Studies on pulmonary function in patients during respiratory treatment. Diagnostic and prognostic evaluations. Twenty-nine patients, divided into three groups: 1) chronic obstructive pulmonary disease; 2) acute or chronic pulmonary disease with left heart failure; 3) respiratory insufficiency after peritonitis, pancreatitis, and/or sepsis, were studied during respirator treatment with regard to gas exchange, breathing mechanics and central circulation. The dead space ventilation was somewhat greater in group 1 than in the other groups. The alveolar-arterial oxygen tension difference was least in group 1, greater in group 2 and extremely high in group 3. Neither dynamic compliance of the thorax nor inspiratory resistance showed any significant differences between the groups. The cardiac output had the highest values in group 3. The venous admixture was generally small in group 1 and extremely large in group 3. The pulmonary artery pressures were highest in group 2. Three variables proved to be valuable when assessing the prognosis of a patient: a large venous admixture; a large alveolar-arterial oxygen tension difference, and a high pulmonary artery pressure indicated a less favourable prognosis.


Supraphysiological glucocorticoid treatment in hypoxic stress in dogs. Effects of supraphysiologic methylprednisolone succinate doses on systolic time intervals, hemodynamic performance, and metabolism were studied in normal dogs during normoxia, after 60 min of normocapnic hypoxemia (PAO2 = 30 mm Hg), and reoxygenation. Bolus injections of 30 or 100 mg/kg methylprednisolone did not exert any positive inotropic action during normoxia. Cardiovascular and metabolic changes induced by hypoxia were modified only to a modest and statistically insignificant degree by sustained high levels of methylprednisolone.


Inadvertent abducens nerve block during therapeutic trigeminal nerve block. A case report. A case is presented where reversible abducens nerve block accompanied second and third division trigeminal block with bupivacaine on two occasions. Intraorbital injection through the inferior orbital fissure most likely took place. Careful poistioning of the needle and limitation of the drug volume is mandatory for therapeutic trigeminal nerve blocks with neurolytic solutions.


Uptake of bupivacaine (Marcaine) in liver and lung after intramuscular administration in the dog. The uptake of bupivacaine in the liver and lung of the dog was studied 10,20,30 and 60 min after intramuscular injection of the drug. It was possible to quantify this uptake by combining measurements of concentrations and flows. The administration of bupivacaine (0.75 mg/kg b.w.) did not result in any significant circulatory changes. Arterial bupivacaine concentrations showed major variations, indicating interindividual differences in absorption rate. Lung uptake after 10 min was high in two dogs with initially high blood concentrations of bupivacaine, but low after 20 min or longer. The other dogs showed little or no uptake. Mean hepatic bupivacaine uptake was about 50% of the total dose during the first hour after injection, this indicates the central role of the liver in eliminating bupivacaine even during the initial period following administration. The hepatic extraction ratio showed interindividual variations, but the mean value of about 55% was constant throughout the observation period. This is in agreement with earlier findings indicating a first-order elimination of bupivacaine.


Respiratory depressant action of tilidine during N2O + O2 anaesthesia. The respiratory depressant actions of pethidine and tilidine during anaesthesia were compared in 18 surgical patients anaesthetized with N2O + O2 after thiopental induction. Five minutes after thiopental, 0.5 mg/kg pethidine or 1.5 mg/kg tilidine were each given intravenously to six patients, the remaining six patients serving as controls. Minute ventilation, respiratory rate, end-tidal CO2 and PCO2 from arterialized venous blood were measured up to 30 min. Pethidine caused the following maximal changes: V -0.98 +/- 0.24 (s.e. mean) 1/min, rate -5.5 +/- 0.7/min, CO2ET + 0.7 +/- 0.1 vol % and PCO2 + 5.7 +/- 1.1 mm Hg. These changes occurred within 10 min of the injection.


Restoration of oxygen uptake and blood flow in the rat cerebral cortex after halothane anaesthesia. Halothane decreases both the cerebral blood flow (CBF) and the cerebral metabolic rate for oxygen (CMRO2) when given in anaesthetic doses. A recent report (GJEDDE & HINDFELT 1975) suggests that when halothane is administered to rats for 1 hour, CBF and CMRO2 are depressed by about 30 and 40%, respectively, for as long as 4 hours after discontinuation of the halothane anaesthesia. In the present study rats were anaesthetized with 1% halothane for 1 hour, and CBF and CMRO2 were measured at the end of a 30 min recovery period, during which 70% N2O was administered. Comparison with animals maintained on 70% N2O throughout the entire 90 min period showed that previous halothane anaesthesia had no effects on CBF or CMRO2.


The dumping valve and its clinical application. An open reservoir for the collection and evacuation of anaesthetic gases permits leakage to room air. The use of a closed reservior for the removal of overspill gas from anaesthetic circuits is described. Calibrated gas evacuation is carried out through an ejector flowmeter from the anesthetic circuit or from a closed reservoir, where the gas is collected via a relief valve. In order to eliminate the risk of high or low pressure in the reservoir employed, a relief valve and a dumping valve is included in the system.


The haemodynamic effects of adrenergic receptor blockade or stimulation druing nitrous oxide anaesthesia in dogs. The effects of ventilation with normoxic and hyperoxic nitrous oxide on systemic, pulmonary and coronary haemodynamics before and after adrenergic receptor blockade or stimulation were investigated in 15 dogs. To evaluate a blocking or stimulating effect of nitrous oxide on the alpha-adrenergic receptors, the animals were given phenoxybenzamine or noradrenaline, respectively. The effects of beta-adrenergic receptor blockade or stimulation were studied after injection of propranolol or isoproterenol, respectively. The experiments showed that in spite of the lack of alpha-receptor blocking properties and despite the tendency to produce beta-receptor blockade, nitrous oxide induced vasodilation. The findings of the present study, together with the increase in cardiac output and peripheral vasodilation, suggest that the cardiovascular effects of nitrous oxide are extra-adrenergic.


The haemodynamic effects of nitrous oxide anaesthesia on myocardial blood flow in dogs. The effects of ventilation with nitrous oxide in oxygen on myocardial blood flow any oxygen metabolism were investigated in 31 mongrel dogs. The results of this study showed that, compared with controls, hyperoxic nitrous oxide mixtures did not cause any great changes in myocardial haemodynamics, despite a decrease in cardiac output and an increase in systemic vascular resistance. Normoxic nitrous oxide mixtures produced an increase of the coronary blood flow due to decreased coronary vascular resistance. To what extent this coronary vasodilatation resulted from a increased myocardial metabolism or from a direct effect of nitrous oxide on the coronary vascular bed cannot be quantified from the present results.


The haemodynamic effects of nitrous oxide anaesthesia on systemic and pulmonary circulation in dogs. The haemodynamic effects of nitrous oxide in normoxia (20% oxygen) and in hyperoxia (50% oxygen) were investigated in 13 dogs. Nitrous oxide in hyperoxia caused a significant rise in total peripheral resistance and a significant decrease in cardiac output, heart rate, myocardial contractility (dP/dt max) and cardiac work. On the other hand, nitrous oxide in normoxia seemed to reverse these findings and did not exert negative inotropic effects on the myocardium. The results indicate that the earlier reported sympathetic activation of the circulation may be related to hyperoxia and not to nitrous oxide as such.


Temporal lobe epilepsy and neuropathology. Histological findings in resected temporal lobes correlated to surgical results and clinical aspects. Neuropathological findings were studied in 74 patients with drug-resistant temporal lobe epilepsy who underwent unilateral temporal lobe resection in 1960-1969 in Denmark. In 60 per cent of the patients a well-defined neuropathological abnormality was revealed (i.e. 13 cases of focal lesions, including four small tumours, 21 cases of gliosis, and 10 cases of perivascular infiltration), in 23 per cent the findings were either questionably abnormal or without structural abnormality, while in the last 18 per cent sequelae of a previous operation dominated the histology. The general trend was for the postoperative clinical outcome to be better, the more specific and circumscribed the histological abnormality. There was no correlation between the neuropathological findings and the preoperative types of seizures. Postoperative recurrence of seizures was more often observed in patients with gliosis than in those with other histological diagnoses. A positive correlation existed between a history of cerebral infection and the presence of perivascular lymphocytic and histiocytic infiltration, and gliosis was a frequent finding in patients with epilepsy of unknown aetiology. No other significant correlation was found between the neuropathological abnormalities and the clinical, hereditary, aetiological, and social aspects.


Neurological disorders and detrusor hyperreflexia. In 152 consecutively selected patients with detrusor hyperreflexia (DH) 96 (63 per cent) had neurological disorders. Thirty-two patients did not show any primary neurological or urological cause for DH. This group was chosen to elucidate the evaluation of possible neurological symptoms in relation to the urological symptomatology. Nine had died and one failed to appear to the neurological examination. Twelve (63 per cent) of the 22 examined patients showed signs of lesions in different parts of the central nervous system, particularly cerebrovascular diseases and myeloneuropathy. Six had had neurological symptoms for years. In two the urological symptoms were first to appear. In the group with no neurological complaints the urological symptoms had existed for 2-30 years. No essential difference was found in the degree of voiding disturbance whether or not neurological signs were disclosed. It is concluded that the discovery of DH should be followed by a neurological examination to disclose further signs of lesions in CNS. Likewise, an extended urological examination with demonstration of DH might help in the evaluation of an obscure neurological disease.


Changes in serum immunoglobulin levels during phenytoin treatment of epilepsy. Immunoglubulin concentrations were determined by radial immunodiffusion in sera from 15 epileptic patients before and during phenytoin therapy. Three reaction patterns were recorded: Two patients developed IgA deficiency (less than 0.05 mg/ml) during the first 3-4 months of treatment. Both patients also had a decrease in serum IgG and IgM, but no significant fall or increase in serum IgE. The IgA deficiency state was apparently reversible, since normalization of serum levels occurred after withdrawal of phenytoin. Five patients developed a 35-80 per cent reduction in serum IgA. In these patients, the decline in serum levels of IgG and IgM was inconsistent. Eight patients showed no significant fluctuations in serum immunoglobulins during phenytoin treatment. When a fall in serum IgA occurred, it did not correspond to a fall in serum or in red cell folate. Mean serum IgG was lower (9.37 mg/ml) in epileptic patients who had taken phenytoin for less than 1 year and had a low IgA, than in patients who had taken phenytoin for 10 years or more (11.50 mg/ml).


Dementia in Parkinson's disease.

Dementia in Parkinson's disease. The occurrence of dementia in patients with Parkinson's disease was studied in a Parkinsonian population consisting of all traceable patients residing in a defined area. The prevalence of dementia was found to be 29 per cent in 444 patients studied. The frequency of dementia increased with advancing age and the patients showing signs of clinical arteriosclerosis were more often demented than the patients without arteriosclerosis. There was, however, an evident association between the stage of the disease and the frequency of dementia. The most severely disabled patients displayed dementia more often than the mildly affected, both among the patients with and without arteriosclerosis. The demented patients showed significantly more severe rigidity and hypokinesia when compared with the non-demented. Increasing severity of rigidity and hypolinesia, in particular was found to have a positive correlation with the degree of dementia. The association between dementia and the degree of motor involvement is considered to suggest the role of subcortical structures in the patholophysiology of dementia in Parkinson's disease.


Detection of carriers and genetic counseling in duchenne muscular dystrophy by ribosomal protein synthesis. The in vitro protein synthesis by polyribosomes extracted from biopsied muscle (vastus lateralis) was studied in 47 known carriers, 87 possible carriers and in 60 normal females. A significant increase in specific activity of monomeric ribosomes, total polyribosomes and collagen synthesis was found in 46 (97.8 per cent) known carriers and 47 (54 per cent) possible carriers of Duchenne muscular dytrophy. The latter showed an increase in ribosomal protein synthesis in 10 (52.6 per cent) of 19 mothers of isolated cases, 31 (53.3 per cent) of 58 sisters, and 6 (60 per cent) of other female relatives. Serum creatine phosphokinase was increased in 30 (63.8 per cent) of 47 known carriers.


The grasp reflex of the foot and related phenomena in the absence of other reflex abnormalities following cerebral commissurotomy. The grasp reflex of the foot and related pheonomena were examined in six subjects with no abnormalities of deep tendon or plantar (and related) reflexes 6 to 10 years after cerebral comissurotomy. In all subjects they were more marked on the same side as the more damaged hemisphere. These tonic phenomena seem to be facillitated by sitting and standing postures. Practical and theoretical implications of the tonic foot responses in the absence of similar phenomena of the hand are discussed.


Ceruloplasmin and copper level in maternal and cord blood and in the placenta in normal pregnancy and in pre-eclampsia. Copper and ceruloplasmin were assayed in maternal and cord blood sera and in the placenta of 10 women with normal pregnancies, in 10 patients mild and 10 with severe pre-eclampsia. Copper and ceruloplasmin levels were significantly elevated in the maternal blood of pre-eclamptic patients as compared with normal pregnant women. The placental and cord blood concentrations of copper and ceruloplasmin showed non-significant changes, which indicates that their increase in the maternal blood is not of placental origin.


Histamine metabolism and female sex hormones in women. Oral combined contraceptives did not seem to alter histamine metabolism in females. During treatment with gonadotrophic hormones in four amenorrhoeic patients there was a tendency towards increasing excretion of methylhistamine (MeHi) followed by a sudden decrease corresponding to changes in the urinary estrogen. The excretion of methylimidazoleacetic acid (MeImAA) seemed to parallel that of MeHi. The findings support the hypothesis that an endogenous surge of estrogen may influence histamine turnover in women. Women of post-menopausal age have about the same histamine metabolism as younger menstruating women. Estrogen medication relieved symptoms of hot flushes or sweats but did not seem to affect the histamine turnover.


The value of amniotic fluid lecithin/sphingomyelin determination in prediction of hyaline membrane disease. 246 samples of amniotic fluid were obtained from 245 women with normal or complicated pregnancy near or at parturition. The lecithin/sphingomyelin (L/S) ratio was determined and retrospectively correlated with the clinical course of the neonate. Ten neonates developed hyaline membrane disease (HMD). The highest L/S-ratio in this group was 1.82. Cesarean section was not associated with HMD if L/S-ratio indicated pulmonary maturity (L/S greater than 2). With the exception of children born by women with toxemia or chronic hypertensive disease, where no case of HMD appeared among nine infants children with birth weights less than 2000 g developed HMD in about 50% (6/11 cases). The results show that the L/S-ratio correlates well to the pulmonary maturity of the neonate. Determination of L/S-ratio is therefore of great importance in cases of high risk pregnancy or doubtful gestational age prior to induction or Cesarean section.


A comparative study of patients with cancer of the ovary, who have survived more or less than 10 years. With the purpose of elucidating the characteristics in patients with cancer of the ovary who have survived 10 years compared with patients who have not survived 10 years, 161 patients with epithelial cancer and 15 patients with granulosa cell tumor who have survived 10 years, group A, have been compared with 157 patients with epithelial cancer and 14 patients with granulosa cell tumor, who have not survived 10 years, group B. The study showed that among epithelial tumors the stage of tumor and the histological picture in the form of "low potential malignance" or adenocarcinoma was of decisive importance for 10 years survival. No correlation between information such as age, marital status, profession, duration of symptoms, and the nature of symptoms and 10 years survival could be found in patients with tumor in stages I and II. Neither could the gynaecological examination, the nature of the surgical treatment nor radiation therapy be correlated with 10 years survival in stages I and II. 32 of the 152 patients with epithelial cancer in stages I and II, who have survived 10 years, have either died from their ovarian disease or have later on developed cancer localized to cervix ro corpus uteri. The author points out the risk of not removing both ovaries as well as the uterus and recommends that such patients are followed for many years after the treatment. In 29 patients with granulosa cell tumor neither the medical history, the stage of the tumor nor the treatment could be correlated with 10 years survival.


Changes in cardiac function during and after pregnancy expressed by systolic time intervals. Hemodynamic changes during the first and third trimester in pregnancy and in the first week of puerperium were evaluated by non-invasive measurements of Systolic Time Intervals (STI) in supine and left lateral position. The Pre-ejection Period (PEP) was found to shorten significantly in pregnancy  and the puerperium due to the increased blood volume. The electro-mechanical systole (QS2) and left ventricular ejection time (LVET) were shortened too, while PEP/LVET-ratio was increased in the third trimester due to the mechanical compression of the gravid uterus on the inferior vena cava. A lengthening of QS2 and LVET and a decreased PEP and P/L-ratio were demonstrated in the third trimester in lateral position when the pressure of the enlarged uterus was eliminated. Heart rate (HR) increased in late pregnancy as well as after delivery, while arterial blood pressure (BP) only underwent minor changes. Employment of the STI seems to provide more useful information about the changes cardiac function during gestation than HR and BP does. The measurements of STI can be repeated without any risk or inconvenience to the patients.


A comparative study of uterine activity in labour induced with prostaglandin F2alpha or oxytocin and in spontaneous labour. I. Pattern of the uterine contractions. The uterine contraction patterns and the changes in fetal heart rate (FHR) were studied in cardiotocographic recordings from 26 women in oxytocin-induced labour, 26 women in PGF2alpha-induced labour and 24 women during the later part of spontaneous labour. The contraction patterns and their effect on the FHR did not differ between the three groups. During the course of labour an increasing steepness of the upward slope of the contraction wave with increasing intensity of the contraction was found. High frequency of atypical contraction patterns, suggesting some degree of uterine incoordination was found during the active phase of labour in 10 patients, 8 of whom were primiparae. This incoordination could not be related to the effect of induction with either drug. Incoordinated contractions were associated with longer duration of labour and a tendency to more pronounced acidosis in the infant at birth, although mean values still fell in the normal range. Ominous FHR patterns were only seen in 2 cases of uterine hyperactivity during induction of labour.


Radioisotope radical operation for cancer of the cervix. By performing the radioisotope radical operation (pre-surgical labelling of the lymphatic tissue of the pelvis with colloidal 198Au) with the aid of a gamma camera, it was possible in 78 out of 93 cases to completely extirpate the regional lymphatic tissue of the pelvis. In eight out of 24 cases with positive findings on the lymph nodes we were also able to extirpate with this technique residues of carcinomatous lymphatic tissue during the course of a secondary isotope lymphadenectomy. This fact is likely to further improve the recovery rate--all the more so since even the scanner and eye probe technique already reduced the mortality rate due to recurrence by 16.4% after 5 years.


Experimental studies on connective tissue of the capsular ligament. Influences of aging and sex hormones. Influences of aging and sex hormones on connective tissue metabolism in the hip joint capsule of Wistar rats were analyzed both biochemically and morphologically. As age advanced, collagen content and collagen fibril diameter of the hip joint capsule tended to increase gradually in both sexes until sexual maturation was reached. Collagen content was significantly greater in males than in females after sexual maturation. The collagen content and fibril diameter were considerably increased by ovariectomy and significantly decreased by the administration of estrogen, or estrogen combined with progesterone, whereas they were significantly increased by the administration of testosterone in orchiectomized male rats.


Intra-articular injection of high-molecular hyaluronic acid. An experimental study on normal adult rabbit knee joints. High-molecular hyaluronic acid was injected repeatedly into normal knee joints of adult rabbits. Histologically the articular cartilage was not affected by this treatment. The content of chondroitin sulphate, assessed by a histochemical method, was not altered and neither was the water content of the hyaline articular cartilage. On the other hand, in the synovial membrane of joints treated with hyaluronic acid a diffuse infiltration of plasma cells and lymphocytes was observed, indicating that the hyaluronic acid administered exerts its action via the synovial membrane.


Diffusion of tranexamic acid to the joint. Tranexamic acid (Cyklokapron, Kabi, Stockholm) in a dose of 10 mg per kg body weight was given i.v. to 17 patients at various intervals before operation on the knee joint, in order to elucidate the diffusion of the drug to the joint fluid and the synovial membrane. The acid diffused rapidly to both the above tissues, and in the joint fluid it reached the same concentration as in the serum. The biologic half-time in the joint fluid was about 3 hours. In the treatment of joint bleedings in hemophiliacs and in association with intra-articular operations on such patients tranexamic acid is a suitable supplement to conventional substitution therapy.


Mechanical properties and density of bone in a case of severe endemic fluorosis. Mechanical properties of 25 standardized specimens of compact bone from a 45-year-old man with extreme endemic fluorosis were compared with similar specimens of nonfluorotic bone. Data from dry and wet tested specimens were compared. Tensile strength, strain, energy absorbed to failure, and modulus of elasticity were reduced in fluorotic specimens while compressive strength, strain and energy were increased in both wet and dry specimens. Compressive properties exceeded tensile properties. Drying increased tensile and compressive strength and modulus but decreased tensile and compressive strength and energy absorbed. Dry specimens tended to follow Hooke's Law but wet specimens exhibited visco-elastic behavior. Wet fluorotic specimens had lower tensile properties but higher compressive properties and were more dense than fresh human compact bone.


Relations between age, mineral density and mechanical properties of human femoral compacta. Relations between mineralisation and mechanical properties have been investigated in human femoral compacta. Evidence of age-related changes in physical properties of bone, independent of mineral density, is provided by significant (P less than 0.05) partial correlation between ultimate tensile stress and age. However, 75 per cent of variance in ultimate tensile stress, and 85 per cent of variance in ultimate compressive stress could be accounted for by variation in mineral density.


Bone mineral content and mechanical strength of the femoral neck. The bone mineral content of the femoral neck of 61 autopsy specimens was assayed by x-ray spectrophotometry. The mechanical strength of the specimens was also determined experimentally by applying a compressive force perpendicularly to the shaft. The ultimate force at fracture was obtained from force/displacement plots. A coefficient of correlation of 0.89 between bone mineral content of the femoral neck and the ultimate force at fracture was found. Even when limited to a group of women aged 67-80 a fairly close correlation was found. This indicates that the bone mineral level, measured in vivo, can be used as a criterion of the risk of fracture in elderly women.


Skeletal malformations induced by mitomycin C in chick embryos. One hundred and eighty chick embryos were studied for the presence of skeletal malformations after administration of mitomycin C at 72, 96 and 120 hours of incubation. Axial skeleton defects included those of ribs, vertebrae, beak and crania. Appendicular skeletal defects were mainly confined to the lower limbs e.g. absence of phalanges, bent and shortened femur, fibula, tibia and metatarsus, in that order. Absence of phalanges and curved scapulae were noted in the upper limbs. The length of femur, tibia and metatarsus was significantly reduced (P less than 0.001) compared with the corresponding controls especially in the group treated at 96 h.


Effect of tantalum markers of longitudinal bone growth. Small tantalum pins (0.50 x 1.5 mm and 0.32 x 1.2 mm), used as intraosseous radio-opaque markers, were investigated for their effect on growth in 62 young rabbits. The tetracycline growth method was used and a difference in daily growth rate between the marked right leg and the unmarked left leg indicated a slight growth stimulation. The growth rate was slightly stimulated (at most, 26 mum/day) on days 1 and 2 after insertion, only if the larger markers were used. No growth effects were detectable on days 12 and 21.


Pain in osteoid osteoma: histological facts. Six cases of osteoid osteoma were studied histologically using the Gross technique. When the nidus is located centrally, it is reached by amyelinic fibers accompanying the vessel branches or as independent fibers. The pain is generally considered to reflect changes in vessel pressure and it could also be due to direct irritation of the nerve fibers included in or near the calcification focus.


Popliteal pterygium syndrome in a 74-year-old woman. The case of a 74-year-old woman with the rare popliteal pterygium syndrome is presented. This syndrome is inherited as an autosomal dominant trait with incomplete penetrance and varying expression and consists of cleft lip and palate, lip pits, genital anomalies, popliteal pterygium, and malformations of the extremities. The various treatments our patient underwent over the years are reported. Treatment of popliteal pterygium involves special problems whem removing the skin fold because the nerve and vascular cords lie immediately anterior to the posterior fibrous cord. In the present case there are widespread arthrotic changes, both in the extremity joints and in the spine. These patients are short in stature. This, together with the general arthropathy, suggests a hereditary metabolic disturbance in the cartilaginous tissue.


Effect of the Milwaukee brace on vital and ventilatory capacity of scoliotic patients. The vital capacity (VC) and the maximal voluntary ventilation (MVV) were studied in 29 patients with scoliosis (predominantly idiopathic). The results obtained confirmed earlier observations that scoliotic patients have decreased VC and MVV. The immediate effect of the application of the Milwaukee brace was a slight though statistically significant decrease in MV, whereas there was no significant effect on VC. Treatment with the Milwaukee brace for a mean period of 15 months did not appreciably influence the VC or MVV, as a percentage of the predicted normal values of the patients, when measured without the brace applied.


Traumatic hip dislocation in childhood. A report of three cases. Three cases of traumatic dislocation of the hip joint in children are presented. All were subjected to immediate closed reduction under general anesthesia, followed by immobilization by means of skin traction for 2 weeks. Weight-bearing was resumed 2-3 weeks after the injury, and at follow-up examinations 23 to 27 months later the hip joints were found to be normal both clinically and radiographically.


Thrombosis following hip arthroplasty. A study using phlebography and 125I-fibrinogen test. Venous thrombosis after hip arthroplasty was studied using the 125I-fibrinogen test and phlebography. Eight out of ten dextran-treated and six out of ten control patients developed thrombosis. The thrombi were small and most frequently dorsal and dorso-lateral veins were involved. There were no thigh thrombi without concurrent calf thrombi. Half of the thrombi were found within the first postoperative week whereas the remainder occurred later. Preoperative venous pathology predisposed to postoperative thrombosis.


Experimental osteoarthritis in the rabbit knee joint. The development of arthrotic-like changes following the resection of the cruciate ligaments in the knee joint of rabbits has been studied at intervals from 2 weeks to 10 months in 35 animals. Signs of cartilage degeneration were followed by changes in the subchondral bone, where formation of osteophytes and condensation took place. An increased vascular supply was demonstrated by microangiographic and scintigraphic investigations. The uptake of 18F and 99mTc-polyphosphate reached a maximal value about 2 months after the operation and then diminished despite further development of arthrotic changes.


Haematogenous osteomyelitis of the patella. Report of three cases. Three cases of osteomyelitis of the patella are reported. One presented as an acute septic arthritis and another developed a sterile arthritis despite antibiotics. The clinical signs, diagnosis and treatment are discussed. Treatment with rest and antibiotics failed to cure the disease. In all three cases a sequestrectomy was carried out resulting in healing of the affected patella and recovery of knee mobility.


Intraosseous lipoma of the calcaneus. Report of a case and a short review of the literature. One case of an intraosseous lipoma of the calcaneus bone is presented together with a short review of the literature. Only 20 cases of tumors in the extremities have so far been published. The typical X-ray picture shows a cystic, sharply demarcated cavity, which macroscopically at operation is filled with yellowish, adipose tissue. In the present case and one previously published a central sclerotic mass was observed. The histological picture is typical, with mature adipose tissue mixed with a few degenerated bone trabeculae.


Afferent and efferent nerve terminal degeneration in the guinea-pig cochlea following atoxyl administration. Atoxyl causes destruction of both afferent and efferent nerve endings. Degeneration of afferent nerve terminals occurred even though the adjacent hair cell had a normal ultrastructure. The degeneration of the efferent nerve endings took place at the same time as the adjacent cell disintegration. Earlier studies on the effects of atoxyl have shown that it also induces damage to the stria vascularis and Reissner's membrane, thus interfering with endolymph metabolism (Anniko & Wersäll, 1975; Anniko, 1975a, b). The afferent nerve terminals may be more sensitive to changes in the environment (endolymph) than are the surrounding structures, including efferent nerve endings, hair cells and supporting structures, and would therefore be the first structures to disintegrate.


Surface structure of stria vascularis in the guinea pig cochlea. Normal morphology and atoxyl-induced pathologic changes. The normal cell surface of the hexagonal epithelial (marginal) cells covering the stria vascularis is characterized by numerous microvilli and a few depressions. The cells at the spiral prominence are similar to the epithelial cells of the stria vascularis but are more spindle shaped and without depressions on the surface. Atoxyl treatment results in damage to the epithelial cells of the stria vascularis by loss of microvilli and depressions. Later during the degeneration, protrusions from the cell surface occur and the cell borders become fragmented. The cells of the spiral prominence are far less damaged. In advanced stages of strial damage great herniations including several adjacent cells may balloon out into the endolymphatic space.


Intermediate endocochlear potential levels induced by hypoxia. It seems that the positive potential of the scala media (endocochlear potential [EP]) and the high potassium concentration in the endolymph are generated and maintained by an electrogenic pump. In order to study its properties, the EP was measured in cats ventilated with low oxygen gas mixtures (2.25-10%). It was found that the EP could be maintained at intermediate levels which were more or less linear functions of blood oxygen tension (25-60 mmHg), showing that the pump can operate on intermediate levels. This hypoxic preparation may contribute to the study of cochlear blood flow.


The in vitro development of innervated sensory hair cells of a mammal. Twelfth gestation day mouse embryo otocysts with their associated statoacoustic ganglions and otic mesenchyme were explanted to "in vitro". The otocyst explants developed for seven days in organ culture. They were then fixed and studied on a light microscopic and ultrastructural level for the development of synapses. Evidence is presented that strongly suggests that afferent synapses are developing "in vitro" in the vestibular sensory epithelium studied.


Immediate relief of symptoms during acute attacks of Meniere's disease, using a pressure chamber. Five patients with Meniere's disease were exposed to underpressure in a pressure chamber while suffering from acute attacks with vertigo, nausea, tinnitus and fullness of the ear. Spontaneous nystagmus was the objective criterion for the selection of suitable cases. Subjective as well as objective symptoms subsided much faster than they do with other kinds of treatment. Four patients were free from symptoms within 40 minutes, while the fifth case still complained of vertigo, tinnitus and fullness of the ear after the treatment. However, the symptoms were less severe. A mechanism is discussed by means of which an ambient pressure decrease might cause a reduction of the endolymphatic volume, thus relieving acute symptoms of Meniere's disease.


Vestibulo-thalamic projections studied with antidromic technique in the cat. The vestibulo-thalamic projection was investigated in anaesthetized cats. Electrical stimulation of posterolateral thalamic areas frequently changed the spontaneous firing pattern of neurons in the vestibular nuclei but only 5% were antidromically invaded. This group was further analysed with regard to types of labyrinthine and somatosensory input; thalamo-projecting neurons in the vestibular nuclei are frequently located in the lateral vestibular nucleus, they receive no monosynaptic inflow from the labyrinth and they often receive convergent vestibular and somatosensory input.


Plethysmography as an objective method of audiometry. In 37 subjects with normal hearing acuity and normal cardiovascular system, vasomotor reactions to sounds of 1024, 2048, and 4096 Hz frequency and 0, 10, 20, 60 and 80 dB intensity above the hearing threshold determined were studied subjectively. Pure sounds evoked in all persons plethysmographic reactions not subject to extinction under the conditions of audiometric investigation.


Drill-generated noise levels in ear surgery. The noise levels in the cochlea when a drill is used in the mastoid process have been calculated from vibration measurements on intact skulls of human cadavers and temporal bones. The results lend support to the conclusion that, in ear surgery the ipsilateral cochlea is exposed to noise levels of about 100 dB and the contralateral cochlea to levels 5-10 dB lower every time the drill is used.  This noise trauma may account for some of the high-tone sensorineural hearing losses after tympanoplasty described by other authors.


Tensor tympani, a 'tuner' of tensor palati muscle. The author has proved experimentally (in two dogs) that there is reflex hypertonia of the tensor palati muscle, synchronous with the 'shortening' reaction of the tensor tympani muscle in response to its "static" relaxation during the gradual passive inward displacement of the drum resulting from the negative intratympanic 'dip' due to absorption of air imprisoned within the middle ear. The author coined the term 'tuning' for the reflex hypertonia of tensor palati which is directly proportional to the degree of the slackness of its 'tuner', the muscle-tensor tympani. The degree of opening of the eustachian tube on swallowing depends upon the degree of 'tuning' of the tensor palati. The 'untuned' tensor palati fails to open the eustachian tube during swallowing. Presumably the excitation of tympanic chemoreceptors (glomus body) by the excess of CO2 during hypoxia of the tympanic cleft strengthens the 'shortening' reaction as well as the excitability of the tensor tympani muscle.


Development of the labyrinthine receptors in the guinea pig, cat and dog. Light and electron microscope observations were made on the vestibular receptors in fetal guinea pigs and cats, and in kittens and puppies. In the guinea pig hair cells were recognizable by 30 DBB (days before birth), myelinated preganglionary nerve fibers by 25 DBB, and neuro-epithelial synapses by 15 DBB. These observations can be correlated with the early development of the righting reflex in fetal guinea pig. Similar ultrastructural observations were made on cats and dogs at different times in development. A direct comparison between development in the vestibular system and the auditory system is possible since development of the organ of Corti in the same animals has previously been documented.


The prognosis in acromegaly treated by transanthro-sphenoidal operation. The paper is a report of a follow-up study of 80 acromegalic patients treated by transanthro-sphenoidal removal of a pituitary adenoma. The average follow-up time was 3.7 years. Complete restitution or improvement of the visual field defects was noted in 77%. Total regression of the soft tissue swelling was observed in around 1/3 of the patients. Complete regression or improvement of the acromegalic activity was achieved in 94%. Total regression of the dominant symptoms was noted in 74%. The rate of tumour recurrence was around 5% and the total mortality rate in the disease during the follow-up period 7.5%. The transanthro-sphenoidal surgery of the pituitary adenoma in this series resulted in a high rate of regression of the acromegalic symptoms at the same time as normal anterior pituitary function often was restored.


Five-year results of 1000 patients operated on for cancer of the larynx. The five-year results of 1000 consecutive cases of cancer of the larynx operated on at the Clinic of Otolaryngology of the University of Florence are presented. The treatment was cordectomy for T1a glottic cancers and total laryngectomy for the other cases. The five year cure rate is 66.5% of the 606 supraglottic cancers, 76.9% of the 294 glottic cancers and 54% of the 100 subglottic cancers. These crude survival rates consider the 7.6% of patients who died from non-tumoral causes and the 1.1% of untraced patients.


A scanning microscope study of vocal cord carcinoma. A scanning electron microscope study of cell surface topography in squamous cell carcinoma of the vocal cord has demonstrated characteristic changes. The malignant cells showed an irregular surface pattern with an abundance of microvilli-like structures of different sizes and shapes. In addition, the contact between the malignant cells was reduced. Normal vocal cord cells were closely associated and had a smooth surface with microridges.


Pedunculated intraluminal fibro-lipoma of the oesophagus. Case report. Only few cases of pedunculated, benign, intraluminal lipomas and fibrolipomas of the oesophagus have been reported. A further case is now added. The diagnosis is often delayed since it is difficult both for the radiologist and the endoscopist to detect the tumour. Symptoms and signs are few and uncharacteristic. The diagnosis could be made earlier and without sophisticated methods if the possibility of a tumour is kept in mind, especially in patients with a dilated oesophagus and a normal opening of the cardia. The value of fiberoptic endoscopy as a valuable tool for early diagnosis is stressed. The therapy is in most cases extirpation through cervical oesophagotomy.


Effective pulmonary capillary blood flow in infants with birth asphyxia. Effective pulmonary capillary blood flow was measured on the first day of life in twenty term infants with birth asphyxia and twenty-five normal term infants. The infants studied showed no clinical or laboratory evidence of respiratory distress. The mean effective pulmonary capillary blood flow of 121 ml/kg/min in the birth asphyxia group was significantly lower than the mean of 162 ml/kg/min in the normal group. The possible relationship of birth asphyxia and pulmonary hypoperfusion in the aetiology of the idiopathic respiratory distress syndrome is discussed.


Immunologic studies in phenylketonuria.

Immunologic studies in phenylketonuria. Significantly reduced immunoglobulins were found in 22 patients with phenylketonuria. Tests of cellular immune function which included delayed skin hypersensitivity, T rosettes and PHA transformation were normal. Escherichia coli antibodies and the booster response to tetanus toxoid were also normal.


Chronic pulmonary disease in a child with the Ehlers-Danlos syndrome. The presence of chronic pulmonary disease is an uncommon finding in the Ehlers-Danlos syndrome. The patient discussed herein presented with severe irreversible obstructive pulmonary disease characterized by marked hyperinflation, an increase in static lung compliance, and tracheal dilatation. A largely normal lung biopsy ruled out chronic pulmonary emphysema. Despite the similarity of this patient to those with the Mounier-Kuhn syndrome, the degree of tracheobronchial enlargement was not as great as is usually seen in this disorder although these anatomic changes may develop with time. The findings in this case demonstrate that any site within the tracheobronchial tree may be involved in the Ehlers-Danlos syndrome and further emphasize the need to determine the degree of reversibility of obstructive lung disease in children.


Intrarenal reflux.

Intrarenal reflux. Seventy-six children with a total of 123 ureters showing vesico-ureteric reflux were reviewed in order to detect intrarenal reflux (pyelotubular backflow) occuring during micturating cystourethrography. This was found in 7 patients (9.2%). Five patients had unilateral and two bilateral intrarenal reflux. In only 7 out of the 9 kidneys with intrarenal reflux was it possible to outline the kidney contour precisely on excretion urography. In 3 cases renal damage corresponded exactly to the areas with intrarenal reflux. One kidney showed damage which did not correspond to the location of intrarenal reflux and 3 were without signs of damage. Renal damage of varying localization was found in 54 of the 123 kidneys with vesico-ureteric reflux and intrarenal reflux was present in 6 of these (11%). The significance of intrarenal reflux as a cause of renal damage and whether intrarenal reflux might be primary or secondary to the renal damage are discussed, and it is concluded that presence of intrarenal reflux is a definite indication for operation.


An unusual case of Crohn's disease in a West Indian child. Although perianal ulceration is common in Crohn's disease, extensive perineal ulceration particularly in children is rare. The case history is presented of a child who developed progressive hypertrophy of the vulva and ulceration of the groins at the age of 11 years but diagnosis of Crohn' s disease was delayed for 21 months. Treatment with steroids and azathioprine has induced a successful remission but difficulty has been experienced in reducing the steroid dosage.


Menetrier's syndrome in children.

Menetrier's syndrome in children. Since Menetrier's original description in 1888 many cases of hypertrophic gastritis have been recorded in adults. Only recently has a similar syndrome been described in childhood. The case reported demonstrates the characteristic features of the condition (the duration was rather longer than in other reported cases) and diagnosis, clinical course and aetiology are discussed. In contrast to the adult disease this illness is usually short-lived with full clinical and histological remission occurring within a few months.


Hypertension in a patient with acrodermatitis enteropathica. One patient with acrodermatitis enteropathica complicated by hypertension is presented. The pathogenesis of the markedly elevated blood pressure is unknown. The acrodermatitis healed completely on zinc therapy and parallel to this improvement the hypertension could easily be controlled with a gradually decreased antihypertensive drug dosage.


A highly differentiated exocrine pancreatic tumour in a young boy. A primary pancreatic tumour in a 6-year-old boy was removed by radical excision. From both light and electron microscopic observations the tumour was considered to be of exocrine origin, with some differentiation towards acinar cells. Although the tumour was highly differentiated, it was regarded as probably malignant because of tumour growth into the surrounding fibrous capsule. The case is discussed in relation to earlier rare reports of pancreatic tumours in infants and children.


Refractory coagulopathy in an infant with loss of clotting proteins into ascitic fluid. Report of a newborn with massive ascites who developed a severe coagulopathy due to multiple intrinsic and extrinsic clotting factor deficiencies. All deficient coagulation factors were present in measurable quantities in the infant's ascitic fluid. It is postulated that she sustained loss of coagulant proteins by transudation into her peritoneal cavity. A similarly acquired coagulopathy should be suspected in all patients with a known increase in extravascular fluid compartments.


Fine structures of the spleen in hereditary elliptocytosis. Light and electron microscopic studies of the spleen and liver from a patient with hereditary elliptocytosis have been reported. Characteristic findings are congestion of the cordal space, diminished variation of the erythrocyte shape in the cord, relatively empty sinuses and erythrophagocytosis by the cordal macrophages. The same basic defect of the red cell membrane as has been documented in hereditary sperocytosis might be a possible explanation on the pathogenesis of this rare hemolytic anemia.


Intimal thickening of intra-organ arteries and smoking habits. Intimal thickening of the intra-organ arteries of the major organs have been examined in 253 autopsy cases and, the microscopical findings have been analyzed according to smoking habits. It was found that especially that small arteries of the lung present a significantly higher degree of fibrous intimal thickening in cigarette smokers.


Castleman's lymphoma among Japanese population. Since our report on Castlemans lymphoma in 1958, a total of 53 cases by 36 authors have appeared in the Japanese literatures. Among them our first case, whose tumor was found in the pelvic cavity, would be the first patient ever reported in Japan. The outstanding histological features of Castleman's lymphoma consists of variegated morphology of germinal centers due to peculiar capillary proliferation, multicentric germinal centers in a lymph follicle showing a chimerical figure and expansive growth of lymph follicles by compressing interfollicular area. Among these Japanese population, we have noticed the highest age incidence between 10-19 years, with somewhat female predominance, the most preferential site in the upper part of the body, and, as compared to the other ethnical subjects, more frequent tumor multiplicity and less usual plasma cell type of the tumor. A possible pathogenesis that Castleman's lymphoma could be "a benign lymphoma" in contrast to malignant lymphomas is emphasized from various aspects.


Secondary lipidosis in leukemia.

Secondary lipidosis in leukemia. Foam cells in the spleen, bone marrow, liver and lymph nodes were examined on the 73 reliably recorded and sampled leukemia autopsy cases encountered at Kobe University from 1958 to 1972. Although the substances stored in the foam cells were biochemically unknown, the foam cells in leukemia could be morphologically classified into two types: The one was identified with the Gaucher type, but the other was not identified with the sea-blue type and might be considered as to be the transitional type described in another report. Foam cells could be found in the spleen of 6 out of 12 cases of chronic myeloid leukemia, one out of 2 cases of chronic lymphatic leukemia, one out of 7 cases of leukemic lymphosarcoma, one out of 9 cases of acute lymphatic leukemia, and none in 3 cases of monocytic leukemia. In acute myeloid leukemia, the incidence of foam cells in the spleen was 47.5% in 40 cases, and acquired lipidoses were more frequently seen in cases under 19 years of age, in male cases, in cases with an enlarged spleen over 400 g, and in cases of over 4 months' duration.


Histochemical and ultrastructural studies of the adrenal cortex in spontaneously hypertensive rats with high salt solution. The response of the adrenal cortex in weanling Spontaneously Hypertensive Rats (SHR, Okamoto and Aoki) and Wistar-Kyoto Rats (WKR) when given 1% NaCl in drinking water was studied histochemically and electron microscopically. The development of hypertension was accelerated in SHR given 1% NaCl in drinking water. The thickness of the zona glomerulosa in WKR receiving 1% NaCl in drinking water remarkably diminished following the course of experiment and lipid droplets in the zona glomerulosa decreased gradually. The zona glomerulosa cells revealed shrinkage of the cells and a decreased number of mitochondrial cristae were observed at three weeks of experiment. The remaining tubular cristae of mitochondria possessed a milled outline. Golgi apparatus became small and fragmental. Membrane-bounded dense bodies were prominent in the peripheral portion of the cell and around Golgi apparatus. In SHR given 1% NaCl in drinking water, the width of the zona glomerulosa less diminished. A marked decrease in number and size of lipid droplets was seen. However, there was no distinct alteration of cytoplasmic organelles. These morphological changes were discussed from the standpoint of functional state in the zona glomerulosa with relation to the development of hypertension in SHR.


Atrial myxoma associated with multiple hamartomas. A case of cardiac myxoma associated with renal angiofibrolipomas, renal medullary fibromas, thyroid adenoma and jejunal polyp was presented. So far as we know, the combined form of cardiac myxoma and renal hamartoma has not been hitherto reported. The combination of these various complications may suggest the relationships of tuberous sclerosis, Cowden disease, lymphangiomatosis among others. Besides it is noteworthy that the three of them, i.e. cardiac myxoma, renal angiofibrolipomas and thyroid adenoma, presented considerable atypism at the same time. As to the histogenesis of cardiac myxoma, this case may be in accord with the hamartoma theory.


Non-African Burkitt's lymphoma in a young woman. Non-African Burkitt's lymphoma is presented in a 29-year-old, unmarried woman, who developed tumors in both breats and ovaries, ascites and pleural effusion. Assessment of B cells in the tumor cells, derived from ascites, pleural effusion and tumor tissue is 90%, surface IgM being consisted of 86%, in an average. Histologically, the tumor tissue demonstrates prominent, socalled starry-sky effect, and cytologically, tumor cells are poorly-differentiated lymphocytoid cells in their feautures.


Idiopathic retroperitoneal fibrosis.

Idiopathic retroperitoneal fibrosis. This report presents the first autopsy case in Japan of idiopathic retroperitoneal fibrosis which had developed in a 71-year-old man. The clinical course was of extremely long duration of more than 10 years. Malignancy was suspected on biopsy, and at one stage chylous ascites developed. The cause of this retroperitoneal fibrosis could not be determined, but it is considered that the vicious circle of inflammatory processes such as cellulitis and lymphangitis in the retroperitoneum and lymphedema as well as lymphorrhage attributable to mechanical lymphatic obstruction brought about the retroperitoneal fibrosis.


Penetration of fluorescent homologous serum proteins into the wall of the aorta in rats with acute angiotensin hypertension. A few hours of acute angiotensin hypertension in rats increased the permeability of the thoracic part of the aorta for plasma components. The permeability, which was demonstrated by means of homologous circulating fluorescent serum proteins, seemed to be diffuse rather than focal. The fluorescent proteins penetrated into the whole thickness of the aortic wall, but were to a great extent deposited in the subendothelial space and the most luminal part of the tunica media. The deposition took place in the greater part of the circumference of the aortic wall. These results are in agreement with the insudative theory of atherogenesis, and the initial stage seems to be a "damming back" of some of the serum or plasma proteins for deposition in the subendothelial space and the most luminal part of the tunica media.


The diagnosis of cancer from body fluids. A comparison of cytology, DNA measurement, tissue culture, scanning and transmission microscopy. A consecutive series of 70 exudates from 45 patients with clinically suspected malignancy was examined by cytology, cytophotometric measurement of DNA, short-term cell culture, scanning and transmission electron microscopy. In seven patients (21 fluids), the presence of malignant disease was verified. Malignant and benign cases were correctly diagnosed by combination of cytology and DNA analyses. An abnormal DNA profile defined by greater than 10 per cent cells with greater than 2c DNA or single cells with greater than 8c DNA was only seen in malignant exudates. Short-term cell culture with scanning electron microscopy could distinguish between lymphoid cells, histiocytes, fibroblasts, mesothelial cells and cancer cells. Only cancer cells had prominent microvilli on their surface. A future larger series will explore whether a combination of cytology and cytophotometric DNA estimation alone will improve the diagnostic accuracy to the same substantial degree as this pilot study would suggest.


Spindle cell lipoma.

Spindle cell lipoma. A clinical, light- and electronmicroscopic study of 14 patients with spindle cell lipoma is presented. Spindle cell lipoma is considered to be a distinctive lipomatous tumour histologically characterized by a mixture of fat cells and fibroblast-like spindle cells, ultrastructurally similar to fibroblasts, in a matrix with varying amounts of collagen and mucosubstances. The tumours showed a predominance for elderly men and all but one were situated in the posterior neck, shoulder region or upper back. The tumours varied between 1 and 9 cm, with a median value of 5 cm, in the widest diameter and were entirely or almost entirely situated in the subcutaneous tissue. A follow-up study of 11 patients, observed for 1-25 years, confirmed that the clinical course is benign. The differential diagnosis is discussed and it is emphasized that spindle cell lipoma is easily misinterpreted as sarcoma. Three tumours showed a pronounced nuclear polymorphism without mitotic activity, thought to be regressive in nature. The cellular change in these three tumours are presumed to be analogous with those in so called ancient neurilemmoma and therefore the name ancient spindle cell lipoma is proposed for the polymorphic spindle cell lipomas.


Glycosaminoglycans of cartilage and bone tissue in two cases of osteogenesis imperfecta congenita. Epiphyseal cartilage and bone tissue from two cases of osteogenesis imperfecta congenita and one control case with similar skeletal age were examined regarding their glycosaminoglycan content. The diseased bone tissue showed a 3-fold increase in glycosaminoglycans, and 20-25 per cent of the chondroitin sulphate disaccharides seemed to be disulphated. The diseased cartilages showed only traces of material with characteristics of disulphates disaccharides. No disulphates disaccharides were isolated from the control materials. No difference between diseased and control material was indicated regarding molecular size, chondroitin-4-sulphate/chondroitin-6-sulphate ratio or contents of keratan sulphate and hyaluronic acid. The disease is thus associated with fundamental changes of the glycosaminoglycan structure, and these changes may be of functional importance to the mineralization process as well as to the organisation of collagen.


The localization of precancerous changes and carcinoma after previous gastric operation for benign condition. Sixty-five patients operated on for a benign gastric condition showed at re-operation in 9 cases precancerous changes, in 22 cases carcinoma in situ, and in 34 cases infiltrating carcinoma. The median time to elapse between the two operations was 20 years. The pathological diagnosis established at the first operation was most often benign duodenal ulcer. Investigation revealed in 9 cases precancerous changes and in 47 cases various grades of adenocarcinoma within the anastomosis. In 37 cases of Billroth II operations, 5 precancerous changes, 15 carcinomas in situ and 17 infiltrative cancers were located on the posterior gastric wall near the efferent small intestinal loop. In these cases there were additional changes, one precancerous, 7 carcinomas in situ and two infiltrating cancers, situated against the cephalic part of the afferent small intestinal loop. Nineteen Billroth II patients had precancers or cancers at other sites within the anastomosis or gastric remnant. The remaining 9 cases of Billroth I, gastro-enterostomy and gastric Roux-en-Y procedures are too few to allow conclusions concerning the localization of precancer or cancer in the anastomosis.


Growth of rabbit aortic smooth muscle cells in serum from patients with juvenile diabetes. The effect of human diabetic serum on the growth of rabbit arterial smooth muscle cell cultures was studied in the stationary phase of growth. The serum was obtained from young, male, non-obese, juvenile diabetics and non-diabetics. The experiments were carried out using dialysed as well as non-dialysed serum. The concentration of cholesterol and triglycerides were equal in normal and diabetic serum. Media supplemented with diabetic serum from both short term and long term diabetics stimulated the outgrowth of the smooth muscle cells significantly (2p less than 0.01). A statistically significantly stimulation of growth was also observed using dialysed human diabetic serum (2p less than 0.05). Autoradiographic studies showed that the number of 3H-thymidine labelled cells and of cells in mitosis increased appreciably after incubation in diabetic human serum (2p less than 0.005). The present data show that human serum from juvenile diabetics contains a factor or factors which promote an excessive growth of arterial medial cells. The factor(s) is not lipids as hyperlipemia was not present nor is it glucose, aminoacids, fructose or ketones, as the growth effect remained after dialysis.


Evidence for an initial, thymus independent and a chronic, thymus dependent phase of DOCA and salt hypertension in mice. Treatment with desoxycorticosterone acetate (DOCA) and 1 per cent saline as drinking water for 21 days caused a significant and similar increase in blood pressure in haired mice, with a normal thymus function, as in nude mice with genetical aplasia of the thymus. After 57 and 78 days there was, however, a significantly more pronounced increase in blood pressure in haired than in nude mice. A marked degree of round cell infiltration around intrarenal vessels and degenerative changes including wedge-shaped infarcts were observed in the kidneys of the haired mice, commencing after 57 days of treatment, while no such changes were found in nude mice. Thymus grafting in nude mice, successively treated with DOCA and salt, conferred the ability to react with chronic hypertension and intrarenal vascular disease, equal to the reaction seen in haired mice. The present investigation has provided evidence for the existence of an initial thymus independent and a chronic thymus dependent phase of DOCA and salt hypertension in mice. It still remains an unsolved problem whether the secondary blood pressure fall observed in nude athymic mice is a direct consequence of the lack of perivascular cellular immune reactions, or caused by other defects in this strain of mice.


G-band analyses of a human intestinal leiomyosarcoma. The chromosomes of a human intestinal leiomyosarcoma were studied by a direct method. The tumour had a hypodiploid stemline (S = 42) with both numerical and structural changes. These could be clarified using a G-banding method. The evolutionary pattern in the sarcoma was reminiscent of that found earlier in human meningiomas.


Possible functions of peptide antibiotics during growth of producer organisms: bacitracin and metal (II) ion transport. The inhibitory effect of bacitracin upon growth of the producer strain Bacillus licheniformis ATCC 10716 was dependent upon the presence of several different metal (II) ions, particularly Mn (II), Co (II), or Zn (II) ions. This supports our previous suggestion that the normal function of bacitracin during growth of the producer organism may be to promote the uptake of several divalent metal ions. Due to the striking similarity between the antimicrobial effect of bacitracin towards susceptible organisms and the effect of bacitracin towards the producer organisms B. licheniformis ATCC 10716, the possibility that the antimicrobial effect of bacitracin may be an induction of uptake of toxic amounts of metal ions is discussed. The possibility that peptide antibiotics may normally participate in ion transport during growth of producer organisms is also discussed.


The haemolytic activity of Haemophilus species. The importance of the species of blood employed for detection of haemolysis in seventy-seven Haemophilus strains of human and porcine origin was studied. Significant differences in the visibility of haemolytic zones obtained on the different blood agar media were observed. In decreasing order, the suitability of the species of blood was: calf, sheep, human, rabbit, poultry and horse blood. On plates containing washed sheep or calf red cells the haemolysin of all 36 strains of Haemophilus pleuropneumoniae acted synergistically with the beta-toxin of the Staphylococcus aureus strain used as "feeder strain", giving rise to a lytic phenomenon resembling the CAMP reaction.


Age- and sex-related distribution of antibodies to hepatitis B surface and core antigens in a Swedish population. Serum samples from people born between the years 1895 and 1970 were collected and tested for antibody to hepatitis B surface antigen (anti-HBs) by passive haemagglutination (PHA) and radioimmunoassay (RIA), and for antibody to hepatitis B core antigen (anti-HBc) by immunoelectroosmophoresis (IEOP). Neither anti-HBs nor anti-HBc was detected in the serum from anyone under 15 years of age. The prevalence of anti-HBs and anti-HBc showed peaks of 9.2 and 8.3 per cent, respectively, in the age group of 40-49 years. The distribution of antibody was equal between men and women. Eighty per cent of the sera with anti-HBs were also positive for anti-HBc. All sera positive for anti-HBc also contained anti-HBs.


Effect of antibiotics on interferon production in mice. Neomycin, chloramphenicol, gentamycin, rifampicin and oxytetracycline were tested for their influence on virus induced interferon (IF) production in mice. Repeated intraperitoneal (i.p.) injections of antibiotics were given to produce significant serum concentrations during the time of IF production, induced by i.p. injections of Newcastle disease virus (NDV). IF titres in antibiotic-treated mice determined 6 hours after induction were compared to titres in control mice given NDV only. The IF production was not significantly modified in most of the antibiotic treated mice. Only the highest dose of chloramphenicol (2500 mug/mouse) appeared to cause a reduction in IF production (p less than 0.10). Addition of antibiotics in vitro did not alter the antiviral titres of IF.


Antibodies to influenza A/swine-like viruses (Hsw1N1) in human sera: antigenic stimulation and changes in antibody status. Human sera collected at the end of 1975 were studied for HI antibodies to influenza A/Mayo Clinic/103/74 (Hsw1N1). The frequent occurrence of these antibodies in subjects born before 1930 suggested that they are present in about 25% of the Finnish population. During the H3N2 epidemic in winter 1975-76 a low response of antibodies to A/swine-like viruses was recorded in about half of the influenza patients with a pre-existing titre, but not in any of the patients without pre-existing antibodies. A comparison of samples collected in 1969 and 1975 suggested that at the community level the antibodies to A/swine-like viruses have not decreased during the era of the H3N2 subtype.


Ultrastructural studies on the endogenous development of Eimeria brunetti. The schizonts of Eimeria brunetti were studied in the epithelial cells of the small intestine of infected chickens. The morphology of the host/parasite relationship was typical of that reported for other Eimeria spp. The initial dedifferentiation of the infecting organism generally occurred within the parasite cytoplasm but it was also observed that cytoplasm containing organelles could be budded off into the parasitophorous vacuole. Development into the schizont was accompanied by cytoplasmic growth and nuclear division. During nuclear division an eccentrically located nuclear spindle was present. Merozoite formation was initiated just below the limiting membrane of the schizont and was associated with the final nuclear division. The merozoites developed as protrusions from the schizont surface and merozoite organelles developed within these cytoplasmic projections. From this early stage, the developing merozoite grew and matured and the fully formed merozoites were found attached to a small residual mass of schizont cytoplasm. The 1st generation schizont is the only one which can be separately characterized. It differs from those of subsequent generations in a) possessing a refractile body, b) being larger and producing a larger number of merozoites, c) possessing invaginations of the limiting membrane, and d) the intra vacuolar folds of its parasitophorous vacuole are more extensive.


Correlation of the characters fermentation of trehalose, non-transmissible resistance to tetracycline, and relatively long flagellar wavelength in Proteus morganii. An investigation of strains of Proteus morganii isolated from patients in Odense, Denmark, and of 21 serotype strains revealed a close correlation between the fermentation of trehalose and a non-transmissible resistance to tetracycline. The trehalose fermenting, tetracycline resistant strains had a longer flagellar wavelength than the non-fermenting, sensitive strains. Resistance to chloramphenicol occurred only in strains of the former group.


Transforamtion of twitching strains of Streptococcus sanguis. Ninety-five strains of S. sanguis, 90 of which were twitching, were screened for competence in transformation with DNA from the "Challis" strain. Seventy-two strains, 68 of sero-group H and 4 of the provisional group 10043, were competent. Fourteen of the competent strains and all strains which appeared to be incompetent were tested with DNA from 3 other strains. The 14 competent strains were transformed by all the 3 DNAs. One of the apparently incompetent strains was transformed by autologous DNA only. Among 8 reference strains (including ATCC 10577, Type II of Washburn et al.) 5 were competent. Three of these did not show spreading or twitching. Among 16 non-spreading strains of alphahaemolytic streptococci which did not possess either the H or the 10043 group antigen, only one showed competence. The results indicate that twitching mobility is not a prerequisite for competence.


Haemagglutination of twitching Streptococcus sanguis. Among 86, mostly twitching, polarly fimbriated strains of Streptococcus sanguis, 55 agglutinated guinea pig erythrocytes (GPE) after cultivation in Todd-Hewitt broth (TH), and 21 strains agglutinated GPE only after growth in TH with 10% horse serum (THS). Two of the positive strains were non-twitching and unfimbriated. Ten strains failed to haemagglutinate. Among 5 twitching strains belonging to the 10043 group, 3 agglutinated GPE after growth in TH and 2 only after growth in THS. Among 35 non-twitching strains of alpha-haemolytic streptococci, only 6 agglutinated GPE after growth in TH, and among 8 negative strains which were tested after growth in THS, only 1 agglutinated GPE. Tests using 6 different kinds of erythrocytes (guinea pig, rabbit, sheep, horse, chicken, human) revealed that differences between these were slight only. The results do not indicate that there is an absolute association between twitching and haemagglutination in S. sanguis. The haemagglutination of S. sanguis was not mannose-sensitive.


Identification of paramyxovirus-specific haemolysis-inhibiting antibodies separate from haemagglutinating-inhibiting and neuraminidase-inhibiting antibodies. 2. NDV and mumps virus haemolysis-inhibiting antibodies. Egg-grown Newcastle disease (NDV) and mumps virus were used for preparation of rabbit hyperimmune sera against purified whole virus and projectionless virus particles. These sera and convalescent sera after natural NDV and mumps infections in chickens and human subjects, respectively, were studied in haemolysis-inhibition (HLI), haemagglutination-inhibition (HI) and neuraminidase-inhibition (NI) tests both before and after absorption with Tween 80-ether (TE) treated virus preparations. In addition, neutralization tests using the different sera were carried out. HI and NI antibodies and the major population of neutralizing antibodies in convalescent sera were removed by absorption with TE treated virus material without changing the titre of non-HI HLI antibodies. Rabbit hyperimmune sera directed against projectionless virus particles exhibited HLI antibody titres in marked excess of HI and NI antibody titres, whereas this was not found in sera against whole virus. Absorption with TE treated virus material resulted in removal of all demonstrable antibody activities in sera against whole virus. The corresponding absorption of sera against projectionless particles eliminated HI antibodies without changing the titre of non-Hi HLI antibodies. In rabbit hyperimmune sera, HI antibodies were of primary importance in neutralization tests. After addition of anti-gamma globulin to the test, an efficient neutralization was observed if mumps non-HI HLI antibodies were used whereas this was not found if NDV non-HI HLI antibodies were used.


Yersinia pseudotuberculosis as the cause of septicaemia in a patient with amyloidosis. Septicaemia caused by Y. pseudotuberculosis in a female patient, aged 61, is reported. The patient suffered from amyloidosis with extensive infiltration of liver, spleen, and kidneys. While under treatment with corticosteroids and azathioprin, Y. pseudotuberculasis, serotype IA, was isolated from each of 6 blood cultures. The infection responded favourably to treatment with ampicillin. The development of Y. pseudotuberculosis septicaemia owing to impairment of the defence mechanisms by the underlying disease and the treatment given is discussed.


The macrophage response in mice after primary and secondary immunization with sheep red blood cells. A primary and a secondary immune response to sheep red blood cells (SRBC) was evoked in mice by intraperitoneal injection of the antigen. Macrophage proliferation and migration as well as induction of the lysosomal enzyme acid phosphatase in macrophages were assessed along with lymphocyte proliferation. The proliferative responses were evaluated by 3H-thymidine labelling (autoradiography). The secondary response elicited a faster and stronger lymphocyte proliferation than the primary response. This pattern was not seen to apply to the macrophages where the highest proliferative rate was found in connection with the primary response. The macrophages acquired an increased content of acid phosphatase during both types of responses, but the significantly highest level was reached in the secondary response. Large numbers of monocytes migrated into the peritoneal cavity during the first day after immunization. However, macrophage proliferation took place in resident as well as in immigrant cells.


Immunological memory after priming with a thymus independent antigen, NIP-ficoll. 4-hydroxy-5-iodo-3-nitrophenylacetyl coupled to polymer of sucrose and epichlorhydrin. The capacity of mouse spleen fragments to mount an anti-NIP (4-hydroxy-5-iodo-3-nitrophenylacetyl) response in vitro was studied. The fragments came from unprimed, NIP-Ficoll (polymer of sucrose and epichlorhydrin) or NIP-CG (chicken globulin) primed mice. Unprimed spleen fragments from C57BL/6 mice gave a good anti-NIP response to NIP-Ficoll, whereas CBA fragments did not. Priming with NIP-Ficoll made CBA fragments responsive and enhanced slightly the response of C57BL/6 fragments when stimulated with the same antigen. This memory effect could be seen only after a small priming dose. Priming the mice with NIP-Ficoll made their spleen fragments responsive to a protein conjugate of NIP (NIP-CG), but this effect was seen only after priming with a high dose. The antibody class distribution and the kinetics of the appearance of different immunoglobulin classes were similar in the primary and secondary responses in vitro. The peak responses of IgM, IgA and IgG were reached on day eight and the relative amount of IgG was the same in the primary and in the secondary responses. Spleen fragments derived from NIP-CG primed mice produced more IgG anti-NIP antibodies than fragments derived from untreated mice when immunized in vitro with NIP-Ficoll. The amount of IgG was, however, much higher when these fragments were challenged with the homologous antigen, NIP-CG.


Studies of smooth-muscle antibodies in acute hepatitis. Smooth-muscle antibodies (SMA) of the IgG and IgM class in titres of 10 to 80 were demonstrated in 19 of 38 patients with acute hepatitis (50 per cent). No IgA-SMA were detected. IgM-SMA occurred in the beginning of the disease, while IgG-SMA were found both early and late in the course of disease. There was no correlation between the occurrence of SMA and the biochemical liver parameters or the mode of exposure to infection, but IgM-SMA were found more often in the first serum sample obtained from patients without hepatitis-B-associated antigen (HBAg) than in HBAg-positive patients (P1 + P2 = 0.04) and it is suggested that hepatitis virus A more readily than hepatitis virus B can elicit the formation of SMA. The mean PHA-induced lymphocyte-transformation response was significantly lower in hepatitis patients than in the controls (0.02 greater than p greater than 0.01). The lymphocyte-transformation response to a low PHA dose (1 mug per ml) was lower in hepatitis patients without SMA than in those with SMA (0.10 greater than p greater than 0.05). SMA were not found in 28 control persons, and the incidence of tissue antibodies other than SMA did not differ in hepatitis patients and controls.


Decreased delayed hypersensitivity to tuberculin demonstrated in experimental leptospirosis in guinea pigs. Skin reactivity to tuberculin has been studied during the course of experimental leptospirosis in guinea pigs. A depression of the delayed hypersensitivity to tuberculin was demonstrated in the infected animals. The depression was most pronounced when icterus had developed. The depression was not correlated with the amount of infectious units administered or with the demonstration of live leptospirae in the peritoneal cavity. In the infected animals there was no correlation between the initial and the final skin tests which is in contrast to findings in the control group.


The effect of nitrogen mustard on human mononuclear blood cells. The effect of nitrogen mustard on the function of human blood monocytes and lymphocytes cultured in vitro, was studied. After a single in vitro exposure to the drug at culture start, an inhibition of the survival of non-proliferating mononuclear phagocytes was observed. No immediate cytotoxic effect was registered. Nitrogen mustard given in therapeutic doses to patients with malignant lymphogranulomatosis did not reduce the survival of mononuclear phagocytes cultured at different times after the administration of the drug.


C1R levels in normal human sera determined by electroimmunoassay. C1r levels in normal adults were determined by electroimmunoassay. The 95 per cent range was 71-133 per cent of a normal reference pool. C1r values were well correlated to the levels of C1q (r = 0.708) and of C1s (r = 0.768). The interplate variation of the method on double determinations was 3.4 (SD). C1r values in normal sera not appreciably affected by storage at room temperature or by repeated freezing and thawing. The C1r antigen in EDTA plasma was found to be labile.


C1 subcomponent conplexes in normal and pathological sera studied by crossed immunoelectrophoresis. Selected pathological sera gave three molecular species of C1s protein on crossed immunoelectrophoresis in the presence of calcium. C1s precipitates were obtained at the origin and in the beta1 and alpha2 regions. 12 normal sera gave C1s protein peaks at the origin and in alpha2 position. One of the normal sera also contained a small amount of the beta1 C1s protein. The C1s protein at the origin represented macromolecular C1. The alpha2 peak was a complex composed of C1 IA, C1s and C1r proteins. This complex was preformed in serum and did not show C4 cleaving activity. The molecular species in the beta1 region was shown to be a calcium-dependent complex of C1r and C1s, probably in proenzyme form. the C1r-C1s complex formed macromolecular C1 on addition of purified C1q to serum. During electrophoresis activation of C1 subcomponents was initiated by a mechanism involving CIr with generation of CIs activity in eluted fractions corresponding to the position of macromolecular C1 as well as in the beta region. The significance of beta1 C1s complexes or of alpha2 C1s complexes in normal and pathological sera was discussed.


Effect of sodium-salicylate on the function of cultured, human mononuclear cells. The in vitro effect of Na-salicylate on some functions of human mononuclear cells was studied. In therapeutical concentrations the drug was found to interfere both the function of lymphocytes and monocytes/macrophages. Na-salicylate in concentrations of 400-800 mug/ml slightly inhibited the digestion of yeast particles. When the drug was present in the culture medium in doses above 160 mug/ml during the cell differentiation period from 90 minutes to the 8th day of culture, a reduction in the number of adhesive, viable cells was recorded. The remaining cells, however, were found to have a normal phagocytic function. A strong and dose dependent inhibition of the ability of lymphocytes to proliferate after antigenic stimulation with BCG bacilli was recorded. The inhibitory effect on the PHA response, however, was less prominent. The results presented indicate that Na-salicylate has a direct inhibitory effect on lymphocyte proliferation and monocyte differentiation and phagocytosis, which may be part of the explanation of the anti-inflammatory effect of the drug.


Lymphocyte markers in newborn infants.

Lymphocyte markers in newborn infants. Purified peripheral blood lymphocytes from 20 newborn infants and 12 adults have been studied for the presence of surface markers. Adults and infants did not differ in the percentage of sheep RBC-binding cells (means 58-65%) or in Ig-bearing cells measured by the mixed antiglobulin reaction (means 7.2-11.6%). However, newborn infants had a significantly lower percentage of lymphocytes binding Fc of IgG (mean 10.4%) as compared to adults (mean 17.2%). No overall correlation between plasma Ig levels and Ig-bearing lymphocytes was found but a single infant with increased plasma IgA also showed the highest level of Ig-bearing lymphocytes among all infants.


Immunological unresponsiveness of nude mice to LCM virus infection. The acute LCM infection in nude mice runs a course which is clinically inapparent, and neither a humoral nor a cell-mediated immune response could be detected. Furthermore, during this infection the blood virus titers reached extremely high values. These observations are contrary to what is seen when ordinary normal mice are infected with the LCM virus but identical with the events following infection of ordinary but immune-deficient mice. Despite the absence of immune responses to the virus in the nude mice the very high virus titers obtained within the first few days of the infection declined somewhat during the following weeks. This and the other observations made are discussed briefly in the light of the current hypothesis concerning the immune status of the nude mice and the pathogenesis of the LCM virus infection in mice.


On the formation and effects of thromboxane A2 in human platelets. Incubation of arachidonic acid and prostaglandin G2 with a suspension of human platelets led to formation of an unstable (t1/2, 41+/-7 s) compound, thromboxane A2. Thromboxane A2 induced irreversible aggregation of washed platelets and of platelets in platelet-rich plasma and caused release of serotonin and ADP from platelets in platelet-rich plasma.


Some physical properties of the pulmonary arterial bed deduced from pulsatile arterial flow and pressure. This study aimed to quantify changes of vascular compliance and resistance of the proximal and the peripheral pulmonary arterial vessels when vascular smooth muscle was stimulated. These above vascular characteristics were derived from registrations of pulsatile pressure and flow in the pulmonary artery (PA). An in situ cat lung preparation was used, with the right heart by-passed by a pulsatile blood pump. Vascular input impedance was derived from PA pulsatile pressure and flow recordings, and impedance characteristics were used for calculation of the variables of a simple lumped analog representation of the arterial bed. PA smooth muscle was stimulated by infusions of collagen suspension, by general hypoxia and by noradrenaline injections. Collagen caused 40% reduction of vascular compliance (C), no changes in proximal arterial resistance (R1) and 180% increase in peripheral vascular resistance (R2). Hypoxia caused 50% reduced C, 20% increased R1 and 7u% increased R2. Noradrenaline caused 20% reduced C and 30% increased R1 and R2. These results, together with results derived from simulation of the observed impedance changes in a computer model of the lung arterial bed, indicated that collagen infusion elicited contraction of small and medium-sized arteries, with increased arterial volume as result of increased distending pressure. Hypoxia and noradrenaline, seemed both to cause contraction of the total arterial bed. This effect being most pronounced during hypoxia.


Biosynthesis of acetylcholine in different brain regions in vivo following alternative methods of sacrifice by microwave irradiation. Endogenous acetylcholine and biotransformation of tritium-labelled choline (3H-CH) were studied in mouse brain regions following different methods of sacrifice, viz. dislocation of the spine (7 min until enzymes inactivated), whole body microwave irradiation (7 s) and irradiation of the head (0.25 s). The brain temperature was measured in different locations 10 to 60 s after irradiation. The slope of the temperature time curves indicated a brain temperature of about 85-90 degrees C at the termination of exposure to both types of irradiation. Acetylcholinesterase (AChE) and choline acetyltransferase (CAT) were practically completely inactivated when measured one to two min after sacrifice. For turnover studies, mice were killed 1, 5, 10 or 20 min after i.v. injection of 15 nmol of 3H-Ch. The brains were dissected into 6 regions, extracted and analysed. No significant difference (except in cortex) in the amount of endogenous ACh was found when whole body irradiation was used in comparison to dislocation of the spine. However, the amount of 3H-acetylcholine (3H-ACh) was much higher in the striatum, hippocampus and cortex, in particular. With the shorter inactivation time (head irradiation) endogenous ACh was markedly increased in the striatum, cortex, medulla, oblongata and midbrain. However, there was no further increase in the radioactive ACh. The difference regarding the post-mortem sensitivity of endogenous and radioactive ACh does not seem to have been due to methodological artifacts but rather suggests that they are handled differently by the brain tissue. Plots of the specific radioactivity (SA) of Ch and ACh vs. time indicated fairly distinct precursor-product relationship in the different regions, when the animals were sacrificed by irradiation of the head.


Influence of age, growth, castration and testosterone treatment on the noradrenaline levels of the ductus deferens and the auxiliary male reproductive glands of the rat. The total amount of noradrenaline (NA) in the male accessories increases with normal growth of the organs and also with the age of the rat. The ductus deferens of the old rat has about twice as high NA concentration as that of the young rat. Castration of the prepuberal rat or the puberal rat leads to retardation or cessation, respectively, of the increase in NA amount of the male genital tract. Only in the old rat does castration produce a definite decrease in NA amount of the tract. Castration always raises the NA concentration of the sex accessories. Testosterone treatment of the puberal rat or the old rat produces minor or no increase, respectively, in total amount of NA of the male sex accessories. Testosterone treatment of old prepuberally castrated rats produces a marked increase in NA content of the male organs. It is concluded that androgens have no substancial direct effect on the adrenergic innervation per se, but affects the transmitter levels of the male organs indirectly through changes in number, size and relative proportion of the target cells of the adrenergic nerves i.e. the smooth muscle cells.


A further contribution to the question of trophic and hormonal influences on the noradrenaline content of the male reproductive tract: effect of combined androgen and estrogen treatment of prepuberally castrated rats. 58 days old, prepuberally castrated, male rats were treated with estrogen, testosterone or a combination of both hormones for 18 days. The total noradrenaline (NA)-content of the male accessory glands was increased by the hormone treatments. This increase was smallest in the estrogen treated group and largest in the group treated with both estrogen and testosterone. The NA-concentration, however, followed the reversed picture i.e. it was largest in untreated castrated rats and smallest in the rats receiving both estrogen and testosterone. Neither treatment brought the NA-amount up to the level of uncastrated controls of the same age although the weights of the secondary sex glands of rats receiving both estrogen and testosterone exceeded those of uncastrated controls. Similar, but less definite changes were observed in vas deferens and cauda epididymidis. It is concluded that a developing target area exerts some trophic influence on the adrenergic neurons innervating it. However, the trophic influence exerted by the effector organ on the nerves is not of the kind, that the innervation density and NA-concentration of the organ always are maintained at a constant level.


Influence of acetate on glucose metabolism in the perfused hind-quarter of the rat. The metabolism of U-14C-glucose and U-14C-acetate and the interaction between the two substrates in the perfused hind-quarter of the rat was studied. 5% of glucose taken up was oxidized to CO2, accounting for 15% of total oxygen consumption. Glucose was mainly incorporated into glycogen, while incorporation into lipids was negligible. Acetate did not significantly alter glucose uptake, 14C-glucose oxidation or the incorporation of 14C-glucose into glycogen and lipids. 45% of acetate taken up was oxidized to CO2, accounting for 20-25% of total oxygen consumption. Insulin did not affect acetate uptake but increased 14C-acetate oxidation. Oxygen consumption was slightly increased by simultaneous oxidation of glucose and acetate and in this situation the tissue content.of high-energy phosphate compounds was slightly elevated. It is concluded that only minor effects by acetate on glucose metabolism in the perfused skeletal muscle were found. The insignificant effects compared to previously reported studies on heart tissue (Neely and Morgan 1974) can be explained by differences in acetate metabolism between the two tissues.


A perfluorochemical oxygen carrier (fluosol-43) in a synthetic medium used for perfusion of isolated rat liver. An emulsion of perfluorotributylamine (Fluosol-43) was used as substitute for the gas-carrying function of erythrocytes in a synthetic medium for perfusion of isolated rat liver. The efficiency and effect of this synthetic gas-carrier were evaluated from measurements of the concentrations of rat albumin, the unsaturated vitamin B12-binding capacity of small-molecular-size vitamin B12-binding proteins (UBBC of SBP), urea nitrogen, glucose, sodium, potassium, alanine amino transferase (ALAT) in the medium, and the incorporation of 14C-lysine into the circulating proteins. Secretion of bile, portal pressure, PO2, PCO2 and pH in the affluent and the effluent mediums were also measured. The results demonstrate that the oxygen-carrying capacity of the medium and the metabolic functions of the liver were higher, and the liver damage less, when the medium included Fluosol-43 than without it. The albumin synthesis and the secretion of bile were as high as has been reported for perfusions with erythrocytes. This indicates that the oxygen carried by the Fluosol-43 was utilised by the liver, and that the metabolic functions were not adversely affected during 4 h of perfusion by the medium containing Fluosol-43.


A possible vagal adrenergic release of serotonin from enterochromaffin cells in the cat. The intracellular concentrations of serotonin (5-HT) in enterochromaffin cells (EC) in the cat small intestine have been studied by a cytofluorimetric method before and after long-lasting efferent vagal nerve stimulation in the neck. Such stimulation induces a decrease of 5-HT in EC of the gut as observed previously. Pretreatment with atropine could not block this decrease, suggesting a noncholinergic mechanism. Pretreatment with a beta-blocking agent, propranolol, or bilateral removal of the superior cervical ganglia could, however, block this 5-HT decrease. Pretreatment with an alpha-blocking agent, phenoxybenzamine, caused an increase in the 5-HT content of EC both with and without nerve stimulation; the reason for this is obscure. The results indicate, that vagal nerve stimulation induces a neurogenic 5-HT release from EC in the gut, and that adrenergic fibres, originating in the superior cervical ganglia, mediate this release probably via a beta-receptor mechanism. Whether or not an alpha-receptor mechanism is also involved cannot be judged at present.


Effect of arterial blood pressure reduction on renal hemodynamics in the developing lamb. The relationship between pressure and flow in the kidney has been examined in 2-9 and 31-48 day old lambs. Renal blood flow (RBF), determined by the microsphere technique, and glomerular filtration rate (GFR) were first studied under control conditions. The abdominal aorta was then constricted above the renal arteries until the pressure ranged between 60 and 70 mmHg, i.e. just below the normal autoregulatory range, and the hemodynamic recordings were repeated. During control conditions the arterial pressure was lower in the younger (93 mmHg) than in the older lambs (107 mmHg). During aortic constriction total RBF and GFR were reduced. In both age groups GFR was reduced out of proportion to RBF. The sodium excretion fell around 60% in both age groups. The fall in perfusion pressure resulted in a more pronounced blood flow reduction to the outer than to the inner cortical glomerular capillaries. This pressure-induced blood flow redistribution was found in both age groups. The consequences of the pronounced effect of reducing the perfusion pressure to 60-65 mmHg for the young lambs with their basally low arterial blood pressure are discussed.


Adrenal function in the diabetic mutant mouse (gene symbol dbm). The adrenal function in diabetes mutant mice with misty coat colour (dbm) was investigated by measurements of serum corticosteroids, adrenal weights and adrenal corticosteroid content. Furthermore, the adrenal corticosteroid content was studied in obese-hyperglycemic mice (ob). In the dbm-mice the serum corticosteroid levels were elevated at the age of 5 and 12 months although the adrenal weight only was significantly elevated at the age of 5 months. The adrenal corticosteroid content was significantly lower in the 12 months old dbm-mice. In the ob-mice the adrenal corticosteroid content was elevated at the age of 5 weeks, 5 and 12 months. It is concluded that in both the dbm-mouse and the ob-mouse there is an increased functional activity of the adrenal cortex which may reflect a pituitary hypersection of ACTH, perhaps as a manifestation of a common hypothalamic disorder.


Tissue hyperosmolality as a causal factor in vasodilatation following sympathetic stimulation of the submandibular gland. In a previous investigation, parasympathetic activation of the submandibular gland in the cat was found to cause a considerable increase of regional tissue osmolality, the degree of which was related to the evoked functional hyperemia; intra-arterial hypertonic infusion to the resting gland producing tissue hyperosmolality of similar magnitudes caused graded and marked dilatations (Lundvall and Holmberg 1974). It was concluded that hyperosmolality contributes significantly to the functional hyperemia response. In the present study evidence is presented to indicate that tissue hyperosmolality is a mediator of the dilatation associated with sympathetic activation as well. An increase of tissue hyperosmolality, as traced in the venous effluent, was found at all frequencies of sympathetic stimulation (2-16 Hz). At high stimulation rates it sometimes exceeded the resting control level by more than 20 mOsm/kg H2O. There was a direct relation between the degree of venous hyperosmolality and the hyperemia response observed immediately after cessation of stimulation. Comparison of the dilator effects evoked by sympathetic stimulation and by hypertonic infusion to the resting gland indicated that tissue hyperosmolality is an important causal factor for the nerve induced dilatation, especially at low and moderate stimulation rates.


Slow evoked cortical responses to linear frequency ramps of a continuous pure tone. Slow evoked cortical potentials from ten young normal-hearing subjects have been recorded as responses to linear frequency ramps of a continuous pure tone. Frequency changes from 10 to 500 Hz were studied; the rate of frequency change was varied from 0.02 to 50 kHz/s while the duration of the change was varied from 10 to 500 ms. The rate of frequency change was shown to have the greatest bearing on the responses except for frequency ramp durations below 50 ms and frequency changes below 50 Hz. The base frequencies (250-4000 Hz) and sound levels (20-80 dB HL) exerted an influence on the evoked responses that was qualitatively similar to their influence on behavioral thresholds. The direction of the frequency sweep had no significant influence on the evoked responses. A functional model is proposed in which the time derivate of the signal frequency is integrated with an adaptable integration time that is controlled by the rate of the frequency change.