[Microsporidia of the Simulium larvae: systematic, cytochemical, pathological and ecological data]. At present, 10 microsporidian species belonging to the genera Nosema, PLeistophora, Thelohania, Stempellia, Octosporea, Weiseria and Caudospora are known as parasites in Simuliids larvae. Acid mucosubstances fixing alcian blue and proteinic granules rich in -SH groups appear during sporogony in various species of Thelohania, Pleistophora, Stempellia. The microsporidan contracts intimate relations with larval host-cells of the type host-parasite complex and lengthens larval state as well for the size (a morphological aspect) as for the respiratory rate (a physiological aspect). This is a very good condition for the development of the parasite. The incidence of parasitism does not exceed 8%. It looks independant from various physical and chemical factros (stream velocity, temperature, oxygen concentration) but it rises with the perimaginal population-age because of the lengthening of larval life by the parasite.


[Trichostrongyloidea nematodes, parasites of Microchiroptera]. 1. a) List of Nematodes collected by Professor Aellen in european Microchiroptera. Additionnal morphological data to the study of Molinostrongylus alatus, M. panousei, M. skrjabini. Description of M. aelleni n. sp. b) Description of M. richardae n. sp., M. benexae n. sp. et M. bauchoti n. sp., parasites of malagasian Molossidae. c) Description of M. colleyi n. sp. and M. owyangi n. sp., parasites of Malaysian Vespertilioninae, and of Allintoschius dunni n. sp., discovered in Myotis mystacinus from Malaysia and Pipistrellus nanus from Africa. 2. Taking into account the characteristics of the synlophe, the 17 species of the genus Molinostrongylus may be divided into five groups, each one being reasonably well characteristic of the genus of their Chiropteran host. 3. The composition of the Trichostrongyloidea fauna of Chiroptera and its relationship with Trichostrongyloidea from other Mammals (Tupaiidae, Pholidotes, Primates, Sciuridés) are analysed. Six groups are separated and divided into two well defined lines: 1) genus Strongylacantha, and 2) 12 genera stemming more or less directly from the Molineinae, 4. The three conical outgrowths at the tip of the female tail which differenciate presently the Anoplostrogylinae from the Molineinae appear to be an unreliable characteristic. The two subfamilies form a complex group which will be better understood if the evolution of the synlophe and that of the caudal bursa of the males are taken into account.


[Mode of penetration and localization of the larvas of Morerastrongylus andersoni (Petter, 1972) (Metastrongyloidea, Nematoda) in the intermediate host]. The way of entry and the localization of the larvae of Morerastrongylus andersoni (Petter, 1972), parasite of African Gerbillidae Rodents, were studied in Limnaea stagnalis L. and Planorbarius corneus (L.). The entry occurs by ingestion: indeed, in the Molluscs killed immediatly after one-half to one hour contact with infested Rodents; droppings, the majority of the larvae are found in the digestive tract. After several hours, the larvae are located in the connective tissue and in the muscles and they are distributed everywhere in the Mollusc's body.


[Four new species of heligmosome nematodes, intestinal parasites of a Malyan Trichys lipura Günther; comparison with the Congolese fauna of Atherurs]. Description of four new species of Heligmosome Nematodes parasites of the gut of Trichys lipura: --Heligmonella limbooliati n. sp. has a synlophe of Heligmonella-type and a bursa related to Cordicauda. --Cordicauda trichysi n. sp. is characterized by the relatively small dorsal lobe of the bursa, numerous cuticular ridges and the origin of the 8th rib at the distal third of the dorsal rib. --C. malayensis is closely related to C. trichysi (the female of the two species are morphologically identical but the two species can be separated by the larger dorsal lobe of the bursa and the longer spicula of C. malayensis). --C. magnabursa n. sp. is separated from the other species of the genus by the peculiar morphology of the bursa and the female's tail, dorsally bent. The fauna of Trichys is compared to that of Atherurss africanus, which is parasitized by 8 coparasites species: One Heligmonella and seven Paraheligmonina. From a phyletic as well as an ecological point of view (relative abundance and species location in the gut) the two fauna seem to have evolved in a parallel way, one in Africa, one in Asia, from a single Heligmonella type Nematode, after the host's partition.


[Presence of Phlebotomus bergeroti, Phlebotomus chabaudi, Phlebotomus chadlii and Sergentomyia christophersi in Morocco]. The authors indicate the presence at Morocco of the four following sandflies: Phlebotomus bergeroti Parrot, 1934, Phlebotomus chabaudi Croset, Abonnenc et Rioux, 1970, Phlebotomus chadlii Rioux, Juminer et Gibily, 1966 and Sergentomyia christophersi (Sinton, 1927). Among them, Phlebotomus bergeroti, an element of eremitic affinity, is found at the north of the Atlas under a sub-humide bioclimat.


The clinical role of skeletal scanning.

The clinical role of skeletal scanning. Malignant disease very often spreads to the skeleton. This is particularly true for carcinomas of the breast, the lungs, the prostate, and the thyroid. Knowledge of the state of the skeleton in these disorders is therefore desirable since patient management will largely depend on the early detection of bony deposits. Primary bone disease often spreads to soft tissue (lungs), and the early detection of this may alter significantly the therapeutic approach to the primary lesion. Traditionally, X-ray skeletal surveys and serum enzyme measurements provide indices which can be used in the staging of these disorders. Complementary techniques such as mammography, xeroradiography, thermography, and radionuclide imaging have been used to provide further relevant information. A number of benign bone diseases need early assessment in order to institute the best form of treatment. It is of importance to assess the circulation in localized areas of bone and to predict the appearance of avascular necrosis, to understand the healing mechanisms involved in fractures, and to predict the outcome of bone grafting. In this paper the clinical role of bone scanning is reviewed, particular attention being given to the recent advances brought about by the introduction of the 99mTc compounds. It is important that the non-specialist should be aware of the great improvement in the results obtained and in the help they can give him in deciding on the best management of each patient as an individual.


Incidence of inguinal hernia recurrence. Effect of time off work after repair. A survey of 260 adult male patients who had undergone inguinal hernia repair was carried out to see how long they stayed off work after operation. There was no evidence that a prolonged convalescent period reduced the subsequent hernia recurrence rate. Evidence from the North American literature suggests that patients can resume their usual physical activity without ill effect much sooner after operation than is the current practice in the United Kingdom. General practitioners should be informed of the advice that has been given to their patients about the resumption of physical activities after operation.


Villous papilloma of the colon and rectum. Part I. A clinical study of 213 patients. Of the benign colonic epithelial neoplasms the villous papilloma, although rare, is reported to become malignant in 30--50%. This paper reports a retrospective study of 213 patients with a colorectal villous papilloma. The tumours were subdivided histologically according to Wheat and Ackerman (1958) into four different groups. 20% of the tumours contained either focal or invasive carcinoma. The histology of the tumour correlated significantly (p less than 0.01) with the size of the tumour with a more malignant grading of the larger tumours in general. Blood in the stool, diarrhoea, and mucoid discharge from the anus were the most frequent complaints. Malignant change of the tumour was found especially in older patients (eighth decade of life) and among women. Patients with a malignant villous papilloma complained significantly more of pain on defecation than patients with a benign tumour. Over 30% of the malignant tumours were already incurable at the time of discovery because of invasion of surrounding tissues and metastases.


Villous papilloma of the colon and rectum. Part II. A follow-up study of 213 patients. A follow-up study of 213 patients with colorectal villous papillomas was performed to assess different methods of treatment and the prognostic value of several factors. Recurrences appeared in 26%. Segmental resection of the intestine gave no recurrences. The choice of surgical method had little or no influence on the 5-year survival rate. The 5-year crude survival rate for the whole series was 61% with a relative survival of 80%. The larger tumours had the poorest 5-year survival rates. Tumours with invasive carcinoma in the villous papilloma had a crude 4-year survival of 16% whereas tumours which did not originally show invasive features had a 5-year crude survival rate of 68%. Of the whole series 48 patients (22%) eventually died from colorectal cancer. It is possible that the invasive character of the tumour had been missed originally so thorough microscopic examination of the whole tumour is essential.


The fate of elderly patients treated in the surgical intensive care unit. A survey of 174 patients over 60 years old. The fate of 174 patients over 60 years old treated in the surgical intensive care unit was investigated. During their stay in the hospital the mortality was 39% and 24% in the selected group when hopeless cases with malignancies, mesenteric thrombosis and severe brain lesions were excluded. The prognosis was not affected by the age or concomitant diseases. The importance of meticulous preoperative treatment and surgery is stressed. Modern intensive care in special units has changed the prognosis of aged patients greatly.


Treatment of cerebral embolism in heart surgery. The results in the treatment of air embolism in open heart surgery are presented. Two cases of gaseous cerebral embolism are described. One of the patients had a period of unconsciousness of 54 hours, the other of 17 days. Therapy included administration of vasoactive drugs (xanthinol nicotinate 1500 mg 2 times daily as an intravenous drip) combined with superficial hypothermia (32 degrees C). In both cases complete recovery was achieved.


Disturbances in the function of cardiac pacemaker caused by short wave and microwave diathermies and pulsed high frequency current. The effect of short wave diathermy, pulsed high frequency current (Diapulse, Curapuls) and microwave diathermy on the function of an implantable cardiac pacemaker and its leads was examined by measuring the output (voltage) and rate of the pacemaker under various experimental conditions. It appeared that all these devices had a decreasing effect on the output and an increasing effect on the rate of the pacemaker. When therapeutic doses (power) were applied the greatest changes in output and rate were caused by microwave diathermy and the slightest by Curapuls. The clinical precautionary measures based on these observations are discussed.


Effects of intra-aortic balloon pumping on experimental acute myocardial ischaemia. In an experimental study on dogs, effects of intra-aortic balloon pumping (IABP) on acute myocardial ischaemia without marked cardiac failure were analyzed. With the use of epicardial ST-segment recording IABP was shown to significantly reduce ischaemia when pumping was initiated 10 minutes after left anterior descending coronary artery ligation. Prior to coronary ligation the mean ST-segment height was 6.4 +/- 0.8 mV (mean +/- SE) and 10 minutes after the ligation it was 21.5 +/- 4.6 mV. During pumping ST-segment elevation increased to 6.9 +/- 0.7 mV. A dual-chambered intra-aortic balloon was used, and six dogs were treated with IABP. In the control dog no tendency to spontaneous ST-segment decrease was seen.


First trimester abortion by vacuum aspiration. To compare the efficacy and complications of using the 8 mm diameter metal and flexible plastic cannulae for performing abortions of pregnancies of 7--10 menstrual weeks' gestation by vacuum aspiration, a comparative study was conducted. Both types of cannulae were randomly assigned to 300 subjects in a study design where the physician who performed the abortion was not the same person who evaluated the subject after the abortion or at the time of the follow-up visit. All abortions were performed under paracervical block anesthetic after mechanical dilatation of the cervix to 8.6 mm. The rates of specific complications, blood loss and the need for secondary procedures to complete the abortion were not significantly different for the two types of cannulae. The amount of tissue obtained with a routine curette check following the vacuum aspiration, and the incidence of cannula obstruction were similar for the two types of cannulae.


HL-A antigens in psoriasis with special reference to the clinical type, age of onset, exacerbations after respiratory infections and occurrence of arthritis. HL-A typing was performed in a series of 125 patients with common psoriasis, 12 patients with flexural psoriasis, 16 patients with erythrodermic psoriasis and 16 patients with generalized pustular psoriasis, and compared with typing in a control population. The HL-A antigens 13 and 17 were significantly increased in patients with common psoriasis and erythrodermic psoriasis. HL-A 17 was also found in two of the 16 patients with generalized pustular psoriasis. Neither HL-A 13 nor 17 was increased in patients with flexural psoriasis. It is suggested that flexular psoriasis might be genetically distinct from common psoriasis. TY was increased in patients with common psoriasis. The increase of HL-A 13, 17 and TY was most marked in patients with onset of psoriasis before the age of 40 years. HL-A 13 was found in 38 per cent of the 40 patients with infection-related exacerbations of psoriasis, but only in 17 per cent (p = 0.012) of the remaining 129 patients. HL-A 27 was found in 58 per cent of the 26 patients with sacro-iliitis and in 27 per cent of the 41 patients with peripheral arthritis without sacro-iliitis, but only in eight per cent of the 102 non-arthritic patients (p less than 0.001) and p less than 0.01, respectively).


Regional renal blood flow in hypertensive patients. Renal blood flow measurements in three regions of each kidney were carried out in eighteen hypertensive patients using the radioactive Xenon-133 washout technique in conjunction with renal angiography. It was found that the regional differences were generally small but differences existed in four patients significant in spite of normal angiographic findings. The reduction in blood flow in the two kidneys was generally of the same degree which implies a uniform response to the elevated blood pressure.


Inactive pulmonary lesions: a potent risk factor of tuberculosis. Case histories and previous chest X-ray films of 142 patients with bacteriologically confirmed active pulmonary tuberculosis from eastern Finland were re-examined. In 18% of the series the disease was a reactivation of previously diagnosed and treated tuberculosis. In 70% of the patients with first clinical attack of tuberculosis, previous RP-films revealed fibrotic lesions in the lungs. Only 23% of the whole series had no previous abnormality on chest X-ray examination or previous clinical tuberculosis. Fibrotic pulmonary lesions are therefore a significant risk factor in the epidemiology of pulmonary tuberculosis, which has been given too little attention.


Carcinoma of the oesophagus and gastric cardia at autopsy in Finland. 154 patients in 16,523 consecutive autopsies had carcinoma of the oesophagus or gastric cardia. Thirty-three of these patients had had an oesophagogastric resection, 33 radiation therapy and 88 no effective therapy. In 47% of the cases given effective treatment (66 cases) no tumour tissue was detected at the autopsy. 20% of patients with no effective therapy had a localised tumour. Most of the localised tumours were in the lower third of the thoracic oesophagus. When an oesophageal or cardiac carcinoma without effective therapy was no longer localised, it was more than twice as likely that the tumour had already spread in combined ways. The localised stage and the local invasion of the tumour were to some extent dependent on the length of the tumour, but distant metastasizing was not dependent on it. 84% of the cases had direct or indirect complications caused by the tumour. The patients with oesophageal carcinoma had died twice as often of tumour complications than of metastases, whereas cardiac carcinomas led to death from metastases considerably more often than from tumour complications. The series included three cases of aorto-oesophageal fistula.


Light microscopic characteristics of megathrombocytes in platelet spreading preparations. In platelet spreading preparations some characteristics of unusually large "megathrombocytes" were examined with the light microscope. The appearance of the extremely large spreading forms was a sign for onset of brisk platelet reproduction in severe acute thrombocytopenic states.


The first five years of Annals of Clinical Research. Its international use with special reference to citation analysis. The use of Annals of Clinical Research internationally was studied by citation analysis, its presence in the information retrieval systems and library collections and also by its distribution. According to the journal citation search from ASCA the 308 articles in Annals of Clinical Research published during 1969-73 were cited 297 times between October 1973 and October 1974. The impact factor, ie. the number of citations divided by the number of articles published during 1971-72 was 1,163. Annals of Clinical Research had been mostly cited in the United states, Great Britain, France, Sweden and West-Germany. Occasional citations came from all over the world. It is well included in the biomedical information retrieval systems. On basis of some union catalogues Annals of Clinical Research is in collections of big libraries covering their field widely. 878 subscriptions are distributed to all parts of the world.


Skin manifestations in human yersiniosis. In 1969-1973, acute yersiniosis was diagnosed in 30 cases of erythema nodosum (EN), in 6 cases of EN and simultaneous erythema multiforme (EM), in one case of EN and erythema figuratum, in one case of EM, and in one case of drug eruption-like exanthema, respectively. During these years, 180 patients with EN due to other causes were seen. The most marked difference in the clinical course between yersiniosis and other cases was the duration of the eruption. EN nodules in yersinia EN faded away in 4 weeks in all but one case while the 4-week cure rate among the other patients with EN was only 37%. There were two types of EM lesions, namely cockade-like lesions and vesicopapules. They usually appeared some days before or together with EN nodules and they disappeared within 2 weeks without any scarring. Yersiniosis was caused by Y. enterocolitica serotype 3 in 19 cases. Y.ent. serotype 9 in 17 cases, and Y.pseudotuberculosis in 3 cases. Of the patients, 21 suffered from abdominal pains and/or diarrhoea prior to skin manifestations, but 11 had no pregastrointestinal symptoms resembling those of yersiniosis.


Reduction of motion unsharpness in coronary angiography using rare-earth oxysulfide intensifying screens and green-sensitive X-ray film. During cardiac cycle the coronary arteries move rapidly; the maximum velocity can exceed 400 mm/s. To eliminate the motion unsharpness, exposure times under ten milliseconds are necessary. Using new rare-earth oxysulfide intensifying screens and fast green sensitive X-ray film the exposure times can be reduced to as little as 2 milliseconds. Thus the motion unsharpness can be almost completely eliminated, producing enhanced resolution and better diagnostic accuracy.


Coronary and aortic atherosclerosis in relation to occupational physical activity in male violent deaths. The extent of coronary and aortic atherosclerosis was estimated by point-counting in 172 men aged 25 years or over dying violent deaths. They were classified into three grades of physical activity based on their occupations. The extent of coronary fatty streaks, raised lesions and calcifications tended to be smallest in "active" men while there was no difference between "sedentary" and "moderately active" mean in this respect. When the latter two groups were combined, a significant difference was found between this combined group and the group of active men in the extent of coronary raised lesions and calcification. On the other hand, no consistent or significant differences between sedentary, moderately active and active men were obtained in the stenosis score, which expressed the degree of obstruction in the coronary arterial tree, or in the extent of atherosclerotic lesions in the aorta.


Coronary and aortic atherosclerosis in relation to body-build factors. The relationship between body-build factors and the severity of coronary and aortic atherosclerosis was estimated in a series of 193 men, aged 25 years or over, who had died of violent causes. Overweight showed a significant correlation with the extent of coronary and aortic fatty streaks but not with the extent of coronary or aortic raised lesions or calcifications. The stenosis score, which expressed the degree of obstruction in the coronary arterial tree, showed a slight tendency to a positive correlation with the degree of obesity but the finding was not consistent. Nor correlation was found between the sturdiness factor of body-build and the severity of atherosclerosis. The muscularity factor showed  a significant correlation with the extent of coronary and aortic fatty streaks and an inverse correlation with aortic calcifcations.


Coronary atherosclerosis in cases of coronary death as compared with that occurring in the populatiom. A study of a medico-legal autopsy series of coronary deaths and violent deaths. The severity of coronary atherosclerosis at autopsy was studied in two series comprising 169 cases of coronary death and 231 people who died of violent causes. In the former the fatal attack lasted less than 24 hours from the onset of symptoms in 70% of cases. In only three men did the terminal attack last more than 24 hours, while in the remaining 28% of cases, although death was not witnessed these were also likely to have been sudden deaths. A recent infarct with or without an old myocardial infarct was found at autopsy in 47% of cases and an old infarct alone in 34%. In 19% of coronary deaths no recent or old infarct was detected. The surface areas of the atherosclerotic lesions were assessed in arterial specimens by pointcounting. The degree of stenosis was estimated visually. The mean extent of raised lesions and clacification and the median value of stenosis score, which expressed the degree of stensosi in the coronary arterial tree, were significantly higher in all age groups in persons who died of coronary heart disease than in those  who died violently. A marked overlapping between the individuals in the two series was, however, found in both for the exent of raised lesions and the severity of stenosis score. Raised lesions in coronary patients were calcified to about the same extent as those in persons ten years older in the series of violent deaths. Coronary atherosclerosis was most severe in coronary patients who had had symptomatic heart disease and had an old myocardial infarct and least severe in those in whome sudden death was the first manifestation of coronary heart disease from violent deaths as regards the extent of the raised lesions or prevalence of occlusion. The degree of coronary stenosis in coronary patients was closely related to the total extent of advanced coronary atherosclerosis.


Occurrence and regression of initial and terminal notching of the QRS complex in the electrocardiograms of patients with acute myocardial infarction. The occurrence of initial and terminal notching in the QRS complex of the electrocardiogram was studied in a series of 158 male patients surviving acute myocardial infarction during hospital admission and at follow-up examinations 6-8 weeks, 5 and 12 months after the infarction. In 115 men with their first myocardial infarction signifiant initial notching was found in the acute stage in 30% and significant terminal notching in 32%. One year later these percentages were 14 and 9, respectively. In patients with reinfarction the prevalence of notching was even higher. Inital notches were most often associated with anterior and terminal notches with inferoposterio infarction.


Serum levels and half-life of sotalol in chronic renal failure. The elimination of sotalol was studied in 25 patients with chronic renal failure. All patients were given a single 160 mg dose of sotalol orally and their sotalol serum levels were determined after 4, 6, 8, 10 and 12 hours. The elmination of sotalol was distinctly slower as the serum creatinine concentration rose. The half-lives, calculated graphically, were in lenear ratio to the serum creatinine values (r = 0,91; p less than 0.001). In accordance with the results, it is probable that sotalol accumulates in chronic renal insufficiency. Since beta-blockers may impair renal function, even in therapeutic concentrations, the dosage of sotalol, in particular, must be reduced in patient with kidney disease.


Studies of catecholamines in amyloidosis. Amyloidosis was induced in 21 mice by daily injections of casein solution for four weeks. Thioflavine T staining showed that the induction of amyloidosis took place in all mice. The catecholamine (CA) content was estimated in the spleen, proximal colon and kidney. In spleen the noradrenaline (NA) content per wet weight of tissue in casein-induced amyloidosis was significantly (p less than 0.01) lower than in the controls but this reduction was not apparent because of the huge increase in the weight of amyloid spleens. In the proximal colon and kidney the NA content did not differ from the control values. By fluorescence histochemistry the adrenergic fibres appeared to be well maintained in the spleen, duodenum and proximal colon in casein-induced amyloidosis. The CA content of rectal mucosal biopsies from five patients suffering from amyloidosis was compared with that from seven control persons. There was no significant difference in NA content. The present results suggest that in amyloid disease detectable alterations in the CA content or such morphological changes in adrenergic nerve fibres, which can be detected by fluorescence histochemistry take place only in the most advanced disease, if at all.


[Venereal granuloma (donovaniasis) in France]. The study of six cases of MacLeod-Donovan chancre, 2 in Paris, 4 in Brest, in young men coming from the West Indies, showed after 15 days incubation, a balano-preputial lesion consisting of an oval-shaped granuloma, 1 to 4 cm diameter, raised, indurated, ulcerated, reddish-yellow, spontaneously painful, bleeding easily, accompanied in 50 p. 100 of cases by inguinal adenitis, due to secondary infection. Swabs, which should be repeated, showed Donovan bodies within numerous histiocytes. The inactivity of penicillin may be contrasted with the rapidly favourable effect of streptomycin, chloramphenicol or aureomycin.


[The polarity concept in leprosy: polar types, polar system, polar concept, dichotomy]. The author presents his priority of the polar concept in leprosy, and briefly reviews what he calls the history of an idea. The polar concept was first presented in February-May 1938, and was to receive full recognition from the Havana's Committee on Nomeclature and published in the Annals of the 5th International Congress of Leprosy (April 1948). In recent years many points brought by immunopathology focused the humoral immunity at the level of the immuno-negative L pole, in clear-cut opposition to the cell-mediated immunity present in the immuno-positif T pole. Polar concept thus receiving a remarkable physio-pathological support to the views once expressed by the author.


[Gluteal fistulo-gummatous syndrome (malignant dysembryoma)]. The authors present the case of a 61 years old patient with fistulo-gummutous lesions with ulcer formation and pus formation in the right buttock, loss of weight and asthenia. The lesions appeared six months after a violent blow on the right buttock. General examination of the ano-rectal region, including sigmoidoscopy and fistulography, together with histo-pathological examination, revealed the existence of a perirectal muciparous carcinoma developing on embryonic glanduilform remains, situated in the right perinee-rectal region. The special interest of this case resides in its rareness and the unusual clinical appearance of gummatous fistula.


Recovery from allotype suppression in rabbits and release from this suppression in specific immune response. The recovery of allotypic expression in allotype suppressed rabbits was followed up in specific antibodies and in bulk immunoglobulins. The primary antigenic stimulation with BSA and/or MS2 phage was given at 4 weeks of age. In the early recovery group, where the recovery from suppression began at 11-13 weeks of age, specific antibodies bearing the suppressed allotype were found to be synthesized by the primary stimulation or with successive allotype was scarely expressed in specific antibodies despite its recovered expression in bulk immunoglobulins. The X-ray irradiation followed by the immunization procedures promoted the recovery of the suppressed allotype expression in anti-BSA antibody and in bulk immunoglobulins but not in anti-MS2 phage antibody. The results are discussed in terms of regulatory mecahnisms of immune response in allotype suppressed animals.


[Some characteristics of fucidin biosynthesis]. Some features of fusidin biosynthesis by 2 strains of Fusidium coccineum were studied proceeding from the peculiar properties of the antibiotic molecule structure. It was found that an increase in the levels of the carbon sources in the medium stimulated the biosynthesis of fusidin, while excessive concentrations of nitrogen especially in its inorganic and amino acidpeptide forms stimulated the organism growth and lowered the antibiotic activity levels. The concentration of nitrogen in the medium is considered as one of the possible control mechanisms in the processes of the fungus growth and biosynthesis of fusidin.


Mechanism of immune stimulation and tolerance based on an hypothesis on the cell division mechanism directed by the cell membrane. The binding of the antigen to membrane receptors is suggested to modify the structure of the membrane and consequently the activity of some of its enzymes and the flow of metabolites. The nature of the effects may be a function of the quantity of the interacting antigen.


[Study of the pharmacological properties and safety of a solution of levomycetin in hexamethylene tetramine for intravenous administration]. Pharmacological properties of 2 per cent levomycetin solution in 40 percent hexamethylentetramine solution, as a new pharmaceutical form of levomycetin for intravenous administration prepared at drug-stores were studied. The maximum tolerating doses of the drug for mice, rabbits, and dogs were 26-47 times higher than the therapeutic ones with respect to the content of levomycetin and hexamethylentetramine. No increase in the toxicity of levomycetin and hexamethylentetramine in the preparation was observed. The drug in the doses 16 times higher than the therapeutic ones by the content of levomycetin did not almost change the arterial pressure and the drug in the doses 3.7 times higher than the therapeutic ones did not affect the blood coagulation either in acute experiments, or on its prolong intravenous infusion. Repeated administrations of the drug to rats and rabbits for 15-18 days in doses 3.7-4.8 times higher than the therapeutic ones by the content of levomycetin were innocuous for the animals. Absorption, circulation in the blood, distribution in the tissues and excretion with the urine of levomycetin used in the above pharmaceutical form did not differ from circulation of the antibiotic on its intravenous and oral administration. The drug is recommended for use in medical practice.


[Isolation and partial study of an anti-hemoglobine precipitine in "Biomphalaria glabrata" (author's transl)]. A protein (PaHb) with a precipiting capacity with regard to normal and pathological human hemoglobin as well as horse and hen hemoglobin has been separated on immunoadsorbent from hemolymph of Biomphalaria glabrata. The joining of PaHb and hemoglobin takes place at the level of the polypeptidic chain. A reconnaissance of the spatial structure of the globin seems to exist. The absence of heme does not lead to a decrease in the intensity of the reaction. The coefficient of the sedimentation of PaHb is of 2.74 S and its molecular weight has been estimated at 47,000 per chromatography in thin layer. The divalent cation MgCl2 strengthens the intensity of the reaction, as for CaCl2 no change is observed, and in the presence of sodium citrate one observes a clear decrease in the reaction. The intensifying of the reaction when in presence of divalent cation MgCl2 could be the result of a stabilization or an activation of the natural structure of PaHb when in presence of Mg. PaHb shows no fonctional impairment after exposure at 65 degrees C during 45 min. The localization of PaHb in the total antigenic structure of the hemolymph is situated around the level of the 5th precipitine line. The functional role of the protein seems to carry the hemoprotein of the hemolymph.


[Myeloinhibitory effect of the action of some antitumor antibiotics and its comparative assessment]. General toxic and myeloinhibitory effects of some antitumor antibiotics, such as rubomycin, olivomycin, bruneomycin and karminomycin administered intraperitoneally in a single LD50 to mice were studied. It was found that the general toxicity of bruneomycin and karminomycin was almost the same and 5 to 8 times higher than that of rubomycin and olivomycin. The use of the above antibiotics resulted in definite shifts in the blood systems of healthy mice. The most significant suppression of hemopoesis accompanied by a pronounced depression of the number of the myelocariocytes was observed after the use of olivomycin. The effect of karminomycin was characterized by suppression of erythro-, myelo- and lymphopoesis and depression of the number of the granulocytes and lymphocytes of the blood. Bruneomycin and rubomycin had a short-time myeloinhibitory effect. The erythroid cords of the bone marrow proved to be most sensitive to the inhibitory effect of the antibiotics. However, inhibition of the erythropoesis accompanied by deep reticulocytopenia did not induce the respective depression of the erythrocyte number. The lymphoid cords was in the 2nd place by its sensitivity to the antibiotics and the myeloid and megocariocytal cords were in the 3rd and the 4th places respectively. Complete reduction of hemopoesis in the animals was observed by the 10th day of the drugs use.


Respective role of antibodies and immune macrophages during acquired immunity against toxoplasmosis in mice. Immunity of animals correlated with the destructive ability of their macrophages. Intraperitoneal inoculation of T. gondii led to a very limited infection of macrophages from immune mice. This infection was next rapidly and completely inhibited. Conversely, macrophages from mice immunized with killed toxoplasma were massively invaded and evolved like control cells. Similar results were also obtained with macrophage cultures infected in vitro and followed over a period of 4 days. Even after several washes, immune macrophages still preserved their ability to inhibit intracellular replication of toxoplasma. However, this resistance was not homogenous: in the absence of antibodies, some macrophages supported a parasitic growth whereas some others remained intact. Results have also shown that the engulfment capability of immune macrophages was not modified. The primary role of resistant macrophages in the immune response did not however exclude a participation of humoral factors. Specific antibodies acted on extracellular toxoplasma either by lysing them in the presence of the accessory factor or by slowing their active penetration into the cells. Furthermore, they did not affect the phagocytic activity of macrophages. The in vitro protective role of peritoneal exudate from immune mice seemed similar to that afforded by sera anti-toxoplasma antibodies.


[Proliferative response of peripheral blood lymphocytes induced in rats by ovalbumin feeding (author's transl)]. Seventy-seven Wistar rats were immunized by ingestion of ovalbumin in drinking water for two weeks. Specific response was assessed by the study of the responsiveness of peripheral blood lymphocytes to this antigen. A significant increase of thymidine incorporation was observed in forty-nine orally immunized rats. The reaction could be evidenced for six weeks after the end of antigen ingestion. The nature of the response is discussed.


A study of the mode of lymphocyte recirculation in the dog. Current view of lymphocyte recirculation holds that lymphocytes enter the nodes by migrating across the wall of their postcapillary venules, not by way of their subcapsular sinus. Having explained elsewhere our reasons to question the validity of the concept, we undertood to reinvestigate the problem. Lymphocytes were collected from the thoracic duct of dogs and labelled with3 H-cytidine. Each suspension of labelled cells was transfused to the dog having provided it. Analysis of radioautographs revealed that a significant amount of the labelled cells, which had migrated in the nodes, were present in their subcapsular sinus and the peripheral layer of their cortex. Among the nodes, the mesenteric nodes showed the greatest concentration of labelled cells. In addition, a substantial percentage of the injected lymphocytes, mostly small ones, were found in the lamina propria of intestinal villi and crypts. The findings indicate that, at least in the dog, a large fraction of the lymphocytes recirculate by entering the nodes via the afferent lymph, mostly that of the mesenteric nodes.


[Study of the possibility of using penicillin and a specific globulin for treating the anthracic infectious process in an irradiated organism]. Comparative efficacy of the specific globulin and penicillin in the treatment of Siberia ulcer infection was studied on 160 guinea pigs and 400 albino mice irradiated with Co60 gama-rays in sublethal doses. It was found that penicillin preserved its efficiency, while the curative effect of the specific globulin significantly decreased in the irradiated animals.


[Use of an experimental design method for studying the effect of proteolytic enzymes on the pharmacokinetics of antibiotics]. The effect of chemotripsin on the pharmacokinetics of ampicillin as dependent on the drug dose and the administration intervals was studied on rats using the method of the experiment design. With the use of the method it was found that intramuscular injections of chemotripsin to rats in doses of 3, 4.5, 6, 8 and 10 mg/kg, 0.5, 1, 1.5 and 2 hours before intramuscular administration of ampicillin in doses of 10, 20, 35, 75 and 100 mg/kg caused a simple effect inducing an increase in the antibiotic levels in the blood and organs, when the enzyme and antibiotic were present simultaneously in the animal organism for an hour. The increase in the antibiotic levels in the rat organs due to simultaneous presence of chemotripsin and ampicillin the animal organism for 2 hours was less pronounced


[Importance of some modern methods of diagnosing allergic reactions to antibiotics]. For diagnosis of drug allergy and antibiotic allergy in particular it is necessary to use several cell reactions in combination in vitro and to estimate them in complex with clinical data. To obtain reliable results it is recommended to observe the conditions of choosing the time of the test, antibiotic optimal concentrations and pH 6.8.


[Complications from antibiotic therapy]. Analysis of 302 side effects of antibiotic theraphy is presented. The side effects were studied comparatively as dependent on the antibiotic group. Dependence of the toxic and toxicoallergic reactions to the antibiotics on the antibiotic blood levels were noted. Previous sensitization resulted in more frequent and earlier side effects. The analysis and clinical observations showed that antibiotic therapy should take into account the results of the laboratory tests, i.e. examination of the kidney functional state, antibiotic levels in the blood and urine, tolerance of the drug by the patient.


[Effect of imbrimycin on the body of animals]. Toxicity of imbrimycin administered orally and its local irritating effect was studied experimentally. Imbrimycin was diluted with flagosol for decreasing its local irritating effect on the mucosa of the eye conjunctiva and vagina of rabbits. Administration of imbrimycin suspension to albino rats in doses of 10 and 50 mg/kg for 14 days had no effect on the body weight, liver antitoxic function and pathomorphological indices. Oral administration of the drug to dogs in a dose of 10 mg/kg caused a decrease in the body weight, vomiting and diarrhea, had no effect on the dog blood picture and induced no pathomorphological changes in the inner organs. The local irritating effect of imbrimycin was found to be equal to that of azalomycin F. Flagosol significantly decreased the irritating effect of imbrimycin on the eye conjunctiva and the vagina mucosa.


[Development of resistance in Fisher lymphadenosis cells to dipin and bruneomycin when these preparations are used separately and in combination]. It was shown that dipin and bruneomycin resistant tumor cells appeared in mice with transplanted lymphadenosis after 10 passages on single use of the drugs. When the drugs were used in combination, no lymphadenosis cells resistant either to bruneomycin, or to dipin and their combination were found. The combined use of the drugs prevented development of resistance to them in the lymphadenosis cells at least during 10 passages on mice. The data on the possible prevention of the resistance development in the mouse lymphadenosis cells by means of combined use of low doses of dipin and bruneomycin provided an assumption that it is expedient to test the combination in clinics.


[Experimental data on methicillin tolerance and penetration into the eye media]. Tolerance of methicillin by the eye tissues was studied on its administration subconjunctively, into the front chamber and vitreous body of 20 rabbits. The studies showed that subconjunctival administration of the antibiotic was well tolerated in a dose of 50 mg, and its administration into the front chamber and vitreous body was well tolerated in doses of 1.0-2.5 mg. Penetration of methicillin into the fluids of the front chamber and vitreous body on its instillation into the conjunctive sac in a form of 2.5 per cent solution, its subconjunctival and retrobulbar injection in a dose of 50 mg and intramuscular administration in a dose of 40 mg/kg was studied. Animals with aseptic inflammation of the eyes due to burns of the cornea with 1 N hydrochloric acid were taken into the experiments. The method of agar diffusion with Staph. aureus 209P as the test-microbe was used. The studies showed that the highest methicillin concentrations in the eye media were observed an hour after the antibiotic subconjunctival administration. In the vitreous body they were 16 times lower than those in the front chamber fluid. The retrobulbar injections had no advantages over the subconjunctival administration for the antibiotic maximum concentrations in the vitreous body. The concentration of methicillin in the front chamber fluid on its local administration was many times higher than the minimum inhibitory concentration for staphylococci and may be considered as a therapeutic one.


[Interrelationship of the serum lysozyme level to the leukocyte count in the blood]. The leucocyte counts in the peripheral blood and titers of the serum lysozyme under conditions of various experimental models were compared. Albino rats, mice, guinea pigs and rabbits exposed to the effect of various factors of a biological and chemical nature were used in the experiments. In addition, observations on humans immunized with bacterial and viral vaccines were analyzed. Development of 3 reaction types was shown to be possible. In the 1st type the dynamics of the lysosome activity and blood leucocyte counts changed in the same way (immunization with smallpox vaccine, listeria infection). Decreased counts of the leucocytes due to the use of cytostatic drugs were accompanied by a parallel decrease in the lysozyme activity. Such variant of the reaction was predominating. The 2nd type of the shifts characterized by an impaired synchronous pattern of the dynamics of the indices was not so frequent (the use of high doses of cytostatics). The 3rd type of the reactions with an exactly opposite character of the shifts in the leucocyte counts and lysozyme activity was observed only as an exclusion. It is concluded that the quantitative dynamics of the leucocytes is not enough by itself for creating an opinion on the nature of the changes in the serum lysozyme. The possible role of macrophages in the above processes is discussed.


[Clinical and experimental parallels in studying the effect of chymotrypsin on the pharmacokinetics of antibiotics]. The effect of intramuscular chimotripsin on the levels of methicillin and tetracycline administered respectively intramuscularly and orally was studied in patients with chronic pneumonia and in experimental rats. It was found that the dose of chimotripsin providing higher methicillin blood levels was many times lower than the enzyme doses providing analogous indices for the blood serum and organs of the rats. When the patients were treated with tetracycline and chimotripsin, increased blood levels of the antibiotic were observed. Administration of chimotripsin to the rats had no effect on tetracycline pharmacokinetics in the animals.


[Study of the carbohydrate content in the mycelia of an active strain producing oxytetracycline and in an inactive mutant]. The content of carbohydrates in the mycelium of the active strain and inactive mutant of the oxytetracycline-producing organism under conditions favourable (starch medium) and unfavourable (glucose medium) for the antibiotic biosynthesis was studied. The mycelium of both organisms was fractionated and carbohydrate distribution according to the mycelium fractions and carbohydrate content in every fraction were investigated. No significant differences were observed between the active strain and inactive mutant with respect to the characteristics studied. The carbon source in the medium had the dominating effect on the chemical composition of the mycelium. The mycelium of both strains grown on the starch medium contained much more carbohydrates than that grown on the glucose medium. The carbohydrates of the mycelium grown on the starch medium were mainly found in fraction III and must be represented by polysaccharides.


[Study of the structure of colonies of active and inactive Actinomyces parvullus variants using luminescence and scanning microscopy]. The colony structure of the active and inactive proactinomycete-like variants of Actinomyces parvullus producing actinomycin D was studied with luminescent and scanning microscopy. Clear differentiation of the colony profile was shown by the structure and functions of the mycelium layers. A zone of active synthesis and accumulation of the antibiotic was observed in the colonies of the active variant in the upper part of the substrate mycelium with reddish-yellow self luminescence in UV light and characteristic close hyphae "cemented" by the intracellular substance. Formations of the granule type were often noted on the hyphae of that layer. The layer of the aerial mycelium was loosely connected with the substrate mycelium and consisted of sporophores and spore chains partially broken into single spores. The colonies of the inactive proactinomycete-like variant had a slightly differentiated profile with a sponge-like structure, no zones of the antibiotic synthesis being found. The presence of the intracellular substance was observed in the upper part of the colony supersubstrate mycelium.


[Variability in Penicillium janthinellum Biourge, a producer of the antibiotic janthinellin, under the action of nitrosomethylurea]. Variation of the janthinellin-producing organism P. janthinellum was induced by nitrozomethylurea (NMU). The following concentrations of NMU were tested: 0.5; 0.25, 0.125 per cent at the exposure time of 15 minutes, 1 and 10 hours. The conidia survival had back dependence on the concentration and exposure time. The morphological variation was evident from the presence of forms with changed colour of the colony surface mycelium, light green, brown, light yellow, yellow-pink and white conidia and forms differing in the rate of the mycelium development and sporulation. The reverse surface of the colonies of both cultures was light brown to brown because of pigmentation. The feature of pigmentation was stable and no apigmented froms were obtained under the effect of NMU. Formation of variants producing higher yields of janthinellin (400, 2000 units) as compared to the activity of the control variant was noted. Plus variants were detected among the morphologically unchanged cultures.


[Some characteristics of using polyalcohols as cryoprotectors in preserving Actinomyces noursei LIA-0471]. Freezing of Act. noursei cell suspensions at a rate of 0.5 degrees per minute in the presence of various substances showed that 5 per cent concentrations of glycerol, ethylen-, diethylen-, propylenglycol and polyethylenglycols had a cryoprotective effect. Polyethylenglycols with a molecular weight of 1500-20 000 had the highest protective effect on the actinomycetous cells from the damaging action of repeated freezing and thawing. The method of repeated freezing and thawing is recommended for studying the cryoprotective effect of various compounds.


[Action of heliomycin on protein and mucleic acid synthesis in Staphylococcus aureus]. Heliomycin inhibited synthesis of RNA in Staph. aureua which was clearly shown in the study of the antibiotic effect on RNA synthesis in the lag phase of the culture development: heliomycin markedly lowered the maximum RNA level in the biomass observed in the culture at the beginning of the exponential growth. On further growth of the culture heliomycin induced a significant retardness of the process of the natural decrease in the RNA biomass level resulting in increased content of RNA in the cells growing in the presence of heliomycin as compared to the control culture. Retarded natural decrease in the RNA biomass level in the presence of heliomycin was observed also on the antibiotic addition just at the beginning of the exponential growth, during the period of maximum RNA accumulation in the cells. Heliomycin had no effect on synthesis and biomass levels of DNA. Heliomycin inhibited the protein synthesis and was close to chloramphenicol by the level of inhibition of the summation protein synthesis in the biomass. However, comparison of the effect of the above antibiotics on synthesis of beta-galactosidase, an individual enzyme protein showed that heliomycin was much less active as an inhibitor of protein synthesis in comparison to chloramphenicol.


[Antibiotic sensitivity of S. typhi cultures that have reverted from L forms isolated from the blood of patients]. L-forms of bacteria were isolated in 18 out of 300 fever patients with diagnoses of typhoid-paratyphoid fever, grippe, virus respiration disease and others in the Diagnostic Department of an Infection Hospital during bacteriological tests of the blood. Among the cultures tested 13 were instable and reversed to the bacterial form. The type identification showed that only 9 revertants possessed properties characteristic of the typhoid fever microbes and belonged to S. typhi. Sensitivity of the typhoid fever revertants to levomycetin, sintomycin, streptomycin, pencillin and tetracycline was studied. The studies showed that the typhoid fever revertants from the L-forms isolated from the patients were sufficiently sensitive to levomycetin, sintomycin, penicillin and tetracycline. The minimum bactericidal concentrations of the above antibiotics ranged within 12.5--100 gamma/ml.


[Lysozyme in the overall therapy of patients with burn trauma]. Examination of 108 patients showed that burn disease was accompanied by significant impairments in the host natural resistance. Inclusion of intramuscular administrations of crystalline lysozyme into the complex therapy of such patients during septicotoxemia provided an increase in the factors of humoral and cell immunity. In most of the cases the dynamics of the indices of the host immunological reactivity correlated with the character of the clinical signs of the burn disease. The positive effect of lysozyme was evident in the cases with severe complications such as pneumonia, bacteriemia and burns of the upper respiratory organs.


Bacampicillin: a new orally well-absorbed derivative of ampicillin. Bacampicillin (proposed international nonproprietary name), 1'-ethoxycarbonyloxyethyl 6-(d-alpha-aminophenylacetamido)penicillanate, is a new orally well-absorbed penicillin, highly active in vivo due to rapid transformation into ampicillin. The compound is stable in vitro at gastric pH and hydrolyzed slowly to ampicillin at neutral pH but very rapidly in the presence of biological fluids, e.g., tissue homogenates or serum. In vivo the transformation into ampicillin is so rapid that no unchanged compound could be detected in the blood after oral administration of bacampicillin to rats, dogs, and humans. On oral administration to mice, rats, and dogs, bacampicillin was found to be better absorbed than ampicillin, giving higher and earlier peak blood levels of ampicillin. The bioavailability of bacampicillin in rats and dogs was three to four times higher than that of an equimolar amount of ampicillin. On oral administration to rats, bacampicillin was found to give higher levels of ampicillin in organs such as the kidney, liver, and spleen than ampicillin itself. In "tissue cages" in rats, higher transudate levels of antibiotic were found after oral administration of bacampicillin than after ampicillin. On oral treatment of experimentally infected mice, bacampicillin was found to be more active than ampicillin.


Pharmacokinetics of minocycline in renal failure. The pharmacokinetics of minocycline have been studied after single intravenous infusions and repeated oral doses to human subjects with varying degrees of renal impairment. There was no evidence of reduced drug clearance with reduced renal function after intravenous doses although there appeared to be an increase in the tissue distribution of antibiotic in the body in uremia. After identical multiple oral dosage regimens serum levels of antibiotic were comparable in normal and mildly uremic subjects. There was no evidence of renal toxicity in normal or uremic subjects with the repeated dosage regimen used.


Antimicrobial therapy of experimental enterococcal endocarditis. The successful therapy of enterococcal endocarditis requires prolonged administration of synergistic antibiotic combinations. Controversy has arisen regarding optimal therapy (i) when the organism possesses high-level streptomycin resistance, and (ii) when the patient is allergic to penicillin. This study examines these questions in vitro and in a rabbit model of enterococcal endocarditis. The combination of penicillin with either streptomycin or gentamicin increased the rate of bacterial killing in vitro and in vivo when compared with penicillin alone (P < 0.05) when the test strain was relatively susceptible to streptomycin (minimal inhibitory concentration, 128 mug/ml). Only the combination of penicillin and gentamicin was consistently more effective than penicillin alone (P < 0.01) when the test strain was highly resistant to streptomycin (minimal inhibitory concentration > 150,000 mug/ml). The combination of vancomycin and streptomycin was more rapidly bactericidal than vancomycin alone in vitro and in the animal model against the streptomycin-susceptible strain (P < 0.01). The relative rate of in vitro bacterial killing by various antibiotics and combinations was predictive of the efficacy of these drugs in eradicating enterococci from cardiac vegetation in experimental endocarditis.


Synergism of oxacillin and gentamicin against enterococci. Strains of enterococci isolated from 34 patients were studied for susceptibility to oxacillin and gentamicin alone and in combination. The minimal bactericidal concentrations of oxacillin and gentamicin for these strains ranged from 16 to 250 mug/ml (median 32 mug/ml) for oxacillin and 12 to 48 mug/ml (median 24 mug/ml) for gentamicin. The minimal bactericidal concentration of oxacillin for 50% of strains in the presence of 12, 6, 3, and 1.5 mug of gentamicin per ml, respectively, was 2, 8, 16, and 32 mug/ml. The combination of oxacillin and gentamicin at clinically attainable serum levels was synergistically bactericidal against 27/34 (80%) of these strains using strict criteria. This report reconfirms the original observation that antibiotics which affect the synthesis of bacterial cell walls combine synergistically with aminoglycosides against enterococci. This is so even though enterococci are far more resistant to oxacillin than to penicillin or ampicillin. In addition, this report suggests that the combination of oxacillin and gentamicin administered in the usual dosages includes enterococci in its bactericidal spectrum.


Effect of peritoneal dialysis on serum levels of tobramycin and clindamycin. The pharmacokinetics of tobramycin and clindamycin were examined in patients undergoing peritoneal dialysis for chronic renal failure. Peak serum levels of tobramycin in functionally anephric patients were less than expected, probably secondary to a larger volume of distribution. Peritoneal dialysis resulted in a significant clearance of tobramycin, with a resultant reduction in serum half-life. The present data suggest that, if bactericidal serum levels of tobramycin are to be maintained in patients undergoing peritoneal dialysis, a parenteral loading dose be administered, followed by either (i) an identical dose every third half-life or (ii) one-half the loading dose every half-life. However, optimal therapy is best achieved by monitoring serum levels to insure appropriate drug dosage. Peak serum levels of clindamycin in functionally anephric patients were approximately twofold greater than those expected in normals after an identical parenteral dose. It is, therefore, recommended that the administered dose of this agent in functionally anephric patients be one-half of that required to produce desired peak serum levels in patients without renal impairment. Peritoneal clearance of clindamycin during dialysis was shown to be essentially zero, indicating that dialysis does not affect clindamycin disposition.


In vitro effects of amphotericin B on growth and ultrastructure of the amoeboflagellates Naegleria gruberi and Naegleria fowleri. In vitro effects of the polyene antibiotic amphotericin B (AmB) on growth, viability, and ultrastructure of amoeboflagellates of the genus Naegleria were examined. The strains studied were the nonpathogenic Naegleria gruberi EG(B) and the Carter and TY strains of the pathogenic Naegleria fowleri. AmB was amoebicidal at all concentrations used (0.25, 0.50, and 1.0 mug/ml) when the drug was added to cultures in lag phase, as determined by viability testing, but was mainly inhibitory when added to log-phase cultures. The drug produced ultrastructural modifications at all concentrations (0.05 to 1.0 mug/ml). These changes included distortion of nuclear shape, increase in cytoplasmic membranes (both rough and smooth endoplasmic reticulum), decrease in number of food vacuoles, absence of pseudopod formation, mitochondrial abnormalities, increase in autophagic vacuoles, and blebbing of the plasma membrane. These alterations of amoebic ultrastructure became more pronounced with increased time in AmB and with increase in AmB concentration in the growth medium.


Detection of temperature-sensitive tetracycline resistance plasmids in Staphylococcus aureus. A method is described for the detection of temperature-sensitive plasmids determining tetracycline resistance in Staphylococcus aureus. Temperature-sensitive plasmids were detected in phage group I strains but not in phage group III strains.


In vitro susceptibility of selected bacteria to three diphosphonia heterocyclic compounds. The antibacterial activity of 1,1,4,4-tetraphenyl-1,4-diphosphonia-2,5-diphenylcyclohexadi-2,5-ene dichloride and two of its derivatives were screened for activity using the disk method. All derivatives exhibited antibacterial activity against gram-positive organisms tested, but little inhibition of gram-negative species was noted.


Stability of frozen rat plasma containing different antibiotics. The antibiotic activity was determined at different intervals of time on plasma samples, taken from rats treated with a certain number of commonly used antibiotics, and kept at -20 C up to 8 weeks. The results of the microbiological assays demonstrate that the stability of the antibiotics in the frozen plasma decreases in the following order: oxytetracycline > cephalexin, streptomycin, erythromycin > demeclocycline > ampicillin, amoxycillin > penicillin G, cephaloridine, rolitetracycline, and tetracycline.


Bactericidal activity of combinations of penicillin or clindamycin with gentamicin or streptomycin against species of viridans streptococci. Checkerboard bactericidal studies were performed with two strains each of Streptococcus mitis, S. salivarius, and S. sanguis, and the results were analyzed by the use of isobolograms. Synergy between penicillin and streptomycin or gentamicin was demonstrated with four strains, representing two of S. salivarius, one of S. sanguis, and one of S. mitis; the remainder were either too susceptible or too resistant to be analyzed. Clindamycin with streptomycin or gentamicin acted synergistically with three strains, representing two of S. sanguis and one of S. salivarius; the remainder were either too susceptible or too resistant to be analyzed.


Prevention of herpes keratoconjunctivitis in rabbits by silver sulfadiazine. Silver sulfadiazine, at a concentration of 10 mug/ml when applied immediately after infection by Herpesvirus hominis, prevented the development of acute herpetic keratoconjunctivitis in rabbits. The efficacy was inversely related to the size of inoculum. Subclinical infections were observed in the drug-treated eyes.


In vitro activity and pharmacokinetics in patients of cefamandole, a new cephalsoporin antibiotic. Cefamandole nafate, a new cephalosporin for parenteral use, was evaluated in vitro against 231 recent clinical isolates and in 12 patients. Cefamandole had activity equivalent to cefazolin against Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae. Cefamandole was more active than cephalothin or cefazolin against Proteus mirabilis. Both cefamandole and cefazolin were as active as cephalothin against S. aureus, were slightly more active against K. pneumoniae, and were considerably more active against E. coli. All strains of indole-positive Proteus sp. were inhibited by 6.3 mug of cefamandole per ml but only 20% were inhibited by 25 mug of cefazolin or cephalothin per ml. Eighty-eight percent of Enterobacter sp. was inhibited by 25 mug of cefamandole per ml, but only 20 and 5% were inhibited by the same concentration of cefazolin and cephalothin, respectively. Peak levels of cefamandole ranged from 6.0 to 110 mug/ml in serum and levels ranged from 440 to 16,800 mug/ml in a 4- to 6-h collection of urine after a 500-mg or 1-g intramuscular dose (6.1 to 17.3 mg/kg) in patients with endogenous creatinine clearances of >/=31 ml/min. These levels were done after the first dose, at mid-therapy, and at the end of therapy. There was no evidence of accumulation with the 500-mg or 1-g dose given every 4 to 6 h. The percentage of the dose excreted in the urine within the first 4 to 6 h after administration of cefamandole was >/=43%. The half-life of cefamandole in serum was 49 to 126 min.


Evaluation of a topical interferon inducer in experimental influenza infection in volunteers. The prophylactic and/or therapeutic effect of a low-molecular-weight interferon inducer, CP-20,961, was tested in a double-blind placebo controlled study of experimental influenza A/England/42/72 (H(3)N(2)) infection in normal volunteers. Ten volunteers received CP-20,961 and 10 received placebo. Interferon was detected in nasal secretions of nine of the former and three of the latter group (P < 0.05). Seven in each group became ill, and severity of illness was not different. Also, quantitative virus shedding patterns and antibody response were not different between the two groups. The negative result may have been due to the relatively low quantities of interferon induced.


Drug-resistant Leptomonas: cross-resistance in trypanocide-resistant clones. A Leptomonas of insect origin was highly susceptible to several standard trypanocides and leishmanicides in vitro. Resistance was induced to some of these drugs; clones were isolated from each strain. Cross-resistance patterns of the clones were derived for diamidines, quinapyramine (Antrycide), acriflavin, phenanthridines, and other drugs active against trypanosomes and leishmanias. Clones tested included two each that were resistant to acriflavin, Antrycide, diminazene aceturate (Berenil), and pentamidine and one that was resistant to stilbamidine. Appreciable cross-resistance was evident for all clones. Differences were observed between clones from the same parent strain. Collateral susceptibility towards isometamidium and oxophenarsine was detected in most clone-derived populations. In clones passaged without drug to test for drug fastness, acriflavin and pentamidine clones lost resistance within 10 transfers, whereas Berenil and Antrycide clones retained considerable resistance after 20 to 30 subcultures without drug. Considerations of differences in life cycles suggest that the clone collection may be useful in screening for agents effective against leishmanias and stercorarian trypanosomes rather than against salivary trypanosomes.


Inactivation of the lipid-containing bacteriophage PM2 by butylate hydroxytoluene. Several factors have been investigated which are of significance in the inactivation of PM2, a lipid-containing bacterial virus, by butylated hydroxytoluene (BHT). Studies of the time dependence of inactivation during exposure to BHT showed that virus killing occurs rapidly, with the majority of the effect taking place in the first 5 min. The degree of inactivation is dependent upon the initial virus titer, the solvent from which BHT is added, and the presence of a variety of protective agents, including surfactants, bovine serum albumin, and bacterial cells. Sucrose gradient analysis of (32)P-labeled, BHT-treated virus was used to determine the degree to which the virion is disrupted by BHT. These experiments show that the (32)P-labeled molecules are converted into very slowly sedimentable material by BHT treatment, indicating complete destruction of the virus particle.


Production of bacteriocins in a liquid medium by Streptococcus mutans. A sterile-filtered, liquid medium composed of one-half-strength APT broth and 4% (wt/vol) yeast extract was found to support the production of bacteriocins by Streptococcus mutans strains BHT and GS-5. Culture supernatants, adjusted to pH 7.0 and sterilized by filtration, contained bacteriocin-like activity, which could be demonstrated by spotting dilutions onto top agar lawns seeded with Streptococcus pyogenes as the sensitive indicator and by adding dilutions to log-phase indicator broth cultures. A quantitative assay was developed for BHT bacteriocin, based on its lethal effects. Bacteriocin production did not occur until after the log phase of growth had ceased and was not inducible by ultraviolet irradiation or treatment with mitomycin C. Non-bacteriocinogenic clones of strain BHT occurred spontaneously at high frequency, suggesting control by a plasmid, but this frequency was not increased by treatment with the plasmid-curing agents acridine orange and ethidium bromide.


Relation between lipophilicity and pharmacological behavior of minocycline, doxycycline, tetracycline, and oxytetracycline in dogs. Four tetracyclines were studied in dogs to determine the relation between their lipophilicity and various other pharmacological characteristics. Lipid solubility correlated inversely with the mean concentration of drug in arterial plasma and renal uptake and excretion, and directly with the biliary concentration gradient (level in bile/level of free drug in serum). Only the more lipophilic congeners minocycline and doxycycline passed the blood-brain and blood-ocular barriers in detectable concentrations. Mean levels of minocycline in the brain exceeded those of doxycycline by almost threefold; the difference was of borderline statistical significance (P = 0.05 to 0.1). Lipophilicity correlated inversely with the concentration of antibiotic in renal medulla but not in renal cortex or in the liver. When intestinal loops containing saline, milk, or 10% Gelusil were studied, the only combination exhibiting striking intraluminal accumulation was doxycycline in milk. These results indicate that lipophilicity correlates with many, but not all, of the transport characteristics of tetracycline antibiotics.


Comparison of the antibacterial activities of sisomicin and gentamicin against gram-negative bacteria. Sisomicin was found to be more active on a weight basis than gentamicin against Pseudomonas sp., Klebsiella sp., and indole-positive Proteus. Gentamicin was more active than sisomicin against Escherichia coli, Serratia sp., Enterobacter sp., and Proteus mirabilis. Both antibiotics were very active against methicillin-resistant strains of Staphylococcus aureus.


Biosynthesis of puromycin in Streptomyces alboniger: regulation and properties of O-demethylpuromycin O-methyltransferase. Mechanisms for regulation of puromycin biosynthesis in Streptomyces alboniger were studied by measuring the levels of S-adenosyl-l-methionine:O-demethylpuromycin O-methyltransferase. The enzyme was released in soluble form from mycelia by 3 to 5 min of sonication at 4 C. Maximal specific activities of 0.7 and 0.1 nmol/min per mg of protein were found in cells grown in corn steep liquor-corn starch and Hickey-Tresner media, respectively. In both media, the O-methyltransferase activity rose from low levels to a maximum during midlogarithmic growth and then declined or disappeared completely (in Hickey-Tresner medium) during stationary phase. Either glucose (1%) or ethidium bromide (5 muM) reduced O-methyltransferase formation to very low levels with no effect on overall growth. Complete glucose repression of antibiotic formation occurred on agar. Cells grown in the presence of ethidium bromide continued to produce low enzyme levels after regrowth in the absence of dye, but formed normal amounts of puromycin on Hickey-Tresner agar. The O-methyltransferase, either crude or purified, was rapidly inactivated at 37 C. Each substrate alone, or both together at lower concentrations, protected against this loss of activity. Puromycin inhibited the transferase. Regulation of O-methyltransferase synthesis in S. alboniger includes (i) induction early in growth that is susceptible to catabolite repression and differential inhibition by ethidium bromide, and (ii) protection of the enzyme from inactivation by increased intracellular levels of its substrates. The O-methyltransferase was purified 30- to 40-fold by a combination of protamine sulfate precipitation, ammonium sulfate fractionation, adsorption and gradient salt elution from diethylaminoethyl-cellulose and Sephadex G-200 gel filtration. The enzyme was very unstable, even at low temperatures, upon purification beyond the salt fractionation step, but was stabilized by the addition of S-adenosyl-l-methionine during later stages of purification.


The pineal gland and Rosenthal fibres.

The pineal gland and Rosenthal fibres. 115 pineal glands, collected from patients who died from various neurologic and visceral diseases, were studied. The Rosenthal fibres (RF) forming gliosis is consistently evident in the subependymal tissue around the gland, in the pineal recessus and in the intrapineal glial proliferation. In several instances the focal gliosis exhibited a central cystic degeneration. The RF-forming gliosis of the pineal gland appears independent of the basic diseases and of the process of atrophy and degeneration of the gland parenchyma. The embryonic development of the pineal gland could explain why the formation of RF may be considered a quasi-physiologic process of this region.


Temporal orientation in patients with brain disease. A brief schedule of questions, based on empirically derived norms, disclosed significant inaccuracy in temporal orientation in 24% of a groups of nonaphasic patients with brain disease. Conventional neurological examination detected temporal disorientation in only 15%. Patients with bilateral lesions showed a higher frequency of temporal disorientation than did those with inilateral lesions. In a group of 15 aphasic patients, 5 (33%) showed evidence of temporal disorientation according to the test while only 3 (20%) were detected on clinical examination. It is suggested that a schedule of questions scored on the basis of empirically derived norms should be incorporated into the neurological examination to assess temporal orientation.


Effect of exogenous catecholamines in the amygdala of a 'rage' cat. Minute amounts of epinephrine or norepinephrine alter the behavior of 'rage' cats (prepared by ventromedial hypothalamotomy) when these substances are focally instilled into both amygdalae via chronic brain cannulae capped with a silastic membrane. Hyperactive defense reactions are replaced by lethargy and placidity. Similar injections of epinephrine or norepinephrine into the amygdalae of normally placid cats who had not been subjected to ventromedial hypothalamotomy did not appreciably alter their behavior.


Ultrastructure of Rhizobium-induced infection threads in clover root hairs. Ultrastructural studies of Rhizobium-induced infection threads in clover root hairs show that the infection thread is initiated by an invagination process. Root hair wall growth is redirected at a localized point, resulting in the formation of an open pore. There is no direct penetration through the wall, and the bacteria remain extracellular within the root hair.


Evaluation of petroleum-degrading potential of bacteria from water and sediment. Bacteria from water and sediment of an oil-polluted harbor were examined for ability to degrade petroleum. Water samples contained a greater variety of bacterial species capable of degrading petroleum than sediment. Cultures from both water and sediment contained Pseudomonas and Acinetobacter spp. Bacteria present in the water samples produced significantly greater degradation of 2-,3-,4-, and 5-ring cycloalkanes and mono-, di-, tri-, tetra-, and pentaaromatics compared with bacteria in sediment samples.


Repulsion of bacteria from marine surfaces. Organic compounds are capable of repelling motile bacteria from marine surfaces. The most effective compounds were acrylamide and benzoic and tannic acids. These were active at concentrations that were not toxic to the bacteria. Repellents were incorporated in nontoxic paints and applied to metal panels. Treated panels immersed in seawater developed a bacterial film of only 10(6) bacteria per cm6 after 12 days compared with untreated panels, which had 5 times 10(12) bacteria per cm2 after the same period. Field studies confirmed the effectiveness of these repellents. The use of biological repellents provides a new approach to the control of marine fouling.


Fate of ochratoxin A in brewing.

Fate of ochratoxin A in brewing. The fate of ochratoxin A in brewing was investigated by adding (3H)ochratoxin A to the raw materials at 1- and 10-mug/g levels during mashing in a conventional microbrewing process. The results indicated that large portions (28 to 39%) of the added toxin were recovered in spent grains, with less recovery in the yeast (8 to 20%) and beer (14 to 18%). About 38 and 12% of the added toxin at levels of 1 and 10 mug/g, respectively, were degraded during brewing.


Separation of spores and parasporal crystals of Bacillus thuringiensis in gradients of certain x-ray contrasting agents. Spores and parasporal crystals of Bacillus thuringiensis can be separated at moderate centrifugation speeds (10,000 to 12,000 rpm) in gradients of Renografin or sodium diatrizoate.


Studies on the biosynthesis of aspergillin by Aspergillus niger. Two inhibitors of the biosynthesis of aspergillin, the black spore pigment of Aspergillus niger, have been investigated. 2,4-Dithiopyrimidine exerted its inhibitory effect by intracellularly chelating cupric ion required for normal pigmentation. Dimethylsulfoxide prevented the synthesis of certain phenolic precursors of the native pigment. Partial purification and characterization of pigments from mature cultures revealed the presence of at least three components: (i) a high-molecular-weight (approximately 20,000) native pigment fraction in untreated mold cultures, (ii) a lower-molecular-weight (approximately 5,000) melanin pigment found in both types of inhibited cultures, and (iii) a low-molecular-weight (368) green pigment found only in the 2,4-dithiopyrimidine-inhibited cultures and proposed to be a pentacyclic quinonoid derivative. A pathway for aspergillin biosynthesis is suggested based on these results.


Screening test for assessment of ultimate biodegradability: linear alkylbenzene sulfonates. A relatively simple shake-flask system for determining CO2 evolution was developed to assess the ultimate biodegradability by soil and sewage micro-organisms of chemicals which enter the environment. Linear alkylbenzene sulfonates (LAS) were used as model compounds to evaluate the method and were found to undergo substantial biodegradation in this dilute system. At the 30 mg/liter test concentration, higher-molecular-weight LAS compounds were biodegraded at a slower rate and to a lesser extent than lower-molecular-weight LAS, an effect which was eliminated or greatly reduced upon incremental addition of the LAS to the test medium during the first week of incubation. LA35S was used to demonstrate rapid LAS desulfonation, and 14CO2 evolution studies with (14C) benzene ring-labeled LAS indicated concomitant biodegradation of the entire LAS molecule as well as the LAS aromatic component. The test can be employed to examine numerous compounds at the same time and is readily adapted to studies of the effect of variation in temperature and oxygen concentration on biodegradation.


Incorporation of (2-14C)acetate into lipids of mink (Mustela vison) liver and intestine during in vitro and in vivo treatment with aflatoxin B1. The in vitro and in vivo incorporation of (2-14C)acetate into lipids of mink (Mustela vison) liver and intestines was studied. In vitro, a dose of aflatoxin B1 as small as 7.5 mug/ml of medium reduced by 20% the amount of (2-14C)acetate incorporated into lipids of mink liver slices, whereas 180 mug caused 76% reduction in the synthesis of lipids from the radioactive precusor. Similar inhibition of lipid synthesis by aflatoxin also was observed with tissues from mink intestines and fatty liver. The degree of inhibition (19 to 84% for tissue from intestines and 19 to 64% for tissue from fatty livers) depended on the amount of aflatoxin B1 (7.5 TO 180 MUG) present in the medium. In vivo, a substantially increased amount of 14C-labeled lipids was found in the livers of mink injected with 600 mug of aflatoxin B1 per kg of body weight 20, 28, and 40 h earlier. However, no appreciable difference in incorporation of (2-14C)acetate into lipids was observed between toxin-treated and control animals when these animals were sacrificed and examined for 14C-labeled lipids at 4 and 10 h after toxin was administered.


Chemical alteration of carotene biosynthesis in Phycomyces blakesleeanus and mutants. The effects of diphenylamine, dimethyl sulfoxide, streptomycin, AMO-1618, and beta-ionone on the carotene composition of a wild-type and three mutant strains of Phycomyces blakesleeanus have been examined. Diphenylamine increased the phytoene and phytofluene concentrations of all strains while reducing the levels of the color carotenes. Dimethyl sulfoxide reduced the concentration of both cyclic and acyclic carotenes, whereas AMO-1618 increased the levels of all carotenes in all the strains. The wild type and mutants responded differently to the presence of streptomycin and beta-ionone. The possible mode of action of the above agents on carotenoid biosynthesis is discussed.


[From anal atresia to continent organ].

[From anal atresia to continent organ]. In deep anal occlusion complete continence can nearly always be obtained by means of a perineal or sacroperineal operation. On the other hand, the results after reconstruction in case of high recto-anal agenesis are still doubtful. Placing the neorectum inside the junction of the levator ani muscles by the sacro-abdomino-perineal approach has improved the continence function. Manometric studies have shown that the organ of continence has to learn its function first, which may take months or even years. In cases of congenital motor or sensory defects, or iatrogenic lesions, at least partial normalization can be brought about by specific reconstructive operations.


Cholelithiasis and cholecystitis in children. Case reports of four children with cholelithiasis and cholecystitis without clear-cut etiology are discussed. Symptoms in children are frequently not specific and do not readily suggest cholecystopathy. The diagnosis of cholecystitis and/or cholelithiasis should be considered in cases of children with vague, recurrent abdominal complaints, pyrexia, nausea and vomiting. In children presenting these symptoms, an X-ray survey of the abdomen is indicated in view of the increased possibility of demonstrating gall stones. No cause of this phenomenon could be demonstrated in our material, since routine analysis of calculi was not performed.


Isolated regional perfusion in the treatment of malignant melanomas of the extremities. The authors present a survey of changed views on the treatment of patients with malignant melanoma of the extremities. In addition to conventional therapy, regional perfusion is discussed. Over the period 1964-1970, 115 perfusions were performed in 75 patients. The perfusions were confined to patients with a tumor infiltrating beyond the stratum papillare. The 4-year survival of 30 patients with a primary tumor, without demonstrable metastases at the moment of perfusion, was found to be 77%. The percentage of local recurrences was significantly lower after perfusion than after conventional surgery.


Duodenal bile acids in infancy.

Duodenal bile acids in infancy. Duodenal bile acids have been estimated in three age groups in infancy from birth to 7 months, and age-related changes have been shown. The lowest concentrations of duodenal bile acids occurred in the youngest infants, and increasing concentrations were found with increasing age. Taurine conjugated bile acids predominated in early infancy, while in older infants bile acids were mainly conjugated with glycine. The probable presence of taurolithocholic acid in the duodenal bil of 2 newborns before the establishment of a gastrointestinal microflora remains to be confirmed, but could result either from transplacental passage of secondary bile acids or from endogenous synthesis by the fetal liver.


Specificity of ultrastructural changes of small intestinal epithelium in early childhood. Electron microscopical features of the small intestinal mucosa in 30 consecutive biopsies from 14 newly diagnosed coeliac patients, and 16 patients with chronic intermittent diarrhoea due to different causes, were studied. An attempt to define specific changes in each condition was made. An abnormal brush border, increased number of free ribosomes, rich rough endoplasmic reticulum, poorly developed smooth endoplasmic reticulum, large Golgi complexes, and thickened basal lamina were the most frequent findings in the coeliac biopsies. These changes suggest abnormal cellular metabolism, but as they were also observed in children with a variety of clinical conditions, they could not be specifically related to coeliac disease. These observations suggest that in small children different causes leading to different degrees of abnormal small intestinal mucosa, as observed with the light microscope, produce nonspecific changes of the cellular ultrastructure, which cannot be related to the degree of abnormality observed at the light microscope level.


Lecithin/sphingomyelin ratio in hypopharyngeal aspirate of newborn infants. The lecithin/sphingomyelin (L/S) ratio was measured in the hypopharyngeal aspirate of 41 newborn infants. In 20 without respiratory distress the ratio within 24 hours from birth ranged from 1.5 to 5.8 with a mean value of 3.3. In 6 with 'transient tachypnoea of the newborn' the ratio ranged from 2.0 to 6.7 with a mean value of 3.2. In 15 infants with idiopathic respiratory distress syndrome (RDS) the ratio ranged from 0.9 to 2.1 with a mean value of 1.4. In 14 of these infants the ratio within 24 hours from birth was 1.7 or less. One infant with a higher ratio and severe RDS is described in detail. Serial hypopharyngeal aspirate L/S ratios were determined in the infants with RDS. There was a possible trend toward the earlier attainment of a ratio of 2.0 in infants who received continuous distending airway pressure compared with infants who did not.


Congential H-type tracheo-oesophageal fistula. Five cases of congenital H-type tracheo-oesophageal fistula are presented. The clinical features common to all were choking and coughing precipitated by feeds, recurrent chest infections, and episodes of abdominal distension. The usefulness of repeated oesophagograms in diagnosing the condition is emphasized. Operation in all cases was by the cervical approach. The single postoperative death was related to pre-existent severe chest infection, and no postoperative complications were encountered in the other patients.


Comparison of an amino acid mixture and protein hydrolysates in treatment of infants with phenylketonuria. This study compares three feeding regimens for infants with phenylketonuria diagnosed by neonatal screening. Group 1 (five children) received Minafen (Cow & Gate) until they weighed twice their birthweights; Aminogran (Allen & Hanbury) was then added to the feeds in increasing amounts and replaced Minafen at between 8 and 10 months of age. Group 2 (five children) received Aminogran from the neonatal period. Group 3 (five children) received Minafen until they weighed twice their birthweights; Cymogran (Allen & Hanbury) was then added in increasing amounts and replaced Minafen at between 8 and 10 months of age. In all three groups growth was normal and control of phenylalanine levels satisfactory. During the first few months of life the Aminogran regimen proved more complicated and caused more practical difficulties than the regimens starting with Minafen. Later in the first year, when mixed feeding was introduced, and particularly when the bottle was exchanged for the cup, Aminogran had advantages over Cymogran because of its low calorie content, small bulk, and less unpleasant taste. At this age feeding problems were fewer and easier to manage with Aminogran than with Cymogran. A method of using Aminogran in the management of such problems is described. For these reasons, the regimen fed group 1, in which Minafen is used initially and then replaced by Aminogran, is preferred to the other two.


Sick sinus syndrome. Symptomatic cases in children. In 20 children needing treatment for symptomatic sick sinus syndrome, the average age at presentation was 7.1 years and ranged from 9 months to 18 years. Symptoms were never precise but, in retrospect, 5 children had syncope, 7 had a rapid heart action, 6 had dyspnoea or tachypnoea, 2 had nonspecific chest pains, 2 had pale spells, and 1 had a sudden hemiplegia. Symptoms followed cardiac surgery in 15 cases and were related to unoperated congenital heart disease in 2 and to myocarditis in 2. The aetiology was unknown in 1 case. The type of cardiac surgery resulting in the development of the sick sinus syndrome was predominantly related to atrial suturing. Both tachy- and bradydysrhythmias were found, including wandering atrial pacemaker (9 cases), junctional rhythm (19 cases), supraventricular tachycardia (9 cases), atrial flutter (11 cases), and atrial fibrillation (2 cases). Both atrial (8 cases) and ventricular (7 cases) premature beats were seen. All patients were given trials of drug therapy but difficulties were encountered. Cardioversion was used for tachyarrhythmias in 11 cases without serious problems. Six children had permanent cardiac pacemakers inserted with good results. Recognition of the sick sinus syndrome in childhood is important and treatment must be regulated by the severity of symptoms.


Septicaemia from prolonged intravenous infusions. Four cases of septicaemia in children were traced to contaminated intravenous infusions and volume control sets. In each case Pseudomonas cepacia was isolated from multiple blood cultures and from intravenous fluid within the volume control set. The first patient died of septicaemia after a long and complicated postoperative period. The other three patients received appropriate antibiotics after removal of the contaminated intravenous sets and they recovered within 2 weeks.


Vestibular dysfunction in familial dysautonomia. The Riley-Day syndrome. We report the bilateral absence of response to tests of vestibular function in 5 patients with familial dysautonomia.


Secretion of prednisolone into breast milk. The secretion of 3H in the breast milk of seven volunteers was studied over a period of about 48 hours after the oral administration of 5 mg of 3H-prednisolone. A range of 0.07 to 0.23% of the dose per litre was recovered.


Watery diarrhoea and ganglioneuroma with secretion of vasoactive intestinal peptide. A young girl presenting with diarrhoea and stridor was found to have a thoracic ganglioneuroma. The tumour, which was partially resected, contained an abnormally high amount of vasoactive intestinal peptide (VIP) as measured by radioimmunoassay. This decreased after the operation. In addition, analysis of urine showed the presence of abnormal amounts of catecholamines and catechol metabolites. The findings suggest that the diarrhoea in the syndrome of ganglioneuroma and bowel dysfunction is due to an excess of VIP secreted by the tumour.


Exchange transfusion in severe neonatal infection with sclerema. Two critically ill newborn babies with severe infection associated with sclerema were successfully treated with appropriate antibiotics and repeated exchange transfusions.


Serum hemopexin in patients with dermatitis herpetiformis on dapsone (di(4-aminophenyl)sulphone). Twenty patients with dermatitis herpetiformis treated with di(4-aminophenyl)-sulphone (Dapsone) were analyzed with respect to serum hemopexin concentration as well as some other haematological parameters. With one exception, there were normal concentrations of serum hemopexin when the haptoglobin and methaemoglobin concentrations were normal. Ten out of 11 patients with haptoglobin below 0.3 g/l, which is the lower limit of reference interval at this laboratory, had their hemopexin concentrations reduced to various extents. There was an inverse relationship between the concentration of serum hemopexin and blood methaemoglobin. There was no correlation between amount of Heinz bodies and the concentrations of blood methaemoglobin, serum haptoglobin or serum hemopexin. It is concluded that serum hemopexin measurement should be of value in the assessment of the severity of the haemolysis caused by the drug treatment in those cases who have a low serum haptoglobin concentration.


["Keratoacanthomas" in mastomys natalensis (author's transl)]. 54 Tumors of Mastomys natalensis (GRA Giessen), described in the literature as "Keratoacanthomas" were investigated by light and electron microscopy. They are induced by a virus of the Papova group. Their histogenesis and their course are very different from human keratoacanthoma. The results reveal problems related to experimental animal tumour models and the similarities of different malignancies in the nomenclatures of several disciplines.


[Multiple skin plasmocytomas, increased serum IgA and lack of bone marrow lesions (author's transl)]. Extramedullary plasmocytomas of the skin are rare, especially if a participation of the bone marrow is lacking. A 76-year-old patient developed multiple skin tumours within 2 months. In addition he showed an increase of serum immunoglobulin A. Histopathologically the tumours resembled reticulum cell sarcoma with few plasma cells, partly immature.


Predisposing factors on the surface of the skin in persons with pityriasis versicolor. This is a report on biochemical and physiological examinations carried out on 20 test persons who in the last 2 years had contacted and completely recovered from pityriasis versicolor and on 25 control persons of corresponding age and sex. The tests on the skin surface of the patients with pityriasis versicolor show, when compared with the corresponding control group, the following significant results: 1. Significantly more amino acids could be extracted from the skin of the pityriasis versicolor patients than from the skin of the control persons. 2. A significantly shorter alkali neutralisation time was to be found in the pityriasis versicolor patients than in the control persons. 3. The degree of water spreading on the skin was found to be significantly reduced in the pityriasis versicolor patients when compared with the control persons. It is probable that these results point to important predisposing factors for pityriasis versicolor.


[Further investigational results with the dermatometer according to bingmer (author's transl)]. Further results of investigations using the dermatometer according to Bingmer for the determination of the actual moisture content of superficial skin layers are presented. The investigations are divided into in-vitro tests, tests on excised skin and tests on humans. Results indicate that the Bingmer apparatus used in these trials shows considerable specific sensitivity to changes in the moisture content of the media examined. Different results obtained by other workers might be due to the use of Bingmer apparatus with a different carrier frequency. The advantage of apparatus based on 9 Kc carrier frequency is stressed. As a whole, the use of the Bingmer apparatus may be considered a step forward in dermatological and cosmetic examination techniques.


[Influence of concomitant treatment with D-penicillamine and beta-aminopropionitrile on mechanical properties of rat connective tissue (author's transl)]. In order to study the influence of D-penicillamine (DPA) and beta-aminopropionitrile (BAPN) as well as of a combination of both substances (proportion by weight 1:1) on the collagen of skin, aorta, and femoral epiphysial cartilage, the mechanical properties of these fibrous organs were examined, after having performed tests on onset and dissipation of action, measured by the decrease of ultimate load of excised strips of skin using the two individual compounds. The action of 320 mg/kg of DPA sets in within 7 days reaching a maximum value after 14 days. After discontinuance of the substance the control values are reached within 15 days. BAPN shows its maximal effect on the 18th test day. After discontinuance of treatment the control value is not reached within 35 days. DPA and BAPN show organo-specific actions: DPA has a considerably stronger influence on the collagen of skin than on the collagen of the aorta; under the present test conditions it does, however, not affect the collagen of the distal femoral epiphysial cartilage. As compared to DPA, BAPN exerts a less pronounced influence on the collagen of the skin, similar influence on the collagen of the aorta, and a strong influence on the collagen of the distal femoral epiphysial cartilage. If both substances are administered together, the organospecific actions of DPA on the one hand and BAPN on the other hand are maintained. It is discussed whether the different chemical compositions of the collagen (Type I--IV) may be connected with the organospecific effects of the test substances.


[A device for the measurement of the horny layer transparency. The stripping method]. A new measuring device for the determination of transparency of horny layer material stripped off the skin surface with adhesive tape is being described. This method enables a differentiated and reproducible objectification of light absorption of stripped horny layer material. The horny layer is being fixed on a glass plate and then conducted past a light source and a photo cell at constant speed, whereby the respective light-current-variation caused by the varying degrees of light permeability of the horny layer material is being synchroniously registered by a continuous-line-recording instrument thereby serving as a parameter for each respective strip sample. The systematic evaluation of the original curves takes into consideration amplitude, angle of climb and medium route and results in a horny layer sample-obtained successively from one and the same horny layer strip-series test area-impressioned by individual and regional horny layer conditions. This permits conclusions concerning not only the horny layer transparency but also the horny layer solidity and stripping capability. Thus, the procedure opens new horizons for experimental and clinical questions regarding horny layer diagnostics.