The relationship between maternal height and weight at booking and perinatal mortality. In this study, more of the Coloured women weighed less than 45 kg and more of them were significantly shorter than Black and White women. The short (less than 149 cm) Coloureds had a high perinatal mortality, as did the thin Coloureds (less than 45 kg). The short, thin Coloured women had the highest perinatal mortality, and fetal loss in this group was associated with preterm delivery, stillbirths before labour and fetoplacental inadequacy. Maternal height is an indicator of nutrition in childhood and maternal weight an indicator of more recent nutrition. Weight gain in pregnancy is particularly important in short, thin individuals.


Hypertension in pregnancy and perinatal mortality. The effect of various forms of hypertension on perinatal mortality has been investigated. Non-essential, non-proteinuric hypertension had relatively little effect on perinatal mortality, whereas essential and proteinuric forms of hypertension had a marked influence. Diastolic blood pressures of less than 110 mmHg did not influence perinatal mortality. Fetal loss from hypertensive disease was largely accounted for by fetoplacental inadequacy, accidental haemorrhage and preterm delivery. Management more suited to individual needs and induction of labour, once biological and lung maturity has been achieved, is advocated.


The challenge of obstetrics in a developing country. For the 13 months between 1 May 1975 and 31 May 1976 a prospective study was made in a maternity wing of a hospital in a developing country. Out of 2196 mothers who gave birth, 278 were classified as requiring special care. The rate of caesarean section showed a steep fall, from 30,76% in 1967 to 2,98% in 1976. The rate for the present series was just over 3%. The series has highlighted the challenges the obstetrician has to meet in a developing country. Patients with pre-eclampsia rank high in the admissions, as do patients with a bad obstetric history, Venereal disease is commonly encountered and requires adequate treatment. Lack of adequate medical services is among the important factors responsible for the obstetric difficulties encountered. Lack of communication and transport facilities aggravates the problems of midwives and obstetricians in developing countries. This study shows how a simple plan and hard work by all concerned can achieve commendable results in spite of the overwhelming inadequacies.


Lymphogranuloma venereum presenting as superclavicular and inguinal lymphadenopathy. A 46-year-old woman developed a febrile illness characterized by supraclavicular and inguinal lymphadopathy. The diagnosis of lymphogranuloma venereum was made by a fourfold rise in complement fixing antibody titer. Treatment with tetracycline was successful. Lymphogranuloma venereum can yield protean manifestations, and should be considered in the differential diagnosis of patients with constitutional symptoms and lymphadenopathy at any site.


An evaluation of microcult g.c. in venereal disease clinics. Microcult G.C. is a kit for cultivation and identification of Neisseria gonorrhoeae. ue of this kit was compared with the cultivation and identification methods of the Neisseria Department, Statens Seruminstitut, Copenhagen (WHO collaborating center for reference and research in gonococci). The investigation included 203 men and 80 women who appeared for examination at our veneral disease clinics. For examination of urethral specimens from men the predictive value of positive tests was found to be 93% and the predictive value of negative tests was 94%. For specimens from the urethra and cervix of women, the predictive value of positive tests was 95% and the predictive value of negative tests was 90%. The reliability of these results makes Microocult G.C. a valuable supplement to microscopy in venereal disease clinics with a relative high prevalence of gonorrhoea. The predictive value of positive tests from the anal canal was 21% and from the tonsils 3%; in these locations the test is not suitable for diagnostic purposes.


Inhibition of Corynebacterium vaginale by metronidazole. Metronidazole [1-(2-hydroxyethyl)-2-methyl-5-nitroimidazole], previously thought to only inhibit obligately anaerobic bacteria, was found in vitro, to inhibit the growth of 15 facultatively anaerobic strains of Corynebacterium vaginale (Haemophilus vaginalis) using agar disk diffusion and broth dilution methods.


An evaluation of the microcult gonorrhea detection system. The Microcult Gonorrhea Detection System employs a dehydrated selective medium adsorbed into a cellulose matrix. The medium is rehydrated before use, then incubated in a foil pouch with a tablet that releases carbon dioxide. Duplicate specimens were plated in parallel on modified Thayer-Martin media and Microcult media. In all, 131 urethral specimens which contained gram-negative intracellular diplococci, 311 cervical specimens and 308 anal specimens were studied. Gonococci were isolated on modified Thayer-Martin media from 128 urethral, 63 cervical, and 29 anal specimens. In contrast 109 urethral, 48 cervical, and 5 anal specimens were shown to contain gonococci using the Microcult system. The Microcult system is inferior to fresh modified Thayer-Martin media for detecting gonococci.


Serologic testing for gonorrhea.

Serologic testing for gonorrhea. A simple, adequately evaluated serologic test is not now available for use in gonorrhea screening programs. Some of the factors responsible for the relatively low sensitivity and specificity of serologic tests for gonorrhea as compared to cultural techniques are discussed. These include the time required for development of an immunologic response after infection, cross-reactivity with other antigens, and the persistence of antibody after therapy. At present, gonococcal serologic tests may be useful to the clinician in establishing the diagnosis of disseminated gonococcal infection, especially if paired sera demonstrate a change in antibody titer. Current research on the antigenic structure of the gonococcus may lead to the development of improved serologic tests for use in screening programs. However, the performance of any test may vary according to sex of the patient, presence of symptoms, history of prior gonococcal infection, and duration of the current infection. The physician must understand these factors when considering the use of any serologic test for gonorrhea.


The etiology of nongonococcal urethritis in men attending a venereal disease clinic. Nongonococcal urethritis was identified as a major reason that men attended our Venereal Disease Clinic. The prevalence of several agents that  might cause nongonococcal urethritis was determined. Attempts were made to isolate gonococci; chlamydiae, Ureaplasms urealyticum, trichmonads, Candida sp., and Corynebacterium vaginale from urethral swabs from 307 men. Chlamydiae were recovered from 31% of the 67 men with nongonococcal urethritis compared to only 4% of 86 asymptomatic men without pyuria. Unexpectedly, cultures from only 4% of the 99 men with gonorrhea also yielded chlamydiae. Ureaplasma urealyticum was recovered from 9 of 27 asymptomatic men (33%), 16 of 30 men with nongonococcal urethritis (53%) and 16 of 68 men with gonorrhea (42%). These differences were not statistically significant. However, when chlamydiae-positive men were excluded from the analysis urethritis. Twelve of 18 (76%) men with nononchlamdial nongonococcal urethritis yielded the organism compared to 8 of 26 (31%) men without urethritis. The other organisms sought were recovered infrequently and could not be associated with  nongonococcal urethritis.


Gonococcal meningitis and ventriculitis in the presence of a ventriculoperitoneal shunt. This report describes a young woman with a ventriculoperitoneal shunt who developed gonococcal meningitis and ventriculitis. Her infection responded to treatment with antimicrobial agents without removal of the shunt.


Surgical treatment for thyroid cancer.

Surgical treatment for thyroid cancer. Thyroid cancer, although a rare disease, may cause significant disability and even death. Its proper surgical management is based on an understanding of the different biolgoic behavior of the four subtypes. Papillary and follicular cancers are best managed by total lobectomy on the side of the lesion and subtotal lobectomy on the contralateral side, unless there is gross disease bilaterally or distant metastasis (in which circumstances total thyroidectomy is performed). Cervical lymph node metastasis, when present, is handled satisfactorily by modified neck dissection. Because of its high incidence of multicentricity and its more serious prognosis, medullary thyroid carcinoma is managed by total thyroidectomy and--usually--radical neck dissection for involved nodes. For anaplastic carcinoma, there is no effective treatment at present. Postoperatively, all patients should be given suppressive doses of thyroid hormone to prevent myxedema and to prevent cancer from recurring. Radioiodine therapy may be of value in suppressing metastasis of some papillary and follicular cancers that exhibit a high degree of follicular differentiation.


Paragangliomas of the neck: clinical and pathologic analysis of 116 cases. Neck tumors developing from the paraganglion system are best called paragangliomas. They may be described further as to site of origin and as to whether they are functioning or nonfunctioning. Review was made of 116 cases in which operation for paraganglioma was performed at the Mayo Clinic. The diagnosis depends upon demonstration of a lateral neck mass, elimination of other causes, and a tumor blush on angiography. Screening tests should be done to determine whether the tumor is producing epinephrine. Surgical management should be selective, depending upon the location and involvement of surrounding structures, particularly the carotid artery system. A conservative approach is indicated for those patients whose tumor surrounds the carotid vessels, because the risk of complications is greater than the risk of leaving the tumor in the neck. Conservatism is also indicated for patients in the older age group, because of the slow growth of these tumors and the low incidence of malignancy.


The influence of D-penicillamine on the proliferation rate of cells from the upper limb bud of mouse embryos in vitro. D-Penicillamine was given on the fourth day of culture of limb buds from 11-day mouse embryos at a dose of 100 microng/ml medium and allowed to react for 24 hours. On day 5 there was found a significant decrease in the [3H] thymidine labeling index of cartilage cells and of cells of the perichondrium, whereas mesenchyme cells showed no decrease in proliferation under these conditions. The toxic effects of D-penicillamine on prenatal skeletal developement in vivo could therefore result not only from direct action on collagen but also via inhibition of proliferation of cartilage cells.


Descriptive system for congenital limb anomalies. A descriptive system for the nomenclature, notation and classification of congenital limb malformations, suitable for clinical, epidemiological and experimental use is presented. Every developmental limb anomaly is described by stating the type of anomaly and the affected anatomic structure. All anomalies are classified into three basic types: excess, deficiency and fusion. The anatomic structure of the affected limb is defined within a two dimensional order. This system was used to describe 652 cases with isolated developmental limb anomalies obtained from two series of observations. The observed data are presented in a progressively expanded classification ranging from 4 to 497 diagnostic categories. Observed incidence rates for the four main types of anomaly from a sample of 297,299 consecutive livebirths, are: excess: 1.22; deficiency: 0.17; fusion: 0.20; combined: 0.24 per thousand.


Craniomyeloschisis: a spontaneous mutation of the rat. Craniomyeloschisis (proposed gene symbol cms) was a spontaneous mutation of the rat inherited as an autosomal recessive trait with complete penetrance. Homozygous offspring died at birth with failure of closure of the neural tube caudal to the midbrain. Neural crest derivatives were relatively normal. There were associated severe malformations of the axial skeleton including skull, vertebral column, and ribs. The pattern of malformations was quite uniform. Heterozygotes were anatomically normal. The mutation is extinct.


Trypan blue accumulation in the embryonic gut of rats and mice during the teratogenic phase. Four to 48 hours after iv and sc administration of teratogenic doses of trypan blue to rats and mice the uterus was removed and rapidly frozen, after having been placed in a horizontal plane, and frozen sections were attached to tape and dried at a low temperature. By this procedure embryos and placental structures were present in the same sections and loss or redistribution of the dye was minimized. The dye was found in the yolk-sac cavity and to be accumulated in the visceral (proximal) endoderm. It was also acculmulated in the embryonic endoderm--forming the embryonic gut. This accumulation occurred after the administration of the trypan blue up to the time of closure of the vitelline duct, which occurs at 11 days postconception in rats and 9.5 days in mice. None was found when injection was made after this closure. No dye was detected in the ecto- and mesodermal layers. The period of embryonic uptake of trypan blue largely corresponds with the period of teratogenic sensitivity in these species as reported by others.


Drug-induced limb dysplasias in fetal rabbits. Pregnant New Zealand White rabbits were treated on gestation day 12 with 19.2 mg/kg methotrexate (MTX), 750 mg/kg hydroxyurea (HU), or 1,500 mg/kg acetazolamide. Rabbits were killed either 2-32 hours posttreatment for histological analysis of embryos or at day 29 for gross and skeletal examination of fetuses. tmtx produced cleft palate, hydrocephalus, and fore- and hindlimb reduction defects. Histological analysis revealed pyknosis and edema in mesenchymal tissues at four to eight hours following treatment. The apical ectodermal ridges (AER) of treated embryos permanently lost their characteristic pseudostratified organization. By 32 hours the limb buds had regained their normal appearance except for the AER. HU affected all fetuses with skull and facial anomalies as well as severe reduction deformities of all limbs. Histologically HU-treated embryos had numerous, basophilic, intercellular granules (presumably cell debris) which appeared within two to four hours in the limb bud mesenchyme, neural tube, and dorsal root ganglion. The architecture of the AER was unchanged. Acetazolamide produced bilateral retarded ossification or possible aplasia of the first metacarpal and talus in nearly 80% of fetuses. Microscopic examination disclosed no apparent alterations in limb-bud morphology. Methyl green-pyronin Y staining called attention to green intracellular droplets within the endoderm of the trachea and bronchi at two hours posttreatment. It was concluded that the three drugs do not produce limb dysplasias by a common teratogenic mechanism.


Quantitative structural study of pulmonary circulation in the newborn with aortic atresia, stenosis, or coarctation. Study of the structural features of the pulmonary circulation in various types of congenital heart disease makes it possible to correlate function and structure in the fetal and newborn lung. We applied quantitative morphometric techniques to the injected and inflated lungs of newborn infants who had died with obstruction to left ventricular outflow from aortic atresia, stenosis, or coarctation. The structure and development of the pulmonary circulation was judged by the number of arteries and veins and their size and wall structure, with particular attention to vessels within the respiratory unit. The study established for the first time that the structure of the pulmonary circulation is modified by the antenatal abnormalities in blood flow that occur through the heart and great vessels in the presence of congenital heart disease. Fetal multiplication of intra-acinar arteries in aortic atresia and stenosis is increased as also is the muscularity of both pre- and intra-acinar arteries and veins, muscle extending into smaller and more peripheral vessels than is normal at birth. When the pulmonary circulation is normal before birth but arterial pressure and flow are abnormally increased at birth, as in coarctation with patent ductus and ventricular septal defect, an increase in arterial diameter and muscularity is apparent within the first week of life.


Quantitative structural study of pulmonary circulation in the newborn with pulmonary atresia. The lungs of eight newborn infants who had died from pulmonary atresia were studied by quantitative morphometric techniques. It was established for the first time that the abnormal pattern of blood flow through the heart and great vessels in a fetus with pulmonary atresia is associated with impaired lung development as shown by arteries that are too few, too small, and with an abnormally thin muscle coat, although the distribution of muscle along the arterial pathway is normal. Differences between the cases in the degree of impairment of lung development could be detected and related to the degree of reduction in pressure and flow before birth in the individual case. Although blood flow through the pulmonary circulation is small before birth lung development seems sensitive to any further reduction.


A case of pulmonary veno-occlusive disease respondong to treatment with azathioprine. Histological features of a lung biopsy specimen from a 46-year-old woman showed all the characteristics described in veno-occlusive disease. The clinical features, however, were distinctive in that in addition to the lung involvement there was alopecia, digital vasculitic ulcers, Raynaud's phenomenon, polyarthritis, and muscle weakness. Treatment with azathioprine resulted in a progressive improvement in her condition. It is suggested that pulmonary small vein occlusion may occur as a pattern of tissue response in more than one situation and that is sometimes more amenable to therapy than has been previously reported.


Late-onset post-pneumonectomy empyema.

Late-onset post-pneumonectomy empyema. Nine cases of empyema developing more than three months after pneumonectomy are presented. Diagnosis is difficult; with one exception, all the patients had been ill for at least three weeks and some for several months before the cause was discovered. In four, the radiological demonstration of gas in a previously opaque hemithorax led to the diagnosis. One of these had a bronchial fistula, two had oesophageal fistulae, and one had both. The remaining patients had no fistulae and the diagnoses were not made until empyema necessitatis had developed. Two from this group yielded pure cultures of pneumococci and one a pure culture of Streptococcus viridans. Except for one patient admitted moribund, all were treated in the first instance by rib resection and open drainage without tubes and all survived. Four of the five without fistulae subsequently had their drainage sinuses successfully closed after the infection of the chest wall had cleared. The belief that a pneumonectomy space normally becomes obliterated is challenged. The history and mode of onset of some of these cases suggested that infection of the residual fluid was bloodborne.


A difference in the composition of bronchial mucus between smokers and non-smokers. The ratio of the amount of sulphated to sialic acid mucin (Su/Si) in the mucous glands of the human tracheobronchial tree has been investigated in seven smokers and seven non-smokers. The two mucins were studied in histological sections stained by the high iron diamine/Alcian blue pH 2-5 sequence and assessed by a point-counting method. Su/Si was greater in the smokers than in the non-smokers, who were almost completely distinguished by this ratio. A decrease in the ratio with each generation of branching from the trachea down the inferior lingular bronchial segmental pathway was seen in both the smoking and non-smoking groups. Analysis of the logarithm of Su/Si showed the smoking group means to be 2-3 times that of the non-smokers at each generation, and over both groups the average decrease down successive generations was given by a factor of 0-9.


Distribution of acid mucus in the bronchial mucous glands. The percentage area of the bronchial glands taking up the Alcian blue (pH 2-6) stain for acid mucin was obtained from sections from the trachea and from each generation down the inferior lingular axial bronchial pathway in five non-smokers and five cigarette smokers. The mean percentage value for the smokers (59-5%) was significantly less than for the non-smokers (74-4%). The percentage increased between successive generations from the trachea by an average of 6-5. This gradient did not differ significantly between the smoking and non-smoking groups. It was not possible to attribute these differences to any specific mechanism because many interacting variables were involved which could not be measured. Nevertheless the percentage mucin retention or storage provides an introduction to consideration of these variables and their response to cigarette smoke.


Intrasubject variability of maximal expiratory flow volume curve. Analysis of airflow in the terminal portion of the maximal expiratory flow volume curve has been suggested as a useful test for the early diagnosis of chronic airways obstruction. Whether such an analysis can identify early disease, and whether any subsequent action can prevent the progress of chronic airways obstruction, is unknown and will require prospective studies. As a precursor of such a study we have tried to establish the intrasubject variability of those tests of forced expiration which may be used for screening. We therefore measured expiratory flow volume curves of five healthy males and five healthy females aged 20-30 years as this is an age-group in which early detection of airways obstruction may be of value. Flow volume curves were obtained on the same day of the week for six weeks, and on three separate days during this period we carried out three flow volume curves every hour from 9 am to 6 pm. The data were subjected to analysis of variance to determine the variability of each measurement. Data were collected from forced expired volume in one second (FEV1) forced vital capacity (FVC), maximum expiratory flow rates at 50% and 75% of expired vital capacity, and forced expiratory time (FET). The results showed no consistent pattern of diurnal variation over the working day. The variation in any subject for FEV1 and FVC over the study period was considerably less than variations detected in the maximal expiratory flow rates at 50% and 75% of the expired vital capacity and FET. Our results suggest that the intrasubject variation found in flow rates of the terminal portion of the maximal expiratory flow volume curve and forced expiratory time may limit the usefulness of these tests in detecting early airways obstruction. FEV1 and FVC are more reproducible tests and are therefore particularly suited for cross-sectional screening. The more sensitive maximal expiratory flow volume curve may, however, be more useful for long-term studies in individuals when the onset of disease is sought, or for short-term challenge studies requiring the most sensitive index of change in airway characteristics.


How mild is mild asthma?

How mild is mild asthma? Nineteen asthmatic volunteers underwent methacholine-induced asthma to the point when tightness in the chest was just sensed (threshold symptom). Changes in the following indices of lung function were measured--static lung volumes, forced expiratory volume in one second, and airways conductance. The increase in airways resistance necessary for threshold detection was at least double that previously reported in experiments using external resistive loads. Despite the mildness of the symptom, increases in lung volumes to the levels previously described during acute and severe asthma were occasionally found. It is emphasised that there may be little leeway in respiratory reserve between the development of minor and severe symptoms in some asthmatic patients.


Metabolic response to intravenous salbutamol therapy in acute asthma. In patients suffering from an acute attack of asthma the effects of salbutamol infusion (10 microng/min) on their plasma concentrations of non-esterified fatty acids (NEFA), triglyceride, insulin, and glucose were compared with those in a group of asthmatics not requiring infusion. Salbutamol was found significantly to increase the plasma concentrations of glucose and insulin while having little effect on NEFA or triglyceride. However, NEFA concentrations were found to be significantly increased in patients with an acute attack of asthma at the time of their admission to hospital. This increase is attributed to the stress of the asthmatic attack itself.


Effect of lung function and mode of inhalation on penetration of aerosol into the human lung. The method using radioactive tracer particles has been applied to study the effect of the mode of inhalation of aerosols on the depth of deposition in the lungs of 50 patients with airways obstruction. The findings show that the penetration of particles is directly related to: (1) volume inspired per breath (VI); (2) forced expiratory volume in one second (FEV1); and inversely related to (3) flow rate during inhalation (V). In mathematical terms, alveolar deposition (%) = 40-3 (VI)+10-98 (FEV1)--0-75 (V)+40-4; for this regression F = 4-41 and P less than 0-01.


Protective effect of methylprednisolone on ischaemic myocardium assessed by ventricular function. Intracardiac surgical procedures are best carried out when the heart is still and bloodless. This condition, however, produces myocardial cellular damage with loss of contractility and compliance unless some protection can be provided. Myocardial contractility and compliance is best studied by isovolumic ventricular function tests, which were used to evaluate the protective effect of methylprednisolone on the isolated cross-perfused canine heart made ischaemic for 2 hours. Control experiments included 2 hours of ischaemia without methylprednisolone, and 2 hours of continuous normothermic cross-perfusion. The methylprednisolone-treated hearts had probably significantly better ventricular function after 2 hours of ischaemia than did hearts without the methylprednisolone, while the cross-perfused hearts were best overall. This work suggests that methylprednisolone may have a protective effect on the ischaemic myocardium of the intact canine heart.


Shape changes in static V-P loops from children's lungs related to growth. Sixty-eight sets of deflation data from the left lungs of children who had died from non-pulmonary causes were analysed by the exponential equation model to derive theoretical values of Pst(1) for 50, 60, and 90% of the observed maximum inflation volume. The resultant P50, 60, and 90 values were compared to the same values measured from graphic displays of the V-P data. The graphically derived Pst(1) data at 50, 60, and 90% of TLC were then plotted against the crown-heel length to demonstrate a shape change related to physical growth. It was found that the form of the deflation curve in preterm infants did not fit an exponential model as satisfactorily as did the deflation curve from older children. The exponential model should be used with caution in small infants where Pst(1) values below P90 are sought. A maximum inflation pressure of +30 cm H2O was found to produce a Vmax within 98% of the hypothetical VINF value.


Obstructed tilting disc mitral valve prosthesis associated with placenta praevia. The occurrence of a bleeding placenta praevia in a young woman, with a viable fetus and an acutely obstructed Lillehei-Kaster valve, provided serious difficulties in priorities and decision making. This has prompted an analysis of the problems which others may encounter.


Comparison of occlusion pressure and ventilatory responses. The airway pressure 100 msec after the onset of an inspiratory effort against a closed airway (P100, occlusion pressure) is theoretically a more accurate index of respiratory neuron motor output than ventilation. Occlusion pressure and ventilation responses to hypercapnia were compared in repeated trials in 10 normal subjects while in the seated and supine positions. During progressive hypercapnia changes in P100 were also compared to changes in tidal volume and inspiratory airflow. These studies show that occlusion pressure increases linearly with hypercapnia in both sitting and supine subjects. Changing from the seated to the supine position, or vice versa, had no significant effect on either ventilation or occlusion pressure responses to CO2. Correlations between P100 and ventilation or airflow rate were significantly higher than correlations between P100 and tidal volume or breathing frequency. Intermittent random airway occlusion had no effect on either ventilation or pattern of breathing during hypercapnia. Occlusion pressure responses were no less variable than ventilation responses in groups of subjects whether studied seated or supine. However, maintenance of a constant moderate breathing frequency (20 breaths per minute) reduced the interindividual variability in ventilation and occlusion pressure responses to hypercapnia.


A conservative approach in selected cases of late diagnosed oesophageal perforation. A conservative method is presented for the treatment of oesophageal perforation where the diagnosis has been delayed. A system of tubes is described which allows the patient to be fed and at the same time prevents swallowed material from reaching the fistula. A case is reported which was successfully managed using the method.


[Productive life-span of dairy cows and its economic significance. I. Disposal of dairy cows: the current situation (author's transl)]. The current situation regarding the replacement of dairy cows is discussed. Attention is successively paid to the duration of herd life and the replacement rate, the reasons for disposal and the relationship between age and the probability of disposal. Little research including all the required elements at the same time has been done in this field. Therefore, the literature can offer only a rough idea of the current situation regarding the replacement of dairy cows (Tables 1 and 2). Further research along a few lines presented in this paper is advocated. However, the findings derived from the literature may be used in an economic model to quantify the economic significance of differences in the herd life of dairy cows. This subject will be elaborated in two subsequent papers.


[The use of a dry cow preparation for the prevention of summer mastitis in maiden heifers (author's transl)]. An investigation was made of the preventive value of topical application to juvenile udders of a dry cow preparation containing 300,000 IU of procaine penicillin G (Penzal N 300). Penicillin concentrations in udder secretions of 30 young cows were examined. In calves up to 10 weeks and in maiden heifers up to 7 weeks after application an average concentration of 0.05 ml IU per ml of secretion was found. In the same groups, 12 and 9 weeks respectively after application, the concentration was 0.01 IU per ml of secretion. Experiences in practice in an area with a high infection rate have shown an obvious protection in 700 maiden heifers. Some cases of infection did occur both shortly (1.0%) and from 5 weeks after application (1.9%). The clinical character of the latter was much milder than is usual for summer mastitis. When administered in time and in the correct manner the dry cow preparation examined showed reasonable protection against summer mastitis.


[Productive life-span of dairy cows and its economic significance. II. The replacement of dairy cows: an economic model (author's transl)]. A model, initially based on the work of Zeddies (10), is presented , by which the economic aspects of the replacement problem may be studied. First, the principle underlying the replacement decision is discussed. Then, the data to be included in the model are determined. This mainly concerns the elements associated with age, such as milk production, the value of newborn calves, the slaughter of the cows, the feed cost and the cost of a pregnant heifer just before calving. The age-associated probability of culling is also included in the model. A number of questions regarding the economic importance of the duration of herd life have been studied using this model. In the third paper, the results of this application of the model will be presented.


[Assisted delivery of the calf by manual or mechanical traction (author's transl)]. During the past few years, an increasing number of farmers examined cows at parturition and attempted delivery of calves. Frequently, the veterinarian is merely called in to perform caesarean section. From the point of view of obstetrics, quite a number of caesarean sections could have been avoided if a thorough examination of the cow had been made. Examination and treatment of cows at parturition is described in detail. Particular attention is paid to the mechanical features of delivery. The advantages and disadvantages of manual and mechanical traction are discussed.


[Experiments in animals (author's transl)]. Experiments in laboratory animals are designed to safeguard patients and subjects from possible injury which might be caused by an experiment. It is also expected, however, that results will be more rapidly obtainable, more accurate and more reliable in laboratory animals. Since the beginning of the twentieth century, small animals in particular have been adapted for research by standardization of the genetic pattern, the microflora, the feed and the environment. This was primarily done for the benefit of particular forms of research; subsequently, the need of adapted experimental animals for all research in behalf of medicine, biology, public health and veterinary medicine was recognized. A number of future developments in the field of experimental studies in animals are the following:  standardization of large animals such as monkeys, increasing attention devoted to the choice of the animal model and to controlling the conditions in which an experiment is carried out and the coming into operation of the Experiments in Animals Act. These developments will require increasing expertness and close co-operation between investigators, laboratory animal scientists and animal technicians.


[Productive life-span of dairy cows and its economic significance. III. Economic evaluation: results obtained by model calculations (authors transl)]. A reduction of the forced replacement rate is found to be of major economic importance on the farm level. In the model, the income earned from a fifth lactation of a cow showing an average production is approximately Dfl 440 higher than the earned income per annum over the average herd life of 4.3 lactations. A farm with a herd of fifty cows showing average production and an average herd life of 5.3 years will have approximately Dfl 9600 more earned income each year than a similar farm with an average herd life of 3.3 years. The yield resulting from a longer herd life is subject to the law of diminishing returns. For the annual income from a dairy herd, a sixth lactation is of less importance than a fifth lactation, etc. The economic importance of a long herd life appears to be remarkably stable, i.e. hardly affected by: (a) The average productive capacity of the herd as regards milk and/or meat. (Note: Differences in milk-producing capacity within a herd have a marked effect on the economic value of an additional lactation by an individual cow). (b) The presence or absence of a moderate genetic improvement (1 per cent per annum) in milk-yield.


The occurrence of electron dense intercellular materials and gap junctions in the human intestinal epithelium. Electron microscopy of biopsy specimens from the small intestines in infants and children with various gastrointestinal disturbances revealed that the intercellular space of the mucosal epithelium was often filled with electron dense materials. Here apposed cell membranes were arranged almost parallel with each other. The dense materials also filled the space just subjacent to the epithelium to form a thick, dense layer in which the basal lamina was completely buried. The gap junctions were especially well developed in the epithelia filled with these materials. Long-period fasting of patients seemed to facilitate the occurrence of the dense materials and the formation of gap junctions.


The effect of atropine on ventriculoatrial conduction during ventricular pacing in patients with and without Wolff-Parkinson-White syndrome. Electrophysiological studies were performed in five patients, two with the three without Wolff-Parkinson-White (WPW) syndrome. In the former patients group, the paroxysmal supraventricular tachycardia (PSVT) was concluded to reflect the circus movement utilizing the normal atrioventricular (A-V) conduction system for antegrade conduction and the Kent bundle for the retrograde conduction. Ventriculoatrial conduction time (VACT) was measured during ventricular pacing before and after the administration of atropine sulfate. In patients without WPW syndrome, the VACT prolonged and subsequently second degree ventriculoatrial block developed when the pacing rate was increased progressively and atropine facilitated the retrograde conduction, suggesting the ventriculoatrial conduction took place via the normal A-V pathway. In contrast, the VACT in patients with WPW syndrome remained unchanged during ventricular pacing at rates of 145/min and more before and after atropine, indicating the retrograde conduction was taking place through the Kent bundle. It is discussed that the analysis of the VACT before and after atropine serves as an aid to differentiate the underlying mechanisms of PSVT in patients with WPW syndrome.


Intra-His bundle block following ligation of anterior septal artery in dog. Intra-His bundle block was produced by ligation of the anterior septal artery in dogs. The duration of the His bundle potential was gradually increased following the ligation, and an obvious splitting of the His bundle deflection was observed thereafter. Finally, spontaneous second and/or third degree intra-His bundle block appeared. Before the development of spontaneous block, a pacing induced intra-His bundle block was observed when the duration of the His bundle deflection was prolonged approximately to twice the control value. Careful measurements of the intervals between two split His bundle deflections (H1-H2) in spontaneous as well as in pacing induced block revealed atypical Wenckebach periodicity in all analyzed periods except in one. Repeating and/or transient decreases of H1-H2 intervals were frequently observed as atypical findings.


Statistical study on malignant melanoma in Japan (1970-1976). The authors reported in 1972 a statistical study based on 501 cases of malignant melanoma. As continouous study this review was carried out on 456 cases of melanoma which were reported during six years between 1970 and 1976. These two studies showed quite similar results as follows: (1) Yearly incidnece of malignant melanoma indicated a definite upward trend and the average number of patients was 71.1 per year. (2) Distribution by age showed one peak in the seventh decade. (3) Sex ratio was 1.1: 1. (4) The number of cases per total population in Japan showed great increase in over fifth decades and two peaks in the 7th and 8th decades. (5) Average age of the onset of all melanoma was 51.6 years old, while, that of brain and spinal cord melanoma was 25.4 years old. In the skin melanoma with preexisting pigmented skin lesions, the median age of the onset of primary melanoma on the foot was 38.7 years old and that of originated melanoma except foot was 65.9 years old. (6) Incidence of the melanoma was high in the sole considering the number of melanocytes per unit skin area.


Estimation of the distribution of ellipsoids with random test lines. The distribution F(lambda) of the length lambda of chords delivered by a random test line of unit length, which intersects a sufficiently large number of ellipsoids of different sizes but of uniform shape randomly oriented and dispersed in a three-dimensional space of unit volume, is give by (formula: see text). In this equation, phi(e) is a coefficient determined by two eccentricities of the ellipsoids and N(r) is the distribution function of their major semi-axes r. In the case of spheres phi(e) is 1, but otherwise it is always smaller than 1. N(r) can be further expressed as the product of the probability distribution p(r) of r and the total number Nvo of the ellipsoids in a unit volume. On account of the above equation, it is possible to extend the application of the histometrical methods of spheres with the use of chord length immediately to a group of ellipsoids of uniform shape, so far as the estimation of the parameters of p(r) is concerned. Even with a group of ellipsoids of different shapes, the same principle is valid, provided that all the subgroups of ellipsoids of different eccentricities have a common p(r). Nvo is most practically estimated from Nvo=Tv(h)/2h, in which Tv(h) is the number of tangential points made by ellipsoids with a test plane of unit surface area during its transit h in the direction perpendicular to itself.


Chronotropic effects of coronary vasodilators as assessed in the isolated, blood-perfused sino-atrial node preparation of the dog. Chronotropic effects of 6 coronary vasodilators, carbochromen, dilazep, diltiazem, dipyridamole, nifedipine and verapamil, were compared by close-arterial administration to the isolated, blood-perfused sino-atrial node preparation of the dog. All drugs produced a dose-related decrease in sinus rate, and the order of negative chronotropic potency determined on a weight basis was as follows: (formula: see text). Higher doses of these drugs except dipyridamole caused atrial standstill. The order of potency causing atrial standstill determined on a weight basis was as follows: (formula: see text). Dipyridamole in lower doses produced a negative chronotropic effect alone, but with higher doses a positive chronotropic effect preceded a negative one. Carbochromen in a wide range of doses produced a triphasic response consisting of initial brief positive, succeeding main negative and final gradually-developing slight positive components.


Radiobromine labeled norcholesterol analogs. Synthesis and tissue distribution study in rats of bromine-82 labeled 6beta-bromomethyl-19-norcholest-5(10)-EN-38-OL. 6beta-Bromomethyl-19-norcholest-5(10)-en-3beta-ol (NCL-6-Br) was synthesized directly from cholest-5-ene-3beta,19-diol 19-toluene-p-sulfonate via homoallylic rearrangement with ammonium bromide or sodium bromide in acetonitrile. This method was applied to the radiolabeling of NCL-6-Br with bromine-82. Tissue distribution of bromine-82 labeled NCL-6-Br (NCL-6-Br-82) in rats was determined. The mean percent dose per gram uptake in adrenal at 24 and 120 h was 98 and 80 %/gm, respectively, which indicated a higher adrenal uptake as compared to iodine-131 labeled 19-iodocholest-5-en-3beta-ol (CL-19-I-131), but was at a lower level than that achieved with iodine-131 labeled 6beta-iodomethyl-19-norcholest-5(10)-en-3beta-ol (NCL-6-I-131). The ratio of radioactivity in the adrenal-to-liver concentration was also lower than that of CL-19-I-131 or NCL-6-I 131.


Characterization of C-4-methylated sterols by pyridine-induced solvent shifts in proton magnetic resonance spectroscopy. The proton magnetic resonance (PMR) spectra were measured in deuterochloroform (CDC13) and pyridine solutions for some 4-desmethyl, 4alpha-methyl, 4beta-methyl, and 4,4-dimethyl sterols related to 5alpha-cholestane series as well as for their C-3-oxo derivatives. The influence of pyridine, relative to CDC13, on methyl group chemical shifts was discusssed.  The technique utilizing pyridine-induced solvent shifts in PMR spectroscopy was found useful in characterizing the individual classes of sterols.


Synthesis of new steroid haptens for radioimmunossay. Part IV. 3-O-Carboxymethyl ether derivatives of estrogens. Specific antisera for radioimmunossay of estrone, estradiol-17beta, and estriol. The syntheses of 3-O-carboxymethyl ether derivatives of estrone, estradiol-17beta, and estriol and the preparation of their bovine serum albumin (BSA) conjugates are described. These conjugates were employed for the generation of specific antisera suitable for radioimmunoassay (RIA) of estrone, estradiol-17beta, and estriol. The previous concept that specific antisera for estrogens cannot be obtained by employing estrogens derivatized at the 3-position is unfounded.


Correlation of serum testosterone levels with age in male chimpanzees. Serum testosterone was measured in a group of male chimpanzees of varying ages by radioimmunoassay using a specific antiserum to testosterone-3-carboxym ethyloxime-bovine serum albumin. The juvenile age group, ranging from one through six years (n=26), had a mean serum testosterone value of 13ng/100ml (range 3.5-59ng/100ml). The adolescent age group, spanning years seven through ten (n=19), had a mean value of 178ng/100ml (range 14.6-238ng/100ml). The adult group, comprised of animals over eleven years of age (n=29), had a mean peripheral serum testosterone value of 397ng/100ml (range 92-680ng/100ml). These data suggest that serum testosterone levels may be useful in determing the age and sexual maturity of chimpanzees of unknown age.


Simultaneous radioimmunoassay of tesosterone, dihydrotestosterone, 5 alpha-androstane-3alpha, 17beta-diol and 5alpha-androstane-3beta, 17beta-diol in the plasms of adult male rats. A single thin layer chromatography and three antibodies were used for the specific radioimmunoassay of four androgens in pooled rat plasma (Sprague-Dawley adult males). The following values were found (pg/ml +/- SD). Testosterone: 3, 138 +/-173; dihydrotestosterone: 374 +/-20; 5alpha-androstane-3alpha, 17beta-diol: 284+/-24; 5alpha-androstane-3beta, 17beta-diol: 223+/-11.


Direct measurement of androgen receptors in cultured Sertoli cells. Cytoplasmic and nuclear forms of macromolecules with the properties of androgen receptors have been demonstrated by direct labeling techniques in cultured Sertoli cells. The cytoplasmic form was excluded from Sephadex G-200 and could be distinguished from androgen binding protein (ABP) on the basis of size, heat stability, relative electrophoretic mobility, and binding complex dissociation rate. When cultured Sertoli cells were incubated with 3H-testosterone, a time- and temperature-dependent accumulation of label into the nuclear fraction was observed, 46% of which crystallized as authentic testosterone. Specific binding was saturable with an apparent association constant of 0.4nM-1. Approximately 30% of the nuclear bound hormone was extracted within 1 h by 0.4M KCl and 34% of this was associated with macromolecular species as measured by gel filtration. Unlabeled androgens and to some degree progestogens competed with 3H-testosterone for binding sites. These data constitute direct evidence that Sertoli cells contain androgen receptors.


Formation of a steroidal allyl alcohol in the mammary glands of mice. After incubation of [4-14C]progesterone with cell-free homogenates of mouse mammary gland in the presence of NADPH, [14C]-labeled 4-pregnene-3alpha, 20alpha-diol was identified as a metabolite, besides 20alpha-hydroxy-4-pregnene-3-one which was the major metabolite.


Metabolism of estradiol by uterine peroxidase: nature of the water-soluble products. The nature of the water-soluble products formed by incubating labelled estradiol with uterine peroxidase in the presence of H2O2 and tyrosine was examined by two-dimensional thin-layer chromatography and high voltage electrophoresis. It was shown that the steroid and amino acid were associated in a 1:2 or 1:3 ratio and evidence was provided by 3H-exchange for the interaction of tyrosine with ring A of estradiol at C-2 and C-4. The possible role of estrogen-induced peroxidase in the uterus in vivo is discussed.


Tritium nuclear magnetic resonance spectroscopy. Distribution patterns and nuclear Overhauser enhancements in some tritiated steroids. The distribution of tritium atoms in some labeled steroids has been determined by tritium nuclear magnetic resonance spectroscopy. In addition, the distribution of molecular types (mono vs. polytritiated) and nuclear Overhauser enhancements have been determined. As near maximal NOE's were observed, quantitative distribution information was derived from NOE suppressed spectra.


The safety of local anesthesia and outpatient treatment: a controlled study of induced abortion by vacuum aspiration. The safety of early vacuum aspiration performed as an outpatient procedure using local anesthesia was examined in a controlled study sponsored by the World Health Organization and undertaken in two centers in Yugoslavia and Singapore. The sample consisted of healthy women whose pregnancies were between 7 and 12 weeks in duration. Follow-up four weeks after abortion was nearly 100 percent in both centers. No important differences in complication rates were found between the different types of services and anesthesia, even though overall complication rates differed markedly between centers. Overnight postabortion observation was not associated with any decrease in complications.


Complications following induced abortion by vacuum aspiration: patient characteristics and procedures. Complications following early induced abortion by vacuum aspiration were examined in a controlled study. Data were collected on healthy women 7--12 weeks pregnant at the time of abortion. No association was found between complication rates and age, marital status, or parity. However, women in their first pregnancies and those who had experienced an induced or spontaneous abortion in their previous pregnancy had a higher rate of complications following the current induced abortion.


Patients' evaluation of family planning services: the case of inner-city clinics. The acceptability of family planning services was studied at 12 federally funded clinics in the poor, inner-city area of Detroit by means of a questionnaire given to 535 patients selected at random. The majority of respondents judged clinic care acceptable, but ratings varied among individual clinics, types of clinics (hospital or community-based, single-purpose or multipurpose), and characteristics of patients. Ratings also varied among the factors identified from the 24 questionnaire items as the criteria of acceptability: (1) doctor's care and (2) nurse's care, which were found to be closely correlated with patient's satisfaction with their clinic experience, and (3) waiting time, (4) accessibility, and (5) comfortableness, which were not correlated with overall satisfaction. Overall clinic acceptability was positively correlated with revisits for some of the clinics.


Platelet preservation V. Survival, serotonin uptake velocity, and response to hypotonic stress of fresh and cryopreserved human platelets. The survival in vivo of 51Cr-labeled autologous human platelets, the serotonin uptake velocity, and the response to hypotonic stress were determined both before and after cryopreservation. Changes in platelet survival corresponded to changes in serotonin uptake velocity and response to hypotonic stress. No correlation was observed between the values of the survivla in vivo, the serotonin uptake velocity, and the response to hypotonic stress within the separate suspensions of fresh and cryopreserved platelets. There was no indication that hypercoagulability was induced by infusion of small amounts of cryopreserved platelets.


A highly specialized and motivated volunteer population: platelet donors. The plateletpheresis program of the M.D. Anderson Hospital was established in 1963. Approximately 20,000 units of platelet concentrates are produced per year. Credit for the nonreplacement fee generates the greatest number of donors. No organized recruitment campaign exists. Each donor becomes a recruiter for the program. Also involved in donor recruitment are all laboratory personnel, as well as Donor Room exployees.


How donors and nondonors view people who do not give blood. Ninety Australian college students, both donors and nondonors, were asked why they felt other people did not give blood. Donors tended to stress fears, possible ill-effects, and the inconvenience of giving blood. Nondonors tended to dismiss most reasons, although more than half of them agreed with Fear of Being Pricked with a Neddle, Never Been Asked to Give, and Inconvenience such as Loss of Time.


Hemagglutination inhibiton in capillary tubes--a simple and reliable test for HBsAg. A technique is described which allows testing for HBsAg by hemagglutination inhibition in capillary tubes. The test is rapid, and compares favorably in sensitivity to radioimmunoassay. The equipment is simple, and its design eliminates the risk of infection from the HBsAg reagents.


Blood storage XXIII: 2,3-DPG maintenance for six weeks in a CPD-adenine-inosine preservative with and without methylene blue. In a pilot study the optimal concentration of inosine for 2,3-DPG maintenance in a CPD-adenine (0.25 mM) preservative was confirmed to be at lease 10 mM. In these experiments, 2,3-DPG maintenance was nearly normal for six weeks of storage in CPD-adenine-inosine (10 mM) preservative with or without methylene blue. The control preservative lacking inosine showed a statistically significant decrease in 2,3-DPG concentrations after the 3rd week. Finally, 2,3-DPG levels were significantly better maintained in CPD-adenine preservatives that contained 15 mM concentrations of inosine, whether methylene blue was present or not (10(-6)M), compared to CPD-adenine-inosine preservatives that contained 5 mM inosine, with or without methylene blue. The methylene blue effect, while it can be demonstrated in most experiments to help the red blood cell maintain 2,3-DPG during prolonged blood storage, is judges to be a slight value. However, inosine is of great value in maintaining 2,3-DPG for prolonged (five to six weeks) liquid storage.


Blood storage XXIV: red blood cell 2,3-DPG and ATP maintenance for six weeks in CPD-adenine with higher phosphate, pyruvate, and dihydroxyacetone. The individual and collective effects of various phosphate, pyruvate and dihydroxyacetone concentrations on 2,3-DPG and ATP maintenance during blood storage with CPD-adenine (0.25 mM), were studied. Phosphate concentrations ranged from 2 to 100 mM. Low concentations were best for 2,3-DPG maintenance during the first three weeks, after which there was no difference. ATP concentrations were better maintained by the highest phosphate concentrations in the first week. After the second week the lower concentrations of phosphate were better. With pyruvate 40 and 60 mM were the best for 2,3-DPG levels through six weeks of storage. ATP concentrations were poorest with high pyruvate. Maintenance of 2,3-DPG was above half normal for six weeks of storage in the 60, 80 and 100 mM DHA preservatives. ATP concentrations were best maintained in the preservative lacking DHA. Combinations of phosphate, pyruvate and DHA in concentrations which had been found to be effective when used individually were studied. Best maintenance of 2,3-DPG (above half normal levels) for six weeks was afforded by pyruvate, phosphate and DHA, and by pyruvate and DHA. ATP maintenance was best afforded by CPD-adenine alone and CPD-adenine with pyruvate and phosphate. Pyruvate alone maintained ATP less well and the pyruvate-DHA was worst. Intermediate in maintenance of ATP was the preservative containing pyruvate, phosphate and DHA.


Platelet transfusion survey in a regional blood program. We studied the pattern of use of platelets stored at 4 C. About half of 2,168 platelet concentrates were transfused to achieve hemostasis in 360 transfusion episodes. More than half of the platelet concentrates were given during the second and third day after collection. Of 164 prophylactic transfusion episodes including 44 plateletpheresis packs, 74 percent were given to patients with leukemia. Reactions to platelet transfusion occurred in about 4 per cent of the transfusion episodes. Considering our survey findings, the generally accepted properties of cold stored platelets and the capabilities and limitations of this blood bank, we plan to continue to store platelets at 4 C.


Hemoglobin screening in prospective blood donors: a comparison of methods. The microhematocrit (MHCT) (MHCT) of blood obtained by ear lobe puncture (ELP) was found to be higher than that obtained by fingerstick (FS). Using copper sulfate solution to estimate hemoglobin concentration of ELP blood will lead to accepting prospective blood donors that would be rejected by fingerstick obtained samples. Raising the specific gravity of the copper sulfate solution from 1.053 to 1.055 for females and from 1.055 to 1.057 for males eliminates the discordance for males but leads to rejection of females at a high rate (20 per cent). The use of FS/MHCT to recheck those failing the gravimetric test with higher specific gravity copper sulfate is suggested. The MHCT of venous samples obtained via the needle at the conclusion of phlebotomy will be lower than the  MHCT of a capillary sample obtained during screening because of a combination of : 1) hemodilution due to assumption of the recumbent position and 2) hemodilution in response to phlebotomy.


Exchange transfusion in sickle cell disease using a continuous-flow blood cell separator. An exchange transfusion was performed preoperatively on a patient with sickle cell disease using a continuous-flow blood cell separator. An exchange of 2,825 ml red blood cells achieved a hemoglobin A level of 90.8 per cent. The continuous-flow blood cell separator appears to offer a safe and effective method of exchange transfusion in sickling disorders.


Unacceptable variability of hemoglobin estimation on samples obtained from ear punctures. Sampling techniques were studied for the determination of the hemoglobin in volunteer blood donors. First, finger, ear, and venous samples were collected from 50 volunteers. Then five volunteers were monitored for a three-day period and finger, ear, and venous samples were collected daily. Thirdly, microhematocrits were done on the postdonation EDTA samples of 500 donors who had been screened using ear puncture copper sulfate hemoglobin estimations. Fourth, 25,437 donations were followed up to see whether capillary sampling techniques affected the rate of donor deferral. And finally, the ear sampling technique was varied using vigorous rubbing and manipulation to see if there was abnormal circulation that would affect the hematocrit results from capillary blood from the ear. We found that the microhematocrits averaged 7 per cent higher from blood obtained from ear puncture than from either finger puncture or venous puncture. Microhematocrits obtained from blood obtained by ear puncture were less accurate and less precise than blood from finger punctures. Finger puncture samples exclude approximately 6 per cent more donors than does blood from ear punctures.


An elapsed time-temperature monitor for blood storage. Blood should not be allowed to exceed 10 C while being stored or transported. However, one cannot test the internal temperature of a unit of blood without contaminating it. Most blood banks have established an arbitrary time limit beyond which a blood unit cannot be kept out of the refrigerator. This method is ineffective if blood is stored in a satellite refrigerator, since the blood may be moved in and out of the refrigerator and the blood bank personnel will be unaware of it. An elapsed time indicator is described which employs a small condenser (E-Cell-Plessey Electronics) charged with a known amount of electricity. If the device is removed from the refrigerator, it begins to discharge at a known rate. The amount of time subsequently can be determined by the loss of charge. The prototype of this instrument has been found to be quite accurate and small (2 inches X 2 inches X 1 inch). It would be rather inexpensive if made in considerable numbers.


Studies into the transplantation biology of ultraviolet light-induced tumors. The majority of skin tumors induced in mice by ultraviolet (UV) light are rejected when implanted into normal syngeneic recipients. Subcarcinogenic levels of UV light exposure render the normally resistant mice susceptible to tumor challenge. The immunoregulatory effect of UV light appears to be additive, since the growth rate of a tumor transplant is dependent upon the length of UV exposure administered prior to implantation. This suppressive influence does not appear to be directly mediated by the UV light, because the amputation of UV-irradiated tail skin allows for a retention of tumor resistance in otherwise tumor-susceptible hosts. UV-irradiated mice could also be immunized against UV tumors, which suggests that immune recognition of tumor-specific transplantation antigens has not been inhibited. The ability of UV exposure to alter normal immunological reactivity to UV-induced tumors is possibly an integral factor in the mechanism underlying UV carcinogenesis.


Application of laser cytometry to the analysis of immunologically induced in vitro lymphocyte responsiveness. This study defines an assay (laser analysis) that is a significant advance in our ability to quantitate and analyze immunologically induced in vitro lymphocyte responsiveness. Laser analysis is demonstrated to parallel radionucleotide incorporation (3H-thymidine) in terms of kinetic pattern, dose response characteristics, and statistical accuracy while exeeding radionucleotide incorporation in sensitivity. Direct quantitation of lymphocyte responsiveness, in terms of cellular proliferation, disclosed that substantial numbers of small lymphocytes were produced during in vitro stimulation with mitogen (concanavalin A) or antigen (streptokinase-streptodornase) in addition to the expected increase in lymphoblasts. The magnitude of this "total cellular response" (lymphocytes plus lymphoblasts) was found to be similar for antigen and mitogen stimulation, a finding not suggested by routine radionucleotide incorporation or morphological assays.


Simplified quality assurance of floor model centrifuges. Present methods for calibration of the rotor speed of large floor model centrifuges used for blood component preparation can be cumbersome and/or dangerous. This report describes a safe and inexpensive method of modifying a centrifuge lid so that calibration of the machine with a photoelectric tachometer is a simple and safe procedure.


Altered immune responses in pregnant mice. The immune responses of pregnant mice to alloantigens were studied using the 51chromiun release assay. Four populations of lymphoid effector cells were studied. Control lymphoid cells were from normal, virgin BALB/c females, and BALB/c females specifically immunized to (BALB/c X C3H) F1 spleen cells. Experimental lymphoid cells were from BALB/c females pregnant by BALB/c males (syngeneically pregnant) or C3H males (allogeneically pregnant). Target cells were 51chromiumlabeled phytohemagglutinin-induced lymphoblasts from BALB/c and (BALB/c X C3H) F1 animals. Pooled lymph node and spleen cells from BALB/c females pregnant by C3H males were not cytotoxic for (BALB/c X C3H) F1 target cells. Lymphoid cells were transferred to sublethally irradiated syngeneic recipients that were simultaneously challenged with (BALB/c X C3H) F1 alloantigens. One week later, the spleen cells of the recipient animals were used as effector lymphoid cells. Lymphoid cells from normal, syngeneically  pregnant, and allogeneically pregnant animals were equally cytotoxic for (BALB/c X C3H) F, target cells. Lymphoid cells from BALB/c animals specifically immunized to (BALB/c X C3H) F, alloantigens were highly cytotoxic for these target cells. Compared with the unmixed cell populations, mixtures of lymphoid cells from norman and syngeneically or allogeneically pregnant animals were hyporesponsive to alloantigenic challenge. Serum from neither syngeneically pregnant nor allogeneically pregnant animals inhibited the response of normal lymphoid cells to alloantigen. Immunoregulation in pregnancy was discussed.


Tn-polyagglutinability of red blood cells and acquired A-like specificity. A woman whose red blood cells are polyagglutinable due to Tn-activation is reported. The true blood group of the patient is B but her cells have an acquired A-like specificity. The importance of the lectins, especially of Salvia sclarae extract, for the identification of Tn-polyagglutinability is demonstrated. The possibilities of A-like specificity of Tn-activated group B red blood cells is discussed.


Genetic independence of the Lutheran and Diego blood group loci. The Diego locus had been shown to be genetically distinct from the loci for all the established blood group systems save that for Lutheran. This gap has now been filled, after 21 years, by studies of a Cree Indian family which demonstrates that Diego is separate also from the Lutheran locus.


Tumor-associated lymphoid cells: analysis of host cells that bind to syngeneic and allogeneic tumor cells shortly after tumor administration. A single intraperitoneal injection of irradiated EL-4 leukemia into syngeneic hosts induced in vivo immunity and in vitro cell-mediated response against EL-4. A nonadherent, theta-positive, peritoneal exudate lymphocyte fraction that bound to and lysed EL-4 in vitro was isolated from the tumor site. This system allowed the study of immune processes involving host lymphocytes as early as 3 days after tumor inoculation.


Lymphocyte differentiation and allograft reactivity. Experimental studies on the origin of thymic lymphocytes. The generalization that the developing vertebrate thymus is colonized by circulating stem cells that originate in the yolk sac blood islands is questionable. The view that the yolk sac is the primary source of thymic lymphocytes is based largely on inferences drawn from experimental protocols that are highly artificial.


Artificial colonization as a method for studying the normal habitat of mycobacteria. Sixteen species of mycobacteria were inoculated into samples of earth which were cultured immediately afterwards and then monthly for six months. Five species, and possibility a sixth, colonized the habitat suggesting that it was natural to them. Experiments of this type should provide a useful approach to field studies of the sources of opportunist mycobacteria.


A case of non-pulmonary tuberculosis due to Mycobacterium africanum. A case is reported of tuberculous osteitis of the ileum in an Asian woman who arrived in the United Kingdom from Uganda in 1970. The causative organism was M. africanum.


Solitary tuberculoma of the larynx: a case report. A case of solitary tuberculoma of the larynx in a 56-year-old man from Calabar, Nigeria, is presented. He had upper respiratory tract obstruction severe enough to necessitate a tracheostomy. It is suggested that tuberculoma of the larynx may not be as rare as a review of the currently available medical literature would suggest. More may be discovered if all cases of polypoid masses in the larynx, however innocent they look, are histologically examined.


[Effect of heparin on nitrogen metabolism in the myocardium of dogs under normal conditions and following an experimental myocardial infarct]. Heparin administered at the initial stage of myocardium infarction is shown to prevent a number of shifts in the metabolism of protein and polynucleotides of the injured heart. It does not promote the development of some changes, but intensifies only a few of those evoked by the ligation of coronary artery in the myocardium nitrogen metabolism. The preparation inhibitory effects are also slightly pronounced in the normal myocardium where the preparation activates many metabolic reactions of nitrogen-containing biopolymers. Inactivation of enzymatic systems in a cell is likely to be not the basic, as some researchers consider, but one of the secondary mechanisms of heparin incorporation into metabolism proceeding in normal and pathologically changed tissues.


[Fractional composition and methylation of liver cell nucleus histones during the early stages of radiation injury]. The radiation injury affects the quantitative ratio of histone fractions. The most pronounced changes in the percentage content towards a decrease are observed for the fractions F2a1 and F2a2 as well as for F2a 12 h and 24 h after irradiation, respectively. An increase by 41.8% is observed in the content of the fractions F2b+F3 12 h after irradiation. The methylation for all histones of the fractions increases considerably 2 h after irradiation, drops 12 h later in the fractions F2a1 and F3 and 24 h later in the fractions F3 and F1 as compared to the normal level.


[Conformational changes in rabbit muscle aldolase under normal conditions and following prolonged starvation]. The experiments were aimed at studying conformation differences of muscle aldolase in normal rabbits and those fasting for a long time and at finding the areas of polypeptide chains affected by the changes. For this purpose the difference, temperature- and solvent-perturbation spectra of the compared proteins were examined. On the basis of the data obtained on the same amount of chromophore groups in both proteins a conclusion is drawn on a more hydrophobic surrounding of tyrosine and tryptophan residues in aldolase of the long-fasting animals. When determing the content of the tyrosine and tryptophan surface residues an increase (from 13 to 21) was found in the number of the tyrosine residues in aldolase of the long-fasting animals. An assumption is advanced on localization of the primary structure changes in the molecule sites rich in chromophore groups or those located closer to them.


[Aspartate-carbamoyltransferase activity of rabbit liver tissue following x-irradiation and vitamin and ATP administration]. Under the effect of total X-ray irradiation (450 R) the changes in activity of aspartate-carbamoyltransferase in the rabbit liver are of wavy character depending on the time passed after irradiation. Administration of vitamin B (with ATP, in combination with ATP and B1 as well as with FMN and PP) is shown to produce an activating effect on the enzyme function in the irradiated animals.


[Relationship between tissue mitotic activity, animal age and defects in the secondary structure of DNA]. The content of defects of the secondary structure of DNA native and gamma-irradiated preparations from the intestinal mucosa and liver of adult (6-8 months) and old (24-26 months) rats was studied by the kinetic formaldehyde method. The content of the native DNA secondary structure defects does not depend on the animal and tissue mitotic activity. After gamma-irradiation in vitro (60Co, 550 R/min, 3 and 6 krad) of intestinal mucosa DNA solutions (tissues with a high mitotic activity) the content of the DNA defects is higher in old animals than in young ones. The injuring effect of gamma-rays is more pronounced in experiments with intestinal mucosa DNA than with liver DNA (tissue with a low mitotic activity). In liver DNA the content of the defects caused by gamma-rays does not depend on the animal age.


[Physico-chemical state of DNA after long-term storage]. A physicochemical state of DNA was studied during 1-2 years when stored under different conditions: in the citric-salt solution and in the solution of 0.9% NaCl in the cold, in the citric-salt solution at frozen state (biopolymer concentration in the solution being approximately 2 mg/ml) and under 80% ethanol as a loose filamentous precipitate at 40 degrees C. It is shown that DNA retains its macromolecular structure for a long time under given conditions of conservation. These conditions of DNA preparations storage may be used for biopolymer conservation.


[Degree of polymerization of rat cerebral hemisphere and testicular DNP-complex during hyperoxia and following it]. The concentration-related viscosity (formula: see text) of DNP-solutions in 4.0 M urea, 0.0005 M tris-buffer (pH 7.5) isolated from cell nuclei of cerebral hemispheres and testicles was determined for mongrel and Wistar rats of 5 groups: I -- normal, II -- after the action of 6 gauge atmospheres of pure oxygen before convulsions beginning, III -- 1 hour, IV -- 4 hours, V -- 12 hours after decompression. It was noted that the concentration-related viscosity of these DNP was equal both for mongrel and inbred rats. No differences in the polymerity degree of brain DNP were detected in all groups of animals under study. The viscosity of testicular DNP was found to decrease by 13.3% 1 hour and 10.3% 4 hours after decompression, whereas 12 hours after it does not differ from the control. Differences in the resistance degree of the brain and testicular DNP to the action of hyperoxia may depend on the cell division rates in these tissues.


[Effect of pyruvate and alpha-ketoglutarate on protein and lipid synthesis in rat tissues]. The in vivo and in vitro experiments on rats showed that administration of pyruvate and alpha-ketoglutarate causes stimulation of protein and lipid synthesis displayed in intensification of incorporation of the label from 1-14C lysine and NaCH14O3 into the mentioned components of the liver, kidneys, spleen, myocardium and femur muscles tissues. The stimulating effect of the studied ketoacids is much higher when incubating the slices in the Krebs-Ringer medium on the bicarbonate buffer than on the phosphate one (pH 7.4), that evidences for an important role of carbonic acid in biosynthetic processes.


[14C-nicotinate and 35S-thiamine distribution in the bodies of mice following acceleration]. Radioactivity of some tissues and subcellular fractions of the liver was studied in the control mice and those subjected to the action of acceleration at the different times after intra-abdominal injections of 35S-thiamine and 14C-nicotinate. The vitamins injections were single 20 min after the effect of overload. The overload is established to evoke essential changes in interorgan and intracellular distribution of the vitamins under study, 35S-thiamine in particular. At early periods of the experiment (5-20 min) after injection of 35S-thiamine radioactivity is observed to increase radioactivity in most tissues. In experiments with 14C-nicotinate the changes towards both an increase and decrease in radioactivity of certain tissues are marked to be less essential. The changes in the metabolic processes and permeability of biomembranes under conditions of overload action are a possible reason of the mentioned disturbances.


[Nucleic acid concentration and ribonuclease activity in muscles during their activity]. The content of RNA, activity of RNase and content of amino acids in skeletal muscles were studied as affected by muscular activity. The RNA level is shown to increase in the muscles of trained and untrained animals. The RNase activity lowers in animals of both groups. The load causes quantitative changes in amino acidic composition of the muscles; the content of cystine, cysteine, asparaginic acid, lysin and leucine decreases.


[Concentration of free nucleotides and turnover of adenine nucleotides in the liver of birds of different ages]. The content of free nucleotides and exchangeability of adenine nucleotides were studied in the liver of 1- and 18-month cocks. It is established that adenine nucleotides in the young cocks liver account for 40%, uridine nucleotides for 29%, cytidine nucleotides for 13% of the total amount of nucleotides. These ratios are maintained with age but the amount of adenine nucleotides decreases by 35% and that of uridine nucleotides by 22%. Against a background of a relatively constant level of adenine and uridine nucleotides the content of cytidine and guanine nucleotides varies synchronously within wide ranges, which can evidence for the presence of a common mechanism of regulating synthesis of these metabolites. A direct correlation is detected between the amount of adenine nucleotides and their specific radioactivity. This is due to a higher intensity of synthetic processes in young cocks. The inverse correlation is observed in adult cocks, that results from the effect of "label dilution".


[Alterations in the excess synthesis of riboflavin in Pichia guilliermondii under the influence of branched-chain amino acids]. The effect of the branched-chain amino acids: L-valine, L-isoleucine and L-leucine on riboflavin overproduction was studied in the Pichia (Candida) guilliermondii (Cast.) Lang. et G. yeast, L-Val, L-Ile and L-Leu were found to inhibit riboflavin overproduction only under iron-deficient growth conditions. Other amino acids used did not show this effect. In crude extracts of P. guilliermondii the specific activity of the alpha-acetolactate forming enzyme, pH 8.0, is inhibited by L-Val. It is revealed that the activity of alpha-acetolactate synthetase in iron-deficient riboflavin-overproduction cells was exceedingly higher than in the valine-inhibited cells. Under iron deficiency alpha-acetolactate synthetase shows maximal activity after 48 h of growth. It was possible to detect diacetyl (and aceton) in the culture fluid.


[Guinea pig spinal cord sterols in allergic encephalomyelitis]. Composition of sterols of the guinea pigs spinal cord unsaponifiables fraction was studied with experimental allergic encephalomyelitis (EAE). It is established that under conditions of EAE the cholesterol content is decreased by 48% as compared to normal. The amount of latosterol lowers as well and is 2.64 mg/g under normal conditions and 1.61 mg/g with EAE. A steroid compound which is more polar than cholesterol is found in the spinal cord. It is supposed to be cholesterol ether.


[Amperometric titration of erythrocyte membrane sulfhydryl groups]. The best conditions are selected for amperometric titration of erythrocyte membranes SH-groups by means of silver ions. On the basis of the experimental data, two types of SH-groups according to their capacity of binding Ag+ are found in the membranes. Dynamics of transition of SH-groups of types I into SH-groups of type II is studied. The chemical model explaining the presence of two bends in the course of the membranes amperometric titration curve is created. Calculations were made for the products of R-S-Ag solubility for SH-groups of type I and SH-groups of types I and II as well as for entropy and heat of formation of silver compounds with the membranes sulphydryl groups.


[Isolation and identification of desmosterol and its concentration in animal brain tissue]. A method is developed for isolating desmosterol fro the brain of some animals. Sterols with Rf 0.37 and 0.51 are identified. Desmosterol is found in the brain unsaponifiable fraction of calves, piggies, chickens and rats. Its content in the mentioned animals brain is compared. Desmosterol content is shown to rise sharply in the rat brain during the first 12 days after birth. Interrelation between the level of sterols in the brain and formation of the nerve tissue myelin sheath is discussed.


[Specific proteins of synaptic structures]. The article deals with the data concerning localization, properties and functions of specific proteins of nerve endings, especially in the synaptic vesicles and synaptic membranes, as well as concerning their metabolism. In the fractions of the synaptic vesicles and synaptic membranes simple and conjugated proteins (glycoproteids) typical of these high-specialized structures only are localized. Acid polypeptides, contractile proteins and neurospecific proteins of S-100, 14-3-2 type and glycoproteids are such specific proteins of the studied structures. Their possible function in the mechaninsm of secretion and circulation of mediators in synapses is discussed.


[Concentration of sulfhydryl groups and spectral properties of solutions of oxyhemoglobin modified by sodium dodecyl sulfate and UV-irradiation]. The content of sulphydryl groups and spectral properties of mice oxyhemoglobin (a concentration of 3.38 10(-6) M) were studied as affected by sodium dodecyl sulphate in a concentration of 1.38-10(-1) M. It is established that addition of the mentioned detergent to hemoproteid results in an essential decrease in the amount of SH-groups in it and in the disappearance of the globin absorption peak. An integral flow of UV-irradiation (0.36 = 1.8-10(8) erg/cm2) does not change the content of SH-groups in oxyhemoglobin preliminarily modified by sodium dodecyl sulphate; radiation doses of 3.6 = 10.8-10(8) erg/cm2 decrease it. The effect of long-wave UV-irradiation, inducing changes in the heme electron state, on hemoglobin modified by sodium dodecyl sulphate causes a rise in the number of SH-groups determined by amperometric titration. UV-irradiation of modified oxyhemoglobin, in contrast to irradiation of the native oxyhemoglobin, produces no shifts in the Soret band.


[Influence of adaptation to supercooling on the fatty acid composition of rat tissue lipids]. Adaptation to supercooling produces a considerable effect on composition and quantitative content of certain fatty acids in all the studied tissues. In lipids of the myocardium and skeletal muscles adaptation causes an increase in the content of unsaturated fatty acids in particular of polyenic ones. In lipids of the lungs, vice versa, the content of saturated fatty acids increases, chiefly due to palmitic acids. In lipids of the liver a ratio of certain unsaturated fatty acids changes noticeably: the content of monoenic acids rises but the content of polyenic acids is more than 5 times as low.


[Activity of DNAase I inhibitor in subcellular fractions of rat tissues]. The inhibitory activity in the mitochondrial and postmitochondrial fractions of the liver, spleen and thymus of albino rats was studied with respect to pancreatic DNase I. It is shown to be due to the presence of thermolabile substances of protein nature (natural inhibitors of DNase I) in the subcellular fractions of the organs under study. A higher inhibitory activity is detected in the postmitochondrial fraction of all the tissues under investigation. The lowest inhibitory activity is found in the mitochondrial and postmitochondrial fractions of the liver. The data of a simultaneous study of changes in the activity of tissue DNase and inhibitory activity in the subcellular fractions give reasons to suppose the presence of the nuclease-inhibitory complex in the tissues.


[Methylation of liver tissue amino acyl-tRNA-synthetases under different experimental conditions]. Incorporation of 14CH3-methionine into the total preparations of aminoacyl-tRNA-synthetases (ARSases) of the rat liver was studied under conditions of X-irradiation as well as with administration of neostigmine methylsulphate and nicotinic acid to the normal and irradiated animals. 3 h after irradiation of animals with a dose of 800 R specific radioactivity of the enzymic preparation increases on the average by 70%, and irradiation against a background of neostigmine methylsulphate administration causes its decrease on the average by 65% as compared to the norm. Thin-layer chromatography on silicagel showed the presence of such methyllated amino acids as lysine, histidine and arginine in acidic hydrolyzate of ARSase total preparations under all the studied experimental conditions.


[Label incorporation from 2-14C-glycine into the collagen proteins of the bones of rats with rickets]. The content of collagen in the bone tissue of rats and incorporation of 14C from 2-14C-glycin into it were studied as affected by vitamin D deficiency. It is established that under experimental rachitis intensity of the radioactive label incorporation into soluble collagen is 1.7 times as low as in the norm. A decrease in the amount of the collagen soluble fraction and accumulation of its insoluble fraction and distribution of radioactivity in these fractions might evidence for rapid "ripening" of soluble collagen in the rats with D-hypovitaminosis.


[Age and changes in the concentration of dicarboxylic amino acids and GABA in different portions of the dog cerebral cortex and cerebellum]. The content of dicarboxylic amino acids lowers with age in all the structures of cerebral cortex and cerebellum under study when calculating per I g of fresh tissue and 100 mg of protein. The greatest decrease in the amount of glutaminic and aspartic acids is found in the parietal region at the senile age. The content of GABA in all the brain  structures of three-year dogs is significantly higher than in the one-year dogs and at the senile age it is somewhat lower as compared to the three-year animals when calculating per 1 g of fresh tissue, the degree of the decrease in all the studied regions being practically the same.


[Incorporation of 1-14C-acetate into unsaponifiable lipids of slices of regenerating rat liver]. Incorporation of 14C into unsaponifiable lipids, sterols and their presursors, hydrocarbons, isolated from sections of the rat regenerating liver studied after their 6-hour incubation with 1-14C-acetate. Intensity of the label incorporation into unsaponifiable lipids and sterols increases significantly the first three days after hepatectomy and decreases on the 15th day, intensity of incorporation into hydrocarbons rises significantly the first six days and lowers on the 15th days after hepatectomy. The label is observed to be incorporated more intensively into the total unsaponifiable lipids and hydrocarbon fraction as compared to sterols, that may evidence for activation of these compounds biosynthesis at initial stages.


[Mechanism of labilization of Penicillium vitale glucose oxidase]. The article deals with conditions for splitting the Penicillium vitale glucosooxidase molecule into apoenzyme and coenzyme, for reconstruction of the enzyme from apoenzyme and FAD as well as for the effect of some factors ("labilizing" fraction, dithiotreitol) on it. Specific activity of the reconstructed enzyme is on the average 85% of the initial enzyme specific activity: "the labilizing" fraction inhibits reconstruction of glucosooxidase from apoenzyme and FAD, that is due to oxidation of the apoenzyme sulphydryl groups. Possible participation of sulphydryl groups in adding FAD to apoenzyme is under discussion.


[Changes in the lipid composition of mitochondrial membranes following exposure to low temperatures]. The phospholipid composition of the membranes of the albino rat liver mitochondria was studied by the method of thin-layer chromatography before and after rapid freezing down to --196 degree C and rapid (at 37 degree C) and slow (at room temperature) thawing. Significant reduction of lecithine and ethanolamine phosphatide composition is observed in the mitochondria exposed to rapid freezing and slow thawing. A simultaneous accumulation of diglycerides is found in the membranes. No reliable changes in phospholipid composition of the mitochondria membranes are observed after exposure to rapid freezing and rapid thawing.


[Effect of hyperoxia on RNA and protein concentration in cortical and spinal motor neurons and surrounding neuroglia]. Double-beam recording visible cytospectrophotometry showed that 30-minute convulsions due to 6 at. ga. hyperoxia result in a decrease in the RNA and protein content per cell in layer V neurons of the cerebral motor cortex and in the motoneurons of spinal cord anterior horn in albino rats. A decrease is also found in the glial cells, except for a spinal cord neuroglia. A decrease in the RNA content in the neurons as well as the protein content in the neurons and glia of the spinal cord is more pronounced than in similar structures of the cerebral motor cortex. The quantity of RNA and protein in the neurons and neuroglia of the cerebral cortex remins decreased for 24 h after hyperoxia cessation. In the spinal cord motoneurons the level of the RNA and protein becomes normal 3 h after hyperoxia, and 24 h later it exceeds the initial one.


[Use of angular rotors for analysis and fractionization of calf thymus DNA]. Behaviour of calf thymus heterogenous DNA was studied in the angular rotor Ti50 of the preparation ultracentrifuge. A drop in DNA polymericity from 8-10(6) to 4-10(5) daltons and decrease in the amount of the applied material result in detecting the known satellite component with delta1 = 1.714 g/cm3, the value of the floating density of the main peak takes on the "true" value delta = 1.699 g/cm3. The method of digging up affects the symmetry of polymeric sample profiles. The satellite component is not found when digging up from the tube bottom. The values of GG content of the light and "heavy" fractions calculated from their floating densities during repeated centrifugation in the angular rotor and from fusing temperatures are in good agrrement.


[Influence of different carbon dioxide concentrations on protein, lipid and nucleic acid metabolism in rat liver]. When the content of carbonic acid in the incubation media increases from 10 up to 40 mM at pH 7.2, 7.4 and 7.6, incorporation of 14C into lipids is twice as high due to such precursors as glycine-2-14C, acetate-2-14C and valine-1-14C. A stimulating effect of carbonic acid high concentrations on the intensity of 14C incorporation from the mentioned precursors into proteins and from glycine-2-14C into RNA is observed at all the studied values of pH of the incubation medium, whereas the same activation with respect to DNA is the most pronounced at pH 7.2 and 7.6.


Some consequences of ciliary process swelling in the rabbit and in the human. Experimental and clinical observations have been evaluated in an attempt to gain further information about the effect of ciliary process enlargement on the angle of the anterior chamber. Swelling of the ciliary processes produced by the topical instillation of prostaglandin E2 into the eyes of rabbits has been described and compared to similar changes in a patient with ciliary block glaucoma. There seems little question but that most of what is manifest in the anterior chamber is but a reflection of very significant pathologic change in the posterior chamber.


Pseudo-Duane's retraction syndrome.

Pseudo-Duane's retraction syndrome. Five patients presented with signs that were similar to but opposite from Duane's retraction syndrome. Most had a history of orbital trauma. On attempted abduction a narrowing of the palpebral fissure and retraction of the globe was observed. Diplopia with lateral gaze was present. Roentgenograms (polytomograms) showed involvement of the medial orbital wall. Forced ductuin tests were positive. Surgical repair of the fracture and release of the entrapped muscle as determined by forced duction tests and by postoperative motility led to successful results.


En bloc removal of intrinsic neoplasms of the lacrimal gland. The management of intrinsic neoplasms primary in the lacrimal gland is of serious concern because (1) some of the most malignant primary tumors of the orbit occur in this glandular structure and (2) present surgical techniques may easily disseminate the neoplasm and contribute to death or recurrences. We propose a surgical approach in which the tumor and adjacent adnexa are removed in a one-stage procedure, that is, an en bloc resection of the neoplasm, its periorbital base, and surrounding bone. This technique will minimize seeding of the tumor, provide a more complete eradication of the neoplasm without loss of the eye, and hopefully, assure either a cure or a longer interval free of local recurrences or metastasis than is presently attainable.


Retinal atheromatous plaques: their recognition by elevating the intraocular pressure. Recognition and further study of existing retinal atheromatous plaques in the central retinal artery may be enhanced by pressure on the globe. This simple maneuver should be used when patients with transient ischemic attacks (cerebral or ocular) are examined with or without atheromatous disease of the carotid artery. Previously unseen or suspected plaques may be brought into view. Plaques already visible may appear larger or vary greatly in both color and texture giving indication of their composition. The recognition of these atheromatous plaques is important in the diagnosis of atheromatous disease.


Cryosurgery for treatment of trichiasis. We cryosurgically destroyed eyelashes in rabbits and applied the technique to treat 23 selected patients with trichiasis. Liquid nitrogen was sprayed on the eyelid margin by using a double, rapid-freeze, slow-thaw cycle monitored by a subcutaneous thermocouple to -30 degrees C. It was an improvement on electrolysis and a simple alternative to surgery.


The nystagmus blockage syndrome.

The nystagmus blockage syndrome. A previously unrecognized form of nystagmus associated with esotropia was described in the German literature by Adelstein and Cüppers in 1966 as the nystagmus blockage syndrome. Even though widely publicized in the European ophthalmic literature, this entity has remained virtually unrecognized in this country. We have identified the nystagmus blockage syndrome in 12 of 247 consecutive patients with congenital esotropia. The following characteristic features were encountered: onset of esotropia in early infancy, pseudoabducens paralysis, head turn toward the side of the fixating eye, absence of nystagmus with the fixating eye in adduction, and appearance of a manifest jerky nystagmus as the fixating eye moves into primary position and abduction. It has been suggested that the nystagmus is actively blocked by convergence innervation, the esotropia thus being caused by sustained convergence and secondary changes in the medial rectus muscles. The differential diagnosis includes crossed fixation and bilateral sixth nerve paralysis.


Bone changes in the adult anophthalmic orbit influencing oculoplastic reconstructive considerations. Decreased orbital development following enucleation is a well recognized condition in the young person and is lessened by orbital implantation at the time of inital surgery. Pfeiffer, some 30 years ago, suggested that bone changes as well as the soft tissue changes could also continue to take place in the adult resulting in added orbital changes. While this has been questioned, the findings originally reported by Pfeiffer are firmly substantiated by roentgenograms and documented in this report. If there has been a significant interval of time following the enucleation, careful roentgenographic evaluation prior to cosmetic oculoplastic revision of the orbit should be done even in the adult.


Combined trabeculotomy and cataract extraction as a single operation. A technique for combined trabeculotomy and cataract extraction is described. The application of the combined procedure in 17 eyes with chronic glaucoma and immature senile cataract is described. The results were uniformly good, and only one patient required further treatment for glaucoma.


Disciform lesion overlying melanocytoma simulating progression of choroidal melanoma. A 49-year-old white patient presented with a small pigmented lesion nasal to the disc. The clinical appearance of the area in question was noted to change over a four year period and simulated a progressively enlarging choroidal melanoma. On enucleation, the lesion was histopathologically proved to be a melanocytoma located nasal to the optic nerve head. It caused--or was at least associated with--an overlying disciform hemorrhagic and transudative response secondary to a neovascular ingrowth through Bruch's membrane. Thus, a melanocytoma must now be considered another of the possible causes of a disciform-shaped fundus lesion.


A clinical pathologic study of mercurialentis medicamentosus. Thirty-one patients who used eye drops containing the preservative, phenylmercuric nitrate for from 3 to 15 years, developed a brownish pigmentation of the anterior capsule of the pupillary area. Light and electron microscopic studies on two lenses demonstrated deposits of dense particulate material resembling melanin pigment on and in the anterior capsule of the lens in the area of the pupil. Special studies, including electron microprobe analysis and neutron activation analysis established the presence of mercury in a lens with mercurialentis. No mercury was found in two lenses used as controls.


Total lower lid reconstruction: technical details. The main complications of this type of lower lid reconstruction are lash loss or malposition, entropion of the upper lid, upper lid retraction, undue laxity of the lower lid, and lid margin deformities. These can all be avioded by meticulous attention to surgical details and dressing techniques. I believe that this is the best and simplest method of providing a lid of acceptable function and appearance. The advantages of this type of operation are: (1) The new lower lid is constructed of lid tissue including the tarsus and conjunctiva from the upper lid. (2) The function and appearance of the new lower lid are acceptable with practically no tendency to late retraction. (3) The function and appearance of the upper lid need not be interfered with. (4) No external scars are produced except when a lash transplant is done. This transplant leaves a small, hardly noticeable scar in the lower part of the opposite brow. (5) The technique is relatively simple and well within the realm of any well-trained ophthalmic surgeon. The obvious disadvantages are the surgeon's inability to inspect the eye for two to four months and the inconvenience to the patient of having one eye closed for such a long period of time.


Progressive bilateral essential iris atrophy. A case of bilateral progressive essential iris atrophy, more advanced in one eye than the other, has been studied. Histopathologic examination of the iris from the eye with the more advanced iris atrophy failed to find any vascular abnormalities in that the vessels were patent and appeared normal except for accumulated perivascular connective tissue. Fluorescein angiographic examination of the right eye which was undergoing the earliest changes of iris atrophy failed to show any vascular abnormalities. However, tonographic examination indicated a markedly decreased outflow facility. There does not appear to be any vascular abnormality involved in the pathogenesis of this case.