The interpretation of this fact involves weighing the hypothesis of an inner frictional force dependent on velocity against that of a maximum shortening velocity dependent on the number of activated cross-bridges. The resultant consequences for the estimation of the contractile qualities of the myocardium are discussed.


Hand flexor tenosynovitis in rheumatoid arthritis. Prevalence, distribution, and associated rheumatic features. Tenosynovitis of one or more flexor tendons of the hand (mean 3.1 tendons per patient) was noted in 55% of 100 patients with rheumatoid arthritis (RA) examined periodically during a mean period of 5 years. The third flexor tendon was involved most frequently (71% of patients), followed by the second (62%), fourth (53%), fifth (27%), and first (13%). Patients with flexor tendonitis (FT) had a significantly higher prevalence of rheumatoid nodules (56% vs 33%), carpal tunnel syndrome (47% vs 13%), wrist extensor tenosynovitis (47% vs 9%), and elbow epicondylitis (22% vs 7%) than patients without FT. Dupuytren's contracture, DeQuervain's tenovaginitis, flexor carpi radialis and ulnaris tendonitis, and Achilles tendonitis were found exclusively in patients with FT. A control group of 50 non-RA patients with FT had statistically fewer diseased tendons per patient (mean 1.5) and a different digital distribution, the thumb being affected more frequently (P less than 0.05) than in RA patients.


Effects of antiinflammatory agents on the acute response of immune synovitis in rabbits. Immune synovitis in rabbits was investigated as a potential in vivo model for evaluating new antiinflammatory agents. Antigen-induced increases in knee width as well as beta-glucuronidase and acid phosphatase activities in exudates were observed. Histologically, polymorphonuclear leukocytes appeared within hours in synovial tissues and reached maximum infiltration at about 24 hours. Subsequently, mononuclear cells, including plasma cells, appeared. The 6-hour Arthus-like phase of synovitis can be depressed by some antiinflammatory agents, colchicine and steroids being particularly effective. It is suggested that this model can be utilized to define potentially more effective antiinflammatory drugs.


Experimental studies on cardiac muscle cell adaptation to insult. Studies were carried out in rats on myocardial adaptation to injury produced by left coronary artery ligation. In the ischemic zone, open collaterals were present as shown by studies using the fine structural extracellular protein tracer, horseradish peroxidase (HRP). This phenomenon may explain the inhomogeneous cardiac muscle cell alteration in the early phase of coronarogenic myocardial injury. Reperfusion, as evidenced by the influx of HRP into the damaged cells, unmasked sarcolemmal membrane injury. Cardiac muscle cell stimulation modifies the binding of macromolecules to cell components and may influence the repair processes. In the surviving myocardium, correlative enzyme histochemical and ultrastructural studies demonstrated the development of alternative metabolic pathways and morphological signs of adaptation explaining increasing resistance of such cardiac muscle cells to subsequent insult.


[Solitary neurofibroma of the larynx. Removal by a microlaryngoscopic method]. We report a case of neurofibroma of the larynx arising from the aryepiglottic fold, surgically removed by direct micro-laringoscopy. From a review of the literature the case is extremelly rare (35 cases until 1963), expecially looking to the age of the patient (3 1/2 years old), that seems to be the lowest reported until now.


The metabolism of 3-deoxy-3-fluoro-D-glucose by Locusta migratoria and Schistocerca gregaria. 3-Deoxy-3-fluoro-D-glucose (3FG) administered by injection is toxic to adult Locusta migratoria or Schistocerca gregaria (LD50, 4.8 mg/g). temperature-programmed and isothermal gas chromatographic analysis of poisoned locust haemolymph reveals the presence of a fluorinated metabolite identified as 3-deoxy-3-fluoro-D-glucitol (3FGL). The enzymes responsible for the accumulation of this metabolite are located in the fat body of the insect and partially purified as aldose reductase (alditol: NADP+ 1-oxidoreductase, EC 1.1.1.21) and sorbitol dehydrogenase (L-iditol: NAD+ 5-oxidoreductase EC 1.1.1.14) 3FGL is shown to be both a competitive inhibitor of the NAD-linked sorbitol dehydrogenase with Ki 8¿x 10(-2) M as well as a substrate with Km 0.5 M. A kinetic rate equation is derived and verified to account for the kinetic duality of 3FGL. These results partially explain the toxic effects of 3FG and are consistent with the presence of a hitherto undetected sorbitol metabolism in locusts.


Multiple personality and splitting phenomena: a reconceptualization. Multiple personality and splitting phenomena described in the psychoanalytic literature are placed in juxtaposition. A reconceptualization of multiple personality is attempted. It is assumed that the splitting of multiple personality is qualitatively similar to the splitting in narcissistic character disorders and that the genetic antecedents of multiple personality can be traced to the narcissistic phase. Some of the literature pertaining to multiple personality is reviewed, followed by selected psychoanalytic sources referring to developmental issues and pathology in narcissistic character disorders. Material from three cases is briefly presented to illustrate the various levels of multiple personality and to show its continuity with narcissistic disorders.


Shortage areas for optometrists redefined: New York City, a case study. The geographic maldistribution of health manpower, particularly in rural and inner-city areas, has been a major concern of health planners, administrators, and other government officials. Attempts to deal with the problem through the use of financial incentives, such as loan forgiveness, are reviewed. Applying the present definition of shortage areas to New York City reveals some obvious inadequacies of the definition. A new definition of shortage areas is suggested.


The relationship between sister chromatid exchanges and chromosome aberrations in Bloom's syndrome. The distribution of the break points of sister chromatid exchanges (SCE) was compared with that of chromosome aberrations in Bloom's syndrome by using differential sister chromatid staining and banding techniques. A comparison was made of the distribution in chromosomes 1, 2, and 3, since the exact identification of other chromosomes is difficult with the differential sister-chromatid staining technique. It was shown that SCE and chromosome breaks do not necessarily correlate as to location. Some chromosome break points, e.g., 1q21, 1p36, 2q31, 3q12, and 3p13, were common with those of SCE, whereas others (at 1p13, 2p11, 2q11, and 3q11) showed little or no SCE. SCE breaks were not observed in the centromeric regions. In addition, the SCE frequency was examined in Bloom's syndrome cells with and without chromosome aberrations, and no significant differences of SCE frequency were observed between cells with chromatid- or chromosome-type of aberrations and those with normal complements. Banding analyses indicated a nonrandom distribution of chromosome breaks in the lymphocytes and marrow cells of the Bloom's syndrome patient.


Interindividual differences in the effect of drugs on bilirubin plasma binding in newborn infants and in adults. The nonprotein-bound fraction of bilirubin was determined in undiluted plasma or serum from healthy adult volunteers and newborn infants after addition of unconjugated bilirubin, 12 mg/100 ml. There were significant interindividual difference (2-fold in 13 adults, 2.6-fold in 9 full-term newborn infants) in the free fraction value. Sulfisoxazole, salicylic acid, and salicyluric acid had a pronounced displacing effect on bilirubin in the 10 to 30 mg/100 ml drug concentration range. Aspirin had only a small effect at concentrations below 20 mg/100 ml. There was a very strong correlation between the free fraction value of bilirubin in individual samples of drug-free plasma and in the same plasmas after addition of any one of the 4 drugs studied. This shows that the relative increase of the free fraction of bilirubin induced by any one of the drugs was essentially the same but that the absolute increase varied greatly between subjects. It may be possible, therefore, to predict quanitatively the bilirubin-displacing effect of drugs in individual patients before drug administration by determining the free fraction of bilirubin in a plasma or serum sample obtained prior to initiation of drug therapy.


L cell DNA ligase joins RNA to DNA on a DNA template. L cell DNA ligase catalyzes a covalent linkage between 5'-hosphoryl oligodeoxyribonucleotides and 3'-hydroxyl oligoribonucleotides on a complementary polydeoxyribonucleotide template. This reaction occurs to a substantially lesser extent than does the sealing of DNA to DNA. The joining of [5'32P]d(pA)12-18 to (Ap)11A on poly[d(T)] or of [5'-32P]d(pG)12-18 to 5'-hydroxyl, 3'-hydroxyl oligo(I) ON POLY[D(C)] was demonstrated by the formation of alkaline phosphatase resistant radioactivity. The 32P of the hybrid reaction products became sensitive to the action of alkaline phosphatase after treatment with alkali. Furthermore, hydrolysis of the products of the linkage of [5'-32P]d(pG)12-18 to 5'-hydroxyl, 3'-hydroxyl oligo(I) on poly[d(C)] with micrococcal nuclease and spleen phosphodiesterase resulted in the formation of [3'-32P]IMP. Attempts to seal [5'-32p[-(pA)12 to d(Ap)11-17A on poly[d(T) or [5'-32P]oligo(pI) to d(Gp)11-17G on poly[d(C)] were unsuccessful.


The use of digital rheoplethysmography for the study of psychogenic and neurogenic factors in man. The use of the RPG in the qualitative and quantitative study of the state of the intact digital vasculature of intact man is illustrated and emphasized. Rheoplethysmography is the only method for quantitatively recording continuously and simultaneously the volumes and rates of inflow, outflow and the differences between inflow and outflow and the rate of basal blood flow in the digits of intact man or in any organ or tissue that can be isolated in a plethysmographic cup. The effects of psychogenic and neurogenic factors on the peripheral circulation of man were studied with the RPG, and the results demonstrate how useful this method is for such studies of the fingertip.


Enhancement of barium- and cesium-induced adrenal catecholamine release by lidocaine. Catecholamine release evoked from isolated perfused bovine adrenals by Ba+2 or Cs+ is enhanced by lidocaine or by a calcium-free medium. The action of Cs+ therefore differs from that of K+ or Rb+ in adrenal medulla. Divalent and monovalent metallic cations of relatively large atomic weight like Ba+2 and Cs+, probably penetrate the cell more easily than small highly charged ions and act intracellularly to cause adrenal catecholamine release. Local anesthetics and calcium-free media may allow greater influx of Ba+2 and Cs+ into adrenomedullary cells.


DNA swivel enzyme activity in a nuclear membrane fraction. DNA swivel (nicking-rejoining) enzyme activity has been studied in various cell fractions of a human lymphoid cell line. Swivel activity is found only in chromatin and in a nuclear membrane fraction containing DNA and possessing endogenous DNA synthesizing activity. Twenty percent of the total swivel activity and less than one percent of the total DNA are in the membrane fraction. The swivel enzyme is more tightly bound to the membrane fraction than to the chromatin fraction. These observations suggest that the swivel enzyme may be a replication factor, specifically bound to replicating DNA in the membrane fraction.


Biochemical basis of skeletal defects induced by hydralazine: inhibiton of collagen synthesis and secretion in embryonic chicken cartilage in vitro. Hydralazine (1-hydrazinophthalazine) produces skeletal defects resembling those observed in experimentally induced manganese deficiencies. Since glycosylation of collagen, a step preceding its secretion, requires Mn2+, the effect of hydralazine on collagen secretion and the formation hydroxylysine glycosides was examined in explants of embryonic chicken long-bone rudiments. Auto-radiographic studies showed that hydralazine blocked collagen secretion. Secretion was restored by Fe2+ alone or Fe2+ + Mn2+ but not by Mn2+ alone, suggesting that a Fe2+-requiring step was involved. Biochemical analyses showed that hydralazine inhibited the formation of hydroxylysine, a step requiring Fe2+, but it did not inhibit the formation of hydroxylysine-glocosides by Mn2+-requiring steps, although the reaction was inhibited in vitro. Hydralazine also failed to inhibit intracellular mucopolysaccharide synthesis which involves several Mn2+-requiring enzymes. These observations suggest that the deleterious effects of hydralazine on bones are caused by its inhibition of hydroxylation steps in collagen synthesis.


Lead neuropathy: 2. Random distribution of segmental demyelination among "old internodes" of myelinated fibers. One-hundred teased fibers of proximal and of distal sural nerve of five rats fed lead carbonate for 3 months were evaluated to see whether the pattern of segmental demyelination was random or clustered. If the evaluation was done by the length of the "territory of an old internode" (the region of one Schwann cell) a significant departure from randomness could not be shown for the majority of nerves. However, if the evaluation was by regions with and without myelin a highly clustered pattern of segmental demyelination was found. Since several remyelinated internodes form following internodal segmental demyelination, of one "old internode" the latter method of analysis would be expected to show clustering even though Schwann cell damage was random. Therefore the second method of analysis cannot be used to assess randomness of Schwann cell involvement in neuropathy. We interpret these studies as supporting the concept that Schwann cells are primarily and ubiquitously involved in lead neuropathy of the rat. Possible mechanisms of such primary Schwann cell injury are direct damage from lead of the intrafascicular interstitial fluid or from increased intrafascicular interstitial pressure.


Is nicotine important to tobacco smoking? Tobacco smoking is generally regarded as a form of nicotine dependence, but the evidence for this is slender. Two experiments are described here which examine the hypothesis that habitual smokers need nicotine and that they regulate their intakes of this drug. A laboratory test for smoking was devised which permitted the continuous monitoring of puffing as well as of selected physiologic variables; the procedure was also designed to reduce the influence of smoking habits and rituals. In the first experiment, inhaled amounts of tobacco smoke reduced subsequent ad libitum smoking in a dose-related way. In the second experiment comparable doses of nicotine were given intravenously to the same subjects, but they failed to affect ongoing smoking. However, both the inhaled and intravenous doses of the drug produced very similar physiologic effects. These experiments do not, therefore, support the nicotine-dependence hypothesis; thus the ways, if any, in which this drug sustains the tobacco-smoking habit merit further examination.


[Pulmonary edema of high altitude in childhood. Study of 7 cases]. The study comprised seven children between 6-12 years admitted to Hospital Infantil "Lorencita Villegas de Santos" with progressive respiratory distress attended with cyanosis consistent with pulmonary edema. In all patients there was a previous history of a sudden change in altitude from sea level to 2,600 m. Changes consistent with pulmonary edema were made evident at the X-rays studies. The electrocardiogram showed right ventricular overload. No significant changes were found at the blood picture. All patients were treated with oxygen and rest; relief was attained within 72 hours.


[Metabolic balance technic as applied to the study of the protracted diarrheal syndrome in infants]. Balance technique applied to the study of infants with protracted diarrhea is discussed. Normal balance pattern in a group of healthy infants in presented and compared to data obtained in patients admitted with dehydration and diarrhea. Three cases considered to be representative examples are presented in detail.


[Effects of early and severe malnutrition on the growth of the skull]. A study of the effects of malnutrition on the growth of the skull showed there is a correlation between intensity, duration and magnitude of malnutrition and growth of the skull. Clinical considerations are made on recovery from malnutrition which leads to a parallel recovery in growth of the skull.


[Intestinal pneumatosis].

[Intestinal pneumatosis]. Fourteen cases of intestinal pneumotosis were found in a review of 1 477 plain abdomen X-ray films taken because of different conditions. These 14 cases were associated in most instances with septicemia, gastroenteritis and paralytic ileus. The mortality was high. The treatment should be directed to the management of the primary condition: intestinal pneumatosis, septicemia, gastroenteritis, paralytic ileus.


[Lesch-Nyhan syndrome. Report of a case]. A case is reported with a syndrome characterized by mental retardation, choreoathetosis, high levels of uric acid and aggressive, selfmutilation behavior, diagnosed as Lesch-Nyhan's syndrome. The most important features are, its appearance confined only to males, the absence of abnormalities along the prenatal and newborn periods, as well as the progressive impairment in the clinical course of the patient. The presence of high blood levels of uric acid which was controlled with the administration of allopurinol, the anemia, treated with ferrous sulfate and the complete absence of the AGPRT enzyme, were the laboratory findings. The clinical, pathophysiological and biochemical aspects of the treatment were also reviewed, as well as the experiences and findings reported in other series. The authors stress the very low frequency of these cases, the importance of making the diagnosis and the exceptional and eccentricity of the features which are part of the syndrome, such as the bites.


Survey on controls for the presence of HBsAg in products based on hemoderivatives. In Italy, Health Ministry provisions prohibit the marketing of products based on hemoderivatives unless they have first been controlled for the presence of HBsAg by means of radioimmunoassay. The present survey considers certificates submitted by Pharmaceutical Companies to the Health Department for permission to market their hemoderivative-based products. The results of the survey are discussed, and compared with the data obtained by the AA. in official control analyses, so as to arrive at some conclusion as to the applicability of currently employed RIA methods to HBsAg detection in hemoderivatives.