The neurological manifestations of porphyria: a review. The hereditary hepatic porphyrias, PV, AIP and HC, are characterized biochemically by increased excretion of porphyrins and the porphyrin precursors ALA and PBG. They are characterized clinically by episodes of acute neurological involvement. The increased production of porphyrins and porphyrin precursors has been shown to be due to partial enzyme blocks along the heme biosynthetic pathway which results in secondary depression of the key enzyme ALA-synthetase. The neurological manifestations could therefore be related to either a decrease in essential heme-proteins or other heme-containing compounds within the nervous system, or to a toxic effect of the over-production of the porphyrin precursors ALA and PBG. There is evidence for and against both theories. Recent work from a number of research groups has shown the porphyrin precursors to have potent pharmacological effects on the nervous system, and these are possibly related to the GABA receptor and binding site-porphyrin precursor interactions. Current studies on therapy of the acute attack have concentrated on suppression of ALA-synthetase activity, and consequently, on reduced ALA and PBG production. A number of such methods of therapy have met with remarkable success and hold promise for the future treatment of the acute attack.


[Comparison of various aspects of normal and filamentous forms of S. enteritidis]. For more detailed information on filamentous and normal forms of S. enteritidis, electronmicrographic studies and slide cultures were carried out. The filaments show similarity to normal forms of S. entertidis except for their length. They produce the normal forms of bacteria when transferred to suitable media. Some of the filaments exhibited various degrees of degeneration in their walls. Some of them consist of only a collapsed cell wall, because they lose their cell content. We think those are the filaments which are irreversible and not able to produce the normal forms of bacteria.


[Lipid composition of Escherichia coli cells sensitive and resistant to tetracycline]. The following variants of E. coli resistant to tetracycline have been obtained from a strain of E. coli W-677 susceptible to 2.5 mcg/ml of the antibiotic: Ri, a recombinant resulting from crossing E. coli W-677 (recipient) and E. coli CSH-222 (donor), resistant to 200 mcg/ml of tetracycline; R2, a strain isolated upon numeros passaging E. coli W-677 on media containing the antibiotic, resistant to 25 mcg/ml of tetracycline. The ability of the resistant variants to bind the antibiotic decreased, as was found in experiments with 14C-tetracycline. Preincubation with low concentrations of the antibiotic resulted in an additional decrease of the sorption by the resistant variants, and in a decrease by 15--18 per cent in the case of the susceptible culture. The R2 variant differed in lipid composition from the parent, susceptible culture: it contained less total lipids and unsaturated fatty acids, and more branched fatty acids. The R1 variant hardly differed in lipid composition from the susceptible culture.


[Properties of the common fractions of candida, various yeasts and Salmonella cholerae suis 0 6,7 antigens]. The agglutinating serum of S. cholerae suis, obtained against the 0 6,7 antigens, agglutinated C. guilliermondii var. Carpophila and T. candida, both in tube and on slide. The anti-0 serum obtained from R phase of S. cholerae suis did not agglutinate the mentioned strains anylonger.


[Salmonella typhimurium isolated from the spinal fluid of 2 children]. In this article isolation of S. typhimurium bacteria from cebrospinal fluid of two children is reported.


[Magnius' E-antigen].

[Magnius' E-antigen]. The "e" Ag/Ac system found by Magnius in 1972 is discussed briefly. The new antigen has the same immologic and physiochemical characteristics of HBs and HBc of the hepatitis virus. Its existence shows the chronic evolution of the disease in Ag HBs carriers. Therefore the "e" antigen has a prognostic value in Ag HBs carries.


[Prodigiosin as a possible inhibitor of Serratia marcescens nuclease]. Preparations of prodigiosin inhibited the activity of nuclese of Serratia marcescens. The preparations were fractionated on an alumina column. The activity of nuclease was inhibited by both fractions containing pyrryldipyrrylmethene compounds and fractions in which these compounds were not found by spectrophotometry. The inhibitor was isolated also from the cells of a pigmentless strain. Therefore, the inhibition is exhibited by compounds that are extracted from the cells with acetone and petroleum ether, rather than by prodigiosin.


Teaching decision making to medical undergraduates by computer-assisted learning. Undergraduate medical students improve their ability to make patient management decisions through using computer-assisted learning. With this problem-solving approach an improvement in their factural knowledge also occurs and they retain a significant amount of the content.


[Riboflavin transport in cells of riboflavin-dependent yeast mutants]. Riboflavin was transported at a high rate into yeast cells of Pichia guilliermondii and Schwanniomyces occidentalis mutants capable of growth in a medium containing low concentrations of riboflavin, and having multiple susceptibility to some antibiotics and antimetabolites. Sucrose and sodium azide inhibited transport of riboflavin. Other riboflavin dependent mutants of Pichia guilliermondii, Pichia ohmeri, Torulopsis candida, and Saccharomyces cerevisiae, also growing in media containing low concentrations of riboflavin, were not capable of its active transport.


[Relationship between adsorption of microorganisms and the stage of their development]. Bond strength during adsorption of microorganisms depends on their growth stages, as was found by light optical and scanning electron microscopy. The strenth of adsorption often decreases as a culture growth on the surface of an adsorbent. Adsorption of microorganisms is an important ecological process. Under favourable conditions, microorganisms grow at a high rate when they are firmly bound to a solid surface. After abundant growth which deteriorates their microenvironment, microorganisms desorb and are dispersed. Such is a distribution of microorganisms growing on solid surfaces.


Increased healing of gastric and duodenal ulcers in a controlled trial using tripotassium dicitrato-bismuthate. Thirty-seven outpatients with benign gastric ulcers proved by endoscopy were randomized and treated with tripotassium dicitrato-bismuthate (TDB) and a placebo for four weeks. They were assessed on the basis of symptoms and endoscopy examination. Ulcer healing observed by endoscopy was significantly better in the TDB treated group (18 of 20) than in the placebo treated group (six of 17). There was no statistical difference in symptomatic improvement. Nineteen patients with duodenal ulcers proved by endoscopy were randomized in a double-blind trial and given TDB and a placebo for four weeks. Ulcer healing in the TDB treated group (eight of nine) was significantly better than in the placebo treated group (two of 10). No significant difference was found in the symptomatic improvement of both groups. It is concluded that TDB is an effective agent for the treatment of chronic gastric and duodenal ulcers.


Lung abscess due to Corynebacterium equi in a renal transplant recipient. A case of Corynebacterium equi infection in a renal transplant recipient is reported. This not uncommon pathogen of farm animals caused a lung abscess in a graft recipient who had received continuous immunosuppression with azathioprine and prednisone for seven years. Antibiotic therapy yielded radiological improvement, although the patient died from other causes. C. equi joins a growing list of rare opportunistic organisms which may cause disease in subjects who have received transplants.


[Propranolol for prophylaxis of migraine (author's transl)]. The prophylactic effectiveness of propranolol (80 to 120 mg per day) in 18 migraine patients was compared with a placebo group of 19 migraine patients in a double blind study without cross over for a treatment period of six and twelve weeks. A statistically significant difference in effect could not be ascertained. The results and methodological assumptions of the double blind studies with cross over already under consideration in the literature are discussed.


[Dopamine in patients with cardiogenic shock (author's transl)]. The effect of dopamine was tested in 20 patients with cardiogenic shock. 14 patients suffered from acute myocardial infarction, 6 patients from severe heart failure. In the beginning the dosis of dopamine was 200 to 300 microgram/min. 4 patients with an acute myocardial infarction died in shock. The remaining 10 patients survived the first shock symptomes. All patients with heart failure survived the cardiogenic shock. Hemodynamic studies showed a sigificant increase of the arterial mean pressure and a decrease of the diastolic arterial pulmonary pressure. During dopamine a statistically not significant increase of cardiac index and stroke volume was observed.


Designing a wax phantom to simulate a flat tumor with diffuse edges. A suitable was phantom was designed for evaluating various film techniques used in subtraction radiography. Holes are drilled in a slab of wax and filled with various concentrations of iodinated wax, producing disk-shaped regions with diffuse borders. The technical details of construction and a representative application are described.


Toxicity of aminoglycoside antibiotics.

Toxicity of aminoglycoside antibiotics. In cats, aminoclycosides cause vestibular damage followed in a few days by renal damage. The reverse is true in the dog, except that streptomycin causes vestibular damage prior to renal damage. To avoid toxicities, therapeutic doses of aminoglycosides should not be given longer than a week and they should be given cautiously in animals with renal impairment. Failure of the kidneys to eliminate aminoglycosides will result in very high blood levels, even with therapeutic doses, that can cause further renal and vestibular damage. The oral administration of aminoglycosides is seldom dangerous when normal therapeutic doses are employed. Although it is remote, the possibility exists that animals with renal impairment and intestinal obstruction may become intoxicated. Kanamycin is less nephrotoxic to dogs than neomycin and it is less destructive to the auditory nerve than vestibular damage than streptomycin. Gentamicin in cats is twice as toxic to the vestibular apparatus as streptomycin and more toxic to the cochlea than streptomycin or dihydrostreptomycin. Neomycin is more toxic than kanamycin, gentamicin, and streptomycin to both cats and dogs. Amikacin causes renal damage in dogs similar to other aminoglycosides. It also causes vestibular damage.


Genetic analysis of mutations affecting ribonuclease II in Escherichia coli. Exonuclease activity in an Escherichia coli K12 mutant S296 is less than 1% of that in the wild type strain (Nikolaev et al., 1976). Another mutant N464 has thermolabile ribonuclease II (Castles and Singer, 1968; Kuwano et al., 1969). Genetic analysis of these mutants by Hfr conjugation and P1 transduction indicates that the structural gene (rnb) for ribonuclease II is located near the pyrF gene (28 min on the E. coli genetic map of Bachmann, Low and Taylor (1976)), and the most probable gene order is tyrT-trp-pyrF-rnb.


Host-dependent modification of bacteriophage T7 and SAMase-negative T3 derivatives affecting their adsorption ability. When passaging phage T7 and SAMase-negative T3 mutants between E. coli strains with identical (EcoB) or without (EcoO) DNA host specificity, phenotypically a host-controlled modification and restriction is observed. This phenomenon is not due to "classical" modification and restriction of the bacteriophage DNA but depends on the reversibly altered adsorption capacity of the phages on the different host strains.


[Prosthetic rehabilitation by means of removable dentures with wires for the distribution of forces in Kennedy class 2a and 2a modification 1]. Prosthetic rehabilitation of unilateral distal edentulism (Kennedy class 2) and its combination with intercalated absence on the other side (class 2, modification 1) is discussed. Success obtained in a series of 29 cases followed for 9 yr using a removable prosthesis is described. This solved the difficult problems involved by employing metal wires to distribute the forces axially on the abutment teeth and over the unilateral edentulous ridge, thus creating a mixed dental and mucosal support.


Relative properties of tomography, K-edge imaging, and K-edge tomography. The properties of tomography, K-edge imaging, and K-edge tomography are discussed in relation to the imaging of small concentrations of elements such as iodine and xenon and are compared by means of phantom images. It is demonstrated that the complementary selectivities provided by depth and energy subtraction are combined in K-edge tomography. Using a three-spectrum subtraction technique, the iodine difference signal predicted by computer calculations is on the order of 8000 times that of an equal concentration fo bone. The corresponding ratio in tomography without energy subtraction is 20:1. It is argued that K-edge tomography can successfully eliminate artifacts due to tissue inhomogeneities which presently enable 0.6% variations in tissue attenuation to mimic minimum detectable iodine signals in conventional computed tomography. Various instrumentation possibilities and energy subtraction techniques are discussed.


X-ray photographic method for determination of stable iodine in tissues. A new x-ray photographic technique for imaging of small concentrations of iodine in tissues is presented. The method is based on the use of two x-ray beams of slightly different energies, which are obtained from the same primary source by appropriate use of critical absorbers. The beam energies are chosen so that the more energetic one is high enough to excite K x rays of the element under study while the less energetic beam is just below the required excitation energy. Two x-ray pictures are taken using the beams consecutively; thereafter, a difference picture is made by subtracting photographically the lower energy beam picture from that of higher energy. The difference picture then displays the distribution of the element to be imaged. This method is sensitive to iodine concentrations less than 100 microgram/mm2.


Dependence of DNA dark repair on protein synthesis in Escherichia coli. We investigated the influence of amino-acidless treatments applied prior and after UV irradiation (AA-irradiated AA+; AA-irradiated A-; AA+ irradiated AA-) on survival, dimer excision, postirradiation DNA degradation, DNA synthesis and sedimentation profiles of parental DNA of E. coli B/r Hcr+ cells. In dependence on the treatment applied, the fluence 50 J/m2 yielded distinctly different fractions of survivors within 0,03-85%. In all cases dimers were completely excised. The rate of DNA degradation was similar during a 30-40 min period after UV during which the bulk of dimers was excised. Degradation ceased, however, earlier in the prestarved cells than in exponentially growing ones; it was prolonged by aminoacidless postincubation. Sedimentation profiles of parental DNA did not differ during the whole period of dimer excision. In AA+ AA- cells DNA synthesis was not restored for several hours after addition of amino acids. In AA- AA- cells addition of amino acids resulted in a fast resumption of DNA synthesis. We conclude that removal of dimers and repair of gaps were similar in all cases. We believe that aminoacidless treatments influence production and repair of damage to the sites of DNA replication. The treatment appears to prevent this damage when applied before UV irradiation, but interferes with its restoration when applied after UV irradiation. Consequently, the former treatment increases survival of cells while the latter produces an opposite effect.


Host factor for coliphage Q beta RNA replication: presence in procaryotes and association with the 30S ribosomal subunit in Escherichia coli. The Host Factor required for in vitro coliphage Q beta RNA replication, a heat-stable RNA binding protein present in uninfected Escherichia coli, has been detected by both immunological and functional tests in Acinetobacter calcoaceticus, Klebsiella pneumoniae, Pseudomonas aeruginosa and Pseudomonas putida. It was not detectable by these criteria in Bacillus stearothermophilus, Bacillus subtilis, Caulobacter crescentus, Micrococcus lysodeikticus, Rhodopseudomonas capsulata or Saccharomyces cerevisiae. In Escherichia coli the Host Factor protein has been shown to be associated with ribosomes. It is demonstrated here that this association is specific for the 30S ribosomal subunit.


Trans-dominance of dnaA mutants in Escherichia coli. Temperature sensitivity of growth and DNA synthesis was tested in merogenotes heterozygous for the dnaA allele. All combinations tested (F dnaA+/dnaA5, F dnaA+/dnaA46, F dnaA+/dnaA204, F dnaA5/dnaA+, F dnaA204/dnaA+) were temperature sensitive. The mutant dnaA allele is thus trans-dominant to the wild type allele.


Incompatibility and bacteriophage inhibition properties of N-1, a plasmid belonging to the H2 incompatibility group. N-1, a plasmid isolated from a strain of Shigella flexneri in Japan more than 10 years ago, mediates the phage inhibition phenotype which has recently been found to be characteristic of plasmids of the H2 incompatibility group. Using the criteria of phage inhibition, surface exclusion and incompatibility, the N-1 plasmid is shown to be closely related to H2 plasmids isolated from non-typhoid salmonella and distantly related to H1 plasmids isolated from Salmonella typhi. Plasmids of other incompatibility groups did not show the H2 type of phage inhibition.


Transcription of insertion elements IS1 and IS2 in vitro. Insertion elements IS1 and IS2 integrated within the gal operator-promoter region, an IS1 element in gene galT and insertions IS1 and IS2 integrated in the xycIIOP region of phage lambda were transcribed in vitro with E. coli RNA-polymerase. The insertion elements are transcribed exclusively by polymerase molecules started at the gal promoter and the lambdaPR promoter respectively. No promoter exists on IS1 or IS2 which can be recognized by RNA-polymerase in the pure in vitro transcription system used. Both insertions apparently are transcribed with a lower elongation rate than gal operon DNA or lambdaDNA. RNAs transcribed from the termini of IS1 and IS2 respectively were analysed by hybridization experiments. They are different in sequence.


The effect of the ribosomal protein S1 from Escherichia coli on the synthesis in vitro of bacterial-, DNA phage- and RNA phage proteins. Using an in vitro preparation for protein synthesis, we have studied the effect of the ribosomal protein S1 from Escherichia coli on the synthesis of the coat protein of the RNA-containing phages Qbeta and MS2, on that of an "early" and a "late" enzyme encoded by the DNA containing phage T7, and on that of anthranilate synthetase, an enzyme encoded by the bacterial tryptophan operon. Our results indicate that for the synthesis of these five proteins the presence of S1 is required. From these results we conclude that S1 is an essential protein for the translation of bacterial and bacteriophage messenger RNA.


Bacteria with defective rho factors suppress the effects of N mutations in bacteriophage lambda. A prediction based on the model for N-gene function of bacteriophage lambda proposed by Roberts (1971) is confirmed by showing that a lambdaN- double mutant is able to grow in strains of E. coli with defective rho transcription termination factors. The burst sizes for lambdaN- in these strains range from 5 to 24% the burst sizes for lambdaN+ in the same strain. This low level of suppression is also evident in the levels of synthesis of the lambda exonuclease and is consistent with other evidence that the defect in the rho factors of these strains is only partial. These strains do not suppress the effects of mutations in genes O, P and Q of lambda nor in genes 30 and 43 of bacteriophage T4. The lack of suppression of lambdaQ- is significant because the Q-gene product, like the N-gene product, is believed to function as an anti-terminator of lambda transcription but at termination sites that may not require rho factor action.


A conditional antimutator in E. coli.

A conditional antimutator in E. coli. A pleiotropic mutation in the purB gene of E. coli is described which lowers the spontaneous mutation frequency of other genes. The antimutator effect is very large for some genetic loci, but is absent at other sites. Both forward and reverse mutations are affected. This mutation in purB is temperature sensitive for both adenine auxotrophy and the antimutator action. Adenine, or adenosine, or low temperature growth abolish the antimutator effect. The mutagenicity of base analogs and nitrosoguanidine at several loci was found to be reduced by this purB mutation. The antimutator effect is recessive in strains merodiploid for the purB region. The frequency of reversion of mutation on F' episomes is affected by the chromosomal antimutator, which therefore acts in trans. Xray and UV sensitivity are normal in this mutant, which is the first antimutator characterized in E. coli.


Active protection by bacteriophages T3 and T7 against E. coli B- and K-specific restriction of their DNA. The bacteriophages T3 and T7 are not modified and restricted by E. coli strains with different host specificity (E. coli B, K, O) in vivo. The phages code for a gene product with the ability to overcome classical restriction (ocr): ocr- mutants are subject to modification and restriction via DNA methylation vs cleavage. The T3 genome possesses recognition sites for the restriction endonuclease R.EcoB which, unless the DNA is B-specifically modified, trigger 5-7 DNA cleavages. The ocr gene function of T3 and T7 is located within the gene 0.3 region of these phages and is not identical with the sam (SAMase) function of T3. The mechanism of ocr protection remains unclear, while it is certain that this protection by the gene 0.3 protein is exerted in the infected cell and not through "over-all" modification in the preceding growth cycle of the phage.


A new ribosomal protein locus in Escherichia coli: the gene for protein S6 maps at 97 min. A mutant of E. coli selected for temperature-sensitive growth on rich medium harbored an altered ribosomal protein S6 (Isono et al., 1976). This mutant was found to  possess at least two mutations, one being responsible for the temperature-sensitivity and the other for the S6 alteration. Crosses with various Hfr strains as well as transductions with P 1kc revealed that the former mutation mapped at 98 min and the latter at 97 min. Furthermore, rec A derivatives of this mutant heteromerodiploid for this region possessed both the wild type and themutant forms of S6. Thus it was established that the gene at 97 min was indeed the structural gene for protein S6 (rpsF) and not a gene modifying it.


A mutant of Saccharomyces cerevisiae that exhibits multiple isoacceptors for several of its transfer RNAs. A strain of Saccharomyces cerevisiae, known to produce multiple isoaccepting forms of several tRNA's which differ from a standard wild type strain, has been studied genetically. The multiple isoaccepting tRNA phenotype behaves as if it is caused by a single recessive mutation. Five tetrads were analyzed and all showed a 2:2 segregation of mutant to wild type profiles for Phe-tRNA Phe. Furthermore, the multiple isoacceptors for the other tRNA's in the mutant strain are probably caused by the same mutation, since Tyr-tRNA Tyr and Val-tRNA Val also exhibit 2:2 segregation for mutant versus wild type tRNA profiles and the segregation pattern is the same as that for Phe-tRNA Phe.


Glucosamine resistance in yeast. II. Cytoplasmic determinants conferring resistance. Two cytoplasmic, glucosamine resistant (GR) mutants of Saccharomyces cerevisiae, GR6 and GR10, were crossed to strains bearing known mitochondrial markers. Analysis of vegetative and meiotic segregation patterns in these crosses suggested that the glucosamine resistance conferring factor did not reside on mitDNA. This was confirmed by ethidium bromide treatments which completely abolished oligomycin resistance due to a mitochondrial mutation at the OL12 locus but which failed to eliminate the GR factor present in the same strain. Comparison of GR6 and GR10 to some other known cytoplasmic determinants suggested that while glucosamine resistance is not related to the killer plasmid it may be allelic to the URE3 determinant and/or to the PSI factor.


On the ability of Salmonella typhimurium cells to form deoxycytidine nucleotides. It is known that cdd- S. typhimurium mutants selected for resistance to 5-fluorodeoxycytidine (FdCyd) possess no deoxycytidine kinase activity. The present study postulates that this method of screening selects double mutants defective in cytidine deaminase and in deoxycytidine kinase. To prove this hypothesis, the cdd mutant of S. typhimurium was constructed by P1-mediated transfer of ccd- gene into a new genetic background, and the activity of deoxycytidine kinase was assayed. Transductants exhibited no deoxycytidine kinase activity, showing that the absence of this enzyme is not limited to a specific cdd- mutant, but includes all strains of S. typhimurium. The toxicity of FdCyd for the bacterial strains possessing deoxycytidine kinase, as well as the role of nucleoside phosphorylase in nucleotide formation by S. typhimurium, is discussed.


Repression of inducible enzyme synthesis in a mutant of Escherichia coli K 12 deleted for the ptsH gene. The genome of lambda phage with thermosensitive repressor was inserted into the pts region of the Escherichia coli chromosome. This lysogenic culture possessed the PTS1 phenotype at 30 degrees C. A mutant strain with a deletion covering the ptsH gene was isolated after a prophage curing procedure. The deletion nature of the pts mutation was confirmed in genetical and biochemical experiments. The deletion covered a small fragment of the bacterial genome not extending in the ptsI and lig genes. The isolated deltaptsH mutant possessed all characteristics of known pts mutants: pleiotropical disturbances of transport and utilization of a number of carbohydrates, repression of the enzyme inducible synthesis, and resistance to glucose catabolite repression. From these and other data we can conclude that the phosphorylated form of the heat-stable protein HPr is involved (directly or indirectly) in activation of the DNA transcription process.


A new ribosomal mutation which affects the two ribosomal subunits in Escherichia coli. A new ribosomal mutant resistant to erythromycin is described. The product of the gene eryC seems to be implicated in the assembly of the two ribosomal subunits, particularly in the maturation process of the RNA 23S and 16S.


Effect of mutant host RNA polymerase on the bifunctional activities of P22 gene c1. The product of phage P22 gene c1 has two functions: (1) it promotes synthesis of repressor and (2) during the first minutes of infection it retards expression of some lytic genes. We call the second, negative function "c1 retardation". We investigated c1 retardation in a mutant host of Salmonella typhimurium that is resistant to rifampicin and carries an altered RNA polymerase. No c1 retardation of DNA synthesis was detectable in this  host after infection with wild-type phages. This elimination of the normally detectable c1 function leads to the conclusion that the mutant RNA polymerase interferes with the expression of c1 gene activity. Wild-type genes form clear plaques on the mutant host. Mutants of P22 called cly were isolated by others. These mutants form turbid plaques on the altered RNA polymerase host. Infections with P22 cly in the mutant host resulted in detectable c1 retardation. The cly mutation therefore restores c1 activity in a host which wild-type c1 is not expressed. Two spontaneous mutants were isolated from the mutant host. These two strains allowed partial expression of c1 retardation, although they remained rifampicin resistant. We interpret our data to indicate that expression of the normal functions of the gene c1 product requires an interaction of that product with the host RNA polymerase.


[On certain embryopathies induced by teratogenic agents (author's transl]. In a survey of the literature the teratogenic effects of radiation and some drugs are discussed. Teratogenicity is proved for thalidomide, aminopterin, busulfan, cyclophosphamide, chlorambucil, mercaptopurin and diphenylhydantoin, trimethadione and warfarin. After the thalidomide-tragedy drug-induced malformations of the embryo are extremely rare, whereas malformations due to alcohol are rather frequent. Own experiences with more than 70 patients with alcoholembryopathy are reported. Nicotin seems not to be teratogenic, but due to nicotin the perinatal mortality is elevated. The questionable teratogenic effects of Heroin and LSD are discussed.


Polyamines and protein synthesis: studies in various polyamine-requiring mutants of Escherichia coli. Different Escherichia coli mutants auxotrophic for polyamines were studied in order to investigate the relationships among polypeptide synthesis in cell-free systems, ribosomal distribution profiles and endogenous polyamine pools. The in vitro protein synthetic activity and the polyribosomal content were reduced in extracts from putrescine-starved cells of the double mutans MA 255 and MA 261, but not in the arginine-conditional auxotroph DK 6. Putrescine addition to the cultures of all these strains previously starved for polyamines, provoked a shift towards monomers in the equilibrium involving ribosomal particles. Concomitant changes in the intracellular levels of polyamines were observed: putrescine and spermidine increased markedly, and cadaverine disappeared.


[Diagnostic therapeutic problems of defibrination syndrome in shock, sepsis, and neonatal hypoxia (author's transl)]. The diagnosis of defibrination syndrome in shock, sepsis and neonatal hypoxia is based, in addition to the clinical picture, upon a few parameters of the hemostatic system, which, in part as global tests, provide information about the course of coagulation. The parameters measured are partial thromboplastin time, thromboplastin time, plasma thrombin time, fibrinogen, thrombin-coagulase and reptilase times as well as platelet count. Normal values of these laboratory parameters were established for healthy newborns 1--5 days of age, and for healthy adults. It is suggested that especially partial thromboplastin time, the thrombin-coagulase and reptilase times, the latter influenced by fibrinolysis cleavage products, are representative for the tentative diagnosis of disseminated intravascular coagulation with fibrinolysis syndrome (DICFS). The platelet fall often lags 1--2 days behind the event. Moreover normal values for newborns, are markedly higher than those for older children or adults. In the presence of DICFS, a low-dose heparin therapy is immediately initiated. If completed defibrination is manifest, therapy is supplemented with urokinase and streptokinase, For DICFS with congenital sepsis, an exchange transfusion with heparinized fresh blood is the treatment of choice.


Risks of vesicoureteric reflux in the transplanted kidney. The risk to the transplanted kidney of vesicoureteric reflux was evaluated in 150 consecutive first cadaveric renal allografts surviving for over three months. Of the 119 (79 per cent) allografts studied by micturating cystography 29 (24 per cent) were shown to reflux. The presence of reflux was associated with urine leakage and reoperation, and with ureteric insertion involving a short intramural tunnel. Graft failure (graft nephrectomy or death from renal failure) occurred in 14 of 29 refluxing grafts as compared to 14 failures in 90 nonrefluxing grafts (P less than 0.01). Graft failure in the refluxing group was typically slow, and commonly associated with proteinuria, microscopic hematuria, hypertension and a biopsy appearance of mesangiocapillary glomerular change. Urinary infection, though frequent (69 per cent), was not more common in the group with than in that without reflux. Vesicoureteric reflux is an important cause of late renal-graft failure.


[Neuromuscular interactions--tendencies toward a biochemical-genetic analysis]. The analysis of hereditary neuro-muscular diseases in the mouse and in other vertebrates may contribute to our understanding of the developmental interactions between spinal cord and sceletal muscle. Meaningful biochemical analysis must be preceded by "biological mixing experiments" to demonstrate whether a given mutation is cell-autonomous, and, if so, which cell type caries the primary defect. Techniques are available to carry out the critical experiment in vivo (artificial chimaeras) or in culture.


Combined stereotaxic surgery for relief of intractable pain. We have carried out 43 of our standard combined stereotaxic thalamotomies in 37 patients with intractable pain. Our standard targets in thalamotomy for pain relief consisted of pulvinar, dorsomedial, centromedial, parafascicular and limitans nuclei. 91% of all the cases had excellent or good results. Six patients had bilateral thalamotomy because of severe relapse. Five patients developed mental disorientation and confusion after operation, but in a week returned to a normal state. One of the 37 patients died. Autopsy revealed cardiac infarction. On the basis of our results we consider the use of our standard targets to be most suitable for relieving intractable pain.


VEP and SEP in non-specific thalamic nuclei and pulvinar during stereotaxic surgery. This report is based on recordings of evoked photic (VEP) and somatosensory response (SEP) from the thalamic nuclei and cortex of 17 humans during stereotaxic surgery. The cortical SEP and VEP have relatively uniform patterns. The initial latency of the cortical VEP is shorter than that of SEP. Both thalamic SEP and VEP give relatively constant response to Limitans and Parafascicularis, Centromedian and Pulvinar but Dorsomedial nucleus has a smaller and variable latency. Thalamic SEP gives a better response than thalamic VEP in Nucleus Limitans and Parafascicularis, Nucleus Centromedian, and Pulvinar. This suggests that the non-specific thalamic nuclei, especially Centromedian, Limitans and the nucleus Parafascicularis and Pulvinar, play an important role in pain conduction and function as a relay station in the transmission of non-specific visual impulses. The visual evoked response pattern as well as somato-sensory evoked response from the thalamic nuclei can serve as a very reliable means of controlling the target area prior to subcortical destruction.


Eikenella corrodens isolated in oral infections of dental origin. Eikenella corrodens causes significant clinical infection more frequently than is suspected at the present time. The laboratory must be made aware of the organism and the techniques that are necessary to identify it. The clinician must be aware of the methods of isolating organisms in general. The use of a transport solution was shown to be a highly effective and clinically practical way of isolating those organisms present. The pathogenic potential of E. corrodens can no longer be doubted.


Harmful effects of "aspirin compounds".

Harmful effects of "aspirin compounds". "Aspirin" is the most widely used medication which is considered to be safe and effective, and which can be obtained universally without prescription. A review of the literature and clinical experience reveal that many complications can be attributed to the prolonged use of it. Some of these complications involve damage to various tissues and organs (particularly the gastric mucosa, the renal papilla, red blood cells, and the inner ear) and to coagulation and body temperature control. Hemorrhagic gastritis may result with as little as 600 mg. of salicylate four times a day for 5 days. Papillitis of the renal system may result from a comparable dosage of aspirin compound mediates with phenacetin. The purpose of this article has been to call attention to some of the important complications which may result from salicylate abuse. It is hoped that many of these complications may be avoided by proper and effective indoctrination of patients to the hazards associated with prolonged or indiscriminate intake of salicylates.


Enteric pathogens in infants and children in Shiraz, Iran: A study of their incidences and infectious drug resistance. Gastroenteritis is a serious problem among young children in Shiraz Iran and often requires antibiotic therapy as it is commonly superimposed on other debilitating clinical conditions. Stool specimens from over four hundred cases of gastroenteritis among children up to six years of age were examined for the presence of bacterial pathogens and the pattern of drug sensitivity for each pathogenic genus was determined. The presence of infectious drug resistance factors among these isolates was also established.


Acute pneumonia in the newborn: changing picture. Pneumonia is one of the most serious infections in the neonate and is responsible for a large percentage of neonatal mortality. Pneumonia in a premature or term infant who is debilitated by an underlying problem such as hyaline membrane disease carries an extremely high morbidity and mortality. Since most of the bacterial pneumonias are treatable, early recognition and diagnosis and vigorous treatment are essential. X-ray findings, though helpful, serve only as a guideline. Prognosis is adversely affected if pneumonia results in generalized sepsis, leading to meningitis, disseminated intravascular coagulation, and osteomyelitis. Prompt antibiotic treatment should be begun before the etiologic agent or drug susceptibility is known.


Protection against experimental necrotizing enterocolitis by maternal milk. I. Role of milk leukocytes. A rat model of necrotizing enterocolitis of the neonate in which maternal milk had been protective was studied to determine what components of the milk afforded protection and by what mechanism. Frozen and thrawed rat milk was not protective, but formula supplemented with rat milk cells was. It was concluded that the cells provided protection. The cells, which are principally mononuclear phagocytes, can phagocytize and kill the Klebsiella pneumoniae strain used in the animal model. Animals with necrotizing enterolitis had peritonitis and bacteremia caused by this bacillus.


Characterization and localization of the human genes for ribosomal ribonucleic acid. The genetic sequence complementary to ribosomal RNA was separated from human DNA and its characteristics studied. Both 18S and 28S sequences were located on the same isolated strand. DNA-rRNA hybrids have a melting temperature of 80 degrees or 4 degrees less than that of native ribosomal DNA. Ribosomal genes behave as a satellite when complexed with Ag+ in the Cs2SO4 gradient. With in situ hybridization, these rRNA genes can be shown to chromosomally translocate. The study of a highly fluorescent chromosome indicates that the ribosomal DNA does not contribute to the fluorescent nature of the secondary constrictions. This study examines the molecular organization of human ribosomal genes. The chromosomal inheritance of these genes is explored by in situ hybridization.


Peroxidase technique for the detection of photochemical lesions in intracellular deoxyribonucleic acid. The widespread use of phototherapy for the prevention and treatment of neonatal hyperbilirubinemia has generated some conxern as physiologic substances other than bilirubin may be photoactivated. Little information is available on the long term toxicity of these photodecomposition products. Recent observations of the in vitro DNA-modifying activity of phototherapy lights has encouraged us to develop laboratory procedures which can identify and quantitate these light-induced alterations. The purpose of the present study was to develop a technique capable of detecting photochemical changes in the genetic material of human cells in tissue culture. The results demonstrate that the antinucleoside peroxidase staining procedure is capable of detecting changes in the DNA of human cells exposed to physiologic (riboflavin) and nonphysiologic (methylene blue) photosensitizing agents in the presence of light with a fluence rate (450 nm) of 141 muW-cm2.


Congenital malaria: a rare cause of splenomegaly and anemia in an American infant. A 38-day-old infant had fever, jaundice, hepatosplenomegaly, and a hemolytic anemia. A peripheral blood smear demonstrated intraerythrocytic malarial parasites identified as Plasmodium vivax. Maternal and infant sera contained antibodies to this species. A directed history revealed the mother had suffered several febrile illnesses in Mexico during her pregnancy. Malaria had not been diagnosed nor was it considered at the time of her delivery at this hospital. Review of this and six other cases of congenital malaria reported in this country since 1950 indicates clinical manifestations seldom appear before 3 weeks of age. Although these signs are more frequently associated with other transplacental infections, their occurrence in an infant whose mother is from or who has traveled in an endemic area should prompt consideration of the diagnosis of congenital malaria.


Human time estimation: bibliography.

Human time estimation: bibliography. Journal articles and several other types of publications concerned with human time estimation are divided into the following three chronological sections: 1960-1964, 1965-1969, and post 1969. Each section includes experimental, theoretical, and methodological papers.


Bibliography: Piaget's theory and exceptional children, 1974. This is a bibliography of 55 citations which, in lieu of annotations, is keyed to abstracts in Child Development Abstracts and Bibliography, Dissertation Abstracts International, ERIC Research in Education, Exceptional Child Education Abstracts, Mental Retardation and Developmental Disabilities Abstracts, and Psychological Abstracts.


[Wound healing in viscera studied using a hemostatic gelatin-starch sponge of Polish manufacture]. The authors studied the reaction of liver, spleen and kidneys in rats to the implantation of Polish made hemostatic gelatin-starch sponge. The sponge under study evoked no disadvantageous tissue reactions in the case of liver; it was readily resorbed and did not inhibit the wound healing. It facilitated the healing of lienal wounds without any suturing and produced neither local nor general disadvantageous results. When dressing renal wounds, the sponge was completely resorbed within 3 weeks and the wound was completely healed. The renal wounds healed without any complications despite of a greater tissue reaction compared with that of liver and spleen.


Recent developments in diarrheal diseases. Diarrheal diseases result from two different processes: toxin elaboration by pathogens such as Vibrio cholerae and some strains of Escherichia coli and invasion of tissue, eg, by shigellae and salmonellae. Intestinal motility serves as a normal cleansing mechanism of the intestine, and drugs that decrease this motility may facilitate replication of pathogens and their attachment to or invasion of the intestinal tissue. Therapy should not be aimed at suppressing the symptom of diarrhea. It is now known that the electrolytes lost in the course of diarrheal disease can be replaced orally if they are given in solution with glucose. Although commercial preparations are not readily available, an effective solution can be made from ingredients commonly found in the home. Oral rehydration has greatly simplified treatment and has significantly reduced the morbidity and mortality associated with diarrheal diseases.


Influenza virus pneumonia after renal transplant. A 40-year-old woman who had recently undergone kidney transplantation was succesfully treated for diffuse influenza virus pneumonia. The illness was acute, with rapid onset, high fever, nonproductive cough, dyspnea, cyanosis, crepitations and rales over both lung bases, and associated arterial hypoxemia, leukopenia, and thrombocytopenia. Prophylactic use of antibiotics to prevent superimposed bacterial infection and reduction of immunosuppressive therapy to minimal dosage during the critical phase of the respiratory infection contributed to the patient's survival. An episode of graft rejection was reversed by resumption of immunosuppressive therapy at standard dosage levels.


Hepatic porphyrias. Current concepts.

Hepatic porphyrias. Current concepts. Acute intermittent porphyria, variegate porphyria, and hereditary coproporphyria are hepatic porphyrias due to enzyme defects that are inherited as autosomal dominants. Porphyria cutanea tarda is considered an acquired disorder. Similar drugs or circumstances are precipitants of acute attacks in all three inherited hepatic porphyrias. The respective biochemical abnormalities are identifiable by simple, readily available laboratory tests. Management of patients with any of the inherited hepatic porphyrias is directed primarily toward prevention of attacks through avoidance of precipitants and through a diet high in carbohydrate. Therapy for porphyria cutanea tarda includes interdiction of alcohol use and repeated phlebotomy.


[Renal transplantation: results and conditions for donor-nephrectomy (author's transl)]. The role of renal transplantation as a method of treatment of chronically uraemic patients is presented considering recent data. The number of chronically haemodialysed patients is 64,0000 in the world. About 20,000 kidneys have been transplanted. In spite of advantages of a combined treatment by dialysis and transplantation, the frequency of transplantation is very low in West Germany. Lack of donor-organs is one of the most striking factors in this situation. Cooperation between the different disciplines would solve these problems. The conditions for donor procurement are presented.


[Anaesthesiological problems in donor-nephrectomie and kidney transplantation (author's transl)]. The quality of cadaver renal homografts is not at least dependent on the anaesthesiological management. The latter should include artificial ventilation with oxygen, correction of acidosis, abundant infusion of iso- and hyperosmolar solutions, phenoxybenzamine infusion, heparin i.v. Preoperative disorders and anaesthesiological problems in patients undergoing renal transplantation are discussed. Neuroleptanalgesia was performed in all 112 patients.


[Intravenous glucose tolerance test and insulin and growth hormone secretion in chronic pancreatitis]. The serum content of immunoreactive insulin and growth hormone was determined during the intravenous glucose tolerance test in 104 patients suffering from chronic pancreatitis at the stage of exacerbation and of clinical remission. Reduction of glucose tolerance was more pronounced during the exacerbation of the disease than at the period of clinical remission. In comparison with the control group, insulin hypersecretion (more pronounced during the exacerbation) was revealed in these groups of patients as a whole. A reduction of the insulin/glucose ratio in the patients indicated a relative character of insulin deficiency. The maximal reduction of the insulin/glucose ratio was noted in the patients with a diabetic character of glucose tolerance. Elevation of the growth hormone basal secretion in comparison with control was revealed in the patients at the period of exacerbation.


[Experimental aspects of the central nervous system - the insular system. 2. Reaction of the dorsal nucleus of the vagus nerve to insulin deficiency]. The kariometric method was used to study the response of the nerve cells of the Nucl. dorsalis nervi vagi to insulin deficiency in rats with alloxan diabetes. Response to experimentally-induced diabetes of the nerve cells of the Nucl. tractus solitarii, adjacent nucleus in the medulla oblongata, served as control. In both cases the size of the cell nuclei of the areas under study was compared with the size of the cell nuclei in the same regions of the medulla oblongata of intact rats. Distinct and statistically significant shifts in the size of the cell nuclei of the Nucl. dorsalis nervi vagi in rats with alloxan diabetes were revealed in comparison with control measurements. Thus, sensitivity of the central nucleus of the vagus to insulin deficiency was revealed. Possible ways of participation of the vagus in the control of the insular apparatus are discussed.


[Ultrastructural analysis of the effect of alloxan on the insular apparatus of the pancreas in amphibia]. Administration of alloxan to Rana temporaria in a dose of 300 mg/kg caused a complex of reactive changes in the pancreas (degranulation of B-cells, of acino-islar cells of B type, and of the exocrine pancreocytes; edema of the secretory granules, lysosome activation, disturbance of the secretory cycle course), which were irreversible in the majority of cells.


Experimental evidence for kinetic proofreading in the aminoacylation of tRNA by synthetase. The enzymatic aminoacylation of tRNA can be viewed as a means of proofreading either the amino acid or the tRNA or both. We have conducted further experimental tests of kinetic proofreading in  discriminating between cognate and noncognate amino acids and tRNAs as follows: (formula: see text). In cases (i) and (ii) the amino acids are proofread, in cases (iii) and (iv) the tRNA is proofread, and in case (v), both the amino acid and the tRNA are proofread. ATP consumed per acylation was 400, 1.5, 40, 25, and 1000, respectively. High ATP/aminoacylation ratios are diagnostic for kinetic proofreading.


Inactivation and proteolytic cleavage of phage lambda repressor in vitro in an ATP-dependent reaction. We have reproduced in vitro the inactivation of bacteriophage lambda repressor that occurs in vivo when a lambda lysogen is treated with agents such as ultraviolet radiation that attack DNA. ATP and a divalent cation are required for the inactivation reaction. The ind- repressor is insensitive to the inactivation mechanism. A proteolytic cleavage of repressor accompanies inactivation in vitro, as it does in vivo.


Use of polylysine for adsorption of nuclei acids and enzymes to electron microscope specimen films. Enzymes and nucleic acids, both free and as bound in binary complexes, adsorb to electron microscope specimen films in well-distributed fashion if a dilute solution of polylysine is previously applied to the films. Electron micrographs are exhibited that demonstrate the usefulness of the technique in visualizing double- and single-stranded DNA, Escherichia coli RNA polymerase (nucleosidetriphosphate:RNA nucleotidyltransferase, EC 2.7.7.6) in negative stain, and polymerase complexed to poly(dA-dT) and to an 1100 base-pair restriction fragment of bacteriophage T7 DNA containing the early promoters. The base-pair spacing of DNA prepared for electron microscopy by the polylysine method was found to be 0.326 nm. Four promoter sites on the T7 fragment were located at 215, 440, 560, and 670 base-pair distances from the left terminus. When poly(dA-dT) was incubated with a 20-to-1 weight ratio of polymerase the bound enzyme particles were found to be about two-thirds as closely packed as is sterically permissible.


Shape of the 50S subunit of Escherichia coli ribosomes. Extrapolation of a series of low-angle neutron scattering curves to infinitely high contrast gives a scattering function IC(kappa) which is dependent on the shape of the solute molecule. For the 50S subunit of E. coli ribosomes, the first part of the structure determination by neutron scattering, namely the determination of the molecular shape from IC(kappa), is reported. The result is in good agreement with models of the 50S subunit determined by electron microscopy.


The complete amino acid sequence of prochymosin. The total sequence of 365 amino acid residues in bovine prochymosin is presented. Alignment with the amino acid sequence of porcine pepsinogen shows that 204 amino acid residues are common to the two zymogens. Further comparison and alignment with the amino acid sequence of penicillopepsin shows that 66 residues are located at identical positions in all three proteases. The three enzymes belong to a large group of proteases with two aspartate residues in the active center. This group forms a family derived from one common ancestor.


Nucleic acid helix-unwinding properties of ribosomal protein S1 and the role of S1 in mRNA binding to ribosomes. The presence of ribosomal protein S1 in 30S ribosomes is indispensable for the formation of 30S initiation complexes with natural mRNA. The 30S subunits lacking S1 retain activity with AUG as mRNA and are also active in poly(rU)-directed binding of Phe-tRNA. Isolated protein S1 stoichiometrically disrupts the secondary structure of helical and stacked single-stranded polynucleotides and converts them into their fully or partially denatured forms. A mono-N-ethylmaleimide derivatives of S1 is nearly devoid of any RNA helix-unwinding properties but is readily incorporated into 30S subunits deficient in S1. The resulting N-ethylmaleimide-S1-containing 30S subunits are completely inactive in the binding of MS2 [3H]RNA and in the formation of an initiation complex with MS2 RNA as mRNA. They retain activity in the binding of the initiator fMet-tRNA in response to the trinucleotide AUG and in the binding of Phe-tRNA in response to poly(U). They also retain the capacity to bind 50S subunits and to form 70S couples. These results suggest that a correlation exists between the RNA helix-unwinding capacity of isolated S1 and the function of S1 in the ribosomal binding of natural mRNA when the protein becomes part of the 30S subunit.


Sensitivity, polarity, and conductance change in the response of vertebrate hair cells to controlled mechanical stimuli. Hair cells, the primary receptors of the auditory, vestibular, and lateral-line sensory systems, produce electrical signals in response to mechanical stimulation of their apical hair bundles. We employed an in vitro preparation and intracellular recording to investigate the transduction mechanism of hair cells in the sacculus from the inner ear of the bullfrog (Rana catesbeiana). When stimulated directly by mechanical deflection of their hair bundles, these cells gave graded responses up to 15 mV in amplitude; the peak sensitivity was about 20 mV/micron deflection. The depolarizing component of the receptor potential corresponding to stimuli directed towards the kinocilium. Depolarizing responses were associated with a membrane resistance decrease, and hyperpolarizing responses with a resistance increase. Action potentials, possibly calcium spikes, were occasionally evoked in hair cells by mechanical or electrical stimulation.


Membrane ultrastructural changes during calcium phosphate-induced fusion of human erythrocyte ghosts. Nascent calcium phosphate promotes the agglutination and fusion of human erythrocyte ghosts. Membrane phospholipids of erythrocyte ghosts treated with Ca2+ and phosphate ions become exposed to attack by phospholipase C (phosphatidylcholine cholinephosphohydrolase, EC 3.1.4.3) (Bacillus cereus). Freeze-fracture pictures of fused erythrocyte ghosts show the presence of regions deficient in intramemebrane particles in the protoplasmic face which we believe to be regions of fusion. Discontinuous regions of the protoplasmic and exoplasmic faces are observed, which are apparently intermediate stages in the process of fusion. TH-in-section electron micrographs reveal deposits of calcium phosphate in areas of contact and fusion of ghosts. Ca2+ in the presence of N-[tris(hydroxymethyl)methyl]glycine (Tricine) buffer causes the formation of blebs in the membrane but does not cause changes in the intramembrane particle pattern or induce fusion. It is suggested that nascent calcium phosphate acts by forming protein-free regions of phospholipid bilayer which can fuse readily.


Isolation and preliminary characterization of 10-nm filaments from baby hamster kidney (BHK-21) cells. A procedure for isolating 10-nm filaments as juxtanuclear caps from normal and colchicine-treated BHK-21 cells is described. These aggregates of 10-nm filaments retain their birefringence and their structural integrity. The major proteins comprising the filament preparations can be resolved as two bands on sodium dodecyl sulfate gels, corresponding to approximate molecular weights of 54,000 and 55,000.


Immunoflourescent staining of cytoplasmic and spindle microtubules in mouse fibroblasts with antibody to tau protein. tau protein isolated from porcine brain microtubules was further purified by electrophoretic elution from polyacrylamide gels and used to prepare antisera in rabbits. The antiserum to tau specifically stains mitotic spindles and a filamentous network within mouse fibroblasts when the indirect immunofluorescence technique is used. The staining of the filamentous network and mitotic spindles is identical to that observed when cells are treated with antiserum prepared against electrophoretically purified tubulin. The filamentous network observed with either serum is sensitive to Colcemid. Absorption of anti-tau serum with electrophoretically purified tubulin does not remove the immunofluorescent staining of the mitotic spindle, whereas absorption with electrophoretically purified tau protein does. Conversely, absorption of antitubulin serum with tubulin eliminates its ability to stain the mitotic spindle, whereas absorption with tau has no effect. We conclude that tau protein and tubulin are antigenically distinct proteins and that tau is an integral part of microtubules in vivo. These results also provide evidence that tau protein, or an antigenically related protein, is associated with microtubules not only in brain but also in other cell types.


Selection of reconstituted cells from karyoplasts fused to chloramphenicol-resistant cytoplasts. Murine Balb/3T3 and murine A-MT-BU-A1 mammary tumor cells were separated in the presence of cytochalasin B into enucleated cytoplasmic components (cytoplasts) and nucleated subcellular components (karyoplasts). Karyoplasts were derived from 3T3 cells, while cytoplasts were derived from A-MT-BU-A1 cells that were both chloramphenicol-resistant (CAP(r)) and sensitive to hypoxanthine/aminopterin/thymidine (HAT(s)). CAP(r) has been shown to be cytoplasmically transmitted (possibly a mitochondrial gene mutation), while sensitivity to medium containing HAT has been shown to be transmitted by the nucleus (i.e., nuclear gene mutation). Such CAP(r) cytoplasts derived from A-MT-BU-A1 cells were then fused, using polyethylene glycol, to HAT-resistant 3T3 karyoplasts. The mononucleated reconstituted cells produced by such procedures were cloned in medium containing both HAT and CAP. Some of the reconstituted cells survived, because they were resistant to both drugs, while the nuclear and cytoplasmic whole cell contaminants were killed by one or the other of the two drugs. The results of these experiments indicate that reconstituted cells that are derived from two different cell lines are viable, as indicated by their ability for long-term proliferation in culture. Most of the clones derived resembled morphologically the 3T3 nuclear donor parent cells, but some of the clones did not resemble either parental cell line. It is anticipated that such selection techniques will permit more complete analysis of interrelationships between nucleus and cytoplasm.


Cell surface-associated structural proteins in connective tissue cells. Collagen and/or procollagen was demonstrated on the surface of monolayers of fibroblasts from normal rat kidney by indirect immunofluorescence with affinity-purified antibodies to collagen. The protein was arrayed in a reticular fashion on the cell surface and, in cells attached to a substratum, was severely restricted in its ability to undergo antibody-induced translational movement in the plane of the membrane. A similar pattern was observed for fibronectin (LETS protein, fibroblast surface antigen). These macromolecules were lost when fibroblasts were dissociated and examined in suspension cultures and were not regained until after the cells were replated. On the basis of the morphological findings, and in view of the likelihood of an interaction between fibronectin and collagen, we propose that these that these proteins form a meshwork on the cell surface. This external protein meshwork may mediate a number of important cellular functions, including attachment to a substratum and other interactions with the extracellular matrix.


Visualization of a system of filaments 7-10 nm thick in cultured cells of an epithelioid line (Pt K2) by immunofluorescence microscopy. During our studies with antibodies against structural proteins of the cytoskeleton of eukaryotic cells we have observed that sera from many normal rabbits decorate a fiber system in cells of the established rat kangaroo cell line Pt K2. The display and organization of these fibers are different from those of microfilament bundles (decorated by antibody to actin) and microtubules (decorated by antibody to tubulin). This new fiber system can be further distinguished by its resistance to reorganization when cells are treated with Colcemid or cytochalasin B. The decoration of this fiber system is not detected if Pt K2 cells are fixed with formaldehyde. Such sera also appear to decorate swirls of perinuclear fibers in mouse Neuro 2a cells, and in mouse 3T3 cells treated with mitotic drugs. Comparison of the immunofluorescence pictures with electron microscopic data suggests that the sera are visualizing bundles of intermediate 7- to 10-nm filaments.


Selective amplification of genes on the R plasmid, NR1, in Proteus mirabilis: an example of the induction of selective gene amplification. The drug-resistance plasmid, NR1, is a 37-micron circular DNA molecule that contains two components: the resistance transfer factor (29 micron) carrying the transfer genes and the genes for tetracycline resistance, and the r-determinant (8 micron) carrying the genes for resistance to several other antibiotics including chloramphenicol (Cm). In Proteus mirabilis, these two components are capable of independent replication, or they may replicate as a composite molecule. When cells of P. mirabilis containing NR1 are cultured in medium containing Cm at 250 microgram/ml a growth lag of 20-35 hr ensues. During this lag, Cm induces the selective amplification of the r-determinant, including the gene for resistance to Cm. The amplification results from the excision of the r-determinant from the R plasmid, the independent replication of the r-determinant to give polymeric as well as monomeric r-determinants, and the eventual reintegration of multiple tandem copies of the r-determinant with the resistance transfer factor to form a new R plasmid with multiple copies of the r-determinant. This mechanism represents a new level of control of gene expression in bacterial systems--namely, the induction of selective gene amplification.


Regulatory deficits after surgical transections of three components of the MFB: correlation with regional amine depletions. Parasagittal knife cuts along the lateral border of the diencephalon (PS), coronal cuts across the lateral (LMFB) or medial (MMFB) components of the medial forebrain bundle reproduce most of the persisting deficits in responding to glucoprivic and hydrational challenges that characterize rats with lateral hypothalamic lesions or intracranial injections of 6-hydroxydopamine (60HDA). Each of these cuts produced a differnet pattern of regulatory deficits, suggesting that individual components of the LH syndrome may be mediated by different neural substrates. This interpretation is supported by the results of our correlational analysis of the relationships between specific behavioral and biochemical effects of our cuts. For example, feeding responses to insulin were reliably correlated with striatal DA concentrations but feeding responses to 2-deoxy-d-glucose (2DG) were not. Water intake during periods of food deprivation was reliably correlated with striatal DA but water intake after an experimental osmotic challenge was not. Only one of the common persisting deficits (impaired feeding response to peripheral injections of insulin) was positively correlated with the duration of aphagia and adipsia.


[Effects of N,N-dimethyltryptamine (DMT) on tests of psychoticism (author's transl)]. In a controlled study on 38 volunteers the effects of 250 micrograms/kg N,N-dimethyltryptamine (DMT) i.m. on objective and performance tests measuring psychoticism according to Eysenck were assessed. The hypothesis was tested that subjects treated with DMT (N = 26) differ from those receiving placebo (N = 12) in the same way as endogenous psychotics differ from normals. Confirmation was obtained in 7 out of 19 variables, most of which may be considered as tests of concentration. These results are similar to those of a previous study on the effects of (-) delta9-trans-Tetrahydrocannabinol.


Baclofen (para-chlorphenyl-GABA) in schizophrenia. 21 schizophrenic patients were treated in a single blind study with para-chlorphenyl-GABA (baclofen) for 20 days after a placebo period of at least 1 week. Global clinical impression identified five patients as behaviorally unchanged, seven as improved and nine as worsened during the active drug administration. Four patients had to be withdrawn from the trial because of serious and unmanageable psychotic exacerbations. Overall incidence of psychotic symptoms in the group of the schizophrenic patients did not change substantially neither did the remission coefficient as calculated from the AMP documentation system. No differential effect was detected either on selected Schneiderian first rank symptoms or on symptoms more characteristic for chronic defectuous schizophrenia. It is concluded that baclofen is not a useful drug in the therapy of schizophrenia.


Considerations of the application of indicator dilution methods to the measurement of the flow rates of fluids. In circumstances when the flow velocity of a fluid non-homogeneous, difficulties arise in the application of the familiar indicator dilution equations. These and other relevant relationships have therefore been derived from first principles in order to clarify the conditions in which they may be expected to apply. It is shown that the method of introduction of the tracer into a fluid stream as well as its method of measurement are important factors, and the implications of these results for biological measurements are discussed. Illustrations are provided of the indicator dilution curves which are likely to be obtained under conditions of laminar fluid flow in a straight tube and when the diffusion of the tracer can be neglected.


Indicator dilution measurements of flow parameters in curved tubes and branching networks. An experimental investigation has been made of the application of the indicator-dilution bolus-injection technique to measure flow rate, mean transit time and vessel volume with steady flow in curved tubes and branching networks. Measurements were made with 131I in 2N KCl and 131I-human serum albumin in isotonic saline, plasma and whole blood under laminar flow conditions up to a Reynolds' number of 460. The flow rate estimations are more reliable than those obtained for flow through straight tubes, due to secondary flows tending to disperse the indicator uniformly over the vessel cross-section. Even so, estimations of mean transit time and vessel volumes, using accepted theoretical formulae, may be as much as 200% in error. Similar measurements have been made of the flow parameters with bifurcations and branching networks. The indicator is not partitioned between the branches in proportion to the flow rate, as is assumed in the original indicator dilution theory, except when there is complete symmetry of the flow. An alternative method of estimating the vessel volume was used and shown to give an accurate estimate of the true volume in these circumstances.


Reconstruction of the lower lip after radical resection for cancer: the "Pharaoh technique". For patients affected by far advanced lower lip cancer, with great local tumor destruction but few or no metastases, we advocate radical resection. Here we describe a method for these repairs, using two deltopectoral flaps. It produces a good functional result and satisfactory appearance. No recurrences have been observed in our 5 cases during a two-year follow-up.


Experimental definition of independent myocutaneous vascular territories. Experimental studies were undertaken in dogs to determine whether useful island myocutaneous flaps could be based on the gracilis, sartorius, biceps femoris, trapezius, or rectus abdominis muscles. Dissection and injection studies on these muscles were also undertaken in human cadavers to determine the contributions of these muscles to the blood supply of the overlying skin. In most instances it was considerable. The use of island myocutaneous flaps seems promising in many situations. Such transfers can be done in one operation, without delay procedures, and result usually in a better blood supply with the transfer of a thicker amount of tissue. Clinical research on such flaps in patients will be described in a subsequent paper.


Gluteus maximus myocutaneous flaps for repair of pressure sores. Myocutaneous flaps based on the gluteus maximus muscle, and its blood supply, have many advantages for the surgical repair of pressure sores in paraplegics. These are described, as well as the techniques used in various areas.


[From Paul Flechsig to the Paul Flechsig Institute for Brain Research. Development of brain research at the Karl Marx University]. A review is given on the development of the brain research institute of the Karl-Marx-University of Leipzig during the directorates of Paul Flechsig (1883-1920), Richard Arwed Pfeifer (1925-1957), and Wolfgang Wünscher (1957-1971).


Helen Flanders Dunbar (1902-1959) and a holistic approach to psychosomatic problems. I. The rise and fall of a medical philosophy. Despite Dunbar's central in the American psychosomatic movement, few successors seem to have grasped the nature and context of her work. This is partially because most histories of psychosomatic theory and research overlook the holistic, organismic point of view shared by Dunbar and other psychoanalysts of the psychobiologic persuasion. The medical-philosophical context of Dunbar's work is here reviewed.


A view of the background of Freudian theory. A major concern of nineteenth century scientists was to delineate the objective units or entities with which science deals. While some philosophers of science abandoned the search as futile and tried to redefine science, investigators in the biological sciences and the sciences of man attempted to discover new entities upon which to base their disciplines. A new understanding of hypnotism gave Freud the opportunity to isolate objective entities within the mind and to found a psychology on that basis.


[Drugs and sexual behavior].

[Drugs and sexual behavior]. The abundant scientific literature on the addictions does not unclude many papers on the subject of sexual behaviors under the effect of self-administration of drugs. The results of the studies and of the experiments carried out in this field do not allow a classification of drugs in homogeneous groups according to their specific actions on sexual behavior. For each of the most common drugs the most reliable existing data have been examined. Final conclusions cannot be reached for each drug, since several substances may often act, according to many variables, in different cases as depressants or stimulants. The need to study this aspect of drug addiction has been underlined with the aim to improve our knowledge both in the field of the new sexual therapies and of the prevention and control of drug addiction.


Developmental abnormalities of the cervical spine below the axis. The majority of cervical spine anomalies of clinical significance occur in the occipital, atlas, and axis areas. Below the axis, changes may occur as local solitary anomalies simulating significant disease, or in the form of more widespread segmentation and ossification anomalies categorized as the Klippel-Feil syndrome.


Lumbar spinal stenosis.

Lumbar spinal stenosis. Recognition and management of problems inherent in spinal stenosis require a clear understanding of the diverse anatomic changes, their radiologic representations, and careful correlation with a wide spectrum of fluctuating clinical manifestations. Although a common basis might be postulated for narrowing of the spinal canal, emphasis should be placed on its various forms.


The pathophysiology of spinal cord injury. The definitive treatment of severe injuries to the spinal cord is yet to be established, except in the few rare cases in which realignment or decompression results in functionally significant salvage of long tracts coursing through the injured cord segments. The author believes that the best chances for successful therapy lie in a better understanding of the process of spinal cord self-destruction.


Application of the radiological sciences to advance clinical and fundamental knowledge of the animal kingdom. New Horizons for Radiologists Lecture. Many radiological techniques are useful in fundamental research. Selected clinical problems in animals as well as certain basic research projects are utilized to emphasize the potential of radiological imaging. The author describes the use of several radiological methods in studies of how birds breathe.


Radiographic changes in the posterior-superior iliac crests following bone marrow aspiration. The appearance of multiple lucencies in the posterior-superior iliac crests of patients in a bone marrow transplantation program is described. These benign lucencies should not be misinterpreted as bone destruction in patients with malignant disease who undergo multiple bone marrow aspirations.


Clinical significance of 99mtechnetium sulfur colloid accumulation in renal transplant patients. The accumulation of 99mtechnetium sulfur colloid (99mTcSC) was evaluated in 47 studies performed on 19 renal transplant patients by comparing its transplant activity to its bone marrow accumulation. There was a diagnosis of rejection of 21 of 22 studies (96.5%) in which marked transplant accumulation was noted. In 11 studies of patients with a clinical diagnosis of post-transplant acute tubular necrosis (ATN), the transplant activity varied from none to moderate. Rejection developed in 5 of 6 studies with minimal to moderate accumulation. Normally functioning renal transplant patients, or those with ATN and no superimposed rejection, do not show evidence of 99mTcSC accumulation.


[Humoral and cellular immunity in children vaccinated with oral B.C.G. (author's transl)]. The humoral and cellular immunity of 23 children with ages between 1 and 5 years, nonreactors to 10 mu of PPD, were investigated after oral vaccination with one dose of 100 mg of fresh oral BCG, Rio de Janeiro strain (Moreau strain). The tests performed shortly before and 70 days after vaccination showed that the schedule used was neither sufficient to stimulate the production of antibody anti-PPD, nor to change the levels of serum immunoglobulins and T, T-active and B blood lymphocytes. However, about 60% of the children became responsive to 10 mu of PPD after treatment and all gave positive reactions to PPD on "in vitro" assays of leukocyte migration inhibition. New schedules for oral vaccination with fresh BCG are in progress in our laboratory.


Problems in evaluating the effect of secretolytic agents on the mucociliary system by means of radioactive particles. In a double-blind cross-over study the effect of two secretolytic agents on the mucociliary clearance was tested in 8 patients with mild chronic obstructive bronchitis. Clearance was assessed from the removal rate of previously inhaled sulfur colloid particles, tagged with 99Tcm. For the interpreatation of the results, obtained by this method, it is essential to take into account the pattern of particle deposition. For example there was a faster clearance under placebo compared to the secretolytic drugs because of a more central deposition. To overcome this problem different approaches were therefore tested. The following constellations proved to be useful in assessing the effect of secretolytic drugs: (1) change in deposition patter; (2) clearance rate, if no change in deposition takes place; (3) clearance rate from a peripheral area of the lung. An attempt to apply a simple three compartment model proved to be unpracticable probably becuase of the complexity of the mechanism involved. One of these mechanisms could be a reversal in mucus transport, observed at least in one patient, a finding which might be of pathophysiological relevance.


[Tumors of the upper air-ways in xerotomograms (Part II) (AUTHOR'S TRANSL)]. Results of 92 xerotomographies of the upper air-ways are demonstrated on selected cases of benign and malignant neoplasms. In tomography of the throat we prefer the positive type of development. Xerography provides a good insight into site and size of tumors in larynx and pharynx.


[Study of T and B lymphocytes in blood and synovial fluid during rheumatoid arthritis]. The quantitative study of lymphocyte populations is one means of approaching the immunological profile of patients with rheumatoid polyarthritis. In the present work we have studied the proportions of T and B lymphocytes in the blood and synovial fluid of 70 patients presenting classical or clearly defined rheumatoid polyarthritis. The number of T cells (E rosettes and anti HTLA serum) and B cells (membrane immunofluorescence and EAC rosettes) were found to be identical in both patients with rheumatoid polyarthritis and healthy subjects of the same age. On the other hand the number of "fast" rosettes, indicating a sub-population of T effector cells, and of EA rosettes formed at the expemnse of cells with a receptor for IgG Fc, are reduced in the blood and increased in the rheumatoid synovial fluid. In the course of rheumatoid polyarthritis there is therefore a displacement of certain lymphocytic sub-populations from the blood towards the synovial site where they are probably involved in lesional mechanisms.


[Diagnostic value of synovial membrane immunofluorescence]. The immunofluorescent study of 93 synovial membranes of persons suffering from various types of arthropathy has shown that the only element sufficiently specific to have real diagnostic  value is the presence of cells with a fluorescent cytoplasm. This appearance was in fact found in 63% of the cases of rheumatoid arthritis, irrespective of their being either seropositive or seronegative, in 69% of the cases of probable rheumatoid arthritis, in only 15% of the unclassified cases of arthritis, in 28% of the cases of various types of arthritis (20% with exclusion of a case of mixed connectivitis and of a case of Waldenström's macroglobulinemia with rheumatoid arthritis) and in 0% of the cases of mechanical arthropathy. The results of immunofluorescent examination compare favorably with those of standard histology: the classical histologic appearance of rheumatoid synovitis with a node-forming tendency of the infiltrate was observed in only 36% of the verified cases of rheumatoid arthritis, while immunofluorescence was positive in 63% of the cases in this group. In the category of unclassified arthritis, these percentages were comparable, viz. 19% and 20%, repectively. The presence of cells with fluorescent cytoplasm during immunofluorescent examination of the synovial membrane may be regarded as an additional criterion supporting the diagnosis of rheumatoid arthritis.


[Cellular immunity in rheumatoid arthritis. Effect of therapy]. In 89 cases of rheumatoid polyarthritis the number of B lymphocytes was shown by an immunofluorescence technique and the number T lymphocytes by a rosette test. 30 untreated polyarthritics were distinguished into two groups: in one there was no change in the number of T cellules; in the other there was a reduction in the number of T cells and lymphopenia. The same differences were found under corticotherapy (10 cases), antimalarial drugs (8 cases), penicillamine (21 cases), chrysotherapy (11 cases) and levamisole (9 cases). Levamisole only infrequently increases the number of T cellules (2/9). No relation with any developmental parameter was found in any group.


[The action of D-penicillamine on the distribution of T and B-lymphocytes in rheumatoid arthritis]. Comparative study of the numbers of T and B lymphocytes in cases of rheumatoid polyarthritis treated and untreated with D-penicillamine shows that in the untreated subjects  the distribution of these two types of lymphocytes is comparable with that in normal subjects and that D-penicillamine does not alter this distribution. This purely quantitative investigation does not rule out the possibility of functional modifications in the cells studied.


[Value of the detection and characterization of circulating immune complexes in rheumatoid arthritis]. The authors analyse the value of research into and identification of immune complexes (IC) in chronic inflammatory rheumatisms (CIR) and  in rheumatoid polyarthritis (RP) in 93 patients hospitalise in a Rheumatology Department. Comparative levels of ICs were established simple and quick technique of measuring the 50% haemolytic complement (HC 50) used up by the ICs. The rheumatoid factor (RF) is identified at the PEG IC precipitates with the Waaler-Rose test. The existence of raised levels of IC containing RF in both seropositive and seronegative PRs and to a similar degree in a non-negligable percentage of clinically non-classable RICs conforms the diagnostic value of this research. On the other hand there is no relationship between the levels of ICs and either clinical signs or age of the illness. In RPs other than CIR circulating ICs are found whose nature is still unknown.


[Problems posed by fixation after Lefort III osteotomy]. The author confines himself to the problems posed by contention after Lefort type III osteotomy. He considers that the posterior iliac crest of the patient may be used to major advantage. Osteosynthesis is essential but it is sometimes possible to avoid maxillo-mandibular block. The results obtained in 18 cases are presented.


[Prognostic significance of immunologic tests in cancer of the oral cavity]. An analysis of delayed action cell immunology tests involved 300 patients suffering from stomatological cancers. The tests used, tuberculine, candidine, varidase and DNCB have no particular value as far as discovering the size of the tumour, the quality of eradicating treatment or its progress. On the other hand, bias in the same direction and, even more, variations in the direction of immunity in the course of evolution seem to be a reflection of the patient's immune defence potential. This immune defence potential which can be roughly assessed in this way dose not seem to be reduced by chemotherapy or increased by immunotherapy, at least judging by the criteria used.


Effects of 16,16 dimethyl prostaglandin E2 on food-stimulated pancreatic secretion and output of bile in man. The effect of 140 microgram 16,16 dimethyl prostaglandin E2 on food-stimulated pancreatic and biliary response has been studied in 7 healthy subjects, using a multiple indicator dilution technique. Intragastic administration of the methyl analogue decreased significantly the pancreatic and the biliary response, despite an enhanced gastric emptying rate of the test meal.


The effect of vitamin D2 treatment on bone mineral after partial gastrectomy. A controlled clinical study of the effect of 1000 IU of calciferol daily for 8 months was performed on patients with postgastrectomy bone loss. The treatment produced no observable increase in bone mineral density measured by photon absorption.


Allergic bronchopulmonary aspergillosis in a cane-sugar mill. Allergic bronchopulmonary aspergillosis is reported in two (1.5%) of 131 workers occupationally exposed to Aspergillus fumigatus at the U.D. Sugar Mills, Shamli. Twelve of the workers revealed Type I (9.2%) and three (2.8%) Type III skin hypersensitivity against with fungus. Serum preciptins were demonstrated in two out of 44 workers and positive sputum cultures in 26 out of 58 workers. It is suggested that constitutional predisposition of the host may be a more important factor than the extent of exposure to the fungus in the development of allergic bronchopulmonary aspergillosis.


Bronchial asthma of occupational origin: a review. There are immediate benefits when one can establish the diagnosis of occupationally induced asthma. It is a man-made disease and is thus reversible. Diagnosis depends on knowledge of the source and types of exposure which can be correlated with the clinical, physiological and immunologic patterns of affected workers. The discovery of one case can often lead more readily to recognition of others. Individuals with asthma of an occupational origin should be removed from work. Equally as important is the initiation of proper industrial hygiene procedures which would improve the occupational environment and periodic medical surveillance of workers for the identification of early disease or individuals with few or no symptoms.


Water-to-air transfer of virus.

Water-to-air transfer of virus. Bubbles rising through suspensions of the bacteriophages T2 and T4 and of Escherichia coli adsorb and eject these particles in droplets that are formed when the bubbles burst. The concentration of the viruses in ejected droplets, determined from electron microscopy, exceeded the suspension concentration by 50 times. Similar results were obtained for Escherichia coli. The viability of some of the adsorbed particles was established by biological counts.


Antibiotic agranulocytosis: association with cephalothin and carbenicillin. A 65-year-old woman developed agranulocytosis on two separate occasions following prophylactic administration of antibiotics before cardiac surgery. In the first leukopenic episode, large doses of cephalosporin derivatives were the only drugs implicated, and in the second, carbenicillin was believed responsible. Life-threatening septicemia occurred with Pseduomonas aeruginosa and later with Escherichia coli. Erythrocytes, platelets, and lymphocytes were not affected during these granulocytopenias. Bone marrow examination revealed an arrest of maturation in the granulocytic series. Review of the hematologic complications of cephalosporins, particularly agranulocytosis, suggests an interesting association between carbenicillin-induced neutropenia and previous administration of cephalosporins.


Management of ankylosing spondylitis with flurbiprofen or indomethacin. The effects of flurbiprofen (150-200 mg daily) and indomethacin (75-100 mg daily) were compared in the management of 26 patients with active ankylosing spondylitis in a parallel, double-blind, and randomized trial of six weeks' duration. No patient in either group withdrew from the study because of lack of efficacy of the drugs. Both drugs were equally effectivein relieving the pain and tenderness of the affected joints. Overall subjective improvement, assessed by the patient and the investigator at the end of the trial, was present in 90% of the patients in the flurbiprofen group and in 75% of the indomethacin group. The mean values of all the spinal motion tests improved in the flurbiprofen group but not in the indomethacin group. Statistically significant improvement of the Schober test was achieved in the flurbiprofen group and of the chest expansion measurement in the indomethacin group. Untoward effects related to the central nervous system and gastrointestinal tract were present in a few patients in both groups.


Effect of delta-9-tetrahydrocannabinol on intraocular pressure in humans. As early as 1971, it was noted that smoking marijuana lowered intraocular pressure. In this study one of the active components of marijuana, delta-9-tetrahydrocannabinol, was given intravenously to ten subjects with normal intraocular pressures. Two strengths were used--0.022 mg/kg of body weight and 0.044 mg/kg of body weight. Intraocular pressure was found to decrease as much as 51% of baseline normal with an average decrease of 37%. Heart rate increased in a range of 22% and 65% of the resting pulse. Respiratory rate was not affected. No analgesic properties were demonstrated by either cutaneous or periosteal stimulation. Anxiety levels were increased by delta-9-tetrahydrocannabinol over placebo and diazepam (Valium). The mechanism of action is still uncertain but it is believed by some workers to be similar to that of a beta-adrenergic stimulator.


Selection among benzodiazepines for alcohol withdrawal. Four pharmacologic differences among the benzodiazepines, which are the drugs of choice to conduct alcohol withdrawal, guide selection of the appropriate one: chlordiazepoxide, diazepam, oxazepam, or chlorazepate. Bases for selection include: (1) availability of other than oral dosage forms; (2) differences in additive effect with alcohol in producing central nervous system depression; (3) differences in anticonvulsant effect; and (4) differences in duration of effect in the body (ie, half-life). Decreasing dosage schedules are preferred to a steady dosage. Illustrative dosage schedules for using chlordiazepoxide and diazepam to conduct alcohol withdrawal are given.


Therapeutic acupuncture: a selective review. The use and effectiveness of acupuncture has become a major controversy. The limited data on the subject and the wide variety of methods referred to as "therapeutic acupuncture" have added to the confusion. Among physicians who use acupuncture as one modality of treatment, there exist many opinions regarding the definition of an acupuncture point, the usefulness of the concepts of traditional acupuncture, the methods of stimulating the acupuncture points, the selection of points used, and the optimal frequency and number of treatments. This review analyzes some of the studies published in English language journals pertaining to these controversies. The possible effects of acupuncture in releasing endorphins and stimulating the autonomic nervous system are discussed. The differences in methods must be identified and resolved before an accurate assessment of "acupuncture" can be made.


Group B streptococcal colonization in a newborn nursery: effects of iodophor and triple dye cord care. Control of nosocomial group B streptococcal (GBS) colonization of newborn infants was attempted in a four-cycle study alternately employing single applications of povidone-iodine (iodophor) and triple dye to the umbilical cord stump and periumbilical area. GBS colonization rates were 49% and 34% following iodophor cord care (cycles II and III) and 11% and 50% following triple dye cord care (cycles II and IV). The apparent significant reduction of GBS colonization during triple dye cycle II could not be reproduced in a subsequent follow-up culture survey and remains unexplained.


The effect of diethylcarbamazine treatment on the development of bancroftian microfilariae in Culex p. fatigans. Bancroftian microfilarie survived after one to three courses of diethylcarbamazine treatment in carriers and the larvae able to reach the infective stage in Culex p. fatigans. The infection rate and the development of infective larvae per infected mosquito from DEC-treated carriers was much lower than from the untreated carrier. The fact that surving MF can develop to infective stage in their vector indicates that such filarial carriers may be important sources for transmission of filariasis in the endemic areas after suspension of control measures.


Differentiation of nonfermentative gram-negative bacilli in the clinical laboratory. A rapid and simplified system for the differentiation of nonfermentative Gram-negative bacilli, encountered frequently in clinical specimens, is presented for use in the clinical laboratory. Nonfermentative bacteria can be grouped initially by the motility, oxidase and OF glucose reactions. This grouping simplifies the choice of additional tests for further identification. The additional tests included Gram stain, acid production from 10% lactose agar, nitrate reduction, arginine dihydrolase activity, fluorescein production, deoxyribonuclease activity, hydrolysis of aesculin, growth at 42 degrees C, gelatinase activity and susceptibility to antibiotics.


Luteinizing hormone-releasing hormone and serum growth hormone in insulin-dependent diabetes. Growth hormone (GH) responses were studied in 26 insulin-dependent diabetics after the intravenous administration of 100 microgram of synthetic luteinizing hormone-releasing hormone (LH-RH). Although the mean basal GH concentration was significantly higher than that of 20 matched non-diabetic controls, no significant increment occurred after the LH-RH injection. (The controls also showed no rise in GH.) It seems that the GH hypersecretion of insulin-requiring diabetics does not, as is frequently noted in acromegaly, respond to the injection of LH-RH.


The pharmacological management of postoperative pain. The physiology and pharmacological management of postoperative pain are briefly discussed. Although narcotic analgesics are still the mainstay in the management of postoperative pain the judicious use of non-narcotic analgesics, anticholinergics, tranquillizers and soporifics as well as the administration of local anaesthetic agents could contribute greatly to the alleviation of postoperative pain and discomfort. Certain regimens for intravenous medication are outlined and strong emphasis is placed on the fact that postoperative pain relief is the duty of the doctor and not that of unskilled nursing staff.


Medicare patients: geographic differences in hospital discharge rates and multiple stays. Marked regional variations are found in patterns of use of short-stay hospitals by Medicare patients. Variations found in the rate of hospitalization, as measured by the number of discharges per 1,000 enrollees, and on the upward trend in that rate are the focus here. The data indicate that reductions in length of stay are offset by the rising number of admissions. An examination of multiple stays--a major factor in the number of discharges--shows that States with high rates of discharges have high percentages of patients with multiple stays. Furthermore, in these States the percentage of multiple stays is high, no matter what the diagnosis. In other States, the rate is low for all diagnoses. These findings suggest that options exist for the provision of care for the same or similar conditions and that geographic patterns appear in the use of those options. An urgent need exists for research to establish the variables affecting utilization and to explore ways of changing some of the patterns of delivering services.


Systemic vascular performance in endotoxic shock. Sixteen dogs were studied in an effort to investigate certain peripheral vascular and metabolic parameters in endotoxic shock. Cardiopulmonary bypass was instituted for 12 of the dogs to study systemic parameters at constant circulatory flow rates. From these studies, it appears that endotoxin is capable of initiating profound hemodynamic and metabolic changes. Initially, cardiac output and arterial pressure drop precipitiously, despite a transient rise in systemic and pulmonary vascular resistance. Subsequently, peripheral arterial pressures and systemic vascular resistance continue to decline, even if arterial flow remains at constant levels. Oxygen extraction by peripheral tissues decreases after endotoxin injection, despite adequate oxygen availability and constant hemoglobin levels.


Reconstruction of extensive tissue defects of the scalp by microsurgical composite tissue transplantation. Two cases of severe and extensive electrical burns of the scalp and skull are presented. Large segments of composite groin tissue were successfully transplanted to cover the scalp defects. Microvascular surgical techniques were employed. Both patients had short postoperative hospitalizations. It is possible that a cranioplasty may now be performed as a second stage under the healed full-thickness skin. The advantages of providing a thick protective skin cover in a single operation are outlined.


Intramedullary spinal abscess: a case report with a review of 53 previously described cases. A patient suffering from intramedullary spinal cord abscess associated with an infected dermal sinus, meningitis, and low-lying  spinal cord, underwent laminectomy and drainage, after which there was marked improvement. Review of previously reported cases provides a better understanding of this process. The embryology and anatomy of cutaneous lumbrosacral defects are discussed with reference to their potential for subsequent infection and possible association with severe neurological dysfunction. Prophylactic intervention is recommended.


Percival Bailey Oration. Surgical treatment of epilepsy during childhood and adolescence. Seizures, being symptoms of pathophysiological abnormalities of the brain, require thorough investigations to ascertain localization of the epileptic discharge and determination of the underlying pathology in each patient. This approach makes possible appropriate medical or surgical therapy which will provide meaningful life and reduce the chances of progressive disability. Neurosurgical procedures currently being used to treat epileptic children and adolescents are described, and include temporal lobectomy, nontemporal cortical exisions, hemicorticectomy, commissurotomy, stereotaxic ablations, and cerebellar stimulations. The results of surgical therapy in 50 young patients are discussed.


Treatment of pulmonary aspergillosis with di-iodohydroxyquinoline. Thirteen patients with a clinical diagnosis of pulmonary aspergillosis were treated with the anti-amoebic drug di-iodohydroxyquinoline, 1500-1800 mg/day orally, for 20 days. All were precipitin positive before treatment and all but one became negative after treatment. Sputum became negative in all of the 10 patients in whom it had been positive before treatment. Clinical improvement was marked in four patients, moderate in three, and slight in three, no change occurring in the remaining three. These results suggest that di-iodohydroxyquinoline may be of value in the treatment of pulmonary aspergillosis.