Forced expiratory time--its reliability as a lung function test. Three studies of factors affecting variability of forced expiratory time (FET) have been carried out. In the first, different observers or repeated measurements over a few minutes were shown to make no significant contribution to FET variability. Time of day was also relatively unimportant. In the second study, FET was shown to vary considerably more than peak flow rate, forced expiratory volumes, and mid expiratory flow rates over the course of five days. In the third study, FET was shown to correlate with other measurements of airways obstruction though the correlation coefficients were relatively low. The measurement of FET is thought to be too variable to be of practical use as a screening test for small airways disease, though its clinical value is not questioned.


Plasma levels of carcinoembryonic antigen in bronchial carcinoma and chronic bronchitis. The plasma levels of carcinoembryonic antigen were increased in 80% of 49 patients with bronchial carcinoma and in 68% of 25 patients with an acute exacerbation of chronic bronchitis. There was no statistically significant difference between the two groups. A single determination of the plasma carcinoembryonic antigen level has no prognostic value in patients with bronchial carcinoma.


Effect of lung resection for bronchial carcinoma on pulmonary function in patients with and without chronic obstructive bronchitis. Pulmonary function was measured before and after lung resection (pneumonectomy or lobectomy) in 58 patients with bronchial carcinoma, 33 of whom also had chronic obstructive bronchitis. Lung resection was well tolerated and caused no greater impairment of lung function postoperatively in the bronchitics than in those without bronchitis.


Use of an ear oximeter to assess lung function. Values of arterial oxygen saturation were estimated using an ear oximeter while subjects breathed a mixture of 15% oxygen in nitrogen. Results obtained from patients with lung disease were clearly separated from results obtained from normal subjects, and the lowereing of saturation was related to the clinical severity of the disease. Patients with low oximeter readings with 15% oxygen also had low levels of arterial oxygen tension during exercise.


Performance of heat exchangers used in whole body perfusion circuits. The performance of some commonly used heat exchangers has been investigated with particular reference to the effect of varying the water flow. The results demonstrate that there is considerable variation in the performance of most units when the water flow is changed. It is suggested that more information should be provided by the manufacturers of heat exchangers and that there should be a supply of water in cardiothoracic theatres at a sufficient pressure to allow the full performance of the heat exchangers to be realized.


Pulmonary function in tropical eosinophilia before and after treatment with diethylcarbamazine. Spirometric and lung volume measurements were carried out before and after treatment with diethylcarbamazine in 19 patients with tropical eosinophilia. The total lung capacity and vital capacity returned to or nearly to normal while the FEV1 and PEFR, though improved, tended to remain below normal, indicating some residual airways obstruction especially in patients whose treatment began more than one month from the onset of symptoms. The time taken for the pulmonary function to return to normal with treatment was found to be much longer than for the clinical and haematological response.


Hypothalamo-pituitary-adrenal function in intrinsic non-atopic asthma. Sixteen patients with intrinsic non-atopic asthma with persistent wheezing who had never been treated with corticosteroids showed normal adrenocortical responses to prolonged stimulation with Tetracosactin Depot. In a subgroup of six patients the hypothalamo-pituitary-adrenal (HPA) response to a standard insulin stress test was normal. It is concluded that impaired responsiveness of the HPA axis is unlikely to be a common factor in initiating or maintaining airways obstruction in patients with intrinsic asthma.


An intrapulmonary teratoma associated with thymic tissue. A benign teratoma was removed by segmental resection from the upper lobe of the right lung in a girl aged 19 years. This is the twentieth case report of a teratoma occurring in the lung substance and is of special interest because of the identification of thymic tissue histologically. The significance of this in relation to the pathogenesis of intrathoracic teratoma is discussed.


Thymic lymphoma--an unusual presentation. A patient with a thymic lymphoma invading both chest wall and lung is presented. Extensive systemic-pulmonary arterial communications had developed through this lymphoma. Hodgkin's disease should be included as a rare cause of systemic to pulmonary communications.


Oral anticoagulant therapy and its control: an international survey. A survey for the International Study Group for Anticoagulant Control has been conducted in which a questionnaire was sent to members in 39 countries. Information based on 37 replies obtained indicated that the most widely used test in oral anticoagulant therapy is the Quick one stage prothrombin estimation. There is a great diversity in the method of reporting prothrombin time results. Percentage activity of normal on the basis of saline dilution curves is the most popular. Only six countries have national or regional systems for anticoagulant control. Recommendations for the therapeutic range of dosage vary widely. The upper limit in one country may be the lower limit in another. In many centres doses of anticoagulant drugs are advocated which elsewhere are considered either inadequate anticoagulation or dangerous overdosages. The variation of therapeutic range may still be considerable even when a standard thromboplastin is available.  Data collected from the survey indicates the need for urgent measures to provide a uniform of laboratory control of clinical dosage of anticoagulant drugs. Until such measures are implemented it is meaningless to try to compare the efficacy of oral anticoagulant therapy from country to country or even to attempt multicentre trials within national boundaries.


Use of a lyophilized reference plasma to compare coagulation test procedures: Normotest, Simplastin-A and Thrombotest. In 4 collaborative trials, involving a varying number of hospital laboratories in the Stockholm area, the coagulation activity of different test materials was estimated with the one-stage prothrombin tests routinely used in the laboratories, viz. Normotest, Simplastin-A and Thrombotest. The test materials included different batches of a lyophilized reference plasma, deep-frozen specimens of diluted and undiluted normal plasmas, and fresh and deep-frozen specimens from patients on long-term oral anticoagulant therapy. Although a close relationship was found between different methods, Simplastin-A gave consistently lower values than Normotest, the difference being proportional to the estimated activity. The discrepancy was of about the same magnitude on all the test materials, and was probably due to a divergence between the manufacturers' procedures used to set "normal percentage activity", as well as to a varying ratio of measured activity to plasma concentration. The extent of discrepancy may vary with the batch-to-batch variation of thromboplastin reagents. The close agreement between results obtained on different test materials suggests that the investigated reference plasma could be used to calibrate the examined thromboplastin reagents, and to compare the degree of hypocoagulability estimated by the examined PIVKA-insensitive thromboplastin reagents. The assigned coagulation activity of batches of the reference plasma agreed closely with experimentally obtained values. The stability of supplied batches was satisfactory as judged from the reproducibility of repeated measurements. The variability of test procedures was approximately the same on different test materials.


Alterations in the effects of warfarin in dogs by halofenate: an influence upon the kinetics of prothrombin. The interaction between warfarin and the new lipid lowering agent halofenate (MK 185) [2- acetamidoethyl (p-chlorophenyl) (m-trifluoromethylphenoxy) acetate] was studied in dogs in both short- and long-term experiments. Our data suggest that halofenate potentiates the anticoagulant effect of warfarin by increasing the degradation of prothrombin (factor II) (Kdeg on placebo = 211 +/- 32 X 10(-4) X Hr-1 mean +/- SEM; on halofenate = 268 +/- 39 X 10(-4) X Hr-1 mean +/- SEM; P less than 0.01). However, a concomitant increase in factor II synthesis of 34% results in resistance to warfarin's effect if halofenate is administered prior to warfarin. The mean prothrombin time of 4 dogs on 2 mg of warfarin following halofenate pretreatment for 8 weeks was 74.8% +/- 17.3 (SE) of the anticoagulated control dog. On 2 mg of warfarin alone, it was 133.7% +/- 42.0 (P less than 0.001). Cessation of halofenate from combined therapy resulted in a delayed augmentation of warfarin effect. These data suggest that the nature of the interaction between warfarin and drugs such as halofenate which alter the kinetics of prothrombin may depend on the sequence of administration.


Serial changes in the coagulation system following clotting factor concentrate infusion. Various parameters of the coagulation system have been monitored in patients with Christmas disease following the infusion of clotting factor concentrates. Significant reduction of clotting factor VIII and serum antithrombin III were observed in each of the five studies, whilst the plasma fibrinogen level fell in four subjects. The induced abnormalities were shortlived and there were no clinical sequelae. Further studies are required to assess the effects of similar concentrates in patients with liver disease.


Studies in experimental animals on disseminated intravascular coagulation (DIC). Changes in the clotting system, as well as morphological and functional alterations corresponding to that of the pathologic phenomenon of disseminated intravascular coagulation (DIC) or consumption coagulopathy, were produced by thrombin infusion (550 NIH U X kg-1 X h-1) in rats and simultaneous inhibition of fibrinolysis by PAMBA (100 mg/kg). Changes in the fibrinogen level and platelet count as well as the appearances of fibrin monomers and the formation of microthrombi in several organs were evaluated. Simultaneously, the function of the respiratory system was investigated by continuous measurement of oxygen consumption as well as elasticity and water content of the lung. From the time course of the alterations in the several parameters, conclusions can be drawn for the pathogenesis and the possible therapeutic influence on DIC.


Assessment of different mathematical models for calculating and expressing the results of coagulation test procedures. Coagulation activity, expressed as percentage of normal and as clotting time ratio, was estimated in 220 specimens from patients on long-term anticoagulant treatment by 3 different coagulation test procedures, i.e. Thrombotest, Simplastin-A and Normotest. The estimates were calculated from the same determinations. The distribution of percentage values showed a fairly pronounced deviation from normality. After logarithmic transformation, the distribution was normalized, the regression lines between Thrombotest and other tests became parallel, and that between PIVKA-insensitive systems was shifted to a 45 degree line. Logarithmic transformation also stabilized the residual variance. These features make percentage values accessible for treatment according to the standard methods of bioassay statistics. Attempts to normalize the distribution of ratio values by various transformations were unsuccessful. Formal analysis of data revealed a variation in the proportionality of ratio values with the level of estimated coagulation defect. This may restrict the usefulness of the ratio approach. Logarithmic transformation partly reduced the discrepancy.


The filtragometer: a new device for measuring platelet aggregation in venous blood of man. A new device for the direct assessment of spontaneous platelet aggregation in human venous blood is described: the Filtragometer. The principle of the method is based on measurement of the pressure difference across a filter with pores of 20 mum diameter through which blood from a forearm vein is drawn. Platelet aggregates, obstructing the filter, cause a change in the pressure difference which is proportional to the degree of platelet aggregation. The measurement takes only a short time and a small amount (5-10 ml) of blood. Platelet aggregation as measured with the Filtragometer depends on the type of anticoagulant used. The Filtragometer response decreases on inhibition of platelet stickiness in vitro by prostaglandin E1 and in vivo by aspirin ingestion. Moreover it appeared to be higher in a group with a high thrombosis tendency than in a group less susceptible to fatal arterial thrombosis. The Filtragometer seems especially useful in monitoring the results of diet and/or drug therapy.


An investigation of the parameters which determine the fertility of a cattle population and of some factors which influence these parameters. The investigation consisted of the analysis of the records of four A.I. centers, Apart from a calculation of the average value of the parameters which determine the fertility of a cattle population (the calving rate, the number of inseminations per conception, and the interval from parturition to conception), the investigation covered also the influence on these parameters of respectively, the age of the inseminated cow, the month in which insemination took place, the interval from parturition to first insemination, the course of parturition, the retention or non-retention of the placenta, and the size of the herd.


Plasma concentrations, plasma protein binding and residues of sulfamonomethoxine in pigs, horses and cattle. The protein binding, the plasma half-life and the residue depletion of sulfamonomethoxine (SMM) after intramuscular administration were investigated in pigs, horses and cattle. Protein binding was weakly concentration-dependent. The bound fraction in plasma in the therapeutic range amounted to approximately 45, 40 and 50% for pigs, horses and cattle respectively, and the plasma half-lives were approximately 5.1, 5.7 and 3.1 hours respectively. SMM levels were less than 1 mug/g in muscle tissue after 36, 20 and 12 hours in pigs, horses and cattle respectively. In the kidney SMM levels were not less than 1 mug/g until 48, 60 (extrapolated) and 36 (extrapolated) hours respectively. In pigs and horses SMM residues in the injection site were extremely variable. In cattle, SMM disappearance from the injection site was more regular. SMM concentrations in pig, horse and cattle liver remained more or less constant in the latter part of the period investigated.


[Estimation of the concentration of urea in the blood of horses, cattle, goats and dogs using the "Merckognost Harnstoff" method compared with an enzymatic, photometric method (author's transl)]. To examine the suitability and reliability in field use of the "Merckognost Harnstoff" method in estimating the concentration of urea in the blood of horses, cattle, goats and dogs, the levels determined by this procedure were compared with those determined by an enzymatic (urease) photometric method widely used in laboratories. It was concluded from the results obtained that estimation using the "Merckognost Harnstoff" is sufficiently reliable for the rapid assay of urea in the blood under field conditions.


[Committee on anthelmintics. Residual group]. A number of the older and a few recent anthelmintics are enumerated or briefly discussed. Moreover some attention is paid to anthelmintics, used for nematodes and trematodes which have a limited effect on cestodes.


[Comparative studies on the effectiveness of intramammary treatment of clinical mastitis cattle (author's transl)]. To study the effectiveness of intramammary treatment of clinical mastitis in cattle, three different suspensions containing antibiotics for intramammary injection were compared in a field trial in the provinces of Friesland and North Brabant. Milk samples from the clinically abnormal as well as from the clinically normal quarters were examined for pathogenic bacteria and cell counts were made prior to treatment, within one week after treatment and within three weeks after treatment. The clinical diagnosis was confirmed by laboratory studies in approximately 90 per cent of the cases in which quarters were abnormal. However, 50 per cent of the clinically normal quarters also showed increased cell counts and/or bacterial infection. Treatment of these quarters should therefore be considered. Apart from regional variations as regards the character of the mastitis and the results of treatment, there were no significant differences between the effects of the three suspensions. Clinical recovery occurred in approximately 90 per cent of the cases, the pathogenic bacteria disappeared in approximately 75 per cent of the cases and the increased cell counts were restored to normal in approximately 60 per cent of the abnormal quarters.


HL-A transplantation antigens in subjects susceptible to recrudescent herpes labialis. We have shown in retrospective and prospective studies that there is an increased frequency of HL-A1 in subjects with recrudescent circum-oral herpes when compared with the frequency in the background population. This is the first association of a human disease of known viral aetiology with a specific transplantation antigen, and it is possible that this may represent a marker for an immune response gene.


Radioimmunoassay of progesterone, 17-hydroxyprogesterone, estradiol-17beta and prostaglandin F in human corpus luteum. Radioimmunoassay procedures have been adapted for the assay of progesterone, 17-hydroxyprogesterone, estradiol-17beta, and prostaglandin F in human corpus luteum. The method utilises a single homogenisation and extraction of the tissue followed by fractionation of the steroids on alumina, and separation of the prostaglandins of the F series from the E and A series on silica gel, prior to radioimmunoassay. An attempt has been made to validate the method for the progestins by comparison with results after fractionation of the progestins on Sephadex LH-20, for estradiol-17beta by comparison with values obtained with competitive protein-binding, and for prostaglandin F by comparison with values after additional purification. The results showed that peak concentrations of the three steroids in corpora lutea from women during the luteal phase of the menstrual cycle were comparable to those found in corpora lutea from women in early pregnancy. However, in six out of fourteen corpora lutea from non-pregnant women, prostaglandin F levels were higher than those found in corpora lutea from seven women in early pregnancy, i.e. 13-46 ng/g compared with 1-7 ng/g. Of the above six corpora lutea, four were on days 23-25 of the cycle, at a time when luteolysis would be commencing. The results in this paper support the conclusion that the corpus luteum is a major site of synthesis of the three steroids examined, although the site of synthesis of prostaglandin F is still equivocal.


The determination of five steroids in avian plasma by radioimmunoassay and competitive protein-binding. A method has been developed for the simultaneous determination of testosterone, 5alpha-dihydrotestosterone and corticosterone, or of estrone,  estradiol-17beta and corticosterone, after separation on a Celite:propylene glycol:ethylene glycol column (6:1.5:1.5 w/v/v). The lower quarter of the column was packed with a Celite: water mixture (3:1 w/v) as a stationary phase (glycol) 'trap'. This effectively prevented leaching of the glycols into the eluate as the concentration of ethyl acetate in the mobile phase was increased to elute the more polar steroids. In addition, a second system utilizing a Celite: ethylene glycol column (2:1 w/v) for the separation of estrone and estradiol-17beta is described. Testosterone, 5alpha-dihydrotestosterone, estrone and estradiol-17beta were measured by radioimmunoassay and corticosterone by a competitive protein-binding technique. Reliability criteria are presented showing that the assay systems used are accurate and reproducible. Plasma-steroid levels of eight avian species are also presented and compared with those found by other investigators.


Chemical synthesis, spectral properties, and chromatography of 4alpha-methyl and 4beta-methyl isomers of (24R)-24-ethyl-5alpha-cholestan-3beta-ol and (24S)-24-ethyl-cholesta-5,22-dien-3beta-ol. Described  herein are chemical syntheses of the following compounds: 4-methyl-(24S)-24-ethyl-cholesta-4,22-dien-3-one, 4,4-dimethyl-(24S)-24-ethyl-cholesta-5,22-dien-3-one, 4beta-methyl-(24R)-24-ethyl-5alpha-cholestan-3beta-ol, 4alpha-methyl-(24R)-24-ethyl-5alpha-cholestan-3beta-ol, 4alpha-methyl-(24S)-24-ethyl-5alpha-cholest-22-en-3beta-ol, 4-methyl-6beta-bromo-(24S)-24-ethyl-cholesta-4,22-dien-3-one, 4alpha-methyl-(24S)-24-ethyl-cholesta-5,22-dien-3beta-ol, 4alpha,5alpha-epoxy-(24S)-24-ethyl-cholesta-4,22-dien-3beta-yl acetate, 4beta-methyl-(24S)-24-ethyl-cholest-22-en-3beta,5alpha-diol, 4beta-methyl-5alpha-hydroxy-(24S)-24-ethyl-cholest-22-en-3beta-yl acetate, 4beta-methyl-(24S)-24-ethyl-cholesta-5,22-dien-3beta-yl acetate and 4beta-methyl-(24S)-24-ethyl-cholesta-5,22-dien-3beta-ol. Chromatographic, nuclear magnetic resonance, and mass spectral data are presented for the compounds under consideration.


Radioimmunoassay of serum medroxyprogesterone acetate (Provera) in women following oral and intravaginal administration. A radioimmunoassay (RIA) method for measuring medroxyprogesterone acetate (MPA, Provera) in serum has been developed utilizing benzene:iso-octane extraction, 3H-MPA to assess procedural losses, goat anti-MPA-3-(0-carboxymethyl) oxime-bovine serum albumin serum and dextran-coated charcoal separation. Control serum blanks were undetectable, 200 pg/ml of MPA was measurable with a high reliability, and intra- and interassay coefficients of variation were 6 and 13 percent, respectively. MPA added to control serum was quantitatively recovered. Serum MPA levels measured in 2 women after ingestion of 10 mg MPA rose to 3.4 to 4.4 ng/ml within 1 to 4 hours after oral intake and fell rapidly thereafter to 0.3 to 0.6 ng/ml within 24 hours. Insertion of Silastic intra-vaginal rings (IVRs), containing 100 or 200 mg of MPA, into 4 women for periods of 3 weeks resulted in a rapid rise of serum MPA after insertion, rather stable MPA levels of 0.9 to 1.6 ng/ml while the IVRs were in place, and a rapid decline of serum MPA following IVR removal. Serum estradiol-17beta and progesterone concentrations, measured about 3 times a week in these patients, indicated that ovulation was consistently inhibited. The serum MPA levels observed in this study were approximately 5 times lower than those reported by other investigators using a double-antibody RIA of MPA in unextracted serum.


The metabolism of the epoxide of testosterone by human placental microsomes. Although 19-hydroxy-4beta,5-oxido-5beta-androstane-3,17 dione (2a) is converted to estradiol-17beta by human placental microsomes, the incubation of 17beta-hydroxy-4beta,5-oxido-5beta-androstan-3-one (2b) under the same conditions produces only metabolites which are more polar than 17beta-estradiol. The metabolites have been isolated and identified as 3alpha-hydroxy-4beta,5-oxido-5beta-androstan-17-one (4a), 4beta,5-oxido-5beta-androstane-3beta, 17beta-diol (5a) and 4beta,5-oxido-5beta-androstane-3alpha,17beta-diol (6a). These results indicate that functionalization at C-19 is a prerequisite for the biological aromatization of such androgen epoxides.


Animal model of TIA: an experimental study with intracarotid ADP infusion in rabbits. Adenosine diphosphate (8 mg per minute for five minutes) was infused into the carotid artery of 63 rabbits. The effects were twofold: systemic hypotension and platelet aggregation in the cerebral circulation. As a consequence of the last effect, platelet emboli were produced which occluded cerebral arteries in a number and size sufficient to cause cerebral ischemia. Areas of focal ischemia were observed through a cranial window, and documented with antipyrine autoradiography. Platelet thrombi were almost entirely transient, being fragmented and removed within a very short time of cessation of ADP infusion. Consequently, no permanent tissue damage ensued. This experimental model approaches the spontaneous transient ischemia attacks (TIAs) in man, demonstrating that these can be caused by pure platelet emboli. A high cholesterol diet administered for two months prior to ADP infusion did not enhance the effect of the procedure or make the platelet aggregation and the following ischemia longer in duration or more severe.


Intracranial aneurysms and subarachnoid hemorrhage. A cooperative study. Antifibrinolytic therapy in recent onset subarachnoid hemorrhage. In this cooperative study among 13 institutions, 502 patients were treated with antifibrinolytic medication (epsilon-aminocaproic acid or tranexamic acid) within a 14-day period following rupture of an intracranial aneurysm. Mortality at the end of 14 days was 11.6%; proved rebleed rate was 12.7%. Patients with an internal carotid or anterior cerebral aneurysm had the highest mortality and rebleed rate. Most rebleeds occurred between the sixth and eleventh days following the initial bleed. Significantly higher mortality was reported among patients with cerebral vasospasm, yet rebleed rate was no different among those patients with or without vasospasm. The same pattern was observed among patients with a mean blood pressure value above and below 110 mm Hg. We conclude that antifibrinolytic therapy provides beneficial treatment to patients with recent onset subarachnoid hemorrhage (SAH) following rupture of an intracranial aneurysm.


Cerebrospinal fluid in cerebral hemorrhage and infarction. Cerebrospinal fluid (CSF) abnormalities were correlated with pathological diagnoses in 61 patients with autopsy-verified intracerebral hemorrhage or cerebral infarction. Lumbar punctures were performed within one week of onset of symptoms. The CSF color and red blood cell counts were the most useful CSF parameters in differentiating between intracerebral hemorrhage and cerebral infarction. In 75% of the patients with intracerebral hemorrhage, the CSF was either grossly bloody or xanthochromic; in 25%, the CSF was clear. In patients with cerebral infarction, the CSF was never grossly bloody; in two patients with hemorrhagic infarction, the CSF was xanthochromic. The CSF pressure, protein values and leukocyte counts were less useful in differentiating intracerebral hemorrhage from cerebral infarction. Cases with hemorrhagic infarction could not be separated from those with ischemic infarction on the basis of CSF analysis. In clear CSF, the polymorphonuclear neutrophilic leukocyte (PNL) counts were never greater than 20 per cubic millimeter. In xanthochromic or cloudy CSF, leukocyte counts, especially PNLs, were frequently elevated, occasionally to the high levels.


Kinks, coils, and carotids: a review.

Kinks, coils, and carotids: a review. Kinking and coiling of the internal carotid artery (ICA) sometimes may result in symptomatic cerebrovascular disease, but indisputable evidence linking the two conditions is lacking. However, there is enough evidence to warrant careful consideration of surgical correction in patients who have features of the carotid artery syndrome and kinking of the ICA as shown on angiography. Kinking or buckling of the artery is due to atherosclerosis and is to be distinguished from coiling, which is ascribed to embryological causes. Definite recommendations regarding the advisability of surgery for infants who are discovered to have coils cannot be made, but coiling is generally asymptomatic. Adults with kinks in their carotid arteries who have recurrent transient ischemic attacks (TIAs) benefit most from surgical correction, particularly if symptoms are aggravated on head rotation, which may cause the kink to obstruct.


Determinants of response of pial arteries to norepinephrine and sympathetic nerve stimulation. Feline pial arteries larger than 100 mu in diameter constricted in response to cervical sympathetic nerve stimulation suggests or in response to topical application of norepinephrine. Smaller pial arteries were unresponsive to norepinephrine. This unresponsiveness persisted when norepinephrine was dissolved in CSF with high calcium ion concentration, or in CSF with both high calcium ion and zero magnesium ion concentration, or when it was dissolved in the acid fluid used by Wahl et al. and applied by constant infusion or by intermittent application. Comparison of the responses of the larger pial vessels to norepinephrine and to sympathetic nerve stimulation that maximal activation of sympathetic nerves achieves a concentration of released norepinephrine equal to 5.9 x 10(-6) M. The constriction of the larger pial vessels in response to sympathetic nerve stimulation could account for modest reductions in cerebral blood flow.


The value of brain scanning in the management of strokes. The usefulness of brain scanning in the diagnosis and management of strokes was evaluated in 313 serial cases. Of 38 patients with transient ischemic attacks (TIAs), only one had a positive test. The optimal time for scanning completed strokes was between seven and 14 days after onset. The pattern of uptake was characteristic of a vascular lesion in 76.8%. When uptake was indistinguishable from tumor, follow-up scans were useful. Patients with negative scans in the second week have a significantly better prognosis than the ones with a positive study. Cerebral angiography and brain scan correlated well in 56 patients who had both tests performed. The postmortem findings in 12 cases again emphasize the importance of the correct timing of the study, and the fact that a brain scan does not usually demonstrate lesions smaller than 2 cm in diameter. It is concluded that the brain scan represents a useful tool in the diagnosis of strokes and helps in predicting the degree of recovery following a vascular insult.


Comparative study of cerebral vasoactivity in vascular sclerosis of the brain in elderly men. Thirty-five elderly patients underwent a systematic series of cerebrovascular examinations. The patients were divided into three groups on the basis of clinical criteria: normal patients (Group 1), patients with sequelae of a previous stroke or with minor mental disorders (Group 2), and patients with arteriosclerosis dementia (Group 3). The vasomotor reactions of the cerebral arteries were investigated by estimating regional cerebral blood flow (133Xe clearance technique). The authors emphasize the existence of cerebral vasoreactivity in subjects with clinical symptoms of senile dementia. Furthermore, in each of the three groups of elderly patients, there seemed to be a lack of correlation between the clinical symptoms and certain specific vascular examinations.


Energy metabolism during brain ischemia. Stability during reversible and irreversible damage. The permissible duration of brain ischemia without sustaining damage is short. Less clear are the mechanisms accounting for the vulnerability of brain to ischemic insults. Neurochemical factors implicated include impairment of energy synthesis by mitochondria and of energy-dependent processes such as synaptic transmission, ATPase activity, membrane conductance and altered protein and lipid synthesis. To clarify the vulnerability of energy metabolism, we investigated energy availability and synthesis in our model of global cerebral ischemia. Our studies evaluated in vitro mitochondrial ATP synthesis and the in vivo quantitation of the cortical adenylate pool. Results of our investigations support a growing body of evidence showing the energy state to be relatively stable to ischemia. We conclude that an energy-dependent process of brain is primarily vulnerable to ischemia.


Trace metal content of cerebral vessels in American Blacks, Caucasians and Nigerian Africans. Trace metal contents of cerebral vessels in age-matched and sex-matched subjects from three population groups were estimated. The trace metals included calcium, manganese, zinc, magnesium, copper and iron. The American blacks in Washington, D.C., who are ethnologically related to Nigerian Africans, have different patterns of trace metal contents in their cerebral vessels and the observed levels also differed in some respects from Minnesota Caucasians living in a similar environment. The greatest amounts of calcium, zinc, and copper were found in the vessels of American blacks while the greatest amount of magnesium was found in vessels of Minnesota Caucasians. There was no statistically significant difference in the manganese content of the cerebral vessels in three population groups. Nigerian Africans had the least amounts of copper and magnesium but had the highest iron content. A similar high level of iron was observed in the vessels of American blacks. Since it has been shown that American blacks have the most extensive and severe degree of atherosclerosis among the three population groups, it would appear that iron, calcium and manganese in the cerebral vessels may not directly relate to the severity of cerebral atherosclerosis. Relatively high levels of copper and magnesium, which were observed in the cerebral vessels of American blacks and Caucasians, may be of significance in the pathogenesis of cerebral atherosclerosis. The low levels of the trace metals in Nigerians may be protective. The possible role of zinc requires further studies.


The Behr pupil revisited. Anisocoria following cerebrovascular accidents. Three hundred and sixty-three cases of cerebral infarction were reviewed: 19 had anisocoria. Eighty percent had the larger pupil contralateral to the hemispheric lesion. The mydriasis was associated with long tract signs in all instances. If the abnormal pupil and long tract signs are not on the same side, the long tract signs are the most accurate evidence of the side of thhe hemispheric lesions. When the pupil was 4 mm or larger and reacted sluggishly, the prognosis was poor. The mechanism of the production of the anisocoria is still uncertain; the lesion is probably "cortical" and in the contralateral hemisphere.


Brain scan in cerebral ischemia. An experimental model in the rat. A rapid embolic method for consistent induction of stroke in the rat is described. Brain scans were performed using a micro-pinhole collimator system, and the value of the model for studies in localization of radiopharmaceuticals in cerebral ischemia is demonstrated.


Cerebrospinal fluid and arterial lactate, pyruvate and acid-base balance in patients with intracranial hemorrhages. Lactate and pyruvate concentrations and acid-base balance in cerebrospinal fluid (CSF) and arterial blood were determined in patients with intracranial hemorrhages (28 subarachnoid hemorrhages and 15 intracerebral hemorrhages). A greater increase in CSF lactate and lactate-pyruvate ratio (L/P ratio) was observed in patients with impairment of consciousness, focal neurological deficits, poor prognosis, or CSF pressures higher than 300 mm H2O. A combination of CSF lactate greater than 2.5 mM per liter, L/P ration above 20, bicarbonate less than 20.4 mEq per liter, pH below 7.276, or arterial PCO2 below 31.5 mm Hg seems to indicate poor prognosis from intracranial hemorrhage. The mechanism of hyperventilation in acute cerebrovascular diseases and of CSF pH regulation in acid-base disturbances was also discussed.


Antibody to the hepatitis B surface antigen in immune serum globulin. A collection of 1,278 lots of immune serum globulin (ISG) prepared by 19 United States manufacturers between 1962 and 1974 were tested for the hepatitis B surface antigen (HBSAg) and antibody (anti-HBS). Ten lots (0.8%), all of which were produced between 1962 and 1965 by two different manufacturers, were weakly positive for HBSAg (by radioimmunoassay). Seven hundred and seven lots (55.3%) were positive for anti-HBS (by passive hemagglutination). In general, titers of anti- HBS in lots of ISG were low, and the prevalence of anti HBS positive lots varied considerably among different manufacturers. ISG prepared from placental material was more commonly positive for anti-HBS than was ISG prepared from plasma. There was a striking overall increase in prevalence and titer of anti-HBS in ISG lots prepared during 1973 and 1974. This probably reflects the effect of elimination of strongly HBSAg-positive plasma units with the onset of routine screening for HBSAg which began in 1972.


Viable lymphocytes in frozen washed blood. Samples of glycerolized, frozen, packed cells, were washed by each of three systems and then were cultrued for viable lymphocytes using the short-term culture method. Of the 39 samples, 17 (43.6%) showed definite evidence of growth of lymphocytes. Of the 17, 11(64.7%) were washed by Elutramatic, two (11.8%) by Haemonetics, and four (23.5%) by IBM. The 4 C prefreeze (two to five days) as well as the -80 C (21 To 40 days) storage times were the same for both positive and negative specimens. In all samples, clumps of distorted granulocytes with pyknotic nuclei were seen in addition to a number of well-preserved mononucleated white cells. In the 17 specimens which showed growth, incorporation of 3H-thymidine was seen only in the PHA-induced blast cells; typical mitotic figures were seen in some cultures. These observations demonstrate that lymphocytes remain viable in frozen blood stored at -80 C up to 40 days. The significant difference in removal of viable lymphocytes noted in specimens washed by different instruments requires further evaluation.


Unusual response to ABO incompatible blood transfusion. Three units of group A blood were inadvertently administered to a group O recipient during surgery without evidence of hemoglobinemia, hemoglobinuria, hypotension, disseminated intravascular coagulation, acute renal tubular necrosis, or other signs and symptoms of transfusion reaction. The recipient had normal concentrations of IgG, IgA, and IgM as well as complement (C3) prior to transfusion and anti-A agglutinins titered to 64 (titer of 128 by the antiglobulin technic). Seventeen hours following the transfusion, 28 per cent of the circulating red blood cells were group A (equivalent to 475 ml of packed cells); they were eliminated by day 5 without evidence of hemoglobinuria, hemoglobinemia or hyperbilirubinemia. Anti-A titers (antiglobulin) had risen from a posttransfusion low of 4 to 4,096 by day 10. After treatment of serum with 2-mercaptoethanol, however, hemolytic activity which was first noted on day 5 was lost and the antiglobulin titer dropped to 24 which suggested that most of the anti-A produced in response to the transfusion was IgM rather than IgG. The anti-A titer had dropped to essentialyy pretransfusion levels and the majority of anti-A present was IgM by day 91. The recipient suffered no untoward effects from the transfusion and was in good health three months following the transfusion.


Granylocyte transfusion: a controlled study in patients with acuute nonlymphocytic leukemia. Granulocyte transfusions are frequently used during the leukopenic phase of induction chemotherapy for acute nonlymphocytic leukemia (ANLL) although no controlled study has documented their usefulness. We have compared the morbidity and mortality of febrile episodes in granulocytopenic (less than 500/mm3) adults with ANLL who received granulocytes and those who did not. Granulocytes were obtained from related normal donors using a continuous flow centrifuge. Seventeen patients who received 98 transfusions during 23 febrile episodes were compared with 22 patients who received no granulocytes during 35 febrile episodes. No significant difference in clearing of documented infection occurred between the transfused (71%) or the control (76%) group. Granulocytes did not result in more rapid termination of febrile episodes nor in significant decrease in fever 24 hours following the transfusion. Factors contributing to the lack of obvious clincal benefit are discussed.


Inherited mosaicism affecting the ABO blood groups. Blood samples from two families and three other unrelated people contain a mixture of red blood cells of two different ABO types. Previously described causes of red blood cell mosaicism have been excluded from responsibility. Other blood group systems are not involved. The phenotypes, which have been designated ABO mos, are inherited through a variant allele at the ABO locus and appear to arise from a change in regulation of an ABO gene of some somatic cells.


Improved granulocyte collection from normal donors by combination of continuous-flow centrifugation and filtration leukapheresis. A total of 30 leukaphereses were performed with the Aminco Cellseparator on 27 healthy donots. Pretreatment by steroids and addition of fluid gelatin to the input line was performed in all runs. The combination of continuous flow centrifugation and filtration leukapheresis (CFC-FL) in nine of the 30 runs resulted in a highly significant increase of the yield to a mean of 59.6 X 1o(9) granulocytes as compared with a mean of 30.8 X 10(9) granulocytes obtained with conventional CFC. This significance is valid for the total yield of granulocytes, the yield per hour of run, or per liter of blood processed. No adverse reaction occurred.


An adverse pulmonary reaction to cryoprecipitate in a hemophiliac. An adult with classif Hemophilia A experienced a very severe reaction to transfusion with cryoprecipitate which was manifested as an adverse pulmonary reaction with marked hypoxemia in spite of oxygen therapy. The patient had neither leukoagglutinins nor lymphocytoxic, anti-platelet, or anti-Gm antibodies. His IgA level was normal. The possibility that debris in the cryoprecipitate from leukocytes and platelets contributed to the reaction is discussed.


Anti-Holley (hy): characterization of another example. Anti-Hy, in a serum of a black man who had received multiple blood transfusions, was found to be a warm reactive and polyclonal IgG antibody which did not bind complement in vitro. 51Cr-labeled Hy-positive red blood cells in the patient showed a shortened "2-component" survival curve. Hy antigens were not detected on leukocytes, platelets, or in the serum of Hy-positive individuals.


Banked and fresh autologous blood in cardiopulmonary bypass surgery. When 50 patients having autologous transfusions of two units of blood collected intraoperatively during coronary bypass surgery were compared with 50 patients receiving only homologous donor blood, it was found that a two-unit (20%) decrease in homologous blood usage per case occurred in the group receiving the autologous blood. No decrease occurred in total units of blood used per case. In 15 patients undergoing coronary bypass surgery, in addition to the two units of autolobous blood collected during surgery, two or four units of autologous blood were obtained preoperatively and administered intraoperatively. When four units were collected, the red blood cells were frozen until just prior to surgery. Total blood usage per case remained unchanged but a 4.6 unit (41%) decrease in homologous donor blood usage was noted. Patients phlebotomized preoperatively took 325 mgm of oral iron t.i.d. through the postoperative recovery period. These patients had an average decrease in hematocrit of 4.25 to 4.3 per cent following the final phlebotomy and just prior to surgery.


In vivo platelet function following cardiopulmonary bypass. In order to test the in vivo hemostatic function of platelets exposed to cardiopulmonary bypass, template bleeding times (TBT) were performed prebypass, three hours postbypass and 18 to 20 hours postoperatively in 22 patients undergoing open-heart surgery. The Harker-Slichter formula was applied to platelet counts below 100,000/cu mm to determine the expected TBT if the platelets function normally but were associated with a prolonged bleeding time merely from thrombocytopenia. Half of the patients received only frozen erythrocyte transfusions. Twenty of the 22 patients (91%) had normal or shorter than the expected TBT. Eight of the ten patients with platelet counts under 100,000/cu mm had shorter than predicted TBTs. All of the patients receiving only frozen erythrocytes had normal or shorter than predicted TBTs. It is concluded that in vivo platelet hemostatic function is usually normal postbypass, that routine platelet transfusions are therefore not necessary, and that most open-heart surgical procedures can be performed using frozen erythrocyte transfusions exclusively.


ABO discrepancy caused by an auto anti-N. This report describes an auto anti-N reacting at a high thermal amplitude that caused an ABO cell and serum discrepancy.


Characterization of IgG-containing DEAE fractions of canine serum. A high-titered canine antilymphocyte serum was chromatographed on DE-52 cellulose and the fractions were assayed for cytotoxic activity. Although cytotoxicity was associated with the first 63% of the column effluent corresponding to fractions 1 through 7, significant activity (256) was demonstrable only in fractions 2, 3, 4, and 5. An immunoelectrophoretic study of fractions 1 through 5 showed only IgGa in fraction 1, IgGa and IgGb as electrophoretically separate arcs in fraction 2, and as electrophoretically inseparable arcs in fractions 3 through 5. Cytotoxicity is postulated to be associated with the IgGb subclass, since titers correspond with the distribution of IgGb in column fractions.


Successful control of life-threatening thrombocytosis with a blood processor. A patient with polycythemia rubra vera developed marked thrombocytosis and hemorrhage after splenectomy. Plateletpheresis with a blood processor proved to be a safe, efficient, and rapid method for the mechanical removal of large quantities of platelets prior to adequate control with chemotherapy.


Preliminary evidence for a fourth phosphoglucomutase (PGM) locus in the dog. The PGM polymorphisms were investigated in starch gel electrophoresis in a total of 34 dogs. After prolonged incubation, a zone located 5-6 cm anodal to PGM3 was found in which two clear bands were identified. Two dogs had only the faster band, and two dogs had only the slower band. This provides preliminary evidence for the existence of a fourth PGM locus in dogs. A series of exclusion experiments indicates that the newly found bands contain PGM activity.


Functional and ultrastructural status of platelets prepared by the Celltrifuge. Function and morphology of platelets collected by the Celltrifuge were investigated. In vitro platelet tests included aggregation by adenosine diplhosphate, collagen, and epinephrine, ability to support clot retraction, uptake and release of labeles serotonin, and morphology at the ultrastructural level. Each of these tests was also performed on platelets obtained from the same donor before the collection procedure was instituted. Data obtained from pre- and post-Celltrifuge platelet samples were compared and analyzed on individual donor basis as wass as on eight donors as a group. The hemostatic effectiveness of Celltrifuge-collected platelets was evaluated by their ability to raise platelet counts and to shorten the template bleeding time in four thrombocytopenic recipients. Our results indicate that platelets prepared by this continuous flow centrifugation equipment retained their functional and ultrastructural integrity, and significantly raised the platelet counts and shortened the bleeding time of all four patients.


Snyaptic and dendritic development and mental defect. The hypothesis that specific defects in synaptic and dendritic development of cerebral cortex may form the anatomical basis in some cases of mental defect has been examined by electron microscopy and by use of the Golgi-Cos method. Two types of abnormality have been identified to date. One is a specific lesion of presynaptic terminals, first reported by Gonatas and Goldensohn (14) in a child with mental retardation and myoclonic seizures. This lesion, consisting of massive proliferation of membranous structures in terminal axons, appears to be rare and may be the anatomical substrate of one or more genetically determined dementing illnesses in infancy. More commonly, cerebral cortex from the severely retarded shows defects in number, length, and spatial arrangement of dendrites and synapses, best demonstrated by the Golgi method. Such abnormalities have been found in six out of eleven brains from severely retarded individuals examined by us. The etiology of the retardation was unknown in the majority; two had other recognizable developmental malformations of brain. It is suggested that a number of different etiological factors, if active during the period of rapid synaptic and dendritic growth in cerebral cortex (i. e., from the last trimester of pregnancy to the end of the first postnatal year) may result in stunted development of these structures.


Unit recordings during Pavlovian conditioning. The aim is to find some switches in the brain and to characterize them if possible as either temporary and requiring some reverberatory process or as more stable and structural. There were five assumptions involved; (a) that the very large population of neurons in the brain could be effectively sampled in a limited set of experiments; (b) that a middle kind of electrodes could direct themselves to a sufficiently stable single unit population to permit extended conditioning experiments: (c) that averaging could be used to eliminate the effects of all unwanted variables that were not correlated with the main auditory signals: (d) that latency mapping would permit the tracing of a signal even through the multiple-channeled pathways of the brain (and would help us to identify switching points; (e) that a middle kind of conditioning (not Pavlovian entirely nor Slinner experiment with the clear CS of a Pavlovian one...


Hepatic phenylalanine hydroxylase and PKU. The conversion of phenylalanine to tyrosine in mammalian tissues is catalyzed by a complex enzyme system composed of several essential enzymes and cofactors. All of these components have been assayed in liver biopsy samples from patients with the classic form of PKU. They are all present except for phenylalanine hydroxylase, thus establishing this enzyme as the missing component. This conclusion has been confirmed in immunotitration experiments with a specific antiserum to phenylalanine hydroxylase. With the use of a highly sensitive assay for the hydroxylase, 0.27% of the normal activity of phenylalanine hydroxylase has been detected in a liver sample from a patient with classic PKU. There is some evidence that this low level of catalytic activity is due to the presence of a nutant form of the enzyme rather than to very low levels of the normal enzyme. These results rule out the possibility that clasic PKU is caused by a deletion mutation. The finding that the properties of the enzyme are different from the normal enzyme also suggests that the low hydroxylase activity in PKU is not caused by a regulatory hene mutation, but rather by a mutation in the gene that codes for the structure of the hydroxylase.


Neuronal sprouting after hippocampal lesions. It appears that aberrant but functional circuitry can rapidly develop after removal of particular afferent projections. The parameters describing this process appear to vary according to (1) the age at which the experimental manipulation was performed, (2) the specific afferent being studied, and (3) the particular input which is eliminated or possibly the brain region which is deafferented. It must also be emphasized that abnormal growth is not always found after lesions even in situations which a priori appear appropriate. Hopefully, these anatomical and physiological results obtained in a relatively "simple" brain system will be of help in evaluating the role played by abnormal wiring in the development of behavioral deficits.


Segmental ultrasonic test for the study of cholecystodyskinesia. Ten patients of ages 35 to 61 years with 'cholecystopathy' received an injection of 20 ml, 40% biligrafin. X-rays of the gall-bladder area were taken before and at certain intervals after the injection. This was followed by ultrasonic stimulation (applied using the impulse technique) for ten to twenty minutes at frequencies of 3 MHz, effective intensity of 1.4-2.8 W cm-2 and with paraffin oil as a contact agent. The dorsal segments were subjected to ultrasonic stimulation of weaker intensity but longer duration than the ventral segment. The gall-bladder shadow was analysed planimetrically, and an approximate volumetric calculation was attempted. The results show that the gall-bladder responds to segmental ultrasonic stimulation by both contraction and dilatation, presumably through a cutaneous visceral reflex arch, a qualitatively and quantitatively different response to that of egg yolk. Segmental ultrasonic stimulation of the gall-bladder seems to be a suitable complement to fatty meal treatment, particularly where this 'contra-indicated'. In addition it offers the possibility of differentiating between hyper and hypokinetic forms of gall-bladder dyskinesia. Finally, it was observed that a more marked effect on the gall-bladder can be produced by dorsal-segmental stimulation than by stimulation over the ventral points.


Aneurysmal bone cyst of the sphenoid sinus. Aneurysmal bone cyst is now recognized as a distinct clinicopathologic entity. It has characteristic clinical, radiologic, and pathologic feactures. The two modalities of treatment are surgical resection or curettage and radiotherapy: recurrence rates with each modality are discussed. A case report of an aneurysmal bone cyst presenting in the sphenoid sinus and treated with the compbined modalities of irradiation and surgical curettage is presented.


Surgical reconstruction of complications associated with fronto-ethmoid mucocele surgery. Devastating complications can occur following an uncomplicated resection of a fronto-ethmoid mucocele, namely, total blepharoptosis, diplopia, and vertical-horizontal extraocular muscle abnormalities. Four stages of reconstructive surgery were required over a two-year period of time to arrive at an acceptable appearance and useful binocular vision. Maximum care must be exercised when resecting a fronto-ethmoid mucocele. Inadvertent trauma to the orbital anatomy may result in a multitude of serious ocular complications.


[Effect of mitral valve calcinosis on the remote results of commissurotomy]. The results of 249 mitral commissurotomies in calcification of the mitral valve are analysed. The authors have differentiated three grades of calcification of the valve and two groups according to its functional state. Late results were followed up in 177 patients within the terms up to 10 years and longer. The persistant positive result was noted in 99 patients, in 11 cases it was regarded as poor, and in 37--unstable. Postoperatively 34 patients died. The analysis enabled the authors to state that the positive effect of closed mitral commissurotomy could be also gained in considerable calcification. Prosthetic replacement of the valve is indicated in the presence of massive calcinosis associated with the rigidity of cusps and marked regurgitation.


[Importance of lactacidemia for evaluation of severe postoperative condition of patients with peritonitis]. Based on the analysis of a number of organic acids, blood pH in the early postoperative period in 56 patients with diffuse peritonitis, it is concluded that the level of lactic acid depends both on the intensity of the inflammatory process in the peritoneum and on the degree of tissue perfusion disorders. During the intensive therapy these microcirculatory disturbances are liquidated during initial two postoperative days, whereas the kinetics of blood organic acids reduction allow characterization of the degree of pathophysiological shifts in diffuse peritonitis and possible issues of the disease.


[Causes of errors in x-ray diagnosis of diseases of the digestive tract]. Eighty three cases of an erroneous x-ray diagnosis of diseases of the gastrointestinal tract were analyzed and compared with operative findings (3269) operations. In 75 observations a divergency in diagnoses was related with pathological conditions of the stomach and pancreatoduodenal zone. The greatest number of erroneous diagnoses is due to an improper interpretation of roentgenological symptoms and underestimation of functional signs of the lesion. Errors in the method of roentgenological studies resulted in a wrong diagnosis. There were 8 cases of incorrect diagnosis in tumors of the small and large bowel, 5--in diseases of the operated stomach and 2--in nonepithelial gastric tumors, these were mostly due to objective difficulties of the differential diagnosis and limitations of the roentgenological method of investigation.


[Modification of step-by-step aortography]. A modified technic of step aortography was suggested and used clinically. Following it a metallic obturator, used for closing a top portion of a catheter, is introduced hydraulically. The suggested modification would allow angiographic studies of a more short duration, that is of special importance in case of an emergency investigation.


[Repeated lung resections in patients with bronchiectasis]. Among 1000 patients with unilateral and bilateral bronchiectases 35 patients were subjected to repeat pneumonectomies for residual and recurrent bronchiectases. In residual bronchiectases segmental resections are mostly indicated, while in persistant atelectasis with bronchial fistula, chronic pleural empyema and bronchiectases a removal of the remain lung portions seems to be the only radical method of treatment.


[Outcome of surgical treatment of acute cholecystitis at different phases of the disease]. Due to some features in the clinical course of acute cholecystitis operative interventions may be performed in different terms. "Emergency" operations are performed on vital indications during the first day of patient's stay at the hospital; "urgent" operations are indicated, if there is no improvement in patients' status despite energetic conservative measures with antibiotics during 2-6 days. Delayed surgery is accomplished following the subsidence of clinical signs of the inflammatory process and adequate investigation of the object. Delay operations are certainly more advantageous, nevertheless in established diagnosis of suppurative inflammation in the gallbladder the expectation policy and persistant conservative therapy are hazardous because of a possibility of development of grave and multiple complications. A question of indications to emergency operations should be solved, if possible, during the first day of patients' stay at the hospital. According to the author's material the mortality rate after emergency operations was 3.1%, after urgent procedures--10%, and delayed operations--1.6%. An average per cent of the mortality in surgical therapy for acute cholecystitis makes 4.3%.


[Thromboendarterectomy of the aorta and renal arteries in vaso-renal hypertension]. Based on the clinical experience with 309 operations performed for the renal arteries pathology indications to and pecularities of various modifications of the operation are analysec. According to the authors' data the specific weight of thrombendarterectomy made 42.9%. The technic of transaortic eversion thrombendarterectomy from the renal artery by means of a posterior arciform seems to be preferable. As evidenced by the authors' findings transarterial methods of thrombendarterectomy proved to be a failure. The technic of thrombectomy from the aorta and renal artereis ostia in a high ascending thrombosis of the aorta is discussed in detail. More frequently reconstructive procedures for the associated pathology of the abdominal aorta and its branches have been performed. During 73 operations totally 106 kidneys were revascularized. It is emphasized that this technic of renal arteries plasty is one of basic importance in surgery for vasorenal hypertension, but it should not be opposed to other methods of an operative correction of the renal circulation.


[Additional diagnostic symptoms of perforated peptic ulcer]. Utilization of abdominal puncture after the author's technic and the analysis of pathological peritoneal content enabled the recognition of a number of signs typical for perforated gastroduodenal ulcer, which are described in this communication. Such conclusion was drawn based on the use of punctures in 167 patients and examination of the peritoneal exudate in 375 patients with different surgical affections of abdominal organs.


[Clinico-roentgenological parallels in congenital hypoplasia of the deep veins of the limbs]. The authors report  the results of clinical and phlebographic investigations in 34 patients with congenital hypoplasia of profound veins of the extremities. The specific weight of this lesion among phlebological patients was 2.7%. An extreme degree of aplasia--the total absence of deep crural and femoral veins was diagnosed in 4 cases, arteriovenous fistulas--in 14. The studies performed allowed wider indications to operative treatment employed in 21 cases. It was accomplished with the purpose to unload the lower limb venous system (ligation of arterio-venous fistulas, excision of angiomas and varices, ligation of communicant veins). These interventions improve considerably the patients' state and prevent a progression of the disease. However, they are but of a palliative character.


[Roentgeno-functional comparisons in post-thrombotic disease of the lower limbs]. In patients with the sequelae of acute thrombosis of profound large veins the results of kinetic phlebotonometry, venous blood flow rate, tissue hydrophilia, shin electrothermometry and arterial oscillography were compared with the degree of decompensation of the collateral venous outflow, revealed phlebographically. With the development of phlebographic signs of decompensated collateral venous outflow a progressing venous atonia, diminished venous tonus and venous pressure, the valvular apparatus insuffieicny, retardation of the venous blood flow, alterations in tissue microcirculation and insufficient peripheral arterial circulation were detected. The authors' materials allowed a conclusion as to the important role of collateral venous outflow in pathogenesis of postthrombic disease, development of hemodynamic disorders in the involved extremity, and the rationality of using functional methods of investigation to characterize compensatory capacities of the venous network.


[Remote results of surgical treatment of post-thrombophlebitic disease of the lower limbs]. An analysis of late results of surgery for thrombophlebitic affection is reported. 55 patients were examined in different terms (up to 7 years after reconstructive operative procedures). Favourable and satisfactory issues were gained in 44 of them Control phlebograms proved the patency of anastomosed and free grafted veins. The following operations are recommended for a wider clinical application: croos shunting, the femoral vein plasty with a free venous autograft, the construction of anastomoses between v. saphena magna and profound veins of the extremity. The need for reconstructive procedures that would be associated with the removal of pathologically changed subcutaneous veins and ligation of insufficient communicant veins of the leg and foot is emphasized.


[Lymphographic semeiotics of inflammatory and dystrophic lesions of the lymph nodes in the light of morphological data]. The authors report clinica, roentgeno-lymphographic and morphological findings in 164 patients whom lymph nodes showed various changes of non-tumor origin, 584 lymph nodes being studied by aimed lymphographic and morphological correlations. The changes observed were subdivided into 2 groups: diffuse and focal. Diffuse inflammatory and reactive changes, and multiple micrometastases as well, are manifested by an analogous lymphographic picture. In focal hyperplasia a lymph node is somewhat increased in size, it shows smooth and distinct contours, defects of filling and absorption.


[Treatment of diabetic gangrene].

[Treatment of diabetic gangrene]. The results of treatment in 68 patients with vascular lesions of the lower limbs in diabetes mellitus are analysed. Fifty patients showed a necrotic and gangrenous stage of the disease. A grave form of diabetes was observed in half of them. In every case of diabetic angiopathy of the lower extremities vessels, irrespective of the gravity and stage of the process, insulinotherapy should be instituted. A complex therapy and preoperative management also include an adequate physiological diet, spasmolytics, vitamins, antibiotics according to an antibioticogram, and anticoagulants, local enzymotherapy, if indicated. In 13 cases spontaneous sequestration occurred, 31 patients were operated upon: sequestration--in 6, amputation--in 25. The operation was performed after elimination of auetonuria and ketonuria and reduction of hyperglycemia as low as 200 mg% (the latter was gained but not always). Recently, low amputations have been accomplished more frequently than before. No postoperative mortality was noted.


[Surgical treatment of injuries of the anterior segment of the pelvic girdle]. The author described the results of surgical therapy for fractures of the anterior portion of the pelvic girdle and rupture of the pubic symphysis. The author has studied the surgical anatmy of these injuries, also original securing devices and some instruments were devised and operative approaches, employed in surgical procedures on pelvic bones, were elaborated. Indications and contraindications to surgery and the rationality of using some or other metallic constructions were studied. Observations over 27 of 76 patients operated upon for different pelvic fractures during the period of 1963-1974 are reported. The method allowed a close juxtaposition and fixation of fragments with the resulting good anatomical and functional issues without using external immobilization. The results of the treatment were mostly favourable.


[State of hemodynamics and external respiration during peridural anesthesia]. The author reports the results of hemoynamic, spirographic and biochemical studies conducted in patients, operated upon on the organs of the lower abdomen, pelvis and lower extremities. Arterial pressure and pulse rate were studied in 165 patients, venous pressue--in 50, spirographic studies--in 50, blood alkaline reserve--in 42.


[Sacro-epidural anesthesia in an out-patient clinic]. During operative procedures the authors have employed sarcoepidural anesthesia successfully in 51 patients, operated upon under outpatient conditions. No complications while using this kind of anesthesia were observed. Due to its duration and feasibility the latter seems to be rational in ambulatory conditions.


[Errors, risks and complications in esophageal alloplasty]. The author summarized systematically errors, hazards, difficulties and complications encountered in esophageal alloplasty. An analysis of 50 clinical observations (diverticulectomy, intubation of the esophagus in inoperable cancers, recanalization of stenosed entero-esophageal anastomoses after esophagoplasty, intubation of the enteroesophageal anastomosis in cancer recurrence after gastrectomy, previously performed) and 260 experiments on dogs (autoalloplasty of terminal and segmental portions of the esophagus) is given. Some measures for prevention of possible complications are recommended.


[Complications in extrafocal compression and distraction for nonunion of the tibia]. While analysing the results of 118 operations for extrafocal compression, distraction and compression-distraction osteosynthesis with the G. A. Ilizarov apparatus in 116 patients showing nonunion of fractures and pseudarthrosis of the tibia, the author observed 53 various complications among 40 operations (33.9%). 78 operations were without any complications (66.1%). The greatest number of complications was noted while using a distraction method. Some recommendations on the treatment and prophylaxis of such complications are given.


[Complications of reconstructive jejunogastroplasty in the late periods following surgery]. In the late period after reconstructive jejunogastroplasty such complications would arise as the resumed hydrochloric acid production and resulting peptic ulcers. Vagotomy is felt to be an effective measure for prevention and treatment of peptic ulcers of this origin. Some other complications of reconstructive jejunogastroplasty proved to be an obstruction of the interposed intestine of the functional character. The latter may necessitate surgical therapy.


[Functional state of the resected stomach stump in peptic ulcer]. The authors report the results of examination of 80 patients with ulcerous disease of the stomach and duodenum prior to and in the immediate period, as well as in 85 patients in late terms after typical Hofmeister-Finsterer gastrectomy. The acid-production of the stomach and its stump was studied by intragastric pH-metry, pepsine in the gastric juice was determined and also the resected stomach excretory function was studied by fibrochromogastroscopy. It is shown that the method of intragastric pH-metry is more advanrageous, since it gives an estimation of acid-production of the resected stomach in the immediate postoperative period, in particular.


[Metastases of esophageal cancer to the bones]. The data reported support the idea on possible hematogenic metastases spread in esophageal cancer, especially in bones (in 5 of 209 examined patients). Clinical and roentgenological findings of esophageal cancer metastases in bones do not differ from the manifestations of osteolytic metastases in bones of malignant tumors of other localizations. Timely recognition of distant metastases in esophageal cancer seems to be important from the point of view of selecting the most rational and warranted method of treatment.


[Tumor-like formations in the stomach wall]. Six cases of pseudotumorous lesions simulating gastric cancer are described. Pathological changes in the gastric wall were characterized by diffuse mainly lymphoid infiltration, associated with sclerosis and ulcers. These lesions are regarded as pseudo-sarcomatous lymphomatosis of the stomach. It is the authors' opinion that these are a benign nonsystemic reactive process in response to the previously suffered inflammation.


[Prolonged infusion therapy via the major vessels]. Some aspects of continuous infusion therapy by means of catheterization of large vessels are discussed. The authors share their experience of 215 punctures and catheterizations of the subclavian vein for persistent parenteral feeding after various thoracoabdominal operative interventions in patients with diseases of the gastrointestinal tract, lung, mediastinum and other lesions. The puncturing resulted in 13 complications, making 5.2%.


[Use of polidez for treating patients with endarteritis obliterans of the lower extremities]. To treat patients with chronic arterial occlusion of the lower extremities, the authors used 3% solution of low molecular polyvinyl alcohol in 0.9% sodium chloride solution-polydese. The substance was injected intravenously and intraarterially in a dosage of 10 ml per k Kg of weight. There was noted a good tolerance of the drug, and also the absence of toxic, pyrogenic and allergic reactions. In polydese therapy a marked improvement of the peripheral blood circulation was observed. The conducted clinical observations, laboratory studies have proved polydese to be the drug of a positive rheological effect.


[Clinical x-ray characteristics of acute suppurative destructions of the lungs of a nonstaphylococcal nature in children]. The authors conducted complex clinico-roentgenological and immuno-bacteriological studies in 63 children, aged from 14 days to 14 years, with acute suppurative destructions of the lung, complicated with the development of pyothorax. As a result of these investigations, it was found that clinico-roentgenological symptomatics in children with acute suppurative destructions of the lung of the non-staphylococcal nature (Proteus, pyocyanic bacillus and others) show evident peculiarities and differ from typical manifestations of staphylococcal destruction of the l,ng in children. Complex clinico-roentgenological and immuno-bacteriological studies in children with the mentioned pathology enabled the authors to differentiate an infective nature of the disease.


[Lesion of the hip joint in osteomyelitis of the pelvic bones and of the proximal portion of the femur in the newborn]. During 14 years the authors observed 52 newborn infants with acute hematogenic osteomyelitis of pelvic bones and proximal femoral portion, complicated with coxitis in 43 patients, pathological dislocation - in 32, phlegmon with burrowing in 37. A septicopyemic form of the disease was noted in 33 subjects, local-focal in 19. The symptomatics and an early topic diagnosis depending on a stage of the process are described in detail. The treatment includes timely surgical intervention on the pathological focus, intensive genaxis and treatment of pathological dislocation of the femur. An early diagnosis and timely complex therapy within recent 5 years provided the opportunity to reduce the mortality and the percentage of disability due to this disease.


[Peridural anesthesia with neuroleptoanalgesia in operations for goiter]. The paper is concerned with the use of peridural anesthesia (PA) in operations for struma in a considerable size and retrosternal localization of the latter, thyrotoxicosis, grave concomitant lesions. The authors have employed PA in 12 patients, in 2 of them in association with endotracheal narcosis, in 9 in combination with neuroleptoanalgesia (NLA), and in 1 postoperatively to liquidate successfully the laryngeal mucosa edema, developed following surgery for struma performed under endotracheal narcosis.


[Hemodynamics of the lesser circulation following bronchial resection for bronchiectasis in children]. In 12 patients in different terms after bronchial resection for bronchiectases changes in the minor circulatory circuit were analysed, taking into account catheterization findings in the pulmonary artery and the data of angiopneumonography. The studies have indicated that after resection of segmental bronchi the corresponding segments remain airful, if in the boundaries of the same lobe normally ventilated segments are preserved. Blood flow through pneumotized (with resected bronchi) segments is functionally blocked. Segmental angiopneumonography performed following a year and a half proved a complete anatomical patency of the vascular bed.


[Errors and difficulties in diagnosis of cecal volvulus]. Clinical manifestations of the cecum ileus fall into three specific clinico-anatomical types, the knowledge of which permits establishing the correct preoperative diagnosis in a considerable number of cases. A description of these typical clinico-anatomical variants is presented, and some practical recommendations are given.


[Vagotomy and pyloroplasty in patients with duodenal ulcer with decreased acid production]. It is the authors' opinion that low values of acid production do not exclude the importance of the acid-peptic factor in formation of duodenal ulcers. Vagotomy and pyloroplasty in most patients showing duodenal ulcer with reduced posthistamine secretion provide for good results.


[Urgent tasks of emergency diagnosis and treatment of acute cholecystitis]. An analysis of issues of surgical therapy for acute cholecystitis has indicated the advantages of an active policy contrary to expectation and conservative methods. Among 397 patients operated upon on urgent indications 9 patients died (2.2%). By means of accelerated chromoduodenal sounding and cholecystocholangiography (if not contraindicated) the function of the gallbladder could be judged preoperatively. Using these methods of estimation of the gallbladder state intraoperatively and studying the preparations a non-functioning (excluded) gallbladder was found in 75% of patients. It is believed that conservative therapy in this category of patients is unlikely to be a success. They are amenable to surgical treatment as soon as the reliable diagnosis is established.


[Surgical treatment of patients with acute pancreatitis]. Since 1963 to 1973 in the clinic 1449 patients were treated for acute pancreatitis and cholecystopancreatitis. A considerable increase in the number of these patients was observed during recent 8 years, mainly on account of destructive forms. 92 patients were operated upon (6.3%), including 9 subjects with pancreatic edema, 39--with hemorrhagic pancreatitis, 36--with pancreonecrosis, 8--with purulent pancreatitis. Indications to surgical therapy are considered to be as follows: the presence of initial signs of diffuse peritonitis or prounced signs of limited peritonitis, if the conservative therapy during 8-10 hours was a failure.


[Surgical treatment of peptic ulcer after gastroenterostomy]. Based on a comparison of the immediate and late results of treatment in patients with peptic ulcers following gastroenterostomy by means of gastric resection (24 patients) and by vagotomy, it is concluded that vagotomy in most cases results in a complete cure of patients, thus this procedure is felt to be more advantageous than gastric resection due to its technical feasibility and small operative risk.


[Saving of the spleen in resection of the left-side portion of the pancreas]. Chronic pancreatitis was produced experimentally in 26 dogs, morphological alterations in the spleen and changes in the pancreato-splenic ligament being studied. On 20 cadavers the authors studied topographoanatomical correlations between the pancreatic tail and the spleen with its vellels, in 8 of them--under conditions of chronic pancreatitis. The authors have definitely demonstrated a possibility to preserve the spleen in resection of the left portion of the pancreas in chronic pancreatitis. This possibility of remaining the spleen intact was supported clinically in 11 cases.


[Diagnosis and treatment of intestinal obstruction caused by biliary calculi]. During a 20-year period among 513 patients, subjected to surgery for acute intestinal obstruction, the intestinal obstruction with bile stones was noted in 10 cases. The clinical picture of cholelithic intestinal obstruction is characterized by an intermittent course, that would result in late hospitalization and a delayed surgical therapy. Among 10 patients under treatment there were 5 lethal issues. Despite a comparatively not infrequent spontaneous cure in this lesion, it is felt that active surgical measures should be employed. An initiated operative intervention should be as minimum as possible, i. e. be limited by a liquidation of the obstruction by means of removing a cholelith from the intestinal lumen.


[Effect of operations with artificial circulation on the protein balance of the body]. The content of total blood plasma protein and its fractions in absolute quantities was studied in patients with acquired and congenital heart lesions in different terms of the early postoperative period (82 patients) after operative procedures, performed under conditions of artificial blood circulation. The indices were compared in two groups of patients showing different regimens of protein loss replenishment and normalization of the protein metabolism during the operation and after it. There were observed considerable intraoperative losses of protein that remained also during 3-4 days following the operative procedure. Therefore, some recommendations are given as to the substitutive protein therapy.


[Infusion of drugs through the umbilical vein]. In the clinic an infusion therapy via the umbilical vein was performed in 456 patients with various diseases of abdominal organs. Recanalization and catheterization of this vessel was accomplished both by intraperitoneal and extraperitoneal methods. Medical drugs infused in the umbilical vein would not differ from those routinely used for intravenous infusion in one of caval veins. The clinical results obtained indicate an outright advantage of this method infusion, especially in suppurative lesions of the liver and bile ducts.


[Oeration of cross autovenous shunting in post thrombophlebitic disease of the lower limbs]. The author reports 32 operations of cross autovenous shunting performed at the clinic of Leningrad Research Institute of Hematology and Blood Transfusion. Late results during 1-7 years were followed up in 17 patients. Good results were gained in 5 cases, satisfactory--in 8, and poor--in 4. A phlebographic check was accomplished in 8 patients, the transplanted vein being patent in 3 observations. It is concluded that a clinical use of such operations seems to be rational.


[Diagnostic laparotomy and splenectomy in lymphogranulomatosis in children]. Diagnostic laparotomy and splenectomy have been performed in 19 children suffering lymphogranulomatosis (13 primary patients, 6--treated previously). In 11 of 19 children (56%) lymphogranulomatous foci were revealed, these would not be recognized by methods of a preoperative exploration, in 9 cases splenic involvement being noted (in 7 cases--in association with the involvement of splenic lymph nodes), in 2--solitary involvement of splenic lymph nodes. In primary patients the frequency of such findings was higher. Some complications are described. The operative procedures concerned are stated to be of great informative value.


[Hydronephrosis in newborn infants].

[Hydronephrosis in newborn infants]. During a 20-year period the author observed 40 newborn infants with congenital hydronephrosis. In 28 patients hydronephrosis of the normally developed kidney and in 12- of the abnormal organ was noted. Twelve patients were hospitalized for developmental anomalies that necessitated urgent surgical intervention, the diagnosis of hydronephrosis in them being established at autopsy. Twenty eight children were admitted to the clinic with symptoms of hydronephrosis. All children were operated upon, nephrectomy was performed in 18 cases, in the remainder-organ-preserving and corrective operative procedures were performed.


[Convulsive mechanism of ketamine anesthesia]. Experimental studies conducted on rabbits enabled the authors to reveal the central mechanism of the ketamine effect. Based on the experimental data obtained, the authors elaborated and used clinically the method of balance ketamine anesthesia consisting in a combination of ketamine with antispasmatic drugs: seduxen and mydocalm. This method of anesthesia is recommended for eliminating ketamine side effects.


[Exocrine function of the pancreas after vagotomy with economical gastric resection]. The authors have studied the effect of vagotomy, associated with an economic gastric resection, on exocrinous function of the pancreas and compared the sequelae of selective and trunkal vagotomy in this respect. The secretin and vagus mechanisms of secretion are analysed. Ten investigations were carried out in patients with duodenal ulcerous disease prior to surgery, and in 68 patients within the terms up to 3 years postoperatively. Vagotomy results in a reliable decrease of the basal amount of pancreatic secretion in maintaining the response to stimulation with hydrochloric acid and insulin hypoglycemia. Changes in exocrinous function of the pancreas were found to be identical after trunkal and selective vagotomy.


[Results of repeated operations after primary nerve suture]. The results of repeat suturing of 124 nerves following a failure of the initial intervention are analysed. In most cases nerves were injured at the level of the forearm (67%). A delay of the reoperation ranged from 1 month 19 days to 2 years 11 months, more frequently 3-6 months. The results were studied basing on a clinical investigation with grade estimation of muscular strength and sensitivity, measuring skin temperature, perspiration rate and the use of electrophysiological methods.


[Remote results of alloplastic reconstruction of cruciform ligaments of the knee joint]. The results of plastic reconstruction of genicular crucial ligaments with a Lavsan implant are reported. The results obtained were estimated basing on the analysis of clinico-roentgenological findings in 120 patients within the terms from 1 to 12 years following surgical therapy. The issues of reconstruction of one of crucial ligaments are reported as well as the results of operations for the damage to several ligaments of the knee joint. The data obtained were assessed using the 2 mark system and in 94.6% the results were regarded as being favourable and satisfactory.


[Clinico-experimental study of different types of allotenoplasty]. The results of an experimental study carried out on 140 rabbits with the aim to investigate auto- and allotendinoplasty are briefly described. General clinical, morphological, lymphographic and histochemical data allowed a conclusion as to the presence of a decreased lymphoido-plasmocytic reaction as the process of replacement of conserved allogenic grafts by connective tissue proceeded. Clinical utilization of conserved tendinous allografts in 32 patients in restoration of 41 injured digital tendons revealed positive aspects of this kind of tendinoplasty.


[Homoplastic reconstruction of the Achilles tendon]. The authors suggest a new type of plastic reconstruction of the Achilles tendon, using homotendons of fibular muscles. After this technic 60 patients were operated upon, the immediate and late results of the treatment were studied. Positive issues of this therapy obtained in 59 patients enabled the authors to recommend this method of surgical reconstruction of injured Achilles tendons for the orthopedo-traumatological practice.


[Rehabilitation of patients with fractures of humeral diaphysis and radial nerve injury]. Under observation were 27 patients, treated during the period of 1969-1973, with fractures of the brachial diaphysis and injury of the radial nerve. These patients showed temporary impairment of the radial nerve conductivity: in 21 cases immediately after the trauma, in 6--after operative intervention on the bone. Along with the treatment using orthopedo-surgical methods the complex of rehabilitation measures was employed. A special attention is given to labour therapy.


Cytology of tracheobronchial aspirates in horses. Tracheobronchial aspirates were obtained from 27 normal horses and from 57 horses with respiratory disease. Aspirates from normal horses contained mainly ciliated columnar epithelial cells, mononuclear cells, a few neutrophils and mucus. Aspirates from horses with acute suppurative bronchopneumonias or chronic bronchiolitis had predominantly neutrophils and usually large amounts of mucus; in severe suppurative inflammatory diseases, many of the cells were degenerated, and there were coils of fibrinous material resembling Curschmann's spirals. Eosinophils were rarely found, even from horses with histories suggestive of allergic respiratory disease. Aspirates from horses with epistaxis frequently had macrophages with intracytoplasmic green globules (hemosiderin). Tracheobronchial aspirates occasionally revealed subclinical lung disease. Four horses with no clinical signs of lung disease and lungs that were unremarkable on percussion and normal on auscultation had adpirates suggestive of inflammation; histologic examination confirmed bronchiolitis.


Morphological and histochemical observations on renal microbodies in cats. The diaminobenzidine method for catalase showed two distinct morphological populations of renal microbodies in healthy mature cats of both sexes. Microbodies in the proximal convoluted tubules, which in this species also contain abdundant neutral lipids, were polyhedral and had distinct marginal plates. Those in the remaining renal tubules, which are lipid-free, were rounder and less uniform in size. Both forms of microbodies had homogenous granular matrices without nuceloides. The morphological variations of the microbodies may depend on their association with renal lipids. The cat may serve as a model to explore functional or pathological relationships between microbodies and fat metabolism.


Pathogenesis of sialodacryoadenitis in gnotobiotic rats. The pathogenesis of sialodacryoadenitis was studied in gnotobiotic CD rats inoculated intranasally with the causal virus. Virus replication was detected sequentially in the nasopharynx, tracheobronchial tree, cervical lymph nodes, submaxillary and parotid salivary glands, exorbital gland, and Harderian gland. Acute rhinitis appeared within 2 days after inoculation, and salivary glands had lesions in 4 days. Early changes in salivary and exorbital glands were characterized by necrosis of ductal epithelium, which rapidly progressed to widespread acinar necrosis, marked inflammation, edema and total effacement of glandular architecture. Harderian glands also had massive necrosis of tubuloalveolar units. Repair in all glands was characterized by marked squamous metaplasia of tubuloalveolar units. Repair in all glands was characterized by marked squamous metaplasia of ducts. Neutralizing and complement-fixing antibodies were detected in 7 days, and there was a concomitant decrease in tissue-virus titers. There was no detectable evidence for hematogenous spread of virus or for retrograde infection by way of major salivary ducts.


Old dog encephalitis and demyelinating diseases in man. Pathologic findings in mature dogs with old dog encephalitis were compared with the findings in multiple sclerosis, subacute sclerosing panencephalitis and neuromyelitis optica in man. Fluorescent antibody studies in animal and human tissues were compared. Optic neuritis in dogs with chronic distemper shows changes similar to those in the optic tract of human patients with severe demyelinating disease. The pathologic changes in multiple sclerosis, such as perivascular infiltration with lymphocytes, plasma cells and demyelination are similar to those seen in old dog encephalitis. Demyelination in old dog encephalitis is usually diffuse. The findings strongly support a possible relationship of old dog encephalitis to multiple sclerosis, subacute sclerosing panencephalitis, and neuromyelitis optica.


Mycoplasmas and cuffing pneumonia in a group of calves. The mycoplasmas found in the lungs of 20 calves, housed together for six months, and the related pulmonary pathology are reported. Twelve calves had cuffing pneumonia and in this group there was a significantly higher isolation frequency of Mycoplasma dispar and Ureaplasma spp compared with the non-pneumonic group. Mycoplasma bovirhinis and Acholeplasma laidlawii were isolated from the lungs of calves in both groups. Mycoplasma arginini was not recovered from the lungs of any calf. The significance of the peribronchiolar lymphocytic accumulation in the lungs of the non-pneumonic animals and their differentiation from peribronchiolar lymphocytic cuffs is discussed.


The role of radiotherapy in veterinary practice. It is common knowledge today that cancer is by no means an incurable disease and therefore it is no longer necessary to propose euthanasia for all inoperable cases of malignant neoplasia. The veterinary surgeon has a duty to inform his client of current methods of treatment, particularly radiotherapy, which may possibly provide a cure or prolong life without pain for several months. This article outlines the availability and usefulness of this important line of treatment.


The epidemiology of the "collapse syndrome" in suckled calves. Cases of a diarrhoeic syndrome characterised by acute collapse were seen in single-suckled beef calves on hill farms during a three year period. The association between the occurrence of this syndrome, which we have termed the "collapse syndrome", and various epidemiological parameters, is investigated and discussed.


[Study of Vibrio strains isolated from swine]. Antigen and biochemical studies were carried out of nine Vibrio strains isolated from pigs, testing their pathogenicity and toxicity for experimental animals. According to their biochemical behaviour six of the strains were shown to belong to type I, three--to subtype I, and on the grounds of their antigenic characteristics six belonged to type I and three--to type II. It was found that the strains producing hydrogen sulfide were more weakly pathogenic and toxic. No substantial differences were found between the strains isolated from miscarrying and normally farrowing sowa originating from pig breeding farms with a record of vibriosis.


[Study of cows experimentally infected with atypical mycobacteria]. Cows were infected subcutaneously with Mycobacterium aquae, Mycobacterium fortuitum, Micobacterium vaccae, and Mycobacterium smegmatis. The investigations carried out on the thirtieth day following infection revealed allergic reaction in all cows with close variations when avian and bovine tuberculin were used. The complement-fixation test with blood sera pointed to the presence of specific antibodies for the Mycobacterium genus. The histopathologic reaction in the lymph nodes, established after the slaughter of the animals on the 45th day of infection, was a proliferative-infiltrative one, the epitheloid cells being located at the periphery of the trabecules. Giant cells and necroses were missing.


[Effect of a ration with a varying amount of fat and protein of plant and synthetic origin on some indices of ruminal content and of the blood in lactating sheep]. The pH value of the rumen content in lactating ewes given sunflower expeller was 7.10, and that in ewes given urea was 6.70. The amount of ammonia in the rumen of ewes fed expeller was at a dependable lower level than the amount of ammonia with ewes fed urea. In animals fed expeller with the ration the blood sugar, protein, and lipids were higher, while acetone, beta-oxibutyric acid, and cholesterin dropped. In urea feeding, the levels of acetone, betaoxibutyric acid, and cholesterin rose, while blood sugar, protein, and lipids were lower. The Ca, P, Na, K, and Fe contents as well as the activity of the SGOT and SGPT enzymes in the blood of lactating ewes did not change essentially except for the amounts of Mg and Cu.


[Isolation of Toxoplasma strains via the digestive method]. Tested was the effectiveness of the digestive method for the isolation of Toxoplasma strains. This method was used to study the musculature of the diaphragm in 80 sheep, 40 cattle, and 80 pigs. Isolated were one strain that was pathogenic and 3 apathogenic strains for albino mice. They were found only in the diaphragm of sheep. It is believed that the digestive method is effective for the isolation of Toxoplasma strains.


[Histochemical tracing of the iron in the body of piglets injected with an iron-dextran preparation]. A comparative study was carried out with thirteen pigs, aged 1 to 3 days, to follow up the resorption and distribution of the Bulgarian iron-dextran preparations Ferdex-100, Dextrofer-75, A-100, and Miofer-100 in the body. Histochemically, an activation of the reticulo-endothelial system was established. Most macrophages that had phagocytised iron were established in the regional lymph nodes, followed by the liver, kidneys, marrow, while in the spleen their count was negligible. Using the histochemical reaction for the demonstration of iron in the viscera it was established that the A-100 preparation was best utilized by the organism. It was concluded that by the amounts of iron found in some organs it even exceeded Miofer-100.


[Hormonal correlations in hyperplasia of the breasts in women with ovulatory cycles]. An excretion of the follicle-stimulating hormone (FSH), estrogens, pregnandiol, 17-KS, vaginal cytology were studied in 22 patients with dyshormonal hyperplasias of mammary glands and in 12 healthy females with ovulatory cycles. The age of patients under study ranged from 20 to 49 years. The patients showed a higher level of excretion of FSH, estriol, pregnandiol and a lower level of 17-KS excretion than healthy persons.


[Correlation of some nitrogenous compounds in the blood and tissues of tumor-bearing rabbits in hyperglycemia]. In rabbits transplanted Brown-Pearce carcinoma the content of nitrous compounds in tissues is changed in a different way: in the liver and kidneys -- nitrous compounds are accumulated, while in cardiac and skeletal muscles their concentration is diminished. It is found that tumor cells in mice with Ehrlich carcinoma accumulate radioactive aminoacid considerably faster than adjacent tissues not involved by neoplasma. A continuous glucose administration in tumor-bearing rabbits renders a marked nitrogen-saving effect by means of attenuation of catabolism of myoproteins, as a result of it the balance between the processes of synthesis and catabolism in host tissues is shifted toward synthesis.


[Characteristics of the reproduction of Djungarian hamsters in captivity and spontaneous tumors]. Breeding behavior and fertility of the Djungarian hamster (D. h.) -- Phodopus sungorus campbelli Th-during 8 years (1966-1973) have shown that this hamster species is a suitable laboratory animal. The decline of breeding in winter months, observed in the first years of maintaining D. h. in our laboratory, became less pronounced in the last three years. D. h. seems to be resistant to common infections of laboratory animals. The only infection observed in D. h. was on outbreak of trichophytosis which was successfully liquidated. Spontaneous tumors developed in 130 of 1277 D. h. (10%). Mammary carcinoma, squamous cancer of the skin and lung tumors prevailed. In the recent years, the incidence of mammary carcinoma became higher, whereas the frequency of skin tumors was decreased.


[Effect of unsaturated fatty acids on the carcinogenic activity of overheated sunflower seed oil]. Non-pedigree rats were injected subcutaneously either overheated oil or the oil and one of unsaturated fatty acids (linoleic, linolenic, oleic acids), or overheated oil and fresh oil. The greatest number of tumors in earlier terms occurred in the group of rats not receiving fatty acids. In simultaneous injection of overheated sunflower oil and fatty acids (oleic and linolenic), as well as fresh oil, tumors would arise considerably more rarely. Whereas, in injection of overheated sunflower oil and linoleic acid tumors did not arise at all. The mechanism of an inhibitory action of fatty acids on tumor development is discussed.