A minimum-volume, flow-through system for rearing frog tadpoles: aquarium. A flow-through system requiring a low flow rate (4-10 ml/minute/aquarium) was developed for rearing tadpoles. This permitted tadpoles to be raised in tap water that had been dechlorinated and acidified. The aquarium consisted of a 7-liter plastic outer shell. A screen-bottomed basket, inserted into the shell, facilitated handling of the tadpoles. A bottom-scraper and flushing system permitted periodic removal of solid wastes.


Physical mapping of Staphylococcus aureus penicillinase plasmid pI524: characterization of an invertible region. The staphylococcal penicillinase plasmid pI524 and a series of derivatives have been extensively mapped by restriction endonuclease digestion and by heteroduplex analysis. We report here the identification of a 2.2 kb region that undergoes a reversible, rec-independent inversion. This sequence is bounded by a pair of inverted repeats 650 base pairs in length, and has asymmetrically located recognition sites for at least three restriction endonucleases. A series of deleted derivatives and one naturally occurring, closely related plasmid, were studied. Two of these retain the inversion; the remainder are incapable of inverting and were all found to be locked in the same orientation of the inversion. The invertible sequence is adjacent to the region of the plasmid encoding beta-lactamase (bla); this entire region appears to be transposable and the inversion may be involved in the regulation of beta-lactamase expression or in translocation.


A hex mutant of Haemophilus influenzae.

A hex mutant of Haemophilus influenzae. A mutant of Haemophilus influenzae which does not discriminate between low efficiency (LE) and high efficiency (HE) markers has been isolated. The mutant does not differ wild type in its sensitivity to ultraviolet radiation, methyl methanesulfonate (MMS) mitomycin C, and nitrous acid. Spontaneous mutation frequencies for three loci studied are 10- to 30-fold higher in the mutant than in the wild type strain. Low- and high-efficiency transforming markers are equally UV-resistant when assayed on this mutant. This mutant is thus similar to the hex mutant of Streptococcus pneumoniae.


A B lymphocyte mitogen extracted from a fungus Peziza vesiculosa. A water-soluble mitogen was extracted with hot-water from the fruiting bodies of a fungus, Peziza vesiculosa, collected in the wild. The active substance, named vesiculogen, was able to stimulate selectively murine B cells because mitogenic activity was observed in the spleen cell cultures of congenitally athymic nude mice, but not in the thymus cell cultures. The possibility that the mitogenicity of vesiculogen was due to lipopolysaccharide was denied completely by the following evidence: 1) lipopolysaccharide in vesiculogen was undetectable(less than 0.001% in the Limulus test), 2) vesiculogen was able to stimulate strongly DNA synthesis of spleen cells from C3H/HeJ mice, and 3) the mitogenic activity of vesiculogen was not inhibited by polymyxin B. Vesiculogen increased antigen-nonspecifically the number of direct plaque forming cells to sheep erythrocytes, horse erythrocytes, and trinitrophenylated-horse erythrocytes. This result shows that vesiculogen acts as a polyclonal B cell activator on murine spleen cells.


"Neuro-cardiovascular" surgery: innovations for the treatment and prevention of cardiovascular disease. The concept of performing surgery on the conduction system and the nervous system of the heart with the use of peripheral nervous tissue, Purkinje fibers or biophysical means, may solve many enigmas concerning the treatment of arrythmias. More importantly, a correlation is suggested between coronary artery disease, the state of depolarization of the myocardial cells, local electrical and magnetic fields, the state of local innervation of coronary blood vessels, the activity of the specialized conducting system, and higher central nervous system centers. This suggested correlation may contribute significantly in the treatment, and eventually, in the prevention of coronary artery disease.


[Computerized tomography in neurodegenerative diseases in childhood (author's transl)]. The early diagnosis of neurodegenerative diseases in childhood is of great interest for genetic counseling. The development of cranial computerized tomography (CCT) has led to an improvement in the recognition of progressive neurological disorders. On one hand CCT is of importance in distinguishing the neurodegenerative diseases from perinatally acquired cerebral lesions. On the other hand CCT permits the differentiation from degenerations of cerebral gray and white matter. In this connection repeated controls with CCT are of great significance. 4 characteristic case studies are described.


Specific in vitro antibody response to influenza virus by human blood lymphocytes. Advances in understanding of human immune responses depend, for obvious reasons, on the use of in vitro techniques for culture of peripheral blood lymphocytes (PBL). We report here that specific antibody responses to influenza virus can readily be obtained using simple, reproducible methods. The system will be useful for the analysis of the cellular requirements for antibody production, the genetics of immune responsiveness and in clinical studies of immunosuppressed and immunodeficient patients.


Computed tomography combined with gas cisternography for the diagnosis of expanding lesions in the cerebellopontine angle. A new method combining selective gas cisternography and computed tomography for the examination of expanding lesions in the cerebellopontine angle cistern is described. Small amounts of gas injected by lumbar puncture can, with proper technique, easily be trapped in the cerebellopontine cistern. Acoustic neuromas protruding into the cistern are visualized as filling defects in the gas. Filling of the internal auditory canal with gas may be demonstrated in normal cases. The possibility of diagnosing intracanalicular tumors is uncertain.


[Meckel's diverticulum in surgical practice]. Notes on the surgical management of Meckel's diverticulum in the light of 32 personal cases are presented. Stress is laid on the advisability of making a systematic search for this form during laparotomy and the removal on principle of even apparently unimpaired diverticula as a means of avoiding the very frequent and serious complications that may arise when diverticula are left in situ.


[Electric stimulation in cases of flaccid paralysis]. Forty-six patients with flaccid paralysis of muscles were treated with stimulation with exponential currents. In 7 groups of patients three grades of muscle paralysis were distinguished, on the basis of muscle reaction to a definite duration of electrical stimulus. The best therapeutic results were obtained in paresis, fairly good in moderate paralysis, less good in severe paralysis. The results depended on the degree of muscle denervation, the extent of damage to the peripheral motor neuron and to the conditions of regeneration of the peripheral nerve.


[Electron microscopic study of the intercellular junctions during the ciliary epithelial differentiation of the eye of the common frog]. Intercellular junctions in the eye ciliary epithelium were studied in Rana temporaria by means of transmission electron microscopy beginning from the stage of appearance of the light sensitivity in the larval eye and until the completion of metamorphosis. In the ciliary epithelium inner layer the apical parts of adjacent cells are tied by contacts forming the junction complex already at a very early  developmental stage. The most apical position in this complex is occupied by the focal junction which appears to be an early stage of zonula occludens; this complex includes also zonula adherens and macula adherens which may follow in any succession focal junction or zonula occludens. No definite order was found in the localization of cell contacts between the outer and inner layers of ciliary epithelium, as well as between the side surfaces of the cells within each layer. Contacts were found everywhere termed as "lengthy" which may be considered as gap junctions. Regional differences were found in the ultrastructure of the ciliary epithelium cells with respect to unequal distribution of functional loads.


Effects on pulp and dentin of iontophoresis of sodium fluoride on exposed roots in dogs. Experiments were performed on young permanent teeth in which there was demonstrable active dentin formation. Following surgical exposure of roots and removal of cementum with scalers, 1 percent sodium fluoride in aqueous solution was applied either topically or with direct-current iontophoresis. Two levels of current, therapeutic or five times therapeutic, were used. Observation periods were 7 and 80 days. There were no demonstrable histologic or ultrastructural alterations of the underlying pulp; nor was there a resultant change in the rate of dentin formation. While exposure of root surface dentin alone (negative control) produced no alterations, grinding the surface (positive control) caused noticeable changes in dentin, odontoblasts, and pulp.


Congenital abnormalities induced by heterologous antisera directed against rat kidney glycoproteins isolated by concanavalin A affinity chromatography. It has been well established that heterologous antisera against whole rat kidney homogenate when injected into pregnant rats during the embryonic organogenetic period may induce abnormal embryonic development. Attempts were made to isolate the active components from soluble rat kidney extract by ammonium sulfate precipitation, anion-exchange chromatography, and concanavalin A-Sepharose 4B affinity chromatography. The glycoproteins isolated were capable of stimulating the production of potent rabbit antisera. When injected ip into the 9th day pregnant rats, these antisera induced embryonic death, congenital abnormalities, and fetal growth retardation. Eighty-four surviving fetuses were examined, all of them were malformed. The most frequently observed congenital defects were anophthalmia and microphthalmia. Attempts were made to analyze the glycoprotein fraction by discontinuous and sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis. The results indicate that the glycoproteins were of high molecular weight and could be dissociated by SDS into a multitude of molecules or subunits. Although double immunodiffusion indicated that there were one major and two minor antigens in the glycoprotein fraction, attempts to identify the antigens as to their size by analytical gel electrophoresis have not been successful. Electron microscopic study seemed to suggest that the glycoproteins might tend to aggregate to form particulates. The underlying mechanism whereby the antisera to these glycoproteins induce abnormal embryonic development is not understood. The hypotheses to explain the possible sites of teratogenic antibody interaction are discussed.


Refractory Pneumocystis carinii infection in chronic granulomatous disease: successful treatment with granulocytes. Pneumocystis carinii pneumonia developed in an 11-year-old girl with chronic granulomatous disease who had normal cellular and humoral immunity. The patient remained febrile during treatment with sulfamethoxazole-trimethoprim and pentamidine but became afebrile when treated with a series of 12 granulocyte transfusions combined with sulfamethoxazole-trimethoprim. In addition to documenting P carinii infection in chronic granulomatous disease our findings suggest that granulocyte transfusions may be of value in the treatment of severe infections in chronic granulomatous disease.


Application of ART to time-coded emission tomography. Devices for single-photon emission tomography currently take projections either in a plane over a full angular range (0--360 degrees) or in a volume with a limited angular range. The planar, pseudo-random, time-coded aperture, in conjunction with an Anger camera, is a device of the limited angular range type. It employs multiple pinholes whose transmission varies as a function of time. Previously, image reconstruction was accomplished by simple back-projection of coefficients obtained by time-correlating pinhole transmission with detector-element count rate, resulting in a low-contrast image. Using the Algebraic Reconstruction Technique (ART) a method is introduced for division of the correlation coefficients into subsets allowing the three-dimensional reconstruction to be accomplished on a minicomputer. Results from simulations and experimental phantom data show that ART improves depth resolution compared to back-projection, that under-relaxation produces better images in the case of noisy data, and that the division of the correlation coefficients into subsets has no effect on quality. The images depict the expected resolution degradation in the direction normal to the detector plane due to the limited angular range of projections but yield quantitative results whose relative values are good, even though attenuation is neglected.


[Treatment of bleeding esophageal varices by embolization of the left gastric vein. (Preliminary note) (author's transl)]. The author reports eleven cases of embolization of the left gastric vein in patients with esophageal varices due to schistosomotic hepatic fibrosis. The technique of the procedure is briefly described. The results have been favourable and no recurrence of bleeding was observed so far.


[Oral manifestations of Letterer-Siwe disease. Clinical and histological study of lesions centered in the mouth of a infant with acute and disseminated histiocytosis X]. The clinical, radiological and histological aspects of acute histiocytosis X of Letterer-Siwe disease are reviewed after personal observation of such cases. In spite of many advanced hypotheses the etiopathogenesis of Histiocytosis X is wide open to research. The diagnosis became possible by the discovery of histiocyte cells of a special order, the X-bodies, under the E. M. Recent research allows a classification of Letterer-Siwe disease, Hand-Schüller-Christian disease, and the eosinophilic granuloma under the same nosologic grouping. Finally, the prognosis of the Letterer-Siwe disease-so far much in the dark-may be improved by a properly conducted therapy.


Benzo(a)pyrene-7,8-dihydrodiol 9,10-oxide adenosine and deoxyadenosine adducts: structure and stereochemistry. The structure and absolute stereoconfigurations of four adenosine adducts with (+/-)-7 alpha,8 beta-dihydroxy-9 beta, 10 beta-epoxy-7,8,9,10-tetrahydrobenzo(a)pyrene (BPDE) and their deoxyadenosine analogs have been determined. They result from both cis and trans addition of the N6 amino group of ademine to the 10 position of both enantiomers of BDPE. This was determined from studies of the nuclear magnetic resonance spectra, mass spectra, and circular dichroism spectra, as well as from their pKa values and chemical reactivities.


Cigarette smoke inhalation decreases alpha 1-antitrypsin activity in rat lung. Brief inhalation exposure of rats to three or six puffs of cigarette smoke significantly decreases elastase inhibitory capacity per milligram of alpha 1-antitrypsin in lung lavage fluid. This effect is not observed in ozone-tolerant rats and can be reversed by treating the lung lavage fluid from smoke-exposed rats with reducing agents. Samples of human serum obtained immediately after smoking also show decreased elastase inhibitory capacity per milligram of alpha 1-antitrypsin. Again, elastase inhibitory capacity can be restored by treatment with a reducing agent. Cigarette smoking may cause emphysema by inactivating alpha 1-antitrypsin through oxidation.


Cigarette smoking induces functional antiprotease deficiency in the lower respiratory tract of humans. Current concepts of the pathogenesis of emphysema suggest that it results from an imbalance of elastase and antielastase activity within the alveolar structures. Although emphysema that is associated with hereditary deficiency of serum alpha 1-antitrypsin conforms to this scheme, the major risk factor in the more common form of emphysema is cigarette smoking. A study was designed to evaluate the premise that cigarette smoking may be associated with an acquired, functional defect in lung alpha 1-antitrypsin. Determination of the antielastase activity of alpha 1-antitrypsin obtained from the lungs of smoking and nonsmoking individuals revealed a nearly twofold reduction in the functional activity of this elastase inhibitor in the lungs of cigarette smokers. These data suggest that cigarette smokers may lose some of the normal antielastase protective screen of the lower respiratory tract, making them more vulnerable to destructive lung disease.


Aortoenteric fistula: a mandatory early operative diagnosis. The records of eight patients with aortoenteric fistulas from 1961 to 1976 were reviewed. The aortoenteric fistulas were primary in three patients and secondary in the remaining five. The most common symptom was gastrointestinal hemmorrhage, seen in seven of eight patients. Four patients also had fever. Seventy percent of patients survived more than 24 hours after the initial hemorrhage, allowing time for a rapid work-up. An algorithm is presented for evaluating a patient suspected of having an aortoenteric fistula. It is a work-up of exclusion and requires six to eight hours. The definitive diagnosis and management of the patient is accomplished by surgical exploration. Primary aortoenteric fistulas are best managed by aneurysmectomy and Dacron graft replacement. Management of secondary fistulas should be tailored to the condition of the patient at the time of operation. The preferred treatment consists of excision of the graft and extra-anatomic bypass. The operative mortality in this series was 25%.


Intraoperative gastrointestinal endoscopy in the management of occult gastrointestinal bleeding. Intraoperative gastrointestinal endoscopy has become an increasingly valuable diagnostic and therapeutic adjunct in the management of a variety of complicated problems in surgical patients. At the Medical College of Georgia, intraoperative gastrointestinal endoscopic technics have been successfully used to locate the site and cause of occult gastrointestinal bleeding; to diagnose, biopsy, and, when appropriate, resect lesions during operations conducted for other pathologic processes; to gain endoscopic access for resection of lesions otherwise inaccessible (endoscopically) by virtue of intestinal distortion caused by adhesions; to guide the operating surgeon to an area of resectable disease through dense adhesions secondary to multiple previous laparotomies; and to enhance diagnosis at laparotomy. The value of intraoperative gastrointestinal endoscopy in lesions resulting in occult gastrointestinal hemorrhage and the value of combined radiographic and intraoperative endoscopic technics in diagnosing and managing occult GI bleeding are discussed.


Brunner's gland adenomas: clinical presentation and surgical management. Tumors of the Brunner's glands are rare, and the etiology remains obscure. Bleeding is the most common presenting symptom and may be occult or exsanguinating. Gastric outlet or duodenal obstruction may also occur. Often there is a history of preexisting nonspecific upper gastrointestinal symptoms, or the adenoma may be an incidental postmortem finding. Although contrast studies usually suggest the diagnosis confirmation requires endoscopy or operation. Resection is the preferred therapy, but bypass of the lesion has been done becaue the adenomas are not considered premalignant. Gastroduodenoscopy may facilitate definitive management. Our experience in managing three patients with Brunner's gland adenomas, including a patient with life-threatening upper gastrointestinal hemorrhage from an ulcerated Brunner's gland tumor, is cited.


Treatment of Pneumocystis carinii pneumonia with trimethoprim-sulfamethoxazole and pentamidine: efficacy and toxicity. A 39-year-old man with Pneumocystis carinii pneumonia responded poorly to oral trimethoprim-sulfamethoxazole (TMP-SMX) therapy, despite excellent serum concentrations of the drug. He developed severe thrombocytopenia when pentamidine was added to the regimen. This case illustrates problems of drug efficacy and toxicity in the treatment of P carinii pneumonia and suggests caution in the use of TMP-SMX and pentamidine in combination.


Hyperfibrinolysis in a patient with cellulitis. A case of acute hyperfibrinolysis complication in cellulitis was reported. The bleeding did not stop for two days because of hematological defect. After giving antifibrinolysin and treating the etiologic factor, the bleeding stopped within a few hours. One should be aware that excessive bleeding in infection can possibly be caused by hyperfibrinolysis.


A primary choroid plexus papilloma of the cerebellopontine angle. Papillomas of the choroid plexus arising in and occupying the cerebellopontine angle are rare. Such a case occurring in a 41-year-old woman is reported. The signs and symptoms are described. The literature is reviewed.


Chiari Type I malformation with hydromyelia: findings at computerized metrizamide ventriculomyelography. Computerized Metrizamide ventriculomyelography consists of CT exploration of the head and neck performed one hour after introduction of Metrizamide into the lateral ventricle via a frontal burr hole. This procedure permits visualisation of all soft-tissue anomalies present in Chiari malformation with hydromyelia as seen in two cases.


Non-communicating hydrocephalus caused by dural arteriovenous malformation. The case of a female infant with a non-communicating hydrocephalus caused by an enormously dilated straight sinus and the dilated posterior one third of the sagittal sinus is presented. These sinuses drained a torcular dural arteriovenous malformation. Conray ventriculography revealed a complete obstruction of the junction of the aqueduct and fourth ventricle with cephaloventral displacement of the ventricular system by the dilated sinuses. Placement of a ventriculoperitoneal shunt was followed by artificial embolization, by selective catheterization, into the dural feeding arteries.


Lung distensibility and airway function in intermediate alpha 1-antitrypsin deficiency (Pi MZ). We examined the role of intermediate alpha 1-antitrypsin deficiency in predisposing to abnormalities of lung distensibility and airway function in 20 heterozygotes (Pi MZ) who were individually matched with a control Pi M subject of similar age, height, and smoking habits drawn from the same male, working population. There were no significant differences between the heterozygotes and their controls in the results of spirometry, maximum expiratory flow-volume curves (breathing air), single breath nitrogen test, arterialised capillary blood oxygen pressure, or single breath carbon monoxide transfer. Additional studies were made in 12 of the pairs of Pi MZ and Pi M subjects. Comparison of maximum expiratory flow-volume curves breathing air and 80% helium-20% oxygen showed no differences between the Pi MZ and Pi M subjects. Although airway function was similar in the two groups, four of 12 Pi MZ subjects showed abnormalities of the pressure-volume curve of the lung (reduction in lung recoil pressure, abnormal shape factor, increase in functional residual capacity). Abnormalities of washout of a helium-sulphur hexafluoride gas mixture, of a type previously described as characteristic of emphysema, were found in two of the men with abnormal pressure-volume curves. The results suggest that Pi MZ subjects have an increased susceptibility to alveolar abnormalities without increased abnormalities of airway function; this may explain the increased frequency of emphysema at necropsy despite many studies showing no predisposition to abnormal airway function in life. The functional changes we observed would be unlikely to cause symptoms. The risk of disablement from chronic lung disease appears to be only slightly enhanced by intermediate alpha 1-antitrypsin deficiency.


[Alterations of the plasma ribonuclease activity in female wistar rats under the conditions of combined therapy of the ovary carcinoma (author's transl)]. The authors have analysed the influence exercised by the combined therapy of the ovary carcinoma on the plasma ribonuclease activity in Wistar rats. The medicaments "Proresid", "VM-26", and "Methotrexat" together with a percutaneous irradiation of the abdomen did not alterate perceptibly the enzyme activity during the experiment, but there was a considerable reduction of the enzyme activity after an application of "Endoxan", "Adriblastin" and "Methotrexat" with subsequent administration of "Leukovorin". The most violent ribonuclease suppression, however, was obtained by an intraperitoneal instillation of radiogold and a fractioned percutaneous irradiation of the abdomen with intercalated administration of "Endoxan".


Surgical treatment of intestinal complications after radiotherapy and surgery for malignant lymphoma and carcinoma of the testis. The aim of this paper is the analysis of the complications occurred after surgical and radiological procedures, for staging and treatment of malignant lymphomas and testicular carcinoma with an evaluation of the possible efficacy of their surgical treatment. At the Istituto Nazionale dei Tumori of Milan during the period 1970-1976, 718 patients with malignant lymphomas were staged with laparosplenectomy; 444 of them received radiotherapy on the abdominal area. Laparosplenectomy was not performed on other 123 cases that were irradiated as well on the abdominal area. Retroperitoneal lymphadenectomy or explorative laparotomy were carried out in 98 patients with carcinoma of the testis and 46 of them received adjuvant radiotherapy; other 29 were irradiated without previous surgical procedures. After surgery alone morbidity and mortality rate were 2.7% and 0.73% respectively. The mortality/morbidity ratio was 26%. The incidence of complications after radiotherapy alone was 3.3%. No deaths followed the treatment. Combined treatment had a morbidity rate of 5.5% and mortality rate of 2%. The mortality/morbidity ratio was 37%. Complications were treated mainly by surgery: out of 50 interventions, 22 were intestinal resections. New secondary complications were however frequent (more than 50% after intestinal resection) especially in patients originally treated with laparosplenectomy or retroperitoneal dissection plus radiotherapy.


Maximal electrical stimulation for urinary incontinence: report of 98 cases. Ninety-eight patients with urinary incontinence have been treated with maximal electrical stimulation (MES) The MES method used is a modification of previously used similar methods of maximal stimulation with respect to reduced intensity of stimulation and reduced number of electrodes. Thus, discomfort to the patient during treatment is considerably lessened. Anal or vaginal MES produced temporary or sustained improvement or relief of incontinence in 47 of 98 patients.


[Cytogenetic changes in the peripheral lymphocytes and immunity of typhoid fever patients and in chronic bacterial carriers]. A study of the frequency of acrocentric chromosomes associations and chromosome aberrations in peripheral blood lymphocytes together with the immunologic indices permits a separate estimation of functional activity for the T- and B-lymphoid systems in patients with abdominal typhoid and in carriers.


[Possibilities of emergency endoscopy in the diagnosis and treatment of acute gastrointestinal hemorrhages]. The diagnostic and curative potentialities of the urgent endoscopy in acute gastrointestinal hemorrhages was assessed in 150 patients who were subjected to 208 examinations. The cause of hemorrhage was found out in 94,6%. An original method of sclerosing injections into hemorrhagic veins was used in patients with portal hypertension in order to stop the hemorrhage from varicose formations of the esophagus.


[Importance of emergency fiber endoscopy in the diagnosis of hemorrhages from the upper parts of the digestive tract]. The work elucidates the role of the urgent fibroendoscopy in diagnosing hemorrhages from the upper parts of the gastro-intestinal tract. The urgent fibroendoscopy was performed in 121 patients with acute gastric hemorrhage. The cause of the hemorrhage was revealed in 111 patients (92%). In 25% (28 patients) the endoscopic examination has revealed additional changes, not responsible for hemorrhage. The endoscopic examination is most effective within the time of the proceeding hemorrhage.


[Nonspecific reactive state of the body in gastroduodenal hemorrhages]. The clinico-immunological investigation of 99 patients with gastroduodenal hemorrhages has shown pronounced changes in the humoral defensive system of the organism to develop due to hemorrhage which are dependent mainly on the degree and duration of the hemorrhage. The complement system is the first to suffer. The authors believe that the indices of the antiinfectional immune reactivity might be one of the criteria in determining the optimal terms of surgery in the posthemorrhagic period.


Resection of the pancreas for acute hemorrhagic and necrotizing pancreatitis. The role of surgery in the treatment of acute hemorrhagic or necrotizing pancreatitis is discussed on the basis of a series of 996 patients with all types of acute pancreatitis who were treated in the years 1967--1976. Pancreatic resection was performed in 29 patients with hemorrhagic or necrotizing pancreatitis during the past 3 years. The extent of resection ranged from 60 to 100% of the pancreas. Eight patients died, for a mortality rate of 28%. Eight of 21 surviving patients developed diabetes requiring substitution therapy. During a follow-up period of 6 to 36 months, 17 patients were able to resume work, 3 are still convalescing, and 1 has retired.


[Fiber-type morphology and function of the triads in frog (Rana esculenta) skeletal muscle)]. 1. Owing to differing structural characteristics of the contractile substance, the muscle fibres have been divided into the three types A, B and C in former papers. This distinction seems to be corroborated by our investigations into the different structure regarding the traids. As for the A-fibres, they are structured in terms of the T-system being connected in its entire length with the SR-cisternae and circling the myofibrils at the level of the Z-layer. In the B-fibres, this permanent couping of the two membrane systems is partially interrupted so that the T-tubules are arranged round the myofibrils in such a way that they are isolated or only coupled on one side with the SR-cisternae. Apart from the triads we also find diads. There is a totally different arrangement of the membrane systems in the C-fibres. In this instance the T-tubules are not only arranged transversally but also vertically along the contractile elements. They are surrounded by an "SR-labyrinth" which forms individual minor cisternae which are lateraly coupled with the T-tubules. So the axis of these triads is turned by 90 degrees as compared to the A and B fibres. As a result of this different arrangement, these triads always appear in cross-sections, not however, in longitudinal sections as is the case with the A and B fibres. The tirads have a varying shape in the cross-sections depending on the level of the section and due to the fact that the cisternae are not always coupled congruently with the T-tubules. 2. In our discussion we have tried to related these differing shapes and arrangements of the triads in the fibre types A, B and C to known physiological findings. Therefore we deduced that the excitation transmittance and calcium release can be correlated with the anomal rectification of the triads, which has been localized in the region where the T-tubules and SR-cisternae are coupled. However, we can only reckon with a solution once the morphology and function of the "feet" and the eletronmicroscopically "blank" spaces which fill the gap-junction between the T-tubules and the SR-cisternae have been explained. Whatever function the free surface of the T-tubules has remains open. It is directly adjoining the sarcoplasm and we are tryping to relate it to the delayed rectification which appears on the fibre membrane. 3. Moreover from the arrangement of the SR-cisternae i- the individual fibre types we can deduce th intrafibrillar directions of expansion of the calcium after its release and thus the process of the excitation in the A, B and C fibres. It appears that calcium is being directed homogeneously from the SR-cisternae of the A-fibres to the actinfilaments. here the morphological appearance of the twitch fibre presents itself to us. In principle this pattern of expansion of calcium in the B-fibres remains consistent. Owing to the interruption between the T-system and the SR-cisternae we may assume that the process of contraction is delayed in contrast to the A-fibres...


[Effectiveness of electrotherapy on the pressure of the urethral sphincter]. In 4 out of 6 patients the effectivity of the swelling current therapy on the profile of the urethra-pressure could be proved, in which case in the functional length of the urethra as well as in the maximum occlusion pressure of the urethra an increase was to be seen in contrast to the profile without swelling current.


[Immunologic properties of malignant and non-malignant L cell sublines. II. Immunogenicity, sensitivity to complement and T-lymphocytes, cell secretions modifying immune reactions]. The malignant subline of L cells did not differ from the initial benign subline in such immunological parameters as immunogenicity, ability for modigying immunological reactions by their metabolic products, sensitivity to the lyzing action of the complement, ability for surface adsorption of lymphocytes. The cells of the malignant subline were somewhat less sensitive to the lyzing action of T lymphocytes than the cells of the initial subline.


[Characteristics of the mitogenic activity of different staphylococcal strains]. The mitogens of human peripheral lymphocytes were detected in the metabolic products of 59 out of 71 S. aureus strains. The preparations of S. epidermidis were inactive. When stimulated with filtrates of various S. aureus strains, 72-hour lymphocyte cultures were found to have 0--46% of blasts. Two-year observation of a strain showed its stable mitogenic characteristics. The mitogenic properties of the preparations did not correlate with their coagulase, alpha-toxic, dermonecrotoxic, cytotoxic, enterotoxigenic, neutrophil-stimulating activity and the quantitative content of A protein.


Molecular properties of cytochrome P-45011 beta from adrenal cortex mitochondria. Cytochrome P-45011 beta has been solubilized and partially purified from bovine adrenal cortex mitochondria using chromatography on Octyl-Sepharose CL-4B or DEAE-Sepharose CL-6B. The partially purified P-450 preparations were about 90% pure as judged by SDS-polyacrylamide gel electrophoresis. In the presence of purified preparations of adrenodoxin reductase and adrenodoxin, the partially purified P-450 preparations catalyzed NADPH-supported 11 beta-hydroxylation of unconjugated and sulphoconjugated deoxycorticosterone. In presence of Triton X-100 the partially purified cytochrome P-45011 beta had a Stoke's radius of 4.5 nm, a sedimentation coefficient of 3.1 S and a partial specific volume of about 0.85 cm3/g. These results indicate that the cytochrome P-45011 beta-Triton X-100 complex has a molecular weight of about 100 000 and that P-45011 beta bound about 1.1 g of Triton X-100 per g of protein. The P-45011 beta-Triton X-100 complex was catalytically active in hydroxylation reactions supported by NADPH or the hydroxylating agent ortho-nitroiodosobenzene, suggesting that the monomer of cytochrome P-45011 beta is an active form of the protein.


[Distribution of myelinated fibers in the outer plexiform layer of the optic tectum in the frog, Rana temporaria]. Distribution of myelinated nervous fibers in the layer 9 of the optic tectum of the frog Rana temporaria has been investigated in normal animals as well as 6--9, 60 and 134 days after contralateral enucleation. Counts were made on long and oriented sections at the screen of electron microscope. Fields of myelinated fibers in the layer 9, visible under light microscopic, are not distinguished by higher density of these fibers and differ from the other parts of sections probably due to some qualitative differences, especially because of parallel orientation of these fibers within a field. In rostral part of the tectum, myelinated fiber density in the most superficial zone of the layer 9 (0--50 millimicrons from the outer surface) is higher as compared with central and caudal parts. After degeneration of myelinated optic fibers, there are many unchanged fibers of this type in the layer 9.


[Microtopography of cerebellopontine angle structures in acoustic neuroma]. The structures of the cerebellopontine angle in neurinoma of the auditory nerve were studied in autopsy material and during surgical intervention with the use of an operative microscope. Principally different variants of the relationships between the cerebellopontine angle structures and the neurinoma capsule in intra- and extracisternal localization of the tumor were revealed. The greatest difficulties occur in exposure of the capsule of an intracisternal neurinoma which is tightly connected with the structures of the cerebellopontine angle by means of strong connective-tissue trabeculae. In extracisternal localization of the tumor its capsule is easily separated from the arachnoid, which is pushed to the brain stem, because there are no trabeculae between these structures. The main source of blood supply to the tumor irrespective of its localization is the anterior inferior cerebellar artery.


Influence of the electrical activity of muscle upon the excitability of neighbouring nerve. Starting from studies concerned with the electrical interaction between adjacent nerve fibres, experiments were carried out to investigate the different subthreshold effects of the electrical activity of muscle upon the neighbouring nerve. The results obtained on frog's sciatic-gastrocnemius preparations show that electrical muscle activity has an influence upon the excitability of the nerve in contact with the muscle. The results support the assumption that electrical muscle activity could play an additional role in the regulatory mechanism of the excitatory processes in nerve and muscle functions.


Study of force development in resting and activated muscles during velocity dependent stretching. The time course in force development of gastrocnemius muscles isolated from frog (Rama esculenta) were investigated under the effect of stretching with different velocity and time characteristics. Time course of stretching were linear, parabolic and exponential. It was found that the changes in force development of both resting and activated muscles depend on the time characteristics of the stretching applied. Corresponding to data in literature, the length-tension curve of resting muscle in dynamic stretching differs from the length-tension curve measured in static circumstances, but the shape of the length-tension curve is not essentially affected by the change of the average rate of stretching with a duration of 0.1-0.4 s and constant size (0.2-0.25 lo, lo is the reference length). The results can be interpreted with the aid of a muscle model as well. In the case of a contracted muscle, if the stretching and the stimulation of the muscle begin at the same time, the active force development reaches its maximum approximately at about half-length of maximum stretch.


Psychiatric disorder in Canberra. A standardised study of prevalence. A standardised survey of prevalence has been carried out in a general population. The epidemiological method employed is innovative in its use of two established instruments, the GHQ and the PSE, harnessed together in a two-phase design. 756 persons were interviewed, giving a response rate of 85% in phase 1. 157 were then interviewed with the PSE in phase 2 within a few days, giving a response rate of 92% in this weighted subsample. The point prevalence of non-psychotic morbidity, based on the distribution of GHQ scores, is higher than elsewhere in Australia, the excess being in Canberra males. The PSE data weighted back to represent the total population, show a distribution of morbidity in women which is remarkably similar to that in the very different population of Camberwell. The overall point prevalence of threshold and definite cases is 9.0% +/- 3.2. Case rates did not vary significantly with age or sex, but were higher in the separated, the single and the widowed. This study represents an advance in the reliable and economical detection of psychiatric morbidity at specified levels of severity in general populations.


Acquired hydrocephalus VI. The influence of some competitive diseases in the treatment of acquired hydrocephalus. Based on the results of quantitative isotope ventriculography (QIV) a group of 25 patients was divided into 17 hydrocephalic and 8 non- or doubtfully hydrocephalic patients. An atrio-ventricular shunt (A-V shunt) was inserted in all 25 patients. Eight of the hydrocephalic patients improved or became well, while nine hydrocephalic patients were unchanged, worse or dead at the time of follow-up. These nine patients suffered either from severe brain damage, chronic alcoholism over several years, arterial hypertension, severe diabetes, or acute meningo-encephalitis caused by a virus infection. None of the eight non- or doubtfully hydrocephalic patients improved after the operation. From this it was concluded that QIV is of considerable diagnostic value in acquired hydrocephalus.


Percutaneous epidural neurostimulation in modulation of paraplegic spasticity. Six case reports. Six cases of paraplegic, post-traumatic spasticity, alleviated by percutaneous epidural neurostimulation with temporary or permanent implanted neuroelectrodes from the L1 to L4 intervertebral levels are presented. Modulation of this spasticity and secondary beneficial physiological effects were achieved, including regulation of bowel regimens, production of sweating and piloerection below the level of the lesion, and morning erections. The main advantages of percutaneous epidural neurostimulation in modulating spasticity are the avoidance of destructive neurosurgical procedures, the regulation of secondary physiological and autonomic responses, the avoidance of antispasticity medications, and the reversibility of the neurostimulation procedure.


Immunobiology of paediatric intracranial tumours. A preliminary report. Preliminary findings in the evaluation of the immune response of children with primary neoplasms of the CNS, mainly medulloblastomas, are reported and discussed. A broad scheme for the monitoring of B- and T-cell-dependent immunity and of delayed hypersensitivity reactions in this type of patient is presented. The most important immunobiological findings are discussed. Special attention is given to the striking failure of the T-cell-dependent pool (currently identified by "active" RFC and blastigenesis tests) and to the remarkable decrease of hypersensitivity reactions (depressed skin-test response), both of which seem to be related to the degree of malignancy of the tumour. A very peculiar feature, i.e., the appearance of cells with natural cytotoxic activity, is dealt with in some detail. Our present knowledge concerning the immunobiology of primary CNS neoplasms is still very incomplete, but seems to suggest a possible role for immunotherapy in paediatric neurosurgery.


The biology of choroid plexus papilloma in infancy and childhood. Choroid plexus papillomas account for only up to five per cent of the intracranial tumours occurring in childhood, the published cases representing only a minority of the scattered clinical experience. A review of 265 published cases, including seventeen personal examples, showed that the majority of the childhood tumours are in the lateral ventricles and behave clinically like cases of infancy-onset hydrocephalus, but are often somewhat bizarre and frequently show identifiable features due largely to the tumour being physiologically active. The fourth ventricular tumours behave clinically like most other posterior fossa tumours. Almost all of the tumours are benign; only a few are histologically or clinically malignant, and seeding only occurs in occasional cases. If the tumours are recognized for what they are and special precautions are taken to compensate for their physiological behaviour and abolish for the frequently accompanying basal cistern block, choroid plexus papillomas could be one of the most rewarding childhood tumours to treat surgically.


Comparison of encephalotomograms and computerized tomograms in midline tumours in infants. Even after the introduction of the computerized tomogram, midline tumours in infants may give diagnostic problems. In the present study 41 children with tumours in the midline were investigated by both computerized tomography and encephalotomography. The results could be divided into two groups, according to the method and according to the localization of the space-occupying lesion. The diagnostic procedure may be restricted to computerized tomography in cases with direct signs (density differences, contrast enhancement). In cases showing indirect signs on the computerized tomogram (dislocation of ventricles or cisterns or both), further investigation would appear to be valuable. Encephalotomography is the method of choice in patients with negative or uncertain CT findings and contradictory clinical symptomatology.


Effect of intraperitoneal aprotinin treatment in acute and chronic peritonitis. Our results demonstrate that peritoneal absorption even of large amounts of fluid is not restricted in either acute or chronic peritonitis. According to investigations reported elsewhere, antibiotics administered intraperitonealy can be found quantitatively in the serum, if peritoneal absorption is not impaired. The retardation effect of proteinase inhibitor TRASYLOL on peritoneal absorption in peritonitis may indicate that proteolytic processes are necessary to break up the protein binding of antibiotics which only then are able to permeate the peritoneal wall. This may also pertain to other substances of pharmacologic activity, like toxins -lipoproteins, lipopolysaccharides- and medicaments. With respect to the clinical relevance of this effect it should be regarded as beneficial. Alternatively, the role of kallikrein/kinin-system for transmembranous absorption of proteins and protein split products has to be considered.


Tests to localize free proteolytic enzymes in vivo by 14C-cysteine-aprotinin. Aprotinin, a polyvalent protease inhibitor from bovine organs, has been labelled with 14C-cysteine in 6 M urea to produce a radioactive conjugate, without effect on the inhibitor activity. 138x10(3) dpm of radioactive product, containing 5 mg of protein (20.000 kal. inhibitor units) in 5 ml of Locke's solution were perfused in anesthetized rabbits via ascending aorta. Then the anesthetized rabbit was killed and specimens of some organs were admitted to autoradiographic analysis. Small intestine, ischiatic nerve and testis have been the most rich radiolabelled organs (+++). In kidney, stomach, large intestine, liver and eye the radiolabelled aprotinin was found in fair amounts (++); while in pancreas, spleen, spinal cord, brain, cava vein and aorta of rabbit the 14C-cysteine-Aprotinin was practically undetectable by autoradiography.


Vitamin E-induced chronic inflammation in rats. Sub-plantar injection of vitamin E (VE) oil produces a highly localized, chronic inflammation which is sustained for at least 8 weeks. As a result of studies using mediator inhibitors and depletors, it appears that histamine, serotonin, kinins, and prostaglandins may be involved in at least the early response to VE. This early phase is dominated by a massive influx of neutrophils, with the reaction rapidly progressing to a sustained mononuclear cell pathology. Results of studies in leucopenic rats suggest that edema formation and accumulation of white cells may be dissociable, although at this time it is not possible to conclude that edema can occur in the absence of cells since profoundly leucopenic rats are still able to locally mobilize polymorphonuclear cells in response to VE. Vitamin E-induced inflammation, produced under the conditions described, can be effectively suppressed by corticosteroids but seems relatively insensitive to the action of most non-steroidal anti-inflammatory agents tested.


Rapid assay for von Willebrand factor activity using formalin-fixed platelets and microtitration technic. An inexpensive assay for von Willebrand factor using microtitration plates, formalin-fixed platelets, and ristocetin is described. With this technic, the assay for von Willebrand factor is simple enough to be considered for use in any diagnostic laboratory for patients with prolonged bleeding times.


Failure of endoscopy to establish a source for upper gastrointestinal bleeding. In a series of 500 patients undergoing emergency endoscopic examination to detect the source(s) for upper gastrointestinal bleeding, the examination failed in its purpose in 55 cases (11%). This group was analyzed. Thiry-seven of these individuals demonstrated large and extensive esophagogastric varices which, while not observed to bleed during the examination, represented a potential bleeding source of great significance. The clinical implication of this endoscopic finding is described. Variceal bleeding frequently recurs sporadically, ceases abruptly and leaves no visible evidence of the point of rupture. Lacking this latter factor, the endoscopist is usually reluctant to assign responsibility for bleeding to these lesions. When, however, large varices are discovered as the sole potential source for bleeding, they may be assumed, with good reason, to represent the actual source and specific treatment logically may be instituted.


Fever in systemic lupus erythematosus.

Fever in systemic lupus erythematosus. The frequency, causes, clinical and laboratory features, and outcome of febrile episodes in 160 hospitalized patients with systemic lupus erythematosus were reviewed. Eighty-three febrile episodes were identified in 63 patients and were ascribed to active lupus erythematosus alone (60 per cent), infections (23 per cent) and miscellaneous causes (17 per cent). Bacteremia was present in nine of the 19 infectious episodes and resulted in a fatal outcome in a third of the patients. Leukocytosis, neutrophilia, shaking chills and normal levels of anti-DNA antibodies were associated with infection in febrile patients with lupus erythematosus.


Chronic mucocutaneous candidiasis. Immunologic studies of three generations of a single family. A family consisting of eight members in three generations (age 10 months to 53 years) affected with chronic mucocutaneous candidiasis was studied along with three unaffected relatives. Dermatophytosis, loss of teeth and recurrent viral infections were present in some members. Results of tests for endocrinologic, muscle or liver disease, thymoma, iron deficiency, antitissue antibodies and malabsorption were normal in all patients. Antibody function and levels, B cell counts, serum complement, leukocyte enzymes, chemotaxis, phagocytosis and adherence were normal in all members. Plasma inhibitors to lymphocyte transformation and leukocyte inhibitory factor were not found. No unique HLA haplotype or antigen segregated in this family. Evaluation of cell-mediated immunity revealed total cutaneous anergy in three of eight whereas four of the other five had negative lymphocyte transformation and skin tests to Candida but responded normally to other antigens. Leukocyte inhibitory factor was not produced to Candida antigen in all four patients tested. T cell counts were within normal limits in all. Extensive evaluation of all limbs of the immune system in this family revealed a defect in cell-mediated immunity to Candida that appeared to be inherited as a dominant characteristic.


A visual profile of the alcoholic driver. Some visual characteristics of the chronic alcoholic were investigated in a sample of 100 male alcoholic patients and 100 matched controls. The purpose of the retrospective study was to determine whether these characteristics may contribute to an increased motor vehicle accident rate among alcoholics. Significant differences between the two groups, which might affect driving abilities, were found for color vision deficiencies and the breakage and loss rate of spectacles. No significant differences were found for stereopsis deficiencies, limitation of visual field, distance phorias, ductions, or the need to wear spectacles for driving. An analysis of the refractive data suggests that alcoholic patients may be slightly more hyperopic and less astigmatic than others; however, these differences are not sufficient to influence driving ability.


[Noncontact detection of intraocular lesions by means of a gamma scintillation camera]. A gamma scintillation camera is used for noncontact detection of intraocular mass lesions. A double aperture pinhole collimator was designed for this special application. The collimator projects a magnified image of the radioactivity present in each eye onto the detector crystal of the camera. Details of the collimator design are described. The image-making properties of a double aperture pinhole collimator for ocular scintigraphy in regard to resolution and response were studied and demonstrated by phantom experiments. So far we have studied 50 cases with this new nuclear medicine procedure, using mainly technetium-pertechnetate as the radioindicator. Case histories and records of some typical results are presented. Better designed radiopharmaceuticals with appropriate tumor-seeking properties should be developed. Labeled melanin precursors are promising for detection of these lesions.


Vitreous seeds in retinoblastoma, clinical significance and ultrastructure. Vitreous seeds in retinoblastoma were studied clinically and pathologically. Vitreous seeds were found in 36.6% of retinoblastoma eyes. When tumors involved more than three quadrants of the retina and vitreous seeds were present, the prognosis was poor. When the tumor involved less than one-quarter of the retina, vitreous seeds were rare. Vitreous seeds were found most frequently in cases of undifferentiated tumor cells and endophytum type of proliferation. Although most vitreous seeds were necrotic tumor cells, some were almost intact tumor cells which were apt to be situated along blood vessels. The blood vessels in vitreous seeds had no pericytes and were derived from the tumor itself. Thus it is possible that tumor cells in the vitreous body can migrate to the anterior segment of the eye. Some tumor cells in vitreous seeds had much cytoplasm which contained mitochondria, ribosomes, fibrils, centrioles, and cilia with a presumed photoreceptor outer segment and intercellular junctions. These cytoplasmic features are very similar to those of neuroepithelial-type retinoblastoma cells. Undifferentiated cells were necrotic. Calcium deposition was found mainly in the necrotic cytoplasm of the tumor cells and occasionally on the chromatin granules of the nucleus. This may provide evidence that calcium can be bound to DNA to form radiopaque masses. No calcium-producing cells were found. Vitreous seeds contain a small number of almost intact tumor cells which are neuroepithelial in type, but most cells are necrotic. Although tumor cells may migrate to the anterior segment of the eye along or through blood vessels, the presence of vitreous seeds in itself is not always a bad prognostic sign. The prognosis is probably more closely related to the extent of the invasion of a tumor associated with vitreous seeds.


Infantile glaucoma in unilateral uveal ectropion. Two case reports are presented where a unilateral uveal ectropion was associated with congenital and late infantile glaucoma. Ipsilateral to the anterior segment anomaly a dysgenetic angle was found to be the basis of the glaucomatous process. The clinical implication that when such an iris malformation is found in a young child the possibility of glaucoma must be considered is discussed in detail.


[Experimental microscopy and photography of the bulbar conjunctiva capillaries]. The authors worked out a new method of in vivo observation and microphotography of the rabbit bulbar conjunctiva capillaries in this experiment. A Soviet-made luminescent contact microscope LUMAM K-1 (LOMO) was employed. In general, maximal magnification of this microscope for visual observation equals more than 600. The photographs for this experiment were made with magnifications of 150 and 200. A 10% sodium fluorescein solution was injected in the ear vein before the experiment (0.2 ml/kg of the body weight). The 500-unit, sensitive film was used for the photographs. Microvessel diameter was measured on the film with the help of a stereocamparator. As the data obtained demonstrate, conjunctival capillary diameter varied from 3 to 9 mcm, averaging 8 mcm. This method of contact biomicroscopy permits to the performance of capillarography and capillaroscopy of bulbar conjunctiva along with quantitative evaluation of capillary parameters and some reological indicators.


[Morphological changes in ciliary ganglions of healthy subjects and glaucoma patients]. The authors studied morphological changes in eleven ciliary ganglions. Seven ganglions were obtained from four corpses of patients with primary glaucoma in different stages, and four control ganglions were obtained from corpses of healthy people. The ciliary ganglion neurons of healthy subjects demonstrated age-related changes revealing nucleus shift toward the periphery, atypical hairy Kahal neurons, nerve fiber irritation phenomena, and other effects. The stage-dependent changes observed included: devastation areas, reactive proliteration around prolapsed neurons, nerve fiber degeneration, and hemorrhages. Maturing glaucomatous nerve cells and fiber degeneration also grew in proportion. In absolute glaucoma, ganglion cells were not present in ganglions. The authors believe that the existence of age-dependent structural changes in ciliary ganglia shows that ciliary ganglia are responsible for neurotropic innervation of eye membranes and participate in the glaucomatous process.


Rapid detection of changes in the optic disc: stereochronoscopy. III. Retinal venous pulse as an interfering factor. In the evaluation of stereochronoscopic pairs of fundus pictures (Sc) venous pulse is an interfering factor. Visual observation and photography show that when a magnification of 15x is used, as in our case, venous pulse is seen only at the emerging part of the big veins and in their immediate neighborhood, whereas veins of 100 microns diameter or less show no pulsation. Over relatively short time intervals (some minutes) the temporal course of venous pulse in terms of vessel width is a more or less periodic phenomenon; for longer periods (months) a study is underway. In the majority of cases the filling state of pulsating veins seems to reach a minimum shortly after the R peak of the ECG. An investigation as to whether the interference of venous pulse can be reduced by coupling the camera flash to the R peak has been begun. However, for the time being, it appears that the best method is to pass over the pulsating vessel parts, and to observe Sc effects only in the small vessels, when Sc evaluation is applied. Statistics show that venous pulse is significantly more frequent in suspected and early glaucoma subjects (T greater than 21 mm appl.) than in healthy subjects. We feel that with the methods proposed all conditions pertaining to an extensive follow-up of ocular hypertension and early glaucoma cases are now established.


Mechanical behaviour of cerclage material consisting of silicon rubber. Silicon rubber specimens of circular or rectangular cross-section (cross-section area between ca. 2 and 7 mm2) are used as cerclage bands. A series of commercial cerclage elements was investigated for mechanical characteristics, such as stress-strain behaviour and modulus of elasticity, using a tensile-testing machine. Large differences in these properties exist among the various specimens. Moreover, time-dependent effects, such as stress-relaxation, retardation, and creep, were analysed by the present investigations. One has to take into consideration that the initial length and stress of the cerclage band vary significantly with time after the operation.


Scanning electron microscopy of the vitreous body. Massive vitreous retraction after perforating injury. Scanning electron microscopy of vitrectomy material shows a disintegrated vitreous fibril network which is partly replaced by newly formed collagen fibers and invaded cells.


[Experimental investigations of the aqueous humor and blood serum of rabbits following injection of tobramycin]. In animal experiments the concentration of the antibiotic Tobramycin in the aqueous humor and blood serum following intramuscular and subconjunctival injections was tested by diffusion on agar plates. After intramuscular injections, only traces of Tobramycin were found in the aqueous humor, but a significantly higher concentration of the antibiotic was obtained by subconjunctival injections. The subconjunctival application of the antibiotic was well tolerated.


B-lymphocyte differentiation, using pokeweed mitogen stimulation: in vitro studies in leukemic and normal cattle. B-lymphocytes from 7 normal cattle and from 3 persistent lymphocytotic, 6 lymphosarcomatosus, and 3 bovine leukemia virus-infected animals with diverse defects in humoral immunity were examined for their capacity to undergo terminal differentiation in vitro. Pokeweek mitogen-stimulated cells from normal and leukemic cattle were stimulated to synthesize and secrete immunoglobulins, and these were detected by radial immunodiffusion. Lymphocytes from normal cattle synthesized more IgM than those from persistent lymphocytotic-, lymphosarcomatous-, and bovine leukemia virus-infected cattle. Leukemic cattle have a higher percentage of cells containing intracytoplasmic immunoglobulins; most cells are believed to contain IgG. The serum IgM in normal cattle is significantly (P less than 0.05) higher than that in leukemic cattle. The results indicate that there is an abnormality either in synthesis or secretion of IgM or in abnormal catabolism of Ig from leukemic B-lymphocytes.


Alpha 1-antitrypsin deficiency and increased susceptibility to elastase-induced experimental emphysema in a rat model. Administration of 200 mg of D-galactosamine/kg intraperitoneally to rats produced a decrease in the serum concentrations of trypsin and elastase inhibitory capacities. Induction of emphysema by intravenous injection of pancreatic elastase resulted in significantly increased severity of the disease in the animals depleted of alpha 1-antitrypsin. The degree of severity of the disease determined by mean linear intercept suggested a correlation with trypsin and elastase inhibitory capacities at the time of elastase injection.


Antimicrobial resistance of Haemophilus species in patients with chronic bronchitis. Haemophilus influenzae strains resistant to ampicillin have become an important cause of disease in pediatric patients. Because many adults with chronic bronchitis carry Haemophilus organisms in their tracheobronchial tree and because antimicrobial agents are used commonly in these patients, we assessed the prevalence of resistance to ampicillin and other antimicrobial agents in this population. We studied 150 Haemophilus isolates (73 H. influenzae, 69 H. parainfluenzae, 6 H. parahemolyticus, and 2 H. hemolyticus) obtained from 138 patients with chronic bronchitis from January 1978 through March 1979. Ampicillin resistance due to production of beta-lactamase was found in 7 of the 150 isolates (4.7 %)-2 H. influenzae, 4 H. parainfluenzae and 1 H. parahemolyticus. Resistance to tetracycline was found in 9 strains (6 %), but all strains were susceptible to chloramphenicol.


Effect of transverse temporal bone fracture on the fluid compartment of the inner ear. Five temporal bones exhibiting transverse fractures were studied with a view to determining whether such fractures could lead to symptomatic endolymphatic hydrops. Four out of the five temporal bones showed the fracture line traversing the vestibular aqueduct. Two of these four showed complete obstruction of the endolymphatic duct. One of these had an intact membranous labyrinth and severe endolymphatic hydrops. The other had ruptures of the membranous labyrinth and no hydrops. Three ears exhibited partial preservation of auditory and vestibular hair cells and neurons. These findings are consistent with the concept that a transverse fracture may produce endolymphatic hydrops by obstructing the vestibular aqueduct while preserving enough audiovestibular epithelium and neurons to present as symptomatic Menière's disease.


Mesencephalic chronic electrodes in pain patients. An electrophysiological study. Early components of lemniscal potentials after contralateral median nerve or mechanical stimulus are due to lemniscal pathways, whereas later components, after 70 msec appearing bilaterally and at higher stimulus intensities probably express extralemniscal activity. Evoked potentials in the central gray matter show much smaller amplitudes compared with somatosensory cortical evoked potentials (SSEP). The strongest component is a negative wave after 70--100 msec. Longer conditioning stimulation of the lemniscal system inhibits late components in the median nerve evoked cortical potentials. On the contrary, stimulation of the nonspecific periaqueductal gray matter produces inhibition of early components of cortical SSEP together with facilitation of late components.


Mechanism of synergistic action of a combination of ampicillin and dicloxacillin against a beta-lactamase-producing strain of Citrobacter freundii. The mechanism of synergistic activity of a combination of ampicillin and dicloxacillin was studied on beta-lactamase-producing Citrobacter freundii GN346 and its derived beta-lactamaseless mutant GN346/16. The synergistic activity was exhibited against the parent strain but not against the mutant strain. Precultivation of the parent strain with the combination reduced the amount of the subsequent binding of [14C]penicillin G to the membrane fraction from the treated cells, but no reduction was observed in the case of cells treated with ampicillin or dicloxacillin alone. On the other hand, the amount of binding of [14C]penicillin G to the membrane fraction from the mutant strain was reduced by ampicillin treatment alone. These results clearly indicated that dicloxacillin inhibited the beta-lactamase activity produced by the parent strain, and, consequently, ampicillin can penetrate through the outer membrane and periplasmic beta-lactamase barrier into its target sites on the cytoplasmic membrane.


Effect of inoculum size on the susceptibility of Haemophilus influenzae b to beta-lactam antibiotics. The current prevalence of ampicillin-resistant Haemophilus influenzae b meningitis requires accurate knowledge of susceptibility to alternative antibiotics. One variable affecting susceptibility is inoculum size. We studied the susceptibility of 200 clinical isolates of H. influenzae b to ampicillin, carbenicillin, and cefamandole at inocula of 10(5) and 10(7) CFU by two techniques. Fifty ampicillin-susceptible and fifty ampicillin-resistant strains were tested for susceptibility to ampicillin by broth dilution while 100 of each were tested by agar dilution. An inoculum effect was found, being greatest with the ampicillin-resistant strains. The range of minimal inhibitory concentrations for the resistant strains was 25 to 800 microgram of ampicillin per ml at an inoculum of 10(5) and 2,000 to less than 6,000 microgram of ampicillin at 10(7); 1.0 to 150 microgram of carbenicillin per ml at 10(5) and 6.2 to 2,000 microgram of carbenicillin per ml at 10(7); 0.4 to 2.0 microgram of cefamandole at 10(5) and 1.0 to 125 microgram/ml at 10(7). Because of this inoculum effect, we would not recommend the use of carbenicillin or cefamandole for therapy of ampicillin-resistant H. influenzae meningitis.


Radioimmunoassay of serum SP 1 and HPL in normal and abnormal pregnancies. Serum concentrations of the pregnancy-specific beta 1-glycoprotein (SP 1) and human placental lactogen (HPL) were measured by radioimmunoassay in 372 blood samples obtained from 40 women in the second half of a normal singleton pregnancy. The mean level of SP 1 steadily increased from 40 micrograms/ml in the 22nd week of pregnancy to 168 micrograms/ml in the 36th week of gestation and thereafter reached a plateau. The half-life of SP 1 during the first week after delivery was about 39 h. The clinical value of SP 1 in comparison to HPL estimations was assessed in a prospective study of a few high risk pregnancies. There were no significant differences between serum SP 1 and HPL levels in pregnancies complicated by preeclampsia with or without intrauterine growth retardation and in twin pregnancies. Serum HPL and SP 1 levels were equally effective in predicting placental insufficiency with fetal growth retardation.


Surgery in von Willebrand's disease.

Surgery in von Willebrand's disease. Fifty-eight major surgical procedures were performed in 38 patients with von Willebrand's disease (VWD), one of the most common of the inheritable hemorrhagic disorders. Specific treatment with fraction I-0, (AHF-Kabi) in addition to a fibrinolytic inhibitor, was given to all patients. The effect of the treatment was checked by measuring the Duke bleeding time and factor VIII:C level. A marked difference between hemophilia and VWD from a surgical point of view is demonstrated. While most of the surgery in hemophiliacs is performed for severe joint deformities, contractures and blood cysts, surgery in VWD is mostly general surgery, often necessitated by massive hemorrhages from mucous membranes.


The importance of myocardial protection in combined aortic valve replacement and myocardial revascularization. To determine the importance of different methods of myocardial protection for combined aortic valve replacement and coronary revascularization, we analyzed the records of 82 consecutive patients who underwent the combined procedure between 1973 and 1978. Sixty-three (77%) had angina and 63 (77%) were in New York Heart Association Functional Class III or IV. Moderate to severe left ventricular impairment was present in 59%, and the mean number of diseased vessels was 1.9 per patient. Group I consisted of 18 patients with intermittent ischemia, almost all of whom had operation between 1973 and 1976. Group IIa consisted of 24 patients operated on between 1973 and December, 1976, with coronary perfusion, and Group IIb had 18 patients in whom a similar technique was used in 1977 and 1978. Group III consisted of 22 patients operated on in 1977 and 1978 in whom cold chemical cardioplegia was used. The early mortality (less than 30 days) for Group I was 50% and for Group IIa 29%. There were no deaths in Group IIb and Group III. The incidence of perioperative myocardial infarction was 21% in Group I, 6% in Group IIa, 11% in Group IIb, and zero in Group III. The incidence of cardiogenic shock requiring prolonged inotropic support and intraaortic balloon counterpulsation was significantly less in Group III (9%) than in Group IIb (50%) (p less than 0.05). If other manifestations of myocardial injury, such as perioperative infarction and cardiogenic shock requiring intraaortic balloon counterpulsation or inotropic support, are taken into consideration, cold chemical cardioplegia appears to provide better myocardial protection than coronary perfusion of the fibrillating heart.


Radionuclide assessment of aortocoronary bypass surgery. Rest and exercise thallium 201 myocardial scintigraphy and multiple gated radionuclide angiography were correlated with the results of clinical status, exercise electrocardiography, coronary arteriography, and contrast left ventriculography in a series of 12 prospectively studied consecutive patients before and after aortocoronary bypass operation. Patients were divided into two groups based on a comparison between preoperative and postoperative 201T1 scintigrams. Group 1 (6 patients) demonstrated improved or normal postoperative perfusion scintigrams and excellent correlation between the site of a patent graft and the improvement in myocardial perfusion on the postoperative exercise scintigrams. Regional wall motion remained normal in 3 patients and improved in 3. In Group 2 (6 patients) the postoperative 201T1 scintigrams were unchanged or worse. Each patient demonstrated graft occlusion, graft stenosis, distal disease, or a perioperative myocardial infarction. No improvement in regional wall motion occurred in 4 of these 6 patients. Neither the symptomatic response to aortocoronary bypass operation nor the response to exercise testing successfully predicted graft patency.


Future needs for psychiatrists and other mental health personnel. Approximately 15% of the population suffers a diagnosable mental disorder, and with the increasing availability of community-based mental health services, growing demand is placed on the mental health specialty sector. Though the general health sector and nonmedical mental health specialists provide services to a large proportion of this case load, psychiatrists possess unique skills for the diagnosis and treatment of mental disorder and for the provision of consultation and liaison services to nonpsychiatric physicians. In spite of the need, a number of factors, including restrictions on foreign medical graduates and federal emphasis on the primary care specialties, have created an accelerating reduction in the production of psychiatrists. The federal government and medical schools are encouraged to devise strategies collaboratively to address issues to ensure an adequate supply of psychiatrists for the future.


Color blindness not closely linked to bipolar illness. Report of a new pedigree series. A new pedigree series of bipolar manic-depressive patients admitted to the National Institute of Mental Health intramural research program was evaluated for linkage between bipolar illness and red-green color blindness, since previous studies had indicated that close linkage was generally present. Using family study methods, six informative pedigrees were investigated. Analysis was performed using a multigenerational procedure and taking into account variable penetrance. Close linkage could be definitively ruled out as a general finding. Bipolar and related illnesses are thus not generally transmitted by a single major gene close to the protan/deutan region of the human X-chromosome.


Color blindness linkage to bipolar manic-depressive illness. New evidence. Linkage between protanopia and deuteranopia and bipolar manic-depressive illness is demonstrated in a sample of eight informative families ascertained in Brussels. Genetic heterogeneity of bipolar affective disorders is also shown in the present study. These results add new evidence to the hypothesis of X-linked dominant genetic transmission of affective liability in a subgroup of patients with bipolar affective disorders.


Canine hemorrhagic enteritis: detection of viral particles by electron microscopy. At necropsy, several dogs which died showing symptoms of hemorrhagic diarrhea, had significant lesions of the mucosa that were found especially in the duodenum and upper part of the small bowel. Study of ultrathin sections from the diseased mucosa revealed particles resembling parvoviruses in altered nuclei of cells of the intestinal crypts. Electron microscopic examination of intestinal contents by negative staining has shown the presence of many viral particles which have a diameter of 24 nm and whose profile is consistent with an icosahedral shape. These virions float at a density of 1.43 g/cm3 in cesium chloride and agglutinate rhesus monkey and swine red blood cells at 4 degrees C. A possible etiological role is discussed. This virus is compared with the minute virus of canines and the Feline Panleukopenia virus.


[Immunological changes in diabetes mellitus. Study of lymphocyte populations]. In view of some data of the literature suggesting that immunological changes could play a role in the pathogensis of diabetes mellitus and of its complications, we carried out a study of the lymphocyte populations of 44 diabetic subjects by means of E, EA, EAC rosettes and membrane immunofluorescence. A quarter of the patients had decreased E rosettes: all of these had long-lasting, insulin-dependent, poorly controlled diabetes. Some of these patients had also increased membrane IgG globulins. In 5 patients with recent onset, insulin-independent diabetes, E rosettes were increased. No significant changes of EA and EAC rosettes were observed. These findings suggest that changes of lymphocyte populations do not play any role in the pathogenesis of diabetes, while these may be the consequence of the metabolic disorder and these may favour the onset of complications  of the disease.


Lissamine green staining in the clinical diagnosis of xerophthalmia. Lissamine green staining of the conjunctiva, a new and widely heralded aid for diagnosing early xerophthalmia, was found to be a reasonably specific but inadequately sensitive test for practical use. While 82% of clinically normal children failed to show staining, so did 57% with night blindness, 29% with vitamin A responsive Bitot's spots, and, most significantly, 26% with severe, vitamin A related corneal involvement. The test also failed to distinguish vitamin A responsive "Bitot's spots" from nonresponsive ones.


[Immunity and neoplasms. Behavior of E rosette-forming lymphocytes in patients with malignant neoplasms]. The per cent and absolute figures of E rosette forming lymphocytes have been evaluated in the blood of normal subject and of patients with non-neoplastic diseases and with epithelial and lymphoreticular tumours. The percentage of rosetting lymphocytes was not affected by non-neoplastic diseases, whilst it was by tumours, especially by lymphoreticular ones. However differences were not statistically significant in view of the large dispersion of values. Absolute counts of rosetting lymphocytes displayed lesser variations. These findings are better explained by Schwartz's concept of immunoregulation than by Burnet's theory of immunosurveillance.


Ultrastructural development of the vestibular system under conditions of simulated weightlessness. Electronmicroscopy was used to track the development of the gravity system of frog embryos and larvae which have bred for 5, 7, and 10 d after egg fertilization under conditions of simulated weightlessness on the fast-running horizontal clinostat. Although no differences in the morphologic structure of the organ between test and control animals could be found up to 7 d of development, there is a significant accumulation of vacuoles in sensory epithelia of frog larvae develpoping for 10 d (stage 17) in simulated zero G.


[Analysis of cellular components in immunocompetent organs treated with ionizing radiations]. The nucleic acid and protein content has been evaluated in lymphoid cells from the thymus and the Bursa of Fabricius of chicks exposed to different doses of radiation. A different response to radiation damage of the two cell populations is suggested by these analysis when compared with ultrastructural data.


Thallium-201 imaging in assessment of aortocoronary artery bypass graft patency. Fifteen patients with significant coronary artery disease confirmed by cardiac catheterisation were studied before and after aortocoronary artery bypass graft surgery by rest and exercise 201Tl myocardial scintigraphy in an attempt to predict graft status non-invasively. Segmental myocardial perfusion comparisons in pre- and postoperative exercise images allowed correct predictions of high (greater than or equal to 67%) or low (less than or equal to 50%) graft patency rates in 10 of 15 patients, while similar comparisons in postoperative rest and exercise images yielded 13 of 15 correct predictions. Furthermore, 20 of 21 myocardial segments with increased postoperative perfusion when compared with corresponding  segments in preoperative exercise studies were supplied by patent grafts. Regional graft occlusion, however, was difficult to predict. It was also difficult to predict graft status when myocardial segments were shown to have unchanged perfusion postoperatively as compared with the preoperative segmental assessment. Despite these limitations, the non-invasive technique of 201Tl imaging can provide useful information regarding coronary artery bypass graft patency.


Haemodynamic effects of disopyramide in patients after open-heart surgery. Disopyramide phosphate was administered intravenously in a dose of 1.2 mg/kg body weight over one minute to nine patients after open-heart surgery and coronary artery bypass grafting. The haemodynamic changes were studied during and for 30 minutes after drug administration. Heart rate was unchanged throughout the study. During infusion the only significant changes were an increase in systemic blood pressure and systolic impedance signifying a direct increase in peripheral arterial resistance. Systemic blood pressure remained significantly higher for 10 minutes and systolic impedance for 30 minutes. Immediately after infusion max. dPower/dT, a measure of ventricular contractility, was significantly depressed for 15 minutes. Both cardiac output and aortic flow were significantly depressed for 30 minutes. DPTI/TTI, an estimate of subendocardial supply/demand ratio, showed an insignificant increase throughout the study. This study shows that intravenous disopyramide starts acting within 45 seconds of the start of infusion, directly increases peripheral arterial resistance, has a breif negative inotropic action, and does not reduce subendocardial blood flow.


Entrapment of proteins in phosphatidylcholine vesicles. The trapping efficiency of globular proteins in four different types of phosphatidylcholine vesicles was systematically studied. Vesicles were generated in a mixture of 125I-labeled proteins of various molecular weights. The trapped proteins were separated from untrapped proteins by gel filtration and ultrafiltration and subsequently analyzed by gel electrophoresis and autoradiography. Entrapment of proteins was demonstrated by their resistance to trypsin digestion. The relative amount of each entrapped protein species was then compared to that of the original protein solution. In multilamellar vesicles and large unilamellar vesicles, proteins of molecular weight up to 97 000 had the same trapping efficiency as sucrose. In small unilamellar vesicles generated by either sonication or ethanol injection, however, the relative trapping efficiency of protein decreased progressively as the molecular weight of the protein became greater. For example, the trapping efficiency of alpha-amylase (Mr 97 000) was only half of that for sucrose. The apparent decrease in trapping efficiency with the protein's molecular weight in small unilamellar vesicles canbe accounted for by the combination of the bound water layer at the vesicle's internal surface and the steric hindrance when protein is captured during vesicle formation.


Cell-specific antigens in chicken erythroid nuclei: species specificity. Antisera raised to dehistonized chicken reticulocyte chromatin were tested for their cell and species specificity. Quantitative microcomplement fixation and immunohistochemical localization revealed the presence in chromatin of erythroid cell-specific nonhistone protein antigen(s). The antigenic specificity was shown to depend on the association of the antigenic protein(s) with deoxyribonucleic acid (DNA). Although the antisera were exceptionally cell specific, they cross-reacted with erythroid cells of other avian species. The extent of cross-reactivity was found to approximate the phylogenetic distances of the tested avian species. Erythroid cells from fish and amphibians were not reactive. Reconstitution experiments of partially purified chicken reticulocyte chromosomal nonhistone protein antigens with DNAs isolated from several vertebrate species showed that the species specificity of the antigenic complexes is determined principally by the species origin of the nonhistone proteins. Our results show that a cell-specific chromosomal nonhistone protein(s) has undergone evolutionary change and the relative immunological differences are consistent with the accepted phylogenetic distances of the species examined.


Isolation and properties of bacterial luciferase-oxygenated flavin intermediate complexed with long-chain alcohols. Nonsubstrate long-chain aliphatic alcohols, carboxylic acids, and their methyl esters were found to complex reversibly with and stabilize an oxygenated flavin-luciferase intermediate, with alcohols being more effective in stabilizing the intermediate. Dissociation constants for the binding of alcohols to luciferase intermediate are in the order of K8 greater than K10 greater than K12 congruent to K14 where the subscripts represent the numbers of carbon atoms of various alcohols. Thermodynamic activation parameters for the decay of oxygenated flavin-luciferase intermediate complexed with alcohols or aldehydes were determined, and similarities were noted between alcohol and aldehyde complexes. Luciferase intermediate complexes formed with 1-decanol and 1-tetradecanol were isolated at 0 degrees C in neutral phosphate buffer, and both showed absorption properties characteristic of 4a-substituted dihydroflavins. The 1-tetradecanol-intermediate species contained one favin per luciferase molecule. Initially this complex was weakly fluorescent, but upon exposure to 370-nm light it was transformed to a highly fluorescent species. The latter shows a fluorescence excitation peak at 370 nm, and its fluorescence emission (lambda max 505 nm) and quantum yield (0.17) closely correspond to that of bioluminescence in vitro. Both the weakly and the highly fluorescent species exhibit full bioluminescence activities when reacted with decanal.


[Role of T- and B-lymphocytes in the heterogeneity of human cell-mediated reactions to bacterial antigens]. Leucocytes from 30 patients with allergy to tuberculin and bacterial antigens were treated with antithymus (ATS) and anti-immune globulin (AIGS) sera. The leucocyte migration inhibition test (LMIT) was performed with these antigens. ATS abolished the LMIT induced by tuberculin and sometimes by bacterial antigens (staphylococcal, streptococcal etc.). AIGS frequently abolished the LMIT induced by bacterial antigens, but not by tuberculin. In some cases the treatment with any serum abolished the LMIT induced by the antigens, or, on the contrary, it was abolished only by a successive treatment with both sera. The lymphocyte types (T or B) determining the secondary immune response to the same antigen are different in various patients, as well as they differ in the same patients in relation to diverse antigens. Five types of lymphocyte - antigen interrelation in the LMIT have been distinguished.


[Effect of nootropil and contvykal on the structural changes in the central nervous system in hypoxic brain edema]. The brain cortex of rabbits exposed to 15-minute ishemia in the presence of monitored hypotonia was studied in 27 experiments in order to verify the efficacy of nootropil and contrykal as agents intended for the treatment of posthypoxic edema of the brain. The therapeutic efficacy was assessed on the basis of the evidence obtained with the aid of light and electron microscopy. It was found that nootropil exerts a favourable action on the ultrastructure of intracellular organella of the neuron: mitochondria, lysosomes, ribosomal apparatus, nuclear envelope, etc. Under the effect of nootropil and contrykal the posthypoxic microcirculatory changes showed signs of compensation and proved reversible. Manifestations of posthypoxic edema of the brain were less pronounced. It is suggested that the efficacy of the treatment regimen offered is related to the normalizing effect of nootropil on metabolic and repair processes in neurons and cellular elements pertaining to the microcirculatory system as well as with a direct action of contrykal on the local factors of capillary permeability.


[Functional activity of T and B lymphocytes of mice undergoing spontaneous loss of tolerance]. The functional activity of splenocytes and thymocytes of mice tolerant to sheep red blood cells was investigated one and four weeks after tolerance induction. The tolerance was achieved by cyclophosphamide. The immunocompetence of thymocytes was fully reversed in  lfour week time. The functional activity of T and B lymphocytes of the spleen was also partially recovered four weeks after tolerance induction. Preliminary thymectomy weakened but did not prevent completely the immunocompetence of T cells of the spleen from being recovered. No Tsuppressants were found in the thymus or spleen of the tolerant animals.


[Electrophoretic separation of rat spleen and thymus leukocytes and their reactions to mitogens in vitro]. Electrophoretic mobility (EPM) of lymphocytes from the thymus and spleen of August and Wistar rats as well as capacity of lymphocytes with different surface hemagglutinin (PHA) and concanavalin A (Con A) were studied by the method of free flow electrophoresis. Lymphocytes of the rat spleen were shown, depending on the surface charge, to divide into two groups during cultivation: cells with high and low electrophoretic mobility. At separation the lymphocytes consisted of 8--10 fractions with different EPM. There was a relationship between the surface charge of the lymphocytes and their stimulation rate by mitogens. Increased thymidine-3H uptake was recorded at mitogenic exposure of lymphocytes from the spleen with high EPM. Low mobile lymphoid elements of the spleen did not respond to mitogenic stimulation. A subpopulation of thymocytes with low EPM was resistant to Con A stimulation. The thymocytes of rats did not virtually respond to PHA irrespective of EPM.


[Role of adhesive lymphoid cell subpopulation in areactivity to hepatoma 22a]. The role of adhesive fraction of T lymphocytes in nonreactivity of mice to hepatoma 22a was studied. It was shown that the removal of the adhesive fraction from the spleen suspension enriched with T lymphocytes promotes intensification of cell immunity in tumor-tolerant mice.


Antagonism of excitatory amino acid-induced responses and of synaptic excitation in the isolated spinal cord of the frog. 1. A range of compounds has been tested for excitatory amino acid agonist or antagonist activity and for effects on synaptic activity on isolated hemisected spinal cords of frogs. 2. L-Monoamino dicarboxylic acids of chain length up to 8 carbon atoms (L-alpha-aminosuberate) were all agonists. 3. Within a series of D-monoamino dicarboxylic acids, and with diamino dicarboxylic acids (mainly unresolved mixtures of diasteroisomers), there was a progression from agonist activity, for compounds of chain length equal to or shorter than glutamate, to antagonist activity, for compounds of longer chain length equal to or shorter than glutamate, to antagonist activity, for compounds of longer chain length, D-alpha-Aminosuberate (D alpha SD) was the most potent antagonist. 4. The antagonist actions of these substances showed a Mg2+--like selectivity with respect to depolarizations produced by different excitants. N-methyl-D-aspartate (NMDA) was the most susceptible agonist and quisqualate and kainate the least susceptible. Responses to other excitatory amino acids, including L-glutamate and L-aspartate, showed intermediate sensitivity to the antagonists. 5. A parallelism was observed between the relative potencies of mono- and diamino dicarboxylic acids as NMDA antagonists and their relative potencies as depressants of synaptic responses. 6. The results support the concept of different types of excitatory amino acid receptors, with NMDA and its antagonists acting predominantly on one type. These NMDA receptors are probably transmitter receptors activated by an excitatory amino acid transmitter.


A new variety of "empty sella" with cystic intrasellar dilatation of the recessus infundibuli. A new variety of the "empty sella" consisting of polycystic intrasellar dilatation of the infundibular recess is described. The underlying embryonal developmental anomaly of the pituitary gland and diaphragma sellae and the possible effect of increased intracranial pressure are discussed and the malformation is compared with embryonal stages of ventricular development.


Emergency treatment of variceal haemorrhage. For the initial control of haemorrhage from oesophageal varices, two methods of vasopressin administration have been compared--the conventional bolus of 20 units and a low dose infusion of 0.4 units per minute. Twenty patients bleeding from oesophageal varices, confirmed by endoscopy, were allocated into either treatment group (10 in each). Vasopressin infusion stopped bleeding in 86 per cent of the episodes in contrast to 12.5 per cent (P less than 0.01) with bolus doses. Balloon tamponade with a Sengstaken-Blakemore tube was used to control bleeding in only 2 episodes in patients on infusion and in 10 episodes in patients on bolus doses of vasopressin (P less than 0.05). Our study confirms that low dose vasopressin infusion in more effective in controlling bleeding from oesophageal varices than conventional bolus doses.


Return to work and quality of life after surgery for coronary artery disease. Changes in work capability and quality of life were assessed retrospectively in 130 patients with ischaemic heart disease who had undergone aortocoronary bypass operations during 1976-7 because of medically uncontrollable angina. A total of 85 patients (65.4%) reported complete relief from angina six months after operation, though 12 later suffered a recurrence. Substantially fewer patients needed drugs after the operation. Before operation 9 out of 117 men fully employed at the onset of angina were working without restriction or doing lighter, fulltime work, 38 were at work but seriously incapacitated by angina, and 70 were forced to stop work. After operation 70 were working without restriction or engaged in lighter work, 15 were at work but still restricted by angina, and only 32 were forced to stop work. This result was highly significant (P less than 0.001). These differences were even more pronounced in heavy manual workers, of whom none cobld work normally before operation, whereas 16 were working without restriction afterwards. Of patients wishing to engage in hobbies or sports, social activity, and sexual intercourse but were restricted before operation, about two-thirds could resume these activities afterwards. Coronary artery surgery provided dramatic symptomatic relief in up to 90% of patients and permitted rehabilitation and return to gainful employment irrespective of type of labour. The degree of symptomatic improvement and increase in exercise tolerance after successful surgery is usually far greater than occurs with any other form of treatment and directly improves quality of life and work capability.


Factors influencing in vitro production of colony-stimulating factor by mononuclear leukocytes from humans. The purpose of this study was to identify factors that influence the production of colony-stimulating factor by leukocytes of humans. The use of nonadherent light-density bone marrow cells is semisolid agar cultures to assay the concentrations of colony-stimulating factor in the supernatant of monocyte and mononuclear leukocyte cultures made it possible to distinguish between colony-stimulating factor, which stimulates colony-forming cells directly, and monocyte-dependent stimulating activity, which acts indirectly, by increasing the monocyte production of colony-stimulating factor. Colony-stimulating factor was not detectable in the cytosol of monocytes; that detected in culture must, therefore, have been newly synthesized. Synthesis was enhanced independently by heat-inactivated human serum and by semipurified serum fractions enriched with monocyte-dependent stimulating activity. The kinetics of the production of colony-stimulating factor in the presence and absence of monocyte-dependent stimulating activity indicated that the latter facilitated monocyte production of the former. Factors released from neutrophils were shown to reduce the production of colony-stimulating factor and thr proliferation of colony-forming cells and thus may provide a feedback control mechanism limiting the proliferation of neutrophils.


Noninvasive perfusion control by thallium-201 myocardial scintigraphy after coronary artery bypass surgery. Thallium-201 myocardial scintigraphy, which has been shown accurate in the assessment of myocardial perfusion, was employed in the evaluation of 34 patients after coronary artery bypass surgery. In 28 patients (82.4%), there was a clear correspondence in the postoperative studies between the defects shown on scintigraphy and the coronary artery stenosis documented by arteriography. Thallium imaging after coronary artery bypass revealed an increased or newly developed scintigraphic defect in eight of 10 patients with recurrent angina. Follow-up arteriography in these 10 patients revealed occlusion or stenosis of the bypass graft in five, perioperative myocardial infarction in two, and increased stenosis of a preoperatively less occluded artery in two. In 24 patients with postoperative clinical improvement or relief of angina, 201Tl scintigraphy revealed complete normalization of thallium uptake in three, improvement of uptake in 17, and unchanged uptake defects in four.