Epidemiology of trichostrongylidosis in cattle: development of infective larvae in the second part of the grazing period and their contribution to infections in the same year. A grazing experiment was performed in the Swiss midland region with 22 first-season calves which were grazed together from May to mid July when they were allocated to two equal groups, one receiving a morantel sustained-release trilaminate bolus (Paratect Flex) bolus, Pfizer, Zurich, Switzerland) and the other one remaining as an untreated control. Each group was moved to a clean pasture on 21 July. The larval contamination on the pasture with the control animals reached 4652 third stage larvae (L3) per kilogram of dry matter (L3 kg-1 DM) after 10 weeks. Parasitic gastroenteritis was observed in two calves of the control group in August, and mean serum pepsinogen levels exceeded 4000 mU tyrosine in this group in September. Eggs from Ostertagia sp. and Cooperia sp. that were excreted by the animals at the beginning of July and the end of August showed similar hatching rates of 94% and 99%, respectively. In the calves of the bolus group the egg output was reduced by 95% within 14 days of administration of the bolus. Larval contamination on the pasture of the bolus group was zero until the beginning of September when a slight increase occurred, reaching 793 L3 kg-1 DM in October. At the end of the trial the bolus-treated calves had a mean weight gain advantage of 18 kg (P < 0.05) compared with the controls. The results confirm that a second generation of larvae developed on pasture in August and September and caused parasitic gastroenteritis in first-year grazing calves in late summer. The relevance of the results for the prophylaxis of parasitic gastroenteritis in calves in mixed grazing systems with calves and older cattle is discussed.


The efficacy of ivermectin against the eyeworm, Thelazia skrjabini, in experimentally infected cattle. The anthelmintic efficacy of ivermectin (administered subcutaneously at 200 micrograms kg-1 body weight) was assessed for control of Thelazia skrjabini in experimentally infected calves. Twenty-four uninfected male Holstein calves, 1-2 weeks old, were artificially infected with Thelazia skrjabini by placing 15 third-stage larvae under the third eyelid of calves. The challenge larvae were recovered from naturally infected face flies, Musca autumnalis. The exposed calves were randomly assigned to either an ivermectin treatment group or a control group within pairs ranked by weight. Equal numbers of calves were housed in each of four indoor fly-free rooms. The calves were treated with ivermectin or saline 35 days post-infection, then slaughtered 14 days later to determine eyeworm numbers. All eyes and associated tissues (including the lacrimal glands and ducts) were removed and examined for total number, species and viability of eyeworms. Thelazia skrjabini was found in the control group of calves only. The efficacy of ivermectin against Thelazia skrjabini was thus shown to be 100%.


Proteolytic enzymes from Trichinella spiralis larvae. Trichinella spiralis larvae infect their hosts by the penetration of small intestine enterocytes. The exact mechanism of penetration is unknown, but the presence of proteolytic enzymes is suspected. In this study, whole worm extracts and excretory-secretory (ES) components were obtained and their proteolytic enzymes examined. Enzymes from worm extracts were capable of hydrolysing azocoll, a general protease substrate in a wide range of pH (2-8), with maximal activity at pH 5. Trichinella spiralis larval enzymes were sensitive to metalloprotease and serine protease inhibitors. Three proteases were identified in worm extracts at molecular weight (MW) 48, 54 and 62 kDa by incorporating a gelatine substrate into a standard or a modified sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) set-up, in which we used low SDS concentration in gel and electrophoresis buffer (0.01%). Intact larvae incubated in a medium containing azocoll showed azocollytic activity. Subsequent analysis of ES products by modified SDS-PAGE in gels containing gelatine demonstrated the presence of three protease of apparent MW 33, 62 and 230 kDa.


The biology of Ctenocephalides canis in Ireland. A colony of Ctenocephalides canis was established using dogs as hosts. Two diets were used as media. Fleas reared on cats did not develop beyond the first larval stages. The effects of different temperatures on egg hatching and larval development were examined. Larval survival was poor at 22 degrees C and 25 degrees C at 50% relative humidity, but good at 75% relative humidity at these temperatures. The development from egg to adult took 21 days.


Field efficacy of injectable and pour-on moxidectin in cattle naturally infested with Psoroptes ovis (Acarina: Psoroptidae). Field efficacy of moxidectin, a macrocyclic lactone endectocide, was evaluated in cattle naturally infested with Psoroptes ovis. Three groups of six animals were used based on parasitological and clinical status. Group 1 animals received one subcutaneous injection of injectable moxidectin at 0.2 mg kg-1 body weight; Group 2 animals received topically one dose of 0.5 mg kg-1 body weight of pour-on moxidectin; Group 3 individuals remained untreated as controls. Efficacy was assessed by (a) taking skin samples from each animal on Days -4, 14, 28, 42 and 56 post-treatment (PT) and observing numbers of viable mite stages and species and (b) clinical examination of animals on Days 14, 28, 42 and 56 with the percentage of affected body surface calculated for each animal on Days -4, 28 and 56. Both formulations gave 100% efficacy as no live mites were found in Groups 1 or 2, 14, 28 and 56 days after treatment. Clinical indices showed a sharp decrease in the affected body surface area from a mean of 5.48% and 6.1% on Day -4 in Groups 1 and 2, respectively, to 0% in both groups on Days 28 and 56 PT. All untreated animals remained positive until Day 28. The clinical condition of the controls worsened rapidly during the experiment (mean clinical index: 2.87% and 13.05% on Days -4 and 28, respectively) and they were given an emergency treatment on Day 28. No side-effects were observed with either formulation.(ABSTRACT TRUNCATED AT 250 WORDS)


Human serum for in vitro cultivation of Babesia bovis. Various combinations of human serum (from blood of groups A and Rhesus positive) with bovine serum, i.e. 20% + 20% (Medium I), 30% + 10% (II), 40% + 0% (III) and 0% + 40% (IV) and Medium-199 (60%) were used in the propagation of Babesia bovis. Babesia bovis stabilate revived by inoculation in a bovine calf was used at a level of 6% parasitized erythrocytes (PPE). The medium was replenished every 24 h. The medium changed from bright red to dark-coffee color every 24 h. The increase in PPE was maximal between 24 and 48 h. It was also observed that the increase in PPE was significantly higher in a 1:2 dilution compared with a 1:1 dilution. The increase in PPE was highest in Medium I with a 50% replacement of bovine with human serum. However, the parasites could not be subcultured and maintained continuously. Fifty percent replacement was thus optimal for the human-bovine serum combination in a microaerophilous stationary phase (MASP) system. The results indicate that B. bovis can also multiply in a human/bovine serum MASP culture system at least for a period of 48 h, and this is consistent with the zoonotic nature of Babesia species.


Detection of stable diagnostic antigen from bile and feces of Fasciola hepatica infected cattle. Diagnostic antigens in bile and feces from Fasciola hepatica infected cattle were detected and characterized by enzyme-linked immunotransfer blot (EITB) techniques. As sources of antigen, samples of bile, intestinal contents and feces were collected from five uninfected calves and from 10 calves with known Fasciola hepatica burdens. A band detected by EITB using a densitometer in the area corresponding to 26 kDa reacted with rabbit anti-fresh fluke antigen and infected cattle sera but not with fluke-negative rabbit sera, rabbit anti-Fasciola hepatica egg sera, Fascioloides magna positive or negative cattle sera. This band was not detected by Coomassie blue in sodium dodecylsulfate polyacrylamide gel electrophoresis (SDS-PAGE) gels or by Ponceau-S stained nitrocellulose strips. Band groups located at 104-66, 66-42, 42-26 and 25-16 kDa reacted inconsistently with the above sera. Sera from mice hyperimmunized with Fasciola hepatica excretory-secretory (ES) products detected only the 26 kDa band by EITB, without cross-reactivity with bands in the other molecular weight (MW) ranges. The results suggest that the 26 kDa antigen may consist of a stable component of ES products and/or tegument-related worm antigen. Diagnosis of Fasciola hepatica through detection of specific, stable antigens in feces of infected animals offers potential advantages over serum-based tests of better sample accessibility, discrimination between previous and current infections, and possible semi-quantitation of fluke burdens.


The pathophysiology of ovine trypanosomosis: haematological and blood biochemical changes. The course of Trypanosoma congolense infection in sheep was followed for 96 days. Infected animals developed fluctuating parasitaemia, macrocytic normochromic anaemia and leucocytosis which was principally a lymphocytosis. Following treatment with the trypanocidal drug, diminazene aceturate at 84 days after infection, the haematological values returned to normal within 12 days. Infected sheep developed hypocholesterolaemia and hypophospholipidaemia leading to a reduction in total serum lipids. This study has shown that sheep infected with T. congolense develop anaemia, the onset of which follows the first wave of parasitaemia. The changes in blood lipids observed in infected sheep appeared to be related to the intensity and duration of parasitaemia.


Pathological changes in kidneys of dogs with natural Leishmania infection. A study was made of the nephropathy in canine leishmaniasis produced in ten adult dogs naturally infected with Leishmania infantum. Renal function analyses were performed (uraemia, creatinaemia, plasma proteins, biochemistry and urinary sediment), the humoral immune response (fluorescent antibodies and levels of serum IgG, IgM and IgA) was assessed and histopathological studies were carried out. Correlation of the results showed acute renal insufficiency which was reversible in two animals (endotheliomesangial glomerulonephritis) and irreversible in four cases corresponding to glomerulonephritis in its Type I and Type II proliferative forms; extensive increase in the glomerular basal membrane, proliferation of mesangial cells and growth of the mesangial matrix were observed, as was a widespread incidence of immune complex deposits. Two animals showed chronic renal insufficiency. Lack of renal changes (minimal-changes glomerulonephritis) in two dogs was accounted for in one animal by an almost complete absence of symptoms and in the other by chronic viscerocutaneous symptoms; neither showed more than a slight immunoglobulin response.


Humoral and cellular immune responses in rats during a primary infestation with Fasciola hepatica. The antibody and lymphocyte responses to Fasciola hepatica were studied in rats. Infested rats were shown to produce antibodies against excretory-secretory (ES) products of adult flukes as early as the first week after infestation. Immunoblotting revealed fractions of ES products of adult flukes to which antibodies were progressively produced during the course of the infestation. Proliferation of peripheral blood lymphocytes, splenocytes and thymocytes when incubated with different mitogens (Concanavalin A (ConA) or Pokeweed mitogen (PWM) or different liver fluke antigens (metacercariae antigen (EM) or ES products of adult flukes) have been studied. In response to these mitogens or antigens, splenocytes were stimulated on the second and fourth weeks after infestation. Thymocytes were significantly activated by PWM on the second week but peripheral blood lymphocytes did not show any statistically significant response. Results obtained in antibody production, immunoblotting and lymphocyte proliferation suggested sequential releases of F. hepatica substances and the existence of common proteins between adult and juvenile parasite stages. Cellular and humoral responses observed in this work did not seem to confer a complete resistance to liver fluke primary infestation on the rat.


Schistosoma mansoni antibodies in tissue specimens demonstrated by a diffusion-in-gel ELISA technique. A modification of the diffusion-in-gel enzyme-linked immunosorbent assay (DIG-ELISA) for analysis of antibodies in tissue fragments has been elaborated. In this technique, tissue specimens are placed on top of a thin gel layer covering a plastic surface coated with an antigen preparation. The gel thus serves as a medium through which diffusion of antibodies contained in tissue samples may occur. Specimens from skin, lung, liver, kidney, heart and skeletal muscle as well as blood serum and blood sampled onto filter paper were successfully used for analysis of the antibody response to two different antigens (soluble adult worm antigen and soluble egg antigen) during experimental infection of mice with the helminth parasite Schistosoma mansoni. It was concluded that skin and lung tissue reflected the serum antibody response more closely than the other tissues tested, although zone sizes were slightly smaller than those registered for corresponding serum samples. The DIG-ELISA reaction zone size was, as expected, shown to be dependent on the weight (size) of the tissue specimen. The variability of the modified technique was comparable to that found for analysis of serum by the conventional DIG-ELISA technique. It is concluded that the described technique may be used for serological analysis when blood samples cannot be easily obtained, e.g. at examination of animal carcasses or single organs.


Immunological detection of chemotherapeutic success in bovine fasciolosis using the specific antigen f2. An improved hemagglutination (HA) test using the purified specific f2 antigen of Fasciola hepatica has been evaluated with regard to its potential use for the prediction of chemotherapeutic success in natural bovine infections with F. hepatica. Lactating cows (n = 16) from a herd naturally infected with F. hepatica were successively treated with nitroxynil (Dovenix, Specia) and with oxyclozanide (Zanil, ICI) 1 month later. Their f2-specific antibodies were significantly lower than those of a non-treated control group (n = 15) from the second month after the first treatment, and continued to decline thereafter to negative values 5-6 months post-treatment. In a second experiment, culled and fattened cows (n = 32) of unknown fasciolosis history were treated with closantel (Janssen Pharmaceutica). Three months after treatment, f2-specific antibodies of the serologically positive animals (n = 24) were reduced nine-fold. In contrast, in the control group (n = 28), the titers of f2-specific antibodies of the serologically positive animals (n = 21) were not modified significantly. The results show that the f2-HA test is useful for the prediction of chemotherapeutic success in bovine fascioliasis.


Use of Echinococcus granulosus worm antigens for immunodiagnosis of E. granulosus infection in dogs. Echinococcus granulosus worm excretory/secretory antigens (WES) were used in ELISA for diagnosis of E. granulosus infection in dogs and compared with protoscolex somatic antigens (PSM). Sera from 224 dogs were tested. There was no correlation between ELISA absorbance values and E. granulosus worm burdens using either antigen. There was a significant linear relationship between absorbance values of sera tested in the ELISA using WES (W-ELISA) and the ELISA using PSM (P-ELISA). However, there was a small but significant difference between the absorbance values of the sera tested against the two antigens. Western blot analysis of WES using sera from E. granulosus-infected and uninfected dogs revealed antigenic components of relative molecular mass (Mr) larger than 94,000, Mr 94,000-68,000 and Mr 43,000-39,000 in worms, and these were specific for E. granulosus and not identified in PSM; these antigenic differences may be responsible for differences in reactivity in ELISA. The sensitivities of W-ELISA and P-ELISA were 80.8% and 75.6%, respectively. The specificities of W-ELISA and P-ELISA were 93.7% and 97.9%, respectively. The reduced specificity in W-ELISA was mainly attributable to increased background reactivity of sera from Taenia hydatigena-infected dogs. Despite the reduction in specificity, both ELISAs are valuable epidemiological tools to determine the prevalence of antibody to E. granulosus in dog populations and to monitor the success of hydatid control campaigns.


[The effect of nicergoline on the systemic and cerebral hemodynamics of patients with circulatory encephalopathy and an atherosclerotic lesion of the major cerebral arteries]. The Evans blue dilution method and ultrasound dopplerography were used to study the effect of nicergolin on the systemic and cerebral hemodynamics in 31 patients with dyscirculatory encephalopathy against the background of atherosclerotic lesions of the major head arteries. It was established that nicergolin reduces the arterial pressure, diminishes the minute blood volume, cardiac and stroke indices, increases the specific peripheral vascular resistance, the linear blood flow velocity prevailingly in the stenosed major head arteries, results in a regression of the subjective and objective neurological symptomatology. Considering the cardiodepressive effect of nicergolin, this agent is indicated in patients with the hyperkinetic type of the systemic hemodynamics.


[The characteristics of the autogenic training of patients with a history of craniocerebral trauma]. The author describes a new variant of autogenous training specially designed for patients who sustained head injuries. Principles are outlined of the formation of treatment groups, details of the training, specific perfection of the routine autogenous training (degree I) and new techniques of autogenous training (degree II).


[Ultrasonic dopplerography in the diagnosis of the initial manifestations of insufficiency of the blood supply to the brain]. Sixty-eight patients with cerebrovascular insufficiency received a course of quantum hemotherapy by means of ultraviolet irradiation of the blood. The cerebral hemodynamics was evaluated by ultrasound transcranial dopplerography. It was found that this method may be used for early diagnosis as well as for the control of treatment efficacy. It was established that ultraviolet irradiation of the blood essentially effected the cerebral hemodynamics, reduces interhemispheric asymmetry, causes no cerebral steal syndromes.


[The use of acetylcysteine in the combined treatment of patients with acute 1,2-dichloroethane poisoning]. The authors analyse the use of acetylcysteine as specific antidote treatment in 37 patients with acute 1,2-dichlorethane (DCE) poisoning. Administration of dichlorethane did not produce any determining effect on the outcome of the treatment in critical and irreversible concentration of DCE in the blood. The main component in complex therapy is early hemosorption. Acetylcystein may be used in the complex treatment of acute DCE intoxications after early extracorporal detoxication with the purpose of reducing the severity of troxic of hepatopathies.


[The medical aspects of agricultural production and rural ecology under the new management conditions]. Problems of rural hygiene are evaluated related to new conditions of agricultural production, technization of working processes, development of microbiological industry. Working conditions of women are emphasized. Medical aspects of ecology are discussed in detail. Socio-hygienic problems are evaluated.


[A new methodological procedure for studying the health status of the population of industrial cities]. Investigation and evaluation of the population health depending on the environment are realized in two directions. One of them are values characterizing separate indices of the health status. The other direction is based on a study of nosological entities observed in separate systems of the body, evaluation of the functional state of these systems in the whole body and determination of their dependence on environmental factors.


[The characteristics of the course of tuberculosis in children under the ecological conditions in Bukovina]. The pathomorphosis of tuberculosis in children was evaluated in conditions of unfavourable ecological conditions of Bukovina. Five clinical cases are analyzed. Mass screening of children is recommended (mucus analysis).


[A comparative evaluation of the efficacy of quantum methods for treating hypertension patients]. A study is presented of the effect of laser and microwave resonance therapy on the hemodynamics and hemorheology in 56 patients with hypertensive disease. The hypotensive effect of intravascular laser therapy is related to the positive changes, reduction of blood viscosity and general peripheral vascular resistance. The effect of low molecular electromagnetic radiation on acupuncture points favoured clear reduction of peripheral vessel resistance. Combination of laser and microwave resonance therapy produces a positive effect due to potentiation of these methods and, thus, influencing the systems of hemodynamics, hemostasis and hemorheology.


[The level of total immunoglobulin E in the blood serum of rheumatism patients]. The mean level of total IgE in the sera of patients with active rheumatism was significantly higher than during non-active phase of the disease and in healthy blood donors. The highest level of hyper-IgE-emia is observed in the continuously relapsing variant of rheumatism. Increased content of total serum IgE in active rheumatism is observed both in manifest and in latent variants of the disease. Articular and cerebral manifestations of rheumatism are not, apparently, related to the IgE level. The serum IgE may be a supplementary diagnostic criterion of rheumatic activity, especially with advance of the cardiovascular insufficiency.


[Laser irradiation of the blood in patients with refractory tachyarrhythmias]. A study of 108 with paradoxic tachyarrhythmias including 80 with tachyarrhythmias refractory to antiarrhythmic drugs revealed that a major role is played by the structural functional changes of the membranes and in humoral chain of the immune response that is accompanied by functional disorder of the cell receptor apparatus. Laser blood irradiation effecting neurohumoral regulation promotes normalization of barrier and receptor functional of myocardium cell membranes and overcoming refractivity of tachyarrhythmias to antiarrhythmic agents.


[The rheology of the gastric mucus and the secretory activity of the main gastric glands in patients with duodenal peptic ulcer]. A study of 150 patients with ulcer and 38 healthy persons revealed that duodenal ulcer is characterized not only by an increase of the acid- and pepsin-secretory gastric function but also by a reduction of the resilient-viscous properties of the native parietal mucus. Complex determination of acid and pepsin secretion, rheological properties of the gastric mucus is of high diagnostic and prognostic importance.


[Changes in the trace element content of the blood in chronic hepatitis]. Trace elements were examined spectrophotometrically in 45 patients with chronic hepatitis (persisting--31; chronic--14). Lead and cadmium showed a significant increase both in the healthy and hepatitis patients. A reduction of zinc and increase of copper was found in patients with chronic hepatitis. Changes in the content of microelements depended on the severity of the disease.


[The verification of amyloidosis by biopsies of the gastric and duodenal mucosa in patients with destructive tuberculosis and chronic nonspecific lung diseases]. Biopsy of the gastric and duodenal mucosa was carried out during diagnostic esophagogastroduodenofibroscopy. Histological examination was realized using the light polarization microscope. Amyloid was found in 48.8% with pathological changes in the urine. In patients without pathological changes of the urine amyloidosis was diagnosed bioptically in 8.6% of duodenal and 10.3% of gastric biopsies.


[Plasmapheresis in the combined therapy of patients with chronic glomerulonephritis and the nephrotic syndrome]. Plasmapheresis (P) was used in the complex treatment of 16 patients with chronic glomerulonephritis (CHG) and nephrotic syndrome. Before P. 12 patients were treated ineffectively with prednisolone and curantyl. After 3-5 sessions of P detoxication was observed in all patients, increased diuresis (15 patients). Renal function normalized in 4 of 5 patients, proteinuria reduced by 50-80%. The authors discuss indications of including P into the complex treatment of patients in whom chronic glomerulonephritis with the nephrotic syndrome was present.


[The treatment of meningococcemia by preserving immune homeostasis]. A study is presented of the cellular-humoral immunity in patients with typical meningococcemia complicated by infectious-toxic shock. Obtained data evidence significant changes of the cellular-humoral immunity in meningococcemias, especially those accompanied by infectious-toxic shock along with traditional methods the authors propose immunoregulatory and pathogenetic treatment: human immunoglobulin, aminocaproic acid, sodium, ethamsilate or dicinon, thymalin or T-activin, dopamin, rifampycin. The dosage of these drugs should be individual. The indications and efficiency should be controlled immunologically.


[The morphological aspects of the protective action of enterosorbent K(2)9 during the use of the antitumor anthracycline antibiotic carminomycin]. The authors substantiate morphologically the protector effect of K(2)9 enterosorbent during its parallel use with the antitumour anthracyclin antibiotic carminomycin. The agent was administered intraperitoneally in animals at the maximum tolerable dose. Use of the K(2)9 enterosorbent reduces the cardiotoxic effect of carminomycin.


[The effect of reflected glare on overall and visual work capacity in visually stressed work]. It was established that used in some working placed light may create reflected lustricity that worsens discrimination of objects. This in its turn worsens general and visual working capacity.


[The effect of solvents and emulsifiers on the toxicity of synthetic pyrethroids]. It was established that the preparation form of pyrethroid during peroral, percutaneous uses is significantly more toxic than its components. The solvent in the composition of the preparative form increases the irritative properties of deltametatrin and also essentially effect mean time of death of half of the animals. Other toxicokinetic effects are discussed in detail.


[The brain function of animals exposed to the action of centimeter electromagnetic waves]. It was established that centimeter electromagnetic waves (EMW) are a biologically active factor. Dynamic of changes of behavioural reactions under the effect of EMW evidences instability of the functional state of the brain EMW densities of 1000, 1500 mW/cm2 produce a response characterized by inhibition of motor activity.


[The endocrinological aspects of cancer of the vulva]. Patients with cancer of the vulva showed significant disorders of pituitary adrenal cortex, ovarian and thyroid function. This requires carrying out corrective hormone therapy with the purpose of increasing the efficiency of combined treatment.


[The potentials of homeopathic treatment in the clinical picture of internal diseases]. In this review the author describes the main principles of homeopathy, the stages of its development, methods of approach to the treatment of diseases of the internal organs. The wide range of homeopathic treatment of different kinds of pathology is evaluated. The absence of side effects, availability of raw materials, simple methods of manufacturing homeopathic drugs substantiate the return to homeopathy as one of the effective methods of treatment, in particular, chronic diseases.


[The complications of manual therapy in osteochondrosis of the cervical spine]. The authors analyze literary and own findings on complications of manual therapy. The causes and clinical picture of possible complications are discussed. An original classification of complications due to manual therapy of cervical spine disorders is presented.


[Laser puncture in the treatment of diabetic angiopathies of the lower extremities]. Laseropuncture in patients with diabetes mellitus associated with angiopathies of the lower extremities (grade II and III) produced a pronounced clinical effect which was manifested by removing the pain syndrome, improvement of the peripheral circulation and extremity function and function of the lower extremities, improvement of thermographic values. But this positive dynamics was more pronounced in angiopathies of the lower extremities of the stage of functional disorders than obliterating atherosclerosis of the legs. Sterility of the laser beam, possibility of local effect on biologically active points, non-painful procedure, absence of age limits and side effects allow to widely recommend this method for the treatment of Diabetes mellitus associated with angiopathies of the lower extremities.


[The classification of myocardiodystrophies]. The importance of singling out myocardial lesions of non-coronary genesis. A classification of myocardiodystrophies is presented. The problem of etiology, pathogenesis, clinical and treatment of myocardial dystrophies is discussed.


[The efficacy of a 4-year course of drug treatment for patients with juvenile hypertension]. To evaluate the hypotensive efficacy and effects of some hypotensive drugs on the hemodynamics and concentration of testosterone in its blood plasma the authors examined 205 patients with juvenile hypertension (JH): main group--134 patients; comparison group--71 patients). Course treatment (1.5-2 months) with obsidan, niphedipin, verapamyl was carried out with nondrug treatment during intervals. The obtained data evidence efficacy of the hypotensive treatment. Most patients with JH showed a characteristic increase of the blood testosterone level. After a four-year treatment the testosterone level was within normal levels.


[The dynamic electrocardiogram in the late period after the surgical treatment of obesity patients]. An analysis is presented of ECG of 68 patients with obesity (grade III-IV) before the operation of jejunoileal shunting and 1-2, 3-5 and 6-10 years after surgery. It was found that the main changes in the cardiovascular system occur during the first 2 years, i.e. during the period of body mass reduction. The importance of ECG in the diagnosis of hypertrophy of different compartments of the heart in obesity of grade III-IV.


[Combined pathology of the biliary and urinary tracts]. Association of chronic cholecystitis and pyelonephritis as well as associated formation of calculi are the cause of prolonged course of the disease, resistance to antibacterial therapy, frequent exacerbations. For his reason the authors recommend detailed examinations of the kidneys in patients with chronic cholecystitis for early diagnosis of their pathology and institution of adequate treatment.


[The incidence and nature of hepatobiliary system diseases in workers of the Ternopol Clothing Association]. A detailed clinico-laboratory examination of workers of Ternopol sewing factories revealed in 13.9% chronic inflammatory diseases of the hepatobiliary system which exceeds 4 times the indices of seeking medical advice (3.5%) mainly due to latent course. Entropy of blood serum protein data are more informative than bilirubin and transaminase data used in evolution of homeostasis disorders in these patients.


[The treatment of acquired deficiency of alpha 1-proteinase inhibitor in the early stages of chronic obstructive lung diseases]. A new treatment scheme is proposed with a differential approach to correction of acquired deficiency of proteinase alpha-1 inhibitor. The treatment includes periodically repeated courses of antioxidant agents. In case of failure antioxidant agents are supplemented with courses of substitutive therapy by courses of proteolysis inhibitors up to normalization. Further treatment included repeated courses of antioxidant treatment for a more prolonged remission and prophylaxis of exacerbations.


Do thermal lasers increase the risk of distal embolism in angioplasties? An experimental study with cw Nd: YAG and excimer lasers. A thermal (contact cw Nd:YAG) and non-thermal (Xe-Cl excimer) laser were used to irradiate fresh human blood in an experimental setting to investigate the possible thrombogenic properties of lasers and to compare the two laser modalities. Blood was obtained into 10 ml citrate test tubes from healthy volunteers. Laser irradiations were performed with cw Nd: YAG laser (10W, 3 and 6 secs) and with excimer laser (20 mJ, 60 ns pulses, 15 secs). Altogether, 80 samples were collected. A thromboelastographic (TEG) analysis was performed for each sample as well as the controls, which were taken simultaneously. Serum potassium levels indicating haemolysis were also determined. Thermal laser energy seems to have more thrombogenic effect than excimer laser. There appear to be no previous reports available in the literature using TEG to determine thrombogenicity of different lasers.


Hematocrit dependent changes of muscle tissue oxygen supply in the lower limb muscle of patients with intermittent claudication. Hematocrit dependent changes of muscle tissue oxygen supply at rest and after exercise were detected in 23 patients with chronical arterial occlusive disease stage IIb according to Fontaine. In these patients with a concomitant high hematocrit a stepwise isovolemic hemodilution by vena esection and subsequent infusion of 10% hydroxyethylstarch solution (200/0.5%) was achieved intraindividually. Measurements of muscle tissue oxygen pressure (pO2) values in the lower limb muscle using a standardized pedalergometric exercise test as well as pain free walking distance with a treadmill were performed. Improvement of muscle tissue pO2 supply after pedalergometric exercise as well as muscular performance on the treadmill were found at an average hematocrit value of 40.50%, whereas muscle tissue oxygen supply and pedalergometric performance were markedly reduced at hematocrit 50.60% as well as 33.75%. Thus it is likely that an improvement of muscle tissue oxygen supply in severe intermittent claudication can be achieved by isovolemic hemodilution to hematocrit values about 40-41%.


The effect of antimicrobial impregnation on vascular graft healing. An experimental porcine study. This study evaluates the impregnation of a phenol derivative (Y105) to polymerized Dacron grafts. Y-105 has broad spectrum anti-microbial characteristics. The grafts were inserted end to side in the iliac artery of pigs. Reexploration and graft removal was performed after 7, 14 and 30 days. After pressure fixation with glutaraldehyde the grafts were evaluated for gross morphology and by scanning electron microscopy. A gradual development of pseudo-intima was observed without sign of graft occlusion. The addition of the antimicrobial impregnation did not interfere with healing.


Hematologic changes in type 2 diabetic patients with various localizations of peripheral vascular disease. Some hematologic parameters have been measured in 80 patients with Type 2 diabetes mellitus. The patients were divided into three groups: (a) proximal (pelvic and femoral) lower limb macroangiopathy; (b) distal (tibial) macroangiopathy; and (c) control group of diabetics without lower limb macroangiopathy. Mean hemoglobin, hematocrit and fibrinogen values were significantly higher in both the proximal and distal macroangiopathy groups in comparison with the controls. On the other hand, mean leucocyte and platelet counts were significantly elevated only in the proximal macroangiopathy group. Significant correlations were observed in univariate and multivariate analyses between blood fibrinogen concentration and pressure indices expressing severity of lower limb macroangiopathy (ankle/thigh, ankle/arm). In summary, increased levels of hematologic parameters contributing to the increase of whole blood viscosity were observed in Type 2 diabetics with arteriosclerosis obliterans. The observed relationship between fibrinogen concentration and severity of arteriosclerosis obliterans could be an evidence in favor for fibrinogen lowering therapy in this pathologic condition.


Collagen and gelatin-impregnated vascular grafts--is their thrombogenicity enhanced? An experimental study. The early thrombogenicity of dacron vascular grafts with and without impregnation with collagen (n = 7) or gelatin (n = 7) was evaluated in a sheep carotid artery interposition model. Autologous platelets were labelled with 32P and reinjected. Flow was reduced to 25 ml/min to mimic a situation with poor run-off and the graft thrombogenicity was studied for 4 hours. The results showed no difference as regards patency, thrombus-free surface, or uptake of 32P-labelled platelets between collagen- or gelatin-impregnated grafts and their parent dacron grafts. Thus, no difference in early graft thrombogenicity could be documented.


[Aneurysms of the hepatic artery].

[Aneurysms of the hepatic artery]. A series of seven cases of hepatic artery aneurysms is reported. Guidelines for diagnosis and therapeutic approach to this rare disease are specified based on our own results and on the work of other authors. Because of high mortality, hepatic and biliary complications in cases of ruptured hepatic aneurysms elective vascular surgery is recommended in symptomatic and asymptomatic patients. In cases of intrahepatic localization percutaneous catheter embolization may be the method of choice except for some cases of false aneurysms in transplanted livers.


[Preoperative cardiovascular assessment of patients with vascular diseases]. Pathologic cardiovascular symptoms and signs were assessed preoperatively in 72 consecutive patients scheduled for vascular surgery. All postoperative cardiovascular complications were monitored and statistical relation to the preoperative pathology was tested using the X2-method. The following preoperative cardiovascular symptoms are associated with a significant incidence of postoperative complications: Angina pectoris (p < 0.05); congestive heart failure (p < 0.025); ventricular and/or supraventricular arrhythmias (p < 0.01); pathologic ECG (p < 0.01); ejection fraction < 50% in echocardiography (p < 0.05); myocardial hypokinesias in echocardiography (p < 0.025). The use of preoperative echocardiography as a reliable and accurate method is emphasized.


Percutaneous transluminal angioplasty in 226 iliac artery stenoses: role of the superficial femoral artery for clinical success. We reviewed the results of 174 consecutive percutaneous transluminal angioplasties (PTA) for 226 iliac artery stenoses (mean length 1.6 cm, range 0.2-9.6 cm) in 150 patients with lower limb ischaemia. Vascular intervention was indicated by intermittent claudication in 123 and critical ischaemia in 51 (29%) limbs. There were 12 (7%) failed guide-wire recanalizations. Four (2%) serious complications from puncture site haemorrhages or peripheral embolizations were handed surgically and caused one major amputation. Five-year patency in 162 successful dilatations was 68% primarily and 81% secondary to vascular surgical reconstructions during an average 28 (range 1-60) months of observation. One hundred and thirteen (70%) limbs improved clinically. In 95 limbs treated exclusively by iliac PTA, clinical improvement was achieved in 38/47 (81%) limbs with patency and 24/48 (50%) limbs with occlusion of the superficial femoral artery (SFA) (p < 0.003), whereas vascular patency of iliac PTA was unaffected by status of the SFA. Five-year limb salvage rate was 50% in limbs with critical ischaemia. We conclude that PTA for iliac artery stenoses is a low-risk procedure offering acceptable clinical results provided the SFA is patent. As an adjunct to distal bypass surgery, iliac PTA improves inflow without the requirement for major aorto-iliac surgery and may extend indications for vascular intervention in patients with lower limb ischaemia.


[Double-blind study of the effect of dipyridamole in patients with intermittent claudication]. 32 patients (mean age 65 years, range 51-75 years) were included in this controlled, double blind study to evaluate the effect of dipyridamole in patients with intermittent claudication. Following a run-in phase of one month, 15 patients received 400 mg dipyridamole per day and 17 patients placebo. Patient characteristics (risk factors, age, clinical and apparative tests) of both groups did not differ significantly before and during the study period. Mean pain free und absolute walking distance on the treadmill (3.2 km/h, 12.5 degrees gradient) increased significantly in both groups during study period (p < 0.001 and p < 0.01). Explanations are more intensive physical activity and increasing adaptation to treadmill exercise. However, dipyridamole did not induce a significantly longer walking distance in comparison with placebo. The working hypothesis that the drug with inhibiting properties of thrombocyte function prolongs walking distance in intermittent claudication, could not be confirmed.


[Comparison of the effectiveness of physical training with parenteral drug therapy in Fontaine stage IIb peripheral arterial occlusive disease]. In an open, randomized study in patients with peripheral arterial occlusive disease in state IIb according to Fontaine the clinical efficacy and tolerability of Actovegin upon intravenous and intraarterial application was examined compared to vascular training. 30 patients were included in each of the three therapy groups. Over a period of four weeks each patient received daily therapy--except for weekends. Patients of group I received a daily intravenous infusion of 250 ml Actovegin 20% p.i. the patients in group II received this medication by the intraarterial route. The third patient group received standardized vascular training. From a total of 90 patients 73 completed the study according to the study protocol. In all three groups the therapy resulted in the improvement of pain-free and pain-limited walking distances. Upon comparison of relative changes in the intraarterial and intravenous group significant differences turned out: whereas patients in the intravenous group achieved a mean increase in pain-free walking distance of 37.8%, a mean increase in walking distance of 44.9% in the intraarterial group was observed. With respect to maximum walking distances the relative improvements amounted to a mean of 44.0% in the intravenous group, and 64.3% in the intraarterial group. After training over four weeks in the vascular-training group the patients achieved a mean increase in pain-free walking distance of 69.6% and 53.5% in pain-limited walking distance. This meant a significantly greater improvement in pain-free walking distance compared to the intravenous group; the difference compared to the intraarterial group was not significant; however the mean values indicated that the vascular-training group showed greater improvements in pain-free walking distance, and more moderate improvements in maximum walking distance than the intraarterial group. However, these results were significantly modified, if a differentiation was made in the vascular-training group between patients with high and low compliance. In the patients' rating all three therapies were described as throughout beneficial, however, less positive for the intravenous therapy, which is in accordance to the results of changes in walking-distance. The results of the present study are discussed having in mind physical therapy being limited through contraindications and insufficient patient compliance.


[Gingko biloba extract EGb 761 and pentoxifylline in intermittent claudication. Secondary analysis of the clinical effectiveness]. Clinical trials on the efficacy of EGb 761 and pentoxifylline are summarized in the context of their methods and results and compared with each other. All placebo-controlled, randomized and double-blind studies with the major target objective of "pain-free walking distance" were selected. The pentoxifylline studies were adopted from a survey of the existing literature in the English language, which has been brought up to date via DIMDI research. The studies on both active substances are fraught with similar difficulties as to method, and are not different as regards their quality. The increase in walking distance is highly variable, especially in the pentoxifylline studies. On average through each and all of the studies on both preparations, an increase of 45% (EGb 761) or 57% (pentoxifylline) in relation to initial values is here found. No differences in the documentation of efficacy and the clinical efficacy were discovered between the two substances, both of which are registered as effective substances in the treatment of peripheral arterial occlusion (pAO) in accordance with the Federal German Drugs Law (Arzneimittelgesetz, AMG) of 1976.


[Effect of naftidrofuryl on viscoelasticity, thrombocyte aggregation and erythrocyte fluidity of blood]. In 30 patients suffering from cerebrovascular disease stage I with atherosclerotic plaques in the carotid's bifurcation the effect of a 7-days application with 400 mg Naftidrofuryl versus NaCl was tested. As parameters viscosity and elasticity of whole blood, plasma viscosity, erythrocytes' and membrane fluidity point, as well as platelet aggregation (spontaneous, ADP-, Epinephrine- and Collagen-induced) were determined before onset, after 4 days and after 8 days. After 8 days treatment with naftidrofuryl there was a significant improvement in viscosity and elasticity of whole blood as well as in erythrocytes' elongation, membrane-fluidity and in the induced test of platelet aggregation.


[Bilateral brachial claudication as the initial manifestation of giant cell arteritis. Case report and review of the literature]. A 69-year-old woman presented with bilateral arm claudication caused by segmental occlusions of both brachial arteries. Bilateral retrograde ring-desobliteration resulted in restauration of full pulses. Microscopic examination of the resected specimen revealed giant cell arteritis. No other manifestations of the disease could be detected. At autopsy affection of the aortic arch and of the arm arteries is found in about 70% of patients with giant cell arterities. Symptoms occur in only about 5% of them. Arterial stenoses are successfully treated with corticosteroids. In case of chronic occlusion, however, ischemia-induced symptoms may necessitate an operation. Endarterectomy (i.e. total dissection of the destroyed inner arterial wall layers) should be preferred to bypass procedures. Subsequent long-term corticosteroid therapy should be instituted in order to treat the underlying disease, and to prevent reocclusions.


[Aorto-aortic bypass through the right pleural cavity in recurrent coarctation of the aorta]. A patient with recurrent coarctation of the aorta was treated by a bypass between ascending and descending aorta performed through a right-sided thoracotomy. The procedure resulted in a normalization of the previously elevated blood pressure. The efficacy and simplicity of the method and the low risk of the access through the right pleural cavity are emphasized.


[Popliteal anastomotic aneurysm as the origin of recurrent embolism]. We report on a young patient who underwent numerous arterial interventions after injury to the right groin. After several years, a popliteal anastomotic aneurysm, unidentified at that time, began to cause recurrent peripheral emboli. The importance of an intensive search for the source of the emboli is demonstrated. Bland arteriography does not rule out the presence of an aneurysm and should prompt further investigation with duplex-sonography and/or MR-imaging. Aneurysms causing recurrent peripheral emboli are an absolute indication for surgery.


Stability of retinol in milk during frozen and other storage conditions. The effect of storage temperature and storage time on the retinol content of four commercial unfortified whole UHT milk samples was studied by HPLC. Significant losses of retinol in these milks were observed after 1 month of storage at 30 degrees C. Losses generally increased with storage time. Increasing the storage temperature from 30 degrees C to 40 degrees C had a variable effect depending on the particular milk. Short periods of frozen storage (up to 60 days) had no effect on the retinol content. However, frozen storage time from 4 to 8 months led to significant (P < 0.05) losses in retinol content. The effect of water activity and temperature conditions during storage of unfortified whole milk powder on the stability of retinol was also studied. Increasing the activity of water and temperature of storage significantly lowered the retinol content in milk powder.


Immunoaffinity-chromatography purification of salbutamol in liver and HPLC-fluorometric detection at trace residue level. A method combining immunoaffinity-chromatography (IAC) and high-performance liquid chromatography (HPLC) for the analysis of Salbutamol in liver with a low quantification limit of 1 micrograms/kg has been developed. Salbutamol was extracted with 0.01 mol/L HCl and purified by IAC. The samples were analysed on a liquid chromatograph fitted with a C18 mu-Bondapak column. A fluorometer was used for the detection of salbutamol. Recoveries of 67-80% could be obtained.


The frequency of mutations in exon 11 of the CF gene in Polish cystic fibrosis patients. Results of mutation analysis in exon 11 of the CF gene have been presented. Using the SSCP technique 18 mutations (of four different types) were detected in cystic fibrosis patients of Polish origin. Thus, we were able to detect in exon 11 about 10% of all CF mutations occurring in the affected population examined.


Is the tRNA ochre suppressor supX derived from gltT? Some of the argE3-->Arg+ revertants show supX suppressor activity. The genetic relationship of supX is not yet known but the evidences are presented, that supX does not derive from gltT encoding tRNA(Glu)UUG.


Thromboxane increase in irradiated animals is caused by stimulation of cyclooxygenase activity. The irradiation of whole body of rabbits with a dose of 6.0 Gy causes an increase in thromboxane synthesis from exogenous arachidonic acid. The uptake of [14C]arachidonic acid and the total amount of radioactivity released during collagen stimulated aggregation of platelets are not changed following the exposure of animals. The irradiation changes the relation between released arachidonic acid and synthesized thromboxane. The amount of 12-hydroxyeicosatetraenoic acid remains unchanged. The results indicate that the increase in thromboxane synthesis is not associated with the activation of phospholipase but is caused by stimulation of cyclooxygenase activity.


Two intron-containing pre-tRNAs(Tyr) from Triticum aestivum are efficiently processed and spliced in homologous cell-free extract. Two wheat pre-tRNAs(Tyr) containing introns and flanks are accurately and efficiently spliced in homologous wheat germ S23 extract. The initiation and termination sites upon in vitro transcription in HeLa cell extract have been estimated for both pre-tRNAs.


Enzyme activities in human breast tumours. The activities of six enzymes associated with carbohydrate metabolism were measured both in carcinomas and in normal breast tissues. The following differences were observed. 1. The carcinoma showed higher enzyme activities than the normal mammary tissue. 2. The ratios of glutamate dehydrogenase, hydroxybutyrate dehydrogenase, glutathione reductase and catalase to lactate dehydrogenase were lower in carcinomas than in normal tissues. Similarly, the ratios of glutamate dehydrogenase, hydroxybutyrate dehydrogenase, glutathione reductase and catalase to glucose-6-phosphate dehydrogenase were also significantly lower in carcinomas. 3. There were no significant differences in enzyme activities between I and II stage of the disease and the metastatic tissues, however, there were significant differences between I and III stage. The significance of these findings is discussed in terms of the alterations in the balance between the metabolic pathways.


The nucleotide sequence of 5S rRNA from bovine liver. We have determined the nucleotide sequence of ribosomal 5S RNA from bovine liver. The comparison of this sequence with those from other eukaryotic sources shows that a common secondary structure model for all eukaryotic 5S rRNAs may exist. Analysis of the evolutionary conserved nucleotides in metazoan 5S rRNAs suggests that the tertiary interactions, proposed earlier for plant 5S rRNA, are also possible.


A small yaws survey on the island of Sumatra, Indonesia. Yaws (framboesia tropica), caused by Treponema pallidum subspecies pertenue, is a chronic infectious disease, found in tropical rural regions. As a result of mass treatment campaigns conducted in the 1950s and 1960s the prevalence of yaws and the other endemic treponematoses (pinta and endemic syphilis) has decreased greatly. However, in several tropical regions in the world resurgence of yaws was reported in the 1980s. In this article we present the results of a small survey on yaws in six health centres in the Pariaman region in West Sumatra, Indonesia. A general conclusion from this small survey is that yaws is far from being eradicated and that in this region the disease is on the increase again. Some major findings of T. pertenue research are presented here.


Ultrastructural changes in the blood-brain barrier of mice infected with Plasmodium berghei. Mice infected with the rodent malaria parasite Plasmodium berghei exhibit ultrastructural changes of the blood-brain barrier during the course of infection. Firm adherence including cellular interdigitation of infected cells or leucocytes and even clusters of cells to the vascular-endothelial lining is repeatedly observed early during infection. Ghosts and membrane remnants can be found engulfed in the surface of the endothelial cells. Frequently leucocytes migrate between endothelial cells and even cause a lift off and degeneration of these cells. In addition, endothelial cells exhibit increased pinocytotic activity, many irregular cytoplasmic extensions and even phagocytic activity. These changes are associated with degenerative changes in the basement membrane. Swelling and deposition of collagen-like fibres and even loss of fragments of basement membrane is observed. In some places fingerlike extensions of pericytes passed through the basement membrane and contacted or even bulged into the cytoplasm of endothelial cells. Ballooning and even coalescence of perivascular astrocytes was observed and contributed to the appearance of a perivascular oedematous space. The observed changes indicate a progressive deterioration of the blood-brain barrier eventually leading to endothelial lesions and hemorrhage.


Onchocerca Volvulus infection in Sierra Leone: relation between prevalence, intensity of infection, and ocular problems in a 'forest' region. A two-year longitudinal study carried out in five villages in a forest region of Gorama Chiefdom, Kono District, Sierra Leone, revealed that infection with Onchocerca volvulus was hyperendemic, the overall rate of infection being 61.6%. Prevalence rose from 28.6% in the 1-5-year age group, peaking among the 21-30-year age group (82.5%) and then levelling off. The intensity of infection though low, peaked in the 31-40-year-old males and in the 41-50-year-old female cohorts. The iliac crest was more sensitive for microfilarial (mf) recovery than the shoulder and the outer canthus. The majority of the nodules were located in the pelvic region. Microfilariae invasion of the eye was low, with low anterior chamber lesions but high posterior chamber lesions comprising mainly optic atrophy and choroidoretinitis. The rate of blindness was 1.6%, ocular onchocerciasis being the leading cause of blindness followed by cornea opacities.


Onchocerciasis in the forest-savannah mosaic region of Sierra Leone. Prevalence, intensity of infection, and endemicity levels. The present study was carried out between December 1986 and January 1988. A series of 3,048 individuals (46% males and 54% females) were examined in 56 villages; onchocercal dermatitis and lymphadenitis were seen. The crude prevalence of nodules and of microfilariae amounted to 14% and 43%, respectively. The prevalence of nodules was significantly higher at the femoral trochanter than at other anatomical sites. The overall prevalence of nodules, and of microfilariae, was significantly higher in males than in females. The age-adjusted prevalence and the geometric mean microfilarial load were significantly higher in the cohort of males older than 15 years than in their female counterparts. The overall geometric mean microfilarial load was 18 microfilariae per skin snip. The correlation between prevalence and intensity of infection was poor, but was perfect between mean microfilarial density per skin snip and mean microfilarial density per milligram skin. The ratio of mean microfilarial density per skin snip to mean microfilarial density per milligram skin was 1:6. The correlation between prevalence of onchocercomata and microfilarial prevalence or microfilarial density was weak. Both of the latter criteria identified the Rokel/Seli as the river with the highest proportion of hyperendemic villages. The implications of the present findings for the epidemiology of onchocerciasis are discussed.


Typing leptospira from the perspective of a reference laboratory. Leptospirosis is caused by different leptospiral variants. Analysis by cross agglutination absorption tests (CAAT) led to the definition of entities called serovars to distinguish between leptospires on sub-species level, and to the designation of reference strains representing serovars. For decades CAAT has been used to classify leptospires and now approximately 200 serovars have been recognized. In the last few years, it has become increasingly more clear that the serovar concept is no longer fully satisfactory as it may fail to adequately define epidemiologically important entities. In addition, CAAT is too cumbersome and time-consuming for routine typing. Various methods have been developed based on antigenic or genetic analysis with the purpose to supplement or to replace the CAAT. Most of these methods are still in an experimental state. It is to be expected that a typing method based on genomic analysis will eventually become most important. Such a new method should have considerable advantages in order to be acceptable for the development of a new classification system replacing the system based on serovars, which is widely accepted and in many respects still satisfactory. From the new methods, analysis of leptospiral DNA fragment length after digestion with restriction enzymes (REA) has been widely used and proven to be useful for typing. Pending the development of new typing methods that have clear advantages and may lead to a new classification system, it is suggested that the classification system based on serovars is maintained and that REA is added to each description of a new serovar.


[Aseptic necrosis of the femoral head following renal transplantation: assessment of a 25-year experience]. From June 1963 to December 1988 aseptic necrosis of the femoral head has been treated surgically in 84 renal transplant recipients (150 surgical procedures). The long-term results of drilling of the neck and head of the femur (16), cup arthroplasty (32), cemented cup (1) and hemiarthroplasty (8) were unsatisfactory, as 23 of these 57 hips underwent a secondary procedure. Total hip arthroplasty progressively became the standard procedure for treatment of hip disease in transplanted patients. Since 1971, 63 renal transplant recipients underwent 92 cemented total hip replacement (THR) as a primary (73), secondary (16) or third (3) surgical procedure for severely symptomatic femoral head necrosis. Hospital stay averaged 22 days, and follow-up averaged 53 months. Two deaths related to the surgical procedure occurred in the first 4 years of our experience (one major local sepsis, one pulmonary infection). Other postoperative complications were urinary tract infection (12), pulmonary infection 1, transient sciatic nerve irritation (3), wound hematoma (6), reversible deterioration of renal function (3) and rejection of the graft (2). Thromboembolic complications did not occur. All operated hips showed a marked symptomatic improvement. Loosening of one or both components was definite in one, probable in two and possible in three of the 33 hips followed up more than 5 years. Other late complications included dislocation (6), painful class III heterotopic ossification (4), recurrence of previous sepsis (1) and late hematogenous sepsis. Late hip revision was required in 5 cases (recurrent dislocation, 1, ossification, 2, sepsis, 2). Two renal complications (one graft infarction and one reversible acute tubular necrosis) occurred after these revisions. The functional results of THR compare favourably with the results of other surgical procedures used in our early experience. We conclude that THR has become the treatment of choice for symptomatic established osteonecrosis of the femoral head in renal transplant patients. A relatively high rate of early and late complications is nevertheless to be expected.


The effect on cortical bone of reaming and filling of canine tibial diaphysis with inert bone wax. In canine studies the effect of intramedullary reaming on tubular bone was investigated in 4 dogs. Intramedullary reaming was further compared with reaming and intramedullary filling with bone wax in 6 dogs. Bone blood perfusion was measured by a microsphere technique and bone remodelling activity by 99mTc-MDP uptake. From histological sections bone necrosis and remodelling activity were estimated. The biological response increased with the surgical trauma. If the medullary cavity was only reamed, endosteal apposition was the predominant reaction. Obturation of the medullary cavity resulted in more vigorous subperiosteal and cortical reaction. It is concluded that the remodelling processes differ significantly between reamed bone and bone where the medullary cavity is reamed and blocked. Thus when testing bone cement the studies should include a control operation with obturation of the medullary canal in a way simulating bone cement.


Osteoid osteoma as a cause of knee pain. A review of 10 cases. Osteoid osteoma is a benign tumor frequently situated around the knee. It should therefore be considered as a possible cause of atraumatic knee pain in young adults. The mean interval from onset of symptoms to diagnosis is 14 months. Clinical symptoms are the most reliable diagnostic factors. Block resection is the treatment of choice. A retrospective study of 10 patients is presented.


The influence of automated percutaneous lumbar discectomy (APLD) on the biomechanics of the lumbar intervertebral disc. An experimental study. Twenty human lumbar motion segments were prepared and tested in an electromechanical materials testing machine in order to investigate the biomechanical changes, i.e. intradiscal pressure, radial extension and height of the intervertebral disc, after automated percutaneous lumbar discectomy (APLD) developed by Onik. The biomechanical data were statistically analyzed with the Friedman test (significance level p < 0.05). The APLD lasted 45 minutes in every segment. The mean weight of material removed was 4.6 g. The removal of 4.6 gram of nucleus pulposus material reduced the height of the disc by an average of 1.42 mm. The intradiscal pressure also decreased by an average of 5.7 bar. The radial bulge increased by an average of 0.45 mm. Our results show that the mechanism improving radicular pain in patients with herniated disc after treatment with percutaneous nucleotomy is still in question. While clinical studies show an improvement of 70% to 85% of patients treated with APLD for herniated disc, this in vitro study showed clearly that radial bulge increases after removal of nuclear material. We postulate that loss of height of the disc and, as a consequence, reduction of tension in the affected nerve root, plays a major role with regard to this improvement.


Congenital flat foot: different clinical forms. Using standard lateral x rays of 32 congenital flat feet (CFF) treated in our institutions, we studied the alignment in the sagittal plane of the tarsal and metatarsal bones. All feet presented with a complete dislocation of the talonavicular joint and a vertical talus. In some cases, however, the alignment of the calcaneocuboid joint was abnormal. In these, both the talus and the calcaneus appeared verticalized with no apparent subtalar joint subluxation (type I). Other cases, by contrast, had a normally aligned calcaneus thus implying subluxation of the subtalar joint (type II). Between the two types, a spectrum of clinical forms combining features from both categories exists. Recognition of the different varieties of CFF is of importance when planning surgery. Type I CFF requires reduction and stabilization of the whole midtarsal joint, while in type II CFF attention must be given to both the subtalar and calcaneocuboid joints.


[Rupture of the metallic lining in bicentric hemi-arthroplasties of the hip. Apropos of 3 cases]. Three cases of rupture of outer shell of biarticular prostheses used for femoral head fractures are reported. Insufficient thickness of this metallic surface is observed at the pole of the cups. The biomechanical forces inducing the rupture of such a defective surface are the result of mobility of the acetabular horns with weight-bearing. This 3-dimensional behavior of the acetabulum may explain the individual variations of mobility of the floating cups.


Perioperative analgesia by 3-in-one block in total hip arthroplasty. Prospective randomized blind study. In a prospective randomized blind study of 182 patients undergoing total hip arthroplasty, the patients per- and postoperative need for analgesics was assessed in two groups, one receiving general anesthesia and a 3-in-one block, the other group only general anesthesia. Although we found a significant reduction in analgesics per- and postoperatively in the 3-in-one block group, the difference in analgesics was small and has no clinical relevance in the patient with a healthy cardiovascular status. We conclude that 3-in-one block in combination with light general anesthesia is not the anesthetic of choice in total hip arthroplasty using the posterior approach.


A review of the 2- to 8-year results with a proximally fixed noncemented threaded modular total hip. A review of 50 cases of a proximally modular noncemented stem has been carried out. The primary method of fixation was a proximal threaded sleeve which was screwed into bone. Mean follow-up was 5.2 years. Six cases were revised, two for stem loosening. The remaining cases rate 69% excellent, 14.3% good, 11.9% fair and 4.8% poor. Two cases showed distal lucency due to polyethylene debris which leaked through the taper lock because of two vertical grooves. The results were felt to be adequate, but the threaded sleeve is too difficult to insert which lead to an alternative method of sleeve fixation. The longitudinal grooves, which were obviously a fault in design, have been removed.


Factors affecting survival of patients with hip fractures. The preoperative findings of 111 patients after 117 fractures of the proximal femur were recorded retrospectively. Data on survival, present type of residence and ambulatory status were analyzed. After age and sex, the presence of dementia, renal insufficiency and cardiac failure seemed to be the most important factors affecting the outcome. A full preoperative evaluation of patients with a proximal femoral fracture is needed to identify those at risk. This evaluation may help in the selection of the operative procedure.


Lesions of the triangular fibrocartilaginous complex. The authors present a retrospective study of 14 triangular fibrocartilaginous lesions in 13 patients. Based on their radiographic and clinical observations a new classification is presented taking into account associated lesions in the wrist.


The meningovertebral ligaments as a barrier to the side-to-side migration of extruded lumbar disc herniations. The hypothesis that side-to-side migration of an extruded lumbar disc herniation can be blocked or restrained by the presence of the ventral meningovertebral ligaments has been verified by the author by using the presently available methods of imaging of the spinal canal in vivo. The images obtained at levels L4-L5 and L5-S1 from nine patients showing this type of pathology and preoperatively assessed by transverse CT (eight patients) or MRI (one patient) seem to support the above assumption. These ligaments should not be confused with pathologic adhesions.


[Dissection of the sub-astragalar ligaments and magnetic resonance imaging]. The aim of this study is to find the different ligamentous structures in the subtalar region through dissection and to compare them with images obtained on MRI. MRI allows visualization of the different ligamentous structures with greater precision than with computerized tomography. This investigation should permit a more precise diagnosis of injuries often poorly understood in this region.


[Electronic podometry--2-year experience: preliminary report]. The authors relate their experience with the EMED system for the dynamic assessment of plantar pressure used in clinical practice for 2 years: how the measurement device was chosen; how the examination is performed; the usefulness of this type of examination in foot surgery. They discuss the specific problems related to the application of this new diagnostic tool in clinical practice.


Avascular necrosis of the humeral head after dislocation with fracture of the greater tuberosity. A case of posttraumatic avascular necrosis of the humeral head in a young patient was detected 3 years after an anterior dislocation with a nondisplaced greater tuberosity fracture. The evolution to degenerative joint disease is described.


[Progressive correction of an ulnar deviation of the hand following defective healing of the 2 forearm bones and probable sequellae of a Volkmann contracture]. The authors describe the progressive correction of a deformed forearm and an ulnar deviation of the hand as a result of a bullet wound. The injury comprised a fracture of the two bones of the forearm, with deformed callus and after effects of a probable Volkmann syndrome. The correction was obtained after 10 months. This report illustrates the interest and the difficulty presented by osteogenesis by distraction and osteotomy with a minimal cutaneous wound. This allows the reduction of risk to the cutaneum and vessels involved in extemporaneous corrections.


A phalangeal osteoid osteoma. Case report. We describe a typical case of a phalangeal osteoid osteoma in the hand. The clinical (night pain with complete relief with aspirin, tender local swelling) and radiographic features (a zone of bone sclerosis surrounding a small area of translucency) were obvious. We performed an "en bloc" excision with histological confirmation of the diagnosis and complete relief of symptoms.


The missed thorn.

The missed thorn. Following surgical exploration, a swelling on the back of a boy's hand was thought to be a tuberculous granuloma and was treated as such. Eleven months later, when the lump was re-explored, a plant thorn was retrieved from the middle of a foreign body granuloma. Even though a definite history of trauma is not given, an organic foreign body lesion should be considered in the differential diagnosis of a lytic lesion of bone.


Medial meniscal cyst as a cause of bone erosion. A case of a medial meniscal cyst which was so extensive that it caused erosion of the medial tibial condyle is described. Clinical data and roentgenographic features of this case are discussed.


Spontaneous ruptures of the flexor carpi radialis tendon secondary to STT osteoarthritis. Two cases of closed ruptures of the flexor carpi radialis which resulted from attrition of the tendon caused by bony spurs secondary to Scapho Trapezo Trapezoidal (STT) osteoarthritis are described. Treatment is conservative.


Season of birth of schizophrenics in Mississippi, USA. Prior reviews indicate that schizophrenics tend to be born in the winter, relative to non-psychiatric controls. This conclusion has been criticized, however, as the association between birth seasonality and schizophrenia may be the result of a statistical artifact, the age-incidence effect. To examine this possibility, we studied the birth seasonality of 2892 schizophrenics, controlling for the age-incidence effect. Both before and after instituting these controls, we found excesses for the months of December and March. We conclude that the age-incidence hypothesis does not provide any general explanation of the season-of-birth effect in schizophrenia.


Age at onset in a cohort of schizophrenics in Nigeria. Over a period of 3 years, 340 patients (199 men and 141 women) who met DSM-III-R criteria for schizophrenia and who knew their exact date of birth were interviewed to determine the age at onset of illness. The immediate family's first awareness of psychotic symptoms was used as the index of onset. Men had a significantly earlier mean age at onset (24 +/- 6) than the women (27 +/- 8). By the time they were 30 years of age, 83% of the men and 66% of the women had become ill. The findings are remarkably similar to those of an earlier report in the same cultural setting, and add to the evidence of sex differences in age at onset of schizophrenia.


Similarities in diagnostic comorbidity between suicide among young people in Sweden and the United States. A significant difference in the prevalence of personality disorders was reported between similar studies of suicide among young people (under age 30) performed in San Diego, California (10% of 133 cases), and Göteborg, Sweden (34% of 58 cases). The difference was due entirely to the absence of borderline personality disorder (BPD) reported in the San Diego sample. In this study, we used preselected variables to reassess the suicides from the San Diego study for criteria consistent with BPD. We found that 41% met the criteria, which was now not significantly different from the Göteborg sample. Comparisons among a number of other demographic, social, and diagnostic variables revealed many similarities in the two samples, particularly Axis I comorbidity with depression and/or substance abuse and Axis II comorbidity with antisocial personality disorder. We conclude that the characteristics associated with BPD identify similar young persons who committed suicide in Sweden and the United States. Questions remain as to whether or not Axis I and II disorders are independent in relation to suicide. The comorbidity pattern described here must be considered seriously in the clinical setting for its fatal implications.


Alzheimer's disease in adults with Down's syndrome: the relationship between regional cerebral blood flow equivalents and dementia. Twenty adult patients suffering from Down's syndrome (DS) were recruited from hospitals and the community, together with 14 age- and sex-matched controls of normal intelligence. Dementia was diagnosed in patients using a structured psychiatric and physical examination as well as a carer interview and case notes. All patients and controls were imaged using single photon emission computerized tomography with 99mTc-exametazime. Four patients were clinically demented and all of them showed regional cerebral blood flow (rCBF) changes commonly found in patients with Alzheimer's disease, namely bilateral temporo-parietal deficits. These changes were also observed in about half of the patients without clinical evidence of dementia, but in none of the healthy controls. Across the group of patients, temporo-parietal rCBF deficits were associated with evidence of deterioration, but not with advancing age.


Postimperative negative variation and skin conductance response in chronic DSM-III-R schizophrenia. The hypothesis was tested that there are relationships between schizophrenic negative or deficit symptoms, the skin conductance nonresponding and an elevated amplitude of the postimperative negative variation (PINV). These variables were recorded in 16 chronic schizophrenics and 10 healthy controls. Clinical symptoms were assessed by the Brief Psychiatric Rating Scale, Scale for the Assessment of Negative Symptoms, Frankfurt Complaint Questionnaire 3 and Chapman Questionnaire. In the patient group we found a significantly elevated PINV at Fz. Surprisingly, only one patient was a skin conductance nonresponder. PINV amplitude at Fz and the number of skin conductance responses to habituation were not correlated with negative or deficit symptoms inclding anhedonia. The hypothesis thus had to be rejected.


Reduced bone density and major hormones regulating calcium metabolism in anorexia nervosa. Bone density of lumbar vertebrae (L2 to L4) and the whole body in 29 patients with anorexia nervosa were measured by dual photon absorptiometry, and the results were compared with those of 10 age-matched normal controls. The patients had significantly lower bone mineral density (BMD) in L3 and L2-4 than controls. However, there was no difference in whole-body BMD. L3 and L2-4 BMD was positively correlated with body weight and was negatively correlated with duration of illness and amenorrhea. Patients who had been more active 6 months before the time of the study had significantly higher L3 BMD than the less active patients. Most patients had an abnormally low serum estrogen level, whereas the mean serum levels of thyroid hormone (T3, T4), cortisol, calcitonin, parathyroid hormone and vitamin D were within the normal range. No correlation was found between L3 or L2-4 BMD and the levels of these hormones. These results suggest that severe weight loss, low physical activity, longer duration of amenorrhea and deficiency of estrogen contribute to bone loss in patients with anorexia nervosa, whereas calcium-regulating hormones such as parathyroid hormone, calcitonin and vitamin D are unlikely to be a primary contributor to bone loss.


Debrisoquine oxidation phenotype and neuroleptic-induced dystonic reactions. To evaluate the role of defective drug oxidation as a predisposing factor for neuroleptic-induced dystonic reactions, 26 patients who developed the reaction and 53 with no history of dystonia were phenotyped by the debrisoquine hydroxylation test. The percentage of poor debrisoquine metabolizers was similar in patients with dystonic reactions (11.5%) and in the control group (9.4%). These results suggest that there is no association between the individual's drug oxidative status and the occurrence of neuroleptic-induced dystonia.


Familial influences on the clinical characteristics of major depression: a twin study. We sought in this study to clarify the role that familial factors play in influencing the clinical presentation of major depression (MD). We examined the similarity of the historical and symptomatic features of MD in 176 pairs of female-female monozygotic (MZ) and dizygotic (DZ) twins from a population-based registry, where both members reported a history of MD defined by DSM-III-R criteria. The age at onset and treatment-seeking were significantly correlated in all twin pairs and the correlation in concordant DZ pairs was actually somewhat higher than in concordant MZ twins. The degree of impairment was modestly correlated in all twin pairs with substantially higher correlations in MZ vs DZ twins. No twin resemblance was observed for number of episodes or longest duration of an episode. Twin resemblance for the clinical features of MD was modest, but so was their consistency for the same individual over successive 1-year periods. However, in 5 of the 6 neurovegetative symptoms involving changes in appetite, weight and sleep, MZ twins were significantly correlated and correlations were significantly greater in concordant MZ vs DZ twins. Although the familial factors that cause twin resemblance for the age at onset and treatment seeking appear to be largely environmental, twin resemblance for the degree of impairment and neurovegetative symptoms are probably due largely to genetic factors. Our results suggest that familial factors influence the predisposition to some clinical features of MD.


Multivariate modelling and the Defence Mechanism Test: a comparative study of defensive structures in borderline, other personality disorders and schizophrenic disorder. The study aims at discerning discriminating patterns in the perceptual responses according to the projective percept-genetic method Defence Mechanism Test (DMT) among 45 subjects with the diagnoses borderline personality disorder (BPD), other personality disorders (OPD), schizophrenic disorder (SD) and a non-patient group. The overall results show that, by means of partial least squares (PLS) discriminant analysis of 130 DMT variables, it is possible to separate these groups. Patients with a BPD or a SD diagnosis and the non-patient group are clearly separated, whereas the OPD group shows a less homogeneous pattern. The findings support both the validity of the DMT as a method to measure personality features and the psychodynamic validity of BPD. The most characteristic properties of the BPD group are responses of emotional expressions, especially introaggression and frequent distortions of the stimulus picture. Regarding the SD/OPD group, a pattern of high threshold values for perception emerges as a discriminating feature as well as different variants of introjection. The non-patients are characterized by very few DMT distortions and consequently show a good reality orientation. The conclusion is that the DMT and the PLS discriminant analysis are powerful methods in the assessment of personality pathology.


Plasma homocysteine in vascular disease and in nonvascular dementia of depressed elderly people. Depression among elderly people with reversible cognitive loss often manifests with concomitant vascular disease and can also precede the development of nonvascular degenerative dementia. Little is known about etiological factors for reversible or irreversible dementias in older depressed people. The amino acid homocysteine (HC), which is both a vascular disease risk factor and a precursor of the excitotoxic amino acids cysteine and homocysteic acid, could play a role in the pathophysiology of such individuals. Twenty-seven depressed elderly acute inpatients by DSM-III-R criteria had significantly higher plasma homocysteine levels and lower cognitive screening test scores than did 15 depressed young adult inpatients. HC was highest in the older patients who had concomitant vascular diseases (n = 14). HC was lowest in the older depressives who had neither vascular illnesses nor dementia (n = 8), comparable to the young adult depressives. Higher HC correlated significantly with poorer cognition only in the nonvascular geriatric patients (rs = -0.53). The findings extend earlier work showing higher HC in vascular patients from general medical populations, and also suggest a possible metabolic factor in certain dementias associated with late-life depression.


A double-blind comparison of raclopride and haloperidol in the acute phase of schizophrenia. The British Isles Raclopride Study Group. This is the first comparative double-blind study of raclopride. Ninety-one patients with acute schizophrenia received either raclopride 2-8 mg twice daily or haloperidol 5-20 mg twice daily for 4 weeks. Both neuroleptics produced clinical improvements. There were no significant between-drug differences in overall efficacy measurements as assessed by the schizophrenia change sub-scale of the Comprehensive Psychopathological Rating Scale and the Krawiecka (Manchester) Rating Scale. Assessment by the Clinical Global Impression scale found haloperidol to be more effective. There were significantly fewer extrapyramidal symptoms with raclopride and a significantly lower incidence of acute dystonia. The results suggest that raclopride has an antipsychotic effect with a low incidence of extrapyramidal side effects.


Associations between self-induced vomiting and personality disorder in patients with a history of anorexia nervosa. Fifty-five patients of an eating disorders service with a history of anorexia nervosa (AN), defined by a history of refusal to maintain body weight above a level of 15% below that expected, completed a modified version of the revised Personality Diagnostic Questionnaire (PDQ-R) based on DSM-III-R personality disorders (PD). The subjects were divided into 2 groups based on AN subtypes: vomiters, defined by a history of self-induced vomiting, and non-vomiters, who had maintained low weight mainly or only by diet +/- excessive exercise. Vomiters showed significantly higher scores on self-report measures of borderline and antisocial PD criteria. Discriminant analysis based on PD scores for all 13 DSM-III-R PD categories correctly predicted AN subtype membership based on vomiting history in 85.5% of patients. The implications of PD comorbidity for the development and management of eating disorders are discussed.


Are siblings of schizophrenic individuals psychologically disturbed? A perceptgenetic inquiry. Questions about psychopathology among siblings of schizophrenic individuals were addressed by means of a projective test, the Perceptgenetic Object-Relation Test (PORT), which uses tachistoscopic presentations of 3 object-relation themes: attachment, separation and oedipal. Twenty-two siblings of schizophrenic individuals--10 siblings of patients with recent onset, and 12 siblings of chronic patients--were compared with normal controls and with siblings of mentally handicapped people. Earlier observations of unstable defensive organizations among the siblings of chronic schizophrenic patients were corroborated, particularly in response to the attachment theme. The schizophrenia siblings fell within the narcissistic-borderline spectrum of PORT. The 50% drop-out rate was discussed as reflecting anxiety and evasiveness, and the results were seen as substantiating that siblings of schizophrenic people are structurally if not clinically affected by their sibship.


Sulfur amino acid levels and related enzyme activities in various brain regions (and other tissues) in normal mice and rolling mice Nagoya. The contents of the sulfur amino acids, and the activities of cystathionine beta-synthase and cystathionine gamma-lyase were measured in various regions of the brain and several other tissues in both normal mice and rolling mice Nagoya. The cystathionine content and cystathionine beta-synthase activity were found to be unevenly distributed in various regions of the brain in both normal mice and rolling mice Nagoya, being highest in the cerebellum. Except for the mesencephalon and thalamus plus hypothalamus, the cystathionine content and cystathionine beta-synthase activity in the brain regions of rolling mice Nagoya were much higher than those of the normal mice. The cystathionine content after D,L-propargylglycine treatment was also found to be unevenly distributed in various brain regions in both normal mice and rolling mice Nagoya. The concentrations of cystine and methionine were also higher in all regions of the brain of rolling mice Nagoya than those of normal mice, while the concentration of taurine in the various regions of the brain was almost the same in normal mice and rolling mice Nagoya. Cystathionine beta-synthase and cystathionine gamma-lyase activities in the liver, kidney, and pancreas were almost the same in both the normal mice and rolling mice Nagoya.


Detection of oncogene rearrangements in human non-Hodgkin's lymphomas. Southern blot hybridization was used to detect the rearrangement and amplification of five proto-oncogenes (bcl-2, bcl-1, c-myc, c-myb and c-Ha-ras) and one tumor suppressor gene (RB-1) in 55 Japanese patients with non-Hodgkin's lymphoma; 16 with T-cell lymphomas and 39 with B-cell lymphomas (7 follicular and 32 diffuse lymphomas). Genetic abnormalities of the proto-oncogenes were detected in 7 of the 55 (13%). Genetic abnormalities of bcl-2 plus other genes were detected in 5 of 7 cases of follicular lymphoma (71%), rearrangements of bcl-2 and c-myc, rearrangement of bcl-2 and amplification of c-myb. Genetic abnormalities were observed in only three cases of diffuse lymphoma. In each of 3 cases of B-cell lymphoma, one of the genes, blc-2 mbr, bcl-2 mcr and c-myc, was rearranged respectively. The incidence of genetic abnormalities in diffuse lymphomas (6.3%) was lower than that in follicular lymphomas. None of diffuse lymphomas had double oncogene abnormality. No abnormalities were found in RB-1, bcl-1, and Ha-ras. These findings suggest that follicular lymphomas are associated with some abnormalities of oncogenes not restricted to bcl-2 that facilitate growth which may be associated with their clinical features.


Report of a study using phantom materials, and clinical experience with simultaneous radio-hyperthermotherapy. Simultaneous radiohyperthermotherapy (SRH) is a combined hyperthermia-radiation therapy in which irradiation is given during heating. Mutual interference between the high energy radiotherapy system (Toshiba LMR-15A) and the 13.56 MHz capacitive heating system (Omron HEH-500C) was tested with phantom materials prior to a clinical trial with SRH. The energy and flatness of irradiation were not affected by the heating system within the range of clinical use. The high energy radiotherapy system did not affect the increase or distribution of temperature during simultaneous treatment. The results of this phantom study indicated that these apparatuses would not produce clinically significant mutual interference during SRH. A clinical trial was performed on a 57-year-old woman with postoperative recurrence of rectal cancer. This is the first reported clinical case treated with true SRH in which external irradiation was administered during mid capacitive heating. Twelve SRH treatments were performed on the recurrent lesion at a frequency of twice a week for six weeks using the apparatuses described above. There was a significant reduction in pain after treatment. The tumor marker carcinoembryonic antigen (CEA) level decreased after treatment. On CT images taken after treatment, the tumor site became a low density area which indicated necrosis. There were no side effects. These results suggest that further clinical study of SRH should be performed to clarify its advantages.


Sensitive detection of ganglioside GD3 on the cell surface using liposome immune lysis assay. We developed a sensitive method for detection of glycosphingolipid (GSL) antigen(s) on the cell surface. As a model of GSL antigen, ganglioside GD3 was used. An IgM monoclonal antibody (DSG-1) specific for ganglioside GD3 was preincubated with standard inhibitor liposomes containing ganglioside GD3. Then carboxyfluorescein-entrapped indicator liposomes containing ganglioside GD3 and complement were added. Release of the marker from the indicator liposomes was specifically inhibited by inhibitor liposomes. The assay system was simple, sensitive, reproducible, and semiquantitative. Pg to ng of ganglioside GD3 could be detected. Furthermore, ganglioside GD3 on the cells was investigated with SK-MEL-28 human melanoma cell line and human red blood cells (HRBC). When SK-MEL-28 melanoma with ganglioside GD3 was used as an inhibitor, specific inhibition was observed. However, HRBC without ganglioside GD3 showed no significant inhibition. The marker release was 50% inhibited by 1.4 x 10(6)SK-MEL-28 melanoma cells/ml. The amount of ganglioside GD3/melanoma cell was estimated to be at least 1.1 x 10(-14) g from the standard curve made with the liposomes containing 10% epitope density of ganglioside GD3. This assay system may be useful for detection of GSL antigen on the cell.


Fetal and neonatal excretion of free and conjugated ritodrine. The ability of the human fetus and neonate to conjugate and excrete ritodrine, a beta 2-sympathomimetic drug, was investigated. Free and conjugated ritodrine concentrations in the plasma, amniotic fluid and urine were measured in 11 mother-infant pairs, to whom intravenous ritodrine had been administered before elective cesarean section at term. Ritodrine was determined by HPLC with electrochemical detection. At delivery, conjugated ritodrine values were significantly higher than those for the free form in maternal and fetal plasma. There were significant positive correlations between the concentrations in the maternal and umbilical vein plasma for both free and conjugated ritodrine. In the amniotic fluid, the total ritodrine concentrations were much higher than those in the fetal plasma, the conjugated form accounting for 90.2% of the total. Furthermore, the percentages of conjugated ritodrine in the amniotic fluid and neonatal urine were significantly higher than the percentage in the maternal urine on the day of birth. In the neonatal urine, the concentrations of free and conjugated ritodrine decreased rapidly after birth as did those in the maternal urine, on day 3 postpartum being less than 2% of the values on the day of parturition. These results indicate that the fetus at term is capable of forming conjugated metabolites of ritodrine and of excreting free and conjugated ritodrine in its urine.


Kimura's disease: clinical, histological and immunohistochemical studies. In the present study, 14 cases of Kimura's disease were clinicopathologically studied. The disease occurred at ages ranging from 5 to 75 years. The average age was 37.8 years. Sexes were about equally affected. The most common sites were the subcutis of head and neck, and parotid gland. Simultaneous involvement of lymph nodes occurred in 5 cases. Laboratory findings revealed eosinophilia in almost all the patients, but serum IgE levels were not elevated in 2 patients. Lesions were surgically removed and the clinical course thereafter was favorable for all but one case. Histologically, lesions were characterized by lymphoid follicles, granulation tissue with infiltration by many eosinophils, lymphocytes, plasma cells, mast cells and histiocytes, proliferation of blood vessels and fibrosis. Immunohistochemically, IgE reacted strongly in germinal centers, showing a reticular pattern. IgG-, IgA- and lysozyme-positive cells were scattered mainly in interfollicular granulomatous areas. Pathogenesis of this disease is briefly discussed.


Antiproliferative effects of suramin on human cancer cells in vitro and in vivo. The present experiment was undertaken to study what types of human cancers are responsive to the antiproliferative effects of suramin. The human malignant cells used were as follows: cervical cancer (HeLa), mammary cancer (MCF-7), bladder cancer (EJ), hepatoma (HuH-7, PLC/PRF/5), embryonal carcinoma (PA-1), in vitro transformed fibroblasts (KMST-6, SUSM-1, VA-13), five myeloma cell lines (KMM-1, KMS-5, KMS-11, KMS-12, RPMI 8226), Burkitt's lymphoma (Raji), acute promyelocytic leukemia (HL-60), chronic myelocytic leukemia (K562), Epstein-Barr virus nuclear antigen positive lymphoblastoid cells (KMS-9). The cells were treated with 25 to 100 micrograms/ml suramin for 72h. Proliferation of HuH-7 and two human myeloma cells (KMS-11 and KMS-12) was remarkably inhibited, and that of PA-1, PLC/PRF/5, KMST-6, two other myeloma cell lines (KMM-1 and KMS-5), Raji and HL-60, was moderately inhibited. In order to confirm part of the results obtained from in vitro experiments, in vivo experiments were also undertaken. The growth of HuH-7 cells transplanted subcutaneously into nude mice was significantly suppressed by intravenous injection of suramin. We discussed the possibility that certain types of human cancers, the growth of which seemed to be more or less dependent on polypeptide growth factors, might be sensitive to the antiproliferative effects of suramin.


Long-term results of surgery for mitral regurgitation due to mitral valve prolapse: a comparison of valve replacement and annuloplasty. Patients with mitral regurgitation (MR) due to mitral valve prolapse operated at the Second Department of Surgery, Okayama University Medical School, between 1976 and 1986 were divided into two groups. The first consisted of 20 patients who had mitral valve replacement (MVR) and the second 15 patients who had mitral annuloplasty (MAP). Long-term results of surgery, cardiac function, hemodynamic status, and surgical findings were compared between the two groups. Before surgery, there were no significant differences in patient's clinical status and cardiac function between the two groups. However, after surgery statistically significant differences emerged between the two groups in ejection fraction (EF), cardiac index (CI) and mean circumferential fiber shortening velocity (mVcf). Left ventricular pumping function and myocardial contractile force tended to decrease after surgery in the MVR group and to remain unchanged or even increase in the MAP group indicating that valve preservation procedures should be selected as often as possible for the patients involved in mitral valve prolapse.


Gadolinium-DTPA enhanced magnetic resonance imaging of bone and soft tissue sarcomas in comparison with pathological findings. We compared gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) enhanced T1-weighted images (T1-Gd) with the histopathological findings in 13 patients with bone or soft tissue sarcomas. Signal intensity of the viable tumor tissue was increased in T1-Gd in 92% of the patients. The necrotic or cystic areas in the tumor were not enhanced, rendering them distinctly. The degree of enhancement of the edematous area around the tumor was similar to or more marked than that of the tumor in 54% of the patients. Area showing inflammatory cells infiltration and edematous areas in the tumor tissue were also enhanced. Thus, the effect of preoperative chemotherapy in tumor tissues other than necrotic and cystic areas tended to be underestimated in T1-Gd. Its effect should be comprehensively evaluated based on not only T1-Gd but also T2-weighted images and findings of other imaging techniques.