Reinvestigation of disulfiram-like biological activity of Coprinus atramentarius (Bull. ex Fr.) Fr. extracts. A ninhydrin-positive aqueous fraction isolated from Coprinus atramentarius (Bull. ex Fr.) Fr. showed significant disulfiram-like activity in mice. The isolation of the fraction from the mushroom crude extract and a convenient pharmacological test for following the physiological activity in each fraction are described.


D-penicillamine therapy of neonatal jaundice: comparison with phototherapy. A total 330 newborns suffering from haemolytic disease of the newborn and hyperbilirubinaemia was treated with D-penicillamine. The therapy resulted in a significant decrease in the frequency of exchange transfusions and of high serum bilirubin levels among preterm and fullterm babies with or without sensitization. Concerning the drug's mechanism of action, reduction of the bilirubin level is achieved by means of the copper stored in the liver. The intravenous route is suggested for application of the drug. In preterm infants D-penicillamine treatment proved more effective than phototherapy.


Effects of stress upon the oxidative metabolism and its correlation with gastric ulcer formation: the role of sex. The metabolic-oxidative activity of different nervous and glandular structures (amygdala, hypothalamus, lateral-frontal cerebral cortex, adrenal glands) in male and female rats under acute stress caused by physical immobilization, was determined. The sexual cycle of the female rat was controlled by examination of their vaginal frotis. One experimental group during estrus and another one during diestrus were selected. At the same time ovariectomy was performed on an experimental group in order to eliminate the hormonal influences of the ovary. Results show there are no significant differerneces in the oxidative metabolism. Nor in the numbers of ulcers. Hypothalamus-hypophyseal-adrenocortical activation was made manifest on obtaining significant differences in the weight of the adrenal glands, a fact long ago reported in a number of studies. Necropsy showed severe gastric hemorrhages and ulcer in the stomach. Nevertheless, no significant differences between the distinc experimental groups were obtained. The likely participation of sexual hormones in female rats is discussed in the light of our results.


Morphine withdrawal reactions in male and female mice. In the present study we have used the morphine implantation method to investigate the intensity of the abstinence syndrome in both male and female Swiss Webster morphine-dependent mice. It is evident from our data that naloxone induced no significant difference in the jumping behavior of both morphine-dependent male and female mice when weight variables were controlled.


The dilemmas of coordinating treatment with criminal justice. Problems the Abraxas Foundation encountered in accommodating therapeutic community practices to the justice system in order to develop an alternative for courtstipulated drug offenders are reviewed. First, traditional expectations for prospective clients' motivation proved to be unrealistic. Second, courts' needs for information on their clients' progress appeared to conflict with client confidentiality laws. Finally, Abraxas resented what it initially took to be the courts' intrusion into program affairs. In response, Abraxas has sensitized its staff to the courts' role, established a uniform policy on progress reports, promoted communications with external agencies, and emphasized coordination of treatment effort with court officials.


Burkitt's lymphoma of the ovary in association with pregnancy. Two case reports. Burkitt's lymphoma of the ovary, occurring in association with pregnancy, is rare, only one case having been previously reported. Two cases are reported here and the possible effect of pregnancy discussed.


Menstruation per urethram. A case report. The case history is presented of a 24-year-old woman who had a uterus duplex, grossly underdeveloped cervices, absent vagina and who menstruated regularly through a communication between one cervical canal and the urethra.


Purification of interferon by adsorption chromatography on controlled pore glass. Human fibroblast and mouse L929 cell interferons can be purified by adsoprtion to and subsequent elution from Controlled Pore Glass. Purification of 40 to 90-fold to specific activities of 1 to 5 times 10(6) units/mg of protein can be achieved in a single step, with good recovery of activity. Human leukocyte interferon does not bind to the glass and cannot be purified in this way.


A new method for assessment of fetal lung maturity. A new method for evaluation of fetal lung maturity in utero is described. The method is based on the fluorescence polarization (P) of the lipids in the amniotic fluid after labelling with a special dye. Tests performed with 49 amniotic fluid samples drawn from 33 pregnancies clearly demonstrated a decrease in P during gestation which correlated with the increase in the lecithin/sphingomyelin ratio (L/S) in the fluid. During gestation the P value at 24 degrees C decreased steadily from about 0-4 to 0-2 and the value of P (24 degrees C) = 0-310 has been tentatively chosen as the threshold above which respiratory distress syndrome may develop. The described method, which requires a specially designed instrument, offers a series of important advantages over the presently available methods. It is simple, rapid, highly accurate and reproducible, and independent of amniotic fluid volume. The P value reflects the microviscosity in the whole lipid assembly of amniotic fluid and is not confined specifically to lecithin.


Galactose oxidase: applications of the covalently immobilized enzyme in a packed bed configuration. Galactose oxidase (E.C. 1.1.3.9) was covalently immobilized to chemically modified porous silica particles by reaction of the native enzyme with pendant benzoyl azide groups on the carrier. The enzyme loading on the carrier was 100-150 units per milliliter. The immobilized enzyme was incorporated into a hardware assembly suitable for the determination of galactose or lactose concentrations in complex biological fluids. The prototype instrument as described is suitable for continuous, on-line monitoring or discrete sample analysis. Reaction conditions can be readily provided which maintain global first order kinetics within the reactor and strict linearity of the procedure over a wide range of sample concentrations. Auto-inactivation of the immobilized enzyme can be prevented by K3Fe(CN)6 and long-term reactor stability can be achieved by the periodic application of the reagent to the enzyme reactor in situ.


Prolonged eradication of urogenital mycoplasmas after administration of tetracycline to men in the Antarctic. Meatal swabs were obtained at intervals over 1 year from 23 men in the Antarctic. A 5-day course of tetracycline was given to twelve of them. In retrospect it was found that the antibiotic had been received by two men who were harbouring ureaplasmas, one of whom also had M. hominis. After treatment, these organisms  were not found in any of the swabs taken over the next year, except in a swab from one of the men following sexual contact after this time. One of the twelve men developed N.S.U. just before arriving in the Antarctic. He responded clinically to a shorter course of tetracycline and ureplasmas were not recovered from a meatal swab immediately thereafter. However, without further sexual contact, ureaplasmas and disease recurred about a month later. This time, after a 5-day course of tetracycline, disease was not seen, and ureaplasmas were not isolated, over the next year. In contrast, ureaplasmas were isolated consistently over a year from two men who were not given the antibiotic. The evidence strongly suggests that, under natural conditions, the most likely cause of mycoplasmas, particularly ureaplasmas, recurring in the genital tract after apparently adequate tetracycline therapy, is re-infection as a result of sexual re-exposure.


Shigellosis. Another sexually transmitted disease? Following the clinical observation that there appeared to be an association between shigellosis and male homosexuality, the medical records of 113 patients at The New York Hospital were reviewed retrospectively. Of the 38 males studied who were between the ages 19 and 61, seventeen were homosexual (44-7 per cent.). Only one of the matched controls was homosexual. Of the men with shigellosis who had a history of foreign travel, 10 per cent. were homosexual; however, among the patients without a travel history, 57-1 per cent. were homosexual (P less than 0-05). For male patients with shigellosis who do not have an appropriate travel history, the physician should expand his epidemiological investigation to include sexual contacts. Men and women who perform rectal intercourse should be cautioned to abstain from this activity until their stool cultures are negative for shigella. If a male patient with shigellosis is homosexual, he should be screened for other sexually transmitted diseases such as syphilis, gonorrhoea, hepatitis B, and amoebiasis.


Successful therapy with methotrexate of a multicentric mixed lymphoma of the central nervous system. Primary lymphoma of the central nervous system (CNS) is extremely rare. A case of mixed histiocytic lymphocytic lymphoma of the CNS that initially occurred in the spinal cord is reported. Multicentric recurrence following radiotherapy was successfully treated with intrathecal methotrexate and the patient remains free of disease after 4 years. The role of intrathecal methotrexate as alternative therapy following irradiation failure is discussed.


Methotrexate pneumonitis induced by intrathecal methotrexate therapy: a case report with pharmacokinetic data. A patient with adenocarcinoma of the breast metastatic to the leptomeninges was treated with 10 doses of intrathecal methotrexate (MTX) administered at intervals of 2 days. Following these treatments she developed fever, hypoxemia, and bilateral pulmonary infiltrates without documented pulmonary infection. Autopsy findings were consistent with the pneumonitis that has been associated with intermittent oral, intramuscular, and intravenous MTX therapy. It is suggested that this patient's pulmonary process represented MTX pneumonitis following intrathecal MTX. Cerebrospinal fluid and serum MTX concentrations determined retrospectively on frozen samples reflect an atypically rapid transport of MTX from this patient's cerebrospinal fluid to a slowly decaying systemic pool. Because of this, serum MTX levels probably exceeded 10-8M during the entire 20-day course of therapy, thus exposing the pulmonary parenchyma to significant drug concentrations for a prolonged interval. It is suggested that these unfavorable pharmacokinetics may have contributed to this patient's susceptibility to MTX pneumonitis.


A comparison of cyclophosphamide, vincristine, and prednisone (COP) with nitrogen mustard, vincristine, procarbazine, and prednisone (MOPP) in the treatment of nodular, poorly differentiated, lymphocytic lymphoma. This study was designed to test the efficacy and toxicity of COP (cyclophosphamide, vincristine, and prednisone) and MOPP (nitrogen mustard, vincristine, prednisone, and procarbazine) in 13 previously untreated patients with disseminated, nodular, poorly differentiated, lymphocytic lymphoma, and to test for patient cross-resistance to the regimens. Complete remission was initially achieved in six of eight patients on COP and three of five on MOPP. Three patients were crossed over to the alternative induction regimen because of progressive disease after an initial partial response; one was crossed over because of toxicity. On crossover, four patients achieved complete remission, two on either regimen. Durations of unmaintained complete remission range from 6-46+ months, with 8/13 still in their first complete remission. Only one patient has died, while in remission, from progressive Kaposi's sarcoma; one was lost to follow-up while in complete remission at 44 months; the others (85%) remain alive 33-54 months from the initiation of chemotherapy. MOPP was significantly more toxic with respect to thrombocytopenia, duration of myelosuppression, and cumulation of toxicity. Because of its more acceptable toxicity, COP is recommended as initial therapy for patients with nodular, poorly differentiated, lymphocytic lymphoma. MOPP or another regimen of non-crossresistant combination chemotherapy would be more appropriate for primary treatment failures.


Effects of an antiandrogen, cyproterone acetate, on the kidney of the three-spined stickleback (Gasterosteus aculeatus L.). The fine structure of the kidney is studied in the sexually mature male three-spined stickleback after administration of an antiandrogen, cyproterone acetate. Under these conditions, the dedifferentiation of renal tubules is characterized by the same involutive processes as those induced by castration, with the difference that cyproterone acetate only begins to act after 14 days whereas after castration the first signs of involution are visible after 7 days. The ultrastructural modifications affect the nucleoli, the rough endoplasmic reticulum and the Golgi apparatus. They reflect an inhibition of the secretory process. The results obtained demonstrate that administration of cyproterone acetate to male sticklebacks has an inhibitory effect on renal target cells, apparently indistinguishable from the changes induced by lack of male sex hormone, and that this drug may be a valid substitute for castration in fish.


[Drepanocytosis and navigation personnel]. In West and Central Africa one adult in 4 or 5 carries AS trait. This haemoglobin abnormality therefore underlines the question of aptitude of navigation personnel in national or international air-lines. Among these personnel one should separate commercial navigation personnel (CNP) and technical navigation personnel (TNP), if the aptitude in flight of CNP may perhaps be acquired without systematic previous submission to files of Civil Aeronautics Medical Advice, on the other hand a definite and irrefutable decision on the aptitude of TNP can only be envisaged after proving tests for placing the personnel carrying sickle cell trait in the context of airling work.


[Results of a survey of potential dengue vectors in the Neo-Caledonian archipelago]. The author gives the results of an entomological survey in neo-caledonian archipelago (New Caledonia and Loyalty Islands), november-december 1972. Concerning the distribution and the abundance of Aedes aegypti, the local dengue vector, this study shows the presence of this culicid not only in Noumea, but also all along the western developped coast of New Caledonia, and in Ouvea Island. This constitutes a great risk of outbreak extension from Noumea if a dengue virus is again imported there.


[Surgey of tick-borne arboviruses in the Central African Republic (1973-1974). Isolation of Dugbe, CHF/Congo, Jos and Bhanja viruses]. As a complement of the study of the epidemiology of the arboviruses in Central Africa a survey of tick borne viruses has been done, in the Central African Republic, from December 1972 to June 1974; 15.103 ticks were collected, mainly from cattle at the slaughterhouses. They include: 10.085 Ambylomma variegatum, 4.113 Boophilus, 542 Rhipicephalus and 363 Hyalomma. From 892 monospecific pools inoculated into baby mice, 98 isolates of virus were obtained. Among the 57 isolates which have been fully identified (the identification of 41 other isolates is still in progress), 4 different serotypes of arbovirus have been found: Dugbe virus has been the most frequently found with 45 isolates from A. variegatum and I from B. decoloratus; this virus, previously isolated from human cases in Central African Republic in 1967 and 1970 has been isolated from a new human case in 1973. One isolate of CHF/Congo virus has been obtained from Hyalomma nitidum, but this virus has not yet been isolated from human beeings in C.A.R. The two other tick borne viruses isolated during this survey are Jos virus (9 isolates) and Bhanja virus (I isolate), all of them from A variegatum.


A multi-centre general practitioner assessment of butriptyline hydrochloride ('Evadyne'). A multi-centre open study in general practice was carried out to assess the efficacy of and incidence of side-effects with the tricyclic antidepressant, butriptyline. Of a series of 153 patients with non-psychotic depression, with or without anxiety, 105 (69%) were judged as having a good or fair response to treatment with 75 mg to 150 mg butriptyline daily. Side-effects of an anticholinergic nature were seen in 13.7% of patients, but the incidence decreased to less than 4% in the 101 patients receiving treatment for over 7 weeks.


Circulating immune complexes in Graves' disease. Circulating immune complexes in Graves' disease sera were detected by the 125I Clq deviation test. High titers of immune complexes were detected and correlated significantly with the microsomal antibody but not with the thyroglobulin antibody titer nor with serum thyroxine levels. Serum fractionation studies in a patient with high titer of immune complexes revealed these to be heterogeneous in size, sedimenting in 19S, intermediate and 7S regions. The data suggest a role for immune complexes in the pathogenesis of Graves' disease.


[Epidemiology of leishmaniasis in Algeria. 6. Survey of clinical cases of infantile visceral leishmaniasis from 1965 to 1974]. The authors present the results of an inquiry conducted in the principal hospitals of Algeria. The number of cases of visceral leishmaniasis recorded over the last ten years (1965 to 1974) totaled 497. The disease occurs essentially in children under 5 years of age (94%); it is mainly detected in central and eastern parts of the Tell region: principally in the Grande Kabylie, Algerois and Constantinois areas (humid and sub-humid bioclimatic stages). The results of the malaria eradication campaign in relation to the incidence of visceral Leishmaniasis is discussed.


Questions to the supply of young infants with fat and fatty acids. II. Fat content and fatty acid pattern in milk formulae for healthy infants in the first 6 months of life. The fat content and the fatty acid pattern were analyzed in 30 commercially prepared milk formulae for healthy infants in the fisrt 6 months of life. We found an average fat content of 3.4 g or 3.6 g/100 ml in "partly adapted" and "adapted" milk formulae, between 1.4 g and 3.3 g/100 ml in "not defined" milk formulae. We regard a fat content lower than 3.0 g/100 ml and more than 4.0 g/100 ml as not advisable. In most milk formulae the ratio of saturated: unsaturated fatty acids is similar to the ratio in human milk fat. This ratio is obtained from a mixture of cow's milk fat with vegetable oils or by a mixture of various vegetable fats. The difference in the fatty acid pattern between the milk formulae and the fatty acid pattern in mature human milk are demonstrated and discussed. The tolerance of milk formulae for young infants is not influenced in an unfavorable manner by butyic acid. A high portion of lauric acid in mild formulae seems undesirable. The importance of the position of palmitic acid in the triglycerides of milk formulae for infants is discussed, and it is referred to the advantage of a mixture of cow's milk fat with vegetable fats. A linoleic acid content of 3 kcal% in the minimum and 7 kcal% in the maximum in milk formulae for infants is regarded as advisable.


[10 new clinical cases of mycoses caused by Entomophorales in Cameroon]. Authors describe ten new cases of Entomophthoromycosis in Cameroon. In four cases of subcutaneous phycomycosis, Basidiobolus meristoporus was isolated in one case. In six cases of rhino-entomophthoromycosis, we have obtained by culture two Basidiobolus meristoporus and one Entomophthora coronata. In Cameroon, rhino-entomophthoromycosis may be caused by the two species Basidiobolus meristoporus and Entomophthora coronata.


[The average degree of parasitosis, a criterion for evaluation of the geohelminthic contamination of a population, and for application of santiary measures]. The severity of ascaridiasis in a region depends first of all on the degree of pollution by ascaris ova of the environemtn and consquently on the per diem output of ascaris ova in the stools. Therefore, the importance of ascaridiasis as an endemic disease, depends of course upon the number of positive cases, their prevalence, but still more, it depends upon the intensity of the infection of the diseased population (global parasitic discharge). Practically, this concept of global parasitic discharge is expressed by the number of ascaris ova expelled per gram and per day by a sample of the considered population. The mean parasitic discharge is the quotient of the global parasitic discharge through the number of positive cases of the sample. An epidemiological survey and a mass chemotherapy test at La Réunion has showed us that the conept of global parasitic discharge is a more representative reliable and sensitive measuring method than prevalence, to evaluate the gravity of endemic ascaridiasis and its variations.


Changes in erythropoiesis and renal ultrastructure during exposure of mice to hypoxia. During hypoxia, elevated ESF levels occur which are accompanied by increased erythropoietic activity resulting in progressive elevation of the haemoglobin and haematocrit concentration. An attempt has been made to correlate ultrastructural changes in the kidney with changes in serum ESF concentrations and the erythropoietic state of mice exposed to continuous hypoxia for 3 weeks. A series of changes in the epitheloid and proximal tubules cells occurred which may be related to the biogenesis of erythropoietin. However, no detectable ESF or renal erythropoietic factor could be extracted from the kidneys at the time of maximal ultrastructural changes. Although some ESF-inhibitory material was demonstrated, it could not be extracted into lipid solvents. It is suggested that the failure to consistently extract an erythropoietic factor from the kidneys of hypoxic mice may be related to the absence of renal storage at the onset of increased peripheral demand. Other levels and durations of hypoxia may help to elucidate the role of the kidneys in regulating serum ESF levels.


Arthroscopy of the Knee.

Arthroscopy of the Knee. Two hundred and twenty-one consecutive arthroscopic examinations of the knee are reviewed to establish diagnostic accuracy based on subsequent arthrotomy and the clinical course in the absence of arthrotomy. One hundred and nine knees showed an arthroscopic accuracy of 89.9 per cent at subsequent arthrotomy. Ninety-five patients who did not have an arthrotomy revealed 73.7 per cent clinical improvement between 9 months and 4 years after arthroscopy. Arthroscopy is a simple diagnostic procedure which, with experience, can be done safely and accuratly with minimal morbidity and, in this series, allowed 33.5 per cent of patients to avoid arthrotomy.


[Role of the autonomic nervous system in the differentiated response of pancreatic enzyme secretion]. In chronic studies on fistular dogs, the basal secretion of pancreas and secretion stimulated by the duodenal perfusion of acid (pH 1.5) solutions of albumen and its poly-peptide hydrolysate was studied. Perfusion of the hydrolysate stimulated the pancreatic release of enzyme more than albumen itself. Pentamin, atropin, and ergotal suppressed basal secretion and secretion stimulated by the duodenal perfusion with the above solutions.


Effect of localization of L-asparaginase as the concanavalin A conjugate on anti-tumor activity. A method potentially capable of enhancing the effectiveness of therapeutic enzymes such as L-asparaginase was investigated. The method was suggested by the following properties that have been observed for lectins injected into tissues: (1) six lectins with differing specificities were retained near the site of injection in the feet of mice 10 to 100 times longer than several non-lectin proteins. Prolonged retention of 125I-labelled concanavalin A was also observed in other normal and malignant mouse tissues. (2) The retention of 125I-labelled concanavalin A was not affected by prior immunization against concanavalin A. (3) Electrophoresis of tissue extracts on sodium dodecyl sulfate-poly-acrylamide gels followed by radioautography indicated that the 125I-labelled concanavalin A retained in the tissue remained as intact in form as prior to injection. Since the therapeutic efficacy of many enzymes may be enhanced by localization at the intended site of action, in principle it should be possible to enhance the effectiveness of therapeutic enzymes by combining the tissue-localizing properties of a lectin with therapeutic effectiveness of the enzyme. A conjugate of E. coli L-asparaginase and concanavalin A has been prepared by covalent cross-linking with glutaraldehyde and has been shown to be retained in mouse tissue 90 times longer than the free enzyme. However, it is completely ineffective in the treatment of the L-asparaginase-sensitive lymphosarcoma 6C3HED in C3H/HeJ mice. The ineffectiveness of the conjugated enzyme may be associated with the interiorization of the conjugate by the cells of the tumor.


The immunospecificity of altered initial arrest patterns of circulating cancer cells in tumor-bearing mice. The early arrest patterns of a methylcholanthrene-induced fibrosarcoma were determined after injection of 125IUdR-labelled cells into the systemic circulation of mice bearing transplanted lymphosarcomas, and of normal animals. Similar experiments were performed using radiolabelled lymphosarcoma cells and normal or fibrosarcoma-bearing mice. The results showed that shifts in normal distribution patterns previously observed in tumor-bearing animals injected with cells of the same type as that borne by the animal, were not detectable when cells of a different tumor type were injected. Peritoneal exudate cell migration inhibition assays showed little immunologic cross-reactivity between the two tumors and, together with the results of the distribution studies, indicated that alterations of early arrest patterns in mice sensitized to their tumor is an immunologically specific phenomenon.


Infection of a nonspecific urethritis patient and his consort with a pathogenic species of nonspecific urethritis Corynebacteria, Corynebacterium genitalium, N. SP. A patient with nonspecific urethritis (NSU) and his consort were examined for infection with NSU corynebacteria, mycoplasmas, and gonococci. No classic and T-mycoplasmas or gonococci were cultured, but one species of NSU corynebacteria was isolated not only from the patient's urethral discharge during three episodes of NSU but also from his consort. It was not isolated after successful treatment of the patient with tetracycline and the use of condoms prevented reoccurrence of urethritis. This NSU corynebacterium was isolated previously from one epididymitis patient and two NSU patients but not from any of the normal male and female subjects examined. Therefore, this strain is considered to be one of the etiologic agents of NSU and female subjects are asymptomatic carriers. In consequence, it is suggested that NSU corynebacteria which are commensals and pathogens of the male and female urogenital tracts should be incorporated in a new species, of the Coryneform group, and that this strain should be the type species, Corynebacterium genitalium n. sp.


The reliability and diagnostic validity of the physical and neurological examination for soft signs (PANESS). Twenty-one children, mean age of 8 years, were each examined on separate occasions by two pediatric residents, blind to diagnosis, using the neurological examination (PANESS) included in the group of instruments recommended by the National Institute of Mental Health for psychotropic drug studies in children. Half the children were hyperactive/aggressive, one quarter were normal, and one quarter had histories or signs strongly presumptive of brain damage. Many of the signs, though reliable, did not occur in the majority of children. Examiners did achieve a high level of agreement about global neurological status. It was concluded that the neurological examination probably contains a substantial number of non-contributory items and should be regarded as experimental rather than definitive.


Catechol-O-methyltransferase activity in psychotic children. Catechol-O-Methyltransferase (COMT) activity was studied in three groups of institutionalized children: (1) a group of schizophrenic children; (2) a heterogeneous group of chronic psychotic children characterized by severe symptomatology and onset before 5 years of age; (3) a group of acting-out but nonpsychotic children. Erythrocyte COMT activity was found to be significantly lower among the schizophrenic subjects in contrast to the greater activity in both the other groups--the nonpsychotic and chronic psychotic children. The difference in COMT activity between psychotic groups appeared to be related to diagnosis and age of onset of disorder. Generality of findings is limited by the small sample size (N = 42) and by the difficulties inherent in the diagnosis of severe mental disorder in children. However, this preliminary study suggests that enzymatic activity may be associated with the development of schizophrenia in children.


Autistic children exhibit undetectable hemagglutination-inhibition antibody titers despite previous rubella vaccination. The etiology of autism is unknown, but autism has been associated with a number of diseases, including prenatal rubella. Rubella vaccine challenge was used in an attempt to retrospectively diagnose prenatal rubella in autistic children. This test was selected because unresponsiveness of antibody titer has been reported as helpful in retrospective diagnosing of prenatal rubella. Fifteen autistic children and 8 controls matched for age were challenged with rubella vaccine. Rubella vaccine challenge did not differentiate autistic children from the control subjects. However, 5 of 13 autistic children had undetectable titers despite previous vaccine; all control subjects had detectable titers. This finding of undetectable titers in autistic children suggests these children may have an altered immune response.


Multiple factors in short-term behavioral control of protein intake in rats. The availability and concentration of dietary protein was varied in an examination of the nature of the day-to-day intake of protein solutions by 60-day-old male rats. It was found that the rats consumed a remarkably constant absolute amount of protein each day, adjusting overall caloric intake to maintain protein at a roughly constant proportion of total calories. Factors such as the time of access to a protein source or the extent of prior experience with a protein source were seen to influence the overall constancy of protein intake, whereas daily shifts in preference between two available concentrations of protein did not interfere with such short-term control. The mechanism for this behavioral control is likely to be different from mechanisms mediating the conditioned response to dietary protein, as in the response to dietary amino acid imbalance.


Incidence and identification of phospholipase C-producing bacteria in fresh and spoiled homogenized milk. Bacteria which produced phospholipase C were isolated from 13 of 34 fresh and 15 of 35 spoiled samples of homogenized milk. No single off flavor was assigned consistently to samples with phospholipase producers, but 75% of them were bitter. Pseudomonads constituted 62% of the isolates. Other phospholipase C-producing genera and their numbers were Acinetobacter, two; Alcaligenes, three; Bacillus, two; Citrobacter, one; Enterobacter, three; and Flavobacterium, two. Two unidentified yeasts also were isolated.


The content of 90Sr in the bone tissue of the population of the Soviet Union. (1959-1971) (The basic laws of its accumulation and distribution). On the basis of the results of long-term observations, general laws have been identified determining the dynamics of 90Sr concentration in the bone tissue of the population of the USSR in 1959-71, the peculiarities of 90Sr accumulation in different age groups and the connection and dependences between the intake and the contect of the isotope in human organism. It has been found that maximum 90Sr concentration occur in children born in the year when nuclear tests were carried out. The type of distribution of the frequency of occurrence of cases showing different levels of 90Sr content in uniform population groups was determined. Characteristic features of 90Sr distribution in different bones of the skeleton and its changes in the course of time were demonstrated.


Intussusception in the older child- suspect lymphosarcoma. Examination of the records of 378 children with intussusception at our institution revealed that 29 cases were caused by an identifiable intestinal lesion. A Meckel's diverticulum was the causative agent in 21 children, all of whom were under 2 yr of age. A previously undiagnosed ileal lymphosarcoma produced the intussusception in six other children, all between 6 1/2 and 9 yr of age. Our experience indicates that any child over 6 yr of age with the clinical findings of colicky abdominal pain, bloody stools, and a palpable mass plus the radiographic evidence of intussusception must be considered to have ileal lymphosarcoma until proven otherwise. Hydrostatic reduction of the intussusception must be accompanied by extensive small bowel reflux of barium in order to effectively rule out a small intestinal lesion. If this is not accomplished, surgery should be planned with the suspicion that a malignancy may be present. If this suspicion is confirmed by frozen section, the operation procedure should include wide surgical excision of the lesion along with the regional lymph nodes.


Bioavailability assessment under quasi- and nonsteady-state conditions III: Application. The applicability of bioavailability assessment at quasi- and nonsteady state is illustrated with data from a study comparing two formulations of amitriptyline hydrochloride in humans. Relative bioavailability as a function of the observed mean plasma concentrations may be expressed in closed form, provided the affected intervals begin and end in the log-linear region. Alternatively, numerical, graphical and/or electronic computational techniques may be used to stimulate the appropriate [Cp(i)]sim, the proximity of which to [Cp(i)]obs is a function of relative bioavailability and omega. If a model can be found to fit the data adequately, it would be sufficient that only one sampled interval end in the log-linear phase.


The electrophysiologic effects of tolamolol (UK-6558-01) on the passive membrane properties of mammalian cardiac Purkinje fibers. Tolamolol (UK-6558-01) is a relatively cardioselective beta receptor antagonist which is effective clinically in the treatment of supraventricular and ventricular arrhythmias. Animal studies suggest tolamolol may have significant antifibrillatory properties. The effect of tolamolol on the passive membrane properties of sheep cardiac Purkinje fibers was studied using multiple microelectrode techniques. In sodium-deficient Tyrode's solution, we measured the resting transmembrane voltage (Vr) at differing external potassium concentrations (K+]0, investigated current-voltage relationships and per formed cable analysis. Tolamolol was found to hyperpolarize the membrane in the presence of a large driving force [i.e., when (Vr - VK) was significantly greater than zero, where VK is the potassium equilibrium voltage ]; to hyperpolarize fibers with a Vr decreased due to stretch at [K+]0 = 4.0 mM; to increase membrane chord and slope potassium conductance; to decrease the membrane length constant; and to decrease the membrane time constant. In normal sodium Tyrode's solution, tolamolol could suppress automaticity. These results suggest that tolamolol increases membrane potassium conductance within the range of the pacemaker potential. This action can account, in part, for its ability to suppress automaticity and for its ability to prevent reentrant arrhythmias. In normal sodium Tyrode's solution, tolamolol suppressed oscillatory and sustained rhythmic activity occurring at a low transmembrane voltage which may be related to its alleged antifibrillatory effects.


Correlation between analgesia and the decrease of acetylcholine turnover rate in cortex and hippocampus elicited by morphine, meperidine, viminol R2 and azidomorphine. In rats, an ED50 for analgesia of morphine, meperidine, viminol R2 or azidomorphine decreases the turnover rate of acetylcholine (TRACh) in cortex and hippocampus. These four analgetics fail to change to TRACh in striatum when given in a dose range from ED30 for analgesia up to a cataleptic dose. Viminol S2, a nonanalgesic stereoisomer of vimonol R2, fails to decrease the TRACh in cortex and hippocampus. Naltrexone, an opiate antagonist, also fails to change the cortical and hippocampal TRACh but it antagonizes the decrease in cortical and hippocampal TRACh elicited by the four analgetics. Since the ED50 of these four analgetics fails to change the TRACh in striatum which contains a high density of opiate receptors and intrinsic cholinergic neurons, but decreases the TRACh in hippocampus and cortex which contain a low density of opiate receptors, it can be inferred that opiate receptors are not exclusively involved in the regulation of TRACh. However, the results suggest that certain cholinergic pathways participate in the mediation of analgesia.


Effects of pituitary graft and 2-bromo-alpha-ergocryptine on mammary DNA synthesis in mice in relation to mammary tumorigenesis. 3H-thymidine incorporation into mammary DNA as an index of mammary DNA synthesis in C3H/He virgin females was significantly higher at proestrus than at estrus and diestrus. The rise in incorporation at proestrus was completely blocked by the administration of 2-bromo-alpha-ergocryptine (Bromocriptin) 1 day before proestrus. The incorporation was maintained at a higher level than that at proestrus by pituitary grafts. The results supported the view that mammary DNA synthesis, which is stimulated by prolactin, is an important factor for mammary tumorigenesis.


Interaction of estrogen and prolactin in spontaneous mammary tumorigenesis of the mouse. Daily treatment for 12 months of young nulliparous C3H mice with 0.1 mg 2-bromo-alpha-ergocryptine (CB-154), an effective suppressor of prolactin secretion, significantly reduced and in some instances virtually eliminated the incidence of spontaneous mammary tumors. The CB-154-treated mice had normal body weight gains and normal estrous cycles. Ovariectomy of young nulliparous C3H mice also reduced mammary tumor incicence, but appeared to be slightly less effective than treatment with the ergot. Chronic administration of 17beta-estradiol for 12-19 months (via drinking water) to young nulliparous intact or ovariectomized-hysterectomized C3H mice significantly increased mammary tumor incidence. Concurrent administration of 0.1 mg CB-154 to the estrogen-treated mice significantly reduced the incidence of mammary tumors when compared with mice treated with the steroid alone. Chronic sc administration (0.1 mg/mouse, twice weekly for 20 months) of Enovid to young, nulliparous, intact C3H mice significantly increased mammary tumor incidence, whereas concurrent administration of 0.1 mg CB-154 to the Enovid-treated mice significantly reduced the incidence of these tumors. Thus significant inhibition of spontaneous or estrogen- or Enovid-induced mammary tumorigenesis by concurrent drug-induced prolactin suppression has been demonstrated in these studies.


Bronchial artery embolization for massive hemoptysis. Improved angiographic techniques have proved that therapeutic embolization is effective in controlling massive hemorrhage in selected sites of the gastrointestinal tract and central nervous system. We have controlled massive hemoptysis in five cases with use of our improved techniques and bronchial artery embolization. Because mortality due to massive hemoptysis in both benign and malignant disease is high, therapeutic bronchial artery embolization is the preferable approach in some cases.


Y-chromosomal genes in a phenotypic male with a 46XX karyotype. A number of patients with a male phenotype and a female (46XX) karyotype have been described. Although there is little or no evidence for the presence of a Y chromosome in their cells, these individuals resemble patients with Klinefelter syndrome (47XXY). Using a new serological assay for the presence of H-Y antigen, a cell surface component associated with the Y chromosome, we have demonstrated the presence of Y-chromosomal genes in a 46-year-old man with an XX karyotype. In addition, using standard cytological technique, we have located a minor population of XXY cells as well as cells bearing and abnormal chromosome 17 among the blood leukocytes of this individual.


Severe transient pancytopenia associated with procainamide ingestion. A 73-year-old woman was found to have clinically significant pancytopenia in association with procainamide hydrochloride ingestion. The syndrome, resembling systemic lupus erythematosus, which has been reported to develop in patients treated with this agent, is characterized by mild to moderate anemia and mild to moderate granulocytopenia. Severe granulocytopenia in patients taking procainamide and unrelated to a lupus syndrome has not previously been reported in association with significant thrombocytopenia. The clinical severity of this patient's presentation, suggesting an aleukemic leukemia, and its complete remission after cessation of procainamide administration occasional this report.


Mycoplasmemia in adult male patients.

Mycoplasmemia in adult male patients. Mycoplasma hominis mycoplasmemia was associated with obstruction, manipulation, or surgery of the genitourinary tract in five adult men. A four-fold increase in specific antibody titer against M hominis was demonstrated in serial convalescent serum obtained from one patient. Two patients became afebrile after treatment with tetracycline; a third recovered without therapy for a Mycoplasm infection. The two remaining patients died of thier underlying diseases.


Hemiparesis in cervical spondylosis.

Hemiparesis in cervical spondylosis. Two patients with hemiparesis were thought to have intracranial lesions. Cervical spondylosis was discovered, and the condition of both patients improved after laminectomy. Although it has been rarely emphasized in the past, cervical spondylosis should be considered in the differential diagnosis of hemiparesis.


Intrinsic asthma in adults. Association with gastroesophageal reflux. Of 28 patients with severe asthma routinely examined with upper gastrointestinal (UGI) x-ray films, 18 (64%) were found to have hiatus hernia and 13 (46%) were found to have demonstrable gastroesophageal reflux. These prevalences differed significantly (P less than .001) from those seen in a control population (19% and 5%, respectively). These data suggest that aspiration of gastric acid is a frequent incitant to severe asthma and that it should be routinely sought in the treatment-resistant asthmatic patient. Intensive medical regimens directed against reflux and acidity may bring notable improvement in asthma symptoms. Surgical restoration of effective lower esophageal spincter function has proved to be curative in other reported studies.


Multiple epiphyseal dysplasia. A family case report. Six cases of multiple epiphyseal dysplasia were found in a 30-member kindred. The kindred showed an increased incidence of other joint abnormalities. A dominant pattern of inheritance was not confirmed.


Syphilis surveillance. Failure to screen in a university hospital. Of 5,954 adult inpatients consecutively discharged from a university hospital during a three-month period, only 8.4% had serologic tests for syphilis performed during hospitalization. The testing rate was 20.1% on patients admitted to a medical teaching service and 1.4% on a surgical teaching service. In patients tested, a positive rapid plasma reagin test result was obtained in 6.2% and the diagnosis was confirmed by further testing, but effective therapy was not always given. On 9 of 30 patient records listed syphilis as a diagnosis on discharge. We conclude that serologic testing for syphilis is routinely omitted in the evaluation of hospitalized patients; even when tests are positive, the results are often ignored.


Adverse reactions in treatment with lithium carbonate and haloperidol. Hospital records of 425 patients who had been treated simultaneously with lithium carbonate and haloperidol were examined. Adverse reactions in these patients were the same as in patients given lithium alone or haloperidol alone. None of the patients developed a syndrome resembling that described by others in patients treated with a lithium and haloperidol combination.


Destructive bone disease in early syphilis. Although destructive bone disease is a well-known complication of tertiary syphilis, osteitis or osteomyelitis are not commonly recognized as complications of early (primary or secondary) syphillis. A patient with secondary syphilis characterized by generalized lymphadenopathy, perianal condyloma lata, and positive rapid plasma reagin (RPR) and fluorescent treponemal antibody-absorption (FTA-ABS) tests also complained of headache, right should pain, and right anterior chest pain and swelling. Roentgenograms showed mottled osteolytic lesions consistent with previously described luetic bone disease. Biopsy confirmed the diagnosis of syphilitic osteomyelitis, and treatment with penicillin resulted in prompt resolution of symptoms.


Nonsurgical closure of large arteriovenous fistulas. We report a nonsurgical closure of large postnephrectomy arteriovenous fistulas in two patients. To out knowledge, this method has not previously been attempted because of the large size of the communication and the risk of pulmonary embolization. However, the development of new embolization techniques makes a nonsurgical approach feasible and safe.


Successful protection of humans exposed to rabies infection. Postexposure treatment with the new human diploid cell rabies vaccine and antirabies serum. Forty-five persons severely bitten by rabid dogs and wolves in Iran were treated after exposure with a new rabies vaccine produced in cultures of human diploid cells. All except one also received one injection of rabies immune serum. This treatment, in contrast to past experience with other vaccines, resulted in protection of all individuals against rabies. Thus, almost a century after the postexposure treatment of humans was initiated, an effective tool for protecting man against rabies has finally been developed.


Identifying patients at risk for thromboembolism. Use of 125I-labeled fibrinogen in patients with acute myocardial infarction. Fibrinogen labeled with iodine 125 was used to detect deep vein thrombosis (DVT) in 35 patients during their course and convalescence from acute myocardial infarction. Clinical status was assessed and scored with the use of a modified coronary prognostic index. According to the prognostic scores, patients were allocated to one of two groups. Of 27 patients in good clinical condition, DVT developed in only one patient, whereas thromboembolic complications occurred in seven of eight patients who were severely ill--a highly significant difference. Prophylactic anticoagulation is advisable in patients at risk.


Unexpected cardiac arrest during anesthesia and surgery. An environmental study. Medical and legal records of 41 cases of cardiac arrest that occurred during surgery were supplied by a professional liability insurance company and a review was undertaken in an attempt to identify recurring or common factors. The majority of patients in this study were healthy and required relatively routine elective surgical procedures. Only three of the patients survived the cardiac arrest and returned to normal activities. The remaining patients either died in the hospital or had a major central nervous system deficit. Hypoxia from hypoventilation and low levels of inspired oxygen appeared to be the chief cause of cardiac arrest in this study. Because of the unknown frequency of cardiac arrest during surgery, we recommend the establishment of a national registry of cardiac arrest cases that occur in surgical patients, in order to monitor incidence, causes, and outcome. Only in this way will it be possible to lessen the frequency of this disastrous event.


Patients' response to tubal division.

Patients' response to tubal division. Of the 187 women who underwent laparoscopic tubal division at the Massachusetts General Hospital between September 1969 and June 1973, one hundred thirty-nine were interviewed in a follow-up study. The mean age was 33.9 years; the mean gravidity was 5.0 and mean parity 3.8. Most women were married, with religious affiliations reflecting those of the general hospital population, and most underwent tubal division because they felt they had had enough children. The majority (85.6%) were satisfied with their decision and reported similar or improved mental and physical health and sexual activity. Almost all (93.5%) said that they would make the same choice again, and more than half (54.7%) would have liked to have had this operation earlier. Those ambivalent or regretful about their decision could not be readily identified by any preoperative characteristics such as age, parity, and marital status.


Reversible renal failure and myositis caused by phenytoin hypersensitivity. A 38-year old woman receiving phenytoin (diphenylhydantoin) noticed maculopapular erythema as the first manifestation of a syndrome that included acute renal failure and myositis in addition to fever, lymphadenopathy, exfoliative dermatitis, and hepatitis. Prednisolone sodium phosphate therapy resulted in resolution of this hypersensitivity reaction, and she recovered from renal insufficiency. The occurrence of renal failure and myositis in the spectrum of phenytoin hypersensitivity reactions is discussed, and the importance of a morbilliform rash in a patient receiving phenytoin is emphasized.


Hyperkalemia with cardiac arrhythmia. Induction by salt substitutes, spironolactone, and azotemia. In two patients, severe hyperkalemia and serious cardiac arrhythmia developed after excessive use of potassium-containing salt substitutes. Both had impaired ability to handle and excrete additional potassium load due to chronic congestive heart failure, azotemia, and administration of spironolactone. Prompt recognition of the arrhythmia and immediate restoration of the cardiac rate and rhythm by pacemaker support followed by intensive regimen to lower the serum potassium prevented a potentially fatal outcome. These cases emphasize the potential danger of salt substitutes when used by patients who are predisposed to retain potassium.


Human umbilical cord. A new source for vascular prosthesis. Reconstructions were performed to the popliteal, tibial, and peroneal arteries employing a modified umbilical cord vein prosthesis. The latter was obtained from human cords and was made available as an onshelf graft for surgery following glutaraldehyde tanning. The early patency and limb salvage rates are equivalent to those obtained with autogenous saphenous veins. Additional benefits include significant decreased operative time and morbidity. It is also probable that this new graft may be resistant to biodegradation and therefore may obviate many of the causes for late failure that occur with the use of living biologic tissues or collagen tubes. Long-term follow-up and study are essential to validate the results obtained thus far and  to assess the potential of this new graft in a variety of vascular reconstructions.


Shoulder enlargement as the presenting sign in syringomyelia. Report of two cases and review of the literature. Two adult patients had painful enlargement of the shoulder and complete destruction of the humeral head. Angiograms of the shoulder showed highly vascular lesions in both patients. Both patients had syringomyelia, for which the swollen shoulder was the first manifestation.


Evaluation of a new aerosolized steroid for asthma therapy: beclomethasone dipropionate (Vanceril inhaler). Beclomethasone dipropionate, an esterified derivative of betamethasone, can be given in small doses in aerosol form to patients with severe asthma whose symptoms cannot be controlled with nonsteroidal agents (bronchodilators and cromolyn). Many asthmatic patients who previously required systemic steroids can be transferred to this safer anti-inflammatory agent. In usual doses, beclomethasone produces few, if any, systemic side effects. The only susbstantial reaction is Candida infections of the oropharynx and larynx.


NDV-O agglutinins and heteroagglutinins in sera of blood donors. In sera of healthy blood donors advancing age was accompanied by a decrease in the levels of agglutinins against human group O erythrocytes modified by Newcastle disease virus (NDV-O agglutinins) and of heteroagglutinins against sheep, guinea-pig and rabbit erythrocytes. Significant correlations of titres existed between the different heteroagglutinins, but not between these and the NDV-O agglutinins. The origins and interrelations of the natural agglutinins are discussed.


[Oerations on peripheral nerves, plexus and nerve roots, including subarachnoid block with phenol in chronic pain (author's transl)]. Peripheral surgery was performed in 112 patients. Neurolysis or resection of neurons gave rather poor results in pain after nerve injury and stump pain. Rhizotomy is considered to be more effective in those cases. Rhizotomy is also successful in radicular, especially coccygeal, pain syndromes. Subarachnoid blocks with Phenol gave similar promising results. Causalgia responds well in a high percentage of cases to sympathectomy; cases of postherpetic neuralgia phantom pain and tabetic crises generally do not respond to peripheral surgery.


Changes in cholesterol synthesis and excretion when cholesterol intake is increased. The metabolic responses to increased amounts of dietary cholesterol include, in man, a reduction in the synthesis and an increase in the re-excretion of cholesterol. The effectiveness of these compensating mechanisms in preventing increases in the plasma cholesterol concentration was studied in nine subjects. Cholesterol absorption, the excretion of bile acids, the excretion of endogenous neutral steroids, and the cholesterol balance (synthesis) were measured twice during intakes of cholesterol of about 250 and 750 mg/day. The serum of the compensating mechanisms (reduction in synthesis and increase in excretion of cholesterol) almost equalled the increase in absorbed cholesterol when the intake was raised by 500 mg (mean change in compensation, 226 mg/day; mean changes in absorption, 230 mg/day). In three subjects in whom re-excretion of cholesterol was predominant and compensated for absorbed cholesterol, the plasma cholesterol levels rose substantially. In five others, in whom the predominant change was reduction in cholesterol synthesis, the rise in plasma cholesterol levels was not significant. At moderate intakes of cholesterol both compensating mechanisms prevented retention of dietary cholesterol in the body, though a rise in the plasma cholesterol level was prevented only when cholesterol synthesis was suppressed.


[Clinical experiences with iodoxamic acid in the cholecystography-cholangiography (author's transl)]. Intravenous contrast media must have an optimum biliary excretion and a small urinary excretion, also a good tolerability. These demands are not dependent on the proportion of iodine, but of the proportion of the transport medium. By searching for a good transport medium iodoxamic acid has been found. In experiments this acid was compared with other intravenous contrast media. A better tolerability and better diagnostical effectivity had been proved. At the clinical examination of 86 cases we could point out a very good to good tolerability and a good diagnostical effect. Our experiences conform to other authors all of the world. In the Federal Republic of Germany this contrast medium is called Endomirabil and exists in ampoules of 20 cc and 30 cc contents and in bottles of 100 cc contents.


Growth and synthesis of rubratoxin by Penicillium rubrum in a chemically defined medium fortified with organic acids and intermediates of the tricarboxylic acid cycle. A sterile glucose-mineral salts broth was fortified with equimolar concentrations (10--3 M) of various organic acids and intermediates in the tricarboxylic acid cycle. Appropriate media were neutralized with 2 N NaOH, inoculated with spore suspensions or mycelial pellets of Penicillium rubrum and incubated quiescently for 14 days or with shaking for 5 days. Rubratoxins were recovered from culture filtrates by ether extraction and resolved by thin-layer chromatography. Toxin formation in quiescent cultures was enhanced by malonate but was not markedly affected by ethyl malonate, shikimate, and acetate or by isocitrate or oxaloacetate added in the presence of malonate. Citrate, cis-aconitate, alpha-ketoglutarate, succinate, fumarate, and malonate when present in the medium alone or in conjunction with malonate caused a 15 to 50% reduction in rubratoxin formation. Acetyl-CoA (10--5 M/flask) caused an 80% increase in toxin yield. Rubratoxin formation in shake cultures was not affected by succinate and malonate. All other combinations of intermediates and malonate caused a 10 to 50% reduction in toxin formation. At 10--3 M, citrate enhanced rubratoxin B formation and stimulated rubratoxin A production by as much as 100%. Above 10--3 M, citrate inhibited toxin production. Incorporation of [2-14C]acetate into rubratoxin was enhanced by malonate, fumarate, and malonate. A combination of pyruvate and malonate produced a 40% increase in [2-14C]acetate incorporation into rubratoxin. The highest reduction of labeled acetate incorporation (36%) was caused by succinate or alpha-ketoglutarate combined with malonate.


[Detection of mineral oil and paraffin in foods]. The author describes a thin-layer chromatographic method for the detection of small amounts of mineral oil and paraffin in foods. Fatty acids, glycerides, fat-soluble vitamins, sterols, and unsaturated hydrocarbons remain at the starting point. This method permits to detect as little as 0.2 mug of mineral oil or 20 mug of mineral oil/kg of food in low-fat products. 0.01% of mineral oil-like contaminants may be detected in fats.


[Lead and cadmium content of baby food and their nutritional hygienic-toxicological significance]. Little is known of the amounts of lead and cadmium which the infantile organism takes up from the total diet. The author's analyses of more than 150 jars or packs of ready-to-use baby food produced in the German Democratic Republic (trade mark: Für's Kind) revealed lead contents of less than 100 mug/kg and cadmium contents of less than 10 mug/kg. Only spinach showed higher lead values. In liver -containing ready-to-use foods the cadmium contents were higher than 10 mug/kg (25-50 mug/kg). Like liquid milk, powdered milk-base foods contained no cadmium. From these values it was calculated that the daily lead and cadmium intake of an infant during his first year of life amounts to 42-47 mug of lead and to 6,4-11,5 mug of cadmium, respectively. A conversion to mg/kg of body weight shows that, in both cases, the load on an infant equals that on an adult or is even greater. Literature data lead intake are in good agreement with these results. Corresponding studies for cadmium are not known.


[Neuroendocrine aspects of Parkinson's disease. Therapeutic/effect of a prolactin inhibitor]. On the basis of a reassessment of the aetiopathogenetic problem and the neuroendocrine implications, the therapeutic effectiveness of a prolactin inhibitor, 2-alpha-Br-ergocryptine (CB 154), in Parkinson's disease is assessed. Five patients were treated for a total of two weeks using doses between 10 and 15 mg/die. CB 154 was found to act as a dopaminergic receptor agonist at nigro-striatal level, considerably improving tremor and rigidity and to a lesser extent bradykinesia and total disability.


Treatment of fibrocystic disease of the breast with a prolactin inhibitor: 2-Br-alpha-ergocryptine (CB-154). In order to evaluate the importance of prolactin in the pathogenesis and clinical evolution of fibrocystic disease of the breast, serum prolactin levels were determined in 7 patients affected by this condition before and during treatment with a prolactin inhibitor, 2-Br-alpha-ergocryptine (CB-154). Serum prolactin levels were found to be low or normal before treatment. During treatment with CB-154 there was an improvement in all patients but 2. The results of the study do not allow any conclusion on the possible relation between serum prolactin levels and fibrocystic disease of the breast but they indicate that CB-154 may be useful for treating patients with this disorder.


[On the radiotherapy of the carcinoma of the tonsils (author's transl)]. In the period 1932 to 1975 469 patients were admitted with a malignoma of the tonsils. 74,9% were stage T3. Nearly 50% showed up with involvement of fixated and suspicious lymphnodes. The relation men to women was 80:20. The highest incidence was found in the age group 61-70 a. The patients were treated using Radium: interstitial implants and external radiation, later Cobalt sources and the Betatron. The over-all 5 year survival rate is 21.6% for carcinomas and 32% for sarcomas. In the case histories there are predominantly late ones because difficulties in swallowing are neglected for a long time. The prognosis for cases stage T3 is rather bad. Considering the literature our material is the greatest out of a single department.


[Five years treatment of advanced solid malignomas with a combination of four cytostatic drugs (author's transl)]. 132 patients with advanced solid malignomas were treated with a combination of four cytostatic drugs (vinblastine, amethopterine, 5-fluorouracil and cyclophosphamid) given on one day. This was repeated once every 2-3 weeks. In every case the diagnosis was made histologically and the tumour was staged according to the TNM-system. The treatment of breast and ovarian cancer brought the best results, improved by a synchronisation therapy. Good results were achieved also in the treatment of special kind of sarcomas and of carcinoma of the urine bladder. The general condition of patients with colon carcinoma could be improved in about 30%. Only one patient died by drug-induced pancytopenia, otherwise severe side-effects were not noted. Before beginning the therapy the cell-mediated immunity of 31 patients was tested by skin-tests with tuberkulin purified protein derivative (PPD) and dinitrochlorbenzole (DNCB). Before and during cytostatic therapy PPD reactions were proven by 23 patients. In accordance to other authors we found that cell-mediated immunity is decreased in the advanced stage of malignoma. Further we noted that delayed hypersensitivity and the number of lymphocytes and monocytes in peripherel blood are important to prognosis and course in patients with cancer.


Pregnancy of the wife of a complete paraplegic by homologeous insemination after an intrathecal injection of neostigmine. A case of successful pregnancy following artificial insemination following intrathecal neostigmine injection in the wife of a complete traumatic paraplegic (T7-T8 to T11-T12) is described.


[Surgical treatment of Basedow's disease]. Specific surgery of Graves' disease in the patient prepared by prior medication is a low-risk method of treatment. Subtotal thyroidectomy can be regarded as a specific therapeutic procedure which brings about a prompt euthyroid status. Mandatory and circumspect exposure of the recurrent nerves affords greater certainty of avoiding damage to them.


[Radioiodine treatment in Basedow's disease]. Radioiodine (131I) is the standard treatment for hyperthyroidism with Graves' disease because of ease of performance, relatively low cost and minimal complications. The patient must be followed up regularly at 1-2 year intervals although the risk of "early myxedema" (less than 3%) and the cumulative myxedema rate (less than 2% per year) are now minimized thanks to smaller single doses of radioiodine and to an individualized scheme for dose calculation. For patients in poor condition, 131I should be combined with thyrostatic therapy for at least 2 1/2 months.


[Treatment of internal hemorrhoids by the method of nonsurgical ligature combined with proctoglivenol]. In the Research Laboratory of Proctology with the clinic of the RSFSR Ministry of Health since 1974 a nonoperative ligature method was employed for treatment of 50 patients at high risk for this affection. A combined use of the nonoperative method and proctoglivenol suppositories is a rather effective therapeutic measure, which is indicated for treatment of hemorrhoids in patients, in whom operative intervention is contraindicated.


The use of a technicon SMA 12/60 multichannel biochemical analyzer in veterinary clinical pathology. This article has described many of the advantages of using a sequential multichannel autoanalyzer to obtain a biochemical profile on animal blood specimens and how this profile can be used in assessing the patients biochemical status. Precautions concerning the collection of blood samples to avoid spurious results have been emphasized. Hemolysis should, in particular, be avoided. Ideally, plasma should be separated from cells shortly after collection and refrigerated. If this is not possible, storage of whole blood under refrigeration (4 degrees C.) is permissible for a short period. In these cases minor changes in blood glucose, total CO2, and calcium may be expected. Also presented are some of the statistical calculations and manipulations that are possible utilizing a data bank containing the data from the SMA 12/60. This information is being used to update much of our knowledge of veterinary clinical pathology.


[Primary malignant tumours of the small intestine (author's transl)]. In the years between 1936 and 1973 19 patients with malignant tumours of the small intestine were admitted to the 2nd Department of Surgery, University of Vienna. Analogous to the findings of large-scale investigations adenocarcinomas (7 cases) preponderate in the upper small intestine in our case material, while lymphosarcomas and carcinoids mainly occur in the ileum. A radical surgical procedure was possible in 11 cases. The adenocarcinomas have the most unfavourable prognosis, whilst survival times of up to 10 years were found with lymphosarcomas and carcinoid tumours.


[The lung phospholipid content in newborn infants with idiopathic respiratory distress syndrome in relation to lung histology and survival time (author's transl)]. In an autopsy series on 25 newborn infants who died in the perinatal period (19 with and 6 without respiratory distress syndrome [RDS]) the total phospho-lipid, lecithin, and sphingomyelin content was determined in lung homogenates as parameters of the surfactant content. Histologically, the newborn infants with RDS were subdivided into those with and those without hyaline membranes. Newborn infants with RDS hat a lower lung phospho-lipid content than mature newborn infants without RDS but there was no difference in phospholipid content in relation to the presence or absence of hyaline membranes. The lecithin content of the lungs in those infants with RDS who had survived for more than 24 hours was higher in the absence of hyaline membranes than in their presence.


[Residues of chlorinated hydrocarbons in milk and milk products - situation and evaluation (author's transl)]. Residues of the most varied chemical substances can be found in milk and in milk products. For the transfer into milk such factors as fat solubility, persistance with respect to metabolic processes and accumulation capacity in certain organic systems are of particular importance. For the description of the situation with respect to residues of chlorinated insectides the results of analyses obtained in 20 supply areas of the German Federal Republic are presented and interpreted. In 1974 the following mean values were found (fat basis): alpha-HCH 0.04, gamma-HCH 0.072, heptachloro-epoxide 0.024, dieldrin 0.021 and DDT 0.20 ppm. These mean values are far below the max. quantities legally permissible and in no way constitute a toxicological risk (referred to ADI). In the German Federal Republic the concentrations of hexachlorobenzene in some cases reach the permissible max. quantity of 0.5 ppm on a fat basis. There is reason to assume that this substance finds its way into the milk not only via its application as a fungicide but probably also via a number of other, in part unknown, sources of contamination in or on vegetable products. With PCB (polychlorinated biphenyls) average concentrations from 0.2 to 0.3 ppm must be expected to be present in milk and milk products (fat basis). At present a toxicological interpretation of the values found is hardly possible.


The first international standard for human urinary FSH and for human urinary LH (ICSH), for bioassay. This paper describes the preparation and nature of the First International Standard for Human Urinary Follicle Stimulating Hormone and for Human Urinary Luteinizing Hormone, for Bioassay, and of two batches of working standard which were prepared from the same material. A collaborative study of these materials was carried out by six laboratories in six different countries. The FSH and LH activities of the Standard were assayed in terms of those of the Second International Reference Preparation of Human Menopausal Gonadotrophins, Urinary, for Bioassay, which it replaces. The results from 20 valid FSH assays and 30 valid LH assays (using four different methods) obtained in this way gave a weighted combined potency estimate for FSH of 53.7 IU, with 95 % fiducial limits of 47.2-61.1 IU, and for LH of 46.2 IU, with 95 % fiducial limits of 43.3-49.3 IU. Accelerated degradation studies of the Standard stored at elevated temperatures suggested that the stability of both FSH and LH activities under normal storage conditions would be satisfactory. The FSH and LH activities of the two batches of working standard (WS-A and WS-B) were compared with those of the Standard and were not found to differ significantly, except for the LH activity of WS-B which appeared to be slightly higher than that of the Standard. Accelerated degradation studies did not show any significant differences in stability between the Standard and batches of working standards. On the basis of these results the Standard has been established by WHO and allocated a potency for FSH of 54 IU per ampoule and for LH 46 IU per ampoule. The International Units for FSH, Human Urinary, for Bioassay and for LH (ICSH), Human Urinary, for Bioassay are thus defined as the activities contained in 0.1138 mg and 0.13369 mg of the International Standard, respectively.


Prolactin in the ram: seasonal variations in the concentration of blood plasma from birth until three years old. Peripheral prolactin levels were measured by radioimmunoassay in nine Ile de France rams, born in autumn and reared under natural conditions of light and temperature until three years old. During December, when the rams were 80-100 days old, a brief and transitory peak of prolactin occurred (70 ng PS6/ml plasma +/- 10 ng). During each following year, the prolactin level fell in winter to approximately 20 ng/ml. However, in summer the prolactin was 4 times higher than the winter level during the first year and 11 times higher during the 2nd and 3rd years. A possible role of prolactin variation throughout the breeding season is discussed.


Thyroid hormone response to varying doses of TSH. Fifty-five normal subjects were studied following intravenous injection of increasing doses of bovine thyrotropin (b-TSH) from 0.5 to 250 mU/kg. Serum triiodothyronine (T3) and thyroxine (T4) were measured 1, 2, 3 and 4 h after the TSH injection. Dose-related increments in serum T3 and T4 were demonstrated with doses of b-TSH = 2.5 mU/kg and a maximum response was obtained after approximately 100 mU/kg. The fractional increase in serum T3 was greater than in serum T4, but the ratio between the increase in serum T4 and serum T4 and serum T3 (21.3/l ng/ng) was independent of the dose of b-TSH and time after TSH stimulation. The T3 response was reproducible and unaffected by sex and age.


Dynamic study of post-natal thyroid function in the rat. The thyroid function in development was investigated in post-natal rats. The thyroid iodine content rapidly increased from birth (137 +/- 26 ng iodine/mg thyroid) up to day 10 (338 +/- 42 ng iodine/mg thyroid) then increased more slowly up to day 30 (425 +/- 34 ng iodine/mg thyroid). The maximal plasma concentration of thyroxine was observed on day 16 (56.9 +/- 3.5 ng T4/ml) and of iodide on day 10 (110.2 +/- 12.6 ng I-/ml). The turnover rate constant of extrathyroidal thyroxine was higher at birth (8.0 +/- 2.3 %/h) than at any older age studied (average 6 %/h). Thyroxine secretion by the thyroid was more intense before weaning (37 ng hormonal iodine/h/100 g body weight on days 10 and 20) than after weaning (22 +/- 6 ng hormonal iodine/h/100 g body weight in 30 days old rats). The peripheral deiodination rate of thyroxine represented about 90 % thyroxine secretion rate in newborn and 10 days old rats and only 40% in adult females. In pre-weaning rats, after a single injection of both [131I]L-T4 and [125I]Na, extrathyroidal radioactivity disappeared more slowly than in 30 days old rats and adult animals. This suggests that iodide concentrations of extrathyroidal tissues are higher before than after weaning.


Antigoitrogenic effect of casein.

Antigoitrogenic effect of casein. Epidemiological findings from the city of Cali, Colombia, support the hypothesis that water supply and iodine intake are not the only dietary factors which influence the magnitude of the goitre endemia. Experiments were conducted in rats to determine whether casein has a counteracting effect on the goitrogenic and antithyroid activities of methimazole (MMI) and goitrogenic water extracts (GWE) from the endemic area of the Cauca Valley. Female albino rats (Charles River, DC strain) 100-110 g initial weight, receiving 12 mug of iodine daily, were divided into three groups annd put on special diets: protein-free, 8 % casein, or 60 % casein, respectively. Each group (24 rats) was then divided into three subgroups. Subgroup one received goitrogen-free water and was used as a control. Subgroup two was administered MMI, 50 mug/day/rat. Subgroup three was given per animal a daily amount of GWE equivalent in antithyroid potency to 50 mug of MMI. At 77 days, the thyroid glands were studied for weight, 131I uptake, and 127I concentration. Animals on the protein-free diet showed significantly (P less than 0.05 - less than 0.01) larger thyroid glands per 100 g body weight and lower thyroidal 4 h 131I uptake and 127I-concentrations than rats on casein diets. These differences were significantly increased (P less than 0.01) by the administration of MMI and GWE. All the effects were completely reversed by the 60 % casein diet showing no differences between control rats and those on MMI or GWE. Rats on 8 % casein showed intermediate values between those of animals on protein-free and 60 % casein diets; differences were still present between the control as against the MMI or GWE groups, The results indicate that under these experimental conditions, a poor-protein diet impairs the thyroidal transport of iodine, decreases its concentration in the thyroid and is accompanied by an enlargement of the gland. Under these circumstances, the action of thiourea-like antithyroid agents is enhanced. The administration of protein reverses these alterations and decreases the action of such antithyroid agents. Whether the changes observed are due to a direct action of casein on the thyroid and/or to effects of malnutrition on the metabolism of antithyroid compounds remains to be determined.


The effect of atropine on the insulin release caused by oral and intravenous glucose in human subjects. Oral and intravenous glucose tolerance tests were performed on normal fasting subjects, with and without atropine. Insulin release after oral glucose was significantly diminished by atropine, and this effect could not be ascribed to the drug delaying glucose absorption. However, insulin release brought about by intravenous glucose was not altered by atropine. Possible interpretations of these results are discussed.


The distribution of blood flow to the reproductive tract of anaesthetized ewes near oestrus. Radioactive microspheres were used to measure the rate and distribution of blood flow to the reproductive tract of anaesthetized sheep. Seven sheep were examined on day 14, 6 on day 15 and 10 on day 16 of the oestrous cycle: oestrus is normally on day 16 or 17. The rate of blood flow to the myometrium, endometrium and oviducts increased by 2-fold from day 14 to 15: the weights of these organs increased on day 16. Blood flow to the vagina and cervix increased by over 10-fold from day 14 to 15 but vaginal and cervical weights remained unchanged. Thirty minutes after the administration of 1200 IU PMSG, blood flow increased in the vagina and cervix on day 14, the myometrium on day 15 and the vagina, cervix and oviducts on day 16. However, these results must be viewed with caution since there were substantial, though not significant changes in the controls. The results favour the hypothesis that, near the end of the oestrous cycle, oestrogen has a dominant role in the control of blood flow to the reproductive tract of sheep.


Cytosol and nuclear [3H]oestradiol binding in the foetal tissues of guinea pig. The formation of [3H]oestradiol macromolecule complexes was studied in vivo and in vitro in the kidney, lung and liver of intact foetal guinea pig. Specific binding of [3H]oestradiol was demonstrated in the cytosol and nuclear fractions of foetal kidney. Intensive binding was found in the cytosol of foetal lung but most of the bound radioactive material (70 %) was [3H]oestrone. Some binding was found in the cytosol of foetal liver but not in the nucleus of this tissue. In the in vivo experiments, the binding of radioactive material to plasma proteins was studied: 22 % of the plasma radioactivity was bound of which 67 % was identified as oestrone sulphate. Oestradiol sulphate represented 7% and unconjugated oestradiol only 0.6 % (0.1 % of the total plasma radioactivity). On the other hand, 2-3 % of the foetal plasma radioactivity was found as unbound [3H]oestradiol. In the kidney, the formation of [3H]oestradiol complexes in the cytosol fraction does not depend on temperature while nuclear [3H]oestradiol complexes increase with increasing temperature. Maximal formation of [3H]oestradiol complexes in the cytosol fraction and the 0.1 M TRIS and 0.3 M NaCl nuclear extracts was reached after 15 min but binding in the 1 M NaCl nuclear extract continued to increase up to 30 min. After incubation of purified nuclei of foetal kidney with 1.1 x 10(-7) M [3H]oestradiol, specific binding was found in the different nucelar fractions. Specific binding was also detected in isolated nuclei previously extracted by 0.1 M TRIS and 0.3 M NaCl before being incubated with 1.1 x 10(-7) M [3H]oestradiol. The Kd of binding of [3H]oestradiol in the renal cytosol fraction is 2.5 x 10(-10) M with n = 4.5 x 10(-14) moles/mg protein. Incubation of isolated 1 M NaCl nuclear extract from foetal kidney with [3H]oestradiol gives a Kd of 3.3 x 10(-10) M with n = 2.5 x 10(-14) moles/mg protein. It is concluded that the nuclear complexes in the foetal kidney could be formed either through an intermediate cytosol complex or that the "two step" mechanism could take place in the nucleus. Furthermore, direct binding of [3H]oestradiol with high affinity was observed in the 1 M NaCl nuclear extract.


Studies in congenital generalized lipodystrophy. IV. Effect of muscular exercise on carbohydrate and fat metabolism including plasma levels of IRI and HGH. Two patients with congenital generalized lipodystrophy have been studied at rest, and during and after long-term exercise at different carefully measured work loads. The two patients represented different stages of diabetes development. Both patients derived most of their energy used during muscular exercise from carbohydrate, and comparatively little from fat. FFA levels remained low throughout the period of observation in contrast to normal individuals and patients with juvinile diabetes. The data presented seem to show that deposition of glucose and free fatty acids (FFA) as triglyceride, must be impaired and are not compatible with the concept of increased triglyceride turnover in the adipocytes. The fall in blood glucose concentration (BCG) was less than in normal individuals and juvenile diabetes during exercise, and the glucose tolerance remained unchanged following work stop in both patients (k-values unchanged), in contrast to normal persons and patients with juvenile diabetes. Both patients showed significant falls in circulating immuno-reactive insulin (IRI) levels during exercise irrespective of a rise or fall in BGC. Thus, the exercise itself might activate endogenous mechanisms which could, on the one hand increase the circulating BGC, and at the same time force circulating IRI to decrease, thus disturbing the well-known relationship between circulating glucose and IRI levels as has been exhibited in normal subjects. The high IRI levels, also during exercise in these patients, indicate a relative insulin resistance in the muscles, but less marked than the insulin resistance in the adipose tissue. The IRI response after glucose infusion did not change significantly with increasing work loads with one exception. Exercose did not alter significantly the human growth hormone (HGH) levels in either the diabetic or the non-diabetic patient indicating an abnormal regulation of the HGH secretion in congenital lipodystrophy.


Changes in amniotic fluid phospholipids on treatment with glucocorticoids to prevent respiratory distress syndrome. Amniotic fluid was obtained by transabdominal amniocentesis in 51 women in the 29th-36th week of pregnancy. The lecithin/sphingomyelin ratio was determined. In 28 patients,the ratio was less than 2.2. Beta-methasone was given for three days to 14 of them; the rest served as controls. On the fourth day, a second amniocentesis was performed on all patients. The lecithin/sphingomyelin ratio rose to a value greater than 2.2 in 4 of the patients in the betamethasone-treated group and in one of the controls. The percentage of palmitic acid in the lecithin increased concomitantly with increasing lecithin/sphingomyelin ratio. These results suggest that glucocorticoid induced acceleration of fetal pulmonary maturation may be reflected in the amniotic fluid as changes in its phospholipid composition. The lecithin/sphingomyelin ratio was found to be greater than 2.2 in 23 patients at the first amniocentesis. In such cases treatment with glucocorticoids can be avoided.


Changes in erythrocyte lipid stroma in the premature infant according to dietary fat composition. Eighteen premature infants of similar gestational age, divided into three groups, were fed 3 milk formulas containing different amounts of linoleic acid. All the cases received 120 calories per kg of weight and day, of which formula A supplied 6.1% of the dietary total calories as linoleic acid, formula B 15.9% and formula C only 0.6%. The fatty acids of red cell ethanolamine and choline phosphoglycerides were studied in a first sample obtained during the first hours of life before the infants had received any food, and in a second sample taken at the age of three weeks. In the group fed formula C (0.6% of the total calories) changes similar to those described in EFA-deficient rats were found, namely, a decrease of linoleic acid, and an increase of oleic acid and of 20:3 (n-9), with a consequent rise of the triene to tetraene ratio. When the supply of linoleate was highest (15.9% of the total caloric intake) linoleic acid increased, oleic acid decreased and the 20:3 (n-9) practically disappeared. None of the three groups showed any clinical symptoms.


Nitrogen retention and plasma amino acids of adults who consumed isonitrogenous diets containing rice and milk or wheat versus their constituent amino acids. Nitrogen retention and concentrations of plasma amino acids were compared when young adults consumed isonitrogenous diets containing proteins (3.0 g of N from rice plus 3.0 g of N from milk or 3.0 g of N from rice plus 3.0 g of N from wheat flour) or mixtures of their constituent amino acids. Diets containing proteins induced greater nitrogen retention than did those containing corresponding amounts of amino acids in crystalline form, and the difference between the combinations of proteins was delineated more sharply. Concentrations of several amino acids were elevated by substituting crystalline amino acids for proteins, especially in postprandial plasma. Subjects responded differently to addition of the limiting amino acids, lysine and tryptophan, to the diets containing amino acids instead of rice plus wheat. Therefore, data obtained by means of combinations of cereals and by mixtures of their constituent amino acids cannot always be used interchangeably.


Gynecologic disease in young, sexually active women. There has been a significant change in adolescent sexual behavior in the past decade. This report of 1,594 young, sexually active women, primarily from middle and upper socioeconomic backgrounds, identifies the obstetric and gynecologic problems characteristic of the group. While supposedly in a low-risk category these patients displayed a high incidence of cervical epithelial abnormality, problem pregnancy, and other obstetric and gynecologic abnormality. The incidence of veneral disease  was somewhat lower than anticipated.


125I therapy in Graves' disease. Long-term results in 355 patients. Because of the physical and radiobiologic differences between 125I and 131I, a trial using 125I to treat hyperthyroidism was undertaken in the hope of controlling hyperthyroidism without causing subsequent hypothyroidism. Three hundred fifty-five patients with diffuse toxic goitres were treated and have been under review for an average of 49.4 months:  63.4% are euthyroid, 33.5% are hypothyroid, and 3.1% remain hyperthyroid. Different groups of patients received a wide range of doses of 125I (4.0 to 56.0 mCi), and the lowest incidence of hypothyroidism (23%) was in the group that received between 6.0 and 10.5 mCi. Sixty-three percent of the patients whose initial dose was greater than 20.0 mCi are hypothyroid. Persistent hyperthyroidism was common in patients who received small doses. Because of the high incidence of posttreatment hypothyroidism in this series and because 131I has stood the test of time, we believe that 131I is the radionuclide of choice for the routine treatment of hyperthyroidism.


Antibodies to Yersinia enterocolitica in thyroid disease. The prevalence of elevated antibody titers against Yersinia enterocolitica was studied in normal subjects, patients with a variety of nonthyroidal illnesses, and patients with thyroid disease. In contrast to the low prevalence of antibodies in controls (less than 8%), 48 of 67 patients (75%) with a variety of thyroid disorders had titers greater than 1:8. Antibodies were found in 24 of 36 patients with Graves' disease, five of six with autonomous adenoma, seven of seven with Hashimoto's thyroiditis, three of five with idiopathic primary hypothyroidism, four of 11 with nontoxic nodular goiter, and one of two with thyroid carcinoma. Antibodies to serotype 3 were the most prevalent, occurred in the highest titers, and were found particularly in patients with Graves' disease. These observations indicate that in spite of the infreqent occurrence of yersinia infection in the United States as compared with Scandinavia, patients with thyroid disorders have a higher prevalence of antibodies to Yersinia than normal subjects or patients with other disorders.


Prolonged rupture of membranes, pre-eclamptic toxaemia, and respiratory distress syndrome. A retrospective analysis was made of the incidence and severity of the idiopathic respiratory distress syndrome (RDS) in babies of less than 35 weeks' gestation born at this hospital from January 1967-December 1974. There was a lower incidence of RDS in babies born after pregnancies complicated only by prolonged rupture of membranes (PRM) (19%) and in babies born vaginally after pregnancies complicated only by pre-eclamptic toxaemia (PET) (18%) compared with the incidence of RDS after uncomplicated pregnancies (35%). Babies born vaginally who developed RDS after pregnancies complicated by PRM or PET had less severe disease compared with those who developed RDS after uncomplicated pregnancies. Mortality in babies who developed severe RDS was not influenced by the occurrence of PRM or PET. The biological implication of the study is that certain complications of pregnancy may accelerate pulmonary surfactant production in preterm babies.


Intrathecal antibiotic therapy for neonatal meningitis. Twenty infants with neonatal meningitis were treated with systemic and lumbar intrathecal antibiotics upon initial diagnosis. Failure to sterilize the CSF in 2-3 days was associated with evidence of ventriculitis in these infants who were then treated with intraventricular antibiotics. 4 infants died, but only 2 of them may be regarded as treatment failure. It is suggested that many deaths from neonatal meningitis may be preventable by early detection and treatment of ventriculitis with intraventricular antibiotics.


Acute renal failure following halothane anesthesia. Acute renal failure was observed postoperatively in a patient after halothane anesthesia. The clinical and pathologic findings in this case were remarkably similar to those found in patients with renal failure after methoxyflurane anesthesia.


Abnormal vessels in the urinary tract following analgesic abuse in man. A brownish discoloration of the bladder mucosa around the ureteric orifices has been observed on cystoscopy in three patients taking excessive quantities of analgesics. Biopsy specimens revealed an unusual degree of hyalinization of the vessels in the submucosa. Similar changes have been noted in the renal medulla, pelvis, and ureter of patients with classical analgesic nephritis. This vascular change may play an important part in the development of the characteristic infarct-like necrosis seen in the analgesic kidney.


Pulmonary injury and repair. Organ culture studies of murine lung after oxygen. Samples of mouse lung were cultured at various stages of the injury-repair cycle induced by oxygen. At intervals during and after a six-day exposure, pulmonary explants were prepared and cultured in media labeled with tritiated thymidine. Lungs cultured during the first three days in oxygen, when only interstitial edema was observed, resembled control explants in morphologic features and labeling. Cultures prepared from animals after four to six days of exposure, when necrosis of type 1 epithelial cells and hyaline membranes were observed, showed reduced thymidine uptake and reduced epithelial regeneration. Fibroblastic proliferation and collagen deposition occurred directly beneath areas with hyaline membranes, indicating that, in severely damaged lungs, cellular proliferation is predominantly fibroblastic rather than epithelial. The results suggest that the organ culture system is suitable for studying the reparative capacity of injured tissue.


Primary pulmonary neurilemoma. Report of a case with ultrastructural examination. The electron microscopic features of a primary neurilemoma of the lung, a very rare neoplasm, were studied. Characteristic Schwann cells were present, with cytoplasm and elongated cytoplasmic processes coated with a basal lamina. The highly characteristic Luse bodies were also seen. We add electron microscopic corroboration to the previous tissue culture confirmation of this unusual benign pulmonary neoplasm.


Tubular stenosis of the aorta with aortic fibromuscular dysplasia. The autopsy findings in a 2-year-old girl with severe hypertension resulting from stenosis of the lower part of the thoracic and the abdominal aorta were reviewed. The lower portion of the thoracic aorta and the abdominal aorta showed uniform narrowing down to the level of the bifurcation of iliac arteries. Histologically, the aortic wall of the stenotic site showed irregular proliferation of smooth muscle cells and collagen fibers. The elastic fibers had disappeared from outside the media. No intimal thickening and inflammatory cell infiltration were observed. These histologic changes of the aortic media in this case are apparently similar to fibromuscular dysplasia (medial hyperplasia).


Identification of calcium oxalate deposits in bone by electron diffraction. Oxalosis involving bone secondary to prolonged chronic renal failure and long-term dialysis occurred in a living patient. The cystalline deposit in the small fragment of bone was identified by electron diffraction.


Wilson disease. Comparative ultrastructure in a sibship of nine. Comparative electron microscopy was done on liver tissue from a family of nine siblings to determine whether presymptomatic, affected patients with Wilson disease could be differentiated from heterozygous, normal carriers. Two of the nine had developed the neurologic manifestations of the disease; three others were considered to be homozygous but normal, two were heterozygous and normal, and two were classified as genotypically uncertain because of borderline biochemical abnormalities. Alterations of the mitochondria and endoplasmic reticulum suggestive of copper toxicity were present in both the heterozygous and the genotypically uncertain siblings, and a clear distinction could not be made on this basis. The severity of the abnormalities appeared to correlate with liver copper level, and organelle changes were found to precede lipid accumulation.


Meningioma with sarcomatous change and hepatic metastasis. A 72-year-old patient had a meningotheliomatous meningioma that invaded through the skull and into temporalis muscle. One year following craniotomy for removal of the neoplasm, he developed headaches, diplopia, and proptosis of the left eye. Biopsy of the orbital contents revealed a malignant supporting tissue neoplasm having a resemblance to the previous meningioma. No curative therapy was possible and the patient died 33 months after diagnosis. Autopsy examination showed extensive residual intracranial neoplasm and a 3-cm metastasis in the liver. The metastatic tumor appeared similar to the meningioma and did not appear malignant histologically. The case illustrates the distinct histologic variations in meningiomas and the difficulties in predicting their biologic activity. Aggressive local behavior may indicate possible malignant areas in the neoplasm. Therefore, examination of the neoplasm should be thorough. Such a correlation may suggest malignant biologic potential.


[Local pO2- and pH2-measurements with needle electrodes for the examination of the hydrogen maintenance and microcirculation of the cochleae (author's transl)]. The local partial pressure of oxygen (pO2) and the rate of hydrogen elimination were measured in the three scalae of the basal turn of 28 Guinea-pig cochleae under conditions of normoxia, hyperoxia and hypercapnia and with acoustical stimulation with the needle electrodes developed by Baumgärtl and Lübbers. In the scala tympani a pO2 decrease from the round window toward Corti's organ was registered and pO2 values of over 100 mm Hg were measured near the membrane of the round window and of 10-40 mm Hg near the basilar membrane depending on how deeply the electrode penetrated into the scala tympani. The pO2 profiles were changed or reversed when the animal breathed a mixture of 95% oxygen and 5% carbon dioxide and when the round window membrane was covered with agar-agar or paraffine and exteriorly flooded with nitrogen. Acoustical stimulation with a white noise of 85 dB caused a considerable pO2 drop in the perilymph of the scala tympani while in the endolymph of the scala media we observe only a slight decrease. Intravenous application of dextran of low viscosity leads to a pO2 increase when the original oxygen value in the scala tympani was low. The half-life of hydrogen in the scala tympani amounts to about 4 min. The results permit the conclusion that, in the area of the cochlear basis, Corti's organ receives its oxygen supply via the capillary system as well as via the membrane of the round window.


[On the practice of audiological balance-tests (author's transl)]. The psychological factors influencing the common test-situation of the ABLB are still unknown. The fact that always on the same ear the intensity is remaining constant and that this intensity is increased in equal steps is no longer due to modern psychological principles of testing. Both--the side and the intensity--should be randomized within the given range (both sides and all possible intensities). Therefore the test-procedure is controlled by a computer, which also calculates the significance of the relative recruitment. When the test is finished a diagram is plotted containing the values and the regressionline. Also the monaural test (comparison of two frequencies) is well practicable using the same program, because the incertainty (being greater if the test is more difficult) is included in the statistic calculation.


A comparison of acidic glycosaminoglycans in the inner ear and other organs: electrophoretic microanalysis. Acidic glycosaminoglycans in the ground substance of the membranous cochlear lateral wall, kidney, brain and liver of the guinea pigs were quantitatively and qualitatively analyzed, using electrophoretic microanalysis. The lateral wall of the cochlea showed highest content (0.46 +/- 0.08%/D.W.) of acidic glycosmainoglycans, which were chondroitin sulfate-B (75%), chondroitin sulfate-A (12%) and hyaluronic acid (13%). However, the pattern of these acidic glycosaminoglycans in the inner ear differed from the other organs. A possible role of acidic glycosaminoglycans in the inner ear was discussed.