Treatment of refractory thrombocytopenic purpura with cyclophosphamine. Cyclophosphamide, an immunosuppressive agent, was administered as an additional mode of therapy to 30 patients with idiopathic thrombocytopenic purpura (ITP) refractory to conventional management. Of 22 previously tested by splenectomy an excellent response was achieved in 12, who remained in complete hematologic remission for 14-96 months after therapy was discontinued; a fair response in 3, with definite increase in platelets, but not to normal levels; and a poor response in 7 who failed to improve. Of 8 nonsplenectomized patients who failed to respond to steroids or maintain a response after steroids were discontinued, 4 were considered excellent, 1 required continued therapy to remain in remission (good response), 2 were fair, and 1 was poor. Remission was observed in 2-10 weeks in both groups and appeared to be related to duration of disease; presence of disease for less than 1 year was associated with a much better response to treatment (11 of 15) when compared with disorders lasting over 2 years (6 of 15). Cyclophosphamide therapy offers additional means of treating patients with ITP who fail to respond to conventional therapy and may serve as an alternative to splenectomy when surgery is contraindicated.


Effects of chorion type on variation in cord blood cholesterol of monozygotic twins. Cholesterol levels were measured in the cord blood of 30 pairs of monochorionic and 22 pairs of dichorionic monozygotic (MZ) twins. Cholesterol levels were found to be significantly higher in female twins when data was combined over chorion type. The type of chorionic development had no significant effect on variation among twin pairs. Chorion type did, however, have a significant effect on the within-pair variation. The variation within dichorionic pairs was more than five times that within monochorionic pairs (P less than .01). This result suggests that the variation in placentation has a significant effect on within-pair variation in serum cholesterol of newborn MZ twins.


Estimating the risks for offspring of first-cousin matings. An approach. Effects of parental consanguinity on morbidity and mortality can be estimated from observations on families ascertained through a child with a disease or defect, provided that appropriate corrections are made for the ascertainment bias. The risk of first-cousin parents having a child with a recessively inherited disease appears to be low (less than 1%). Data obtained by this approach suggest that the increased infant mortality associated with inbreeding (upon which calculations of lethal equivalents are based) may result in part from environmental differences between consanguineous and nonconsanguineous matings, which may be changing. Thus estimates of the number of lethal equivalents in a population can change as the environment changes.


Diurnal pattern of water and electrolyte excretion and body weight in idiopathic orthostatic hypotension. The effect of three treatments. The diurnal pattern of water and solute excretion and body weight were examined in five control subjects and in a patient with idiopathic orthostatic hypotension before and during treatment. The patient had a reversed diurnal pattern of excretion of sodium, urea and water but not of potassium and creatinine, and there was an excessive diurnal variation in body weight. The effects of three treatments, high salt diet alone and then with the addition of head-up tilt, and later fludrocortisone, were studied. Fludrocortisone caused marked clinical improvement and retention of sodium and water. Once a steady state was achieved none of the treatments had any significant effect either on the diurnal variation in weight or on the water and solute xcretion pattern except for a small reduction in sodium excretion at night when the patient slept with a head-up tilt. In is concluded that these treatments cause symptomatic improvement in idiopathic orthostatic hypotension through an increase in extracellular fluid volume rather than through any change in the abnormal diurnal pattern of water and salt excretion.


Gonadoblastoma: histologic, ultrastructural, and histochemical observations in five cases. In this series of gonadoblastomas it appeared that the germ cells were the motivating force underlying either tumor proliferation or regression. The ultrastructural morphology confirmed the presence of undifferentiated gonadal cells with active steroid synthesis by the interstitial cells. The Call-Exner-like bodies which showed extensive calcification were composed of basement membrane material containing a sulfated mucosubstance. A histochemical comparison with the noncalcifying Call-Exner bodies of a granulosa-cell tumor differed only in their glycoprotein content. The calcium deposits were identified as oriented hydroxyapatite crystals by electron diffraction, and it is proposed that the basement membrane material serves as a nucleation site for calcification. High serum testosterone levels were correlated with the presence solely of interstitial cells in one case. The finding of a gonadoblastoma without the presence of a Y chromosome contradicts earlier proposals concerning the requirement of a Y chromosome for germ cell proliferation.


Medical and social factors affecting early teenage pregnancy. A literature review and summary of the findings of the Louisiana Infant Mortality Study. A total of 414 births occurred to women under 15 years of age in Louisiana in 1972. The infant mortality rates of these children ranged from 6 to 50 per thousand live births when various combinations of medical and social factors were considered. Highest risk is asigned to the offspring of mothers who were poor, or white, or married, or with limited prenatal care. Prenatal care was generally less in the teenager than the older woman. The teenage stillbirth, perinatal mortality, prematurity, and infant mortality rates are generally higher than those in older women. This study confirms the findings of other authors that the offspring of teenage mothers are at greater risk than the offspring of older women although quality prenatal care and origin in a favorable socioeconomic background will ameliorate substantial elements of this risk.


The management of the pregnant patient with idiopathic thrombocytopenic purpura. The approach to management of idiopathic thrombocytopenic purpura (ITP) during pregnancy remains controversial--particularly regarding the method of delivery. Regardless of the maternal platelet count, we believe that these patients should be delivered by elective cesarean section at term because of the continued presence of maternal antiplatelet IgG antibodies, which cross the placenta. Despite the method of treatment used to increase maternal platelets, immunologic factors are significnat for neonatal involvement and should be considered in the management of these patients. The single largest factor responsible for reported neonatal losses has been intracranial hemorrhage secondary to thrombocytopenia and birth injury. Two patients with ITP are presented with data to substantiate our position on the method of delivery. The infants were transiently thrombocytopenic following delivery (despite adequate maternal levels of platelets).


Thrombotic thrombocytopenic purpura associated with pregnancy. Thrombotic thrombocytopenic purpura (TTP), a disorder of unknown etiology, appears to be a syndrome often associated with infectious, vascular, or autoimmune diseases. When it occurs in pregnancy, TTP can mimic other gestational complications. Two patients with TTP associated with pregnancy form the basis of this report. On patient is the second person known to have survived longer than 2 years after concurrent TTP and pregnancy. This patient had underlying glomerulonephritis and was treated with corticosteroids and heparin. The other patient, in whom an underlying disease process was not identified, was treated unsuccessfully with most of the recommended therapeutic modalities. Patients with concurrent TTP and pregnancy have the same prognosis as nonpregnant patient with TTP. Both groups have a prolonged survival rate of only 10 per cent. Primary treatment should consist of corticosteroids and inhibitors of platelet aggregation. If a rapid response does not occur, splenectomy is indicated. Care must be taken to recognize the pregnancy complicated by TTP, a circumstance which appears to occur more frequently than past reports have indicated.


Free-feeding patterns of rats in response to changes in environmental temperature. Four adult Sprague-Dawley rats (430-450 g), maintained on a 12:12 h dark/light cycle and 15% casein diet, were exposed to cold (5 degrees C) for 77 days and then transferred back to 24 degrees C. Throughout thisperiod, the feeding patterns of the rats were measured with recording balances. Cold exposure caused an immediate reduction in nocturnal meal frequency that remained low during the cold exposure. In contrast, diurnal meal frequency was unaltered. Average nocturnal meal size, which did not significantly increase before 8 days of cold, reached a plateau in 2 wk, whereas the average diurnal meal size did not significantly change until late in the exposure period. "Warm" (24 degrees C) reentry elicited an abrupt increase in nocturnal meal frequency and a reduction in average nocturnal as well as diurnal meal size. It thus appears that even in the face of a sudden increase in energy expenditure resulting from cold exposure, adult rats do not immediately adjust their daily food intake. On the other hand, the adaptive hyperphagic response occurring after cold acclimation is abolished when the energy demand is eliminated, i.e., when the animals are removed from the cold.


Effects of psychosocial stimuli on plasma renin activity in rats. The effects of two types of psychosocial stimuli on plasma renin activity (PRA) were studied in unanesthetized rats, blood being collected by decapitation. Thirty minutes of exposure to a novel environment ("open field") produced statistically significant increases of PRA in rats maintained on either a standard (1% NaCl) or sodium-free diet. No change in plasma renin substrate occurred. Prior treatment with propranolol (approximately 2 mg/kg) reduced the renin response by approximately 50% but did not completely abolish it. Plasma renin activity was also increased significantly by exposure of caged rats to the presence of a hungry cat for 30 min. We conclude that psychosocial stimuli can produce significant increases in renin secretion and that this response is mediated, at least in part, by the sympathetic nervous system.


A Bicentennial address: Benjamin Rush and those who came after him. In this Bicentennial year, the author takes a look at the early days of Amercan psychiatry, focusing on some of the great men who helped to form the discipline. These men have much to teach us in a time when the field is divided within and faces a crisis of public confidence without. We can learn much from men like Benjamin Rush, who although they were actively involved in the social movements of their day, remained always the physician. Dr. Braceland suggests that it is time for psychiatry to move back into the mainstream of medicine, retaining, of course, mastery of psychotherpeutic techniques and knowledge of psychodynamics. This move can best be accomplished by employing the principle of complementarity, the art of encompassing different approaches to problems and utilizing the essentials of each to arrive at workable solutions.


The broad role of Ego Functions Assessment. The need for accurate assessment and accountability is of paramount professional concern to psychiatry. The authors state that ego functions assessment (EFA) is reliable and valid quantitative technique, useful for these purposes in a variety of psychiatric settings. They suggest the various uses of EFA in five such areas: Professional Standards Review Organizations (PSRO) and third-party funding, forensic psychiatry and legal responsibility, the monitoring of psychotherapeutic drugs, research and planning in psychotherapy, and psychological testing. The authors condlude the EFA is a dynamically sophisticated and easily learned form of mental status examination and that its refinement by extensive use and simplification is likely.


A dynamic synthesis of analytic and behavioral approaches to symptoms. The symptom-formation process involves a complex interaction between internal symbolic expression and secondary reinforcing consequences in the patient's environment. Symptoms are considered from a practical clinical perceptive integrating behavioral and analytic approaches and the implications for diagnosis, disposition, and treatment are outlined.


Histomorphological and histochemical studies on the female genitalia of aging goat. III. Polyovular follicles and polynuclear ova in ovary. Polyovular follicles and polynuclear ova have been recorded to occur only in 5 goats out of 24 goats of ages between 2 months 24 days and 5 years 2 months 18 days, studied. These structures were recognized at proestrus, estrus and metestrus only but never in the animals over 1 year of age. Polyovular and polynuclear follicles with no apparent degenerative changes were seen at estrus whereas degenerating ones were commonly seen at proestrus and metestrus also.


On cestodes of Passer domesticus I. Choanotaenia, Raillietine and Proparuterina. An investigation on the cestode fauna of the common sparrow, Passer domesticus (Linnaeus) was carried out for about five years. In all 445 birds were examined during this period and only five species of cestodes were found to parasitize this bird: of these, three are known while two are new forms, the latter are the rarities. This part includes critical accounts of Choanotaenia passerina (Fuhrmann, 1907), Raillietine (R.) galeritae (Skrjabin, 1915) and Proparuterina lali sp. nov. - Choanotaenia passerina (Fuhrmann, 1907) has been previously studied by Fuhrmann (1907), Johnston (1909), Stunkard & Milford (1937) and Kintner (1938). The present study provides additional data. The writers find two rows of rostellar hooks in the present material. Fuhrmann and Johnston reported two rows of rostellar hooks, but Kintner apparently found a single row of rostellar hooks. Variations have been found in the number of testes and extent of cirrus sac. Amongst the previous workers, only Johnston (1909) paid attention to study the protective coverings present around the hexacanth and described two envelopes, but the writers find three. - Raillietine (R.) galeritae (Skrjabin, 1915) has been restudied and redescribed from fresh material. Previously Mahon (1958) studied this species from P. domesticus. The present account includes important variations and some additions too. Suckers have been found to be armed in contradiction to what Mahon stated. Gravid proglottides have been found to develop a velum. Egg capsules contain 3-13 eggs each. Two protective envelopes have been found around the hexacanth. This is the first record of the occurrence of this species in P. domesticus in India. Proparuterina lali sp. nov. is a rare parasite of Passer domesticus. Only one more species viz. P. aruensis Fuhrmann, 1911 is known. The present species differs from P. aruensis in the number and distribution of testes, bilobed nature and median position of ovary, position of vitellarium and of genital pore. The generic diagnosis of Proparuterina Fuhrmann, 1911 has been amended in the light of the morphology of the present species.


[Cardiovascular effect of various morphine-line analgesics in rabbits anesthetized with thiopental or alphadione (Alfatesine)]. Alphadione (Alfatésine, Althesin, CT 1341), a steroid anaesthetic with a quick and short action, has but a very moderate analgesic activity, so it is necessary in human anaesthesian, to associate with it a morphinic analgesis systematically. Therefore it was interesting to study the response of cardiovascular system when using this type of association. Our results show that the cardiovascular depressive effects of morphinic analgesics, when they exist, are not increased by the presence of alphadione.


[Effect of general anesthesia with Alfatesine on the newborn infant in obstetrical practice]. We studied in 130 parturients during childbirth the effects of general anaesthesia by Alfatesine on the state of the foetus at birth. The examinations took into account the APGAR score, blood gas analysis, pH, bases excess in the umbilical artery and vein and the foetal EEG. The subjects are divided into three groups: prophylactic caesarians, extractions during labor in the absence of any foetal distress and extractions for reasons of acute or chronic foetal distress. The results are evaluated in comparison with the same tests conducted on a series of newborn infants in normal conditions and without anaesthesia. The APGAR score is hardly affected by the Alfatesine; the EEG is perturbed (but without any clinical manifestations) during the two hours following delivery. However, theses modifications are less pronounced than those observed with barbiturates. The study of blood gases and pH shows lower values under anaesthesia than without.


Physiologic responses of preparturient and postparturient Holstein-Friesian cows to summer heat stress in Arizona. A group of 18 Holstein-Friesian cows were studied in central Arizona to evaluate seasonal heat stress factor in preparturient and postparturient dairy cows. Physiologic measurements were made within 2 weeks before calving and within 1 week after calving. The studies were conducted during the cool winter months of December and Janurary and during the hot summer months of July, August, and September. Comparisons were made of rectal temperatures, vaginal temperatures, skin temperatures, respiratory rates, and heart rates between the 2 groups of preparturient and postparturient cows and between the 2 seasons of the year. Rectal temperatures, vaginal temperatures, skin temperatures, and respiratory rates of both preparturient and postparturient cows were significantly higher during the hot weather season than during the cool weather season. Heart rate was not significantly affected by hot weather. The respiratory rates, heart rates, and rectal temperatures of preparturient cows were significantly higher than in postparturient cows during cool weather; however, this relationship was masked by hot weather.


Recurrent nocturnal asthma after exposure to grain dust. Bronchial provocation tests performed on two seperate occasions in a farmer with dust from his own grain led to immediate and late respiratory reactions followed, without further exposure to grain dust, by severe respiratory reactions during subsequent nights. Studies of lung function, including measurements of closing volume, suggested that both large and small airways rather than lung parenchyma were primarily involved. Examination of the grain samples together with the results of skin and serologic tests suggested that the grain mite, Glycyphagus destructor, might be an important allergen. Serum concentrations of C3 and C4 did not alter during these recurrent nocturnal asthmatic reactions.


Voluntary muscle involvement in hypertrophic cardiomyopathy. A study of eleven patients. Hypertrophic cardiomyopathy is generally considered to be a primary disease of cardiac muscle, although several clinical observations suggest that the pathologic process might be more diffuse. To further examine this possibility, electromyography and voluntary muscle biopsies were done on 11 patients with hypertrophic cardiomyopathy. In 10 of 10 patients electromyography showed reductions in mean potential amplitude and duration, with an increased incidence of short-duration polyphasic deflections (findings traditionally accepted as indicative of a myopathic process). Light and electron microscopic studies of the biopsy material showed abnormalities in eight of 11 patients: four had central core or target fibers, or both, and two of these, plus four others, had subsarcolemmal mitochondrial proliferation with or without abnormal ultrastructure. These findings indicate that hypertrophic cardiomyopathy is only one aspect of a larger disease spectrum, with abnormalities in both voluntary and cardiac muscle.


Scintigraphy of sacroiliac joints in acute anterior uveitis. A study of thirty patients. HLA-B27 is a transplantation antigen found in a high proportion of patients with ankylosing spondylitis. Recently, an association has been shown to exist between HLA-B27 and acute uveitis, even in the absence of ankylosing spondylitis. We have examined the HLA antigen profile of 45 patients with acute nongranulomatous anterior uveitis and have confirmed this relation. In addition, using 90mtechnetium stannous pyrophosphate we have been able to demonstrate abnormal bone scan in 19 of 30 patients studied. Such abnormalities are limited to the sacroiliac joints but are otherwise the same as those seen in overt ankylosing spondylitis. Seven of the 19 patients did not have HLA-B27. These factors suggest that acute anterior uveitis may often represent a manifestation of a spondylitic diathesis even in the complete absence of any suggestive symptomatic or radiologic change and, in some cases, even though the antigenic marker HLA-B27 may be absent.


[Idiopathic intestinal lymphangiectasis. Evolution with M.C.T. (author's transl)]. A case of idiopathic intestinal lymphangiectasis is reported in a three month old child. Clinical course and laboratory findings are given in relation to administration of three diets containing different concentrations and types of fat. Short term improvement was only noticed with diets containing low concentrations of long chain triglycerides supplement with medium chain triglycerides. Clinical manifestations related to fat malabsortion improved greatly but there was no relationship with serum protein level. No effect on low level of gamma-globulins and lymphatic displasia was found as sawn in an intestinal biopsy performed after three months of treatment. Nevertheless, long-term results were poor and only were evident in a diminution of steatorrhea and normalization of stools.


[Survival of parasitic elements in liquid manure: effect of xylene (author's transl)]. The spreading of liquid manure may play a role in the transmission of parasitism. In this preliminary study, we have investigated the evolutionary and survival capacities of parasitic elements in liquid manure, their development potential after extraction and the destructive action of xylene in concentration of 1 p. 1000. As parasitic models we have retained: the coccidial oocyst (E. tennella), a thick-shelled egg (A. suum), thin-shelled eggs (H. contortus, O. quadrispinulatum), a trematode egg (F. hepatica) and larva III of H. contortus. The studies were carried out in Erlenmeyer with parasite free liquid manure taken from a bovine cowshed. Water was used as control medium. The parasitic models were kept in the liquid manure for a maximum of 17 days excpet for Ascaris suum, 45 days. Only the coccidial oocyst is little affected. The eggs of Trichostrongylides and of Fasciola show a poor resistance to this environment and to a lesser degree the egg of Ascaris. The larvas III are rapidly destroyed and those obtained from eggs that stayed in liquid manure have a greatly diminished viability. The antiparasitic action of xylene varies according to the type of parasitic element. Its action is particularly clear on the eggs of Trichostrongylides and of Fasciola hepatica.


Twinning and anencephaly.

Twinning and anencephaly. The literature on anencephaly in twins ascertained in series has been reviewed and some hitherto unpublished data presented. 1. Anencephaly rates in opposite-sexed twin pairs seem not to differ appreciably from those in related singleton births. 2. There is good evidence that the incidence of anencephaly is higher in same-sexed twin pairs than in opposite-sexed pairs. One would infer that anencephaly is commoner in MZ than DZ pairs: this inference is supported by some data on anencephaly in twins of which the zygosity has been diagnosed. It is estimated that members of MZ twin pairs are about 1 2/3 times as likely to be anencephalic as are other individuals. 3. Concordance rates are not low, as is sometimes suggested, but are of the same order as recurrence rates. 4. It seems likely that concordance rates are higher in same-sexed than in opposite-sexed pairs. This would be expected because of the sex-preferential nature of the condition, and the hypothesized higher incidence rates in MZ pairs.


Transbronchoscopic cryosurgery of respiratory structures: experimental and clinical studies. Although resection is the only treatment proven effective for localized malignant tumors in the tracheobronchial tree, alternative methods for cure or control of unresectable or recurrent tumor should be explored. In 24 dogs, cryonecrosis of sizable portions of carina, main stem bronchi, first division bronchi, and lung parenchyma was well tolerated, and the necrosis was localized, reproducible, and followed by prompt healing of frozen tissue. The gross architecture of the bronchi was not permanently altered, and no strictures formed. Six patients with endobronchial tumors were treated transbronchoscopically with cryosurgery. All patients tolerated the procedures well, and there were no complications. Palliation was achieved in five of the six patients.


[Dipetalonema lineage. New attempt at classification]. Through comparing the morphological evolution to the host range and the geographical distribution we can suggest Dipetalonema sensu-largo may be interpreted as a gondwanian lineage which may have evolved after the three main austral continents drifted apart. Therefore, we propose the following systematic splitting: --Sprattia n.gen., type species: S. venacavincola parasite of Australian Marsupials, which may be related to Litomosa; --Breinlia Yorke and Maplestone, 1926, and Breinlia (Johnstonema) (Yeh, 1957), parasite of Australian Marsupials; --Skrjabinofilaria (Travassos, 1925), parasite of American Marsupials; --Macdonaldius (Khanna, 1933), parasite of American Reptiles; --Dipetalonema (Orihelia) n.sub. gen., type species: D. (O.) anticlava, parasite of Dasypodidae; --Dipetalonema (Acanthocheilonema) (Cobbold, 1870), parasite of Insectivora, Carnivora, Pinnipedia, sometimes Rodents; --Dipetalonema (Molinema) (Freitas and Lent, 1939), parasite of Caviomorpha and Beavers; --Dipetalonema (Loxodontofilaria) (Berghe and Gillain, 1939), parasite of Ethiopian Ungulates; --Dipetalonema (Chenofilaria) (Kou, 1958), parasite of Asiatic Pholidota and Australian Marsupials; --Dipetalonema (Dipetalonema) (Diesing, 1861), parasite of American Primates; --Monanema Anteson, 1968, parasite of Rodents other than Cariomorpha; --Ackertia (Vaz, 1934), parasite of Caviomorpha; --Tetrapetalonema (Sandnema) n.sub.gen., type species: T. (S.) digitata, parasite of Asiatic Insectivora and Primates; --Tetrapetalonema (Tetrapetalonema) (Faust, 1935), parasite of Tupaidae, Platyrhinii, and, sometimes, American Rodents and Carnivora; --Tetrapetalonema (Esslingeria) n. sub.gen., type species: T. (E.) perstans, parasite of African African Anthropoidea and Humans; --Filarissima (Chabaud, 1974), parasite of Caviomorpha.


Chemical control of breathing in identical twin athletes. Studies in identical twin athletes, using a wide range of methods of measuring chemical control of breathing, have demonstrated identity of ventilatory responses to hypoxia and hypercapnia in such subjects. This suggests that, when the effect of a major environmental factor, physical activity, is removed, genetic factors predominate in determining the ventilatory responses to carbon dioxide and hypoxia.


Ultrastructure and biochemical function of skeletal muscle in twins. Muscle biopsies were obtained from eleven pairs of monozygotic and six pairs of dizygotic twins, and maximum oxygen consumption (Vo2) was measured. There were no differences between the two groups of twins in their intra-pair variation, except for two enzyme systems, glyceraldehyde-3P-dehydrogenase (GAPDH) and 3-hydroxyacyl-CoA-dehydrogenase (HAD). The effects of training were assessed by comparing the differences between twins when one member of each pair undertook a 23 week training programme. There were significant differences in VO2 max, heart volume and maximum oxygen pulse after training, and some significant cytological differences. It was concluded that environmental factors were stronger than genetic influences, as far as physical performance was concerned.


Laser adapter for tracheoscopy.

Laser adapter for tracheoscopy. This adapter makes it possible for the operating microscope to be used monocularly, to see axially down the CO2 laser beam, to use the aiming light and its joy stick control. This makes the laser useful for upper tracheal lesions through a tracheoscope.


Antibiotic resistance of bacteria in water containing ornamental fishes. Water containing ornamental fishes was found to frequently contain countable numbers of bacteria that were resistant to one or more antibiotic or chemotherapeutic agents. The multidrug-resistant strains most commonly isolated were lactose-fermenting Citrobacter freundii. The overall resistance of these aquaria strains was greater than the previously described resistance of clinical isolates of C. freundii. Although the strains examined appeared to lack R-factors, this pool of resistant bacteria may have public health implications.


Radioimmunoassay of iodinated tobramycin. A radioimmunoassay for tobramycin was developed using antisera from rabbits injected with a tobramycin-bovine serum albumin conjugate. The antibody had a relatively high affinity for (125)I-labeled tobramycin (1.6 x 10(9) liters/mol), thus indicating little interference in immunoreactivity by iodination. The radioimmunoassay was highly specific, and only minor cross-reaction occurred with other aminoglycoside antibiotics. The radioimmunoassay was also more sensitive than previously published tobramycin assays (minimum sensitivity, 280 pg), and there was a significant correlation (P < 0.05) with both the radioenzymatic and microbiological assays.


Degradation of ochratoxin A by a ruminant. The fate of ochratoxin A during incubation with contents from the four stomachs of the cow was studied. It was concluded that ochratoxin A was cleaved into the nontoxic ochratoxin alpha and phenylalanine by the contents from all but the abomasum.


Rhizobium japonicum derivatives differing in nitrogen-fixing efficiency and carbohydrate utilization. Four derivatives of Rhizobium japonicum 110 were isolated on the basis of morphologically different colonies formed on yeast extract-mannitol-HM salts medium. All are able to nodulate Lee soybeans. The bacteria-plant associations formed by each clone have measurable acetylene-reducing activity, but those formed by two of these clones (designated L1-110 and L2-110) are 5- to 10-fold less efficient than those formed by the others (designated I-110 and S-110). These derivatives were not detectable with ordinary culture techniques since, because of cell adherence, genetically mixed colonies result. When a detergent (Tween 40 at 0.01%, vol/vol) was added to the dilution medium, separate clones resulted. The metabolic basis for the gross differences in colony morphology on yeast  extract-mannitol-HM salts medium was found to be that L1-110 and L2-110 utilized p-mannitol for growth, whereas I-110 and S-110 did not. These clones differ analogously in ability to utilize D-arabitol. Clones I-110 and L1-110 were chosen for studies of growth rates on various carbohydrates. Although clone I-110 and clone L1-110 did not differ in growth rates on a number of sugars, such as gluconate, arabinose, glycerol, and mannose, they differed in growth rates on glucose and fructose. Although clone I-110 grew faster on glucose than did clone L1-110, clone L1-110 grew faster on fructose than did clone I-110. Clones I-110 and L1-110 showed identical responses to several antibiotics and deoxyribonucleic acid (DNA) synthesis inhibitors and identical susceptibility to some highly specific bacteriophages. Identical buoyant densities of their DNAs in isopycnic CsCl density gradients and identical thermal denaturation temperatures of their DNAs suggest that clones I-110 and L1-110 have the same DNA base composition. Preliminary DNA/DNA hybridization experiments show that strain I-110 DNA and strain L1-110 DNA have a high degree of common polynucleotide sequences.


Identification of mycotoxins produced by species of Fusarium and Stachybotrys obtained from Eastern Europe. Isolates of Fusarium and Stachybotrys spp. and crude extracts from these fungi were obtained from Hungary and the U.S.S.R. and used for the evaluation of the mycotoxins they produced. The cultures were grown on millet and oats and extracted in Budapest, Hungary (Veterinary Medical Research Institute) and chemically analyzed at the University of Minnesota using thin-layer chromatography (TLC), gas-liquid chromatography (GLC), gas chromatograph-mass spectrometry (GC-MS), and the rat skin bioassay. Zearalenone was found in most of the Fusarium cultures, T-2 toxin, neosolaniol, T-2 tetraol, and HT-2 toxin were found in extracts of Fusarium poae and F. sporotrichioies. A special effort was made to isolate the steroid-like toxins reported in the early Russian literature as sporofusarin and poaefusarin. None of the extracts from the Fusarium species yielded poaefusarin or sporofusarin when analyzed by our chemical methods or by those of L.E. Olifson, S.M. Kenina, and V.L. Kartashova, 1972. We therefore accounted for the toxicity of the Fusarium extracts as due to the 12,13,epoxytrichothecenes. One culture of Stachybotrys alternans yielded a macrocyclic ester of 12,13-epoxytrichothecene which, upon hydrolysis, yielded verrucarol; a steroid-like molecule (SB-3) was also isolated. The former had skin-irritant activity but SB-3 did not; the latter exhibited cardiac activity on the heart of the cockroach.


Isolation of strains of the cellular slime mold Dictyostelium discoideum capable of growing after a single passage in axenic medium. Wild-type strains of the cellular slime mold Dictyostelium discoideum grow on bacteria. Axenic strains of D. discoideum capable of growing in a simple salts-yeast extract-proteose peptone-glucose medium have been isolated from wild-type strains fo both mating types after a single passage in this medium. This result is consistent with the theory that the axenic phenotype has a simple genetic basis.


Effect of alfalfa fiber substrate on culture counts of rumen bacteria. A medium has been developed using alfalfa fiber as the sole substrate. It gave high culture counts (3 X 10(9) to 8 X 10(9)/ml) of rumen bacteria. When this medium was combined with the medium 98-5 of Bryant and Robinson, modified to contain 33% rumen fluid instead of 40% clarified rumen fluid, a higher count was obtained than with either medium alone.


Basal medium for the selective enumeration of rumen bacteria utilizing specific energy sources. A 40% rumen fluid basal medium has been developed that without added substrate will support growth of about 10% or less of the total colony count obtained with 40% rumen fluid-glucose-cellobiose-starch-agar medium (RGCSA). The basal medium is prepared by anaerobic incubation of all ingredients in RGCSA medium except the carbohydrates, Na2CO3, and cysteine for 7 days at 38 degrees C. After incubation, substrate(s), Na2CO3 and cysteine are added and the medium is tubed and sterilized as in normal medium preparation. When xylose was included with glucose, cellobiose, and starch as added carbohydrates in the incubated medium, colony counts were comparable to those obtained with RGCSA medium. The addition of specific carbohydrates or other substrates as energy sources to the basal medium suggested that the percentage of the bacterial population capable of utilizing these energy sources was influenced by the ration of the animal; however, considerable animal variation and day-to-day variation in a given animal was observed. Comparison of the population in animals fed either orchardgrass hay or 60% corn-40% orchardgrass (60-40) indicated little or no difference for the percentage of bacteria utilizing glucose, pectin, xylan, or mannitol. Increases in the percentages of xylose-, cellobiose-, Glycerol-, and lactate-utilizing bacteria occurred with the orchardgrass hay ration, whereas the percentage of starch-digesting bacteria was increased significantly (P less than 0.01) in the animals fed the 60-40 ration. A limited number of bacterial strains were isolated from the basal medium without added substrate, most of which were atypical with respect to the predominant rumen bacteria. Growth of these strains, even in complex media, was very slow and limited. Based on these data with isolated strains and colony counts obtained in roll tube medium containing only minerals, resazurin, agar, Na2CO3, and cysteine, the selective medium overestimated the percentage of bacteria able to use a specific energy source. This overestimate was  6 to 7% of the total culturable count.


Surgical treatment of acute diverticulitis by staged procedures. A retrospective 10-year experience with the traditional three-stage plan (diverting colostomy, resection, colostomy closure) for perforated diverticulitis of the colon in four urban hospitals was reviewed to accurately assess the mortality rate. Only patients who were admitted in a non-elective manner with signs of an acute abdomen or who were already hospitalized with another illness and developed an acute abdomen were considered. Fecal or generalized purulent peritonitis, or pelvic peritonitis with abscess were observed at laparotomy in all instances. Two hundred and eight patients representing 211 episodes met the above stated criteria for inclusion in the study. A transverse colostomy was performed in 203 instances associated with 16 deaths, and 8 sigmoid colostomies were associated with two deaths. The overall mortality after the first stage was 8.5%. A loop colostomy was constructed most frequently and a completely divided colostomy performed in only 31 of 211 (15%) instances. Of 147 instances in which the diseased sigmoid colon was resected, 44 (30%) had the colostomy ablated at the same operation, resulting in only one death (0.7% mortality). Colostomy closure as a separate procedure in 103 instances resulted in 4 deaths (3.9% mortality). The highest mortality rate occurred in patients in the in the eighth decade. Staged procedures for perforated colonic diverticula can be carried out with a mortality rate of 11%.


Effects of lithium on foot shock-induced aggressive behavior in rats. The effects of lithium chloride (LiC1; 1, 2, 3 mEq/kg, i.p.) were studied on foot shock-induced aggressive behavior categorized as 'hyperreactivity' 'pre-attack' and actual 'fight' or 'attack' scores in rats. The attack score was significantly decreased at all doses between 2 to 48 hr post-drug intervals. LiCl also antagonized both amphetamine-induced facilitation and scopolamine-induced suppression of the shock-induced aggression; these effects suggest a probable role of lithium in normalizing induced disturbances of both central adrenergic and cholinergic mechanisms and may at least partly be responsible for its psychotherapeutic efficacy as a "mood normalizer".


Psychological correlates of coronary angiographic findings. Prior to undergoing diagnostic coronary angiography, 94 men responded to tests for the coronary-prone behavior pattern, anxiety, depression, and neuroticism. Independently, cardiologists rated cineangiograms by the percent of atheromatous luminal obstruction in four major coronary arteries. The patients with greater atheromatous obstruction scored significantly higher than those with lesser disease on all four scales of the test for the type A coronary-prone behavior pattern. Those with more seriously diseased vessels also scored significantly higher on anxiety and depression scales but significantly lower on a denial scale. Men rated as having more frequent and intense angina pain scored significantly higher on hypochondriasis, depression, and admission of symptoms than men less subject to ischemic pain. Multivariate statistical analyses revealed that the findings regarding extent of atherosclerosis are independent of anginal pain or congestive heart failure.


Pathogenesis of isoproterenol-induced lesions in the rat myocardium. The aim of this study was to investigate the action of isoproterenol (ISP) on the myocardium by means of light microscopy, histochemistry, autoradiography with tritiated ISP and electron microscopy. One hundred and sixty four Wistar rats were divided into 8 groups. Group A, B, C and D were given 10 mg/kg i.p. ISP (plus 5 uC of tritiated ISP). The animals were sacrificed at different intervals. Group E served as control to proceeding groups. Group F was given 10 mg/kg i.p. ISP and subjected to "holding" stress; Group G was its corresponding control. Group H received 9 mg/kg. prenylamine, as inhibiting drug, 1 hour before and hour after ISP injection. Histopathology of "infarct like" lesions presenting localized necrosis, myocytolysis, homogenization and positive tests for ischemia are correlated to the localization of tritiated ISP on sarcolemma and to changes in succine dehydrogenase enzymes in the groups A, B, C and D. Hypercontraction and widening of Z bands of sarcomers are found in electron microscopy. These ischemic changes are inhibited by prenylamine, a drug acting as moderator of catecholamine effects by slowing down Ca transport. It is concluded that myocardial necrosis induced by ISP is probably due to an increased activation of the "calcium pump". The ISP provoked lesions appear to be a promising model to study experimental myocardial necrosis.


[Experience in the use of porcine heterologous grafts of the Hancock type for replacement of the mitral valve. 4 years of continuous use]. We present a statistical analysis on the use of the Hancock porcine heterograft for mitral valve replacement in 151 consecutive cases. A 14% early, and 3.9% late mortality rate is found. An evaluation of the factors contributing to this figure shows that the most important is the degree of myocardial derangement prior to surgery, with 3.5% mortality for stage III and 32% for stage IV (New York Heart Association classification). Our rate for thromboembolism is 9%. Study of other conditions favoring this complication indicates that factors other than valve replacement are present in all cases, making the evaluation of the thrombogenic qualities of these prosteses difficult. In a period of study of 4 832 patient-months (21 average) or 5 526 valve-months (19 average) which nicludes all our Hancock prosteses. There have been no failures that can be traced to mechanical derangement nor biological deterioration. This fact together with their favorable hemodinamic characteristics, make us recommend this model for clinical use.


Secretion of beta-glucosidase by Ochromonas danica. beta-Glucosidase released by the phytoflagellate Ochromonas danica was the result of secretion; this was adduced from the following: (1) The enzyme was released during growth, including early log phase. (2) The amount released was calculated to be much more than could be attributed to cell lysis. (3) beta-Glucosidase was released by cells during short term incubation in a dilute salt solution; this release was nearly linear for at least 24 h. (4) Release occurred while cell counts remained nearly constant and cells remained viable. (5) Control experiments excluded cell damage resulting from incubation and cell manipulation as a source of the exoenzyme. (6) No alkaline phosphatase was released and 5 times less phosphoglucose isomerase than glucosidase was released while the cells contained 7 times more phosphoglucose isomerase. (7) The kinetics of release of nonspecific protein and UV absorbing material was markedly different from glucosidase release. (8) Glucosidase release was temperature and energy dependent; anerobiosis decreased enzyme release. (9) Release was inhibited by cycloheximide. (10) Cells incubated with 3H-leucine synthesized labeled protein which was secreted linearly for at least 24 h. Cycloheximide inhibited incorporation of 3H-leucine into protein and the secretion of the labeled protein.


[Studies on the prenatally toxic effect of parathionemethyl in Wistar rats compared to cyclophosphamide and trypan blue]. Higher yield and performance in plant and animal production will depend on reinforced use of pesticides, particularly alkyl phosphate esters and insecticidal carbamates. Prenatal toxic action of the pesticides used today may be detrimental to human and animal health. Prenatal-toxicological tests, using parathion-methyl, were conducted on the basis of known but modified experimental methods. The vulnerability of a rat strain was tested by applying to it teratogenic model substances (trypan blue and cyclophosphamide). Several oral applications of parathion-methyl (3 ppm) during the sensitive phases of germ formation and growth (fifth to ninth and eleventh to fifteenth or eleventh to nineteenth days from conception) were followed by clear embryotoxic effects, such as retardation and increased resorption. The average number of resorption sites grew from nine in the control group to 20 in the experimental group. Postnatal malformations were not observed.


Primary structure of apovitellenin I from hen egg yolk and its comparison with emu apovitellenin I. The amino acid sequence of apovitellenin I from hen egg yolk has been determined using both automatic and manual procedures; it comprises 82 residues. Hen apovitellenin shows considerable homology with emu apovitellenin I which contains 84 residues. Besides two deletions in the sequence, the hen protein differs in 28 positions from the emu protein; 26 of these positions may have arisen from single base changes. The changes are largely conservative ones, which suggest that the structure and function have been preserved despite extensive mutation.


Correlated response in selection for aggressiveness in female mice. I. Male aggressiveness. Males from the fifty selected generation of a selection program for aggressiveness in female Mus musculus (Ebert and Hyde, 1976) were tested to determine whether male aggressiveness showed a correlated response in selection for female aggressiveness. The results indicated that male aggression had not shown a correlated response. Differences among males from the high, control, and low lines were not statistically significant in one replication and were significant but not in the predicted order in the other replication. There were marginally significant line X sex interactions. The rank correlation between male and female aggression scores was 0.20, which was not significant. The results suggest that male aggressiveness and female aggressiveness are under separate genetic control. Data for generation S5 females are also reported; differences among the high, control, and low lines continue to be significant.


A note on the IQ of monozygotic twins raised apart and the order of their birth. This note examines James Shields' sample of monozygotic twins raised apart to entertain the hypothesis that there is a significant association between the measured IQ of these twins and the order of their birth. A non-parametric test supports this hypothesis and then a linear probability function is estimated that discriminates the effects on IQ of birth order from the effects of birth weight.


Path analysis of aptitude, personality, and achievement scores in Brazilian twins. Achievement at school and performance on the Dominoes test, the Differential Aptitude Tests (DAT), and Griéger's Characterological Questionnaire of 45 monozygotic and 46 same-sex dizygotic pairs of twins were analyzed using a new linear model for familial corrrelation. For 14 of the 20 sets of data, the genotype's contribution to the total variance is estimated to be higher than 50%. The effect of common environment seems to be important only for achievement in Arts.


Inherited inadequate uterine environment leading to mental retardation: negative evidence in pedigree data. The frequency of mental retardation in the offspring of maternal aunts of retarded probands is compared with the frequency in offspring of other aunts or uncles of the same probands. There is no support for inherited uterine inadequacy as an explanatory factor for mental retardation.


Level of functioning of siblings and parents of probands of varying degrees of retardation. A further analysis of already published data supports the position that retardates of low ability level less frequently have retarded siblings, retarded parents, and parents low in occupational level than do retardates higher in ability level. The analysis supports the position that there are two types of retarded individuals, persons retarded as a result of gene or chromosomal anomalies, brain injury, etc., who more frequently occur in the lower-level retardate group, and persons whose retardation represents polygenic segregation, who more frequently occur in the higher-level group.


Transport of calcium ions by Ehrlich ascites-tumour cells. Ehrlich ascites-tumour cells accumulate Ca2+ when incubated aerobically with succinate, phosphate and rotenone, as revealed by isotopic and atomic-absorption measurements. Ca2+ does not stimulate oxygen consumption by carefully prepared Ehrlich cells, but des so when the cells are placed in a hypo-osmotic medium. Neither glutamate nor malate support Ca2+ uptake in 'intact' Ehrlich cells, nor does the endogenous NAD-linked respiration. Ca2+ uptake is completely dependent on mitochondrial energy-coupling mechansims. It was an unexpected finding that maximal Ca2+ uptake supported by succinate requires rotenone, which blocks oxidation of enogenous NAD-linked substrates. Phosphate functions as co-anion for entry of Ca2+. Ca2+ uptake is also supported by extra-cellular ATP; no other nucleoside 5'-di- or tri-phosphate was active. The accumulation of Ca2+ apparently takes place in the mitochondria, since oligomycin and atractyloside inhibit ATP-supported Ca2+ uptake. Glycolysis does not support Ca2+ uptake. Neither free mitochondria released from disrupted cells nor permeability-damaged cells capable of absorbing Trypan Blue were responsible for any large fraction of the total observed energy-coupled Ca2+ uptake. The observations reported also indicate that electron flow through energy-conserving site 1 promotes Ca2+ release from Ehrlich cells and that extra-cellular ATP increase permeability of the cell membrane, allowing both ATP and Ca2+ to enter the cells more readily.


Incorporation of choline and ethanolamine into phospholipids in germinating soya bean. 1. Incorporation of [Me-14C]choline and [2-14C]ethanolamine into lipids was studied in germinating soya bean (Glycine max L.) seeds. The precursors are only incorporated into phosphatidylcholine and into phosphatidylethanolamine respectively. 2. Base-labelling via a phospholipase-D type of reaction was eliminated as a significant factor. 3. Cyclo heximide inhibited labelling of phosphatidylcholine from [Me-14C]choline but did not affect labelling of the aqueous choline pool. It had no effect on [2-14C]ethanolamine uptake or incorporation into phosphatidylethanolamine. 4. Hemicholinium-15 at 10mM concentrations decreased uptake and lipid labelling from the both bases. 5. There was no evidence for base competition. 6. The endogenous pool of choline was much larger than that of ethanolamine, which resulted in higher specific radioactivities for phosphatidyl-ethanolamine than for phosphatidylcholine. 7. The results can be interpreted as indicating that the kinase and phosphoryltransferase enzymes of the CDP-base pathways are separate for each phospholipid.


Uptake and metabolism of tryptophan by the isolated perfused guinea-pig mammary gland. Tryptophan uptake by the isolated perfused lactating guinea-pig mammary gland was 46.5+/-4.6 mug/h per g. Results of absorption studies and the use of [methylene-14C]tryptophan suggest that tryptophan is one of the group of amino acids that are transferred almost quantitatively from blood plasma to milk protein.


Circular Dichroism Studies of Cyanate-Induced Conformational Changes in Hemoglobins A and S. Circular dichroism and difference spectroscopy have been used to study dilute aqueous solutions of oxygenated, deoxygenated, and carbamoylated deoxygenated hemoglobins A and S (HbA and HbS, respectively). The spectra of HbA and HbS, in comparable state of oxygenation or carbamoylation, are identical, strongly implying identical conformations about the heme groups of the respective proteins. The spectra of the oxygenated forms change little upon addition of KCNO, which is known to carbamoylate the NH2 terminals of the individual chains (Cerami and Manning, 1971). The spectra of the deoxygenated forms, on the other hand, are markedly altered. The decreased magnitude of the 430-nm extremum with increased cyanate concentration can be used to calculate an addition curve which becomes asymptotic at a cyanate:heme molar ratio of approximately 10(3). This conformational change occurs in the absence of O2 and has been predicted (Njikam et al.,1973); it can also be demonstrated by difference spectroscopy techniques, whereby a comparable addition curve can be constructed from changes in the 555-nm absorption, while the 541-nm absorption remains invariant. The change described corresponds to the formation of a new conformation, corresponding to carbamoyldeoxyhemoglobin, carrying one carbamoyl group per chain. In the presence of a small quantity of oxygen, however, the above reported changes in CD are accompanied by a concomitant rise in the 415-nm peak-corresponding to the formation of oxyhemoglobin-while those in the difference spectra reflect not only a change in the 555-nm band but also a parallel one at 541 nm, confirming the formation of oxyhemoglobin. Thus the conformation achieved upon carbamoylation of deoxyhemoglobin has the higher oxygen affinity predicted by Nigen et al. (1974) for carbamoyldeoxyhemoglobin. Cyanate has been used (Cerami and Manning, 1971) as an antisickling reagent in vivo and in vitro, but, although it has been shown that it binds covalently to the NH2-terminal residues of hemoglobin (Lee and Manning, 1973), its effect on hemoglobin conformation has not been previously shown nor has its mechanism of action been fully clarified. The results presented here show that the effect of cyanate on hemoglobin is the formation of a new conformation with heightened oxygen affinity. Since oxyHbS does not aggregate while deoxyHbS does, in a temperature-dependent fashion, the formation of carbamoyldeoxyHbS interferes with such aggregation in vitro in deoxygenated samples. In vivo, where there are generally low residual concentrations of O2, the formation of oxyHb is favored by the higher O2 affinity of carbamoyldeoxyHbS, and aggregation with concomitant red cell sickling is therefore disfavored.


Alterations in phosphatidylcholine species and their reversal in pulmonary surfactant during essential fatty-acid deficiency. Previous studies (Kyriakides, E.C., Beeler, D.A. and Balint, J.A. (1974) Clin. Res. 22, 717a, and Burnell, J.M. and Balint, J.A. (1975) Fed. Proc. 34, 426) have indicated that essential fatty-acid deficiency in rats resulted in significant reduction of palmitate content of lung tissue and lavage phosphatidylcholines. Experiments were, therefore, undertaken to confirm and further characterize these changes and to examine the reversal of these alterations when essential fatty acid deficient rats were fed fat-free diets supplemented with linoleate for 1-14 days. Analysis of the fatty acid composition of liver lipids was used to confirm the presence of essential fatty-acid deficiency in rats that were fed a fat-free diet supplemented with 4% by weight of tripalmitoylglycerol for 14 weeks. Phosphatidylcholines from lung tissue and lavage fluid of essential fatty-acid deficient rats contained significantly less palmitate and significantly more palmitoleate and oleate than those rats receiving linoleate. These changes in fatty acid composition were reflected in a significant reduction of disaturated phosphatidylcholines (predominantly dipalmitoyl) in lung tissue and lavage fluid from essential fatty-acid deficient rats, while the total phosphatidylcholine content remained unchanged. On feeding the diet containing linoleate to the deficient rats, a reversal of these changes began after one day and was nearly complete by 7-14 days.


Heterogeneity of immunologic markers and surface morphology in childhood lymphoblastic lymphoma. The neoplastic cells from seven patients with childhood lymphoblastic lymphoma were studied for cell surface markers and surface morphology in the scanning electron microscope (SEM). The cells were studied for surface immunoglobulin (Slg), complement receptors (EAC), receptors for cytophilic antibody (IgGEA), and nonimmune rosette formation with sheep red blood cells (E). In one patient the cells exclusively bound E, suggesting a T-lymphocytic origin. In two patients the cells bound EAC, but demonstrated no other B-lymphocytic markers. In two patients no markers were detected, and in two patients receptors for both E and EAC were demonstrated. Additional studies in one of these patients permitted simultaneous demonstration of both markers on the same neoplastic cells. The neoplastic cells were also examined by SEM after fixation and critical point dehydration. No consistent surface morphology was observed. In four patients the cells were predominately smooth, whereas in two patients variable numbers of surface microvilli were present. A correlation of the surface features with membrane markers could not be established. A comparison of the surface markers with clinical and cytologic features revealed clinical homogeneity in spite of the heterogeneous immunologic markers. This heterogeneity was most likely a reflection of neoplastic alteration and disordered differentiation of the cells. The observation of complement receptors on the cells of four cases is a feature not previously reported in this disease and should be investigated in other presumed T-cell malignancies.


Transplacental induction of lymphomas in Swiss mice by carbendazim and sodium nitrite. Swiss mice at different stages of pregnancy were treated intragastrically with the pesticide Carbendazim (MBC, BCM, methyl-2-benzimidazole carbamate) together with sodium nitrite. Lymphomas developed in 33.3% of young mice whose mothers were treated in the first week of pregnancy, in 53.3% of whose mothers were treated during the second week, and in 38.8% of those born of mothers treated during the third week. Treatment during the whole period of pregnancy yielded on an average 70.0% malignancy in offspring. However, administration of Carbendazim by itself did not produce lymphomas in the first generation. In lymphomas induced by in vivo-formed n-nitroso compounds, A- and C-type oncornavirus particles were observed with the electron microscope.


Bolus injection test for measurement of cerebrospinal fluid absorption. The significance of the bolus injection test lies in supplying data for evaluation of the cerebrospinal fluid (CSF) bulk flow. It provides pressure-time (PT) curves by the process of direct recording, while the pressure-volume (PV) and volume-time (VT) plots are subsequently computed...


The application of x-ray analysis in the transmission electron analytical microscope (T.E.A.M.) to the quantitative bulk analysis of biological microsamples. This paper describes: (a)methods for the high and low temperature ashing of biological tissue samples about 10(-4)-10(-5) g in weight; (b)a method of spraying the solubilized ash on to specimen grids which produces droplets of a size convenient for their quantitative analysis in a transmission electron analytical microscope (T.E.A.M.), but without the need to know the actual volume of individual droplets; (c)the construction of standard curves for determining the absolute concentration of Na, Mg, P, S, K, and Ca simultaneously in a given sample. For most of the elements the error in analysis was about 5% or less. It was proposed that the technique is useful for detecting local element-compartments in complex tissues, and thus may be an important aid in the interpretation of the results of point analyses performed on sections taken from adjacent micro-volumes.


X-ray microanalysis of ultrathin frozen and freeze-dried sections of human sperm cells. X-ray microanalysis of air dried and ultrathin frozen and frozen dried sections of human sperm cells has indicated a large deviation of elemental composition between cells in a single sample and between samples. Analysis of air dried cells indicates a similar subcellular elemental distribution to that found in sectioned material. Sodium to potassium ratios are found to be similar in both preparations. Air drying is considered a valid method for the preparation of sperm cells for analysis.


An improved culture flask for photographic and visual observation of living cell cultures. A new type of culture vessel is described, identical in shape to the classic T15 vessel but with the advantage of optical surfaces that allow photography at medium resolution (with numerical apertures of 0-60-1-0). Details of flask manufacture are given.


Breast cancer. Relationship to thyroid supplements for hypothyroidism. This study was undertaken to determine the relationship between thyroid supplements and breast cancer. The incidence of breast cancer among the patients who received thyroid supplements was 12.13%, while in the control group it was 6.2%. The incidence rate of breast cancer was 10%, 9.42%, and 19.48% among patients who received thyroid supplements for one to five, 5 to 15, and for more than 15 years, respectively. The incidence of breast cancer among nulliparous women who received thyroid supplements was 33%, while in the nulliparous women without thyroid supplements the incidence was only 9.25%. Even in a specific age group, the incidence rate of breast cancer was higher among patients receiving thyroid supplements, when compared to the control patients in the same age group.


Acute hemolytic anemia with Mycoplasma pneumoniae pneumonia. A patients was seen with severe hemolysis due to cold antibodies associated with Mycoplasma pneumoniae pneumonia. Therapy with tetracycline hydrochloride, prednisone, and folic acid was initiated, and complete recovery ensued. Data is presented documenting the presence of autoimmune hemolysis due cold agglutinins associated with Mycoplasma infection.


Severe atypical endometrial changes and sequential contraceptive use. Of eight young women, seven had a diagnosis of well-differentiated endometrial adenocarcinoma and one had atypical endometrial hyperplasia. The average age was 40.1 years, with 6.04 years of dimethisterone-ethinyl estradiol (Oracon) sequential contraceptive use. The patients were not typical of those in whom endometrial carcinoma develops. Although these cases do not prove that long-term administration of dimethisterone-ethinyl estradiol causes endometrial adenocarcinoma or atypia, they indicate that it may do so.


Residual effects of septic arthritis in infancy and childhood. Septic arthritis affects weight-bearing joints in three fourths of cases. When the disease occurs in infancy, joint dysfunction may not be apparent until many months later. We located 49 children who had had 50 episodes of septic arthritis from 1 1/2 to 12 years earlier (mean, 4.3 years). Thirteen patients (27%) had sequelae, and in eight (16%), there was impairment of ambulation. Residual damage was more common with hip and ankle involvement than with knee joint disease. Sequelae were equally common after Haemophilus influenzae and Staphylococcus aureus infection. Evaluation at the time of hosiptal discharge correctly identified only four of the 13 children with sequelae, and four others who were normal at follow-up had been thought to have permanent damage at discharge. Children with sequelae tended to have been sick longer before diagnosis, and drainage of pus was delayed.


Pressure monitoring devices. Overlooked source of nosocomial infection. Contaminated pressure monitoring devices recently have been implicated as a source of epidemic organisms in three outbreaks of nosocomial bacteremia, one outbreak of candidemia, and one outbreak of hepatitis. Measures necessary to prevent monitoring-related infections have not always been appreciated or taken. As a minimum, pressure monitoring devices should be sterilized between use with different patients; strict aseptic technique should be employed when setting up and using monitoring systems; and each patient's monitoring tubing, fluid, and monitoring devices should be changed at regular intervals.


Disposition of presumed coronary patients from an emergency room. A follow-up study. All patients with presumed coronary problems seen at the Chaim Sheba Medical Center during a one-year period were followed up. The fate of those who were not hospitalized and the factors contributing to the two types of erroneous decisions, ie, refusing hospitalization to those needing it and unnecessary hospitalization of others, were evaluated. Approximately 50% of the patients were not admitted. Myocardial infarctions were later diagnosed in 6% of these patients. Another 8% were eventually categorized as other cardiac emergencies. Ten percent of all patients subsequently diagnosed as having myocardial infarctions were not admitted. On the other hand, 56% of the patients whose cases were later not considered to have been emergencies were hospitalized unnecessarily. Previous hospitalization for cardiac disease played a major role in making an error of both types. Other factors influencing the physician's decision regarding the patients' disposition included their age, sex, ethnic origin, and the findings from the emergency room electrocardiogram.


Psychiatry and the primary care physician. Psychiatry makes an important contribution to the training and practice of primary care physicians by emphasizing a holistic approach to patient care, by teaching psychiatric skills and by providing knowledge that enables primary care physicians to give basic psychological care to the large numbers of their patients who need it. Consultation-liaison psychiatry and psychiatry education programs for medical students, both of which are given high priority for support by the Psychiatry Education Branch of National Institute of Mental Health (NIMH), are model settings in which to teach the psychiatric aspects of primary care.


Urinary tract infections in patients with severe renal disease. Treatment with ampicillin and trimethoprim-sulfamethoxazole. Twelve patients with severe renal failure and intercurrent urinary tract infections were treated with either ampicillin trihydrate, 500 mg four times a day, or trimethoprim-sulfamethoxazole, two tablets (80 mg trimethoprim, 400 mg sulfamethoxazole) twice a day. All patients achieved bacteriologic cure, including six with proved upper tract infection. Serum levels of all drugs were increased to values above those seen in normal subjects without adverse effects. Urine concentrations of trimethoprim, 28.6 mug/ml, and ampicillin, 88.6 mug/ml, were well above the minimum inhibitory concentrations of urinary pathogens. Urine sulfamethoxazole concentrations were less than 10 mug/ml in four of the six patients treated; however, this did not hamper bacteriologic success. It is concluded that both drugs can be used to treat urinary tract infections in patients with renal functional impairment.


Cephalosporin-associated pseudomembranous colitis. Diarrhea and pseudomembranous colitis appeared in a patient receiving antibiotic therapy with cephalosporin derivatives only. There was a prompt remission following treatment with cholestyramine resin.


Metastatic renal cell carcinoma 24 years after nephrectomy. Recurrence of renal carcinoma 20 years after primary resection is uncommon. A patient is reported in whom two pulmonary metastases developed 24 years following nephrectomy for renal carcinoma. After a left lower lobectomy and a right pulmonary wedge resection were performed, he survived an additional two years before dying from metastatic disease.


[Rapid enzymatic-colorimetric method for detecting organophosphorous insecticide residues in milk]. The authors developed a new enzymatic-colorimetric rapid method for testing milk for residues of organophosphorous insecticides. The test is based on the colour reaction of indoxyl acetate with the esterase of the OROSERAN (Dessau) horse serum which is inhibited by organophosphorous insecticides. Calibration curves were established for Trichlorphon and Dichlorphos (DDVP). The limit of detection lies at 0.02 mg/kg. The time actually needed per sample is about 15 min. The result is obtained within 90 min. Since this procedure requires no clean-up operations, it is labour-saving compared to other thin-layer or gas chromatographic methods. It may be recommended as a screening test for the detection of organophosphorous insecticides in milk samples.


Intracisternal dimer X: toxicity and prophylaxis. Although Dimer X is said to be a low toxic water soluble contrast medium, epileptic seizures sometimes occur during or after Dimer X ventriculography. The toxicity of this dye was examined in rats and possible prophylactic measures were evaluated. From the results of our experiment it was concluded that Dimer X of low concentration should be used with premedication of Valium and Decadron.


Acute myopathy in three brothers.

Acute myopathy in three brothers. Three brothers are reported who presented simultaneously with acute myopathy, which resolved rapidly. Muscle biopsy showed vacuolar degeneration, with no inflammatory changes. An echo virus was grown from the stools of two of them. Their course, together with that of a fourth brother, who had an acute illness with rash, lymphadenopathy and splenomegaly, suggests a possible viral aetiology.


[Cavitating neutral fat leukodystrophy with recurrent course]. A girl with non-contributory family history, at the age of 7 years developed a recurrent ataxic-spastic syndrome followed by disorders of consciousness and seizures. She died in a decerebrate state at the age of 10 9/12 years. Diffuse EEG abnormalities changed in accordance with the clinical course. CSF findings were always negative. Brain biopsy performed at the age of 9 5/12 years was non-diagnostic. No clinical signs of adrenal insufficiency were present. Neuropathological examination disclosed severe demyelination of the cerebral white matter with formation of large periventricular cavities, relative sparing of the subcortical arcuate fibers, and peripheral myelin breakdown of the orthochromatic (neutral fat) type. There was complete absence of inflammatory lesions, comparative preservation of axons and oligodendroglia with moderate astroglial reaction. The optic system and cerebellum were not involved. Additional postanoxic changes were seen in the thalamus and hippocampus. The sporadic case is suggested to represent a cavitating form of neutral fat (simple orthochromatic) leukodystrophy which is to be separated from Schilder's diffuse sclerosis and adrenoleukodystrophy. The etiology of the disorder is unknown.


[Lumbar disc protrusion in childhood. Description of a case]. This is a case of lumbar disc protrusion in a 14 year old girl, with typical symptomatology. Special attention should be called to the rarity of this case. The clinical and myelographic diagnosis showed a lumbar herniation L 4/L5. Treatment was performed by lumbar hemilaminectomie. The post operative controll showed remission of the clinical findings.


The evolution of neurophysiological features in holoprosencephaly. The evolution of EEG, visual and auditory evoked responses (VER and AER) and sleep is described in three cases of semilobar holoprosencephaly. During the neonatal period, the waking EEG was characterized by almost continuous high amplitude rhythmic alpha-theta activity in case 1 and 2, which became discontinuous during quiet sleep. Moderate amplitude rhythmic alpha-theta waves were seen in case 3. This rhythmic alpha-theta activity gradually disappeared with increasing age, being replaced by non-specific slow dysrhythmia. In case 3, the subsequent EEGs were characterized by focal spikes at 4 months, multifocal spikes at 5 and 6 months, hypsarrhythmia at 8 months and bisynchronous diffuse sharp and slow wave discharges at 2 years and 7 months. Ictal EEGs were characterized by desynchronization and/or rapid synchronization, epileptic recruiting rhythm and postical high amplitude slow waves. Definite but mostly abnormal VERs or AERs were obtained in all three cases. In two cases, the evoked responses showed a progressive decrease in amplitude and VERs were abolished finally. No sleep cycle could be identified during the neonatal period probably because of frequent seizures. In two cases no circadian rhythm of sleep developed, although almost normal REM-NREM sleep cycle was present.


Guillain-Barré syndrome in children with special reference to the natural history of 38 personal cases. 38 children which had had an episode of Guillain-Barré syndrome were studied after a period between 2 and 12 years. The age of the children at the follow-up varied between 7 years 9 months and 27 years. 11 of the children were not completely cured from the point of view of the peripheral nervous system. 9 showed slight signs of motor weakness, 2 of which also had a slight distal atrophy of some leg muscles. None of these 9 patients however had any subjective symptoms of diminished capacity in every-day life. 2 of these and 2 other patients without any muscle weakness had loss of one or more tendon reflexes. 4 other patients apart from the 9 mentioned above had a very slight intention tremor. All of these had had some cerebellar ataxia during the acute phase. A sweat test done in 19 of the 38 controls never showed any asymmetry. 36 patients were examined electrophysiologically during the follow-up: EMG was done in only 35 and in one only conduction velocities were measured. In 16 patients a pathological EMG and (or) an anomalous conduction velocity was found. The only correlations which seemed to exist between the amount of residual findings and some elements during the acute phase of the illness were a positive correlation with the importance of maximum motor deficiency and with the time between the beginning of maximum motor weakness and the beginning of recovery.


Polygraphic recordings in subacute sclerosing panencephalitis. A study of the pathophysiology of the periodic EEG complexes. Polygraphic whole night recordings were performed in 10 patients with SSPE. In most cases sleep states could not be classified according to the usual criteria, but two different states with differing EEG patterns were always seen. A significant correlation was obtained between EEG complexes and phase of the respiratory cycle in 8 out of 9 patients, irrespective of the sleep state. Slowing of heart rate for one R-R interval was observed to occur during the onset of the complex in 7 patients in both sleep states, and in 2 patients only in one state. Periodic occurrence of complexes was stable throughout the night. This stability seems to be maintained by a mechanism regulating the duration of an interval according to the duration of the preceding one. It is suggested that diffuse involvement of subcortical structures rather than a localized change is responsible for the generation of the EEG complexes in SSPE.


Agyria-pachygyria (lissencephaly syndrome). A clinico-pathological report is given on 4 cases of agyria (premature neonate to age 13 months), 3 cases of pachygyria (aged 2,5 to 4,3 years) and a boy aged 4,5 years with temporal pachygyria and frontal microgyrias. Clinical features, more pronounced in agyria than in pachygyria, were microcephaly, frequent facial anomalies, neonatal feeding difficulties, hypotonia with subsequent seizures, hypsarrhythmic EEG pattern in 3 children, arrest of psychomotor development and signs of decerebration. One case of agyria occurred with familial faciorenal dysplasia, two were associated with congenital heart disease, and the fourth with chromosomal abnormality. Morphologically, the colpocephalic brain showed a four-layered agyric pallium with radially aligned cell columns and periventricular heterotopias, lacking differentiation of the claustra, olivary heterotopias and cerebellar dysgenesias in the 4 younger infants. In the agyric neonate additional agenesis of corpus callosum was present. Pachygyric brains showed a six-layered cortex, periventricular heterotopias, lacking differentiation of the claustra, but no cerebello-olivary anomalies. Cytoarchitectonic analysis of the agyric cortex suggests a disorder of neuronal migration during stage III of neocortex formation (Rakic and Sidman) between the 11th and 13th fetal week, while the pachygyric cortex showing the later formed layers II and IV presumable is caused by an attenuated and later disorder acting in early stage IV of neocortex formation, i. e. around or after the 13th fetal week. Additional insula-claustrum dysplasia, olivary and cerebellar anomalies are due to concomittent migration disorders between the 11th and 14th week. Along this period there is a gradient from agyric to normal six-layered cortex, whereas microgyria presumably results from an event occurring after migration has terminated (after the 16th fetal week). Etiological factors of agyria-pachygyria may be both hereditary (familial lissencephaly-syndrome) and environmental ones (prenatal drug application or intrauterine perfusion disorders).


Hypertensive encephalopathy in childhood. Diagnostic problems. Oppenheimer and Fischberg's vasoconstriction-hypothesis on the pathogenesis of hypertensive encephalopathy was subsequently supported by animal experiments. Later on the role of decompensation of the autoregulatory mechanism of the cerebral blood flow was revealed. The transient symptomatology comprises headache, seizures, focal cerebral symptoms (hemiplegia etc.), visual disturbances, mental disorders, papiledema etc. The age-dependency of the influence of edema is probably expressed by the predominance of seizures in childhood and the long duration of the symptoms in our third and fourth patient. The differentiation between hypertensive encephalopathy and a local complication of hypertension (hemorrhage) can be difficult, not at least because the first disturbance may be followed by the second (patient 3). Hypertension is not always present as initial symptom (patient 1 and 2). Hence a series of blood pressure readings is required in acute cerebral incidents in childhood. Steroid-treatment may lead, especially in patients suffering from a hypocomplementemic form of membranoproliferative glomerulonephritis, to a sudden rise of the blood pressure and subsequently to hypertensive encephalopathy (patients 2 and 3). Hypertensive encephalopathy is a neuropediatric emergency. The urgent treatment with dioxaside, fursemide and sodium nitroprusside is shortly reviewed.


Subarachnoid phenol block for pain relief in gynecologic malignancy. One hundred and thirty-three subarachnoid phenol blocks were performed in 90 patients with intractable pain secondary to gynecologic cancer at the University of Iowa Hospitals in the period 1961 to 1975. Excellent to moderate pain relief was obtained in 77% of 117 evaluable blocks. Fifty-two percent of the blocks gave relief of over 1 months' duration and 27% over 2 months. Fourteen patients had a second contralateral block and 11 obtained 4 to 8 weeks' relief. Complications were temporary and occurred in 71% of the blocks, the most common being urinary and rectal incontinence. Subarachnoid phenol block is an effective method for relief of intractable pain; its use in gyneclogic oncology is discussed.


Factors, other than surfactant, in the etiology of respiratory distress syndrome. A review of 23 recently published series demonstrates that many infants with immature or intermediate surfactant patterns do not develop respiratory distress syndrome. This suggests that factors other than surfactant deficiency must be present. It is suggested that surfactant deficiency is a predisposing factor, but aspiration of amniotic fluid and its contents at the time of delivery is the most important precipitating cause.


Computed tomography in orbital pseudothumor (idiopathic orbital inflammation). CT scans of 9 patients with orbital pseudotumor (bilateral in 6 and unilateral in 3) showed findings distinct from those observed in Graves' ophthalmopathy. In bilateral involvement, they ranged from localized mass lesions to complete obiliteration of normal orbital CT anatomical landmarks; diffuse or multifocal lesions involving the posterior globe and muscle insertions were most typical of the diagnosis. However, findings in unilateral psedotumor may be indistinguishable from orbital mass lesions other than Graves' ophthalmopathy. Serial CT scans were used to show progression of disease and response to treatment.


Behaviour of leukocyte acid phosphatase in various chronic diseases. Leukocyte acid phosphatases were investigated in 146 patients with different chronic diseases. The method of investigation used was that of Kaplow and Burstone slightly modified by the authors in what regards the pH of the incubation medium. Normal or slightly increased scores were observed in the granulocytic series of patients with chronic myeloid leukemia. In patients with rheumatoid arthritis, chronic hepatitis, lupus erythematosus disseminatus and chronic lymphocytic leukemia a moderate enzymatic activity was generally observed in the lymphocyte and more marked in severe forms of disease. A marked increase of the enzyme activity was observed in patients with myeloma. The possibility of a correlation between the intensity of enzyme activity and immunoglobulin formation is discussed.


Structural peculiarities in developing coronary arteries located in the epicardial connective tissue. A striking difference was observed in the coronary bed between the histogenesis of the main stem vessels and that of their branches. The developing main stem vessels exhibited the structural pattern of arteries submitted to intense hemodynamic stresses, whereas the developing branches showed the structural pattern of arteries protected against these stresses. This striking difference was related, histologically, to the existence of sphincteral mechanisms located in all the branching points present in both right and left coronary arteries.


An electron microscope study of receptor site on rat mast cells for human immunoglobulin E. Previous studies using immunofluorescence and autoradiography demonstrated the presence of specific immunoglobulin E (IgE) receptors on rat mast cells (RMC). This finding was confirmed by the use of transmission electron microscopy (TEM) combined with X-ray microanalysis (XMA) employing ferritin labelled antisera XMA was used to detect ferritin as Fe in the target cells. On examination by TEM and XMA, 25 per cent of RMC showed a dense area of Fe deposits on the surface of the cells. No Fe could be detected on neutrophils or eosinophils or in the control cell preparations without human IgE. The Fe was concentrated in well-defined areas of the treated mast cells and this distinct concentration of receptor sites was similar to that observed by other investigators who have termed this phenomenon, "cap" formation.


Release of chymotrypsin-like esterase from isolated rat peritoneal mast cells by arginine-rich calf thymus histone. Release of chymotrypsin-like esterase from isolated rat peritoneal mast cells by arginine-rich and lysine-rich calf thymus histones was investigated. The arginine-rich histone released the esterase, but the lysine-rich histone did not release the esterase from the mast cells. The isolated mast cells spontaneously released the esterase gradually. The chymotrypsin-like esterase released from the mast cells is considered to digest the destructed material in tissues in a state of chronic destruction, such as chronically inflamed tissues and malignant tumours.


On the interpretation of depth dependent light scattering measurements in normal corneas. In recent studies other investigatiors have presented traces of "light scattering" versus depth into the cornea. The present investigation demonstrates that these traces do not measure the actual light scatter intensity and that a proper interpretation of such traces shows that most of the scattering is from within the stroma.


Bacterial flora in relation to cataract extraction. IV. Postoperative inflammation. The role of conjunctival bacteria and certain surgical factors. In 499 patients operated on for cataract, the clinical postoperative signs of extraocular inflammation (conjunctival hyperaemia, chemosis, discharge and oedema of the lids), the number of infiltrates around the corneoscleral sutures, and the severity of intraocular inflammation in the anterior chamber (aqueous-flare) were assessed on the fourth postoperative day and correlated with the bacterial conjunctival flora examined both qualitatively and quantitatively on the same day. Patients with potential pathogens (Staphylococcus aureus, gram-negative bacilli and streptococci) on the conjunctiva following operation did not show any increased inflammatory reactions when compared with those without such pathogen. The quantity of bacteria, i.e. number of colonies, did not appear to play a role. The reasons are discussed. The clinical postoperative inflammatory signs were further correlated with the following factors: surgical complications, quality of suturing technique, use of alpha chymotrypsin, systemic disease, sex and age. A positive correlation was found between the severity of extraocular inflammation and retained lens material and hyphaema. Furthermore, extraocular reactions were more severe in males than in females. The incidence of infiltrates around corneoscleral sutures was found to vary with age, i.e. occurred more frequently in patients less than 60 years. No relationship was found between the severity of aqueous-flare and the above mentioned factors.


[Intolerance to cow's milk].

[Intolerance to cow's milk]. The authors report results of allergological history, of passive haemagglutination reaction, lymphocytes blast transformation and leucocytes migration inhibition tests in  100 patients suffering from affections involving the gastro-intestinal tract. Control investigations were carried out in 20 practically healthy individuals. From these results the authors conclude that the data of the allergological history and clinical symptoms of the cow milk intolerance are determined, above all, by the immuno-allergic mechanisms, this being confirmed by the results of the "in vitro" methods characterizing the humoral and cellular types of the immunological reactivity.


Central corneal thickness in newborns and children. Central corneal thickness was measured optically in premature and full-term babies and in children. The thickness was found to decrease from the values found in premature and full-term babies to those found in small children aged between 2-4 years. The thickness of the adult cornea is reached at the age of about 3 years. These findings are discussed with respect to the possible role of corneal thickness as a biometric parameter, to intraocular pressure measurement, and to corneal thickness steady state regulation.


Trephine sections for cataract surgery.

Trephine sections for cataract surgery. In 100 cases of senile cataract keratoplasty trephine was used for making lamellar cataract sections from the 3 to 9 o'clock position. The results are compared with sections made by keratome and scissors. The advantages achieved by performing the sections with the trephine are discussed. Complications due to defective wound healing are reduced to the bare minimum. There was no astigmatism in 41% of the cases. The sections were ab externo enabling preplaced sutures to be inserted.


Static perimetry: strategies.

Static perimetry: strategies. In static perimetry the method of limits is widely used for threshold determinations. Its performance is compared with that of a certain modification of the staircase method (repetitive up and down) by means of simulations, where the behaviour of the observer is described by an assumed psychometric function. Systematic and random errors are considerably smaller with the up and down method. Further consideration is given to signal detection theory and to the concept of optimal strategy.


Static perimetry: accuracy and fluctuations. Threshold fluctuations are divided into short-term and long-term effects applying statistical methods. Sixteen normal and pathological visual fields were analysed in order to obtain values for the short-term, long-term and total fluctuations. Special attention is paid to fortuitous variations between the results obtained at successive examinations. Finally the concept of spatial correlations is introduced.


Mast cells and pterygium.

Mast cells and pterygium. A total of thirty pterygia were studied for mast cells using metachromatic dye (toluidine blue) together with routine histological stains. On microscopic examination, the lesion was differentiated and classified into angiomatous, fibrous and mixed varieties based on the vascular and collagenous components. The mast cell counts were undertaken in all types and were found to have significant correlation with the morphological types when compared to normal conjunctiva. 15.1 +/- 3.1, 22.7 +/- 3.8, 9.5 +/- 3.2 mast cell per mm2 were found in the angiomatous, mixed and fibrous types respectively. In the control material, the mast cell count was 12.4 +/- 2.3 per mm2. The results are discussed. It is believed that mast cells are actively involved in the genesis and progress of pterygium.


Interference filter for colour and black-and-white fluorescein angiography. A new dichromic interference filter was used as the excitation filter in colour and black-and-white fluorescein angiography of the human fundus. The interference filter transmits light shorter than 490 nm (blue) and longer than 640 nm (red). In colour photography the red light shows the topography of the fundus. In black-and-white photography, the red light is prevented from reaching the fundus by an additional absorption filter used together with the interference filter. These two comprise the excitation filter, which eliminates the pseudo-fluorescence from black-and-white angiograms.


Changes in 35S-sulphate uptake in different tissues in the knee and hip regions of rabbits during immobilization, remobilization the development of osteoarthritis. In order to observe phenomena accompanying the development of osteoarthritis of the rabbit knee, consistently appearing within 4-6 weeks as a consequence ofimmobilization of this joint, studies on 35S-sulphate (Na2 35SO4) uptake were carried out. The investigation suggests that immobilization of the knee leads within 2-4 weeks to increased sulphate uptake in bone, cartilage and ligaments in the knee region and in the hip (not immobilized) of the same leg. The first marked changes in 35S-sulphate uptake were found in the ligaments and the articular cartilage as early as after 4 days of immobilization.


Radical mastectomy in a patient with coexistent Graves' disease. A patient with the coincidental occurrence of thyrotoxicosis and medullary carcinoma of the breast is reported. Survivorship was considered optimal by performance of a mastectomy without the six to eight weeks' delay required to achieve euthyroidism by antithyroid drugs or radioiodine. The hyperthyroidism was controlled with propranolol, permitting an uneventful radical mastectomy.


Milk sensitivity and soybean sensitivity in the production of eczematous manifestations in breast-fed infants with particular reference to intrauterine sensitization. Three cases of milk sensitivity and two of soybean sensitivity are presented, suggesting that both pre-natal and post-natal sensitization may have been involved in the production of eczematous manifestations of early infancy. Hemagglutinating antibody titers against lactalbumin and soybean in the amniotic fluid were unusually high. This suggests that hemagglutinating antibody estimation against foods in the amniotic fluid may possibly predict infantile allegic manifestations in the newborn.


Natal teeth and steatocystoma multiplex complicated by hidradenitis suppurativa. A new syndrome. A new syndrome, consisting of natal or defective teeth, or both, steatocystomas of the skin, and epidermal cysts of the scalp, is described in several generations. One member of the family had eruptive molars. Male-to-male transmission suggests autosomal dominant inheritance. This syndrome should be separated from pachyonychia congenita I and II.


Immunoblastic lymphadenopathy. A report of two cases. Two patients who had immunoblastic lymphadenopathy with clinical symptoms of fever, anemia, hypergammaglobulinemia, and enlarged lymph nodes were treated with chemotherapy. The lymph node biopsy specimens were originally interpreted as malignant processes because of severe immunoblastic and plasmacytic infiltration that practically obliterated the architecture of the lymph nodes. One patient recovered and was free of symptoms five years after clinical onset of the disease. The second patient died of massive gastrointestinal bleeding six weeks after the onset of disease and five weeks after administration of cytotoxic drug therapy. The cases illustrate the ineffectiveness and possible adverse effect of chemotherapy, as well as the importance of differentiation of immunoblastic lymphadenopathy from frankly malignant lymph node diseases.


The specificity of split renal membranes in hereditary nephritis. This study was undertaken to assess the specificity of split renal basement membranes in hereditary nephritis (HN). Thirteen specimens from eight patients with HN were mixed in a random fashion with specimens from control patients with either idiopathic nephrotic syndrome or various forms of glomerulonephritis and with specimens from patients with benign recurrent hematuria (BRH). Each biopsy specimen was scored for splitting of glomerular basement membranes (GBMs). Control and BRH specimens contained focal splitting in the GBMs; the biopsy specimens from HN patients had widespread lesions. Evaluation of split GBMs is useful in differentiating patients with HN from those with BRH and other renal diseases that may be confused with HN.


Unilateral glomerulonephritis.

Unilateral glomerulonephritis. Three patients had unilateral glomerulonephritis. In two, the protected kidney was associated with stenosis of its renal artery, and in the third patient, a hydronephrotic kidney was spared. These clinical examples of unilateral glomerulonephritis and similar experimental models illustrate the effect of hemodynamic and hydrostatic influence in the manifestation of glomerulonephritis. Glomerulonephritis associated with unilateral arterial or ureteral disease may cause clinical confusion and error in diagnosis and treatment.


Experimental Toxoplasma retinitis: a light and electron microscopical study. In a light and electron microscopical study of the morphological lesions of acute experimental Toxoplasma retinitis in the rabbit, produced by intravitreal inoculation with RH strain T gondii, all layers of the retina were found to be infected with the parasite. The Bruch membrane appeared to be a relatively impermeable barrier to invasion by the parasite. The underlying choroid showed an inflammatory cellular infiltrate but was free of organisms. Evidence of lateral spread of infection between the layers of the retinal tissue was observed. Examples of glial cell infection were also seen. Trophozoities may enter the brain by spreading along contiguous glial cell elements of the optic nerve; retinal tissue destruction occurs by direct invasion of cells by trophozoites. In other areas, tissue destruction by inflammatory cells occurred in the absence of organisms and may indicate an immunologically induced process of tissue destruction.


[Diagnosis and evaluation of cervico-facial cancers in children]. Malignant neoplasia of head and neck in children are mostly embryonal sarcoma and non Hodkgin's lymphomata. Squamous-sell carcinomas are only 10%. The main locations are in nasopharynx and paranasal sinuses. Symptoms are corelated with location of the primary. Treatment depends of the pathologic type. Combination of chemotherapy and radiotherapy, and sometimes surgery, yield now more cured patients, especially in embryonal sarcoma.


Malignant APUDoma (carcinoid) of the anterior mediastinum. Simplified methods of demonstrating biogenic amines in endocrine neoplasms. Endocrine neoplasms of the thymus and mediastinum are uncommon. This report describes such a carcinoma and the difficulty in determining its true nature. A simple modification of the technique for formaldehyde-fume-induced fluorescence (FIF) demonstrated biogenic amines in the cells. Electron microscopy and histochemical findings confirmed the close relationship of these neoplasms with neural-crest cells capable of amine precursor uptake and decarboxylation (APUD). The FIF technique is also a more sensitive method of detecting these tumors, since it has less of the sampling problems of electron microscopy, and the fluorescent granules are more easily seen than those stained by the usual methods. The techniques are simple enough for screening all poorly differentiated carcinomas in this area to determine a more accurate incidence figure.


Microcysts of the permanent adrenal cortex in perinates and infants,. Microscopic cysts in the permanent cortices of adrenal glands were studied in a series of 274 infants, some of whom had been stillborn and none of whom were more than 12 months old. After correction for length of gestation, there were no significant relationships between the occurence and number of microcysts and various maternal, placental, and perinatal diseases. A significant direct correlation was demonstrated statistically with shorter gestational period and shorter survival time after birth. We concluded that the adrenal microcysts are either a developmental feature or the result of a greater susceptibility to stress in the fetus and newborn than in older infants.