Heptadecapeptide gastrin: measurement in blood by specific radioimmunoassay. The characteristics are described of an antibody (designated L6) which has virtually absolute specificity for heptadecapeptide gastrin. This antibody binds G17, but does not bind peptide fragments or molecular forms of gastrin comprising G17 with either amino acid deletions, or additions, at the carboxyl- and amino-terminals. In serum from patients with Zollinger-Ellison syndrome the only form of gastrin revealed by L6 was compatible with G17, and there was good agreement between estimated G17 concentrations in serum analyzed by gel filtration and by direct radioimmunoassay using L6. Using L6 in conjunction with antibodies specific for carboxyl- and amino-terminals of G17 it has been possible to measure concentrations of different forms of gastrin in serum of normal subjects after a meal in greater detail than previously possible. After a light meal consisting of eggs, toast, and Oxo, serum concentrations of G17 measured by L6 increased to a peak 20 min after feeding (delta gastrin, 19 pmoles per liter; n = 17). In contrast, concentration of G34 peaked at 50 min (delta gastrin, 27 pmoles per liter). Small amounts of amino-terminal fragments of G17 were present throughout the digestive period. Applying the known ratio of biological potencies of G34 and G17 for stimulation of acid secretion in man, it is estimated that G17 accounts for about 75% of the biological activity in blood after a meal, even though G34 is present in higher molar concentrations.


Effects of synthetic human gastrin I on movements on water, electrolytes, and glucose across the human small intestine. The effect of graded doses (0.125, 0.500, 1.00 and 2.00 mug per kg per hr) of intravenous synthetic human gastrin I (SHG) on jejunal transport of water, electrolytes, and glucose from a glucose-saline solution (solution II) was studied in 12 healthy volunteers, using an intestinal perfusion technique with a proximal occluding balloon. SHG when infused at rates of 0.500 mug per kg per hr or greater significantly reduced water and electrolyte absorption; this effect was linearly related to the dose and reached 40 to 60% of basal absorption (and only 10% for glucose) with the highest dose; insorption of sodium and water were significantly decreased by SHG. In a further group of 9 subjects no effect of SHG (2 mug per kg per hr) was found on jejunal absorption from a mannitol-saline solution (solution I) and on ileal absorption from solutions I and II; in 5 additional subjects, SHG did not decrease jejunal transit time of intraluminal fluid. There was no increase in serum thyrocalcitonin during SHG infusion. It is proposed that SHG selectively depresses the glucose-stimulated sodium transport as suggested by the reduction of the rate of net sodium absorption per micromole of glucose absorbed during SHG infusion. Physiological and pathological implications of these findings are discussed, especially in the light of the circulating levels of immunoreactive gastrin achieved during SHG infusion.


Studies on translocation of immunoglobulins across intestinal epithelium. II. Immunoelectron-microscopic localization of immunoglobulins and secretory component in human intestinal mucosa. To define mechanisms involved in the transport of immunoglobulins into intestinal fluids, we localized IgM, IgA, IgG, and secretory component (SC) in human intestinal mucosa by the peroxidase-labeled antibody technique. At the light microscopic level, immunocytes containing IgA, IgM, or IgG were found in the lamina propria. IgA, IgM, and SC were prominent in the epithelium of gland crypts; IgG was limited to a few cells at tips of villi. At the electron-microscopic level, SC was localized to perinuclear spaces, endoplasmic reticulum, saccules associated with Golgi complexes, cytoplasmic vesicles, and lateral and basal plasma membranes of columnar epithelial cells. IgA and IgM, but not IgG, also were localized to plasma membranes and cytoplasmic vesicles of these cells. Neither the immunoglobulins nor SC was found within other types of epithelial cells (Paneth, goblet, endocrine). The findings provide evidence that (1) the site of SC synthesis in intestinal epithelium is secretory columnar cells, principally those in gland crypts; (2) the polymeric immunoglobulins IgM and IgA are translocated through such SC-containing cells by a process that involves formation of cytoplasmic vesicles; (3) IgM and IgA could combine with SC during transcellular transport (likely sites are lateral or basal plasma membranes or supranuclear cytoplasm); (4) the monomeric immunoglobulin IgG does not share the transepithelial cell route involved in IgM and IgA transport.


Mechanism of action of metoclopramide on opossum lower esophageal sphincter muscle. The purpose of this study was to investigate the mechanism of action of metoclopramide on the lower esophageal sphincter (LES) muscle of the opossum. Metoclopramide gave a dose-related increase in LES muscle active tension. A peak response of 12.5 +/- 2.1 g (mean +/- SEM) was achieved at 3.1 X 10(-4) M. The maximal and submaximal LES muscle response to metoclopramide could not be antagonized by atropine, hyoscine, hexamethonium, tetrodotoxin, phentolamine, diphenhydramine, or propranolol. Metoclopramide did not augment the submaximal muscle responses to gastrin I, acetylcholine, or norepinephrine. These studies suggest that in the opossum, metoclopramide acts through a direct action on the smooth muscle.


Relationship of cervical and abdominal vagal activity to lower esophageal sphincter function. The purpose of this study was to compare the effects of electrical stimulation of the abdominal and cervical portions of the vagus on lower esophageal sphincter (LES) pressure in the anesthetized opossum. Unilateral or bilateral abdominal vagotomy gave no significant change in basal LES pressure or in the sphincteric response to swallowing. Electrical stimulation of the peripheral end of the sectioned cervical vagus gave a frequency-related decrease in LES pressure with a maximum reduction of 93.5 +/- 2.5% at 10 HZ, 10 V. Stimulation of the central end of the cervical vagus increased LES pressure, with a maximum response of 34.0 +/- 1.9 mm Hg. Neither peripheral nor central stimulation of the sectioned abdominal vagus had significant effect on LES pressure (P greater than 0.05). Additionally, LES relaxation in response to swallowing or cervical vagal stimulation was intact after bilateral abdominal vagotomy. These studies suggest that whereas the cervical portion of the vagus mediates inhibitory and excitatory changes in LES pressure, the abdominal vagus has no demonstrable role in the control of LES function.


[Breech presentation and its significance (author's transl)]. From 1959 to 1975, 1060 (3.6%) breech presentations were found among 29,463 infants. The breech deliveries from May 1, 1959 to December 31, 1965 were compared with those from January 1, 1966 to December 31, 1975. Among the 3.6% breech deliveries there were 47% male and 53% female. There were more primigravida breech deliveries in both groups. The mean age of the mothers was 25.4 years for primigravidas and 29.4 years for multiparas. There was a maternal mortality of 0.2% (2 cases) in breech delivery. 29% of the breech deliveries were premature deliveries. There was a strickingly high incidence of frank and full breech deliveries among all patients. Knee presentations were rare. Delivery was primarily accomplished with the Bracht manoeuver in over 80% of the cases. Complete breech extractions decreased and the incidence of Caesarean Sections rose from 6% in the first group to 21% in the second group of patients. During the past 3 years the Caesarean Section rate was approximately 30%. Perinatal complications in the breech deliveries compare well to those reported in the literature. Of 750 mature infants (70.8%), 12 died (1.6%). Discounting children with congenital malformations and intrauterine stillbirth there remained 5 deaths from breech deliveries (0.7%). Of 1032 breech deliveries with a birth weight of 1000 grams or over, 74 infants (over all perinatal mortality 7.2%) died. 110 infants of all breech deliveries had a birth weight of less than 2500 grams (prematurity rate 29.2%). Of 102 cases of perinatal mortality in breech deliveries including those below 1000 grams 90 (88.2%) were premature. Of those 90 premature deaths, 28 infants were less than 1000 grams. 25 infants showed fetal congenital abnormalities. The corrected perinatal mortality of the premature deliveries was therefore 11.9%. The rate of birth trauma was 6.3% in the first group and 2.7% in the second group.


[The prognosis of intrauterine fetal growth retardation (author's transl)]. Intrauterine growth retardation is described and 232 cases observed between 1970 and 1973 are reported. The prognosis for the infant is dependant upon the birth weight. Dysmature infants with a birth weight above 2000 grams show relatively few signs of antenatal and postnatal pathology. With a birth weight between 1000 and 2000 grams a perinatal mortality of 50% must be expected unless delivery is performed by primary Caesarean Section. The available methods of observation of high risk pregnancies permit an accurate determination of the best time to terminate the pregnancy. Under optimal conditions the long term prognosis for dysmature infants around 1500 grams birth weight is good.


[The importance of the results of pretreatment pelvic lymphographies in the prognosis of carcinomas of the uterine cervix. A critical evaluation of the proposal to classify these tumors according to the TNM system (author's transl)]. Between 1966 and 1969, 494 patients with carcinoma of the uterine cervix stages I a to IV were admitted in our hospital for primary treatment. In 420 of these patients with carcinoma of the cervix stage I b to IV, complete results of bilateral pretreatment pelvic lymphography are available. The correlation between the results of the lymphographies, the choice of the operative treatment and the cure rates in these 420 cases are reported. All the correlations between the results of the pretreatment lymphography and the prognosis are described. A positive lymphography was in our series of high prognostic value. A plea is therefore made to include the results of the pretreatment lymphography into the classification of carcinoma of the cervix. Classification of the carcinoma of the cervix into the TNM categories is desirable. Our series is reported in these TNM categories. The advantages of such classification are described. The morbid entity of carcinoma of the cervix becomes more transparent to the observer and the choice of operative therapy becomes easier. The prognosis is more clearly established. The proposals of the TNM committee of the UICC for the classification of carcinoma of the cervix according to the TNM categories and the staging according to these categories are discussed critically.


[The maternal and fetal levels of human chorionic gonadotropin, human placental lactogen and prolactin during the perinatal period (author's transl)]. The levels of human chorionic gonadotropin (HCG), human placental lactogen (human choriosomatomamotropin HCS) and prolactin (PRL) were determined in the serum of 72 maternity patients and the serum of the newborn infants. The determinations were done with radioimmunologic tests (RIA). These three protein hormones were also determined in the amniotic fluid and in the maternal serum from 4-6 days prior to the delivery of the infant. The concentration of HCG or HCS in the serum of the newborn infants was a mean 0.43 or 0.37% of the level in the maternal serum. The concentration of PRL in the serum of the newborn was 118% and slightly higher than in the serum of the mothers. The concentration in the amniotic fluid was 1.5% for HCG, 5.8% for HCS, and 252% for PRL, compared to the corresponding levels in the maternal serum. The fact that the hormone concentrations in the amniotic fluid are significantly higher than in the serum of the newborn suggests excretion of the hormones from the fetal circulation via the fetal liver and the fetal kidney. The high levels of PRL in the maternal and the newborn serum may be caused by the high concentrations of estrogen or progesterone. Increased during the course of the pregnancy there was a significant sex linked difference in the level of HCG in the maternal serum correlated to the sex of the newborn infant.


[Further reproduction after clomiphene-induced pregnancy (author's transl)]. The study of menstrual pattern and further pregnancy after clomiphene-induced pregnancy showed a comparatively high rate of improved menstrual pattern and of spontaneous conception. 12 of 29 women, who concluded a clomiphene-induced pregnancy more than 2 years ago, showed an improvement of menstrual pattern. Spontaneous conception occurred in 16 of the 29 women, in 2 cases once more. It is remarkable, that 7 of these 16 women conceived spontaneously without any improvement of menstrual pattern following the clomiphene-induced pregnancy. It is therefore difficult, to advise patients and to make a prognosis concerning further fertility. It is not possible to say, that spontaneous conception can be excluded respectively that it will occur. In case of desire for pregnancy another induction of ovulation is indicated, on the contrary contraceptive questions are to be discussed.


[The prognosis of female genital sarcomas of the adult woman with special reference to sarcomas of the uterine corpus (author's transl)]. Report on 88 cases of sarcomas of the female genital organs. The sarcomas were confined to the uterine body in 72 cases. The prognosis of this disease depends primarily on the adequacy of the treatment. The treatment consists of as radical an operation as possible followed by external radiation and intra-vaginal application of radium. The microscopic type of the sarcoma of the uterus is of secondary importance. Patients who survived for 3 years following this treatment have a good prognosis for a 5 year or a 10 year cure. Other sarcomas of the female genital tract are mentioned.


[Vaginal hysterectomy for therapeutic abortion and simultaneous sterilization (author's transl)]. Report about the experiences in termination of 25 early pregnancies by vaginal hysterectomy in cases final infertilisation was necessary. Advantages of the method are seen in avoiding dilatation of the cervix and in the calculable blood loss as compared to suction or curettage for abortion and simultaneous sterilization. In contrast to many apprehensions the risks do not seem to rise when performing vaginal hysterectomy of the pregnant uterus up to the 12th week. Advantages and criteria of the method are discussed.


[Cytogenetic studies in women with primary amenorrhea (author's transl)]. During the past 10 years, 106 women with primary amenorrhea were studied. According to the X chromatin determination the cases were subdivided into 2 main groups. In the X chromatin negative group the Y chromatin positive and the Y chromatin negative cases were differentiated by fluorescent methods. The diagnosis was made according to the chromosome analysis. The X chromatin positive cases were classified following in detail clinical and cytogenetic studies. In our series, 50% of the cases showed chromosomal abnormalities whereas the literature reports 20-25% chromosomal abnormalities.


[Cytological, bioptical and cytophotometric studies on tumors of the breast (author's transl)]. 209 mammary biopsies were evaluated by cytological and histological methods. 23 of them were analysed by microspectrophotometry. 9,5% of the cases could be classified as Papanicolaou III. At one hand the mammary carcinomas of this group were underestimated, on the other hand fibroadenomas and hyperplastic lesions of cystic disease of the breast were overevaluated. The DNA-histograms of these fibroadenomas and hyperplastic lesions reflect closely the tendency of proliferation of epithelium and correspond with the cytomorphological findings, a reliable differentiation of these diseases on the basis of a tumor-histogram is not possible. False negative tumor histograms are particularly found in high differentiated carcinomas. In the other groups the cytological findings were in agreement with histological examination in 92-98% of the cases.


[The success prognosis of plastic diaphragma operation on women with stress incontinence (author's transl)A1]. The paper refers to 126 patients on whom a plastic diaphragma operation was performed at the 1st Department of Obstet. and Gynec. of the University of Vienna. Based on the results one year after the operation, the success chances are shown and set into relation to several preexistent factors, such as severity of the incontinence, weight, parity, age and conduct of life. An increasing of the two first mentioned factors led to a significant deterioration of results. The influence of an incontinence remains incontested, yet a higher parity does not lead to significantly poorer operation results. As to the factor "age", there were no significant differences in our material. Conduct of life and additional stress in women employed in an occupation are being discussed. Furthermore it was possible to confirm the postoperative space of time needed until restoration of an undisturbed bladder function as a relatively reliable prognostic hint to the expected success of the operation. For this confirmation an objective examination method (sphincterotonometry) was used.


[The uterotropismus of halothane, chloroform or methoxyflurane in clinical use (author's transl)]. To perform episiotomy, 89 women after childbirth were anaesthetized with either halothane (50 patients), methoxyflurane (24 patients) or chloroform (15 patients). The activity of the uterus was registered tocodynamographically. To examine the alternate influence of narcotics and uterotonica, 57 patients were pre-medicated with sintocinon and methergin i.m. as a prophylaxis. The second group (32 patients) received no premedication to stimulate labor activity, however in 18 cases towards the end of narcosis oxytocin and methergin were given i.v. In addition to these examinations 5 vaginal deliveries were anaesthetised with halothane only. Concerning our own experimental study it can be observed: 1. The relaxative properties of halothane wich suppresses completly the activity of myometrium during the deep stages of anaesthesia are superior to chloroform and methoxyflurane. 2. More rapid relaxation of the uterus with halothane compared with chloroform and methoxyflurane. 3. After the use of halothane a quicker return of the activity of the uterus compared with chloroform and methoxyflurane. 4. The value of a prophylaxis with uterotonica can be demonstrated by a comparatively reduced slowing-down of labour-activity during anaesthesia. 5. In every one of the cases, an interuption of the labour-suppressing, caused by the anaesthesia, can be obtained by injecting intravenously oxytocin or methergin. 6. During vaginal delivery, compared to the post placentar phase, there is no need for higher concentrations of halothane to be used to suppress labour contractions. The discussion deals with the intensity of reduction of the uterus contraction caused by the above mentioned narcotics, the dangers of the atony of the uterus, and the indications and contra-indications of obstetrical anaesthesia with halothane or methoxyflurane.


[Religion and size of family (author's transl)]. In the present economic society with its production patterns, religion slowly looses its influence on the size of the family. The vital statistics from 1973 to 1975 in Bavaria were reviewed regarding the birth registry in correlation to the religion of the marriage partners and to the birth rate was obvious not only in mixed marriages but also in marriages of the same religion. This development was especially apparent in marriages of less than 2 years duration. Exceptions were marriages in which one of the 2 christian religions, Roman Catholic or Protestant. In these cases, one marriage partner was usually not a German citizen. Different religions, value systems, different ethical values and ethnic considerations were of importance. In industrial societies, technology and economics are the dominant factors influencing human reproduction. This opens a large field for investigation by demographers, sociologists, psychologists, and physicians.


[Experience with the use of cystometry and simultaneous cystometry and urethrometry to clarify urinary incontinence in women (author's transl)]. Cystometry and simultaneous cystometry and urethrometry were conducted in 81 incontinent female patients (46 Grade I, 35 Grade II, according to the Ingelman-Sundberg Scale). The tonometric criteria for stress incontinence were presented and discussed by statistically comparing the pressure parameters for continent and incontinent patients. The results of both examinations indicated that, in almost all cases, the cause of incontinence (bladder, bladder obstruction or combination of both) can be determined with certainty. This method is well suited as a routine procedure to clarify urinary incontinence in women.


[Local tissue necrosis after appendicitis in pregnancy (author's transl)]. A local necrosis of the abdominal wall in the previous appendectomy scar was observed in a Gravida 3 at 32 weeks gestation following appendectomy for acute appendicitis. The findings and the clinical course were suspicious of a condition resembling local Shwartzman Phenomenon.


[The untreated congenital adrenogenital syndrome on the light of modern diagnosis and individualized treatment (author's transl)]. A case of untreated adrenogenital syndrome in a 19 year old patient is described. The patient refused treatment and a name and sex change was effected in the registry following psychiatric consultation. The clinical, genetic and psychological problems of the adrenogenital syndrome are discussed. The importance of early diagnosis and treatment are again emphasized.


[A report about the problem of Mayer-Rokitansky-Kuester-syndrome (author's transl)]. Twenty cases of Mayer-Rokitansky-Kuester-syndrome from Iran are reported with the results of corrective surgery. One pecularity of this syndrome never recorded previously is the unilaterality of the condition and endometrium in the secretory phase. We suggest that this abnormality may have some racial or sectorial incidence.


[Transcervical electro-resection of large polyps of the uterine cavity (author's transl)]. A 65 year old hypertensive and diabetic patient who had several laparotomies and several unsuccessful curettages for vaginal bleeding was relieved of bleeding endometrial polyps with the aid of a 24 Charrier-Wolf electro-resectoscope for urological use.


[A case of actinomycosis of the fallopian tube (author's transl)]. Reported is the rare case of an actinomycosis of the right Fallopian tube. The clinical picture is characterized by a comparatively sudden onset of abdominal pain, obstipation and feaver as well as a markedly increased ESR. Good co-operation between the various clinical disciplines (urology, surgery, internal medicine, gynecology) lead to an exact preoperative localization of the scaring and infiltrating process that is then verified by laparotomy. The right adnexae show massive inflammatory infiltrates and form a conglomerate tumor with the adjacent sigma and appendix. Characteristic actinomycetic druses are found histologically only in the right Fallopian tube. On the left side a florid non-specific salpingitis is antibiotics is withoug complications. Mode of infection, differential diagnosis and prognosis that is dependent on a correct diagnosis at an early stage are discussed.


[Ultrasound diagnoses and cardiotocography in case of full-time carried intraligamentous gravidity (author's transl)]. Description of the course of disease concerning an intraligamentous pregnancy carried to full term, but diagnosed only during operation. Subsequent evaluation of the ultrasonic and cardiotocologic graphs. Constantly rectilinear pressure curves without uterine activities are interpreted as characteristic tocographic criteria of an advanced ectopic gravidity.


[Arteriopathia calcificans infantum (author's transl)]. Three stillbirths of one woman are reported, which showed an arteriopathia calcificans infantum in the autopsy. There are 84 cases of this illness in the international literature. After a presentation of the autopsy results, comments are given on the etiology and pathogenesis, using the clinical and chemical findings of the mother.


[Cytology and histology of vaginal leiomyosarcoma: a rare tumor (author's transl)]. Leiomyosarcomas as primary tumors are usually found in the corpus uteri or the cervix, they are extremely rare in the vagina. Case report of a 45 yr old woman with primary Leiomyosarcoma of the vagina. The cytological diagnosis was difficult, as a differentiation between Leiomyosarcoma, Melanoma and mesodermal mixed-tumor by means of cytology is not univocal. The histological diagnosis is certain. The tumor is demonstrated in its many histological and cytological aspects. The reaction to radiation is poor. Prognosis depends upon time of diagnosis and treatment and is usually unfavorable.


[The value of ultrasonography in the diagnosis of female genital tract tumors (author's transl)]. In 199 patients with female genital tract tumors the preoperative diagnosis recorded by palpation and ultrasound examination with the A and B apparatus of Kretz were compared with the microscopic findings at laparotomy. The sonographic description of the findings was accurate in 60% of the cases, largely correct in 33% of the cases and mostly erroneous in 7% of the cases. By palpation a correct diagnosis was made in 38% of the cases, largely correct diagnosis was established in 45% of the cases and a mostly erroneous diagnosis was made in 17% of the cases. With tumors up to 4 cm. in diameter, both methods were of approximately equal value. A prognosis as to the likely histology was not possible with the ultrasound technique. A prediction as to malignancy was possible in many cases. Only 4% of the homogenous tumors were malignant whereas 27% of the inhomogenous tumors were malignant tumors.


[Comparative cytogenetic studies of a primary squamous cell carcinoma of the uterine cervix and the local recurrence of the same tumor (author's transl)]. Comparative cytogenetic studies of a primary squamous cell carcinoma of the uterine cervix and the local recurrence of the same tumor following radio therapy are reported. The microscopic features of both tumors were identical. The cytogenetic features of both tumors were almost identical as to the degree of ploidy, the disturbances of the distribution of the chromosomes from Group A to Group G and the type and frequency of Marker chromosomes. It is therefore concluded that the primary tumor and its local recurrence are represented by the same cell lines. Apparently certain cell lines are of decisive importance in malignant growth.


[Evaluation of the results of diminution mammoplasties (author's transl)]. The results of diminution mammoplasties are reported. From 1972 to 1974, 70 diminution mammoplasties according to Strömbeck were carried out. Indication for the operation was hypertrophy of the breasts with side effects of morbid value. In 47 patients side effects of the body posture were the leading indication. In 23 patients, psychosocial problems were the indication. Only patients with side effects of morbid value were considered to be sufficiently motivated to tolerate the total stress of the operation and the possible post-operative complications. The technical problems of the operation and the post-operative complications are described. 43 patients were followed up at least one year after the operation. In 36 patients the pre-operative complaints were alleviated by the operation. In 7 patients there was improvement. No patient had continuing pre-operative complaints. The mentally depressed and physically and psychologically in their relationship to their environment handicapped patients became usually more satisfied by the operation. Diminution mammoplasties are recommended for the operative treatment of hypertrophy of the breast with side effects of morbid value.


[The psychosomatic aspects of complaints of varicose veins during pregnancy. A psychosometric investigation in 345 antenatal patients (author's transl)]. A discrepancy between complaints of varicose veins of the legs such as stabbing in the legs, pain in the legs, tiredness of the legs, heaviness of the legs, feeling of swelling in the legs and nocturnal cramps in the calves, and anatomical signs of varicose veins in the legs was observed. Therefore these complaints were analyzed in 345 antenatal patients regarding their psychological aspects. No complaints of venous insufficiency were found in 47% of the pregnant women. Of the 53% antenatal patients with complaints, 24% had mild, 18% had moderate and 11% had severe complaints. Antenatal patients with well noticable neurotic personality traits in the MPI had complaints twice as often as women without neurotic traits (p smaller than 0.05). Introverted antenatal patients (according to the MPI) had more venous leg complaints than expected (p smaller than 0.05). Pregnant women with frequent psychosomatic complaints and altered general well being had the highest incidence of varicose veins complaints (p smaller than 0.001) or p smaller than 0.05). In addition to these psychometric data, there was also a correlation of the gynaecological history with complaints of venous insufficiency in the legs during pregnancy. Pregnant women with a very painful menarche had more varicose vein complaints than expected (p smaller than 0.05). The incidence was also higher with a history of abortion (p smaller than 0.05), marked dysmenorrhea (p smaller than 0.01) and side effects from oral contraception (p smaller than 0.01) and in primigravida (p smaller than 0.05). Age was only correlated to the symptom of stabbing pain in the legs in a statistically significant correlation (p smaller than 0.05). The results were tested statistically for significance with the X2-method.


The psychological development of orphanage-reared infants: interventions with outcomes (Tehran). This paper describes five successive interventions in the rearing of infants at an orphanage in Tehran, with their outcomes. The outcomes were assessed longitudinally. The first of the successive groups, here called "waves", numbered 15. These Ss constitute the controls. The only intervention consisted of examining the infants every other week during the first year and every fourth week thereafter with the ordinal, sensorimotor scales of Uzgiris and Hunt. The audio-visual intervention intended for the second wave of 10 infants was tape-recorded mother talk and music under the control of the infants and mobiles that the infants could activate. This plan was never adequately implemented because of inadequate supervision. The third wave of 10 infants got extra untutored human care. The fourth wave of 20 infants got the kind of audio-visual intervention originally intended for the second wave plus access to responsive inanimate materials. For the fifth wave, numbering 11, the infant-caretaker ratio was reduced to two or three to one and the caretakers were taught the Badger program supplemented with procedures to foster vocal imitation and semantic mastery of body parts, clothing, toys, and other objects and events regularly encountered. The results show that each successive wave, excepting the second, achieved the top steps of nearly all seven of the ordinal scales at mean ages younger than the preceding wave, and the fifth wave surpassed even home-reared American children from predominantly professional families in achieving the top steps on five of the seven scales. The findings show that infants need not advance along all branches simultaneously and that the kinds of experience encountered determine the branch along which advancement occurs. A number of theoretical implications are examined. Especially important is the idea that a dependable educational psychology for infancy and early childhood calls for much more knowledge than we now have of the kinds of experience that advance development along each of the various branches.


A child's conception of space as a prerequisite to his understanding of spatial locatives. This study was performed to test whether or not cognitive structures give rise to linguistic forms. In this research, 12 male and 12 female Ss, ages 2-1/2 to 7-1/2, were assigned to stages of spatial development as a result of performance on a Piaget task of spatial conception. A series of language tasks was then administered to test both comprehension and production of spatial locatives. The results showed that spatial stages, whether topological, projective, or Euclidian, determined the use of locatives, suggesting that cognition precedes and is a prerequisite to certain language forms. A finding of some interest was that objects which have inherent fronts and backs, like cars or dolls, facilitate the comprehension and production of some locatives, presumably because the objects themselves provide additional linguistic cues which aid the child in organizing the structure of his language.


Partitioning average and heterotic components of direct and maternal genetic effects on growth in mice using crossfostering techniques. Crossfostering was performed using lines selected for increased 6-week body weight (H6) and increased 3-to 6-week postweaning gain (M16) and their reciprocal F1 crosses as nurse dams in the selected crossfostering group, and base population controls (C2, ICR) and their reciprocal F1 crosses in the control group. The offspring suckled were H6, M16 and F2 crosses in the selected group, and C2, ICR and their F2 crosses in the control group. Measurements taken on the individual offspring were body weights at birth (WB) and at 12, 21, 31, 42, and 63 days (W12, W21, W31, W42 and W63, respectively) and weight gains between adjacent ages (GB-12, G12-21, G21-31, G31-42 and G42-63, respectively). Least squares constants fitted to populations of genetic and nurse dams were used to calculate specific linear contrasts. Correlated responses to selection in average direct genetic effects were significant and positive for all traits examined in both H6 and M16, while the correlated responses in average maternal genetic effects were negative in M16 and negligible in H6. Selection response was primarily due to average direct genetic effects while the contribution of average maternal genetic effects was of secondary importance. The response in average direct genetic effects was smaller in M16 for postweaning weights (W31, W42 and W63). The correlated responses in average maternal genetic effects were consistently smaller in M16 than in H6. Direct heterosis was significant for all traits except for G12-21 and G42-63 in the control group, whereas maternal heterosis was significant for weight gains at early ages and for body weights. Direct heterosis tended to be larger than maternal heterosis in both selected and control crosses. Percent direct heterosis for body weight was larger in the selected crosses relative to the control crosses through 31 days of age, but the trend was reversed by 63 days. Percent maternal heterosis was consistently larger in the selected crosses.


Selection for rate and efficiency of lean gain in the rat. Full-sib family selection for rate (WP) or efficiency (WP/F) of protein gain in rats from 3 to 9 weeks of age was applied for five generations. Three rats per litter were killed to estimate carcass protein. Standardized response/cumulative selection for WP was .19+/-.10 for WP, .28+/-.10 for 3- to 9-week gain .28+/-.08 for 9-week weight, .16+/-.08 for litter size, .22+/-.12 for skinning loss and -.07+/-.09 for fraction of protein in the live weight. Response from selection for WP/F was .18+/-.16 for WP/F, .20+/-.11 for WP, .21+/-.11 for weight gain, .16+/-.11 for 3-week weight, .21+/-.10 for 9-week weight, but negligible  for skinning loss or body protein. Response to WP/F selection was extremely variable among generations, associated with generation differences in weight and composition at 9 weeks. Estimates of heritability from offspring-midparent regression were .20+/-.12 for WP and .24+/-.08 for WP/F. Estimates of genotype-generation environment interaction were large for growth, feed intake and skinning loss. Maternal effects were large for weaning weight, fraction of body protein and WP. Sire component genetic correlations were 1.08+/-.13 for WP with total gain, .92+/-.08 for WP/F with gross efficiency and .29+/-.25 for WP with WP/F. A partitional calorimeter was used to evaluate heat production of rats. Lines differed in average heat loss but not in heat loss per unit actual or metabolic weight. Response to selection has been steady for WP but probably could be improved by selecting for WP/F at a constant weight rather than a constant age.


Genetic variation in a heterogeneous environment. II. Temporal heterogeneity and directional selection. The maintenance of genetic variation is investigated in a finite population where selection at an autosomal locus with two alleles varies temporally between two environments and the heterozygote has an intermediate fitness value. When there is additive gene action and equal selection in both environments, the autocorrelation between subsequent environments must be negative for more maintenance of genetic variation than for neutrality. The maximum maintenance occurs when there is equal selection in the two environments and the autocorrelation approaches -1.0 (for a stochastic model), or when there is short repeating cycle such as one related to seasons. Also comparison of the effects of stochastic variation in selection in finite ans infinite populations is made by using Monte Carlo simulation. One situation was found where temporal environmental variation maintains genetic variation very effectively even in a small population and that is when there is evolution of dominance, i.e., the heterozygote is closer in fitness to the favored homozygote than the other homozygote. An important conclusion is that in a finite population genetic tracing of environmental change, particularly when there is a positive autocorrelation between environments or a long environmental cycle, leads to an increased loss of genetic variation making such a response undesirable in the long term, a result different from that in infinite populations.


Q- and C-band chromosome markers in inbred strains of Mus musculus. Differences in the number of chromosomes with secondary constrictions and in the size of the C-band region on certain chromosomes have been observed among the following inbred strains of Mus musculus: C57BL/10J, C57BR/cdJ, DBA/1J, CBA/J, BALB/cJ, and AKR. These differences are useful as indicators of the location of rRNA genes and as normal chromosome markers. The size of each C-band region appears to remain constant over many generations. Only one probable change in the size of a C-band region was found.


[Effect of mutagens on RNA-containing phages and its infectious RNA. VII. Genetic nature of morphologic mutants of RNA-containing phage MS2]. Temperature-sensitive "leaky" mutants of phage MS2 having white dense ring around negative colonies are described. As these mutants are used for quantitative genetic studies, the white ring presents interest. Typical mutant 40 is used as a model for investigation. Light microscopy has shown, that cells from white ring zone have spore-like inclusions, which determine the characteristic structure of surrounding mutant negative colonies. Cytochemical reactions for the presence of glicogen, lipids, volutin, nuclear material and spores were negative. Electrone microscopy of negatively stained samples and ultrathin sections has revealed that cells from white ring zone, unlike phage-infected wild type cells, have two types of electron dense inclusions: 1) crystalline structures formed with great number of closely packed mature phage particles, and 2) large amorphic bodies. Electrone microscope-cytochemical data showed that inclusions remain intact under treatment of ultrathin sections of white zone ring with DNase and perchloric acid, while nuclear material was completely destroyed. Amorphic bodied were completely destructed after the treatment with RNase, while nuclear material and crystalline phage aggregated remained unchanged. Therefore, amorphic bodies consist of RNA, which has not been used to form virions. Single cycle of the development of mutant 40 at 37 degrees and 43 degrees C and under the temperature of incubation 37 degrees leads to 43 degrees C and 43 degrees leads to 37 degrees C in the course of intracellular reproduction is investigated. Influence of the phage on growth on infected culture is studied. The data obtained draw to a conclusion that the impaired function belongs to cystron protein of the phage membrane. As certain mutations in this cystrone of RNA-containing phage result in the depression of cystrone RNA polymerase, it is supposed that the formation of RNA containing bodies in infected cells, determining the formation of white rings in NA, together with cristalline aggregates of cells, is a result of mutation damage of cystrone protein of the phage MS2 membrane.


[Increase in the frequency of spontaneous chromosome aberrations with age in rats]. 675 oocytes from 1294 studied were found suitable for counting chromosomes and caryotyping. 86,8% of oocytes (586) had a normal chromosome number, while aneuploidy was observed in 12,7% of oocytes (86). Among them 72 (10,67%) were with hypoploidy, while only 14 (2,07%) were hyperploid with 22 chromosomes. Structural chromosome aberrations were found in three oocytes: two of them had chromosome fragments and one had a break in the long arm of the chromosome 1.


[Cytogenetic effect of ultraviolet rays in mammalian cells at the DNA synthesis stage]. The frequency of chromosome aberrations induced by UV light at various wavelengths in the primary culture of mouse embryonic fibroblasts during the S-phase was studied. The aberration frequency is wavelength-dependent and reaches a maximum at 265 nm. The action spectrum for the chromosome aberrations determined at 254, 265, 280 and 302 nm closely conforms to the absorption spectra of thymidine. The value of caffeine potentiation was the same for 265 and 280 nm UV-induced aberrations. This indicates that primary chromosome damages and their transformation in cells are similar at these two wavelengths. The data obtained suggest that the formation of DNA cross-links following thymine dimerization is the first step in the formation of UV-induced chromosome aberrations in mammalian cells at the S phase.


[Suppression of DNA-ligase deficiency and selective breeding of mutants and recombinants of T4 phage with phenotype rII]. A number of methods which greatly simplify the introduction of frame shift mutations in the limited segment of the phage T4 rII genes were developed for studying genetical recombination between closely linked markers. These methods enable to construct multiple rII mutants with relatively small expenditure of labour. Suppression of gene 30 deficiency by rII mutations has been studied for a variety of conditions. The results obtained indicate that rIIB polypeptide is involved in two different activities: rIIB region which is dispensable for growth on lambda-lysogenic Escherichia coli strains behaves as indispensable in phenomenon of suppression of ligase deficiency.


Effects of Cis- and trans-clomiphene on the uterine blood flow of oophorectomized ewes. Changes in the left uterine artery blood flow (YBF) after intraarterial administration of estradiol-17beta and cis- and trans-clomiphene citrate to conscious, oophorectomized ewes were monitored by chronically implanted electromagnetic flow probes. Cis-clomiphene produced UBF increases comparable to or greater than those produced by estradiol-17beta but at dose levels 20 times greater. Comparison of UBF response curves for cis-clomiphene with those for estradiol-17beta showed a delayed onset of initial vasodilation and a delayed peak response. The duration of uterine vasodilation produced by cis-clomiphene was dose-dependent and exceeded that produced by estradiol-17beta. Similar reponses were observed with trans-clomiphene but at dose levels at least 1,000 times those of estradiol-17beta. The characteristics of clomiphene-induced UBF responses that differed from those after estradiol-17beta may reflect differences in estrogen receptor activation between the compounds.


In vitro perfusion studies of the human placenta. IV. Some characteristics of the glucose transport system in the human placenta. In vitro perfusion studies of glucose transport in the human placenta show saturation kinetics at high glucose concentrations and competitive inhibition of glucose transfer by the nonmetablizable glucose analog 3-O-methyl-alpha-D glucopyranoside. These characteristics provide further evidence that glucose is transported by a facilitated diffusion process in the human placenta.


Alterations in metabolism of H-epinephrine in the pregnant and non-pregnant state and in males. The influence of sex, pregnancy and parturition of biological accumulation and metabolic fate was studied in Sherman rats. 3H-epinephrine was used as a tracer to determine differences in metabolite formation in normal males and females as well as pregnant rats from 18 days post coitum to the end of parturition. The disappearance of 3H-epinephrine and its metabolites was measured in blood, heart, kidney and brain at different intervals but 20 min after the injection of tracer was found the most appropriate time to find appreciable radioactivity in most of the organs studied. All the comparisons for 3H-epinephrine accumulation and its transformation to metabolites have been reported 20 min post-perfusion period. Marked changes of high statistical significance in 3H-epinephrine accumulation and its transformation to 3H-metanephrine and 3H-acid metabolities were observed between males and females. Heart, adrenals, and spleen showed lower rate of metabolism but higher rate of accumulation during pregnancy. Kidney, ovary, and uterus demonstrated higher rate of metabolism but lower rate of accumulation during gestation. In brain regions, hypophysis discriminated greatly between males and females for the three parameters studied. There were important alterations in metabolite formation during 18 and 21 days of pregnancy. The observed variations have been considered due to modified endocrine activity during pregnancy and parturition.


The validity of the atropine test.

The validity of the atropine test. In order to evaluate the clinical validity of the so-called "atropine test", it has been performed in 83 women in their 35th to 43rd week of pregnancy. A statistical evaluation of the data has shown a serious limitation of both diagnostic and prognostic possibilities of the test; this can be attributed to the great variability of maternal environments.


Thermography as a diagnostic aid in tennis elbow. Thermal screening was used in order to distinguish between Tennis Elbow and entrapment of posterior interosseous nerve. Both conditions have a very similar clinical picture but there should be an altogether different approach concerning treatment. The differential diagnosis is therefore of great importance and thermography of the elbow is a valuable aid in this distinction.


[Transaxillary approach for the resection of the first rib in costo-clavicular compression syndrome]. 80 operations for decompression of the thoracic outlet were performed on 70 patients. Clinical follow-up examinations with phono-angiograms were obtainedin 60 cases. The majority of patients with total relief of symptoms were found after transaxillary resection of the first rib combined with scalenotomy. The phono-angiographic controls of postoperative results were in accordance to signs and symptoms.


[Radial nerve compression].

[Radial nerve compression]. A new compression syndrome of the deep branch of the radial nerve is described, in which a sudden anterior displacement of a part of this nerve under maximal tension is followed by an axonotmesis. This happens in an area in which the deep branch of the radial nerve crossed some narrow structures which are unyielding and have more compression strength (tense cords of connective tissue Fig. 3). The operative finding of a torsion of the injured fascicles justifies the correctness of the immediate operative revision; otherwise the nerve regeneration would be impaired by the torted empty endoneural tubes. This description is a further constribution not observed before to the compression syndromes of the radial nerve, since in 1970 the author was able to give an explanation for the pathogenesis of compression palsies of the radial nerve, unclear up to that time but observed after forceful muscle contractions again and again since the beginning of this century. This observation gives the evidence that the occurrence of a peripheral compression lesion of nerves is not bound absolutely on the existence of a "physiological narrowness" (fibrous or osteofibrous tunnel etc.). This is also true for the median nerve.


[Intraneural neurolysis of the median nerve in carpal tunnel syndrome]. Out of 250 neurolyses with microsurgical technique in the past six years 51 performed in carpal tunnel syndrome. The nerve compression was caused in most cases by unspecific sclerotic and fibrous tendovaginitis with pathologic changes of the nerve by adhesions between epineurium and tendon sheath. One patient showed a tuberculous tenosynovitis. In 20% of the patients no visible changes of the nerve was found during operation (stage I), while more than 50% showed slight compression (stage II) and 25% severe compression. Postoperatively the clinical examination including some special tests for function revealed in almost all cases a normalization of sensibility and motor function.


[Evaluation criteria in follow-up studies of flexor tendon therapy]. A comparison of results in flexor tendon repair is of value only if standard methods of measurement and recording are used. The function of the involved finger(s) can be judged by measurement of the distance between the finger tip and the distal palmar crease, the total maximum flexion at all three finger joints (composite flexion), the lack of extension as an aggregate of the minimum angles which can be achieved at each of the three finger joints (composite extension deficit), and the total amount of movement (composite flexion minus composite extension deficit). Each of these measurements graded according to a scale of values (table 2 and 3); the sum of these values gives a final classification (excellent, good moderate and poor). In a series of 157 follow-up examinations with 223 fingers with flexor tendon repair this method of recording the results of flexor tendon repair was evaluated.


[Treatment of the contracted thumb web space by means of an augmented transposition flap method]. The augmented transposition flap plasty consists of a Z-plasty, to which a triangular flap from the dorsal ulnar aspect of the thumb is added. Remaining skin defects have to be covered by thick split thickness skin grafts. This procedure has been successfully during the past five years for the release of congenital or posttraumatic first web contractures of moderate severity.


[Modification of the Kutler flap: neurovascular pedicle]. Digital pulp reconstruction by a modification of the KUTLER double V-Y plasty has been performed in all digits. Greater mobility of the flaps was obtained by dissecting out the neuro-vascular pedicle employing microsurgical techniques. This permits successful coverage of larger pulp defects, giving satisfactory padding and excellent sensibility following reconstruction of finger tip. The technique is described and late results reported.


[Moberg's neurovascular pedicled palmar moving flap. Analysis of unsatisfactory results]. Large soft tissue defects of the pulp of the thumb and fingers may be successfully covered using the palmar advancement flap described by MOBERG, which is based on both neurovascular pedicles. In a series of 21 cases there were no shortcomings with regard to sensibility, padding of the distal phalanx or joint function. In 50% of the cases however there was a deformity of the nail and dysesthesia in the region of the hyponychium.


[Prosthesis control by traction instead of myoelectricity in upper arm amputations]. This paper is concerned with the provision of an upper limb prosthesis in the presence of an axillaris nerve paralysis and additional injuries such as clavicular and scapular fractures, dislocation of the shoulder and major psychological changes. Such paralysis and injuries exclude the use of a myoelectric prosthesis. The shoulder muscles were trained to provide traction forces which controlled an MGH-S hand (VIENNATONE).


[The 2 prong star].

[The 2 prong star]. The development of a device for determining two point discrimination is described. Prongs of metal set apart by distances ranging from 2 mm to 25 mm protrude from the periphery of a metal disc and permit speedier evaluation than that achieved by conventional methods. The instrument weighs a standard twenty grams and so a constant pressure is applied to whichever prongs are employed.


Psychosocial aspects of sickle cell disease. The study described in this article deals with sickle cell patients in Jamaica whose illness is accompanied by leg ulceration, a common complication of sickle cell disease. After exploring the disease's psychological, social, and economic effects, the authors suggest various ways for social workers to help sickle cell patients.


The four Rs: social diagnosis in health care. As limited stays in the hospital become more the rule, a patient's record must be comprehensive enough to include both his medical condition and the social problems that may accompany it. The conceptual model presented in this article -- the four Rs of the medical-social diagnosis -- can be used as a checklist to insure rapid and systematic intervention.


Histochemical studies on the mucins of the vertebrate tongues. VIII. Histochemical analysis of mucosubstances in the tongue of the turtle. The tongue of the fresh-water turtle, Geomyda trijuga, was investigated histochemically to determine the localization and nature of mucosubstances in it. The results were considered in comparison with the lingual mucosubstances of other vertebrates. A heterogenous distribution of neutral mucosubstances, sulphomucins, sialomucins and hyaluronic acid in various lingual sites was noted. The anterior half of the lingual surface was keratinized, whereas on the posterior half numerous broad papillae and three types of goblet cells were found. The lingual salivary glands were absent from the turtle tongue. The importance of lingual histology in establishing the phylogeny of vertebrates and the possible functional significance of mucosubstances in the physiology of gustation are discussed.


The activity of certain hydrolases of rat erythrocytes in experimental magnesium deficiency. In rats with induced syndrome of chronic magnesium deficiency, occurrence of haemolytic anaemia in conjuction with a shortening of the erythrocyte survival time and marked reticulocytosis among other symptoms became noticeable. In the present experiment the authors undertook to study the behaviour of the lysosomal enzymes in the erythrocytes of magnesium-deficient rats. In these animals anaemia and reticulocytosis as well as a marked increase in the percentage of the erythrocytes showing positive reactions to the acid phosphatase and beta-glucuronidase tests developed. It seems likely that the positive lysosomal reactions were obtained with younger blood cells which did not stain with brilliant cresyl blue but still retained single lysosomes in their cytoplasm. This assumption was confirmed by ultrastructural studies which demonstrated the presence of siderosomes inside both the reticulocytes and the mature erythrocytes. The changes in the percentages of reticulocytes and enzyme-positive erythrocytes were independent of the histological structure of the experimental rat's thymus. In the reticulocytes as well as in the mature erythrocytes, the noteworthy presence of degenerated mitochondria containing electron-dense material seems to be a morphological sign of impairment of the magnesium-deficient rat's erythrocytes.


Histochemistry of mucosubstances in the mantle of fresh water mussel Parreysia corrugata var. nagpoorensis (Lea). I. Mucosubstances of the inner marginal fold. Formol-calcium acetate-fixed sections of the mantle of Parreysia corrugata var. nagpoorensis (Lea) were subjected to various histochemical reactions for mucosubstances. The results of these reactions on the inner marginal fold indicate that it possesses two types of mucous cells secreting sulphomucins and sialomucins. The sulphated mucus is strongly alcianophilic. Its alcianophilia persists when the tissues are stained with Alcian blue in concentration of up to 0.5 M magnesium chloride. The basal inner epithelial cells of the fold contain glycogen while the remaining cells contain neutral muscosubstances. The role of the mucosubstances with reference to feeding is discussed.


Cytochemical and ultrastructural studies of changes in the nucleus and nucleolus during cell differentiation in the root cortex of Haemanthus katharinae. Dimensions,dry mass content, binding of [3H]actinomycin D ([3H]AMD), and [3H]uridine incorporation in the nuclei and nucleoli as well as their ultrastructure during growth and differentiation of the root cortex cells of Haemanthus katharinae were compared. The dry mass of the nuclei did not change, the condensed chromatin content was slightly augmented, and the ability of the nuclei to bind [3H]AMD became somewhat decreased, whereas a considerable reduction was observed in the [3H]uridine incorporation. The highest capability for the binding of [3H]AMD and the highest intensity of RNA synthesis were demonstrated by nuclei in the meristematic zone and during the most intensive cell growth. The size of the nucleoli, their dry mass, the amount of granular component, and the intensity of [3H]uridine incorporation underwent a steady decrease as the cells grew and differentiated. The progressing differentiation of the cells was accompanied by an increasing participation of arginine-rich histones in restraining the capacity for [3H]AMD binding.


Thymineless death in a thymine-dependent mutant of Micrococcus radiodurans T2 in the presence of chloramphenicol and rifampicin. A possibility to prevent cells of a thymine-dependent mutant of Micrococcus radiodurans T2 from thymineless death was investigated. It was found that the presence of chloramphenicol (CAP) in a thymineless medium only decelerated the death of cells. The presence of rifampicin (RFP) considerably decreased the death rate of cells but could not prevent thymineless death completely.


A method of preparation and  application of nitrous acid as a mutagen in Claviceps purpurea. A simple and speedy procedure is described for the preparation and application of nitrous acid in mutagenic experiments. The conventional incubation mixture of sodium nitrite solution with acetate buffer is replaced by an aqueous solution of nitrous acid prepared by running a solution of sodium nitrite through a column of ion exchange.  The procedure eliminates also the interference of other substances. Experimental appraisal of the technique was done during the mutagenic improval of the fungus Claviceps purpurea.


Ergot alkaloids. VI. Nitrogen metabolism during the development of sclerotium of Claviceps purpurea. The developmental transition of ergot from the sphacelial to the sclerotial phase is accompanied by marked changes in morphology, growth and metabolism. The production of alkaloids is paralleled by a concomitant protein synthesis, a decline in the contents of both total N and P, and an attendant rise in the value of the N/P ratio. The total level of free amino acids drops with proceeding development of the sclerotium. The most conspicuous drop, observed at the beginning of the production phase, is due to a sharp decrease in the level of free lysine. This drop attests to profound changes in the metabolism of the parasite in the period of transition from nonproducing sphacelium to producing sclerotium. The gradually decreasing level of free proline reflects the accumulation of the alkaloids. In a parasitic culture, proline is probably supplied in sufficient amounts by the host plant and the main difference between the metabolism of fungal sphacelium and sclerotium is a different utilisation of acetyl-CoA.


Composition of lipids and production of mucidin in a submerged culture of the basidiomycete Oudemansiella mucida. Mycelial lipids of the submerged culture of Oudemansiella mucida contain acylglycerols, free and esterified sterols. Free fatty acids are not present. Development of the culture is associated with an increased content of unsaturated fatty acids and, on the contrary, with a decreased content of saturated fatty acids. Content of total lipids depends on age of the culture and is inversely related with production of the antibiotic mucidin.


Ontogenetic studies of seizure patterns and seizure activities induced by cortical focus. Ontogenetic studies of epileptogenic process were carried out in albino rats ranging in age from birth to 45 days. Experimental epilepsy was produced by two different procedures and the results were compared with each other. Tungstic acid gel was applied to the motor area of the left side of the cortex, and the following results were obtained. The latency of the seizure appearance was long during 10 days after birth, became progressively short thereafter and reached the minimum in about 20 days of age, and gradually returned to the adult level again by 45 days of age. No abvvious seizure was exhibited until five days of age. Seizure patterns developed from tonic or twitch-like jerky convulsion (10 days old) to rhythmic or clonic type of seizure (13 days old), and the seizure patterns similar to those in the adult rat were observed in about 20 days of age. Cortical seizure activity was initially observed in about 10-day-old rats; single high amplitude slow wave appeared and small spikes became superimposed on it in the course of maturation. Atypical spike and wave complexes were observed after 20 days of age. Electrical stimulation was applied to the left cortical motor area by constant current stimulator, and the following seizure patterns were observed: No obvious seizure could be elicited in newborn rat, whereas from three days of age, tonic seizure of the whole body, and from seven days old twitch-like convulsion of extremities were observed. In ages from 10 to 20 days, seizure induced by electrical stimulation was mainly tonic in pattern; extension of forelimbs and flexion of hindlimbs in most cases were observed before 13 days old, but both fore-and hindlimbs were extended therafter. Tonic-clonic seizure patterns were exhibited after 20 days of age. From these results, it was considered that tonic convulsions and high voltage slow cortical seizure activites were produced from the activites of the local cortical neuronal connections, and rhythmic and/or clonic seizure patterns and spike and wave seizure activities were elicited from the more complex, i.e. cortico-subcortical neuronal circuits. Possible contributing factors for the determination of seizure susceptibility in immautre rats were also discussed.


Prognosis of the Lennox syndrome-long-term clinical and electroencephalographic follow-up study, especially with special reference to relationship with the West syndrome. The long-term clinical and electroencephalographic follow-up studies were carried out for more than three years, up to 14 years in the longest, on 116 cases with Lennox syndrome. And the results of s-ystematic study on changing patterns and out come have been reported. The follow-up examination was performed also on West syndrome which is closely related with Lennox syndrome; especially the relationship between both syndromes regarding prognosis has been clarified. (1) According to the long-term follow-up on 116 cases with Lennox syndrome, there were 98 cases (84.5%) having mes (61.2%) and persisted as Lennox syndrome except for one case. (2) Generally speaking, the cases with age of onset before two years old showed unfavorable outcome. (3) There were 42 cases (36.2%), which were converted from West syndrome and showed markedly unfaborable prognosis in regard to intelligence as well as the remainging of seizure. (31 cases, 77.5%) (4) On thehand, in 23 idiopathic cases, which showed no developmental retardation before onset of seizure, had favorable outcome, and the remaining of seizure was observed in eight cases (34.8%). However, even in such cases, it was noticed that those displaying mental defect at the follow-up attained 14 cases (60.9%). That is to say, it was clarified that persistence of even minor seizures induced mental deterioration. (5) The cases with favorable prognosis showed usually a typical slow spike-and-wave pattern electroencephalographically, whereas those with poor prognosis showed mostly an asymmetric or disorganized slow spike-and-wave pattern. (6) In many cases displaying signs of brain atrophy with pneumoencephalograpm and accompanying overt neurological signs at the initial examination, prognosis is obviously poor. (7) From the follow-up examination on 94 cases with West syndrome for three to 15 years transformed into Lennox syndrome Among them, those cases with the remaining of seizure at the time of follow-up were 44 (46.8%) out 94 cases, of which 37 cases (83.8%) had remaining seizure as Lennox syndrome. (8) From the above results, it is emphasized that Lennox and West syndromes show close relationship with each other and that a study should be done on the interrelation between their prognosis.


Long-term prognosis of epilepsy in children--a follow-up report beyond 18 years of age. The long-term prognosis of 185 children with epilepsy, who continued to attend the Clinic for Epileptic Children, the Department of Pediatrics, the University of Tokyo, beyond the age of 18 years, was reported. The length of follow-up varied from three to 20 years, but most of them were followed longer than 10 years. The presumed etiology in these children was divided into a cryptogenic group (124, 67.0%) and a symptomatic group (61). The types of seizures were classified into grand mal (86 cases), focal seizure (27), petit mal absence (4), psychomotro seizure (5), infantile spasms (7), and so on. It may be noted that the highest frequency of grand mal was demonstrated, while the incidences of infantile spasms, myoclonic seizure, and akinetic seizure were low in the series. Only 28 children (15.1%) had complications of physical and/or mental handicaps. The follow-up study revealed that 140 patients (75.7%) had been seizure-free in the last 12 months. One hundred and fifteen of them had no seizures for five years or longer. On the other hand, electroencephalographic abnormalities generally continued for a long time after disappearance of seizures. Eightly-one of well-controlled patients were gradually decreasing the doses of anticonvulsants. As for seizure types, it is noted that focal seizure, psychomotor seizure, and infantile spasms were relatively difficult to be controlled. Except for 27 patients, most of them attended normal schools, including junior colleges or universities, and engaged in various occupations. Fifteen female patients had already married, and out of 13 babies who were born from these patients, there were one with ventricular septal defect, one with mental deficiency, and one with anencephaly, while the rest were entirely normal. Additional problems on withdrawal of anticonvulsants after a long-term seizure-free period, and what a medical system should be for treatment of epilepsy in children up to their adulthood were discussed.


The electroencephalographic study on adult-type Lennox-Gastaut syndrome. Polygraphic recordings were performed 22 times during a period of about two years on a 25-years-old man with the Lennox-Gastaut syndrome of the adult type. He had several generalized convulsions initially when he was eight years old, and had the Lennox-Gastaut syndrome since the age of 17 years. The paroxysmal fast rhythm shown 214 times in the recordings, which appeared only in the light stage of sleep, was analyzed. The pattern of the paroxysms, and the relationship between the pattern and the clinical seizures was studied. The parozysms were composed of a series of spikes and slow spike and wave. They appeared diffuse and bilaterally synchronous. And so, were classafied these paroxysms into four types. A through D, from the differences of basic activity before appearance of the paroxysms, amplitude, frequency and fluctuation of amplitude and frequency. Consequently D type was thought to be different from the other types of the pattern in spite of the differences in frequency, fluctuation of that and duration of the discharge. All of the clinical seizures which appeared with these paroxysmal fast rhythms was local tonic spasm in the lip. But D type never failed to associate with local tonic spasms and usually developed generalized tonic seizure. Except for D type, it was shown obviously that the same local tonic spasm appeared when the duration of the paroxysm was longer than 4.9 sec. We proposed the paroxysmal fast rhythm of a name "tonic seizure discharge" on the basis of the findings of this patient.


Photoconvulsive response and disposition. A total of 21 siblings of 17 cases (16 epileptics and one patient with atypical psychosis), in which generalized paroxysmal discharges were provoked either by red-flicker or flickering-pattern and/or pattern, was examined by giving the same stimuli. Similar generalized paroxysmal dischages were provoked in five siblings (23.8%). Of these, two pairs of siblings were identical twins. As a control group, the same EEG activation was carried out in 37 normal healthy 11-year-old children (18 males and 19 females); there were no activation effects. The difference between the two groups was highly signifcant (p less than 0.005). From this study, it was stressed that possible functional vulnerability in the centrencephalon due to disposition might play an important role in the appearance of the GPD's provoked by the visual stimuli as described above. A discussion was also given about the exogenic factor influencing this mechanism.


A neuropathological case-study of myoclonus epilepsy. A 28-year-old male of progressive myoclonus epilepsy was reported, who had showed a gradual progression in myoclonus, mental retardation and cerebellar symptoms, and had been treated with a large dosage of diphenylhydantoin. Neuropathologically, slight degenerative changes of the cerebrl cortex, especially in the IV layer, the external pallidum, and the dentate and olivary nuclei were observed. The most obvious change was diffuse reduction of Purkinje's and granular cells in the cerebellum. A congenital cyst was found with surrounding gliosis in the central tegmental tract of the pons. A significant relationship between myoclonus and the cyst was proposed, and furthermore, influences of diphenylhydantoin intoxication on the clinicopathological development of myoclonus epilepsy were emphasized.


Etiology of convulsions in neonatal and infantile period. 1) Etiology of convulsions starting prior to two years of age was discussed in 418 cases. Neonatal seizures before 30 days old appeared in 86 cases (53 boys and 33 girls). Three hundred and thirty-two patients (172 boys and 160 girls) had convulsions in infancy. Twelve patients (9 boys and 3 girls) suffered from convulsions both in neonatal and infantile period. 2)Etiology of convulsions was prenatal in 67 cases (16%), natal in 49 cases (12%), postnatal in 158 cases (38%) and unknown in 144 cases (34%). Prenatal factors consisted of cerebral malformation (23 cases, 6%), associated physical minor anomaly such as cataracta or finger abomaly (11 cases, 3%), abnormal pernatal history (8 cases, 2%), congenital heart disease 3) cases, 1%), tuberose scleorsis (7 cases, 2%) and positive family history (13 cases, 3%). Postnatal causes included hypocalcemia or hypoglycemia (7 cases, 2%), brain tumors (3 cases, 1%), breath-holding spells (21 cases, 5%), febrile convulsion (44 cases, 11%), bathing (3 cases, 1%), afebrile colds (3 cases, 1%), purulent meningitis (17 cases, 4%), DPT immunization (10 cases 2%), vaccination (7 cases, 2%) and acute hemiplegia (10 cases, 2%). The group of unknown etiology were as fns (38 cases, 9%), epilepsy associated with interictal signs (23 cases, 6%), benign infantile convulsions (57 cases, 14%), neonatal convulsion of unknown etiology (12 cases, 3%) and miscellaneous categories (4%). 3) Pregnancy was abnormal in 53% of cases with cerebral malformation. Asphyxia at birth was noted in 43% of patients with tuberose sclerosis and in 35% of congenital cerebral abomaly. 4) Pneumoencephalographic examinations revealed midline anomaly in 50% of cerebral malformation. It was abnormal in all cases with tuberose sclerosis, head injury and epilepsy with interseizure neurological signs. 5) There were no correlations between the seizure pattern and the etiology in neonatal convulsion. In infancy, focal-unilateral convulsions and infantile spasms were frequently associated with organic damages. Generalized seizures were seen in organic lesions as well as functional ones although approximately half of the cases were febrile convulsion, benign infantile convulsion or breath-holding spell. 6) EEG features of cerebral malformation were asymmetrical or multifocal dischages in neonatal period and hypsarhythmia or focal-unilateral spike discharges in infancy. Tuberose sclerosis showed hypsarhythmia in infancy. In birth injury or cerebral anoxia, EEG mostly revealed focal-unilateral abnormality or suppression-burst activity in newborns and hypsarhythmia or focal features in infants. 7) The occurrence rate of neonatal seizures in autopsy cases with intracranial pathology was demonstrated. EEG with intravenous diazepam was useful to know pathophysiology of infantile spasms.


A prospective study of epilepsy following neonatal convulsions. In a prospective study of 130 infants with neonatal convulsions, the frequency and type of epilepsy and the relationship between the presumptive etiology of neonatal convulsions and subsequent epilepsy were investigated in 82 survivors exclouding those dying and lost to follow-up. Of these 82 children, 15 (18.2%) were found to have epilepsy, which was of generalized type in seven (8.5%), infantile spasm in four (4.9%), focal seizures in three (3.6%) and myoclonic seizures in one (1.2%). Febrile convulf neonatal convulsions were asphyxia, intracranial hemorrhage or neonatal meningitides in most instances, but no particular relationship was noted between the presumptive etiology of neonatal convulsions and the type of subsequent epilepsy. In 11 (73.3%) of the 15 epileptic children, convurrent mental retardation, cerebral palsy and postmeningitic hydrocephalus were noted. Evidence from RI cisternography, pneumoencephalography and cerebral angiography indicated that perinatal or neonatal brain damage responsible for epilepsy might be organic in nature. The fact that epilepsy occurred later in many of cases of neonatal convulsions of unidentified etiology suggests that brain damage incurred during fetal life might also be implicated at least in some instances. The onset of epilepsy in this series was relatively early, invariably before three years of age.


Clinical investigation of infantile convulsion. We investigated 104 cases of infantile convulsions which occurred before two years of age. These cases had no detectable signs of acute brain disorders, and they had normal psychomotor development and normal EEG findings at onset. (1) Sex ratio was 1:1. (2) A positive family history of various types of convulsions was obtained in 30.8% (Febrile convulsion: 65.7%) (3) The incidence of perinatal anoxic brain damage was higher than that in the control group. This was probably related to the incidence of infantile convulsion. (4) More than half the cases (66.3%) had the first convulsion between three and eight months of age, and 95.6% of prospectively follow-up cases were shown free from attacks before two years of age. (5) Precipitating factors to convulsion were found in 45.1% of all cases. These factors were bathing and non-febrile infection. (6) The most common form of infantile convulsion is generalized tonic and/or clonic convulsion (78.8%) within 5 min. (82.7%). This convulsion reccurs frequently in a relatively short period. (7) The incidence of subsequent epilepsy seems to have been found among patients who had had an initial attack between three and five months of age, and had then experienced convulsion more than six times or in a prolonged state.


[Old and new views on resuscitation].

[Old and new views on resuscitation]. The pro and contra of reanimation are discussed and the essentials of cardiopulmonary resuscitation are lined out according to the ABC of reanimation by Safar. The review of the literature shows that the majority of the therapeutic measures practised today is known already for over 200 years. A survey of the results of these live safing measures is given and the attitude and opinion of resuscitated patients are discussed.


[Psychophysiological studies in the pre-school children]. The behavior of 24 children, aged 3-6 years, was recorded on video-tape. Simultaneously the ECG was recorded telemetrically. These observations were made during two pre-school educational programs lasting 90 minutes each: "Didactic games" and "Elementary music and movement program". For each child a scale was developed to show the correlation of mean heart-rate and well defined motor-activity. It was evident that the mean heart-rate was higher during the music program than during the didactic program, corresponding to the higher motor-activity. But it was found that in the didactic program the variation of the heart-rate within short intervals was higher due to the more frequent occurrence of respiratory arrhythmias. It was also seen that during the music program the children showed no signs of exertion as they did towards the end of the didactic program. Respiratory arrhythmias were not seen in children who according to the Schellong-test were classified as stable in their cardiovascular system. The arrhythmias occurred mainly when the children showed signs of fatigue.


[Chronic geriatric patient in the hospital]. The cost explosion in the health system, especially in the hospital field, and the prolongation of life, i.e. the increase of the proportion of old people in the total population, oblige us to ask the question as to the part of geriatric patients in the present and future hospital treatment. By means of statistically relevant material, i.e. 25,342 female and 20,189 male in-patients in the Municipal Hospitals Nuremberg during the year 1974, compared with investigations of the year 1964, the growing significance of the geriatric patients for the total health system is demonstrated. Particular interest is paid to the old chronically ill persons, as is shown in an estimate of the internal in-patients. 50% of the internal in-patients are chronically ill persons. The present structure of hospitals is by no means complying with this situation. As an improvement, a ward system with different aims instead of the one complex acute hospital is presented. Apart from the existing acute stations there should be provided geriatric rehabilitation wards, social stations and day-hospitals. Humanitarian and financial advantages to be expected of these new wards are outlined. Particular emphasis is given to the active rehabilitation in the sense of a comprising social-medical help.


[Influence of isoxsuprine HCl on blood viscosity]. A decrease of blood viscosity is a working principle in the therapy of severe disorders of arterial blood flow. Isoxsuprine-HCl was found effective in lowering the blood viscosity when given intravenously in a dose of 30 mg over 60 min. This effect derives probably from a decrease of the tendency to aggregate and an increase of the flexibility of red blood cells. 30 min after termination of the infusion this effect has its maximum and 60 min later still is significantly raised.


[Surgery of malignant kidney tumors].

[Surgery of malignant kidney tumors]. Critical examination of the results in surgical treatment and new surgical techniques have lead to some changes in operative therapy of hypernephroid kidney cancer. Indications for surgical treatment and different operative techniques are described in dependence of grade of metastases. The possibility of arterial embolization in renal hemorrhage in inoperable patients is discussed.


[Modified in situ perfusion of the kidney using balloon catheters]. Experiences with the in situ hypotherme perfusion in the operative treatment of calculus in kidneys and calices are reported. A modified technique is presented using an inflatable Swan-Ganz-ballon catheter for simultaneous blocking of renal blood flow and perfusion.


[Transvenous kidney puncture. New procedure for withdrawal of kidney tissue]. A transvenous catheter technique for renal puncture is described which was successful in 9 of 11 punctures performed in 8 dogs. Macrohematuria was not observed in any case. Autopsy revealed only small subcapsular hematomas. The advantage of this procedure is the reduced risk of bleeding achieved by peripheral puncture and by-passing of the great central vessels with aid of phlebographic controls. Moreover localization of kidneys by excretion urography--impossible in patients with renal insufficiency--is unnecessary.


[Effectiveness of nuclear medicine kidney clearance procedure]. Methods and clinical indications of divided renal clearance determination using 131I-hippuran are presented and their value as a diagnostic tool in urology is shown by two case reports. For quantitative assessment of renal function we prefer the whole body clearance (with partial shielding of kidneys and bladder), which obviates the necessity of the theoretical assumption of compartmental distribution of radiopharmaceuticals. Using simplified clearance tecniques only based on analysis of plasma disappearance curves (slope clearance one- and two-compartment model), clinically useful results are also obtainable, especially in follow up studies. The evaluation of tubular and glomerular kidney function by simultaneous application of 131I-hippuran and 99mTc-DTPA is suitable for estimation of filtration fraction in patients with urological and nephrological diseases. Even with regard to therapy and follow up studies of urinary tract tuberculosis, remarkable diagnostic informations may be achieved.


[Sickle cell anemia].

[Sickle cell anemia]. Sickle cell disease is a hereditary chronic hemolytic anaemia mostly found in negroes. The blood of these patients contains hemoglobin S. Absence of oxygen determines the sickling to the red blood cells. In the heterozygous state clinical manifestations usually are absent. The homozygous form shows different symptoms. The progressive course with hemolytic, aplastic or thrombotic crises mostly ends in an early death in infancy or childhood. Treatment is largely palliative. Transfusions, treatment of the crises and general measures play the most essential role.


[Clinical pictures of hemiblock and fascicular block. Diagnosis and clinical significance]. In intraventricular conducting defects distal the bundle of His we see different forms, i.e. left anterior and left posterior hemiblock, left bundle branch block and right bundle branch block. The left anterior hemiblock is electrocardiographically responsible for a left axis deviation, the left posteriof hemiblock for a vertical axis or right axis deviation. If there is in addition to a hemiblock a right bundle branch block, it is called a bifascicular block. Are at the same time all three fascicles concerned, there will be a trifascicular block, i.e. a complete atrioventricular block, the so-called peripheral form. The common cause of fascicular blocks is coronary heart disease. Because of the possible progressing of the disease patients need further surveillance and eventually therapy.


[Pacemaker implantation data registry. Supervision of the function of pacemaker and longevity]. To prolong the expected lifetime of pacemakers, more and more pulse generators with reduced output and electrodes with high impedance are used nowadays. Therefore it becomes necessary to measure carefully the physiological parameters as threshold, intracradial potential or the electrode-myocard impedance. When evaluating the threshold it is important to know the output properties of the pacemaker to be used and to take into consideration that the pacemaker itself also will influence the size of the intracardial potential. As no reliable data about the longevity of pacemaker electrodes is available, the total electrode impedance should be measured. Thus at least insulation defects can be detected and impending pacemaker failure be avoided. To observe long term changes in those parameters it is advisable to keep a comprehensive implantation protocol.


[Dysphagia. Diagnosis, differential diagnosis]. The wide scope of differential diagnosis in dysphagia makes interdisplinary team-work essential. The aim of this review therefore is to show the various specialties of medicine dealing with dysphagia and to point out possible causes and therapeutic measures.


[Gastritis. Cause and significance].

[Gastritis. Cause and significance]. Despite the high incidence and the increasing frequency gastritis is a true pathological process of the gastric mucosa. The importance of gastritis is not due to the symptoms but due to the altered reagibility of the stomach mucosa against exogenous and endogenous noxes. Two different forms fo chronic atrophic gastritis are to be distinguish concerning localization and etiology. Type A possibly is caused by an immunological process and is localized in the corpus mucosa. The more frequent typ B is localized in the antral mucosa and may be caused by exogen factors. None of these different forms of gastritis is a true precancerosis. However, dysplasia and enterocolic metaplasia which can appear in the course of chronic atrophic gastritis should be payed special attention because of a possible increased frequency of malignancy.


[Endocrine regulation of the menstrual cycle]. Physiological data concerning the serum concentrations and the pituitary content of varian steroids and gonadotropins, respectively, are reviewed. On the basis of these physiological data results from experimental studies are critically evaluated as far as their significance for the understanding of the physiology of the cycle is concerned. Data from the literatur and results from own studies are incorporated in a concept of the endocrine regulation of the human menstrual cycle.


[Drug-induced icterus].

[Drug-induced icterus]. From the clinical point of view, the classification of drug-induced liver damage into predictable, unpredictable and simulated, has proved useful (Popper and Greim 1973). Forms of jaundice can be predominantly cholestatic or predominantly hepatocellular and can closely imitate an obstructive syndrome or hepatitis. Mixed forms are also frequent.


[X-ray symptoms in ulcerative colitis].

[X-ray symptoms in ulcerative colitis]. Barium enema studies in 200 patients with ulcerative colitis were analyzed according to radiological symptoms. The results of the radiological examination were compared with those of rectoscopy and biopsy. In about 75 per cent of patients good agreement was achieved.


[Influence of various forms of vagotomy on the exocrine function of the pancres]. In surgical treatment of the duodenal ulcer a selective proximal vagotomy is the only method to vagotomize parietal cell area of the stomach alone and to let the motoric and endocrine function of the antrum, as well as the vagal innervation of the liver, the pancreas and the gut indisturbed. Our experimental investigations on dogs with total and selective proximal vagotomy show, that an intact vagal innervation of the pancreas is important for its normal function and that selective proximal vagotomy does not change the exocrine pancreatic secretion. Otherwise a total vagotomy diminishes significantly the pancreatic production of volume and enzymes after insulin stimulation. In respect of the vagal innervation and normal function of the pancreas, a selective proximal vagotomy therefore seems to be the best method in surgical treatment of the duodenal ulcer.


[Behavior of exocrine pancreatic function during treatment with antibiotics and antineoplastic agents]. The thesis is composed of two parts, the first part is concerned with experiments in rats, the second part confirms the findings in human beings. After administration of oxytetracycline, chloramphenicol and cyclophosphamide, respectively, to rats an approximately dose-dependent decrease in the pancreatic secretion of proteins and enzyme activities was demonstrable in vivo under exogenous stimulation. The exocrine pancreatic function was studied in humans by performing a secretin-pancreocymin test before and after treatment with oxytetracycline or chloramphenicol and before and after massive-dose therapy with cyclophosphamide or combined cytotoxic treatment (as outlined by De Vita). The investigations further included an examination of the exocrine pancreatic function in subjects on maintenance therapy with cyclophosphamide or busulfan and a comparison with the exocrine pancreatic function in a group of controls. In the oxytetracycline-treated humans there was a depression of the amylase and lipase activities in the duodenal secretion. Administration of chloramphenicol produced a decrease in the amylase output only. In the patients on massive-dose or continued therapy with cyclophosphamide the pancreatic function remained essentially unchanged. In contrast, cytotoxic combination treatment resulted in decreased activities of amylase and lipase. After maintenance treatment with busulfan a reduction of the trypsin and amylase activities was detectable. The volume and electrolyte outputs were found to remain essentially unchanged in all investigations. An impairment in enzyme synthesis is suggested as the major cause of the observed changes of pancreatic secretion after antibiotic and cytotoxic treatment.


[Serum cholesterol concentrations in various basic diseases. Studies in 2466 hospital patients]. In 2466 in-patients the blood cholesterol concentration was measured. Also age, height, weight, excretory liver function, glucose tolerance, the concentration of total lipids, uric acid and the clinical diagnosis were correlated with the cholesterol levels. Higher cholesterol levels were found in elderly patients and in patients with impairment of liver function, glucose tolerance and with overweight. With increasing hight cholesterol decreases. Patients with disorders of gallbladder and liver had significantly higher cholesterol levels compared with patients with hematological disorders, malignancies and pulmonary affections.


[Redioimmunoassay for secretin (author's transl)]. The synthesis of a secretin with an elongated N-terminus, namely Nalpha-(deaminotyrosyl-beta-alanyl)- secretin (DATA-secretin), using a conventional strategy, is described. After purification of the product by means of ion exchange chromatography on SP-Sephadex C-25 and by continuous carrier-free electrophoresis, immunological studies on the synthetic DATA-secretin were carried out using secretin antibodies. In comparison to 125iodine-labelled secretin and [Tyr6]secretin, 125iodine-DATA-secretin proved to be by far the best "tracer". Elaboration of a radioimmunoassay for secretin is therefore possible.


Quantitative mass spectral identification of p-bromophenylthiohydantoins from Edman degradations by tetradeuterated internal standards. p-Bromophenylisothiocyanate is a reagent well suited for the Edman degradation of peptide chains[1-5]. The relative rate of the coupling reaction at the N-terminus is slightly more rapid than with phenyl- or methylisothiocyanate, but less rapid than with pentafluorophenylisothiocyanate. The latter reagent, however, is rapidly hydrolyzed under the conditions of the coupling reaction. The p-bromo substituent facilitates mass spectral identification of the p-bromophenylthiohydantoins obtained, due to its characteristic double peak[1-4]. Quantitation of the amount of p-bromophenylthiohydantoin obtained can easily be achieved in the parent mass spectrum by addition of a known amount of tetradeutero-p-bromophenylthiohydantoin as an internal standard. The tetradeuterated standards give rise to molecular ion peaks four mass units higher than the corresponding undeuterated probes. Standard and probe volatilize almost equally well. The composition in the vapor indicated by the H/D ratio reflects the molar concentrations over the entire range of probe evaporation. A procedure for the preparation of the tetradeutero-p-bromophenyl-isothiocyanate and the respective tetradeuterated amino acid p-bromophenylthiohydantoins is given.


Succinylation of proteins associated with the ribosomal attachment site on microsomal membranes. Ribosome-free membranes, prepared from rat liver endoplasmic reticulum by means of 2M LiCl, lost 90% of their ability to accept ribosomes for reattachment after exposure to succinic anhydride. However, treatment of rough-surfaced endoplasmic reticulum with succinic anhydride, prior to the removal of bound ribosomes by 2M LiCl, gave rise to membranes that were still able to accept ribosomes for reattachment. Succinylation of rough-surfaced endoplasmic reticulum resulted in the removal of some loosely-bound ribosomes and also a slight loss in glucose-6-phosphatase activity. Rough-surfaced endoplasmic reticulum, preincubated with succinic anhydride prior to treatment with lithium chloride, was exposed to [3H]succinic anhydride and subsequently analysed by dodecylsulfate polyacrylamide gel electrophoresis. By this means it was found that there were at least three proteins of different molecular weights that were associated with the membrane ribosomal attachment site.


[Synthesis of conjugates of heptalysine and penicillins (author's transl)]. Heptalysine was synthesized as a non-immunogenic carrier for artificial antigens with penicilloyl-group specificity. The synthesis was carried out by conventional techniques via different routes by condensation of appropriately protected intermediates. Best results were obtained with the use of the benzyloxycarbonyl group for intermediate protection of the alpha-amino-groups and the tert.-butyloxycarbonyl-group together with the tert.-butylester for permanent blockage of the terminal alpha-amino group, the epsilon-amino groups and the terminal carboxyl group. Heptalysine and also lysine were reacted with benzylpenicillin, alpha-aminobenzylpenicillin and tert.-butyloxycarbonyl-alpha aminobenzylpenicillin--to prevent the alpha-amino groups of penicillin from reacting--in aqueous solutions at pH 10.6-11.6 according to Levine and Redmond. The products were isolated after precipitation with acid or dialysation against water by lyophilisation. The penicilloyl group content of the conjugates as estimated from elemental analysis, penamaldate tests and the NMR spectra proved to be rather high: 5-7 residues/mol.


Facilitated purification of hypoxanthine phosphoribosyltransferase. Three major approaches to the complete purification of hypoxanthine phosphoribosyltransferase from human erythrocytes and rat brain are described. Preparative isoelectric focusing which has been used for the isolation of the human enzyme was not fully successful in the case of rat brain. Preparative polyacrylamide-gel electrophoresis in gel blocks yields enzyme samples of high purity as judged by analytical gel electrophoresis, but with a comparatively low specific enzyme activity. The most rapid and convenient method, a modification of the affinity chromatography on GMP agarose first described by Hughes[5] gives hypoxanthine phosphoribosyltransferase which is superior to the other preparations in its homogeneity and its specific activity. All three methods produce an identical enzyme protein detected by polyacrylamide electrophoresis on nondenaturing and sodium dodecylsulfate gels. Molecular data of hypoxanthine phosphoribosyltransferase derived from these studies are: Isoelectric points of 5.60; 5.85 and 5.90 for three isozyme peaks of the rat brain enzyme; and a molecular weight of 72000 for the native rat brain enzyme and of 25000-27000 for the subunit of human and rat enzyme. Guanylate kinase does not interfere with the purification of hypoxanthine phosphoribosyltransferase on GMP agarose and moreover is itself partially purified by this chromatography.


Estimation of glucose turnover in rats in vivo with tritium labeled glucoses. Starved and starved-refed rats were injected intravenously with labelled glucose (a mixture of [2-3H]-, [3-3H]- and [U-14C]glucose with either [5-3H]- or [6-3H]glucose), and the decay of the specific activity of [14C]glucose followed. Glucose was degraded to obtain the 3H/14C ratios for 3 isotope combinations in the same sample. The apparent rates of replacements, apparent carbon recycling, and the body glucose mass were calculated for the different tracers. The 3H/14C ratio from [2-3H, -U-14C]glucose declined much faster than that of the other tracers. Apparent recycling as calculated in fasted rats was 28% for [2-3H, U-14C]- 18% for [5-3H,-U-14C]- 17% for [3-3H, U-14C]- and 14% for [6-3H,U-14C]glucoses. The values in fed rats showed a similar pattern. We estimate that in fasted rats 85 to 90% of the 3HOH liberated from injected [2-3H]glucose is formed by catabolism in the periphery and the rest by recycling in the liver between glucose and glucose 6-P. Detritiation of other labels by hepatic recycling accounts for a very small fraction of the total 3HOH yield.