[Change in rheographic properties of blood in congestive circulatory insufficiency treated with diuretics]. Proceeding from a dynamic study of the rheological properties of blood in 85 patients with stage II-III congestive circulatory insufficiency treated with diuretics (Furosemid, Hypothiazid, Uregit, Verospiron) a conclusion is made that a rational employment of diuretic agents does not result in any increase in blood concentration, and does not increase the risk of thrombotic complications. On the contrary, in some patients with stage IIB-III circulatory insufficiency some normalization of the rheological properties of blood, that had been impaired before the treatment, was noted. The use of diuretics only moderately increased the hematocrit and blood viscosity values, but decreased the aggregation of the erythrocytes and platelets. The improvement of the rheological properties of blood was attributed to the normalization of the water-electrolyte disorders that the patients had had. In cases in which thrombotic complications occurred a low hematocrit and blood viscosity level was common, while the erythrocytes and platelets aggregation was increased.


[Clinico-morphological comparisons in thrombosis and insufficiency of mitral valve prosthesis]. Clinical and morphological comparisons were conducted in 31 patients with thrombosis and insufficiency of mitral valve prostheses. The morphology of these complications was studied on the basis of autopsy data in 19 cases, and in 12 reoperations. Prosthetic thrombosis was observed in 18 patients. The leading causes of the functional disorders in the prosthesis were septic complications, persisting hypotension in the early postoperative period, errors of anticoagulation therapy. The clinical manifestations of thrombosis of a prosthesis depend on the extent and localization of the thrombus. An important role in the diagnosis of such complications belongs to a dynamic observation, especially to repeated phonocardiographic examinations. A phonocardiographic semiotics of the complications is presented. The results of reoperations for thrombosis of a mitral valve prosthesis and its insufficiency are also presented. The rationale of secondary interventions is demonstrated.


[Aortic coarctation associated with endocardial fibroelastosis in infants (clinical aspects, diagnosis and surgical treatment)]. Among 111 infants with coarctation of the aorta, fibroelastosis of the left ventricular endocardium was found in 14 cases comprising 12.6%. Such a combination usually caused an extremely poor state of the patients and served as an indication for surgery. A resection of the coarctation of the aorta in cases of fibroelastosis provides for a significant reduction of the workload on the left ventricular myocardium, for an improvement of the patient's state permitting to survive the critical first three years of life. The problems of intravital diagnosis of fibroelastosis in patients with coarctation of the aorta are presented, the importance of chronic ischaemia of the left ventricle in the development of fibroelastosis is emphasized. The details of surgical tactics and postoperative care of such patients are discussed.


[Hypoplasia of the right ventricle with interatrial communication through the coronary sinus]. Isolated hypoplasia of the right ventricle is a rare congenital anomaly. The complex defect comprises also a communication between the atria in the form of an oval window or secondary atrial septal defect. The possibility of a communication between the atria via the coronary sinus having in such cases an additional orifice in the left atrium cannot be excluded. In cases of isolated right ventricular hypoplasia the right-to-left shunting goes via the interatrial communication. To eliminate the arterial hypoxemia the interatrial communication has to be closed. When an isolated hypoplasia of the right ventricle is combined with a communication of the coronary sinus with the left atrium, the coronary sinus orifice in the right atrium may be closed by suturing.


[Effect of adaptation to altitude hypoxia on vascular resistance]. The resistance of vessels in the hind limbs was determined under controlled perfusion in rats adapted to hypoxia at 2100 m altitude and in control animals at 200 m above the sea level. It was found that 15 days after the onset of adaptation the resistance of the resistive vessels decreases, after 30 days the degree of this decrease of resistance grows and it becomes statistically significant. The decrease of resistance in the resistive vessels of adapted animals persists after denervation of the extremity and depends on the reduction of the myogenic component of the vascular tonicity. This reduction of the myogenic component of the tonicity is accompanied by a reduction of the pressor reactions to asphyxia and addition of noradrenaline to the perfusate. The obtained data indicate that preliminary adaptation decelerates the development of experimentally induced hypertension.


[Myocardial infarct in young persons].

[Myocardial infarct in young persons]. A study of 106 patients with myocardial infarction, aged under 40 demonstrated a predominance of males (90.5%) with prevailing marco-focal and transmural myocardial infarctions. In 88 patients (83%) risk-factors of ischaemic heart disease were found: arterial hypertension, hypercholesterolemia, heavy smoking, excessive weight, sedentary life. The severity of the course of myocardial infarction is directly related to the presence of risk factors in the patient. Studies of the content of immunoglobulins in 15 patients revealed an immunologic hyperrectivity in young patients with myocardial infarction when they developed complications. Autopsy data of 5 mortality cases demonstrated atherosclerotic lesions of the coronary arteries in all of them.


[Response to the orthostatic test in patients with macrofocal myocardial infarct under different tempo of activization]. In 68 patients with large-focal myocardial infarction subjected to different tempos of activization the orthostatic test was conducted while assuming the vertical position for the first time and prior to being discharged from the hospital. Orthostatic complications and changes in the terminal part of the ventricular complex on ECG were found to be much more frequent in cases of slow tempo activation. A qualitatively different response to the orthostatic test was revealed in myocardial infarction patients with or without circulatory insufficiency. In those with signs of circulatory insufficiency the acceleration of the cardiac contractions rate in the orthostatic position, the shortening of the ejection phase, the reduction of the rheographic amplitude in the lungs and the lower extremities were negligible in  comparison with those free of circulatory insufficiency and having statistically significant shifts in the above parameters. The patients with circulatory insufficiency tended to a greater increase of the diastole-systolic ratio of the lower extremities rheogrammes which proves a hindered outflow of blood from this vascular zone. Faster tempos of activization, even in the presence of circulatory insufficiency, helped to prevent the above shifts.


[A case of cyclotropia (author's transl)]. Forward displacement of the superior oblique insertions, associated with partial anterior myectomies of the inferior obliques, compensated a cyclotropia which was not accompanied by other significant deviations.


[Areas of anomalous binocular single vision in small angle concomitant esotropia: evaluation by means of a modification of the v. Graefe technique (author's transl)]. A red filter in front of the fixing eye according to the v. Graefe technique was used in order to detect binocular visual field in patients with anomalous retinal correspondence and small angle esotropia. A striated glass was also placed in front of the deviated eye, in order to check whether single perception was related to suppression or to binocular vision. It has been demonstrated that these patients prevalently enjoy an anomalous binocular vision supported by an anomalous retinal correspondence. The suppression scotoma described by the v. Graefe perimetric technique may therefore in certain cases be in reality areas of single anomalous binocular vision. It has also been seen anomalous retinal correspondence is more deeply rooted at the center than at the periphery of the binocular visual field.


[Problems of automated perimetry (author's transl)]. The choice of the most convenient computer, the strategies for stimulus presentation, the fixation control, the presentation of results and the response objectivation are the main problems of automated perimetry, some of which are already solved, others are likely to be solved in the near future. The authors present their experiences on automation of perimetry and indicate future perspectives of this procedure.


[Examination of the venous system of the uvea (author's transl)]. The authors examined the microvascular venous aspects of the uveal membrane and have divided it into three territories: anterior, intermediate and posterior. They showed a double drainage system of the anterior territory. In addition, they believe that there is a difference between the anterior and the intermediate territories, which show sectorization, and the posterior venous territory which presents morphological and functional homogenity.


[Clinical and therapeutic aspects of haemorrhagic glaucoma (author's transl)]. Haemorrhagic glaucoma is a clinical syndrome. It is in fact the terminal stage of many very different ocular conditions. During the evolution towards the hypertensive haemorrhagic stage two conditions are essential: venous stasis and neoformation of capillary vessels. These factors have different incidence, but they are always present and affect each other. On the base of the pathogenesis the therapy of haemorrhagic glaucoma is more effective the sooner it is applied. When the syndrome is clear-cut the therapeutic possibilities are very poor. For these cases the authors suggest the operation of diathermotrabeculectomy whose surgical procedure is detailed.


[Variations of intraocular pressure induced by psychological stress (author's transl)]. Peculiar psychic reactivity of glaucomatous patients detected clinically and widely treated in the literature, has led us to study the behaviour of intraocular pressure in normal and glaucomatous subjects when submitted to various stresses. The data obtained show that prolonged stress increases intraocular pressure in normal subjects, unlike shorter stress which only causes an increase of intraocular pressure in glaucomatous patients. The possible genesis of the phenomenon is discussed.


[Vascular effects of adrenergic drugs and their action on intraocular pressure (author's transl)]. By means of the continuous contemporary recording of arterial blood pressure and intraocular pressure, the relationship between the two parameters was analyzed following the intravenous administration of adrenergic drugs. The aim was that of determining if during a change in systemic blood pressure the behaviour of intraocular pressure may indicate an active or passive participation to such a change. In the present studies the most important representatives of the different adrenergic groups (adrenalin, dibenamin, ergotamin, propranolol and isoproterenol) were taken in consideration. The results in normal eyes and in eyes with experimental hypertension showed that the adrenergic drugs affect the intraocular presure through a primary vasomotorial effect. An active vasodilatation of the intraocular vessels could not be demonstrated, whereas an active (adrenalin, ergotamin) as well as a passive (propranolol, isoproterenol) vasoconstriction was evidenced. The present studies allow an interpretation of the ocular hypotonizing mechanism of action of adrenergic drugs.


[Experimental triethyltin ocular hypertension. Pharmacological and histopathological studies (author's transl)]. The experiments were prompted by the need felt in pharmacology of eyes with hypertension of easy availability, rather long duration and fairly constant levels, to allow observation of the effects of hypotensive agents and to study their mechanism of action. Single doses of 1 mg Triethyltin, a substance producing a hydrodynamic compromission of the brain, were injected into the anterior chamber of rabbit eyes. A rise in ocular tension, beginning within 24 hours and lasting seven to ten days is obtained in about 70% of eyes. The pressure increase ranged from 12 to 30 mm Hg. Biomicroscopic and histologic examinations evidenced an uveitis-like reaction in the first week after treatment. Neoprene casts evidenced an impaired vascularization in the ciliary processes and choroid. Topical and parenteral administration of the most commonly used antiglaucomatous drugs showed how well this hypertension responded to hypotonizing agents. The occurrence of producing an ocular hypertension in the untreated fellow eye following repeated intra-cameral injections of small dosage (1 microgram) of Triethyltin, every two days for more than one month, in the other eye is described. Hypertension resulted in 40% of eyes.


[On the possibility of reducing systemic side-effects of isoproterenol eyedrops by means of topical propranolol (author's transl)]. Topical administration of Isoproterenol reduces the intraocular pressure in glaucomatous eyes, but produces systemic side-effects (tachycardia arterial hypotension) that make its clinical use unadvisable. Such side-effects are significant when the concentration of Isoproterenol is 4 and 5%. Pre-treatment of the contralateral eye with a solution of Propranolol 1%, 30 and 60 min. before Isoproterenol instillation, markedly reduces systemic side-effects, without diminishing the ocular hypotensive effectiveness.


[A contribution on the clinical pictures, fluorescence angiography and histology oe essential progressive iris atrophy (author's transl)]. The clinical and irisangiographical findings of 2 patients with essential progressive iris atrophy of the juvenile are reported. Histopathological examination was possible in one case. The differential diagnosis including to iridoschisis, Chandler's syndrome, Cogan-Reese (iris-naevus) syndrome is discussed. The aetiology of this rare disease remains obscure. Most authors believe that the iris stroma changes and pigment epithelial atrophy result from a vascular deficiency. Iris angiographical findings confirm this belief. The prognosis is poor, due to the therapy resistant secondary glaucoma. Surgery of the ciliary body appears to be the only possible procedure.


[Reiter's disease in an infant (author's transl)]. A case of Reiter's disease in a 15-month-old child is presented. The manifestation of this syndrome in childhood is an extraordinary event, so far few cases only have been observed. The symptoms of the syndrome are urethritis, arthritis and iritis. A specific infection could not be demonstrated. The typical clinical features are discussed and compared with earlier reports. Speculations on the etiology are made.


[Experiments on suture material prolene 10-0 and vicryl 11-0 compared with nylon 10-0 in the rabbit cornea (author's transl)]. Synthetic absorbable suture material Vicryl 11-0 and not absorbable Prolene 10-0 are tolerated well by the corneal tissue as compared with nylon 10-0. Vicryl 11-0 sutures remained intact for only 13.2 days on an average, this is too short for normal corneal surgery. As nylon shows signs of absorption with time Prolene may be preferable to nylon where permanent sutures are necessary.


[Development of idiopathic dacryostenosis (clinical and pathologico-anatomical findings)]. The authors describe microsurgical appearances of tear-sac and nasal mucous membranes from 45 patients suffering from dacryostenosis without clinically manifest nose or sinus conditions. In addition the observations of Henle (1865), that described the continuation of expandible conchal mucous membrane up to the lower part of the tear duct were controlled. The observations gave the following results: 1. In all cases of dacryostenosis there was a past history of more or less severe acute or chronic inflammation of the nasal and tear-duct mucous membrane. 2. The submucose of the ductus naso-lacrimalis surrounded by bone contains arterioles with sphincters and cavernous vessel complexes which can cause swelling up to displacement of the canal lumen, according to the blood flow. The results support the hypothesis of the authors that "idiopathic" dacryostenosis is caused by ascending inflammations from the region of the nose and sinus cavities, which can be clinically quite inconspicuous.


Abnormality of erythrocyte membrane protein in a case of congenital stomatocytosis. A new method of membrane protein analysis was used to demonstrate an erythrocyte membrane protein anomaly. Our approach employed electrofocusing linked to sodiumdodecylsulfate polyacrylamide gel electrophoresis. We observed an aberrant protein, isoelectric at approximately pH 4.5 with an apparent molecular weight of approximately 25,000 in membrane preparations from a patient with congenital stomatocytosis. This protein has not been observed in any healthy donor examined to date.


Intracellular histidine content of various tissues (brain, striated muscle and liver) in experimental chronic renal failure. Intracellular histidine levels were determined in brain, striated muscle and liver of rats with chronic renal insufficiency (5/6-nephrectomy) and compared both with normal rats and food-restricted (pair-fed) animals. There was no difference in plasma histidine concentration of the three groups whereas in the brain of the uremic rats histidine was significantly increased. Since there existed no alteration of the cerebral histidine in the corresponding pair-fed group, the finding of a raised histidine level in the renal insufficient rats seems to be due to a specific uremic disorder caused by a cerebral disturbance in histidine metabolism.


Relationship between glomerular lesions, serum creatinine and interstitial volume in membrano-proliferative glomerulonephritis. Morphometric investigations in 33 patients suffering from membranoproliferative glomerulonephritis at different grades of glomerular involvement showed that there is no certain relationship between the severity of glomerular lesions and the serum creatinine level. On the other hand there is a significant positive correlation between the relative interstitial volume and the level of serum creatinine. The best congruence (r=+0,87, p less than 0.0001) showed an exponential function y=0.563-e0.049x. We therefore conclude that in membranoproliferative glomerulonephritis which is generally considered to be a glomerular disease, interstitial changes have to be taken into account as a cause of renal insufficiency. Glomerular lesions alone cannot explain the functional impairment. The pathophysiologic factors concerning increased interstitial volume as a cause of renal insufficiency - probably immunologic in origin - are yet to be completely clarified.


Seasonal variation in litter size, bodyweight and sexual maturation in juvenile female house mice (Mus musculus). Over a 4-year period a higher proportion of mated females bore litters during spring and summer than in late autumn and winter. Litter sizes were larger and young female mice weighed more at 21 days of age during spring and summer than at other times. However, young females attained sexual maturity, as indicated by vaginal smears, earlier during the winter months. This contrasts with data indicating that pubertal female mice have lower uterine weights in winter, A multiple regression analysis revealed that mouse bodyweights at 35 days of age and at 1st oestrus were important variables for predicting the age of puberty. Possible factors influencing reproductive seasonality in female house mice maintained under laboratory conditions are discussed.


Treatment of purulent staphylococcal conjunctivitis in rabbits with autogenous vaccine. Autogenous Staphylococcus aureus vaccine produced temporary clinical improvement in 4 cases of conjunctivitis and may have a role where drugs are inappropriate.


Problems of undernutrition research with breeding mice. Rats undernourished throughout pregnancy and lactation lose few young during the suckling period and wean normal size litters of extremely growth-retarded offspring. Comparable treatment of maternal mice, on the other hand, resulted in considerable nestling mortality. Thus few young were reared to weaning and these were not nearly as growth-retarded. Detailed evidence is given of the effects of different schedules of undernutrition throughout pregnancy and lactation on the reproductive performance of mice. These findings are compared with those for rats and possible reasons for the difference in nestling mortality discussed.


Ultrastructure of proliferative ileitis in hamsters (Mesocricetus auratus). The ileum of affected hamsters bore microvilli which were much shorter, less regularly arranged and less densely packed than those from control animals. Organelle derangements such as atrophy of mitochondria, degranulation and dilated cisterna of endoplasmic reticulum, were observed. Some hyperplastic epithelial cells contained multiple intracytoplasmic inclusion bodies and amyloid deposits were present extracellularly.


Relationship between bodyweight and spleen size in guinea-pigs. The normal weight, width, length and area of the guinea-pig spleen and their corresponding relationships to bodyweight were studied. A total of 224 males and 229 females were selected at weights ranging from 150 to 1000 g. Females had significantly larger and heavier spleens than males, but exhibited greater individual variation in spleen weight, width and length. The width and/or length of the spleen presented the smallest coefficients of variation, suggesting the feasibility of using these parameters together with the calculated base line to establish whether a spleen comes from a normal guinea-pig or from an animal having an infection causing splenomegaly.


Sexing mouse pups.

Sexing mouse pups. Data on the early sexing of random-bred albino mice (Mus musculus) is presented. It is shown that accurate sexing of newborn pups cannot be made by anogenital distance measurement unless the proportion of animals falling into the overlap-zones are discarded. However, 8-day-old pups may be sexed by the display of abdominal (inguinal) teats in the females.


Infectious form of Spironucleus (Hexamita) muris: banded cysts. Spironucleus muris is a facultative pathogen which may impair experiments on rodents. During examination of thymus-deficient (nu/nu) mice of Han:NMRI stock which were spontaneously infected with this flagellate, infectious cysts were found in the lower intestine and in the faeces. The disease was reproduced in animals fed these cysts. The observed prepatent time was 2-3 days. The cysts are supposed to be the only infectious form of S. muris. The immature and mature stages, of the cyst with a characteristic banded appearance ('Easter-egg cysts') are described. The description of the cystic form of S. muris in the faeces of infected mice makes possible the diagnosis of spironucleosis without sacrificing the host.


Hydronephrosis in male rats.

Hydronephrosis in male rats. Section of the right internal spermatic artery and vein where they overlie the ureter in Wistar-related male rats suggests that the right hydronephrosis found in these animals is not a consequence of simple obstruction by the blood vessels. The diverse effects of this operation on testicular weight presumably reflect variation in the relative importance of internal and external spermatic blood supply.


High-resolution NMR studies at 270 MHz of alternating poly(gamma-benzyl D-L-glutamate) in double-stranded helical conformations. NMR spectra (270MHz) are presented of strictly alternating poly(gamma-benzyl D-L-glutamate) in dioxane, chloroform, and methylene chloride solutions from which cast films have been demonstrated to have a molecular conformation in the pi pi DL 9.0 and pi pi DL 7.2 double-helical forms. Unusually low chemical shift values are observed for the alpha-CH (approximately 5.5 ppm) and NH (approximately 9.0 ppm) resonances, well separated from those of the alpha and pi DL single helices. The aromatic protons and benzyl-CH2 resonances are found slightly upfield of those of the single helices. It is proposed that these shift values are characteristic of the double helices and that the conformation of the PBD-LG sample in these solvents is the same as in the film obtained therefrom. This conclusion is supported by NMR spectra of a solvent-induced pi pi DL 7.2 leads to pi pi DL 9.0 double helical transconformation and a similar TFA-induced double helix leads to single helix conformational transition.


Unperturbed dimensions of disordered proteins containing an interchain disulfide cross-link. Mean-square unperturbed radii of gyration, (s2)0, have been calculated for several proteins cross-linked via an interchain disulfide bond. Thirty different polypeptide chains were used. Characteristic ratios tend to be smaller for cross-linked proteins than for the uncross-linked chains, although exceptions to this generalization do exist. Random flight statistics tend to overestimate the value of g, defined as the ratio of (s2)0 for the cross-linked protein to (s2)0 for analogous linear polypeptide chain containing the same number of amino acid residues. The parameter fi, defined as the ratio of the (s2)0 for the ith uncross-linked polypeptide chain and the cross-linked protein, is usually more accurately estimated by random flight statistics than is g. When the cross-link connects two chains of identical amino acid sequence, the values of fi obtained via random flight statistics are within 6% of those provided by rotational isomeric state theory.


The great society and health: policies for narrowing the gaps in health status between the poor and the nonpoor. The "Great Society" may be characterized as a loosely knit program of policies for domestic reform, promulgated by the Johnson Administration in adaptation of the general philosophy and strategies of the New Deal, the Fair Deal, and the New Frontier to certain conditions of the middle 1960s. Among these conditions were demographic, social, political, and economic dimensions, both immediate and long term. The program was marked by some diversity in the strategies of reform and in the particulars of implementing legislation, but also by a general underlying view of the state of American society, the requisites for participation in the benefits of the society, and the appropriate role of the federal government in supporting prosperity and assuring freedom.


Mental health and the poor: have the gaps between the poor and the "nonpoor" narrowed in the last decade? Because of the difficulty of measuring mental health status and the lack of systematic and longitudinal data reflecting economic status and mental health, and arbitrary definition is used for this paper: changes in the accessibility to and utilization of psychiatric services by the poor compared with that of the nonpoor will be interpreted as changes in mental health status. Patterns of utilization of mental health facilities in the United States and in Monroe County, New York, by economic variables and/or by race, for periods spanning the Great Society programs, are descirbed. In addition, the location and availability of services provided by community mental health centers since their development are examined. Although these data indicate increased accessibility to facilities by the poor, there continue to be differences in the ways different economic groups use psychiatric facilities. In addition to a discussion of the implications of the findings for service delivery, definitional limitations are cited and additional information needed for making any judgements totward planning future mental health programs are explored.


Unperturbed dimensions for homopolypeptides and sequential copolypeptides cross-linked via a disulfide bond. Rotational isomeric state theory, in the form appropriate for branched molecules, has been used to calculate the mean-square unperturbed radius of gyration, (s2)0, for cross-linked polyglycine, poly(L-alanine), poly(L-proline), poly(L-alanyl-D-alanine), poly(L-propyl-L-prolylglycine), poly(L-prolyl-L-alanylglycine, poly(glycyl-L-alanyl-L-proline), and poly(L-alanyl-L-alanylglycine). The central amino acid residue in each polypeptide chain is replaced by the L-cysteinyl residue involved in cross-link formation. Each cross-linked molecular is considered to contain two trifunctional branch points, the alpha-carbon atoms of the two L-cysteinyl residues. Random flight statistics provide a poor estimate for g, defined as the ratio of (s2)0 for branched and linear polypeptides containing the same number of amino acid residues, for molecules of moderate molecular weight. The values of g obtained by random flight statistics and rotational isomeric state theory merge as the molecular weight becomes infinite. Deviations of g from its random flight value correlate with the size of the characteristic ratio, (s2)0/nplp2, for the linear polypeptides. The number of peptide bonds is np, and lp denotes the distance between neighboring alpha carbon atoms. Random flight statistics perform better in estimating the change in (s2)0 accompanying the cross-linking of the two polypeptide chains than it does in the estimation of g.


Interactions between poly(L-lysine) and chondroitin 6 sulfate. Quasi-elastic light scattering studies. Quasi-elastic laser light scattering studies have shown that large multimolecular aggregates are formed on mixing dilute aqueous solutions of poly(L-lysine) and chondroitin 6-sulfate. For the two components in equimolar residue proportions at a total concentration of 0.178 mg/mL, the aggregates have hydrodynamic radii of 1200 A. Circular dichroism spectroscopy indicates that the polypeptide conformation changes from a coil to the alpha-helix on cooling the solution. This change can be reversed by increasing the temperature; the midpoint for the transition is 47 degrees C. Throughout these changes the size of the aggregates remains approximately constant, and thus the conformational transition detected by circular dichroism occurs within the aggregates, which otherwise remain intact. In addition, changes in ratio of the two components, pH, and ionic strength, affect the size of the aggregates.


Managing change in health care organizations. The forces for change seem more potent today than ever before; increased technological advancement and rapid "societal upheavals" create a more critical need for change and a more significant need for skills to manage and channel change toward meaningful ends. The area of health care delivery is probably one of the fields most impinged upon and most affected by these turbulent times. Organizational development is presented herein as an approach to assist people in health care organizations with the problems of adaptation and change. A specific change strategy, action research, is discussed and a concrete case example is presented to illustrate the ways in which the action research model can be applied. Advantages and pitfalls are discussed in the concluding section.


Using systems performance data for ambulance management. The ambulance service is an important component in the emergency medical system of a community. The availability of performance information on several aspects of the ambulance system may improve ambulance management. The location of new ambulance stations, selection of the destination hospital for urgent cases, scheduling of crew changes, and evaluation of crew performance can be approached through an examination of existing data. Management use of such an information system by the Victorian Civil Ambulance Service in Melbourne, Australia is included in the discussion.


[Formation of an x-ray cinematographic image]. The consideration of the process attending the formation of a roentgenokymographic image enables one to theoretically substantiate the informative characteristics of the roentgenokymographic apparatus, as well as concrete numerical values of the principal parameter of the kymogrid i.e. the dimensions of the slit. In an ordinary roentgenokymograph the slit should equal 0.5 mm, while in a protected one--0.13 mm (in examination of adults) and 0.24 mm (in examination of children).


[Analysis of the basic characteristics of a scintillation gamma-chamber]. The key characteristics of a scintillation gamma-chamber that determine the quality of the obtained radiodiagnostic information are power and spatial resolution and the field of vision diameter. An analysis of these characteristics allowed it to outline the ways for their further improvement, which, within the bounds of the scintillation method of detection, can be achieved through employment of image intensifiers with a system of photomultipliers at the output screen.


[Standardization of the resistance of grounded electrocardiographs with patient circuits ground-insulated to electrical cophase interferences from an external main]. The possibility of simulating conditions for electrocardiographic interferences examination by current and voltage generators is shown. These two models allow it to adopt for appraising the resistance of electrocardiographs to outside cophasic electric interferences any one of the two equivalent parameters, viz. "the equivalent resistance of cophasic interferences" and "coefficient of cophasic rejection". The said parameters represent the relation between the differential value of the interferences voltage at the inlet of the electrocardiograph and the interferences current and interferences voltage of the current generators and of the interverences voltage that produced the former, respectively. The required magnitudes for these parameters have been found, namely less than or equal to 14 Om and 0.5-10(-6) V. For practical purposes it is preferable to use the coefficient of cophasic rejection.


[Effect of voltage errors of an x-ray diagnostic apparatus on the quality of the x-ray image]. The technical suitability of key assemblies in the roentgen unit and the quality of X-ray examinations depend upon a proper choice of permissible voltage setting errors in the X-ray tube. To determine the permissible voltage setting errors in the roentgen apparatus a criterion for the required accuracy of such settings has been suggested and the voltage error in Soviet-made units operating in medical establishments assessed experimentally.


[Problems in the methods and equipment of dielectrography]. An equivalent diagram representing the study sector of the body with non-contact electrodes placed upon it is considered. The relationship between the equivalent parallel circuit capacitance value and changes in the electric conductivity and capacitance of the study tissues is analyzed. Dielectrography enables it to register changes occurring in the active conduction of the body section lying between electrodes, i.e. to watch over the volume of blood filling various tissues and organs. Circuitry variants for registration dielectrograms are proposed. Recordings taken from different body areas are submitted.


[Device for the calibration of x-ray cardiographs with photoelectronic transducers]. A device for calibration (gauging) of roentgenocardiographs carrying a photoelectronic sensor and operating with photo-imitation of X-radiation is described. This method of calibration reduces the irradiation dose received by the attending staff and permits it to easily gauge the devices during their manufacture and adjustment.


[Scintigraphic systems and their evaluation using computers]. A comparative characteristics of modern scintillation chambers manufactured by different firms is given. Basic parameters of the chambers and the methods of their appraisal effected by using computer technique are considered and results obtained by comparing major parameters of three chamber models ("Fo-Gamma III HP", "Fo-Gamma LFOV" and "Daina-2C") through experimental procedures by following a chosen method are presented. The authors come to the conclusion that the use of computer technique tends to greatly facilitate the procedure of the chambers' control and increases the significance and reliability of the scintigraphic findings.


[Photocinematography of moving objects utilizing pulsed and continuous x-ray radiation]. The paper described advantages of pulsed X-radiation over the continuous one. Experimental technique employed with a roentgen-diagnostic unit is depicted. It is shown that the use of pulsed X-radiation helps to substantially cut down the radiation load on the physician and the patient and to heighten the resolution of the moving organs image.


[Systems approach to the development of equipment provision for roentgenological research]. A systemic approach to the X-ray out fits allowed 3 levels of the roentgen-diagnostic process to be singled out, viz. the lower with the data the data "normally--anormality", the medium, with a tentative conclusion and the highest, with an authentic diagnosis at the output end. The levels may be characterized by formulas reflecting the number of inputs, processes (methods) and outputs. The optimal roentgenological facilities should be in keeping with the diagnostic levels formulas. The prospects for improving the facilities involve a systemic approach to the development of equipment and an integration on this basis of the investigation methods, both horizontally (within the framework of roentgenology) and vertically (outside roentgenology).


Toxin isolation from a Kanagawa-phenomenon negative strain of Vibrio parahaemolyticus. Production of a toxin by Vibrio parahaemolyticus Kanagawa-phenomenon negative strains was examined. Ammonium sulfate fractions of broth culture filtrates were dialyzed, concentrated by lyophilization, and tested for toxic effects by mouse intraperitoneal injection. One fraction, which we think is a toxin, was isolated from a broth culture filtrate of V. parahaemolyticus FC 1011 (a Kanagawa-phenomenon negative strain) and consitently produced lethal effects in mice at high concentrations and diarrhea in lower concentrations. The toxin was assayed for mouse LD50 and ability to produce diarrhea via forced feeding in mice. V. parahaemolyticus FC 1011 toxin was found to be protein, to be inactivated by heat or trypsin hydrolysis, and to produce positive skin permeability reactions in rabbits. However, it failed to induce fluid accumulation in ligated ileal loops in rabbits.


Gastric acid secretion in chronic atrophic gastritis and chronic (superficial) gastritis. Basal and pentagastrin-stimulated peak acid outputs were determined in 21 subjects with chronic atrophic gastritis and 10 subjects with chronic superficial gastritis. All subjects were Caucasian. The histological diagnosis was based on multiple gastric biopsy specimens obtained through a fibregastroscope. Comparison of the results with those of a previously reported Caucasian control group show that the mean basal acid outputs of subjects with chronic (superficial) gastritis were significantly higher than that of controls and subjects with chronic atrophic gastritis. No significant difference was found in the mean peak acid outputs of controls and subjects with chronic atrophic gastritis or chronic (superficial) gastritis.


Vasectomy: a simple postoperative regimen. Five hundred men have been followed up for 12 to 15 months after vasectomy. A simple postoperative regimen for confirmation of sterility has proved to be reliable. This comprised examination of a single fresh seminal specimen after 10 ejaculations, non-motile sperm being disregarded and the test being repeated only in those rare cases in which motile sperm were found. Sterility was demonstrated for 26% of men within four weeks of operation, and for 69% of them within eight weeks.


Hospital costs--the medical student component. A study of indirect costs which could be attributed to undergraduate teaching in a large affiliated teaching hospital has shown that they are very small. Thus direct university costs in 1975 were $1,800,000 (7-6% of all expenditure at the hospital); indirect costs were $41,000 (approximately 0-2% of the hospital expenditure). It is concluded that the 45% difference in bed costs per day between teaching and non-teaching hospitals from a previous investigation is therefore not the result of the clinical school indirect demands on hospital expenditure.


Plasmapheresis in Goodpasture's syndrome with renal failure. Four patients who presented with severe proliferative glomerulonephritis associated with linear deposition of IgG on the basement membrane have been treated by intermittent massive plasmapheresis. Two patients had all the features of Goodpasture's syndrome. In the other two cases, the characteristic renal lesion was present but there was no pulmonary involvement. In all cases, renal function improved after plasmapheresis while in two, renal function deteriorated after plasmapheresis was stopped. On of these patients responded to a second course of plasmapheresis but failed to respond to a third. This study supports previous reports of the value of plasmapheresis in patients with Goodpasture's syndrome and renal failure in whom recovery without plasmapheresis has not been recorded. The present study emphasizes the importance of continuing treatment for a period of weeks to permit prolonged remission. If treatment is withdrawn too early, rapid deterioration in renal function may result, and unless plasmapheresis is recommenced at once the renal failure may then prove irreversible.


Phenacetin and analgesic nephropathy.

Phenacetin and analgesic nephropathy. A prospective survey of 322 autopsies of adults conducted some months after phenacetin was removed from a popular compound analgesic showed to reduction in the incidence of advanced or earlier forms of analgesic nephropathy from levels noted in an earlier survey. Apparently active nephropathy was seen in persons taking two different compound analgesics, neither now containing phenacetin. Crystals observed in early and intermediate analgesic nephropathy had no diagnostic significance and represented a tissue breakdown product.


Urinary tract infections in childhood: the place of the nitrite test. The effectiveness of the nitrite test available on the N-Multistix (Ames Co.) was compared with that of the microscopic examination of urine as a screening test for the detection of urinary tract infections in children presenting to a general paediatric clinic. The nitrite test gave a positive result in 59% of children with urinary infections, while microscopic pyuria (more than 50 white blood cells per cubic millimetre of uncentrifuged urine) was found in 72% of the same group. Of children who did not have a urinary tract infection, 2.8% had microscopic pyuria compared with only 0.2% who showed a false-positive nitrite test result. The ease and rapidity of the nitrite test make it a useful screening test for the presumptive diagnosis of urinary tract infections, and in certain circumstances it is preferable to the conventional microscopic examination of urine. However, as in the case of microscopic examination, urine culture must always be performed to avoid missing the urinary infections that are not detected by the screening test.


Wound infections in Australia from halophilic vibrios. Halophilic vibrios were isolated from extra-intestinal sites of two patients. The organisms isolated, both apparently of marine origin, were probably pathogenic at their respective sites. It is suggested that extra-intestinal infection caused by halophilic vibrios may be more common than reported, and may be more easily demonstrated by the use of the Analytab Products Inc. (AIP) system.


Cystic fibrosis screening by sweat analysis: a critical review of techniques. Currently employed methods for the assay of electrolytes in sweat, relevant to the diagnosis of cystic fibrosis, are critically evaluated with particular reference to the measurement of electrical conductivity. Attention is drawn to the factors responsible for potentially large errors. On the basis of experimentation, supported by laboratory practice, recommendations are made for the reduction of these errors to clinically acceptable levels. Data concerning sodium and potassium content, electrical conductivity and osmolality of undiluted sweat collections are compared. The feasibility and comparative advantages of measuring sweat osmolality with a vapour pressure osmometer are discussed.


Recurrent venous thrombosis (thrombophlebitis migrans) and carcinoma of the lung. A case of thrombopheblitis migrans associated with a poorly differentiated adenocarcinoma of the lung is presented. The patient died of a massive pulmonary embolus despite anticoagulant therapy. Disordered fibrinolysis may be the cause of the clotting tendency in this condition.


Factors affecting aboriginal nutrition.

Factors affecting aboriginal nutrition. A description of the past and present mode of living of Aboriginals in the Northern Territory is followed by information on sources of food. Other factors which have affected the nutritional situation are described. The article concludes with a discussion on the philosophical and socioeconomic aspects of improving Aboriginal nutrition.


Aboriginal children in hospital.

Aboriginal children in hospital. In 1974 there were 932 admissions of 624 Aboriginal infants and children to the Princess Margaret Hospital, Perth, where they were treated for a period of 10,952 bed days. More than 50% of the patients were malnourished and many were anaemic. Most admissions were for nutritional and related disorders, especially chronic and recurrent infections of the respiratory and gastrointestinal tracts and the skin. The average stay in hospital was 12 days, approximately double that for non-Aboriginal children. There were six deaths, mostly in infants with overwhelming infections. These findings indicate the need for at least maintaining programmes aimed at improving the health and nutritional standards of young Australian Aborigines.


The weights of aboriginal infants: a comparison over 20 years. At Cherbourg Aboriginal Settlement the weight gains of infants remained at a constant level below the Australian average from 1953 to 1972. During this period the infant death rate decreased from about 28 per 1,000 live births to about 40 per 1,000 live births. At Palm Island Settlement the death rates have remained high and the growth rates low. The pattern at Cherbourg suggests that the people at Cherbourg have learnt how to use appropriately the hospital and health services, but have not yet made any major changes in the standards of infant care.


Social unrest in an aboriginal community. Social unrest among Aboriginals of western Australian deserts, who are now congregated in settlements, is discussed with particular reference to fighting and alcoholism. While recent administrative changes are seen as desirable in the long term, over the short term they appear to increase unrest by bringing out a conflict between the old, traditional, ways and the new. How this happens is discussed in some detail and tentative suggestions aimed at minimizing it are made.


Employment problems among tribal aboriginals. Despite financial encouragement to desert Aboriginal communities, only a small proportion of persons have been persuaded to adopt a Western work style. Some of the Aboriginal attitudes to work and the differing implications of work for black and white people are described. These differences are particularly marked in the areas of motivation, social implications of work, such as status, acquisition of money, and uses to which money can be put. Higher levels of skill are also affected by differing ideas of group conformity, individual excellence, and, to some extent, traditional philosophical concepts. Some of the defects in higher levels of performance may be developmental rather that attitudinal, arising from a radically different childhood environment. It is maintained that understanding work problems from the Aboriginal's point of view may help to circumvent some of them, but radical change, if it comes at all, must come from within their community by their own modification of traditional attitudes.


Aspirin, phenacetin, and the kidney: a rheumatism clinic study. In a rheumatism clinic study in Brisbane, the consumption of aspirin and phenacetin compounds (APC) containing more than one kilogram of aspirin and phenacetin was significantly associated with overt renal papillary necrosis (RPN) and with a renal score, but when more than one kilogram of aspirin was taken without phenacetin there was no such association. Analysis and comparison with the parallel New Zealand study showed an overall risk of RPN of at least 10-6% when more than one kilogram of aspirin was taken in APC form, and 0-3% when aspirin was taken without phenacetin. An additive interaction of phenacetin and aspirin is postulated. It is concluded that phenacetin use should be severely restricted.


A kindred with red cell pyruvate kinase deficiency. A case is described of mild haemolytic anaemia in a female homozygous for pyruvate kinase deficiency, with 20% of normal enzyme activity and with the unexplained associations that she suffers from angina pectoris and that three of her children died in childhood from a muscular dystrophy presumed to be Werdnig-Hoffman disease.


A case of chancroid.

A case of chancroid. After a visit to Hong Kong, a 27-year-old salesman developed penile ulceration which failed to respond to three weeks' penicillin therapy. He then presented to hospital with acute paraphimosis. A clinical diagnosis of chancroid was confirmed by isolation of Haemophilus ducreyi. The ulcers healed after sulphonamide and streptomycin therapy. Although chancroid is an uncommon venereal disease in Australia, its incidence is still high in many tropical countries. It should be considered as a possible cause of genital ulceration in patients who have travelled overseas.


Student health team project at the Wayside Chapel. The student health teams were organized by the Australian Medical Students Association (AMSA) as the means of student involvement in community health projects. In July, 1976, at the Wayside Chapel several student health teams each consisting of a medical student, a nursing student, and a student social worker, began a friendly, non-judgemental "first aid" service for street people with health problems. The project lasted 12 weeks and aid was given to 76 people. An evaluation of the project appears below.


[Evaluation of a pyridopyridazine as a drug with marked antihypertensive properties (author's transl)]. Compound BQ 22-708 is a pyridopyridazine with marked antihypertensive effects on experimentally induced hypertension. At this study hemodynamic reactions were controlled in 5 patients with resistent hypertension, two of them with the complication of hypertensive, two of them with the complication of hypertensive crisis, after oral administration of a mean dose of 11 mg BQ 22-708 (range 5 to 15 mg). Mean arterial pressure was reduced by 40 mm Hg. The onset of drug activity occurred 10 to 20 minutes after application. Maximum was reached after 90 to 180 minutes, whereas the antihypertensive effect lasted for about 5 to 6 hours. Peripheral resistance was reduced by about 50%. Heart rate and cardiac output increased. In patients with normal cardiac function stroke volume remained constant, whereas in patients with heart insufficiency an increase occurred. BQ 22-708 led to a slight reduction in pulmonary artery pressure and pulmonary capillary wedge pressure. Right atrial mean pressure remained unchanged. Additional treatment with a beta-adrenergic-blocking-agent or a drug with Ca-antagonistic-activities is indicated for inhibition of BQ-related increase of heart-rate.


[The influence of the new beta sympathicolytic agent carazolol on sympathicotonic false regulation (author's transl)]. In 18 patients with tachycardia at rest the effect of treatment with the beta sympathicolytic agent Carazolol was investigated, using Schellong's test, venous occlusion plethysmography, ECG and a questionaire evaluating concomitant effects. A significant reduction in heart rate (about 20 percent) as well as a decrease in systolic blood pressure were observed. No further therapeutical effect was seen during long term treatment. There wer no significant influences on venous occlusion plethysmography and ECG. The patients reported a considerable improvement of their heart complaints.


[Sclerosing peritonitis and practolol (author's transl)]. Skin manifestations, eye complications, a nephrotic syndrome, appearance of lupus erythematosus cells and antinuclear antibodies, sometimes combined with a systemic side effects of the beta adrenergic blocker Practolol. Another side effect is though to be sclerosing peritonitis. The latter is identical with the idiopathic fibroplastic peritonitis, described at the turn of this fibroplastic peritonitis, described at the turn of this century by German authors. Our own observation of a case of sclerosing peritonitis is compared with the literature. There is strong evidence for a causal relationship between longstanding Practolol-therapy and sclerosing peritonitis. Practolol was withdrawn from the market in 1975.


[Diagnosis and therapy of esophageal webs (author's transl)]. Esophageal webs are thin, eccentric stenoses of the lumen, which are easily detected and treated by endoscopy. This is illustrated by a case report of a lower esophageal web.


[Atrophic gastritis (author's transl)].

[Atrophic gastritis (author's transl)]. Gastroscopy was performed in 543 patients with an average of 52.8 years. Of these patients 248 had atrophic gastritis. In over one third of the 248 patients the gastritis inclosed the entire mucosa. In the remaining patients the antrum was most frequently inclosed. In a higher age group more extensive involvement was found. Males had a significantly higher association with alcohol and tobacco abuse (73.0 and 73.7%) as compared to females (20.8 and 13.5%). Out of 21 patients in the group under 30 years all but one were males, probably because of higher alcohol and tobacco abuse in males. It is recommended, that periodic gastroscopic examinations with biopsies be performed in these patients since a significant portion of patients with atrophic gastritis develop gastric carcinoma.


[The histo-morphologic patterns of cholestatic hepatosis (author's transl)]. Histologic liver examinations performed in 500 autopsies showed 32 times the incidence of cholestatic hepatosis. Males are affected more commonly than females as our statistic indicates. Furthermore it was shown that chronic alcoholism seems to be a more aggravating cause for hepatosis than a long term treatment with psychopharmacologic drugs. No correlation however was found between the extent of cholestasis and morphologic alterations (inflammation, fatty degeneration, iron storage and necrosis).


Mitochondrial genes in Podospora anserina: recombination and linkage. A fifth cytoplasmic mutation (capr 1) obtained in Podospora anserina is described. In addition to chloramphenicol resistance it confers a strong deficiency in cytochrome aa3 and impairs the germination of ascospores. Genetic analysis shows: 1) strict maternal inheritance of (capr 1) allele; 2) selection against the (capr 1) allele as well in sexual crosses as during vegetative growth; 3) complete reversion of this selection by even low concentration of CAP. On the basis of their cytoplasmic inheritance and altered cytochrome spectra the five cytoplasmic mutations are assumed to be mitochondrial. Analysis of crosses between them allows to class them in 3 loci, 2 of which being closely linked.


Inhibitors of mitochondrial function prevent senescence in the ascomycete Podosprora anserina. The onset of senescence, i.e. decrease of growth rate followed by cellular death, is prevented when inhibitors of mitochondrial function (ethidium-bromide, streptomycin, tiamulin) are present in the culture medium. If mycelia are transferred to a medium not containing one of these substances, senescence occurs after the usual time interval (30 d at 26 degrees C). Inhibitors of cytoplasmic protein synthesis such as emetine and cycloheximide have no effect in preventing senescence.


Characterization of glycerol nonutilizing and protoperithecial mutants of Neurospora. Mutants defective in polyol metabolism and/or in protoperithecial development were selected in Neurospora tetrasperma, a species in which protoperithecial development occurs at nonpermissively high temperature if certain polyols are used in lieu of sucrose as carbon source. Mutants selected for nonutilization of one of the four polyols tested, glycerol, mannitol, sorbitol, or xylitol, were usually found to be nonutilizers of the other three polyols as well. Mutants blocked at various stages of protoperithecial development complemented pairwise to produce more advanced developmental stages, usually mature protoperithecia and, when of opposite mating type, mature perithecia. About one-third of the mutants manifested both polyol auxotrophy and defective protoperithecial development upon initial isolation, but protoperithecial defectiveness in such mutants usually showed erratic segregation in crosses and/or instability to repeated vegetative transfer, whereas polyol auxotrophy usually did not and was, therefore, studied further. Two glycerol nonutilizing strains were introgressed into N. crassa to facilitate genetic analysis. One, glp-4, lacked both inducible and constitutive glycerol kinase and mapped to linkage group VI, between ad-1 and rib-1; the other, glp-5, lacked glyceraldehyde kinase and mapped to linkage group I, proximal to ad-9. Another mutant, gly-u(234), has been reported by other investigators to lack inducible glycerol kinase but to map to linkage group I, distal to ad-9.


A selection procedure for obtaining conditional gametogenic mutants using a photosynthetically incompetent strain of Chlamydomonas reinhardi. A new selection procedure has beed developed for the isolation of temperature sensitive gametogenic mutants in Chlamydomonas reinhardi. This technique makes use of pet-10-1, a mutant strain incapable of photosynthetic electron transport, and the redox dye, methyl viologen. Two mutants found by this method are discussed. The first, gam-4, does not agglutinate at 35 degrees, whereas the second, gam-5, is capable of sexual agglutination, but not of zygote formation at the restrictive temperature. Both mutants appear to be inherited in a Mendelian fashion and are expressed in mating type (+) and mating type (-).


Dose any enzyme follow the Michaelis-Menten equation? A literature search has been conducted to see to what extent steady-state kinetics studies in the period 1965-1976 have revealed deviations from Michaelis-Menten kinetics. It was found that over 800 enzymes have been reported as giving complex curves for a variety of reasons and a group by group classification of all these enzymes has been carried out listing all the types of variations reported and the authors' explanations. In addition, for highly complex curves, we have determined the minimum degree of the rate equation. There were very few determined attempts to demonstrate adherence to the Michaelis-Menten equation over a wide variety of experimental conditions and substrate concentration and almost invariably detailed experimental work revealed unsuspected complexities. For these reasons, it is concluded that the assumption that most enzymes follow the Michaelis-Menten equation can not be supported by an appeal to the literature.


Myo-inositol dehydrogenase(s) from Acetomonas oxydans. Experimental studies have been undertaken with a view of isolation of the enzyme(s) responsible for the stereospecific oxidation of myo-inositol. A partial fractionation has been achieved and the properties of this extract examined. Results show that the active enzyme may well have a cytochrome component and there is indication that the stereospecificity of Acetomonas oxydans results from permease as opposed to dehydrogenase activity. Kinetic experiments suggest that only one type of active enzyme site is involved in the dehydrogenation of myo-inositol.


Interactions of lanthanum with purified and intact cell acetylcholinesterase of Electrophorus electricus. The effects of lanthanum on the activity of purified preparations of acetylcholinesterase (AChE) from the electric organ of E. electricus and on the activity of AChE in intact electroplaques from the same species were studied. 0.1 mM LaCl3 produced an initial inhibition of purified AChE which was followed by a delayed activation of the enzyme. Upon pretreatment of purified enzyme with LaCl3, initial activity was markedly increased. LaCl3 exerted a marked, concentration-dependent inhibition of intact cell AChE. La3+ and Ca2+ appear to interact competitively. In the presence of both 10 mM CaCl2 and 0.1 mM LaCl3, the initial activitity of purified AChE was increased at lower ACh concentrations and inhibited at ACh concentrations greater than 3 X 10(-4) M. Inhibition of intact cell enzyme by 0.1 mM LaCl3 was relieved by increasing the CaCl2 concentration to 10 mM at ACh concentrations less than 2 X 10(-4) M. The data were analyzed assuming Michaelis-Menten kinetics and interpreted with reference to the differential binding of divalent and trivalent cations to regulatory anionic sites which are separate and distinct from the anionic site of the active center of the enzyme.


Protein synthesis in resting and stimulated human lymphocytes. The ribosomal profiles in lysates from resting and phytohemagglutinin stimulated human lymphocytes have been analyzed by sucrose gradient centrifugation. The percentage of polyribosomes increased during lymphocyte transformation reaching a maximal value of 60 to 70% of the total ribosomes after 72 hours of mitogen addition. This time period coincides with maximal in vivo protein synthesis. On the other hand, in nonstimulated lymphocytes, about 25% of the ribosomal particles appeared as aggregates, independently of the incubation period. Experiments performed with homologous cell free systems containing ribosomes and supernatant fluids prepared from unstimulated or activated lymphocytes demonstrate that the mixtures containing both components from stimulated lymphocytes are several fold more active in polypeptide synthesis than the systems which contain ribosomal particles and cell sap from resting cells. Assays carried out with mixtures combining the components from both sources indicate that the increased activity depends on ribosomes as well as on the supernatant fractions.


Synthesis of dolichol derivatives in human erythrocyte membranes. Human erythrocyte membranes contain the enzymes responsible for the synthesis of dolichol-P-glucose, dolichol-P-mannose, dolichol-PP-N-acetylglucosamine, dolichol-PP-NN' diacetylchitobiose and of dolichol-PP-oligosaccharides containing NN' diacetylchitobiose and mannose or the same sugar residues plus glucose. The transfer of the oligosaccharide moieties from the dolichol-PP-oligosaccharides to endogenous proteins could not be detected. These enzymes appeared to be integral membrane proteins.


Glycosylation of endogenous protein(s) of the rough and smooth microsomes by a lipid sugar intermediate. Several problems regarding the protein acceptor of the oligosaccharide from GEA (glucosylated endogenous acceptor) were investigated in the present work using rat liver microsomal subfractions. It was found that the acceptor molecule is present in rough and smooth liver microsomes. Furthermore both fractions have closely similar specific activities. The problem of whether nascent peptides must be ribosome bound for glycosylation to occur was studied. The results suggests that binding of peptides to ribosomes is not a necessary condition for the transfer of GEA oligosaccharide to protein. The increase in specific activity found after partial release of the microsomal vesicular content suggests that the acceptor protein for GEA is membrane bound. Evidence obtained in attempting to elucidate whether nascent or completed chains are glycosylated favours the later possibility.


Synthesis of a compound soluble in organic solvents from deoxycytidine triphosphate in permeabilized normal human lymphocytes. Normal human lymphocytes may be rendered permeable to deoxynucleoside triphosphates. When [3H]dCTP is furnished to permeabilized lymphocytes tow compounds are formed: DNA and a compound soluble in organic solvents. [3H]dCTP incorporation is higher in stimulated lymphocytes than in unstimulated cells. Some characteristics of the system are reported.


Porphyrin biosynthesis from prophobilinogen by duck blood hemolysate. The formation of porphyrins from porphobilinogen by a duck blood hemolysate was examined. The system was found to form mainly protoporphyrin IX and hemin, and accumulated lesser amounts of uroporphyrins, hepatacarboxylic porphyrin, and coproporphyrins. By storage at -20 degrees the accumulation of uroporphyrins and heptacarboxylic porphyrin was increased. Both porphyrins were mainly the type III isomers. By addition of dithiothreitol the porphyrin pattern reversed to the original one formed by the fresh hemolysate. Addition of a number of amines also inhibited the decarboxylating system without affecting the original isomer distribution among the porphyrins. Addition of Fe2+ (3mM) did not affect the porphyrin pattern or the isomer distribution. Addition of Pb2+ (2.5 mM) partially inhibited the decarboxylating system, whereas at higher concentrations (4 mM) it increased the decarboxylation rate of the heptacarboxylic porphyrin. The obtained results are discussed in relation to porphyrin accumulation in porphyria cutanea tarda and in acquired hepatic porphyrias.


A lipid linked oligosaccharide which contains hexosamine, mannose and glucose. Previous work showed that liver microsomes catalyze the transfer of glucose from dolichol monophosphate glucose to an endogenous acceptor believed to be a dolichol pyrophosphate derivative of an oligosaccharide. This oligosaccharide has now been prepared on a larger scale so as to permit the determination of its sugars. The purification procedure includes, as a last step, a thin layer chromatography on kieselguhr-silica gel to obviate glucose-containing contaminants. After complete hydrolysis mannose, glucose and a small amount of hexosamine were detected.


Synthesis of polyprenol-monophosphate- beta -galactose by acetobacter xylinum. A particulate enzyme preparation from Acetobacter xylinum synthesizes ficaprenol-monophosphate-beta-galactose from ficaprenol monophosphate (FMP) and UDP-galactose in the presence of detergent. The product has the same properties as those previously reported for the compound formed with the endogenous acceptor. Dolichol-monophosphate (DolMP) is also a good galactose acceptor but the product obtained has different properties. Lipid extracts from Acetobacter contain galactose acceptor capacity which is lost by mild acid treatment. FMP behaves in a similar manner but DolMP is resistant to this treatment. It is concluded that the endogeneous acceptor is an allylic phosphate ester of a polyprenol.


Diabetes-induced alteration in subcellular distribution of poly(A)-rich RNA from skeletal muscle. Skeletal muscle ribosome preparations from diabetic rats have lower polysome content than those from normal animals. The ratio of poly(A) containing RNA between polysomes and postribosomal supernatant has been measured both in normal and diabetic rats. The results suggest that in diabetic animals there is a greater proportion of free poly(A) containing RNA, in postribosomal supernatant.


Binding of estradiol receptor complexes to isolated human breast chromatin. The interaction of estradiol-receptor complexes and isolated human breast tumor chromatin was studied under equilibrium conditions. The estradiol-receptor complexes bound specifically to the chromatin of hormone dependent tumors and showed a single class of binding sites with a Ka of 0.96 X 10(10) M-1 and a binding capacity of 1.5 pmoles/mg DNA. The binding was a temperature-dependent process and involved a "transformation" of the receptor protein. The heat-activated hormone-receptor complex was more active than the 8S form in the binding phenomenon. The specific interaction of estradiol-receptor complex with isolated chromatin was saturable and sensitive to conditions of temperature and ionic strength. Furthermore under optimal conditions no acceptor sites were detected in chromatin of hormone independent tumors.


Lectin activity of chromatin non-histone proteins. Non-histone proteins from chromatin of sea urchin embryos were found to possess the ability to agglutinate erythrocytes.


Template active chromatin structures: degradation by deoxyribonuclease I. Chicken embryos were pulse-labelled in vivo with [3H]uridine (10 min), the chromatin isolated and treated with DNAse I. The residual chromatin was separated from the degradation products by centrifugation. The nascent pulse-labelled RNA is completely recovered in the residual chromatin even after prolonged incubation with DNAase I, whereas the DNA is completely degraded to 80 base polynucleotide fragments and smaller fragments.


Detection of methyltransferase activities which modify Gppp G to m7GpppGm in embryonic chick lens. GpppG was modified to m7 GpppGm by a cytoplasmic extract, prepared from embryonic lens cells, in a reaction mixture which contained S-adenosyl-methionine as methyl group donor. The appearance of m7 GpppGm was a function of time and lens extract concentration. S-adenosyl-homocysteine inhibited both the m7G and Gm modification reactions. Analogues of GpppG, pG, ppG and pppG were relatively ineffective as substrates.


Comparison of the protein content of free and membrane-bound rat liver polysomes and of the derived subunits. Ribosomal proteins from pure free and membrane-bound rat liver polysomes were analyzed with a highly resolutive two-dimensional gel electrophoresis technique, using sodium dodecyl sulfate in the second dimension. Three acidic proteins found in free polysomes were always absent from the membrane-bound polysomes. Their molecular weights were estimated to be 20 000, 19 500 and 18 500. When free ribosomes were dissociated into subunits, the three protein spots were still found in the 60S subunit pattern, but they were weaker than in polysomes. A possible involvement of these three proteins in the attachment of ribosomal structures to the membranes is proposed.


Denaturation of mouse satellite and ribosomal DNA during hydroxyapatite thermal chromatography of chromatin. Mouse DNA and chromatin were melted on hydroxyapatite and the denaturation profiles of ribosomal and satellite DNAs were followed by hybridization with their complementary RNAs. Neither ribosomal nor bulk DNA had significantly different melting profiles in chromatin as compared to DNA. However, most of satellite DNA eluted at higher temperature from chromatin than from purified DNA. One explaination for the higher melting temperature of mouse satellite DNA in chromatin suggests that the complex between this particular DNA component and at least some proteins in chromatin is more stable than the average DNA-protein interaction.


Oral choline administration to patients with tardive dyskinesia. We gave pharmacologic doses of choline to patients with tardive dyskinesia in an attempt to suppress involuntary facial movements. Choline is the physiologic precursor of acetylcholine, and its administration elevates brain acetylcholine levels in laboratory animals and, possibly, in human beings. Hence, we thought that its use could benefit patients with diseases like tardive dyskinesia, which is believed to result from deficient central cholinergic tone. Twenty patients with stable baccal-lingual-masticatory movements took oral doses of choline for two weeks according to a double-blind crossover protocol. Plasma choline levels rose from 12.4 +/- 1.0 to 33.5 +/- 2.5 nmol per milliliter (mean +/- S.E.M.; P less than 0.001) during this period. Choreic movements decreased in nine patients, worsened in one and were unchanged in 10. Thus, oral doses of choline can be useful in neurologic diseases in which an increase in acetylcholine release is desired.


Adverse effects on offspring of maternal alcohol abuse during pregnancy. To evaluate the risk of offspring of heavy drinking during pregnancy, we administered a questionnaire to 633 women at the first prenatal visit. Nutritional status, smoking, drug and alcohol use were determined. Women were classified into three groups: abstinent and rare drinkers; moderate drinkers; and heavy drinkers. After delivery, detailed pediatric, neurologic and developmental examinations were administered by a physician without prior knowledge of any history. Infants born to heavy drinkers had twice the risk of abnormality of those born to abstinent or moderate drinkers (P less than 0.001). Thirty-two per cent of infants born to heavy drinkers demonstrated congenital anomalies, as compared to 9 per cent in the abstinent and 14 per cent in the moderate group (P less than 0.001). Microcephaly and multiple congenital anomalies were much more frequent in this group (P less than 0.001). Heavy drinking during pregnancy increases the risk to offspring.


Violent death in a metropolitan county. Changing patterns in homicide (1958-74). Analysis of homicide patterns in Cuyahoga County, Ohio (metropolitan Cleveland), for 1958-1974 discloses the following major trends: a dramatic rise in overall homicide rates in the city (320 per cent) and suburbs (200 per cent); an increase in justifiable homicide; a doubling of the percentage of homicides incident to other felonies; a markedly increased incidence of homicide among younger persons; a conspicuous rise in firearm killings (now 81 per cent of all homicides); and a continued preponderance of intraracial homicide, with the highest rates among nonwhite males in the city. The trends in Cuyahoga County are consistent with those in other United States metropolitan counties. Homicide is responsible for a major part of the decreased life expectancy among young, urban, non-white men. The factor most consistently associated with these trends is the increased use of handguns.


Mortality among patients with ankylosing spondylitis not given X-ray therapy. We investigated age-specific mortality rates of 836 patients with ankylosing spondylitis diagnosed during 1935-57. These patients were not given deep x-ray therapy, and thus their mortality was not confounded by possible late effects of radiation. Follow-up observation was to January 1, 1968--on the average, over 13 years from enrollment. Men had higher mortality than women; excess mortality was observed in men for diseases known to be associated with spondylitis, such as ulcerative colitis, nephritis and tuberculosis or other respiratory disease. In addition, their mortality risk relative to the general male population was fourfold for all gastrointestinal disease, nearly twofold for accidents, suicide and cerebrovascular disease and 40 per cent in excess for other circulatory diseases. These results indicate that, at least in men, ankylosing spondylitis has life-threatening consequences related to many organ systems, consistent with systemic vascular degeneration as one long-term consequence of the disease.


Fetal loss, twinning and birth weight after oral-contraceptive use. To evaluate the effect of oral-contraceptive use on subsequent offspring, I reviewed information on the pregnancies of 19,887 women who indicated, in response to a mail questionnaire, that they had used oral contraceptives. The rates of spontaneous abortion and stillbirth were smaller for former users than for nonusers--a finding consistent with previous studies. Twinning was more frequent among births of infants conceived soon after cessation of oral contraceptives, the rate being approximately twice the expected value for women who had used oral contraceptives for more than six months (P = 0.1). The sex distribution of the twins indicated that the increase was mainly in dizygous twins (P = 0.02), in accordance with predictions about increased twinning after cessation of oral contraceptive use. No relation was evident between oral contraceptive use and birth weight.


Lateral mobility of human erythrocyte integral membrane proteins. Fluorescein isothiocyanate-labelled integral membrane proteins are mobile in the membranes of human erythrocytes that have fused (and haemolysed) by Sendai virus or polyethylene glycol. Minimum diffusion coefficients are of the order of 10(-11) cm2 s-1 at 37 degrees C. This mobility is reduced several-fold at room temperature, not detected at 0 degrees C, and is significantly greater in fresh than in aged blood. Mobility was assessed by observing the spread of fluorescence on labelled cells which had been fused with unlabelled cells; neither intramembrane particle aggregation nor spectrin release occurred during this process.


Complement fixation test of Nebraska calf diarrhea virus with calf serum. A complement fixation (CF) test for neonatal calf diarrhea has been developed with Nebraska calf diarrhea virus (NCDV) as antigen. The CF antigenicity of NCDV appeared in BK cell cultures for the first time 3 days after inoculation. Usually, the unconcentrated BK cell culture fluid infected with NCDV possessed poor CF antigenicity. The fluid concentrated by ultracentrifugation and ultrafiltration and with polyethylene glycol 6000 revealed a high-titered CF antigenicity to antiserum against NCDV. The antigen was not sensitive to lipid solvents, but was relatively resistant to heating. It was recognized that the concentrated fluid of cell culture infected with NCDV was available as antigen in the CF test for the serological demonstration of infection with a calf reovirus-like agent. The wide prevalence of diarrhea among Japanese calves with the calf reovirus-like agent was revealed from the results of CF and neutralization tests of NCDV.


Effect of indomethacin on the synthesis of glomerular basement membrane and on proteinuria in rats with nephrotoxic nephritis. The effect of indomethacin on protein excretion and on the synthesis of glomerular basement membrane (GBM) was studied during various stages of nephrotoxic nephritis (NTN) in the rat. Daily administration of indomethacin (4 mg/kg) was instituted 1, 6, or 21 days after the induction of NTN with 210, 240, or 268 microgram kidney-fixing antibodies (KFAb). Proteinuria in rats with nephritis induced by 210 microgram KFAb decreased under treatment with indomethacin regardless of the day on which treatment was started but was not affected by indomethacin in rats with clinically more severe nephritis induced with higher doses of KFAb. GBM synthesis was measured in vivo and in vitro by determination of the incorporation of 3H-proline into the GBM. NTN rats treated with indomethacin showed increased GBM synthesis early in the course of NTN, over and above an already increased synthesis. In the later phase of NTN indomethacin treatment did not affect GBM synthesis. The absence of a relationship between the effect of indomethacin on proteinuria and its effect on GBM synthesis clearly shows that the reduction of protein excretion occurring under indomethacin treatment is not mediated by alterations in the rate of GBM synthesis.


A method of continuous renal capillary microperfusions of the same area at different solute concentrations. The microperfusion pump described in this paper allows to perfuse the same peritubular capillary area on the renal surface with different test solutions. Solutions can be changed by means of a microcannula inside the pump which for this purpose can be moved near to the tip of the pipette. Concentration effect relations of various agents may thus be obtained on the single nephron level in vivo. This is illustrated on the example of the inhibitory effect of acetazolamide on proximal tubular reabsorption. Inhibition of this tubular function has been assessed by means of repeated determinations of split droplet half times.


Activities of intestinal enzymes in experimental chronic renal insufficiency. Rats with chronic uremia following five-sixths nephrectomy showed a significant fall in the sucrase and maltase activities in the small intestinal mucosa, the lactase and cellobiase activities in contrast remained uninfluenced. The activity of the L-leucyl-L-proline and L-methionyl-L-proline dipeptidases in the small intestinal mucosa was significantly increased, while the activities of seven other dipeptidases studied were unaffected. The mucosal protein and DNA content likewise remained unchanged. Occasional slight alterations of the mucosa were the only finding at histology.


Effect of dialysate calcium concentration on plasma parathyroid hormone during hemodialysis. The effect of changes in the dialysate calcium concentration on calcium fractions and parathyroid hormone species in plasma during hemodialysis has been examined. C-terminal immunoreactive parathyroid hormone was suppressed when plasma calcium increased by greater than 25% whereas N-terminal fragments demonstrated an increase. The significance of this is discussed in light of present knowledge of parathyroid hormone metabolism.


Nephronophthisis. Renal function and histologic studies in a family. Nephronophthisis (previously described as familial juvenile nephronophthisis and medullary cystic disease) is characterized by insidious renal failure, its main features being increased urinary sodium loss, pitressin-resistant hypotomic polyuria, polydipsia, normal urine sediment and absence of hypertension. Renal function and histologic studies were performed in a family in which two siblings had this disorder, while the parents and two other siblings appeared clinically normal. Both parents demonstrated a moderate impairment of maximum urinary concentration. The values for tubular free water reabsorption (TcH2O) were relativley normal in the parents and the healthy siblings. One of the index patients showed only minimal sodium wasting even though he had hyposthenuria, thus suggesting an involvement of the collecting ducts in the early stage of neophronophthisis. No evidence of proximal tubular dysfunction was found. Although the light-microscopic examination of renal biopsies from the parents and the healthy siblings was unremarkable, electron microscopy revealed probable abnormalities in all four. An autosomal recessive mode of inheritance is, therefore, suggested in this family. The etiology of nephronophthisis is obscure but a likely possibility is that the renal damage results from an inborn metabolic error.


[Growth hormone, LH and FSH under function dynamical conditions in serum and basic corticol and testosterone serum levels in brain-injured patients during dexamethasone treatment]. In 14 male patients with severe head injury the following hormones were measured by radioimmunological methods in plasma: Basal levels of LH, FSH, GH, testosterone and total corticoids; furthermore LH-releasing-hormone- and insulin-hypoglycaemia-tests were done. The investigations have shown, that in patients with severe head injury no essential impairment of the hypothalamus-hypophyseal-system controlled by LH-, FSH- and GH-secretion could be detected. Diminished testosterone and accelerated LH-levels are measurable, whereas total corticoids were not significantly accelerated. Because of treatment with dexamethasone the effect of this substance has to be discussed.


[Histological and ultramicroscopic aspects of the small intestine in aregenerative enteropathies after treatment with 2-mercapto-propionyl-glycine (Thiola)]. The results of using alpha-mercapto-propionyl-glycine treatment (500 mg i.v. pro die for a time varying from one to four months) in a group of 25 patients suffering from aregenerative enteropathy with differing aetiopathogenesis are reported and compared with 29 control patients, i.e. patients suffering from the same situation and not treated with the drug. Morphological (by optical and electronic microscope) and functional (absorption of oleic acid, xylose and B12) study of the small intestine showed up the effectiveness of alpha-mercapto-propionyl-glycine on the trophism of small intestine mucosa, by way of normalization of intestinal cytokinetics, in aregenerative enteropathies due to special physiopathological situations (gastroresection) or to drugs (cytostatics, etc.) inhibiting enterocytic regeneration.


[Estrogen therapy of advanced breast cancer]. The results obtained with oestrogen treatment of diffuse malignant cancer of the breast are reported. Improvement was obtained in 50% of cases, 23.3% remained stationary and 26.6% worsened. Side effects were confined essentially to liver trouble of colostatic type, a disturbance that was temporary and closely linked with the drug dose employed. Some aspects of high dose antitumour hormone treatment are examined in detail: hormone dose in the induction phase and during maintenance, latency time before the appearance of the first signs of improvement, relationship between age, sexual endocrinal state and therapeutic result, correlation between time of onset of the disease, free interval and result obtained.


[Clinical experience with an antaminic drug in the treatment of post-traumatic and vasomotor headaches]. After some brief remarks on the pathogenesis of vasomotor cephalea, the properties of the antiaminic drug BC 105 (Sandomigran) are described and the results reported of using it in 171 patients suffering from cephalea of three types: vasomotor cephalea in 50 cases, vasomotor cephalea with associated neurosic component in 26 cases, and post-traumatic cephalea in 95 cases. In the first two types, the positive results obtained confirm the usefulness of BC 105 in basic treatment of vasomotor cephalea. In post-traumatic cephalea which is a notoriously difficult therapeutic problem, the results obtained, although only partially positive, are worthy of the fullest consideration.


Injuries to the hand and wrist in athletes. Injuries involving tendons, ligaments, and bones are commonplace with many physical activities. Although the majority of these injuries are minor and cause only temporary discomfort, their potential for producing serious and occasionally permanent disabilities must not be ignored. The initial physical and roentgenographic examination of the injured part must be thorough. Only then can the severity of the injury be recognized and appropriate treatment undertaken. Promptness will limit the period of disability and minimize the chances of development of a chronic condition.


Evaluation of blood glucose, insulin, growth hormone and cortisol response in heroin addicts. Oral glucose tolerance tests were performed on 16 addicts and 16 control subjects. A flat delayed glucose response was demonstrated, with hyperinsulinaemia, elevated plasma growth hormone and normal plasma cortisol in heroin addicts compared with control subjects. These studies suggest a relative insulin resistance in addicts which might be mediated by the elevated growth hormone or some other pharmacologic effect of the chronic opiate abuse.


Sex-chromatin in Iranian newborn females. The incidence of sex-chromatin-positive cells during the first five days of life was investigated in buccal smears stained with aceto-orcein in three groups of newborn females: 51 term infants, 17 small-for-date prematures and 9 prematures with birth weight appropriate for gestational age. In addition, single buccal smears were obtained from a control group of 50 older female children. No significant difference was found in the number of sex-chromatin positive cells between the three groups of infants. The mean incidence of sex-chromatin-positive cells in the neonatal period was lower than that of the older control girls, as has been reported by previous workers. The mean incidence of sex-chromatin-positive cells on the fifth postnatal day never reached 17% which was the mean frequency of sex-chromatin positive cells in older controls. This contrasts with the findings of other workers who reported the rise of sex-chromatin positive cells to occur on the second or third days of life.


The role of coronary care unit in reduction of mortality rate and sudden death in acute myocardial infarction. One hundred and seventy consecutive unselected patients suspected of having acute myocardial infarction (AMI) were admitted to our Coronary Care Unit (CCU); 100 of them proved to have AMI (CCU group). These patients were compared with another 100 cases of AMI, which were admitted to our hospital in the period immediately preceding the establishment of CCU (prior group). Criteria of selection used for both groups were the same. The mortality rate in the CCU group was 11% compared to 31% of the prior group. There was no single case of sudden death due to primary ventricular fibrillation, though only one due to ventricular asystole in the CCU groups. Our findings also were compared with those reported of elsewhere and the difference is discussed. The reasons for lower mortality rate and sudden death are explained. In coronary care unit, in addition to try to decrease the total mortality rate, also should try to reduce the incidence of Primary ventricular fibrillation and asystole. The two main causes of sudden unexpected death in AMI.


A survey of intestinal parasitic infestation in Khorasan Province, Iran. The prevalance of various intestinal parasites has been determined from a study of 40, 267 people from both urban and rural areas of Khorasan province, Iran. Except for G. lamblia, T. hominis, and H. nana, the prevalence of intestinal parasites seems to be lower in this province than in other areas of Iran. The incidence of infestation in village females was higher than in village males, but was similar in the two sexes in the towns and cities. Of those infested, more than 20% from urban areas and 35% from rural areas had multiple infestations.


Staphylococcal susceptibility to penicillin G. In acute Staphylococcal infections, antimicrobial drug therapy must often be initiated before culture results and antibiotic susceptibility testing are completed. Three hundred and ten cultures of coagulase-positive Staphylococcus aureus were tested for antibiotic sensitivity by the Kirby-Bauer method at the Nemazee Hospital in Shiraz, Iran. The overall resistance to penicillin G was 97.10% whereas over 99% of the isolated Staphylococci were sensitive to the penicillinase-resistance penicillin cloxacillin. A penicillinase-resistant penicillin should therefore be used in the initial management of all serious Staphylococcal infections until the organism responsible for infection can be shown to be specifically sensitive to penicillin G.


Colloid milium. A clincopathologic study of four cases. Four cases of colloid medium are presented. The light and electron microscopic pathological changes are described and the important role of  the sunlight exposure in producing these lesions in out-door workers in Iran is emphasized.


Atypical mycobacterial infection of intraparotid lymph nodes. Clinical and sialographic observations. Four children are reported with a chronic caseating granulomatous infection on the intraparotid lymph nodes most likely due to atypical mycobacteria. The sialogram showed one or more masses within the parotid gland.


The sella in childhood hypothyroidism.

The sella in childhood hypothyroidism. Two sellar configurations have been noted in primary childhood hypothyroidism. In the older child the sella appears unusually round and slightly enlarged, and the term "cherry" sella has been used to describe its appearance. Enlargement is due to rebound hypertrophy of the pituitary gland and is reversible with adequate, early treatment. If reversal of these changes is not accomplished one should consider the possibility of an adenoma having developed. In the young child an infant the sella appears more immature and "bowl-like". Enlargement is not a prominent feature in this age group, and indeed was difficult to detect with certainty. Both configurations, but especially the "cherry" sella of the older child, are characteristic enough to enable one to suggest the diagnosis of primary hypothyroidism from lateral skull films.


Renal sonography in pediatric patients. A comparative study between sonography and urography. Renal sonograms of 260 children were compared with the corresponding excretory urograms. Since each kidney was evaluated separately 520 sonographic and urographic findings could be compared. The study is based on single investigations only, serial investigations were not included. 326 kidneys could be classified as being normal, primarily on the basis of the urogram. By sonography only 10 out of these 326 were misinterpretated as being pathological, 2 by urography. 194 kidneys could be classified as being pathological either by urography or- if necess -by other methods. In 16 out of these 194 no evidence for a pathological process could be found in the sonogram (7 cases of destructive pyelonephritis, 3 cases of double kidneys, 2 cases of slight obstruction of urine flow, 2 cases of small kidneys, 2 cases of ureteral buds), in 10 cases no evidence was seen in the urogram (6 cases of glomerulonephritis, 2 cases of polycystic kidneys, 1 case of preversial ureteral buds), in 10 cases no evidence was seen in the urogram (6 cases of glomerulonephritis, 2 cases of polycystic kidneys, 1 case of prevesical ureterolith, 1 case of ureteral bud). In 2 cases pathological alterations of the kidney was found by both methods, however, the diagnosis differed. Nonfunctioning kidneys were found in 15 cases. In all of these the sonogram provided important complementary information. Our results show 1) that by a systematic application of sonography the early diagnosis of urinary tract malformations can be improved 2) that renal sonography provides the basis for a stricter application of excretory urography and 3) that by the combination of both methods the diagnosis of renal diseases can be improved.


Dominantly-inherited polycystic kidneys in infants: association with hypertrophic pyloric stenosis. Newborn male fraternal twins presented at 10 days of age will bilateral flank masses; intravenous urograms showed polycystic kidney disease. Both babies also had hypertrophic pyloric stenosis (HPS). Their father has radiographic and sonographi findings of previously unsuspected polycystic kidneys and has a history of HPS in infancy. The association of dominantly-inherited polycystic kidneys (DPK) and HPS in this family is probably due to chance. However the authors speculate that the autosomal gene for DPK may occur at one of several loci that carry the genetic liability for HPS, A DISORDER TRANSMITTED BY POLYGENIC INHERITANCE.


Anterior intervertebral disc herniations in children. Report of four cases. Four boys with anterior lumbar disc herniations probably secondary to chronic trauma are reported. Anterior disc herniations may appear as separate lesions-as in our patients-or coexist with Scheuermann's disease. Although Scheuermann's disease, discitis and tuberculosis are regarded as the most common causes of intervertebral disc lesions in childhood, trauma should be excluded as a possible cause in all children with chronic back pain who show localised radiographic signs of narrowed disc spaces with erosive and sclerotic changes in the adjacent vertebrae. Localised mild platyspondly may be the result of abnormal, prolonged stress and early osteoarthritic changes are to be expected.


Ileo-ileal intussusception in the newborn. Report of a radiologically diagnosed case. Ileo-Ileal intussusception was demonstrated preoperatively in a newborn infant by gastrografin enema with deliberate reflux of the contrast material into the small bowel. An intraluminal filling defect and stretching of the mucosal folds were demonstrated. The indications and proper use of contrast enemas are discussed.


Spinal cord compression by vertebral hemangioma. Asymptomatic vertebral hemangiomas occur frequently in adults but the discovery of a similar lesion in the pediatric are group is uncommon. A case which involves all the neural arch components with resultant spinal cord compression is rare and is reported with a review of pertinent literature.


Lymphangiography and bone scan in the study of lymphangiomatosis. Lymphangiomatosis is a rare congenital systemic lymphatic malformation involving multiple bones and other sites. A 12-year old boy with lymphangiomatosis was studied with lymphangiography and bone scan. Lymphangiogram demonstrated irregular pooling of contrast medium in both the mediastinal tumor and bones. Bone scan also revealed increased activity in areas which were not demonstrated radiographically.


Melnick-Needles osteodysplasia associated with pulmonary hypertension, obstructive uropathy and marrow hypoplasia. A three and one half-year-old female with Melnick-Needles osteodysplasia is presented. In addition to the characteristic bone roengenograms and obstructive uropathy, the patient had inadequate formation of bone marrow elements and pulmonary arter hypertension.


Carnitine content of blood and amniotic fluid. Free carnitine levels were determined in amniotic fluids between the 10th and 40th week of gestation. They were found to decrease significantly with gestational age. Blood levels of carnitine were lower in pregnant than in nonpregnant women. Levels were found to be higher in cord blood than in maternal blood and usually were higher in the umbilical artery than vein. Intra-arterial injection of L-carnitine into a pregnant ewe did not cause a rise in the fetal blood level of carnitine, which, in contrast to human fetal blood, contained less than half the level of carnitine in maternal blood.


Plasma somatomedin activity in normal and scoliotic children. In a study of plasma somatomedin activity in childhood scoliosis a group of five patients with congenital scoliosis was found to have significantly lower plasma somatomedin levels compared with a group of 20 normal children. A group of 52 patients with "idiopathic" scoliosis had normal plasma somatomedin levels. There is no apparent difference in the plasma somatomedin activity between the sexes, and no change in plasma somatomedin activity with chronologic age in these children, suggesting that normal adult somatomedin levels have been reached.