[Characteristics of capsular bacteria, isolated from children with acute intestinal diseases]. A study was made of 256 young children suffering from gastroenterocolitis, dyspepsia, food poisoning for the presence of conditionally pathogenic representatives of the Enterobacteriaceae family. Klebsiellae were isolated in 39.8% of the patients and in 22.3% of 67 healthy children. A study was made of morphological, cultural-biochemical properties and the antigenic structure in 308 strains of the Klebsiella denus. Capsules were detected by microscopic examination. Biochemical properties were determined after Kaufman, and some of the cultures proved to differ from the typical biochemical pattern described by this author. K-antigen was found in 185 klebsiella strains; of this number 99 strains belonged to Kl. pneumoniae and 86--to Kl. aerogenes. Fimbria were revealed in some of the Kl. pneumoniae and Kl. aerogenes strains. Bacteriocines were detected in 103 of 206 strains (by Abbot and Shennon's method).


[Morphological changes during intestinal dysbacteriosis in rats]. Inclusion into the food of rats of living E. coli strains produced an inflammatory-destructive process in the mucose of the cecum. When a strain isolated from the patient suffering from carcinoma of the stomach was fed the changes appeared in 2 to 3 months after the beginning of the experiment and were accompanied by atrophy of the mucosa; after colibacterin administration the inflammatory process occurred later, it was less pronounced and accompanied by the repair reaction.


[Experience in the use of Tebrophen for influenza prevention]. The efficacy of influenca prophylaxis by a new Soviet chemopreparation tebrophen was studied during the influenza epidemics of 1972-1973 caused by the influenza virus of A/Hong-kong/68 and A/England/72/H3N2/types. Investigations were carried out under conditions of an epidemiological experience among the organized (adult) collective bodies (4352 persons in all). The preparation was instilled intranasally in the form of a 0.25 and 1% ointment on vaseline base. The efficacy index was 2.0-2.7, and the protection index--51--60%.


[Dynamics of dysenteric diseases, caused by Sh. sonnei of different enzymatic and conditional colicinogenotypes, in Kharkov in 1965-1972]. Results of studying the enzymatic (by maltose, rhamnose and xylose) properties of 9277 freshly-located Sh. sonnei strains isolated in Kharkov in 1965-1972 showed that they were referred to 14 enzymatic types (a, b, c, d, e, f, g, k, l, m, n, o, p, q). The strains under study were additionally--within the range of each of the enzymatic type-divided into 8 conditioned coli phi,cinogen types (I-VIII) by their sensitivity to colicines of the indicator E. coli, K12 and B cultures. Subdivision of the strains with the use of the two mentioned tests permitted to establish the prevalence among the Sh. sonnei strains isolated during the individual years of definite conditioned enzymatic-colicinogenic types. During the period observed group diseases were caused by Sh. sonnei of only some of the enzymatic-colicinogenic types-aII, aVI, dI, dII, dVI, etc. Three enzymatic types of Sh. sonnei-a, d and k-dominated in Kharkov beginning from 1969.


[Relation of the immune response in rats to the state of the lysosomes and intensity of protein synthesis]. In stimulation of an immune response to salmonellae in rats by dibasol and methyluracil and its depression by chlorophos and an amine salt of 2,4-dichlorphenoacetic acid it was found that the intensity of the immune response depended more on the level of protein biosynthesis than on the state of lysosomes at the period preceding the immunization.


[Induction of autologous tissue disorders in animals tolerant to cross-reacting microbial antigens]. Injection to newborn C3H mice of streptococcus, group C, or C. albicans vaccines prevented in adult mice induction of the skin autotransplant affection caused by the immunization of these animals with the mentioned microbial vaccines. In response to the immunization with the streptococcus or monilia vaccines the tolerant mice displayed a reduction in the number of cells reacting with the microbial vaccines in the immunoadhesion and blasttransformation reactions; their cytotoxic activity in respect to the syngenous target cells was also diminished.


[Detection of atoxigenic variants in Cl. botulinum type A and B cultures exposed to different treatments]. A possibility of detection of atoxigenic clones in the cultures of Cl. botulinum, types A and B, under conditions of treatment with acridine strains, UV-irradiation and heating of spores was studied. Of the 10 strains investigated, atoxigenic variants were obtained only in 3, belonging to type B; the frequency of formation of atoxigenic clones under the effect of ethidium bronide constituted 36--45.7%, and of the UV-irradiation-4.2%; heating of spores proved to be ineffective. A frequent loss of the toxigenicity sign coincided with the view on the elimination of the episomal determinant of the toxin-formation, not with the mutational nature-of this change. An association between the differences in stability of retention of the toxigenicity signs in various strains and types of Cl. botulinum and possible differences of the corresponding genetic determinants of the toxin formation is discussed.


Alkylated cytosine nucleosides: substrate and inhibitor properties in enzymatic deamination. Cytosine nucleoside deaminase (EC 3.5.4.5) from Salmonella typhimurium LT2 catalyses the deamination of ribo-, deoxyribo- and arabinosyl nucleosides of cytosine alkylated at the C-5, but not at the N3 or exocyclic N4, of the pyrimidine ring. The enzyme was inert towards analogues etherified at the 3'-OH and 5'-OH of the sugar ring; it was active against the 2'-O-methyl derivative of cytidine, but not arabinosycytosine. The N4-and 5'-O-alkyl non-substrate analogues competitively inhibited deamination of deoxycytidine and arabinosylcytosine, the most inhibitory being 5'-O-methylarabinosylcytosine. The alpha anomer of 5'-ethyldeoxycytidine, the 2,2'-anhydro derivative of cytidine, and the 3'-O-alkyl derivatives were neither substrates nor inhibitors. The presence of cytidine deaminase was demonstrated in both granulocytes and lymphocytes from human peripheral blood. The specificity of this enzyme differed significantly from that of the bacterial enzyme, a finding of some relevance in relation to the frequently encountered intracellular deamination of therapeutically active arabinosylcytosine to the inactive arabinosyluracil.


Advantage of defined tissue slices against minced samples in biochemical in vitro investigations of brain cortex. A cutting device for the preparation of brain cortex slices with a regular cylindric shape and a defined thickness is described. Determinations of the glucose and the electrolyte metabolism and the reactions of both to substances' additions were made with minced brain and with brain slices of different thichknes. The comparison of the methods and of the results makes evident that experimentation with slices has several advantages.


[In-vitro cultivated cells of smooth muscular organs. 1. Cultivation of isolated rat bladder cells]. Cells obtained from the rats urinary bladder by enzymatic treatment were cultivated on glass surfaces in completely synthetic nutrient media supplemented with 10% calf serum. The occurrence of smooth muscle cells, in addition to fibroblasts and multinuclear giant cells, in the monolayer cultures obtained is postulated.


Application of histoacryl-N-blau and Surgicel in experimental pancreas injuries and resections. A new method has been worked out for the treatment of experimental pancreas injuries and resections. The surfaces were coated with SurgicelR and the coating was fixed with the adhesive Histoacryl-N-Blau. Use of these two completely absorbable substances prevented the complications caused by sutures. The results confirmed by histological and laboratory tests have been satisfactory, hence the method appears to be clinically applicable.


Superior mesenteric blood flow in man studied with a dye-dilution technique. The superior mesenteric blood flow in the post-absorptive state was studied with a dye-dilution technique using indocyanine green in 37 patients with apparently normal small bowel function. All the patients except 2 had been, or were to be, treated because of malignant disease, mostly rectal carcinoma. The investigations were performed in connection with portography. The dye was injected into the superior mesenteric artery as a single injection during continuous sampling of blood from the superior mesenteric vein, catheterized through the reopened umbilical vein. The blood flow was calculated from the dye-dilution curves obtained with a modified Stewart-Hamilton formula. As recirculating dye appeared in the later part of the dye-dilution curves, the appearance of the recirculating dye was timed in 4 patients. The hepatic extraction of the amount of dye usually injected, 1.25 mg, was 60%. The superior mesenteric blood flow averaged 706 ml/min (397 ml/min/m-2 body surface) or 12% of the cardiac output. The appearance time, mean transit time, vascular resistance and vascular volume were also determined.


Superior mesenteric blood flow in man following injection of bradykinin and vasopressin into the superior mesenteric artery. The superior mesenteric blood flow was studied with a dye-dilution technique after catheterization of the superior mesenteric artery and vein. The investigation was performed in connection with portography in 22 patients with apparently normal small bowel function. Intra-arterial injection of 5, 10 or 20 mug bradykinin was followed within one minute by an increase, on the average, of 114, 176 and 223% respectively, in the superior mesenteric blood flow. The blood flow was dose-dependent in this range. The estimated vascular resistance decreased by 52, 61 and 67%, respectively. The portal venous pressure was increased slightly after intra-arterial injection, but the pressure was unchanged after intra-portal injection. Intra-arterial injection of bradykinin causes a highly improved venous phase at superior mesenteric angiography. This may be due not only to the increased flow but to some extent also to increased capillary permeability produced by bradykinin. Intra-arterial injection of 0.125 and 0.250 IU of vasopressin decreased the superior mesenteric blood flow by 53 and 54%, respectively, within 3 minutes of the injection. The dye-dilution method used was not applicable to blood flow below a level of about 200 ml/min. Continuous infusion of 0.05 IU/min decreased the superior mesenteric blood flow by, on an average, 58%. The portal venous pressure was decreased by 25% after the intra-arterial injection, but no change in pressure was recorded after intra-portal administration. The clinical use of intra-arterial infusion of vasopressin during gastrointenstinal bleeding is discussed.


Preservation of kidneys for transplantation. Assessment of ischemic damage by renal autoperfusion. Autoperfusion of canine kidneys was investigated as an alternative method to determinate the ischmic organ damage following various preservation procedures. As a compromise between implantation of the donor kidney and normotherimic isolated perfusion, autoperfusion is shown to offer some advantages in the study of the pathophysiology of the ischemic damaged kidney. Within 3 hours of autoperfusion, we obtained detailed information about the immediate regenerative ability of the glomerular, tubular, and vascular functions following various sorts of ischemic trauma.


Diagnostic value of the LH-releasing hormone stimulation test in functional amenorrhea. LH-releasing hormone (25 mug, iv.) was administered to 37 women with functional amenorrhea. In addition to the clinical classification, these patients were divided into three groups according to the basal level of serum LH. A significant correlation was found between the base-line levels of LH and the serum concentration of oestradiol plus oestrone. The absolute increment of LH after the injection of LH-RH was found to be dependent only on the base-line level of LH. Except for the patients with anorexia nervoxa, the base-line levels and the response pattern of FSH were almost the same for all three groups. From the results of this study, it was concluded that: 1. The circulating levels of oestradiol and oestrone, where derived from ovarian secretion, actually depend on the gonadotrophic stimulus. In patients with functional amenorrhea, the oestrogens do not make an independent contribution to the pituitary response to LH-RH. 2. Dysregulation of releasing hormones, whether located at the hypothalamic or suprahypothalamic level, necessarily influences the secretory capacity of the pituitary gland; long-standing deficiency of LH-RH, may finally lead to a state of pituitary "functional" unresponsiveness to releasing hormones. 3. In view of the excellent correlation between base-line levels of LH and the absolute increment of LH following stimulation with LH-RH, this test only accentuates the existing pituitary secretroy capacity, which can be roughly estimated from circulating levels of LH and FSH. 4. This test may be useful in distinguishing the milder cases of psychogenic amenorrhea from extreme gonadotrophic dysfunction in patients with anorexia nervosa.


The influence of time, dose and gonadal steroids on LH-RH-induced gonadotrophin release in rats. Hypophyseal responses to LH-releasing hormone (LH-RH) were studied in ovariectomized rats, pre-treated once with 50 mug oestradiol-3-benzoate alone or in combination with 25 mg progesterone either 16, 24, 48 or 72 h before the administration of LH-RH.  The highest serum gonadotrophin increase was detected in ovariectomized rats pre-treated with oestrogen 48 h before the LH-RH injection.  The serum LH concentration change in intact male rats was markedly lower in terms of order of magnitude than in ovariectomized, oestradiol-3-benzoate, progesterone-treated rats ("O.Oe. P."-rats).  These latter test animals showed the maximal increase of serum LH concentration, depending on the dose of LH-RH, after 10 to 25 min and that of FSH after 40 min.  The dose-response curves for LH release in "O.Oe.P."-rats were linear for short (10 and 15 min) and sigmoid for longer time intervals (20, 30 and 40 min) between LH-RH injection and sacrifice.  The possible reasons for this difference in both magnitude and time-lapse for maximal increase of serum LH and FSH concentration, the influence of steroid pre-treatment and the variation of the time course of serum LH concentration, depending on the dose of LH-RH, are discussed.


The sequence of pituitary responses to synthetic luteinizing hormone releasing hormone (LH-RH) throughout the normal menstrual cycle. Thirty-one ovulatory women between 20 and 33 years of age were given 150 mug of synthetic LH-RH during different phases of the menstrual cycle. Five patients were studied during the early follicular phase (days 4-7); 10 patients during the late follicular phase (days 9-12); 6 patients during the "LH Surge"; 5 patients during the early luteal phase (days 14-16); 3 patients during mid-luteal phase (days 17-21); and 2 patients during late luteal phase (days 22-27). Oestrogen, progesterone, FSH and LH levels were determined from 30 min prior to LH-RH administration to 90 min thereafter in all cases. LH response to LH-RH increased progressively during the follicular phase. Enhanced pituitary responsiveness to LH-RH occurred at mid-cycle for both LH and FSH and maximum LH responses occurred during the "LH Surge" and early luteal phase. LH responses during the mid and late luteal phases were similar to late follicular phase responses. There were no significant differences between FSH responses during the early follicular, late follicular, mid-luteal and late luteal phases. Maximum pituitary responsiveness appears to occur in a gonadal steroid milieu of high oestrogen levels in association with rising but low progesterone levels. Progesterone or a crucial oestrogen: progesterone ratio may in fact potentiate pituitary release of LH during the early stages of corpus luteum formation. Pituitary responsiveness to LH-RH correlates positively with basal LH and oestrogen levels during the menstrual cycle and with the oestrogen:progesterone ratio during the luteal phase.


Testosterone undecanoate: a new orally active androgen. Oral testosterone undecanoate (TU) in arachis oil has been evaluated with a view to its possible use as a means of androgen replacement therapy. A single 100 mg dose was found to elevate plasma androgen levels and urinary 17-ketosteroid excretion in 6 normal men. Ninety mg/day and 60 mg/day doses taken by a hypogonadal man resulted in sustained levels of androgen which appeared physiological when measured by radioimmunoassay without chromatography. However, upon separation of the steroids by chromatography it was found that much of the androgen present was in fact dihydrotestosterone not testosterone. Both TU and dihydrotestosterone undecanoate were detected in plasma by gas chromatography and it is suggested that the ester is absorbed as such from the intestine and the unesterified steroid subsequently released by hydrolysis. The convenience of oral administration, the resulting prolonged elevated plasma androgen levels and the probable lack of deleterious effects on the liver may render oral TU of value where androgen replacement therapy is indicated.


Mast cell sensitizing antibodies in experimental candidiasis. Inoculation into foot-pads of guinea-pigs of a living suspension of Candida albicans together with Complete Freund's Adjuvant, provoked a hypersensitive state, characterized by: 1) positive skin tests; 2) direct degranulation of peritoneal mast cells when exposed in vitro to the antigen; and 3) homologous "mast cell sensitizing antibodies" detected by the "indirect mast cell degranulation test". The mast cell sensitizing antibodies were heat labile, and their activity could not be restored by complement.


Treatment of children with perennial rhinitis with brompheniraminemaleate and phenylpropanolaminehydrochloride (lunerin mite). The effect of a combined pediatric preparation of brompheniramine maleate and phenylpropanolaminehydrochloride (Lunerin mite) was studied in 17 children (aged 4-14 years) with allergic rhinitis. A double-blind cross-over technique was used, and a score system was used for evaluation of symptoms and signs. The results show that the drug had a good effect with statistical differences on the 1 per cent level between the active preparation and the placebo. The effect was less pronounced in children aged more than 10 years, for whom a higher dose of the drug is recommended. The frequency of side-effects was negligible.


Mast cell sensitizing antibody (MCSAb) response in experimental candidiasis: chromatographic studies. A single dose of the yeast-like fungus Candida albicans (CA), mixed with Complete Freund's Adjuvant (CFA), and inoculated into guinea-pig foot-pads, provoked the productions of homologous mast cell sensitizing antibodies (MCSAb) present in the psiI-globulin fraction only, and of agglutinins localized in the same fraction. Heterologous MCSAb and skin-sensitizing antibodies detectable by passive cutaneous anaphylaxis (PCA) were constantly absent. These facts are in contradiction to results of previous experiments performed with other antigens; which after similar inoculation elicited production of heterologous MCSAb attaching themselves on rat mast cells (MC) and present in the psi2 fast moving globulin, homologous MCSAb localized in the psiI-globulin and in the psi2 fast moving globulin, and PCA antibodies. The immunogenicity of CA is discussed.


Effect of cobalt salts on the glycemia and islet histology of Channa punctatus (Bloch). Channa punctatus responds to the intramuscular administration of cobalt chloride and cobalt nitrate by exhibiting an increase in the blood glucose level. The hyperglycemia persists till 120 h, after which the fish become moribund and ultimately die. Cobalt salts evoke degranulation and vacuolization of the alpha-cells in the initial stage but later the beta-cells are also found to be severely damaged. Cobalt chloride has been found to be more toxic than the cobalt nitrate.


Scintillation camera studies of isotope flow in arteriovenous malformations. A significant proportion of arteriovenous malformations are still undetected on conventional brain scans. Dynamic scintillation camera studies have shown a pronounced and rapid isotope accumulation in these structures. By means of data processed flow studies, one can distinctly select the inflow phase etc., display TV pictures in optimal phase, and make quantitative comparisons. Thereby, one can obtain a very probable diagnosis, even when the AVM is small or has the characteristics of a fistula which is not seen on routine scans. As the method is simple and not time consuming, it is well suited for clinical screening.


[4-year-observation of results of VM 26 treatment of pathologic syndromes from the lymphoma malignum group]. The  authors used the preparation VM 26 in 66 patients with various pathological syndromes belonging to the group of malignant lymphoma. The patients were divided into three groups. Group A received only VM 26, group B VM 26 and ultracorten, group C VM 26, cyclophosphamide, methylhydrazine and glycocorticosteroids. In all observed groups a therapeutic activity of VM 26 was demonstrated. The best therapeutic results were obtained in group C, in group B they were slightly worse.


Subjective symptoms in epileptic patients on anticonvulsant drugs. A controlled therapeutic trial on the effect of vitamin d. The possibility (based on the recognised existence of anticonvulsant osteomalacia), of an osteomalacic origin of a number of subjective symptoms in epileptics (back pain, tiredness, sleepiness, irritability, and giddiness) was tested during a controlled therapeutic trial in 226 outpatients. There was no correlation between subjective symptoms and objective pathological indices of osteomalacia, and group treated with vitamin D (2000 international units daily for 3 months) showed no amelioration of subjective symptoms above that seen in the placebo group. The findings do not support the view that all epileptic patients on anticonvulsant therapy should be treated prophylactically with vitamin D.


Piribedil (ET 495) in the treatment of Parkinson's disease combined with amantadine or levodopa. The further therapeutic benefit of piribedil when combined with amantadine or Levodopa was studied by a double-blind, cross-over trial in 15 patients with Parkinson's disease. A significant improvement at the 5 per cent level for akinesia, gait, speech disorder and facial expression occurred when piribedil was added to Levodopa; and a more highly significant improvement at the 1 per cent level for akinesia, facial expression and finger dexterity occurred with piribedil and amantadine. No significant improvement occurred for special timed tests. Improvement was associated with side effects in both groups of patients. Side effects occurred with both placebo and active piribedil. Only nausea during piribedil and Levodopa treatment reached statistical significance when compared with the placebo. Piribedil did not give rise to any haematological or biochemical complications. Our findings suggest that piribedil is of further therapeutic benefit when added to amantadine or Levodopa. It was suggested that the improvement which occurred together with amantadine could be due to the combined action of both drugs on dopamine receptors.


Intranuclear inclusions in a case of Creutzfeldt-Jakob disease: an ultrastructural study. Two types of intranuclear inclusions were described in a brain biopsy from a patient with Creutzfeldt-Jakob disease. The first type of intranculear inclusion was papova virus-like and was observed within 20% of the nuclei of all astrocytes and neurons examined. The particles measured 32 nm in diameter and consisted of a dense core surrounded by a multi-layered shell. The second type of intranuclear inculsion was a granulo-fibrillar nuclear body found within the nuclei of astrocytes and neurons. The possible significance of these inculsions to the etiology of Creutzfeldt-Jakob disease is discussed.


Morphology and classification of malignant lymphomas and so-called reticuloses. There is general agreement as to the definition and subclassification of Hodgkin lymphomas, which is acceptable for practical reasons. However, the nature of the different types of Hodgkin lymphomas needs further consideration. On the other hand, today we are as far from agreement on non-Hodgkin lymphomas as ever before. Earlier European and American classifications have now to be reconsidered in the light of modern concepts of experimental immunology. It has become necessary to apply immunochemical and immunomorphological methods in addition to histological, histochemical, cytological, and ultrastructural techniques. Only such a complex approach has been able to provide new insight into the functional properties of the tumor cells. The result was a new lymphoma classification, which conforms to LUKES' concept in many respects. It was fundamentally accepted by a group of European lymphoma experts and has been condensed and modified in order to be applicable by as many lymphoma centers as possible. It has received the name "Kiel Classification" 1974. The main principles of the classification are as follows: 1. A distinction is made between malignant lymphomas of low-grade and those of high-grade malignancy; "-cytic", "-blastic" m.l. 2. The terms "sarcoma" and "leukemia" are avoided. All types of malignant lymphoma can be leukemic, however with differnt frequencies. All B-cell lymphomas can also show a monoclonal immunoglobulin increase ("paraproteinemia") in the blood, mostly of IgM. So-called macroglobulinemia of Waldenström is therefore not itself an etity, but instead a clinical syndrome. It has been shown that so-called reticulosarcoma is derived from immunoblasts, not from reticulum cells or histiocytes. The group of reticuloses also needs reconsideration. The term "reticulosis" is cytologically incorrect in most cases. Otherwise it refers to a group of diseases which we do not yet understand.


Primary and borderline brain lymphosarcoma: a neuropathological review of nine cases. Brain lymphosarcoma may be divided into the circumscribed forms, surrounded by marked oedema with fibrin, and the diffuse or infiltrating forms. Cytology of the former is more uniformly lymphocytic, its clinical course is more rapidly fatal. Anatomically primary diffuse lymphosarcoma of the brain may be secondary to 'cured' systemic lymphoma.


The classification of microgliomatosis with particular reference to diffuse microgliomatosis. In 13 of 14 autopsied cases of microgliomatosis, there was macroscopic evidence of tumour in the brain. In 11 of these 13 cases, microscopical examination disclosed many other small foci of microglimatosis. In the brain which appeared normal macroscopically, there was only diffuse microgliomatosis. This was histologically indistinguishable from that found in the cases with distinct masses of tumour.


Patterns of proliferation in cerebral lymphoreticular tumours. A study of eighteen cases of primary lymphoreticular tumours in the brain is described. In four of these there were extraneural lesions and in one macroglobulinaema. The use of whole brain sections embedded in celloidin, and of metallic impregnation methods, revealed certain constant patterns of proliferation. The tumours were diffuse and multicentric; the leptomeninges and perivascular spaces especially in the subependymal regions were frequently involved. Mature microglia were active both in infiltrated and in apparently tumour-free regions.


"Malignant lymphoma" of the brain following renal transplantation. A patient is described who was thought to have developed a malignant lymphoma of the brain after renal transplantation. The correct diagnosis was toxoplasmosis.


Human and experimental reticulum cell sarcoma (microglioma) of the nervous system. The histology and ultrastructure of primary central nervous system and metastatic (epidural) reticulum cell sarcoma is described. The tumors showed varying numbers of argyrophilic microglial cells which in all cases constituted a minority of all tumor cells. A primitive, undifferentiated cell, common to all tumors, was a small cell with a large dense nucleus and a narrow rim of poorly structured cytoplasm. These cells frequently showed small fatty inclusions and were tentatively identified as primitive multipotential cells from which all other tumor cells develop. It is concluded that reticulum cell sarcoma of the nervous system (primary or metastatic) and microglioma or microgliomatosis are one and the same tumor.


Fine structure of primary reticulum cell sacroma of the brain. An electron microscopic study was made on two cases of reticulum cell sarcoma (microglioma) of the brain. In both, the tumour was composed of several type of cells; cells with an undifferentiated appearance and cells with ultrastructural features of the reticulum cell and histiocyte. There seemed to be no significant difference in the fine structure between the tumour cells in reticulum cell sarcoma of the brain and extracerebral forms. The ultrastructures of a lymphosarcoma of the spinal epidural space was also examined and resembles that of such tumours occurring elsewhere in the body.


Primary cerebral reticulosis and plasma cell diffenentiation. Cerebral proliferative and tumour forming reticulosis are primary pathologic processes of the brain originating in the perivascular adventitial cell. In these conditions this cell can transform into a histiocyte or microglial cell with characters of a macrophage. A reactive cell with endoplasmic reticulum, basement membrane and fibril forming properties, is also present (fibril forming reticular cell). The malignant tumours of the perivascular spaces (cerebral reticulosarcoma) are characterized by the presence of the dedifferentiated cells originating from the intraadventitial cell. Under both proliferative and tumour forming conditions this cell may transform into a cell rich in endoplasmic reticulum, sometimes charged with Russell bodies and corresponds morphologically to the protein-forming plasma cell. The properties of the intracerebral periadventitial cells are identical with those of the reticulo-histiocytic system described by ASCHOFF. As its structure and the elements into which it differentiats sharply differ from those of the cells belonging to the lymphocyte series the term malignant lymphoma of the brain given to these processes does not correspond to the fundamental characters of these pathological process.


Ultrastructural features of human lymphomas. The diagnostic value of some ultrastructural details in a series of 73 lymphomas, 7 thymomas, 6 cases of Waldenström's disease, and 5 myelomas has been critically reviewed. The light microscopical diagnoses of "reticulum cell sarcoma" seems now inadvisable, since thhe majority of these cases, when examined by electron microscopy, were found to be "blast cell sarcomas", probably lymphoid in nature. Clear-cut relationships between cell ultrastructure and immunfluorescence data about surface Ig in lymphoid cell populations have not been ascertained.


Certain notable clinical attributes of the histiocytic sarcomas of the central nervous system. By the term reticulum cell sarcoma we denote any tumor composed predominantly of undifferentiated cells, some of which have the qualities of histiocytes. The origin of such CNS tumors may be traced to circulating monocytes, perithelial ro meningeal histiocytes or microgliocytes. The ubiquity of cells of the monocyte-histiocyte series allows six possibilities of CNS involvement: a) primary in the brain: b) secondarily involve the brain or spinal cord by extending from a cranial bone or vertebra to the epidural space c) rarely to involve intraneuronal tissues (lymph nodes, bone, viscera) and then later to localize to the brain substance d) to spread from brain outside the nervous system e) to evoke any one or several of the paraneoplastic diseases (polymyositis, polyneuritis, cerebellar degeneration, f) to permit widespread infections of the nervous system such as multifocal leucoencephalitis. Clinical attributes to be emphasized are the relative rarity of hematogenous metastases (2 of 121 cases), the relatively high incidence of such tumors in immunologically suppressed individuals (12 of 5000 cases), the frequency of primary tumors of CNS (23 of 144 cases), the high incidence of epidural and dural involvement from osseous lesions (13 of 121 cases); the rapid evolution of clinical phenomena; the rarity of paraneoplastic syndromes; the occasional spontaneous and frequent therapeutic regression upon x-radiation. The common invasion of pia and ependyma by the tumor cells and their natural tendency to phagocytosis opens unrealized possibilities of clinical diagnosis by cytological examination and culture of CSF. Early diagnosis by these methods permits avoidance of surgery and the use of radiation and possibly chemotherapy, which may be rewarded by symptomatic regression and potential cure.


Differential diagnostic aspects in malignant lymphomas involving the central nervous system. Neoplastic cells were found in the cerebrospinal fluid (CSF) cytograms in 57% of patients with lymphocytic leukemia and reticulum cell sarcoma. Tumor cells may be observed in CSF specimens showing normal cell count and total proteins. Quantitative and/or qualitative changes in CSF proteins in absence of corresponding abnormalities in serum may indicate a malignant lymphorproliferative process involving the central nervous system even in absence of neoplastic cells.


Light- and electron microscopic studies in hemoblastosis with CNS-disorder. Some cases of hemoblastosis with CNS-involvement were investigated by methods of light microscopy, cytochemistry and electronmicroscopy. The unique cell picture, as observed by light microscopy could not be proven by electronmicroscopic results. This fact was supported by comparative investigations of inflammation processes. Typical structures are described and discusses.


Clinical and pathological studies in a case of reticulum cell sarcoma. A case of reticulum cell sarcoma associated with involvement of the central nervous system was presented. This seems to be an atypical case of reticulum cell sarcoma for the following reasons. 1. Hepatosplenomegaly and enlarged lymph nodes were not observed through the entire clinical course. The main abnormalities were psycho-neurological. 2. These cells did not form a tumour mass, but infiltrated diffucely into the central nervous system and extraneural sites, and the primary focus could not be determined. Four cases of reticulum cell sarcoma in Japan, in which the initial symptoms were of neurological involvement, are reviewed.


Diffuse reticulosis with leukomalacia.

Diffuse reticulosis with leukomalacia. A malignant lymphoproliferative disease with acute clinical course and selective clinical CNS involvement is described. The metastatic lesions in the brain are compared with a primary microglioma of the brain.


Differentiation of lymphoid cells of the B cell series according to membrane and cytoplasmic determinants. Previous investigations have shown that a large proportion of normal human lymphocytes bearing membrane-bound IgM have also independently moving IgD molecules on their surface. Since it is known that in the majority of chronic lymphatic leukaemias (CLL) high numbers of lymphocytes with easily detectable membrane IgM can be found, we investigated CLL cells for the presence of membrane-bound IgD. In all 18 cases studied, high proportions of cells bearing surface IgD and IgM could be found. In none of the 18 cases crystalline Ig inclusions could be detected.


Malignant lymphomas of the nervous system. In a series of some 7,000 patients with tumors of the central nervous system, 208 patients (about 3%) had some form of a malignant lymphoma. Slightly less than half of these tumors were primary in the brain; the remainder had cranial involvement as part of a generalized process. The tumors consisted of Hodgkin's disease, lymphosarcomas, reticulosarcomas and plasmacytomas. The brain was involved in one of two ways: either as localized tumor masses resembling certain gliomas, or as diffusely invasive neoplasms resembling exudative cellular inflammatory processes. They had a peculiar predilection for the septum pellucidum but occurred also in the cerebral lobes, basal ganglia, brain stem and cerebellum. They all produced a fibrillary stroma of reticulin fibers and they spread along the perivascular spaces, in the cerebrospinal subarachnoid space, or intraventricularly on and beneath the ependymal lining. One type of lymphoma often fused into another - thus a single tumor often consisted of Hodgkin's sarcoma, lymphosarcoma and reticulosarcoma. In an addition series of 57 cases of spinal cord involvement by malignant lymphomas, there were no instances of a primary tumor; all patients had either primary lymphomas of the brain with secondary spread to the spinal subarchnoid space, or had spinal cord compression as a result of tumor in the vertebrae, the spinal epidural space, or the spinal dura. Hence the spinal cord involvement was a secondary manifestation of a lymphoma elsewhere. Peripheral nerve involvement by lymphomas resulted in destruction of myelin sheaths and axons by tumor cell infiltration and the neuropathy was always part of a generalized lymphomatosis.


Lymphoreticular proliferative disorders of the CNS and other organs: analogies and differences. Authors review differences between CNS and extraneural reticuloses, and consider the immediate threat to life by CNS lymphomas contrasting to other organ lymphomas, which usually become fatal only after generalization. Other special features of CNS reticuloses include the role of microglial cells, reactive astrocytosis, variations in meningeal vs. parenchymatous involvement and easier morphologic confusion with inflammatory processes. Analogies exist between CNS and extranodal "organ" lymphomas in terms of relatively late or no generalization. The entire spectrum of lymphomatous and histiocytic proliferation may occur in the CNS, the latter including atypical fibrous xanthomas and xanthosarcomas. A further analogy is seen in the presence of lymphocyte and plasma cells in cerebral and organ lymphomas that may well represent host defense reaction. When present in large numbers they may be responsible for the "inflammatory" appearance of some reticulum cell sarcomas of the brain.


Neoplastic involvement of the CNS in generalized lymphomas. In 49 autopsies on patients with generalized malignant lymphomas a thorough histological examination of the CNS was performed. Isolated neoplastic foci were found in the CNS in 10 cases. It is believed that most of the tumour infiltrations in the CNS as a result of neoplastic transformation of local mesenchymal cells and are not blood-borne metastases.


Pathology of primary reticulum cell sarcoma of the human central nervous system. Among 6000 consecutive autopsies, 9 cases of primary reticulum cell sarcoma of the central nervous system were discovered. There were 5 males and 4 females from 17 to 68 years old, and the mean clinical duration was 5 months. Gross examination revealed a wide range of lesions in the cerebral hemispheres, cerebellum and spinal cord. Histologically, the same type of malignant reticulum cell proliferation was encountered in every case.


Primary malignant lymphomas of the central nervous system in man. Sixty-eight primary malignant lymphomas of the CNS exclusively confined to the brain and its leptomeninges from a series of about 8000 intracranial neoplasms (incidence 0.85%) were examined and classified according to current histopathologic criteria. Average age at onset of symptoms was 55 years, mean duration of illness to time of diagnosis was 3 months. Survival averaged 1,8 months with supportive care, but 17,2 months with surgery, radiation and/or chemotherapy. CSF cytology was useful and reliable tool for clinical diagnosis. The cerebral hemispheres were affected in about 50%, the basal ganglia in 18%, posterior fossa in 10%, while multifocal lesions amounted to 22%. All CNS tumors were of the diffuse type of non-Hodgkin's lymphomas; no follicular (germinal center) lymphomas were observed. Three histological patterns comparable to extraneural lymphomas were distinguished: Immunoblastoma (reticulosarcoma) occurred most frequently (58.8%), lympho-plasmacytoid immunocytoma constituted 28 percent, while lymphoblastic lymphoma occurred least frequently (13.2%). There were no significant differences with regard to onset, location, growth pattern or clinical course except for a much poorer prognosis of lymphoblastic lymphoma. Although there are no definite cytological differences between malignant lymphomas arising in extraneural sites or as primary lesions in the CNS, the latter showed a much greater proportion of phagocyting histiocytes (and microglia) and a frequent occurrence of plasmacytes and their precursors which apparently exceded pure host reaction. The prognostic value of modern classification schemes for CNS lymphomas needs further critical evaluation.


Bacterial flora of the normal conjunctiva. II. Methods of obtaining cultures. The methods used for obtaining bacterial cultures from the normal conjunctiva were reviewed. A comparison was made between four methods; a) platinum loop, b)calcium alginate swab c) dry, and d) wet cotton wool swab, using agar (all methods) and serum-bouillon (methods b, c, d) as culture media. The comparisons were based on the isolation rate of Staphylococcus albus and corynebacteria. At the same time, four topical anaesthetics (benoxinate, tetracaine, proparacaine, cocaine) and one vital stain (tetrazolium - alcian blue mixture) instilled into the conjunctiva immediately before taking samples, were studied for their effects on the isolation rate of Staphylococcus albus and corynebacteria. For isolating Staphylococcus albus, method d was found to be superior to the others when the methods were used in the above mentioned order, and when agar was the only culture medium used. On the other hand, after instillation of the above mentioned eyedrops, causing the so-called "washing-out" effect (Fahmy et al. 1974), method a was found better than the others, providing the methods were used in the a-b-c-d order and when agar only was used. When considering the growth of Staphylococcus albus in serum boullion as well, methods b, c, and d were found equal in effect, but somewhat superior to a. Corynebacteria showed nearly the same isolation rate with all the methods before as well as after the instillation of eye drops.


Asymptomatic bacteriuria in schoolgirls. II. Differences in escherichia coli causing asymptomatic bacteriuria. Three hundred and forty-three E. coli strains isolated from the urine of patients with asymptomatic bacteriuria (ABU), symptomatic cystitis, or pyelonephritis were analysed with regard to O group distribution and sensitivity to the bactericidal effect of normal serum. Strains of O groups 1, 2, 4, 6, 7, 16, 18 and 75 were found in 31.3% in ABU, in 58.7% in cystitis and in 79.8% in pyelonephritis. Spontaneous agglutination was noted in 45.2% of ABU, 6.5% of cystitis and 1.7% of pyelonephritis strains. The strains from patients with ABU were significantly more sensitive to the bactericidal effect of normal serum than were those from patients with symptomatic urinary tract infection. In some patients with untreated ABU, changes in the characteristics of the urinary strains isolated were noted. The strains tended to become spontaneously agglutinating as well as more sensitive to the bactericidal activity of normal serum. The strains found in patients with ABU probably had an altered cell wall compared with those found in patients with symptomatic infections such that they produce fewer symptoms and possibly be less virulent.


Asymptomatic bacteriuria in school girls. IV Difficulties of level diagnosis and the possible relation to the character of infecting bacteria. As no method for localization of urinary tract infection has been shown to be absolutely reliable, six methods have been run parallelly in a study of 60 school girls with asymptomatic bacteriuria caused by E. coli. A poor correlation was obtained between "high infection" indicated by bladder washout test and abnormal findings of C-reactive protein, sedimentation rate, antibody titres or renal concentrating capacity, while findings of parenchymal reduction on the pyelogram and reflux on the urethrocystogram were often found within this group. The low frequency of abnormal findings of C-reactive protein, sedimentation rate and renal concentrating capacity in girls with a "high infection" may be explained by the finding that the ABU patients were infected with changed E. coli strains probably not able to cause the usual inflammatory reactions. The patients' bacteria were found to be less efficient in providing antigen for antibody determinations than were standard strains of same O group, indicating a difference between strains from ABU patients and standard strains. From the battery of tests used it seemed that most of the girls had a bladder infection. All tests were normal in 48% of the patients while at least three of the methods were abnormal in 12%.


Pulmonary vascular lesions in chickens following intravenous injections of disintegrated cells of Escherichia coli. Intravenous injections of disintegrated cells of Escherichia coli in chickens were almost constantly followed by extensive lesions in pulmonary arteries; the alterations consisted of mural fibrinoid necrosis, sometimes with slight intramural occurrence of mononuclear inflammatory cells and eosinophils. Massive perivascular accumulations of the same cell types were also very common findings. Affected arteries were frequently occluded by precipitates, predominantly consisting of the injected material, which were rapidly replaced by proliferating endothelial cells, resulting in obliterative lesions, where giant cells sometimes occurred. The conclusion was drawn that the arterial lesions could most adequately be categorized as hypersensitivity angiitis.


Influence of thymectomy, transfer of thymus and bone marrow cells and treatment with thymosin on the depressed splenic release of lymphocytes into the blood after irradiation. The content of lymphocytes in blood samples from the splenic vein and the splenic artery of guinea pigs was determined and the veno-arterial difference in number of cells was used as measure of the net release of cells from the spleen into the blood. The splenic release of lymphocytes was reduced after whole body irradiation with 300 rad. This reduction could partly be prevented by transfusion of bone marrow cells after irradiation, 10(6) cells being the most effective dose. In thymectomized, irradiated animals the restoration of the splenic release of lymphocytes after irradiation was impaired in comparison with sham-operated animals. In the thymectomized animals the transfusion of 10(6) thymus cells had a restitutive effect on the splenic release of lymphocytes, while transfusion of bone marrow cells or daily treatments with thymosin, alone or combined with transfusion of bone marrow cells, had no such restitutive effect. The results indicate that restoration of the splenic release of lymphocytes into the blood after irradiation is thymus dependent and probably caused by a traffic of lymphocytes from the thymus to the spleen.


Antihypertensive and hypertensive effects of the kidney. Elucidated by treatment with medullary transplants and with blockade either of the reninangiotensin-system or of the prostaglandin biosynthesis. After subcutaneous isotransplantation of renal medulla either from normal donors or from the ischaemic kidney of renal two-kidney hypertensive rats, the blood pressure of the renal two-kidney hypertensive recipients was lowered-but not to normal levels. After i.v. injection of the converting enzyme inhibitor SQ 20,881, the blood pressure was further decreased to, or close to, normal blood pressure. A complete normalization of the blood pressure was obtained by the combined treatment with medullary transplants and infusions of the angiotensin II inhibitor Saralasin. The difference between the effects of these two blockers was probably caused by differences in the doses used. Administration of indomethacin, an inhibitor of the prostaglandin biosynthesis, to renal two-kidney hypertensive rats with or without renomedullary transplants failed to provoke a rise in blood pressure. This indicates that the anti-hypertensive activity of renomedullary transplants is not due to the group of prostaglandins, the  synthesis of which is inhibited by indomethacin, and furthermore that these prostaglandins are not of importance to the blood pressure level in renal two-kidney hypertensive rats.


Directional preponderance, 1942-1974. A review. The subject reviewed is the phenomenon of Directional Preponderance (DP), a term first proposed in 1942 by Fitzgerald & Hallpike for an abnormality in the pattern of the caloric responses found to occur in association with a variety of unilateral lesions, both central and peripheral, of the vestibular system. On the basis of observations carried out upon a series of human subjects, Fitzgerald, Hallpike & Cawthorne (1942) argued that the DP towards the unaffected labyrinth which follows unilateral labyrinthectomy is subserved in part by a unilateral loss of utricular function--a utricular paresis. Support for the utricular paresis hypothesis, as developed in the course of subsequent studies by Hallpike and his co-workers is thought to be provided by a substantial body of evidence, both clinical and experimental, which has since become available. This is reviewed.


For new Escherichia coli o antigens, o158, o159, o160 and o161, and two new h antigens, h53 and h54. Four Escherichia coli strains were established as antigenic test strains for four new o groups, o158, o159, o160 and o161. The strains of o158 and o159 were isolated from cases of infantile diarrhoea in Great Britain, while the o160 and o161 strains were isolated from faecal specimens in Arabia. The o161 strain was at the same time designated as test strain of a new H antigen, H54, while a strain belonging to o group 148 was established as antigenic test strain for H53; this strain was also isolated from human faeces in Arabia.


Two new Escherichia coli o antigens, o162 and o163, and one new h antigen, h56. withdrawal of h antigen h50. Three E. coli strains representing strains from faeces of normal persons were established as antigenic test strains of two new O antigens, O162 and O163, and one new H antigen, H56.


Radioimmunoassay of hepatitis b antigen and antibody in dialysis and transplant patients. 57 dialysis patients, 29 of whom had been exposed to hepatitis in 1968-69, were re-examined for hepatitis B antigen (HB-Ag) and antibody (HB-Ab) by means of radioimmunoassay (RIA) and counter immunoelectrophoresis (CIE). Infected patients were followed for five years. Compared to CIE, RIA did not detect additional HB-Ag-positive patients, but antibody could persistently be detected in seven out of fifteen patients previously supposed to have escaped infection. tnine surviving HB-Ag-positive transplant patients remained carriers for 50-72 months. None developed clinical signs of chronic hepatic failure.


New immunofluorescence method for the identification of group a, b, c, e, and g streptococci. An immunofluorescence method for the identification of groups A, B, C, E, F, and G beta-haemolytic streptococci has been developed, using FITC-labelled F(ab')2 fragments of IgG with optimal staining characteristics. The method is useful for the rapid confirmation of beta-haemolytic streptococci in cultures; in a blind comparison with Lancefield grouping, there was a 97 per cent agreement.


Microbial growth on agar surfaces studied by incident light differential interference contrast microscopy. Microbial surface growth on routine opaque agar media was examined by various incident light microscopical techniques. Only differential interference contrast regularly gave good resolution and contrast. The arrangement of units approaching the size of individual bacteria may be judged by low power dry objectives.


Application of the passive haemolysis test for the determination of rubella virus antibodies. A passive haemolysis test for the determination of antibodies against rubella virus haemagglutinin is presented. According to this method, the principle of radial immunodiffusion techinque is applied. Rubella haemagglutinin-coated chick erythrocytes in the agarose gel were lysed by the diffusing positive sera of complement at 37 degrees C. The passive haemolysis test was compared with the conventional haemagglutination inhibition method, and the diameter of the haemolysis zones was shown to be a direct measure of the quantity of antibody added to the well. A plot of the log (HI titre) against the zone diameter gives a straight line. There is no need to remove nonspecific haemagglutination inhibitors. However, all serum samples must be inactivated at 56 degrees C for 30 minutes before testing. Tests of 200 serum samples from healthy women showed a good correlation between the haemagglutination inhibition titre and the antibody titre determined by the passive haemolysis technique. Twenty-one samples with a haemagglutination inhibition titre less than 10 were also negative in the passive haemolysis test. With the exception of one, all sera with a positive haemagglutination inhibition titre showed a positive haemolysis reaction. The method was found to be as specific and as sensitive as the haemagglutination inhibition test. In addition, the technique is rapid and simple for quantitative studies of antibodies against rubella virus.


Common enterobacterial antigen in Yersinia enterocolitica. Production of the common enterobacterial antigen (CA) by strains of Yersinia enterocolitica (Y.e.) serotypes 3 and 9 (Winblad), by strains of 5 different Y.e. serogroups (Wauters) and various other bacteria was examined. Antibody against CA was raised by immunization of rabbits with E. coli O 14. Extract prepared from S. typhimurium was used for the sensitization of sheep erythrocytes with CA. Absorption and haemagglutination inhibition experiments showed that CA could be detected in heat extracts from all Y.e. strains examined, and in that from Yersinia pseudotuberculosis. CA was not detected in extracts from Pasteurella multocida, Francisella tularensis, Brucella abortus, Acinetobacter calcoaceticus or Pseudomonas aeruginosa. Anti-CA antibodies could not be demonstrated in serum from rabbits immunized with Y.e. bacteria, but were demonstrated in serum from rabbits immunized with a CA-containing fraction of the Y.e. extract. The possibility of participation of anti-CA antibody in indirect haemagglutination tests for detection of antibody to Y.e. O antigens is emphasized.


Effect of temperature on optical density of rabbit blood in dye dilution studies. The optical desity of rabbit blood increased on cooling. This increase was additive to the deflection produced by indocyanine green at all concentrations measured. If calibration curves were not corrected for any increase in optical density produced by cooling the blood, and error (minimum 11%) was introduced in the estimation of cardiac output. The effect of temperature was investigated with three different densitometers. Its wave-length dependence did not follow the absorption spectrum of oxyhemoglobin.


The effect of spironolactone (Aldactone) and methyldopa in low and normal renin hypertension. The effect on BP of 100 and 200 mg spironolactone/day has been compared with that of methyl-dopa, 750 mg/day, and with combined treatment with both drugs in 32 patients with essential hypertension. The 28 patients who completed the entire investigation were treated for 30 weeks, divided into 4 treatment periods and 4 placebo periods of equal duration. BP did not fall significantly during the initial placebo period, and at the end of each of the intervening placebo periods it rose to pretreatment levels. A signifcant decrease in mean BP was found during the 4 treatment periods. A fall exceeding 14% was registered in 32% of the patients after methyldopa, 750 mg/day, in 50% of the patients after spironolactone, 200 mg/day, in 89% after combined treatment with both drugs, and in 29% after spironolactone, 100 mg/day. Low renin hypertension was found in 9 of the 28 patients. The average decrease in mean BP after sironolactone, 200 mg/day, methyldopa, 750 mg/day, and after combined treatment did not differ significantly between the low and the normal renin group. The rationale for using diuretics such as spironolactone or thiazide as the basic therapy in essential hypertension is discussed. It is concluded that both are useful in the treatment of essential hypertension and might be used alone or in combination.


Antihypertensive effect of beta-1 receptor blockade and beta-2-receptor stimulation in essential hypertension. The antihypertensive effect of practolol, a beta-1-blocker, alone and in combination with a beta-2-stimulating drug, salbutamol, has been studied in a double-blind cross-over trial on 19 patients. Practolol treatment induced a significant BP reduction, while the addition of salbutamol failed to give any further decrease.


The impact of August Krogh on the insulin treatment of diabetes and our present status. The influence of August Krogh on the introduction of insulin preparations in Scandinavia is mentioned, and his outstanding physiological background is outlined. Developments in preparation of insulin depending on the progress in protein-chemistry are summarized. The latest step in the purification of insulin extracted from pork pancreas now allows treatment of diabetics with protamine-pork-insulin without causing formation of insulin-antibodies in at least 90 per cent treated with insulin through several months. In only 3 out of 51 diabetics was it possible to demonstrate insulin-antibodies. This new step may be of great interest in two ways 1) it is now possible to make insulin-estimations in the plasma of insulin-treated cases and 2) it will be possible to find out whether elimination of insulin-antibody-formation will reduce the degree of vascular lesions in diabetics, such lesions being the greatest problem in clinical diabetes.


Effect of hypothermia and endotoxin on phagocytosis. Experiments with colloidal 198Au indicated that gold clearance highly decreased in rabbits cooled to 29-30 degrees C. The capacity of storing colloidal gold decreased especially in the spleen and liver. Endotoxin reduced the gold clearance in normothermic rabbits; the decrease was more marked in hypothermic animals.


Study of Escherichia coli O114 associated with a hospital outbreak. Escherichia coli O114 strains isolated from infants in the course of a hospital outbreak of enteritis were identical with type strain 26W in antigenic structure (O114:K90a, 90b), and in immunoelectrophoretic pattern (ORSKOV's group 1Bb) but differed from it in fermenting salicin late (18-22 days) and in phage pattern (group A4); the strains produced colicin and were lysogenic. Pathogenicity of the organism was proved by IgM type antibodies in a patient's serum rising in a titre of 1:128 and by its enterotoxin-producing capacity shown by the rabbit ileal loop assay.


The mutagenic effect of pesticides on Escherichia coli WP2 try. Thirty pesticides commercially available in Hungary and three well-known chemical mutagens were applied to agar plate cultures of her+ and her- derivatives of Escherichia coli WP2 try- strain. After incubation, the plates were examined for a relative increase in reverse mutation number. N-Trichloro methylthio-1,2,3,6-tetrahydrophthalimide, dimethyl-3,2-dichlorovinyl-phosphate and N-trichloro methylthiophyhalamide proved to have definite mutagenic activity.


Macromolecular synthesis during conjugation in yeast. Morphological changes and synthesis of DNA, RNA and protein during conjugation of Saccharomyces cerevisiae was studied. It was found that during conjugation distinct cell expansion and increase in the dry mass of the cell takes place. DNA synthesis is inhibited during mating while synthesis of RNA and protein is not affected. Conjugation of temperature sensitive mutant defective in elongation of DNA chain was normal both in permissive and restrictive temperature. Conjugation of mutants defective in the initiation of DNA synthesis or defective in RNA and protein synthesis was inhibited in restrictive temperature. The results obtained with temperature sensitive mutants suggest that RNA and protein synthesis is necessary for mating reaction while DNA synthesis is not required.


Specificity and origin of the Mod2- mutation which restores respiratory sufficient phenotype in some pet mutants in Saccharomyces cerevisiae. It has been found that Mod2- mutation restores respiratory sufficient phenotype in cytochrome b less mutant MB127-20C. Mod2- gene when present in the same haploid cell with mutant gene pet25 causing deficiency in cytochromes a+a3 and b seems to be responsible for reappearance of cytochrome b in the cytochrome spectrum as well partial respiratory activity. However, the restored respiratory activity seems to be inefficient as growth on unfermentable carbon sources is still impossible. Evidences are presented that the Mod2- mutation originates from respiratory sufficient strain 18-27 in which op1 mutation has been induced.


Comparison of mutagenic efficiency of decay of 32P incorporated in E. coli WP-2 and E. coli WP-2S cells. 32P-labeled Escherichia coli WP-2 and Escherichia coli WP-2S cells were stored at minus 196 degrees. The lethal effect induced by 32P decay was equal in both strains. Lethal efficiency of 32P leads to 32P transmutation in DNA amounted to 0.046. Reversion try leads to try+ were induced with a ten times higher efficiency in UV--sensitive strain WP-2S, as compared with strain WP-2.


Interaction of concanavalin A with the surface of virus-infected cells. Infection of untransformed cells with a wide-range of non-oncogenic enveloped viruses causes a significant increase in their susceptibility to agglutination by concanavalin A (Con A). The increased Con A agglutinability of these cells is not caused by an increase in the number of Con A sites on the cell surface but involves alteration in the surface properties of infected cells to allow redistribution of Con A receptors to form "patches" following binding of Con A to the cell surface. Similarities between Con A-mediated agglutination of normal cells infected with non-oncogenic viruses and the agglutination response to cells transformed by oncogenic viruses will be reviewed. Finally, the use of Con A as an experimental tool to modify the replication and cytopathogenicity of non-oncogenic viruses grown in mammalian cells will be presented.


Effects of concanavalin A on cellular dynamics and membrane transport. How does Con A affect the cellular dynamics and cellular transport of various substances? It has been observed that following a 30 minute incubation with Con A (20-66 mug/ml) the tumor cells (Anaplastic carcinoma Type 15091a), unlike the normal cells, gradually retract their pseudopodia, take on a rounded shape and lose their motility. The maximum rounding of tumor cells takes place during the period of 200-250 min following the withdrawal of Con A from the incubating medium. All of these rounded cells later develop their regular pseudopodia. A partial synchrony of cell division is also observed. Associated with the rounding effect, there is a decrease in the rate of uptake of some specific amino acids by the tumor cells. The maximum reduction in the uptake coincides with the stage of maximum rounding. Con A also affects some of the electrical properties of tumor cells. In addition, the incorporation of radioactive thymidine into the nuclei is reduced to a much larger extent than can be accounted for by the reduction in the rate of entry of thymidine into cytoplasm. The saturation densities of both normal and tumor cells are not significantly altered by Con A. Tumor cells treated with Con A (chronically or acutely) are equally as potent as the untreated cells in yielding solid tumors when the host animals are injected with these cell subcutaneously. In conclusion, it is suggested that while Con A does not revert or destroy this particular line of tumor cells, this lectin has some interesting selective effects on the morphology and transport properties of tumor cells.


Concanavalin A and other lectins in the study of tumor cell surface organization. Cell surface structures of two mouse ascites tumors were studied using lectins. The tumors are sublines of the spontaneous mammary adenocarcinoma TA3 in strain A, differing in two main characteristics. Subline TA3-St grows only in syngeneic mice and has high expression of H-2 antigens. Subline TA3-Ha, in contrast, proliferates in all mouse strains, and has low amounts of exposed H-2 antigens. Concanavalin A (Con A), phytohemagglutinin (PHA) and Helix pomatia anti A hemagglutinin (HP) were used in agglutination tests, in binding experiments with 125I-labelled lectins and also in fluorescence studies with FITC-labelled lectins. Con A and PHA agglutinated the TA3-St cells but not the TA3-Ha cells. However, fluorescein-labelled Con A and PHA were bound to all cells (greater than 90%) of both sublines. Moreover both cell types contained an identical number of Con A receptors. The same result was obtained when the number of PHA receptors on the two sublines was compared. HP agglutinated TA3-Ha cells but not TA3-St cells. However, in this case, the difference in agglutinability between the lines was due to the presence or absence of HP receptors. All TA3-Ha cells contained large numbers of HP receptors. In contrast the majority (greater than 90%) of the TA3-St cells lacked HP receptors. (See article.) Trypsin released the HP receptors from TA3-Ha cells, at the same time making these cells agglutinable by both Con A and PHA. We conclude that the Ta3-Ha cells have a trypsin sensitive surface glycoprotein (or glycoproteins) detectable by HP, which is absent on most TA3-St cells. It is possible that this glycoprotein interferes with the agglutinability of TA3-Ha cells by Con A and PHA; whether it is also responsible for the low expression of H-2 alloantigen on this cell remains to be seen.


Effect of concanavalin A and phytohemagglutinin on the modification of immunogenicity of canine kidney allografts. Mongrel dog kidneys were allografted to unrelated nephrectomized recipients which were then treated with subimmunosuppressive doses of azathioprine (2.5 mg/kg/day). Dog kidneys treated in vitro with perfusates containing concanavalin A (Con A) or phytohemagglutinin-P (PHA) survived as long as 60 days (mean 39.8 +/- 4.3) after transplantation, whereas normal kidneys survived less than 16 days. The optimal prolongation was achieved by perfusing the kidneys with 500 ml Ringer's lactate containing 25 mg/L Con A, 25 4 degrees C. Lesser effects were achieved with higher or lower concentrations of Con A, or with perfusions carried out at 25 degrees C. Most evidence suggests that Con A and PHA bind to cell surfaces and interfere with the perception of the graft antigens by the host.


Evidence for the activation of 3-methylcholanthrene as a carcinogen in vivo and asa mutagen in vitro by P1 -450 from inbred strains of mice. Genetic differences in aromatic hydrocarbon "responsiveness" exist among various mouse strains. New formation of cytochrome P1-450 and the induction aryl hydrocarbon (benzo [a ])pyrene) hydroxylase (as well as numerous other monooxygenase activities) appear to be associated ultimately with genes that cosegregate at a small number of genetic loci. By comparing "responsive" and "nonresponsive" siblings, we can evaluate the susceptibility of each individual to various mutagenic chemicals in vitro or carcinogenic agents in vivo.


Pathology of dendrites in subacute spongiform virus encephalopathies. The spongiform changes in the cerebral cortex of scrapie mice and of chimpanzees afflicted with experimental kuru and Creutzfeldt-Jakob disease were examined by electron microscopy. The pathognomonic findings consisted of swelling and vacuolation of neurons, particularly of dendrites. Fusion of swollen cells and processes occurred. The changes were associated with alterations of plasma membranes. Curled fragments of membranes accumulated at points of cell fusion and at the margin of vacuoles within dendrites. The abnormal membranes were wider and more osmiophilic than normal plasma membranes. These findings as well as other data on the nature of the atypical viruses of scrapies, kuru, and Creutzfeldt-Jakob disease indicate that the infectious agents are closely associated with membranes and that alterations of neuronal membranes initiate the spongiform degeneration of neurons.


Sutures and iris wound-healing in the baboon. This paper reports an experimental study of iris wound-healing and the response of iris tissue in baboons to different suture materials following a planned surgical incision. The wound was sutured with 8-0 virgin silk, 22 mum Ethilon or 7-0 chromacised catgut, or left unsutured. The iris produces a minimal inflammatory response to aseptic trauma characterised by round cell infiltration, clump cell proliferation, pigment cell proliferation from the posterior epithelial surface and proliferation of non-pigmented ciliary epithelium (knots). This response is associated with microscopic hemorrhages in the iris. There does not appear to be any fibrous union of wound edges, instead the wound surfaces become lined with a layer of pigmented cells, probably from the posterior epithelium. Sutures play the dual role of accurately apposing the wound edges and, because there is no fibrous union of iris tissue, of keeping them in apposition. Therefore, they must remain in situ permanently. Catgut is poorly tolerated by the iris and is eventually absorbed. For these two reasons it is unsuitable. Ethilon is the least reactive and virgin silk only slightly more reactive. Both of these are suitable for iris suture. The suture material at present available is not entirely satisfactory. Finer suture material is required to reduce even more the iris response to sutures. Needles, even those supplied with Ethilon or virgin silk, are too large and clumsy. The answer to this problem probably lies in strengthening and sharpening the suture material ends so that they can act as needles.


Animal experiments on an absorbable synthetic thread made of polyglycolic acid (PGA) in corneal surgery. Monofilaments of the absorbable synthetic thread Dexon made from PGA have properties similar to nylon 10-0. Experiments with intra-lamellar implantation of the monofilament in rabbit corneas showed the same good material tolerance as nylon 10-0. Perforating corneal wounds were closed with interrupted and running sutures from PGA monofilaments, respectively. One week post-operatively, increased intraocular pressure caused a wound rupture but not a thread rupture. Two weeks post-operatively an increased intraocular pressure of more than 300 mm Hg could no longer rupture the wound. Slit lamp and histological examinations revealed symptoms of absorption after the second week. According to our findings, PGA monofilaments may be suitable for corneal surgery in patients.


A new technique for measuring the consistency of faeces: a report on its application to the assessment of Senokotot therapy in the elderly. The use of a penetrometer provided a reliable and simple method of measuring stool hardness which enabled the stool softening effect of Senokot medication to be quantified.


Radioimmunological evidence for early functional activity in chick embryonic alpha cells. A radioimmunoassay for glucagon was utilized to investigate early developmental aspects of glucagon synthesis and release in the chick embryo. Immunoreactive glucagon was detected in both the pancreas and blood plasma from the fifth embryonic day onwards. The present data show that the chick embryonic alpha cell has the potential for secretory activity very early in development, and suggest a developmental role for glucagon in hepatic glycogen metabolism.


Sensitivities of strains of enteropathogenic Escherichia coli to cephalexin and other antibiotics. The sensitivity patterns of strains of enteropathogenic Escherichia coli to nine antibiotics were determined. Most strains were sensitive to gentamicin, kanamycin, neomycin, and colistin. Sensitivity to cephalexin was generally greater than sensitivity to ampicillin. Compared with sensitivity patterns of strains isolated in previous years, no significant change in sensitivity patterns of recently isolated strains was detected. All ampicillin-resistant strains destroyed the drug by producing beta-lactamase. The activity of this enzyme against cephalexin was significantly lower than its activity against ampicillin. The role of beta-lactamase, the correlation between its production and resistance to beta-lactamase antibiotics, and the similarity between beta-lactamase produced by EEC and the classified beta-lactamases produced by other enteric bacteria and Escherichia coli, are discussed.


T-cell lymphoma. Report of a case.

T-cell lymphoma. Report of a case. The morphologic, immunologic, and clinical findings in the case of a patient with a T-cell mediastinal lymphoma ((Sternberg sarcoma) are presented.


Studies of mitogen-induced lymphocyte transformation by a semi-microtechnic. The authors have demonstrated that mitogen-induced lymphocyte transformation can be effectively studied in a semi-microsystem allowing multiple studies from  a reasonably small volume of blood, which makes the technic more feasible for clinical studies of cellular immune mechanisms. The variability among individuals, and from day to day in the same individual, makes repeated, careful kinetic studies necessary for valid data. Moreover, the very wide range of normal responses in man makes the interpretation of cellular hyporesponsiveness difficult in pathologic states and necessitates the use of several mitogen concentrations and sequential kinetic studies to establish the validity of results.


Differential characterization of the "reticulum cell" in lymphoreticular neoplasms. Differential characterization of the "reticulum cell" in lymphoreticular neoplasms. Am J Clin Pathol. 64: 171-179, 1975. The term "reticulum cell" is confusing, having been applied to the cells involved in many hematopoietic neoplasms, such as reticulum-cell sarcoma, histiocytic medullary reticulosis, leukemic reticuloendotheliosis, and monocytic or histiocytic leukemias. In histologic sections, even the cells from poorly differentiated extramedullary lesions of chloroma or myeloblastic leukemia have been called "reticulum cells."A combined morphologic and cytochemical approach has been used to study "reticulum cells"in smears and tissue sections of neoplasms involving "histiocytes" or "reticulum cells."The cytochemical markers are: chloracetate esterase for neutrophilic granulocytes; nonspecific esterase and fluoride-resistant esterase for monocytes and histiocytes (phagocytes); tartrate-resistant acid phosphatase for the reticulum cells of leukemic reticuloendotheliosis; pyronin for the lymphatic reticulum cells (germinal center cells). The morphology of these cells is very well appreciated in smears, and the locations of these marked cells in tissue sections are easily recognized. The use of cytochemical and immunochemical methods and functional studies, in addition to simple morphology, may be useful in subclassification of lymphoreticular neoplasms.


Cutaneous infection due to a rough variant of Mycobacterium marinum. Spreading lesions clinically resembling lymphangitic sporotrichosis developed on the right arm and chest of a 60-year-old man with chronic lymphocytic leukemia. Acid-fast bacilli were seen in exudates from lesions and in biopsies, and were cultured from them. The isolant grew initially as a yellowish-orange scotochromogen on Lowenstein-Jensen medium at room temperature and at 35 C., but failed to grow at 37 C. It failed to grow on 7-H-10 medium. On repeated subculturing over a 2-year period it gradually converted to a photochromogen. Histologically, there was ulceration with extensive acute and chronic inflammation with fibrosis. Organisms occurred intracellularly as dense, compact, cigar-like packets resembling lepara bacilli. The appeared to have a predilection for the nucleus. The patient was anergic to PPD S, B, Y and G, and lacked antibodies to BCG phosphoglycolipids. The mycobacteriosis was alleviated by combined INH and ethambutol therapy. The isolant was identified as a rough variant of Mycobacterium marinum. It may have been transmitted by an insect vector.


Long term treatment of steroid dependent asthmatic patients with beclomethasone dipropionate. In the efforts to avoid the side-effects of the peroral cortisone drugs in the treatment of asthma, trials have been made since the early fifties with the administration of steroids in aerosol form applied direct on the bronchial mucosa. Hydrocortisone as well as prednisolone and dexamethasone have been used with a documented effect on the obstruction. However, the drugs were found to be resorbed and thus resulted in suppression of adrenal function and appearance of Cushing syndrome and other well-known steroid side-effects (12). More recently, beclomethasone dipropionate -- a steroid with potent topical activity -- has been used as a pressurised aerosol. In 1972 Morrow Brown et al. (1) as well as Lal et al. (10) reported a good therapeutic effect with this drug and at the same time found evidence for the opinion that its systemic effect, if any, was insignificant. Less ositive results were reported by Choo-Kang et al. (4) and also by Herxheimer (8), who considered beclomethasone spray not to possess any advantages as compared with the earlier steroids. The purpose of the present study was to assess the clinical value of beclomethasone in the treatment of adult patients previously on long-term oral steroids.


Enteroinvasive and enterotoxigenic Escherichia coli. Occurrence in acute diarrhea of infants and children. The abilities of Escherichia coli to induce diarrhea by enterotoxin production and by intestinal cell penetration have not been explored simultaneously in children with diarrheal disease. In this study, we investigated 36 infants and children with acute diarrhea and 17 healthy controls. From each patient's rectal swab culture, E coli colonies were tested for enterotoxin production by intragastric inoculation in suckling mice and screened for cell penetration with HEp-2 cells. Colonies showing invasiveness in HEp-2 cells were further tested by inoculation into guinea pig conjunctivae. Salmonella or Shigella strains were isolated from 42% of the patients with diarrhea. Enterotoxin-producing strains of E coli were found in 86% of the diarrhea group and in 41% of controls. Strains with capability to invade epithelial cells were found in 30% of the diarrhea group and in 12% of controls. In seven patients, E coli strains demonstrated both enterotoxin production and invasiveness. In an overall view, considering Salmonella, Shigella, and enteroinvasive or enterotoxigenic E coli, a possible etiologic agent was demonstrated in 94% of infants with diarrheal disease. However, the high frequency of enterotoxigenic strains in healthy controls suggest that in some patients with diarrhea there may be a coincidental carrier state with diarrhea actually due to another cause.


Osteogenesis imperfecta. Review of the literature with presentation of 29 cases. Twelve families with 29 patients showing various patterns of osteogenesis imperfecta are described, along with the genetic, pathological, and clinical features. No abnormal blochemical features were found. It has been shown that the best treatment is prophylactic (such as intramedullary nailingy or supportive. There was no remarkable improvement from any form of medical treatment. These data are compared to those of other authors.


Duodenal microflora: a prospective study in pediatric gastrointestinal disorders. Culture of the duodenal microflora was performed on 96 infants and children with a variety of gastrointestinal disorders. The resident microflora consists predominantly of oral-type microorganisms such as alpha-Streptococci and Neisseria. A fecal-type microflora was found in all 6 infants with post-surgical diarrhea and temporary monosachcaride intolerance; 4 of 22 patients with protracted diarrhea of infancy, 3 of 22 patients with celiac disease, and none of 32 patients with nonspecific diarrhea or 14 others with miscellaneous disorders. Anaerobic microorganisms were seldom isolated. Only 9% of the duodenal cultures were completely sterile, although a further 17 had a quantitative culture less than 5 times 10(4) microorganisms/ml. Small-bowel contamination with fecal-type microorganisms is associated with stasis and disturbance of the normal peristaltic-clearing mechanism. Duodenal culture is essential in any infant with temporary monosaccharide intolerance. It is occasionally useful in other situations where motility may be disturbed.


A controlled trial of azathioprine in Crohn's disease. To determine the efficacy of azathioprine in the treatment of Crohn's disease, a 26-week double-blind trial was performed. 20 patients with Crohn's disease, requiring at least 10 mg of prednisone/day over the 3 months prior to entering the study were randomized into placebo (10 patients) and major criterion of success in the trial. There were 7 relapses in the placebo group (5 patients) and 2 relapses in the azathioprine group (2 patients). Complications including fistulae were not affected by the medications. The mean reduction in steriod dosage in the azathioprine group at the end of the trial (-15.5 mg) was greater than in the placebo group (-6.1 mg). These results suggest that azathioprine may permit reduction or discontinuation of steroids without the worsening of symptoms in some patients who appear to require steroids for control of their symptoms. The clinical features of this "AZA-responsive subgroup" remain to be defined.


Quantitation of intestinal-tissue layers from their histology. A line-sampling technique was applied to microscopic histology of human peroral small-intestinal biopsies to quantitate the relative proportions of the tissue layers. In healthy individuals the villus epithelium formed 41--46%, the crypt epithelium 20--26%, and the lamina propria 34% of the mucosa. In gluten enteropathy the villus epithelium formed 7%, crypt epithelium 43%, and lamina propria 50% of the mucosa. In individuals suffering from chronic diarrhea with malabsorption, the percentages of the tissue components were intermediate between those of healthy individuals and those with gluten enteropathy. The validity of the technique was tested in male and female rats with different intestinal size. In adjacent segments, the actual weight of the scraped mucosa and that of the underlying tissues correlated very well with their corresponding weights estimated from the microscopic histology, using the line-sampling technique. The intestinal-tissue layers quantitated were the villus epithelium, crypt epithelium, the lamina propria + muscularis mucosae+submucosa, and the muscle+serosal coats.


Colonization of intensive care unit patients with gram-negative bacilli. A prospective study of 64 patients admitted to a medical intensive care unit and 86 patients admitted to a surgical intensive care unit was done to determine the frequency of pharyngeal, intestinal, and tube site colonization with Gram-negative bacilli. Studies were carried out over a 13-week period. The pharyngeal carrier rate among the surgical patients increased by a total of 34 strains compared to 14 strains among medical patients. Similarly, the intestinal carrier rate increased by 35 strains compared to 12 strains. The increased carriage in surgical patients was related more to the presence of indwelling tubes and colonization of multiple sites in the same patient than to the use of antimicrobial drugs. Pharyngeal and rectal colonization in medical patients was related to antibiotic therapy. Indwelling tubes were used predominately in surgical patients and were a significant reservoir of these organisms.


Glomerular lesions after renal transplantation. Significant changes in glomeruli on light microscopy has been observed in 27 of 109 cadaveric renal allografts which functioned beyond 6 months. Tissue was available for study from all but two allografts. The histologic lesions were classified as follows: recurrent glomeruloneophritis, 9 cases (3 focal scierosis, 2 mesangial immunoglobulin A[IgA] disease, 2 mesangiocapillary glomerulonephritis, 1 dense deposit disease, 1 familial nephritis); de novo glomerulonephritis, 1 case (diffuse proliferative glomerulonephritis with crescents); and glomerular change of uncertain etiology, 17 cases (10 mesangiocapillary, 5 focal scierosis, 1 focal proliferative and 1 mesangial proliferative). These lesions were not distinguishable on light, fluorescent and electron microscopy from those in patients with spontaneous renal disease. All patients with glomerular lesions had proteinuria, and all but 3 had microscopic hematuria. Glomerular lesions were not significantly associated with early clinical rejection episodes or HLA compatibility. Presensitization of HLA antigens was significantly related to the occurence of a nonrecurrent glomerular lesion. Vescoureteral reflux was significantly more frequent in those with glomerular change (14 of 24) than in those without (13 of 48). Glomerular lesions were associated with a higher rate of graft loss due to renal transplant failure; renal function in survivors was significantly worse than in those without glomerular lesions.


Chronic membranoproliferative glomerulonephritis. A patient with recurrent episodes simulating rheumatic fever and acute nephritis. A most unusual case of chronic membranoproliferative glomerulonephritis with nodule formation is reported in an elderly man in whom it was possible to document many episodes of acute oilguric and hemorrhagic glomerulonephritis and a syndrome resembling acute rheumatic fever. Severe renal failure necessitating peritoneal dialysis occurred on three occasions. Renal function returned to near preexacerbation levels in each episode. Although there was strong clinical evidence for streptococcal hypersensitivity, convincing laboratory documentation was lacking. The histologic and immunopathologic findings changed comparatively little during the several exacerbations. Impairment in fibrinolytic and coagulation activities by circulating macromolecular complexes is postulated for the induction and perpetuation of the glomerular injury.


Cardiac amyloidosis. Diagnosis by transvenous endomyocardial biopsy. Endomyocardial tissue, obtained from two patients presenting with restrictive cardiomyopathies, demonstrated amyloid infiltration. The percutaneous transvenous cardiac biopsy technic, using a modified Konno-Sakakibara cardiac bioptome, was safe and quick. Physical examination and catheterization data may not provide a definite differential diagnosis between restrictive and constrictive myocardial disease. Confirmation by biopsy of the cardiac amyloidosis assisted in providing optimum diagnostic and therapeutic care for these patients.


Membranoproliferative glomerulonephritis. Progression from the pure form to the crescentic form with recurrence after transplantation. Described are the clinical course and renal morphologic findings in a patient with membranoproliferative glomerulonephritis. intially, the patient had a pure form of membranoproliferative glomerulonephritis but after a 3 year course, it became crescentic. After a renal allograft was performed, membranoproliferative glomerulonephritis recurred within 1 month in a pure form and subsequently developed into the crescentic form. This change occurred in the host kidney as well as in the allograft immediately after immunosuppressive and steroid therapy was discontinued.


Repeat Marshall-Marchetti procedure for recurrent stress urinary incontinence. Thirty-six patients with recurrent stress incontinence had undergone a total of 109 previous procedures, at least one of which had been a Marshall-Marchetti-Krantz (MMK) operation. At the time of operative dissection, it was apparent that most of these patients had had an "alleged" MMK operation with no evidence of adhesion or scarring in the periurethral and vesical neck regions. With the transvesical approach, accurate assessment of the tone and quality of the bladder neck and the proximal urethra is possible. This approach also provides an opportunity to "see and feel" the effect of the properly placed periurethral and suspending suture. Thirty-two of 36 patients are continent after repeated suspension augmented by plication and bladder revision


Computer diagnosis of labor progression. Abnormal labor has been suspected of being inherently delectorious to the fetus.  In order to explore this problem, clinical factors, labor progress, and fetal monitoring parameters were compared in matched groups of high-risk patients whose fetuses were in theoccipitoposterior (0P) and occipitoanterior postions.  The OP group showed significant excesses of dysfunctional labor aptterns, uterine contraction pattern abnormalities, and late and variabl fetal heart rate decelerations not accounted for by theuse of oxytocin or the presence of cord problems.  In OP labor, lower Apgar scores were associated withasignificant excess of preceding fetal heart rate decelerations independant of operative delivery.  This study suggests that neonatal depression in OP laboris related to intrapartum factors preceding delivery and provides direct support for theconcept that abnormal labor may adversely affect the fetus.  The OP position is an indication for close fetomaternal supervision during labor.


Management of infertility resulting from anovulation. Recent methods for induction of ovulation in the woman are described. The only indication for use of these medications is induction of ovulation and pregnancy. In properly selected patients, the success rate is quite high, but treatment has undesirable side effects which occasionally may be severe.


Successful induction of follicular maturation and ovulation by prolonged treatment with LH-releasing hormone in women with anorexia nervosa. Four women with anorexia nervosa were treated with synthetic LH-releasing hormone (LRH) in an attempt to induce ovulation. All the women had very low pretreatment levels of gonadotropins and estrogens. Administration of LRH resulted in significant gonadotropin increases. The FSH response to LRH in relation to the LH response was higher than in regularly menstruating women. LRH (500 mug) was administered parenterally three times daily over about 4 weeks. During this period there were no significant effects on mood, eating behavior, weight, or libido. All the women responded with follicular maturation and ovulation to the prolonged LRH treatment.


Serological reactions to Nocardia antigens. Sera from 23 patients with nocardiosis were tested for the presence of precipitating antibodies against an extract of Nocardia asteroides. Sera from nine of 20 patients infected with Nocardia asteroides and one of three sera from patients with Nocardia brasiliensis produced one to three precipitin lines with the antigen. Sera from eight of 55 patients with tuberculosis and 11 of 13 patients with leprosy also contained Nocardia precipitins. None of 33 sera from patients with cryptococcosis, blastomycosis, actinomycosis, histoplasmosis, coccidioidomycosis, mucormycosis or candidiasis contained Norcardia antibodies. None of the sera from ten patients infected with Staphylococcus aureus, ten patients infected with Pseudomonas, or 16 sera from uninfected patients contained Nocardia precipitins.


The incidence of retinal detachment after penetrating keratoplasty. Of 610 penetrating keratoplasties reviewed, retinal detachments did not occur after any phakic graft, or after aphakic or combined (keratoplasty and cataract extraction) procedures unless these were associated with vitreous manipulation. A 5.4% incidence of retinal detachment occurred after keratoplasty that involved vitrectomy. The resultant detachments had a poor prognosis probably because of delayd diagnosis and difficulties in visualization. Vitreous manipulation, therefore, may be essential to graft clarity but it is hazardous.


Keratoplasty wound separations.

Keratoplasty wound separations. Forty cases of partial or full-thickness corneal wound separtions after penetrating keratoplasty comprised three groups. One group of separations occurred before suture removal, due to technical problems encountered at surgery or increased intraocular pressure, or both. Most separations occurred immediately after suture removal and may be the most preventable. The third group of separations occurred long after suture-removal and may not be associated with obvious trauma. About 50% of all wound separations caused graft failure, but patients with fullthickness wound separations had a worse prognosis for visual acuity recovery. Of those grafts that failed after wound separation and were retransplanted, there is a good chance of visual recovery. In our series, fullthickness wound separations or partial wound gape occurred in about 5.7% of our transplant cases. With delay of suture removal associated with a more adequate clinical means of evaluating wound healing, this number may be decreased.


Coagulation and platelet adhesion-inducing factor in the endothelium of the retinal vessels. By means of an immunofluorescent technique, we found factors promoting blood coagulation and platelet adhesion in the intima of retinal vessels. These factors coexisted with other agents causing the opposite process, fibrin dissolution. The components of this vascular hemostatic balance are possibly involved in the thrombotic occlusion of the retinal vessels, their canalization, and in the pathogenesis of diabetic retinopathy.


Computerized axial tomography in the detection of orbital space-occupying lesions. Of 41 patients we examined for a suspected primary orbital tumor, 25 patients had evidence of a lesion either histologically, angiographically, or surgically. We examined nine of the 25 patients by means of an EMI-Scanner and 16 by a fine matrix addition (160 times 160 cells), and compared these results to those we received by axial tomography, orbital venography, and B-scan ultrasound. We also compared the absorption values of the recorded tumors. The EMI-Scanner had a diagnostic accuracy of 84%; orbital venography, 84%; axial hypocycloidal tomography, 71%; and ultrasound, 76%. The fine matrix scanner gave a preoperative diagnostic rate of 93% and defined optic nerve abnormalities accurately. However, EMI, scanning should complement existing noninvasive procedures and orbital venography.


Evaluation of intraocular lens fixation in pseudophakia. I developed my own lens designs after analyzing the reasons for failure of previous designs. The iris clip lens and the capsular lens are supported by the iris and by the capsular membrane, respectively, the former having minimal and the latter having nearly no contact at all with intraocular tissues. A comparison between the iris and capsular membrane as support for an intraocular lens favor the capsular membrane.


Repair of cicatricial entropion of the upper eyelid. The disparity in vertical length between the skin muscle lamellae and the tarsoconjunctival lamellae in cicatricial entropion of the upper eyelid secondary to contracture of the transconjunctival layer was corrected by a transconjunctival incision allowing the eyelid to straighten. The resultant defect in the tarsoconjunctival lamellae was corrected by means of a bare scleral graft 20% larger than the defect in the eyelid. The graft was allowed to epithelialize spontaneously and was not covered with mucuous membrane.