[Current place of hemorrhagic rectocolitis in intestinal pathology]. Rectocolitis remains, at the present time, in spite of the large amount of work carried out, a condition of which the cause and the physiopathological mechanism are unknown: none of the theories proposed has been confirmed by the facts; none has made it possible to propose an effective therapeutic regimen. The diagnosis of haemorrhagic rectocolitis rests solely on an assembly of clinical, radiological, and anatomological findings, together with findings on progress of the disease; none of these findings taken separately being pathognomonic. Because of this it is essential in cases of inflammatory colic disorders to analyse critically these different elements before affirming the diagnosis that is often arrived at too easily. Different affections, even apart from Crohn's disease (parasitic, microbial, and iatrogenic affections, etc) may, in fact, give rise to radiological and clinical pictures close to those of haemorrhagic rectocolitis.


[Rheumatic manifestations of Crohn's disease. A national survey]. The authors analyse the results of a national survey, by questionnaire, in which 44 rheumatologists participated: the 102 cases of Crohn's disease discovered are divided as follow - 47 cases of peripheral rheumatism, and 55 cases of axial rheumatism, spondylarthritis and sacro-ileitis. The cases of peripheral rheumatism were closely related to the enteritis: appearing after the first digestive symptoms, they follow closely the development of, and recede with intestinal resection of the lesion; mono, oligo, or polyarticular, they develop in brief episodes, in an immune context and are only one symptom among the others of Crohn's disease. In contrast, preceding or following the first digestive symptoms, pelvispondylitis (34 cases) developed quite independently of the enteritis and was modified neither by medical treatment nor surgical treatment; these cases were characterized by equal distribution between the two sexes, inconstancy of syndesmosis, and frequent peripheral involvement. As regards the cases of sacro-ileitis, whether discovered by chance or because of rachialgia and arthralgia, these appear to be similar to the cases of pelvispondylitis and their appearance is probably conditioned by a polygenic transmission factor different from the HL-A B 27 marker.


[Dysenteric rheumatism. What remains in 1976?]. Joint manifestations that occur during or after an episode of dysentery, grouped under the name of dysenteric rheumatism, have been known since antiquity, and have been mainly found in military circles, in camps, or during military campaigns. After reviewing the principal epidemics of rheumatism complicated by joint manifestations, the authors show that the only different feature about what is called dysenteric rheumatism is the particular character of the joint manifestations which may be isolated or associated with other manifestations, notably ocular or urethral, forming then what is called the Fiessinger-Leroy-Reiter syndrome. The role of the dysentery bacillus in the genesis of the joint lesions is not clear. Although it may been suspected on the basis of epidemiological or bacteriological arguments in some cases, it has never been formally demonstrated and is often non-existent. The term dysenteric rheumatism is too restrictive and should henceforth be abandoned.


Passage of barium meal through esophagus in patients with balloon tamponade of esophageal varices. Four patients in different states of consciousness in treatment with Sengstaken-Blakemore tube were given a barium meal. In every case the contrast medium passed the balloons and was cleared from the upper esophagus in less than four minutes, and none of it was aspirated to the bronchi.


Antibody-dependent lymphocyte-mediated cytotoxicity. The nature of the effector cell and characterization of its fc receptor. The effector cell in abtibody-dependent lymphocyte-mediated cytotoxicity (ADLMC) have been studied. The cells do not adhere to glass and bear Fc receptors independent of surface Ig and complement receptors. Whereas monocytes have IgG1 and Ig G3 Fc receptors, these Fc receptor lymphocytes appear to have receptors for aggregates of all four IgG subclasses.


Prolonged treatment with tolfenamic acid in inflammatory rheumatic diseases. The aim of this study was in the first place to elucidate the tolerance of rheumatic patients to prolonged treatment with tolfenamic acid. 91 patients took part in the trial, most of them suffering from rheumatoid arthritis. The daily dose of tolfenamic acid was 600 mg and the trial lasted 6 months. The side-effects were usually slight: diarrhea occurred in 8, other gastrointestinal disturbances in 11, dysuria in 8 and other side-effects in 3 cases. Six patients broke off their treatment because of side-effects ascribed to tolfenamic acid. However, laboratory tests failed to show any significant changes caused by this drug. One case of reversible thrombopenia was seen in a patient who had also received gold treatment. On the whole, the clinical effect was found to be good, and tolfenamic acid appeared to be well suited for long-term symptomatic treatment of rheumatics.


Haemophilus from the lower respiratory tract of patients with cystic fibrosis. Fifty-six non-haemolytic Haemophilus strains were isolated during current bacteriological examinations from material from the lower respiratory tract of 39 patients with cystic fibrosis during a 6-month period. Except for six strains which belonged to Haemophilus parainfluenzae, all strains were identified as Haemophilus influenzae. Biotype I of H. influenzae was the predominating taxon (38%) and was especially related to patients with recurrent or prolonged colonization. Only two strains were capsulated. An unexpectedly high percentage of the strains produced lysine decarboxylase. The significance of this property in the pathogenesis of the respiratory tract colonization is discussed.


Lymphocyte mobilization in response to physical work in sarcoidosis. Influence on lymphocyte subpopulations, DNA synthesis and cytotoxicity. Peripheral blood lymphocytes of nine patients with pulmonary sarcoidosis were collected before and after a standardized bicycle ergometer test. The lymphocytes were characterized by various cell surface markers as T or B lymphocytes, and functionally by mitogen- or antigen-induced DNA synthesis and by antibody dependent cell-mediated cytotoxicity. Physical work resulted in an increase of circulating lymphocytes. Proportionately more B lymphocytes were mobilized. The DNA synthesis of lymphocytes in response to mitogens and antigen was reduced, whereas the cytotoxicity was augmented. Compared with normals the mobilization of lymphocytes was less, and a deficiency of both T and B lymphocytes was revealed. The functional impairment of lymphocytes in the patient group persisted.


Photoreceptor shedding is initiated by light in the frog retina. Frogs maintained on a diurnal light-dark cycle (14 hours light and 10 hours darkness) shed their rod photoreceptor outer segment tips shortly after the onset of light. Shedding is synchronous and occurs in about 25 percent of the rod photoreceptors each day. Prolonged exposure to total darkness decreases the amount of shedding, after which exposure to light results in a large burst of synchronous shedding. Thus in the frog retina, the synchronous shedding of rod outer segment tips is shown to be directly related to light stimulation.


Modification of blood flow to the extremities by electrical stimulation of the nervous system. Sixteen patients who had electrical stimulation applied to various portions of the nervous system were examined for increase in blood flow to the extremities. Clinical observations and a one-channel plethysmograph were used to measure arterial dilatation. Seven patients had transcutaneous stimulation applied over the cervical or thoracic spinal cord, peripheral nerves, or low lumbar region; eight had electrical stimulators implanted over the spinal cord in attempts to relieve intractable pain or some of the symptoms of multiple sclerosis; and one patient had electrical stimulators implanted over the C-6 dorsal roots for small artery disease of the upper extremities. Twelve of 13 patients who had electrical stimulation applied to the spinal cord or dorsal roots had significant arterial dilatation in one or more extremities. Electrical stimulation applied to the ulnar nerves did cause arterial dilatation. One patient did not show any change in the central arterial pressure curve during transcutaneous stimulation of the cervical spinal cord.


Cellular immunity to herpes simplex infection in humans. A comparison of lymphocyte interferon production and transformation as in vitro parameters of cellular immunity to herpes simplex in humans in different types of mononuclear cell cultures is reported. Mononuclear cells were purified on Ficoll-Hypaque gradients and nylon fiber columns (purified T lymphocytes). Reactivity was then compared to that observed in autochthonous macrophage-lymphocyte cultures. The quantity and type (I or II) of interferon, as well as the magnitude of the transformation response, is affected by the type of cell culture used for assay. The kinetics of lymphocyte reactivity in doners studied within 12 weeks after disease were compared to those occurring at greater than 12 weeks after disease and in seronegative donors. The observed kinetics were variable according to the methods used to prepare mononuclear cells for culture.


[Follow up study of patients operated on metastases of the lung and pleura (author's transl)]. From 1956 til 1974, 1851 patients have been operated on a malignancy of the lung. 29 of them had a solitary lung metastasis and 2 of them a metastasis of the pleura. Among those, the primary malignancies showed the following frequency: 7 malignancies of the uterus, 7 sarcomas, 4 carcinomas of the breast, 4 carcinomas of the large bowel, 4 malignant goiters, 3 hypernephromas, 1 seminoma and 1 malignancy of the pancreas. The mean survival time was 3.3 years. 25.8% of the patients survived 5 years. Patients with a primary malignancy of the uterus appear to do best. In case of repeated metastases we did not operate upon again.


[Resection for pulmonary metastases: results and prognosis (author's transl)]. From 1955 to 1975 in 25 patients lung surgery has been carried out because of intrapulmonary metastases of extrapulmonary malignant growth. 6 patients survived longer than 5 years. There was no relationship between survival time and length of the time interval between initial surgery (primary) and second operation (i.e. diagnosis of pulmonary lesion). On the other hand a definite relationship resulted for survival time and the size of the growth. In bad-risk patients surgery for metastatic lung cancer is not indicated, but it is very successful in selected cases.


[Results after surgical treatment of solitary metastasis of the lung (author's transl)]. The surgery of solitary metastasis of the lung has special ranges of indication which refer to pathomorphology, cardiorespiratory and oncological programming. By systematical selection the own material of 45 cases shows a two year survival time of 33% and a five year of 11%. Last results with survival rate are similar to the treatment of the bronchus carcinoma of all stages and are further justifying this therapeutical consequence.


[Early experiences with arterial heterografts (author's transl)]. Since April 1975 we used 50 bovine arterial heterografts for reconstructive surgery after chronic arterial occlusions or for the production of AV-shunts needed for chronic dialysis. In none of the cases incompatibility was seen. The early results (with a follow-up period of 6-10 months) after femoro-popliteal bypass were excellent, as far as a good peripheral run off was present. Several shunts (n = 7) containing 2-3 transplants, are still functioning 3-10 months after implantation. At present, we use bovine transplants in reconstructive vessel surgery when a thrombendarterectomy or the connection of venous grafts is impossible or when the operative procedure should be kept short in high-risk patients. To produce AV-shunts in patients with renal insufficiency we prefer this type of grafts when all conventional techniques were already used.


[Early and late complications due to direct and indirect aortic-isthmus-Plastic (author's transl)]. During the last 20 years 156 patients underwent a direct and indirect aortic-isthmus-plastic. Early complications occurred in 7.6%. 5 patients developed an aneurysm in the area of isthmus-plastic. The mortality rare was 4.5%. There was no evidence of recurrent coarctation in a group of children and in adult patients. The indirect aortic-isthmus-plastic first described by Vosschulte represents an elegant surgical method of functionally reestablishing the aortic lumen by retaining the posterior wall for further growth potential. This technique can be performed with a low mortality rate and no recurrent coarctation of the aorta.


[Open-heart surgery during deep hypothermia in infancy]. A total of 47 infants (2,7 to 9,6 kg in weight, 3 days to 21 months of age, 89% under one year) underwent early total correction of severe congenital heart defects in profound hypothermia of about 22degreesC and circulatory arrest (11 to 64 minutes). 8 patients were operated upon without extracorporeal circulation (ECC) (mortality 63%). 37 infants were additionally cooled and rewarmed with ECC (mortality 22%). The most common diagnosis were: Total atrioventricular canal (11), aortic stenosis with and without combined lesions (8), tetralogy of Fallot (7), ventricular septum defect (7) and transposition of the great arteries (4).


[Surgical considerations on levo-atrial systemic vein (author's transl)]. The levo-atrial systemic vein is a special type of persistent left superior vena cava and is associated with other intracardiac lesions most often. Hemodynamically there is a right to left shunt. The operative procedure may consist in a ligature in relation to the anatomic situation. The intraatrial correction intends a drainage to the right atrium. Of 7 cases four times a intracardiac rerouting was achieved but two times a ligation was performed.


[Obstruction of the hepatic portion of the inferior vena cava: morphological characteristics and surgical treatment (author's transl)]. Operable obstructions of the hepatic portion of the inferior vena cava (IVC) are rare but probably diagnosed more frequently nowadays. Since 1969 we operated 2 patients, one of them twice. Concerning to these cases the problems of diagnosis, morphology and surgical treatment are discussed. In the patient, who were operated twice, we found the combination - which has not been reported in medical literature yet - of a membranous stenosis of the hepatic portion of the IVC and a large Eustachian valve obstructing the IVC.


[Some somatic and psychological predictors of psychopathological disorders after cardiac surgery (author's transl)]. Some new predictors of postoperative psychosis in open-heart surgery have been identified in a multifactorial study of somatic and psychological factors: Somatic predictors are lower body weight, higher blood levels of urea nitrogen and creatinine, preoperative use of tranquilizers, especially in patients with double valve replacement or congenital heart disease and preoperative cerebral embolism in mitral valve disease. Bypass-time has not proved to be a valid predictor. Psychological predictors are distress provoked by severity and duration of illness, repeated delay of surgery as well as the manner of psychological coping with the illness.


[Performance of the Lillehei-Kaster-prosthesis. A critical haemodynamic study (author's transl)]. 11 patients were studied 6 to 12 months after aortic valve replacement with Lillehei-Kaster-prosthesis (LKP). We found pressure gradients (deltaP) at rest of 31 mmHg (7 to 52 mmHg), 37 mmHg (8 to 69 mmHg during exercise and 8 mmHg during ventricular pacing delta P was influenced by stroke volume and valve size, but not by the width of the aorta. The opening angle alpha of the disc was only 62degrees and depended on stroke volume and on the orientation of the value within the aorta. The blood passed the valve ring only through the larger part of the orifice, the opening area was only 50% of the given area. Thus in practice the LKP does not perform to manufacturers specification.


[The Lillehei-Kaster valve prosthesis hemodynamic and mechanic features in vivo (author's transl)]. 29 patients with Lillehei-Kaster vale prostheses, 22 in aortic position and 7 in mitral position, were examined. With small aortic valves (A 14 - A 16) mean gradients averaged 32 mm Hg, valve area varied between 1 and 1.2 cm2. Only size A 20 and larger showed satisfying gradient and valve areas of 1.9 cm2 and greater. The mitral gradients averaged between 10 and 5 mm Hg according to size and valve areas were about 1.6 cm2. The maximal measured opening angle of the pivoting disk averaged 64degrees in the aortic valves and 61degrees in the mitral valves; complete opening (80degrees) was not observed.


[Clinical and hemodynamic evaluation on the functional performance of the Starr-Edwards low profile valve prosthese in mitral position (author's transl)]. 205 patients with isolated mitral valve replacement using the Starr-Edwards low profile valve prostheses (model 6520 and 6550) were followed 3 to 67 months (mean of 30,4 months) after surgery. While these prostheses seems to reliable substitutes with regard to functional performance and to mechanical dysfunction, postoperative hemodynamic investigation revealed significant diastolic pressure gradients across the valve as well as reduction in functional mitral valve area relative to pulse and stroke volume. The incidence of thromboembolism was comparable to other artificial valves.


[Hemodynamic studies after the implantation of Hancock-heart valves (author's transl)]. Velocity profile, pressure gradient across the valve and blood flow have been measured in 10 patients after the implantation of bioprostheses of the sizes 27 and 29 millimeters in aortic position. According to these hemodynamic measurements the use of bioprostheses for the aortic valve replacement is recommendable. The low flow velocities in the area of the muscle containing valve cusp did not effect a detectable stenosis intraoperatively under the conditions of rest. The hemodynamic data showed no differences between the Hancock-Zuhdi and the Edwards-Carpentier bioprostheses. Despite of good hemodynamic conditions and a low risk of thromboembolic complications after the aortic valve replacement with bioprostheses reservation is recommended to its clinical use until the long term mechanical stability (more than 6 years) of the biological heart valve prosthesis has been secured.


[Intraventricular conduit for complex forms of transposition of great vessels (author's transl)]. Complex forms of transposition of great vessels necessitate different approaches to correction. In a case of double outlet right ventricle with d-transposition and atrioventricular concordance and a subvalvular pulmonary stenosis an intraventricular conduit with a 16 mm Dacron vascular prosthesis was used. This was anastomosed in an acute angular manner with the muscular margins of the VSD and routed to the base of the aorta. Surgical and anatomic implications are discussed.


[A new method for patch enlargement of hypoplastic aortic annulus. An experimental study (author's transl)]. The purpose of this communication is to propose a new surgical procedure to enlarge the hypoplastic aortic valve ring of more than 20 mm and to permit the replacement of the aortic valve with a suitable prosthesis. The aortic incision is extended about 20 mm across the fibrous origin of the mitral ring downwards into the aortic leaflet of the mitral valve. A fusiform Dacron patch was sutured to the defect in the aortic leaflet of the mitral valve with running suture lines. In acute experiments mitral valve abnormalities are excluded by hemodynamic data, angiocardiography and echocardiography.


Presence of antigen-antibody complexes in antiallogeneic and antixenogeneic sera. Antilymphocyte sera (ALS), either allogeneic (for example, Lewis anti-August rat serum) or xenogeneic (the classic ALS), may retain the antigen used for the immunization of the animal producing the serum in the form of antigen-antibody complexes, at least when the animal is bled within the first 2 weeks following the last immunizing injection. Evidence for this has been obtained in vivo and in vitro. In vivo experiments showed that injection of Lewis anti-August serum to a normal Lewis rat can induce a delayed active immunization against the August strain. In vitro studies proved the presence of August antigens in the anti-August sera, by precipitation of the antigen-antibody complexes with 6 M urea, removal of the antibody by filtration, and demonstration that the filtrate specifically inhibits complement-dependent cytotoxicity of anti-August antibodies. The interpretation of a number of previous works on so-called passive enhancement of grafts or on various effects of ALS may have to be reconsidered on the basis of these findings.


Transition from T cell protection to T cell enhancement during tumor growth in an allogeneic host. The cell-mediated immune response of mice toward a lethal allogeneic tumor was investigated during tumor development. The activity of spleen cells from the tumor-bearing mice was studied by transferring them together with 3LL tumor cells into normal C3H/eb recipient mice. The activity depended upon the time interval between inoculation of the tumor and transfer. Spleen cells taken relatively early, 1 week after tumor inoculation, mediated protection against tumor growth. In contrast, spleen cells taken 4 weeks after tumor inoculation markedly enhanced tumor growth. The tumor-enhancing cells, like the tumor-protecting cells, appeared to be T lymphocytes. The enhancing activity could be transferred by extra cellular medium prepared by incubating the enhancing T cells. Protecting activity could not be transferred by cell-free medium prepared from the protecting T cells. Both activities were found to exist to a relatively slight degree in populations of spleen cells from normal mice. The transition from T cell protection to T cell enhancement might be a determining factor in the outcome of the host-tumor relationship.


Antibody-dependent lymphocyte-mediated cytotoxicity (Ab-LMC), definition of the "K cell" in the rat. The nature and membrane characteristics of the "K cell" of antibody-dependent lymphocyte-mediated cytotoxicity (Ab-LMC) were investigated in a widely used rat model of transplantation. Treatment of sensitized effector cell populations with anti-immunoglobulin and complement eliminated K cell cytotoxicity without diminishing the component of T cell-mediated injury. EA and EAC depletion experiments, although demonstrating no loss of K cell cytotoxicity after removal of complement receptor-bearing lymphocytes, produced a marked abrogation of cytotoxicity following the removal of the Fc receptor-bearing lymphocyte pool. Studies on phagocytic properties showed K cell activity to be shared by an adherent as well as a nonadherent cell population. Thus, the Fc receptor emerged as the only constant surface marker of the rat K cell in Ab-LMC.


[Emergency endoscopy in acute upper gastrointestinal bleeding (author's transl)]. A report is given of 135 panendoscopic examinations in acute upper gastrointestinal bleeding. The importance of endoscopy is underlined by the high incidence of erosions and potential bleeding sources, since these lesions are not detected by radiological examination. Nor is it possible by means of X-rays to distinguish actual sources of haemorrhage from potential sources. The case history is only of limited value in pin-pointing the source of the haemorrhage. Endoscopy yields the best results in the diagnosis of the cause of gastrointestinal bleeding.


[The laboratory diagnosis of von Willebrand's disease (author's transl)]. This investigation was undertaken in order to determine the most suitable methods for diagnosing von Willebrand's disease (v. W. d.), with particular reference to "mild" cases. 50 healthy persons, 21 patients with "severe" v.W.d. (verified according to all hitherto-established criteria) and 39 persons suffering from "mild" v.W.d. were examined. Even though - as far as the latter group is concerned - some of the characteristic laboratory findings were absent, the fact that these persons are related to the patients with "severe" v.W.d. made verification of the diagnosis nevertheless possible. In the group with "mild" v.W.d. 85% had decreased functional factor VIII activity and 82% showed reduced platelet adhesiveness; a prolonged bleeding time according to Borchgrevink was recorded in 72% of the cases and 64% had pathological values for the Ristocetin-induced platelet aggregation were pathological in less than 50% of the group. There was a close relation between the diagnostic significance and reproducibility of the various methods; in regard to the group of patients with "mild" v.W.d., the methods yielding the greatest number of pathological findings (functional factor VIII and platelet adhesiveness) were the ones with the lowest variation coefficients, i.e. 3.1 and 2.1%, respectively. The consideration of a time-dependent rise in the aggregation capability of washed platelets with Ristocetin was of decisive importance in the reproducibility of the rather sophisticated technique of determining the Ristocetin cofactor. The addition of EDTA largely inhabited this effect. Even in the group of patients with "severe" v.W.d., part of the findings obtained with screening tests of the intrinsic coagulation system remained within the normal range. There was no statistical correlation between the individual laboratory findings in the group of healthy persons. In the group with "mild" v.W.d., there was a significant correlation between platelet adhesiveness and Ristocetin-induced platelet aggregation on the one hand, and platelet adhesiveness and the Ristocetin cofactor on the other. In addition, a verified correlation was found to exist between Ristocetin-induced platelet aggregation and Ristocetin cofactor and between functional factor VIII and factor VIII-related antigen. In the group of "severe" v.W.d., only platelet adhesiveness and functional factor VIII were not significantly correlated, whilst all other correlations were of statistical significance. Further problems involved in the diagnosis of v.W.d., such as the variablility of laboratory findings, the existence of subgroups, as well as the difficulties involved in the statistical evaluation of individual cases suffering from v.W.d. are discussed.


[Alpha-1-antitrypsin in children with glomerular diseases (author's transl)]. Alpha-1-antitrypsin was determined in children with glomerular diseases by means of a quantitative radial immunodiffusion method. The concentration of this inhibiting protein has been found to be very low during relapses. An attempt has been made to correlate this finding with the clinical picture and the presumed underlying pathological mechanism. The loss of this inhibitor due to proteinuria is one of the explanations, in concurrence with the findings of other authors. The second explanation lies in the consumption of the inhibitor protein as a consequence of the reaction with liberated proteolytic enzymes.


[Significance of changesin the topography of the superior cerebellar artery in the angiographic diagnosis of tumors of the posterior cranial fossa (II)]. Typical shifts of the superior cerebellar artery and its segments were studied in 67 vertebral angiogrammes showing 33 acoustic neurinomas, 7 meningiomas of the cerebellopontile angle, 13 cerebellar hemispheres tumours, 10 pontile tumours and 4 meningiomas of the free margin of the tentorium. The rationale of accounting for the angiographic symptom complexes typical for acoustic neurinomas with varying directions of growth were singled out.


[Possibilities of the immunological in vitro-diagnostic in nonspecific lung diseases (author's transl)]. Immunological in vitro-methods can be used in the improved diagnostic of nonspecific lung diseases. A short review is given about the recommended tests in the diagnostic of the four types of immunological reactions responsible for allergic disorders of the lungs (IgE-mediated immediate-reaction, cytotoxic-reaction, Arthus-reaction and cell-mediated hypersensitivity), the alpha1-antitrypsin deficiency and the immunological defence in the bronchial mucosa.


[Effects of brain extract and hydrolysate on nerve tissue in vitro]. Explants of PNS and CNS of chick embryos or fetal rats were cultivated and brainhydrolysat cerebrolysin or a synthetic aminoacidsolution or a brain extrakt was applied to the cultures. Cerebrolysin exercised in vitro an effect, which is related to charge only trifling. The cerebrolysin effect is essential related to the concentration/medium. High concentration of cerebrolysin decreases the growth of nerve fibers. Migration of non-neuronal cells increases. A stimulation of nerve fibers growth resembling to NGF was not seen. The density of cells or number of cells/volume unit, rate of mitosis and phases of mitotic non-neuronal cells is changed by cerebrolysin. The effect of cerebrolysin in vitro is compared to the tested aminoacidsolution and brainextract resembling. NGF may be important selectiv for stimulation of the activity of sympathetic and sensoric ganglia. Brainextract and brainhydrolysat and aminoacidsolution influenced in vitro PNS- and CNS-tissue cultures.


Trace elements in tissues of normal and vitamin D2-treated rats. Comparative spectroscopic investigations were performed on 22 trace elements regarding their presence and quantitative relations in cartilages (costal cartilage, intervertebral disc) and in soft tissues most exposed to metastatic calcification (aorta, kidney) of normal, vitamin D2-treated and rachitic rats. The results revealed differences in concentration and distribution of trace elements between soft tissues and cartilages on the one hand, and untreated controls and vitamin D-treated rats on the other. On vitamin D treatment an increase in the Cr, Fe and Cu contents was noted in the soft tissues, whereas in cartilages a higher Zn content was shown. It is suggested that these trace elements may play an important role in the mechanism of calcification, some acting as challengers, others as adjuvants or inhibitors.


[Radioimmunological demonstration of DNA-specific antibodies]. Using 125I chemically labelled denatured (d) and native (n) DNA, specifically binding antibodies were demonstrated in the sera of Lupus erythemathodes patients by means of the Farr technique. (NH4)2SO4 was used to separate the immunologically bound 125I-d-DNA. For 125I-n-DNA the use of a secondary antiserum for the precipitation of the primary immune complex is advantageous. The influence of antigen concentration upon the binding rate was studied. Titre determinations can be made with the proposed method.


[L-carnitine as a basis of cholinomimetic substances]. Acetylcarnitine, though having the same configuration as acetylcholine and Acetyl-beta-methylcholine, is devoid of cholinomimetic properties as long as the carboxylic group is free. Contrary findings are explainable by the lack of uniformity of the test substance, caused by substitution of the carboxylic group and intramolecular cleavage of water or acetic acid from carnitine or acetylcarnitine and by admixtures of active substances, and are attributable to the formation of metabolites in vivo. Already the recrystallization of salts of L-acetylcarnitine and L-carnitine in alcohols causes the formation of active carboxylic esters. The latter can be separated and identified by t.l.c. from the starting substances. At the isolated frog heart (Rana esculenta), neither L-carnitine nor L-acetylcarnitine have muscarine-like effects; higher concentrations of them (0.03-0.15 M) exert positively inotropic effects that increase with concentration and are qualitatively and quantitatively equal for L-carnitine and lower O-acyl-L-carnitines. As betaine, L-carnitine affects the heart rate only at 42 +/- 12 mg/ml, crotonic acid betaine at 22 +/- 7 mg/ml, gamma-butyrobetaine at 15 +/- 8 mg/ml. As a result of carboxyl substitution of betaines, the cholinomimetic properties increase to the level of the stimulation system choline/acetylcholine. The LD50 of L-acetylcarnitine for mice injected s.c. with 8.4 (7.3-9.7) mg/g body weight is within the range of LD50 of L-carnitine. Both substances, even when administered in high doses, give no such symptoms as cholinomimetic substances. Carnitine carboxyl ester, acetylcarnitine carboxyl ester, and other carnitine derivatives, on a molar basis, are 2-10(1) to 2-10(3)-fold more toxic than carnitine and acetylcarnitine. The modes of action of carnitines and their metabolites upon the heart rate are discussed.


Studies on column fractionation of immune cells. VI. Separation of thymus-derived lymphocytes by means of protein beads coated with antigen-antibody complexes. Calf serum beads coated with antigen-antibody complexes were used as cellular immuno-adsorbents to separate mouse T-lymphocytes with a purity of more than 90%. The beads coated by means of glutaraldehyde could be used at least three times without loss of cell-binding capacity.


[Organization of the rhythmic activity of the spinal center motoneurons of the lymphatic hearts of Rana temporaria frogs]. Spontaneous rhythmic impulse discharges of motoneurons of spinal centers of the posterior lymphatic hearts have been recorded from the ventral roots of isolated spinal cord perfused by oxygenated Ringer's solution. Inhibition of the transmission in interneuronal synapses evoked by abolition of Ca ions from the external solution and by the addition to the latter of 1--4 mM EDTA was accompanied by the block of the spontaneous impulse activity. Blocking of rhythmic efferent discharges in the anterior roots was also observed after the addition to normal Ringer's solution of 10--30 mM MgCl2. Inhibition of the spontaneous activity by high Mg content in the perfusion fluid could be alleviated by the addition of 5--15 mM CaCl2 to this solution. Antidromic impulses in the ventral roots of the XI and X segments, evoked by rhythmic electrical stimulation of these roots, did not affect the intrinsic rhythm of motor discharges.


[Comparison of the protein composition of the chromatins of several species of vertebrates]. Protein composition of chromatins from the liver of various Vertebrates (frog, turtle, hen and rat) has been compared by the immunological method of double diffusion in gel. It was shown that non-histone chromosomal proteins and histones exhibit evident species specificity.


[Restoration of the behavioral reactions of Rana esculenta frogs during regeneration of visual nerve fibers]. After sectioning the optic nerve, various forms of visually guided behaviour in the frog R. esculenta recover unevenly. Within 16--20 days, the onset of reactions was observed which are associated with perception of relatively large unmoving objects during active locomotion of animals (1); within 55 days -- avoidance reactions (2); within 90 days -- feeling reactions (3) were formed. In electrophysiological experiments it was shown that axons of the ganglionic retinal cells from various classes form contacts with the tectum also at different periods. The data obtained confirm the significance of specialized "canalization" of the retino--central nervous systems of transmission and evaluation of visual information for organization of separate forms of visually monitored behaviour in frogs.


May Trichomonas vaginalis provoke conjunctivitis? In the world literature we have found descriptions of five cases of Trichomonas vaginalis in the conjunctiva. Conjunctival swabs taken from 122 patients with conjunctivitis or keratitis revealed no flagellate micro-organisms on phase-contrast microscopy and culture. Neither did conjunctival swabs from 272 newborn infants, in spite of the fact that 3.7 per cent of their mothers had Trichomonas in the vagina. Trichomonas vaginalis is hardly likely to be responsible for conjunctivitis.


Examination of colour vision by use of induced contrast colours. Design of a new series of tissue paper contrast tests. The ability to induce contrast colours is evident in normal persons by the tissue paper contrast principle. However, tests of good quality are not easily available. The design of a new series of charts follows two principles: 1) Selection of background hues in accordance with the maximally desaturated regions of the spectrum as seen by the colour defectives. 2) Exact adjustment of the neutral test field (constituted by the chart figures) in order to eliminate any false clue due to brightness contrasts. By introducing chart figures of alternative grey values appropriate tests can be attained for each type of colour vision defect. 37 persons with congenital colour defect and 15 persons with acquired defects were examined. The charts, according to the criteria for selection, proved to be selective in their screening efficiency.


[Surface structure of human T and B lymphocytes forming rosettes with erythrocytes in scanning microscopy]. The authors tried to evaluate the surface of T and B cells in scanning microscope. The lymphocytes were isolated from the blood of healthy men and separated into T and B cells on the basis of rosette tests E and EAC. About 80% of T cells in type E rosettes showed marked bulgings of surface corresponding to numerous, densely crowded microvilli. The remaining 20% of lymphocytes T had more smooth surface. Difficulties were observed frequently in finding differences in the appearance of these cells in relation to lymphocytes B in type EAC rosettes whose surface was covered with minute bulgings corresponding to more delicate and less densely arranged microvilli. The differences in the structure of T and B cells after formation of E and EAC rosettes were not so evident that a decisive separation of both these cell populations on morphological basis would be possible.


The immunological function of the adenoid. The proportions of T and B cells. The proportions of T and B cells in lymphocyte suspensions prepared from peripheral blood and adenoids from children undergoing adenoidectomy were determined, using Ig fluorescence and E rosetting techniques. The proportion of B cells is higher in the adenoid than in the blood, and the proportion of T cells is correspondingly lower. Preliminary results of stimulations of adenoid lymphocytes by antural antigens, such as N. catarrhalis, indicate that both mitogenic and antigenic responses are induced. Separation of lymphocyte suspensions on leucopac, and subsequent stimulation by N. catarrhalis and PHA result in abolition of the response to N. catarrhalis, indicating that reaction to this natural antigen is a B cell function.


Immunodeficiency syndromes with otorhinolaryngological manifestations. Among patients with recurrent, protracted or chronic infections of the respiratory tract involving the middle ear, 18 were found to have immunodeficiencies. In 10 of the patients, deficiency of immunoglobulins belonging to the IgG, IgA and IgM classes was found. Seven patients had an isolated IgA deficiency. One patient had a combined immunodeficiency with defects of the T-cell system and the B-cell system. One patient had an isolated T-cell deficiency.


The vestibular aqueduct in Meniere's disease. The vestibular aquaeduct was evaluated blindly in tomograms from patients with Meniere's disease or chronic otitis and from patients without ear disorders. The descending part of the aquaeduct was clearly visible in 95% of the patients without ear disease. In the two other groups, it was visible only in about 50%. It is suggested that a narrow or invisible vestibular aquaeduct is an unspecific radiological sign in a variety of ear diseases.


Non-hyperbolic force-velocity relationship in single muscle fibres. The force-velocity relation has been studied in sixteen single fibres from frog semitendinosus muscle with particular attention to the high-force portion of the curve. The force-velocity curve was hyperbolic except for a reversal of curvature near 80% measured isometric tension (PO). Rectangular hyperbolas fitted (linear, least-squares method) these data well only when values below 0.78 PO were considered. Extrapolation of these hyperbolas above 0.78 PO gave predicted isometric tensions (P*O) which averaged 32+/-6% above the measured PO values. Hill's constants (1.84 degrees C) for these hyperbolas were: a/P*O=0.177+/-0.021, b=0.329+/- 0.035 M.L./sec, Vmax=1.91+/-0.074 M.L./sec. The reversal of curvature persisted when force-velocity data were obtained using: 1 or 60 min response intervals, afterloaded isotonic responses, grid stimulation, electrically induced contractures and bundles of fibres. The reversal of curvature diminished when force-velocity data were obtained from slightly stretched fibres (about 2.3 mum sarcomere length as compared to 2.1 mum in the control). The results indicate that sarcomere length redistributions probably do not account for the non-hyperbolic force-velocity relation. An explanation for the behavior based on the geometry of the contractile filament lattice is discussed.


LDH isoenzymes and myocardial infarction in patients undergoing coronary bypass surgery: an excellent correlation. To evaluate the efficacy of LDH isoenzymes in the detection of myocardial infarction in patients undergoing coronary bypass surgery, 73 patients were studied pre- and postoperatively by ECG, CPK, SGOT, total serum LDH, and LDH isoenzyme measurements. A reversal of the LDH1:LDH2 ratio was considered indicative of myocardial necrosis. Accordingly, the patients were separated into two groups: Group A (23 patients) who demonstrated an LDH1:LDH2 ratio exceeding 1.0 and Group B (50 patients) who failed to reveal an LDH1;LDH2 reversal. The two groups were similar in regard to preoperative evaluation and operative procedure performed. The postoperative ECG findings were significantly different. In Group A 18 of 23 patients (78 per cent) developed significant new Q waves. This occurred in only one patient in Group B. Significant arrhythmias occurred in 70 per cent of the patients in Group A as compared to 14 per cent of those patients in Group B. Severe congestive heart failure and/or clinical evidence of shock occurred in 39 per cent of Group A patients and in none in Group B. The results of our study indicate that the reversal of the LDH1:LDH2 ratio is a valuable tool for the evaluation of postoperative myocardial infarction.


"Warm" E rosettes as an index of activation of T lymphocytes. Rosetting at 37 degrees ("warm" rosettes) was assayed as a technique to determine the degree of activation of T lymphocytes. Standard "cold" rosettes and an index of "warm" to "cold" rosettes were used to correct possible changes in the total percentage of T cells. Statistically higher numbers of "warm" rosettes were obtained in Pokeweed mitogen stimulated cultures when compared with unstimulated control; but not in old tuberculin stimulated cultures of lymphocytes from PPD positive individuals when compared with those of PPD negative. Also a significant rise was found in control cultures of 3 and 5 days when compared with those of day 1. We think that "warm" rosetting may be a useful technique for determining the degree of immunological activation of a lymphocyte population.


Vascular and cardiac contractile reserve in the dog heart with chronic multiple coronary occlusions. Nineteen mongrel dogs survived chronic occlusion of the left circumflex and of the right coronary artery without infarction due to the timely development of a collateral circulation. Only 38 per cent of the conductance of the arteries before occlusion was restored by collateral vessels. In these animals and in 15 control dogs with normal coronary arteries myocardial contractility, contractility reserve, and myocardial blood flow were studied. The same was done in dogs with chronic coronary artery occlusion after aortocoronary bypass. Myocardial blood flow was determined woth the tracer microsphere technique. Contractility reserve was tested and defined as isovolumetric left ventricular pressure and dp/dt max with norepinephrine infusion and cross-clamping of the aorta. Contractile reserve was not significantly different between normal dogs and dogs with chronic coronary artery occlusion before and after aortocoronary bypass. Myocardial blood flow during control conditions was homogenously distributed in all three groups studied. The ratio of blood flow to the endocardium and the epicardium was not significantly different from inity. Coronary reserve was determined at peak reactive hyperemia following a 20 second period of coronary artery occlusion, with ongoing norepinephrine infusion. Under these conditions subendocardial fow in normal dogs rose by a factor of 7.9 while subepicardial flow increased 7.4 times. In dogs with chronic occlusion of two coronary arteries the increase of myocardial flow was nonnomogenous; subendocardial flow to areas supplied by a normal coronary artery rose by a factor of 7.0 while subepicardial flow increased 5.7 times control. Subendocardial collateral flow rose by a factor of 2.4 and subepicardial collateral flow increased 3.5 times control. In normal dogs norepinephrine alone did not result in maximal coronary flow but only 57 per cent thereof. Dogs with chronic coronary occlusion, however, required the entire coronary reserve in areas that were supplied by a normal coronary artery, whereas areas supplied by collaterals became ischemic. Opening of an aortocoronary bypass restored normal flow to previously ischemic areas, and reduced the flow to areas supplied by a normal artery. With the bypass open no differences existed between normal dogs and those with two occluded coronary arteries. We conclude that the norepinephrine-stimulated contractile reserve of hearts with chronic coronary occlusion was comparable to that of normal hearts; however, norepinephrine forced these hearts to spend the entire flow reserve of the remaining normal artery while producing ischemia in collateral-dependent areas. The same dose of norepinephrine did not require the entire flow reserve of normal dogs.


Immunosuppressive effect of corticosteroids on rabbit's humoral and cellular response. The immunosuppressive effect of two of the most used steroids, 16-Methylen-prednisolone and betamethasone, was studied in rabbits sensitized to bovine serum albumin (BSA). In the steroid treated animals the hemagglutination and precipitation titres obtained in Boyden's test and gel-diffusion respectively, were strongly decreased as compared with the controls. The Arthus reaction was also inhibited. No response was detected in the lymphocyte transformation test (LTT) against the antigen (BSA) in the treated animals, and also the PHA induced transformation was suppressed but not completely abolished. A remarked decrease in the number of circulating mononuclear cells was observed in the treated animals. The number of T rosette-forming cells was also strongly decreased, but the percentage of B cells bearing IgG on their membrane detected by immunofluorescence offered only a slight decrease as compared with the controls. All these changes were observed earlier and more intensely in the Betamethasone treated rabbits.


Quantitation of "acute-phase proteins" postoperatively. Value in detection and monitoring of complications. Serial determinations of serum C-reactive protein are helpful in the detection and monitoring of postoperative complications associated with inflammation and/or tissue necrosis. The serum C-reactive protein level begins to increase within sex hours after operation, peaks on the second day, and by the third postoperative day begins to decrease toward the preoperative level. In cases with surgical complications involving inflammation, serum C-reactive protein levels remain elevated and do not show a decline on the third postoperative day. Serum levels of other "acute-phase proteins," such as alpha-1 acid glycoprotein, ceruloplasmin, alpha-1 antitrypsin, and haptoglobin, were found to increase in response to surgical procedures, but subsequent to the increase in C-reactive protein. These other proteins offer no additional information in monitoring the postoperative acutephase response,


Cellulitis due to Haemophilus influenzae type B. Antigenemia and antibody responses. The techniques of serum countercurrent immunoelectrophoresis, hemagglutinating (HA), and bactericidal (BC) antibody determinations were applied to seven patients with Haemophilus influenzae type B cellulitis. Capsular antigen was detected (greater than or equal to 10 ng/ml) in two patients at the time of admission and was found in two additional patients two days following hospitalization. Antibody responses in the patients with cellulitis were deficient, similar to those in children under 2 years of age with H influenzae type B meningitis. One of the patients with cellulitis had HA and BC antibody present in convalescent serum, and two additional patients demonstrated BC activity. The clinical presentations of our patients were typical except that violaceous discoloration of overlying skin was noted in only one of the seven. Two additional patients had atypical facial swelling that closely resembled angioneurotic edema and initially led to incorrect diagnosis. Countercurrent immunoelectrophoresis may  be helpful in the diagnosis of patients with Haemophilus cellulitis, particularly if serial serum determinations are performed. Bacterial cultures obtained from blood and aspirates of the lesion appear to be more sensitive in determining the cause of H influenzae type B cellulitis.


Congenital generalized fibromatosis. An African case with gingival hypertrophy and other unusual features. What is believed to be the first reported case of congenital generalized fibromatosis in an African infant is described. Features in our patient, which were not noted in previous reports of the disease, include gingival hypertrophy, ankylosis of joints, skeletal hyperostosis, and lymphatic dilation of the ileal villi. Corticosteroid therapy was tried in the patient, but did not produce any beneficial effect.


Histiocytic medullary reticulosis in acute lymphocytic leukemia of T cell origin. A patient with acute lymphocytic leukemia of T (thymic-derived) cell origin was successfully treated and was maintained in remission for four months by combined chemotherapy. He died following a seven-week, fulminant course with fever, refractory pancytopenia, and marked hepatosplenomegaly. The autopsy showed lymphoid leukemic infiltration and extensive histiocytic medullary reticulosis in various organs. The possible relations between these two lymphoreticular diseases are discussed.


In vivo dissociation of factor VII (AHF) activity and factor VII-related antigen in von Willebrand's disease. Using monospecific rabbit antihuman factor VIII antiserum, we have examined the amounts of factor VIII-related antigen and compared these to the levels of factor VIII procoagulant activity in normal subjects and patients with von Willebrand's disease. We have observed that even without transfusion all nine probands with von Willebrand's disease and 20 of their 34 relatives possessed a significantly elevated factor VIII activity/factor VIII-related antigen ratio when compared to that of 55 normal subjects. It is suggested that an elevated factor VIII activity/factor VIII-related antigen ratio may be used for detection of the carriers of von Willebrand's disease.


Need for "counter-detailing" antibiotics. Selected antibiotic advertisements in medical journals are discussed to illustrate the misleading information that is often disseminated to physicians by the pharmaceutical industry. Laboratory and clinical data are presented to question the validity of selected advertisements which (1) encourage the use of Keflex for severe respiratory infections in children, (2) recommend the use of Keflex for the treatment of bacterial bronchitis, (3) suggest that high tissue penetration is a unique property of Vibramycin, (4) present pooled susceptability data which do not reflect microbial resistance patterns in the patient's hospital, (5) recommend twice-daily administration of Ancef for urinary tract infections but do not clearly state the potential danger of this regimen for other infections, (6) suggest that gentamicin should be given to adults in only two dosage sizes for the treatment of serious Gram-negative infections, and (7) lead the reader to assume that only women need to be treated for Trichomonas infections. It is suggested that as antibiotics are marketed, hospital therapeutics committees should evaluate their advantages and permit formulary additions for only those agents demonstrating increased efficacy, decreased toxicity or decreased cost. Pharmacists who monitor drug therapy can provide information to the physician which will increase his awareness of optimal antibiotic therapy.


Vision profile of deaf children.

Vision profile of deaf children. The vision status of 77 deaf children from Beverly School for the Deaf, Beverly, Massachusetts, was investigated in 6 general areas: visual acuity, refractive status, binocularity, color vision, pathology, and visual perceptual motor function. The significant results of this study that were different from the previously investigated work were in the areas of myopia and visual perceptual motor function. Myopia of only moderate to low degree was found in about 5.8% of the total poulation, which is significantly below the mean percentage found in a normal population. Almost 50% of the children showed deficiencies in and 1 or more of the 3 perceptual motor areas investiaged, i.e., visual memory, spatial organization, and Gesell copy forms.


Mediastinal wound infection and aortocoronary graft patency. In our experience, eight of ten aortocoronary grafts in five patients remained patent in the face of mediastinal infection. Combining reports of seventeen other grafts from the literature, we conclude that patency can be anticipated in approximately 70 per cent of such grafts and that mediastinal infection does not necessarily adversely affect aortocoronary saphenous vein bypass graft patency. We recommend aggressive therapy of mediastinal infection in this setting due to the high survival rate which can be anticipated with modern methods of therapy, as well as the high probability of graft patency.


Fluorescein in the human optic disc. II. The fluorescein appearance rate. Automatic intravenous infusion of fluorescein with constant speed during 25 sec is followed by a gradual increase of fluorescein in the retinal arteries and in the disc tissue. The slope of this increase Sd divided by the maximum fluorescein Md in an area of the disc Sd/Md is called Fd, the same for a retinal artery is called Fr. Fr was found to be independent of intraocular pressure in the range examined (mean pressures 15--30 mm applanantion). Fd/Fr = omega, the "fluorescein appearance rate" is correlated to the linear velocity of blood in the capillaries of the observed disc area and hence to its circulation. omega was found to be diminished in 6 out of 9 cases with ocular tension between 26 and 38 mm applanation, but not in 3 cases. It was not diminished in 4 cases with 22-25 mm applanation. Further studies are necessary to elucidate these findings suggesting some adaptation of disc circulation to intraocular pressure but not proving it: fluorescence from vessels behind the lamina cribrosa has the tendency to seemingly "normalise" omega.


[Electrooculographic investigations after oculopression (author's transl)]. The influence of oculopression on the EOG in 6 persons with healthy eyes and in 7 patients with advanced glaucoma was investigated. The reaction of the potential produced by oculopression may be an objective feature of the ability of compensation.


Histopathology and ultrastructure of busulfan-induced cataract. A 49-year-old man with chronic myelogenous leukemia developed dense posterior subcapsular cataracts and punctate cortical opacities after five years of busulfan (Myleran) therapy. We found that the histopathologic appearance of busulfan-induced cataracts is similar to other forms of human and experimental cataracts, regardless of cause. Ultrastructural examination revealed cortical liquefaction with formation of Morgagnian droplets, involving primarily the region from the equator to the posterior subcapsular space. In contrast to previous findings in rats, we observed posterior migration of equatorial nuclei and bladder cell formation. Also present were socalled crystalloid rays and abundant degenerate lens fiber membranes manifested as mutli-layered, irregularly folded configurations resembling myelin figures.


Lens changes in car painters exposed to a mixture of organic solvents. The relationship between exposure to organic solvents and the prevalence of lens changes was studied in a group of 92 car painters and a comparison group of 92 engineers from the Finnish State Railways. Both groups were examined ophthalmologically. Among the 92 car painters, with a mean age of 34.9 years (range of 21--64 years; S.D. 10.4 years), two had been operated on for a cataract and 46 had lens changes, mainly nuclear sclerosis, clefts, lamellar separation, or cortical and subcortical opacities not affecting visual acuity. In 69 age-matched pairs, for whom the factors inducing false-positive results had been excluded, 2 car painters had more lens changes than their age-matched pairs. Lens changes occurred with increased frequency after 10 years of exposure.


Elevation of intraocular pressure after pars plana vitrectomy. To determine the incidence and causes of increased intraocular pressure (IOP) after pars plana vitrectomy with the vitrophage, we studied 118 eyes under-going vitrectomy during a one-year period. Fifty-one (43%) were in diabetic patients; 67 (57%) were in nondiabetics. Of the entire group, 33 (28%) developed a postoperative increase in IOP, which was defined as a rise in IOP of at least 10 mm Hg above the preoperative level by applanation tonometry. Of the diabetic eyes 25 (49%) developed increased IOP; 11 (22%) of these eyes required surgical intervention for control of IOP. Of the nondiabetic eyes eight (12%) developed increased IOP postoperatively; all were either transiently elevated or medically controllable. Postoperative rubeosis iridis occurred only in diabetic eyes.


Characteristics of human saccadic eye movements in different directions. Saccadic human eye movements in different directions were recorded by an infrared technique. Disturbances by movements of the eyelids are prevented by means of a plaster pulling down the lower lid. The peak values of the velocity, acceleration, deceleration, and the duration of the saccades were drawn in a direction diagram. Each eye has its specific diagram. The shape of the diagram is independent of the saccadic amplitude. There are directions in which the values are equal for eccentric and centric saccades and those, in which significant differences are to be found. In the latter case centric saccades are faster than the eccentric ones.


[A canthi-skin electrode electroretinogram, independent of eye movements (author's transl)]. In order to avoid misinterpretation of ERG recordings taken with canthiskin electrodes, the potential deriving from the two electrodes was fed into a balancing amplifier that eliminated opposing voltages and amplified unidirectional voltages. During voluntary as well as nystagmus caused eye movements as well as those caused by nystagmus clearly distinguishable averaged ERG's were recorded.


Diabetic retinopathy study. Preliminary results from 215 patients treated uniocularly with photocoagulation. Preliminary results of a controlled study on diabetic retinopathy are reported. Two hundred and fifteen patients with proliferative (PDR) and nonproliferative (NPDR) retinopathy were uniocularly treated by Xenon photocoagulation and followed for a minimum of 6 months--6 years. Intra- and epiretinal new vessel formations (RNF) decreased in treated but increased in untreated eyes at a high statistical significance. A transition of background retinopathy into the proliferative stage was significantly retarded after photocoagulation. An improvement of new vessel formations on the disc (DNF) was not evident after 3 years of follow-up. The progression of preretinal neovascularization (PRNF) was significantly reduced only for 1--2 years after treatment. The incidence of massive vitreous hemorrhages, however, which showed the highest quotient of contingency with PRNF was much lower in treated eyes also after 3 years. The difference was significant only in extensively photocoagulated eyes with more than 100 lesions on average. The effect of photocoagulation on diabetic maculopathy with preservation of a useful visual acuity was highly significant only in diabetics under 60 years of age, the effect increasing with time as the control eyes fared worse. By contrast, in patients over 60 years of age, the course of maculpathy was not influenced, and a linear decrease of visual acuity occurred in both treated and untreated eyes.


Regional ischemic infarcts of the retina. Macroscopic and light microscopic features of regional ischemic infarcts of retina in autopsy eyes are described. Lesions were found throughout life span, most patients having significant primary or secondary vascular disease (younger had systemic hypertension, rheumatic heart disease, vasculitis or sickle hemoglobinopathy; most older patients had arteriosclerosis). Diabetes mellitus and infarction of other organs (including brain) also were common. Topographically almost all lesions were found in posterior fundus; most were temporal and involved anatomical macula. Microscopically there was destruction of inner retinal layers with preservation of outermost cells of inner nuclear layer; occasionally ganglion cell layer was relatively spared.


The effect of central chemical sympathectomy on the oxygen uptake; anaerobic glycolysis and lactic acid dehydrogenase activity in the retina of white rats. Male Wistar rats were injected intraventricularly with two doses of 250 mcg of 6-hydroxydopamine (6-OHDA) in two consecutive days. Two weeks later the oxygen uptake, anaerobic glycolysis and lactic acid dehydrogenase (LDH) activity in the retina were determined. The decrease of oxygen uptake (-28%), anaerobic glycolysis (-31%) and LDH activity (-12%) in rats treated with 6-OHDA in comparison to control animals was found. The possible role of the adrenergic system in regulation of the metabolism of the retina is discussed.


[The astigmatism bioblique. II. Mathematical description (author's transl)]. Optical surface showing an astigmatism bioblique could only approximately be described by mathematical formulas. The best approximation is that one which shows a close relation between regular and bioblique astigmatism. It allows the calculation of the best correcting cylinder, which brings the anavoidable residual astigmatism to a minimum.


The content of glycosaminoglycans in bovine corneal epithelium and precorneal fluid-film. Histologic staining of hen cornea and precorneal fluid-film with ruthenium red lead to the assumption of existent coating glycosaminoglycans. Quantitative and chemical analytical examinations of bovine corneal epithelium with and without the fluid-film could not demonstrate the characteristic components of glycosaminoglycans. Even small amounts of glycosaminoglycans are not found after incubation of the cornea with radioactive precursors. But the extracted material have been proved by degradation with amyloglucosidase enzyme for pure glycogen. Most probably ruthenium red stains glycosaminoglycans nonspecifically but marks the glycoproteins as well which have been demonstrated in the precorneal fluid-film.


Radiation therapy of choroidal metastases from breast cancer. Radiation therapy of 26 patients with choroidal metastases from breast cancer has been reviewed. At the time of initial diagnosis of choroidal metastases 13 patients had bilateral choroidal metastases. The median age of the patients was 54 years and the survival from the first symptom of choroidal metastases varied from 2 to 45 months with a median survival of 9.5 months. End results of radiation therapy had been recorded in 22 patients. Local radiation therapy improved vision permanently in 16 patients.


Changes of activity of alkaline and acid phosphatase in the rabbit eye in the early phase of alkaline and acid injury. Rabbit corneas were burned either with 1.0 N sodium hydroxide or 1.0 N hydrochloric acid. Enzyme activities of alkaline and acid phosphatases were examined spectrophotometrically in the homogenates of cornea, iris, aqueous humor and vitreous body. On the 3rd day after alkaline as well as acid burn, a significant decrease of both enzyme activities was produced as compared with untreated animals. A more pronounced change was found in the case of alkaline injuries. With both kinds of caustic agents the decrease of acid phosphatase activity was more striking than that of the alkaline phosphatase. Advantages and shortcomings of biochemical and histochemical enzymatic determinations in experimental ocular inflammations are briefly discussed.


Effect of prostaglandin E2 on the isolated rabbit iris sphincter. Experiments on twenty-eight New Zealand albino rabbits have shown that prostaglandin E2 causes contraction of the isolated iris sphincter and is about five times as effective as acetylcholine. Prostaglandin E2 does not act on the cholinergic receptors; the effect of prostaglandin E2 was not increased by eserine, and not abolished by atropine. In high doses indomethacin (3 X 10(-4) M) reversed the prostaglandin effect, but lower concentrations (3 X 10(-5) M) left it unaffected.


[Electromagnetic radiation damage to the retina (author's transl)]. Basic mechanism involved in electromagnetic radiation damage to the retina are described. Those are photochemical, thermal and non-linear effects. The absorption of radiant energy by the retina occurs primarily in the visible spectral range. Different wave lengths are absorbed in different layers of the retina. Photochemical injury for minimal lesions is uniform and the damaged area may be larger than the irradiated area. Thermal injury for minimal lesions produces usually a more intense central core of damage surrounded by edema. Non-linear effects are caused by ultrashort exposure times and are produced from strong electric fields, acoustic signals, shock waves, etc. generated by high temperature gradients. Wave lengths play a part in the severity and origin of retinal damage at relative long exposure times but contribute little to retinal injury at ultrashort exposures e.g. psec ranges.


Comparative electron-microscopic studies on the conus papillaris and its relationship to the retina in night and day active geckos. The ultrastructure of the capillary endothelium of the conus papillaris within the vitreous body was studied in night, day, and mixed (night and day) active geckos (Homopholis wahlbergi, Gekko gecko, Pachydactylus bibronii, Tarentola mauritanica, Lygodactylus conraui, Phelsuma guimbeaui, Phelsuma madagascariensis). Capillary endothelial cells were poorly developed in night and mixed active animals, whereas in day active animals they were highly organized. In particular the number and height of the luminal and basal microvilli and the frequency of micropinocytotic vesicles were distinctly increased in day active geckos. It is assumed that these structural mechanisms improve the transendothelial transportation capacity of metabolic substances. When the thickness of the retinal layers was compared, we found that the inner retinal layers of those geckos in which the conus capillaries were poorly developed, were approximately 60% of the thickness of the inner retina in the day active geckos. The results indicate that the structural organization of conal endothelial cells is related primarily to the retinal structure rather than to the animals' daytime behavior. Furthermore, our observations support the theory that the conus papillaris of lizards, like the pecten oculi of birds, has a primary function in the nutrition of the avascular retina and/or is involved in the exchange of fluid in the vitreous.


Influence of sodium chloride on the amount of CRF-granules and "classical" neurosecretory material (NSM) in the neurohypophysis of bilaterally adrenalectomized rats. Bilaterally adrenalectomized female SPF Wistar rats were given tap water containing various concentrations of sodium chloride to drink ad lib. After a survival period of 14 days the animals were killed by perfusion-fixation. Their brains were removed, fixed in picric acid formalin solution and embedded in Paraplast. Serial sections of median eminence and hypophysial posterior lobe were cut and stained with crotonaldehyde-fuchsine. In the stained sections the amount of CRF-granules visible in the external zone of the median eminence, and the amount of "classical" neurosecretory material (NSM) occuring in the internal zone of the median eminence and in the posterior lobe of the hypophysis were estimated. After administration of drinking solutions to which 0%-1% sodium chloride were added, the amount of CRF-gr anules increased with increasing NaCL uptake, whereas the amount of "classical" NSM was not changed. Application of tap water containing 2% NaCl led to a marked decrease in the amount of "classical" NSM but did only slightly impair the amount of CRF-granules. From the findings it is concluded that 1. following bilateral adrenalectomy administration of sodium chloride inhibits the secretion of CRF-granules; 2. CRF-granules and "classical" NSM, although histochemical identical, have different functional significances; 3. the mechanisms regulating the secretion of CRF-granules are different from those controlling the release of "classical" NSM.


Follow-up evaluation of a prevalence study for chronic bronchitis and chronic airway obstruction. Follow-up of the prevalence study of respiratory symptoms and chronic airway obstruction was performed after a 6- to 7-year interval. One hundred fifteen of 117 subjects (98%) originally labeled "abnormal" (chronic bronchitis or asthma by history, or ratio of 1-sec forced expiratory volume to forced vital capacity less than 60 per cent), and 111 of a random sample of 116 subjects (96%) originally labeled "normal" were traced. Nineteen patients were dead, 14 "abnormal" subjects, and 5 "normal" subjects (P less than 0.01). Eighty-eight of the originally labeled "abnormal" subjects and 91 of the random "normal" sample could be retested by spirometry. Subjects with lower initial ratios of 1-sec forced expiratory volume to forced vital capacity tended to lose more 1-sec forced expiratory volume and forced vital capacity. Early identification of respiratory symptoms and spirometric abnormalities may identify persons at increased risk of death who could benefit from appropriate therapy.


Clinical, epidemiologic, and pulmonary function studies in alpha,-antitrypsin-deficient subjects of Pi Z type. The results of pulmonary function testing and systematic medical history and epidemiologic data collection are reported for 20 persons with alpha 1-antitrypsin deficiency of Pi Z phenotype. The most common symptom, reported in 19 subjects (95 per cent), was dyspnea on exertion; 16 subjects (80 per cent) gave a history of wheezing, and 8 (40 percent) reported chronic cough and sputum production. The 8 women who had been pregnant reported a miscarriage rate of 29 per cent for all pregnancies. Respiratory symptoms and disease were commonly reported in the children of study subjects. Pulmonary function testing revealed abnormalities for 18 of 20 subjects, all of those 26 or more years of age. The test that was most frequently abnormal was the 1-sec forced expiratory volume expressed as a per cent of the forced vital capacity. All pulmonary function studies demonstrated a trend toward increased impairment with increased age, which was evident by the fourth decade. Within this group of persons having severe alpha1-antitrypsin deficiency, there was no correlation between serum concentrations of antitrypsin and subjective or objective indices of pulmonary disease. A group of 7 subjects who were incidentally found to have Pi Z alpha1-antitrypsin deficiency exhibited symptoms and pulmonary function abnormalities comparable to those of 13 subjects who were originally referred for known or suspected pulmonary disease. These data suggest that if interventions such as smoking cessation and occupational counseling are to be effective, they should be initiated before the fourth decade of life.


Lymphocyte subpopulations in sarcoidosis: correlation with disease aetivity and duration. We studied lymphocytes from the peripheral blood of 29 sarcoid patients to relate T- and B-cell populations with disease activity and duration. In patients with acute (less than 1 year) and chronic (greater than or equal to 9 years) active disease, the absolute lymphocyte count was reduced; the absolute number of T cells was reduced; and the proliferative response of lymphocytes to phytohemagglutinin was depressed compared with control subjects. Ten of 21 patients with active disease had 5% to 32% atypical lymphocytes. The proportion of cells bearing surface immunoglobulin (Ig) was increased in patients with active disease, but the absolute number of cells bearing surface Ig did not differ significantly from controls. However, studies using overnight in-vitro culture indicated that a large fraction of these cells bound exogenous Ig. The number of cells indentified by complement receptors was significantly reduced in patients with active disease. In contrast, patients who had complete reasolution of their disease showed no significant differences from controls in either T- or B-cell populations or in the proliferative response of their lymphocytes to phytohemagglutinin.


Late infections following filtering procedures. In 364 patients with filtering conjunctival blebs, the incidence and outcome of exogenous late infections were determined. The rate was lowest among patients who had undergone Scheie's procedure. After treatment, the visual acuity in 62.5% of the infected cases was the same as before the infection occurred.


[Autoradiographic study of the DNA synthesis process along metaphasic chromosomes of Pleurodeles waltlii Michah (urodele amphibian)]. Chromosomes from embryos (stage 34) of the amphibian urodele Pleurodeles waltlii were labeled by 3H-thymidine at different times of the DNA synthesis cycle and studied at metaphase. Terminal segments of the chromosomes, induced secondary constrictions, and satellites were found to be late-labeling. Therefore, they may be considered as formed at least partially by heterochromatin. However, after other treatments or stainings, they do not present other features considered characteristic of heterochromatin. The question of the heterogeneity of their structures is discussed and the ambiguity of the term heterochromatin is emphasized. The proximal part of the long arm of chromosome VII shows characteristics similar to satellites, which may indicate the presence of a previously unrecognized satellite.


[Holoprosencephaly by triploidy 69 XXX in a 5 month old fetus]. Microcephaly, occipital meningocele, and uveal coloboma were observed in a 5-month-old fetus with a 69, XXX karyotype. Autopsy showed an holoprosencephaly, which has never before been reported in triploidy.


[2 cases of partial trisomy 10p due to a paternal translocation t(10p;18)(p13;q23)]. Two brothers trisomic for the distal two thirds of 10p are reported. Trisomy results from the malsegregation of a familial translocation rcp (10;18)(p13;q23) present in the father, a half-brother and the grand-father of the propositi. The phenotype is comparable to that of other 10p trisomic patients reported in the literature.


[45, X/47, XY, +13 mosaicism in a 19-year-old girl]. The 45, X/47, XY, +13 mosaicism was observed in a 19-year-old mentally deficient girl who was examined because of primary amenorrhea. Certain clinical features were reminiscent of Turner's syndrome, while no features of trisomy 13 were present. The study of blood groups, HLA genotypes, and cytogenetic markers provided no evidence of chimerism.


[Chromosome effect of cyclophosphamide in various strains of mice]. The chromosomes of four different mouse strains were examined after administration of a single dose of cyclophosphamide, 100 mg/kg. Chromosomal breaks and rearrangements were produced in C3H mice three to four times as frequently and in AKR mice twice as frequently as in C57 B1 and XLII Orl mice. This indicates that cytogenetic investigations in mutation research using mice as in vivo test systems may be variable depending on the mouse strain employed. Because the effect of the alkylating agent was not pronounced in the two strains having a high incidence of cancer and leukemia (C3H and AKR), the possibility of a relationship between chromosomal instability and cancer proneness is discussed.


[Translocation t(Y;14) in an azoospermic man]. A study of meiosis in an azoospermic man with a translocation between the Y and 14 chromosomes shows complete arrest of gametogenesis after the second division (spermatocyte II stage). At pachytene, the distal segment of the Y chromosome which is translocated onto the 14, is in contact with the sex vesicle.


[Translocation 46,X, t(Y;7)(q122;q11) in a case of male sterility]. A Y-autosome translocation--46,X,t(Y;7)(q122;q111)--in a steril man is reported and compared with others already reported in the literature.


Susceptibility of Haemophilus influenzae type b to cefatrizine, ampicillin, and chloramphenicol. The susceptibility of 269 isolates of Haemophilus influenzae type b to cefatrizine (BL-S640), ampicillin, and chloramphenicol was evaluated by disk diffusion susceptibility tests, using a modified Bauer-Kirby method. Broth dilution susceptibility tests were performed on 88 of these isolates, including all isolates resistant by disk to cefatrizine or ampicillin. Six of the isolates were resistant by disk to cefatrizine (zone size, <16 mm), four were resistant to ampicillin (zone size, <19 mm), and none were resistant to chloramphenicol (zone size, <17 mm). Only two of the six isolates of H. influenzae that were resistant to cefatrizine by disk were resistant to more than 4 mug of drug per ml. The four organisms resistant to ampicillin on disk were resistant, when tested by the broth method, to >128 mug/ml. These four ampicillin-resistant H. influenzae were susceptible to <4 mug of cefatrizine per ml. The two isolates resistant to >4 mug of cefatrizine per ml were susceptible to 0.5 and 2 mug of ampicillin, respectively, per ml. The activity of cefatrizine appears to be comparable in vitro to ampicillin against H. influenzae.


New method for detecting in vitro inactivation of penicillins by Haemophilus influenzae and Staphlycoccus aureus. A new technique for detecting penicillinase production in Haemophilus influenzae and Staphylococcus aureus was compared with the capillary procedure for detecting beta-lactamase and the Bauer-Kirby disk susceptibility procedure. Isolates were classified similarly by all three procedures.


Chemotaxis and transport of amino acids in Allomyces arbuscula. Among a number of amino acids tested, L-lysine and L-arginine are the principal attractants in the chemotaxis of the zygotes of Allomyces arbuscula. The reaction can be stimulated to a greater or lesser extent by a number of compounds chemically related to L-leucine. No relationship between transport of attracting amino acids and their effect on chemotaxis has been found.


Formation of protoplasts from Ustilago maydis. Protoplasts of Ustilago maydis were obtained by incubating sporidia of the fungus with a combination of Helicase and a commercial "Onozuka" R-10 enzyme preparation of Trichoderma harzianum in the presence of 0.6 M (NH4)2 SO4 as an osmotic stabilizer. In the presence of the organic stabilizers sorbitol and sucrose, however, the release of protoplasts was inhibited. Combinations of Helicase with other lytic enzymes such as cellulase from Aspergillus niger, cellulase and hemicellulase from Rhizopus, and Driselase or Nagarse were inactive.


Subpopulations of B lymphocytes and the carriage of immunological memory. Thoracic duct lymphocytes from rats primed with DNP-BGG confer on irradiated, syngeneic recipients the ability to mount a large, IgG anti-DNP response after challenge with the immunizing conjugate. An analysis of this adoptive response lead to the following conclusions. the B memory cells which generate the IgG response carry IgG on their surface and are present in a subpopulation amounting to less than l0% of all B cells in thoracic duct lymph. The view that memory cells carry exclusively IgD is untenable. The majority of B lymphocytes in thoracic duct lymph are recirculating cells which carry surface IgM...


Lactate metabolism in Propionibacterium pentosaceum growing with nitrate or oxygen as hydrogen acceptor. When anaerobic cultures of Propionibacterium pentosaceum were shifted to low dissolved-oxygen concentration (D.O.C.), acetate production from lactate diminished and propionate production stopped, whereas pyruvate accumulated and oxygen was consumed. Assuming that energy is generated in the electron transfer to oxygen, YATP values (g dry wt bacteria/mole ATP) of between 7.2 and 11.9 were calculated from molar growth yields and product formation. When oxidative phosphorylation in the electron transfer to oxygen was ignored, unreasonably high YATP values were obtained. From these results it is concluded that energy is indeed generated in the electron transfer to oxygen. However, synthesis of cytochrome b was strongly repressed by oxygen. Furthermore, synthesis of all catabolic enzymes studied was impaired in bacteria growing at low D.O.C. Thus, the anaerobic character of P. pentosaceum may be explained by the inhibition of synthesis of both cytochrome b and enzymes in the presence of oxygen. It was demonstrated that nitrate reductase is synthesized constitutively in P. pentosaceum. Synthesis of nitrate reductase was stimulated by nitrate and repressed by oxygen. Synthesis of fumarate reductase was also repressed by oxygen, whereas only a small effect of nitrate on this enzyme was observed. However, propionate formation is inhibited during growth with nitrate. The absence of propionate formation in the presence of oxygen and nitrate is explained by inavailability of NADH needed for the conversion of oxaloacetate into malate in the reductive pathway to succinate, so that succinate and propionate cannot be formed.


Starch degradation by the mould Trichoderma viride. II. Regulation of enzyme synthesis. The synthesis of amylolytic enzymes by the maltose not-utilizing Trichoderma viride strain CBS 354.44 requires the presence of starch or dextrins. Several readily utilizable carbon sources such as glucose and glutamic acid were shown to exert a strong catabolite repression which completely inhibited enzyme induction by starch or dextrins. Enzyme synthesis occurs in the exponential and in the stationary growth phase. In the latter, the ratio between saccharifying and dextrinizing enzyme activity is invariably high. In the exponential growth phase this ratio depends on the nature of the inducing substrate. Growth on starch results in an initially high production of dextrinizing activity, the saccharifying one becoming predominant in the course of exponential growth. The latter activity in dextrin DE 30 cultures is predominant from the very beginning. Thus, the amylolytic enzyme system of T. viride consists of at least two different enzymes, the synthesis of each being controlled specifically. The careful regulation of the synthesis of the dextrinizing enzyme is discussed with special reference to the production of non-utilizable maltose by the latter.


Microbial metabolism of alkylbenzene sulphonates. Variance in enzyme complement of a Bacillus in response to growth substrate. Growth of a Bacillus species at the expense of an alkylbenzene sulphonate (ABS) synthetic detergent homologue (1-phenylundecane-p-sulphonate, 11-ABS) containing an odd number of carbon atoms in the alkyl side chain induced an enzyme complement able to biodegrade 11-ABS by alkyl side-chain oxidation, and "ortho cleavage" aromatic-ring oxidation reactions. Growth of the Bacillus at the expense of an ABS homologue containing an even number of carbon atoms in the alkyl side chain (1-phenyldodecane-p-sulphonate, 12-ABS) induced an enzyme complement able to biodegrade 12-ABS by alkyl side-chain oxidation, and "meta cleavage" aromatic-ring oxidation reactions. The results of a number of different growth and enzyme induction experiments confirm that both 11-ABS and 12-ABS are initially biodegraded by an identical complement of enzymes catalysing the alkyl-side-chain oxidation reactions, but that the subsequent metabolism of the aromatic moieties remaining after the removal of the alkyl side chain from 11-ABS and 12-ABS occurs by two separate pathways requiring the de novo induction of different substrate-specific enzyme complements. The detection of the predicted changes in enzyme complement subsequent to changes in the growth substrate of the Bacillus provide confirmation of the biodegradation pathways operating in the microorganism.


A chemically defined medium for cephalosporin C production by Paecilomyces persicinus. A chemically defined medium was developed for the biosynthesis of cephalosporin C by Paecilomyces persicinus Nicot strain P-10. Glucose served as the major carbon source and nitrogen was supplied by five amino acids, L-arginine, L-aspartic acid, L-glutamic acid, glycine and DL-methionine. Omission of any of the first four diminished or prevented production of cephalosporin C; omission of methionine did not. Methionine is not critical for the production of cephalosporin C in this defined medium. Production of the antibiotic was affected by the concentrations of inorganic salts employed. Biotin was required for growth and cephalosporin C synthesis. The addition of L-lysine precursors to the medium did not influence cephalosporin C levels and L-lysine itself inhibited antibiotic production. Known precursors of beta-lactam antibiotics as well as oleic acid did not affect biosynthesis of cephalosporin C. Chemical changes occurring in the defined medium revealed that glucose was efficiently utilized after 96 hours incubation whereas total soluble nitrogen levels increased following an initial sharp decrease. Mycelial weight and cephalosporin C production were both maximal after 96 hours incubation. Mycelial nitrogen was highest after 48 hours incubation whereas mycelial lipid levels were greatest after 72 hours.


The ascigerous state of Candida chodatii. In Candida chodatii, a mycelial yeast having denticulate conidiogenous cells, the asci are formed by conjugating budding cells (conidia) and usually contain 2 hat-shaped, small ascospores. It is classified in Hyphopichia, a new genus of the Ascoideaceae. A key to the genera of the Ascoideaceae is given.


Cell-wall composition and taxonomy of Cephaloascus fragrans and some Ophiostomataceae. Carbohydrates of intact cells and cell walls were studied by gas-liquid chromatographical analysis after acid hydrolysis. Isolated cellulose was determined by infrared spectrophotometry, pyrolysis mass spectrometry and histochemistry. Biochemical characters do not support an assumed relationship between Ophiostoma (including Europhium) and Cephaloascus fragrans. Cephaloascus fragrans differs from Ophiostoma by a high mannose content and by the absence of cellulose and rhamnose. A relationship between Cephaloascus fragrans and Ceratocystis cannot be excluded on the basis of the biochemical characters, although there is a marked difference in conidiogenesis. Saprolegnia ferax (Oomycetes) was included as a cellulose-containing fungus for comparison.


Prosthecobacter fusiformis nov. gen. et sp., the fusiform caulobacter. Four strains of heterotrophic, fusiform caulobacters have been isolated from freshwater sources. A single prostheca extends from one pole of mature cells, and cells attach to various substrata by means of a holdfast located at the distal tip of the appendage. Thus, superficially these bacteria bear a strong resemblance to bacteria in the genus Caulobacter. However, unlike Caulobacter these bacteria do not exhibit a dimorphic life cycle of motile, non-stalked daughter cells and immotile, stalked mother cells. Instead both mother and daughter cells are immotile, and at the time of cell separation the daughter cells are essentially identical mirror-image replicas of the mother cell. In addition, the prosthecae of these fusiform caulobacters do not have crossbands, they are somewhat wider than the stalks of Caulobacter and the pseudostalks of Asticcacaulis, and they terminate in a bulbous tip. The deoxyribonucleic acid (DNA) base composition ranges from 54.6-60.1, well below the 62-67 range for the genus Caulobacter. Based upon these and other differences a new genus and species, Prosthecobacter fusiformis, is proposed for the fusiform caulobacters.


Pichia humboldtii sp. nov., the perfect state of Candida ingens. The perfect state of Candida ingens was found after treatment with N-methyl-N'-nitro-N-nitrosoguanidine, a mutagenic agent. The species fits into the genus Pichia. A description of Pichia humboldtii is given.


The isolation and properties of a denitrifying bacterium of the genus Flavobacterium. A previously undescribed denitrifying bacterium was isolated from soil. The cells are small gram-negative rods, asporogenous, and non-motile. Colonies become yellow after long exposure to light. This colouring is due to the production of a carotenoid pigment. The organism shows no fermenting activity, and grows only in the presence of one of the following electron acceptors: NO2, N2O, and O2. It does not reduce nitrate. It gives a positive oxidase test and has a cytochrome c and catalase. It requires no growth factors, is a chemoorganotroph and uses only sugars as carbon and energy supply. The DNA base composition is 40.8 moles percent GC. Although presenting the physiological characteristics of a pseudomonad, the organism described has been placed in the genus Flavobacterium because of its pigmentation and its low GC percentage.


Heterothallism in Pichia kudriavzevii and Pichia terricola. Pichia kudriavzevii and P. terricola were found to be heterothallic, but not interfertile with one another; nor did they mate with P. membranaefaciens, P. scutulata, Candida lambica, C. diversa, C. ingens, C. silvae, C. valida, C. vini, C. norvegensis, or Torulopsis inconspicua. Limited conjugation occurred between mating types of P. kudriavzevii and C. krusei and conjugation and sporulation occurred in mixtures with C. sorbosa. The data indicate C. krusei and C. sorbosa to be the same species and to represent imperfect forms of P. kudriavzevii.


Mixed connective tissue disease.

Mixed connective tissue disease. Three patients with mixed connective tissue disease (MCTD) had clinical features that included a high incidence of Raynaud phenomenon, arthritis, myositis, and swollen hands. The diagnostic laboratory test result was the presence of high titers of antibody to extractable nuclear antigen. These antibody titers are notably reduced or abolished in patients with MCTD when the tanned red blood cells that are used in the test are pretreated with ribonuclease. Speckled antinuclear antibodies were present in all patients. Patients with MCTD have a low incidence of renal disease, are responsive to treatment with prednisone, and have a good prognosis.


Fc-rosette inhibition by hypocomplementaemic systemic lupus erythematosus sera. Human red cells sensitized with one of the Rh antisera (Ripley) form rosettes (Fc-rosette) with human B lymphocytes and the rosettes are well inhibited by aggregated human IgG. Since sera of hypocomplementaemic patients with systemic lupus erythematosus (SLE) have frequently been reported to contain immune complexes, they were used for the inhibition of Fc-rosette formation in this study. The results of Fc-rosette inhibition rates of the sera were inversely correlated with the serum CH50 levels. When the sera were separated into top, middle, and bottom fractions by ultracentrifugation, the bottom fractions showed more effective inhititions than the others. Similarly, the strongest inhibition was found in the void volume of the serum separated by Sephadex G200 gel filtration. Reduction and alkylation of IgG resulted in the loss of reactivity with Fc receptor of B lymphocytes, and the rosette inhibiting activities of the SLE sera were markedly reduced after reduction and alkylation. Some of anti-HLA sera were inhibitory for the Fc-rosette formation, while the tested sera did not contain anti-HLA activity assessed by the microcytotoxicity test. These results indicated that circulating immune complexes contained in the sera inhibit the rosette formation, and that the Fc-rosette inhibition test is a simple and relatively sensitive method for the detection of circulating immune complexes. Antinuclear antibody activities of the sera were tested by the indirect immunofluorescent method; however, clear correlations were not obtained between Fc-rosette inhibition rates and staining patterns of antinuclear antibodies. On the other hand, the positive groups of LE-test exhibited slightly greater inhibition rates of the rosette than the negative groups.


Lymphocytes in rheumatoid and nonrheumatoid synovial fluids. Nonspecificity of high T-cell and low B-cell percentages. Lymphocytes were studied in paired peripheral blood and synovial fluid samples from patients with various forms of arthritis, including rheumatoid arthritis (group I) and other polyarthritides of unknown origin (group II), as well as arthritides generally considered not to be immunologically mediated, such as crystal synovitis, traumatic arthritis, osteoarthrosis, and pigmented villonodular synovitis (group III). In all 3 groups the percentages of T lymphocytes were significantly higher in synovial fluids than in the peripheral blood, whereas those of the synovial fluid B lymphocytes were consistently very low and occasionally nil. Absolute numbers of synovial fluid lymphocytes were significantly higher in groups I and II as compared with group III, and in the peripheral blood absolute numbers of lymphocytes in groups I and II were significantly lower than in controls. No correlation was found between absolute numbers of lymphocytes and complement activity in the synovial fluid. The characteristic pattern of high T-cell and very low B-cell percentages in synovial fluids is a general feature of inflammatory exudates and cannot be considered an expression of cell-mediated immunity in itself.


Effect of penicillamine therapy on circulating immune complexes in rheumatoid arthritis. The sera of 40 patients with severe progressive rheumatoid arthritis were examined for the presence of soluble immune complexes before penicillamine therapy was started, and again after treatment for a mean period of 14-4 months. The methods used were radiobioassay (macrophage uptake), C1q-binding capacity, and precipitation by 4% polyethylene glycol. Before treatment the sera of 37 patients showed significantly enhanced uptake of 125I-labelled aggregated human IgG by guinea pig macrophages. Treatment produced significant falls in mean erythrocyte sedimentation rate, differential agglutination titre, and serum IgG and IgM levels, and enhancing complexes (EC) decreased or disappeared in 20 patients. In 9 patients EC changed to inhibiting complexes, and in 8 EC levels were unchanged. In 6 of 8 patients with cutaneous vasculitis initially, both lesions and EC disappeared. The total protein and the IgG and IgM precipitated from patients' sera by 4% polyethylene glycol fell significantly on treatment. Antinuclear antibody titres were unchanged by penicillamine, and 3 patients acquired these antibodies during treatment. These findings suggest that penicillamine treatment in rheumatoid arthritis reduces the level of circulating soluble immune complexes in which IgM rheumatoid factor is a component.


Effect of penicillamine treatment on immune complexes in two cases of seropositive juvenile rheumatoid arthritis. A correlation has previously been observed between the presence of enhancing complexes and cutaneous vasculitis in rheumatoid arthritis. Two parients with seropositive juvenile rheumatoid arthritis are described in whom enhancing complexes were detected before the appearance of cutaneous vasculitis. Their contrasting response to penicillamine is discussed in relation to the role of of rheumatoid factor and antinuclear antibodies.


Recognition and operative management of patients with arteriosclerotic coronary artery aneurysms. Arteriosclerotic aneurysms of the coronary arteries have been noted in 38 patients undergoing cardiac surgical procedures. Age, sex, and risk factors are similar to those in other patients with coronary artery disease. A high incidence of previous myocardial infarction (24 of 38) is related to the frequency of clot formation and embolism associated with such aneurysms. There is also an increased risk of perioperative infarction following coronary artery bypass grafting if the suture line involves the aneurysm wall (6 of 6), but not when sutures are placed away from it. The importance of recognition and proper operative management is stressed.


Combined valvular and coronary artery surgery. Between July 1, 1971, and March 1, 1975, 45 patients underwent combined valvular and coronary artery operation. Aortic valve disease was present in 30 patients, mitral valve disease in 13, aortic and mitral valve disease in 1, and tricuspid valve disease in 1. The average age was 57 years. Seventeen patients were in New York Heart Association Functional Class IV. Seventeen patients had had a previous myocardial infarction. Significant coronary artery disease was an unexpected finding at the time of coronary angiography in 14 patients. The average number of grafts inserted was 2.5 per patient. The grafts were placed prior to valve replacement, and periods of myocardial ischemia were kept at a minimum by maintaining coronary perfusion throughout the operation. Operative mortality was 16%; late mortality was 8%. Perioperative myocardial infarction occurred in 2 patients.