Inflammatory carcinoma of the breast.

Inflammatory carcinoma of the breast. Inflammatory carcinoma of the breast was found in 30 of 1,458 patients with carcinoma of the breast seen at this medical center during a 20 year period from 1951 to 1971. These patients were evaluated for predisposing factors, presenting symptoms, physical characteristics and histologic findings. No single mode of therapy produced more than a rare five year survival period. Radical surgical procedures are seldom indicated.


Definitive emergency treatment of perforated duodenal ulcer. A retrospective survey was made of all patients with a proved diagnosis of perforated duodenal ulcer admitted to a regional hospital during a recent six year period. The over-all mortality from this condition in the 192 patients was 11.4 per cent and mortality after operation, 6.3 per cent. One hundred and seventy-six patients were treated surgically. Seventy-seven patients underwent simple suture only with a mortality of 13 per cent and are compared with 99 patients treated by emergency vagotomy and pyloroplasty procedures with a 1 per cent mortality. Emergency definitive operations were performed without increased morbidity, mortality or hospital stay by junior surgeons with greatly improved long term results compared with simple suture. At the present time, emergency vagotomy and pyloroplasty procedures are the treatment of choice for a perforated duodenal ulcer.


Clinical evaluation of truncal vagotomy performed in a community hospital. A consecutive personal experience in a community hospital involving 871 operations during a 30 year period indicates that truncal vagotomy provides excellent long term results with minimal mortality. In the surgical management of peptic ulcer disease associated with increased risk not only are highly acceptable results obtained, but also truncal vagotomy and pyloroplasty constitute an effective conservative operation with a decreased morbidity rate and lowest  mortality. An over-all mortality of 0.9 per cent and a mortality of 3 per cent in the patients presenting with gross bleeding emphasizes the need for early surgical care of the patient with an actively bleeding ulcer.


Primary inoperable cancer of the breast. In a retrospective study of 305 patients with primary inoperable cancer of the breast, the over-all survival rate at five years was 12 per cent for those presenting with extensive lesions of the breast alone and 5 to 7 per cent for those with distant metastases. There was little difference in the survival times for any group within the study. Primary inoperable remains a useful classification for predicting prognosis. All survival curves suggested that distant metastases were present when the patients were first seen, whether obvious or not, and early use of combination chemotherapy for all patients is encouraged. Radiation therapy was the most effective treatment in terms of survival times for patients with local lesion. Palliative mastectomy after radiation therapy increased local control but not survival times. The influence of distant metastases on prognosis reflected both the site of metastases and the over-all extent of involvement. Bone metastases did not seem to detract from survival times as much as extensive lesions of the breast did when either of these sites of involvement accompanied other metastases. Outlook was so poor for patients with advanced lesions of the breast plus disease in the pleura and lung or in the liver that the early use of the most effective therapy available is encouraged. Endocrine ablation in these patients with no predictive criteria available was as effective as in those patients with recurrent inoperable cancer and favorable selection factors present.


Liver regeneration and lymphocyte activation. A 70 per cent partial hepatectomy in the rat results in a massive deoxyribonucleic acid synthesis not only in the remaining liver cells but also in the lymphoid organs. Serum factor present in the rat after hepatectomy stimulated both hepatocytes and lymphocytes in culture. Lethally irradiated rats, followed by a partial hepatectomy, could be restored their regeneration ability only when the lymphocytes taken from rats after hepatectomy were injected. A hypothesis is that the replications of the regenerating liver cells and the antigen stimulated lymphocytes are triggered by a common pathway, probably through adenosine 3':5'-cyclic phosphate activation.


Preservation of the superior hemorrhoidal artery in resection of the colon and rectum. As an alternative to anterior resection of the rectum requiring ligature of the inferior mesenteric artery at its origin, it is proposed to carry out this procedure preserving the inferior mesenteric artery and freeing it as far as the origin of the superior hemorrhoidal artery and its division into rectal branches to improve the blood supply to the rectal stump. The results of this new procedure were compared with those of anterior resection. Post-operatively, the blood supply of the rectum was studied by means of angiography. The results of 84 anterior resections for neoplastic disease of the colon were studied. In 56 patients, the inferior mesenteric artery was preserved and in 28 the inferior mesenteric artery was ligated. Postoperative complications due to leakage of the colorectal anastomosis rarely occurred in the first group and were frequent in the latter. In patients in whom the inferior mesenteric artery was preserved, arteriograms showed that vascularization of the preserved rectal stump is supplied essentially by the branches of the superior hemorrhoidal artery.


Hepatic inactivation of renin in the treatment of hyperreninemic hypertension. The concept of the hepatic inactivation of renin secreted by the juxtaglomerular apparatuses of the ischemic kidney was used for reversal of hypertension in dogs. In three dogs, the left renal artery was constricted, and a significant and well established hyperreninemic hypertension was recorded. The performance of an end-to-end splenorenal shunt following renal artery constriction reversed the hyperreninemia and hypertension. Shunting of the renal venous drainage into the portal system prior to constriction of the main renal artery prevented, as demonstrated by the limited data available, the development of hyperreninemic hypertension.


The management of atheromatous emboli to the lower extremities. Atheromatous emboli to the small vessels of the feet usually cause  painful, cyanotic areas on the distal portions of the extremity. Complete resolution of the symptoms is the rule, and recurrent episodes are common. Atheromatous emboli to the major vessels of the leg often cannot be distinguished from emboli originating from other sources, unless characteristic gross or microscopic features are present in the embolous material. If the embolus contains atheromatous debris or if the origin is uncertain, aortic arteriograms are indicated to determine if an ulcerated lesion may have been the source. Apparently, two mechanisms of embolization exist; they are fragmentation with distal embolization of atheromatous material and embolization of plateletfibrin thrombus material from ulcerated plaques. Endarterectomy of the involved segment of aorta has been uniformly successful in preventing recurrent episodes of embolization.


Revascularization of the peroneal artery. In the absence of a suitable popliteal or tibial arterial system with direct communication to a pedal arch, the peroneal artery may be used for distal anastomosis with the expectation of achieving patency rates exceeding 60 per cent. Morbidity can be minimized by careful patient selection and by imporved surgical technique and materials. In 14 of 23 peroneal bypasses, patency was maintained compared with 27 to 35 bypasses to the tibial artery system. Limb salvage was 57 per cent for th peroneal artery group compared with 71 per cent for tibial artery reconstruction.


Double pyloroplasty and vagotomy for gastric ulcers. A group of 31 patients with a variety of gastric ulcers were treated by vagotomy, biopsy, oversewing of bleeding points and a wide double pyloroplasty. On patient, a quadriplegic with multiple stress ulcers, rebled and had to undergo resection. He died a month later of progressive respiratory problems. A second quadriplegic died a month after a bleeding episode from myelitis and encephalitis resulting from a gunshot wound of the neck. He had no rebleeding. A third patient died two years after a gastric operation as a result of bronchial carcinoma. He had no recurrence of the ulcer problem. The remaining 28 patients were observed from six months to five years, an average of two and one-half years. There were no recurrences and only minimal untoward symptoms. It would appear that, for this period of observation, vagotomy with double pyloroplasty offers good treatment for patients with benign gastric ulcers.


A multiparametric computer analysis of carcinoma of the colon. From 1957 to 1973, 656 patients with carcinoma of the entire colon, excluding those with carcinoma of the rectum, were reviewed with the aid of a computer. Of 457 patients, 69.7 per cent were observed for a minimum of five years. Sixty-five per cent of the lesions were located in the cecum or sigmoid colon. In patients with type A lesion, the five year plus survival rate was 71.15 per cent while, in patients with type D lesions, the five year plus survival rate was zero per cent. Patients who presented with intestinal obstruction had a significantly lower five year survival rate. Roentgenographic visualization of the cecum was significantly less accurate in demonstrating carcinoma when compared with that of the sigmoid colon. An emergency surgical procedure had a significantly higher operative mortality than did elective procedures. In both groups of patients undergoing emergency and elective operations, primary resection and anastomosis led to similar operative mortality rates, although staged procedures resulted in the lowest operative mortality in both groups. In the group of patients who had elective operations, resection an primary anastomosis led to a significantly lower wound infection and fistula rate when compared with the group of patients who had emergency procedures. In comparison with other series, no improvement in survival was illustrated in patients with carcinoma of the colon. The use of new modalities of adjuvant therapy, such as radiotherapy or chemotherapy, or both, actually should be evaluated.


The obstructed bladder syndrome in the neonate. Eleven neonates with bladder obstruction, causing retention of urine, and a large, palpable lower abdominal mass were treated at the Yale-New Haven Hospital during a five year period. Intrinsic and extrinsic lesions, including urethral atresia, posterior urethral valves, ectopic ureteroceles, hydrocolpos and a neuroblastoma of the pelvis, were diagnosed by cystography, vaginography, pyelography and barium enema examination or a combination of these reoentgenographic methods. The multiplicity of underlying lesions make the obstructed bladder syndrome in the neonate a unique condition.


Jet injection anesthesia for tissue culturing of biopsies of the skin. The use of a jet injection instrument was particularly helpful in the anesthetic preparation of biopsy sites selected for tissue culturing of skin and did not lessen culturing success.


"Standardized" spinal cord trauma: biomechanical parameters and lesion volume. The T5-6 level of the feline spinal cord was traumatized by the weight-dropping technique. The following "400 gm-cm" trauma groups were studied:I) 5gm X 80cm; ii) 10gm X 40cm; III)20gm X 20cm; IV) 40gm X 10cm; and V) 80gm X 5cm. It was found that the lesion volume was different in each of the groups even though all had a "400 gm-cm" injury. In Groups I through IV the deformation velocity, energy and lesion volume were related to the height in a hyperbolic manner. In all groups a linear relationship was noted between lesion volume and impulse while a sigmoid-shaped nonlinear relationship between lesion volume and energy was present. The amount of energy transferred to the spinal cord was dependent upon factors such as mass, height, impounder mass and velocity. Energy absorbed by the spinal cord in Group IV was approximately 100 times that in Group I.


The prevention of postoperative deep vein thrombosis and pulmonary embolism with low dose subcutaneous heparin and dextran. The standard low dose of heparin for the prevention of deep venous thrombosis in patients who are operated upon is 5,000 units administered subcutaneously two hours before operation and at eight or 12 hourly intervals for the next seven days. Heparin in low doses can at present be recommended as an effective agent in the prevention of deep venous thrombosis in patients over the age of 40 years who are undergoing a major abdominothoracic or gynecologic operation. There is reasonable evidence that heparin in low doses also offers a satisfactory protection against fatal pulmonary embolism for patients at high risk after general abdominothoracic operations. The evidence of the effectiveness of low doses of heparin in the prevention of deep venous thrombosis is less well established in other patients and particularly those at high risk, as after urologic and hip operations. This important distinction is to be made in terms of the population at risk and the efficacy of heparin in low doses. Considering the evidence so far available, it appears that the postoperative state in which dextran has been shown to reduce the incidence of phlebographically confirmed deep venous thrombosis most convincingly is after orthopedic operations. Major orthopedic operations are precisely the type in which the superiority of heparin in low doses is controversial. Unless proved otherwise, dextran 70 in an infusion of 500 to 1,000 milliliters of a 6 per cent solution started before operation and 500 milliliters the following and next three alternate days may be the agent of choice in preventing deep venous thrombosis in major orthopedic operations. Using this scheme, the prophylaxis of postoperative deep venous thrombosis appears equally effective with dextran 70 as with oral anticoagulants. Whether the protection offered by dextran 70 will also prevent fatal and nonfatal pulmonary embolism is still an open question. Low doses of heparin and dextran do not expose patients to serious risks of bleeding after operation, and with the recommended doses of the latter drug, other untoward effects are rare. At the doses recommended, neither of these two drugs requires laboratory monitoring.


Hydrocephalus: possible role of an internal cerebrospinal fluid fistula in therapy. Transfer of cerebrospinal fluid from the lateral ventricle transcerebrally to the distal subarachnoid space was performed in the hydrocephalic dog. These fistulae were formed with the aid of a small suction tip and the operating microscope. Clinical evaluation of the dogs was made daily until sacrifice at four to six weeks. Documentation of the clinical course and ventricular size of the shunted and control animals was made. The studies indicate that the microsurgically produced fistulae may be an effective form of treatment in the hydrocephalic animal.


Primitive hypoglossal artery associated with basilar artery aneurysm. A case of persistent primitive hypoglossal artery, accompanied by a basilar bifurcation aneurysm, is reported. The persistent primitive hypoglossal artery was seen on the right side and the left vertebral artery was hypoplastic. The right vertebral artery was absent, while a normal sized posterior communicating artery was seen on the right side at the operation on the aneurysm. The combination of a basilar bifurcation aneurysm and a persistent primitive hypoglossal artery is rare. A review of related reports has been made.


Positional vertigo with cerebellar astrocytoma. The authors present two surgically verified cases of cerebellar astrocytoma extending into the fourth ventricular floor. Each patient presented with positional vertigo, and electronystagmography revealed positional nystagmus indicative of a central lesion. The findings in these cases emphasize the need of looking for positional nystagmus in patients with suspected posterior fossa lesions.


Primary respiratory arrest due to basilar aneurysm. A healthy woman had two episodes of transient, complete respiratory arrest without preceding neurologic abnormalities. Following the second episode, she lapsed into coma and autopsy disclosed a thrombosed basilar artery aneurysm. Primary respiratory arrest is a rare condition but should prompt extensive and immediate neurologic evaluation.


The effect of T-myelotomy on spasticity. Dorsal myelotomy with lateral extension (T-myelotomy) provided excellent relief from spasticity in the lower limbs in 12 patients. Averaged evoked potential recordings helped delineate the limits of the myelotomy and were useful for evaluation of injury to the dorsal columns. While preservation of any residual motor function is unlikely following T-myelotomy, the risk of permanent loss of preserved sensory, bladder or sexual functions is not great.


Some observations in progressive arterial occlusions in children and young adolescents: (Moyamoya disease). In "primary arterial occlusions of children", an unusual collateral circulation has been described first by Japanese, and later by others worldwide. As experience was gained some workers started to realize that the "typical angiographic appearance" could be found in several disease entities. It thus became evident that angiographic differentiation is important. In this communication we wish to discuss this entity and outline its significance as well as emphasize the pitfalls.


Distal shunt herniation simulating testicular torsion. A case of herniation of the catheter of a peritoneal shunt into the scrotum is reported. Infection of the catheter caused scrotal inflammation simulating torsion of the testicle.


Parinaud's syndrome: cerebrovascular disease as a common etiology: analysis of 16 cases. Sixteen consecutive adult cases of Parinaud's syndrome are reviewed. Ten of the sixteen cases were due to brain stem infarction while four patients were suspected of harboring tumors. Parinaud's syndrome alone did not favor a diagnosis of tumor in the pineal region in this series. Associated neuroophthalmic findings are discussed.


Unusual cranio-cerebral injuries: report of two cases in Nigerians. Two unusual cases are reported in which nails were driven into the heads of victims of criminal assults in Nigeria. The special risk to the superior sagittal sinus is discussed.


Cholinomimetic teratogens. IV. Effects of the genotype for muscular dystrophy in chickens. Embryos of a family of chickens homozygous for muscular dystrophy (md/md) reacted with a higher incidence of malformations to treatment with carbachol than did White Leghorn embryos. The same difference in response of embryos from the two stocks occurred after treatment with sulfanilamide. Embryos of reciprocal crosses between these two stocks differed greatly, however, in their response to carbachol, F1 embryos from dystrophic hens producing a much higher incidence of malformations than did those from Leghorn hens. In contrast, both F1 sibs reacted similarly to sulfanilamide, the teratogenic effects being intermediate between those of embryos from the parent stocks.


Cardiovascular malformations in Oryzias latipes embryos treated with 2,4,5-trichlorophenoxyacetic acid (2,4,5-T). Exposure of fertilized Oryzias latipes eggs to concentrations of 2,4,5-trichlorophenoxyacetic acid up to 14 ppm had no gross developmental effects. Exposure to concentrations above 14 ppm resulted in multiple malformations of the heart and blood vessels. Embryos failed to hatch when exposed to concentrations above 25 ppm.


Graphic reconstructions of craniofacial structures during secondary palate development in rats. Lateral and ventral graphic reconstructions of coronally sectioned rat fetuses at four stages of secondary palate development were made to illustrate the size, form, and spatial relations of craniofacial structures at each stage, and to indicate changes between stages. The results illustrated extensive changes in the nasomaxillary and tongue-mandibular complexes and spatial relations in the oronasal cavity during this 2-day period. During closure of the palate the palatine processes and molar dental laminae moved medially, the vertical dimension between the cranial base and Meckel's cartilage increased, and the Meckel's cartilage changed in shape from a "U" to a "V". During the 2-day period extensive increases in anteroposterior and vertical dimensions and limited changes in lateral dimensions resulted in a change in shape of the complete orofacial region. More extensive investigations, preferably quantitative, of the changes shown are indicated to identify the relative contribution of various craniofacial components and to establish the role of differential growth in secondary palate closure.


Embryonic development in ectopic human pregnancy. Ectopic pregnancy in the fallopian tube occurs in about 1 in 50 human pregnancies. Maternal factors in the etiology of this condition have been well documented. There is less information available on the development of the embryo or fetus. To document this information morphological and cytogenetic data were obtained from pregnancies occurring in the fallopian tube. Analysis of the data showed that tubal implantation was associated with a high proportion of severely disorganized embryos. There was also a high incidence of maternal tubal disease. The importance of these factors and the etiology of ectopic pregnancy is discussed.


Exencephaly in fetal hamsters following exposure to hyperthermia. Exposure of pregnant hamsters on gestation day 8 to 40 or 41 degrees C for one hour caused an increased rate of resorption and a high frequency of exencephaly and encephalocele. Longer exposures often killed pregnant females. Hamsters that had fetuses with abnormalities usually experienced body temperature elevations of 3-4 degrees C above normal (37 degrees C).


The "stright-jacket" syndrome in chicks. II. Mechanism of development. In a longitudinal study including measurement of the pressure in the amniotic cavity, amniotomy, and planimetric evaluation of the size of the amniotic sac, we investigated the development of the "strait jacket" syndrome in White Leghorn chicken embryos injected intraamniotically (ia) or paraamniotically on the fourth day of incubation with histone or embryotoxic serum, with the following results. Hyperlordosis and eventration developed as an outcome of tonic contraction of the amnion, which was observed only three hours after ia administration. Contraction of the amnion caused elevation of the intraamniotic pressure, which, 12 hours after ia injection, attained a mean value of 22.4 Pa (2.3 mm H2O). This value was not only significantly higher than the mean for control embryos (3.9 Pa), but it was critically close to the mean fluid pressure in the brain vesicles. Loss of the latter overpressure caused the vesicles to collapse, and the walls shriveled and exencephaly developed. Paraamniotic injection was not followed by either contraction of the amnion, or significant increase in intraamniotic pressure. This did not prevent heart malformations and cranioschisis of various extent. The majority of cardiovascular malformations were probably the hemodynamic consequence of overfilling of the intraembryonic vascular bed, which was one of the early signs of the effect question. Cranial-vault defects can be causally associated with the formation of amnionic adhesion and fusion with the epidermal ectoderm. This observation stresses the significance of the embryonic membranes and the fluid pressures within them for the development of certain congenital deformities and concentrates attention on teratological study of substances that induce protracted contraction of smooth muscle.


An evaluation of the embryotoxic effects of blighted potatoes on chicken embryos. The embryotoxic properties of an ethanol extract of boiled potatoes infected with Phytophthora infestans were investigated in White Leghorn chicken embryos, using controlled subgerminal injection on the second day of incubation and intraamniotic injection on the third and fourth days. A dose of 0.3 mg of sublimation-dried extract interfered at the somite stages with the function of the caudal morphogenetic system and induced various degrees of the caudal regression syndrome. Administration on the third and fourth days led to the development of a malformation syndrome comprising cranioschisis, celosoma, and cardiac septal defects. An equivalent amount of extract of healthy potatoes of the same variety and injection of pure solanine had the same effect. The results warrant the claim that the main factor responsible for the direct embryotoxicity of potatoes attacked by P. infestans is solanine, which evokes tonic contraction of the smooth muscle elements of the amnion.


Somatic cell genetic studies of cystic fibrosis. The expression of the gene coding for the cystic fibrosis ciliary inhibitor has been examined in somatic cell hybrid clonal lines. Hybrids were produced by the fusion of cultured skin fibroblasts from cystic fibrosis patients with mouse RAG and LM (TK-) cell lines. The ciliary inhibitor was detected by the oyster ciliary assay in several primary hybrid clones but not detected in others, indicating the segregation of an associated nuclear gene.


Electron microscopy and microchemical analysis of cystic fibrosis diploid fibroblasts in vitro. Fibroblasts derived from cystic fibrosis homozygotes and heterozygotes were compared to normal fibroblasts topologically, ultrastructurally, and microchemically. Topological examinations, by means of scanning electron microscopy (SEM) revealed no significant differences between the 3 genotypes surveyed. The cells were generally flattened and/or fusiform structures that were more or less devoid of surface details. However, the dividing cells, in all of the populations surveyed, were found to have a more or less spherical configuration involving a highly complicated surface. The surface manifestations included blebs, ridges, and microvilli. Representative samples of the cells in all stages of growth, lag phase, exponential phase, and plateau phase, were surveyed in this study. Ultrastructurally, the fibroblasts of the 3 genotypes were found to have similar cytological detail. Highly infolded nuclei, distinct organelle components, and surface details, also seen in the SEM study, were observed. Numerous bundles of microfilaments were noted within the cytoplasm. Metachromatic granules were observed in cells from all 3 genotypes. Microchemical analysis, by means of energy dispersive X-ray analysis, demonstrated slight but recognizable differences in the elemental composition of the 3 genotypes. Of notable interest were the peak intensities of calcium and sulfur. The CF homozygous cells presented higher values for both of the elements when compared to the values observed in the CF heterozygous and normal cell populations. Although consistent differences could be observed in the CF genotypes when compared to the non-CF cells, no attempt was made to quantitate the concentrations of each of the elements within the cells.


Detection of cystic fibrosis heterozygotes using the zeta potential reduction method. Parotid saliva samples from cystic fibrosis homozygotes, heterozygotes and normal individuals were tested by the zeta potential technique for secretion factor in a double-blind experiment. There was no overlap between zeta potential reduction of the control group and the cystic fibrosis test groups, indicating that the zeta potential test may be detecting a unique component in saliva of cystic fibrosis genotypes.


Effects of cystic fibrosis serum ciliary inhibitor on oyster gill ultrastructure: analysis by scanning and transmission electron microscopy. Ultrastructural analysis including scanning and transmission electron microscopic studies (SEM and TEM) were carried out on oyster gill tissue after exposure either to serum fractions from individuals homozygous or heterozygous for cystic fibrosis (CF), to comparable serum fractions from normal individuals, or to sea water. In 4 of the experiments examined topologically (SEM), the CF sera (either heterozygous or homozygous) stimulated the production of mucus that was found in close association with the cilia. The association of excessive mucus with the cell surface could be responsible, in part, for the well-known inhibition of ciliary activity by a factor in CF serum. In 3 additional SEM experiments involving shorter treatment times, very little difference could be observed between homozygous CF, heterozygous CF, and normal serum-fraction-treated oyster tissues. In parallel experiments, ultrathin sections of gill tissue were examined by means of TEM. Those samples that were responsive, as determined by TEM, displayed several characteristic features, including enlarged and partially exuded goblet cells, altered mucus structure along with twisted and matted cilia. An overall swelling of the gill filament was also observed in the responsive tissues. From TEM analysis no detectable alteration in fine structure was apparent in gill tissues that were treated with sera from heterozygous or normal individuals.


Effect of polyamines and cystic fibrosis serum on glucose transport. The effect of plasma or serum from homozygotes and heterozygotes for the cystic fibrosis (CF) gene on the active uptake of 3-0-14C-methyl-D-glucose (3-0-14C-MDG) by rat jejunal epithelium was studied. Furthermore, the role of the polyamine, spermidine, and its products of metabolic degradation on glucose transport were investigated, and a relationship to the pathogenesis of membrane dysfunction in cystic fibrosis was postulated. Glucose transport in everted rat jejunal rings was used in the study. Results were expressed as 3-0-14C-MDG concentration ratio between the intracellular (ICF) and the extracellular fluid spaces (ECF) of the jejunal rings at the end of a 60 min incubation period. The mean ratio obtained from incubations of the rat jejunal rings in medium consisting of Krebs-Ringer-bicarbonate buffer and the labeled sugar was considered as 100% uptake. When plasma or serum, with or without spermidine, was mixed with the medium in a volume ratio of 1:3, a decrease in the active uptake of 3-0-14C-MDG was observed, expressed as percent inhibition. Percent inhibition of 3-0-14C-MDG uptake obtained when the rat jejunal rings were incubated in normal plasma was compared to that obtained with plasma from cystic fibrosis genotypes. It was found that: 1) plasma from 25 homozygous children had greater inhibitory effect on glucose uptake than plasma from 26 normal children; 2) plasma from 9 heterozygous women had greater inhibitory effect than that from 6 normal women; 3) the inhibitory effect of plasma from 3 homozygous children was not influenced by dialysis; 4) the inhibitory effects of paired plasma and serum samples from 9 homozygotes were comparable; 5) spermidine added to the incubating electrolyte solution did not affect glucose transport; 6) the addition of spermidine to reaction mixtures containing normal plasma potentiated the inhibitory effect; and 7) mixing and incubation of fresh bovine serum with reaction mixtures containing plasma from homozygotes decreased the inhibitory effect. The predominant inhibitory effect of plasma or serum from homozygotes and heterozygotes for the CF gene appears to be related to a nondialyzeable molecule(s). It does not seem to reflect the presence of high plasma glucose levels in cystic fibrosis nor to be the result of competitive inhibition between sugars. It does not seem to be the result of sodium or other electrolyte differences. A similar inhibitory effect is acquired by normal plasma after the addition of spermidine. On the other hand, plasma from CF homozygotes loses its inhibitory effect after incubation with fresh bovine serum. These findings may indicate that products of metabolic degradation of spermidine are responsible for the inhibitory effect of glucose transport and suggest the possibility of a role in abnormal polyamine metabolism in the pathogenesis of cystic fibrosis.


Polyamine metabolism in cystic fibrosis. Increased blood levels of spermidine and an increased spermidine/spermine ratio is documented in 31 patients with cystic fibrosis (CF). Some 29 percent of CF patients overlap with the control group. An abnormality of urinary free polyamines or their metabolic derivatives related to electrolyte transport, serum ciliostatic factors, and the autonomic nervous system are elaborated upon.


L-fucose metabolism in cystic fibrosis fibroblasts. The capacity of skin fibroblasts from cystic fibrosis (CF) and non-CF individuals to incorporate exogenous L-fucose into various metabolic pools was compared. Incorporation into intracellular acid-soluble pools and extracellular glycopeptides was measured by a dual-label co-chromatographic technique, whereas total macromolecular incorporation was measured by a single-label procedure. Although CF and normal fibroblasts incorporate exogenous fucose into intracellular acid-soluble and high molecular weight compounds in a similar manner, CF cells appear to be characterized by an increased incorporation of label into low molecular weight extracellular glycopeptides.


Electrophoretic studies of the cystic fibrosis ciliary inhibitor and its interaction with immunoglobulin G. The cystic fibrosis ciliary inhibitor (CFCI) has been partially purified from serum and plasma of cystic fibrosis (CF) homozygotes and heterozygotes, and from media of cultured fibroblasts derived from cystic fibrosis genotypes. Characterization and comparison of fractions containing the CFCI were carried out by polyacrylamide gel electrophoresis. Gel electrophoresis confirmed previous molecular weight estimations of 4,500 to 11,000 for the CFCI and provided an estimate of the number of proteins present in the fractions. Low molecular weight proteins from serum and media were combined with IgG preparations. No specific binding to IgG by the media fraction containing the CFCI could be demonstrated by the techniques employed. There was decreased binding of the low molecular weight serum fraction containing CFCI to native IgG molecules from cystic fibrosis patients as compared to IgG from normal individuals. However, IgG from CF individuals demonstrated increased binding of the cfci-containing low molecular weight serum fraction after gel filtration in the presence of guanidinium chloride. This suggests: 1) that very low concentrations of CFCI are present in media fractions; and 2) that native CF IgG cannot bind the low molecular weight CFCI fractions to the same degree as native IgG from normals or CF IgG that has been dissociated from non-covalently bound components.


Larval brine shrimp (Nauplii): a potentially useful model to study cystic fibrosis. One of the most consistent characteristics of cystic fibrosis is the abnormal handling of electrolytes by exocrine glands. The present study has examined the possibility that diminished respiratory energy formation is a primary biochemical error responsible for this abnormality. Using oxygen consumption of intact larval brine shrimp, quantitative differences have been observed from reaction of mixed mouth saliva between CF heterozygotes and CF homozygotes. In addition, information demonstrating a correlation between a biochemical abnormality and disease severity was observed. The differences observed in inhibition by saliva from both CF homozygotes and obligate heterozygotes may occur as the result of 1) interference with electron transfer from organic fuel molecules to molecular oxygen or 2) interference with the mechanism responsible for generating the biochemical reducing power necessary for multiple biosynthetic reactions.


On the nature of the defect in cystic fibrosis. Sera and lymphocyte culture media derived from cystic fibrosis (CF)-affected and carrier subjects contain ciliary dyskinesia factor (CDF) detected by our rabbit tracheal bioassay. In addition, we also find CDF in fibroblast media from these same donors and in amniotic fluid cell media derived from CF carrier or affected fetuses. In these latter instances, the media were inactive in the bioassay, but became active when mixed with purified IgG. In all instances, CDF activity was eliminated by the addition of anti-IgG. We have separated a low molecular weight fraction, between 1,000 and 10,000 M.W., from CF sera and culture media which is inactive in the bioassay until IgG is added. Presumptive and indirect evidence indicates that this fraction behaves similarly to the complement derived anaphylatoxin C3a. In addition, we have found activity in sera from CF patients and, to a lesser extent, carriers that induces degranulation of cytochalasin-B-treated human polymorphonuclear leukocytes. Since this activity appears to be in a different molecular species from that containing CDF, we postulate that the primary defect in CF is the deficiency of an enzyme whose substrates include a family of membrane-active molecules.


Further purification and characterization of serum proteins used to detect cystic fibrosis genotypes by isoelectric focusing. Sera from cystic fibrosis (CF) homozygotes and obligate heterozygotes contain a CF factor (gamma CF factor) not found by isoelectric focusing in thin-layer polyacrylamide gels in most normal control sera. In addition, sera from most obligate heterozygotes lack another protein (bland B, C, or D) that is commonly found in sera from most normal and cystic fibrosis individuals. A standardized, biophysical assay is described that employs isoelectric focusing for the detection of both CF homozygotes and heterozygotes based on the analysis of whole serum for the presence of the gamma CF factor and bands B, C, and D. Results of analyzing sera from selected CF patients by isoelectric focusing indicated that there is a general correlation between the amount of the gamma CF factor and the clinical severity of the disease. Partial purification and characterization of the gamma CF factor and protein bands B, C,  and D was accomplished by using DEAE-cellulose chromatography, Sephadex G-200 gel filtration, sequential molecular filtration through a series of Amicon Diaflo ultrafiltration membranes, affinity chromatography, and cellulose acetate electrophoresis. The gamma CF factor is a cationic protein with a pI of 8.46+/-0.05, has gamma electrophoretic mobility, a molecular weight between 3,500 and 10,000, and apparently exists in CF serum in 2 forms (free in solution and complexed to IgG). Bands B, C, and D are cationic proteins with pI values of 7.85 to 8.10, have gamma electrophoretic mobility and a molecular weight of approximately 100,000-150,000.


Review of the growth characteristics of cystic fibrosis and normal human diploid fibroblasts in vitro. The growth kinetics of human diploid skin fibroblasts derived from cystic fibrosis (CF) homozygotes, CF heterozygotes and normal individuals was determined. The population doubling times increased with time in culture, and no difference was observed between the 3 genotypes tested. The cell cycle times remained constant through the 10th subculture, while the growth fraction, or fraction of cells in the cell cycle, decreased with culture time; however, changes in the growth fraction and population doubling time appear to be related to cellular senescence in vitro rather than to cystic fibrosis.


Second primary lung carcinoma.

Second primary lung carcinoma. Ffity-five patients suffering from second primary lung carcinoma, 10 synchronous and 45 after resection for lung carcinoma (metachronous), have been observed from 1400 resections. The first manifestation of a second carcinoma in this series has always been the appearance of a new shadow in the follow-up radiograph. In our experience, second primary lung carcinoma is a disease affecting only heavy cigarette smokers. Heavy cigarette smokers suffering from squamous-cell carcinoma are at special risk. The results of re-operation, the significance of the time interval between the original operation and the appearance of the second primary carcinoma, and the slow growth rate of some second primaries are briefly discussed. No clear-cut methods exist for distinguishing a second primary from a metastasis from the original carcinoma.


"Sentinel lines"--an unusual sign of lower lobe contraction. Of the various densities occurring in the lower zones of the standard postero-anterior chest radiograph, one sign has been ignored. Coarse linear densities at the bases may be due to adjacent lower lobe contraction. The cause is related to bending or kinking of the lower zone bronchi, usually the superior and inferior branches of the lingular bronchi. The densities are probably due to mucus-filled bronchi or alveolar atelectasis distal to the kink. resulting from poor bronchial drinage, and may indicate more extensive disease. The left lower lobe collapse may not be visible on the chest radiograph but the presence of these densities should alert the observer to the more important associated abnormality.


Evolution of disability in coalworkers' pneumoconiosis. Retrospective analysis of the results of serial ventilatory capacity tests (FEV 1-0), which had extended over an average period of almost 15 years, has been carried out in 215 miners and ex-miners who suffer with coalworkers' pneumoconiosis. All were unselected previously diagnosed cases who attend the Cardiff Pneumoconiosis Panel at regular intervals for re-assessment examinations. They consisted of 68 miners and 147 ex-miners and they were divided into three groups according to their radiological category at their most recent examination, carried out in either 1973 or 1974. There were 90 cases of category B progressive massive fibrosis (PMF), 50 cases of category A PMF and 75 cases of simple pneumoconiosis. Findings for the 38 life-long non-smokers within the 215 were compared with those for the smokers. All three groups showed progressive impairment of ventilation over the whole period of observation. This was most marked in the category B cases but this group had already acquired a substantial proportion of their eventual impairment while still classified radiologically as category A or as simple pneumoconiosis. These findings are not compatible with the view that coalworkers' pneumoconiosis does not cause significant impairment of ventilation until the category B radiological stage is attained; they suggest rather that cases destined to progress to serious disablement show evidence of progressive impairment of ventilation at very much earlier radiological stages. Non-smokers showed a pattern of impairment similar to that of the smokers but were less disabled; the differences, however, were slight and not statistically significant.


Post-mortem studies of the semistatic volume-pressure characteristics of infants' lungs. Semistatic air volume-pressure (V-P) loops were recorded from 172 isolated lungs obtained from infants and children at necropsy. Technically unsatisfactory V-P loop behaviour and the presence of pathological changes led to the exclusion of 98 lungs. A further 10 lungs were excluded as it was decided to study the period of growth up to 90 cm crown-heel length. A total of 64 left lungs remained which were designated "normal". Control data were collected in an attempt to quantify the effects of storage and variations in inflation technique. A maximum inflation pressure of +30 cmH2O was used as a standard Pmax. The resulting maximum inflation volume (Vmax) data showed a cubic relation to the crown-heel length which deviated from the values obtained by the use of in-vivo regression equations. The extent and pattern of the deviation suggest that the technical factors are not a major contributory cause, and other explanations are discussed. The low-pressure proportional data from the deflation limb of the V-P curve are plotted against the crown-hell length, and the resulting curve is analysed. There is a sharp fall in the proportion of Vmax retained in the lung at +5 cmH2O and +2-5 cmH2O with increasing body length, but proportional volume at zero transpulmonary pressure follows the same growth-related pattern as Vmax.


Effect of chlorphentermine on the lipids of rat lungs. Chronic administration of chlorphentermine to rats resulted in a reduction of body weight compared to a normal control group. The weight of the heart, liver, kidney, and spleen was less in the treated group while the weight of the lungs was increased significantly. There was no change in the ratio of right ventricular to left ventricular weight in the rats treated with chlorphentermine, supporting the views that this drug does not cause pulmonary hypertension. Biochemical analysis showed that the increase in the weight of the lungs was due to the accumulation of phospholipid. All classes of phospholipid were affected, but particularly phosphatidyl choline, the tissue concentration of which increased nine times. Chlorphentermine also increased the proportion of palmitate present in pulmonary phosphatidyl choline. Histological examination of the lung after treatment with chlorphentermine showed evidence of this drug-induced lipidosis. No conclusion can as yet be reached as to the mechanism involved in the accumulation of phospholipid in the lung after chlorphentermine.


A simple cooling circuit for topical cardiac hypothermia. Rapid uniform cooling of the heart is the most important requirement of any method using local hypothermia for protection of the myocardium during open intracardiac surgery. We report the construction and operation of a recirculation cooling circuit comprising a reservoir, pump, and heat-exchanger for this purpose. It is operated by the perfusionist and can deliver up to 1 litre of fluid per minute at 4 degrees C into the pericardium or interior of the heart. Advantages of the system include rapid cooling of the myocardium, simplicity of operation, and applicability to all routine cardiac surgical procedures.


Hypertrophic osteoarthropathy in adults with cystic fibrosis. Three adult patients with cystic fibrosis presented with arthralgia, and investigation for the usual causes of arthritis proved negative. Radiographs of long bones revealed periostitis and new bone fromation characteristic of hypertrophic osteoarthropathy. Symptomatic improvement occurred after analgesic and anti-inflammatory therapy. In patients with cystic fibrosis and bone or joint pain, the diagnosis of hypertrophic osteoarthropathy should be considered and long bone radiographs obtained.


Localized pulmonary Wegener's granuloma simulating lung cancer: report of four cases. Clinical features suggesting lung disease in three patients and a chance chest radiograph in the fourth led to films showing localized lung lesions with some characteristics of neoplasms. Two were heavy smokers, two were non-smokers. In two the lesion was peripheral, in one lobar (RUL), and in the fourth it crossed the interlobar fissure (apical and posterior segments LUL and apical LLL). Malignant cells were not seen on sputum cytology examination in any, but in one, atypical cells were reported. All four patients had lung resection for suspected cancer, two by pneumonectomy, one by lobectomy, and one lingulectomy. All patients recovered, and their clinical course has so far been uniformly benign. Two have been followed long term (16 and 10 years), one 2 1/2 years, and one a year. Pathologically, the lesions appeared to be strictly limited without extra-pulmonary involvement, except that the patient followed for one year has developed hyporegenerative anaemia responsive to prednisone therapy. The pathological features of focal necrosis, granulomatous inflammation, and vasculitis were sufficiently striking, although often focal, to suggest that incisional biopsy from frozen-section histological diagnosis could be useful to prevent extensive lung resection for lesions not positively diagnosed before thoracotomy.


Pulmonary hypersensitivity to Ramin (Gonystylus bancanus). Transient airways obstruction associated with reduction in the transfer factor (diffusing capacity) of the lungs is reported in a patient with a clinical syndrome in keeping with extrinsic allergic alveolitis after exposure to Ramin dust (Gonystylus bancanus). The alterations in pulmonary function were consistently demonstrated on testing the patient in his working environment and were reproduced in the laboratory after inhalational challenge. The importance of the temporal relationship of changes in pulmonary function to contact with suspected allergenic material is emphasized.


Double outlet right ventricle with L-position of the aorta, D-loop, subaortic VSD, and pulmonary stenosis. We describe a case of double outlet right ventricle with subaortic ventricular septal defect and pulmonary stenosis treated successfully with cardiopulmonary bypass. We consider the clinical history and angiocardiographic and surgical findings of this rare anomaly. We stress the difficulties of reconstruction of the outflow tract of the right ventricle, because of the anomalous pathway of the right coronary artery, the posterior situation of the pulmonary artery, and the abnormal anatomy present in the outflow tract of the right ventricle.


Spontaneous haemothorax in a mild haemophiliac. Spontaneous haemothoraxis is a very rare presenting manifestation in haemophilia, only four previous cases being recorded in the English literature. The clinical features and management of such a case by intercostal tube drainage in a previously unrecognized haemophiliac are described.


Haemorrhagic pulmonary oedema: post-pulmonary embolectomy. A case of haemorrhagic pulmonary oedema after successful pulmonary embolectomy is presented. The relevant literature is reviewed. Thirteen cases are analysed as well as the four survivors. The aetiology appears to be ischaemic damage of the capillary bed. This had previously been called incomplete infarction by Castleman. The incidence is low after acute pulmonary embolectomies but appears to be much higher after chronic endarterectomies, especially with severe pulmonary hypertension. Therapy is outlined.


Chylothorax: report of a case complicating ductus ligation through a median sternotomy, and review. An unusual case of chylothorax is described in a 4-year-old child after repair of a ventricular septal defect and ligation of a patent ductus arteriosus through a median sternotomy. Left chylothorax developed after a latent period of six days and was treated initially with continuous drainage and parenteral supplementation of proteins and lipids. Operative intervention with oversewing of the site of the leak in the anterior mediastinum proved necessary after three weeks. The anatomical variations of the thoracic duct are outlined to explain the occurrence of chylothorax after diverse intrathoracic operations. The physiological effects of a thoracic duct fistula and various aspects of management are reviewed.


Lymph node tuberculosis presenting as chyluria. Chyluria is a rare manifestation of tuberculosis. A patient in whom it was a presenting symptom is described.


Effects of copper deficiency and copper loading on 67Cu in supernatants of rat organs. Eleven organs of the rat were studied 1 hr and 24 hr after the intravenous administration of 67CuCl2 and 67Cu-ceruloplasmin. The rats were normal, copper-deficient, or copper-laden. The amounts of stable copper and 67Cu in the whole organ and supernatant fractions, corrected for whole blood copper and 67Cu, were measured. The distribution of supernatant 67Cu was determined in three Sephadex G-100 chromatographic zones: Peak I (150,000 daltons), Peak II (31,000 daltons), and Peak III (11,000 daltons). All organs took up 67Cu from both sources, but there was a tendency for increased uptakes in copper-deficient rats and decreased uptake in copper-laden rats. Only lung, heart, and testis took up more 67Cu from 67Cu-ceruloplasmin than from 67CuCl2. Supernatant 67Cu tended to be in Peak I when the source was 67Cu-ceruloplasmin and in Peak II when the source was 67CuCl2. When 67Cu-ceroloplasmin was added to supernatant fractions in vitro, the 67Cu was in Peak I. However, when 67CuCl2 was added to supernatant fractions, Peak III predominated in kidney, brain, testis, and liver; Peak II predominated in none; and Peak I predominated in spleen, muscle, large and small bowel, stomach, lung, and heart. A high-molecular-weight copper-binding substance seems to be present in organ supernatant fractions.


Evaluation of recommended methods for radioisotopes red cell survival studies. Mean red cell life-span in normal subjects and in patients with various hematological disorders was examined with 51Cr and DF32P. The results with 51Cr were corrected for 51Cr elution using correction factors. The results by the two methods agreed fairly well with each other. Elution rate in various hematological disorders was 2.3% per day or less except for the patients with extracorpuscular hemolytic agents such as autoimmune hemolytic anemia or congestive splenomegaly. It is concluded that estimates of mean red cell life-span by corrected 51Cr method are more useful and sufficient than uncorrected 51Cr or DF32P method in general hematological disorders.


Application of microassay technique in cell-mediated immunity to measles virus infection. A microassay technique for the detection of cell-mediated immunity to measles virus is described. Lymphocytotoxicity of peripheral blood lymphocytes was determined employing the percent reduction of target cells surviving on the microtissue culture plate. Simultaneously, subpopulation of peripheral blood lymphocytes was also measured. Significant measles specific cytotoxicity was only demonstrated in the subjects with prior histories of measles but no reactivity was observed in the children without the history. Cell-mediated immunity appeared slightly earlier than the elevation of hemagglutination inhibition antibody titer. Both reactivities progressively increased and exhibited the maximal responses at the reconvalescent period of 2nd to 3rd week after skin rash. Depletion of T lymphocyte was most prominent at the stage of Kopliks enanthema or the early stage of exanthema.


The maximum expiratory flow rate and volume dependent respiratory resistance in small airway obstruction. In 8 healthy subjects (group A) and 4 subjects with respiratory symptoms (group B), the lung pressure-volume curve (P-V curve), maximum expiratory flow-volume curve (MEFVC) and respiratory resistance (Rrs) at all vital capacities were measured. To avoid laryngeal artifact on a mouth pressure, an intratracheal catheter was used for measurement of Rrs which was obtained with 3 cycles/sec oscillatory forced pressure. Group B did not show a different elastic recoil from group A. In comparison of the maximum expiratory flow (Vmax) at 80, 70, 60 and 50% of the total lung capacity (TLC). Vmax of group B showed lower values than that of group A. Rrs was almost the same in both groups from 70% TLC upwards, but Rrs of group B was higher than that of group A from 65%TLC downwards. Since the lung elastic recoil pressures (Pst (1)) in the two groups were not different and Rrs's were different significantly only at low lung volumes, the decrease in Vmax of group B was supposed to be due to the increased Rrs which might reflect small airway obstruction.


The effects of ligation of vas deferens, corpus epididymidis and vasa efferentia on the testicular function in rats. The effects of ligation of the vas deferens, the corpus epididymidis and the vasa efferentia on the testicular function were studied in sexually mature rats. The significant decrease in the testicular weight was observed after ligation of the corpus epididymidis and the vasa efferentia. However, neither the weight of the ventral prostate and of the seminal vesicle, nor the plasma testosterone level showed significant changes. The results suggest that the ligation at the three locations would not affect the endocrine function of the testis. The changes in the testis would mainly affect the spermatogenesis. The effects of sperm stasis on the testicular function were also discussed.


Graphic analysis of osmotic fragility of erythrocytes. A precise and highly reproducible method for analyzing the osmotic fragility of erythrocytes with a minute amount of blood (less than 10 mul) is described. The osmotic fragility curves are recorded with a coil planet centrifuge with accessories and a scanning photodensitometer. The recorded curves are transcribed by a DuPont Curve Resolver and their components are analyzed. Normal fragility curves obtained from healthy adults revealed slightly skewed Gaussian curves and they were resolved into several typical Gaussian components which differed according to the physical and clinical conditions of subjects. Each resolved component is supposed to correspond to the population of erythrocytes having a nearly identical osmotic fragility. The method is proved to be useful for the detection of altered membrane properties of erythrocytes in various diseases.


Insulin and glucagon response in patients with chronic pancreatitis. The oral glucose tolerance test and arginine infusion test were carried out on 22 patients with chronic pancreatitis and 11 normal control subjects. According to the glucose tolerance curve, the patients were divided into three groups; group I (normal or slightly impaired), group II (mildly diabetic) and group III (moderately diabetic). Markedly impaired insulin responses to oral glucose as well as to arginine infusion were observed in groups II and III. In group I, the mean plasma insulin levels during glucose tolerance test were the same as those in the controls, but the insulin response to arginine was reduced except in two cases. On the other hand, the glucagon levels during arginine infusion test were within the normal range in group I and slightly reduced in the other groups with diabetic glucose tolerance. The ratio of increment area of insulin to that of glucagon during arginine infusion in the patients was slightly decreased in comparison with the controls. Neither insulin nor glucagon response after arginine infusion showed a significant correlation with pancreatic exocrine function. It is concluded that in chronic pancreatitis insulin response to glucose as well as to arginine is markedly decreased, and that glucagon rise after arginine infusion is lowered compared with the controls.


Blocking effect of tripelennamine on histamine--induced positive chronotropic and inotropic responses of the dog atrium. The effects of histamine on inotropic and chronotropic activity were investigated in isolated canine atrium preparations which were suspended in a bath and perfused with arterial blood from a carotid artery of heparinized support dog. Histamine administered into the cannulated sinus node artery in a dose range of 0.3-100 mug produced dose-related positive chronotropic and inotropic effects. The positive responses to histamine were not suppressed by treatment with propranolol in doses which blocked responses to norepinephrine, but these were significantly suppressed by a histamine H1 receptor blocking agent, tripelennamine. On the other hand, these histamine-induced effects were not modified by a histamine H2 receptor blocking agent, burimamide. From these results, it is assumed that positive chronotropic and inotropic effect of histamine may be mediated by histamine H1 receptors in the dog heart.


[Salbutamol therapy of chronic bronchopathic patients with cardiac arrhythmias]. Salbutamol was used in 16 patients affected by chronic obstructive bronchial disease accompanied by disturbances in the cardiac rhythm. This beta stimulant, administered by mouth or by aerosol, did not aggravate the disturbances in the cardiac rhythm.


Oxonic acid and fetal development: I. Embryotoxicity in mice. Feeding the uricase inhibitor potassium oxonate (K Ox) as 3( of the diet to pregnant mice during days 8-10 postconception caused a 95-98% incidence of embryonic mortality with resorption. The same treatment during days 10-13 of gestation caused no changes in litter size and fetal weight; however, if in addition to feeding K Ox, three concurrent i.v. injections of 2.5 mg/day of Na urate (Na UR) were given then 47% of the mouse fetuses were killed and resorbed. Intravenous Na urate alone during the same stages of early and middle pregnancy had no effect on fetal survival or development. A 3.6% incidence of cleft palate was caused in mice treated with the combination of K Ox and Na UR during middle pregnancy. In groups of mature nonpregnant female mice exposed to the same treatment regimens, serum uric acid, potassium and sodium were elevated in a treatment-related manner. Serum urea levels were unchanged. K Ox is lethal to mouse fetuses during early embryonic development. Hyperuricemia, hyperkalemia or hypernatremia are maternal alterations which may be responsible for, or contribute to this effect.


Sex-related differences in cadmium-induced alteration of drug action in the rat. 3 days after pretreatment of rats of both sexes with cadmium (2 mg/kg, 1.p.) the duration of hypnosis induced by hexobarbital (75 mg/kg, 1.p.) was potentiated in males but not females. Likewise similar treatment with cadmium leads to significant inhibition of the metabolism of hexobarbital by hepatic microsomal enzymes obtained from male but not female animals. These data suggest that there is a sex-related difference in the ability of cadmium to alter drug action in rats.


Oxonic acid and fetal development: II. Teratogenicity in rats. Feeding the uricase inhibitor potassium oxonate (KOx) as 3% of the diet to pregnant rats beginning on the 8th day of gestation for either 2 or 3 days caused a time-related increase in fetal resorptions, with the incidence in the experimental group treated for the additional day being 72% higher than the 2-day group. The shorter treatment period permitted more rat fetuses to survive to term; however 9.3% of these showed gross malformations, exencephaly and/or visceral herniation. Thus, KOx is demonstrated to be both embryotoxic and teratologic in the rat.


[Radiotherapy of salivary gland carcinomas (results from 80 patients)]. Of 102 patients irradiated because of a tumor of the salivary glands between 1952 and 1973, 80 cases are evaluated in this paper. 67 tumors were localized in the parotid gland. We found 12 tumors in the submandibular gland, one tumor in the sublingual gland. The tumors turned out to be benign in 17 cases, whereas the remaining 63 tumors evidently proved to be malignant. 28 patients underwent either sole irradiation, or radiation therapy was performed after a subtotal operation the number of the patients only irradiated being very small. In 29 cases radiation therapy followed a radical operation; the remaining 23 patients were sent to us for radiation therapy not earlier than after a single or repeated recurrences following surgical treatment. In 23 patients a local recurrence developed after irradiation. Metastases to the lymph nodes were observed in 24 patients, in 17 cases being already manifest at the beginning of the irradiation. Distant metastases were found in 30 patients, six of these existing already at the beginning of the radiation therapy. Till now, thirty patients died because of their cancerous disease, 13 patients because of intercurrent diseases. The five-year survival recovery rate amounted to 50%, the rate of seven-year survival to 42%. The results of surgery for malignant tumors of the salivary glands are distinctly improved by radiation therapy. Especially the high percentage of recurrences after sole surgical treatment reveals the necessity of postsurgical radiation therapy. For the prevention of local recurrences, however, very high doses have to be delivered to the tumor generally. We recommend 6500 rd as a minimal dose to be applied within five to six weeks. In certain cases, with particularly radioresistant tumors, a local dose of up to 7500 rd may be delivered to a small volume. Irradiation of the highly malignant tumors of salivary glands should encompass the regionary lymph nodes too, even if they are not affected metastatically.


[Radiotherapy of pinealoma].

[Radiotherapy of pinealoma]. The possible methods of radiation therapy of the pinealoma are treated with regard to two own cases. The methods used by other therapeutists are also taken into consideration. The dose distribution in the target volume and the surrounding volume is discussed for different irradiation methods. The troubles felt by the two persons (a girl of 15 years and a boy of 15 years) were declining continually during the radiation therapy.


Methyl mercury degradation in mink.

Methyl mercury degradation in mink. Degradation of methyl mercury by mink was investigated in a series of experiments. Mink were fed daily with a diet containing methyl mercury-contaminated fish. Contents of total mercury, methyl mercury and selenium were determined in different tissues from the animals, as were the contents in faeces. Of the total amount of mercury detected, only about 73% was found as methyl mercury. In liver and kidney the proportions were 46 and 55%, respectively. Selenium contents were low compared with those found in marine mammals where equivalent amounts of mercury and selenium on a molar basis have been reported. The conditions in mink are compared with earlier studies on cats and marine mammals.


Decrease of the sella turcia to normal size, a major sign of the effectiveness of pituitary tumour irradiation. In this preliminary paper, the authors review 20 cases of pituitary tumours, with sella reduction to normal size, associated to the biological recuperation and social rehabilitation of most patients, after conventional radiation therapy given in high-dose courses. It is evaluated that sella reduction to normal size, whenever encountered, can be considered as the major anatomico-radiological sign of the effectiveness of different therapeutical methods applied in the case of secretory and non-secretory tumours.


[Possible incompatibility of deep radiotherapy and high-dose adriamycin or cyclophosphamide therapy in advanced genital tumors of the female]. A report is given of the treatment of three patients with advanced malignant tumors. Combined percutaneous irradiation and application of adriamycine produced severe side effects which, in one case, took a lethal end. A combination of relatively good tolerance consisting of an irradiation therapy and stosstherapy with cyclophosphamide is presented as an alternative treatment of the advanced ovarian carcinoma. The authors express a warning of simultaneous application of radiation and adriamycine therapy.


[Gonadal load in 60Co irradiation of peripheral, mediastinal and retroperitoneal lymph nodes]. A telecobalt therapy of lymph node groups was simulated on the Alderson phantom and the gonad dose caused by each irradiation field was measured with LiF dosimeters. When the supradiaphragmatic and the para-aortal lymph nodes were irradiated, the ovary dose showed rates up to 20% of the dose maximum. The irradiation of the same zones brought about a testicle dose of less than 50% of the dose maximum, and only 1/20 of this rate was achieved when a lead plate of about four cm was used in order to protect the testicles. The results are discussed under the point of view of the genetic risk.


Studies on the effects of orally administered Di-(2-ethylhexyl) phthalate in the ferret. A target-organ study of the effects of the phthalate ester di-(2-ethylhexyl) phthalate (DEHP) has been conducted in mature male albino ferrets. DEHP treatment caused a loss of body weight when administered as a 1% (w/w) diet for 14 months. Additionally marked liver enlargement with associated morphological and biochemical changes was observed. These changes consisted of liver cell enlargement, lysosomal changes, dilatation of the endoplasmic reticulum and the depression of a number of marker enzyme activities. The only other tissue observed to be affected by DEHP treatment was the testes where histological evidence of tissue damage was observed in some animals. Studies on the metabolism of [14C]DEHP in the ferret indicated that the diester was metabolised to derivatives of mono-(2-ethylhexyl) phthalate which were excreted in the urine both unconjugated and as glucuronides. The results obtained have been compared with previous studies in the rat and it is concluded that DEHP is hepatotoxic in both species.


A semi-empirical formula for approximate estimation of the fall-off of intensity in the penumbra region of 60co teletherapy beam. The nature of the observed fall-off of intensity across the teletherapy beams for two different 60Co therapy units has been studied. The fall-offs for various field sizes have been compared and an empirical function derived to represent the fall-off. This function is of trigonometric  tan inverse form and makes use of only one parameter. The value of this parameter is directly related to the geometrical penumbra width, which can be calculated from the source diameter, the source-to-diaphragm distance and the source-to-skin distance.


Comparative study of the teratogenicity of phenobarbitone, diphenylhydantoin and carbamazepine in mice. Three selected anticonvulsants, phenobarbitone (PHB), diphenylhydantoin (DPH) and carbamazepine (CAA) were examined for embryotoxic and teratogenic activity in albino mice. After oral treatment of the dams during the period of organogenesis (days 6-15 of gestation) with both PHB and DPH in doses causing marked symptoms and signs of toxicity (40 and 170 mg/kg/day respectively), an abnormally high incidence of cleft palate was observed in the foetuses (4.3% and 9.3% resp.). In a cumulative control group of foetuses, the incidence of this particular malformation was only 0.13%. No significant change in the malformation rate was seen after the administration of CAA in doses up to 250 mg/kg/day. Slight to moderate retardation of foetal growth was noted after treatment with DPH and CAA, but only at the higer and toxic dose levels. DPH also increased the incidence of early embryonic deaths (deciduomata).


Selenium and lead: mutual detoxifying effects. Antagonistic toxic effects of selenium and lead were studied in growing rats. Chronic lead intoxication was produced by cutaneous application of lead naphthenate solution (80-200 mg Pb/kg body weight) for a period of 8 weeks and chronic selenium intoxication was induced by giving 5 ppm, 10 ppm and 15 ppm selenium in drinking water. The growth rate and food consumption of rats receiving selenium in addition to lead approached normal rate while animals treated with only one of them showed hampered growth rate and lower food consumption. The enzymatic activity of delta-aminolevulinic acid dehydrase (ALA-D) in whole blood, liver and kidney and liver P-450 enzyme activity were normal in rats receiving both selenium and lead. The enzymic activities assayed were, however, depressed in the animals receiving either lead or selenium. Assay of lead and selenium in liver, brain, kidney and blood was carried out. Rats receiving both metals and higher concentrations of these metals in the organs studied, as compared to those only receiving one component. The data seem to indicate that the effect of selenium on the toxic effects of lead is similar to its protective role against methylmercury intoxication.


[Xeroradiographic field controls on a telecobalt unit in the thoracic, abdominal and pelvic region and in the extremities]. After having modified the method of direct field control by the telecobalt unit for the cranial region and the neck, it has been possible to effect these controls for the thoracic, abdominal, and pelvic region, too. If two sources of radiation are used, it is decisive to cover with lead the zones of half-shadow on the field limits. The technology of direct field control and the advantages for planning and control of the radiation therapy are described.


[Properties of Masonite as phantom material]. The radiophysical properties of the material "Masonit" are examined by experimental methods. Indications are given as to atomic composition, density, effective atomic number, concentration of electrons, and linear attenuation coefficient. A comparison with water shows that "Masonit" is a suitable phantom material especially for the purposes of radiotherapy.


[Histologic studies on pancreas changes, caused by experimental fractionated local roentgen irradiation]. After exposition to a total dose of 8000 R delivered with 16 fractions, the pancreatic parenchymal changes in rats were investigated by the author using histological and histochemical techniques. The observations were performed from the first to the 150th day following the last fraction. During the period of acute changes (1st to 15th day), the most part of the acini is morphologically intact, many smaller or greater necrotic foci, however, are to be seen. This is partly due to the enzymes with cytolytic effects coming from the damaged smaller ducts and from glandular acini. The formation of the other part of the necrobiotic foci originates not only from direct radiation injury, but also from the capillary lesion by radiation. The injury to the wall of greater ducts induces edema, inflammations, dilatation of efferent ductules and stasis, all this leading consequently to an atrophy of the acini associated with the efferent ducts. During the period of chronical changes (50th to 150th day), the number of capillaries diminishes, the necrobiotic foci are multiplied especially in places where no capillaries are visible. This clearly emphasizes the role of the pathological reasons for capillary lesions. The regenerative phenomena occur only to a lesser extent, being confirmed to the efferent ducts. The extension of the necrotic zones together with the insignificant regeneration leads to a gradual destruction of the tissular substance. All this draws attention to the fact, that the radiation sensitivity of the organ can only be determined, if its acute and chronical changes are known.


Patterns of changes in peripheral blood composition in the course of combination chemotherapy of cancer. During MOPP (mechloretamine, vincristine, procarbasine and prednisone) chemotherapy in Hodgkin's disease a pattern of haematological injury develops gradually, and the period of maximal disturbances in peripheral blood parameters includes the last two or three months (the last 2 or 3 courses) of treatment with insufficient rebound between the courses. On the contrary, in the case of "synchronization" chemotherapy (vincristine and cyclophosphamide) in lung cancer a pattern of haematological injury develops rapidly, and the period of maximal disturbances in peripheral blood parameters takes only a few days, 7-12 days after each course, with sufficient or enhanced rebound between the courses. These differences are probably due to different scheduling of drugs in these methods of therapy.


A pilot experiment to compare regression of transplants of two different human tumors in athymic nude mice following single exposures to 60co radiation. Human tumor transplants were grown in a thymus defective nude mouse mutant (nu/nu BALB/c/A/Bom). Procedures for local irradiation of the tumor with 60Co-radiation are described. An introductory test of the usefulness of these transplants in studies of radiation effects on human tumors is performed by investigation of the time course of regression of adenocarcinoma transplants in six mice following single exposures of 375, 750, 1180 and 1575 rd, respectively, and malignant melanoma transplants in two mice following single exposures to 1475 and 2420 rd, respectively. The higher radioresistance of the malignant melanomas relative to that of the ovarian tumor is expected on the basis of clinical experience and indicates that radiation effects on human tissue implants in nude mice mirror some of the fundamental features of the in situ situation.


Heritable chromosome rearrangements induced in rat spermatids by x-irradiation. The induction of reciprocal translocations by an exposure of rat spermatids to X-irradiation has been studied by cytological examination of dividing spermatocytes of F1 sons. The incidence of F1 translocated males was found to vary from 7.89% after exposure to 125 R to 22.44% after exposure to 500 R.


The predictability of fertility planning status. For any couple, the planning status of a pregnancy (what they intended, whether they used contraception, and whether they were successful) is strongly dependent on the planning status of their preceding pregnancy. The introduction of more acceptable and effective methods of fertility regulation has, however, attenuated the strength of these relationships. The patterns of continuity and change in planning status from pregnancy to pregnancy provide a parsimonious description of reproductive behavior over the course of the life cycle and of the major trends in planning in the recent past.


The Model Family Planning Project in Isfahan, Iran. In the 1972-74 Isfahan Model Family Planning Project, which grew out of previous family planning projects in Isfahan, contraceptive education and services were provided by private doctors, family planning clinics, health centers, nurses, midwives, full-time field-workers, functionaries, and the mass media on a comprehensive and integrated basis. The percent of married women aged 15-44 using modern methods rose from 6 percent to 21 percent by the end of the project period. Continuation rates for the pill and IUD were comparable to those in other, more urban programs. Field-workers proved to be more effective in recruiting new acceptors than health workers and functionaries; mass media and relatives played indirect roles.


Analyst biases in KAP surveys: a cross-cultural comparison. The analysis phase of the KAP survey, in which meanings are ascribed to found empirical relationships, has largely been ignored in investigations of this data-gathering method. In order to determine the extent to which a lack of familiarity with the culture of data origin might influence survey interpretation, standardized KAP survey data from Bangladesh were presented to four groups of analysts who differed in degree of familiarity with the Bangladesh culture. Meanings ascribed by the analysts to the same empirical relationships were found to vary significantly by the degree to which they were familiar with the culture.


Medical opinion on abortion in Jamaica: a national Delphi survey of physician, nurses, and midwives. A national sample of 120 Jamaican physicians, public health nurses, and licensed midwives participated in a two-stage Delphi survey to identify medical opinion on proposed liberlization of Jamaica's abortion law, and to predict the likely impact of such legislative action on existing health and family planning services. More than 80 percent of the respondents favored legalization of abortion, and most supported changes in the health service delivery system to accommodate the expected demand. They believed that clandestine abortion, involving pharmacists and physicians, is already widely practiced.


A review of small canned computer programs for survey research and demographic analysis. A variety of small canned computer programs for survey research and demographic analysis appropriate for use in developing countries are reviewed in this article. The programs discussed are SPSS (Statistical Package for the Social Sciences); CENTS, CO-CENTS, CENTS-AID, CENTS-AIE II; MINI-TAB EDIT, FREQUENCIES, TABLES, REGRESSION, CLIENT RECORD, DATES, MULT, LIFE, and PREGNANCY HISTORY; FIVFIV and SINSIN; DCL (Demographic Computer Library); MINI-TAB Population Projection, Functional Population Projection, and Family Planning Target Projection. A description and evaluation for each program of uses, instruction manuals, computer requirements, and procedures for obtaining manuals and programs are provided. Such information is intended to facilitate and encourage the use of the computer by data processors in developing countries.


Family planning opinion leadership in Korea, 1971. The characteristics of Korean family planning opinion leaders are assessed through a secondary analysis of the 1971 national survey conducted by the Korean Institute for Research in the Behavioral Sciences. In effect, what characterized Korean family planning opinion leaders was a rather national and democratic model. Those who had tried methods, discussed them, and knew a lot about them assumed leadership roles more than others. Place of residence, education, and other such variables mattered relatively little unless a woman had credibility imparted by actual use and knowledge imparted by use or discussions with family planning professionals.


The presuicidal syndrome.

The presuicidal syndrome. The Presuicidal Syndrome, first described in 1958, relates to that specific psychic state of mind that leads to suicidal acts. It is an alarm signal indicating a tendency to suicide. The Presuicidal Syndrome has three principal components: constriction; inhibited aggression turned toward the self; and suicidal fantasies. The clinical details of these components are explicated. It is proposed that the Presuicidal Syndrome provides a basis for better judgment of the danger of suicide, makes more focused suicide prevention possible, and is an aid in the disclosure of those factors in society that often lead to suicide.


Suicide and drug abuse in the medical community. In the United States each year the equivalent of an average-size medical school graduating class commits suicide, with the highest incidence occurring in the decade following the completion of training. Of these suicides, 20% to 30% are associated with drug abuse and 40% with alcoholism. Various problem areas are considered. Role strain, leading to excessive drug use in an attempt to increase work efficiency, is coupled with a denial of the physician's own dependency needs and gratification. The problem of identity occurs in relation to the exaggerated sense of duty and obligation the physician feels in attending to the demands of the patients and their families. Medicine as magical thinking is also discussed, revealing the physician's belief in his own immunity, which is strenuously tested when he actually sets up in practice. The community's high regard for the physician further complicates the situation. Too little has been done about working with emotional problems of medical students during their training and after they begin to practice. Unfortunately, physicians feel uncomfortable in turning to colleagues for help; rather, they tend to isolate themselves, resorting to alcohol and drugs. One should question the selection of medical students and their overall training, not only in terms of academic learning but also with more consideration for the stresses and strains of the future career.


Development and use of pediatric frozen red cell packs. Repeated transfusion of small increments of blood are frequently required for the sick and premature newborn infant to correct endogenous hypovolemia and/or to replace blood obtained for laboratory monitoring purposes. Previously fresh group and type specific whole blood was used. To eliminate waste of fresh whole blood, maintain fresh red blood cell properties, eliminate the hazards of transfusing plasma and to provide a more efficient system, a pediatric frozen red cell pack (PFRCP) has been developed. Units of group O rr red blood cells are glycerolized using a high glycerol method. The glycerolized red blood cells are separated into three equal aliquots and frozen. When needed, the PFRCP are deglycerolized by a modified procedure using the IBM Cell Processor. During a six month period, 71 infants were given 153 separate transfusions of deglycerolized red blood cells using 102 PFRCP prepared from 34 units of red blood cells. Red blood cell recovery, hematocrit, white blood cell removal, residual glycerol, total protein, and supernatant hemoglobin levels were measured. Clinical response was followed and found to be excellent.


Quantitative and thermodynamic studies of erythrocytic ABO antigens. This paper presents recent data from quantitative and thermodynamic investigations on A and B erythrocyte antigens. In regard to weak A phenotypes on the basis of quantitative data, practically no gap is observed from the weakest Aend to the strongest A3. Weak B phenotypes give a similar distribution. However, a more precise structural analysis including kinetics and thermodynamic measurements provides convincing evidence for the heterogeneity of each type of weak B reactive structures. Weak B antigens appear to be different from one to another, but similar inside one family. However, thermodynamics failed to demonstrate a qualitative difference between the weak B antigen in BX groups and the enhanced B antigen in ABX heterozygote, phenomenon that occurs in some very rare families. The same data were obtained from kinetic and thermodynamic analysis of B reactivity in cis AB samples; it can be assumed that such mutants are all different.


The specificity of immunosuppression by alloantibody in the mouse. The ability of alloantibody to suppress the humoral immune response to transplantation antigens in the mouse has been studied in relation to its specificity. It was found that antibody was able to suppress the cytotoxic antibody response to determinants other than those against which it was directed when there was some common antigenicity between the different H-2 types used for immunising. It was also found that suppression of the response to both parental haplotypes of an F1-hybrid cell could be achieved by antibody to only one parental haplotype, the antibody being made in the other parental strain to avoid any possibility of cross-reactivity. Such nonspecific immunosuppression was not achieved when cells of the two parental strains were administered mixed together.


A study of acute "short-wind" (pneumonia) in village pigs of Papua New Guinea. Observations were made over a 12-month period in two villages of the incidence and nature of an acute pneumonia syndrome of village pigs. A detailed ante-mortem and post-mortem examination was made of seven pigs with acute pneumonia, "short-wind". The principal ante-mortem findings were gross malnourished stunted young pigs with severe respiratory embarrassment. Post-mortem examination revealed acute bacterial pneumonia, superimposed on existing chronic enzootic and lungworm pneumonia. No single bacterial species was constantly isolated, Pastuerella spp. and Staphylococcus were the most frequently isolated. The pathogenesis of the disease is discussed. It is suggested that enzootic pneumonia is not a significant limiting factor in traditional pig husbandry. Low nutritional status and heavy nematode infections resulting in increased susceptibility to bacterial pneumonia of pigs are thought to be responsible for the high incidence and mortality from acute pneumonia.


Research into the relative importance of Tabanidae (Diptera) in mechanical disease transmission. IV. A contribution to the epidemiology of bovine trypanosomiasis in Africa. The incidence of trypanosomiasis was studied in a herd of dairy cattle near Dar es Salaam over a period of 4 months. The apparent density of tsetse flies and prevalence of various species of Tabanidae were measured. There was no statistical correlation between the disease incidence and the seasonal occurrence of Tabanidae. Although anaplasmosis was concurrently transmitted by Tabanus taeniola on an economically significant scale in this herd and there was a high incidence of Trypanosoma vivax infections it was thought, however, that trypanosomes were transmitted by Tabanidae at an insignificant rate. The only measureable result of such mechanical transmission was a change of the T. vivax/T. congolense ratio in favour of T. vivax (69 per cent of the infections).


Preparation of cryoprecipitated factor VIII concentrates. Factors affecting the yield of factor VIII in cryoprecipitate have been investigated in the context of a blood component program. Both in vitro and in vivo measurements were used to assess the effects of critical variables on the yield of factor VIII activity. Variables such as anticoagulant, plastic bag, mixing during collection, and platelet contamination had no significant effect on yield of factor VIII activity in cryoprecipitate. Among the most critical factors affecting yield were storage time of whole blood and procedures for freezing, thawing, and reconstitution. The following procedures were found to assure a 60 per cent recovery of factor VIII in cryoprecipitate: 1)processing of whole blood within six hours of collection; 2)use of a technique to freeze plasma within 30 minutes either in a -70 C ethanol bath or -85 C freezer; 3)rapid thawing (1 1/2 hour or less) in a 4 C circulating water bath; 4)centrifugation at 4,500 X g for 10 minutes at 4 C followed by draining of the supernatant in a 4 C cold room; 5) storage of the precipitate at -20 C until ready for use; 6) thawing in a 37 C water bath for at least 15 minutes followed by addition of 20 ml of 0.15 M saline for a 20 minute period at room temperature, and gentle mixing before pooling units for transfusion. The recovery of factor VIII in cryoprecipitate appears to be limited to about 65 per cent by its solubility in plasma at 4 C. Therefore, further effort to increase the amount available for treatment should involve improving the supply of plasma for its preparation and decreasing the cost of processing.


Clinical conditions of East African birds of prey. The author discusses 50 bird of prey cases of 24 species submitted for clinical examination and treatment in East Africa. Traumatic injuries constituted the largest group, 31 birds being presented in this category. Other conditions encountered included those involving the feet, respiratory disease, enteritis, nervous disease and a number of birds in poor nutritional condition. The treatment of the cases is discussed.


Abortion and reproductive performance of cattle in northern Nigeria: a questionnaire survey. A survey on abortion and reproductive performance in cattle was carried out in the six northern States of Nigeria in 1972-73. Three hundred and ninetten herds with 8,970 breeding cows were sampled. One hundred and thirteen herds reported abortion (35 per cent); the lowest incidence was in local herds in Kano State and the highest was on government ranches. Twenty-six herds reported recurrent or chronic abortion. The majority of abortions in non-government herds was not reported to local veterinary authorities (75-8-100 per cent). Average age at first conception in government herds was 2-5 years and 3-5 years in local herds. The percentage of calf crop was highest in the government herds (67 per cent) compared with local Fulani herds (34-2-54-5 per cent) and the pregnancy rate was almost double in the government herds. The percentage of Fulani herds reporting repeat breeding varied from 16-6 to 58-8. Although the survey gave no information as to the causes of abortion or the financial loss, it indicated that bovine abortion was more widespread in the northern states of Nigeria, than previously thought.


A second example of anti-Lu14.

A second example of anti-Lu14. Anti-Lu 14 has been found in the serum of a gravida 2 pregnant woman who had not been given any blood transfusions. Her husband is Lu:14 but otherwise of common Lutheran blood type. Maternal immunization probably occurred during the first pregnancy. The second child did not inherit the father's Lu14 gene and was not affected by the maternal antibody.


Studies on the livestock of Southern Darfur, Sudan. IV. Production traits in goats. The results of a 15 months' intensive study on seven flocks of indigenous goats in the Southern Darfur region of the Sudan are discussed in this paper. Birth rates in the region approached 2-1 kids per doe per year. A high total offtake of 28 per cent and a weighted average death rate of about 16-5 per cent were insufficient to offset this high birth rate and flock numbers are increased. Mortality in kids was unrelated to number of births. Weighted average rate of gain for all surviving kids was 87 g per day to 3 months and 67 g per day to 6 months of age. The growth rates of twin and single were similar, but triplet kids grew at a slower rate. For each kilogramme liveweight of breeding females, goats produced 1-5 and 8 times the weight of meat produced by sheep and cattle respectively under the same management and environmental conditions.


Experimental immunisation of six-month old calves against infection with the cysticercus stage of Taenia saginata. Three groups of calves aged 6 months were completely protected against oral challenge with Taenia saginata eggs following immunisation by three different methods. These were hyperimmunisation with six serial inoculations of a homogenate of T. saginata strobila in Freund's complete adjuvant, a single intramuscular inoculation with hatched T. saginata eggs or a single oral dose of unhatched T. saginata eggs. The calves immunised with tapeworm homogenate developed the strongest haemagglutinating and precipitating antibody response to the complex of antigens in an extract of tapeworm strobila, cysticercus tissue or cysticercus fluid. The orally infected calves developed a moderate antibody response to these antigens but the calves inoculated with hatched eggs showed only a very weak antibody response. The calves infected orally with eggs developed a peripheral eosinophilia but the other two methods of immunisation did not evoke this response. After challenge infection all groups showed an increase in peripheral eosinophil counts except the group immunised with tapeworm homogenate.


Removal of HBSAg from blood in vitro. I. Effects of washing alone, glycerol addition and removal, and glycerolization, freezing, and washing. Red blood cells from HBSAg-positive blood were washed in the Fenwal Elutramatic, Haemonetics Processor 15, or the IBM Blood Processor with sodium chloride solutions, or in the Huggins Cytoglomerator with sugar solutions. The Fenwal Elutramatic and IBM Blood Processor were the most efficient washing systems, the Haemonetics Processor 15 was less efficient, and the Huggins Cytoglomerator was the least efficient in removing the HBSAg. Washing to remove the HBSAg from red blood cells containing 40 per cent W/V glycerol in an ionic medium was more efficient than washing HBSAg from liquid-stored red blood cells or red blood cells containing 20 per cent W/V glycerol. The original and modified dilution/agglomeration wash cycles used in the Huggins Cytoglomerator were not able to remove the HBSAg from units of blood that were radioimmune assay (RIA) positive and counterelectrophoresis (CEP) negative. Freezing had no effect on the removal of the HBSAg in vitro, whereas the concentration of 40 per cent W/V glycerol in the red blood cells that were washed did. HBSAg was not found in the amorphous debris remaining in the polycarbonate disposable bowl used in the Haemonetics Processor 15 or in the microaggregates remaining in washed red blood cells.


Cryoprecipitates as a source of fibrinogen in treatment of disseminated introvascular coagulation (DIC). Cryoprecipitates, in addition to containing factor VIII, contain about one third of the fibrinogen in the plasma from which they were derived. This fibrinogen is functional, as established by successfully preparing two congenital hypofibrinogenemics for major surgery by infusing cryoprecipitates. Cryoprecipitates and platelet concentrates are also used for patients with low levels caused by disseminated intravascular coagulation (DIC). We feel that these patients benefit not only from the factor VIII in the cryoprecipitates, but from the fibrinogen, which adds its support to the fibrinogen in platelet infusions, plasma, and whole blood. Such support makes it possible to heparinize such patients more heavily than would be safe without such preparation. The authors report three patients with severe and life-endangering DIC who were heavily heparinized, and supported with cryoprecipitates, as well as other blood fractions. Response to this therapy was excellent.


Clinical importance of the rare erythrocyte antibody anti-Jra. Alloantibodies to high-frequency antigens create serious problems for a transfusion service. It is obviously important to know the clinical significance of such antibodies. In the present study, an attempt was made to determine this with respect to the antibody anti-Jra in a patient of the rare blood type Jr(a-). A small volume of 51Cr-labeled Jr(a+) erythrocytes was infused intravenously and cell survival was monitored. The T1/2 of these cells was approximately 80 minutes indicating the in vivo potency of the antibody.


Measurement of the acoustic properties of a nerve-muscle preparation as a function of physiologic state. Nerve-muscle preparations of Sprague Dawley rats were exposed to low dosage ultrasound. The objectives were to measure the velocity of propagation and attenuation of ultrasonic energy in both the relaxed and contracted states. A tension-measuring system and associated ultrasonic instrumentation were designed to measure the tension developed in stimulated muscle and its corresponding acoustic parameters, ie the attenuation coefficient, alpha (db cm-1) and the velocity of propagation, c (ms-1). Each test was performed at ultrasonic frequencies 3.1, 5.35, and 7.68 MHz and with the preparation maintained at 23 +/- 0.5 degrees C. Attenuation of ultrasonic energy was observed to increase by 10 +/- 0.5% in the active state from its value in the relaxed state. The relation between the attenuation and the acoustic frequency was found to be approximately linear over the frequency range tested. The velocity of propagation in the active state did not change appreciably from its value in the relaxed state and was observed to be independent of the acoustic frequency in the range used.