Lysosomal enzyme secretion and volume contraction induced in neutrophils by cytochalasin B, chemotactic factor and A23187. The secretion of lysosomal enzymes from rabbit peritoneal polymorphonuclear leukocytes caused by either cytochalasin B, or cytochalasin B plus chemotactic factors, or by the divalent ionophore, A23187, is associated with a decrease in the volume of these same cells. No quantitative correlation could be found between the extent of lysosomal enzyme secretion and volume decrease for any of the three stimuli. This suggests that the volume decrease is neither the direct cause nor the result of the secretion.


Similar vasoconstrictor responses to calcium in normotensive and esssential hypertensive men. To study limb vascular responses in man to elevations in plasma calcium concentrations, we infused test isosmolar solutions of CaCl2 (0.115, 0.230, and 0.460 meq calcium/min) and NaCl and control isosmolar solutions of NaCl into the brachial arteries of 10 normotensive men and eight men with essential hypertension of mild to moderate severity. Limb blood pressures were monitored, limb blood flow was measured by indicator-dilution, and limb vascular resistance was calculated as mm Hg/ml flow/min/100 cm3 limb volume. Measured concentration of calcium in limb venous plasma during infusion of 0.460 meq calcium/min was 11.5 +/- 0.8 meq/liter (mean +/- SEM) with individual values ranging up to 20 meq/liter. Changes in limb venous serum sodium, potassium, magnesium, and osmolality were similar during control and CaCl2 infusions. Decreases in limb venous blood hematocrit during CaCl2 infusions were the same or greater than those during control infusions. The infusions did not significantly change systemic blood calcium concentration or blood pressures. Limb blood flow decreased and resistance increased in response to CaCl2. Increments averaging as little as 2.2 meq/liter elevated limb resistance by about 45%. Log dose-response curves were linear. Responses did not differ in normotensives and hypertensives (P greater than 0.8). We conclude that the vascular response to acute elevation of plasma calcium concentrations up to 20 meq/liter in the limb oman is an impressive vasoconstriction. We found no evidence for abnormal vascular responses to calcium in essential hypertensive men.


Effects of stress and drugs on the catecholamine and pepsin concentrations in stomach wall of rat. Reserpine, serotonin, and histamine as well as stress were employed to produced dystrophic lesions in the gastric mucosa of rats. Analysis of stomach tissues revealed that agencies which reduced catecholamine concentration also decreased endogenous levels of pepsinogen. Concentrations of the zymogen were increased after parenteral administration of dopa, but were not changed by injections of alpha-methyl-dopa. The evidence supports the suggestion that catecholamines participate in the control of pepsin production and are involved in the secretory function of the stomach.


Infrared scattering: a method for evaluating the mass and size of bacteria. In the realm of biophysics and biochemistry, light scattering is used extensively to evaluate the molecular weight and size of macromolecules and particles in suspension. Bacteria scatter strongly but are too large for the conventional procedures. By extending the wavelength lambda of the incident radiation into the infrared, we show that the effective size of the bacteria (relative to lambda) is reduced, and the usual Zimm plot measurements and procedure can be applied to evaluate the molecular weight and size. Details of the apparatus, its alignment, calibration and use are given along with data for aqueous suspensions of the three species Serratia marcescens, Escherichia coli and Thiobacillus ferrooxidans. The method has the advantages of being suitable for rod-like or ellipsoid-like bacteria as well as spheres, for polydisperse samples and for monitoring the effects of environment, antibodies and chemical therapeutic agents on the bacteria.


Effects of 6-hydroxydopamine on shock-elicited aggression, emotionality and maternal behavior in female rats. Tests of emotionality and shock-elicited aggression, which have revealed consistent changes in behavior in male rats given 6-hydroxydopamine (6-OHDA), were administered to female rats intraventricularly injected with 250 mug of 6-OHDA to determine whether aspects of the 6-OHDA syndrome are shared by female and male rats. The results confirmed that female rats become hyperemotional as well as hyperaggressive after 6-OHDA, as do males. Using the hypothesis that the behavioral effects of 6-OHDA lesions of catecholamine neurons result from a general reduction in threshold to aversive stimuli, it was predicted that arbitrarily selected stimuli having aversive components should enhance the behavior normally elicited by these stimuli. Stimuli selected for testing were those that normally elicit maternal defensive aggression and maternal retrieval. Both of these behaviors were found to be enhanced in 6-OHDA treated female rats, thus supporting the prediction. These findings were interpreted as inconsistent with the hypothesis that norepinephrine chemically codes specific behaviors, particularly aggressive behavior.


A 24-hour periodicity in the activity of a nickel-coated glass slide used for carrying out immunologic reactions at a liquid-solid interface. Active nickel-plated slides are prepared by evaporating the metal in the presence of a magnetic field oriented perpendicularly to the slide, the surface being metallized facing the south pole of the field. Active slides coated with an antigen layer (bovine albumin or ovalbumin) can specifically adsorb a layer of antibodies nearly twice as thick (70 to 80 A) as that adsorbed on inactive slides (40 A). The activity of a slide varies within a 24-hour period. Fully active at night, a slide gradually loses its activity from sunrise on but regains it at sunset. The experimental evidence favors the view that inactivation is brought about by soft cosmic rays emanating from the sun. The inactivation can be prevented by keeping the slide under 3.5 cm of lead.


The effect of sodium bisulfite on the melting profiles of nucleic acids and on their respective nucleosides. The effect of sodium bisulfite (0.27 M, pH 7) on melting behavior of DNA, yeast RNA and their respective nucleosides was studied. It was found that bisulfite added not only to pyrimidine bases but also to purine bases of nucleic acids and of nucleosides. The addition products were stable at higher temperatures but reverted to parent compounds at room temperature. The only exception was the addition product of uridine which was stable at room temperature and could be isolated by paper chromatography in a 42-62% yield. Heating of DNA solutions in the presence of bisulfite to 95 degrees C caused a 90% loss of absorbance at 260 nm. On cooling, the absorbance was essentially recovered. When compared to the melting behavior of DNA in 0.27 M NaCl or 0.09 M Na2SO4 (same ionic strength), it was found that bisulfite destabilized double helical structure of DNA and that reversible addition of bisulfite did occur much below the melting temperature of DNA observed in the other two solvents.


Radiographic approach to stereotaxic surgery in rhesus monkeys. A method is described which uses radiographic techniques to identify ventricular and bony landmarks as guides in placing probes into specific areas of the brain in the rhesus monkey. This approach requires a relatively simple modification of a standard stereotaxic instrument and is applicable to various physiological and behavioral experiments in species where cranial variability limits the accuracy of stereotaxic surgery.


The anatomy of several free flap donor sites. The vascular anatomy of the supplying vessels to the iliofemoral, the deltopectoral, the axillary, and the thoracoabdominal regions has been investigated in detail in fresh cadavers. Other donor sites were also examined. The anatomical relationship of the supplying vessels is discussed-and the design, conversion, and utilization of these skin areas as donor sites for free flap transfer are detailed. The iliofemoral region is suggested as the best donor site for most free flap procedures.


Laser, scalpel, electrosurgical, and tangential excisions of third degree burns. A preliminary report. Our clinical experience with laser, electrosurgical, scalpel, and tangential burn wound excisions in 26 patients is presented.


One-stage coverage of the large chest wall defect with a giant bepedicled flap. Case reports. We present a method of closing chest wall defects with a large bepedicled flap from the adjacent chest wall and abdominal tissue.


A method to keep dressings moist prior to delayed skin grafting. A simple method is described of using a commercial drape or sheet of polyethylene to keep dressings moist prior to the application of delayed skin grafts.


Nomifensine: a potent dopaminergic agonist of antiparkinson potential. Nomifensine was shown to be a potent stereotypic agent in rat. Its effect was resistant to a-methylparatyrosine pretreatment but was abolished by combined reserpine/alpha-methylparatyrosine and by haloperidol. Electrolytic lesions placed in dopamine-containing areas of the extra-pyramidal, mesolimbic and amygdaloid systems indicated an effect in all areas, but the globus pallidus and substantianigra were shown to be most important for its action. Also the effect of nomifensine was reduced by lesions of the medial and/or dorsal raphé nuclei. A circling behaviour was recorded following nomifensine administration to animals with unilateral electrolytic lesions of the substantia nigra or asymmetric lesions of the medial raphé nucleus. These effects were resistant to alpha-methylparatyrosine and inhibited by haloperidol. Nomifensine reduced the intensity of harmine-induced tremor. The M2-metabolic of nomifensine mimicked the effects of the parent compound on peripheral administration bu the onset of action was more rapid and  the duration shorter. The M2-metabolite was active on intrastriatal injection to induce stereotyped/hyperactive behaviour and contralateral asymmetries. In all experimental situations nomifensine was compared with apomorphine and d-amphetamine (dopamine and L-Dopa where appropriate). Nomifensine/metabolite was shown to be a potent dopaminergic agonist with an action mainly dependent upon functioning of the extrapyramidal system and partly independent of presynaptic mechanisms.


N-desmethyldiazepam and amylobarbitone sodium as hypnotics in anxious patients. Plasma levels, clinical efficacy and residual effects. Drug plasma levels of N-desmethyldiazepam (10 and 20 mg/day given at night) and amylobarbitone sodium (200 mg/day given at night) were determined in 45 patients after 1 and 7 days of treatment together with estimates of hypnotic and residual effects. No relationships were found between clinical rati ngs of hypnotic effect and drug plasma levels, while significant correlations were observed between some performance taska and drug plasma concentrations of amylobarbitone sodium, and of the higher dose of N-desmethyldiazepam.


Inhibition of d-amphetamine-induced locomotor activity by injection of haloperidol into the nucleus accumbens of the rat. The effect of intracerebral administraton of antagonists of dopamine and noradrenaline upon the locomotor stimulation induced by intraperitoneal injection of d-amphetamine sulfate in rats was investigated. Inj ection of low doses of the dopamine antagonist haloperidol (2.5 mug and 5 mug) bilaterally into the nucleus accumbens antagonized the locomotor stimulation following d-amphetamine. No significant inhibition was observed following administration of the alpha-adrenergic antagonist phentolamine or thhe beta-adrenergic antagonist propranolol into the nucleus accumbens. Injection of the dame doses of haloperidol into the caudate nucleus did not inhibit the d-amphetamine induced locomotor activity in contrast to the effects seen following injection into the nucleus accumbens. The results confirm the significance of dopaminergic mechanisms for the locomotor stimulant effect of d-amphetamine and indicate that the mesolimbic dopamine system plays an important role in this respect.


Changes in morphine self-administration and morphine dependence after lesions of the caudate nucleus in rats. Rats were trained to bar press for intravenous infusions of morphine sulfate during 1-hr daily test sessions.  Small, centrally placed bilateral lesions of the caudate nucleus reduced rats of morphine self-administration to approximately one seventh of preoperative levels; postoperative rates were similar to preoperative rates when the postoperative unit infusion dose of morphine was one tenth of the preoperative dose.  Caudate lesions also lowered the threshold dose at which morphine's rewarding property could be detected.  Physical dependence was studied in other rats receiving a 3-day continuous infusion of morphine sulfate via implanted subcutaneous silicone reservoirs.  Caudate lesions ameliorated withdrawal-induced weight loss and naloxone-induced "wet dog shakes".  Both the self-administration and dependence data are consistent with the idea that morphine blocks dopaminergic transmission in the striatum.


The effect of amitriptyline, desipramine and imipramine on the vivo brain synthesis of 3H-noradrenaline from 3H-L-dopa in the rat. 3H-L-Dopa was given to rats after a peripheral decarboxylase inhibitor Ro 4-4602 (50 mg/kg) and the effect of 30 min pretreatment with antiptyline (10 mg/kg), desipramine (10 mg/kg) and imipramine (10 mg/kg) on the brain formation of 3H-dopamine, 3H-noradrenaline and their major metabolites was investigated. Desipramine produced a decrease in the level of labelled noradrenaline and its major metabolites free and conjugated 3-methoxy-4-hydroxyphenyleneglycol and 3,4-dihydroxyphenyleneglycol. Imipramine decreased labelled noradrenaline and 3-methoxy-4-hydroxyphenyleneglycol, whereas amitriptyline produced no significant effect on noradrenaline metabolism. The thymoleptic drugs produced no significant effect on endogenous brain noradrenaline and dopamine. These findings provide a strong indication that desipramine and imipramine inhibit the 3H-noradrenaline biosynthesis from 3H-L-Dopamthe effect seems closely related to the well-known membrane inhibitory effect of these drugs, since desipramine produced a more marked effect than imipramine and amitriptyline showed no effect. No conclusive evidence for the precise mechanism of action was obtained but it is possible that the decreased 3H-noradrenaline synthesis is related to interference of desipramine and imipramine with the precursor (s) 3H-L-Dopa or 3H-dopamine at sites of 3H-noradrenaline biosynthesis.


Erythroid toxicity of azathioprin. Macrocytosis and selective marrow hypoplasis. In a population of 70 stable renal allograft recipients receiving azathioprine, macrocytosis was present in a majority and its severity was related to azathioprine dosage. There were associated megaloblastoid marrow changes which could not be related to serum folate or vitamin B12 concentrations. Two cases of selective red cell hypoplasia in renal allograft recipients are described; in each patient, azathioprine was incriminated and the effect dose-related. These observations indicate that the erythroid effects of azathioprine may precede, and be independent of, its effects on the myeloid series.


Acute reversible renal failure in patients with acute cholecystitis and cholangitis. Although acute renal failure is a well recognized complication of several extra-hepatic biliary tract diseases especially biliary tract surgery in the presence of obstructive jaundice, there is little information concerning renal failure in acute cholecystitis. Renal function was assessed in 14 patients with acute cholecystitis and two with acute cholangitis. Six patients had no evidence of renal impairment, four had modest elevations of plasma urea and creatinine concentrations and six had acute reversible renal failure of whom three required peritoneal dialysis. Only one patient was hypovolaemic and in the remainder there was evidence that intravasular coagulation was responsible for the renal failure. It is suggested that bacteraemia was the initiating factor. The therapeutic implications of these findings are discussed.


Radiology of the urinary tract: some physiological considerations. Annual oration in memory of John S. Bouslog, M.D., 1890-1973. This paper reviews some of the fundamental technical and diagnostic problems in clinical uroradiology, such as (a) the reason for the obstructive nephrogram; (b) why high-dose urography gives better studies than low-dose; (c) why the Trueta phenomenon has not been demonstrated in man; (d) the case for an intrarenal arterial collateral pathway via the pericalyceal network (these vessels can be demonstrated in man and must not be misinterpreted as tumor vessels or vascular malformations). One of the most baffling problems sometimes occurs with the sudden partial block of a single segmental vessel: the kidney ceases to excrete urine and eventually becomes atrophic even though some excretory function returns. To date, there is no satisfactory explanation for this course of events.


Arteriography of renal transplants.

Arteriography of renal transplants. Arteriograms were reviewed in 60 cases of renal transplant dysfunction and correlated with the final diagnosis. Angiographic refinements included selective injections, 2-4X direct magnification, and flow-dependent injection rates. Angiography permitted recognition of common causes of post-transplantation dysfunction, including acute vasomotor nephropathy (AVN), acute refection (AR), chronic rejection, and obstruction of the ureter, renal artery, or renal vein. In 28 patients with AVN or AR who had technically adequate cortical microangiograms, classification was correct in 57%, indeterminate in 36%, and erroneous in 7%. In addition to its diagnostic value, angiography provides some prognostic information in AR, permitting prediction of functional return when the pattern suggests AVN and lack of return when cortical necrosis is indicated.


The potential of localized heating as a adjunct to radiation therapy. Experimental studies have shown that (a) tumor cells may be more sensitive to heat than normal cells; (b) hyperthermia inactivates cellular repair mechanisms for radiation damage; and (c) heat may lower the OER for ionizing radiation (anoxic cells are at least as sensitive to hyperthermia as oxygenated cells). Localized hyperthemia produced by localized current fields in the range of 100 kHz-10 MHz by direct contact electrodes offers two major advantages: the eletrode configurations may be manipulated to obtain desired thermal dose distributions, and, since the mode of heating is essentially instantaneous, accurate temperature control can be maintained during treatment.


The impact of computed tomography on neuroradiologic practice. To assess the impact of computed tomography (CT) of the head on neuroradiologic and diagnostic practice, we analyzed its capabilities, performance, and usage in our practice during the past 18 months. The results were compared to similar data on other neurodiagnostic tests, i.e., electroencephalography (EEG), A-mode echoencephalography, cerebral angiography, cerebral pneumography, and nuclide brain scanning. All diagnostic techniques except EEG were used less often as the capabilities of CT became known to our clinicians.


An approach to contrast enhancement in computed tomography of the brain. A total of 450 brain examinations were performed using computed tomography before and after intravenous infusion of methylglucamine diatrizoate 30%. In 110 cases involving a documented intracranial lesion, the scans were analyzed to determine the degree and usefulness of contrast enhancement. Enhancement was achieved in a wide variety of neoplastic and non-neoplastic lesions and was found to be of considerable help in detection of abnormality as well as in defining tumor morphology.


Evaluation of mammographic calcifications using a computer program. A computer pattern recognition program was developed to evaluate calcifications seen on mammograms. When the approximate horizontal length, average internal gray level, and contrast were used as criteria, 84.3% of the lesions studied were correctly identified as malignant or benign. These results show that a computer program can help evaluate calcifications of the breast.


Sealed sources in synthetic absorbable suture: a new method for permanent interstitial implantation. Inactive gold grains are embedded at 1-cm intervals along a synthetic, absorbable surgical suture, then subjected to neutron irradiation in a nuclear reactor, forming a new material for permanent interstitial implant therapy. Assembling and activating the sealed sources in an absorbable carrier, the physical properties of the irradiated suture, its behavior in tissue, and the methods and results of implantation in the dog are described.


Luteolysis, estrus and ovulation, and blood prostaglandin F after intramuscular administration of 15, 30 or 60 mg prostaglanding F2alpha. During diestrus in three consecutive estrous cycles, each of six heifers was given (im) 30 mg, 15 mg (twice at 6-hr intervals) and 60 mg prostaglandin F2alpha (PGF2alpha) tham salt. Neither the decline in blood progesterone, the increase in blood estradiol, the duration or the peak of the LH surge, the interval to onset of estrus, nor the interval to ovulation was affected significantly by dose of PGF2alpha. Thus, relative to that after 30 mg PGF2alpha im, two injections of 15 mg at 6-hr intervals or 60 mg PGF2alpha did not hasten luteolysis. Thirty mg was an ample in dose of PGF2alpha to cause luteolysis. Regardless of im dose of PGF2alpha, blood PGF peaked at about 6.0 ng/ml within 10 minutes and returned to basal values (less than 1.0 ng/ml) within 90 minutes. In another trial, after a single iv injection of 5 mg PGF2alpha, blood PGF peaked (25 ng/ml) within 5 minutes and returned to basal values within 15 minutes. During a 30-minute infusion (0.5 mg/minute) of PGF2alpha, blood PGF plateaued at 29.5 ng/ml with a metabolic clearance rate of 17.0 liters per minute.


Effect of the antiepileptic drug sodium valproate on induction of hepatic microsomal P450. Sodium valproate is an anticonvulsant which, unlike phenobarbitone, does not produce an increase in rat hepatic P450 when given in large nontherapeutic doses.


Demonstration of methadone in the human brain by immunofluorescence. Specific neuronal staining for methadone was demonstrated by immunofluorescence in the brain tissue of ten addicts who had died from drug overdose. Areas of the brain most frequently involved were the hypothalamus, thalamus, hippocampus, amygdala, cerebellum and brain stem. Toxicological studies confirmed the presence of methadone in each case.


Frequency of surface immunoglobulin bearing blood lymphocytes in cattle affected with bovine leukosis. Lymphocytes of the peripheral blood from healthy cows and animals suffering from bovine leukosis (persistent lymphocytosis or leukaemia) were examined for the presence of surface immunoglobulin determinants. Using the immunofluorescence technique an average of 18 per cent of lymphocytes from healthy and 67 per cent from leukotic cows could be recognised as positive. An increase of these positive cells, which are supposed to be B cells or of B cell origin, seems to be a characteristic finding in this disease of cattle.


The direct fluorescent antibody test for the detection of Treponema hyodysenteria in pigs. A direct fluorescent antibody technique for the detection of Treponema hyodysenteriae in faeces and bowel smears from pigs produced a better preparation than the indirect method and also had the advantages that it took less time, produced less non-specific fluorescnece and gave direct control over the availability of the reagents used.


[Dentofacial orthopedics and orthopedic surgery]. The authors describe five cases of surgical correction of dysmorphisms of the maxillaries requiring orthodontic treatment before surgery. Pre-operative orthodontic treatment of the adult has the advantage of enabling the arches to be aligned, facilitating the operation when the osteotomized fragments are positioned and resulting in immobilisation in a good position.


[Note on lingual mutilations and their possible surgical repair]. A historical review is followed by a case report concerning a 58-year-old man cured of a pelvilingual carcinoma at the price of severe mutilation in whom it was possible, with the aid of cutaneo-cylindircal grafts, to close a buccocervical fistula and to anatomically reconstruct the tongue. This rare case proves that after treatment for carcinoma, stomatological plastic surgery is possible when cure is certain and the patient's general condition good.


Decrease in gastric secretion during the first three months after proximal gastric vagotomy in duodenal ulcer patients. Gastric secretion was stimulated by intravenous infusion of 15 mug/kg/hr of pentagastrin before and 10 and 90 days after proximal gastric vagotomy in 16 duodenal ulcer patients. Postoperatively 15 ug/kg/hr of pentagastrin was also given in combination with 2 mug/kg/hr of carbacholine. Mean acid output in response to pentagastrin alone was reduced by 48 and 64 per cent at 10 and 90 days after the vagotomy, respectively. Mean pentagastrin-stimulated acid output and volume of gastric juice was significantly higher at 10 days than at 90 days after the operation. Mean pepsin output decreased also, but the decrease was not statistically significant. There was no significant effect of carbacholine on pentagastrin-stimulated acid output either at 10 or 90 days. Carbacholine increased pentagastrin-stimulated volume of gastric juice significantly at 10 but not 90 days postoperatively. The effect of carbacholine on pentagastrin-stimulated pepsin output was significant both 10 and 90 days after the vagotomy. Pepsin output in response to pentagastrin plus carbacholine 10 days after the operation was not significantly different from preoperative values. At 10 days postoperatively the increase in pentagastrin-stimulated volume of gastric juice by carbacholine was significantly greater than at 90 days. The corresponding differences of acid and pepsin outputs were not significant.


Role of intravenously infused insulin in treatment of acute pancreatitis. A double-blind study. The effect of insulin treatment in acute pancreatitis was studied in a double-blind investigation. Fifteen patients with clinical signs of acute pancreatitis were treated with intravenous infusion of glucose and insulin only. Twelve patients were free from pain within four hours of commencement of treatment. Within eight hours all fifteen were free from abdominal pain. Fourteen patients with pancreatitis established by the same criteria were treated with glucose infusions without insulin. Only four of the patients in this group became free from pain within four hours. The role of intravenously infused insulin with respect to the more beneficial effect in the first group is discussed.


Inhibition of leucocyte migration by antigens from human colon and E. coli O 14 in patients with ulcerative colitis. In 55 patients with ulcerative colitis and in 25 controls the leucocyte migration inhibition test was performed. As antigens the extract from human fetal colon and the lipopolysaccharide antigen from E. coli O 14 were used. The leucocyte migration in patients with ulcerative colitis was significantly inhibited in the presence of the antigens mentioned. In patients with an active form of ulcerative colitis the leucocyte migration was significantly inhibited as compared to the leucocyte migration in patients with a nonactive form of the disease.


The effects of acetylsalicylic acid on the human gastric mucosa as revealed by gastrocamera. The influence on the gastric mucosa of acetylsalicylic acid (ASA) given as a buffered solution (Bamyl-SR, AB Hässle, Sweden) and as a conventional disintegrating tablet (MagnecylR, ACO, Sweden) has been compared in 7 healthy volunteers, using the gastrocamera technique. The study was performed crossover with randomized treatment periods. The dosage of ASA was 1 g 3 times daily for 3 days. Before and after each treatment period gastrocamera examinations were performed. The evaluation of the gastro-camera films was made blindly. It was found that after the ASA-tablets all subjects had multiple and prominent erosions. However, in all subjects the erosive effects on the gastric mucosa were less pronounced with the buffered solution. It was concluded that any person taking conventional ASA-tablets in a dose of 1 g 3 times daily for 3 days runs the risk of developing lesions of the gastric mucosa. This risk is less when ASA is taken in the form of a buffered solution.


Output of bilirubin and pancreatic enzymes in response to different liquid test meals in man. The output of bilirubin and pancreatic enzymes was determined after ingestion of three different liquid test meals in man. Doubling the amount of protein in a composite meal was followed by a delivery of more protein per time unit to the intestine and by a higher output of bilirubin and enzymes than was recorded after a similar meal containing less protein. The ingestion of a 15% glucose solution awoke a considerable output of bilirubin and enzymes during the first hour, thereafter it was low and decreasing. The differences in enzyme and bilirubin output corresponded to differences in quality and quantity of the emptied food components.


[The short novel "The jealous Estremaduran", an example of Cervantes' psychopathology]. The Cervantinie short novel "The Jealous Estremaduran" describes with poetic liberty the senile jealousy-imagination of a man nearly 80 years old towards his 15-year-old new bride. The preposterous, patholplastic forms of this jealousy-phantasm make the main figure of the short novel, the old man Carrizales, his absurd, fantastie plans of a hermetical isolation of his wife from the outside-world a reality. CERVANTES describes in his novel, without the noxa alcohol playing any part though, a state of affairs which is similar to the symptoms of the chronic jealousy-phantasm of the alcoholic who only has in his mind's eye the sheer wish to possess his partner. These details prescribed in a person with a pathological derangement, which show CERVANTES as an excellent psychopathologist among the poets, are examined and analysed.


[Primary cheilorhinoplasty for congenital unilateral labiomaxillary fissure. Trial schematization of a technic]. The addition of rhinoplasty to primary cheiloplasty for cleft lip improves not only the post-operative state but also, by re-establishing the equilibrium of all the cartilaginous and musculo-periosteal structures, favourises maxillary growth. The author describes a technique and presents some results.


[Electro-clinical evolution of cerebral spongiosis]. Electroencephalogram was repeated about every third week in the last five months' course of a spongiform encephalopathy, Creutzfeldt-Jakob type. This confirms the interest of EEG and its diagnostic value in certain presenile dementias. The appearance of triphasic stereotyped complexes with a short periodic interval is the fundamental pattern allowing to predict, then to assess, the diagnosis. Our study is based upon 14 polygraphic records (including EEG, respiratory rhythm, ocular movements and limbs' actogram); compared with previous studies from the literature it shows some pecularities: - periodic discharges with an interval of about one second appearing early, i.e. before the clinical picture became typical, -lack of any change under the influence of various drugs and stimulations, - stability of the pattern throughout the whole course of the disease.


[The beginning of neurosurgery].

[The beginning of neurosurgery]. Trephining was practiced by neolithic man. But neurosurgery as a speciality arose only during the second half of the 19th century. Its first pioneers were Sir William Mac Ewen, Sir Victor Horsley, Fedor Drause, and Antoine Chipault. The leaders of the second generation were Harvey Cushing, Walter Dandy, Charles Elsberg and Charles Frazier. Mention deserve also Otfried Foerster, Thierry de Martel, Clovis Vincent, René Leriche and Ludwig Puusepp.


[Lope de Vegas comedy "Los locos de Valencia" a view of a 16th century psychiatric institution]. With the comedy "Los locos de Valencia" (The Insane of Valencia) Lope de Vega left us valuable evidence of the nursing of the insane in the 16th century. After a summarizing presentation of the intricate plot of the play the manifold details about admission, general treatment of the mentally ill as well as the habits in the oldest psychiatric institution of the world are communicated and analysed by means of citations form comedy. Furthermore, an attempt is being made to demonstrate the nosolgic understanding of the Humanist and non-physician Lope de Vega for the psychiatric conditions and way of living from the same source.


[Priapism--pathogenesis and therapy].

[Priapism--pathogenesis and therapy]. Priapism can occur when pathologic stimuli (e.g. lesions of the cervical spinal cord) cause prolonged erection, and when normal stimuli under pathologic circumstances (e.g. sickle cell disease, leukemia) produce prolonged erection. As any priapism eventually leads to permanent impotentia coeundi, immediate therapy is absolutely indicated. All unspecific procedures are useless and merely waste time. The priapism in connection with hematologic diseases must be countered by conservative specific therapy (sickle cell disease by blood transfusions; leukemias by cytostatic drugs). All other forms of priapism must be treated by surgery as soon as possible. The operation of choice today perineal bilateral shunt between the corpus cavernosum and the corpus spongiosum


[Osteoplastic hip buttress in the treatment of osteoarthritis of the hip]. The results of 40 acetabuloplasties of the hip for osteoarthritis have been studied over a follow-up period of 6 months to 7 years. 12 patients have been treated by shelf arthroplasty alone and 26 by the same operation combined with intertrochanteric osteotomy. These operations, which are suitable for use in patients too young for a total hip prosthesis, give very satisfactory results in 80% of the cases, but the patients must be carefully selected. The clinical and radiological criteria on which this choice is based, and the technical peculiarities of the operation, are described.


[Dental and mandibular studies on mummies. Contribution of a stomatologist]. This is the sequence to an investigation on a mummy, 1965. Two further mummies could be examined: the first, a woman about 34 years old, from the 1st to 3rd century, shows similar advanced destruction of the teeth as the mummy investigated in 1965, caused by sand in the hand milled bread flour. This caused an early loss of molars by exaggerated abrasion, exposure of the pulps and periodontal bone loss. There was no evidence of occlusal caries. The second mummy was a 18-year-old young woman, 800-700 b. C. From the inscriptions on the sarcophagus name, family and living circumstances could be found. The same damages were found here, there was only a gradual difference owing to age difference. An interesting special finding was the absence of lip closure and the postmortal damage to the front teeth which may have been caused by the ritual of mouth opening.


Changes in obsessive/compulsive patients as measured by the Leyton Inventory before and after treatment with clomipramine. The Leyton Obsessional Inventory has been found to be a useful measure in assessing patients before and after treatment with clomipramine. Mean scores for symptoms and interference altered significantly during the course of treatment. The Leyton Obsessional Inventory, however, lacks external validation owing to the absence of some valid alternative quantification. In the absence of such external validation it seems justifiable to use the mean Leyton score diagnostically but not as a sole indication of severity or response to treatment.


Flagellar coordination in Chlamydomonas reinhardtii: isolation and reactivation of the flagellar apparatus. The flagellar apparatus (both flagella with basal bodies and accessory structures) of Chlamydomonas reinhardtii was isolated from a wall-less mutant and induced to swim in the presence of adenosine triphosphate. The movement of the flagella of the isolated apparatus was largely synchronous and indistinguishable from the movement of flagella on living cells. These observations suggest that the mechanism of flagellar coordination in this biflagellate alga is largely intrinsic to the structure of the flagellar apparatus itself.


Glucagon release: paradoxical stimulation by glucose during calcium deprivation. During calsium deprivation, the rate of glucagon release by the isolated perfused rat pancreas is positively related to the glucose concentration of the perfusion medium. It is suggested that such a paradoxical behavior, which is reminiscent of the abnormality of glucagon secretion recently disclosed in diabetic subjects, results from a perturbation in the normal structural and functional bridging between pancreatic alpha and beta cells.


Radioligand assay in reproductive biology. Radioligand assays have been developed for the principal reproductive steroids and peptide hormones. Specific binding reagents have included antibodies, plasma binders, and intracellular receptors. In each assay, problems of specificity, sensitivity, and nonspecific inhibitors were encountered. Many features of the endocrine physiology in childhood, during puberty, and in adulthood have been characterized. Hormonal evaluations of endocrine disorders of reproduction are characterized on the basis of their characteristic pathophysiologic alterations.


A clinical evaluation of the efficacy of mebendazole in the treatment of trichuriasis. In a single-blind clinical study of mebendazole, a new, broadspectrum anthelmintic, 70 patients with light to severe infections of Trichuris trichiura were treated. Ten subjects received placebos, and 60 received 100 mg mebendazole twice a day for three and four days. The drug was well tolerated by the patients, and no toxic side effects were observed. Egg count comparisons using the McMaster method on feces collected before and one month after treatment indicated a cure rate for trichuriasis of 65.6% and 89.3% and a total egg reduction of 69.5% and 95.9% for three- and four-day regimens, respectively. Patients not cleared showed an  egg reduction rate of 31.6% and 76.8% on the three- and four-day regimens, respectively.


Variables in objective audiometry.

Variables in objective audiometry. Objective audiometry has a definite application in evaluating problem patients. Three basic tests, electrodermal response audiometry (EDR), evoked cortical response audiometry (ERA), and impedance audiometry, are used to evaluate pediatric and adult patients. Each measurement technic, however, has limitations of which the physician should be aware. Impedance audiometry has the greatest potential as an objective measurement of auditory function.


Hereditary nephritis (Alport's syndrome) in a new kindred. A new kindred with Alport's syndrome is presented with the clinical and historical data permitting diagnosis. History of family members with nephritis and oto-ophthalmologic anomalies in the presence of nephritis in a given patient continues to be the strongest clue to Alport's syndrome. As the disease is one of the few in which life-threatening renal failure can be thus predicted, increased emphasis on diagnosis is urged in place of casually categorizing these patients together with those who have Bright's disease. Public Law 92-603 is a mandata from the public for physicians to exercise every avenue of diagnosis and salvage for the nephritic patient. Alport's syndrome with nephritis represents an opportunity to plan for eventual dialysis and renal transplantation.


Indications for fiberoptic colonscopy.

Indications for fiberoptic colonscopy. In certain clinical situations, fiberoptic colonoscopy has proved most useful and effective as a diagnostic and therapeutic tool. Colonscopy is indicated to remove polyps when feasible and to rule out the presence of toher polyps or tumors undetected by barium enema. Patients with cancer of the colon should have preoperative colonoscopy to rule out the presence of undetected polyps or metachronous cancer. Follow-up examinations are important to insure against residual cancer or recurrence after colonscopic removal of sessile, premalianant, or malignant polypoid lesions, and to evaluate certain patients who have increased risk of polyp or tumor formation. Colonscopy usually can explain persistent, localized abnormalities detected by barium enema (ie, "filling defects") and provide a definitive diagnosis in cases of unexplained rectal bleeding or diarrhea despite negative sigmoidoscopic and barium studies. In experienced hands, this technic is safe, confortable, and effective in avoiding laparotomy to remove clinically significant polyps and in providing definitive diagnosis in many clinical situations.


Problems related to postmenopausal women. The most consistently troublesome symptom of the menopause is the hot flush. It can occur without warning or may be triggered off by emotion, exercise or change of environment or temperature. It is estimated that about 50% of women suffer from hot flushes, but only 5-10% of these seek medical advice. The cause is ascribed to excessive production of follicle-stimulating hormone. There is an increased sensitivity to the effect of locally released dilator substances in the peripheral vasculature.


[Death and the moment of death: several legal aspects]. None of the important legal issues concerning the moment of death and re-animation procedures can be solved by means of simplistic legal formulae. In adjudicating on a particular problem, a court of law will have to be guided by prevailing religious, societal and medical attitudes. But as jurists we must strongly support the individual's "right to die".


Osteonecrosis following renal transplantation. Subarticular osteonecrosis has been described with increasing frequency after renal transplantation and the use of immunosuppressive corticosteroids. Six cases have been encountered among 170 patients in the Johannesburg renal transplantation programme. The commonly affected sites are the femoral head, the femoral condyles, the humeral head, the talus and the capitulum. The radiological and morbid anatomical features of this complication are described, alternative theories of pathogenesis are considered and an approach to treatment is outlined.


A bismuth-peptide complex in the treatment of duodenal ulceration. A double-blind duodenoscopic study. A bismuth-protein complex (Bicitropeptide, BCP-Compound) active at an acid pH was studied in a trial of treatment in ambulant patients with duodenal ulcers. BCP is said to have an affinity for actively granulating tissue, and to coat the ulcer with a protective layer, allowing healing to occur. A double-blind trial of BCP and placebo was undertaken in 60 patients with duodenal ulcers. Assessments were made by duodenoscopy. Healing of the ulcers occurred in 89% of patients on BCP, and the mean time for the disappearance of symptoms on BCP was 4,9 days. Only 16% of ulcers healed on placebo, and the mean time for disappearance of symptoms on placebo was 6,8 days. This result is highly significant and in favour of BCP (X-2 equals 30,52 P less than 0,0005). No side-effects were observed.


[The rebel ambulance of 1914].

[The rebel ambulance of 1914]. The story of the so-called Rebel Ambulance of 1914 covers a period of about 6 weeks. During this time a group of people in Bloemfontein endeavoured to provide medical cover and comforts for casualties among those who participated in the armed protest of 1914 in the Orange Free State. Information about relevant historical facts, the collection of funds and equipment, and the work of the field ambulance are presented.


The effect of vehicle composition on the release of chloramphenicol from creams and eye ointments. The effects that formulation of topical vehicle can have on the bio-availability and effectiveness of active ingrediants are discussed with reference to steroids, salicylic acid and benzocaine.  Results obtained for chloramphenicol-containing preparations are presented, and both dissolution curves and cup-plate assays demonstrate that chloramphenicol has far superior release (and hence activity) from creams than from ophthalmic ointments.  The latter, however, produce adequate zones of inhibition, and are long-acting.


The first fifty - a review of the South African Medical Congresses. This historical résumé, a collation of facts from various sources which lie scattered among the pages of early medical journals of our land, has been composed in an attempt to give some continuity of substance to this particular part of South African medical history which will be celebrated by our Jubilee Congress in Johannesburg this year.


A preliminary report on cephradine.

A preliminary report on cephradine. Plasma cephradine levels were measured after parenteral and oral administration to healthy adults. Plasma cephradine contrations of 7 - 15 mug/ml were measured after 0.5 g had been administered by mouth, and concentrations of 12 - 57 mug/ml were measured after parenteral administration; they fell to 3 mug/ml within 240 minutes except after intramuscular administration. The results of an open clinical trial conducted among 10 patients suffering from urinary tract infections were satisfactory.


Streptococcal cellulitis of the scrotum and penis with secondary skin gangrene. Cellulitis of the scrotum and penis is caused, in the majority of instances, by a beta hemolytic streptococci without a discernible portal of entry. Clostridium, occasionally, will result in this disease as a manifestation of a perirectal abscess. In either instance, fluid accumulates rapidly in the closed space between Colles' and Buck's fascia, producing intense swelling of the scrotum. If this compartment is not immediately decompressed by linear incisions, devascularization of the scrotal and penile skin will often occur, resulting in gangrene. Immediate treatment of the bacterial infection with penicillin also is essential. If gangrene does develop, radical debridement of the necrotic tissue as well as a wide margin of adjacent inflamed skin must be undertaken. Continual monitoring of the microflora of the debrided would is essential for the selection of the appropriate antibiotic against any secondary intruders. Coverage of the granulating would is accomplished when the would bacterial count is below 10-5 per gram of tissue.


The bacterial causation of postoperative osteitis pubis. Five patients with a bacterial causation of postoperative osteitis pubis were treated during a three year period.  In each patient, the bacterial cause was suggested by a known infectious process adjacent of the symphysis pubis.  It is suggested that a bacterial causation be considered for the clinical and roentgenographic syndrome of osteitis pubis if a contigous infectious process is present.


Fulton and penicillin.

Fulton and penicillin. John Fulton, the late noted neurophysiologist, played a little known role in bringing penicillin to the world. He contributed behind-the-scenes support to Howard Florey and the penicillin research and production.


Failure of angiotensin II inhibitor to modify hyperacute rejection. The effect of angiotensin II inhibitor (sar1,gly8 angiotensin II) upon the pig-to-dog (10 pigs to 20 dogs) modified renal xenograft model has been studied. The angiotensin II inhibitor does not prevent hyperacute rejection (HAR). This implies that the vasocaonstriction which occurs during the HAR is not related to high levels of angiotensin II.


The use of monofilament suture in vascular surgery. The blood lost through the suture line holes of vessels closed with braided polyester sutures is compared with that lost when a monofilament polypropylene suture is employed. In a retrospective analysis of blood replacement during saphenous vein aortorenal bypasses, twice as much blood replacement was required when the braided polyester suture was used. Further, ten dogs had one femoral artery reanastomosed with braided polyester suture and the other with monofilament polypropylene. Bleeding was three times greater and lasted six times longer when the braided polyester suture material was utilized.


Pseudoaneurysm of the brachiocephalic arteries: a complication of percutaneous internal jugular vein catheterization. Three cases of arterial pseudoaneurysm formation as a complication of percutaneous internal jugular vein catheterization are presented. Laceration of the posterior common carotid artery or thyrocervical trunk was the source for these lesions. The common antecedent event was the attempted cannulation of the internal jugular vein with the lateral approach. A transcervical rather than transthoracic approach for treatment of these lesions was selected because of its low morbidity rate. This report documents another complication of internal jugular vein cannulation and recommends methods for prevention and successful treatment should it occur.


George J. Heuer, M.D.--a critical analysis of the role that he played in introducing the residency system of training. This presentation of the career of George J. Heuer concerns one William S. Halsted's most trusted and esteemed trainees. Many of the facts concerning Dr. Heuer are known but there also are many that are not known and the purpose of this discourse is to record his important contributions involving the training of surgeons as we know it today. Dr. Heuer had many obstacles to overcome in establishing residency training programs in Cincinnati and New York City, but he was able to overcome most of them with the able assistance of his dedicated lieutenants.


Immunodepression after major surgery in normal patients. Multiple parameters of in vivo and in vitro immune function were measured serially before, during, and following nephrectomy in 12 normal renal transplant donors. All in vitro functions studied (total blood lymphocyte count, B-cell count, T-cell count, mitogen blastogenic response, and mixed leukocyte reactivity as both responder and stimulator) decreased on induction of anethesia and continued to fall during and after operation to reach a low point on the evening after nephrectomy. Depth of depression and rate of recovery varied with the individual function, but all were near normal by the fifth postoperative day. The in vivo delayed hypersensitivity response to cutaneously administered recall antigens declined more gradually and was still falling at the fifth postoperative day. Return of preoperative skin response was delayed, being complete for streptokinase/streptodornase (SK/SD) by 10 to 14 days but incomplete as long as 2 to 3 weeks for mumps and Candida antigens. Serum immunoglobulins did not change. These findings suggest incomplete correlation among the responses to the commonly used in vitro assays of cellular immunity and poor correlation with the in vivo tests. Although surgery and anesthesia results in measurable depression of immune response, clinically significant problems did not arise in these patients.


National Conference on Thrombosis and Hemostosis, Dallas, Tesas 20.-22. November 1974. Clinical Correlations. There are two aspects which are clinically relevant in the relationships among thrombosis and arteriosclerosis. First, the relationship of thrombosis to atherogenesis. Thrombosis is closely related to endothelial injury and there is recent evidence that repeated or continuous endothelial damage leads to the development of all the lesions seen in human atherosclerosis. This occurs in the absence of dietary lipid supplement. The relative importance of the parts played by injury and thrombosis in this process need further delineation. Secondly, established arteriosclerotic disease is associated with thrombosis. This thrombosis is us  ually mural, seldom occlusive. Embolism by platelet aggregates which has been well described in the retinal and cerebral circulations may affect other vascular territories such as the heart and the kidney. Such a mechanism may explain some cases of otherwise unexplained sudden cardiac death and some cases of hypertension. We need better clinical tool to detect the occurrence of thrombo-embolism and to monitor it's progress. Measures to modify thrombosis and embolism may be as useful or more useful than those wer currently employ in the clinical management of atherosclerotic disease.


The phase II urokinase-streptokinase pulmonary embolism trial: a national cooperative study. The controlled clinical trials of thrombolytic agents in the United States have been carried out in two phases, under the auspices of the National Heart and Lung Institute. Phase I was devoted to the comparison of 12-hour Urokinase (12h-UK) followed by heparin (H) with heparin alone in patients with acute pulmonary embolism (Walsh et al. 1969). The results showed that pateints treated with UK had more rapid and gretaer resolution of pulmonary thromboemboli in the first twenty-four hours of therapy than patients treated with H alone, as assessed by serial pulmonary angiography, hemodynamics and lung scanning (The Urokinase Pulmonary Embolism Trial, 1970, 1973; Hyers et al. 1970). Because of the ralatively small size of the Trial and the low mor tality of treated pulmonary embolism, mortality differences were not sought-nor was one found. Although there was early difference in amount of clot resolution, patients treated with H alone showed similar improvement by two weeks. The phase II Urokinase-Streptokinase Pulmonary Embolism Trial (USPET) was begun to assess the comparative results of UK and Streptokinase (SK) therapy. Because of favorable results obtained with SK in other countries, it was deemed necessary to make this comparison (Browse and James, 1964; Hirsh et al. 1968; Miller et al. 1969, 1971; Chesterman et al. 1969). A third group, 12-hour UK, was added to relate this study (24-hour UK and SK) with the Phase I results which employed only a 12-hour infusion of UK. This Phase II Trial represents the first controlled, randomized study of UK and SK in thromboembolic disorders.


The search for a human equivalent of the mouse T-locus - negative results from a study of HL-A types in spina bifida. The spina bifida/anencephaly complex in man in some ways resembles the effects of T-locus mutants in the mouse. To test the hypothesis that these entities are genetically related, HL-A typing was performed in families with multiple cases of central nervous system abnormality. No evidence of linkage was found between HL-A type and the congenital malformation.


Renal transplantation and cancer. The Scandia transplant material. Between 1965 and 1973, 30 malignant tumours were found in patients transplanted in Scandinavia. Of these tumours, 24 were found in the 1,254 patients transplanted in Scandinavia as part of the Scandia Tranplant Programme between 1969 and 1972. Using the information recorded in the programme, 418 Danish patients who received their first and only transplant between 1969 and 1972 were selected and followed until 31/12 1973. Twelve tumours occurred in these patients. A comparison with the expected age, sex and time-specific incidence rates from the Danish Cancer Register was made and the observed tumour incidence was found to be significantly (P less than 0.001) greater than expected. Tumour incidence was found to be associated with incompatibility in the FOUR series, but was unrelated to number of rejections, the presence of HL-A antibodies and sex difference between donor and recipient. Apart from certain special forms of immunosuppression which could be oncogenic, the cause of tumour development appears to be multifactorial, both the allograft itself and immunosuppressive treatment playing a role.


A new method for the screening of unidentified complaints syndrome in pre-, mid- and post-menopausal women. A new simple test for the screening of pre-, mid- and post-menopausal women with unidentified complaints overlaid by psychiatric disorders has been devised. This test is performed by intravenous injection of conjugated estrogen and by comparing Kupperman's menopausal indices before and after the injection. That is, the discriminant function between groups with and without psychiatric abnormalities was obtained from Kupperman's menopausal indices before and after intravenous injection of conjugated estrogen, and from this function was made a calculative differential diagnosis between the two groups. The calculative diagnosis agreed fairly well with the clinical diagnosis by the psychiatrist.


[Studies of the method and distribution of prosthetic care]. Studies on the kind and the distribution of prothetic care. The present paper gives a survey of the achievements of the Prosthetic Service of the Stomatological Clinic at Jena during the years 1961-1970. The studies involved the number of patients who had presented for prosthetic treatment, the most frequent age groups and the kind and extent of prosthetic work.


[Clinical aspects and etiology of prosthesis-induced changes in the oral mucosa]. The clinical picture and the aetiology of prosthesis-induced alterations of the oral mucosa are presented. In the light of personal gerontological observations, the authors deal with the mechanical irritation produced by the prosthesis as the main aetiological factor and discuss its effects on prophylaxis, diagnosis and therapy.


[ Problems of wound dressing after gingivectomy in the periodontally diseased incomplete dentition (report of treatment) ]. After some remarks upon the value and the importance of periodontal surgical dressing in general and in case of incomplete dentition in particular, the author reports of a case in which a temporary plastic bridge had been combined with a dressing plate. This combination may also be recommended as a model to busy stomatological practices.


A reconsideration of immunological privilege within the anterior chamber of the eye. The immunologically privileged status of the anterior chamber of the eye has been confirmed on the basis of skin and thyroid allografts with use of inbred strains of rats. Skin grafts, transplanted across both major and minor histocompatibility barriers, enjoy prolonged survival within the anterior chamber. However, several factors have been found to restrict the privilege exhibited by this site: the magnitude of the immunogenetic disparity between donor and recipient, graft size, type of tissue grafted, and, at least in the case of thyroid grafts, the endocrine status of the host. Although a defect in the afferent limb of the immune response has been the popular explanation offered for immunological privilege in an alymphatic site, this was not the basis of the privilege encountered in the anterior chamber. Furthermore, because the efferent limb of the immunological reflex are within the anterior chamber has been demonstrated to be intact, it was suggested that the unique properties of the anterior chamber may depend upon the forced intravascular presentation of antigen and consequent aberrant central processing.


The effect of cyproheptadine (periactin) on rejection of rat kidney allografts. The effect of cyproheptadine, a potent platelet deaggregator, was investigated in rats bearing renal allografts. Thirty-three bilaterally nephrectomized LEW rats received orthotopic transplants of a (LEW X BN)F-1 kidney. Fourteen rats were treated with cyproheptadine, 1.5 mg/kg i.m. daily, for 60 days after transplantation; the remaining animals served as controls. The median allograft survival time in the cyproheptadine group was prolonged to 64 days compared to 12 days in the untreated group (P less than 0.005). In the cyproheptadine group the blood urea nitrogen rose to over 150 mg/100 ml 1 week after transplantation, fell to 80-120 mg/100 ml, and then rose steadily from the day after transplantation until the death of the animals. Despite prolonged survival, cyproheptadine-treated animals usually showed the histological findings of acute and chronic renal rejection. Cyproheptadine may be a useful adjunct to immunosuppression in the management of human renal allotransplantation.


Therapy against brain swelling in stroke patients. A retrospective clinical study on 227 patients. The effectiveness of cerebral antiedema agents in stroke has been questioned. Animal and clinical work is inconclusive about steroids and osmotic drugs. A retrospective study of a continuous series of 227 stroke patients treated in the acute stage (some with dexamethasone alone, some with dexamethasone plus hyperosmotic mannitol infusions, and some without antiedema therapy) showed no significant difference in the ten-day survival rate. On this criterion, there is no ground for the systematic use of such agents against this type of brain swelling.


Shifts from IgG-2 class to IgG-1 class in CBA and C3H anti-BALB/c antibody. With use of a recently developed method for determining relative levels of IgG-1 and IgG-2 class antibodies of a given specificity within an unfractionated serum, it has been possible to examine anti-BALB/c antibodies in the early and late part of an immunization with allogeneic spleen cells. At about 6 days after primary immunization of CBA or C3H mice with BALB/c spleen cells, suppressive antibodies can be measured in the sera of the animals. About half of these are attributable to IgM class, and this contribution decreases to zero by the 12th day. The remaining suppressive antibodies are of IgG-2 class and these increase in concentration until day 8 or 12, or begin to decline between day 8 and day 12. Anti-BALB/c antibodies of IgG-1 class have not yet appeared on day 6, but thereafter appear and increase in concentration. Thus, antibodies of IgG-1 class begin to appear after those of the IgG-2 class and may still be increasing after the IgG-2 class has stopped to increase in concentration, antibody of IgG-1 class is continuing to increase and may even continue to increase after IgF-2 class antibody has begun to decrease in concentration. Thus, the synthesis of IgG-1 class antibody begins later and continues later than that of IgG-2 class. The implications of this sequence for our data on various effects of anti-H-2 antibodies on retention of skin allografts are discussed.


A mixed antiglobulin test with kidney cells in suspension for IgG antibody in human allograft recipients. A modification of the mixed antiglobulin test for the detection of IgG antibodies directed against human kidney cells has been devised which uses a suspension of individual kidney cells rather than a monolayer culture as antigen so that it may be enployed clinically as a prospective crossmatch for organ transplantation. The antiglobulin reagent is added to the sensitized kidney cells rather than to the indicator erythrocytes, which reduces the background of nonspecific reations almost to zero. It is reproducible. The mixed antiglobulin test detected antibody in the sera of patients on chronic dialysis two to four times more frequently than did either the immune adherence test or the most sensitive modification of the microlymphocytotoxicity test which was utilized. It detected the development of antibody specific for donor kidney cells in the sera of 5 of 10 allograft receipients during periods of good to moderate renal transplant function several months before rejection.


Comparison of blood flow and patency in arterial and vein grafts to basilar artery. Blood flow and patency rates obtained by lingual to basilar artery anastomosis were compared with those obtained by saphenous vein bypass graft from the carotid to the basilar artey in two groups of ten dogs. Flow was measured by an electromagnetic technique while blood pressure and blood gases were monitored. Graft patency also was determined by angiography and histological examination. The arterial and venous grafts carried more than enough blood to maintain a normal flow (9.5 ml per minute) through the basilar system of dogs. Immediately after anastomosis, average flow through the vein grafts was 15.5 ml per minute (range 10 to 24 ml per minute). Six weeks later, average flow through the vein graft was 11.5 ml per minute and through the arterial graft 13 ml per minute. With induced hypertension, flow increased in the arterial grafts to an average of 26.2 ml per minute and in the vein grafts 24 ml per minute. Hypercarbia increased arterial graft flow to an average of 27.8 ml per minute and vein graft flow to 23.5 ml per minute. By angiography, graft patency was shown in only 80% of the grafts at one week and in 60% at six weeks postoperatively, even though all grafts were patent by flow and histological determinations. This failure of angiography represents a limitation of the radiographical resolution in millimeter-sized vessels.


Thymectomy as immunosuppression in uremic patients. Five uremic patients awaiting renal transplantation underwent transcervical thymectomy in an evaluation of the immunosuppressive effect of removal of the thymus in such transplantations. A number of immunological parameters, including lymphocyte transformation tests, were followed in these patients for up to 30 weeks after thymectomy. The number of B lymphocytes in the blood, stem cells in bone marrow, and T lymphocytes in lymph nodes decreased, whereas IgG, IgA, and IgM in four cases and C3 complement in all five cases increased. Blood leucocyte and lymphocyte counts did not show any characteristic changes. The T cell response of circulating lymphocytes was determined after stimulation with mitogens, specific antigens, and allogeneic cells in mixed lymphocyte culture, and showed a large increase. Thymectomy of uremic patients results in a considerable increase in immunocompetence in the first 30 weeks, indicating that it is not suitable as an immunosuppressive treatment.


Studies on the stability of antilymphocyte globulins. An account is given of the effect of storage under various conditions on the physical and immunosuppressive properties of antilymphocyte globulins. No loss of in vivo immunosuppressive potency was shown by horse antimouse lymphocyte globulin when stored for up to 2 years in a liquid, frozen, or lyophilised state. Similar studies on horse antihuman lymphocyte globulin showed no loss of in vitro activity, as measured by an immunofluorescence test. Ultracentrifugal analyses showed no increase in aggregate when antilymphocyte globulin was stored liquid or freeze-dried at 4 degrees C. Storage experiments at abnormally high temperatures demonstrated that under these conditions freeze-dried horse antihuman lymphocyte globulin was stabilised by the presence of glucose (4.6%w/v). Antilymphocyte globulin lyophilised in the presence of glucose showed improved solubility properties as compared with material dried from saline.


The response of the lymphoid system to renal allografts in sheep. The immunological events which occur in lymph nodes situation regional to renal allografts have been studied by collecting lymph from these nodes and monitoring the changes in its cellular and humoral antibody content. Simultaneously, reactions occurring in the renal allograft and in lymph nodes distant to the graft were also monitored in the lymph from these organs throughout thelife of the graft. Large basophilic lymphoid cells appeared first in lymph from the renal allograft at around 48 hr postgrafting, whereas these cells did not appear in the lymph from the regional node until 80-100 hr after the graft was installed. Lymphoid blast cells were not seen inany significant numbers in lumph from nodes situated at a distance from the graft. The first detectable antibody was produced by the regional lymph node between 110 and 175 hr postgrafting, andin other undetermined sites within the next 80 hr. Antibody was not synthesized in any detectable amounts by the graft or by lymph nodes situated at a distance from the graft. The antibody which was present in the lymph from the regional node was produced primarily by fixed cells which remained in the node, and very little antibody was produced by the lymphoid cells which migrated from the node in efferent lymph. The cells in the lymph from the renal allograft produced only small amounts of immunoglobulin. Cells present in lymph from the renal allograft and in lymph from the regional lymph node actively synthesized and secreted significant amounts of nonimmunoglobulin proteins which were separated on Sephadex G-200 columns into peaks which coincided with 19S, 7S, and 4S proteins. The identities and biological activities of these proteins have not yet been determined.


Studies of the behaviour of allogeneic cancellous bone grafts in inbred rats. The degree of new bone formation in isografts and allografts has been assessed by a radiotracer technique. Allografts used have been either H-1-identical or H-1-disparate with the recipient. It was found that new bone formation is curtailed within the first 3 weeks after grafting. This curtailment was significantly greater in those donor-recipient combinations which were H-1-identical but disparate for many weak locus antigens than those in which H-1 disparity existed with only a few minor locus differences. There was no late phase (i.e., host-derived) osteogenesis in the combination with H-1 identity, but multiple minor antigen disparities. In isografts and H-1-disparate grafts significant late phase osteogenesis was found in about 30% of recipients. Resorption of the graft was found to be significantly impaired in both H-1-identical and disparate grafts in comparison with isografts. There was a significant negative correlation between weight of the graft and degree of osteogenesis in isografts during the first 2 weeks after grafting, and also during the later phase (6-8 weeks). A similar negative correlation was found during the late phase in H-1-disparate grafts with few minor antigen disparities, but no correlation was found at any time in H-1-identical grafts with multiple minor antigen disparities.


[Study of invertebrate soft tissues by the smear technic in light and electron microscopy]. A soft tissue is smeared on the surface of an araldite plate, and after fixation is coated by an araldite film. After examination with the light microscope, the araldite slide may be distributed for histological or ultrathin serial processing. The method provides an adequate conservation of cellular structures.


The pathophysiology of renovascular hypertension. Renovascular hypertension, comprising a small percentage of the total hypertensive population, stands out as remarkably important, being the most common cause of surgically correctable hypertension. Its precise diagnosis can be accomplished by judicious application of recently available sophisticated laboratory methods and correct prediction of curability is now possible. Careful selection of cases among the vast numbers of hypertensives by routine screening procedures is essential. The selected few deserve more complete studies including bilateral renal vein renin measurements. Rapid sequence pyelography, split function studies, radioisotope renorgram, and renal arteriography accurately define the presence of a significant structural abnormality involving the renal circulation on either side. Significant bilateral renal vein plasma renin differential, done under appropriate conditions of volume depletion and upright posture, in the absence of interference by concurrent antihypertensive drug therapy, establishes a causal relationship between the structural abnormality and the high blood pressure. A thorough knowledge of the normal physiology of the renin-angiotensin-aldosterone system and its inappropriate response in renovascular hypertension and other related clinical conditions is clearly necessary if one is to plan diagnostic studies intelligently and interpret the results correctly.


New concepts of the renin system and of vasoconstriction-volume mechanisms. Diagnosis and treatment of renovascular and renal hypertensions. Information defining the renin-angiotensin-aldosterone axis as a control system concurrently regulating salt balance and blood pressure has been applied to examine the role of renin in the causation of experimental and clinical forms of renovascular and renal hypertension and thence to develop criteria for differentiating these entities. Experimantally there are two models of renovascular hypertension, one characterized by excess renin with reduced sodium (vasoconstrictor form) and the other by excess sodium with reduced renin (volume form). But with sodium depletion, the volume form switches to a vasoconstrictor form, illustrating how the two factors coordinate to maintain blood pressure. Human renovascular and renal hypertensions appear to be sustained by the same two mechanisms. Experimental and clinical studies both indicate that curable renal hypertension is in fact a renin-dependent vasoconstrictor hypertension. Three criteria, derived from four renin measurements, identify this situation: (1) Hypersecretion of renin is reflected by a high peripheral level when referenced against sodium excretion. (2) Lacteralization of renin secretion with contralateral suppression rules out occult bilateral disease. It is indicated by V-A = 0 from the uninvolved kidney. (3) A third criterion, (V-A)/A greater than 48 per cent from the ipsilat-eral kidney, identifies renal ischemia. These three criteria, when taken together in a combined scoring analysis, provide high precision in identifying the patient with the vasoconstrictor form of renal hypertension that is potentially reversible by appropriate surgery. Absence of these criteria identifies hypertension associated with either occult or overt bilateral renal disease. In these patients, the volume factor often predominates and is expressed by some suppression of plasma renin levels. Here, removal of renal tissue is contraindicated. Corroborative evidence to support these three criteria can be developed from the blood pressure response to angiotensin blocking drugs or to anti-renin therapy with propranolol. Thus in all of these renal hypertensions, the vasoconstrictor and volume factors can be identified using renin measurements and pharmacologic interventions.


Renal autotransplantation and ex vivo renal surgery: surgical treatment of renovascular hypertension. Autotransplantation of the kidney has proved to be an extremely valuable surgical alternative for the treatment of renovascular hypertension. The modern operation is founded in landmark surgical experiments performed during the early years of this century. Despite the relative technical simplicity and considerable potential application of renal autotransplantation, the operation was not employed for at least a decade following the more uncertain initial clinical adventures in renal allotransplantation. Since its inception, however, the successful use of renal autotransplantation for renovascular hypertension has been well documented in a relatively small but impressive series of clinical situations. Renal autotransplantation in the surgical management of renovascular hypertension appears to afford many technical advantages vis-à-vis in situ renal revascularization including the option to perform meticulous ex vivo reconstructive surgery. The need to interrupt the renal circulation during renal autotransplantation and the possibility that the ischemic operative interval might result in renal cellular damage, has been a deterrent to greater consideration of this surgical alternative. Cold perfusion of the ischemic kidney has been regarded as "inherently" necessary in order to prevent intravascular coagulation and to protect the kidney through the use of hypothermia until the circulation is re-established. A wide variety of perfusates and methods of perfusion have been successfully employed for these purposes. A new perfusate has been formulated which is intended to help prevent the rapid and profound changes in the amounts of distribution of intracellular electrolytes and water which are known to occur when the kidney is deprived of its circulation. This solution appears to be effective in preventing significant damage in ischemic canine kidneys during at least three hours of normothermic exposure, and at least five hours of ambiothermic exposure following a single initial cold perfusion. The various perfusates and methods of renal perfusion for clinical and experimental renal autotransplantation and ex vivo renal surgery are herein compared and contrasted with regard to their proposed mechanisms of action, apparent effectiveness, and simplicity of application.


[Indication, techniques and results of the operative correction of hypospadias using modification of the original Denis Browne technique (author's transl)]. The experiences with operative correction of hypospadias 416 patients are reported. In 264 of these patients the correction of the hypospadic deformity was completed, using the original Denis Browne technique or a modification described by Marberger. The results and the complications are demonstrated.


[First experiences with the incontinence operation Kaufman III (implantation of a silicongel prothesis covered with polyurethanfoam) (author's transl)]. For operative treatment of urinary incontinence after TUR of the prostate, radical prostatectomy and meningocele operation the silicongel prothesis described by Kaufman was implanted. By compression of the bulbus urethrae a sealing effect was achieved. The pressure of the detrusor opens the urethra enough to enable urination. Seven patients were operated. The results directly after the operations were: three very good, two good and two bad. We achieved very good results by implantation of the prothesis "large" -in the case of the two bad operative results we used the "medium" size prothesis. By filling these protheses with 5 ml liquid they proved to be leaky. One of these was operatively removed and replaced by the size "large". This patient later developed a urethra stricture in the implantation region with overflow bladder after having been continent. By internal urethrotomy this condition was restored; except for minor dripping after miction the patient was continent. The prothesis of a direct postoperative continent patient had to be filled. This led to and infection with the development of fistula. The prothesis had to be removed. A further patient who sat on a hard object developed a lesion of the prothesis with resulting incontinence. At least six months after the operations four patients remained continent and three incontinent.


[Operative theatment of male pseudohermaphroditism (author's transl)]. The operative treatment of two patients with male pseudohermaphroditism is reported. The patients reported were girls whose psychosexual attitude indicated a male sexual change. During several procedures the vagina was removed, the urethra was extended according to the method of Denis-Browne and a functioning penis was formed using a skin flap plasty supported by rib cartilage or an artificial prosthesis.


[Autovenous aorto-coronary shunting].

[Autovenous aorto-coronary shunting]. It is emphasized that the results of aorto-coronary shunting depend on the shunt patency. It is the author's opinion that the shunt patency is influenced by many factors, among which morphological changes in the wall of the venous graft are of great importance. The technic of taking the large saphenous vein in patients, its preparation for transplantation and a selection of the venous segment for grafting are described.


[Conservation of the lung in the course of 2 to 24 hours with delayed autotransplantation in the experiment]. Opportunities of preservation of the lung at +4 degrees C and in association of this temperature with hyperbaric oxygenation during 2 and 24 hours with postponed autotransplantation have been studied. In 74 experiments on dogs postponed autotransplantation of the lung was performed, including 46--with preservation during 2 hours, and 28--with preservation during 24 hours. Based on the studies carried out, it was found that in preservation of the lung during 2 hours at +4 degrees C or in association of +4 degrees C and hyperbaric oxygenation the lung could be successfully employed for postponed autotransplantation. It is felt that there is no considerable difference between the results of experiments with postponed autotransplatation of the lung in preservation during 2 and 24 hours, depending on different conditions of preservation.


Pediatric renal transplantation.

Pediatric renal transplantation. Thirty-one children received 38 kidney transplants from 22 live and 16 cadaver donors. Among the 31 patients, 25 received one transplant each, 5 received two transplants each and 1 received three transplants. Peritoneal or hemodialysis (or both) was carried out in 22 patients, with an average dialytic maintenance of 12 weeks before transplantation. Posttransplant immunosuppressive therapy included prednisone and azathioprine. Antilymphocyte globulin was administered to 33 recipients as adjunctive immunosuppressive therapy. At present, 23 patients have functioning allografts, 3 are on hemodialysis and 5 are dead. Of 22 live kidney transplants, 18 are presently functioning two months to 14 years after transplantation with an average of 36 months. Of 16 cadaver kidney transplants, 5 are presently functioning 9 to 57 months after transplantation with an average of 32 months. Actuarial live donor allograft survival for one year was 76 percent, for two years was 66 percent and for three years was 64 percent. Cadaver allograft survival was 50 percent, 40 percent and 40 percent, respectively. Complications were urologic and infection related. Of nine recipients with sustained hypertension, in six the condition was due to chronic rejection, while in one it was due to recurrence of the original disease in the allograft. Linear growth was measured in 15 children who were less than 14 years of age at the time of transplantation and in whom allografts survived more than one year. Maximum average linear growth velocity occurred during the first year after transplantation. Our experience indicates pediatric renal transplantation can be successfully used in the treatment of terminal renal failure.


An incubation flask to study metabolism of foreign compounds by intestinal microflora. 1. The design and procedure for use of an all-glass incubation flask which facilitates the production and maintenance of an anaerobic environment suitable for the study of drug metabolism by intestinal microflora is described. 2. Evaluation was based on monitoring available oxygen with an oxygen electrode. 3. Removal of air by the combination of replacement with hydrogen, a room temperature catalyst and a fluching technique, produced low oxygen levels comparable to vacuum systems without the need for adverse pressure changes.


Significance of amniotic fluid phospholipid determination for the prediction of neonatal respiratory distress syndrome. 198 amniotic fluid samples, obtained from 14-42 weeks of 158 patients were assessed for amniotic fluid phospholipids (total phospholipids, lecithin, sphingomyelin, lecithin/sphingomyelin ratio). The TPLP and Lec-concentrations show significant rises in concentration after 34th week whereas the sphingomyelin concentration remains virtually constant during pregnancy. L/S ratio remains relatively constant smaller than or equal to 2 prior to 32 weeks and smaller than or equal to 3 between 32 and 34 weeks but shows then a steep rise. The amount of Lec (expressed as percentage of total phospholipid concentration) rises from 30-40% at 30 weeks to 70-80% at term whereas the amount of Sph declines from 30-40% to less than 10%. In 12 cases neonatal RDS occurred. With L/S ratio treshold values of 3 correct prediction of RDS was made in 83% of cases, whereas probability of RDS occurrence was 63%. With L/S ratio values greater 3 RDS can be excluded in 95% of cases. The corresponding figures for Lec and TPLP concentration are described too. The range of different results in the literature is discussed.


[The amniotic infection syndrome and premature rupture of the amnion. Manifest and threatening unspecific intra-uterine infections of the last third of pregnancy (author's transl)]. In the last third of pregnancy the unspecific bacterial diseases of placenta, umbilical cord and membranes differ from those in earlier months [154; 155; 85]. There is a parallel change in the localization of fetal organs affected. Pathologic anatomical clarification of this led to the conceptual definition of the rare extra-amnial placental-fetal path of infection on the one hand and of primary intra-amnial infection with secondary chorion-amnionitis on the other hand and to identification of the amniotic infection syndrome as a typical entity at the end of pregnancy [19]. While the amnionic sac is closed, unspecific fetal inflammation is rare. Generally this happens only after rupture of the membranes. Since the amniotic infection syndrome often produces only minor clinical symptoms and since fetal infection probably starts early, one searched for means of assessing the risk of infection independently from symptoms. In comparative series of investigations of pregnancies with and without premature rupture of the membranes, cases of neonatal death from infection were preceded by signs of inflammation in placenta, umbilical cord and membranes. Together with the fetal and maternal infections they depended on the length of time between rupture and the onset of labor. pns. The data now available give a clear picture of the development of the inflammatory processes in mature and premature children and suffice for the assessment of fetal and maternal risks.


Determination of serum nucleotidase with cytidine monophosphate as substrate, (I). This paper deals with a new method for the determination of serum nucleotidase (EC 3.1.3.5). The assay is performed with cytidine-5'-monophosphate as substrate, followed by deamination of the generated cytidine. The principle of the method and the determination of the liberated ammonia by the Berthelot indophenol-reaction are comparable to the Persijn--van der Slik method in which adenosine-5'-monophosphate is used as substrate. The correlation between the results obtained with these two methods was found to be good; the new method has the advantage of higher sensitivity.


[Themistocles Gluck (1853-1942), pioneer in endoprosthetics]. There ist reported about the surgeon Prof. Themistocles Gluck, who first invented endoprostheses from ivory in 1890 at Berlin. So we believe, that he was the pioneer in endoprosthetics.


[Results of treatment of congenital hip dislocation by extensionrepositioning and Hanausek-retention]. In the past 4 years all our patients below the age of three years, suffering from luxation or dysplasia of the hipjoint, were treated only conservatively. For repositioning we used a modified overhead-extension (Extensionsreposition). The "Hanausek-Apparat" was used only for retention. By this method all luxations  could be reponed. Because of the low rate of re-dislocations and femur-head-nekroses, which decreased significantly from 23 per cent to 3.9 per cent, our method proved to be superior to manual repositioning under general anaesthesia, plaster-extension or early operation.


[The personality of children with weak posture]. An attempt is made on two groups of children with weak posture and of normal children aged 8 to 10 years to demonstrate a statistical link between fibrous tissue-weakness and certain psychological characteristics. In tests and observations of experiences and behavior of children one finds: Compared with the controls the children  showing symptoms suffer psychosomatic changes. The cause is held to be not just increased psychomotor clumsiness, but their behavior pattern is essentially due to psychological pressure of their environment (parents, school, friends etc). This leads to: reduction self-confidence, increased experience of failure, hypercompensatory view of the self with strong criticism of others and again physical dysfunction. To offer treatment is not enough. We have to demand a spread of information, cooperative efforts of teachers , school-physicians and parents and education by team-work.


Studies on the energetic metabolism of Shigella flexneri and Escherichia coli hybrids devoid of penetration ability. II. Oxygen uptake and dehydrogenase activity. Oxygen uptake and dehydrogenase activity are studied with lac+ kcpminus hybrids of Shigella flexneri, being avirulent to the eyes of guinea pigs, because of having lost ability for penetration in epithelial cells. These strains were obtained by hybridization of the virulent strain Shigella flexneri 222 5 a with the Hfr strain Escherichia coli K-12 P4x. It is established that lac+ kcp minus hybrids are characterized by significant decrease of respiratory activity. This decrease is outlined as a tendency studying O2 uptake and is extremely well expressed studying the dehydrogenase activity. The tests being performed with these hybrids show that the loss of virulence and connected with it the loss of the ability for penetration is related to a decrease of the respiratory activity of these bacteria which supply a part of the energy needed for their viability.


[The anodic-moving thermolabile antigen (ATA) of gram-negative bacteria: its occurrence in rough mutants of shigella flexneri and Escherichia coli(author's transl)]. The thermolabile antigen (ATA) moving to the anode, discovered by us (9) and also described by LARSSON et al. (8), could be detected in Ra-, Rb-, Re- and Rd-mutants of Sh. flexneri and, in smaller amounts, in Rd- and Re- mutants of E. coli O8:K27:H. So it proves to be different from KUNIN'S common antigen (7). Our results lead to the conclusion that ATA is located in a more inner part of the bacterial cell wall and is fixed by noncovalent linkages.


Occurrence of megasphaera elsdenii in faecal samples of young pigs. Important numbers of Megasphaera elsdenii, known as a normal inhabitant of the rumen of cattle and sheep were recently cultured from intestinal contents of man and pigs. Studying the occurrence of this organism in faecal contents of pigs, we paid attention to the use of a strict anaerobic isolating and counting technique. It was demonstrated that Megasphaera elsdenii is a strict anaerobic organism. Exposure to air during 15 minutes caused an important decrease of the colony count. Comparison of the biochemical properties of some isolates with the data of other investigators is given. Pigs isolates were nearly similar to rumen strains.


In vitro study of the influence of virginiamycin and spiramycin on the composition and biochemical activities of the gastrointestinal flora of piglets. I. influence on the composition of the flora. In vitro fermentations with the gastro-intestinal flora of 18 treated piglets (Control, Virginiamycin, Spiramycin) were carried out to study the influence of Nutritional doses of Virginiamycin and Spiramycin on the composition of the microflora. Each total flora was used for three different incubations: Control, 50 ppm Virginiamycin, 50 ppm Spiramycin. To obtain comparable results with experiments in vivo, an artificial fermentation medium was made on the basis of several chemical analyses of intestinal contents. The treatments with nutritional doses in vivo had little influence on the different in vitro fermentations. Addition of Spiramycin during incubation was of little influence on the growth and the composition of the flora. Virginiamycin on the other hand caused marked changes in the gastro-intestinal microflora, such as a decrease of the total growth and a decrease in the number of Lactobacilli and Enterococci, combined with a slight increase of the Gram negative aerobic population.


[Nocardia pellegrini: III. An attempt of phage typing(author's transl)]. The typing of Nocardia pellegrini with different Nocardia-phages was studied. The investigation included 25 Nocardia pellegrini strains, 19 strains of different Nocardia species and also strains of different species of mycobacteria. It could be stated that phages typical for Nocardia pellegrini were also active against other fast fragmentating Nocardia species, such as Nocardia corallina or Nocardia rubra. However, they did not attack Nocardia asteroides or strains of mycobacteria. Phages typical for mycobacteria or for Nocardia asteroides did not lysate the fast fragmentating nocardia (Table 1 and 2). Mutants of one Nocardia pellegrini phage could be isolated which showed a broader host range than the parent phage (Table 1 and 2). Some lysogenic strains of Nocardia pellegrini with a changed phage sensitivity could be isolated after action of the phages (Table 3). The taxonomical position of Nocardia pellegrini and Nocardia rubra is discussed.


Studies on the immunizing capacity of orally administered particulate antigens. II. Production of immunological memory in germ-free mice by orally administered sheep erythrocytes. A study was perfromed to find out, whether or not the oral administration of sheep erythrocytes results in a general primary immune reaction as well as in effective priming for the secondary response in both conventional and germ-free NMRI mice. Whereas negative results were obtained with conventionally held mice, five oral applications of 0.3 ml of a 60% suspension of sheep erythrocytes to germ-free mice, each dose separated by an interval of 24 hr, resulted in a general primary immune response both at the cellular and humoral levels. When such pretreated mice were given an i.p. injection of 4 times 10(8) sheep erythrocytes as a secondary antigenic stimulus 32 days after the last of the five oral applications, the subsequent response was characterized by the predominant development of 7S hemolysin-producing spleen cells. This evidently indicates that effective priming for the secondary response has taken place by the orally administered antigen.


[Laboratory procedures in adenoviruses. II. Sensitivity of various cell cultures as determined by endpoint titration (author's transl)]. The sensitivity of human embryonic kidney (HEK), human amnion (HAm) and HeLa cells for human adenoviruses was investigated by means of endpoint titrations of 13 prototype strains and numerous original specimens from patients. Prototypes and original specimens showed the same behavior. Adenoviruses of subgrouppp III produced nearly identical titers in all 3 cell cultures, while for subgroup I HAm cells showed a 10- to 100-fold lower titer. On the other hand, HAm cells are nearly as sensitive as HEK cells for type 8, whereas HeLa cells are less sensitive. For other viruses of subgroup II and for subgrou IV, HAm (for type 12 also HeLa) cells are less sensitive than HEK cells. Out of three HeLa cell strains tested the Bristol strain was inferior to the other two in its sensitivity. Concerning the speed of the CPE development, HEK cells are superior for all types, the difference being greatest for subgroup I towards HAm and HeLa and for type 8 towards HeLa cells. The length of incubation necessary for the appearance of CPE even with minimal amounts of virus is 40 days for type 8 in all kinds of cell cultures, whereas for adenoviruses of sub-groups I and III, which are predominantly isolated in the routine laboratory, 25 days for HEK and 30 days for HAm and HeLa cells may suffice in most cases. When endpoint titrations are compared with titers obtained by immunofluorescence, it appears that this technique may be applied as a screening method; thus long incubation periods of negative specimens can be saved. The amounts of infectious virus present in original specimens are reported; the highest quantity was found in specimens containing subgroup I viruses.


[Qualitative und quantitative salmonella investigations and their hygienic valuation in connection with the E. coli titre, demonstrated with examples from the coastal waters of Kiel bight (Western Baltic Sea) (author's transl)]. Qualitative salmonella investigations and E. coli titre determinations were carried out in about 4,000 water samples taken from the coastal region of Kiel Bight (Western Baltic) in 1972 and 1973, and evaluated in connection with epidemiological data. Further, about 100 samples were determined quantitatively by the MPN method and set in relation to the E. coli titre. The significance to be attributed to positive salmonella findings particularly in relation to the assessment of risk of infection and as impurity indicators was investigated with reference to this material. A comparison of salmonella findings and E. coli titre showed that with increasing E. coli contamination the proportion of positive salmonella findings also increased (paraboloid curve). Salmonella frequencies and the frequency with which the limiting values of the E. coli titre is exceeded run approximately parallel; the frequency of exceeding a limiting value of E. coli titre of 1.0 and the frequency of salmonella (determination in 100 ml) in sewage laden areas largely coincide. The quantitative salmonella investigations (MPN method) also showed that up to an E. coli titre of 1.0 extremely low salmonella counts only are to be expected (on the average, less than 2/100 ml). With an E. coli titre of 0.1, a marked increase can be seen. A limiting value of 1.0 is proposed for the E. coli titre in coastal waters. Epidemiological data have also shown that an increased risk of infection could not be deduced from positive salmonella findings. According to the present investigations, the value of the information obtained from salmonella findings is small compared with the E. coli titre. Considering the great expense of laboratory investigations, tests for salmonella should be dispensed with in routine examination of water.


[Bacteriological and parasitological investigations in public indoor swimming baths (author's transl)]. The importance of the public swimming bath for the dissemination of Trichomonas vaginalis is disputed. 30 samples, each of 250 ml bath water from four indoor swimming baths, were examined for trichomonads. All the samples were negative. 218 smears taken from the wet places on the heated benches and other seating accommodation in these swimming baths were cultured for trichomonads and bacteria. Trichomonas vaginalis could not be demonstrated. Fecal organisms were found in 56 places, antibiotic-sensitive staphylococci were cultured from 20 samples and Ps. aeruginosa from 8. The negative tests for trichomonads suggests that the indoor swimming bath has no epidemiological importance in the dissemination of this parasite.