Psychiatric patients' perceptions of their milieu therapy program. This study was designed to provide information concerning psychiatric patients' perceptions of their individual treatment program in an inpatient treatment facility with an established therapeutic milieu. The responses of 24 patients aged 16 to 69 years to an 8-item questionnaire, developed and administered by the investigator, constituted the data collected. The 24 patients identified 57 components as part of their treatment programs. Patients with more education mentioned more treatment components than those with less education. Talking with staff members was considered the most helpful treatment component by the most patients, and medication was the most frequently mentioned least helpful treatment component. Six categories were used to organize the data: recreation-physical, recreation-mental, verbal interaction, creature comforts, staff supervision, and diagnostic and medical services. More of the identified treatment components were categorized under verbal interaction than any other category. The second most mentioned category was recreation-physical. As patients listed the most helpful persons during their hospitalization, 36 students and staff members and four other patients were identified. Two psychiatric technicians, a registered nurse, and an occupational therapist were mentioned most often. Patients tended to see persons of their same sex and close to their age as particularly helpful.


An ecological framework for crisis intervention. In summary, the experience of working with children in an institutional setting lends itself to meeting specific learning objectives for the baccalaureate nursing student as well as providing assistance to a child in dealing with a crisis. Utilization of the human ecological approach allows the student to assist the child in a more meaningful way by examining the environmental context (both internal and external) in which his psychic pain is occurring.


Three assessment tools for family therapy. In this paper the authors attempt to utilize existing knowledge of the family and family therapy in order to develop a universal tool for family analysis. The assessment tools represent a conceptualization of the three phases of family analysis. Using a simplistic guide, such as these assessment tools, should aid the therapist in organizing the overwhelming volume of information that is obtained in a short amount of interviewing time. Again the assessment tools are only as applicable as the family therapist is imaginative and creative.


Clinical judgment: an ethical issue.

Clinical judgment: an ethical issue. In conclusion, the position of this paper maintains that clinical judgment is a viable, ethical issue of the highest order. Clinical judgment involves the personal orientation, the ethical framework of the one making the decision. Whatever judgment is ultimately made carries with it the burden of the maker's personal ethical approach to life, to the nature of man and finally his approach to the world at large. Clinical judgment is inseparable from ethics. It is further maintained that there must be more research into the areas of clinical judgment in relation to psychiatric nursing research. Clinical specialists, in particular, will be called on to make increasingly complex judgments. They must have a valid method to assist in the formulation, testing and analysis of their decisions. A model must be developed that assists the decision maker in: 1. Objectively identifying and specifying stimul; 2. Controlling and regulating the conditions of the judgment-making-process, intrinsic as well as extrinsic; and 3. Defining and standardizing the conditions of reporting.


Liaison nursing.

Liaison nursing. In reviewing my efforts to clarify the role of the nurse clinician as a psychiatric consultant in a hospital setting, I came away with many impressions. Inherent in my search was a desire to experiment with various means of providing nursing service and much of my time was spent examining the collaborative aspects of the nursing role that would add greater depth to patient care. This involved role experimentation and allowed me the opportunity to develop my role within the context of the guidelines of community organization and consultation in a hospital setting. Although much of the time I found that the liaison role has been aimed at the supportive level, I have also discovered that as I developed security in the role wherein I could function in new and more independent ways--the parameters of the role expanded. Whereas initially I envisioned working only with nursing staff, I have found myself collaborating with many disciplines and many levels of care givers and I have also been able to function collaboratively with other psychiatric liaison team members. Thus, at this time I see the liaison nurse functioning basically as a coordinator, who, at any time, may assume one or more of the following roles: 1) Integrator; 2) Provider of direct services; 3) Educator and consultant; 4) Change agent.


Partners in therapy: using the co-therapists' relationship in a group. While this article has been necessarily narrow in scope in order to develop the theme of gives some direction toward other related aspects: the process of relationship development was alluded to but not presented; the transference phenomenon has been the subject of numerous psychiatric articles and could be further explored in the co-therapy situation; and the value of preservation of group interactions on recording tape or videotape for analysis by co-therapists could be researched. The final implication that should be left with the reader concerns the broader application of the co-therapy relationship: in what other psychotherapeutic areas, such as individual therapy or therapy with disturbed children, could the conjointly-developed relationship between two or more interdisciplinary therapists utilized expediently and efficaciously? While we are not suggesting that co-therapy is a panacea, we do hope that more thought will be given to the application of interdisciplinary co-therapy in various psychiatric settings and situations.


Applying Yalom's principles to crisis work...some intriguing results. In this paper, the writer has shared some of the results of an innovative eight- to sixteen-week, open-ended crisis group developed at the Community Mental Health Center at Strong Memorial Hospital. The group has been running for over a year and a half. Some of the significant findings were that process interventions can be creatively used in a modified manner to enhance the group interaction, while maintaining the crisis-oriented focus. There were two dimensions of process commentary described, the sense data material of an individual, interpersonal nature, and the mass group interventions with a broader, group development focus. In addition, the secondary function of the group, which was to serve as an assessment tool for an individual's capabilities in long-term group work, proved to be reliable for eighteen out of the twenty members, eventually referred to other groups. A theoretical framework, based on Yalom's work, as well as the writer's synthesis of previous crisis group theory, was outlined. Two clinical illustrations were described, using the paradigm. In closing, the writer wishes to validate the impression that crisis group work is indeed an exciting, clinical adventure. Each week the gestalt of the group varies, so that the crisis therapist must remain a versatile strategist and sensitive role model of communication theory. The interweaving of process issues with more concrete, content-focused group work provides the members with an in-depth, sharply practical interpersonal arena for growth.


Mental health consultation in a home care agency. A mental health nurse, educationally and clinically prepared as a specialist, can be effectively utilized as a consultant to aid nurse generalists in assessment and intervention of patients in a home health care agency. An individual staff nurse consulting with the specialist or a group of nurses provides the setting for consultant led case discussions. Consultation is a highly efficient use of specialist's knowledge and skills in health care delivery, and also provides learning opportunities for staff.


The role of operations research and systems analysis in holding down the costs of hospitals and clinics. In the past, medical care facilities have concentrated primarily on professional clinical evaluation. With the cost of treatment rising rapidly, it is becoming increasingly important to critically review and analyze our delivery systems so that scarce resources can be used optimally. In this paper the applications of operations research (O.R.) and systems analysis techniques that have been employed successfully in private industry are explored to find ways to improve clinical operations and hold costs down.


Studies on the susceptibility of the mouse preimplantation embryo to infection with cytomegalovirus. Intact and zona-free mouse preimplantation embryos were exposed to murine cytomegalovirus in vitro at various stages of development. The embryos developed normally to the blastocyst stage, and there was no evidence of embryonic infection. Intraperitoneal inoculation of female mice with this virus produced an acute generalized infection, and embryonic development was retarded in vivo. The embryos themselves were not productively infected, and they developed into apparently normal fetuses when transferred to uninfected mice.


Luteal function in sows after unilateral infusion of PGF-2alpha into the anterior uterine vein on different days of the oestrous cycle. Prostaglandin F-2alpha (1.5 mg over 10 h) was infused into the anterior uterine vein of pigs on Days 6, 8, 10, 12, 14 and 15 of the oestrous cycle. At each stage of the cycle PGF-2alpha suppressed luteal function although the fall in progesterone secretion was much greater and statistically significant when the infusion was performed on Days 12, 14 and 15 of the cycle than on Days 6, 8 and 10. The concentrations of cAMP was depressed on Days 15 and 17 and fatty degeneration of luteal cells on Days 6--8 or 14 was more pronounced in the ovary ipsilateral to the PGF-2alpha infusion than in the contralateral ovary. The results are compatible with the local perfusion of PGF-2alpha from the anterior uterine vein to the ipsilateral ovary, but a systemic effect was also apparent.


Coxsackievirus in an infant chimpanzee.

Coxsackievirus in an infant chimpanzee. Coxsackie B viruses may cause a severe, often fatal, illness in newborn and infant human subjects. As recorded in this case, infant chimpanzees respond similarly to Coxsackie B-5 virus.


Slow and rapid responses to CW and pulsed microwave radiation by individual Aplysia pacemakers. Specific absorption rates (SARs) of microwave energy that altered firing rates were determined for individual pacemaker neurons in the abdominal ganglion of Aplysia californica. A stripline apparatus provided both for artifact-free recording of transmembrane potentials and for precise determination of the rate of absorption of microwave energy. Exposure for two to three minutes at an SAR of only a few mW/g was capable of changing the firing rate of some pacemakers. Two types of responses were observed. The response that was seen in all neurons developed slowly, reaching a steady state in one to three minutes. The other response was seen in a few neurons and occurred within five seconds from the onset of irradiation. Similar responses were obtained for two microwave frequencies, 1.5 and 2.45 GHz. Pulsed radiation induced rapid changes of firing rate more readily than did CW radiation at the same SAR. A convective heating scheme was used to study the effects of temperature changes on the pacemakers' firing rates. Since all of the responses are not readily explained by general heating of the preparation, alternate mechanisms are suggested for the observed effects.


Analysis of the effects of microwave energy on enzymatic activity of lactate dehydrogenase (LDH). Interactions between microwave energy (3 GHz) and the enzyme Lactate Dehydrogenase (LDH) have been analyzed by monitoring the enzymatic activity during irradiation in steady-state or dynamic conditions, by irradiating the sample with variable power levels (up to 6 W into the sample) and, finally, by knowing accurately the true specific absorption rate. No permanent or temporary changes can be induced when the energy absorption does not cause a temperature variation. For higher energy values, effects are purely thermal in nature. Furthermore the thermal activation of the reaction velocity, caused by microwave irradiation, is in itself sufficient to give a good fit with the experimental time evolution of the enzymatic reaction.


Development of cell-mediated immunity to Marek's disease tumor cells in chickens inoculated with Marek's disease vaccines. Chickens inoculated with herpesvirus of turkeys or with apathogenic or attenuated vaccine strains of Marek's disease virus (MDV) developed a T-cell-mediated immune response to Marek's disease (MD) tumor cells. This immune response was detected in a 4-hour 51Cr-release assay in which effector cells obtained from spleens of vaccinated chickens were reacted with 51Cr-labeled target cells of an MD lymphoblastoid cell line (MSB-1). The cytotoxic effector cells generated by the vaccine viruses had characteristics similar to those noted previously for anti-MSB-1 effector cells generated by MDV. The immune response was specific to MSB-1 cells, because another target cell line (TLT) antigenically unrelated to MSB-1 cells was not lysed by the effector cells nor did the unrelated target cells inhibit the cytotoxicity of effector cells against MSB-1 target in a cold-target inhibition assay. Because MSB-1 cells contain MD tumor-associated surface antigen, we postulated that the immune response detected in the vaccinated chickens may be directed against this antigen and that the antitumor antigen immunity may play a role in the mechanism of vaccine protection against lymphoma development by pathogenic MDV.


Cyclic nucleotide concentrations in 7.12-dimethylbenz[a]anthracene-induced pancreatic cancer in rats. Pancreas cancer was induced in noninbred male Holtzman rats by the implantation of beeswax containing 7.12-dimethylbenz[a]anthracene (DMBA) into the "head" of the pancreas. The tumors that developed 4--6 months later were examined for their cyclic AMP and cyclic GMP levels. The lesions could be considered in one of two categories according to their cyclic nucleotide contents: lesions with significantly smaller amounts and those with greater amounts, compared with levels measured in the pancreas tissues of the control rats. The existence of two biochemically distinct groups may indicate different growth patterns of the DMBA-induced pancreatic neoplasia.


Stimulatory effect of immunization on tumor induction by Moloney murine sarcoma virus. Adult mice were immunized with varying doses of inactivated Moloney murine leukemia virus (M-MuLV). Eight weeks after immunization, mice were challenged with a dose of Moloney murine sarcoma virus (M-MuSV) that could induce tumors in approximately 50% of normal animals. Mice immunized with high doses of M-MuLV (10(10) particles) had significantly decreased tumor incidences, whereas mice immunized with low doses of M-MuLV (10(2) particles) had significnatly increased tumor incidences compared to those in nonimmunized controls. The stimulatory effect could be abrogated by the irradiation of mice with 450 rads 24 hours prior to M-MuSV challenge, whereas the inhibitory effect was resistant to this irradiation procedure. The results suggested that immunization with virus can either stimulate or inhibit virus-induced tumorigenesis, depending on the dose of virus used for immunization.


Expression of RNA of an endogenous replication-defective retrovirus in rat mammary adenocarcinomas induced by 7,12-dimethylbenz[a]anthracene. An investigation into the possible relationship between chemical carcinogen induction of rat mammary tumors and the expression of an endogenous retroviral genome was initiated. Mammary tumors were induced in female SD rats with 7,12-dimethylbenz[a]anthracene (DMBA). Tumors, identified histologically as mammary adenocarcinomas, were analyzed for RNA of a replication-defective endogenous retrovirus or RNA of a helper-independent endogenous type C virus. Expression of RNA of the replication-defective virus was detected in mammary tumors weighing 0.2--2.0 g. Larger tumors, for which histologic examination revealed proportionally more fibroblastic tissue than epithelial cells, did not contain comparable concentrations of this viral RNA. RNA homologous to a helper-independent rat type C retrovirus was not detected in tumors of any size. A cell line was established from a primary DMBA-induced mammary adenocarcinoma and appeared similar to the small mammary tumors with respect to endogenous type C viral RNA expression. We discuss possible implications of the expression of endogenous replication-defective viruses for use as markers for the effects of chemical carcinogens.


Bilateral Wilms tumors.

Bilateral Wilms tumors. The current management of bilateral Wilms tumor is reviewed and the high incidence of concurrent anomalies with bilateral Wilms tumor is demonstrated in 4 of 5 children. Standardization of management has not been established. Of the 5 patients 3 survived 30 months to 11 years without recurrent tumor. Two had unilateral nephrectomy and partial nephrectomy, while 1 had bilateral nephrectomy and allotransplant. All survivors have had adjunctive chemotherapy and radiotherapy.


Primary cytomegalovirus and opportunistic infections. Incidence in renal transplant recipients. Thirty-five renal allograft recipients were studied concerning the relationship between cytomegalovirus (CMV), herpes simplex virus (HSV), and opportunistic bacterial and fungal infections. The incidence of opportunistic infections was determined for patients whose tests prior to transplantation were seronegative in complement fixation and indirect hemagglutination assays of CMV antibody and for those patients whose tests were seropositive. Among the six seronegative patients with seronegative tests, four (66%) experienced active CMV infection within two months, and four died of Candida or Aspergillus infection within six months after transplantation. Among the 22 patients with seropositive tests, only one (4%) had a fungal infection and it was nonfatal (P less than .05). The increased morbidity and mortality due to fungal and bacterial infections in transplant recipients with seronegative CMV tests appears, therefore, to be related to primary CMV infection rather than to generalized immunodeficiency.


Bone marrow sarcoidosis.

Bone marrow sarcoidosis. Five patients' bone marrow was involved with sarcoidosis, but their chest roentgenograms were normal. The diagnosis was substantiated by typical histological appearance of noncaseating granulomas in bone marrow, careful exclusion of infectious disease, and follow-up study for three to six years. Angiotensin-converting enzyme levels were elevated in all patients at the time of diagnosis.


Serum high density lipoprotein in hemodialysis patients. Uremic patients on prolonged maintenance hemodialysis (hemodialysis patients) are at high risk for atherosclerotic cardiovascular complications. To investigate the serum lipoprotein (Lp) abnormalities in hemodialysis patients, high density Lp (HDL) concentration was determined using ultracentrifugal analysis and quantitative immunoelectrophoresis in 23 hemodialysis patients, 8 non-uremic hyperlipidemic subjects, and 12 normal subjects. Immunoreactive HDL as well as HDL-cholesterol (HDL-Ch) in hemodialysis patients was lower significantly than the level in patients with non-uremic hyperlipidemia or normolipidemic healthy  persons. Taking the results of previous reports into counts, decrease in HDL and HDL-Ch seems to contribute to the development of dyslipoproteinemia (broad-midband lipoproteinemia; an accumulation of the intermediate Lp or the remnant Lps) in hemodialysis patients. The results of the present study suggest that protective function proposed by the previous workers of HDL against atherosclerosis may be operated by facilitating the elimination of the accumulated midband Lps.


Screening of anti-B cell antibodies in the sera of renal transplant recipients by using Daudi cell line. In order to examine the presence of antibodies against B cells, 83 sera obtained from 55 renal transplant recipients were screened by microcytotoxicity test using Daudi cell line. Out of 83 samples, 12 were pretransplant sera, 62 were post-transplant sera and 9 were from the patients whose grafts has been removed due to rejection. For the purpose of improving the reliability of the tests, 5 different rabbit complements were selected and cytotoxicity tests with them were carried out simultaneously. Pretransplant sera without blood transfusion did not show any cytotoxicity against Daudi cells. Although 42% of post-transplant sera showed cytotoxicity against Daudi cells, cytotoxic activity of the sera showed no relation with the occurrence of rejection episodes. Three serum samples out of 5 patients whose grafts had been removed due to rejection showed strong cytotoxicity against Daudi cells and the sera of 2 other patients did not. There was no relation between the cytotoxicity against Daudi cells and antibodies against Epstein-Barr virus capsid antigen in the post-transplant sera.


Epidemiological studies on Japanese encephalitis in Kyoto City area, Japan. IV. Natural infection in sentinel pigs. Natural infection with Japanese encephalitis virus in three sentinel pigs held in separate experimental huts was examined daily by virus recovery from blood samples of the pigs and from mosquitoes after incubation for about 7 days from their blood feeding and by HI antibody titration of the blood samples. After a period of low infection rates, below 6%, for about two weeks in engorged Culex tritaeniorhynchus summorosus, high mosquito infections of over 30% from each viremic pig occurred for two to three days. The pigs may be probably have been bitten by many infected but not infective mosquitoes in a period of about 10 days before infection.


[Mechanism of action and clinical effectiveness of the new Soviet-made drug parmidin in the treatment of arteriosclerosis and ischemic heart disease]. The pharmacodynamics and efficacy of the new Soviet drug parmidin depending on the state of the coronary reserve are discussed on the basis of the results of observation over 176 patients suffering from chronic ischemic heart disease with affection of the peripheral arteries of the lower extremities. The activity of the drug in patients with atherosclerotic and diabetic affection of the arterial vessels is shown. The pharmacokinetics of parmidin in patients after the administration of a single 1.0 g dose was studied by determining its content in blood and urine 1, 2, 4, 8, 12, and 24 hours later. The effect of parmidin on the blood kinin system in patients with chronic ischemic heart disease was studied.


[Vaccine-related paralytic poliomyelitis with severe pareses. Report of one case (author's transl)]. In 11-year-old girl paralytic poliomyelitis developed 18 days after administration of trivalent oral poliomyelitis virus-vaccine. In spite of isolation and identification of vaccine-poliomyelitis-virus type III, there was only a slight raise of antibodies in the neutralisation-tests. The possibilities of lacking titer-raising is discussed, especially concerning the question of the claim to maintenance.


[A method for the evaluation of nitroblue tetrazolium reduction in human platelets (author's transl)]. A long term incubation in NBT-solution leads not only to NBT-reduction by polymorphnuclear leukocytes and monocytes, but also in washed human platelets. The reaction is enhanced by ADP and to a smaller and very variable extent also by Thrombin and Ristocetin. It is inhibited by incubation in plasma environment as well by DBcAMP and PGE1. After a detailed demonstration of the applied method, some possible biochemical mechanisms of the NBT-reduction in human platelets are discussed.


Activation of adipose tissue lipoprotein lipase by lipoprotein fractions from normals and patients with type v hyperlipoproteinemia. The effects of the main lipoprotein density classes on the human adipose tissue lipoprotein lipase activity were studied. A dose-dependent stimulation of lipoprotein lipase activity was obtained for HDL and, to a lesser extent, for VLDL on a constant weight basis. LDL exerted virtually no effect. At higher concentrations, HDL as well as VLDL inhibited the stimulated lipolytic activity. In type V hyperlipoproteinemia, the stimulating effect of VLDL and of HDL was significantly lower, whereas the inhibiting action of HDL was markedly increased.


Alcian blue staining intestinal goblet cell antigen (GOA): a marker for gastric signet ring cell and colonic colloidal carcinoma. An Alcian blue staining, perchloric acid-soluble, antigenic acidic mucosubstance (GOA) was purified from human gastric signet ring cell carcinoma with DEAE-cellulose chromatography, Seqhadex G-200 and preparative polycrylamide gel electrophoresis. Specific antisera were raised which reacted in indirect immunoenzyme histology with normal goblet cells of the small and large intestine and with goblet cells of intestinalized gastric mucosa. In surgical resection specimens of the stomach (n = 100) and of the colon (n = 19) 3 gastric signet ring cell carcinomas and 3 colonic colloidal adenocarcinomas stained for GOA, demonstrating an immunochemical relationship with normal intestinal goblet cells.


The effects of Clostridium perfringens enterotoxin on rat and rabbit ileum: an electron microscopic study. Intestinal epithelial damage caused by Clostridium perfringens enterotoxin in rats and rabbits was identified by light microscopy and compared at the surface (scanning electron microscopy), and the ultrastructural (transmission electron microscopy) levels. Under the light microscope damage to the epithelial layer of villus tips was clearly evident in cross-sections. Whole tissue viewed under the scanning electron microscope showed comparable tip localization of morpholigic damage in the form of collapsed tips and a dense covering of rounded blebs on the tips. Ulstructuctural observations included partial and sometimes complete disappearance of microvilli structures, budding of the terminal web region into the lumen, and even complete destruction of epithelial cells. These data suggest that C. perfringens enterotoxin attacks the epithelial cells with a preference for cells at the villus tips and causes damage at least in part by altering the cells' apical membranes. This then leads to cellular sloughing, death, and lysing.


Subpopulations of breast carcinoma defined by S-phase fraction, morphology, and estrogen receptor content. The S-phase fraction (SPF), defined as the number of cells per hundred that showed evidence of nuclear DNA synthesis detectable by autoradiography after in vitro incubation with tritiated thymidine, was measured in 170 primary, invasive carcinomas of the breast. Assay for estrogen receptor was performed on tissue from 129 carcinomas, and 34 were also assayed for progesterone receptor. The concentration of estradiol-17 beta was measured in the serum of 69 patients. All carcinomas were analyzed for a variety of histologic features and were classified into morphologic types. SPF were lognormally distributed and were negatively correlated with the patient's age and presence of estrogen receptor, but not with presence of progesterone receptor, size of the carcinoma, number of axillary nodal metastases, or concentration of estradiol-17 beta in serum. The SPFs of lobular, mucinous, and tubular carcinomas were consistently low (geometric mean 1.2, range 0.05 to 3.55), and the SPFs of medullary and atypical medullary carcinomas were consistently high (geometric mean 14.0, range 7.77 to 20.2), whereas carcinomas of other types (not otherwise specified) had an intermediate geometric mean (4.7) and a broad range (0.09 to 25.4). The carcinomas that were not otherwise specified could be divided into three groups with different geometric mean SPFs by nuclear morphologic criteria (1.2 for minimal atypicality, 3.5 for moderate, and 7.9 for severe). Therefore it is possible to sort breast carcinomas histologically  into groups with low, intermediate, and high SPF. Correlations between SPF, estrogen receptor content, and microscopic morphology indicate the existence of distinctive subpopulations of breast carcinoma that may have epidemiologic and therapeutic importance.


Local regulation of lipolysis in adipose tissue by fatty acids, prostaglandins and adenosine. From this review of the literature the following tentative conclusions may be drawn: 1) The relationship between cyclic AMP and lipolysis is not linear. In particular, only very small elevations of cyclic AMP appear to be necessary for essentially maximal lipolysis. One consequence of this is that some of the studies concerning feed-back regulation of cyclic AMP may not be relevant to our understanding of the regulation of lipolysis. 2) The only substances for which a firm role as feed-back regulators has been documented are free fatty acids. Their importance under in vivo conditions are, however, not settled. 3) The bulk of the present evidence fails to suggest a role for endogenous prostaglandins (and related compounds) as feed-back regulators of lipolysis. 4) There is considerable evidence that endogenous adenosine modulates lipolysis in vivo and in vitro. Adenosine does not appear to act as a feed-back regulator in the strict sense but the formation of adenosine may be enhanced under conditions of lipolysis because of simultaneously occurring breakdown of ATP.


Angiography in the diagnosis and management of extracranial vascular lesions of the head and neck. The angiographic features of various lesions of the head and neck are presented. Angiographically, cavernous hemangiomas display large venous lakes with calcified phleboliths. Arteriovenous malformations reveal massive tumor stain with well delineated feeding vessels from multiple systems. Chemodectomas and juvenile nasopharyngeal angiofibromas are clearly vascular with homogenous tumor staining in the capillary phase. Angiography of cavernous hemangioma, AVM, chemodectoma, and angiofibroma is diagnostic and may preclude the need for tissue biopsy. Angiographically neurilemmomas are less vascular with non-homogenous tumor stain. Carcinomas are typically avascular. The use and benefits of arterial embolization in the management of these lesions is presented.


Cell-mediated immunity to mouse adenovirus infection. Macrophage migration inhibition test. Cell-mediated immunity (CMI) to mouse adenovirus (M-Ad) infection was studied by macrophage migration inhibition test (MMI) as one of in vitro correlates of CMI. Both direct and indirect tests showed clearly that migration of packed peritoneal exudate cells (PEC) (immune mouse or nonimmune guinea pig) was remarkably inhibited; MIF was produced by interactions between immune PEC and infected cell extracts and between immune spleen cells and infected cells or their extracts. The antigen(s) responsible for the above MMI was demonstrated in 6- to 12-hour infected ME cells, and FUdR-treated infected ME cells. Since under these conditions there is S antigen(s) synthesis but not capsid antigen synthesis, the antigen(s) concerned must be an S antigen(s). T cells sensitized to infected cells were shown to be required to induce MMI. The MMI is specific for M-Ad, since no cross MMI was observed between M-Ad and SV40 systems. Time course study of the development of CMI to M-Ad by MMI tests showed that CMI became detectable 4 days post-infection (pi), reached its peak level about 10 days pi, and faded away rapidly in about 10 days thereafter.


A new microplate neutralization test for typing of herpes simplex virus. A microplate serum neutralization test for estimation of complement-requiring neutralizing (CRN) antibody was established as the first step for simplification of typing of herpes simplex virus (HSV). When guinea pigs were immunized with type 2 HSV, the late sera could mostly differentiate the types of HSV better than hyperimmune rabbit sera, the CRN titer against the heterologous type 1 HSV being much lower than the homologous titer. Sera of guinea pigs immunized with type 1 HSV showed about the same level of cross reaction against type 2 HSV as did rabbit antisera. Guinea pig sera having minimal levels of cross reaction were selected, and their high dilution (1:160) and complement were added to serial 10-fold dilutions of virus in the microplate titration of virus infectivity. Selective reduction of virus titer by either antiserum could determine the type of HSV. No equivocal intermediate case was found among a number of stock strains including many fresh isolates. The typing result coincided with that determined by a modification of Yang et al's method based on virus titers obtained with Vero and primary chick embryo cells. The typing based on plaquing in chick embryo cells sometimes failed to identify type 1 HSV.


The cyclic 3',5'-adenosine monophosphate receptor protein and regulation of cyclic 3',5'-adenosine monophosphate synthesis in Escherichia coli. Rates of synthesis of cyclic 3',5'-adenosine monophosphate (cAMP) were measured in cultures of Escherichia coli aerating without a carbon source. This technique provides a representative measure of adenylate cyclase activity in the absence of inhibition caused by transport of the carbon source. Adenylate cyclase activity was found to vary more than 20-fold depending on the carbon source that had been available during growth. Synthesis of cAMP in cells aerating in the absence of the carbon source was highest when cells had been grown with glucose or fructose which inhibit adenylate cyclase activity severely. Synthesis of cAMP was much lower when cells had been grown with glycerol or succinate which cause only minimal inhibition of the activity. The variation in cAMP synthesis due to different carbon sources requires a functional cAMP receptor protein (CRP). Crp- mutants synthesize cAMP at comparable rates regardless of the carbon source that afforded growth. A novel mutant of E. coli having a CRP no longer dependent on cAMP has been isolated and characterized. Adenylate cyclase activity in this mutant no longer responds normally to variations in the carbon source.


[Paramagnetic properties of the conidial pigments of Aspergillus niger and Penicillium notatum fungi isolated from the mesosphere]. The conidia of Aspergillus niger and Penicillium notatum detected in the upper atmospheric layers of the Earth (58--77 km) were found to contain stable paramagnetic centres (PMC) at concentrations of 0.2 X 10(18) and 1.6 X 10(18) per gram of dry biomass, respectively. Aspergillin, the black pigment of Asp. niger, was shown to have (0.1--0.6) X 10(18) PMC per gram of dry substance (depending on the fraction). Stable paramagnetism of the conidial pigments with respect to their active protecting action in vivo is discussed on the basis of these data.


[Granular cell myoblastoma].

[Granular cell myoblastoma]. Authors report a case of multiplex myoblastoma of the skin observed at a male patient aged 34. Epidermies covering the tumour histologically did not show hyperplasia considered to be characteristic. 8 years after the removal of the tumour the patient is well.


[2 cases of sympathetic paraganglioma of the urinary bladder]. Two cases of symphathetic paraganglioma of the urinary bladder are reported. Symppathetic- or parasymphatetic origin of intramural paraganlia or paragangliomas can be determined by demonstration of praesynaptic myelinated fibers. This method gives more reliable results than formaldehyd-induction-method carried out on freezed sections or the Gömöri's chromaffin reaction which often appears to be false-negative.


Comparison of toxicity and mutagenicity of butyl methanesulfonate among human lymphoblast lines. The toxic and mutagenic effects of butyl methanesulfonate (BMS) were compared among four diploid human lymphoblast lines, MIT-2, WI-L2, MGL8B-2 and GM 130. The toxic and mutagenic effects of 24-h exposure to BMS were similar for the MIT-2, WI-L2 and MGL8B-2 lines, while the GM 130 line was strikingly resistant to the toxic and mutagenic effects of BMS.


Rapid diagnosis of cytomegalovirus infection in infants by electron microscopy. Electron microscopy was applied to the diagnosis of cytomegalovirus infection in infants; we used the pseudoreplica method, which permits detection of herpesvirus particles within 15 to 30 minutes. Viruses were most readily detectable in urines with infectivity titers greater than or equal to 10(4) per milliliter (95 per cent correlation with the tissue-culture method). Virus particles were detected in 18 of 20 urines obtained from symptomatic or asymptomatic, congenitally or postnatally acquired cytomegalovirus infections in infants younger than six months. Viruses were demonstrated in six of 14 infants older than six months, whose urines usually contained greater than 10(4) per milliliter. All five oral specimens examined by electron microscopy were also positive. Viruses were readily detectable in specimens stored or shipped at 4 degrees C for several days, thus permitting physicians anywhere to obtain confirmation of a herpesvirus infection (presumably cytomegalovirus) within one to two days.


Defective high-density lipoprotein composition in patients on chronic hemodialysis. A possible mechanism for accelerated atherosclerosis. We determined serum high-density lipoprotein cholesterol content and analyzed the approtein structure of the various lipoprotein fractions in 21 patients on chronic hemodialysis. High-density lipoprotein cholesterol was significantly reduced in all patients as compared with 11 normal persons (mean +/-1 standard deviation: 26 +/- 13 vs. 52 +/- 9 mg per 100 ml; P less than 0.001) whether or not triglyceride levels were raised. In seven of those with Type IV hyperlipoproteinemia, protein content of high-density lipoprotein and its subfractions 1, 2 and 3 were also reduced (P less than 0.001) in parallel with reductions in cholesterol in these fractions. Apoprotein electrophoresis showed an increase in "arginine-rich" peptide in very-low-density lipoprotein and high-density lipoprotein fraction 1, and a reduction in apoprotein Cll in very-low-density and high-density lipoprotein. In addition to their reduced high-density lipoprotein cholesterol levels, a major factor in the atherosclerosis of these patients may be their abnormal high-density lipoprotein composition. Their raised triglyceride levels could be due to defective lipoprotein lipase activation by the reduced very-low-density lipoprotein apoprotein.


Inheritance of apolipoprotein C-II deficiency with hypertriglyceridemia and pancreatitis. A study of the relatives of a patient with apolipoprotein C-II deficiency showed that the defect is inherited as an autosomal recessive trait. The kindred studied originated from an isolated population in which considerable inbreeding has occurred for 140 years. Seven homozygotes had marked fasting chylomicronemia and triglyceridemia, and lacked detectable apolipoprotein C-II by several assay methods. Five homozygotes had experienced one to many attacks of pancreatitis from as early as six years of age. Obligate heterozygotes had apolipoprotein C-II concentrations about 30 to 50 per cent of normal values and had normal plasma triglyceride concentrations. This metabolic defect should be considered in patients with markedly elevated plasma triglycerides who have apparent lipoprotein lipase deficiency, and usually also have pancreatitis.


Apoprotein A-I synthesis in normal intestinal mucosa and in Tangier disease. To determine whether human small intestine synthesizes apoA-I, the major apoprotein of plasma high-density lipoproteins, we used immunofluorescence technics and monospecific antiserums to visualize apoA-I within intestinal epithelial cells from four normal subjects and one patient with Tangier disease. Biopsies from all subjects during fasting showed limited fluorescence. After lipid feeding intracellular apoA-I markedly increased in both normal subjects and the patient. During alimentary lipemia, mean plasma apoA-I levels (milligrams per deciliter) increased in four normal subjects from 161 +/- 12 (+/- S.E.M.) to 180 +/- 15 (P less than 0.05) and in the patient from 1.9 to 6.8. Normal plasma chylomicrons contained apoB, apoE and the C peptides but not apoA-I. The patient's chylomicrons contained ap0A-I. Normal and Tangier-disease intestinal-mucosa cells increase their content of apoA-I during chylomicron formation and subsequently contribute to plasma apoA-I levels. The low levels of apoA-I in Tangier disease are not due to a failure of intestinal synthesis but might be due to abnormal metabolism of chylomicron apoproteins.


Endometrial cancer and estrogen use. Report of a large case-control study. Our case-control study of the relation between estrogen use and endometrial cancer involved 451 cases and 888 controls. The overall risk of endometrial carcinoma was sixfold for estrogen users as compared with nonusers; long-term users (greater than five years) had a 15-fold risk. Excess risk was present for both diethylstilberstrol and conjugated estrogens. The risk associated with cyclic use was as great as that for continuous use. Increased risk was associated with estrogen use for all histologic grades of the tumor. The risk of advanced-stage carcinoma was fourfold for estrogen users, but rhe confidence interval was wide, and this question requires further study. Finally, this investigation contradicts the speculation that the association between this cancer and estrogen use can be explained by swifter diagnosis for estrogen users, misclassification of estrogen-related hyperplasia or treatment of early symptoms of the tumor with estrogen.


Role of the conidium in dimorphism of Blastomyces dermatitidis. Fine details of yeastlike cell development of Blastomyces dermatitidis from its conidium are described and illustrated by electron micrographs. When cultured in an enriched medium at 37C, conidia of two strains of B. dermatitidis readily underwent ultrastructural changes consistent with mycelial to yeast dimorphism. Although hyphal cells contained in the conversion cultures were observed consistently to undergo profound degenerative changes, the conidia rapidly germinated to give rise to short germ tubes which subsequently enlarged to form intermediate yeast mother cells (YMC). The wall of the germ tube arose from the innermost layer of the wall of the germinant. During the transition globoid osmiophilic inclusions of unknown origin and function were observed in vacuolated areas of the germ tube and YMC cytoplasm. Yeastlike daughter cells then budded from the intermediate YMC. Since transformation was readily accomplished under in vitro conditions favoring mycelial to yeast dimorphism, it is suggested that the conidium of B. dermatitidis represents the primary infective unit of this pathogenic fungus.


Structure-activity studies of narcotic agonists and antagonists from quantum chemical calculations. Three classes of flexible opiates have been studied: 4-phenyl piperdines, methadone and enkephalins. Our results show that low energy conformers of the 4-phenyl piperidines have equatorial phenyl rings and cannot completely overlap with rigid opiates at the receptor. A combination of calculated conformational and electronic properties could account for observed potency differences in meperidine, desmethyl, alpha+, alpha-, beta+ and beta- prodines. Our results also indicate that both meperidine and its reverse ester bind to the receptor in a similar mode with the phi ring in approximmately the same position as the phenyl substituent in 5-phenyl benzomorphans. Conformers of methadone which maximally resemble morphine have very high relative energies. The lowest energy conformer has a partial H-bond between the NH and O=C groups. In this conformation methadone resembles meperidine more than morphine. The electronic structure of all three types of opiates indicate a similar cationic charge distribution around the amine nitrogen and imply that their binding to an anionic receptor site could be similar. The determination of peptide opiate conformations present a challenge of a different order of magnitude than the most flexibe exogenous opiates. Because of the extremely large number of possible conformations, search strategies based on energy optimized conformations alone are not adequate to select plausible receptor site candidates. Other criteria such as consistency with known structure activity data and similarities to rigid opiates must be used. With this rationale, we have predicted and characterized a low energy conformer of Met-enkephalin and D-ala2 Met-enkephalin as a likely candidate at the receptor site. With a modest energy input (deltaE approximately 3 kcal/mole) significant overlap of this conformer with the potent opiate PET was obtained. The tyrosine and phenyalanine side chains and the terminal amine and carboxyl groups play a crucial role in this overlap. It is hoped that this calculation with help establish a template for peptide opiate receptor interactions.


The effect of cGMP in rabbit auricle as studied by a cut-end method. Cyclic GMP was applied to the rabbit right auricle by a cut-end method. The nucleotide decreased the spontaneous rate, hyperpolarized the cell membrane and reduced the amplitude and the slow component of the action potential. It also decreased the force of contraction. These results suggest that cGMP may be the mediator of the action of acetylcholine in the rabbit auricle.


[Neurological examinations of workers with chronic exposure to manganese dioxide during the production of piles and batteries]. The authors examined 118 workers making piles and batteries under conditions of exposure to toxic action of manganese dioxide dust. Neurological and EEG investigations showed presence of pyramidal tract lesion signs in 16.9% of workers, extrapyramidal syndromes in 6.8%, peripheral nervous system involvement in 13.5% and neurotic complaints in 42.4%. The frequency of neurological manifestations was directly proportional to the duration of work in exposure. The difference in the frequency of neurotic complaints and signs of peripheral and central nervous system damage was statistically significant between the group exposed to manganese dioxide and the control group. EEG investigations were performed in 51 workers and abnormalities were found in 21 cases.


[Cerebrospinal fluid pressure measurements in the ventricular system during and after surgery in patients with supratentorial brain tumors]. In the light of CSFP measurements by Lundberg's method in 46 patients the authors showed the role of hyperventilation in lowering of intracranial pressure. A considerable efficacy of dexamethasone was demonstrated as well, the use of this drug permitted to achieve stabilization of CSFP during and after the operation. The investigations showed a considerable effectiveness of such drugs as mannitol and furosemide in lowering of CSFP. Pancuronium was found to be superior to suxamethonium for administration during induction of anaesthesia because the former caused no CSFP rise. In polygraphic investigations of nocturnal sleep with parallel recording of CSFP a rise of CSFP was demonstrated during REM phase of sleep.


Enkephalins and nigrostriatal function.

Enkephalins and nigrostriatal function. Unilateral lesions of the substantia nigra were made with 6-hydroxydopamine in rats. In this model, drugs such as naloxone, which block endogenous enkephalin receptors, potentiated agents with postsynaptic dopaminergic actions, while antagonizing agents with presynaptic dopaminergic actions. Drugs which increase brain enkephalin content (d-phenylalanine or methionine-enkephalin) antagonized postsynaptically active agents and potentiated presynaptic agents. Naloxone also reversed reserpine-induced parkinsonism in rats. Separate pre- and postsynaptic enkephalinergic neurons thus seem to modulate nigrostriatal function.


Centrifugal and centripetal connections of the cat visual cortex. In experiments on curarized cats unit responses in the dorsal lateral geniculate body to stimulation of various zones in area 17 of the visual cortex were analyzed. Of all cells tested 69% were found to respond antidromically and 8% orthodromically; in 7.6% of cells IPSPs occurred either after an initial antidromic spike or without it. The velocities of conduction of excitation along the corticopetal fibers of the optic radiation varied from 28 to 4.3 m/sec, but the three commonest groups of fibers had conduction velocities of 28-19, 14-12, and 10-9.5 m/sec. A difference between latent periods of antidromic responses of the same neurons was found to stimulation of different zones of the visual cortex; this indicates that axons of geniculo-cortical fibers split into several branches which form contacts with several neurons in area 17 of the visual cortex. The degree and possible mechanisms of cortical influences on neurons of the lateral geniculate body are discussed.


Asynchronous maturation of pathways for impulses from muscle and skin receptors to the sensomotor cortex in rabbits. A comparative analysis was undertaken of the functional and structural maturation of peripheral pathways for the conduction of afferent impulses to the sensomotor cortex from muscle and skin receptors of the sciatic nerve during postnatal ontogeny in rabbits. The criterion of functional maturity of the fibers was their sensitivity to the blocking action of procaine when applied to muscular and cutaneous nerves. Structural maturation of peripheral nerve fibers was determined by the degree of their myelination. Successive blocking of fibers of muscular and cutaneous nerves by procaine was shown to depress certain components of the cortical evoked potential. As the animal develops, the sensitivity of its nerve fibers to procaine and the configuration of the evoked response are modified. Different peripheral projections, maturing at different times, participate in the organization of individual components of the cortical evoked potentials. This also takes place during maturation of peripheral afferent projections from muscular and cutaneous receptors.


Multicore disease. Report of a case with lack of fibre type differentiation. A six year old boy had congenital hypotonia and nonprogressive proximal muscular weakness, with mild abnormalities in the E. M. G. and normal serum enzyme levels. There was lack of fibre type differentiation in the quadriceps muscle biopsy. The fibres had high oxidative enzyme activity and low ATPase 9.4 activity. In almost every fibre there were multiple areas of focal decrease of oxidative enzyme activity, resembling in few of them the lesion described in Central Core Disease. There was abscence of mitochondria and disorganization of the sarcomere with streaming of the Z line within the lesions. The clinical and histological observations have close similarity to the cases first described by A. G. Engel et al. in 1971 as "Multicore Diseases" and to other similar reported cases.


World Health Organization studies of prostaglandins versus saline as abortifacients. A reappraisal. The World Health Organization (WHO) Task Force on the Use of Prostaglandins for the Regulation of Fertility has sponsored a series of randomized clinical trials and case-series investigations to assess the effectiveness and safety of prostaglandins as abortifacients. Our reanalysis of the WHO studies found the prostaglandins to be faster and more hazardour than hypertonic saline as intraamniotic abortifacients. Moreover, studies by the Center for Disease Control imply that dilatation and evacuation (D&E) may be more effective, safe, convenient, and inexpensive than prostaglandins for abortions after 12 weeks' gestation, especially in the 13- to 16-week interval. For gestations of greater than or equal to 17 weeks, the occurrence of live births in prostaglandin-induced abortions has produced serious legal and ethical problems in the United States. Until the effectiveness and safety of other prostaglandins regimen approach that of D&E, we feel that D&E should be the index of comparison against which newer methods of inducing abortion are tested.


[Kaposi sarcoma. A short review on a rare disease]. Pathological, clinical, epidemiological and immunological aspects of a rare tumor, Kaposi's sarcoma, are briefly discussed. The prevalence of the disease in an African population raises questions about genetic and environmental factors in its carcinogenesis. Immunological data indicate a probable viral origin. The clinical patterns seem to be influenced by alterations of the immune defense mechanisms. Most questions about its biological behaviour remain to be answered yet.


[5-fluorouracil inhibits the collagenolytic activity of invasive colonic adenocarcinomas in vitro]. By means of a biological assay for the enzyme collagenase the activity of this protease was examined in 12 invasive adenocarcinomas of the colon. In spite of considerable quantitative differences collagenolytic activity in the dimensions of 10(-3) units/mm theta tissue could be revealed in all cases. EDTA inhibited the reaction by 19%, normal human serum by 23% in the average, whereas 1,10-0-phenanthroline, D-penicillamine as well as the cytostatic 5-fluorouracil resulted in nearly total inhibition. It can be suggested that the activity of the colonic carcinoma is not derived from granulocytes, serum, or normal mucosa, but from the tumor itself. Contrasting to the limited inhibition by normal serum inhibitors, the enzyme is nearly fully inhibited by 5-fluorouracil.


Unusual intracytoplasmic inclusions in a case of idiopathic scleritis. Large cells containing prominent, refractile PAS-positive inclusions were found in cytological smears prepared from scrapings of the conjunctiva of an elderly diabetic patient with idiopathic scleritis progressing to scleromalacia perforans. Electron-microscopic study of these inclusions revealed them to be intracellular accumulations of dense, flocculent mucoid material within vacuoles whose interior surface was frequently decorated with microvilli. Similar inclusions have been reported in a number of neoplasms in nonocular tissue. The significance of these findings with regard to the patient's condition is not understood.


Pharyngoconjunctival fever caused by adenovirus type 19. A case of laboratory-acquired type 19 adenovirus infection is reported.  The patient showed the classical triad of pharyngitis, acute follicular conjunctivitis and fever. Adenovirus type 19 was isolated from the affected eye, and the infection was confirmed by demonstration of seroconversion to this virus.


Observations on the effect of different methods of processing on the bacterial contaminants of bovine and ovine tripe. A comparison was made of the multiplication of bacteria in specimens of tripe processed in different ways. There was little difference in this respect between commercial tripe as offered for purchase to the consumer and rough and scraped tripe incubated at 30 degrees C for 24 h. Tripe stored at 4 degrees C or in acetic acid (pH 4) at 30 degrees C for 24 h, however, had appreciably fewer bacteria.


Clinical, histologic, cytologic, and ultrastructural characteristics of the oral lesions from hereditary mucoepithelial dysplasia. A disease of gap junction and desmosome formation. Hereditary mucoepithelial dysplasia is an autosomal, dominantly inherited disorder affecting all of the orificial mucosa with cataracts, follicular keratosis of skin, nonscarring alopecia, bouts of pneumonia, spontaneous pneumothorax, and terminal cor pulmonale. The oral lesion is a fiery red, flat or micropapillary-appearing mucosa most frequently involving the gingiva and hard palate. All oral and pharyngeal mucosa may be involved, however. Red scrotal mucosa of the tongue is common. Histologically, the oral mucosa shows a lack of cornified and keratinized cells, a decrease in the thickness of the epithelial cell layer, dyshesion, and dyskeratosis. Papanicolaou smears show lack of epithelial cell maturation, poikilocytosis, anisocytosis, large paranuclear cytoplasmic vacuoles, and cytoplasmic strand-shaped inclusions. Ultrastructural features include a paucity of desmosomes, intercellular accumulations of amorphous material, cytoplasmic vacuoles, and paranuclear lesions with strands of material resembling gap junctions and desmosomes. The condition most likely represents a basic defect in gap junction and desmosome formation.


Odontodysplasia. Report of three cases with vascular nevi overlying the adjacent skin of the face. Three cases of odontodysplasia are described, and the literature is reviewed with reference to proposed etiologic mechanisms underlying the pathogenesis of the disorder. The distribution of affected teeth in all four quadrants of one patient is offered as evidence against a somatic mutation as an etiologic mechanism. As infants all three patients had vascular nevi in the facial skin overlying the area where defective teeth developed. Three cases from the literature involved similar vascular lesions. Hypoplastic teeth radiographically similar to odontodysplastic teeth occur in the linear sebaceous nevus syndrome. These findings strongly suggest that local vascular defects are involved in the pathogenesis of odontodysplasia.


Pathologic fractures of the mandible following invasive oral carcinomas. Invasive and metastatic oral carcinomas can and often do result in pathologic fractures of the facial bones. Three cases of invasive oral carcinomas resulting in fractures of the mandible have been reported. It was only after multiple-view radiographs that pathologic fractures could be identified. It is mandatory that dental practitioners avail themselves of the radiographic views which assist in establishing a diagnosis. In addition, the role of the dental profession in diagnosing primary and secondary oral carcinomas cannot be overemphasized.


Extraosseous tumor uptake of 99m technetium phosphate compounds in children with abdominal neuroblastoma. Sixteen patients with abdominal neuroblastoma had 99m Technetium Phosphate Compounds (99m TC-PC) bone scans as a preoperative evaluation for metastatic disease. Ten patients (62%) had extraosseous tumor uptake while six patients (38%) did not. There was no difference in the incidence of tumor calcification, tumor necrosis or hydronephrosis in the two groups. However, VMA levels were significantly higher in the group with extraosseous tumor uptake. Various bone seeking radionuclides are compared to 99m TC-PC and possible mechanism for extraosseous uptake of such radionuclides are postulated. Awareness of the frequency of such uptake should reduce the possibility of errors in the interpretation of bone scans in patients with neuroblastoma.


Hypercholesterolemia and hyper-alpha-lipoproteinemia in schoolchildren. Elevated levels of high-density lipoprotein cholesterol (C-HDL) can explain apparent hypercholesterolemia in some children, and high C-HDL levels may aggregate in families. In this study, 17 kindreds were identified by virture of hypercholesterolemic proband children whose hypercholesterolemia was accounted for the elevated C-HDL levels Family lipod and lipoprotein sampling revealed three-generation vertical appearance of elevated C-HDL level in two kindreds, and two-generation vertical appearance in eight additional kindreds. Since CHDL level is inversely associated with coronary heart disease in adults, it is important to quantitate C-HDL and low-density lipoprotein cholesterol (C-LDL) in hypercholesterolemic children and to identify those with putatively reduced risk (elevated C-HDL level) or increased risk (elevated C-LDL level).


Discrepant cortisol values: comparison of radioimmunoassay and competitive protein binding technics. Radioimmunoassays are expected to yield precise values representing the antigen, i.e., insulin, growth, cortisol, etc. employed in producing the antibody. However, in a recent study of a synthetic ACTH which involved the measurement of cortisol levels (1), we found that above 20gamma%, the radioimmunoassay (RIA) yields cortisol values distinctly above those obtained with the competitive protein binding (CPB) technic. We now suggest a possible explanation for this discrepancy and have calculated a correction factor.


Growth deceleration patterns in children with constitutional short stature: an aid to diagnosis. A retrospective study of 263 children referred for evaluation of short stature revealed that 149 (56.7%) had constitutional short stature (CSS). A typical pattern of growth was observed in these children. As exemplified by 12 children who had complete serial growth measurements, exaggerated growth deceleration first became apparent between 3 and 6 months of age, was greatest in the first two years of life, and resulted in these children falling more than 2 SDs below the mean for height by 3 years of age. After 3 years of age, the growth rate of these children with CSS was essentially the same as that of normal children, and they ran parallel to the growth curve though below the third percentile. The importance of serial measurements and the growth chart is emphasized, and recommendations are made for the evaluation of short stature or abnormal growth deceleration in the first three years of life. Awareness of this typical pattern of growth in children without disease may aid the pediatrician in his evaluation of short stature and allow for watchful waiting when results of screening tests are normal.


Comparisons of synthetic 1-18 ACTH (Organon 2001) and 1-39 ACTH of animal origin in human subjects. The studies in human subjects herein reported provide data on the relative effects of 1-18 ACTH (Organon 2001) and commercial 1-39 ACTH of animal origin on plasma cortisol, serum non-esterified fatty acids, and certain urinary steroids.


[A simple device for cultivation of anaerobic bacteria (author's transl)]. A new concept for isolation and enumeration of anaerobic bacteria in food is presented. The sample is collected and diluted under anaerobic conditions in a specially designed syringe (M.O.S.), in which cultivation also takes place. A comparison between this method and cultivation in anaerobic jars (GasPak) from a common inoculum revealed a higher number of Clostridium perfringens with the M.O.S.-technique.


Hypervitaminosis D in fur-bearing animals. Investigations concerning the effect on fur-bearing animals of large doses of vitamin D3 were carried out. The material comprised 62 animals in all--10 silver foxes, 17 blue foxes and 35 mink (Table II). Daily doses of 5 IU vitamin D3/g body weight for two months did not produce clinical symptoms in the foxes. However, a short while after the dose was increased to 10 IU, the animals showed loss of appetite, had difficulty in moving, were apathetic and developed dark coloured faeces. Analysis of blood serum showed markedly raised calcium values (Table III). Calcium deposits were demonstrated in the kidneys and in some cases also in the musculature, gastric mucosa, bronchi and the larger blood vessels. No abnormal signs were shown by 30 mink which received 0.6--0.7 IU vitamin D3/g body weight for five months. PM findings were normal.


Plasma lipoprotein separations by zonal ultracentrifugation. Procedures for the separation of plasma lipoprotein classes and subclasses by zonal ultracentrifugation are described. The main density classes, very low density lipoproteins (VLDL), low density lipoproteins (LDL) and high density lipoproteins (HDL), in plasma can be separated in a single run for 20 hours. For the isolation of VLDL-LDL a centrifugation time of only 90 minutes is needed. Separations can be performed on plasma volumes varying from 10 to 400 ml in the Ti-14 rotor used; VLDL can in this way be isolated from 400 ml plasma in 30 minutes. The advantages and disadvantages of zonal ultracentrifugation in comparison with the commonly employed differential ultracentrifugation for separation of lipoproteins are discussed.


Lipoproteins removed from serum and plasma by membrane filtration. Tangential (crossflow) filtration of a plasma/serum mixture through 0.2 micrometer-poresize polycarbonate track-etch membrane filters (PC) at pressures less than 10 psi removes low density lipoproteins (LDL) and very low density lipoproteins (VLDL) but not high density lipoproteins (HDL) from the filtrate. At pressures greater than 10 psi all lipoproteins pass through the PC. Once the filters have been intruded with LDL and VLDL those lipoproteins continue to pass the filters despite subsequent reduction in differential pressure below 10 psi.


A modified procedure for the purification of clostridial collagenase. A method is described for the purification of clostridial collagenase from a crude enzyme preparation employing cation exchange chromatography on SP Sephadex, anion exchange chromatography on DEAE cellulose and gel filtration on Sephacryl S-200. Emphasis was placed on purity using continuous shallow gradients for the ion exchange separations to increase resolution and monitoring eluates both with respect to ultraviolet light absorption at 230 nm and analytical disc gel acrylamide electrophoresis. In addition, protein fractions were assayed for collagenolytic and non-specific proteolytic activity. The purity of the final preparation was assessed by acrylamide electrophoresis, gel filtration and amino acid analysis. The isolated enzyme hydrolyzed between 30 and 40% of rat tail tendon collagen in 1 h at 37 degrees C and lacked measurable trypsin or elastase-like activity.


ACTH, but not corticosterone impairs habituation and reduces exploration. The habituation of an orienting response to auditory stimuli was impaired in rats by the administration of ACTH1-24. This impairment is unlikely to be due to the action of corticosterone because of the time course of the effect, because injected corticosterone had no effect on hibituation and because the peptide fragment ACTH4-10, which does not release corticosterone, also impaired habituation. Both ACTH1-24 and ACTH4-10 reduced the level of exploration measured in a holeboard, but corticosterone had no significant effect. However ACTH did not impair habituation and exploration, thus providing further evidence that there are different mechanisms underlying habituation of orienting and habituation of exploration.


Drinking in water deprived rats after combined central angiotensin receptor and converting enzyme blockade. Saralasin, an angiotensin II receptor antagonist, is ineffective in reducing drinking after water-deprivation (WD). Angiotensin III has considerable dipsogenic potency. It may be formed without angiotensin II as an intermediate. To clarify whether angiotensin III formation masks a role for angiotensin in WD, 48 hr WD rats were infused via a lateral cerebroventricle with a) CSF, b) Saralasin, c) SQ 20,881, a converting enzyme inhibitor, or d) Saralasin + SQ. No drug effect on drinking was observed. The results demonstrate that angiotensin III is not required for WD drinking.


Ultraviolet-induced thermoluminescence and phosphorescence in Mg2SiO4:Tb. Among the common TLD materials studied (Mg2SiO4:Tb, Al2O3:Si, Ti, CaSO4:Tm, CaSO4:Dy, Li2B4O7:Mn and LiF TLD-100), Mg2SiO4:Tb was found to have the highest intrinsic TL sensitivity to UV radiation (wavelength 253.7 nm). The TL response of the dosimetric peak (approximately 200 degrees C) of virgin Mg2SiO4:Tb was studied as a function of UV exposure in the range 10--10(4) J m-2. The UV-induced TL was not affected by room-light and no appreciable fading was observed up to 20 days after irradiation indicating that this is a promising TL phosphor for UV dosimetry. The UV sensitivity was found to increase with increasing preliminary gamma exposure above 10(-2)Ckg-1 (after a post-irradiation anneal at 300 degrees C for 1 h). The degree of sensitisation was found proportional to the intensity of the residual TL peak at 450 degrees C. A study of the TL response of the sensitised sample as a function of UV test exposure has demonstrated the transfer of charge carriers from the deep traps to the dosimetry traps. Both virgin and gamma-exposed Mg2SiO4:Tb were found to exhigit phosphorescence decay at room temperature after UV stimulation. The intensity of the UV stimulated phosphorescence was found to increase with the gamma exposure above 10(-2) C kg-1.


Impaired renal prostaglandin E2 biosynthesis in human hypertensive states. Urinary Prostaglandin E2 (PGE2), a known indicator of renal production, was measured by specific radioimmunoassay in 111 normal volunteers, 85 patients with essential hypertension, 6 with renovascular hypertension, and 23 patients with primary aldosteronism. Women excreted less PGE2 than men in both normotensive and hypertensive groups. When compared to normals, essential hypertensives demonstrated significantly lower PGE2 levels, with one third excreting less than 100 ng/24 hr, values usually seen only in subjects receiving the prostaglandin synthetase inhibitor, indomethacin. Normal PGE2 was seen in patients with renovascular hypertension, and levels were uninfluenced by treatment with the converting enzyme inhibitor SQ14225, Despite normalization of blood pressure and increased plasma renin activity. Normal PGE2 was also encountered in primary aldosteronism. These data indicate that impaired renal PGE2 biosynthesis is specific for human essential hypertension, and is not secondary to the elevated blood pressure. Although PGE2 excretion tends to be lower in low-renin hypertension, a constant relationship between PGE2 and renin is not always apparent.


Effects of cervical sympathetic ganglionectomy on cyclic-AMP and prostaglandins in brain and eye tissues and fluids. Studies were conducted confirming supersensitivity to catecholamines on intraocular pressure and pupil size following bilateral superior cervical ganglionectomy in rabbits. At the termination of these studies we examined changes in cyclic adenylic acid and prostaglandin content in jugular vein effluent and various brain and ocular tissues and fluids of the sympathectomized versus control animals. In the blood effluent we found significant elevation of cyclic adenylic acid and significant lowering of prostaglandin F1alpha in the sympathectomized animals. Although we found elevation of prostaglandin in certain tissues of the sympathectomized animals, there were no significant changes in cyclic adenylic acid levels between sympathectomized and control animals in the tissues examined. The findings of prostaglandin (blood and tissue) and cyclic adenylic acid (blood) changes in sympathectomized animals, associated with known changes in intraocular pressure and pupil size (due to catecholamine supersensitivity) must elicit further interest in the correlation and interpretation of various other central physiological and metabolic events in cervical sympathectomized animals.


Evidence for H2O2 mediating the irreversible action of acetylenic inhibitors of prostaglandin biosynthesis. Oxidizing intermediates formed during prostaglandin biosynthesis can be detected by ferrocytochrome c and epinephrine. Different intermediates were responsible for the oxidative colorimetric changes with epinephrine and ferrocytochrome c, and submicromolar amounts of oxidant were detectable. Catalase diminished the absorbance change with epinephrine, but it did not stop the conversion of arachidonate to prostaglandins. This result indicates that small amounts of H2O2 were formed when producing the colorimetric change, and these had no apparent effect upon the enzyme stability. No colorimetric changes were detected during the time-dependent loss of oxygenase activity caused by various acetylenic acids, indicating that negligible amounts of H2O2 were formed. Nevertheless, the destructive action of the acetylenic acid was prevented by catalase, and it thereby appeared due to small amounts of H2O2 generated in situ as a result of a metastable complex of enzyme, oxygen and the acetylenic substrate analog.


The solitary pulmonary nodule.

The solitary pulmonary nodule. Although most asymptomatic solitary pulmonary nodules are benign, many are truly malignant. Age of the patient, history of antecedent infection or industrial exposure, and radiographic appearance and behavior are helpful in establishing the diagnosis. Invasive techniques and their indications are discussed as well as some of the growth characteristics of potentially malignant lesions.


Occupational lung disease.

Occupational lung disease. Occupational lung diseases can be conveniently classified into disorders of the airways, the alveoli, and the lung interstitium. Diseases of each category have a distinct clinical and pathologic presentation despite diverse causes.


Patients with tracheostomies: goals of management. Care of the patient with tracheostomy is not difficult if care is taken to define clearly the needs of the particular patient. An awareness of the goals of care, daily maintenance, and possible complications is necessary to successful management.


Determination of the crystalline fraction in bone and other mineralizing tissues within the histochemical range by electron spin resonance spectroscopy. The theoretical principle based on the application of electron spin resonance technique for calculation of the crystallinity coefficient of mineralized tissues is presented. The method is based on measurements of radiation-induced stable paramagnetic centres derived from the crystalline fraction of tissue mineral. The high sensitivity and accuracy of the discussed method allows to apply it in the histochemical range.


[Technics of measuring the motive force of very small ameboid cells]. A technic have been perfected which measures directly the motive force of very small ameboid cells and indicates the tropism of the amoeba. By using this technic, the motive force of Entamoeba histolytica was measured. It varied between +/- 1.5 x 10-4 dyne. We have also shown chimiotactism in Entamoeba histolytica. The metabolic coumpound excreted by this cell induced negative tropism.


[Long-term treatment with corticoids in respiratory disorders]. In a first chapter the author reviews the mechanisms of action of corticoids in respiratory diseases. Moreover the causes and the prevalence of unwanted side-effects are discussed. The advantages of synthetic glucocorticoids with short half-life time in pneumology are stressed. In the following chapters, the rationale of long-term corticoid treatments of asthma, in non allergic obstructive chronic lung diseases, in sarcoidosis and in the thoracic localisations of some collagen diseases is presented in detail. Regarding the treatment of asthma the author discusses the advantages of the alternate-day therapy, the use of corticoids in aerosols and the ratioale of ACTH. The usefulness of alternate-day therapy in sarcoidosis is also advocated.


Epidemiology of cytomegalovirus infections during pregnancy and infancy. A prospective study. The occurrence and possible consequences of cytomegalovirus (CMV) infections were studied in 200 mothers and their children by means of immunofluorescent antibody assays in serum, virus isolation from urine and regular clinical and neurological examinations. The prospective study covered the time from early pregnancy to 1 year post partum. The frequency of intrauterine infections was 2%, while 30% of the children became perinatally infected as indicated by the onset of virus excretion and an antibody response at the age of 2--4 months. Later on the occurrence of CMV infections declined sharply. 23 mothers had no CMV antibodies and none of their children contracted CMV during the first year of life. Maternal antibodies seemed unable to protect the child from CMV infections or to delay the onset of virus excretion in perinatally infected children. Intrauterine infections did not correlate with significant increases in the antibodiy titres of the mothers or the presence of IgM antibodies either in the mother's sera or in the cord sera. Perinatal infections were often associated with the presence of IgM antibodies both in the child and in the mother and in these mothers significant increases in CMV antibody titres were frequently seen, probably indicating an activated latent infection. Immunofluorescent antibody assay correlated well with virus isolations and was more sensitive than complement-fixing antibody assay.


[Recent developments in the field of infectious diseases]. A résumé is presented of recent developments in the field of infectious diseases of particular interest of practising physicians. Examples are given to illustrate recent discoveries concerning the frequent misuse of antibiotics, the problem of infections developing in hospitalized patients, the biology of microbial infection, the etiology of well-known illnesses, new infectious diseases, and the development of vaccines. It is evident that the rate at which new and important information is evident that the rate at which new and important information is being reported demands particular effort in medical school teaching to ensure that students learn how to acquire and evaluate new information as well as how to discard ideas which are no longer valid.


[Low HDL cholesterol in close relatives and patients with myocardial infarct]. Male patients aged 40 to 59 who had had acute myocardial infarction three months previously displayed a lower HDL cholesterol than the HDL cholesterol of an apparently healthy control group. The male first degree relatives of patients with acute myocardial infarction, like the patients with coronary disease, had a low HDL cholesterol which differed significantly from the HDL cholesterol of the control group. Low HDL cholesterol appears to be a better "marker" of patients with coronary disease and relatives of patients with acute myocardial infarction than serum cholesterol and triglycerides. The importance of low HDL' cholesterol could be related to the role of HDL in the cholesterol transport system from the peripheral tissues.


Cellular interactions uncouple beta-adrenergic receptors from adenylate cyclase. C6 glioma cells and B104 neuroblastoma cells both possess adenylate cyclase activity, but only C6 cells have beta-adrenergic receptors. However, when cocultured with B104 cells, C6 cells show a marked decrease in their ability to accumulate adenosine 3', 5'-monophosphate upon stimulation with beta receptor agonists. Since both beta receptors and cholera toxin-stimulated adenylate cyclase activities are present in C6/B104 cocultures, we conclude that the beta receptor/adenylate cyclase transduction mechanism in cocultured C6 cells is uncoupled.


Feedback inhibition of brain noradrenaline neurons by tricyclic antidepressants: alpha-receptor mediation. The use of different receptor blocking agents and single-unit recording techniques indicates that feedback inhibition of brain noradrenaline neurons by tricyclic antidepressants is mediated by presynaptic alpha-receptors. After chronic imipramine treatment, noradrenaline neurons in the locus coeruleus of rat brain remained partly depressed, in agreement with clinical data. They were, however, resistant to further inhibition by imipramine or clonidine.


[Etiology of hemoptyses].

[Etiology of hemoptyses]. From hemoptyses as main symptom for the admission of patients during 1975 and 1976 in the pulmonary disease department of a parisian hospital, a retrospective study of the causes of hemoptyses is made by the authors. In 18% of the cases, hemoptysis was the unique revealing symptom of the disease. Tuberculosis and cancer are the main causes, but, now, their rate is inverted : 30% for cancer, 21% for tuberculosis, but in addition there are 9% in relation with sequelae of tuberculosis. Among the other causes, bronchiectases keep an important place, just as cardiovasculary diseases. But there is a portion of patients for whom the cause of the hemoptysis cannot be found. As bronchologic and vasculary explorations are developed, this portion of patients will diminish but will not disappear, because mechanisms of hemoptysis will be better explained but not the real cause.


[Acute hyperparathyroidism, diagnosis and treatment. 10 recent cases]. The authors report 10 observations of acute hyperparathyroïdism crisis cases operated without death. They draw their conclusions from their own experience and from published cases. The evolution on the medical treatment is invariably mortal. The logical treatment is surgery. The operation is a true emergency, preceded by a brief but intensive medical treatment which checks dehydratation up and bring the blood calcium level down.


[Spinal cord compression caused by malignant non-Hodgkin lymphomas. 13 cases]. The authors report 13 cases which permitted them to discuss the clinical signs, which were multiple, completed by further investigations of which the most important was lipiodol myelography. The treatment included usually surgical operation accompanied by radiotherapy, chemotherapy and sometimes immunotherapy. This combined treatment gave a better prognosis espeically in patients operated at stages I, II and III, and we obtained 25% favourable results.


[The treatment of migraine and tension headaches with amitriptyline (author's transl)]. Study of 100 patients followed up for over one year, including 26 cases of migraine (4 classical migraine) and 74 cases of tension headache associated or not with muscular tension. With dihydroergotamin alone 16 cases of migraine, and with amitriptyline alone 17 cases experienced excellent to fair relief, while with the association of both drugs, 21 excellent results were obtained. Among tension headaches patients, 53 were relieved with amitriptyline alone, 56 when DHE was added. The activity of amitriptyline in lower dosages is very likely not an anti-depressant one, but connected with catecholamines metabolism. Dosage must be adjusted in each individual case. The efficiency of DHE in tension headaches suggest a possible part of vaso-motor mechanisms in such cases.


[System e in acute hepatitis B].

[System e in acute hepatitis B]. HBeAg and Ab are investigated by simple radial immunodiffusion in dextrane following Magnius. 14 patients (28%) were HBeAg positive and 2 patients HBeAb positive (4%). HBsAg subtyping was ad in 6 cases and ay in further 5. No relation was found between both determinants and HBeAg. Six of the 10 patients with HBeAg in their sera developed chronic liver disease o fulminant hepatitis, while only 3 of the 21 HBeAg negative controls did so (p less than 0.05). HBeAg is a marker of the evolution of virus B hepatitis.


[Original management in motor, personality and behavior disturbances in ethylic patients in a department of internal medicine (author's transl)]. 33 ethylic patients with motor, personality and behavior disturbances have been treated successfully by tiapride. An oral dose of 5 mg/kg per day was observed to be sufficient in the treatment of lingual and hand tremors. However, in presence of behavior and/or personality disturbances and in predelirium the intramuscular route should be used at the dose of 10 mg/kg per day.


[Use of tiapride in internal medicine (author's transl)]. Tiapride is tested about 47 in-patients among 6 morbid conditions studied. Tiapride is particulary effective in 4 diseases : delirium tremens, nervous and mental disordes associated with alcoholic addiction are obviously improbed in 2/3 of cases ; the betterment of motor and behaviour disordes concerning old people and the prevention of cephalagia succeding spinal puncture is sure with tiapride. The clinical and biological tolerance is excellent particulary in precarious patients.


[Abdominal intercostal hernia. Report of four cases (author's transl)]. The authors report 4 recent cases of abdominal intercostal hernia and in the light of other cases in the literature, discuss the clinical presentation of this curious and rare disease. Presenting all the characteritics of an uncomplicated hernia, abdominal intercostal hernia is an easy diagnosis on a single clinical examination. Further respiratory and digestive investigations are however essential before undertaking a surgical cure of this hernia at the limit of the thorax and abdomen. Treatment is purely surgical. Instead of the classical treatment by the direct approach, where the risk of relapse is important, one should prefer the transperitoneal approach with use of an inert supple prosthesis. This method gave excellent results with a follow-up of from 1 to 3 years.


[Functional results of 280 Pean type gastrectomies for chronic Cruveilhier ulcer]. The authors review 216 gastrectomies of Péan type for gastric or duodenal ulcer with a follow up of between one and 12 years. In 91 patients, the follow up was more than five years. Six criteria were adopted for the essessment of the functional results: increase in body weight which may be of several types, the diet, post-prandial symptoms, return to work, asthenia recurrent ulcer. Each of these criteria were studied separately in all operated patients and analysed in relation to the follow up period. Except for recurrent ulcer, with occurred in 2% of cases, the results obtained improved with time. A routine study such as Visick's method completes this presentation. The good and very good results were 81% at 5 years, average results were 16% and poor results 3%. The differences between gastric and duodenal ulcer were negligeable. After comparison with the data in the literature, this level study seemed more interesting than a statistical study.


[A new variety of chondrosarcoma : so-called "chondro-blastic" sarcomas or "clear cell" chondrosarcomas. Pathology and electron microscopy in 5 cases (author's transl)]. The authors report the pathological and clinical findings in five cases of chondrosarcoma resembling chondroblastic chondrosarcomas as described by Lichtenstein and Bernstein in 1959 and, above all, clear cell chondrosarcomas as described by Unni et al. (1976). These chondrosarcomas have a double peculiarity:--topographic, for their site is often epiphyseal :--anatomica, for they associate, in the usual chondrosarcomatous sectors, areas rich in clear cells, with a rich blood supply, and in some cases a diffuse reactional osteogenesis. Although the long term prognosis is similar to that of all chondrosarcomas, their course is sometimes very slow. One should thus distinguish carefully these tumours from chondroblastomas in spite of certain topographic and radiological similarities.


[Pleuro-pulmonary complications of typhoid fever. 1case]. The authors report a case of typhoid fever with pleuro-pulmonary complications and recall their characteristics: Usually early (second week), may appear under treatment, whereas the disease evolves normally. Characterised by the absence of infective phenomena, the multiple manifestations, the fleeting course and the favourable prognosis. This corresponds to the pleuro-pulmonary typhus syndrome described long ago, which is probably due to immunological phenomena. Sometimes late, evolving towards suppuration, abscess formation and empyema with presence of typhoid bacilli, rarely seen nowadays.


Mechanisms of localization of gallium-67 in tumors. The mechanism of tumor localization of gallium-67 (67Ga) is not known with certainty, although much information has been derived regarding the biodistribution and subcellular fate of 67Ga in a variety of tumors and other tissues from experimental animals. After intravenous administration, 67Ga is bound to transferrin in the blood, and distributed to liver, lacrimal glands, salivary glands, and soft tissue tumors. Within the cells of the liver and tumors, gallium is found in lysosomes, and rough endoplasmic reticulum. Within these organelles, 67Ga is bound to a variety of macromolecules, including transferrin, ferritin, and a 45,000 molecular weight glycoprotein. Recent studies of tumor cells growing in tissue culture suggest an important role for transferrin in 67Ga tumor uptake. This uptake is mediated by a transferrin specific cellular receptor.


[Extensive cellulitis during chicken-pox. Six causes (author's transl)]. The authors report 6 cases of extensive cellulitis, in 6 children with chicken-pox. This is a rare complication during this disease. If streptococcal etiology is not always proved, clinical aspect and the dramatic reponse to treatment by penicillin G, characterize this kind of complication.


Southern Regional Trophoblastic Disease Center, 1972--1977. The experience of the Southern Regional Trophoblastic Disease Center includes 222 patients who were referred from January 1972 to October 1977. The initial tissue diagnosis was hydatidiform mole in 212 patients and choriocarcinoma in ten. There was spontaneous remission of 142 (69%) of the moles and one of the choriocarcinomas, and 77 patients developed persistent trophoblastic disease. Of these, 58 had no evidence of metastasis, and all achieved remission with single-drug therapy. Nineteen patients developed metastases; 13 were in the "good prognosis" category, and all achieved remission with single-drug therapy. Five (83%) of the six patients with metastases in the "poor prognosis" group achieved remission with triple chemotherapy; one died of her disease.


[Steinert's disease and pregnancy].

[Steinert's disease and pregnancy]. The authors present two cases of Steinert's disease associated with successive pregnancies. The interest resides in the possibility of prenatal diagnosis in the light of their characteristic facies, the repeated hydramnios, and the Xray of the uterine contents showing a child with an open mouth. Furthermore, one of the cases was the only in the liteature with that of Sciarra where uterine contractility was recorded during laour.


Early and subtle signs in low-back sprain. The authors have previously reported myalgic hyperalgesia as a useful localizing sign in "low-back sprain" patients with no physical findings. This paper describes some other subtle signs related to the phenomenon of denervation supersensitivity which is well known to physiologists and clinicians involved in peripheral nerve disease, yet its related signs have not been applied to low-back pain. Following denervation of some neurons, muscle and peripheral receptors become supersensitive to transmitter substances and to different forms of stimuli. Since the peripheral nerve is a mixed nerve, findings are multiphasic and include autonomic dysfunction, trophic changes, cutaneous and myalgic hyperalgesia, and increased muscle tone. One or more of these signs occurred in 30 patients with secondary low-back pain but less often in 30 patients with primary or mechanical low-back pain; their presence, though slight, in asymptomatic controls may identify those individuals with a vulnerable back.


[Glucocorticoids and gluco-lipidic metabolism]. Glucocorticoids increase the stocks of carbohydrate and the supra-hepatic flow of glucose. Their excess produces a centripetal redistribtution of adipose stocks and potentialises adipocyte lipolysis. Although their role of glucose and lipid metabolism is evident, the mechanisms and sites of action of glucocorticoids are multiple and not entirely clear. The actions of glucocorticoids become clear in cases of insulin deficiency, especially when the deficiency is marked, which is of great interest in current medical practice.


Preoperative and follow-up bone scans in patients with primary carcinoma of the breast. We have attempted to evaluate the role of preoperative and postoperative bone scans in patients with localized carcinoma of the breast. The yield of positive preoperative scans in patients with Stages I and II disease is low and confounded by a relatively high percentage of false-positive results. Conversely, 16 per cent of patients with Stage III disease had evidence of bony metastasis at the time of operation. Positive bone scans were found three times as frequently in patients with axillary node involvement than in those without. Thirty per cent of those observed for varying times up to 41 months had evidence of bony metastases. Again, there was a correlation with initial clinical staging with 3.6 to 8.0 times more conversions in patients with Stage II or III disease than in those with Stage I disease. It appears that the majority of metastases to the bone become apparent within the first years. This observation deserves further study to elaborate the natural history of metastatic carcinoma of the breast.


[Evaluation of thyroid function in children (author's transl)]. Two main methods must be used in every case for evaluation of thyroid function in children : measurement of plasma thyroxin T4 and thyroid scanning with technetium. If accurately done, they may be sufficient for practical purposes. However, the wide number and variety of methods available for thyroid evaluation offers to pediatricians a choice sometimes difficult. The aim of this review is to summarize the meaning and accuracy of current methods and their usefulness in diagnosis and study of thyroid diseases of pediatric patients.


Results of surgical treatment of carcinoma of the lung by stage and cell type. The results of surgical treatment in 470 patients with carcinoma of the lung were analyzed by stage of disease and by histologic cell type. The need for accurate staging in selecting treatment and in prognosis for survival is emphasized. Surgical resection improved survival time in all categories of patients by effective local control of the lesion. The over-all five year survival rate was 14 per cent. Early stages of carcinoma of the lung were more amenable to surgical cure. The highest five year survival rate was 43 per cent and was observed in resected Stage I carcinomas. Only 29 per cent of this group died of the disease and 28 per cent, of other causes. The continued high incidence of death due to distant metastases underlines the necessity of combining operation with other forms of treatment.


Effects of intravenous nutrition on tumor growth and host immunocompetence in malnourished animals. To evaluate the effects of oral and intravenous nutritional repletion on tumor growth and host immunocompetence in malnourished animals, 60 adult purified protein derivative (PPD) positive Buffalo rats were inoculated with Morris hepatoma 5123 and were fed a regular diet for 14 days. All animals then were switched to a high carbohydrate, protein-free diet for the next 14 days, at which time only 30% of the animals remained PPD positive. Rats then were divided into three groups: group I underwent superior vena cava catheterization and received a constant infusion of 25% dextrose--4.25% amino acid solution; group II was switched to the regular protein diet orally ad libitum; and group III remained on the oral protein-free diet. PPD reactivities were measured prior to death 7 days later. Group I animals gained an average of 14 gm of body weight, and 91% of the animals were PPD positive. Group II animals lost an average of 17 gm of body weight, but 78% of the animals were PPD positive. Group III animals lost an average of 23 gm of body weight, and only 12% of the animals remained PPD positive. Absolute tumor weight and tumor weight: body weight ratios were not significantly different among the three groups of animals. Provision of adequate nutrition intravenously to malnourished tumor-bearing animals restores body weight and host immunocompetence without adversely stimulating tumor growth out of proportion to growth of the host.


[Benign tumors of the lung and pleura (author's transl)]. 218 benign tumors of the lung and pleura, 190 of which were operated, are discussed. Little doubt exists about the necessity of operative removal in cases of benign pleuro-pulmonary tumors. Therapeutic management depends on histology, localisation and the extent of growth. The majority of untreated benign tumors have a poor prognosis even if malignant degeneration does not occur. Postoperative prognosis of rehabilitation and resocialization is good.


Use of live varicella vaccine in children with acute leukemia. Seven children with acute leukemia were given a live attenuated varicella vaccine and successfully seroconverted with minimal clinical reactions. One of them was vaccinated immediately after the contact with natural varicella and successfully prevented from natural infection.


Separation of rat-liver phosphoprotein phosphatases active on phosphorylated pyruvate kinase (type L). The substrate specificity of rat liver phosphoprotein phosphatases has been investigated. The enzymes were resolved into three fractions, termed A, B and C, on elution from DEAE-cellulose with apparent molecular weights, as determined by Sephadex G-200 chromatography, of approximately 250 000, 250 000 and 140 000, respectively. All fractions catalyzed the dephosphorylation of calf-thymus phosphohistones, salmon phosphoprotamine and rabbit skeletal muscle phosphorylase a. The major portion of the activity towards these substrates was found in fraction B. The activity towards rat liver phosphopyruvate kinase (type L) resided almost exclusively in fractions B and C. It is concluded that rat liver contains multiple forms of phosphoprotein phosphatases and that phosphatases of fraction B and C are the major activities towards phosphopyruvate kinase.