Inhibition of thymidylate synthetase of the human lymphocytes. Previous studies had suggested that methotrexate (MTX) may have actions other than inhibition of dihydrofolic acid reductase. In this study MTX was added to the assay incubation mixture of the enzyme thymidylate synthetase. 5-fluorodeoxyuridine (FUdR) or folinic acid was added separately as controls. The three compounds inhibited thymidylate synthetase with MTX achieving the maximal inhibition. It is suggested that MTX could exert its antineoplastic effect through this mechanism especially if malignant cells have little or no activity of dihydrofolic acid reductase.


Presumed vitelliform dystrophy with perimacular flecks and retinal detachment. Seven of eight siblings of asymptomatic non-consanguineous parents were investigated. Two of them had atrophic cystoid macular degeneration and flat or subnormal electro-oculograms suggesting the diagnosis of vitelliform dystrophy. In one eye the central cystoid lesion was surrounded by atypical small whitish hyperfluorescent flecks resembling fundus flavimaculatus. In the other eye of this patient cystoid macular degeneration progressed to shallow non-rhegmatogenous detachment of the retina. One of the asymptopmatic siblings had a mild colour vision defect of tritan-type and some fleckish hyperfluorescence around the macula and another sister showed abnormal EOG responses. These patients are probably carriers of the pathological gene responsible for the disease.


Lanthony's new color test--part III. The neutral zone. With the New Color Test (NCT) the neutral zone was studied in hereditary and acquired dyschromatopsias. Acquired type III blue-yellow defects with neutral zone occurred in heredo-atrophies of the optic nerve, in edematous maculopathies, in choroidal atrophy, in myopia, in glaucoma and in retinitis pigmentosa. With exclusion of the autosomal dominant inherited cases, the type III neutral zone in retinitis pigmentosa becomes complicated by a type I neutral zone when the visual acuity dropped to 0.2.


Biological characterization of guinea pig lymphotoxin production. The generation of serum-free lymphotoxin by antigen-stimulated ovalbumin immune strain 2/N guinea pig peritoneal leukocytes in vitro is dependent upon a number of common variables in cell culture. Lymphotoxin production varies directly with antigen concentration, duration of antigen exposure and leukocyte culture, leukocyte density, and medium volume. The maximum concentration of lymphotoxin generated in the medium has a limiting value that is independent of antigen concentration, leukocyte density, and duration of antigen exposure or leukocyte culture, suggesting feedback control of lymphokine production. Optimal conditions for the reproducible maximum generation of guinea pig lymphotoxin were 10(7) oil-induced peritoneal leukocytes from immune animals cultured for 12-24 hr in 20 ml RPMI 1640 medium containing 100 micrograms ovalbumin/ml throughout the period of culture.


Effect of indomethacin on in vitro T- and B-cell activation and cell-mediated lysis. The effect of indomethacin, an inhibitor of prostaglandin synthetase, on lymphocyte blast transformation induced by T- or B-cell activators has been studied. Simultaneously adding indomethacin (0.03-0.3 x 10(-6) M final concentration) and concanavalin A to mouse spleen cell cultures, led to an enhancement of 3H-thymidine uptake, whereas 30 x 10(-6) M indomethacin inhibited this uptake. The stimulation induced by indomethacin was higher when this drug was present in the cultures before the addition of the mitogen. Neither the optimal concanavalin A concentration nor the day on which the maximum of 3H-thymidine uptake occurred were altered by indomethacin. Activation of B lymphocytes induced by bacterial lipopolysaccharide was inhibited by indomethacin at all concentrations tested. However, indomethacin similarly blocked the prostaglandin synthesis as well in lipopolysaccharide- or concanavalin A-stimulated lymphocyte cultures. Indomethacin enhanced the one-way mixed lymphocyte reaction. No significant effect of indomethacin was found on cell-mediated cytotoxicity of 51Cr labeled targets. The results are discussed in terms of differential sensitivity of B and T lymphocytes to this anti-inflammatory drug.


The effects of cyclophosphamide on mitogen-induced and antibody-dependent cellular cytotoxicity in guinea pigs. Lymph node cells from normal guinea pigs, when stimulated with the non-specific mitogen PHA, were transformed to activated killer cells, capable of lysing 51Cr labeled mouse fibroblasts. Similarly, these lymphoid cells effected lysis of antibody coated chicken red cells in an antibody-dependent cellular cytotoxicity assay. Following cyclophosphamide, 150 mg/kg IP, the reactivity of an aliquot of lymph node cells to effect either cytotoxic reaction was not diminished. These results indicate that this immunosuppressant does not promote a selective decrease in either lymphoid effector. Rather, they are diminished in parallel with the generalized lympholysis resulting from drug administratioin. During the recovery phase, lymph node cells showed increased ability to lyse target cells, suggesting a rebound phase of heightened activity. Thymic cells from normal and cyclophosphamide treated animals were poor effectors in either cytotoxic assay. The addition of an equal number of thymocytes to lymph node cells resulted in decreased mitogen-induced cytotoxicity. Thymic inhibitory activity was mediated only by viable cells and the phenomenon did not represent an altered shift in PHA sensitivity. This suppressive activity persisted when thymic cells from cyclophosphamide treated-animals were employed, indicating that inhibitory cells were also not selectively depleted by this drug. In antibody-dependent cellular cytotoxicity assays, thymocytes from normal or cyclophosphamide-treated animals did not alter the cytotoxicity capacity of lymph node cells.


Catheptic carboxypeptidase B as a major component in "T-cell activating factor" of macrophages. TAF (T-cell activating factor), produced by peritoneal macrophages and assayed by its ability to potentiate DNA synthesis in macrophage-depleted lymph node cells stimulated with Phytochemagglutinin-concanavalin A, was shown to contain catheptic carboxypeptidase B (CPB) which accounted almost quantitatively for its potentiating activity. TAF action was inhibited by CPB inhibitors and could be mimicked by commercial pig pancreas CPB. The activity was absorbed from active supernatants on EACA-Sepharose and could be eluted with free EACA (epsilon aminocaproic acid).


Freeze-fracture studies on the synapse between the type I hair cell and the calyceal terminal in the guinea-pig vestibular system. The apposition between type I hair cells and the calyceal terminals of vestibular ganglion cell peripheral processes was studied in the vestibular epithelium of the guinea-pig, using thin-sectioned and freeze-fractured specimens. Chemical synaptic junctions were exceedingly rare in thin-sectioned specimens, and were not seen in freeze-fracture replicas. Furthermore, no gap junctions were present between the hair cell and the calyx. There were, however, regions along the apposition where the membranes were closely apposed. At these regions, the hair cell was invaginated by cytoplasmic protrusions of the calyx and the plasmalemmata of the two cells were separated by only 6-7 nm. The number and conformation of the close appositions varied between different cells. In freeze-fracture replicas, the closely-apposed plasmalemmata of the hair cell and the calyx had no special distribution of intramembrane particles on either membrane leaflet. However, on the external membrane leaflet of the hair cell, a large patch of widely-spaced, large particles surrounded the regions of close apposition. The corresponding region of the plasmalemma of the calyx had no special distribution of particles on either membrane leaflet. The scarcity of chemical synaptic junctions, the absence of gap junctions between the cells and the unique arrangement of particles in the hair cell plasmalemma surrounding regions of close membrane apposition may indicate an unusual mode of synaptic transmission between the type I hair cell and the calyx.


Genetic counseling of families with Marfan syndrome and other disorders showing a Marfanoid body habitus. Eight pedigrees of patients with Marfan syndrome are presented. In addition, four pedigrees of patients with conditions sometimes showing a marfanoid body habitus are described: Wagner-Stickler syndrome, multiple endocrine neoplasia type III, Ehlers-Danlos syndrome type VIA, and congenital contractural arachnodactyly type II. Emphasis is placed on the importance of genetic information in the differential diagnosis and management of patients and family members by the ophthalmologist.


[Acute leukaemia with lymphoblastic features occurring during myeloma (author's transl)]. Leukaemias which complicate myeloma under treatment are usually acute non-lymphocytic leukaemias. We report here a case of acute leukaemia with lymphoblastic features occurring 30 months after diagnosis of myeloma. The exceptional character of this association lead us to refine the cytological diagnosis by studying surface markers and ultrastructural cytochemistry. Because of the absence of T or B markers, and the absence of peroxidase activity in the nuclear envelope, the endoplasmic reticulum, and the Golgi apparatus of blastic cells, we conclude that this leukaemia is "null" lymphoblastic.


Subpopulations of human T lymphocytes. VIII. Locomotion of lymphocyte subpopulations in patients with primary immunodeficiency disorders. Peripheral blood T and non-T lymphoid cells were examined in 31 patients with a variety of primary immmunodeficiencies for their locomotor activity toward casein and endotoxin-activated serum. T cells from 1 and non-T cells from 2 of 7 patients with Bruton type agammaglobulinemia had poor locomotor activity in this system. Both T and non-T lymphoid cells from all patients with common variable immunodeficiency disease had normal locomotor response to casein and EAS. Heterogeneity in locomotor abnormaltiy of T and non-T cells toward casein and endotoxin-activated serum was observed in other immunodeficient patients. No direct correlation was observed between the proportion of cells in the several T cell subsets and the abnormalities of locomotion of T cells.


The differentiation of T lymphocytes. V. Evidence for intrathymic death of most thymocytes. The DNA of CBA mouse thymocytes was simultaneously labelled with the efficiently reutilized precursor [3H]TdR and the poorly reutilized precursor [125I]UdR, and the subsequent rate of loss of the two thymidine analogues was used to compute the extent of local thymidine reutilization. This should provide a minimum estimate of thymocyte death within the thymus. In agreement with published data, reutilization of thymidine in the "steady state' adult mouse thymus was about 61%. Adrenalectomy was used to show that this turnover was not due to steroid mediated stress effects; nor could it be attributed to direct effects of [125I]UdR itself. Most of the initial uptake and the subsequent turnover was within the major "high theta' thymus subpopulation. A similar study with the growing thymus of 7-day-old mice, when the demand for T cells in the periphery should be high, also revealed a high level (63%) of thymidine reutilization. The results support the view that a minimum of 60% of newly formed thymocytes die within the tyhmus, and that this is a constant and normal aspect of thymus function. This would be compatible with some form of negative selection for the appropriate developing T cells.


Development of amblyopia in infants.

Development of amblyopia in infants. New techniques have permitted serial assessments of visual acuity in infants. Acuity measurements in infants with astigmatism did not reveal meridional amblyopia during the first year of life. Measurements in infants with esotropia showed marked differences in acuity of the two eyes as early as the first 6 months of life. Therapeutic occlusion of the non-deviating eye improves the acuity of the deviating eye but at the expense of the occluded eye. After discontinuing occlusion, rapid increases in acuity of the formerly occluded eye can occur.


[Serum levels of GPI, AAT and CEA in primary lung neoplasms and chronic bronchopneumopathies]. The Authors have tested serum levels of alpha-1-antitrypsin (A1AT), phosphohexose-isomerase (GPI) and carcinoembryonic antigen (CEA) in 133 patients affected with primary lung cancer, not treated with any drug, and in 183 patients affected with not neoplastic lung diseases or healthy, to control the utility of these markers in the early diagnosis of lung cancer. In many patients all the tests have been made at the same time. The three tumoral markers have been also examined in connection with the histological kinds of lung cancer. Results show that is suitable to test GIP and A1AT at the same time because they are percentually more pathological; serum levels of CEA, that are not very elevated in the pathological cases, seem in correlation with the histological kind of cancer.


[Antinuclear antibody (anti-HBc) and liver pathology in acute and chronic virus B hepatitis]. HBsAg and anti-HBc, the antibody to core antigen of hepatitis B virion, were titrated by solid phase radioimmunoassay in 40 sera of HBsAg carriers with acute and chronic hepatitis and in 20 healthy subjects carrying anti-HBc alone or associated with anti-HBs. No correlation was found between HBsAg and anti-HBc titers in the single category of patients. In contrast, geometric mean titer of anti-HBc (ranging from 2(14) to 2(15)) of patients with chronic active hepatitis was significantly higher ( p = < 0.01) than that of patients with acute or chronic persistent hepatitis and healthy HBsAg carriers (ranging from 2(9) to 2(14)). Anti-HBc titer of 20 subjects without detectable HBsAg was less than 2(7). These data suggest that in subjects with persistent B virus infection, anti-HBc response is correlated with synthesis of viral genome rather than of surface antigens, so that a much higher titer of anti-HBc was detected only in patients with a more active liver disease.


Spontaneous cell death in the semilunar ganglion during fetal and postnatal life in the ox, sheep, goat and guinea pig. A massive cell loss occurs in the semilunar ganglion. It is the result of either a casting-off of the semilunar ganglion cells into the cavernous sinus or a transformation of several cells into polyhedral cells with an epithelial-like organization, a process which immediately precedes their further degeneration.


[Early observations of pancreatic ultrastructure during hemorrhagic necrosis in the rat with closed duodenal pouch]. Many problems are still unanswered in the pathogenesis of acute clinical and experimental pancreatic necrosis. A new technique which can be performed in the rat seems a suitable model for reflux pancreatic necrosis without artificial pressure changes in the ductal system. A closed duodenal loop is obtained with ligation proximal and distal to Vater's ampulla and a gastroenteroanastomosis is associated to avoid intestinal obstruction. All the rats die with hemorrhagic pancreatic necrosis in 36 hours. After 12 hours from the operation ductal and acinar lumina are enlarged. In the centroacinar and intercalated duct cells some lysosomes and mitochondria with clear matrix and reduced cristae are detected. Intercellular junctions in ducts and acini have normal morphology. In the basal cytoplasm of acinar cells some prominent autophagic vacuoles are detectable. After 24 hours in the acinar cells autophagic vacuoles are greatly increased and basal cytoplasmic degeneration often occurs, with plasmalemma and basal lamina interruptions. Intercellular junctions are apparently unaffected until cell necrosis sets in. In blood capillaries endothelial cells are swollen, fibrin thrombosis, hemorrhage and leucocyte infiltration are often detectable. As lysosomal activity occurs also in different kinds of experimental pancreatic necrosis, it could be a common pathogenetic factor, responsible for hydrolytic enzyme activation and for vascular damage in the early stages of hemorrhagic pancreatic necrosis.


[T-lymphocyte subpopulations at high altitudes. Morococha, Peru - 4560 meters above sea-level]. We have studied T cell subpopulation in 10 miners of Morococha-Peru and 3 caucasian people as controls. T cells were identifed by E rosette test. Miners show a less number of T cells as compared to caucasian people: respectively 70+/-2% and 77,9+/-3,7%.


Dominant lethality in frog embryos after paternal treatment with triethylenemelamine: cytogenetics, morphology, and swimming capability. Male frogs (Rana pipiens) were injected intraperitoneally with triethylenemelamine (TEM). The injected males were held for seven days to permit TEM interaction with sperm. The TEM-treated males were then spermiated with human chorionic gonadotropin (HCG) and the ova of normal females were inseminated with the sperm. Direct observation was made of in vitro fertilized ova, cleavage, blastulation, and subsequent embryonic development. No differences were detected between the controls and treated animals from any experimental group for fertilization, cleavage, and blastulation. Dose-related morphologic abnormalities first became apparent at the time of gastrulation; the capability of hatched embryos to swim was affected by TEM. Metaphase chromosomes were studied from randomly selected embryos, and the prevalence of chromosomal structural abnormalities increased with dose over a range of 13--1,300 microgram TEM per kilogram frog.


[Considerations on myocardial scintigraphy with 201thallium after stress (author's transl)]. An heterogeneous group of 24 patients has been studied with 201Thallium myocardial scintigraphy after stress (MSS); has been used an electronic calculator which made it possible to increase the reliability of the method. Nineteen patients were males, 5 females; the average age were 51.7 years S.D. = +/- 7.9. The 201Thallium (2 mCi) is iniected through a Teflon cannula inserted in the forearm l' before the interruption of the stress test on the cycloergometer. After 10' tests are made in AP-LAO and LL view; a second test is carried out after an hour, and, if necessary, after 4-6 hours time. The results are interpreted as: a) positive: absence (++) or obvious defect in perfusione (+); b) negative: normal perfusion (-); c) questionable: activity not significantly reduced (+/-). In some cases, the Authors studied correlations and discordances between MSS and clinical, coronarographic and echocardiographic data. Has been considered moreover, the uptake's and release's variations of the radio-isotope in relation with experimental knowledge of myocardial extration and clearance. We conclude by emphasising the interest of this method and suggesting some practical consideration: 1) patients with negative MSS don't need coronarography; 2) positive MSS, but restricted deficit, good delayed reperfusion, good clinical pharmacological control would permit a delay of coronarography. 3) clear multiple deficit need coronarography; 4) usefulness of the MSS for long-term control of the evolution of coronary disease and of patients operated of aorto-coronary bypass.


Radiation-induced DNA strand breaks in deoxygenated aqueous solutions. The formation of altered sugars as end groups. Gamma irradiation of DNA in deoxygenated, N2O-saturated aqueous solution leads to three bound altered sugars present as end groups in broken DNA strands. These sugars are linked to the DNA by phosphoric acid ester bonds. Two of the end groups have the structures (4) and (5). (Formula: see text) The third end group after dephosphorylation has structure (3). The formation of the bound sugars (4) and (5) is explained by a mechanism postulated earlier for the formation of free altered sugars. Except for the phosphoric acid ester linkage, the free altered sugars have the same chemical structures as the bound altered sugars.


Modification of radiation response in HeLa cells by misonidazole. The hypoxic radiosensitizer misonidazole decreases survival in dense cultures of HeLa cells irradiated with gamma rays in a non-dose modifying fashion. Survival curves of treated hypoxic cells display a much larger extrapolation number than untreated cells. In oxygenated randomly dividing cells, drug treatment has an effect opposite to that in hypoxic cells, increasing survival. In cultures initiated from mitotic cells and irradiated soon afterwards, a smaller sensitization under hypoxia and no increase in survival of oxygenated cells was observed. It was concluded that metabolic as well as radiochemical events take place in misonidazole-treated and then irradiated HeLa cells which modify survival.


The dose-dependence of the split-dose response of marrow colony-forming units (CFU-S): similarity to other tissues. The split-dose effect for survival of colony-forming units (CFU-S) in mouse bone-marrow increases with increasing total dose. This is compatible with the shape of the survival curve, since detailed measurements at doses lower than 200 rad show the presence of a marked initial slope, followed by a tendency towards an increased sensitivity at higher doses. The magnitude of the increase in the split-dose effect is quantitatively similar to values observed by others at comparable low doses in skin, intestine and lung, as deduced from multifraction experiments. It is concluded that these cells do not differ markedly, as has been generally believed, from many other cell types in the ability to demonstrate split-dose effects, when the doses used in the experiments are strictly comparable.


Alteration in cell-mediated immunity in patients with chronic active hepatitis. I. Lymphocyte subpopulations. Absolute number of T and B lymphocytes were measured in the peripheral blood of 25 patients with biopsy proven HBsAg-positive Chronic Active Hepatitis (CAH), in 9 with Chronic Persistent Hepatitis (CPH), and in 25 HBsAg-negative healthy controls. In patients with CAH and cirrhosis total T lymphocytes were decreased; no difference were found between patients with CPH and normal controls. This data emphasize the importance of monitoring T-cells population in patients with HBsAg-positive CAH.


Induction and repair of DNA strand breaks in cultured mammalian cells following fast neutron irradiation. Induction and repair of DNA breaks following irradiation with NIRS cyclotron neutrons were studied in cultured mammalian cells (L5178Y) in comparison to those following gamma-rays. The yield of the total single-strand breaks, 3'OH terminals and sites susceptible to S1 endonuclease following fast neutrons was found to be approximately 50 per cent of that following gamma-irradiation. On the other hand, the yield of double-strand breaks was slightly higher after fast neutrons than after gamma-rays. The percentage of the total single-strand breaks remaining unrejoined at 3 hours after post-irradiation incubation was found to be distinctly higher after the fast neutrons than after gamma-rays. The neutron-induced damage appears to carry a higher proportion of alkali-labile lesions compared to gamma-rays. It was concluded that the increase in the yield of double-strand breaks and of unrejoinable breaks is responsible for a high r.b.e. of the cyclotron neutrons.


Quantitative aspects of repair of potentially lethal damage in mammalian cells. Stationary cultures of Ehrlich ascites tumour cells have been irradiated with X-rays and then immediately or after a time interval trep plated to measure the survival. The increase in survival observed after delayed plating is interpreted as repair of potentially lethal damage. A cybernetic model is used to analyse these data. Three states of damage are assumed for the cells. In state A the cells can grow to macrocolonies, in state B the cells have suffered potentially lethal damage and can grow to macrocolonies only if they are allowed to repair the damage and in state C the cells are lethally damaged. A method of deriving the values of the parameters of the model from the experimental data is given. The dependence of the reaction rate constant of the repair of potentially lethal damage on the dose D is used to derive a possible mechanism for the production of the shoulder in the dose effect curve. Finally this model is compared with other models of radiation action on living cells.


Neurotological diagnosis of vestibular disorders in children. The most marked findings in a group of 66 children were a spontaneous nystagmus presenting in 29% of the cases, and an abnormal caloric reaction in 40%. For qualitative and quantitative assessments of the positional test and caloric stimulation, at our University ENT department at Erlangen we use the positiogram and frequency calorigram described here, which are particularly suitable for follow-up observations and for the purpose of providing an expert medical opinion.


T and B lymphocyte rosettes in tonsils of atopic and non-atopic children. This investigation was carried out to determine the immunological function of the human tonsils, especially the role of lymphocytes of atopic and non-atopic children. An E- and EAC-rosette forming technique is introduced, with semiquantitative evaluation of T and B lymphocytes in the peripheral blood of 56 normal subjects, 28 atopic and 5 non-atopic children of both sexes and different ages. The percentage of T and B lymphocytes in removed palatine tonsils in 28 atopic and 5 non-atopic children was calculated. The percentage of rosette-forming cells in E and EAC suspensions appeared to be independent of age and sex. The percentage of T lymphocytes in peripheral blood was significantly higher than in the palatine tonsils, whereas the percentage of B lymphocytes was significantly higher in the tonsils of atopic and non-atopic children than in the peripheral blood. The mean percentage of B lymphocytes in the tonsils of atopic children was significantly higher than in non-atopic children. The percentage of B lymphocytes was found to be significantly higher in hypertrophic than in small tonsils. Also, in the tonsils with adhesions there was a statistically significantly higher percentage of EAC rosettes than in the tonsils free of adhesions. The percentage of T lymphocytes was statistically significantly higher in the small tonsils.


"Atypical" eosinophil granuloma (description of two cases). Two cases of histiocytosis X are reported. One affected a single bone, the other several bones. Both had the usual radiographic appearances, but a somewhat alarming cytological picture. The differential diagnosis between benign proliferative conditions and those possessing malignant or pseudo-malignant characteristics therefore demanded very careful consideration. After discussion of the radiological and histiocytological data, the diagnosis off histiocytosis X was arrived at, and in view of the favourable results, we are inclined to the view that these were atypical cases of eosinophilic granuloma.


[Pregnancy and portal hypertension due to a pre-hepatic block. 3 case histories (author's transl)]. The authors studied the prognosis for the pregnancies in cases of portal hypertension due to pre-hepatic block in 3 patients who between them had 6 pregnancies without having had previous porto-caval anastomoses. In spite of the good results that they had in their cases the literature shows that the condition is a high-risk pregnancy condition: 44 p. 100 of cases have intestinal tract haemorrhages, 19 p. 100 have premature labour and the perinatal mortality is somewhere between 11 and 18 p. 100. The babies are usually delivered vaginally with the aid of an assisted delivery.


[Ligation of the uterine vessels during obstetrical hemorrhages. Immediate and long-term results (author's transl)]. The technique and results of both bilateral round ligament, utero-ovarian and uterine artery ligations for excessive hemorrhage in the third stage have been described. The author have performed this procedure, first in 9 monkeys and in 24 women. Unnecessary emergency hysterectomies may be avoided by the use of this method of which the technique is simple, may be rapidly performed and will be more effective than hypogastric or uterine artery ligation. The ovarian and uterine functions were studied and were most often completely restored.


[Stenosis of the aqueduct of Sylvius and their endocrine manifestations (author's transl)]. In a 14-year-old boy, neurological signs (fall in visual acuity, signs of raised intracranial pressure) led to a diagnosis of stenosis of the aqueduct of Sylvius. Cure was obtained by insertion of a ventriculo-cardiac bypass (Holter's valve). Endocrine signs (delayed growth, excessweight, loss of circadian variations in cortisol levels) regressed in a few months after the operation. Amongst endocrine manifestations of stenosis of the aqueduct, delayed growth and disturbances in gonadal function are the most common, together with obesity. They usually regress after neurosurgical treatment.


[Gastrointestinal haemorrhage related to alcoholic cirrhosis. Prognostical influence of digestive lavage (author's transl)]. During gastrointestinal bleeding associated with cirrhosis, the presence of blood within the lumen of the gut may cause or favorise the onset of hepatic coma. Digestive lavage by rapid intragastric infusion of an isotonic solution based upon mannitol may reduce the mortality due to hepatic coma. The value of this method was studied retrospectively by comparison of two series of haemorrhagic complications: Group I-1971-1976: 224 haemorrhagic complications treated in the usual manner; Group II-1976-1977: 127 haemorrhagic complications treated in accordance with a protocol which included digestive lavage. The results indicate the prognostic significance of certain clinical signs (ascites, jaundice, shock), and also made it possible to determine the cause of death and to demonstrate a reduction in mortality in the group treated by digestive lavage (p < 0.02), concerning only deaths as a result of hepatic coma (p < 0.01) above all in forms with a poor initial prognosis with shock or decompensation with jaundice and ascites.


[The "laetitia syndrome" or "surprise delivery" (author's transl)]. This syndrome is seen essentially in a second or later pregnancy in a woman of modest social background, sometimes delivering prematurely and who is forced to perform certain domestic tasks or to wait for her husband before leaving for the place in which delivery has been planned. This type of untimely delivery may cause perineal lesions, vulval haematomas, post-partum haemorrhage, rupture of the umbilical cord or damage to the foetus.


[Stomatological hemorrhages; hemostasis with GRF (gelatin-resorcin-formol)]. Original haemostasis technique of odontological haemorrhages by means of G.R.F. (gelatin + resorcin + formol) that creates a waterproof cap which is reabsorbant and adherent to oral mucous.


[Alpha 1 antitrypsin in cryptogenetic cirrhosis (author's transl)]. Serum levels of alpha 1-antitrypsin were measured in 118 patients. Among these, 90 subjects presented with hepatic pathology of which 42 were of cryptogenetic origin. Not one of the subjects studied showed a decrease in alpha 1-antitrypsin nor did the results of liver biopsies prove positive for PAS cytoplasmic corpuscles. It is suggested that alpha 1-antitrypsin deficit does not play an important role in cryptogenetic cirrhosis.


[Value of computerised tomography in the diagnosis of colloid cyst of the third ventricle (author's transl)]. The so called colloid cyst of the third ventricle is believed to originate from the neuroepithelium in the diencephalic roof. The diagnosis is notoriously difficult and contributes significantly to the high mortality. A case in an eleven-year-old boy is reported. Computed tomography, also because not invasive, is chiefly indicative in this lesion, reducing the overall mortality.


Polymyositis, myasthenic syndrome and thymoma in a patient with defective cell-mediated immunity. We studied a 57-year old woman with severe myasthenic syndrome predominantly proximal. There was no therapeutic effect using cholinesterase inhibitors. Clinical findings, electromyography, whole body scanning and biopsy revealed polymyositis. Thirteen years before the patient was operated of a benign thymoma. The history of the patient showed numerous life threatening episodes of viral and fungal infections. Autoimmune anemia was diagnosed. Investigations of the immune system in vivo and in vitro revealed severe qualitative and quantitative defects in the lymphocyte population spontaneously forming rosettes with sheep red blood cells (SRBC). Thymoma, autoimmune disorder, such as polymyositis and myasthenia gravis, unspecifically elevated antibody titers, multiple severe viral and fungal infections and the defect of the cell-mediated immunity suggest a T-lymphocyte effector- and regulatory dysfunction in this patient.


Congenital nystagmus and functional vestibular evaluation. In a limited number of cases with congenital nystagmus, we examined to what extend ENG could help in the assessment of the vestibular function. We observed that in half of the cases the presence of this disturbing congenital nystagmus allowed to draw a functional conclusion from the ENG-recording. We propose to associate the laterotorsion technique as a valuable aid for further investigations.


[Ultrastructure of the nasal mucosa cilia in the Kartagener syndrome]. The authors draw the attention on the existence of an "Immotile-cilia Syndrome" in patients with chronic respiratory infections of unknown origin. The study of the ultra structure of the ciliae (TEM, SEM) in a case of Kartagener Syndrome supports the existence of an "Immotile-cilia Syndrome".


Middle fossa vestibular nerve section. A histopathological report. A patient with Meniere's disease underwent a middle fossa superior and inferior vestibular nerve section with excision of Scarpa's ganglia. Studies of this patient's temporal bone, conducted two and one-half years post-operatively, showed normal cochlear and facial nerves. The internal auditory canal showed fibrosis and new periosteal bone formation. There was complete denervation of the vestibular labyrinth except for the posterior semicircular canal crista. Fibrous and osteoid tissue filled the superior and lateral semicircular canals. In this case, these severe degenerative changes, presumably associated with biochemical changes in the vestibular labyrinth, altered the natural course of Meniere's disease. Vertigo was completely relieved, tinnitus improved, and hearing thresholds stabilized during the course of post-operative follow-up.


[Prinzmetal's angina during myocardial revascularisation. Cardiovascular complications in 71 patients (author's transl)]. 71 patients undergo myocardial revascularisation for Prinzmetal's angina; among them, 50 p. cent are operated upon in emergency according to three ways of anaesthesia: neuroleptanalgesia, analgesic anaesthesia, combined anaesthesia. The authors lay stress on the importance of per- and post-operative complications: electrocardiographic ischemia in 22 p. cent of the cases, severe ventricular excitability perturbations were observed in 21 p. cent, myocardial necrosis in 14 p. cent, cardiovascular collapse in 21 p. cent and hypertensions in 22 p cent. These complications are often associated. In the discussion, the authors underline anesthetic induction as a cause of Prinzmetal's angina in 50 p. cent of the cases. They put the accent on the severity of peroperative crisis followed in 50 p. cent of the cases by serious ventricular excitability perturbations. In 25 p. cent of the cases myocardial necrosis is a complication of the spasm of a coronary artery. In this field, posterior necrosis are more frequent and correspond to the spasm of the right coronary artery. All the patients of this series, except one, develop necrosis in the spastic area (by-passed or not). Per-operative hypertension has no incidence on the occurrence of post-operative complications. Lastly, continuous per-operative infusions of nitroglycerine has been performed in several patients in order to reduce morbidity of this type of surgery.


Characterization of human T lymphocyte subpopulations (TG and T non G): cytologic examination and cytographic analysis. Two T lymphocyte subpopulations were separated with an immunological method. In fact recently two T cell subsets with receptors for the Fc of IgM (TM) and of IgG (TG) respectively have been described. We have specifically separated TG and T non G lymphocytes by the rosetting technique. Cytological examination was performed on the two cell fractions: the results are in agreement with that already reported. Cytographic analysis was also carried out confirming the cytologic results. The possible practical implications of these acquisitions and those already applied are discussed.


[Transfer in vivo of cytotoxic immune lymphocytes obtained in vitro in primary culture against a murine lymphoma antigenically altered by DTIC]. Specific cytotoxic T cells were obtained by coculturing "in vitro" normal spleen cells with inactivated histocompatible DTIC-altered lymphoma cells. The "in vivo" antitumor activity of such sensitized lymphocytes was evaluated by injecting a mixture of lymphocytes + tumor into the brains of lethally irradiated syngenic mice. The results indicated that such lymphocytes demonstrate antitumor activity against the same tumor but not against unrelated tumors.


[Inhibitory action of Hodgkin's disease patients serum on T lymphocytes E rosette forming ability (author's transl)]. We have studied the E rosette forming-phenomenon on normal and pathologic lymphocytes after 24 hours of incubation in Fetal Calf Serum. The percentage of E rosette forming cells decreases more after incubation in Hodgkin's disease patients serum than in normal control serum. The findings suggest a specific interaction between serum factors and Hodgkin's disease lymphocytes surface receptors.


[Active transport of chloride across skin isolated from Rana esculenta]. The effect of SITS, ouabain and acetazolamide on potential difference (E) and short-circuit current (ccc) across isolated frog skin after Amiloride treatment have been investigated. It has been found that Amiloride (3.5 . 10(-5)M) reverses the E and ccc values. After Amiloride treatment, with the use of SITS (6 . 10(-4)M) positive values of E and ccc have been measured while Ouabain (10(-4)M) only slightly reduces the reversed E and ccc values. On the other hand the effect of Acetazolamide (6 . 10(-4)M) is additional to the effect of SITS. It is suggested that the frog skin possesses an active transport for Cl-, as demonstrated by the use of Amiloride, and that it is carried out by two distinct mechanism: the first SITS and Acetazolamide sensible, the second one sensible to Strofantine.


Colour vision tests and colour naming by thirteen incomplete achromats in Bishnupur. As an exploratory study six colour vision tests were given to nine male and two female achromats from the Shankhabanik community in Bishnupur, and to two additional similar males. All thirteen subjects had severe photophobia, fixation nystagmus, extreme weakness of vision (4/24 to 3/60) and the red end of the spectrum was much shortened. This research indicates that they had a form of incomplete achromatopsia, varying from an almost complete to a very severe partial loss of colour vision. The condition is inherited as an autosomal recessive. The most likely interpretation of these cases is that they are incomplete rod achromats. Their performance on the colour vision tests is tabulated, and shows complete inability to do the Ishihara test; nearly complete inability on the HRR test, with a possible slight tendency to do better in the yellow-blue than the red-green sub-tests; on Sloan's test they show approximate accordance with her results for achromats; they have severe difficulty with the dichotomous and 100-hue tests, with a possible slight tendency to make fewer errors on the G/B sections. The anomaloscope shows little abnormality of mid-matching points, but great increases in average matching ranges above the normal, although not absolute loss of colour sense, but with extreme darkening or shortening of the red end of the spectrum. Their colour naming was carefully recorded, and was fairly good occasionally, sometimes erroneous without being wildly at fault, and most often completely wrong. The records of colour naming were made, not, of course, as a form of colour vision test, but simply to illustrate the ways in which such defectives make an effort to use colour names in general use among their friends and relatives.


[Complications of idiopathic chronic colitis]. The Authors reviews the acute and chronic complications of chronic idiopathic colitis in a series of 112 cases of his own observation. He discusses perforation, toxic megacolon and massive hemorrhage in terms of their pathogenesis, diagnostic procedures and incidence in the course of ulcerative colorectitis (Crohn's disease). He deals to some length with surgical indications and the choice of operation, both being the subject of considerable controversy, and he outlines his own views in the matter. Among chronic local complications he lists benign stenosis, pseudopolyposis, and fistulization; all of which, unlike neoplastic complications, seldom require surgery.


[Research on heterocyclic compounds. VIII. Heteroarylcarboxamides and-acetamides with antipyretic activity]. A series of imidazo[1,2-a]pyridine-, imidazo[2,1-b]thiazole- and imidazo[2,1-b]benzothiazole-carboxamides and -acetamides were synthesized and their antiinflammatory, analgesic, antipyretic and ulcerogenic activities were evaluated.


Trichiniasis among the animals in North Eastern Iran (1), 1969, 1976, 1977. In 1969, 1976 and 1977, 1,039 rodents and carnivores collected from North East Iran were examined for Trichinella spiralis. Eighty four per cent of golden jackals, 30 per cent of red foxes and nine per dent of dogs were found to be infected. The importance of wild boar Sus scrofa as the source of infection is discussed.


Effects of "lifelong" physical training on functional aging in men. Functional aging was examined in a cross-sectional study of 22 habitually trained and 22 sedentary men (aged 34 to 70 and 33 to 68, respectively) by using various physiological, psychophysiological, and anthropometric measurements. Compared to the control group, the trained subjects had significantly higher maximal oxygen uptake, vertical velocity, maximal breathing capacity, percentage of slow twitch muscle fibers, and muscle isocitrate dehydrogenase activity, in addition to lower values in body weight, systolic as well as diastolic blood pressure, patellar reflex time, serum triglycerides, and fast twitch muscle fibers (particularly glycolytic fibers). The results showed that the effects of endurance training are largely limited to functions which are apparently relevant to physical performance. The age regression lines were parallel or as in some of the variables influenced by training, even slightly steeper for the trained versus the untrained group. It is suggested that the aging process itself is not retarded by habitual physical training. Great differences between the two groups in muscle fiber composition and maximal oxygen uptake indicate that endurance-active people are also selected on the basis of inherited structural and functional properties.


Effect of mefloquine on the immune response in mice. The effect of mefloquine, a new antimalarial compound, on the immune response in mice was studied in vitro and in vivo. Slight inhibition of mitogen-induced lymphocyte proliferative responses was observed at a concentration of 1 microgram/ml, and marked cytotoxicity at 4 microgram/ml. In contrast, a higher proportion of human lymphocytes remained viable at the same concentration of mefloquine. Antibody responses to sheep erythrocytes were impaired in mice receiving a total dose of 60 mg/kg. At this dosage schedule, delayed-type hypersensitivity responses to the same antigen were not affected.


The value of measurement of pregnancy-specific proteins in twin pregnancies. In this study of 53 twin pregnancies, the plasma concentrations of the placental proteins, placental lactogen (hPL), and pregnancy-specific glycoprotein (SP1) were measured. Placental lactogen was found to be of more value than SP1 both in the detection of twins and in assessment of fetal growth. Serial measurement of either protein would seem to be more useful in assessment of fetal growth than single measurements. Preliminary studies of the less well known placental protein, PP5, in a small series of twin pregnancies indicate that it may also prove to be of clinical value in the detection and monitoring of twin pregnancies.


[Cellular and humoral regulation of myelopoiesis in normal persons and in patients with acute myeloses]. Human mononuclear leucocytes release colony stimulating factors. Monocytes and thymocytes release different colony stimulating factors as determined by estimation of molecular weights. Blasts from patients with acute leukaemia do not release substantial activity, while blasts from patients with chronic myeloid leukaemia in blast crises may show production of colony stimulating factors.


[Sézary syndrome. Clinical, immunological and proliferative kinetics]. The development of Sézary syndrome was observed in a patient with mycosis fungoides. The Sézary cells in the peripheral blood were identified as a specific T-cell population with helper cell characteristics. Autoradiographic analysis showed that the Sézary cells obtained from skin biopsies proliferated much more rapidly than those from the peripheral blood. After transformation into a highly malignant T-cell lymphoma (immunoblastic) it came to an abrupt and fatal course of the disease.


[Membrane markers of the lymphocytes of human peripheral blood: techniques of study and normal values in adults]. Peripheral blood lymphocytes from normal subjects were evaluated for their cell surface markers. Normal values were determined in females and males for T-cells (E rosettes and active E rosettes) and for B cells (surface immunoglobulins, EA rosettes and EAC rosettes). Means expressed in percentage and in absolute number per cubic millimeter +/- standard error in normal subjects males and females.


[Pneumocystis carinii pneumonia in chronically immunosuppressed patients. Apropos of 33 cases]. The availability of drugs that are active against Pneumocystis carinii has renewed interest in and underlined the difficulties of the early diagnosis pneumocystis pneumonia. A retrospective study of 33 cases was undertaken to define the optimal management. It is necessary to take into consideration the high mortality of the untreated condition and the risks of investigation and of treatment. Pneumocystis pneumonia affects only those patients who are immunologicaly incompetent, particularly those with defects of cellular immunity. Early symptoms are common but they are insidious. Indirect immunofluorescent tests were positive in 75% of our cases and were useful as screening tests. However it is necessary to identify the parasite (in our cases it was detected in 29 patients) and this requires invasive techniques such as lung puncture, lung biopsy or bronchial brushing. The best method for the rapid diagnosis of pneumocystis is endobronchial brushing, because it is simple, effect and has few complications.


The variation of characteristics of twitch and tetanic contractions with sarcomere length in isolated muscle fibres of the frog. The relation between sarcomere length, tension and time course of tension development in twitch and tetanic contractions at 20 degrees C was determined for isolated fibres from the semitendinosus muscle of the frog (Rana esculenta). In twenty fibres at about 2.15 micron sarcomere length, the peak twitch tension, the maximum tetanic tension and the twitch/tetanus ratio ranged, respectively, from 0.22 to 1.6 kg/cm2, from 2.13 o 3.96 kg/cm2 an from 0.07 to 0.53. The peak twitch tension was found to be: i) directly correlated with the twitch/tetanus ratio and the time to the peak of the first derivative of the twitch tension, ii) inversely correlated with the time to the peak of the first derivative of tetanic tension. No significant correlation was found between the maximal tetanic tension and the peak twitch tension or the twitch/tetanus ratio. Peak twitch tension and twitch/tetanus ratio were not correlated with the fibre cross-sectional area which ranged from 1.052 to 6,283 micron2. Sarcomere length-tension curves for twitch and tetanic isometric contractions at 20 degrees C were determined in twelve fibres. Increases in sarcomere length from about 2.15 to 2.85 micron produced, depending on the peak twitch tension or the twitch/tetanus ratio at about 2.15 micron, either decrease and no change or increase in peak twitch tension, but constantly enhanced the twitch/tetanus ratio and the degree of this potentiation was inversely correlated with the twitch/tetanus ratio at 2.15 micron. Increase in sarcomere length above 2.15 micron did not alter the course of the early development of twitch and tetanic tensions, reduced considerably the variation in peak twitch tension and twitch/tetanus ratio, without altering that of tetanic tension and swamped the correlation between the peak twitch tension and the time to peak of the differentiated twitch tension. However, the peak twitch tension at about 2.85 micron resulted to be directly correlated with the peak twitch tension at about 2.15 micron and in addition the relative length-dependent change in the time of the peak of the first derivative of the twitch tension resulted to be directly correlated with the relative length-dependent change in the peak twitch tension. It is concluded that both the duration of the active state and the rate factors of activation contribute to the determining of the large variation in peak twitch tension at about 2.15 micron, whereas the length-dependent increase in twitch/tetanus ratio appears to be mainly determined by prolongation of the active state duration.


Histological changes in Xenopus laevis Daudin adult specimens kept under dry conditions, then moved back to their natural aquatic environment. II. Skin, kidney and interrenal tissue. Some cytological and histochemical characteristics of skin, the kidney and interrenal tissue were studied in Xenopus laevis adult specimens (1) kept in their natural aquatic environment; (2) gradually exposed to dry conditions under which they were kept one week; and (3) returned from the dry environment to water for 24 hr or a week. In the skin, the most relevant changes are those exhibited by epidermal "flask" cells. These cells are generally rather lean, tall and PAS-positive in "dry" animals and in those 24 hr after replacement in water, whereas in animals placed back in water for a week "flask" cells are often large and faintly stainable. In "dry" animals, the skin mucous glands look more emptied of secretion granules than in control animals kept in water or in "dry" specimens returned to water. Difference in the epidermis thickness or in its histochemically evidenced alkaline phosphatase activity were not observed between different groups. In the kidney a clearcut difference between animal groups was found in the glycogen content of the proximal convoluted tubules of the nephron. Glycogen level is very low in "dry" animals. These variations are tentatively ascribed to different degrees of electrolyte resorption. In the interrenal cells, the sudanophil material is scanty in "dry" animals, while it is much more abundant in those returned to water for 24 hr. Similar, though less pronounced, effects had been obtained in previous experiments of ours, in which some of the animals were kept out of water on moist moss, that is under less severe conditions of water deficiency than in the present experiments.


Membrane water permeability alterations induced by pollutants. Lead ions and the surfactant nonylphenolethoxylate are found to inhibit the active transport-coupled water flow in the leg skin of Rana esculenta. The water permeability for osmotically driven flows remains unchanged for high flows, while it is remarkable lowered near zero osmotic pressure difference. The possible mechanism of the permeability change is discussed in connection with the available data on the electrophysiological effects of the pollutants.


[Lactamase and bacterial resistance to beta-lactam antibiotics (author's transl)]. Bacterial resistance to beta-lactam antibiotics, as indicated on sensitivity tests, is not always directly proportional to their beta-lactamase synthesis capacity. From the epidemiological viewpoint, therefore, it would appear important to look specifically for the various beta-lactamases in bacteria. Chemical and biological methods for this purpose are reviewed, with particular attention to those including special steps which render them speedy, economical and feasible in any laboratory. Practical examples are offered.


Development of a radioimmunoassay for colony stimulating factor. Purified L-cell colony stimulating factor (CSF) and rabbit anti-CSF serum were used to devise a radioimmunoassay for this factor. The CSF was radiolabelled with the aid of lactoperoxidase and precipitated by a double antibody technique. Addition of unlabelled CSF caused a dose-related displacement of the labelled tracer. Similar results were noted with conditioned media and murine serum. The assay required only 4 days for completion as compared with 7 days for the conventional agar gel bioassay. Moreover, the radioimmunoassay proved more sensitive and accurate than the bioassay. This technique should allow further exploration of the role of CSF in granulopoiesis.


[Epilepsy following cisternography with water-soluble contrast (author's transl)]. A case of epilepsy is reported during ventriculography with hydrosoluble triiodate contrast (methylglutamine iotalamate). The cysternal interhemispheric cavities of the midline were flooded. This complication, which could have been lethal was treated with thiopental sodium salt, 6 methylprednisolone, mannitol, curare, trans-larynx intubation, ventilation with oxygen and nitrous oxide. The AA. conclude that the presence of an anaesthetist-resuscitator is essential during ventriculography with triiodate hydrosoluble contrast medium.


Monoamine oxidase activities in patients with migraine or with cluster headache during the acute phases and after treatment with L-5-hydroxytryptophan. The results of a study of the activity of platelet monoamine oxidase (MAO) in patients with migraine or with "Cluster headache" during the acute phases and after treatment with L-5-hydroxytryptophan are presented. MAO levels are higher in migraine subjects than in normals. There is, also, a clear difference between basal MAO levels in migraine sufferers and in Cluster Headache sufferers. The treatment with L-5-hydroxytryptophan tend to normalize MAO activity in the migraine patients, but does not change the MAO activity in cluster headache patients.


[The culture of Trichomonas vaginalis and its incidence in vaginitis]. Direct microscopic and cultural examination of 151 cases of vaginitis have been applied. Trichomonas vaginalis observed in 22 cases by direct microscopic examination and isolated in 42 cases by cultural method. Candida sp isolated in 46 cases. All patients were treated.


[Ophthalmic herpes zoster and delayed contralateral hemiparesis: a chance occurrence (author's transl)]. A 57 years-old woman developed a right hemiparesis with dysphasia four weeks after left Herpes Zoster Ophthalmicus. The CSF was normal while cerebral angiography showed segmental narrowing of the left carotid syphon and terminal branches. The patient's condition improved during the next few days with almost full recovery. Herpes Zoster Ophthalmicus followed by a controlateral hemiparesis or hemiplegia is a relatively infrequent clinical syndrome. After a review of the relevant literature and discussion of the various theories of causation, the authors suggest a chance relation between the two pathological conditions.


Corneal degenerations.

Corneal degenerations. Corneal degenerations are among the most commonly observed clinical disorders in ophthalmology. They may be classified as (1) aging changes, (2) depositions, and (3) marginal degenerations. Aging changes are often incidental findings and do not usually interfere with vision. Depositions can occur secondary to previous ocular disease or trauma. Marginal degenerations are generally of unknown etiology, however, they may sometimes accompany a systemic disorder. The diseases in this latter group are usually the most difficult to treat and the most visually disabling.


[Results and pharmacokinetic aspects of methotrexate therapy in high doses]. We used MTX as single drug treatment on the basis of an incremental dosage schedule, with doses increased from 250 mg/m2 to 750 mg/m2 or from 5 to 10 g, at intervals of 10 days. Moderately high MTX doses (750 mg/m2 at most) plus citrovorum factor rescue, failed to result in objective tumor regression in all of the 18 patients thus treated. High-dose MTX with CF rescue, by contrast, was found to produce partial remissions in 3 of the 19 cases treated thus far. Meticulous clinical monitoring and MTX serum level determinations are imperative for minimizing complications, if this drastic treatment regimen is employed.


[Wirsung hemorrhage in pancreatic pseudocyst]. Case report of a fifty-two year old patient with expansive pleural-pericardial effusion and hypoferric anemia caused by intermittent hemorrhage in a pancreatic pseudocyst drained by the d. wirsungianus. Hemorrhage through the d. wirsungianus is a rare cause of gastrointestinal bleeding of "unknown" origin.


Bacterial endophthalmitis associated with vitreous wick. A culture proven case of bacterial endophthalmitis (alpha streptococci, not Group D, and coagulase-negative staphylococci) occurred in association with a vitreous wick 26 days following uncomplicated intracapsular cataract extraction. Despite intensive antibiotic therapy, the eye was lost to infection. Immediate surgical repair of vitreous wicks which communicate with the external ocular surface is recommended.


Effects o;f vitrectomy infusion solutions containing oxacillin, methicillin, or lincomycin. Experiments conducted in rabbits showed no toxic effects on the retina by electroretinogram after vitrectomy when the infusion fluid contained as much as 50 microgram/ml of methicillin or lincomycin or 20 microgram/ml oxacillin. An abnormal electroretinogram was found in eyes receiving oxacillin in a concentration of 50 microgram/ml. Histologic studies showed ocular damage with concentrations of 50 microgram/ml of methicillin or lincomycin or 20 microgram/ml of oxacillin. All antibiotics were nontoxic to retina at 10 microgram/ml concentration, both by ERG and histology.


Antibiotic prophylaxis of postoperative endophthalmitis. Nonconcurrent analysis of 45,954 cataract operations performed by a single surgeon indicates that periocular injection of penicillin combined with multiple preoperative applications of topical chloramphenicol-sulphadimidine reduced the incidence of postoperative endophthalmitis by 72%. Periocular penicillin alone was ineffective. A concurrent masked randomized study of 6,618 cataract operations confirms the efficacy of combined prophylaxis and demonstrates that the topical regimen, by itself, is as ineffective as isolated penicillin prophylaxis.


Effect of nondialyzable solids concentration and viscoelasticity on ciliary transport of tracheal mucus. The viscoelastic properties of reconstituted canine tracheal mucus were correlated with the ciliary transport rate measured on the bullfrog palate. A maximum in mucociliary transport rate was found at an optimal concentration of nondialyzable solids of 1.5 to 2 per cent. At concentrations less than this value, the mucus had little or no elasticity and low rates of transport; at concentrations greater than the optimum, however, further increases in elastic modulus also resulted in decreasing transport.


The elution profile of vitamin D2 metabolites from sephadex LH20 columns. A metabolite of vitamin D2 in the tissues of primates fed this vitamin co-migrates to a significant extent with 24,25-dihydroxyvitamin-D3 on columns of Sephadex LH20, with chloroform/n-hexane (60/40 by vol) as eluent. In individuals receiving vitamin D2 and in individuals with scant exposure to sunlight this metabolite, which we believe to be 25,26-dihydroxyvitamin-D2, may yield falsely higher concentrations of apparent 24,25-dihydroxyvitamin-D3 if separation on LH20 is used.


Travel for primary care: expectation and performance in a rural setting. Data and findings are presented pertaining to the expressed travel limits for general medical care of a rural population and the degree to which their observed travel behavior reflects these limits. Considerable variation in expressed reasonable and maximum travel distances and times was observed among respondents in a countywide cross-section sample of the resident population in western Maine. A substantial proportion of the respondents' visits for general medical care exceeds their reasonable travel limits and some visits exceed the travel limits they considered maximal. Additionally, a comparison of expectations from this study with those of a similar population in another section of the county reveals significant differences. The findings suggest that health planning could be considerably enhanced by a better understanding of patient preferences for medical care travel behavior, the origins of these preferences, and their relationship to the use of available medical care opportunities. This is particularly true if stated goals of incorporating patient preferences into the health planning process are to be realized.


Diffusion of ions in myelinated nerve fibers. The diffusion of ions towards or away from the inner side of the nodal membrane in preparations, the cut ends of which are placed in various media, was investigated. The ion concentration changes were calculated by numerical solution of the unidimensional electrodiffusion equation under a variety of media compositions, axoplasmic diffusion coefficients, and internal anionic compositions. The potassium and cesium ion diffusion along the axon towards the node was determined experimentally by two different electrophysiological methods. On the basis of comparison between the experimental data and the computational predictions the axoplasmic potassium ion diffusion coefficient was determined to be almost equal to that in free aqueous solution, while that of cesium ion was close to one half of that in aqueous solution. Utilizing the values of diffusion parameters thus determined, we solved the electrodiffusion equation for a number of common experimental procedures. We found that in short fibers, cut 0.1-0.2 cm at each side of the node, the concentration approached values close to the new steady-state values within 5-30 min. In long fibers (over 1 cm long) steady-state concentrations were obtained only after a few hours. Under some conditions the internal concentrations transiently overshot the steady-state values. The diffusion potentials generated in the system were also evaluated. The ion concentration changes and generation of diffusion potential cannot be prevented by using side pools with cation content identical to that of the axoplasm.


Structure determination of asymmetric membrane profiles using an iterative Fourier method. An iterative Fourier method is applied to solving and refining the electron density profile projected into the line perpendicular to a membrane surface. Solutions to the continuous X-ray scattering pattern derived from swelling of multilayer systems or from membrane dispersions can be obtained by this technique. The method deals directly with the observed structure factors and does not rely on deconvolution of the Patterson function. We used this method previously to derive the electron density profile for acetylcholine receptor membranes (Ross et al., 1977). The present paper is an analysis of the theoretical basis for the procedure. In addition, the technique is tested on artificially generated continuous-scattering data, on the data for frog sciatic nerve myelin derived from swelling experiments by Worthington and McIntosh (1974), and on the data for purple membrane (Blaurock and Stoeckenius, 1971). Although the method applies to asymmetric membranes, the special case of centrosymmetric profiles is also shown to be solvable by the same technique. The limitations of the method and the boundary conditions that limit the degeneracy of the solution are analyzed.


On the mechanism of magnetic field effects in bacterial photosynthesis. The recently discovered magnetic field effects in bacterial photosynthesis are discussed by solving a simple model exactly. Analytic expressions are given that permit one to study the influence of the rates of the primary electron transfer reactions and the exchange interaction on the yield of excited triplet states.


Response latency of vertebrate hair cells. An in vitro preparation of hair cells from the bullfrog sacculus produces a transepithelial microphonic potential in response to well-defined mechanical stimuli. If corrected for the electrical time constant of the epithelium, the response follows a fast stimulus with a 40-microsecond delay at 22 degree C. The short latency and its modest temperature dependence limit possible models for transduction by hair cells.


Self diffusion of water in frog muscle.

Self diffusion of water in frog muscle. Self diffusion of cell water has been measured at diffusion times ranging form 0.3 ms to 2.4 s for three muscle types of Rana pipiens, using various magnetic field gradient nuclear magnetic resonance methods. Intracellular diffusion coefficients and membrane permeabilities are calculated with the aid of previous theoretical results for regularly spaced permeable planar barriers. The intracellular diffusion coefficient is 1.6 x 10-5 cm2/s, in approximate agreement with other literature values for skeletal muscles. The outer membrane permeabilities are estimated at 0.01 cm/s for two of the muscle types, and much higher for the other one.


Light diffraction study of single skeletal muscle fibres. Light diffraction patterns from isolated frog semitendinosus muscle fibers were examined. When transilluminated by laser light, the muscle striations produce a diffraction pattern consisting of a series of lines that are projected as points onto an optical detector by a lens system. Diffraction data may be sequentially stored every 18 ms for later processing by digital computer systems. First- and second-order diffraction line intensities were examined from intact, chemically skinned, and glycerinated single fibers. The diffraction line intensities demonstrated a strong length dependence upon passive stretch from reference length to 3.6 micrometer. The first-order intensity linearly increased an average of 15-fold over the range examined. The magnitude of the second order intensity was less than the first order and showed an exponential rise with increasing length. Both first- and second-order intensities decreased upon muscle activation. Data from chemically skinned and glycerinated single fibers were not significantly different from intact fibers, indicating that the membrane structure has little effect upon the diffraction phenomenon in muscle. Theoretical model systems are examined in an attempt to find the basis of these results. Neither an analysis based on a diffraction grating with variable spacing nor the unit cell model of Fujime provides an explanation for the observed length dependency of intensity. Though the origin of the intensity decrease upon stimulation is not known, we have suggested that it could result from lateral misalignment of myofibrils and can occur upon activation.


Increased development of PHA-stimulated murine colonies in vitro subsequent to adriamycin or daunorubicin treatment of spleen donor mice. Spleen cell populations from mice treated with Adriamycin or daunorubicin were found to develop a greater PHA-stimulated clonal response than spleen cells from untreated or cyclophosphamide-treated animals. Daunorubicin, in addition, stimulated an unusual monocytic macrophage-like colony. The results are consistent with the possibility that the concentration of nonspecific T-lymphocyte progenitor and/or accessory cells in the spleen are increased consequent to drug treatment.


Effect of levamisole on the mitosis of murine thymocytes in culture. The effect of levamisole on murine thymocytes stimulated by concanavalin A in culture was measured as the change in number of cells in the DNA synthetic phase (S-phase) and in number of cells undergoing mitosis (M-phase). Addition of levamisole to Con A-stimulated lymphocytes led to an approximately tenfold increase in the frequency of mitosis and a fivefold increase in the frequency of cells heavily labeled with thymidine. Thus, levamisole leads to an increased number of cells undergoing proliferation. Determination of cell viability excluded the possibility that the effect of levamisole was simply due to enhanced numbers of viable cells in culture. Examining the effect of levamisole on the proliferating cells alone, it was found that they had a shorter cell cycle time. It was therefore concluded that levamisole affects thymocyte proliferation in vitro in two ways: enhancement of the number of proliferating cells and shortening the cell cycle time of proliferating cells. A similar effect in vivo might be important in the mechanism of action of levamisole as an immunotherapeutic agent.


Stretch and radial compression studies on relaxed skinned muscle fibers of the frog. The influence of stretch and radial compression on the width of mechanically skinned fibers from the semitendinosus muscle of the frog (R. pipiens) was examined in relaxing solutions with high-power light microscopy. Fibers were skinned under mineral oil. We find that, after correcting for water uptake in the oil, fiber width increased by an average of 28% upon transfer from oil to relaxing medium, with some tendency for greater swelling at longer sarcomere lengths. Subsequently, fibers were compressed by addition of the long-chain polymer polyvinylpyrrolidone (PVP-40, number average molecular weight 40,000) to relaxing solutions. Sarcomere length does not appear to be affected by addition of PVP. At any PVP concentration, the inverse square of the fiber width increased smoothly and linearly with increasing stretch for sarcomere lengths between 2.10 and 4.60 micrometer. At any fixed sarcomere length, fiber width decreased linearly with the logarithm of the osmotic compressive pressure exerted by PVP (2-10% concentration). From this logarithmic relation we estimate that the swelling pressure of the intact fiber is 3.40 x 10(3) N/m2, between that of a 2 and a 3% PVP solution. The pressure giving rise to fiber swelling is not due to dilation of the sarcoplasmic reticulum (SR), since the experimental results above were not significantly different after treatment with 0.5% BRIJ-58, a nonionic detergent that disrupts the SR. Swelling may be due simply to elastic structures within the fiber that are constrained in the intact cell. Values of bulk moduli of fibers, calculated from the compression experiments, and preliminary measurements of Young's modulus from stretch experiments, are quantitatively consistent with the idea that skinned fibers behave as nonisotropic elastic bodies.


Beneficial effect of continuation of propranolol through coronary bypass surgery. The safety and beneficial effect of continuation of propranolol (Pr) through coronary bypass surgery (CBS) was studied in two groups of patients. In the control group (50 patients) Pr was discontinued 24 h before CBS without reinstitution afterwards. In the propranolol group the drug was maintained up to 4 to 10 h before surgery and was restarted within 24 h afterwards. The incidence of subendocardial myocardial infarction was significantly lower in the Pr group (1 out of 30 vs 10 out of 50, p less than 0.05) while the incidence of transmural infarction was the same in both groups (3 out of 30, 10%, vs 5 out of 50, 10%). The incidence of supraventricular tachycardias during the first three postoperative days was significantly lower in the propranolol group compared to control (5% vs 30%, p less than 0.01). The 24 h urinary epinephrine and norepinephrine excretion was significantly greater than normal the day before surgery (136 +/- 12 vs 39 +/- 4 micrograms/24 h, p less than 0.01), and was still high two weeks after surgery (115.1 +/- 14 micrograms/24 h). There were no complications related to propranolol. The left ventricular function as measured from the systolic time intervals was the same pre- and postoperatively in both groups. The results of this study show that administration of propranolol up to 4 h before coronary bypass and reinstitution immediately afterwards is safe and beneficial.


The physiologic recovery trajectory as the organizing principle for the quantification of hormonometabolic adaptation to surgical stress and severe sepsis. Preoperative and serial postoperative clinical, cardiovascular, physiologic, and metabolic studies were carried out on 86 patients undergoing coronary artery bypass surgery (CABG); and 48 patients undergoing abdominal general surgical procedures (GSEL). Multivariable statistical analysis of these data showed the patients to be in different physiologic states and to manifest several types of recovery trajectories that could not be discerned on clinical grounds alone. The CABG patients followed one of three types of cardiogenic recovery trajectories. In contrast, GSEL patients show a normal recovery trajectory different from all CABG types. When sepsis develops, and exaggerated stress response (A state) occurs, with increased oxygen consumption and a pattern of amino acids, fat, and glucose breakdown products, which is heightened but similar to the response of nonseptic GSEL patients. With progression of sepsis severity, an unbalanced hyperdynamic recovery trajectory (B state) develops in which a decrease in oxygen consumption is associated with increases in the aromatic amino acids tyrosine, tryptophane, and phenylalanine; and decreases in the branched-chain amino acids, leucine and isoleucine. Triglycerides rise as keto acids fall, but both lactate and pyruvate rise. Glucagon is persistently high, regardless of insulin levels. The quantifiably different physiologic recovery trajectories reflect altered hormone and metabolic states and imply different responses to therapy.


[Postero'inferior aneurysm of the left ventricle following myocardial infarction. Diagnosis and surgical treatment]. This is a report of the first four cases of left ventricle aneurysm of the posterior and inferior segments successfully treated surgically in the Hospital de Cardiología y Neumología del Centro Médico Nacional, México D. F., and represent the twelve per cent of all realized aneurysmectomies. The patients were all men with 57 years mean age, and a previous history of posteroinferior myocardial infarction, complicated in three of them with angor and severe ventricle arrythmias; chest X ray in lateral view showed a bump of the posteroinferior border of the cardiac silhouette; the echocardiography increase in the ventricular diameter below the mitral valve; the ventriculography made evident a diastolic bulging with systolic expansion of posterior and inferior segments of the left ventricle and no mitral regurgitation; selective coronary arteriography showed a dominant right pattern with 100 per cent proximal occlusion. Aneurysmectomy was done in all four cases and aortocoronary by-pass in two. The posteromedial papilar muscle was found respected in all cases and in two cases a mural thrombus was detected.


Temperature dependence on the passive and dynamic electrical parameters of muscle cells. Measurements of the temperature dependence in the range from 10 C to 30 C on the passive and dynamic electrical properties of single frog muscle cell following Arrhenius relation have been made. The propagated responses (V-t) and conduction velocity theta were analyzed following the H-H propagated cable equation. The ionic current-membrane potential relationship (I-t) was calculated from the phase-plane trajectory analysis (V-V) of the action potential curve (V-t). All the rate and time constants of the excitation and propagation processes kr, kNa, kK, tau Na, tau K, the negative conductance (-gNa) and the ionic conductances gNa, gK, influencing the evolution of the curves (V-t), (V-V) and (I-V) are correlated. The magnitudes of the resting (Vr) and action potential amplitude (Vs), the excitation potential (V*), the negative after potential (Vn), and the sodium equilibrium potential (VNa); the magnitudes of the maximum rate of rise and fall of the spike (V+) and (V-) and those corresponding to the inward INa and outward IK ionic currents, were analyzed. Two general classes of findings were obtained. One group of action potential parameters theta, V+, V-, Vn, kr, kNa, kK, tau Na, tau K, -gNa, gNa, gK, INa and IK is strongly temperature dependent with Q 10 S approximately 2 and energy of activation E approximately 10 kcal/mole. The other group of parameters, Gm (passive conductance), Cm (capacitance), tau, Vr, V*, Vs, and VNa are slightly temperature dependent, with Q10's lower than 1.4. This study contributes deeply to the analysis of temperature effects on the electrical cell responses to adequate stimuli. This temperature dependence analysis was designed to detect possible "masked" actions of microwave radiation on cell membrane functions.


Quantitation of chronic microwave radiation effects on muscle cell electrical excitable properties: a temperature dependence analysis of the H-H cable and membrane current parameters of irradiated cells. Frogs Rana pipiens maintained under constant laboratory environmental conditions were subjected daily to chronic microwave exposure with pulsed microwave (2.88 GHZ) at a power density of 10 mW/cm2, during 0.1 hour, for periods up to 100 days. The whole body Specific Absorption Rate (SAR) was of 1.5 mW/g per 1 mW/cm2. The passive and dynamic electrical parameters of sartorius muscle cells from control and irradiated frogs as a function of temperature in the range from 10 C to 30 C, have been analyzed. This temperature dependence analysis, presented in another work, was planned to be used in this paper for detecting those possible "masked" chronic microwave effects in complex membrane mechanisms highly temperature sensitive, and tightly related to the excitation and propagation of bioelectrical responses. The temperature dependence of the passive (Vr, Gm, Cm, and tau) and the active cell electrical parameters (theta, V*, Vs, VNa, Vn, V+, V-, kr, kNa, kK, tau Na, tau K, -gNa, gNa, gK, INa, and IK) was not altered by chronic microwave exposure. The striking observation reported in another work, about the presence of two groups of cell electrical parameters, characterized by their dependence with temperature, was reproduced on the irradiated muscle cells. Results have indicated that there was not muscle cell cumulative bioeffects resulting from microwave exposure to 10 mW/cm2, over a 0.1 hour period.


Perinatal vitamin D metabolism. IV. Maternal and cord serum 24,25-dihydroxyvitamin D concentrations. Fetal and maternal compartments differ in factors shown to regulate 24.25 dihydroxyvitamin D [24,25(OH)2D] metabolism [calcium, phosphorus, and parathyroid hormone (PTH)] such that one might predict that maternal serum 24,25(OH)2D levels are decreased and fetal 24,25(OH)2D concentrations are increased. To evaluate this, 25-hydroxyvitamin D (25OHD), 24,25(OH)2D, calcium, magnesium, calcitonin, and PTH were measured in 24 paired maternal and cord sera. The mean maternal serum 24,25(OH)2D concentration (2.9 +/- 0.26 ng/ml) was significantly lower than that of nonpregnant females (3.9 +/- 0.37 ng/ml). Mean serum PTH and calcitonin levels were, however, normal in maternal sera. The normal elevations of PRL, estrogen, and placental lactogen in serum of pregnant women could possibly decrease 24,25(OH)2D production, as seen in animal experimental systems. There was no correlation (R = -0.25) between 24,25(OH)2D levels in maternal and cord sera, as predicted; however, mean (+/-SE) fetal 24,25(OH)2D (2.5 +/- 0.26 ng/ml) was similar to the mean maternal concentration and significantly below the mean level in normal adults. The low fetal 24,25(OH)2D concentration may be due to 1) decreased 24-hydroxylase capacity of the fetus; 2) regulation by fetal factors other than calcium, phosphorus, and PTH; or 3) increased utilization of 24,25(OH)2D possibly for fetal bone mineralization.


Pregnancy-specific beta 1-glycoprotein and chorionic gonadotropin-like immunoreactivity during the latter half of the cycle in women using intrauterine contraception. In a cross-sectional study, the serum levels of pregnancy-specific beta 1-glycoprotein (PSBG), hCG, human LH, and progesterone were measured by RIAs during 94 mid or late luteal phases of 69 women using oral contraceptives. Subsequent spontaneous menstruation took place in every cycle. None of the women using oral contraceptives had any PSBG or hCG-like immunoreactivity in serum. In women with intrauterine devices, PSBG was found in six cycles (6.4%) and hCG-like immunoreactivity was demonstrated in one cycle only, where PSBG also was present. In two out of six PSBG-positive cycles, menstruation was delayed by 5 and 16 days. Although rare, the transient occurrence of trophoblastic antigens in women using intrauterine contraception is taken as evidence for an occult pregnancy in these apparently infertile cycles.


T-lymphocytes in chronic renal failure.

T-lymphocytes in chronic renal failure. Impairment of cellular immunity in chronic renal failure was studied by determining lymphocyte rosetting with sheep erythrocytes. There is an absolute decrease of T-lymphocytes in the peripheral blood during chronic renal failure. The effects of uremic serum, AB serum and levamisole on uremic lymphocyte rosetting were studied. T-lymphocyte rosetting with sheep red blood cells was inhibited by the addition of uremic serum, and incubation with normal serum does not restore uremic lymphocyte rosetting to normal. Pre-incubation of uremic lymphocytes with levamisole does not increase lymphocyte rosetting with sheep red blood cells. We postulate that in addition to environmental factors resulting in impaired T-lymphocyte response, there may be a metabolic or intrinsic cellular derangement in T-lymphocytes during renal failure.


Diagnostic and prognostic implications of computed tomography of head trauma. A total of 210 cases of head trauma were examined using noncontrast enhanced and contrast enhanced computed tomography scans. Evidence of contrast enhancement was seen in 97 cases (46%). Subdural hematoma and focal contusion were the most frequent entities demonstrating contrast enhancement. This finding was also frequently seen in patients with intraventricular hemorrhage (IVH) (5 of 17). Every one of the five patients in this series with IVH whose scans showed enhancement died, whereas out of the 12 whose scans showed no enhancement, five survived. Illustrative cases are presented. The authors feel that contrast enhanced scans are valuable in the evaluation of the full extent of head trauma.


Homologous radioimmunoassay for human epidermal growth factor (urogastrone). Epidermal growth factor (EGF), a polypeptide hormone originally discovered in the mouse submaxillary gland, stimulates growth in a variety of tissues in several species. This hormone has recently been identified in human urine. A homologous RIA for human EGF (RIA-hEGF) has been developed. In general, levels were similar to those recently reported using a heterologous RIA system. Twenty-four-hour urinary excretion of RIA-hEGF by normal adult males and females was 63.0 +/- 3.0 and 52.0 +/- 3.5 (mean +/- SE) micrograms/total vol, or 29.7 +/- 1.1 and 39.8 +/- 1.7 micrograms/g creatinine, respectively. Excretion by females taking oral contraceptives was significantly greater (60.1 +/- 2.7 micrograms/g creatinine; P less than 0.01) than that by females who were not. Recent evidence suggests the probable identity of hEGF and beta-urogastrone, a potent inhibitor of gastric acid secretion. Adult males with active peptic ulcer disease appeared to have lower urinary RIA-hEGF excretion (22.9 +/- 2.6 micrograms/g creatinine) than normal men, but this was not significant (P greater than 0.05). Several of those with very low values had histories of alcohol abuse. Excretion by patients with Cushing's syndrome was normal. Patients with psoriasis or recovering from major burns excreted both abnormally high and abnormally low levels of RIA-hEGF, with no obvious correlation to their clinical condition. There was no apparent diurnal or postprandial variation in urinary RIA-hEGF excretion by normal subjects. An excellent linear correlation was observed between RIA-hEGF and creatinine concentrations in each urine sample for each subject, suggesting that RIA-hEGF concentration in a random urine sample provides a valid index of 24-h RIA-hEGF excretion.


Periventricular leukomalacia related to neonatal anoxia: recognition by computed tomography. Periventricular areas of decreased attenuation coefficient were demonstrated by computed tomography (CT) in two infants with neurological involvement after episodes of neonatal hypoxia. This CT finding is related to anoxic periventricular leukomalacia, which is well documented in the literature. Follow-up CT scans in our two patients demonstrated reversibility of the white matter changes.


Addition processing of computed tomograms for whole view of cerebral ventricles. Exposure of several contiguous computed tomograms on the same film with a hard copy unit may be used to produce a survey display of the whole cerebral ventricular system.


A 6 mm collimator system for the EMI CT5000/5005 whole body scanner. A new 6 mm collimator for the EMI CT5000/5005 scanner is described. It consists of a narrower tube side and detector side collimator that can be set up in less than 5 min. The applications are primarily for the orbit and parasellar area. Future applications with the aid of new software include coronal reconstruction.


[Evaluation of the methods of treatment of histiocytosis X in children in relation to its clinical picture]. The work was undertaken owing to great difficulties in diagnosis and treatment of histiocytosis X (HX) in children, which occurs comparatively rarely and its clinical symptoms are of great variety. The analysed material included 45 cases of children with HX treated in one clinical department. A big number of analysed cases makes safe conclusions possible. The aim of this work was evaluation of therapeutic methods used in HX, on the basis of the results obtained from the HX treatment and with consideration of such prognostic factors as: the age of the child when the first pathological symptoms occurred , the extent of the pathological process and the localization of the lesions. The results of the research carried out on 23 children in whom the pathologic process concerned the skeletal system only were evaluated separately. Remaining 22 cases in which the lesions were noticeable not only in the skeletal system, but also in other organs and systems were divided in two groups: group 1 (11 children) included all the cases treated till 1969 by different methods with the use of different cytostatics; group 2 (11 children) included the cases observed by the author introducing a new method of treatment based on intensive therapy followed by the usage of Vinblastine or both Vinblastine and Prednisone. In the evaluation of the extent of the pathologic process and localization of lesions the following symptoms were taken into consideration: skeletal and skin lesions, enlargement of lymphatic nodes and liver, lesions of gums--i.e. movable teeth, lesions in ears, lungs, hematopoietic system, and fever. The presence of these symptoms is proved by the clinical, radiological and laboratory examinations. The age of the patient with the first symptoms of the disease was established through inquiry, the appearance at least one of the HX symptoms such as: protrusion of the soft tissue, skin lesions and discharge from the ears was considered as the beginning of the disease. In the group of children with lesions limited only to skeletal system, the age of the appearance of the first symptoms was between 1-12 years. The greatest morbidity was between the 4-th and the 8-th year of life (Fig. 1). The main methods of treatment were surgery and/or radiotherapy. Chemotherapy was used sporadically as supplementary treatment. In all cases response was good. (Tab. 1.). The generalized form of the disease is observed as a rule among the youngest children. In our own material of 20 cases out of all 22, the first symptoms of the disease appeared before 3-rd year of life was over. (Fig. 4.).(ABSTRACT TRUNCATED AT 400 WORDS)


[Incidence of trichomonas vaginitis among women in the Białystok region]. Nine-year period of examinations, carries out within the former borders of the Bia ł ystok Province including 332 774-391 959 women above 20 years of age, was subjected to analysis. From this group, about 85000-109000 women underwent microbiological examinations. An increasing number of microbiologically examined women corresponds to increasing detectability of trichomoniasis between 1971-1972. From that time on, a distinct decrease in detectability has been observed. Detailed analysis of trichomoniasis detectability was performed in different Departments of Health Services. Significant differences in trichomoniasis detectability were found in the whole region and particular Departments of Health Service. The last detectability has been shown by the Department of Health Service for Bia ł ystok . The scheme of diagnostic procedures in the same for the whole region.


[Comparative studies on Trichomonas vaginalis in the scanning electron microscope]. Different strains of Trichomonas vaginalis isolated from the vagina of women with trichomoniasis were used in these investigations. The cultures were carried out on modified CPLM and Roiron media. Individuals at the highest phase of logarithmic growth underwent the observation. Preparations to be evaluated in scanning electron microscope ( JEOL - JSM -S1) were made from a condensed culture containing 500,000 individuals per ml. Each time, microscopic pictures obtained after washing, demucination and various fixation procedures and after lyophylisation were compared to each other. The pictures obtained from smears taken from the vagina of women with trichomoniasis were compared, too. Special attention was paid to the behaviour of the surface and motion organelles of the parasite.


[Prevention and epidemiology of trichomonal vaginitis in women treated in gynecological departments]. The purpose of the work is to present the results of prophylactic actions used in the Departments of the Institute of Obstetrics and Gynecology of the Medical Academy in Bia ł ystok giving reasons for changes and modifications concerning the present state of procedures. At the same time, attention has been paid to some epidemiological factors of trichomoniasis in women treated in gynecological departments for various diseases of the female genital organ. Women treated in the Departments of the Institute of Obstetrics and Gynecology in 1974-1975 were included in these studies. Total number of the investigated women was 9000 but those with trichomoniasis were 610. There were presented the results of procedures at the admittance rooms of the Gynecological Departments in which examinations and treatment of trichomoniasis, in reasonable cases, were carried out before admitting the patients to proper gynecological treatment were presented. The whole of the evaluation was based on our own scheme of microbiological procedures.


[Levamisole as an immunostimulating factor]. Levamisole--(L)--1-2, 3, 5, 6--tetrahydro-6- phenylimidazo (2, 1-b)-- thiazol monohydrochloride, a simple chemical, first introduced as a broad spectrum antihelmintic , has been recently on the list of the nonspecific active immunostimulants together with BCG, Corynebacterium parvum, polyribonucleosides and transfer factor (TF). This, however, is oversimplification and may cause some confusion because levamisole, in contrast to the so-called immunostimulants, does not stimulate immunity above the normal level in man or prevent the primary growth of most experimental tumors in immunologically normal animals. Levamisole acts as an antianergic chemotherapeutic agent as it restores cell-mediated immunity in immunodepressed patients and prolongs the remission period. It even increases the number of long-term survivors when used as an adjunct to cytoreductive therapy in several animal cancer models. Levamisole is rapidly absorbed from the gastrointestinal tract and from injection site and is very well distributed in all tissues. Levamisole increases phagocytosis by polymorphonuclear cells or macrophages when added to these cells or given to donor animals and humans. The effect was pronounced on hypofunctional cells from patients and it was weak or absent on cells from normal donors. Chemotactic responsiveness of polymorphonuclear cells and monocytes from patients with defective leucocyte motility could be enhanced by levamisole added in vitro or given in vivo. The leucocyte migration inhibition in response to antigenic stimulation could be restored when levamisole was administered to anergic patients or added to their cells in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)


[Sulfamethoxazole concentration in the homogenate of the human embryo]. The investigations on the extent of placental drug transfer has conventionally been based on determining drug concentration in cord blood at delivery. There is, however, data that levels in cord blood at delivery may provide misleading information on the extent of drug transfer in utero. It is due to the fact that not every drug reaches the fetus in pharmacologically active form. Hence, the evaluation of placental drug transfer requires determination of free drug concentration in fetal tissues. Seven women with indications for interruption of pregnancy for social reasons have taken Biseptol 480--Polfa (400 mg sulfamethoxazole and 80 mg trimethoprim) for 4-5 days before the operation. Each woman received 1,92 g of drug (4 tablets) a day in two divided doses. In the tissues obtained during abortion, the concentration of sulfamethoxazole was estimated by the modified method of Bratton and Marchall . The obtained results show that in the first trimester of gestation sulfamethoxazole crosses human placental barrier; it is detectable in embryo in a great amount. This fact indicates that administration of Biseptol to the pregnant mother may be harmful for the embryo. Our investigations have not permitted yet on for the statement that there is the correlation between the sulfamethoxazole concentration and week of gestation during the first trimester.


Synthesis of R-plasmid-coded beta-lactamase in minicells and in an in vitro system. beta-Lactamase encoded by a small, nontransferring R-plasmid, NTP1, conferring ampicillin resistance to its host bacteria, was purified. NTP1 plasmid-coded beta-lactamase was found to be periplasmically located in the host Escherichia coli cell, to have a molecular weight of about 25,000, and to show a relatively low activity against oxacillin and methicillin compared with benzylpenicillin. These characteristics indicate that NTP1 plasmid-coded beta-lactamase is very similar or identical to the "TEM-type" beta-lactamase, which is the most common beta-lactamase coded by R-plasmids in enteric bacteria. In minicells containing NTP1 plasmids, at least six plasmid-specific proteins were synthesized, and beta-lactamase was synthesized in a greater amount than other plasmid-coded proteins. In a cell-free transcription-translation coupled system from E. coli, NTP1 plasmid deoxyribonucleic acid directed the synthesis of several species of plasmid-specific proteins, including active beta-lactamase. The in vitro system also showed preferential synthesis of beta-lactamase, as was observed in minicells containing NTP1 plasmids.


Clinical patterns of chronic iridocyclitis in children with juvenile rheumatoid arthritis. In the present study we have reconfirmed an earlier observation of the association of iridocyclitis with limited joint involvement in children with JRA. Children who develop iridocyclitis are predominantly girls whose sera are positive for antinuclear antibodies. Iridocyclitis was found to be asymptomatic at onset. Only periodic slit lamp examinations will detect the majority of cases. Iridocyclitis began a median of 2 years after onset of arthritis. Although most episodes occurred within 7 years after onset of arthritis, the risk of this development may never be absent in these children, even after they enter adulthood. In the present study, 16% of the afflicted children experienced either unilateral or bilateral blindness.


The B lymphocyte and antibody system. Aberrations in the rheumatic diseases. Abnormalities of B lymphocytes are present in RA including slightly reduced number of peripheral B cells, decreased numbers of T cells (in SLE), synovial infiltration of B and T cells and plasma cells, and increased quantities of B cells in the synovial fluid. Synovial tissues show deposition of immunoglobulin, complement, immune complexes, and abnormal antibodies (e.g., RF). These findings suggest but do not prove B-lymphocyte or antibody involvement in the pathogenesis of the disease. If this system is involved in the pathogenesis, it may result from hypersensitivity, through anaphylactic, cytotoxic, or immune complex reactions; or it may result from immunodeficiency, which favors an infectious disease, immune complex formation, or uncontrolled T-cell response.


Endophthalmitis occurring during hospitalization following cataract surgery. A retrospective 10-year survey of immediate postoperative endophthalmitis in the Princess Alexandra Hospital, Brisbane, is presented. The types of organisms isolated are recorded, and a therapeutic regime based on this is suggested. The various portals of entry of infection are examined and commented upon.