[Artificial ventilation of prematures and new bornes with the bennett pr-2 (author's transl)]. Difficulties and complications during artificial ventilation of prematures and newbornes gave rise to investigate the pressure-flow-characteritics during artificial respiration with the flow-time-cycled respirator Bennett PR-2 in combination with thin tracheal tubes. The flow and corresponding pressures generated by the respirator under different conditions were investigated. It is suggested that a sufficient respiration is not possible with a low generator pressure and high tidal frequencies under pathological conditions as it is often practised.


[Clinical testing of a 0.1 percent difluocortolone valerianate ointment in various chronic dermatoses]. The object of the present study was to investigate the clinical efficacy of Nerisona fatty ointment in very skin conditions. A total of 37 patients, most of them with chronic dermatoses, was treated. Either very good or good results were achieved in 100% of the cases. The side effects observed were very slight.


[Double-blind comparative study between difluocortolone-valerianate and fluocinolone-acetonide ointments]. Nerisone cream (diflucortolon valerate 0.1%) has been clinically compared with fluocinolon-acetate on a double blind basis. The trial was carried out on 30 patients. The author comments that the results, in spite of some slight casuisties, appear to indicate a certain superiority of Nerisone cream when compared with the competitor's preparation.


Electrical apparatus used in medicine before 1900. The Ancients had at their disposal torpedo fish, amber and magnets. It was not until the sixteenth century that ideas on the strange behaviour of amber and magnets were put forward. The eighteenth century saw the application of Newton's theories of matter and the introduction of the electrostatic machine, Galvanism and Volta's battery. In the nineteenth century there was extensive application of electricity in medical practice, with the development of electrocautery apparatus and illuminated cystoscopes, the pioneering of the electrocardiogram and the discovery of X-rays.


Surgical treatment of primary breast cancer according to disease extent. Radical mastectomy should be replaced by a number of different types of operation, either more conservative or more extended according to the extent of the disease. For cases T1NO a new procedure consisting of the removal of a quadrant of the breast, with axillary dissection plus radio-therapy on the residual breast tissue, is under evaluation. In cases T2NO modified radical mastectomy is suggested as a procedure of choice, whilst T3 cases and all N1 cases should still be submitted to radical mastectomy. Cases with tumor of inner quadrants with positive axillary nodes will benefit from the removal of the internal mammary nodes. Superradical mastectomy is limited to special selected cases with extensive lymph-node invasion. All N+ cases are submitted to adjuvant chemotherapy (CMF). In locally advanced cases "reductive" surgery may be part of an aggressive chemotherapy program.


Treatment of chronic radiation injury over the shoulder with a latissimus dorsi myocutaneous flap. We report our experiences in treating chronic radiation injury about the shoulder, a complication of radiation after mastectomy. Left untreated, these can result in chronic infection and/or amputation. The coverage of a large shoulder area presents certain unique problems, which severely limit the usefulness of traditional procedures. We have found that the remarkable size and versatility of the latissimus dorsi myocutaneous flap enables one to use it with relative simplicity and safety. A further great advantage is that it brings new permanent blood supply into this ischemic area, thus favoring rapid healing and durable coverage.


The value of fluorescein in predicting the viability of arterialized flaps. We recommend routine fluorescein examination whenever a major flap is manipulated. It will depict those flaps which are dead at elevation, and it will allow us to critically evaluate the other factors which might have affected flap viability. The examination is safe when precautionary measures are taken.


Surgical treatment of the nasal deformities of leprosy: a 16-year review. We present a retrospective review (from 1959 to 1975) of 86 patients who were treated surgically for nasal leprosy deformities at the Tata Department of Plastic Surgery. The postnasal skin graft inlay was the most frequent procedure, and it seems best suited for these repairs in developing countries where the patients often present late with major deformities. For minor and early nasal deformities, the insertion of a bone graft or a silicone rubber implant is recommended.


Extensive basal cell carcinomas of the neck and trunk: case report. A case is reported of multiple, extensive, basal cell carcinomas involving the neck, thorax, abdomen, and scalp. These had been confused with "pressure sores". We describe the palliative excision of these lesions, and repair of the resulting defects, in 10 operative stages.


[Trial of piracetam in children with cerebral organic mental deficiency]. The administration, in a double blind experiment, of piracetam to two homogeneous groups of 32 and 34 eight- to twelve-year-old brain-injured special education children lacking normal mental ability, where the daily doses administered for a period of thirteen weeks were 3 tablets or 1.2 g (administered to second and third graders) and 5 tablets or 2.0 g (administered to fourth graders), respectively, did not produce a lasting effect upon the capacity to acquire and apply knowledge, the concentration power, the proficiency level, and the behavior shown by pupils during and out of school hours. On the other hand, there was observed, in patients receiving placebos, a nonsignificant tendency toward improvement in physical well-being, so that the effect produced by the drug may here be considered to be a negative one.


Anton T. Boisen's "Psychiatric Examination: Content of Thought" (c. 1925-31): an attempt to grasp the meaning of mental disorder. DURING the early years of PSYCHIATRY, the Rev. Dr. Anton T. Boisen (1876-1965) was among the journal's most regular contributors. Within 14 years he wrote eight articles and four book reviews for PSYCHIATRY, with many of these touching upon the psychosocial aspects of religious experience, empirically considered. Behind Boisen's fondness for PSYCHIATRY was his sense of special relationship to the founding editor, Harry Stack Sullivan. In some ways, this affinity to Sullivan and his world-view can best be appreciated by examining the hypotheses and research questionnaire Boisen used to develop the data for his articles. Likewise, a look at Boisen's detailed questionnaire may help us to understand how humanistic social scientists of an earlier era, the 1920s, attempted to grasp the meaning of mental disorder.


Reasons for the Freudian revolution.

Reasons for the Freudian revolution. Freud's revolution may be viewed as the discovery of a way of locating in the mind objective entities which can be studied like physical things. If Freud's is representative of scientific revolutions, perhaps what Thomas Kuhn has described as a change of paradigm might generally consist of the demonstration of new entities. This particular revolution occurred in the setting of a prevalent concern about the entities underlying all of the sciences. Because of his genius for structural thought, Freud was able to respond satisfactorily to a challenge that all the sciences were facing. It is that common challenge rather than a popular exemplary model, such as mechanics or hydraulics, that shaped Freud's theory.


The management of polycystic kidney disease with special reference to dialysis and transplantation. The records of 65 patients with adult type polycystic kidney disease were examined in an attempt to identify the problems and priorities in the management of these patients, with particular reference to ultimate haemodialysis or transplantation. The three main problems of patients presenting before the onset of terminal renal failure were hypertension (72 per cent), pain (36 per cent) and urinary tract infection (32 per cent). Less common complications included haematuria, splenomegaly, gastro-intestinal disturbances and disorders of calcium metabolism. The polycystic kidney patient who is considered for renal transplantation poses questions of the desirability and timing of bilateral nephrectomy, vagotomy and splenectomy. Eight patients died without receiving a transplant, five of them from uraemia. Thirty-one patients received 36 kidney transplants and 46 per cent of these were functioning one year after transplantation. Thirteen patients who had received transplants died. Analysis of the causes of death suggests that in nearly half, major contributing factors might have been anticipated and we therefore feel that regular surveillance from the time of diagnosis is essential for patients with polycystic kidney disease.


Physiology and theory of tracer washout techniques for the estimation of myocardial blood flow: flow estimation from tracer washout. The time course of washout of tracer from the myocardium provides an estimate of the flow per unit volume when the blood-tissue exchange is flow-limited. Methods of testing for the flow-limitation and for the absence of influences of low permeability or diffusion on the washout include the uses of paired or multiple tracers and the examination for similarity of the shapes of the residue function or washout curves at varied coronary blood flows. A conceptual framework for these studies is provided by a clearance-flow diagram for the myocardium where capillaries are long compared to radial intercapillary distances. This anatomic-physiologic framework coupled with a probabilistic, general analytic approach and with various experimental approaches to tracer studies of mass transport through the heart provides a general basis for methods of estimating myocardial blood flow in the whole organ and in its component regions.


[Bacteriological study of bivalves from the Gulf of Nicoya, Costa Rica. I. Condition of the mollusk recently collected]. During the first six months of 1970 we collected 16 lots of the bivalve Anadara tuberculosa from two areas within the Gulf of Nicoya, Costa Rica. These were examined bacteriologically and the coliform levels found in all of them were such that they had to be graded as not satisfactory for human consumption, according to generally accepted norms. The source of these coliforms is attributed to the sewage discharge of the city of Puntarenas into its estuary.


Intraperitoneal foreign body reaction in rodents. In five experiments with female Marsh mice and male and female Evans rats, open-end cylinders of tin were implanted intraperitoneally with litter mates serving as surgical controls. The experiments were terminated 18-24 months later. The long-term local intraperitoneal foreign-body reaction with some cylinders remaining unanchored, frequent failure to develop a fibrous capsule at the outside of the tin cylinder, and a degree of lympho-histiocytic involvement and adenomatous hyperplasia in the fibrosis within the tin cylinder differed from the foreign-body reaction at the subcutaneous site characterized by avascular, cell-poor fibrosis with fibroblasts. In all the implanted rat series, a significant number of local sarcomas, 30-50% of which metastasized, developed with none in the corresponding controls. The incidences of spontaneous lymphoid tumors were decreased or not increased for the tin-implant series as compared with controls. This indicated that the local solid-state carcinogenic process was only partially, if at all, dependent upon the cell type (lymphocyte) that demonstrated a spontaneous inherently malignant potential.


[Detection and titration of anti-tetanus antibodies by passive hemagglutination]. Human red cells O Rh + are coated with purified tetanus toxoid, by means of chromic chloride as coupling agent. With this reagent and by passive haemagglutination technique, antitetanus antibodies can be automatically screened and titrated in blood donnors plasmas, on Groupamatic equipments. Comparative results of three techniques: counter immunoelectrophoresis; manual passive haemagglutination; automatic passive haemagglutination are given, 4, 92 percent among the 1.219 tested blood donnors plasmas have an antibody greater than or equal to 5 U.I., 16, 24 percent have a titre between 1 and 5 U.I.


Nasal polyps treated by beclomethasone nasal aerosol. A double-blind cross-over study of the effect of insufflation of beclomethasone dipropionate 400 microgram per day for four weeks showed favourable results, as verified statistically, concerning nasal blockage at the end of the treatment period. Rhinomanometry also showed that the nasal patency was significantly improved during the beclomethasone period. There was also a tendency, though not statistically significant, for nasal secretion to react favourable. The polyps did not disappear during the active treatment period and short-term treatment with beclomethasone aerosol can thus only be used as an adjuvant to other models of therapy, whether medical or surgical, in nasal polyps. No clinical side-effects of any importance were observed during the study.


Modifications of macrophage chemotaxis in rats bearing the transplantable tumour reticulosarcoma 'IRE'. Macrophage chemotactic activity was studied as a marker of the anti-inflammatory effect accompanying tumour growth. An inhibiting effect of the tumour on the macrophage mobility was observed by comparing the macrophages collected from normal rats and those from animals bearing the IRE reticulosarcoma. To explain these results, it is postulated that a MIF, or a similar inhibiting factor is released by the tumour. Both the the nature and function of such a factor(s) remain to be clarified.


A pragmatic trial of cimetidine in duodenal ulcer patients. Fifty-eight outpatients with a clinical and radiological diagnosis of duodenal ulcer completed a double-blind randomized trial of the effect of cimetidine on ulcer symptoms. Patients normally treated in general practice were included in the trial. The patients in the treatment group received cimetidine 1 g daily and the controls received inactive tablets. The treatment period was four weeks. During the last nine days 18 (60%) of 30 cimetidine-treated patients were symptom-free against 5 (18%) of 28 controls (P less than 0.005). The antacid consumption, the number of days with pain and the number of hours with pain also differed significantly in the two groups. Apart from a transient rash in one patient no important clinical side-effects were noted. The serum creatinine rose slightly in the cimetidine-treated patients.


Complement activation and phagocytosis of cryoglobulin particles in a patient with plasma cell proliferative disease. The serum of a patient with a non-aggressive plasma cell proliferative disorder contained two monoclonal immunoglobulins: IgG3 lambda in moderate concentration and having cryoglobulin features, and IgA kappa in low concentration and without cryoprecipitability. The patient's serum had low complement concentration and C3 was partly converted into split products in vivo. Complement (C3) together with cryoglobulin and fibrinogen  was found  by immunofluorescence in sections from skin showing vasculitis. The cryoglobulin particles which formed at room temp. were vividly phagocytized in vitro by neutrophile granulocytes from the patient and from normal individuals as demonstrated in light microscopy and ultramicroscopy.


Certain polyclonal antinuclear antibodies cross-react with the surface membrane of human lymphocytes and granulocytes. Five out of 24 human sera with antinuclear antibody (ANA) titers of 1250 or more contained ANA that bound in vitro to normal viable human mononuclear blood cells and granulocytes, but not to erythrocytes. The antibodies can be eluted off from the cell membranes and shown to possess ANA activity. Antinative DNA antibodies and lupus erythematosus factor were not recovered in eluates, indicating that they did not react with the cells. The cells absorbed 75%-87% of the ANA activity from three sera. ANA reacted with both T-lymphocyte-depleted and -enriched mononuclear cells. No or minimal amounts of ANA bound to mouse spleen cells in suspension; in contrast, the ANA eluted from human cells reacted with nuclei of smeared mouse spleen cells. The cross-reacting antibodies were predominantly IgG that bound well at 37 degrees C, and F(ab')2 fragments carried both activities. The ANA-binding plasma membrane antigen was resistant to trypsin and RNAse but was completely inactivated by glutaraldehyde. The data indicate that human leukocyte plasma membranes and cell nuclei from many species contain a cross-specific antigen. Alternatively, the antigen may be produced in the nucleus and somehow attach to the plasma membrane.


BCG influence on 256 Walker carcinosarcoma growth in rats in relation to adrenal cortex status. BCG influence on antitumoral immunity varied in relation to the timing and the way of administration, as well as in relation to the adrenal cortex status of the animals. BCG administration several days before tumor grafting, but especially when mixed with tumoral cells determined a maximum antitumoral effect, while vaccination after the tumor had been formed enhanced its metastasization. The decrease of the endogenous corticoids secretion amplified the antitumoral effect of BCG, while exogenous cortisone diminished this effect. The study of in vitro cultivated tumoral cells as well as microscopic examination of the tumors suggest the involvement of a complex process in the achievement of the nonspecific antitumoral immunity, a process in which the adrenal cortex status plays an important role.


Human leukocyte migration inhibitory factor (LIF) III. Further investigations on the serine protease nature of this lymphokine and its preference for arginine amides. Previous findings suggesting an esterase and protease nature of human leukocyte migration inhibitory factor (LIF) were extended by testing the ability of different protease and esterase inhibitors to reduce LIF activity. The serine-specific inhibitors phenylmethylsulfonyl fluoride (PMSF) and physostigmine (eserine) markedly reduced LIF activity, whereas the histidine-specific inhibitors N-tosyl-L-lysine chloromethyl ketone (TLCK) and L-tosylamide-2-phenylethyl chloromethyl ketone (TPCK) were inactive. That LIF might act as an esterase and a protease was further strengthened by the ability of pralidoxime methansulfonate (2-PAM) to reestablish LIF activity of supernatants previously inactivated by PMSF. Furthermore, the arginine amides N-benzoyl-L-arginine-p-nitroanilide (BApNA) and N-benzoyl-L-phenylalanyl-L-valyl-L-arginine-p-nitroanilide (BPVApNA) were shown to satisfy the substrate specificities of the putative LIF enzyme. Indeed, BPVApNA seemed to possess a particularly strong affinity for LIF, indicating its potential role in an enzymatic LIF assay.


[Proteinuria and kidney transplantation. A quantitative immunochemical study of 7 protein clearances during the first 50 days following implantation of cadaver kidney]. During the initial 50 days following transplantation of a cadaver kidney into 8 patients, determinations of 7 individual protein clearances were performed twice a week. This, the first posttransplantation investigation of single protein clearances utilizing unconcentrated urine, was made possible by the highly sensitive electroimmunodiffusion method of LAURELL [24]. The following results were obtained: 1. Kidney implantation was immediately followed by glomerulo-tubular proteinuria. In patients exhibiting good transplant tolerance the tubular proteins disappeared from the urine by the 43rd day at the latest; on the other hand, excretion of the glomerular proteins transferrin and albumin continued. In patients without complications the proteinuria was already highly selective by the 7th day (70 degrees). 2. In 5 of 8 patients there was a change in the proteinuria pattern during the rejection crisis: glomerulo-tubular proteinuria occurred three times and glomerular proteinuria twice. In two of these cases there was a change in the selectivity. 3. Patients with good tolerance showed plasma prealbumin levels which increased as a function of the time lapse since transplantation. 4. The plasma concentration of retinol-binding protein did not vary following transplantation and remained at 16.8 +/- 2.8 mg% in patients with uneventful course and at 18.5 +/- 4.9 mg% in patients with transplant rejection reactions, both values being markedly above the norm (4.7 +/- 1.1 mg%, [1 SD]).


[Detection of the optimal dose of spironolactone for the treatment of benign essential hypertension]. The blood pressure lowering effects of spironolactone have been studied in 40 subjects with benign essential hypertension in an attempt to determine the optimum starting dose for the drug. The trial was carried out by the double blind method. In almost all patients 100-400 mg spironolactone caused a signnificant decrease in diastolic and systolic arterial pressure. Present findings indicate that 100-200 mg spironolactone represents the optimum attack dose. The medication caused a significant rise in serum potassium. Other parameters were not affected by the treatment. In conclusion, it would appear that spironolactone--in association with other antihypertensive regiments--may improve the treatment of essential hypertension, especially in patients showing a tendency to hypokalemia and uricemia, and may offer an additional possibility or alternative in the therapy of hypertensive diseases.


[The EEG in the aged].

[The EEG in the aged]. The most important characteristic of the EEG in old age is the frequency decrease of background activity, which can be traced back to a lessening of cerebral oxygen uptake. One third of healthy test persons aged 60 or over also show temporal (usually left sided) slow wave groups. The degree of EEG changes in cerebro-vascular insults depends on the nature and the localization of these disturbances. Temporary clinical and electroencephalographic focal seizure symptoms are observed, in particular, in circulatory disturbances within the temporo-parieto-occipital territory. Recurring epileptic seizures which start only in old age usually have either a vascular or a tumoral cause. During the attack-free intervals EEG spikes or sharp waves may be less frequently recorded than in younger test persons. Thanks to its highly typical EEG pattern, Creutzfeldt-Jakob subacute spongiform encephalopathy can be distinguished from other presenile or senile affections of the brain.


[The treatment of hyperuricemia after kidney transplantation]. In this study of 17 renal transplant recipients with hyperuricemia the effects of allopurinol vs. benzbromarone were compared. Both drugs effectively lowered serum uric acid concentrations by 19 vs. 35% of pretreatment values. Adverse reaction to allopurinol consisted in augmenting of azathioprin toxicity for bone marrow, with occurrence of an isolated fall in the hematocrit in several patients. With benzbromarone no drug interactions were observed. However, one patient exhibited uric acid stone formation in the damaged kidney.


[Allogenic bone marrow transplantation in severe aplastic anemia and refractory acute leukemia. 35 cases]. 23 patients with severe aplastic anemia have been treated. 10 marrow grafts between HLA matched siblings were performed after conditioning with cyclophosphamide. 5 are still alive at over 7 months to over 2 1/2 years after grafting. 3 are hemopoietic chimeras and 2 show autologous marrow reconstitution. 13 patients were treated by ALG with or without transfusion of allogeneic marrow. 9 are still alive with partial to complete autologous hemopoietic reconstitution at over 1 month to over 4 years. It is concluded that in many instances aplastic anemia is an autoimmune disease rather than a primary failure of the hemopoietic stem cells. In acute leukemia allogeneic marrow grafts still pose enormous problems and only one of our 12 grafts has become a longterm survivor.


[Analysis of the macrophage function in sarcoidosis]. This study demonstrates that, in spite of the fairly normal functional capacity of T lymphocytes in sarcoidosis, a deficit of cell-mediated immunity frequently develops. It is shown that monocytes of sarcoidosis seem to share in responsibility for the appearance of this deficit. Soluble factors from sensitized healthy monocytes are shown to be capable of restoring this capacity.


[Cerebrospinal toxoplasmosis: detection, clinical course and therapy]. With modern techniques (membrane marking by indirect immunofluorescence and identification by morphological criteria) Toxoplasma gondii can be reliably identified in the CSF. Identification of the causative agent confirms the diagnosis of toxoplasmosis of the meninges, the central nervous system and the nerve roots. Toxoplasma encephalomyelitis associated with meningoradiculitis has hitherto only rarely been described. Our own cases afford evidence of the fact that even in the most typical cases of multiple sclerosis this possibility must be considered. Fansidar (a combination of an ultralong-acting sulfonamide with pyrimethamine combined with spiramycine is recommended as the treatment of choice.


[Mineral content of the skeleton in chronic kidney insufficiency treated with dialysis and after kidney transplantation. Results of isotope densitometry]. By means of a photon densitometer utilizing a 125I-source, bone mineral content was measured in 15 chronic renal failure patients on conservative management, 46 patients on maintenance hemodialysis and 20 patients after renal transplantation. The determinations were made at 4 sites in both radius and tibia. In patients with chronic renal failure on conservative treatment the bone mineral content did not differ significantly from that in normals. Patients on hemodialysis showed a low bone mineral content in 61 percent of females and 53 percent of males. Especially low values were obtained from 5 females who had undergone bilateral nephrectomy. After renal transplantation all female patients showed low values, whereas 50 percent of male patients showed decreased values. No correlations were found between bone mineral content and serum parameters (calcium, phosphate, alkaline phosphatase, creatinine), duration of renal failure, hemodialysis treatment or steroid medication.


Humanity in science: a perspective and a plea. The phrase "humanity in science" encompasses several problems of various dimensions, which have been present for a long period. Their particular force can be most clearly appreciated by seeing the  historical circumstances in which they arose and by examining the changing nature of the social contact between the scientific profession and society. The new ethical imperatives presently operating within society call for new responses. In addition, new ways must be found of mirroring scientific activity so as to more faithfully reflect its real nature to and incorporate it into our culture.


A new highly effective ovulating agent for fish reproduction. Practical application of LH-RH analogue for the induction of spawning of farm fishes. The synthetic analogue of the nonapeptide LH-RH has been found to be highly effective in the induction of spawning of farm fishes (the grass carp, the silver carp, the spotted silver carp, and the black carp.) Its biological activity is many times higher than that of the synthetic decapeptide or natural releasing hormone. Out of a total number of 500 mature fishes treated with the nonapeptide alone and/or combined with a minimum amount of fish pituitary, 396 of them spawned--with an over-all spawning rate of 78%. As far as we know, this is probably the most effective ovulating agent or hormone now available for fishes. This finding is of paramount importance in pisciculture for large-scale production of fry. The recommended dosages for the following farm fishes are: the grass carp--1-10 microgram/kg b.w.; the silver carp--3 microgram or more/kg b.w. in divided doses; the spotted silver carp--1.4 microgram or more/kg b.w.; and the black carp--10 microgram/kg b.w. For the latter species, the efficacy of the peptide could be improved by a concurrent administration of 0.5-2 mg of the pituitary gland. The significance of this work in piscicultural practice and the mechanism of hormonal action are briefly discussed.


Mandelonitrile beta-glucuronide: synthesis and characterization. Mandelonitrile beta-glucuronide, the compound patented as Laetrile, has been synthesized from rabbit liver uridine diphosphate-glucuronosyl transferase immobilized on beaded sepharose, has been analyzed by thin-layer chromatography, nuclear magnetic resonance, and gas chromatography-mass spectrometry, and has been tested for cytotoxicity and mutagenic activity with Salmonella typhimurium strains TA 98 and TA 100. Several commercial laetrile preparations contained no glucuronide; they contained amygdalin and neoamygdalin instead. Mandelonitrile, mandelonitrile glucuronide, and a mixture of amygdalin and neoamygdalin were each found to be mutagenic.


Fifty centuries of right-handedness: the historical record. A survey of more than 5000 years of art work, encompassing 1180 scorable instances of unimanual tool or weapon usage, revealed no systematic trends in hand usage. The right hand was used in an average of 93 percent of the cases, regardless of which historical era or geographic region was assessed.


H-Y antigen and the genetics of sex determination. Widespread phylogenetic conservation of H-Y antigen indicates persistence of a vital function. It has been proposed that this function is the primary determination of mammalian sex. According to this proposal, the indifferent embryonic gonad is induced to differentiate as a testis in the presence of H-Y antigen, and as an ovary in the absence of H-Y antigen. But presence of H-Y antigen does not guarantee testicular differentiation. Other factors may be required: a gene that activates the H-Y structural locus, and another gene that codes for specific H-Y antigen receptors.


Diffuse intravascular coagulation in liver disease? The evidence for intravascular coagulation in liver diseases is critically reviewed. Alternative mechanisms for hypofibrinogenemia and the accelerated disappearance of fibrinogen from blood are proposed, such as loss into extravascular compartments (e.g., ascites, areas of liver necrosis, etc.). Possible mechanisms other than DIC for the elevation of serum FDP are also considered, such as extravascular fibrinogen proteolysis with subsequent transfer of FDP to blood. Therapy is discussed with reference to the current knowledge on pathophysiology of the coagulation defect in liver diseases.


Camera-computer systems for rapid dynamic imaging studies. The extraction of valuable diagnostic information from rapid, dynamic studies performed on a gamma camera requires that the data be recorded for latter analysis. If these data are to be available rapidly and if quantitative analysis is to be performed, it is imperative that a computer be used in conjuction with the gamma camera. This review describes the more important features of a nuclear medicine computer system both from the point of view of hardware and software. The various aspects that cause some limitations to be imposed on the capability of the system in order to carry out fast, dynamic studies are described and some possible solutions are suggested.


Postpartum surveillance for urinary tract infection: patients at risk of developing pyelonephritis after catheterization. Asymptomatic postpartum bacteriuria occurred in ten of 354 patients not catheterized (2.8%) and in 19 of 313 patients who were catheterized (6.1%). Obstetric lacterations were commonly associated with bacteriuric patients who were not catheterized. Primigravidas as a total group were more likely to have significant bacteriuria. Nine of 23 patients with urinary retention (39.1%), requiring catheterization for longer than 24 hours, developed asymptomatic bacteriuria; urinary tract infection tended to be progressive in these patients, ascending from lower to upper urinary tract involvement. Using the fluorescent antibody (FA) test, antibody-coated bacteria were demonstrated in specimens from five of these nine patients (56%), indicating silent renal infection.


Posttraumatic pulmonary insufficiency: a treatable disease. Posttraumatic pulmonary insufficiency was treated using positive end-expiratory pressure (PEEP), intermittent mandatory ventilation, and cardiovascular monitoring and support. These were begun when intrapulmonary shunt exceeded 15% and before development of hypoxemia despite high inspired oxygen fractions; or retention of CO2; or infiltrative changes on roentgenogram. Of 39 patients treated, 28 required aggressive intervention with levels of PEEP up to 40 cm H2O and support of cardiovascular function with fluids, blood, and ionitropic agents. Those sustaining blunt trauma required the same level of interventions as those with penetrating trauma, but for a significantly longer time. All had reversal of respiratory failure with reduction of shunt to 15%. There were no deaths from respiratory failure or the treatment modalities. Early aggressive treatment for all cases was successful and allowed differentiation of the severity of the original insult.


Peritonealization of lymphoceles complicating renal transplantation: dangers of percutaneous aspiration. Lymphocele is a known complication of renal transplantation. The diagnosis is easily made by sonographic technics. Although one may perform percutaneous aspiration or drainage or both, we found that peritonealization of the lymphocele may be more advantageous.


Richter's syndrome.

Richter's syndrome. A 56-year-old man with chronic lymphocytic leukemia who developed Richter's syndrome is described. The criteria for diagnosis are given and the histology is discussed. We agree that Richter's syndrome represents a peculiar complication of chronic lymphocytic leukemia and not a separate disease entity. As such, Richter's syndrome must be known and recognized by those evaluating patients with lymphadenopathy whose basic diagnosis may be confused with Hodgkin's disease or "histiocytic" lymphoma.


Intestinal and blood parasites in the North Lore District, Central Sulawesi, Indonesia. Over 1,000 stool specimens from residents of the Napu and Besoa Valleys, Central Sulawesi, Indonesia were examined. Schistosoma japonicum was detected in 31% of Napu Valley residents while in only 2% of the Besoa Valley residents. Hookworm infections were the most frequently encountered helminth parasitisms in both valleys. Other helminth parasites encountered were: Ascaris lumbricoides, Trichuris trichiura, Enterobius vermicularis, Strongyloides stercoralis, Physaloptera sp., Diphyllobothrium sp., echinostome and heterophyid trematodes. Intestinal protozoa endemic to the area were: Entamoeba histolytica, E. coli, E. hartmanni, Iodamoebe bütschlii, Giardia lamblia, Chilomastix mesnili and Trichomonas hominis. Plasmodium falciparum was responsible for malaria parasitaemias in 5% of 1353 specimens examined and Brugia malayi microfilaraemias were detected in 10% of 972 specimens examined.


Parasitological and clinical survey of bancroftian filariasis in Kepu District, Central Jakarta, Indonesia. A blood and clinical survey for bancroftian filariasis was made in the Kepu District of Central Jakarta in June 1976. About 90% of 614 inhabitants in the survey area was examined. The microfilarial rate was 4.5%; 5.8% in males and 3.3% in females. Most of the carriers were asymptomatic. The microfilarial density was low. There were 15 persons (2.7%) with signs and symptoms of filariasis; 11 males and 4 females. The total filariasis infection rate was 6.7%. The percentage of infected persons increased with years of residency. Persons living in poorly built houses had approximately 9 times higher microfilarial rate and 5 times higher disease rate than those living in modern houses.


Lymphomas of large cells.

Lymphomas of large cells. Historial aspects of the classification of large-cell lymphomas are described. Immunological characterization of the lymphomas has been made possible by identification of T and B lymphocytes according to their cell membrane surface characteristics. The pathogenesis of lymphomas has been clarified by the germinal (follicular) centre cell concepts of Lennert and Lukes and Collins. The various classifications are presented and compared. Whether these subdivisions will have any relevance in the clinical context remains to be seen.


Effect of methacholine on acid and pepsin responses to pentagastrin in cats with innervated and denervated fundic pouches. The effect of threshold dose of methacholine on gastric secretion stimulated by pentagastrin (PG) was studied in two groups of cats, four with Pavlov pouches (PP) and four with Heidenhain pouches (HP). In the PP group methacholine did not alter the maximal response (MR) and the dose producing half of the maximal response (D50) for PG. In the HP group the highest acid response to PG combined with methacholine was greater than the MR to PG alone. Methacholine decreased the D50 for PG in the HP group to that in the PP group with and without methacholine. Methacholine increased the pepsin response to all doses of PG both in the PP and the HP groups. The effect was more pronounced in the HP group. In both types of pouches, the percentage increase of pepsin secretion was larger at low than at high doses of PG. Methacholine increased the pepsin/acid (P/A) ratio for PG in the HP group to that in the PP group with and without methacholine. Accordingly, methacholine sensitized the oxyntic glands and increased the pepsin response to PG in the HP group as did basal vagal tone in the PP group. Methacholine did not further sensitize the innervated oxyntic glands to gastrin but increased the response of the peptic glands.


Prognostic significance of the active thymus derived rosette forming cells in renal allograft survival: a preliminary report. The prognostic significance of hemodialysis, blood transfusions, total T (T-T) and active T (A-T) lymphocytes, as they relate to renal allograft survival, were evaluated in 36 renal transplant recipients. The A-T cell is thought to be a surveillance cell responsible for cellular immunity and the only prognostic factor for graft survival observed in this study. An 83% graft survival rate occurred in patients having a lower percentage of A-Ts (fewer surveillance cells) prior to renal transplantation, as compared to 50% graft survival in patients with a higher percentage of A-T cells. Evaluation of pretransplant T-T cells, phytohemagglutinin (PHA) response, and number of transfusions was not prognostic for graft survival. Similarly, there was no difference in graft survival rates in patients hemodialyzed for more vs less than 1 year. Patients hemodialyzed for more than a year received twice as many blood transfusions. There were no differences in the number of T-T or A-T lymphocytes in either group. However, lymphocytes from patients hemodialyzed less than a year were more responsive to PHA stimulation. These data suggest that pretransplant determination of A-T cell values may be prognostic for graft survival and may delineate patients, by an immunological parameter, who may be at high risk for allograft rejection.


Some aspects of the automation of perimetry. Manual perimetry has certain inherent limitations stemming from both the patient and the examiner. Automated perimetry, if properly developed, can offer the advantages of exact reproducibility of the examination strategy, accuracy achieved through  averaging of repeated determinations, and systematic application of previous data to the current examination. The history, concepts and clinical practically of  automated perimetry are discussed. Several systems capable of performing functions resembling human intellectual activity are commerically available; one, the OctopusTM, is described in detail.


Abnormal serum lipid patterns in primary renal allograft recipients. The blood lipids profile was determined in 59 patients with successful primary renal allografts, who were followed for an average period of 31.8 months (range, 6 to 80 months). Elevated levels of cholesterol (greater than 250 mg/100 ml) were found in 51% of the patients, elevated levels of triglycerides were found in 56%, and elevated levels of phospholipids in all but one of the patients who were studied (45 of 46). Correlation analysis revealed significant relationships among the systolic blood pressure with total cholesterol (r equals 0.36, P less than 0.01), triglycerides (r equals 0.56, p is less than 0.001), and phospholipids (r equals 0.40, P is less than 0.001). No significant correlations were found between the lipid levels and daily prednisone dosage or with the duration of the period following transplantation. The most significant finding in our study was an elevation of serum phospholipid level--a pattern unreported previously in transplant recipients but which has been reported to be associated with hepatic derangement in nontransplant population. Of 32 patients who had elevated levels of serum phospholipids, the liver function tests were abnormal in 22 patients (69%).


Ischemic bowel disease following bilateral nephrectomy or renal transplant. In a 2 year period five patients developed pathologically proved ischemic bowel disease (IBD) following either renal transplantation or bilateral nephrectomy in preparations for transplantation. This entity accounted for 42% of all major gastrointestinal complications in this transplant unit. Three patients presented with abdominal pain and ileus, and two patients developed massive lower gastrointestinal hemorrhage. All five patients had nonocclusive ischemic disease because obstruction of a major intestinal vessel could not be documented in any case. Each patient was treated with bowel resection and three of the five patients survived. Although sepsis, shock, and large doses of immunosuppressive drugs have been implicated in predisposing such patients to IBD, these factors were not uniformly present in our cases. Blood volume redistribution with transient episodes of hypotension, especially during postoperative hemodialysis, may be significant. IBD in uremic patients can occur in the presence or absence of renal transplantation and may be the cause of massive intestinal hemorrhage in these individuals.


The effect of intraocular pressure on resistance to outflow. As intraocular pressure is increased, facility of aqueous outflow decreases. For many years this fact was obscured by the often used procedure of experimental perfusion into the anterior chamber. Anterior chamber perfusion deepens the anterior chamber; retrodisplacement of the iris-lens diaphragm tenses the trabecular mesh with resulting facility increase and obscuration of the facility-reducing effect of pressure. The probable mechanism of facility reduction under experimental conditions is apposition of the inner wall of Schlemm's  canal to the outer wall. Since facility of aqueous outflow is not constant at different intraocular pressures, application of poiseuille's law to the eye must be restricted to each pressure investigated.


Tear physiology and dry eyes.

Tear physiology and dry eyes. The conditions of tear film formation and stability are governed by the surface chemical characteristics of the tear film system and by the proper functioning of the lacrimal apparatus. The tear film has to remain continuous between blinks in order to fulfill it function. The presence of an abnormal tear film results in dry eye states that can be detrimental to vision. The diagnostic tests presently available are limited mainly to approximately determining tear secretion rate and estimating epithelial damage by staining techniques. The only test that directly measures tear film stability is one which determines tear  film breakup time. The treatment modalities depend on the type of irregularity causing the dry eye state and range from the application of artificial tear substitutes or the obstruction of the puncta to surgical alterations  of the lacrimal system.


Hyperbaric oxygen in burn management: a controlled study. Using the methods and protocol outlined, we have found that hyperbaric oxygen functions as a mild antiseptic agent and provides no advantage in the treatment of full-thickness and partial-thickness burns, alone or in combination with topical treatment with silver sulfadiazine. No effects were observed on metabolic balance in the postburn state determined by percentage of weight change, the time to complete healing in partial-thickness burns or the rate of eschar separation and vascular proliferation in granulation tissue formation in full-thickness burns.


Volvulus of the cecum following transplant donor nephrectomy. Volvulus of the cecum, a rare postoperative complication, occurred on the first postoperative day following left nephroureterectomy in a volunteer kidney donor. Postoperative cecal volvulus can occur after practically any operation, may present insidiously like adynamic ileus, but may progress rapidly to gangrene of the involved intestine. Etiologic factors, diagnosis, and treatment are reviewed briefly.


[Immunoglogulins in swine. (A) A review supplemented by a report on findings in personal studies (author's transl)]. the literature is reviewed and the importance of studying immunoglobulins in farm animals, particularly swine, is stressed. Possible methods of clinical immunological investigation in pigs are suggested. The literature as well as personal studies show that the immunoglobulin titre in the serum of piglets continues to be very low over a prolonged period from the seventh day post partum. This incomplete state of immunity should be taken into account on weaning piglets.


[Immunoglobulins in swine. (B) Immunohistological studies on the localization of cells containing immunoglobulin in the tissues of the small intestine and spleen (author's transl)]. Antisera to porcine immunoglobulins, conjugated with flurescein isothiocyanate, were used in studies on the localization of cells containing immunoglobulin in the tissues of the intestine and spleen in pigs. Cells containing IgM and IgA were found to be present in the lamina propria of the intestinal mucosa, the villous membrane showing fluorescence due to liberated immunoglobulins. Cells containing IgG and IgM were detected in the marginal areas of the splenic lymph nodes but could not be definitely identified as mature plasma cells.


[Endocrine features in the treatment of cystic ovarian follicles in cattle with gonadotrophin-releasing hormone (author's transl)]. Ten animals of the Meuse-Rhine-Yssel breed of cattle, in the thirty-two month to twelve year range, showing cystic ovarian follicles, were treated with intravenous injection of gonadotrophin-releasing hormone (Lutal, Hoechst). All animals responded to treatment with increase in the concentration of luteinizing hormone in the peripheral blood within from 120 to 150 minutes after injection. Luteinizations were observed in the ovaries within from seven to fourteen days after treatment, a process emphasized by increased concentration of progesterone in the blood. Of ten treated animals, six became pregnant. This required a total number of nine injections of gonadotrophin-releasing hormone and seven inseminations. The cycle was restored to normal in two animals but unfortunately these were not inseminated or given only a single insemination. The two other animals had recurrences.


[Spongy encephalopathy in man and animals (author's transl)]. With reference to new points of view on the pathogenesis and nature of diseases showing microscopically perceptible spongy features as the main lesion in haemalum-eosin-stained sections of particular portions fo the central nervous system in various animals and man, important findings reported in the literature on the subject are reviewed.


Determination of transcoronary circulatory transport function. A method is described to determine the transcoronary circulatory transport function (h(t)) from input (Ci'(t)) and output (Co'(t)) dye-dilution curves obtained at the inlet and outlet of the coronary circulation. Assuming the mathematical linearity and stationarity of the coronary circulation, it is demonstrated that h(t) can be computed in terms of lagged normal density curve as a model from the sole measurement of the first to third moments of Ci'(t) and Co'(t) when recorded by a pair of our dye sampling systems that have shown to have identical response to step function. The method is useful because of its simplicity in practice. The physiological meaning of the determination of h(t) is discussed. It could be helpful to the estimation of the change in coronary path-length distribution under some conditions, although the method is still of limited value at present, because the averaged path-length through the coronary circulation cannot be evaluated correctly.


Measurement of cardiac output by earpiece dye-dilution method with automatic calibration of dye concentration. A non-invasive method for measuring cardiac output by an earpiece dye densitometer was proposed. The densitometer is dichromatic and has an air capsule to make subject's ear bloodless by inflation, so that it can calibrate indocyanine green dye concentration without blood sampling. Duplicate measurements of cardiac output showed a good agreement in 40 cases (r = 0.97, standard deviation (S.D.) = 8.9%), which was comparable to the result of the cuvette method (r = 0.98, S.D. = 8.1%). Simultaneous measurements of cardiac output by the earpiece method (x) and the standard cuvette method (y) revealed a good agreement (r = 0.91, y = 0.96x+0.34, S.D. = 16.4%) in 52 measurements of 25 cases. A similarly good correlation was obtained between the two methods during ergometer exercise in supine position in 5 cases. These suggest that this earpiece dye-dilution method is reliable for cardiac output measurement and advantageous for clinical use because of non-invasive technique.


Immunohistochemical demonstration of somatostatin-containing cells in the human, dog and rat thyroids. By an indirect immunofluorescence technique using the somatostatin antibody, somatostatin-containing cells were demonstrated to exist in the human, dog and rat thyroids. These cells were located predominantly in the interfollicular areas and more scatteringly in the follicular areas. The source of these somatostatin-containing cells was discussed.


Preparation of anti-M and -N antibodies by use of dextran gel as an immunoadsorbent. Anti-M and -N antibodies are usually prepared from rabbit immunized with human O.M or O.N red cells. The crude antisera must be adsorbed with non-corresponding red cells to remove heteroagglutinin. To specify the crude antisera, we have employed dextran gel (DEAE-Sephadex A-50) as an immunoadsorbent, which was mixed with M or N group substance prepared by the phenol-saline method, and was fixed with formaldehyde. The substance-coupled gel was added to the corresponding crude antiserum and washed with cold saline. Then, the gel added with an equal volume of saline was heated at 55 degrees C for 10 min and applied on a funnel with slight evacuating. By this method, specific anti-M and -N antibodies (titer 1:16 to 1:32) were prepared, but the antibody was not eluted from the gel reacted with IgM fraction. The recovery rate and specificity of the eluted antibodies are discussed.


Comparative double-blind trial of dl-alpha-tocopheryl nicotinate on vibration disease. Sixty inpatients with vibration disease were examined on the effect of dl-alpha-tocopheryl nicotinate by comparative double-blind study. The observed period was 6 weeks and the dose was 6 capsules a day (600 mg as dl-alpha-tocopheryl nicotinate, Juvela Nicotinate, referred to as EN). The physical exercise therapy was applied to all patients throughout the test period. EN group became better with a significant difference from P (placebo) group in the subjective symptoms, the clinical examinations and the collective improving rate (p less than 0.01, 0.05, 0.01), respectively. The improvement of the subjective symptoms of both groups was higher 6 weeks than 3 weeks after administration. Most items in EN group became better significantly (p less than 0.05) as compared with those in P group. The examinations of the peripheral functions in EN group showed a significant improvement 6 weeks after administration in comparison with those in P group. Blood chemistry, blood cell counts and serum electrolytes changed within normal range. Thus, this preparation would be a curative agent for patients with vibration disease.


Enzyme immunoassay of serum testosterone. An enzyme immunoassay of serum testosterone using the testosterone-glucoamylase complex is described. Testosterone was estimated by the enzyme immunoassay after extraction with hexan: ether (4:1) for serum from men and additional thin layer chromatographic step for serum from women. The within and between assay errors, measured as the coefficient of variation were 11.1 percent (n=8) and 12.0 percent (n=12). The sensitivity of this assay was 0.25 ng. The mean testosterone concentration (+/- SD) in 19 normal men and 4 normal cycling women were 5.3 +/- 1.8 and 0.52 +/- 0.12 ng/ml, respectively. The level of testosterone found by the present assay compared favorably with those obtained by other methods.


Effect of an infusion of Gn-RH upon levels of sex hormones in prepubertal and pubertal girls: evidence for relative ovarian insensitivity. Changes in levels of sex steroids and gonadotropins were measured in 16 normal prepubertal and 15 pubertal girls prior to and after a 3 hour infusion of 100 microgrm synthetic gonadotropin releasing hormone (Gn-RH). Plasa estradiol (E2) concentrations rose significantly (p less than 0.02) from 29.7 +/- 4.6 (SE) pg/ml in the basal period to to 46.8 +/- 7.1 at the end of the infusion in the pubertal girls but were unchanged in the prepubertal girls. Estrone (E1), progesterone (P), 17-HYDROXYPROGESTERONE (17OHP), TESTOSTERONE (T), DIHYDROTESTOSTERONE (DHT), and androstenedione (A), dehydroepiandrosterone (DHA) and dehydroepiandrosterone sulfate (DHAS) levels were not altered in either maturity group. Basal plasma E2, E1, T, DHT, DHA and DHAS concentrations significantly correlated with the releasable pool of LH evoked by Gn-RH from the pituitary gonadotropes. We conclude: 1) The ovary is not highly and rapidly responsive to transient elevations of endogenous gonadotropin, and 2) Adrenal androgens may to some extent modulate the maturation of the hypothalamic-pituitary-gonadal system, at least as reflected by the pituitary response to exogenous Gn-RH.


[Report on experiences with Eskici's vertical incision for apicoectomies]. The vertical incision described by Eskici for apicectomy had been used in 100 patients and verified for appropriateness. It was found that this technique has a more limited range of indication compared to the angular incision (prefered by the authors) since it creates a smaller field of operation. Its advantages consist in the absolute sparing of the marginal periodontium and in certain peculiar features of wound healing.


[The quantitative determination of gingival sulcus fluid by means of filter paper strips--an objective measure in the evaluation of success of periodontal treatment?]. The success of various periodontal treatments can be demonstrated by the quantitative determination of the gingival sulcus fluid if these treatments improve the peripheral blood supply. Compared to the manual method of determining the diffusion height of the exudate prior and after periodontal therapy (the extent of exudate reduction being used as a criterion for the degree of regression of the inflammatory circulatory disorder), the photometric-planimetric techniques yield exacter and even more favourable results. Due to its easiness and rapidity, the measurement of the diffusion height of the exudate is, as an additional control examination, useful in assessing the success of periodontal treatment.


Exchange transplantation of the liver in the pig. An original technique is described for exchange transplantation of the liver in the pig. The procedure also allows a complete autograft to be performed with the same operative trauma as a transplant. The initial problems that were encountered, but overcome in both autografts and transplants, included difficulty with adequate perfusion of the liver in the live animals, gas gangrene resulting from hepatic arterial thrombosis in animals under 22 kg, and fear of devascularisation of the pancreas or stomach during dissection. In this series, six successful pairs of pigs were transplanted and, in three pairs, one animal showed severe rejection and early death while the other lived longer with a different response. The technique has significant immunological and economical potential.


Splenic involvement in amphibian transplantation immunity. The spleen has been identified as a centre of alloimmune reactivity in control Xenopus. Levels of tritiated thymidine labelling and pyroninophilic cells are elevated in spleens of skin-allografted toadlets when compared with autografted and nongrafted animals. Second-set alloimmune reactivity can be transferred by implanting a spleen from a donor that has rejected one or two grafts into a nonsensitized host. Spleen donor and host in these experiments were mutually tolerant, following reciprocal transfer of embryonic tissue grafts. In contrast, studies on the uptake of tritiated thymidine and levels of pyroninophilia in animals thymectomized at 7 or 8 days of age suggest lack of splenic involvement in the chronic first-set allograft rejection that can still occur in the absence of the thymus. The lymphoid organ origin of "thymic-independent" alloimmunity still awaits clarification.


En bloc transplantation of the liver, pancreas, duodenum, spleen, and kidney in the rat. Five organs consisting of the liver, pancreas, duodenum, spleen, and kidney from (Lewis X Brown Norway)F1 rats were transplanted simultaneously as an en bloc graft to Lewis recipients. No immunosuppression was given postoperatively. Serial laporatomies were performed for macroscopic examination and biopsies of the grafts. Macroscopically, the first evidence of rejection was splenic enlargement followed by fatty metamorphotic change of the liver, dilation and loss of peristalsis of the duodenum, and injection of the pancreas. The kidney maintained normal color and consistency until late in the rejection process. Histological examination suggested that the liver and the spleen may be more vulnerable to immune attack, since in these organs cellular infiltration started earlier and was more extensive in comparison to other organs. While the pancreas exhibited a typical, although somewhat delayed rejection pattern, the kidney seemed to maintain a well preserved structure. Interestingly, the duodenum showed no significant cellular infiltration throughout the postoperative period of examination despite severe mucosal destruction.


Immunosuppression with polyunsaturated fatty acids in renal transplantation. A double-blind controlled trial has been undertaken to assess the value of a preparation containing polyunsaturated fatty acids (PUFA) in human cadaveric renal transplantation. Eighty-nine patients were studied and followed for 6 months after transplantation. Forty-four took the PUFA preparation and 45 the placebo (oleic acid). Other immunosuppression was standardised. Functional graft survival was significantly better in the PUFA group than in those taking the placebo during the first 3 to 4 months post-transplant. At 6 months, however, although the difference between the groups persisted, it was no longer statistically significant. Complications were equally distributed between the groups.


Renal homotransplantation with venous outflow or infusion of antigen into the portal vein of dogs or pigs. Transplantation at portal site. Kidneys were transplanted in mongrel dogs so that renal venous drainage was into the portal system of the hosts. Thirty-one recipients were not treated, 11 were given one dose of 3 mg of azathioprine per kg, and 11 were given 2 mg of azathioprine per day. Survival was not statistically increased compared with that in three comparable series in which renal venous drainage was into the vena cava, nor were the histopathological findings favorably altered in the "portal" kidneys. The injection of semisoluble antigen into the portal vein at the same time as renal transplantation at the caval site, had an effect no different from that if the antigen were given systemically during caval site transplantation. The conclusion that drainage of grafts into the portal vein was not beneficial was reached in 20 pigs evenly divided between the portal and vena caval sites, and in 12 pairs of dog to pig or pig to dog xenografts. Thus, none of these experiments has identified an advantage of antigen delivery into the portal as opposed to the systemic venous system.


A proposal for the analysis of kidney graft survival. A survival analysis using a model provides numerous advantages over other approaches. The effectiveness of concomitant variables in describing the data can be evaluated whether the variables are continuous or dichotomized. We can evaluate the effectiveness of such variables in describing either short- or long-term components of the risk. The expected life span of the graft may be computed with the model and complements the insight obtained from the more commonly displayed survival curves.


Immune competence of the streptozotocin-induced diabetic rat. I. Absent second-set skin allograft response. A study was designed to assess the cellular immune competence of Lewis rats with streptozotocin-induced diabetes. First-set Fischer skin allografts were rejected in 10.9 days by nondiabetic Lewis recipients and in 12.0 days by diabetic Lewis recipients. Second-set skin allografts in the same strain combination, utilizing the same recipients, were rejected in 8.1 days by nondiabetic recipients and in 13.0 days by diabetic recipients (P less than 0.01), indicating an absence of second-set rejection in the streptozotocin-induced diabetic rat. Treatment with NPH insulin, 3 units daily, although only slightly corrective of hyperglycemia, reduced second-set graft rejection to 8.0 days. These findings offer evidence of impaired cellular immune responsiveness in the streptozotocin-induced diabetic rat. Insulin was shown to correct deficient allograft immunity.


Differential kidney graft survival associated with interaction between recipient ABO group and pretransplant blood transfusion. In 1973 we reported significantly superior survival of kidneys transplanted to blood group O recipients compared with recipients of those from blood groups A, B, and AB taken together. In this extended series, the difference between these categories was less prominent and no longer significant. In the present study, blood transfusion significantly improved the survival of kidney grafts in patients of blood group O, but not of combined A, B. and AB groups. The difference between the graft protecting effect of transfusion in group O and combined groups A, B, and AB recipients was also significant. This suggests that the improvement in subsequent graft survival after transfusion is either confined to blood group O recipients, or is much stronger in them than in recipients of other groups. Our previous policy of restriction of blood transfusion is seen as one of the causes of the reduced superiority of group O over other groups in this extended series in comparison with our 1973 series. It seems that transfusion of group O recipients can markedly improve the prognosis of a subsequent first kidney graft.


Orthotopic skin graft survival in rats that have harbored skin implants in the anterior chamber of the eye. Allogeneic tissue implantation to the anterior chamber of the eye indicated that the host response varies with the size of the implant. Small implants (0.5 mm2) placed in the anterior chamber prolonged the survival of subsequent orthotopic skin allografts across major histocompatibility differences. In contrast, large implants (2.0 mm2) accelerated the rejection of specific skin grafts. The observed delay in graft rejection of small implant-bearing rats was specific to the implant donor, since the third-party unrelated skin grafts on these animals showed neither increase nor decrease in survival times.


[Increase in stability of isolated tissues and proteins caused by the action of chemical stimulants]. Chemical agents in subtoxic concentrations prolongate the survival time of living muscles and the time of contractile ability of glycerinated muscles. They preserve also the native property of actomyosine over the control time. The increase of resistance of living muscles and their models may be explained by stabilization of proteins or of their complexes. It is accompanied by the change of the indices of the functional state of the living muscle--by the decrease of the binding of vital dyes, by the hyperpolarization, by reducing the consumption of O2 and by the conservation of the quantity of SH groups at the high level.


[Study of lymphoid tissue cells by the method of optico-structural machine analysis]. The possibility to use the method of optically-structural machine analysis for automatical classification of lymphoid cells of tumour-bearing rats and lymphoid cells of malignant tumour was studied. The preparations were fixed by methanol, stained by azureosin and scanned on the automatical microscope-analysor "Protva-3". The isolated cells of 6 different groups were scanned. Histogramms of optical density distribution amplitudes were received for every cell and the phase analysis was carried out. The statistical characterization for every cell was based on the results of this analysis. The average values were calculated for 1) the area of the nucleus and cytoplasm: 2) the average density of nucleus and cytoplasm; 3) dispersion of densities of nucleus and cytoplasm; 4) nucleus-cytoplasm relation for every six groups. It was shown that every group of cells may be separated from each other, at least, on the basis of one of the measured parameters. The results are consistent with the morphological data.


Effect of high doses of intravenous methylprednisolone and cyclophosphamide on renal homografts. The intravenous administration of high doses of methylprednisolone and cyclophosphamide during pretreatment of the heart-beating canine and human cadaveric allograft donor has caused no observable adverse effect on renal allografts. This is in contrast to that noted when high doses of these drugs are added to the preservation perfusate in which they are not metabolized and may possibly cause renal damage.


Serum antibody titers in urethritis and chronic bacterial prostatitis. Serum antibody titers were measured by direct bacterial agglutination technique against various strains of Escherichia coli found in the fecal flora of a control group of men who had no history of genitourinary tract infection, against the strains of E. coli responsible for urethral infection in 7 men with urethritis, and against the strains of E. coli responsible for prostatic infection in 25 men with chronic prostatitis. Low serum titers were found in both the control group (median titer of 1:20) and in the urethritis group (median titer of 1:10). Excluding 3 men who had self-agglutinating strains, 18 of 22 (82 per cent) in the prostatitis group had serum titers of 1:320 or greater (median titer of 1:640). Measurement of serum antibody titers by this technique can be a valuable adjunct to diagnosis in cases of chronic prostatitis due to strains of E. coli.


Cinoxacin: new antimicrobial agent for urinary tract infections. One hundred forty-six patients with recurrent urinary tract infections were treated with 500 mg. of cinoxacin twice daily for seven to fourteen days. Satisfactory clinical response occurred in 94 per cent. Of the 100 patients with significant pretherapy bacteriuria (greater than or equal to  10(4) organisms/ml. of urine), 65 had complicated infections. Approximately the same per cent of patients with (90 per cent) as without (94 per cent) complicating conditions had a satisfactory clinical response to treatment. The pathogen was eliminated in a higher percentage of patients without underlying disease (90 versus 80 per cent), and infections recurred less frequently in this group (3 versus 14 per cent). Emergence of resistance by initially susceptible organisms during the course of therapy occurred in 4 of 76 patients (5 per cent). A satisfactory clinical response occurred in all 46 patients with an initial colony count of less than 10(4) organisms/ml. urine. Only 1 patient in this group was a bacteriologic failure. Adverse effects of a relatively wild nature were seen in 4 of 146 patients (2.7 per cent). Successful eradication of 12 of 23 urinary infections in patients whose pathogens were resistant to the 30-microgram. cinoxacin disk suggests that the 100-microgram. disk may be more realistic for determining bacterial susceptibility by the disk diffusion method in view of the very high urinary concentration of the drug.


Reticulum cell sarcoma of testis.

Reticulum cell sarcoma of testis. Malignant lymphoma is reviewed briefly. Recent literature emphasizes the rarity, bilateral tendency, and poor prognosis of primary testicular involvement. Lymphoma, however, is the most frequent metastatic tumor in this location. A case is reported of a patient living and well ten years after orchiectomy for reticulum cell sarcoma.


Diagnosis and management of lymphoceles after renal transplantation. Eight lymphoceles were encountered in 232 renal transplant procedures. The patients presented with either a palpable pelvic mass, ipsilateral leg pain and edema, or deteriorating renal function. Two patients were asymptomatic. The diagnosis is readily established by a combination of intravenous urography, ultrasound, and aspiration although ultrasound is the most useful method for the diagnosis and follow-up of these lesions. A functioning arteriovenous shunt in the leg on the side of the transplant may predispose to lymphocele formation. Most lymphoceles may be managed conservatively initially. However, if surgery is required, open drainage and packing would appear to be the most reliable procedure.


The face-lift operation.

The face-lift operation. The five sequential steps of the technique described (1) hair immobilization with surgical lubricant; (2) conversion of the cheek flap into a bilobed flap: (3) use of active, concurrent, and postoperative aspiration; (4) creation of a long, defatted tragal flap; and (5) accurate placement of the flap by precisely placed fixation sutures, facilitated uniformly good results with a substantial reduction in operating time and minimizes most of the hazards attendant upon the face-lift operation.


Correcting prominent ears with the island technique. A surgical procedure is described which corrects the ansiform ear by repositioning and reconstructing the anthelix and the anterior crus with the formation of the triangular fossa. This corrects the scaphoconchal angle and improves the cephaloauricular angle, overcoming the problem of prominent ears. Correction in early childhood is recommended in order to avoid personality problems that may result from the deformity, particularly in boys. The technique employed yields important advantages: (1) prolonged use of the helmet-type of surgical dressing is unnecessary; (2) scars are less conspicuous; (3) the outcome is attractive and normal; (4) bleeding and inflammatory complications are avoided; and (5) recurrence of the malformation is unlikely.


Secondary rhinoplasties and composite grafts. We have discussed composite grafts and some of their uses in secondary rhinoplastic procedures, the donor sites, and methods of application as to the dynamics of the iatrogenic problems and large septal perforations. A technique for nasal tip revisions as well as a safer septoplasty surgery that we have used for some years has also been shown.


[Treatment of lesions of the liver].

[Treatment of lesions of the liver]. 232 cases of trauma to the liver were observed and treated by the authors. Some problems of surgical tactics and choice of surgical procedure, depending on the data, obtained at the estimation of the severity of the injury, and also the outcome of the treatment are covered in the papaer.


A study of swine dysentery by immunofluorescence and histology. Twenty-six specific-pathogen-free pigs were fed pure cultures of Treponema hyodysenteriae. Five untreated pigs were controls. Distribution of this large spirochete in pigs with swine dysentery was shown by the indirect fluorescent antibody technique. Findings by this method were compared with those from dark-field examination of colonic mucosal scrapings and from tissue sections. The cultures caused mucohemorrhagic colitis which by 10 days after inoculation was indistinguishable from the colitis of swine dysentery. Control pigs remained normal. Pigs killed when spirochetes were first seen in the feces had normal colonic mucosa with only a few spirochetes. At the first sign of diarrhea, however, the colonic mucosa was thicker than normal and had many spirochetes. T. hyodysenteriae was confined to regions of hypertrophy and exudation of the large intestine mucosa throughout the course of disease.


Breeding record analysis in pig herds and its veterinary applications--2: Experiences with a large commercial unit. A computer program was used to analyse data from a large commercial pig unit over two years to assess reproductive efficiency and the efficiency of weaner production. Monthly inspections of the farm and quarterly post mortem examinations of all dead pigs provided further information. The effects of controlled changes in management on production were assessed. Overall the number of piglets reared per sow per year was increased from 15-1 to 17-2 and the eight-week weights improved from a mean of 10-3 kg to 15-0 kg during the two year-study period.


A survey of "normal" broiler mortality in East Anglia. A survey of routine mortality was carried out on six different broiler sites. A total of 535 individual post mortem examinations was carried out. The chief cause of mortality on all six sites was colisepticaemia. Fatty liver and kidney syndrome caused significant loss on three of the six sites and on three of them a low incidence of an oedema syndrome was of interest. Salmonella senftenberg was isolated during the first four weeks from the intestines of chickens from five of the six sites but on none of them was this occurrence associated with any manifestations of disease. The vaccination procedures against Newcastle disease and infectious bronchitis were not producing adequate immunity against a possible challenge by a virulent virus of either although the administration of the vaccines appeared to be causing stress sufficiently severe to be one of the factors predisposing to a high incidence of colisepticaemia.


Controlled trials of the anthelmintic oxfendazole in ewes and lambs naturally infected with gastrointestinal nematodes. Oxfendazole doses at a rate of 5 mg per kg, before or after lambing, reduced nematode egg output to insignificant levels in ewes, most of which were not exposed to re-infection. Ewes treated with oxfendazole had a significantly lower egg output than those treated with levamisole, although the latter anthelmintic was also highly effective. In lambs, oxfendazole at a dose rate of 5 mg per kg, showed 100 per cent efficacy for Ostertagia circumcincta, O trifurcata, Teledorsagia davtiani, Trichostrongylus axei, T vitrinus, T colubriformis, Nematodirus battus, N filicollis, immature Nematodirus, Chabertia ovina, and 93 per cent efficacy for Trichuris spp. Levamisole showed similar efficacies but did not remove Trichuris.


Diagnosis of swine dysentery using an absorbed fluorescent antiserum. The specifity of a direct fluorescent antibody test for the detection of pathogenic Treponema hyodysenteriae associated with swine dysentery was improved by absorbing the original conjugated serum with a non pathogenic treponeme.


Intestinal obstruction in cattle.

Intestinal obstruction in cattle. Based on a series of 100 cases, the paper reviews the causes, diagnosis and treatment of apparent bowel obstruction in cattle with particular emphasis on non-obstructive tympanitic disorders of the intestine.


[Radioisotope diagnosis of postoperative deep-vein thrombosis of the leg in oncological patients]. The authors have studied the frequency and characteristic features of postoperative thrombosis of profound crural veins (PTPCV), using the method of radioindication with fibrinogen J125. Among 80 oncological patients PTPCV), was found in 47 (58.7%). It is noted that PTPCV in 92% of cases developed during 5 days postoperatively, bilateral involvement is more frequently observed (70.2%), and in 28.7% of cases thrombosis involved the upper crural third. Clinical signs of PTPCV were revealed only in 44% of cases and, on the average, 2 days following the onset of the thrombotic process. Radioindication of PTPCV with fibrinogen J125 is a simple, early and precise method of establishing the diagnosis of theis postoperative complications.


[Observation of the changes in the locomotor apparatus and calcium-phosphorus metabolism in kidney transplant patients]. Renal function indices were analyzed as well as those of calcium-phosphorus metabolism and the state of bone skeleton in seven patients with renal transplantation. Consideration is given to a grave complication resulting from a long-term treatment with corticosteroids--aseptic osteonecrosis, found in two of the subjects observed and severe cortisone myopathy in one of the patients.


Upper gastrointestinal hemorrhage--diagnosis and management. THE CURRENT MANAGEMENT OF A PATIENT WITH UPPER GASTROINTESTINAL HEMORRHAGE INVOLVES THREE STEPS: initial correction of unstable hemodynamics, obtaining the specific diagnosis of the lesion responsible for gastrointestinal blood loss, and therapy directed at the specific bleeding lesion. The current approach to upper gastrointestinal hemorrhage is carrying out upper gastrointestinal endoscopy following stabilization of the patient. Although improved morbidity and mortality statistics have been slow to appear, the use of endoscopy permits appropriate therapy directed at the specific lesion. Specific therapeutic measures have been outlined for seven common causes of upper gastrointestinal hemorrhage. The advent of therapeutic endoscopy promises to bring further advances in therapy in the near future.


[Oral photochemotherapy (author's transl)]. Photochemotherapy (PUVA) with oral administration of the photosensitizer 8-methoxypsoralen and irradiation with UVA light has become a proved method for the therapy of psoriasis. The treatment is based upon repeated PUVA exposures, which are monitored by exact dosimetry within the desired therapeutic ranges. The present study, which covers an observation period of 3 years, is engaged with the practicability of the PUVA method for the treatment of the various forms of psoriasis, mycosis fungoides, atopic eccema and lichen planus, and, on the other hand, with its side effects and potential long term hazards. Photochemotherapy was shown in clinical routine as an highly effective treatment, which lead to complete clinical remission in all diseases investigated. By maintenance treatment patients with psoriasis could be kept in remission even for long periods of time. Following the dosage parameters toxic side effects were rare and reversible. Histological, histochemical and ultrastructural investigations showed no alteration of skin under photochemotherapeutic conditions. Experimentally induced massive PUVA overdosage, however, led to damage of epidermis and corium and to long lasting benign changes of the melanin pigment system. To study potential long term side effects (hepatotoxicity of 8-methoxypsoralen, cataract formation, development of degenerative or hyperplastic skin changes and disturbances of the immunologic reactivity) laboratory investigations, histologic, ophthalmologic and immunologic studies have been performed. During an observation period of up to 3 years no evidence of long term side effects was found.


[Complex therapy of rheumatic diseases]. Chronic progressing rheumatic diseases are not accessible to a satisfactory rehabilitation by a sole medicamentous treatment. In specialized departments of hospitals already very good results are achieved by the additional, coordinated use of operative and conservative orthopaedic measures, the physiotherapy and working therapy as well as by a psychological and social care apart from the treatment of lesions of the organs and sequels. The principle of the complex therapy in the hospital is gradually to be transferred to the outpatient care, achieving a full success of rehabilitation using rational methods of work.


[Basic therapy of rheumatoid arthritis]. Apart from the conventional treatment of the rheumatoid arthritis with steroidal and non-steroidal antirheumatic remedies, physiotherapy and balneotherapy as well as orthopaedic and surgical measures the basis therapy is an important factor. It has no or only slight analgetic effect, but shall inhibit the immunological processes in the pathogenesis of the rheumatoid arthritis. To the basis therapy belong the antimalarial remedies, the gold salts, the cytostatic remedies as immunosuppressive drugs and the D-penicillamine. Their possible and different modes of action are described, their clinical applications are explained and it is referred to their side-effects and contraindications. In these cases also the value of the individual preparations in the complex plan of treatment of rheumatoid arthritis are evaluated.


[Nonsteroid antirheumatic agents].

[Nonsteroid antirheumatic agents]. It is given a short, oriented to practice survey on the at present internationally most usual non-steroidal antirheumatic drugs. Picture of effect and efficiency, side-effects, indications and contraindications of these remedies are described and compared. The description comprises salicylates, phenylbutazone, indomethacin, flufenamine acid and mefenamine acid, ibuprofene as well as new substances (benorylate, clofezone, nuflumine acid, azapropazone, bumadizone calcium, naproxene and others). In their qualitities of effect the new drugs do not essentially differ from the classical antirheumatic drugs. However, they partly reveal a more favourable relation between desirable and undesirable effects.


[Cortisonoids in the therapy of rheumatic diseases]. Taking into consideration the special therapeutic problems in rheumatology a short survey oriented to practice on the treatment with cortisonoids is given. The pharmacology of these compounds is dealt with in short. Emphases of the description are general principles of treatment, indications and dosage in systemic and local treatment, side effects, problems of long-term treatment, application of ACTH, the cortisonoid withdrawal syndrome, prophylaxis of therapy complications and references to the reduction of the dose or to the withdrawal of the treatment with cortisonoids.


[Therapy of rheumatic fever].

[Therapy of rheumatic fever]. After making the diagnosis the rheumatic fever as a secondary disease after streptococcal infection is immediately to be treated with penicillin G. Parallel to this or overlapping the rheumatic inflammatory mesenchymal tissue reactions are treated with prednisolone or derivatives, aminophenazone or salicylic acid preparations, in which cases in children prednisolone and aminophenazone are preferred. The combat against the streptococcal infection by means of penicillin transgresses into a recidivation prophylaxis with benzathin-penicillin, which is to be performed up to an age of 5 years. Substitutes for the recidivation treatment with benzathin-penicillin are V-tablopen or erythromycin, perhaps also sulfaclomide. The treatment is to be performed in a hospital up to the time that the patient is free from signs of inflammation and at least 4 weeks without fever, then a gradual rehabilitation begins.


[Therapy of gout].

[Therapy of gout]. The therapy of gout is discussed taking into consideration the concomitant diseases occurring significantly frequently in patients with gout: Hypertension, uric acid-nephrolithiasis, hyperlipoproteinaemia, obesity, premature arteriosclerosis as well as diabetes mellitus. In contrast to other opinions the authors are of the opinion that the dietetic treatment is furthermore of essential importance. It is referred to the still allowed sufficiently great number in the supply of nourishment, in which cases, however, the limitations in the supply of calories, protein or purin bodies, respectively, lipid and carbohydrate do not remain unmentioned. The propositions for the medicamentous treatment essentially correspond to the central therapeutic recommendations. For the acute attack of gout, however, following to the international experiences, the colchicine therapy is more emphasized again. The medicamentous therapy of the asymptomatic hyperuricaemia is to be included into the considerations after full exhaustion of all dietetic and other possibilities in constant increase of the serum-uric acid-level more than 8 mg/dl.


[Immunomorphological and ultrastructural findings on the musculature in progressive scleroderma]. Muscle biopsies taken from 30 patients with generalized scleroderma were studied immuno-histologically as well as by light and electron microscopy. The immunological investigations have demonstrated that an increase of IgM and/or complement depositions in capillaries and in the walls of small arteries have been involved in most cases. Similar alterations were found in the subsarcolemmal zone. Vascular Ig-G precipitates were observed in the later stage of the disease only, whereas a positive reaction of fibrinogen have been proved in the most cases. By light and electron microscopy a variety of pathologic alterations have usually been found, but the most prominent changes involved were thickening of the capillary basement membrane and interstitial fibrosis. Scattered cellular infiltrates consisting of lymphocytes, histiocytes and plasmocytes were also seen either perivascularly or throughout the interstice. Around fibroblasts and capillaries, fine protocollagen fibrils and glycosaminoglycan filaments have been observed. They may partly represent fibrogenesis. Filamentous structures could be seen within the cytoplasm of numerous fibroblasts.


[Combined treatment with beta-receptor blocker pindolol and diureticum trichlormethiazidum in patients with essential hypertony in stadium II WHO (author's transl))]. A double blind study was performed concerning effects and endurance of a combined therapy with beta-receptor blocker Pindolol (LB 46 Visken Sandoz/2 X 2 tabletes per 5 mg daily and Trichlormethiazidum Eurinol Spofa 3-dicholor-methyl-6-chlor-7-sulfamoyl 3,4-dihydro-1,2, 4-benzothiadiazin-1, 1-dyoxydum) 1 X1 tablet per 4 mg daily in 74 patients with essential hypertony in stadium II WHO. Reduction of the systolic as well as the diastolic blood pressure was already highly significant after the first two weeks of treatment (p less than 0.05). Heart frequency dropped from the average of 86,6 +/-8,6 per minute to 74 +/-16.8 per minute. All patients endured the medication very well.


Iron metabolism in Trypanosoma lewisi infection: serum iron and serum iron-binding capacity. Progressive changes in iron levels, total iron binding capacity and hematocrit values in sera of rats infected with Trypanosoma lewisi are described. The host dietary group were: (1) complete or full complement; (2) iron-deficient, and (3) pair-fed or calorically restricted. The hematocrit values of T. lewisi-infected rats given the various diets were not significantly different from those of the controls. The decrease in total iron binding capacity (TIBC) of rats inoculated with T. lewisi and fed complete and pair-fed diets ranged up to 15% over uninfected controls. TIBC levels in rats fed an iron-deficient diet and inoculated with T. lewisi ranged up to 32% over uninfected controls. TIBC levels of deficient infected rats were significantly different from the controls from day 90 to infection to the end of the observation period. Serum iron (SI) values of non-infected rats regardless of dietary regimen showed significantly higher values than T. lewisi-infected animals between days 95 and 120. The average SI value, for this period, in adequately fed control rats was 204 +/- 7 microgram/100 ml as compared to 172 +/- 5 microgram/100 for trypanosome-infected rats. SI levels of rats on a pair-fed diet and infected with T. lewisi decreased to 17% over uninfected controls. SI levels of animals on an iron-deficient diet and infected with T. lewisi decreased up to 76% over uninfected controls.


Babesia argentina: observations on the immunogenicity of the cryofibrinogen complex. Rabbit antisera were prepared against the soluble and insoluble fractions of a cryofibrinogen complex that formed in plasma of cattle acutely infected with Babesia argentina. Analyses of the rabbit antisera indicated that the cryofibrinogen complex contained proteins from erythrocytes and parasites as well as fibrinogen and related proteins.


[Immunohistochemical findings in renal biopsies performed on diabetics (author's transl)]. Renal biopsies obtained from 22 patients with diabetes (8 women, mean age 38.5 years; 14 men, mean age 27.3 years)--including patients with potential, latent, short-term, and long-term diabetes--were examined by light microscopy as well as by immunofluorescence microscopy. Histologically, segmental and focal proliferation of mesangial cells as well as a mesangial broadening and an increase of substance deposited in the mesangium was found. These findings well documented by cell counting an differentiation are described in detail elsewhere (see Sorger et al. 1976 Immunhistochemically, we detected most frequently IgA (9/17) and IgG(9/17), usually in a linear or mesangial pattern, less frequently IgM (1/17). We failed to detect beta 1C and IgE in the glomerulus. Labeled insulin was demonstrated 5 times. Out of the plasmaproteins albumin, fibrinogen, transferrin, and beta-lipoproteid only albumin was perceptable. We consider the deposition of immunglogulins and serum-proteins in the glomerular filter to be an unspecific stimulation of proliferation of the mesangial cells being caused by overfunction and obviously produce an excess of the mesangial matrix.


[Phagocytosis of lymphocytes in the orthopic porcine liver homograft (author's transl)]. Electron microscopical studies of sinusoids and Kupffer cells of the orthotopic porcine liver homograft were systematically performed. The obtained findings show the presence of phagocytosis of host lymphocytes circulating in the sinusoids by Kupffer cells of the homograft in the late stage after transplantation at the time of a compensated function during the late rejection. The findings are described, demonstrated and shortly discussed.


[Experimental and clinical aspects of the living articular cartilage transplantation and half-joint transplantation (author's transl)]. The articular cartilage transplantation and the half-joint transplantation necessitate the assessment of specific biological-transplantation questions as to the structure and function of the hyaline cartilage. Compared with other organ transplantations biometric and biomechanical factors have to be taken into consideration additionally. Up to now contradictory results were obtained in the animal experiment. On principle a survival of grafted non-preserved parts of cartilage seems to be possible. In clinical practice therapeutic trials for autogenous reimplantation of articular cartilage, autogenous joint surface partial transplantations and half-joint transplantations are justified. Allogenous half-joint transplantations may also be possible in exceptional cases.


[Technical failures in small bowel surgery (author's transl)]. A certain amount of relaparotomies after small bowel surgery is caused by technical failures, such as the technique of suturing the anastomosis and the kind of re-establishing the continuity of the bowel. An end-to-end-anastomosis with sufficient vascularisation at the cut ends, tension free, and without an overdone inversion will guarantee a more successful suturing of the bowel than a side-to-side-anastomosis. At first the whole small bowel should be explored to recognize multiple lesions. Postoperative malabsorption due to the exclusion of more less extended segments of the bowel--by bypass anastomoses or construction of blind loops--can be repaired successfully by corrective laparotomies. Special problems in operative tactics and technique of Crohn's disease are discussed.


[Surgical procedures in portal hypertension (author's transl)]. Successful therapy of portal hypertension and especially bleeding oesophageal varices can only be achieved by decompressing surgical measures. An emergency porto-caval shunt has the advantage of short operating time and optimal decompression. Blocking procedures are only indicated in rare cases. In the time free of bleeding spleno-renal-anastomosis is the procedure of choice. Postoperative encephalopathy is still a menace in surgery of portal hypertension.


[Stage of development and perspectives of Berlin's Charité-Frauenklinik]. The starting point of this paper are works from H. Kraatz, written in 1958 and 1960 about history and future and propositions of the Hospital. It could be shown nearly all the plans of Kraatz to be realized during the following years. Under preserve of the traditions the modern development of science leaded to the present works astructure of the clinic. Some results are published to give reasons for this.


[Surgical correction of the sagging abdomen]. The classification of pendants is made from the view of constitutional type and operating method. There are only two different kinds: skin pendant and fat pendant. The operating correcture of skin pendants is made by Contamin and of fat pendants by Schrimpf. Good operating results, little complications and no case of death make it possible beside the pendant plastic to do other surgical interventions so as laparotomies, herniotomies and vaginal operations. Beside an operating method that takes care of the skin, the following conditions must be fulfilled: an intact coronary- and circulation system, thrombosis prophylaxis, most carefull haemostasis, skin suture without tension and REDON-Drainage.


[Experience with Strömbeck's reduction plasty]. In the reduced plasty of Strömbeck the author sees an exact standard method for nearly all forms of macromastia and mamaptosis. Operation results of the author are documented. Further on advantages of a self-made mamillotom are shown and the treatment without bandage is propagate.


[Use of an autocolpotransplant in surgery for genitalia prolapse with urinary incontinence]. The authors use an autocolpotransplantate in the surgery of the genitale prolapse with urinary stress incontinence (vaginale colpohysterectomy, Manchester-Fothergill-Operation anterior and posterior colporrhaphy). The autocolpotransplantate functions as a subvesical belt which is able to avoid recidivs and also favours the formation of new tissue in the urethro-vesico-vaginale area. The newly formed scarplate is the basis to prevent postoperative vesical continence disorders.


[Contributions to the immunodiagnosis of echinococcosis (author's transl)]. Serum samples of 49 patients with echinococcosis, 32 of whom were diagnosed parasitologically (demonstration of protoscolices) and 17 of whom were diagnosed clinically (scintigram, histology), were examined for the presence of antibodies. The control group included sera from 74 patients with liver disease and tumors, 10 sera from blood donors, and 1330 sera for which serological tests for echinococcosis had been requested. The antigens used were two types of hydatid fluid, and aqueous extract from E. multilocularis cyst material, and protoscolices from E. granulosus and E. multilocularis. The results showed that the indirect immunofluorescence test with vital protoscolices was the most specific reaction whereas the indirect hemagglutination test with hydatid fluid and the extract from E. multilocularis was the most sensitive reaction. The latex turned out to be the least specific of the methods used. The sensitivity and specificity of our own results are compared with those of other investigators to emphasize the limitations of the immunodiagnosis of echinococcosis.


[Morphologic characteristics of the large bodies in cultures of the L-forms of bacteria according to scanning electron microscope studies]. Large bodies appear at the time of protoplast and spheroplast formation and are revealed at all the L-transformation stages and at the initial stage of reversion. They can be represented both by a single giant cell and by a conglomerate of different cells connected with one another. They are not only spheroid, but can be of the most varied shape, and structurally they are connected with other L-colony elements: filamentous structures, spheroid cells, elementary bodies and the so-called acellular material. At the early L-transformation stage the large bodies probably appear as a result of coalescence of lysed cells and represent polygenome formations. Elementary bodies and spheroid cells form within the large bodies and on their surface at the late stage of L-transformation. In case of reversion bacterial cells form from them.


[Origin of plague moderate phages of serotype 2]. Results of study of the negative colonies morphology, the structure of corpuscles, antigenic properties, specificity, and the action range permitted to refer the phages obtained from 18 E. coli strain, 1 plaque strain, and 1 pseudotoberculosis bacillus strain to the same group and to identify them with plague phages of serological type 2. Isolation of the same phage type from different bacterial species permits to regard them as "polyhostal" ones. E. coli should be considered as the main carrier of phages belonging to serological type 2. It is suggested that phages existing on microbes belonging to different species should be called "polyhostal".