Sulfonamide resistance mechanism in Escherichia coli: R plasmids can determine sulfonamide-resistant dihydropteroate synthases. Several natural isolate E. coli strains highly resistant to sulfonamides and antibiotics are shown to contain a sulfonamide-resistant dihydropteroate synthase (2-amino-4-hydroxy-6-hydroxymethyl-7,8-dihydropteridine-diphosphate:4-aminobenzoate 2-amino-4-hydroxydihydropteridine-6-methenyltransferase, EC 2.5.1.15) in addition to the normal sensitive enzyme. The resistant dihydropteroate synthases examined are determined by an R plasmid and are smaller and less heat stable than the normal sulfonamide-sensitive enzyme. One synthase resistant to any sulfonamide tested, and to sulfanilic and arsanilic acids, was still inhibited by several non-sulfonamide analogs of p-aminobenzoate. Citrobacter and Klebsiella pneumoniae strains also show similar mechanisms of sulfonamide resistance.


Release of (oligo) peptidyl-tRNA from ribosomes by erythromycin A. Erythromycin A released peptidyl-tRNA in the in vitro polypeptide synthesis system with bacterial components programmed by synthetic polynucleotide. This is consistent with our hypothesis that erythromycin A inhibits translocation by preventing proper situation of oligopeptidyl-tRNA in the donor (D) site on ribosomes.


Origin of hemopoietic stem cells in embryonic bursa of Fabricius and bone marrow studied through interspecific chimeras. The histogenesis of the bursa of Fabricius and of bone marrow was studied by a biological cell marking technique based on differences in the nuclear structure of two species of birds, Japanese quail (Coturnix coturnix japonica) and chick (Gallus gallus). In quail cells the nucleus contains a large amount of heterochromatin associated with the nucleolus. That makes it possible to distinguish them from chick cells after Feulgen-Rossenbeck staining and by electron microscopy. By grafting bursal rudiments and limb buds of quail into chick and inversely it was possible to demonstrate that the whole hemopoietic population of the bursa of Fabricius and of bone marrow is derived from bloodborne extrinsic stem cells. Neither endoderm nor mesoderm of the bursal rudiments is capable of differentiating into lymphoid cells. Combinations of quail bursal endoderm with chick homologous mesenchyme showed that the reticular cells of the follicles are the only endodermal derivatives of the bursa. The mesenchymal bursal component gives rise to the interfollicular connective cells. The contribution to bone marrow histogenesis of cells of vascular and blood origin, on one hand, and of the elements of the cartilaginous model, on the other hand, was analyzed. It appeared that osteoblasts, osteocytes, and stromal cells of marrow are derived from the perichondrium. In contrast, the endothelium of the vascular buds and the hemopoietic cells which invade the diaphysal cartilage during the endochondral ossification process do not belong to the mesenchymal bone primordium but have a fully extrinsic origin.


Conditional-lethal mutations that suppress genetic defects in morphogenesis by altering structural proteins. An analysis of revertants of missense mutants in phage P22 has shown: (i) New temperature-sensitive (TS) and cold-sensitive (CS) phenotypes are often acquired concomitant with reversion. (ii) In many cases, these new phenotypes are due to second-site mutations (suppressors) that correct the original defect. (iii) Sometimes the suppressor mutation is not in the same gene as the original mutation. (iv) Extragenic suppressors are almost always in genes whose products are known to interact physically with the original gene products. (v) The suppressor mutations typically retain their TS or CS phenotypes when crossed into wild-type genetic backgrounds. (vi) Some TS and CS mutants derived by reversion can themselves be reverted to produce additional mutations. We have shown that genetic reversion of missense mutants can be of value in producing new temperature-sensitive and cold-sensitive mutations affecting related functions. We suggest that our approach can be extended to organisms with large genomes.


Cluster of genes in Escherichia coli for ribosomal proteins, ribosomal RNA, and RNA polymerase subunits. The transducing phage lambdarifd18 isolated by Kirschbaum and Konrad [(1973 J. Bacteriol. 116, 517-526] was found to carry structural genes for several 50S ribosomal proteins and 16S and 23S rRNA. It has previously been demonstrated [Kirschbaum & Scaife (1974) Mol. Gen. Genet. 132, 193-201] that this phage carries genes for the DNA-dependent RNA polymerase (nucleosidetriphosphate:RNA nucleotidyltransferase; EC 2.7.7.6) subunits beta and beta'. Thus, the region of the E. coli chromosome carried by lambdarifd18 contains a cluster of genes essential for transcription and translation.


Inducible error-prone repair in Escherichia coli. A hypothesis that ultraviolet-induced mutagenesis arises from the induction of an error-prone mode of postreplication repair that requires the exrA+ recA+ genotype has been tested with alkaline sucrose gradient centrifugation coupled with assays of fixation determined by loss of photoreversibility. The inhibitor of protein synthesis, chloramphenicol, added before irradiation, prevented a small amount of postreplication repair and completely eliminated mutation fixation in E. coli WP2s uvrA. However, chloramphenicol did not affect strand joining: (a) in uvrA bacteria allowed 20 min of growth between irradiation and antibiotic treatment; (b) in nonmutable uvrA exrA bacteria; and (c) in uvrA tif bacteria grown at 42 degrees for 70 min before irradiation. These observations indicate that an inducible product is involved in a fraction of postreplication repair and is responsible for induced mutagenesis.


New chromosomal location for structural genes of ribosomal proteins. An Escherichia coli mutant, ts9, previously reported by Flaks et al. (Cold Spring Harbor Symp. Quant. Biol. 31, 623-631, 1966) to have an electrophoretically altered ribosomal protein, has been further characterized and the altered component has been identified as L7/L12. Although mutant ts9 is temperature sensitive for growth (rts-), the rts and L7/L12 mutations are genetically separable and are both located between argH and rif. The L7/L12 mutation (rpyL) maps very close to relC, mutants of which have a defect in the 50S ribosomal subunit. The gene order is argH-rts-(rpyL,relC)-rif. Protein synthesis directed by bacteriophage lambdacI857S7drifd18 in ultraviolet-irradiated cells indicates that L7/L12, As well as L1, L10, L11, and possibly L8 or L9 are coded by the phage DNA. Our results indicate that rpyL is the structural gene for L7/L12 and that this region of the E. coli chromosome contains a cluster of structural genes for ribosomal proteins.


A bacterial mutation blocking P2 phage late gene expression. A mutant of Escherichia coli strain C has been isolated, called gro109, that blocks bacteriophage P2 propagation by interfering with late gene expression. DNA replication proceeds normally in P2+-infected gro109 cells, but late phage proteins are not made. Early P2 mRNA is made in normal amounts, but very little late mRNA can be detected. P2 mutants (P2 ogr) able to overcome the gro109 block have been isolated in which synthesis of late P2 mRNA and phage proteins Is restored. The gro109 mutation is closely linked to the cluster of ribosomal genes at 64 min and is recessive to the wild-type (gro+) allele. A P2 ogr mutation has been mapped on the left arm of the P2 genome, between the right-most known late gene (D) and the phage attachment site. P2 ogr can complement P2+ in gro109 cells, indicating that ogr codes for a diffusible product.


Somnolence, akinesia, and sensory activation of motivated behavior in the lateral hypothalamic syndrome. After lateral hypothalamic damage in rats, somnolence, akinesia, and sensory neglect combine to produce complete aphagia. Only simple automatisms (such as grooming, chewing, licking) are present, but intense stimuli can activate more complex actions (walking, orientation, swimming). In the anorexic stage, tactile stimuli dominate in steering locomotion and "spontaneous" locomotion depends on activation from the empty stomach.


Increased glycolysis in immature rat ovaries using endogenous gonadotropins secreted in response to exogenous luteinizing hormone-releasing hormone. The rate of glycolysis, as indicated by in vitro lactic acid production, in ovaries from immature rats was stimulated by raising serum concentrations of endogenous LH and FSH by intravenous injections of luteinizing hormone-releasing hormone. The rate was shown to be a function of the serum concentration of gonadotropin but the response required the presence of elevated hormone levels for about 1 hr. These data are offered as further evidence for the lack of physiological importance of brief changes in pituitary function.


Cryoglobulins. III. Further studies on the nature, incidence, clinical, diagnostic, prognostic, and immunopathologic significance of cryoproteins in renal disease. Serial serum samples from a large number of patients with immunologic renal disease, normal healthy controls, acute infections as well as non-immunological renal disease were studied for the presence, nature and properties of cryoproteins, and these correlated with serial renal functional, morphologic, immunohistologic and clinical fingings as well as serologic observations. A high incidence of cryoproteins were found in renal disease thought to be mediated by immune complexes. Cryoprecipitates were not detected in the other patients. The presence of fibrinogen in a serum cryoprecipitate was always associated with rapidly progressive disease and poor prognosis. An association between the detection of cryoproteins and the clinical and morphological activity of disease was observed. Persistence of cryoproteinemia was associated with progression and apparent disappearance with resolution or progression to end stage renal disease. In patients with hematuria or proteinuria of questionable significance cryoprotein detection was always associated with immune complex nephritis. Renal transplantation in the presence of cryoproteinemia was associated with recurrent nephritis in the graft. Cryoproteins were found to have biologic properties attributable to antigen-antibody complexes, to contain immune complexes of antigen and antibody and to have serologic factors concentrated. The detection of serum cryoglobulins was found to be a better index of clinical and morphologic activity of immune complex renal disease than was serum complement. As in our previous studies, these proteins appear to be of diagnostic and prognostic value in renal disease and provide a method of antigen identification in these disorders.


Bronchial asthma in the Nigerian savanna region. A clinical and laboratory study of 106 patients with a review of the literature on asthma in the tropics. One hundred and six asthma patients were studied in Zaria in the Nigerian savanna region. This group resembled hospital attenders in general in containing a disproportionately large number of immigrants from southern Nigeria and students undergoing higher education. Childhood asthma was rare. Asthma started after the age of 19 years in 69 per cent of patients. Twenty-seven per cent gave a history of rhinitis but none had had eczema. Twenty-two per cent gave a family history of asthma. Cutaneous hypersensitivity to house dust supported by a history of attacks being precipitated by dust was found in 41 per cent of patients. Asthma was worst in the rainy season in 45 per cent of patients. Mites were found in mattress dust samples; the mean count was 243 mites per g dust; Dermatophagoides farinae formed 86-6 per cent of the total mite population. The variability of airways obstruction averaged 50 per cent of maximum values for forced expiratory volume in the first second (FEV1) and peak expiratory flow (PEF). The median severity of airways obstruction measured as FEV1/VC per cent was four standard deviations below predicted normal. Eighty-seven per cent of patients were positive to prick skin tests with one or more allergens. The commonest reactions were to house dust (58 per cent), house dust mite (45 per cent) and Dermatophagoides farinae (44 per cent). Fifty-one per cent of a group of controls were also positive on skin testing but the pattern of responses was different from the asthmatic patients. This high proportion of reactors is explained by high allergen load. Serum IgE levels were lower in the asthmatics than in a group of healthy controls who showed the very high levels characteristic of some African populations. We suggest that the controls were protected from atopic disease by developing high blocking levels of non-specific IgE, perhaps in response to gut helminths. The clinical pattern of asthma in Zaria is compared with other countries in the tropical and temperate zones. The particular problems of treating asthma in developing tropical countries are discussed.


Treatment of Paget's disease of bone with porcine calcitonin: clinical and metabolic responses. The clinical and metabolic responses of 12 patients with painful Paget's disease have been assessed before, during and after an 18-day course of treatment with purified porcine calcitonin, 160 MRC units i.m. daily. The indices of response included relief from pain, changes in concentration of serum alkaline phosphatase, calcium, magnesium, electrolytes and plasma inorganic phosphate; balance studies of calcium, phosphate, magnesium and in some cases sodium and potassium were undertaken. Urinary excretion of hydroxyproline was also measured. Remission of pain was complete in 11 of 15 courses of treatment. Coexistent osteoarthrosis was considered to be responsible where remission was incomplete. The mean duration of remission of pain was 12 months. Three patients who received a second course of treatment achieved further remission of pain. Side effects were not troublesome. Serum levels of alkaline phosphatase decreased to 67 per cent of the initial reading and the degree of suppression depended on the initial alkaline phosphatase activity. Urinary hydroxyproline correlated closely with the activity of serum alkaline phosphatase before, during and after treatment. The ratio of serum alkaline phosphatase:hydroxyproline excretion rose at the start and at the termination of treatment. Retention of calcium and inorganic phosphate occurred during the early phase of treatment only. Withdrawal of treatment resulted in a rebound retention of calcium and inorganic phosphate. The degree of calcium retention after treatment correlated with the level of plasma inorganic phosphate prevailing before treatment. The efficacy of these short courses of calcitonin are discussed and the metabolic observations related to theories of bone remodelling at a cellular and hormonal level.


Avascular necrosis of bone following renal transplantation. Assessment of 78 successful renal transplants carried out in Newcastle upon Tyne between October 1967 and March 1973, revealed avascular necrosis of bone (A.N.) in 11 patients (14 percent). Pain and restriction of movement were the cardinal symptoms, while the onset was from five to 35 months after transplantation. In some patients one joint only was affected but in seven patients (64 per cent) A.N. developed in other joints too in an additive and progressive fashion. A time lag was usually noted between the onset of symptoms and radiological proof. These 11 patients with A.N. were compared with two control groups of unaffected renal transplant patients. Taking into account the patients' body weight, the cumulative dose of prednisone received by affected patients during the first three post-transplant months was found to be significantly higher than that for both control groups (P less than 0.05). Patients with A.N. were found to have had an unusually high incidence of early post-transplant surgical complications and the length of their initial stay in hospital was significantly prolonged (P less than 0.02) when compared to both control groups. It is possible that excessive corticosteroid therapy is more deleterious in transplant patients weakened by peri-renal haematomas, urinary extravasations and stormy prolonged post-operative periods. Having emphasized the detrimental effects of excessive anti-rejection corticosteroid therapy it must be mentioned that occasionally patients develop avascular necrosis even after low doses of steroid therapy, while others, receiving high doses of steroid therapy and undergoing a stormy post-operative course, do not develop this complaint. It is suggested that although excessive steroid therapy is positively harmful, avascular necrosis is not an invariable complication and that ofther factors including possibly a genetic predisposition operate to produce avascular necrosis of bone in renal transplant patients.


Analysis of PCP-data to determine the fraction of cells in the various phases of cell cycle. Mathematical models for the analysis of pulse-cytophotometric (PCP) data are described. With computer programs based on these models the fractions of cells in G1-, S- and (G2 + M)-phase are obtained. The methods are applied to PCP-measurements of Ehrlich ascites tumor cells, human bone marrow cells and L-929-cells in culture. The results of the L-cell experiment are compared with autoradiographic results; for both methods the duration of the various phases has been calculated. Two different mathematical models for PCP-data evaluation and the autoradiographic method yielded results agreeing within statistical error. The application of the two models on different types of DNA-histograms is discussed: One model is suitable for asynchronous cell populations with a low fraction of S-phase cells, the other can be applied for partially synchronized cells and high S-phase fractions as well.


Biological damage from the Auger effect, possible benefits. Decay of radioactive isotopes by K-capture leads to the Auger effect and results in the loss of several orbital electrons and the emission of X-rays. Whereas radiation effects are produced from the emitted electrons, the consequences of the Auger effect are strictly localized to the site of the decaying nuclide. The paper reviews the biological consequences of the decay of 125I which produces the Auger effect. Nearly all data were obtained from DNA labeled with 125I-5-iodo-2'-deoxyuridine (IUdR) in bacteria and mammalian cells. Parameters of effects were cell death, DNA strand breaks, and mutation induction. In order to recognize in a cell the contribution from the Auger effect and that of absorbed radiation, experimental data are analysed in terms of the specific energy for the nuclear volume which contains the isotope. The data indicate that decay of 125I is far more toxic than is expected on the basis of absorbed dose to the labeled nucleus. Moreover, it is emphasized that the toxicity of the 125I decay is largely determined by events immediately localized to the site of decay. Because the consequences of the Auger effect are stricly localized to the molecular site of the decay, 125I and perhaps other nuclides decaying by K-capture promise to be interesting tools in cell biology and molecular biology. First data on the Auger effect as a tool are summarized. It appears that recognizable biological damage is only observed when the Auger effect takes place in vitally important molecules, an example of which is DNA.


[Pathophysiology of renal hypertension (author's transl)]. The review discusses the pathophysiology of the renal mechanisms of blood-pressure control. The physiology of the renin-angiotensin system is described and the mineralo-corticoid function has also been considered. The implications of alterations of these systems in various nephropathies are briefly summarized (renal artery stenosis, infarction, Page's syndrome, acute glomerulonephritis, essential hypertension a.o.).


[Pancreas scan (author's transl)].

[Pancreas scan (author's transl)]. A Review and a report of our ten years experience with pancreas scans. The diagnostic value of 75Selen-Methionine (75Se) scan is limited because of the lack of organ specificity of this substance. There is no improvement by pharmacological stimulation of the pancreas or subtraction techniques of the 75Se-activity in the liver. In the early phase after the injection of 75Se the distribution is more favourable for the pancreas compared to liver and intestine. Four descriptive terms are in use: normal, spotted, organ defect, and lack of uptake. There are no specific signs for pancreatitis, carcinoma, or exocrine dysfunction. Considering these limiting factors the use of pancreas scans is valuable to exclude pancreatic diseases.


Rapid computer-aided radiographic calculation of total lung capacity (TLC). Methods currently used for determining total lung capacity are either simple but inaccurate in the presence of airways disease (gas dilution) or accurate but not generally available (body plethysmography). The manual radiographic method is accurate both in normals and in patients with airways disease but is very tedious to use. The authors have developed a semi-automatic radiographic method utilizing a position transducer and a small computer which reduces the time for each determination from approximately 20 min. to 1 min. Agreement with manual calculations in 80 controls and 80 patients with airways disease is excellent (average correlation coefficient, 0.9872; average residual error, 2.65% or 156 ml).


Effects of delta-9-tetrahydrocannabinol on mouse spleens. A study was undertaken to ascertain the effects of delta-9-Tetrahydrocannabinol on the plaque forming cell response of mice immunized with sheep erythrocytes. It was found that a marked suppression of plaque forming cells occurred concomitant with a general loss of spleen cellularity following administration of delta-9-THC. These results suggest rather marked effects of this drug on antibody synthesis.


Dynamic alveolar mechanics as studied by videomicroscopy. The in vivo morphology of rat alveoli has been recorded and studied on videotape. The dynamic internal structure has been compared to that observed by histologic section from lung rapidly frozen with liquid nitrogen. The irreversible nature of local alveolar wall movement has been demonstrated in animals ventilated both with and without positive end-expiratory pressure (10 cm water) by parametrically comparing the distances between two sets of paired points measured sequentially across internal alveolar surfaces at intervals of 0.017 sec. Geometric hysteresis was significantly less in the animals ventilated with positive end-expiratory pressure. This hysteresis can be explained by irreversibility in alveolar surface area apart from any irreversible dependence on surface tension. Sharp reverses and rapid changes in geometric hysteresis suggest that the length-tension properties of elastic tissue within the alveolar wall and interface forces from adjacent alveoli are important determinants of local alveolar wall motion and pulmonary hysteresis.


[Polygraphic recording of tremor and of hypertonic phenomena. Application to the action of various drugs]. The recording technique described makes possible the detailed analysis of hypertonia and tremor in Parkinson's disease, as well as the action of different drugs. It may contribute to the understanding of the physiopathological basis of these motor disturbances and the mode of action of anti-parkinsonian drugs. It also represents a reliable method of repeated observation, independent of subjective factors, in the evaluation of the long-term effectiveness of a medication. We were particularly concerned with the evaluation and comparison of the effect of different drugs in the course of a short study, involving the administration of a single dose of the medications used. In this way were studied: Apomorphine, given sub-cutaneously in non-emetic doses, which decreases in a constant and spectacular fashion both tremor and hypertonia ; Piribedil (1-3 mg IV) ; L-Dopa (100 mg IV) ; Ro-080576/007 F in a dose of one capsule containing 200 mg of L-Dopa and 50 mg of L-dopa-decarboxylase inhibitor. The effect of these various medications was invariable greater than that of a placebo and lasted much longer. With these doses, and under the special experimental conditions of this study, Piribedil was better tolerated and in general more active than L-dopa, in particular in relation to tremor. The action observed in the course of this short study prior to treatment might, to a certain extent, make it possible to predict the effect of long-term treatment.


[Aseptic osteonecrosis in renal transplantation ; apropos of 29 cases]. Over a period of observation of 14 years, one or more aspetic osteonecroses (AON) were discovered in 29 patients who had undergone renal transplantation. Altogether 64 AON were discovered. In patients who had survived at least 1 year, the frequency of this lesion was 18 percent. These transplantation necroses were often bilateral (16 cases out of 21 AON of the femoral head) or multiple (6 patients presenting AON in more than 3 sites) ; necroses were sometimes found in unusual sites (shoulder, ankle, upper end of the tibia, scaphoid, condyle of the humerus). The AONs of the lower limbs were remarkable because of their extent and because of the rapid evolution of the radiological signs. This is in contrast to the moderate nature of the pain. Latent types of necrosis are also found (3 cases of AON of the femoral head). During a search for factors favouring the development of AON, the authors noted that the average duration of haemodialysis was longer in the patients with AON than in a control group of transplant patients. The average daily dose of corticoids for the first six months after transplantation was not significantly different in the two groups studied. However, the 15 patients with transplants who were not given corticoids did not develop AON.


[Systematic study of sequential salivary gland scintigraphy during rheumatoid arthritis and collagenosis. Apropos of 150 examinations]. Sequential salivary scintigraphy has been practised systematically in 130 patients hospitalized in a rheumatology unit. These patients were suffering from typical, classical rheumatoid arthritis, rheumatoid arthritis with high positivity for anti-nuclear antibodies, clearly defined polyarthritis, systemic scleroderma, other types of collagenosis, forms of inflammatory polyarticular rheumatism other than rheumatoid arthritis and collagenosis, and from different degenerative diseases. The scintigraphic anomalies were divided in three stages according to a personal classification. Nine patients presented a patend Gougerot-Sjögren syndrome. All of them had abnormal or very abnormal scintigraphy. However, the patients with classical rheumatoid arthritis without signs of the Gougerot-Sjögren syndrome, also showed a high frequency of isotopic anomalies that were equally severe. These were clearly connected only with the particular diagnosis (with classical rheumatoid arthritis, but not with clearly defined polyarthritis or collagenosis). No other direct relationship could be established between these diseases and the clinical, radiological, laboratory, or therapeutic aspects of the case. On the other hand, they were often associated with a reduction in lacrymal and salivary secretion. These isotopic studies, in combination with other findings shed a new light on the Gougerot-Sjögren syndrome, taking into account the diffusion of the exocrine lesions and of the contributions of the most modern methods of investigation.


[Treatment of a case of extreme micrognathia. Significance of continuous traction]. A case of very marked mandibulary atrophy was corrected by osteotomy and bone grafting of the ascending ramus. This procedure was performed in two stages with continuous traction of the mandible. This traction avoided the retro-displacement caused by the skin and muscle contracture and stabilized the post-operative immobilization.


Comparison of five growth media and two anaerobic techniques for isolating bacteria from dental plaque. Five agar media in combination with the Hungate roll tube technique and conventional anaerobic jar technique (Baird & Tatlock¿ jars) were evaluated to determine the most suitable medium for non-selective isolation of the viable microorganisms in dental plaque. The highest colony count was obtained by using "Modified Medium 10" with the roll tube technique. About twice as many plaque colonies were recovered by roll tube technique as by the conventional anaerobic technique. With the MM 10 roll tube technique, 7 d of incubation revealed only 93% of the colonies that could be detected after 14 d of incubation.


Effect of 2-years' use of chlorhexidine-containing dentifrices on plaque, gingivitis, and caries. Chlorhexidine digluconate in 0.1% and 0.4% concentrations was added to dentifrices to evaluate its effect on plaque formation, gingival conditions and caries in 73 dental students over a 2-year period. No differences were found in the Pl I and the G I indices between the active and the placebo dentifrices, but a possible effect on caries was demonstrated. Discolorations of anterior teeth and fillings were the only side effects observed.


[Experimental study on the role of the mylohyoid muscle in the instability of dental prostheses]. Using cinematographic and radiocinematographic recording techniques, the authors studied the movements of inferior prosthesis unstable in the lingual region. Pronunciation of the diphthong La... La... La... causes upward and forward projection of the prosthesis. Electromyography records contraction of the mylo-hyoid during pronunciation of these diphthongs. In the totally edentulous patient, the crest of the mylo-hoid is very close to the alveolar crest. From a clinical standpoint, functional exploration of the mylohyoid is easy, the index finger being placed along the mylo-hyoid crest and the patient asked to say La... La... La... If the index finger is pushed forwards and up, surgical intervention to lower the mylo-hyoid (Trauner's operation) is indicated, in association or not with other procedures designed to treat the other causes of instability or the prosthesis.


[Retention of a complete denture by the enclave method. Convergent enclaves]. The authors propose a technical variant of the method of enclaves for the retention of the full denture, this in the inferior maxilla because it is there that the problem of retention is posed with the greatest acuity and frequency. But whereas in the processes described the enclaves, 2 in number, corresponding with the zone of implantation of the canines, are perpendicular to the mandible in the frontal and sagittal planes, in the technique explained here each of the enclaves makes with the mandible, in the frontal plane, an angle of 10 degrees with respect to the median axis, thus leading to a convergence and hence an increased retention of the prosthesis with which they are connected.


Gastric secretory response to graded doses of pentagastrin alone or in combination with carbacholine in unoperated duodenal ulcer patients. Dose-response studies of pentagastrin-stimulated secretion were performed in 6 unoperated duodenal ulcer patients. On different days pentagastrin was given in doses of 0.15, 1.5, and 15 mug/kg/hr, either alone or in combination with carbacholine, 2 mug/kg/hr. There were no significant differences between mean acid or pepsin outputs or mean volumes of gastric juice after infusion of pentagastrin alone or pentagastrin plus carbacholine at any dose step of pentagastrin. The dose of pentagastrin required to elicit half maximal acid output (Km) and the calculated maximal acid output (Vmax) were the same for pentagastrin alone and pentgastrin plus carbacholine. Thus, carbacholine did not increase the sensitivity of the parietal cells to pentagastrin in the unoperated duodenal ulcer patients.


An inhibitor of chemotaxis and phagocytosis in reticulum cell sarcoma. In a study of neutrophil functions in haematological disorders using in vitro techniques, a heat-stable inhibitor of chemotaxis and phagocytosis was demonstrated in the plasma and serum of a 64-year-old woman with reticulum cell sarcoma. In partial purification by chromatography, the inhibitor activity could not be separated from IgG. Clinically the patient did not exhibit abnormal susceptibility to infections.


In vitro inhibition of endotoxin induced platelet aggregation with hydrocortisone sodium succinate (Solu-Cortef). Citrated canine platelet rich plasma stimulated with ADP, thrombin, collagen and E. coli endotoxin demonstrated platelet aggregation when measured with Payton aggregometer. Following incubation with hydrocortisone sodium succinate (Solu-Cortef) the same platelet rich plasma did not undergo platelet aggregation when stimulated by these agents. Solu-Cortef added to platelet rich plasma during ATP, thrombin, collagen and endotoxin stimulated platelet aggregation resulted in a reversal of the optical density suggesting deaggregation. These in vitro observations support the beneficial effects observed when steroids are administered in vivo to experimental or clinical shock.


Complement activation in relation to protective function of antibodies to Escherichia coli O antigens. The relation between complement activation in an indirect hemolysis assay of E. coli O antibodies and their protective function in experimentally infected mice was analyzed. The antibody amounts and avidities were estimated in antisera and in IgG and IgM antibody fractions by the ammonium sulphate precipitation (ASP) technique of Farr. The protection obtained was due to both IgG and IgM antibodies and showed a close relation to the quantity of antibodies measured by the ASP technique. No link between complement activation capacity of the antibodies and their protective function could be seen. In the system used, the IgM antibodies showed a correlation between antibody avidity and complement activating efficiency, whereas the IgG antibodies activated complement poorly. The results do not indicate a major function of the complement in antibody-mediated protection against E. coli in this experimental system in mice.


Effect of polyclonal B-cell activators on DNA synthesis in fibroblasts. The polyclonal B-cell activators (PBA) lipopolysaccharide (LPS), type III pneumococcal polysaccharide (SIII), dextran, dextran sulphate, pentosan sulphate, and polyvinylpyrrolidone (PVP) were found to cause an increased DNA synthesis in mouse fibroblast monolayer cultures in the presence of calf serum, provided the background cpm were within certain values. The same PBA suppressed DNA synthesis when the cultures showed high background [corrected] cpm. Since the PBA did not activate DNA synthesis in serum-free cultures, it was concluded that PBA could be directly activate fibroblasts but rather influenced factors responsible for regulation of DNA synthesis in fibroblasts. In contrast PBA directly trigger lymphocytes.


Antibody production by human colostral cells. I. Immunoglobulin class, specificity, and quantity. The production of antibody by human colostral cells was assayed by the hemolysis in-gel technique. When sheep erythrocytes coated with O antigens from frequently encountered Escherichia coli bacteria were used as detector cells and anti-IgA serum was added for development, numerous plaque-forming cells (PFC) were demonstrated in all samples tested. In contrast, plaques were rarely seen in the presence of anti-IgG developing serum. The direct (IgM) plaques occasionally noted with both antigen-coated and uncoated sheep erythrocytes were mainly due to the production of heterophil antibodies, since they were not formed when human erythrocytes were used as O-antigen carriers. A strikingly high number of the colostral lymphocytes formed antibodies to the E. coli antigens, up to 8%. This suggests that these cells represent a rather selective population--possibly cells from the gastrointestinal tract exposed to enteric bacteria. The large number of plaques observed, the predominance of the cells forming IgA antibodies, and the marked changes in PFC number in relationship to parturition pose a number of questions relevant to the antibody-producing colostrum cells and their relationship to the secretory immune system.


Acute epiglottitis; a clinical, bacteriological and serological study. 25 patients, 15 children and 10 adults, with the clinical diagnosis of acute epiglottitis were studied. Patients severely ill on admission, 13 children and 1 adult, were immediately treated with tracheotomy and antibiotics; the remaining patients with antibiotics only. Haemophilus influenzae type b was the causative organism in all children and in 3 adults. One adult had a Diplococcus pneumoniae infection. No pathogens were isolated from the 6 remaining patients. Four of the children developed H. influenzae type b meningitis. All patients recovered. Anti-b antibodies were not demonstrable in any initial serum sample while agglutinating anti-b antibodies were found in subsequent samples (indirect hemagglutination). All patients with a type b infection had already initially precipitating anti-O antibodies against their own strain, and in most cases complement-fixing anti-O antibodies (mixed H. influenzae O antigen) with rising titers in subsequent serum samples. A possible connection between the presence of anti-O antibodies initially and the development of the acute epiglottitis is discussed.


Bacteremia in a general hospital. A prospective study of 102 consecutive cases. A prospective clinical-bacteriological study of 102 consecutive cases of confirmed bacteremia at a Copenhagen City general hospital was carried out during 5 months of 1973 with special concern given to focus of infection and acquisition of microorganisms. Valid positive cultures were obtained from 7.2 patients per 1000 admissions. 50 of the 102 bacteremias were by all probability acquired in the hospital, mainly due to transurethral manipulations or intravenous lines. Pneumonia and hepatobiliary infections accounted for most of the non-hospital acquired bacteremias. 26/102 patients died in relation to the bacteremia. Escherichia coli and Staphylococcus aureus caused more than half of the infections. Bacteremia caused by proteus, klebsiella, enterobacter species of staphylococci was in most cases nosocomial and carried the highest mortality, i.e. 40%, verus 15% when other organisms were responsible. It is concluded that nosocomial bacteremia is a frequent and life-endangering complication which is often preceded by certain diagnostic or therapeutic procedures, not invariably linked to severe underlying diseases. Consequently, attempts to reduce bacteremic episodes should include surveillance of ecological factors and certain hospital procedures.


Comparative double-blind trial of intra-articular injections of two long-acting forms of betamethasone. Two injectable betamethasone preparations, betamethasone dipropionate/betamethasone phosphate and betamethasone acetate/betamethasone phosphate were compared in a controlled trial on 22 "matched patient pairs" with rheumatic diseases. The two preparations were injected intra-articularly in knee joints affected by active synovitis. The time until onset of action and the duration of clinically adequate anti-inflammatory effect were recorded. All injections produced clinically significant effects. The interval before recurrence of symptoms varied from 2 days to more than 3 months. The dipropionate form showed statistically significantly longer duration of action. No difference was noted in the time until onset of action. Local side effects were not observed. The double-blind method of clinical evaluation proved useful in comparing duration of action between long-acting corticosteroids.


Use of pectoralis skin pedicle flap for closure of large bronchial fistula connected with postpneumonectomy empyema. In 4 patients, the postpneumonectomy empyema was connected with a large bronchopleural fistula. The empyema was in all cases treated by a permanent open window thoracostoma. The fistulae were closed later with pedicle flaps made of the pectoralis muscle and the adjoining skin. In 2 patients the closing of the bronchial fistula was successful, and the treatment of one patient is not completed. In one patient the open pneural cavity was covered completely by skin using an additional pedicle flap and free skin transplantation. The surgical technique of the pedicle flap operation is described and the cases are reported.


Toxicity and pollution potential of thallium. Toxicity and pollution potential of thallium are reviewed. Thallium is slightly more acutely toxic to mammals than mercury, and as acutely toxic as copper to fish. Its present industrial uses are too limited to generate pollution, but thallium, discharged in wastes from mines, ore-processing, and coal-burning plants, is contaminating the environment.


Lymphocyte surface immunoglobulins.

Lymphocyte surface immunoglobulins. Immunoglobulins have been isolated from the surface of B (bone marrow-derived) and T (thymus-derived) lymphocytes. Two types of membrane immunoglobulin occur on B lymphocytes; one type resembles the 200,000-dalton subunit of IgM, the second possesses a heavy chain electrophoretically distinct from mu chain and does not correspond to any of the known classes of mouse immunoglobulins. It might correspond to human sigma chain. T lymphocytes possess only one type of surface immunoglobulin. This molecule has a mass of approximately 200,000 daltons and contains light chains and heavy chains similar to, but not identical to, mu chains. Evidence now exists that surface IgM-like immunoglobulins of B lymphocytes and T lymphocytes activated to certain antigens can bind specifically to antigen. These observations suggest that surface immunoglobulin functions as a receptor for antigen on B cells and at least on some T cells. The mechanisms by which combination of antigen with surface immunoglobulin initiate differentiation remain to be determined.


Implication of Phlebotomus sand flies as vectors of bartonellosis and leishmaniasis as early as 1764. A written account implicating Phlebotomus sand flies as vectors of Carrion's disease and cutaneous leishmaniasis in Peru was published by Cosme Bueno in 1764. Bueno's report precedes other publications implicating sand flies in the transmission of human pathogens by nearly a century and a half.


Complement-mediated bactericidal system: evidence for a new pathway of complement action. The early components of human complement (C1, C4, and C2) plus certain serum euglobulins will kill pathogenic strains of Shigella sonnei. Serum from patients with hereditary C3 deficiencies and specific antiserums to C3, C5, and C6 were utilized to demonstrate the absence of requirements for late-acting complement components in this unusual bactericidal system.


Epidemiologic investigation of an outbreak of Shiga bacillus dysentery in an island population. An epidemic of dysentery broke out in St. Martin island during May through July 1973. The epidemic was caused by Shigella dysenteriae type 1. The dysentery could not be controlled by conventional antibiotics and other antidysenteric drugs. The average attack rate was 32.9%. The age specific attack rate was highest in the age group 1-4 years (52.2%). The attack rates were higher in smaller families. The rates were not greatly different amongst people using different sources of water. The overall death rate was 2.1%. The overall infection-to-death rate was 6.4% but amongst children less than a year old, it was 41.1%. A common source outbreak was unlikely. The higher attack rate in smaller families suggested limited possibility of person to person spread. No particular water source could be implicated with higher attack rate. Flies may have played an active role in transmission.


Intravenous ketamine for postoperative analgesia. Thirty-six consecutive patients who had undergone major surgery were carefully studied for 6 hours postoperatively in an attempt to evaluate the relative analgesic and respiratory-depressant effect of morphine, ketamine, and placebo administered by continuous intravenous infusion. Side-effects, vital signs and respiratory measurements were recorded hourly by a consultant physician. With regard to the dosage and method of administration, ketamine was shown to be less effective than morphine for the first 3 hours postoperatively, but equally effective subsequently, whereas the patients who received ketamine showed a greater progressive tendency for their respiratory parameters to improve with time. Recommendations regarding the postoperative control of pain are made, and the need for further study is noted.


A serological survey of toxoplasmosis in the Bloemfonetin area. The IFA test revealed the presence of antibodies to Toxoplasma gondii in 10, 3% (62) of sera from 600 pregnant women. The incidence of antibodies varied from 8,0% in the Black population to 10,5% in White and 12,5% in Coloured women. In the Coloured and Black populations the highest incidence of antibodies was found in the 31-40-year age group, while in Whites this occurred in the 21-30-year age group. Twenty-eight sera also contained complement-fixing antibodies. The results are discussed in relation to the epidemiology, complications, diagnosis and treatment of toxoplasmosis.


Probable chloroquine-resistant Plasmodium falciparum malaria from Mozambique A case report. A female patient with Plasmodium falciparum malaria apparently resistant to chloroquine is descirbed. She had recently returned from Mozambique, which may prove to be a new endemic are with resistant strains. The infection was successfully treated with quinine.


A specific radio-immunoassay for gonadotrophin-releasing hormone. A specific antiserum has been made to synthetic gonadotrophin-releasing hormone (GnRH) conjugated to keyhole limpet haemocyanin and appears to be directed against amino acids 6-8 of this decapeptide. This has allowed the development of a radio-immunoassay for GnRH sensitive to 5 picograms per tube. Although it is easily measurable in hypothalamic extracts, we have failed to detect GnRH in plasma and urine from normal subjects and menopausal women.


History of mental health services in South Africa. Part VIII. Services for epileptics. The development of services for epileptics in South Africa is reviewed. In the field of education, the history of the Jan Kriel school at Kuils River in the Western Cape is described. Treatment is provided at government mental hospitals, institutions for defectives, and general hospitals. The Epileptic Employment Association provides epileptics with work and opportunity to live a normal life. Information about epilepsy is provided by the South African National Epilepsy League, which also provides opportunities for employment.


Historical perspective of myocardial infarction. The history of myocardial infarction ('coronary thrombosis'), a condition which was only recognised as a clinical entity in the 20th century, is reviewed up to the time of the introduction of the intensive coronary care units. Early observations of presentations, complications, diagnosis and treatment of the disease are emphasised. The increase in incidence of myocardial infarction, real or relative, is discussed and the remarkable variation shown in earlier reports on the mortality rate of myocardial infarction is explained. Many of the important principles which revolutionised the management of the disease through coronary care units, are evident in the earlier reports.


Practical aspects of a cholera surveillance programme. The recent invasion of southern Africa by cholera stimulated the establishment of a regional cholera reference laboratory and surveillance centre. This article describes its activities in general and details the methods employed in the isolation of Vibrio cholerae from sewage, water, seafoods, patients, and carriers. Importance is also attached to the isolation of NAG (non-agglutinable) V. cholerae and V. parahaemolyticus from certain categories of specimens. In recognition of the importance of regional co-operation in combating the problem of cholera, the collaboration of other countries on the subcontinent was invited, and the response is encouraging.


History of mental health services in South Africa. Part IX. The protection and care of the feebleminded. Interest in mental deficiency was at low ebb in the 19th century. The invention of intelligence tests in France and the publication of a book in the USA stimulated the Child Life Protection Society in Cape Town to call a meeting which led ultimately to the formation of the National Council for Mental Health. Details of early intelligence tests are given and the mental state of poor Whites is described. The reports of two committees on mental deficiency are discussed.


Regional infusion chemotherapy for cancer of the head and neck. The experience with intraarterial infusion chemotherapy in the 24 years since its development has established that it is not a substitute for conventional methods of management. Its prime indications are for palliation of advanced and recurrent cancer unsuitable for irradiation or surgery or as an adjunct to the latter. Several specific observations are relevant to its use in the head and neck region: 1. With currently available antineoplastic agents more than half of the neoplasms in this region can be made to regress. Epidermoid carcinomas, the most frequent tumor of the head and neck, as well as less frequent carcinomas and sarcomas can be affected. 2. Regressions are usually incomplete and brief, lasting but a few months, and despite complete tumor regression microscopic cancer usually persists. Occasionally, unpredictably, and for uncertain reasons a regression is complete and permanent. Small, well-differentiated and exophytic (verrucous) epidermoid cancers appear most liable to such a response. 3. Temporary or permanent neurologic damage is the most distressing morbidity associated with treatment. This hazard can be minimized by avoiding infusion of the internal carotid artery and protection of the patient from embolism of air or particulate matter through catheters. 4. The combined use of two or more chemotherapeutic agents is promising as a means for increasing the frequency and possibly the duration of tumor regressions. 5. The value of infusion as an adjunct to irradiation or surgery for potentially curable cancers is still unproved. Uncontrolled data suggest that local control of cancer may be improved, particularly if all three modalities are combined. A controlled clinical trial by experienced investigators could resolve this issue. 6. Although the arterial route increases the activity of some chemotherapeutic agents, significant progress appears to depend upon the development of drugs with greater specificity for neoplastic tissues. 7. In its present form, arterial infusion chemotherapy offers a brief period of palliation to many patients with cancer of the head and neck who are otherwise untreatable, and occasionally to such individuals a final chance for cure.


Experimental stress ulcers: a review.

Experimental stress ulcers: a review. The restraint model and other models for the production of experimental stress ulcers have been reviewed. The mechanism of experimental stress ulcers appears to depend on an interaction between the presence of acid, changes in mucosal circulation, an increase in the excretion of glycoproteins in the mucus, and a decrease in mitotic activity of the mucosal lining of the stomach. Factors enhancing ulceration are cold, starvation, increased acidity, burns, reflux of bile, endotoxin, adrenalectomy, and hemorrhage. Factors inhibiting ulceration are vagotomy, anticholinergics, elemental diets, vitamin A, antacids, prevention of bile reflux, corticosteroids, epinephrine and norepinephrine, serotonin antagonists, and immediate replacement of blood loss with low molecular weight dextran. The role of sepsis is unclear and more work is needed in this area. Ulcers from intracranial injury are usually associated with the hypersecretion of gastric acid. Stimulation of the hypothalamus, directly or indirectly, with resultant vagal stimulation is thought to be the responsible mechanism for the increase in acid.


Role of the endogenous gastrointestinal microflora in postoperative wound sepsis. Most infections following gastrointestinal surgery are caused by the escape of endogenous microorganisms at the time of operation. A thorough understanding of the gastrointestinal microflora in health and disease is essential to the intelligent treatment of postoperative septic complications. The oral flora found under certain circumstances in the proximal gastrointestinal tract is usually penicillin sensitive. Both aerobic and anaerobic resident microflora of the distal ileum and colon are penicillin resistant; therefore, other antibiotic agents must be prescribed for successful treatment of sepsis following resection of these organs.


Anesthesia and the immune system.

Anesthesia and the immune system. Anesthesia and operation may impair the immune system so that bacterial growth and tumor spread may occur more readily, and host response to transplanted tissue and allergenic substances may be altered. Suggestions are presented regarding the anesthetic management of patients at risk from infection or tumor spread.


Effects of anesthetics on splanchnic circulation and metabolism. In the last 10 years intense interest in "halothane hepatitis" plus simpler and more reliable technology for measuring splanchnic blood flow have led to a fuller understanding of the splanchnic effects of anesthetics. For the first time, a rational choice of anesthetic technique can be made for the patient with splanchnic organ dysfunction.


The biochemical basis of anesthetic toxicity. The inhalational anesthetics reversibly inhibit mitochondrial electron transport from NADH-linded substrates at the level of the enzyme NADH-dehydrogenase. The effect of this inhibition on ATP production is probably not the basis of the anesthetic state, as the level of high-energy phosphate in the brain does not decrease during anesthesia. Anesthetics, therefore, interfere with brain energy untilization, in addition to brain energy production. Inhibition by anesthetics of mitochondrial calcium uptake, which results from the inhibition of electron transport, may be an important anesthetic effect if it raises the intracellular calcium level. Other areas of investigation which have not been discussed here include the effects of anesthetics on glycolytic and other enzyme systems, ion fluxes, neurotransmitter synthesis and release, and on the structure of natural and artificial membranes. It is now appreciated that most of the inhalational anesthetics are metabolized by the endoplasmic reticulum of hepatocytes. The biotransformation of several anesthetics can be increased by drugs which induce hepatic microsomal enzymes. The organ toxicities of chloroform, trichloroethylene, fluroxene, methoxyflurane, and possibly of halothane and enflurane are related to their intermediary or final metabolites. It is of anesthetic drugs for an individual patient.


Anesthetic management of patients with cardiac disease. The course of anesthesia for patients with cardiac disease includes assessment and management of complications during the entire perioperative period. A thorough understanding of the pharmacology of anesthetic drugs and their interactions with medications taken by patients with heart disease is of utmost importance. The rapid changes in intraoperative circulatory status may often necessitate second-to-second invasive monitoring techniques to maintain stability. Finally, knowledge of complications occurring commonly in such patients allows the anesthesiologist to prepare ahead of time for corrective measures which may be lifesaving.


Deliberate hypotension.

Deliberate hypotension. Deliberate hypotension can reduce major blood loss and indelicate operations can produce a drier field increasing the ease of surgery and the likelihood of a good result. The techniques used to induce hypotension can also  be used to avoid dangerous hypertension during and after surgery. These benefits must be weighed against the risks of inadequate perfusion: especially cerebral, myocardial, or renal. In previously normotensive patients these risks are minimal when the arterial pressure is held above 80 torr systolic, and may be acceptably small even at mean pressure of 50 to 60 torr. Previously hypertensive patients show signs of cerebral ischemia at higher pressures; they should probably not be subjected to deliberate hypotension, but they also can be harmed by severe hypertension which can be avioded by the proper use of hypotensive agents. For most situations a balanced technique is suitable: after a stable anesthetic level has been achieved using halothane or enflurane, hypotension can be induced with sodium nitroprusside or trimethaphan camsylate. Longer-acting agents such as pentolinium are sometimes desirable, but the shorter-acting agents are easier to control. Careful monitoring with observation of intra-arterial pressure, electroencephalogram, electrocardiogram, and determination arterial blood gas tensions is likely to make for safer conduct. Close postoperative observation is essential. With careful preparation and monitoring deliberate hypotension can be a safe technique for reducing blood loss or facilitating delicate procedures.


Trace anesthetic exposure. Consequences and control. Epidemiologic and animal studies indicate that chronic exposure to anesthetic gases may consitute a potential health hazard. This is suggested by a higher incidence of spontaneous abortion among female operating room personnel, congenital anomalies in the offspring of operating room personnel, and neoplasia of the reticuloendothelial system. Human data show that performance can be compromised during exposure to anesthetic traces. A direct cause and effect relationship between anesthetic exposure and the alleged hazards will require further prospective studies. Such a study is being planned by the Ad Hoc Committee of the American Society of Anesthesiologists. In the interim, monitoring programs should be established to define adequate clearances of the anesthetic agents. Minimum standards and recommended procedures should be established regarding operating room ventilation and design. The use of effective scavengers and anesthetic techniques not requiring the use of inhalational agents should be encouraged. In this way a clear distinction may be defined by the prosepective study planned by the American Society of Anesthesiologists in 1978.


Hypothermic storage of the canine kidney for 48 hours in a low chloride solution. In studies of 52 dogs, kidneys were stored at zero degrees C. using a low chloride hypertonic intracellular solution. When stored for 24 hours, one-half of the kidneys resumed normal function upon reimplantation. With storage for 48 hours using a brief washout at 24 hours, up to 38 per cent of the reimplanted kidneys provided life sustaining function without azotemia.


The role of the nurse epidemiologist in infection control and continuing education. A university affiliated Veterans Administration Hospital had an increase in the number of serratia isolates. An epidemiologic investigation, including personnel and environmental prevalence study, helped correct errors in technique, management and judgment. A nurse epidemiologist prevented a cluster of infections from becoming an epidemic.


Simultaneous study of gastric and pancreatic secretion in a preparation perfused ex vivo. A canine gastroduodenopancreatic block was isolated and perfused ex vivo with homologous blood. This preparation allowed a simultaneous collection of gastric and pancreatic secretion under various conditions of stimulation. To stimulate gastric secretion, pentagastrin, bethanechol chloride or histamine was infused intra-arterially during a six to eight hour period, or both vagi were electrically stimulated. To stimulate pancreatic secretion, secretin was infused by the same method. Secretin infusion inhibited gastric juice volume and acid output by stimulated stomachs and induced an increase in pepsin concentration. Secretin infusion also resulted in a significant increase of flow of pancreatic juice and in both concentration and output of pancreatic secretion of bicarbonate. Arterial perfusion pressure and peripheral vascular resistance of this ex vivo preparation were significantly reduced by secretin. The method described permits the simultaneous study of the secretory function of the stomach and pancreas as well as the evaluation of biochemical changes of perfusion blood and hemodynamic changes in the circuit. Easy accessibility of the vessels and vagus branches also allows direct infusion of drugs and placement of stimulation electrodes.


Vascular access for hemodialysis.

Vascular access for hemodialysis. The subcutaneous arteriovenous fistula has become the method of choice for vascular access for chronic hemodialysis in the vast majority of dialysis centers in the United States and abroad. The Silastic cannula external arteriovenous shunt is an acceptable alternative and is the access of choice for treatment of acute renal failure or drug overdose. Surgeons dealing with these patients will have to familiarize themselves with both procedures, as well as with the various modifications currently in use in order to offer the best procedure for the particular patient and to make dialysis possible for all patients who need it.


Post-transplant function of cadaver kidneys preserved with plasma perfusate containing antidonor antibody. Two cadaver kidneys were preserved by the perfusion method with AB cryoprecipitated plasma which contained antidonor lymphocytotoxic antibody. The kidneys were transplanted subsequently and no demonstrable immunologic damage to the kidneys was observed in the preservation and post-transplantation periods. In one patient renal function was immediate, and function has remained satisfactory in the 3 month follow-up period. The other patient had an initial period (2 weeks) of acute tubular necrosis, but renal function became satisfactory and the patient's condition has remained stable in the 3 month follow-up period. The significance of antidonor lymphocytotoxic antibody in the plasma perfusate on subsequent kidney function has been discussed.


Tissue levels of prostaglandin E following heterotopic rat heart allografting. Heterotopic rat heart allografts were performed in 35 rats. At intervals after transplantation, rats were killed and tissue concentrations of immunoassayable prostaglandin E (PGE) were measured in the native heart, transplanted heart, spleen, and thymus. A significant increase in allograft PGE activity was observed at days 5 through 7, coinciding with the onset of the rejection reaction. These studies implicate PGE in the host response to allografting, but further studies are needed to determine what (if any) role prostaglandins play in the rejection reaction.


Orthotopic liver transplantation: an experimental study on mechanisms of hemorrhagic diathesis and thrombosis. The hemorrhagic diathesis after transplantation of preserved livers generally is attributed to intravascular coagulation, whereas postoperative "hypercoagulability" of the blood is considered the main cause of thrombosis of the hepatic artery anastomosis. Since our preliminary studies, however, suggested other mechanisms, parameters of coagulation, fibrinolysis, and platelet function were prospectively studied before and after 28 orthotopic liver transplantations, with and without preservation, in dogs and pigs. In addition, the arterial anastomoses were evaluated routinely by angiography and, after removal at reintervention or autopsy, inspected for thrombosis and tested for fibrinolytic activity and fibrin deposition. Concerning the hemorrhagic diathesis, prolongation of bleeding time without concomitant thrombocytopenia was the main abnormality found and occurred only in the nine dogs with liver transplants previously preserved for 3 to 6 hours. As only two of the nine dogs had postoperative hemorrhage of clinical significance, we consider surgically imperfect hemostasis facilitated by an acquired platelet dysfunction the principal cause of hemorrhage. Thrombosis of the arterial anastomosis was found in 38 percent of animals in which an end-to-end anastomosis was made but was not encountered with celiac artery-aorta anastomoses. Local factors due to surgical technique therefore appear most important in the pathogenesis of thrombosis of the hepatic artery anastomosis, although the postoperative hyperfibrinogenemia and diminished local and systemic fibrinolytic activity may contribute as well.


The composition of massive lesions in coal miners. The nature of the material forming the massive lesions in the lungs of coal workers has never been demonstrated. The concept that it was in fact massive fibrosis, implying that it consisted of collagen impregnated with coal dust, has been challenged only during the last ten years. It was agreed that the best chance of obtaining more definite information was from a combined study of the biochemical, pathological, ultrastructural, and immunological features of a number of lungs containing these lesions. Six cases which were found to contain suitable material were studied. The preliminary results obtained suggest that collagen is present in the capsule of these lesions but that at the centre it is replaced by another insoluble protein or proteins which is probably stabilized by some form of cross-linking. This protein complex accounts for one-third of the weight of the lesions, the remaining two-thirds consisting of approximately equal amounts of mineral dusts and calcium phosphate. Serum proteins were also observed but their association with the lesions has yet to be determined.


[Effect of the diluent on the aerobic bacterial count in raw minced meat and similar meats (author's transl)]. A report on the changes in the aerobic bacterial count in commercial minced meat, which appear when samples, decimally diluted with 0.85 per cent sodium chloride or with 0.85 per cent sodium chloride plus peptone (peptone physiological saline solution, p.ph.s.s.) are stored at room temperature for some time. When the higher dilutions (10(5) to 10(7) inclusive) were stored for periods of thirty minutes and more, significantly higher counts were recorded on using p.ph.s.s. and significantly lower counts were observed on using sodium chloride. Significantly higher counts were produced, however, when the two diluents were used following storage of the lowest dilution (10(1)) for a similar period. The dilutions have to be mixed again after each period of storage. The presence of "sublethally injured" bacteria in commercial minced meat is discussed. These bacteria may recover when a diluent having a sufficiently protective effect is used. Substances from the natural substrate are probably still active at the lowest dilution. A number of the injured bacteria which fail to multiply when the pour-plate method is used, will probably be able to produce colonies when the streak-plate method is adopted as more oxygen will be present in this case. Even when a rapid procedure is used in examining the samples (mixed agar method), the average number of colonies produced on using sodium chloride will be significantly smaller than that produced when p.ph.s.s. is used.


Leptospirae of serotype lora of the serogroup Australis isolated for the first time from swine in the Netherlands. Leptospirosis in swine, caused by serotype lora (serogroup Australis) was detected both serologically and by culture. The most important symptoms consisted in abortion during the final month of gestation and the birth of dead or not viable piglets.


A new CoDNA-ase spot plate method for the detection of coagulase and DNA-ase activity of staphylococci. A new method for the determination of the coagulase and DNA-ase activity of staphylococci is described. The method enables the analyst to test large numbers of strains for this microorganism without the loss of time involved in the conventional technique.


Immune responses in Mycoplasma pneumoniae infections. All children with Mycoplasma pneumoniae infection showed a significant response in IgG immunofluorescent (IMF) antibody titers, which were similar to that of complement-fixing (CF) antibody titers. However, there was a certain degree of variation in IgM IMF antibody response and its persistence. This variation also occurred in cases with pre-existing specific antibodies and good CF and IgG IMF antibody titers. Thus, it was considered that a reinfection with M. pneumoniae might not have an important effect upon the individual variation in IgM immune response, and that after a secondary immune response with M. pneumoniae infection with specific IgM antibody could be detected in some patients.


[The bonding of enamel and dentin by means of adhesive materials. 4. Possible use of noracryl 100 in orthodontics]. The present paper deals with first personal experience. The indications concern orthodontic space elimination and movement of single teeth in the anterior region. This method is a true rationalization in orthodontic practice.


[The model casting method for inlays and bridgework]. The authors deal with the advantages and disadvantages of the direct and the indirect method of inlay making and describe the precision casting technique for inlays and bridges. Furthermore, they present the telescopic tray which has been developed in the Rostock Clinic. This tray permits to apply the impression material under increased pressure. The use of the compound embedding material and dental alloys indicated allows to obtain good treatment results in a rational manner.


[Stomatological morbidity study--Berlin 1972. 4. State of prosthetic-stomatologic care and the need for it]. In the course of a representative morbidity study in the capital of Berlin of 1972, it was found that almost 56% of the adults needed prosthodontic care. Only nearly half of them had dental prostheses of sufficient quality, one fourth had insufficient dental prostheses, and one fourth were untreated.


[The state of cytology in dentistry--a review]. Cytological examinations have been introduced into stomatology relatively late though the material is easy to collect and the techniques used are inexpensive. At present, cytological examinations may be employed for the following purposes: 1. Differential diagnosis of bullous lesions of the oral mucosa. 2. Supervision of inflammatory processes of the periodontium and related surgical interventions. 3. Detection of malignant and premalignant processes in the oral cavity and its environments. Apart from the well-known staining procedures, the acridine orange fluorescence method and recently, the cytometric evaluation of historadiographic techniques are used. Especially in the diagnosis of tumours, cytology is only an adjunct however worthwile.


[Edlan-Mejchar's method as a preprosthetic surgical measure for the stabilization of total mandibular prostheses. Report on first experiences]. In the present 1-year study, the method inaugurated by Edlan and Mejchar as a "periodontal-preventive operation intended for deepening the lower oral vestibule" was used as a preprosthetic-surgical measure. The operating technique is described in detail and the suitability of this method is proved by the results from 13 patients. It is a very recommendable method for deepening the lower oral vestibule.


Neutralizing antibody in Rodent Malaria. Small numbers of rat erythrocytes infected with viable P. berghei, when inoculated into susceptible rats together with hyperimmune rat serum (HIS), are fully neutralized. Serum from convalescent rats delays the onset of patency but does not neutralize. The neutralizing efficiency of HIS rises in proportion to the number of successive reinoculations of hyperimmune rats. In contrast, mice inoculated with parasites together with either HIS or normal rat serum succumbed to the disease at the same time after inoculation. Neutralization in rats occurs in vivo and is completed within 22 hours of inoculation. Much larger amounts of HIS are needed to achieve neutralization in splenectomized recipients than in intact rats. The action of HIS is dose-dependent. Thus, the degree of suppression of parasitaemia is proportional to the dose of HIS, while the mortality rate is inversely proportional to the dose. Suboptimal doses may even enhance the infection of recipient rats. The ability to produce neutralizing antibody is dissimilar in two strains of rat. Thus, the outbred Sabra strain produces neutralizing HIS, while the inbred Lewis rat is incapable of producing perceptible neutralizing antibody in our experimental model.


The contribution of computerized axial tomography to the diagnosis of cerebellar and pontine hematomas. Case histories are reported of seven patients in whom the diagnosis of cerebellar (four) or pontine hemorrhage (three) was made by computerized axial tomography (CT). In all of the patients except two the diagnosis, established on the basis of a space-occupying high absorption lesion, was proved by either operation or autopical for an intracerebral hematoma, i.e., the high absorption zone was transformed into an area of reduced density. It is concluded that CT is a highly reliable method for the diagnosis and location of posterior fossa hematomas. A CT syndrome, observed in four of the seven cases, is described consisting of a hydrocephalus with the tips of the posterior horns being filled with blood. This seems to be specific for a posterior fossa hematoma having penetrated into the fourth ventricle.


Effect of cyclandelate on dementia.

Effect of cyclandelate on dementia. Cyclandelate, a vasodilator, was administered to 24 patients with dementia. The dementia in these patients was presumed to be due to cerebral ischemia caused by atherosclerosis in cerebral vessels after other possible causes were ruled out. In a double-blind, cross-over study, patients received 200 mg of cyclandelate four times daily for six weeks and a placebo for six weeks. Six psychological tests, which reflect various aspects of higher cortical ability, were used to evaluate the effect of cyclandelate on the dementia. Cyclandelate was found to be no more effective than placebo in improving higher cortical function in these demented patients.


Comparison of a 9-phenanthrene methanol (WR33063), a 4-quinoline methanol (WR30090), and quinine for falciparum malaria in Thailand. Quinine was compared with a 9-phenanthrene methanol (WR33063) and a 4-quinoline methanol (WR30090) for the treatment of 207 patients with falciparum malaria in Southeast Thailand. Quinine eradicated parasitaemia (average 70 hours) more rapidly than either WR30090 (72 hours) or WR33063 (77 hours). But WR33063 had a higher cure rate (92%) than WR30090 (86%) or quinine (85%). The mean duration of fever and of parasitaemia were combined with the failure rate to form an arbitrary efficacy index. Using this concept WR33063 was the most effective drug. The recrudescence rate correlated with the degree and duration of parasitaemia and with the duration of fever. WR33063 was the least toxic drug. Side effects associated with WR30090 appeared to be headache, backache and urticaria. Quinine was the most toxic drug. All 3 drugs were inconvenient in having to be administered every 8 hours for 6 days. One patient did not respond to oral quinine but did respond to an intravenous quinine infusion (IVQ). A "Medication Ward Round" was perfected during the study and comprised sequential history, drug administration, physical examination, dose notation and patient observation. Falciparum nephrosis was diagnosed in one patient.


A disquisition on suppressor T cells.

A disquisition on suppressor T cells. The main points that  I have put forth are that: (1) suppressor T cell activity cannot be explained as simply being too much help; (2) feedback signals from target cells are of crucial importance in determining and maintaining the activity of suppressor T cells; (3) whenever T cells are triggered by antigen, suppression occurs. Immune responses only occur when countermanding signals are also generated. Both intrinsic and extrinsic adjuvanticity is the operational production of countermanding signals; (4) memory T cells are qualitatively different from normal T cells in their sensitivity to feedback signals and also in their susceptibility to suppression; (5) mature thymus dependent B cells cannot be rendered tolerant by the direct action of antigen, while immature and thymus independent B cells can; (6) the mechanism of suppression induced by exogenously administered antigens and that by normal differentiation products (i.e.: GVH; allotypes), is different; (7) generation of suppressor cells requires or results from complex interactions between subpopulations of cells, making it impossible under present conditions to determine which cell is doing what and to which; (8) further work is required before a full understanding of the importance, mechanism of action and other aspects of suppressor T cell function can be fully understood.


An evaluation of some factors affecting the detection of blood group antibodies by automated methods. Some factors affecting the sensitivity of the automated methods for blood group antibody detection have been evaluated. The experiments revealed influencing differences between various albumin preparations. In the BMC method, one lot of albumin permitted no significant antibody detection. In the LISP technique, a plateau of maximum Polybrene activity was found. The beginning of this plateau depended on both the albumin preparation and the Polybrene lot. In the BMC method, methyl cellulose gave optimal sensitivity within a concentration range of 0.3 to 0.5 per cent. The stability of test cells stored in ACD at 4 C was studied. All test cells could be used safely up to two weeks. Cells from different donors showed variable reactivity after three weeks.


Comparison of HL-A typing with NIH trays and the NIH technique with typing by the fluorochromasia cytotoxicity assay. A comparison of HL-A phenotypes determined with plates containing predispensed typing sera supplied by the NIH Serum Bank with phenotypes determined by the fluorochromasia cytotoxicity assay using local reagents showed that the NIH plates (as dispensed in 1972) had an insufficient number and variety of typing sera. Using NIH trays, it was difficult to detect HL-A9 and W19, both of which specificities are now known to have subtypes. The NIH trays also appeared to detect more HL-A antigens than were consistent with the current theory of two segregant series, each expressing a maximum of two antigens. The excess antigens could not be comparatively evaluated in view of the small number of sera defining each. With the NIH technique, it was impossible to interpret the reactions if the preparation had too many dead cells. A high proportion of dead cells was occasionally noted when lymphocytes had been previously frozen or obtained from lymph nodes. When the NIH and fluorochromasia techniques were compared using the same antisera and fresh lymphocytes, they proved equivalent in sensitivity.


Skin grafting across H-Y incompatibility after organ culture. Mouse skin maintained in organ culture for 7 days was transplanted across the H-Y histocompatibility barrier in two inbred strains: C57BL/6 and C3H/An. Cultured grafts were invariably rejected and at a faster rate than noncultured control grafts. Recipients of the cultured male skin grafts rejected subsequent noncultured male skin grafts in accelerated fashion.


The effect of donor blood on renal allograft survival in DL-A tissue typed beagle littermates. A single transfusion of 200 ml of donor blood 14 days before renal transplantation in prospectively DL-A tissue typed beagle littermates appeared to have an effect on graft survival. Seventeen per cent of the recipients did respond to the transfusion with formation of lymphocytotoxic and haemagglutinating antibodies. These "responder dogs" rejected kidney grafts in an accelerated way, compared with the "nonresponders" and with the nontreated control dogs. Responsiveness appeared to occur in pairs of littermates, which suggests that responding potency is genetically determined. There was histological evidence of acute arteritis in the renal grafts of responders, whereas cell-mediated rejection was noted in nonresponders.


Inhibition of tumor growth in syngeneic chimeric mice mediated by a depletion of suppressor T cells. Syngeneic chimeric (lethally irradiated and reconstituted with syngeneic bone marrow cells) mice manifested an increased resistance to the development of Lewis lung carcinoma. In addition, these mice had a higher response to polyvinylpyrrolidone and a reduced reactivity to T mitogens. The present findings suggest that syngeneic chimeric mice lack suppressor T cells shown to regulate the development of Lewis lung tumor and the response to polyvinylpyrrolidone. Other components of the T cell population, such as helper cells responding to sheep red blood cells or cells involved in allograft rejection, assayed in these syngeneic chimeras were found unaffected. The fact that chimeric mice are deficient in a certain suppressor T cell population whereas other T activities are normal suggests the existence of different cell lines within the T cell population.


Effect of immunosuppressive therapy for renal allografts on the number of circulating sheep red blood cells rosetting cells. Patients receiving renal allografts from relatively incompatible donors were randomly assigned to one of two immunosuppressive regimens: azathioprine and prednisone with or without a 2-week course of horse antihuman thymocyte globulin (ATG). The number of circulating lymphocytes fell to about one-third of pretreatment values in both groups of patients. In patients given ATG, the proportion of sheep red blood cell-rosetting lymphocytes (SRBC-R) fell promptly to less than 10% of pretreatment values. In contrast, the percentage of SRBC-R remained at about 70% in patients receiving only prednisone and azathioprine. The addition of ATG reduced the number of SRBC-R/mm3 to one-tenth to one-thirtieth the number seen in non-ATG-treated patients. Plasma of patients undergoing therapy did not inhibit rosetting in vitro. It is proposed that the monitoring of circulating rosetting cells may be a useful clinical guide to the degree of T cell immunosuppression. It is also suggested that the regimen of azathioprine, prednisone, and ATG results in a more effective suppression of circulating T cells than that produced by azathioprine and prednisone alone.


Sex-determined antigens in rats detected by bone marrow transplantation but not skin grafting. Skin grafting in untreated rats and bone marrow transplantation into minimally immunosuppressed recipients have been used to investigate histocompatibility differences associated with the Y chromosome. Male skin survived for upwards of 120 days with no sign of rejection when grafted into female rats in circumstances where male bone marrow was rejected. Y chromosome-associated antigens were only detected with skin grafting by prior exposure of the female rats to male cells. It is concluded that bone marrow grafting into minimally immunosuppressed recipients may provide a more sensitive index of minor histocompatibility differences than skin grafting. The need to recognise donor cells in recipients prepared for bone marrow grafting with cytotoxic chemicals is emphasized.


Xenogeneic skin and kidney transplants in a closely related canine system, fox-dog. Fox kidney and skin grafts were transplanted into dog recipients. Fox kidneys, transplanted en bloc into untreated dogs, survived 6.2 +/- 0.4 days. The skin transplants survived 5.9 +/- 1.4 days. The grafted kidneys showed almost normal function before rejection. Both skin and kidney rejection were mediated through a cellular mechansim. Performed natural antibodies against donor tissue were not present in the serum of the recipients. These results combined with absorption studies suggested a close relationship between fox and dog, but different number and morphology of chromosomes, immunoelectrophoretic patterns of serum proteins, and disparities of the transplantation antigens proved that the fox is a species quite separate from the dog. It was concluded that the fox-dog system, with its similarity to the chimpanzeeman relationship, offers a unique model to study clinically applicable methods of managing xenografts between closely related species.


Attempts to compare the effectiveness of blocking factors and enhancing antibodies in vivo and in vitro. Sera from rats carrying tolerated skin allografts were tested for the presence of blocking activity in vitro. Sera with blocking activity had no effect on transplantation tolerance induction in newborn animals. Immunological enhancement of tumor growth was procured by passive transfer of serum from tolerant animals bearing skin allografts. It made no difference whether or not the serum contained blocking activity in vitro. These results suggest that there is no relationship between blocking factors and enhancing activity in vivo.


Longitudinal malaria studies in rural Northeast Thailand. Chloroquine treatment of falciparum malaria infections. The efficacy of chloroquine in the treatment of falciparum malaria was studied in two villages in Northeast Thailand, an area endemic for chloroquine-resistant falciparum infections. Chloroquine did not appear to reduce the duration or density of parasitemias experienced by asymptomatic villagers, but did benefit, usually temporarily, many subjects with symptomatic or high-density infections. These observations suggest that the high prevalence of chloroquine-resistant infections in the villages is similar to data from the hospital and clinics serving the area. The question whether chloroquine should remain available to this population should be evaluated.


[Ultrastructure of the secretory cells of the pancreatic islets in human fetuses]. An electron microscopic study of pancreatic islets of human fetuses 16--28 weeks old discovered four types of secretory cells -- B, A, D and type IV, which has not yet been given a generally accepted name. These cells contain small secretory granules more dense than granules D. In three cases endocrine elements with "mixed" granulation (D--A) were noted. The formation of insulin- and glucagon-containing granules in the ergastoplasm and Golgi complex was observed. The hormone secretion is realized by emyocitosis.


[Comparative morphometric study of the ultrastructure of cells in vivo and in vitro]. A morphometrical study of the fine structure of normal and malignant cells, both taken immediately from the organism (in vivo) or previously cultured (in vitro) was carried out. A high level on the mitochondrial morphological coefficient -- Km was discovered in normal and malignant cells in vitro. Unlike, the ergastoplasmic morphological coefficient -- Ke was high in the in vivo cells and low in the in vitro cells. The in vitro factor causes considerable changes in the fine structure of cells, which are more important than distinctions between normal and malignant cells. This fact must be taken into account in morphological studies of cells in vitro.


[Rapid method of obtaining ultrathin sections in monolayer embedding]. It is proposed to employ a simple optical method for a correct relative adjustment of the knife and the roof of the piramid for obtaining ultrathin sections of monolayer embedding. For the material embedding, plastic cuvets and a lavsan film are employed, this technique facilitating the process of embedding.


Quantitative colour-ultrasonography by means of a computer aided simultaneous tomogram. In this newly developed method, the ultrasonic diagnosis has become quantitative. The data will remain quantitative so far as an image storage tube is used. With the conventional storage type CRT, it is impossible to memorize the reflected echo signals of different strength levels. But with our method, it becomes possible to memorize the images according  to individual levels. By the direct digitalization of the ultrasonic echo images, more information is obtained from the reflected echo signals. By processing the original information with a computer, more accurate diagnosis is possible. It is hoped and believed, that this computer aided ultrasonic examination, with single scan display in colour or black and white, will further promote ultrasonic diagnosis in future.


Rotational skin flaps to cover wound defect in groin. A technique of a lower relaxing incision and use of a rotational skin flap from the anterolateral thigh to close an extensive defect in the inguinal area is described. Its use is especially applicable for palliation in patients with large fungating metastases in the inguinal region.


[Phage typing of strains of S. enteritidis isolated in Bulgaria]. Studied were a total of 221 strains of Salmonella enteritidis isolated from birds, pigs, cattle, dogs, rodents, forage, environment, food products of animal origin, and human beings, in terms of their phage typing, in order to study the epizootiology of the foci of infection. Twelve phages were established: 2a, 3a, 4a, 5a, 6a, 7a, 8a, 9a, 15, 19, 20 and 21. Most widely distributed proved phage type 6a, followed by phage type 2a. The remaining phages occured more rarely, and some of them--15, 19, 20 and 21--were found only in particular districts and farms.


[Permeability of the mitochondrial membranes of the organs of white rats innoculated with Walker carcinoma to lipoic acid and thiamine labelled with S35]. Mitochondria isolated from organs of intact white rats and those with Walker carcinoma were incubated in Gubler medium containing S35-lipoic acid or S35-thiamine. An accumulation of lipoic acid by mitochondria is higher in tumor-bearing animals, while that of thiamine in most organs is lowered. In healthy animals mitochondria were found to accumulate S35-thiamine more intensively than S35-lipoic acid. In tumor animals these indices become nearly similar, while organ differences are leveled.


[Prevention and treatment of cancer of the cervical stump]. Of total number of patients with cervical cancer (12687) since 1962 to 1972 155 (1.2%) were subjected to therapy for cancer of the cervical stump. In 5 of 155 patients (3.2%) preinvasive cancer of the cervical stump was observed. Preliminary supravaginal hysterectomy was performed for benign pathological processes of the female genitalia, hysterectomy was performed for benign pathological processes of the female genitalia, including 86.5%--for uterine fibromyoma. Recently, a prolonged interval (10 years and longer) elapsed since supravaginal hysterectomy is typical for patients in whom cancer of the cervical stump develop. Hence, a careful follow-up of patients during the life period after supravaginal hysterectomy seems to be hardly feasible as it should be recommended, and it could not be an adequate prophylactic measure without using a cytologic assay. An idea of the rationality of using extirpation in climacteric and menopausal patients with fibromyoma is being substantiated.


A mild method for the isolation of folded chromosomes from Escherichia coli. Until now it has not been possible to obtain nuclear bodies from Escherichia coli after treatment with rifampicin. It was generally assumed that the cross-connections between the DNA double strands which are sensitive towards ribonuclease are destroyed under the influence of inhibitors of RNA synthesis like rifampicin. In this paper a new lysis procedure is described for preparing nuclear bodies from E. coli. These particles differ in some respects, especially in salt sensitivity from those prepared by earlier methods. Using the new lysis method it is also possible to obtain folded chromosomes from cells after treatment with rifampicin. These nuclear bodies can be destroyed by ribonuclease. Therefore, it has to be postulated that a fraction of RNA being sufficient to hold the chromosome in the folded shape is not susceptible to the action of rifampicin.


Unfolding of the chromosome of Escherichia coli after treatment with rifampicin. Until recently it has been assumed that the factors being responsible for the condensation of the DNA in the nucleoid of Escherichia coli are destroyed by rifampicin because it has been impossible to obtain folded chromosomes from cells treated with this inhibitor. In this paper it is shown by viscosity and sedimentation measurements that unfolding of the DNA does not take place during the process of the cell lysis as it should be predicted from this assumption, but is occurring distinctly afterwards. Since the observed unfolding process is too slow to be caused simply by molecular movements it is concluded that it is brought about by the action of salts or detergents of the lysis medium. The structure of the nucleoid is still intact in vivo despite inhibition of RNA synthesis by rifampicin.


Rat liver alcohol dehydrogenase isozymes: influence of infection with Trypanosoma. A study has been made of changes in alcohol dehydrogenase (ADH) isozymes in livers of rats infected with the following trypanosomes: Trypanosoma cruzi, T. rhodesiense, T. congolense, and six geographical isolates of T. lewisi. A control group of the same age was injected with saline, and another left uninjected. Liver homogenates were electrophoresed in noble agar gels followed by formazan staining according to the method of Ursprung and Leone (1965). Of a total of 25 replicates, 15 showed that the level of rat liver ADH isozymes was similar in the uninjected and saline injected animals; 6 replicates showed a slightly higher level of ADH isozymes in uninjected than saline injected control rat livers, and 4 replicates had a higher level in saline injected than in the uninjected. With either 1-octanol or ethanol as substrate, a marked elevation of ADH activity was observed beginning with day 7 post inoculation in rat livers infected with T. cruzi, T. lewisi, and T. congolense, or as early as day 4 post inoculation with T. rhodesiense. The elevation persisted 59 days or more in rat livers infected with T. lewisi, but rats infected with the pathogenic species usually died 5 to 14 days after infection. The elevation of ADH isozymes has also been demonstrated spectrophotometrically for the first 5 minutes of reaction time, using acetaldehyde as substrate. Also observed in livers infected with pathogenic species and certain strains of T. lewisi were: (1) ADH isozyme pattern changes involving an elevated level of certain isozymes only, and (2) abnormal isozyme mobilities.


[Correction osteotomy of tibia for malalignment at the knee and the bone-suture (author's transl)]. Correction osteotomy of the tibia in genu valgum and varum is discussed on the basis of the literature and two cases. After considering critically the well-known techniques of fixation, the almost forgotten bone-suture with silk or Perlon is recalled which may replace osteosynthesis. The advantages of the plaster cast of the leg which permits much earlier weightbearing then osteosynthesis and adds to bony union are emphasized. The author warns against too early mobilization.


[Serogrouping of Escherichia coli from urinary tract infections (author's transl)]. Serological grouping with 44 anti-O-sera was performed on 215 E. coli strains isolated from urine of patients with significant bacteriuria. 95 strains (44.2%) were typable, 34 strains (15.8%) proved to be rough strains, and 86 strains (40%) were untypbale. The O-groups 2, 6, 9 and 75 were found to be more frequent in patients with chronic pyelonephritis. Among pregnant women with asymptomatic bacteriuria a typical frequency was not observed.


Profuse fimbriae conferring O-inagglutinability to several strains of S. typhi-murium and S. enteritidis isolated from pasta products. Cultural, morphological, and serological experiments. During the last 2 years several O-inagglutinable Salmonella strains were isolated from pasta products the typing of which presented great difficulties. Serological and morphological tests (by electron microscope) revealed a fimbrial antigen which was thermolabile to a certain degree. This antigen represents (in corroboration of J.P. Dugiud) a special type of fimbriae of Salmonella and is morphologically different from type 1 and typ3-2 fimbriae previously described. It is probably an abnormal mutant form of fimbriae. Morphologically characteristic are its very much finer structure of filaments (2,7 nm) (Type-1 and type-2 of fimbriae measure in the range 6-8 nm.) and the 2,7 nm) (Type-1 and type-2 of fimbriae measure in the range 6-8 nm.). and the 2,7 nm) (Tpe-1 and type-2 aof fimbriae measure in the range 6-8 nm.) and the 2,7 nm) (Tpe-1 and type-2 of fimbriae measure in the range 6-8 nm.) and the large number of filamentous appendages...