Identification of blood groups and isoenzymic phenotypes from blood stains, heart blood and nervous tissues after transfusion. A man aged 42 years died from a hemorrhage resulting from stab wounds in his neck, chest and abdomen. The MN blood group and PGM1 phenotype of the victim's heart blood were inconsistent with those of the blood stains around the victim. The victim was transfused with 4000 ml of blood during the 9 hours before his death. Because PGM1 phenotypes obtained from blood stains at the scene of the crime and from the weapon corresponded with those from the victim's dental pulp, peripheral nerve and bone marrow, the victim's blood groups and isoenzymic phenotypes could be determined accurately.


[Thrombosis, embolism and aggregation inhibitors in surgery]. The frequency in letal pulmonary embolism at the I. Chirurgische Univ.-Klinik and the Unfallchirurgie I, Vienna, and experimental and clinical studies of the protective effect of aggregation inhibitors are reported. Significant difference of extent in experimentally induced venous thrombosis was found in animal groups with and without preventive treatment. Two double-blind trials with acetylsalicylic acid and placebo brought significant differences in the frequency of letal pulmonary embolism in patients with hip fracture and a lower rate of immediate post-operative vascular reobstruction due to high peripher vascular resistance in patients undergoing vascular surgery.


[Problems in the special nosological position of keratoacanthoma. Clinical, histological and comparative Feulgen-cytophotometric studies. 3. Classification of keratoacanthomas, therapeutic consequences, conclusions]. Feulgen-cytophotometric examinations of 61 keratoacanthomas of the skin have revealed 3 types differing from each other in their DNA distribution. Keratoacanthomas type I are characterized by a diploid DNA distribution--comparable to epidermis cells. An increasing average DNA content (x) and mean distribution (Sx) compared with diploid cells are, however, conspicuous. Keratoacanthomas type II display DNA peaks in the triploid phase and increasing x and Sx. Keratoacanthomas type III show DNA tumor stem lines in the hypotetraploid, tetraploid and hypertetraploid phases, with x and Sx further increasing. The occurrence of two tumor cell populations of aneuploid localization is noteworthy in part of the keratoacanthomas. Transitional types among the tumors mentioned above are possible. Only type I does not allow cytophotometric demarcation of epidermis cells or tissue lymphocytes based on statistical analysis. The three types of keratoacanthomas can be significantly defined against each other. These cytophotometric findings explain the occurrence of clinical variations of keratoacanthomas with tumor ulceration, increased growth and recidivity. As a rule total excision and careful histological examinations are advisable. The occurrence of paraneoplastic keratoacanthomas and carcinomata disguished as keratoacanthomas is mentioned. Spontaneous healing should not be waited for despite the possible occurrence of benign keratoacanthomas.


[High-dose enzyme-substitution therapy in digestive disorders]. A new highly effective enzyme-substituting product (Combizym forte) was tested clinically on 62 patients suffering from digestive insufficiency to ascertain the improvements of the complaints pain, nausea, meteorism, diarrhea and obstipation as well as the tolerance. 88,7% of the cases were free from complaints within about 14 days of treatment. Three patients had diarrhea; no other sidereactions were observed. Apart from the high enzymatic activity of Combizym forte, the absence of Fel tauri is noteworthy as it allows to increase doses considerably. The demonstration of the therapeutic action of Combizym forte by examinations of the stools and enzyme-chemical measurements will be the subject of another series of tests (2nd information).


[Legal aspects of noise abatement].

[Legal aspects of noise abatement]. Noise abatement is a problem of technology, medicine, law, and education. In the technical field, the problem of avoiding hazards is the primary one. In respect of encroachment upon neighbours mutual regard should be the foremost consideration. From the legal angle, a distinction is made between protection of the individial-above all under the provisions of the German Civil Code (Bürgerliches Gesetzbuch)-and of the community-under the provisions of criminal law and administrative law. Future legislation will have to concentrate increasingly upon governmental control measures especially with a view to prevention, instead of the issue of protection of the individual.


[Erythropoietic protoporthyria. Clinical aspects and therapy]. After introduction in clinical, histological and ultrastructural features of erythropoietic protoporphyria the therapeutic effect of beta-Carotene is reported in 5 patients with erythropoietic proporphyria and in 1 patient with polymorphous light dermatosis. beta-Carotene was given orally in a daily initial dose of 50-100 mg, continued with 25 mg a day. In all patients the therapeutic effect set on about 2 months after beginning of the treatment and was measured by increased toleration to insolation. During the treatment over a period of four years no side effects were noticed by 127 clinical and biochemical controls beside a dose-dependent "icterus" localized as well in the perioral region as on the hands and feet.


[Estrogens and carcinoma of the endometrium]. The physicians and the women were disturbed by recent communications discussing a possible relationship between the postmenopausal application of estrogens and endometrial carcinoma. An analysis of these reports is made critically and in detail. The practical aspects are delineated and a precise guide to postmenopausal estrogen therapy is presented.


[Disorders of libido from the gynecological view point]. Sexual dysfunctions are differentiated according to the following symptoms: libido dysfunction, orgasmic dysfunction, vaginism, algopareunia and polysymptomatic dysfunction. In the out-patient service for sexual and other psychosomatic disorders of the University of Heidelberg's Women's Hospital 90 women with libido dysfunction were treated with conflict-centered psychotherapy after exclusion of organic diseases which could explain the reduction of libido and after exclusion of a depression where the loss of libido is a regular symptom. The success-rate was 63%. It was attempted to reinforce the ego of the patient which enables him to experience his surroundings with less conflicts. Neurotic anxieties and symptoms are decreased and loos their importance so that the patient is able to handle his sexual disturbance. Among the psychosocial factors, i.e. focal causes, responsible for the libido dysfunction we found: In 48% of the cases the relationship between parents and children had been disturbed, which caused difficulties in the identification process (lack of father or mother, cool mother, divorce, borken home). Problems with the partners were found in 42%. 2/3 of these women had not grown up in intact families, which seems to predestinate difficulties in communication later on. Psychodynamically the loss of libido means sexual resistance which can lead to aversion or disgust. When there is no excitement the vasocongestion and lubrication do not take place: cohabitation pain (algopareunia) results. On the other hand the reduction of libido can also be a result of chronic algopareunia, i.e. secondary. Psychogenic bleedings ("aversion-bleeding") during or after intercourse occasionally occur in combination with algopareunia and lack of libido.


[Dermolipectomy for the reduction of redundant skin and local lipodystrophy]. Operative techniques by Pitanguy for abdominoplasty and fat reduction in trochanteric lipodystrophy and their results are presented. In comparison to most other procedures this technique shows the following advantages: low and horizontal final scar; the possibility to remove periumbilical fat and skin by transposition of the umbilicus; a diastasis of the mm.recti can be corrected and infraumbilical scars can be removed. The technique of excision described by Pitanguy for reduction of trochanteric fat is a simple and safe procedure leading to satisfying cosmetic results. During the past 18 months we treated 20 patients using Pitanguys technique. The results are definitely better than those achieved with other methods.


[Reproduction and cohabitation disorders from the andrological viewpoint]. Analogous to gynecological fertility diagnostics as applied to women, the andrological methodology for the examination of men has been expanded into a simple and extended method of fertility diagnostics. Generally, the examination of a male patient begins with simple fertility diagnostics and is followed-up individually by detailed diagnostic procedures only when a certain suspicion exists. As a rule extended diagnostic procedures are not applied to a husband before the wife's ability to conceive has not first been determined at least by a simple gynecological examination. This proceeding sequence is rational and satisfying particularly since some fertility diagnostic interventions can only be imposed upon a patient after all other possibilities are exhausted. Primarily in cases of cohabitational disorders caused by male impotence, a similar diagnostic method is applied. As in the case of fertility examinations, all other possibilities, such as endocrinological malfunctions, metabolic disorders, disease symptoms and neurological defeciencies are thoroughly investigated. After all pathological findings are ruled out, psychoanalytical tests are advised. In most cases, behavioural disorders can be left to the guidance of the andrologist within the framework of minor sexual-psychological psychiatry. In more severe cases, specialized psychiatric diagnostic procedures are recommended. Although the classic spermiogram is still the focal point of diagnostics, normo-zoospermia is no longer necessarily synonymous with reproductive ability. Under given circumstances, differential diagnostic considerations are sometimes necessary taking the entire equipment of extended diagnostic procedures for granted.


[Differential diagnosis of the Prom-standard-values-deviating spermiogram]. Critical remarks to some points of clinical relevance for differential diagnosis of the spermatogram are made. The following parameters of the andrological examination are discussed: testis volume, ejaculate volume, pH, consistency of the ejaculate, sperm density, sperm motility, sperm morphology, biochemistry of the human semen.


[Differential diagnostic significance of cytogenetic findings for family planning]. Numerical and structural chromosome aberrations can be responsible for sterility, infertility and live-borns with multiple malformations. The usefulness of cytogenetical studies in those handicapped families is discussed in respect to medical advice and genetic counseling.


[Differential diagnosis in potency disorders]. Disorders of sexual libido are seldom organic, in general they are of psychological origin. It is, however, difficult to obtain a differential diagnosis. One of the first diagnostic considerations must be the establishment of primary or secondary libidinal dificit, or indeed, whether there is no libido at all. In cases of libido disorders with primary libido dificit, depression, organic disease, or side effects of pharmaca may be the cause. Libido disorders in the presence of functional libido, however, must be regarded as primarily psychologically caused. An exception are libido problems in the presence of diabetes mellitus and peripheral vasculatory defeciencies. In these cases libido is either totally absent or appears only secondarily. The symptomatology of libido disorders in the presence of depression, diabetes melitus, and peripheral vasculatory disturbancies, as well as psychologically caused erectile and ejaculatory difficulties are discussed in detail. These groups are compared with respect to libido and behavior involving erection, ejaculation, anxiety and avoidance.


[Therpeutic experiences with a new antitussive principle]. In the therapeutic schedule of a great sanatorium, primarily specialized in the treatment of bronchial and asthmatical diseases to the effect of a rehabilitation, a new speciality for the treatment of the symptom cough-Contrapect-was tested. Essential clinical and analytical parameters of the pulmonary function were subject to detailed examinations. The results proved that the marginal value of breathing increased and the intensity of the cough and the subjective dyspnoea were reduced. Secondary effects were not observed. The patients liked to take the drug. We also consider the product suitable for therapeutic use in general practice subsequent to clinical treatment, since, in compliance with the appropriate definition, coughing represents the main symptom of chronic bronchitis. A chronic bronchitis is assumed, if permanent cough exists over 3 months at least during a period of 2 years.


Glucose, insulin and glucagon in the diabetic goose. The relationships between plasma glucose, insulin and glucagon were studied in geese made diabetic by subtotal pancreatectomy. As early as the first hours after the operation, the plasma glucose increases and a permanent diabetes develops. This diabetic state is characterized by two features: a very low plasma insulin level, which does not vary during the survival of the diabetic animals and a concentration of plasma glucagon (of pancreatic origin) which transiently diminishes then rises far above the normal level, and is correlated with the basal concentration of plasma glucose. The impaired glucose tolerance observed in diabetic animals is related to the suppression of the glucose-insulin and glucose-glucagon feedback mechanisms.


Somatomedin production in the neonatal rat. The hormonal stimulus to rat fetal and neonatal somatic and skeletal growth has been investigated by a study of ciruclating somatomedin (SM), growth hormone (GH) and insulin levels in rats from 21 days in utero to 40 days of post natal life. Somatomedin activity could not be detected in the serum of fetal rats in which circulating GH and insulin levels were high. In early post natal life GH and insulin levels remained high but gradually declined reaching normal adult levels at 19 days and 40 days respectively. Somatomedin activity was measurable only at low levels until 11 days after birth and thereafter remained steady throughout the time period studied. These studies suggest that somatomedin alone is not responsible for the rapid growth of the rat in early neonatal life and it is suggested that insulin may also be active as a growth factor in this period.


Effect of adrenalectomy on weight gain and body composition of yellow obese mice (Ay/a). It has been reported that the adrenal gland is essential to the development of obesity if Ay/a Yellow obese mice (Hausberger and Hausberger 1960). Since the actual body composition data to support this report has not been published, we attempted to duplicate this observation by adrenalectomy of the Yellow mice before the onset of obesity. Two groups of Yellow mice (Ay/a) and normal mice (a/a) were either sham operated or adrenalectomized at two months of age and at four months of age. Body weight was monitored until body gain had stopped. At that time the animals were sacrified and checked for completeness of adrenal removal. Body composition of dry matter, fat, protein, and ash was determined. Adrenalectomy caused a reduction of body fat of 33% and 30% in both the a/a Control and the Ay/a Yellow mice, respectively. The adrenalectomized Yellow mice were still fatter than adrenalectomized Controls (25.3% fat vs. 10.6% fat). Yellow and control adrenalectomized mice showed similar depression in growth rate. These data suggest that while the adrenal gland is essential for complete expression of the genetic potential for fat deposition, it may not be necessary for partial expression indicating a secondary role in the development of obesity in the Ay/a Yellow mouse.


Experimental hypergastrinaemia in the dog. In order to investigate chronic hypergastrinaemia in dogs, studies with various excluded antrum preparations were performed. Gastric secretion was collected from denervated fundic pouches and gastrin levels were measured pre- and postoperatively by radioimmunoassay. In some samples the gastrins were separated according to their molecular size. Distinct hypergastrinaemia and acid hypersecretion developed in dogs where the antrum was excluded by a mucosal septum. Gastrin levels rose to 349 +/- 64 pg/ml (normal 76 +/- 19 pg/ml). Analysis of the gastrin pattern showed a predominance of smaller gastrin components. Although there was marked hypersecretion in most of the dogs with hypergastrinaemia, no close correlation was evident between these parameters. Some of the dogs with hypergastrinaemia developed anastomotic ulcers.


Superior immunoreactivity of 125I (Des-Tyr-betaAla)-secretin with rabbit anti-secretin sera compared to 125I-secretin and 125 I-6-Tyrosyl secretin. A secretin analogue in which the normal amino acid sequence had been elongated by a (Des-Tyr-betaAla)-residue was studied as tracer for secretin radioimmunoassay. 125I-(DATA)-secretin exhibited superior immunoreactivity with several rabbit anti-secretin sera compared to 125I-6-Tyr-secretin and also to secretin iodinated at its N-terminal histidyl residue. This may be due, at least in part, to higher conformational integrity of the secretin moiety in the 125I-(DATA)-secretin molecule. Thus, at present, 125I-(DATA)-secretin appears to be most suitable as tracer for sensitive secretin radioimmunoassay.


Adrenal and plasma corticosterone levels in the pregnant, foetal and neonatal rat, in the perinatal period. A group of pregnant control rats was sacrificed before parturition, in the morning, afternoon and evening of day 20 and 21 and in the morning of day 22. Another group was sacrificed during parturition, when 2 to 8 foetuses had been expelled. The onset of parturition occurred for the first rat in the afternoon of day 21 and for the last rat in the afternoon of day 22. Corticosterone was extracted from maternal, foetal and neonatal adrenals and plasma, and was assayed by a fluorometric procedure. The maternal adrenal and plasma corticosterone levels, before parturition, were lower in the morning than in the afternoon excepting day 22 when morning values were as high as those in the afternoon of day 21. Adrenal and plasma corticosterone concentrations were elevated during parturition in the mother but not the foetus. Plasma corticosterone values were raised in the newborn compared to their littermates in utero.


Effect of pregnancy on serum alanine concentration in normal and genetically diabetic mice. Serum alanine concentration was determined in nonpregnant and pregnant normal control Swiss albino (SA) and genetically diabetic KK mice. The serum alanine levels were significantly lower in nonpregnant KK than in nonpregnant SA mice. Fasting elicited hypoglycemia, hypoinsulinemia and hypoalaninemia in both groups of pregnant mice. Oral administration of alanine in nonpregnant and pregnant mice resulted in a significant rise in blood sugar levels within 15 min in both groups. However, the initial blood sugar response to oral alanine was greater in pregnant than in nonpregnant mice. This increase in blood sugar response to exogenous alanine appears to be mediated by glucagon. The data suggest that pregnancy elicits hypoglycemia, hypoinsulinemia and hypoalaninemia in both nondiabetic and diabetic mice.


Simultaneous estimation of four plasma androgens before and after dynamic tests in women with hirsutism: correlation with long-term therapy. Concentrations of testosterone, delta4-androstenedione, dihydrotestosterone and delta5-androstenediol were measured in 12 patients affected by hirsutism associated with menstrual disorders. Testosterone was elevated in 9 cases, in whom high levels of delta4-androstenedione and dihydrotestosterone was found, and normal in 3 cases, 2 of which presented high values of dihydrotestosterone and one high levels of delta5-androstenediol. In some hirsute females therefore, other androgens, such as dihydrotestosterone and delta5-androstenediol, play a role in the pathogenesis of hirsutism. Dexamethasone and estrogen progestin combinations were administered for dynamic tests, and results in most cases provided useful information in the selection of suitable long-term therapy.


Characteristics of aldosterone antisera related to the duration of immunization. Three antisera specific to aldosterone and elicited with different aldosterone protein conjugates (aldosterone-3-oxine rabbit serum albumin and aldosterone-3-oxime bovine gamma-globulin) were studied by radioimmunological methods at various times subsequent to first-immunization. A considerable variability of the parameters important in radioimmunoassay was observed over the whole experimental period. Titer, sensitivity and specificity of two antisera tended to increase as long as the animals were boosted. In the third they did not change in a uniform way.


Changes in the concentration of LH, FSH and estrogen in the immature female rat during precocious sexual maturation induced by electrochemical stimulation of the brain. Electrochemical stimulation of the hypothalamus of 23-day-old female rats induced precocious puberty as judged by occurrence of vaginal opening, the degree of uterine hypertrophy, changes in ovarian steroid content and incidence of first ovulation. Three types of responses were observed: (I) pubertal ovulation within 96 h; (II) pubertal ovulation within 120 h, and (III) vaginal opening at 120 h not followed by ovulation. All treated animals showed a sustained increase in the LH/FSH ratio in both pituitary and plasma. Plasma estrogen was also increased 1 h after stimulation. A preovulatory rise in plasma estrogen and gonadotropins was noted in type I and type II animals. These data lend further support to the suggestion that brain stimulation causes a release of gonadotrophins which induced ovarian steroidogenesis leading to an ovulatory gonadotropin surge via a positive feedback effect.


Histochemical localization of some hydroxysteroid dehydrogenases in the mouse epididymis. The mouse epididymis was studied to localize histochemically a number of hydroxysteroid dehydrogenases in the various zones. The epithelium of the posterior half of the initial segment (head) and the anterior half of the middle segment (body) shows a strong reaction for delta5-3beta-, 3alpha,5alpha-, 3alpha,5beta-, 11beta, 16alpha-, 17beta, 20alpha-hydroxysteroid dehydrogenases. This activity attenuates posteriorly. Only the 11beta-hydroxysteroid dehydrogenase is present throughout the length of the epididymis. The luminal contents of the middle segment also show the histochemical utilization of a number of steroids.


Feedback effects of dexamethasone on adrenocortical responses in rats with fornix section. To investigate the sites of the negative feedback of corticoids in the regulation of ACTH secretion, the effect of 10 mug of dexamethasone on adrenocortical responses to ether stress was studied in intact and fornix-sectioned rats. Dexamethasone pretreatment in both groups depressed significantly both the basal and stress plasma corticosterone levels. However, in rats with fornix section the amount of depression of the adrenocortical response was much smaller than in intact animals, when compared to the non-treated group. These data would inicate that extrahypothalamic regions play a role in the action of glucocorticoids in the feedback control of pituitary-adrenal function and that the hippocampus participates in this mechaism.


Regulation of pineal enzymes by photoperiod, gonadal hormones and melatonin in Coturnix quail. The photoperiodic and hormonal regulation of melatonin-synthesizing enzymes was determined in pineals of Coturnix quail. N-Acetyl transferase (NAT) and hydroxyindole-O-methyl transferase (HIOMT) were twofold higher in pineals of female and male Coturnix quail during exposure to darkness (16L:8D). Castration decreased pineal HIOMT activity in both female and male Coturnix, while selective gonadal steroids restored activity. NAT was not affected by castration or gonadal steroids. Implantation of melatonin into female Coturnix decreased both HIOMT and NAT activities. These results suggest that NAT is regulated primarily by photoperiodicity, while HIOMT activity is a consequence of the external perceptive environment and the internal hormonal milieu, with both enzymic activities modulated by the feedback inhibitory influence of endogenous melatonin.


Plasma lipoproteins in pregnancy.

Plasma lipoproteins in pregnancy. Plasma cholesterol, triglyceride and apolipoprotein B were measured in healthy women during pregnancy. Hyperlipidaemia was most marked in the third trimester of pregnancy, but the increases in cholesterol, triglyceride and apolipoprotein-B were not identical (14, 74 and 36%, respectively). The increase in plasma cholesterol was due to a progressive rise in very low density (VLDL) and low density (LDL) lipoproteins. There was a change in composition and size of both VLDL and LDL, demonstrated by a reduction in the ratio of cholesterol to apolipoprotein-B and altered properties of both lipoproteins on polyacrylamide gradient gel electrophoresis. It is difficult to explain these changes but they did not appear to be related to growth hormone, oestrogens or progestogens.


Leucyl naphthylamidase activity in pigeon and toad testes under various experimental conditions. The activity pattern and functional significance of leucyl naphthylamidase (LNase) in the pigeon testis under different hormonal and photoperiod conditions as well as in the testes of short- and long-term HCG-treated toads have been studied histochemically. In both the species, the enzyme activity was present in the maturing spermatids and those embedded in the Sertoli cell components, the mature spermatozoa released in the lumen being devoid of any LNase activity. In pigeon, the stimulation of spermatogenic process was associated with enhanced activity of the enzyme, whereas arrest of spermatogenesis showed little or no activity. In toad, short-term HCG treatment caused mild stimulation of spermiation resulting in sperm release from the Sertoli cells and this was accompanied by moderate decrease in LNase activity. The long-term HCG treatment produced an enhanced stimulation of spermiogenesis and spermiation processes resulting in almost total disappearance of LNase activity. The above observations suggest that the enzyme in the testes of both species is related to spermiogenesis and/or spermiation events of spermatogenesis.


Bioavailability and LH-suppressing effect of different testosterone preparations in normal and hypogonadal men. The therapeutic effectiveness of intramuscularly administered testosterone esters and free testosterone in suppositories was investigated by the measurement of plasma testosterone and LH levels after administration to normal and hypogonadal men. Testosterone levels were elevated above the lower physiological limit for 1 day after 25 mg testosterone one propionate, for 2 days after 50 mg testosterone propionate and for 14 days after 250 mg testosterone oenanthate. LH levels were suppressed for the corresponding periods. Elevated plasma testosterone and suppressed LH levels were maintained by testosterone suppositories (3 x 20 mg for 5 days).


Prolactin and testicular lipids.

Prolactin and testicular lipids. The effects of prolactin and prolactin plus progesterone (P-P) on the testes of adult rats were investigated. The weight of testes, seminal vesicles and the lipid composition of testes were studied 24 h after the administration of hormones. Prolactin treatment increased the weight of seminal vesicles but did not affect testicular weight, whereas P-P treatment had markedly reduced the weights of testes and seminal vesicles. Progesterone did not have any effect on the weight of testes and seminal vesicles. Both treatments had significantly reduced the total testicular lipids, which was more pronounced in the P-P treated group (28, 50%, respectively). The esterified cholesterol was increased by the administration of prolactin and P-P with a concurrent fall in the free cholesterol. The total cholesterol was depleted only by prolactin treatment. Testicular phospholipids, particularly the phosphatidylcholine and phosphatidylethanolamine were markedly depleted by these hormones. This action of prolactin is more significant in the presence of progesterone. The depletion of phospholipids appears to be mainly due to enhanced flow of testicular tubular fluid carrying away phospholipids from testis rather than a shift in the biosynthetic pathway favouring glyceride formation. In our previous study, it has been shown that progesterone favours accumulation of esterified cholesterol by depleting the available free cholesterol. Prolactin on the other hand depletes phospholipids and total cholesterol, increases esterified cholesterol. Thus, prolactin appears to have a role in steroidogensis as well as in the secretory processes of the testis.


Exogenous hypercortisolism and epididymal fat cell count in young rats. The influence of two different grades of exogenous hypercortisolism on body weight, epididymal fat pad weight and the total number of fat cells in epididymal fat pads was investigated in young, growing rats. Cortisol, 4-5 mg/kg/day orally from the 7th to the 9th week, reduced body weight gain, whereas epididymal fat pad weight and fat cell content did not differ from those of the control rats. Cortisone acetate, 2.5 mg per 100 g, given subcutaneously for 2 weeks to rats 4-11 week of age caused in the young rat (4-6 weeks) a partial inhibition of the normal increase in body weight, whereas in the young-adult rat (6 weeks and older) an actual decrease of body weight was seen. At both dose levels and - with respect to the higher dose level- in all age groups studied, the weight and fat cell content of the epididymal fat pad were not changed by the cortisone (cortisol) treatment.


The effect of testosterone on the behavior and coloration of adult male cichlid fish (Haplochromis burtoni, Günther). The African cichlid fish Haplochromis burtoni shows specific behavioral responses to the intramuscular injection of testosterone. Approaching and attacking were significantly increased by injections, while six other observed behaviors remained unchanged. The results suggest that the injected testosterone affected the control of both sexual and agonistic behaviors.


Studies on the biosynthesis of cyclitols, XXXIV[l] Purification of myo-inositol 3-methyltransferase from Pisum sativum and of myo-inositol 1-methyltransferase from Vinca minor to homogeneity by affinity chromatography. With the help of affinity chromatography on an agarose gel containing epi-inositol as the group exhibiting affinity towards enzymes acting on myo-inositol, the two methyltransferases from higher plant materials transforming myo-inositol to D-bornesitol and L-bornesitol, respectively, were purified to homogeneity. The two enzymes show certain similarities as far as pH optima, isoelectric points and specific activities are concerned, but differ significantly in the molecular weight and in their affinity towards the methyl donor, S-adenosyl-L-methionine.


Partial separation of synaptosomes accumulating 4-aminobutyrate or glutamate by zonal centrifugation on a discontinuous sucrose gradient. Rat cerebral cortex slices were incubated with 1muM [3H]4-aminobutyrate or [3H]L-glutamine. The subcellular distribution of the accumulated labelled substances were determined by fractionating the nuclei-free homogenates on a 5-step discontinuous sucrose density gradient in a B XIV zonal rotor. The gradient was designed to separate the synaptosomes into 3 subpopulations of increasing density. The patterns of distribution of [3H]4-aminobutyrate and [3H-a1L-glutamate in the three synaptosomal peaks were distinctly different. This indicates the presence of separate types of nerve ending accumulating these two potential neurotransmitters, which are known to be metabolically closely linked through the enzyme glutamate decarboxylase. Recentrifugation of the 3 synaptosomal peaks on flat step gradients in a swingout rotor did not result in any further enrichment in transmitter-specific synaptosomes.


Cholic acid uptake and isolated rat hepatocytes. Cholic acid uptake was studied in isolated rat hepatocytes using a centrifugal filtration technique to allow rapid sampling. Hepatocytes were found to adsorb as well as to transport cholic acid. The adsorption was characterized by a capacity of 24 nmol X mg cell protein-1 and an association constant of 0.59 X 103 M-1. Cholic acid uptake was linear with respect to concentration at or below 10 degree C, suggesting a unsaturable uptake process which was considered to represent simple diffusion and is quantitated by a diffusion coefficient of 1.76 pmol cholic acid X min-1 X mg protein-1 X muM-1. Above 10 degrees C the uptake curve was biphasic. After subtracting the unsaturable component from uptake rates at higher temperatures, a curve showing saturable kinetics resulted. The apparent Km and V values at 37 degrees C were calculated to be 31muM and 0.8 nmol X min-1 X mg protein-1 respectively. This saturable uptake process was temperature-dependent with an activation energy of 13 kcal X mol-1 (5.44 X 104 J X mol-1) and was inhibited by oligomycin and KCN. Countertransport was demonstrated with cholic, taurocholic and chenodeoxycholic acids. The results suggest that cholic acid is transported by an energy-dependent carrier-mediated process in addition to simple diffusion by hepatocytes, and that the postulated carrier has affinity for other bile acids.


Carbohydrate linkage site in the beta-chain of human fibrin. The beta-chain of fibrin was cleaved with trypsin or cyanogen bromide. Carbohydrate containing fragments were isolated by affinity chromatography on concanavalin A-agarose. The fragments were analysed for amino acid sequence and for amino and carbohydrate composition. The sequence of 21 amino acid residues around the carbohydrate attachment point was determined. The carbohydrate carrying amino acid was identified as aspartic acid/asparagine.


[Rule of antibody structure. the primary structure of a monoclonal IgG1 immunoglobulin (myeloma protein Nie), I: Purification and characterization of the protein, the L- and H-chains, the cyanogenbromide cleavage products, and the disulfide bridges (author's transl)]. Myeloma protein Nie has been isolated from the serum of a myeloma patient by free flow continuous high voltage electrophoresis or by Pevicon-block electrophoresis. It was further purified by ion-exchange chromatography and gel filtration, and characterized by amino acid analysis and end group determination. Serologically, the protein belongs to the IgG1 subclass. It has been typed as Gm1+, 2-,4- and 17+. The L-chain is of the k-type. The L- and H-chains have been separated by gel-filtration after partial reduction and alkylation and characterized by amino acid analysis and end group determination. The F(ab)- and Fc-fragments, prepared by limited tryptic digestion, have been separated and characterized. Cyanogen bromide splitting products have been prepared both from the intact IgG and from the Fc-and the partially reduced and alkylated F(ab)-fragment. These splitting products have been purified and characterized by amino acid analysis and end group determination. By means of these cyanogen bromide splitting products and by partial reduction and alkylation, the disulfide bridges in the protein could be localized: one L-H-bridge, two inter-H-bridges and four loop forming intra-H-bridges.


[1-Adamanty fluoroformate, a useful reagent in peptide chemistry (author's transl)]. 1-Adamantyl fluoroformate was prepared from 1-adamantol and fluorophosgene. The cristalline and stable fluoroformate was allowed to react with amino acids to give the corresponding 1-adamantyloxycarbonyl derivatives in consistently high yields. Additonally this new reagent proved to be ideally reactive for acylation of the imidazol function of histidine and histidyl-peptides.


Studies of the ligand binding to cholera toxin, I. The lipophilic moiety of sialoglycolipids. The fixation of cholera toxin by ganglioside GGtet1 is dependent on the nature of the carbohydrate as well as the lipid moiety of the glycolipid. The role of the lipid in binding to the toxin investigated with synthetic ganglioside analogues (gangliosidoides). The interaction between glycolipid and toxin was followed by precipitate formation, by inhibition of toxicity and in polyacrylamide gel electrophoresis. For specific precipitation, an aliphatic hydrocarbon chain at least 14 C-atoms in length is required. Some of the gangliosidoides form high molecular weight complexes with cholera toxin at lower molar ratios of ligand to protein than the natural compound. None of the synthetic gangliosidoides equalled natural ganglioside in its ability to inhibit the effects of the toxin in vivo, but some did show considerable inhibitory activity ih monosialo-gangliotetraose or corresponding sialo-glycolipids prevents the easy degradation of the B-protein of cholera toxin into protein subunits by sodium dodecylsulfate.


[Di-tert.-butyl-dicarbonate, a useful tert.-Butyloxycardonylating reagent (author's transl)]. Di-tert.-butyl-dicarbonate is an ideal reagent for tert.-butyloxycarbonylating amino acids and their derivatives in regard to both reaction rate and simplicity of the procedure.


Localization of factors controlling spermatogenesis in the nonfluorescent portion of the human Y chromosome long arm. A deletion of the Y chromosome at the distal portion of band q11 was found in 6 men with normal male habitus but with azoospermia. Five of them were found during a survey of 1170 subfertile males while the sixth was karyotyped because of slight bone abnormalities. These findings, together with a review of the literature, suggest that on the distal portion of the nonfluoresecent segment of the long arm of the Y, factors are located controlling spermatogenesis.


Effects of inhibitors of DNA, RNA and protein synthesis on frequencies and types of premature chromosome condensation from X-ray induced micronuclei. Cells containing X-ray induced micronuclei were treated for a few hours before fixation with inhibitors of DNA synthesis (cytosine arabinoside; azathioprine; thymidine; trenimon), of RNA synthesis (actinomycin D; ethidium bromide), and of protein synthesis (puromycin). Only the inhibitors of DNA synthesis lead to a significant suppression of the frequencies of mitoses with micronucleus derived premature chromosome condensation (PCC). We tend to interprete the result as follows: Micronuclei that are in the G1 phase of their cell cycles are accumulated at the G1/S border or in the early S phase of their cell cycles under the influence of the inhibitors of the DNA synthesis. Micronuclei blocked in this way cannot be induced to undergo PCC and seem to disappear from the cells.


Partial trisomy 9q--chromosomal syndrome. The clinical features consisting mainly of enophthalmos, beaked nose, narrow palpebral fissures, receding chin, long fingers and toes, typical for chromsomal syndrome or partial trisomy 9q, were confirmed in a new case.


Partial trisomy 20p derived from a t(18;20) translocation. Two sibs show a strikingly concordant syndrome of congenital anomalies and G-banding reveals that each has partial trisomy 20p resulting from a t(18;20) translocation. They resemble other cases of partial trisomy 20p in some respects but also differ in some ways. Their normal sib, mother, and half-aunt are balanced heterozygotes for the t(18;20) translocation. The segregation of the balanced translocation in this family is associated with an extremely poor reproductive record. The segregation pattern closely parallels that of a t(13;20) translocation in a family described by Carrel et al. (1971) and Francke (1972). The similarity of segregation patterns is predictable on the basis of probable pachytene configurations, but the dissimilarity of phenotypes between families is not readily explained.


Expansion and contraction of hypomelanotic areas in human piebaldism. A case of human piebaldism with white forelock is presented, with emphasis on the unusual aspect of expansion and diminution of the hypomelanotic areas. Possible mechanisms of piebaldism and of changes in the hypomelanotic areas are discussed.


Comparative investigations on cytogenetic effects of X-irradiation on the germinal epithelium of male mice and Chinese hamsters. In one short-term-experiment and one long-term-experiment spermatogonia of mice and Chinese hamsters were compared for their sensitivity of X-ray induced chromosome aberrations. Short-term-experiment: Six hours after varying doses of X-rays the spermatogonia of both species were analysed and the number of induced chromatid breaks determined. At the dose range from 25-125 R the number of induced chromatid breaks per cell per roentgen is 0.01 in mice. In Chinese hamsters this value is 0.0072. The frequencies of chromatid breaks were studied in both species after a single dose of 100 R until 48 h p.i. The frequency in mice decreased more slowly than in hamster spermatogonia. After 12 h p.i. the ratio breaks in mice cells: breaks in hamster cells was 3.5:1, after 24 h this ratio was 5.2:1 after 48 h both frequencies were on the same level. Long-term-experiment: Analysis of spermatogonia and primary spermatocytes has been done 5 weeks after irradiation of the mice and 2, and 4 months after irradiation of the Chinese hamsters. The number of observed reciprocal translocations turned out to be higher in spermatogonial mitoses than in diakinesis-metaphases I in each animal. The conclusion is drawn for mice that a selection against abnormal cells is taking place already during pre-meiosis. In hamster pre-meiosis, the results are only indicative for a similar effect.


Quantitative and qualitative study of acrocentric associations in 109 normal subjects. This study involving 109 normal subjects shows that the mean number of associations by cell seems to represent a biological constant which is not sex related and increases with age, especially after 33 years. From a qualitative point of view, the associations are not at random and their distribution varies from one individual to another. The tendency to associate is a characteristic of a given chromosome in a given individual.


Staining of the spindle apparatus in human lymphocyte and fibroblast cultures. The spindle apparatus of human mitoses can be preferentially stained with Giemsa if the cells are fixed with methanol--acetic acid and treated for about 15 min with 0.1 X SSC at 92 degrees C and for 18 h with 2 X SSC at 60 degrees C.


Stability of X chromosome differentiation in mouse embryos. Reversal may not be responsible for the extreme X-inactivation mosaicism in extraembryonic membranes. By means of a double labeling method with H3-thymidine and 5-bromodeoxyuridine, it was found that the X chromosome showed no sign of change from an allocyclic to an isocyclic state, or vice vers in 6.5- and 7.5-day mouse embryos. Thus, reversal of allocycly may not account for the predominance of cells with the paternally derived X chromosome inactive in the yolk sac and the chorion of the mouse embryo.


Possible intrachromosomal duplication in a case of trisomy 9p. A 5-year-old boy with multiple minor anomalies and mental retardation was found to have chromosomal condition of 46,XY,inv dup(9p) (pter leads to p13::p21 leads to p24::p13 leads to qter). The clinical features of the propositus fit well with those of trisomy 9p which have been established to be a clinical entity.


Trisomy 4p due to a paternal t(4p-;16p+) translocation. A patient is described carrying a duplication 4p12 leads to pter due to a paternal translocation: 46,XY,t(4;16) (p12;p13). Involvement of chromosome No. 16 and the heterogeneity of the clinical picture in cases with dup (4p) are discussed.


Cytogenetic survey of a hospital for the mentally retarded. A cytogenetic survey of all 588 patients in Strathmont Training Centre, an Australian hospital for the mentally retarded, was carried out. Abnormal karyotypes were found in 90 (15.3%) patients, of whom 73 (12.4%) had clinical Down syndrome, 12 (2.04%) other autosomal abnormalities, and 5 (0.85%) sex chromosome abnormalities.


Chromosomal damage in epileptics on monotherapy with carbamazepine and diphenylhydantoin. We analyzed the leukocyte chromosomes of 10 epileptic probands on monotherapy with carbamazepine (CP), of 14 epileptic probands on monotherapy with diphenylhydantoin (DPH) and of 20 clinically normal probands (controls, CO). In the CP and in the DPH group we found a significant elevation of exchange-type aberrations as compared to the CO group. In the CP group we found predominantly chromatid translocations, in the DPH group exclusively dicentric chromosomes.


Studies on frequency of Y chromatin in human sperm. The preparation and evaluation of human ejaculate smears on cover glasses enables double-sided examination of the individual sperm heads in the fluorescence microscope. By this method of observation the frequency of Y chromatin in the ejaculates of 19 probands increased significantly to between 1.7 and 6.3%. However, the frequency of 50% Y chromatin-positive sperms theoretically to be expected is not found by applying this technique. Furthermore, sexual abstention of at least 14 days leads to a statistically significant decrease of the frequency of Y chromatin. These observations could explain why the data on Y chromatin frequency reported in the literature appear so inconsistent.


Hand dermatoglyphics in trisomy 4p.

Hand dermatoglyphics in trisomy 4p. A dermatoglyphic analysis of the hands of 16 patients with trisomy for the short arm of chromosome 4 has revealed an increased frequency of whorl patterns on fingertips, presence of axial triradii in position t' on palms and an increase of the main line index. Although of little diagnostic value these changes must be included in the constellation of major signs which characterize the 4p trisomy syndrome.


Rapid prenatal and postnatal detection of inborn errors of propionate, methylmalonate, and cobalamin metabolism: a sensitive assay using cultured cells. A sensitive, reliable, and easily performed procedure is described for the prenatal and postnatal detection of inborn errors of propionate, methylmalonate, and cobalamin metabolism using cultured amniotic cells and skin fibroblasts. With this assay, control fibroblast lines incorporated a mean of 6.89 nanoatoms 14C/mg protein from [1-14C]propionate into trichloroacetic acid (TCA)-precipitable cell material in 10 h. Twenty-five mutant fibroblast lines from patients with propionicacidemia or one of the methylmalonicacidemias fixed 0.04 to 0.93 nanoatoms 14C/mg. Considerable variation was observed, both among and within discrete mutant classes, with respect to the residual amount of propionate pathway activity, possibly reflecting further molecular heterogeneity in these disorders. We applied this procedure to cultured amniotic cells from controls and 4 midtrimester pregnancies at risk for methylmalonicacidemia and diagnosed one fetus with a methylmalonyl CoA apomutase defect and 3 fetuses which were unaffected.


G6PD Lozere and Trinacria-like. Segregation of two non hemolytic variants in a French family. Two new G6PD variants have been found in red blood cells of the members of a French family originating from Lozere. The father is hemizygous for an electrophoretically fast variant with mild enzyme deficiency (50--60% of normal). The abnormal paternal G6PD gene is segregating in his daughter who is double heterozygous for maternal and paternal variants. This mutant enzyme, different from previously described variants is designated as Gd Lozere. The mother is heterozygous for another G6PD variant. Two sons are hemizygous for this latter mutant enzyme characterized by a moderate deficiency (25--30% of normal) and slower electrophoretic mobility with some slightly altered kinetic properties. This G6PD had been identified as Gd Trinacria like. These two abnormal enzymes are not associated with any hemolytic problem. Case reported is the first showing the segregation of two new mutant enzymes, distinct from common G6PD variants, among the members of the same family.


The distribution of esterase D variants in different ethnic groups. Blood samples collected from a number of human populations belonging to various ethnic groups were screened on cellogel for red-cell esterase D (ESD) variants. These data gathered during the present study together with those that have already appeared in the literature indicate that the common variant allele ESD2 occurs most frequently in the Mongoloid populations, least frequently in the Negroid, and with intermediate frequencies in the Caucasoids. An east to west cline was noticed in the northern populations of the Indian subcontinent; ESD2 gene frequencies in these populations were found to range between those among the Mongoloids and the Caucasoids.


The red cell 3 phosphoglycerate kinase polymorphism. Report of a new allele. Blood samples from 778 Burundian, Rwandan, and Zairan negroes were examined by electrophoresis on cellulose acetate for phosphoglycerate kinase polymorphism. PGK 1 was observed in all but 6 hemolysates; in these cases a new allele was detected, having a frequency of about 0.018 in Rwandans.


"Jumping" satellites in three generations: a warning for paternity tests and prenatal diagnosis. Prominent intensely fluorescent satellites on one chromosome 22 seem to have been transferred, during gametogenesis of a male carrier of a balanced 10/22 translocation, from the normal 22 to the translocated 22 in his daughter and son, both carriers of the translocation. Prenatal diagnosis was performed in the carrier daughter and in the chromosomally normal female foetus the satellites have jumped back to one normal chromosome 22. The phenomenon is probably due to exchanges between the short arms of chromosome 22 at meiotic pairing in the father and in his daughter. These observations give a warning for caution in the use of marker variants for paternity tests and prenatal diagnosis.


Partial monosomy 22 as the result of an unbalanced translocation 5:22 in a patient with cri-du-chat syndrome. A 2-year-old boy with features suggestive of cri-du-chat syndrome had a complex karyotype: 45,XY,--22,5p--,t(5p:22q). Clinical symptoms were catlike cry in early infancy, severe mental and motor retardation, failure to thrive, hypertelorism, antimongoloid slant of the eyes, ptosis of the eyelids, epicanthus, micrognathia, dermatoglyphics abnormalities, and partial syndactyly between 2nd and 3rd toes.


Trisomy 9 associated with an enlarged 9qh segment in a liveborn. This report describes the third case of a complete trisomy 9 in a liveborn infant. A tentative explanation for the origin of a "very large" h-segment which was not present in either parent of the proposita is put forward.


Esterase D polymorphism in Chinese and Japanese. Esterase D phenotypes have been determined in Chinese and Japanese populations in the San Francisco area. The EsD1 gene frequencies were 0.612 for the Chinese population and 0.582 for the Japanese population.


Length of human C-bands in relation to the degree of chromosome condensation. The C-band length of human chromosome 1 in prophase and prematurely condensed interphase chromosomes is relatively shorter than in metaphase chromosomes. However, even in chromosomes with the same degree of contraction the absolute length of the C-band varies considerably. This allocyclic behaviour of human constitutive heterochromatin has to be kept in mind if C-bands of different individuals are compared.


Trisomy 6 associated with aplastic anemia. A clone with 47 chromosomes was observed in the bone marrow of a patient with aplastic anemia and found to be trisomic for chromosome 6. The abnormal clone was not observed in the peripheral blood.


Chromosome 7 short arm deletion and craniosynostosis. A 7p-syndrome. A patient with craniosynostosis and a small deletion of part of the short arm of chromosome 7 is described. A review of the literature indicates that craniosynostosis has occurred in at least four of the five infants (the fifth having microcephaly) affected by structural changes (resulting in deletion) within the terminal region of the short arm of chromosome 7.


Chromosomal constitution of nucleolus-associated chromatin in man. Use of specific stains permits analysis of the frequency of nucleolus-associated heterochromatin in chromosomes 1 and 9 from human fibroblasts. In 81 per cent of interphase nuclei the heterochromatic segment of both No. 1 chromosomes is associated with the nucleolus, while in 19 per cent only one heterochromatic segment shows such an association with the other occupying a random position in the nucleoplasm. The nucleolar association of chromosome 9 heterochromatin is less constant: in 42.3 per cent of the nuclei both segments are associated with the nucleolus, in 39 per cent of the nuclei only one heterochromatic segment presents such an association, and in 18.7 per cent neither of the two heterochromatic segments is in nucleolar association. In 6 per cent of the cells, one or two chromosome 9 heterochromatic segments are in contact with the nuclear membrane. In situ hybridization using tritium-labeled 28S and 18S RNA shows that in the interphase nucleus the acrocentric short arms, carriers of ribosomal cistrons, are associated with the nucleolus. These observations demonstrate the complexity of the nucleolus-associated chromatin which, in addition to segments of chromosomes 1, 9, 13, 14, 15, 21, 22, may include the Y chromosome. They also confirm that the nucleolus constitutes one of the orientation points determining the relative localization of chromosomes in the interphase nucleus.


Chromosomal and clinical findings in 110 females with Turner syndrome. One hundred and ten patients with abnormal karyotypes who were referred to the Department of Medical Genetics with the possible diagnosis of Turner syndrome were reviewed. The frequency of chromosomal abnormalities and clinical findings in the different chromosomal types are summarized.


A new genetic variant of galactose-1-phosphate uridyl transferase. The enzyme galactose-1-phosphate uridyl transferase (E.C.2.7.7.12), which has an important function in the metabolism of galactose, exists in multiple molecular forms. The different phenotypes are genetically determined. They can be distinguished according to their electrophoretic mobility. The enzymatic activity of the different gene products varies within certain limits. A new phenotype of the enzyme has been detected in the red cells of a healthy individual. The electrophoretic migration of this phenotype is slower compared to the wild type and its enzymatic activity is lower, but still sufficient as not to cause galactosemia. An extensive family study revealed that the rare gene is inherited according to mendelian law. Independently the same gene product has been detected in two other, nonrelated individuals out of a total of 1668 samples tested. The gene frequency can therefore be estimated to 0.0009 in the Swiss population. We suggest that the new type be called Berne variant of galactose-1-phosphate uridyl transferase.


The human leukocyte test system. X. higher sensitivity to X-irradiation in the G0 stage of the cell cycle of early as compared to late replicating cells. Leukocyte cultures were set up with X-irradiated whole blood (200 R). Cells starting with their DNA synthesis between 25 and 35 h after cultureinitiation ("early replicating cells") were pulse-labeled with tritiated thymidine ([3H]TdR). Mitoses were collected with colcemid in adjacent intervals from 36 up to 72 h after culture initiation. At fixation times of 50, 56, 62, and 72 h enough mitoses for a determination of the frequencies of chromosomal aberrations (dicentric and ring chromosomes) were found. After that the preparations were processed for autoradiography. All mitoses analyzed for chromosomal aberrations were re-analyzed for labeling, and the frequencies of chromosomal aberrations in labeled (="late replicating cells") mitoses were compared. At all fixation times, higher frequencies of dicentric chromosomes were found in labeled as compared to unlabeled mitoses, indicating a higher sensitivity of early replicating cells to X-irradiation in the G0 stage of the cell cycle.


Localization of the Bf locus within the HLA region. Report on an informative family and critical evaluation of available data on Bf mapping. Since the estimation of recombination fractions is only an arbitrary means to map genetic loci on chromosomal regions, family studies of cases with informative cross-overs within the region in question are of decisive importance. This paper reports the study of a family with a HLA-B to HLA-D cross-over which is informative in the Bf system. The possible reasons for conflicting published data on Bf gene mapping are discussed.


Laser UV microirradiation of interphase nuclei and post-treatment with caffeine. A new approach to establish the arrangement of interphase chromosomes. Laser UV microirradiation of Chinese hamster interphase cells combined with caffeine post-treatment produced different patterns of chromosome damage in mitosis following irradiation of a small area of the nucleus that may be classified in three categories: I)intact metaphase figures, II)chromosome damage confined to a small area of the metaphase spread, III)mitotic figures with damage on all chromosomes. Category III might be the consequence of a non-localized distortion of nuclear metabolism. By contrast, category II may reflect localized DNA damage induced by microirradiation, which could not be efficiently repaired due to the effect of caffeine. If this interpretation is right, in metaphase figures of category II chromosome damage should occur only at the irradiation site. The effect might then be used to investigate neighbourhood relationships of individual chromosomes in the interphase nucleus.


Glutamic pyruvic transaminase and esterase D types in the Asian-Pacific area. More than 11000 blood samples have been examined for glutamicpyruvic transaminase (GPT) and almost 9000 for Esterase D(EsD) in the Asian-Pacific area; GPT3 and GPT6 were detected in several population groups in New Guinea, Singapore and some Pacific islands. No previously undescribed alleles were found in either system.


Asbestos cancers as an example of the problem of comparative risks. Major differences in excess cancer risks have occurred in the asbestos industry in the past; part of this difference is probably related tp dustiness, part to the type of fibre used. In the case of mesotheliomas there is evidence of a major effect of the fibre type in the order of risk, crocidolite greater than amosite greater than chrysotile greater than anthophyllite. Differences of risk within an industry indicate that there is a dose response relation for both bronchial cancers and mesotheliomas. Also that in some instances it has been possible to identify lightly exposed groups in which no excess risks were detectable. As these least exposed groups are likely to have had several orders of magnitude heavier exposure than the general population, the risks to the general public are likely to be negligible. Bronchial cancers in absolute numbers are the major excess risk and are highly smoking-related. Stopping cigarette smoking is likely to be of paramount importance in reducing the excess cancer risks in asbestos-exposed individuals. Cancers in other sites which may possibly be related to asbestos exposure need further study even though the magnitude of the excess risk has been small compared to the lung cancers. In my view it is now possible to use the epidemiological evidence and experimental results to predict with fair confidence the physical and chemical characters and dose of natural and man-made fibres which will not cause a significant hazard in the future.


Effect of changed working techniques on asbestos dust levels in the working environment. The methods are presented for correcting the working environment when asbestos dust concentrations are too high. Asbestos dust, being fibrous, remains suspended longer than most industrial dusts, and has a tendency to pack and cling together. Sophisticated monitoring techniques have made possible the attainment of standards that are effective in controlling risks of asbestos related diseases. The most difficult situation to control is the dust produced in stripping old asbestos lagging, but predamping has greatly reduced the contamination. Special attention has been paid to the special needs of people working with asbestos on building sites. Special hoods have been designed to protect workers drilling, cutting and sanding asbestos material. The Environmental Control Committee has prepared a series of Control and Safety Guides and a Code of Practice for the Disposal of Asbestos Waste Material as part of activities to promote new and improved methods of dust control.


Occupational chemical carcinogenesis: new facts, priorities and perspectives. There is need for a new active approach to the problem of occupational carcinogenesis. It is no longer acceptable to adopt a "wait and see" attitude since: 1. evidence suggests that cancer is an "ecological" disease; 2. The carcinogenic risk has been increasing as industrialisation increased; 3. Factory workers are the most exposed population and hazards spread from the work-place to the general population as consumer goods and pollution. It is necessary and possible, to identify potential carcinogens before workers and the general population are exposed. That predictive experiments could be done, is exemplified by the history of stilboestrol, bis (chloromethyl) ether, vinyl chloride and chromium pigments, all of which were reported carcinogenic in animal tests before any epidemiological results were available. Unforturnately, these results were received with scepticism because the test methods were thought to be inadequate. It is necessary to develop the future policy of prevention by: 1. establishing a priority for testing compounds already produced and widespread in occurence and those about to be produced on a large scale; 2. establishing experimental models for determining carcinogenic risk, especially rapid screening tests; 3. study of the more important compounds by long-term bioassays. Full details are given of the testing of vinyl chloride monamer and preliminary results are tabulated for tests on styrene, acrylonitrile and vinylidene chloride.


Metabolism of 14 C-vinyl chloride in vitro and in vivo. Rat liver microsomes metabolise 14 C-vinyl chloride to intermediates which irreversibly bind to the microsomal protein and to soluble proteins and RNA, when these compounds are added to the incubation. A superoxide (O2) generating system comprised of phenazine methosulfate and NADH also converts 14 C-vinyl chloride to metabolites which irreversibly bind to albumin. These data are consistent with the assumption of chloroethylene oxide being the primary reactive metabolite of vinyl chloride. If rats are exposed to 14 C-vinyl chloride, about half of the radioactive metabolites in the liver microsomal fraction is bound irreversibly to microsomal protein, when assessed immediately after exposure. Large amounts of polar, extractable, metabolites are present in the cytosol fraction. The amount of radioactivity in tissues of the rats, irreversibly bound immediately after exposure, comprises 10 - 40% of the total radioactivity in tissues. This percentage rises up to 70% after 48 hrs. Som radioactivity derived from 14 C-vinyl chloride is also incorporated into DNA and RNA of liver. Whereas the peak of incorporation of 14 C into DNA is already reached immediately after exposure to 14 C-vinyl chloride, specific labelling of RNA increases after exposure until its maximum after 24 hours.


Carcinogenic potential of chlorinated ethylenes tentative molecular rules. Chlorinated ethylenes are activated in mammalian metabolism to oxiranes. Only those with asymmetric chlorine substitution are mutagenic (trichloroethylene, vinylidence chloride and vinyl chloride) whilst the symetric molecules (tetrachloroethylene, cis- and trans-1.2-dichloroethylene) are inactive in this respect. Thus, stability of the oxirances (higher in the symmetric molecules, lower in the asymmetric ones) seems to be the important feature for the mutagenic, and possibly carcinogenic potential.


[Chemical carcinogenesis in tissue culture: criteria and transformation tests]. We belive that there are four criteria for the evaluation of cell transformation in culture: development of transformed colonies, appearance of altered foci when cells sensitive to contact inhibition are used, formation of colonies in agar, and the capacity to induce tumors in animals (tumorigenic potentiality). The formation of transfomred colonies provides a short term (t. of BERWALD-SACHS) to determine the transformating activity of chemical carcinogens. Judging by the published results there is a good correlation between this in vitro test and in vivo results. Nevertheless this test does not seem to me appropriate to studies on the activity of complex mixtures. But the use of a short term test to monitor transformation in the course of long term tests does seem justified and useful. The formation of altered foci is the basis of two intermediate term tests (t. of CHEN-HEIDELBERGER, and t. of HUEBNER'S group). The value of these two tests have been experimentally proven, but their only disadvantage is the necessity of using cells that are not readily available. Formation of colonies in agar is a criterion useful only for the control of cell transformation during long term tests. Tumorigenicity constitutes a long term test. It is the absolute proof of cell transformation. We propose a long term experimental system combined with periodic checks of transformation by cell cloning in liquid medium (criteria of the transformed colonies or altered foci), and by cloning in agar. The reported results show that it is possible to determine cellular transformation accurately without recourse to the animal. This combined long term test permits the classification of treatments based on their transformating capacity.


Application of the results of carcinogen bioassays to man. Animal experiments to test for the possible carcinogenic activity of chemicals provide the best and only deeply researched method for the detection or environmental carcinogens for man. The fact that most known human carcinogens give tumors in animals encourages the belief that these tests have validity. However, there are significant differences in the numbers of the exposed populations of men and animals, in the part of the lifespan during which each is exposed, in the metabolic activation of the carcinogens, and in the longevity of men and experimental rodents. For regulatory purposes, we must assume that the results of bioassay in rodents will closely parallel tumor induction in man, although we cannot be sure of this. In some cases, such as rodent bladder tumors associated with bladder stone, or subcutaneous sarcomas arising locally to massive injection of food dyes, there may be reason to reject an association. It is only by continued research into the way in which both man and laboratory animals react to carcinogens that we may hope to refine our methodologies and obtain an accurate, well-defined net to trap potential environmental carcinogens without depriving the community of chemicals, through false associations or false positive results that may be of great value, sociiologically or economically.


[Capacity of cells in culture  to a accumulate polycyclic aromatic hydrocarbons at microspectrofluoremetric detectable levels. Preliminary results]. In the course of more general microspectrofluorometric studies on intracellular metabolic control mechanisms, the behaviour of living cells was investigated in culture media containing traces of Benzo(a)Pryene (BP) difficultly recordable by spectrofluorimetry. A rapid transfer of BP to the intracellular phase with accumulation was observed. In this manner the recording of the hydrocarbon fluorescence emission spectrum from one single cell became very easy. This fact has led to the investigation of the experimental conditions required for a quantitative detection of trace amounts of aromatic hydrocarbons, and the results presented here are the initial finding of such analysis. In a first part, the requirement for a recording of the complete fluorescence emission spectrum will be emphasized as a condition for a quantitative results. The second part of the presentation is devoted to observations effectively made on fluoresence emission spectra recorded from cells grown in the presence of traces of BP. Due to the aim pursued it is evident that the cells selected for this type of studies should exhibit a relatively slow metabolization of the hydrocarbon. Two significant facts emerge: (a) in most cases the fluorescence spectrum recorded from BP-medium grown cells is not identical to that of BP in solution (less defined structure, displaced maxima, and modified relative intensities of maxima). The spectrum observed in the BP medium grown cells is apparently the result of two spectra, one corresponding to a free BP fraction, the other to a BP fraction interacting with cellular constitutents. (b) When the cells were maintained for periods up to one to three months in presence of low amounts of BP, it was noticed that the BP fractions "interacting" seemed relatively more significant than in cells non "adapted"to BP. Both results are evidently subject to biological intrpretations outside the scope of this communication. However, they permit to draw the attention on the fact, that the quantitative determination of the hydrocarbon in the living cell can be achieved only after definition of a sufficiently precise experimental protocol.


Feasibility of monitoring populations to detect environmental carcinogens. In relation to cancer, monitoring, i.e. "continuing observation in order to decide when changes in incidence or mortality may have occurred" can be of two types: (a) passive (or routine) monitoring using routinely collected cancer statistics for populations in general (b) active (or exposure-oriented) monitoring in which the cancer experience of groups with specific exposures is compared with that of the non-exposed. The advantages and disadvantages of mortality and morbidity data for passive monitoring are listed. It is concluded that passive monitoring can rarely do more than indicate areas for further study. The potential of active monitoring is examined by consideration of industrial and occupational exposures, the follow-up of persons on prolonged drug therapy (including transplacental effects) and changes in cancer risk following migration. As such studies are often univariate, it may not be possible to allow for the effect of other factors, and confirmatory studies will often be required. It is belived that priority should currently be given to monitoring occupational exposures, particularly those involving chemicals shown by animals studies to have carcinogenic activity. To monitor everybody for everything will result in nothing. The social responsibilities which devolve on monitors, the authorities, both sides of industry and the general public as a result of the establishment of monitoring systems are discussed. It is concluded that monitoring, active or passive, does not represent a quick road to the identification of environmental carcinogens but can point to products or processes likely to have a cancer risk - a risk which would have to be confirmed or otherwise by other methods.


Analysis of atomospheric carcinogens and their cofactors. Problems in the sampling and analysis of a variety of key air pollutants have been considered. The pollutants of primary interest were those with carcinogenic, mutagenic or cofactor activity. These include benzo[a]pyrene, polynuclear aromatic hydrocarbons, aldehydes, alkylating agents, amines, chloromethyl ethers, epoxides nitrosamines, nitrogen dioxide, nitrates, sulfate and sulfite. Screening tests of the analytical and bioassay types were also discussed; a large variety of these tests were summarized in tables. Concentrations of benzo[a]pyrene in urban atmospheres, in highly polluted atmospheres and effluents, and in a large variety of environment mixtures were reported.


[Measurement of potential environmental carcinogens. II. Final determination methods]. As part of a general study of the biological activity of atmospheric micro constituants, we have perfected the methods for the rapid determination of polycyclic aromatic hydrocarbons. The method involves the use of two selective collectors, a high output rotatory freeze-drier, two-dimensional thin-layer chromatography and gas chromatography. A pollution map has been prepared of the Lyons areas showing the atmospheric concentrations of 13 polycyclic aromatic hydrocarbons and their variation with weather and sampling point.


[N-nitroso compounds. Analysis and possible carcinogenicity in man]. Much work has been carried out on N-nitroso compounds but their role in human pathology has still to be elucidated. We cannot extrapolate experimental data to the human situation but we do have indirect evidence that nitroso compounds can be carcinogens in man. Although some nitrosamines are organ-specific, the nitroso group induces the development of many different types of cancer in animals  It is probable that the same phenomenon occurs in human pathology, and we cannot therefore expect to have special case reports on their carcinogenicity in man. Therefore, an alternative approach to the study of the role of nitrosamines in human pathology would be to establish a correlation between cancer morbidity in some regions and amounts of N-nitroso compounds in the environment. In view of the complexity of the problem of in vivo nitrosamine formation, it is more realistic nowadays to measure exogenous nitrosamines. Many laboratories are currently engaged on studies on N-nitroso compounds, although systematic information on their presence in the environment is scant. Furthermore, the data acquired by different laboratories has been obtained using a variety of methods for sampling, storage, clean-up and identification and estimation, with the result that it is not known to what extent these results are comparable.Therefore, the standardization and determination of comparability of methods for the identification of N-nitroso compounds is the first step towards their quantitation in the environment. Adequate methods are now available for the determination of volatile nitrosamines, down to the mug/dg level, but methods for non-volatile nitrosamines are still in the development stages. In order to avail all interested laboratories of information on analytical methods for volatile nitrosamines, IARC's analytical chemistry laboratory has organized a three part collaborative study using samples of canned luncheon meat. The results of this study were encouraging, and the European Sub-Committee for the Guidance of Collaborative Studies, at its last meeting, recommended that such studies be continued and extendedto include non-volatile nitrosamines. In parallel with the perfection of analytical techniques, IARC has initiated studies on the measurement of volatile nitrosamines in the environment in conjuction with the epidemiological studies on oesophageal cancer at present being carried out. The data collected up to now is far from being complete but it is important in that it represents the first step towards the evaluation of the risk to health of N-nitroso compounds, which constitute a part of the total carcinogenic load in the human environment.


Control of carcinogenic hazards in industry. Complete control of carcinogenic hazards in industry is an unrealistic concept. Industry, nevertheless, has a duty to give careful consideration to existing carcinogenic hazards, and to the possibility of new ones. Only well recognized hazards can be subjected to legislative control. Industry must take into account published experimental and epidemiological data, along with physical and chemical considerations related to specific agents, and, where necessary, introduce appropriate preventive measures.


The trade unionist's view of occurpational cancer. The Transport and General Workers' Union (UK) has an active programme devoted to monitoring the health of its 1.8 million members. Files on members who died of bladder cancer after exposure to beta-naphthylamine go back to the late 1920's. From the same period came data on members suffering from asbestosis which included same cases of lung cancer before the industrial cause of the disease was recognized. These and other more recent examples including Nonox S and vinyl chloride amply justify the need for setting up registers of all workers who are at risk from industrial exposure. The scientfic community has a responsibility for communicating data regarding hazards both to employers and employees who can then ensure that all who have been exposed can be notified and screened. The trade unions have a part to play in ensuring that industry accepts conditions of greater control under the new regulations in the United Kingdom. There must be a continuing tripartite discussion between industrial management, trade unions and the responsible governement official.


Aviation and environmental benzo(a)pyrene pollution. Spectrofluorescent methods of analysis have shown that soot and exhaust products of aviation engines, both piston and turbine, contain benzo[a]pyrene (BP). A modern aircraft engine releases into the atmosphere from 2-10 mg BP per min. Extracts of aviation engine soot applied to the skin of mice induced malignant tumors in almost all treated animals. The ground within airports is polluted with BP, its level diminishing with distance from the runway. The concentration of carcinogenic hydrocarbons in aircraft exhausts is dependent on the working regime of the engine and on the character of fuel combustion.


Carcinogens in estuaries, their monitoring and possible hazard to man. Bottom-dwelling flatfish and their skin tumors can be used as an early-warning-system for the pollution by chemical carcinogens in sub- and inter-tidal waters. A trial in British Columbia and the State of Washington showed a link between tumor prevalence and urban activity. The possible use of marine accumulator organisms (mussels) in the estimation of benzo(a)pyrene levels of harbours is considered. The combination of biological and chemical assays could provide the basis for a large-scale routine surveillance of the marine environment.


Studies on the effect of feeding nitrite and secondary amines to Wistar rats. 1. When 1 000 mg/l sodium nitrite are added to drinking-water, nitrosamines are formed in the stomachs of Wistar rats at levels greater than the background only if the concentrations of added DMA or pyrrolidine exceed 1 000 mg/kg. Once this concentration is exceeded there is a rapid increase in nitrosamine formation up to 2 000 mg/kg added amine; however, for pyrrolidine, the rate of increase of NPy decreases when the dietary level of amine exceeds 2 000 mg/kg. This threshold level of 1 000 mg/kg amine is one which is rarely reached in normal human dietary patterns. 2. Due to the presence of this threshold it is unrealistic to extrapolate from high experimental dietary concentrations of secondary amines to those found in practice when considering nitrosamine formation in vivo. 3.The concentration of dietary amine has a greater influence on nitrosamine formation in the stomachs of rats than does the concentration of nitrite in drinking-water (up to 1 000 mg/l). This finding is in contradiction to the current kinetic theory of nitrosamine formation, in which formation is predicted to be proportional to the square of the nitrite concentration.


Mass spectrometry of nitrosamines: rearrangement of nitrosobenzylmethylamine molecular ions with loss of OH-radicals investigated by deuterated derivatives. Nitrosamines (R1R2NO) containing a certain R groups yield mass spectra with M+-OH fragments which can be accounted for by intramolecular hydrogen shift with subsequent cleavage of OH-radicals. As can be shown with mass spectra of specifically deuterated derivatives of nitrosobenzylmethylamine - nitrosobenzyltrideuteriomethylamine, alpha,alpha-nitrosodideuteriobenzylmethylamine and o,o',p-nitrosotrideuteri0-benzylmethylamine - hydrogen transfer within the molecular ion of nitrosobenzylmethylamine occurs selectively onto the  oxygen of the nitroso group from the benzylethylene group, probably via a five-membered cyclic transition state. Cleavage of OH radicals leads to formation of M+-17 ions, the stability of which can be explained by mesomerically stabilized cyclic diazirinium ions.


DNA repair synthesis in guineapig pancreas following exposure to nitrosomethylurethane. NMUT, a known pancreatic carcinogen in guineapigs, alkylates pancreatic DNA and RNA, both in vivo and in vitro. Following the in vivo administration of a single maximum tolerated dose of NMUT (30 mg/kg), a significant increase in 3H-Tdr incorporation into DNA was observed in the duodenal segment of the pancreas after four days; this increase in thymidine incorporation probably represents in vivo DNA repair synthesis. The level of normal DNA synthesis was greater in the duodenal segment than elsewhere in the pancreas. In vitro exposure of pancreatic slices from the duodenal segment to 20 mM NMUT for 30 minutes resulted in a significant increase in 3H-TdR incorporation into DNA in the presence of HU, reflecting DNA repair synthesis following NMUT-induced DNA damage; normal DNA synthesis in the pancreatic slices in vitro was markedly suppressed by 10 mM HU. Studies on the kinetics of DNA repair synthesis in pancreatic slices indicated an initial increase of 3H-TdR incorporation, followed by a steady time-dependent decline. It appears that most of the DNA repair synthesis occurs within two hours after exposure to NMUT.


Prenatal and postnatal toxicity induced in guinea-pigs by nitrosomethylurea. Oral administration of NMU at maximally tolerated doses of guinea-pigs from day 34 to 58 of pregnancy induced embryotoxic effects, as evidenced by a high incidence of stillbirths and reduction in birth weight, and postnatal toxic effects, as evidenced by stunting, progressive mortality and extensive fatty degeneration of the liver in F1 progeny. Similar administration of NMUT at maximally tolerated doses did not induce such toxic effects.


Toxic and carcinogenic effects of nitrosodimethylamine in mink. In a feeding experiment, 96 mink divided into four groups were kept on diets in which each animal received from 0.04-0.07 mg/kg bw NDMA/day. After four months' feeding the mink were still in good health. Except for 20 mink kept for breeding, the animals were skinned. They showed no gross lesions; however, in the livers of mink receiving a total of 16-21 mg/kg bw NDMA some of the smaller hepatic veins were partially occluded. The 20 remaining mink and their offspring were all kept on the same diet, which included 10% herring meal with a NDMA content of 7.2-7.8 mg/kg. After 233 experimental days and a total intake of 26 mg/kg bw NDMA one male died of liver fibrosis and occlusive changes in the hepatic veins. The remaining 16 in the parent group and 22 in the F1 group developed haemangiomatous liver tumours after a total intake of 25-87 mg/kg bw NDMA. The carcinogenic action of NDMA on mink appears to be nearly 100% if the exposure time is long enough and if the dose is near to the hepatotoxic level.


A metallurgical examination of fractured stainless-steel ASIF tibial plates. Between 1970 and 1973 99 tibial fractures were treated by rigid internal fixation with ASIF plates. The fractures were all regarded as sufficiently stable for exercise without weight bearing, thus needing no additional external support during the healing period. Four of the plates broke late in the healing period, after the onset of weight bearing. These fractures had some degree of delayed union with slight resorption of the bone ends, resulting in cyclical bending of the plate. Examination of 2 of the fractured plates by scanning electron microscopy, electron microprobe analysis and optical metallography revealed that the primary cause of plate fracture was fatigue. There was no evidence that corrosion fatigue or inclusion content were factors leading to plate fracture.


Anterior urethral injuries.

Anterior urethral injuries. Seventeen patients are reviewed who presented at the Birmingham Accident Hospital over a 20-year period with injuries to the anterior urethra. Fourteen of the injuries resulted from isolated direct blows to the perineum, while 3 were associated with multiple injuries. The clinical features and management of these patients are discussed in conjunction with a review of the relevant literature. A protocol for the management of this type of injury is outlined.


Reversed dynamic slings. A new concept in the treatment of post-traumatic elbow flexion contractures. Following the successful treatment of knee-flexion contractures in haemophiliacs using an external corrective system with reversed dynamic slings, these have been adapted to treat post-traumatic elbow contractures. A case is described in which 90 degrees of fixed flexion was corrected in 1 week without discomfort. Clearly there is no need to resort to an internally applied hinge-distractor apparatus or capsulectomy if a simple external sling system is successful without complications.


Treatment of old unreduced dislocation of the elbow. Twenty-six patients with old unreduced dislocation of the elbow treated by open reduction were reviewed. All patients improved after surgery. It is felt that any patient with an elbow dislocation which is less than 3 months old should be treated by open reduction. The operative technique using a medial and lateral approach and keeping the dissection extraperiosteal is described.


Rotational deformities after fractures of the femoral shaft in childhood. Sixty-two patients with femoral fractures treated conservatively have been studied over an interval of 1 to 6 years. Rotational deformity was assessed by a radiological method of anteversion measurement. The degree of rotational deformity following fracture ranged from 10 degrees to 33 degrees in just over one-third of the whole group; by later assessment there was no evidence of spontaneous correction during growth. In view of the possibility of early complaints, e.g. pain and fatigue in the abnormally rotated extremity, and the potential risk of subsequent arthrosis, we consider that rotational deformity over 20 degrees ought to be avoided. It is suggested that use of the extension table of Weber is the most satisfactory conservative method of treatment of femoral fractures in childhood (Weber, 1969). This enables correction of significant rotation deformity during treatment under radiographic control.


Two episodes of clinical fat embolism following multiple fractures. Second episodes of clinical fat embolism have not previously been reported. This paper presents the case report of a patient with multiple fractures who developed two distinct attacks with a symptom-free interval. The second attack was partly responsible for death, and histological examination confirmed the diagnosis.


A conservative approach to penetrating injuries of the chest. Experience with 131 successive cases. One hundred and thirty-one cases of penetrating injuries of the chest were reviewed prospectively. A policy of conservative management is advocated, based on the intercostal drainage of moderate or large collections of fluid and/or air. The site of the intercostal drain is not an important factor in the management.


Injection injury of the radial nerve.

Injection injury of the radial nerve. Four cases of radial nerve palsy following intra-muscular injections into the arm are reported. Recovery occurred in all 4 cases--1 after neurolysis and 3 spontaneously. The mechanism of nerve damage and its treatment are discussed.


Brachial plexus lesions complicating anterior fracture-dislocation of the shoulder joint. Four cases of brachial plexus lesions caused by anterior fracture-dislocation of the shoulder are reported. The incidence, mechanism of injury and prognosis are reviewed.


Bilateral anterior dislocation of the shoulders: a case report. A case of bilateral subcoracoid dislocation of the shoulder is described and the clinical presentation commented on.


Central dislocation of the hip with complications. A case of severe central fracture-dislocation of the acetabulum is described. This lesion was complicated by a small-bowel rupture and occlusion of the iliac vessels. In order to reduce the dislocation, iliopubic osteotomy and excision of the hip joint capsule was necessary.


Chronic Clostridium septicum infection of a tibial fracture: a case report. An open transverse fracture of the mid-shaft of the tibia of a professional footballer became infected by Clostridium septicum and, after early compression plating, required surgical intervention on three further occasions and extensive antibiotic treatment before healing occurred. Clostridial infection is a recognized complication of open fractures contaminated with soil, and the necrotizing toxins produced by the C. septicum were probably responsible for the persistence of this infection. Infection occurred in less than 1 per cent of our series of 215 operations of compression plating of fresh fractures of the tibial shaft. Infection by clostridium species is a serious complication of open fractures. This patient did not show the spreading inflammation and necrosis, or the marked systemic upset, characteristic of acute clostridial infection, but persistent local infection necessitated prolonged surgical and antibiotic treatment.


Injuries of the axillary artery caused by fractures of the neck of the humerus. Three patients are presented in whom the axillary artery was injured in combination with a simple fracture of the neck of the humerus. The pathological anatomy, symptomatology, diagnosis and treatment of these lesions are discussed with reference to our own experience.


Superior mesenteric artery injury: a case report. A case of blunt trauma to the upper abdomen with multiple organ injury is described. The lesion involveing the superior mesenteric artery was undiagnosed at operation. The subsequent diagnosis and handling of the case is described with a review of the literature on blunt injury to this vessel.


The results of prosthetic replacement in fracture-dislocations of the upper end of the humerus. Eleven patients with fracture-dislocation of the upper end of the humerus treated by a Neer prosthesis are reviewed. The results of treatment are very disappointing. The complication rate is high. From these results in a small series, it would appear that prosthetic replacement of the humeral head does not offer the patient any significant advantage when compared with other reported methods. The possible cause of these poor results are discussed.


Analysis of karate injuries sustained in 295 contests. The injuries sustained in 295 karate contests were analysed. It was noted that in 25 per cent of the contests there was some sort of injury, and in 10 per cent the injury was severe enough to cause the withdrawal of the participant. Injury seemed to occur most commonly among lower-grade participants and more often in the first hour of each day's competition. Protective padding of the arms, legs, feet and hands, and the use of gumshields and protective boxes appeared to reduce the incidence and severity of injury.


The use of the Küntscher Y nail in the treatment of intertrochantertc and subtrochanteric fractures of the femur. Conventional nail plates provide a relatively poor fixation of unstable and pathological fractures of the upper femur, and nail-plate failure is not uncommon. A two-part device, the Küntscher Y nail, provides a strong fixation in these cases and is not difficult ot insert if the method described is employed. The results in 91 patients treated with the Y nail are discussed. Since distal migration of the nail has been prevented by use of a flanged medullary nail, no mechanical failure has occurred. Early weight bearing can be permitted after operation.


Plastic injection injury of the hand.

Plastic injection injury of the hand. A unique case of injection of plastic material into the hand is reported. Treatment was simple because the molten plastic solidified, separated readily from the surrounding tissues and could be withdrawn without fragmentation. There was no evidence of serious damage to the surrounding tissues by the plastic before it has cooled and set. The mechanism of the injury is explained and the need for simple safety precautions is noted.


An unusual ulnar nerve injury associated with dislocation of the elbow. A case of anterior traumatic transportation of the ulnar nerve presenting as a nerve palsy after dislocation of the elbow is described.


Hang gliding injuries.

Hang gliding injuries. Two fatal and 42 non-fatal hang gliding accidents are reported. The commonest cause was stalling the craft, either owing to adverse winds or to pilot inexperience. The most frequent injuries were fractures of the wrist, humerus and spine. Inexperienced pilots were involved in most of the accidents, so that the training and supervision of novices is of fundamental importance if the accident rate of the sport is to be reduced.


Rehabilitation of the brain-damaged survivor. This paper described the detailed examination of 121 patients who had suffered from traumatic brain damage. An important feature of the study was that all patients were examined by methods devised by the therapists in the department concerned, and the results subsequently integrated. The patients are described and their ability to return to independent existence is assessed in relation to the duration of unconsciousness and of post-traumatic amnesia (PTA). One method in particular, devised in the physiotherapy department, seems to suggest scope for developing recovery curves that might prove valuable indicators of the effectiveness of long-term therapy.


Iatrogenic factors in femoral neck fractures. A study of 200 femoral neck fractures in ambulant patients showed that 62 per cent of subcapital and 58 per cent of trochanteric fractures occurred without a significant history of injury. It was also observed that almost 70 per cent of patients in this group were on long-term medication which could affect bone density. In the remaining patients with a definite history of injury, only 20 per cent and 21 per cent respectively were on long-term therapy, figures which corresponded to the 18 per cent of patients on prolonged medication attending with minor injuries (age- and sex-matched). The action of corticosteroids, thyroxine, phenobarbitone, phenytoin, frusemide and bendrofluazide on bone density and their responsibility for femoral neck fractures are discussed.


Activity in saline of phthalylated or succinylated derivatives of mycobacterial water-soluble adjuvant. A water-soluble fraction (WSA) of the cell wall can substitute for mycobacterial cells in Freund complete adjuvant. However, when WSA is administered in saline instead of in a water-in-oil emulsion, its adjuvant activity is very weak, and under certain experimental conditions it can even inhibit the humoral immune response. The data reported in the present study show that after treatment by phthalic or succinic anhydride the adjuvant activity of WSA was markedly changed, since high levels of circulating antibodies were produced when these derivatives were administered with an antigen in an aqueous medium. Moreover, the antigenic determinants of WSA were modified and acylated WSA had no tuberculin-like activity.


Effect of warfarin on the induction and course of experimental endocarditis. The effect of warfarin treatment on an experimental endocarditis was studied in rabbits. Warfarin had no effect on the induction of a Streptococcus sanguis infection in catheter-induced endocardial vegetations, and the course of this infection was also unaltered. However, warfarin treatment resulted in rapidly progressive bacteremia, probably due to impaired circulation in clearing organs such as the lungs, liver, and spleen. Warfarin also reduced the survival time of the infected rabbits, in which pulmonary edema and extensive lung hemorrhages may have been a contributory factor.


Interaction of inflammatory cells and oral microorganisms. II. Modulation of rabbit polymorphonuclear leukocyte hydrolase release by polysaccharides in response to Streptococcus mutans and Streptococcus sanguis. The release of lysosomal hydrolases from polymorphonuclear leukocytes (PMNs) has been postulated in the pathogenesis of tissue injury in periodontal disease. In the present study, lysosomal enzyme release was monitored from rabbit peritoneal exudate PMNs exposed to Streptocccus mutans or Streptococcus sanguis. S. mutans grown in brain heart infusion (BHI) broth failed to promote significant PMN enzyme release. S. sanguis grown in BHI broth, although more effective than S. mutants, was a weak stimulus for promotion of PMN hydrolase release. Preincubation of washed, viable S. mutans in sucrose or in different-molecular-weight dextrans resulted in the ability of the organisms to provoke PMN release reactions. This effect could bot be demonstrated with boiled or trypsinized S. mutans or with viable S. sanguis. However, when grown in BHI broth supplemented with sucrose, but not with glucose, both S. mutans and S. sanguis triggered discharge of PMN enzymes. The mechanism(s) whereby dextran or sucrose modulates PMN-bacterial interaction may in some manner be related to promotion of microbial adhesiveness or aggregation by dextran and by bacterial synthesis of glucans from sucrose.