[Isolation of flagellin antigens of salmonellae by the method of ultracentrifugation and their use for preparation of erythrocytic H-diagnostic agents]. Flagellar preparations were obtained from 6 salmonellae strains by differential ultracentrifugation; they were characterized by morphological, immunochemical, and serological tests. The results of investigations showed that the preparations possessed high serological activity; somatic antigen admixture was insignificant. Flagellins extracted from the flagellae were used to prepare erythrocytic H-diagnostic agents. The results of their use in the examination of sera of healthy persons, and of those suffering from typhoid fever and salmonellosis indicated the expediency of using passive H-hemagglutination for diagnostic purposes.


[Neuramininase activity of the representatives of the genus Yersinia]. The authors demonstrated the presence of neuraminidase in Past. pestis. Optimal conditions for its formation and detection were chosen. Extracellular form of neuraminidase was revealed. An increase of cultivation temperature led to the elevation of the neuraminidase activity in Past. pestis cells. Neuraminidase was revealed in bacteria affiliated to Past. pestis (causative agents of pseudotuberculosis and Y. enterocolitica).


[Ultrastructural changes in plague microbes, strain EV, and splenic cells of guinea pigs in their interaction in vitro]. Dilatation of the endoplasmic reticulum cavities, an increase in the number of ribosomes near bacteria, deformation of mitochondria and coarsening of cristae were revealed in phagocytosis of Past. pestis, strain EV, by reticular cells in the tissue culture of the spleen of intact guinea pigs. Lipophanerous "reticular" inclusions were found in the differentiated reticular cells of the infected cultures. In the reticular cell cytoplasma besides the intact bacteria there were revealed Past. pestis at the initial stages of involution.


[Diagnostic value of individual tests for classification of Shigella]. A total of 1243 strains of enterobacteria were studied by four tests (mobility, lysis with dysentery polyvalent bacteriophage, relation to Christensen's citrate and salicin) for the purpose of determining shigellae genera. A combination of signs characteristic of Shigella genus was observed in 99.1% of laboratory and in 100% of freshly-isolated strains. No such combination was found in any other of the representatives of Enterobacteriaceae family. The tests under study are recommended for the work in practical laboratories to ascertain the reference to Shigella genus of cultures suspected of being Shigellae by the results of growth on combined medium (Olkenisky's, Kligler's, etc.).


[Various indicators of humoral immunity in patients with hematopoietic hypoplasia after bone marrow transplantation]. The authors examined 65 patients with hypoplasia of the hemopoiesis following bone marrow transplantation. To patients of the 1st group the bone marrow was chosen by erythrocytic antigens only, and to patients of the 2nd group both by erythrocytic and by leukocytic antigens. The data obtained pointed to the reduction of isoimmunization to the antigens of leukocytes and platelets in the patients with hypoplasia of the hemopoiesis following transplantation of the histocompatible bone marrow, in comparison with the patients in whom the bone marrow was chosen only by erythrocytic antigens alone.


[Characteristics of the functional activity of human blood neutrophils using the nitroblue tetrazolium reduction test]. A study was made of the test of restoration of the nitroblue tetrazolium (NBT) by the intact blood neutrophils and the neutrophils stimulated with various endotoxin doses of Gram-negative bacteria in 70 healthy persons. A high sensitivity of the test with the NBT for the quantitative assessment of the neutrophil response under conditions stimulating the phagocytic activity was demonstrated. A functional nonhomogeneity of the neutrophil population, the most distinct with the minimal stimulating action, was noted.


[Intraspecies antagonism of Sh. flexneri in an HEp-2 cell line model]. The authors describe an effect of suppression of invasion of the guinea pig eye conjunctiva and the HEp-2 epithelial cells by virulent Sh. flexneri bacilli, with a simultaneous administration of the same dose of avirulent shigella mutants, genetically connected with them. The data of morphological study and experiments with 3H-glucose labeled shigellae carried out on the cell species model indicated that the bacterial competition for the specific sites for absorption on the epithelial cells underlay the observed phenomenon.


[Role of the microbial flora of the palatine tonsils in the pathogenesis of chronic tonsillitis]. Species composition and the potency of a microbial focus of the microorganisms on the surface and in the lacunae of the palatine tonsils were studied in 51 patients suffering from chronic tonsillitis and in 52 healthy indivisuals. The species composition of the microorganisms was identical in the groups under study. However, its quantitative indices displayed significant differences. The potency of the microbial focus of the beta-hemolytic streptococci in the tonsillar lacunae of healthy individuals averaged 0.010 +/- 0.02 million, in patients with simple chronic tonsillitis-0.16 +/- 0.05, and in toxicoallergic tonsillitis of the I degree-1.03 +/- 0.8 million microbial cells. The constancy and a marked increase of all the species of microorganisms in the tonsillar lacunae of patients suffering from chronic tonsillitis, and also a marked dependence of this phenomenon on the extent of decompensation of the pathological process led to the conclusion that all of them played a definite role in the pathogenesis of this disease. It is supposed that the pathogenic influence of the mentioned microbes on human organism was realized both on account of summation of the antigenic-allergic and the infectious action, and by its other possible mechanisms.


[Strains of salmonella with altered antigenic structure]. The authors studied 260 freshly isolated and laboratory cultures of salmonellae belonging to different serological groups. Heterogeneity of the majority of the strains studied by colour fluorescence of the colonies in the oblique light flux was demonstrated. Genetically bound spontaneous stable mutants with a different antigenic composition were selected by this method from a number of serological types. The isolated mutants were in the S-form and failed to differ by morphological, cultural and biochemical properties from the initial parental strains. A study of the antigenic structure by the method of agar immunoelectrophoresis and determination of their serological properties showed the mutants to have disturbances in the processes of O- or K-antigen synthesis.


[Features of the monosaccharide composition and ultrastructure of lipopolysaccharides of different forms of Shigella sonnei]. The authors present the results of study of chemical monosaccharide composition and the ultrastructure of purified lipopolysaccharides (LPS) of the I and the II phases and the R-form of Sh. sonnei. The amount of lipids in LPS preparations increased with the change from S- into R-form. Galactose content in LPS of the II phase was less than in LPS of the I phase, and it was absent entirely in LPS of R-form. It was demonstrated by negative contrasting that LPS dissociation increased with S leads to R dissociation. A marked similarity was found between macromolecular aggregates of LPS of the II phase and of R-form.


[Trial of the toxins of the Sonne microbe and cholera vibrio in an isolated loop of mouse small intestine]. Enterotoxic properties of neuro-and endotoxins of Sonne dysentery bacillus, of cholerogen, and Bowen's cholera vibrio endotoxin were determined on a model of an isolated loop of the mouse small intestine. In definite doses all the mentioned preparations could induce dilatation of the isolated loop of the mouse small intestine. In case of Sonne bacillus neurotoxin this property correlated with the toxicity of the preparation for the animals and failed to depend on the virulence and biochemical reference of the strain from which it was obtained. Marked variations in the sensitivity of mongrel and linear mice to the mentioned preparations were noted.


[Role of the aqueous factor in the epidemiology of dysentery]. Analysis of the dynamics and territorial distribution of bacterial dysentery morbidity during 1959-1973 in the Dagestan ASSR demonstrated that the epidemically unfavourable conditions were largely connected with the use of water in open water bodies for domestic purposes and swimming as well as a wide network of irrigation canals. Persistence of the water factor in the dysentery epidemiology was connected with the ever increasing contamination of water in open water bodies and neglect of sanitary-hygienic requirements of the water supply to population of pertinent and sanitary laws.


[Experimental salmonellosis conjunctivitis and keratitis in guinea pigs]. The authors present the results of morphological study of experimentally-induced conjunctivitis and keratitis induced in guinea pigs by salmonellae. It was revealed that injuries of the conjunctiva and cornea in salmonellae infection were different by development and morphological manifestations from keratoconjunctivitis caused by shigellae. This difference was due to specific peculiarities of the pathogenic properties of salmonellae and shigellae clearly expressed on the given experimental model.


[Phage conversion of escherichia and shigella antigens. I. Phage conversion of type I antigen of Sh. flexneri in entrophatogenic E. coli O129]. The authors realized conversion of type I Sh. flexneri in enteropathogenic E. coli O129 with converting moderate phage phi I Sh. flexneri. Phage phi I lysogenized 7.3--42.7% of the cells of antigenic E. coli variant O129 which lost type V antigen; conversion of the type I antigen of Sh. flexneri was revealed in the agglutination and adsorption of agglutinins tests. As a result, E. coli strain was obtained with the O-antigen identical to the O-antigen of Sh. flexneri Ia.


[Cytolytic activity of human tonsillar lymphocytes]. The radioisotopic method was applied to the study of cytolytic activity of human tonsil lymphocytes against chick erythrocytes, intact and loaded with streptococcus and staphylococcus antigens. Lymphocytes proved to be much more active in the lysis of target cells treated with microbial antigens than of the intact ones. The degree of erythrocytolysis dispension of the tonsillar cells and their treatment with antiglobulin serum.


[Thymus-dependent lymphocytes in the spontaneous rosette-formation reaction in schizophrenia]. The report is concerned with the capability of the peripheral blood lymphocytes in schizophrenic patients (28 cases) and normals (25 individuals) to form spontaneous rosettes with the erythrocytes of sheep. The amount of rosettforming cells in schizophrenic patients is significantly lower. Besides, part of the lymphocytes create less complete rosettforms as compared to the lymphocytes of normals. The achieved results may point to insufficiency of the immunological competency in the system of thymusdependent cells in schizophrenic patients.


[Results of a comparative study of anti-brain antibodies in the sera of healthy subjects and schizophrenic patients by the Coon's indirect immunofluorescent method]. With the aid of the Coombs indirect method the authors studied the blood sera of 79 patients with different forms of schizophrenia and 27 normal donors. It was demonstrate that the blood sera of schizophrenic patients and normals contain globulins capable of fixation on different components of a nervous cell. However, the character and intensity of fluorescence as well as the amount of fluorescent nerve cells in the field of vision distinguishes the examined patients from normal donors.


[Modeling the reflex syndrome of the piriform muscle]. In order to model the piriform muscle syndrome the author utilized clinical and informational-statistical methods. For the same purpose an algorhythm was formed from 2 programmes: the method of hemogeneity in selected medium and correlational analysis. As a result it was possible to create a clinico-statistical model of the main syndromes of a lumbar osteochondrosis, including the model of the piriform syndrome. On the basis of the achieved data the author proposes different differential diagnostical tables of syndromes of lumbar osteochondrosis which can be used for computer and noncomputer diagnosis.


[EEG dynamics in patients with renal failure during treatment with hemodialysis and following kidney transplantation]. The authors conducted an EEG study of 28 patients with chronic renal insufficiency, 20 of whom were on a programme hemodyalysis and 8 were studied at different periods following kidney transplantation. Background registrations detected mild and moderate changes of the bioelectric brain activity, mainly with disorders of alpha-rhythm. Only in 1/3 of the patients there were moderate slow forms of activity of paroxysmal signs. A worsening of the EEG indices after hemodialysis, seen in 11 of the 20 patients was expressed in abundant polymorphic slow activity or paroxysmal hilateral synchronous discharges of a large amplitude and was combined with an appearance of neurological disorders. In a successful kidney transplantation there was a distinct normalization of the EEG picture, whereas in a rejection of the transplant there were signs of expressed anomalies of brain electrogenesis.


[Surgical treatment of some "historical" x-ray dermatites (author's transl)]. Six cases are presented: two degenerated and four necrotic X-ray dermatitis. Four patients had received X-ray therapy for benign lesions. All suffered long standing X-ray dermatitis lasting up to 60 years. The princip of treatment is a complete excision of the diseased skin and the covering of the defect with flaps. Such severe cases which need a complex treatment, must be handled with caution. X-ray therapy is a powerful but dangerous tool; its dangers are often known late; it should be reserved for severe conditions.


[Tissue defects after chest-wall-lung-bloc resection (author's transl)]. Our study groups 7 patients undergoing chest wall resection and 12 patients submitted to en bloc lung and chest wall resection. In the first group, 48 +/- 15 years old, there were 3 females (Darier-Ferrand fibrosis, chondroma, cutaneous gland epithelioma) and 5 males (3 sarcomas, 1 metastasis and 1 osteofibroma). An average of 2 ribs were resected with muscles, pleura and in 3 cases the skin, amounting to between 300 and 1,000 g. Reconstruction was performed : 1 degrees by musculocutaneous flap in 4 cases with 1 fistula; 2 degrees Marlex Mesh in 2 cases with 1 infection; 3 degrees fascia lata in the largest resection that necessitated tracheostomy and prolonged ventilation. There was no death. In the second group, 61 +/- 14 years old, all males, there were 9 bronchial carcinomas and 3 sarcomas. An average 2.5 ribs were resected en bloc with 6 lungs and 6 lobes. The defect was treated : 1. by Marlex Mesh in 3 cases without complications, 2 had tracheostomy and 2 days ventilation; 2. by muscle flap in 9 cases with 3 tracheostomies and ventilation up to 1 month : there were 3 empyemas and 2 atelectasiae. One patient died after a second operation for bronchial stump necrosis. On the whole there is no need for Marlex Mesh.


[Four cases of hemorrhages after surgical repair of iatrogenic tracheal stenosis (author's transl)]. In our series of 23 patients, operated 27 times, for a iatrogenic stenosis of the trachea, there were 4 deaths by hemorrhage of the innominate artery. Three resulted from shearing of the artery by the tracheal sutures. One came from erosion by a tracheostomy cannula. This fatal complication should be prevented by preserving healthy tissues between the artery and the trachea.


Cardiac transplantation at Stanford.

Cardiac transplantation at Stanford. Increasing survival of cardiac allograft recipients has been noted with each year of the Stanford cardiac transplantation program. Current 1 year survival is 67%, compared with 22% 1 year survival in the first year of our program. Five factors are felt to be important in improving survival: 1 degree stringent recipient selection criteria, 2 degrees routine use of serial endomyocardial biopsies for the diagnosis of acute graft rejection, 3 degrees administration of rabbit antithymocyte globulin for the treatment of rejection, 4 degrees aggressive diagnosis and treatment of infectious complications, and 5 degrees reduction of the incidence of accelerated graft arteriosclerosis by appropriate prophylaxis.


Experiences of treating allergic rhinitis with intra-nasal beclomethasone dipropionate. Short-term trials and long-term follow-up. The effect of locally acting intra-nasal beclomethasone dipropionate was observed in 42 patients suffering from seasonal allergic rhinitis and 50 patients suffering from perennial rhinitis. The study consists of three parts: 1) a simple double-blind trial in seasonal rhinitis, 2) a double-blind crossover trial in perennial rhinitis, 3) a 1-year follow-up of the perennial group. The active drug was significantly superior to placebo when comparing subjective symptoms, nasal resistance and secretion eosinophilia in the patients. In long-term use it was possible to reduce the initial dose considerably. On objective examination no significant changes were seen in the epithelium following long-term use. No suppression of the hypothalamic-pituitary-adrenal axis was observed after 1 year's regular use of beclomethasone dipropionate. The side effects were mild, the most common complaint being irritation of the nasal mucous membrane, apparently caused by the propellant gas.


Is there a caudal thyroid artery in the dog (Canis familiaris)? Attempts have been made to establish extent of similarities as well as dissimilarities between the canine caudal thyroid and human inferior thyroid artery. On the basis of origin, course, relationship, branching pattern, major area of supply, level of anastomosis, occurrence, etc., it is proposed to rename the caudal thyroid of the dog as the tracheoesophageal artery.


Histochemical study on the neuro-insular complex in Suncus murinus. Ganglia, rich in cholinesterase substance, were recorded at a little distance to the islets of Langerhans, connected with the fibres of the peri-insular plexus which were referred as neuro-insular complex. The peri-insular complex was made up of a large number of non-myelinated and partially by myelinated nerve fibres, and it was found in association with the post-ganglionic nerve fibres.


Myosin-like microfilaments in the human normal and pathological testis. The immunofluorescent staining of the human normal testis shows that both peritubular and tubular cells bind antimyosin-like antibodies. The same cells are provided with a large amount of microfilaments within the cytoplasm. The thin microfilaments observed by electron microscopy in various cells of the human testis likely correspond to the sites of immunofluorescent staining. In pathological specimens there can be observed a decrease in peritubular smooth muscle cells associated with a decrease in cytoplasmic microfilaments and in the immunofluorescent staining of some cells.


Oligoclonal IgG and measles antibody in CSF of multiple sclerosis patients. Cerebrospinal fluid (CSF) was obtained from 50 neurological patients, 26 of whom suffered from multiple sclerosis (MS). Agar gel electrophoresis and determination of anti-measles antibody titre were performed on the CSF samples. The frequency of elevated measles antibody titre was higher among the MS patients than among the patients with other neurological diseases. Furthermore, oligoclonal IgG in CSF occurred more often among the MS patients than among the other neurological patients. An association between high measles antibody titre and the presence of oligoclonal IgG was observed in CSF from both the MS patients and the patients with other neurological diseases. However, the nature of the correlation between occurrence of oligoclonal IgG and high measles antibody titre remains to be explained.


Oxprenolol in the treatment of migraine. Thirty migraine patients received oxprenolol (Trasicor), which is an adrenergic beta-receptor blocking agent with weak beta-stimulating intrinsic activity. The dosage was 80 mg three times a day. The treatment was given by a double blind cross-over technique in which the effect was compared with placebo. Each compound was administered for 8 weeks with an intermediate week without medication (wash-out). Oxprenolol had no significant effects in the prevention of migraine attacks. Our study lends further support to the assumption that differences may exist between different beta-receptor blocking agents in their effectiveness in migraine prophylaxis.


Localization of organ-specific antigens in the nervous system of the rat. Localization of organ-specific brain antigens in the central nervous system of the rat has been studied by means of indirect immunofluorescence. Rabbit antiserum against homogenate of rat brain, previously absorbed with normal serum and homogenates of rat organs (kidney, liver, spleen), reacted with the water-soluble antigens of rat brain prepared by extraction with phosphate buffer (pH 7.3) and ultracentrifugation at 50 000 X g to give one band in the immunodiffusion test and 2--3 precipitation arcs in immunoelectrophoresis. There was also a positive reaction with peripheral nerve. The antigen was detectable in all regions of the CNS. Cells with distinct cytoplasmic immunofluorescence were most frequently observed in cerebellar white matter, pons, cerebellar pedunculi, longitudinal tracts of the brain stem. Positive immunofluorecence reaction has appeared in the outer plexiform layer and granular layer of the retina, satelite cells of the spinal root ganglia and Schwann cells. A similar reaction was observed in human, mouse and guinea pig brain slices. Both the morphological and immunochemical reactions are indicative of glial localization of this antigen.


Arnold-Chiari malformation and associated anomalies in calves. The Arnold-Chiari malformation is described in 10 calves. Eight of them had internal hydrocephalus and/or spina bifida and two occurred as a single isolated defect without associated anomaly. Malformation of the base of the skull and large foramen magnum appeared to indicate that the abnormal embryonic development of the neural tissue and basal bone may contribute to the development of the Arnold-Chiari malformation in cattle.


Retinoblastoma-like neoplasm induced in C3H/BifB/Ki strain mice by human adenovirus serotype 12. Eighty newborn C3H/BifB/Ki strain mice received a single intraocular inoculation of 0.002--0.003 ml of 10(8.0) TCID 50/0.1 ml human adenovirus 12 (AD 12), within 24 h after birth. Forty mice survived and in seven of these (17.5%) a solid retinoblastomalike neoplasm developed between 64 and 236 days. The tumors have been successfully cultured and also transplanted subcutaneously into syngeneic hosts. Morphologically, all tumors revealed characteristic features of retinoblastoma associated with the Homer Wright type of rosettes. Bizarre giant cells were commonly detectable. Ad 12-specific T-antigens were demonstrated in both the primary and cultured tumor cells using immunofluorescent techniques. Some giant cells also showed numerous T-positive filaments. Electron microscopy disclosed poorly differentiated unipolar cells possessing a large ovoid nucleus. Many tumor cells appeared to contain a well organized solitary cilium consisting of a typical ring of nine doublets with no axial (9 + 0) in close association with a pair of centrioles. Some multinucleated giant tumor cells also contained multiple cilia-centriole complexes within their broad syncytial cytoplasm. Occasional endogenous C particle-like virions unique to murine neuroblastomas were observed for the first time in virus-induced retinal tumors. This unprecedented tumor model in a pure strain mouse adds to the range of known animals sensitive to Ad 12 oncogenesis.


Marginal adaptation of restorative resins in acid etched cavities. The purpose of the present work was to investigate the wall-to-wall polymerization contraction of restorative resins placed in acid etched cavities and to study the effect of water absorption and temperature changes on the formation of marginal gaps on such fillings. Fillings made in extracted human teeth were examined microscopically. Before filling the cavities including 1.5-2 mm peripheral enamel were etched with 35% H3PO4. When polished and examined immediately after setting, fillings of a number of brands showed no marginal gaps. Gaps due to continued polymerization were formed around some of these fillings after 1 day's storage in water at 37 degrees C. These gaps did not close as a consequence of hygroscopic expansion of the fillings. Around fillings after 1 day's storage in water at 37 degrees C. These gaps did not close as a consequence of hygroscopic expansion of the fillings. Around fillings of the brands where no gaps present immediately after setting, gaps were formed by cooling from 37 to 23 degrees C. One day's storage in water at 37 degrees C before polishing generally reduced the frequency of marginal gaps both directly and after cooling. Heating of the fillings increased the risk of gaps being formed by a subsequent cooling.


Oxygen tolerance of anaerobic bacteria isolated from necrotic dental pulps. The oxygen tolerance of 43 anaerobic reference strains and 36 anaerobic strains from necrotic dental pulps was studied. All strains survived for two hours or more as colonies on the surface of a medium supplemented with blood, and as many as 26 of the 79 strains survived for more than seven days. The hemolysed blood in the medium significantly increased the survival time for many of the strains. Factors influencing the death rate were studied in one of the strains and it was found that the lysed red cells of the blood and not the serum had a protective effect and that catalase had the same protective effect as the hemolysed blood. The finding that hemolysed blood significantly increased the oxygen tolerance of many anaerobes may explain some of the divergent results regarding the efficiency of various methods for the recovery of anaerobic bacteria from clinical specimens. The use of media supplemented with blood during various phases of processing a specimen might be more important for a high recovery of anaerobic bacteria from clinical sources than the measures taken to minimize exposure of the specimen to air.


On the use of fissure sealants in caries prevention. A clinical study. The aim of the present study was to clarify in the light of a clinical investigation on 6-7 years old children, some questions concerning the use of fissure sealants in public dental care. The results of the study conducted with the Nuva-Seal R (L.D. Caulk, Milford, Del.) compound suggested a caries decrease of 84 per cent one year, and 53 per cent two years after sealant application to permanent teeth. In deciduous teeth the reduction was rather similar. Totally or partially lost sealants were not reapplied or repaired during the investigation. It is obvious that the sealants are, in most cases, apt to postpone the need of restorative treatment for a limited period of time only. Postponement may, however, be considered to achieve some advantages as compared with conventional or prophylactic filling procedures.


Penetration of restorative resins into acid etched enamel. I. Viscosity, surface tension and contact angle of restorative resin monomers. It has been a controversial question whether an intermediate layer of low-viscous, non-composite resin between composite restorative and etched enamel is beneficial. It was the purpose of the present work to investigate some of the factors that govern the penetration of resins into the capillary pores of etched enamel surfaces. Viscosity, surface tension and contact angle on human enamel were measured using monomer mixtures similar to those found in commercial restorative resins. Employing a cylindrical model of relevant dimensions of the capillary pores, and on the basis of Poiseuille's equation the time of penetration was calculated for a relatively high-viscous and a relatively low-viscous monomer mixture. It was concluded that viscosity as such is not a limiting factor for the penetration of restorative resin monomers into the pores of etched enamel surfaces.


Penetration of restorative resins into acid etched enamel. II. Dissolution of entrapped air in restorative resin monomers. Viscosity, surface tension and contact angle are factors that influence the penetration of restorative resins into acid etched enamel. Furthermore, as the resin is drawn by the capillary forces into the pores of the etched enamel the pressure of the entrapped air will increase. The increased pressure has the effect that air will dissolve in a resin that is saturated with air at one atmosphere. The purpose of the present work was 1) to investigate the rate of dissolution of included air bubbles at increased pressure, 2) to use the results to calculate the depth of penetration by means of a cylindrical model of the capillary pores, and 3) to check the results of the calculations by measurements of the tag lengths of restorative resins placed on acid etched enamel. The rate of dissolution was measured in monomers of varying viscosity in a glass syringe by means of a stereo microscope. The calculations showed that the depth of penetration decreases only slightly with viscosity. Thin sections of restorative resins placed on acid etched enamel were prepared whereafter the enamel was dissolved in hydrochloric acid. Tag lengths of 50 micron or more were observed with composite as well as non-composite resins.


Mycotic growth and soft denture lining materials. Mycotic flora was studied from the dentures and denture bearing mucosae of 39 persons who wore soft-lined (Molloplast B) mandibular dentures and heat-cured acrylic resin maxillary dentures. Fungal growth was detected in 85% of the mandibular dentures and in 44% of the maxillary dentures (p less than 0.001). On the mandibular mucosa fungal growth was revealed in 74% and on the mucosa of the maxilla in 69%. In connection with inflamed mucosae fungal growth was always detected on the mandibular denture and on the mandibular mucosa in 93% as well as on the maxillary denture in 50% and on the maxillary mucosa in 75%. Considering the healthy mandibular mucosa fungus was found in 75% on the mandibular dentures and in 62% on the mucous membranes. In connection with healthy maxillary mucosae the corresponding figures were 42% and 68%. The specimens revealed 7 different yeasts and 2 moulds. The most common fungi were Candida albicans (86%), Torulopsis glabrata (31%), and C. tropicalis (14%). The uncured Molloplast material caused a definite inhibition of candida growth in vitro, while the cured material indicated no growth inhibition.


Outflow of tears and its influence on tear secretion and break up time (B.U.T.). Schirmer's test shows that a retarded outflow of tears causes reduction of the tear secretion. The B.U.T. is independent of the outflow of tears in patients with epiphora (119 eyes with mechanical obstruction, functional obstruction, or normal passage). Mucomimetics prolong the B.U.T. and retard the outflow of tears, whereas ointments reduce both the B.U.T. and the outflow (74 eyes). The B.U.T. becomes reduced when tears are absorbed by filter paper in Schirmer's test, but remains uninfluenced by filter paper inserted in the fornix. The B.U.T. is a valuable clinical test. It is the resultant of many different factors (tear volume, mucus, fat, etc.).


Cellular and humoral factors involvement in the enhanced NBT reduction by neutrophil leucocytes of newborn infants. The histochemical NBT test was performed on blood samples from ten healthy newborn infants. High spontaneous NBT reduction has been confirmed for neutrophils and assessed for monocytes. The stimulation of both neutrophils and monocytes with Escherichia coli endotoxin induces a statistically significant increase of NBT positive cells. The reason for the false positive test results in neonates was investigated by incubating neutrophils from adult donors and for different time periods in either neonatal or adult plasma before the addition of NBT. NBT reduction by adult neutrophils was increased after incubation in neonatal plasma, and this increase was related to the concentration of the plasma used. Maximum NBT reduction was observed after 90 min of incubation, at which time the NBT scores of adult cells incubated in neonatal plasma were similar to the results of tests performed on whole neonatal blood. It is concluded that neonatal leucocytes demonstrate efficient spontaneous and stimulated phagocytosis, and that there are, in the plasma of neonates, humoral factors which stimulated phagocytosis by neutrophils and are thus responsible for the false positive NBT test results observed in these subjects.


The effect of cholestyramine on serum lipids and platelet aggregation of hypercholesterolemic children (type II A) while on high linoleic acid diet. 25 children with familial hypercholesterolemia (type II A) were treated with cholestyramine or placebo in a cross over study during 2 periods of each 10 weeks. The medication was added to a high linoleic acid diet, which had been started at least 1 year earlier. Serum lipids and platelet aggregation were investigated at the end of the 2 periods. On cholestyramine, serum cholesterol levels decreased significantly, whereas the linoleate and oleate content of cholesterylesters and serum triglycerides did not change systematically. Platelet aggregation time, measured with a filtragometer, did not systematically change either.


A case of apparent hypopituitarism complicating chronic inflammatory bowel disease in childhood and adolescence. There is conflicting evidence regarding the adequacy of hypothalamic-pituitary function in children and adolescents with chronic inflammatory bowel disease complicated by growth retardation and delayed sexual maturation. A child with Crohn's disease, who has never received corticosteroid therapy, had delay of both growth and sexual maturation and has been investigated over the course of his disease. In addition to a skull X-ray (normal) and thyroid function tests (normal), a standard insulin tolerance test (insulin 0.15 u/kg) and a standard gonadotropin-releasing hormone (Gn-RH) test (100 microgram Gn-RH i/v) were performed when the bowel disease was in relapse and again during a remission of the bowel disease, achieved by surgery. When the bowel disease was in relapse (coincident with growth arrest) results showed an inadequate release of gonadotrophins and of growth hormone (even after pre-treatment with stilboestrol) but normal release of cortisol and prolactin. During a remission of the bowel disease coinciding with a period of rapid "catch-up" growth, release of growth hormone was normal and that of gonadotrophins supranormal. The demonstration of a reversible apparent partial hypopituitarism in this boy not only re-questions the adequacy of hypothalamic-pituitary function in inflammatory bowel disease but also indicates a potential diagnostic pitfall in the routine investigation of growth retardation if gastrointestinal symptoms are not prominent at presentation.


Effect of 1.25-dihydroxycholecalciferol administration on blood glucose and pancreatic islet morphology in mice. 1.25-dihydroxycholecalciferol (DHCC) administration to fed and starved mice had no effect on the blood-glucose concentration or the light-microscopic appearance of the endocrine or exocrine pancreas. Electron microscopy, however, disclosed changes which appeared early after the injection and were more marked in starved than in fed animals. The B-cells exhibited mitochondrial hypertrophy, studied both by qualitative and quantitative methods, invagination and vacuolation of mitochondrial membranes, increased occurrence of light secretory granules, multiple rough endoplasmic cisternae, multi-lamellar bodies, and a rather rich Ca2+-containing pyroantimonate precipitation mainly localized to nuclei and mitochondria. A tendency to mitochondrial hypertrophy was observed also in some D-cells. The A-cells were unaffected. The findings indicate that the endocrine pancreas (or at least the B-cells) is affected in some way, directly or indirectly, by DHCC.


Effects of 1.25-dihydroxycholecalciferol, parathormone and Ca2+ on the pancreatic B-cell sensitivity to alloxan. The sensitivity to alloxan was investigated by blood and urine glucose determination and light and electron microscopic study of the endocrine pancreas in groups of mice differing from each other with respect to food ingestion and treatment before alloxan administration. Because of differences in occurrence of glucosuria, degree and duration of hyperglycemia, and severity of structural lesions, it was concluded that starvation increases the alloxan sensitivity and that pre-treatment with 1.25-dihydroxycholecalciferol (DHCC) or parathormone (PTH), but not with Ca2+, enhances the alloxan effect. The serum-calcium concentration determined 10 minutes after pre-treatment was significantly increased in the group given Ca2+, but not in the groups injected with DHCC or PTH. Starved mice injected with DHCC or PTH 10 minutes before alloxan administration exhibited a pronounced second hyperglycemia of long duration, and extensive, selective B-cell necrosis. Starvation and increased serum concentration of DHCC and PTH are believed, directly or indirectly, to induce B-cell alterations which increase the alloxan sensitivity.


The importance of thymus in the pathogenesis of the chronic phase of hypertension in mice following partial infarction of the kidney. Partial infarction of one kidney and contralateral nephrectomy was followed by a similar initial increase in blood pressure in athymic (nude) and normal mice of the C57/BL/6J strain. The chronic phase of the hypertension was, however, thymus dependent, since the athymic mice failed to maintain an increased blood pressure, in contrast to the normal mice. A response of thymus transplantation in athymic mice was the ability to maintain the blood pressure high in the chronic phase of the hypertension, whereas cyclophosphamide treatment to the normal hypertensive mice decreased the blood pressure in the chronic phase of the hypertension, but not in the early (acute) phase. Some perivascular round cell infiltrations were found in the uninfarcted part of the kidney in normal and thymus-transplanted nude mice after 80 days of hypertension, but the degree of cellular reaction was less than previously observed in the NMRI-strain of mice. Substantial perivascular cellular infiltrations, which appeared to be thymus-dependent, occurred in the ischemic border-zone of the infarcted area. Athymic mice of the NMRI-strain were able to develop the initial blood pressure elevation of DOCA/salt hypertension during the chronic phase of loomis hypertension, in which phase the arterial pressure otherwise would be declining towards normal values.


On the specificity of medium-sized isomarker chromosomes in non-Burkitt lymphomas. The chromosomal observations by G-banding in an intestinal, histiocytic lymphoma are reported. The findings, as those in a series of about 10 other lymphomas, indicate a varying origin of medium-sized isomarkers; the results oppose the view that there exists a specific marker of this type in non-Burkitt lymphomas.


Origin of intestinal beta-glucuronidase in germfree, monocontaminated and conventional rats. The intestinal beta-glucoronidase was studied in germfree, monocontaminated and conventional rats. The greater part of the beta-glucuronidase of the caecum and the large intestine of the contaminated animals was of bacterial origin. No bacterial beta-glucuronidase was found in the small intestine. Monocontamination with Escherichia coli gave activities corresponding to those of the conventional rats, whereas content from the caecum and the large intestine of the rats monocontaminated with Streptococcus pyogenes showed an activity approximately 10 per cent of that of the conventional rats.


Pigment production in group B streptococci. Most haemolytic group B streptococci produced a yellow to orange pigment in Colombia agar and in some Todd Hewitt broths. The composition of the broth medium was important. Trypsin inhibited pigment production, but had no effect on pigment already produced. Optical density measurement revealed three main peaks at 420, 260 and 215 nm respectively with pigment producing strains. Nonpigmented strains gave only the two peaks at 260 and 215 nm.


In vitro studies on normal, stimulated and immunologically activated mouse macrophages. I. Oxidation of 1-14C glucose by macrophages in monolayer cultures. Oxidation of 1-14C glucose of BCG/listeria activated, proteose-peptone stimulated and typhoid-parathypoid vaccine (T.A.B.) stimulated peritoneal and spleen macrophages from C3H, CBA and C57Bl mice was determined at various times after treatment. The study showed no major differences between the oxidation of stimulated and activated macrophages, but a variation was seen in C3H mice in the kinetics of glucose oxidation of BCG/listeria activated and proteose-peptone stimulated peritoneal macrophages. It was also observed, in these mice, that the response appeared and disappeared earlier in the spleen than in the peritoneal macrophages.


In vitro studies on normal, stimulated and immunologically activated mouse macrophages. II. Degradation of radioactive antigen/antibody complexes. Radioactive antigen/antibody complexes are degraded to a greater extent by PE macrophages from C3H, CBA and C57Bl mice injected intraperitoneally with proteose-peptone (stimulated macrophages) and T.A.B. vaccine than by PE macrophages from normal mice and mice immunized with BCG (activated macrophages). On the other hand, spleen macrophages from mice immunized with BCG had a greater digestive capacity than macrophages from mice injected with proteose-peptone or T.A.B. vaccine or from normal mice. Thus, activated macrophages are capable of degrading antigen/antibody complexes, provided that the cells are harvested from one of the foci of BCG infection.


Multiple FC receptors in the human placenta. The presence of Fc receptors on endothelium and trophoblastic tissue in cryostat sections of full-term human placentae has been verified. Fc receptor activity on stem vessel endothelium can be manifest both by immunofluoresence with heat-aggregated IgG and by haemadsorption with antibody-sensitized erythrocytes. However, Fc receptor activity on trophoblastic tissue is manifest only in the haemadsorption reaction, and not in the immunofluorescence reaction. The haemadsorption and immunofluorescence were both independent of temperature, and were completely abolished by formaldehyde fixation of the tissue sections. Both reactions were expressed on first-trimester placental tissue, although more limited and diffuse. In terms of their anatomical location and specificity characteristics the Fc receptors in human placentae may have a biological significance.


Plasma nitrazepam concentrations after an acute intake and their correlation to sedation and serum growth hormone levels. Concentrations of nitrazepam in plasma were determined by gas chromatography in healthy volunteers after an acute peroral administration of nitrazepam (5 and 10 mg). Placebo tablets were also used, and an assessement of subjective drug effects was made during each medication. In addition serum growth hormone levels were determined. The peak plasma nitrazepam concentration was achieved at 120 minutes (46.9 +/- 3.2 ng/ml, mean +/- S.E.M.) after 5 mg of nitrazepam and at 180 minutes (82.8 +/- 10.5 ng/ml) after the dose of 10 mg. The half-life of nitrazepam in plasma ranged from 16.5 to 48.3 (mean 28.8) hours. A significant positive correlation was seen between the subjective sedative effects and the magnitude of the peak nitrazepam concentrations in plasma. This drug effect was highly significant when the plasma levels of nitrazepam were rising. The subjective sedative effects were more prominent after 10 mg than after 5 mg dose of nitrazepam. The plasma nitrazepam concentration was not significantly correlated with the subjective sedative effect the next morning, 12 hours after the drug intake. Serum growth hormone levels rose significantly during the study both after 5 mg and 10 mg nitrazepam doses (peak levels 16.3 +/- 4.0 and 12.7 +/- 3.1 ng/ml) and were significantly higher than after placebo administration (3.7 +/- 0.7 ng/ml).


Studies of endocrine activity, plasma tryptophan and catecholamine excretion on psychosurgical patients. The Geoffrey Knight Psychosurgical Unit admits patients on a regular basis and thus offers special opportunities for studying severely ill psychiatric cases, all having one particular treatment under relatively controlled conditions. The opportunity has been taken to repeat various metabolic studies previously reported to be abnormal in some psychiatric illnesses. In the present investigation several measures of endocrinological activity were studied, as was plasma tryptophan, both free and bound. None of these data confirmed reports of abnormalities and neither did the values found at operation help to predict clinical outcome 1 year later, which was another possibility. Urinary catecholamines were also measured and 2 weeks after operation. Male patients, regardless of diagnosis, showed a mean increase in adrenaline output after operation compared with the pre-operative value and this was significantly different from the females, who showed a small mean decrease. The depressed patients showed a significant reduction in noradrenaline excretion after operation compared with before operation and this trend was enhanced in those of good outcome at 1 year, the difference from those who responded poorly being significant. It could be that the ventromedial lesion that is produced alters noradrenaline metabolism or autonomic activity in depression and this possibility merits further study.


Synaptic membrane protein D2 in the cerebrospinal fluid of manic-melancholic patients. The synaptic membrane protein D2 was measured in the cerebrospinal fluid (CSF) of manic-melancholic patients. The concentration of D2 increased with the age of the patients until about 35 years of age. No difference was found between the D2-concentration in CSF from a control group compared with different manic-melancholic subgroups. The D2-concentration in CSF collected from the patients during depression or mania was compared with CSF collected from the same patients when their moods were normalized. In the case of the depressed patients, we found that the D2-concentration increased slightly when the mood was normalized.


Effect of fusaric acid on tardive dyskinesia and mental state in psychogeriatric patients. A pilot study. The effect of fusaric acid 150-450 mg daily on tardive dyskinesia and mental state was studied in 15 chronic psychogeriatric patients. The patient's previous drug treatment was maintained unchanged during the experiment. Fusaric acid significantly relieved oro-facial dyskinesia, tremor, and rigidity, and it improved the mental state of the patients (BPRS). Akathisia was exacerbated, but this change was not significant. Akinesia and anxiety were not altered.


Suicide attempts, platelet monoamine oxidase and the average evoked response. The relationship between suicides and suicide attempts and two biological measures, platelet monoamine oxidase levels (MAO) and average evoked response (AER) augmenting, was examined in 79 off-medication psychiatric patients and in 68 college student volunteers chosen from the upper and lower deciles of MAO activity levels. In the patient sample, male individuals with low MAO and AER augmenting, a pattern previously associated with bipolar affective disorders, showed a significantly increased incidence of suicide attempts in comparison with either non-augmenting low MAO or high MAO patients. Within the normal volunteer group, all male low MAO probands with a family history of suicide or suicide attempts were AER augmenters themselves. Four completed suicides were found among relatives of low MAO probands where as no high MAO proband had a relative who committed suicide. These findings suggest that the combination of low platelet MAO activity and AER augmenting may be associated with a possible genetic vulnerability to psychiatric disorders.


Comparison of fronto-frontal and temporo-parietal unilateral ECT. An intraindividual double-blind cross-over comparison for the anterograde effect on memory of unilateral non-dominant frontofrontal (FF) and temporo-parietal (TP) ECT was performed in connection with the second and third treatment of an ECT-series, the electrode placement being alternated at random. Treatment technique was standardized and seizure duration was measured by means of EEG. Memory functions were tested after treatments by means of four memory tests: the 30 Word-Pair Test, the 30 Figure Test, the 30 Geometrical Figure Test and the 30 Face Test. Three operationally defined memory variables, immediate memory (IMS, 3 hours after ECT), delayed memory (DMS, 3 hours after IMS), and their difference, forgetting, were scored. No differences were found in the mean time of electrical stimulation, in the amount of methohexital and suxamethonium chloride, and in seizure duration between the two treatment groups. No statistically significant differences in any of the memory tests were found. The FF electrode position did not show any advantage compared with the routine TP electrode placement.


Prognostic value of angiography in early failure of renal transplants. The angiographic findings in 18 patients with irreversible rejection and in 20 patients who regained satisfactory renal function were compared. In 13 of the 18 patients who lost their transplants the outcome was predictable from the angiographic appearances. The diagnosis of irreversibility was more accurate in patients whose transplanted kidneys never functioned and when angiography was performed not earlier than 4 days after the onset of clinical signs of rejection.


Angiographic diagnosis in polymyalgia arteritica. Angiography of the main branches of the thoracic aorta was performed in 20 patients with the clinical diagnosis of polymyalgia arteritica. Lesions were mainly observed in the subclavian and axillary arteries, sometimes also in their branches. The angiographic and pathologic appearances of the lesions as well as differential diagnostic considerations are presented.


Deposits of plasma proteins in the skin during treatment with carbamazepine and diphenylhydantoin. Biopsies from skin of normal appearance from 18 patients treated with carbamazepine and diphenylhydantoin were investigated by a direct immunofluorescence technique. Seventeen had deposits of plasma proteins at the dermoepidermal junction, 16 had deposits in the vessel walls, and one had autofluorescence of the nuclei in the epidermis and vessel walls. These findings did not correlate with changes in serum IgG, IgA, IgM, IgD, IgE or alpha 2-macroglobulin. Eight patients had elevated alkaline phosphatase, 4 elevated IgG and one elevated IgA. Three had low values of IgA, and all had normal values of IgM, IgD and IgE, and blood cells. In three patients, carbamazepine was withdrawn, whereupon the deposits disappeared in two and decreased in the third, who changed to another drug. The changes were quantitatively and qualitatively similar to those seen in systemic lupud erythematosus induced by these drugs.


Bullous dermatosis among patients with chronic renal failure of high dose frusemide. Twelve of 56 patients with chronic renal failure, all treated with frusemide (Lasix) in daily doses of 0.5-2 g, developed bullae in areas exposed to light. In most cases the bullae developed during summer months and disappeared later in the year whether the frusemide treatment was continued or not. In two patients the eruption reappeared when treatment was resumed. Disturbance of the porphyrin metabolism was not found, neither could a change in the frusemide metabolism be demonstrated. Tissue typing and blood groups showed no difference from the average population. It is concluded that the condition presumably is a photo reaction due to the frusemide treatment but it cannot be said whether it is allergic or toxic.


Aseptic necrosis of bone following renal transplantation. Clinical and biochemical aspects and bone morphometry. Aseptic necrosis of bone has developed 5--48 months (mean 23) after renal transplantation in 22 (11%) of 195 patients with graft function for more than 6 months. The bone lesions were mainly localized to weight-bearing cancellous bone areas, most often the femoral heads. The mean duration of hemodialysis was significantly longer in recipients with aspetic necrosis than in those without. The serum concentration of phosphate was reduced and the serum concentration of parathyroid hormone increased in both groups of recipients. Quantitative histological examination of iliac crest biopsies showed a pronounced reduction of spongy bone (osteopenia) in recipients with aseptic necrosis compared with both normals and recipients without aseptic necrosis. Both patient groups showed similar changes in bone remodelling, indicating decreased bone formation. These findings suggest that osteopenia is an important contributory factor in the development of aseptic necrosis of bone after transplantation. The osteopenia may be a consequence of both the uremic bone disease before transplantation and the immunosuppressive treatment after transplantation.


Mitochondrial antibodies without antinuclear antibodies in non-hepatic diseases. The term "pseudo-LE syndrome" was previously used to describe an SLE-like disease in which AMA, but not ANA, were found in serum. In an attempt to find patients with this syndrome, we tested 9 358 sera for AMA and ANA. AMA without ANA was found in six patients without liver disease. One of these patients had an SLE-like disease. Two of the others had diseases of the thyroid and one had rheumatoid arthritis--diseases in which AMA have previously been described. One patient had allergic vasculitis and one hypercholesterolaemia; these diseases are not known to be associated with the presence of AMA.


New trends in pharmacology.

New trends in pharmacology. Among the factors influencing the arterial blood pressure the neural control through the autonomic nervous system is of paramount significance. The sympathetic division of this system holds a key position in this regard and its neural transmission mechanisms represent a well established target for pharmacological interference aimed at lowering blood pressure. This presentation will first deal with the morphological and physiological basis for blood pressure control through the sympathetic nervous system and the various possibilities for antihypertensive drug action through this system. Special attention will be drawn to recent advances in catecholamine research which may offer new leads in the development of blood pressure lowering agents. A second topic in this review will be some remarks on other pharmacological principles for interference with vascular control apart from the sympathetic system, particularly the vasodilator principle.


Aneurysms of the posterior cerebral artery. Locations and clinical pictures. A classification of aneurysms of the posterior cerebral artery from a series of 8 personal cases and 34 cases collected from the literature is attempted. The classification is based on the topography and sites of origin of the cortical and central branches of the artery. The artery was divided into six sections which permitted the description of the origin and projection of typical aneurysms. Single cases of atypical aneurysms can be explained by the known vascular anomalies. The predilective site is section B (origins of the posteromedial choroidal artery and quadrigeminal artery), then section D with the main division of the posterior cerebral artery and origins of the anterior temporal artery, the anterior posterolateral choroidal artery, the hippocampal artery and the thalamogeniculate artery, and finally section C--the junction with the posterior communicating artery. Clinical syndromes corresponding to these locations are described. The classification, when considered together with improved angiographic technique and microsurgery, allows exact preoperative and peroperative definition of topography which in turn enables the avoidance of injury to functionally important typical and atypical central branches of the posterior cerebral artery.


Tumours of the fifth cranial nerve.

Tumours of the fifth cranial nerve. Tumours of the fifth cranial nerve are very rare, comprising only 0.2% of all intracranial neoplasms. The authors critically review the literature, and report on 12 personal cases of trigeminal tumours (nine neurinomas, one meningioma, one epidermoid, one osteochondroma). General pathology, symptoms, and signs are analyzed, and compared with cases from the literature. Because of their insidious onset and slow "illogical" progression of misleading symptoms, trigeminal tumours often prove to be a diagnostic challenge. As a consequence they usually reach a large size before causing sufficient symptoms to lead the patient to a neurosurgical clinic. The diagnosis is therefore likely to be made by radiological investigations. The typical radiological feature (on plain skull films, pneumoencephalography, and angiography) are described, and differential diagnosis is discussed. All the patients in the present series were operated on. Surgical procedures and postoperative results are discussed.


The management of renal osteodystrophy.

The management of renal osteodystrophy. Hyperparathyroidism is the main cause of renal bone disease. At the moment its progress can be retarded by controlling plasma calcium and phosphate. But the prevention and cure of hyperparathyroidism without surgery eludes us. There is a suggestion that the administration of some metabolite of Vitamin D may be more successful. Osteomalacia on the other hand does not appear to be an important problem and is easily prevented and cured.


Bone disease, hypophosphatemia and hyperparathyroidism after renal transplantation. Long-term survivors after renal transplantation (RT) show: 1) decreased s-phosphorus 2) increased s-PTH 3) no correlation between s-PTH and s-phosphorus 4) increased amount of non-mineralized bone (osteomalacia), inversely correlated to s-phosphorus 5) decreased amount of trabecular bone (osteopenia) in RT patients with aseptic necorsis of bone. aseptic necrosis of bone after RT is mainly due to osteoid-induced osteopenia, perhaps aggravated by hypophosphatemic osteomalacia.


Toxic chemical agents as probes for permeation systems of the red blood cell. Chemical agents with different capacities to penetrate into the membrane and with different chemical reactivities can be used to gain information concerning the location of transport sites in the membrane structure and the particular functional ligands. If the agents are highly specific in their interactions and if their inhibitory effects are irreversible, they can also be used as probes to identify the transport components. Several examples are cited using the human red blood cells as a model. The anion transport system in particular has been studied by the use of nonpenetrating irreversible inhibitors, and more recently with a photoaffinity probe, NAP-taurine. In the dark the latter is transported in competition with the normal inorganic anions but after exposure to light, it becomes fixed in an irreversible bond that allows identification of the sites of its transport. It is proposed that anion transport involves a transmembrane protein of about 90,000 daltons that forms a channel through the lipid bilayer. The exchange of anions occurs via a gating mechanism containing a specific anion-binding site. Transport of water, cations and sugars may also involve similar transmembrane protein channels.


On the nature of the transport pathway used for Ca-dependent K movement in human red blood cells. This paper is concerned with the mechanism by which energy-depleted human red cells become permeable to K (but not to Na) when they are exposed to Ca. In an attempt to distinguish a diffusion from a mediated process competitive type effects of different ions and their sidedness of action on K transport are considered as well as the action of certain transport inhibitors. While the nature of the interactions implies the involvement of a mediated process (perhaps an altered form of the Na:K pump apparatus) more direct evidence will be needed to make a definitive assessment.


The effect of cyclandelate in depressed and demented patients: a controlled study in psychogeriatric patients. In a double-blind clinical trial the effects of the vasodilator drug cyclandelate (in a dose of 1200 mg daily) were studied in a group of patients with depressive illnesses or dementing conditions. The measures used before treatment and after six weeks' treatment were: clinical rating, psychometric tests (Paired Associate Learning Test, Digit Copying Test, Digit Substitution Test, and Serial Learning Test), cortical evoked potentials, the sedation threshold and the Gresham Questionnaire. In the depressive group there were no significant differences in the changes in scores at six weeks in three groups: those who received cyclandelate plus amitriptyline, those who received placebo plus amitriptyline, and those who received neither placebo nor cyclandelate. In the demented group there were significant changes in favour of the placebo on two measures (Digit Copying test, and one component of the auditory evoked response). The results do not support the previously reported views claiming, in a number of studies, a significant improvement in the performance of both demented and normal elderly subjects treated with cyclandelate. The significance of these findings is discussed.


Betahistine hydrochloride (Serc) in cerebrovascular disease: a placebo-controlled study. A double-blind, placebo-controlled, clinical study was performed to assess the effects of oral betahistine hydrochloride (Serc) on mental impairment and physical disability in patients with established cerebrovascular disease. Fifty-three patients were admitted to the study during 18 months. Forty-five patients completed the study. They received either betahistine 24 mg daily or placebo for eight weeks. Clinical assessments of general functional activity were done and a battery of nine mental function tests was administered pretreatment and at two-weekly intervals during therapy. The results were analysed statistically using distribution-free tests. Significant differences were demonstrated between betahistine and placebo at week 8 of treatment for associate learning, digit retention, general knowledge, orientation, sentence learning and simple arithmetic. These differences were consistently in favour of betahistine at or close to the 5% level of significance. The results of the remaining mental function tests showed no significant differences between betahistine and placebo, but trends were in favour of the former. General functional activity assessments also demonstrated that betahistine-treated patients were significantly better than those on placebo (P less than or equal to 0.05). No untoward side-effects were noted during the study.


The management of uremia.

The management of uremia. Progressive uremia is the hallmark of many renal diseases, some reversible. The signs and symptoms tend to parallel the declining glomerular filtration rate. With an understanding of the usual progression, the physician is equipped to plan therapy. Hypertension must be treated. Phosphorus binding, protein limitation and fluid and electrolyte control can be started at appropriate times and managed fairly easily. There are several cycles of deterioration that can be reversed if recognized promptly.


Intravenous diazoxide therapy in hypertensive crisis. Ninety-one doses of diazoxide were administered intravenously to 41 patients with hypertensive crises. Diastolic blood pressure was reduced from an average of 139 to 98 mm Hg within 10 minutes. On the basis of a retrospective analysis of the response of diastolic blood pressure, it was possible to determine within 10 minutes of injection whether a second dose would be required. Therapy was judged to be effective in 38 of 41 patients; 35 percent of injections were ineffective. Concomitant administration of furosemide was not shown to have a beneficial antihypertensive effect. Mean blood urea nitrogen was 59.5 mg/100 ml initially and was not significantly different 2 weeks after therapy. None of the patients demonstrated clinical evidence of diazoxide-induced deterioration of coronary circulation. Electrocardiograms obtained 2 weeks after diazoxide therapy failed to show evidence of new ischemic changes. Only 9 percent of patients complained of side effects, and these were transient and relatively innocuous. It is concluded that diazoxide is both safe and efficacious in the management of hypertensive crises.


Cardiac rupture--challenge in diagnosis and management. Previous studies of the incidence, natural history, pathogenesis and diagnosis of cardiac rupture are presented, and 20 additional cases described. Progressive cardiorrhexis after myocardial infarction causes death in possibly more than 25,000 persons a year in the United States, and more frequent antemortem diagnosis is needed. Suggestions for future clinical and experimental studies are described and possible means of early diagnosis and therapy are outlined.


Treatment of diarrheal dehydration.

Treatment of diarrheal dehydration. A regimen for the treatment of diarrheal dehydration is presented. It was devised for use in conditions found in developing countries. Application to large number of patients has been successful. One of its characteristics is the infusion at the start of treatment of a larger amount of fluid than generally recommended. The advantages of magnesium supplementation and phosphate supplementation have been studied. Fecal electrolyte composition has been studied during recovery from diarrheal dehydration. Components of acid balance and generation have been measured with the "net acid" balance technique.


Effect of infection on nutrient requirements. Nearly all expert groups on nutrient requirements have suggested that the nutritional effects of infection need to be taken into account, but specific instructions on how to do this have not been formulated. There is great uncertainty as to how individual requirements are affected or how disease prevalence might alter nutrient requirements for large populations. The traditional principles for establishing dietary allowances must be reevaluated in the presence of acute or chronic infections because of anorexia, withdrawal of solid food, fever, adverse effects of treatment, impaired intestinal absorption, and increased nutrient losses via urine, skin, feces, or through internal sequestration. The effects of an infection on protein and energy needs constitute major problems as do the changes in iron metabolism and those of other essential nutrients. Despite these complexities the increased needs for protein, calories, and iron can be estimated for purposes of nutrition education, dietary evaluation, or nutritional rehabilitation.


Detection of anti-lymphocyte antibodies using the immunoperoxidase antiglobulin technic. Anti-lymphocyte antibodies in sera of multitransfused dialysis patients can be readily identified using the indirect immunoperoxidase method. Concordance between the microlymphocytotoxicity and immunoperoxidase methods was obtained in 61/66 paired specimens. The sensitivity of the immunoperoxidase antiglobulin technic is approximately that of the microlymphocytotoxicity method. This test may be used for lymphocyte crossmatching prior to renal transplantation.


The effects of "anti-platelet" drugs on bleeding time and platelet aggregation in normal human subjects. The effects on hemostasis of several commonly used drugs previously described as inhibiting platelet function were evaluated in a randomized, double-blind study of 54 normal volunteers. The subjects were each given a single dose of aspirin, chlorpromazine, glyceryl guaiacolate, diphenhydramine, indomethacin or lactose placebo. A single dose of aspirin significantly prolonged the template bleeding time and inhibited secondary platelet aggregation two and 24 hours after ingestion. Single doses of indomethacin and chlorpromazine affected aggregation at two hours but had no effect on bleeding time, although multiple doses of indomethacin did prolong bleeding time. Glyceryl guaiacolate inhibited aggregation one hour after ingestion but had no effect on bleeding time. Diphenhydramine did not affect either. These findings suggest that standard doses of many commonly used "anti-platelet" drugs may have little clinical effect on the hemostatic mechanism in normal man. Results of in-vitro platelet-drug incubations may not be directly applicable to in-vivo hemostasis.


Misdiagnosed Salmonella septicemia and endarteritis due to a lactose-fermenting strain: bacteriologic and epidemiologic considerations. In a case of septicemia and endarteritis the causative agent was initially misidentified. The Salmonella had atypical biochemical properties and was resistant to numerous antibiotics. Therapy with gentamicin and cephalothin failed to eliminate the organism. Identification of the organism as a lactose-fermenting Salmonella serotype typhimurium var. copenhagen was confirmed. The possible dissemination of the isolate from Brazil was analyzed by serologic studies of family members and friends.


Staphylococcal and streptococcal colonization of the newborn infant: effect of antiseptic cord care. A randomized controlled study was undertaken to compare the effectiveness of three umbilical cord treatment regimens in controlling neonatal bacterial colonization. The three regimens studied included castile soap, triple dye, and silver sulfadiazine. The triple dye and silver sulfadiazine application inhibited bacterial colonization. Staphylococcal colonization was inhibited by both treatment regimens but most effectively by triple dye. Group B streptococcal colonization was inhibited most effectively by silver sulfadiazine while triple dye application to the umbilicus promoted colonization with this microorganism. Silver sulfadiazine was more effective in controlling colonization with Gram-negative microorganisms.


Drug therapy reviews: management of the disulfiram-alcohol reaction. A review of the proposed mechanisms of the disulfiram-alcohol interaction and recommended management of the interaction is presented. The efficacy of disulfiram in the management of alcoholism, the signs and symptoms of the disulfiram-alcohol interaction, and other agents with disulfiram-like activity are discussed. Recommended treatment consists of supportive measures such as Trendelenberg posture, administration of oxygen and intravenous infusion of fluid, solute, colloid, and, if needed, a pressor agent such as norepinephrine. Iron salts, ascorbic acid, antihistamines and phenothiazines are of no established benefit.


Heterogeneity in Waardenburg syndrome.

Heterogeneity in Waardenburg syndrome. Heterogeneity of Waardenburg syndrome is demonstrated in a review of 1,285 patients from the literature and 34 previously unreported patients in five families in the Netherlands. The syndrome seems to consist of two genetically distinct entities that can be differentiated clinically: type I, Waardenburg syndrome with dystopia canthorum; and type II, Waardenburg syndrome without dystopia canthorum. Both types have an autosomal dominant mode of inheritance. The incidence of bilateral deafness in the two types of the syndrome was found in one-fourth with type I and about half of the patients with type II. This difference has important consequences for genetic counseling.


Computerized system for the identification of ingredients of proprietary compounds. A computerized system which links a code for a prescription drug product with codes for its active ingredients is described. Specialized computer programming techniques were used to insure a rapid system which would fit into the memory of small-to-medium sized computers. The programs are standardized, modular and independent of the codes used for the drugs and their ingredients. Classification of the ingredients in 32,304 prescriptions paid through the Tennessee Medicaid program required less than one minute of computer time on a Xerox Sigma 7 computer and used only 9% of the computer's available memory. The system has potential for use in settings where doctors frequently prescribe combination products.


Sleep-induced apnea syndrome. Prevalence of cardiac arrhythmias and their reversal after tracheostomy. Cardiac arrhythmias during wakefulness and sleep in 15 patients with sleep-induced obstructive apnea, and the effect of atropine and tracheostomy on these arrhythmias were studied by continuous overnight Holter electrocardiographic, respiratory and electroencephalographic recordings. Sleep was characterized by marked sinus arrhythmia in 14, extreme sinus bradycardia ( less than 30 beats/minute) in six, asystole of 2.5 to 6.3 seconds in five, second degree atrioventricular (A-V) block in two, and ventricular arrhythmias--complex premature ventricular beats in 10 and ventricular tachycardia in two. Arrhythmias during wakefulness were limited to premature ventricular beats in six. Atropine administration was partially and tracheostomy highly effective in preventing the majority of these arrhythmias during sleep. Marked sinus arrhythmia during sleep is characteristic of the syndrome of obstructive sleep apnea and is frequently accompanied by potentially life-threatening tachy- and bradyarrhythmias. Possible mechanism of production of these arrhythmias, the mode of action of tracheostomy and atropine, and the probable role of similar arrhythmias in the sudden infant death syndrome are discussed.


Diagnosis of lupus nephritis by skin immunofluorescence, in the absence of extrarenal manifestations of systemic lupus erythematosus. Six patients with glomerulonephritis were found to have granular deposits of complement and/or immunoglobulins at the dermalepidermal junction of normal skin. No patient had extrarenal clinical manifestations of systemic lupus erythematosus (SLE). The only serologic test suggestive of SLE was a positive antinuclear antibody (ANA) reaction; results of complement and antinative deoxyribonucleic acid (DNA)-antibody tests were repeatedly normal. The patients with glomerulonephritis had a favorable initial response to therapy with prednisone with or without azathioprine. These patients may represent a variant of SLE in which the diagnosis can only be established by a direct immunofluorescence test of normal skin. Alternatively, they may constitute a separate new clinical entity. Because of the favorable response to therapy, we suggest that skin immunofluorescence be performed in patients who present with unexplained glomerulonephritis and a positive ANA.


Mesangial proliferative glomerulonephritis with irregular intramembranous deposits. Another variant of hypocoplementemic nephritis. Two patients with a persistent mesangial proliferative glomerulonephritis and reduced serum C3 levels have been followed for six and 10 years. Both have had a mild course with normal renal function and spontaneous morphologic improvement. Levels of the fourth component (C4) and second component (C2) of complement, and properdin factor B have been normal; the third component (C3) of complement nephritic factor has not been detected. Ultrastructurally, irregular intramembranous electron-dense deposits are present, primarily within the lamina densa. These deposits are separated by varying lengths of normal-appearing glomerular basement membrane. Intramembranous and subendothelial electron-lucent areas, containing vesicles, are also seen. Subendothelial deposits, mesangial interposition, splitting of the glomerular basement membrane and ribbon-like intramembranous deposits are not found. The disease in these patients was clinically indistinguishable at onset from mrmbranoproliferative glomerulonephritis (MPGN). The possibility of a variant with mild clinical course, no progression and spontaneous morphologic improvement is important in planning and assessing treatment programs in this disease group.


A comparison of magnesium sulfate and alcohol for the prevention of premature labor. In travenous magnesium sulfate and alcohol were compared as treatments for premature labor. A successful treatment was the absence of contractions for a 24 hour interval. Early treatment was found to be essential for successful management of premature labor. There is a significant correlation of cervical dilatation at the onset of treatment to success at controlling premature labor. There was no statistically significant relation to weeks of gestation or parity to success at controlling premature labor. In this study magnesium sulfate was the better agent for controlling premature labor.


Maternal intravenous ethanol in the prevention of respiratory distress syndrome. The occurrence of respiratory distress syndrome (RDS) was studied in 68 premature neonates whose mothers were treated with at least one six-hour course of intravenous ethyl alcohol within 48 hours before delivery. At the gestational interval of 28 to 32 weeks, significant differences were observed in the incidence of RDS (p = less than 0.05), in severe RDS (p = less than 0.005), and in the mortality rate from RDS ( = less than 0.05), when compared to premature neonates not treated with alcohol and delivered during the same time interval. Several high-risk factors were found unevenly distributed between treated and control groups of patients, and their relevance to RDS was discussed. Premature rupture of membranes of more than 24 hours did not protect infants from RDS in the patients studied. Explanations for possible mechanisms of action are discussed.


Fetal renal tubular function during late pregnancy and diabetes mellitus. The effect, if any, of diabetes mellitus on the fetal renal tubule has not been previously studied. The concentration of beta2 microglobulin in amniotic fluid is a marker of fetal renal tubular function and normally decreases with advancing gestation, implying increasing tubular function. This relationship was found to be disrupted in 12 diabetic pregnancies, suggesting that the fetal renal tubular cell may represent an example of altered fetal functional maturation occurring during diabetic pregnancy.


The clinical usefulness of an ongoing bacteremia surveillance program. Surveillance of bacteremic patients within one week of the detection of a positive blood culture provides information of great clinical utility for relatively little effort. In this report one year's experience is reviewed to illustrate that an individual hospital's experience with bacteremia may diverge from national norms. Such reviews may also detect recurring errors in medical judgment which may be corrected through proper education.


Studies of lymphocyte populations in pre-eclampsia-eclampsia. The possibility that the etiology of toxemia might be immunologic has been held for over 70 years. In the past decade, numerous studies have been instituted in attempts to verify the possible role of the immune system in this disease. The present study was undertaken as a probe to determine if a gross difference in the numbers of T and B cell lymphocyte populations might exist between pre-eclamptic and normally pregnant women. Twenty-five normally pregnant women in the third trimester were compared to 25 pre-eclamptic women, and significant differences were noted. If, indeed, there is an immunologic basis for pre-eclampsia, it is more subtle than the methodology used in this study is capable of detecting.


Reconstructive techniques in radical pelvic surgery. The use of reconstructive surgical techniques accelerates recovery from radical pelvic surgery. It also allows the surgeon greater latitude in the type of procedure and the selection of patients for extended pelvic surgery. The techniques involved in three such reconstructive procedures are described, and their applicability is illustrated with care reports. The use of the compound myocutaneous flap, the axial cutaneous flap, and the omental island flap is discussed.


Simple pressure bandage technique for free skin grafts. We applied sterile packed cellulose sponges in the dehydrated state as a pressure dressing from skin grafts by using the classic "tie-over" technique. At the end of the procedure, the sponges were hydrated, and provided flat, even pressure to a localized area. By using this simple technique, we obtained 26 of 27 successful free skin grafts with flat apposition.


Transscleral ocular siderosis.

Transscleral ocular siderosis. Intraocular migration of iron from iron foreign bodies in an extraocular or intrascleral location was studied in rabbits. Focal changes occurred in the choroid and retina beneath the foreign bodies. Significant amounts of iron diffused through the sclera into the globes. This iron was typically deposited in the epithelium of the ciliary processes and in the tissues at the choroid-scleral junction in the posterior pole.


Ankyloblepharon filiforme adnatum with hydrocephalus, meningomyelocele, and imperforate anus. A 3,780-g newborn girl had multiple, bilateral eyelid adhesions taht connected the upper and lower eyelids by bands of extensile tissue. Although the eyelid lesion was benign, the associated systemic abnormalities may have been serious. We doubt that a single intrauterine insult led to ankyloblepharon filiforme adnatum and the associated anomalies.


The nursing home: occupational therapy services in an institution. The nursing home as an institution was described by presenting information from the literature and from the author's personal experience. Sociological definitions of the term institution were applied to the nursing home, and the negative effects of the institutionalization process on older persons were discussed. The plight of the residents was further exemplified in a discussion of the setting, staffing, financing, and services of nursing homes. Finally, the need for occupational therapy services was indicated, and therapists were urged to assume available jobs as therapists, consultants, or administrators in nursing homes as an initial step toward meeting this need.


Efficacy of ECT in affective and schizophrenic illness. The author reports on studies of the comparative efficacy of ECT, the newer psychotropic drugs, and combinations of both in the treatment of depression and schizophrenia. He concludes that ECT is indicated for acutely suicidal and other severely impaired depressive patients but not necessarily for schizophrenic patients, although ECT has been successful with some schizophrenic patients for whom drugs were ineffective.


Revolutions and the rights of man.

Revolutions and the rights of man. The author describes the dialectical struggle in psychiatric treatment between those who advocate maximum liberty in the management of the mentally disordered and those who believe such patients will benefit more from firm guidance and discipline. He uses illustrations from British psychiatric history to illustrate this struggle. He also points out and discusses two current challenges to psychiatry worldwide: the unconstructive hostility of the various schools of antipsychiatry and the political abuse of psychiatric diagnosis and treatment, particularly in the USSR.


ECT and memory loss.

ECT and memory loss. The author reviews several studies that clarify the nature of the memory loss associated with ECT. Bilateral ECT produced greater anterograde memory loss than right unilateral ECT and more extensive retrograde amnesia than unilateral ECT. Reactivating memories just before ECT did not produce amnesia. Capacity for new learning recovered substantially by several months after ECT, but memory complaints were common in individuals who had received bilateral ECT. Other things being equal, right unilateral ECT seems preferable to bilateral ECT because the risks to memory associated with unilateral ECT are smaller.


The borderline syndrome: evolution of the term, genetic aspects, and prognosis. "Borderline" has been used to designate conditions intermediate between psychosis and neurosis, analyzability and nonanalyzability; also, for dilute or questionable schizophrenia. Contemporary usage inclines toward patients with manic-depressive heredity, although borderlines are still etiologically heterogeneous. Various subtypes are outlined, each responsive to a particular method of psychotherapy or pharmacotherapy. If drug-abuse or antisocial tendencies are absent, prognosis is ofter favorable.


Biofeedback and psychotherapy.

Biofeedback and psychotherapy. Biofeedback, a procedure in which patients observe and interact with personal physiologic events, may serve as an experiential adjunct to the psychotherapeutic process, perhaps by assisting them to develop their abilities to recognize and affect the internal events under scrutiny.


Meditation, esoteric traditions--contributions to psychotherapy. This article is a brief introduction to several different Eastern systems of philosophy and therapy. It surveys the Buddhist contributions and several contemporary applications of traditional meditation techniques within the framework of modern psychologic science. It is suggested that meditative exercises produce three therapeutic gains: insight into repetitive, self-defeating patterns of behavior, desensitization of painful thoughts, and the conditioning of the central nervous system.


Choice of operation for acute gastric mucosal hemorrhage. Report of 36 cases and review of literature. The results of operative treatment of thirty-six patients with acute gastric mucosal hemorrhage are presented. Alcohol and surgery/trauma were the most frequent causes, and renal failure, sepsis, or multisystem disease caused most deaths; overall mortality was 44 per cent. Vagotomy-pyloroplasty and vagotomy-resection are compared, and no statistically significant difference in rebleeding, reoperation for bleeding, or mortality is identified.


Functioning and nonfunctioning cysts of the adrenal cortex and medulla. Adrenal cysts are rare clinical and pathologic entities. The vast majority are minute in size, unilateral, and found in females at autopsy. They come to the physician's attention when they produce symptoms or are identified on x-ray studies. When symptomatic, they generally produce lumbar discomfort and gastrointestinal symptoms, and occasionally are palpable by abdominal examination. There is no significant agreement as to cause and pathogenesis of the disease. The most common histologic types are lymphangiomatous endothelial cysts, secondary to lymphangiectasis, and the fibrous wall or hemorrhagic pseudocysts. In many patients preoperative diagnosis is now possible with high quality nephrotomography, ultrasonography, and adrenal arteriography. The presence of a suprarenal mass with peripheral or laminar calcification strongly suggests the presence of an adrenal pseudocyst. Selective biochemical studies are mandatory to rule out the presence of an occult cystic pheochromocytoma, and adrenal cortical tumor. Adrenal cysts must be differentiated from all space-occupying lesions of the upper abdomen. Surgical exploration is recommended in almost all patients for accurate diagnosis and to rule out malignant disease or occult pheochromocytoma. The choice of the surgical approach should be planned to provide for safe and adequate exposure, depending on the size and location of the lesion. Careful dissection with preservation of the adjacent kidney, liver, and pancreas should be performed.


Salvage and reconstruction of electrical hand injuries. Electrical injury results in serious damage or amputation of the upper extremity in a significant percentage of survivors. Fourteen of sixteen patients with electrical injuries followed over a two and a half year period had major hand wounds. Careful wound assessment, management, and closure combined with appropriate reconstructive technics now available provide the greatest potential for restoration of satisfactory quality of life. Because these injuries are often of an industrial nature, occupational vigilance and prevention remain essential.


The banner flap.

The banner flap. Wide experience with the banner flap for closure of postsurgical defects of the nasal dorsum shows not only that it is a predictably safe and versatile procedure but also that its use enables a superior cosmetic result to be obtained. The operative technic is described in detail along with our clinical experience.


A double-blind short-term trial of guanethidine 3% and adrenaline 0.5% combined in one eye drop. A double-blind short-term trial was done to test the effect of guanethidine 3% - adrenaline 0.5% (G-A) in a combined eye drop in 18 patients with open-angle glaucoma and one patient with narrow-angle glaucoma. In 9 of the 19 patients we expected an IOP lowering agent. There was one false-negative result. The mean fall in IOP due to G-A was 10.1 mm Hg (range 3 to 23) and 8.7 mm Hg (range-1 to 26) 6 and 8 h after application respectively. There was no effect on IOP in the 9 eyes that received the placebo.


Irreversible curarization.

Irreversible curarization. The reversal effect of neostigmine following different doses of tubocurarine was investigated in 20 anesthetized adults. After five minutes, neostigmine could rapidly and effectively reverse a blocking dose of tubocurarine. Doubling the dose of tubocurarine necessitated a much higher concentration of neostigmine to achieve reversal, while a triple dose could be reversed only after enough time had elapsed to allow for lowering its concentration. It is concluded that the degree of reversal by neostigmine is related inversely to the concentration of tubocurarine at the time of reversal. An overdose of tubocurarine predisposes to the so called "neostigmine-resistant curarization".


Poisoning by cresol.

Poisoning by cresol. A man aged 32 years who was poisoned with cresol is reported. It is suggested that in the absence of evidence about haemoperfusion over charcoal, forced diuresis is the only effective means of removing cresols from the body. Artifical ventilation controls early respiratory failure, but the patient remains at risk from toxic damage to the myocardium and lungs.


An improved perfusion fixation method for the testis. A reliable and uniform vascular perfusion fixation method for the testis has been developed by using an initial washout solution containing a vasodilator and an anticoagulant. This is followed by a brief fixation with a sodium phosphate buffered formaldehyde-glutaraldehyde solution of conventional strenght, and then a second more concentrated aldehyde fixative solution containing picric acid. The method takes into account some of the unique features of the vascular supply of the male genital tract for its favorable perfusion and fixation. The advantages of this method are: (1) consistently favorable preservation of the testis; (2) simple and inexpensive apparatus; and (3) stable and relatively innocuous stock solutions.


Cytophysiological studies on isolated pancreatic islets in vitro. Single, isolated pancreatic islets of mice and rats were incubated for varying time intervals (0.5-60) minutes with high (300 mg%) and low (50 mg%) levels of glucose. The structural integrity of islets decreased progressively with time regardless of glucose concentration. Degeneration of islets was greatest after 60 minutes of incubation. The total amount of insulin released from cytologically intact mouse islets incubated with high glucose levels was always greater than that with low glucose except following 30 seconds of incubation when no difference was observed. Peaks of insulin secretion noted after 2 and 15 minutes of incubation were correlated with light microscopic and fine structural changes indicative of active secretion in beta-cells, i.e., degranulation, granule margination. At 5 and 30 minutes of incubation many beta-cells contained enlarged Golgi zones and abundant profiles of swollen rough endoplasmic reticulum containing pale, amorphous granular material presumably indicating insulin synthesis. Emphasis is placed on the desirability of correlating physiological and biochemical studies of isolated pancreatic islets with cytologic examination.


Effects of positive end-expiratory pressure on gas exchange in dogs with normal and edematous lungs. The effects of positive end-expiratory pressure (PEEP) at 5, 10, 15, and 20 cm H2O on the distribution of ventilation-perfusion (VA/Q) ratios was determined in four normal dogs and in ten with oleic acid-induced acute hemorrhagic pulmonary edema. Tidal volume and frequency were held constant at all times with mechanical ventilation during intravenous pentobarbital and gallamine anesthesia. Normal dogs had little or no shunt, and no areas of low (less than 0.1) or high VA/Q (greater than 10.0) at zero end-expiratory pressure (intermittent positive-pressure breathing). In these animals increasing PEEP caused progressive depression of cardiac output, associated with an increase in ventilation to both high VA/Q and unperfused regions. PEEP greater than or equal to 10 cm H2O resulted in a reduction in Pao2 and an increase in PaCO2. In dogs with pulmonary  edema, PEEP's of 5 and 10 cm H2O resulted in dramatic reductions in shunt, virtual obliteration of low VA/Q regions, and market improvement in Pao2. However, at 15 and 20 cm H2O PEEP's high VA/Q and dead space ventilation with CO2 retention again developed in all but the most severely affected (shunt greater than 40%) dogs.


[Comparative study of 2 simple methods of measurement of cardiac output]. The authors compare two methods of simple measures of cardiac output which may be achieved using "bedsides procedures": the thermodilution and the isotopic embolism. The correlation of both series of measures is statistically significant. Besides, each method shows certain constraints. It brings different complementary hemodynamic informations.


Further studies in retention of the orthodontic band. A statistical analysis of 1,976 conventional orthodontic bands cemented to the teeth of 102 patients was carried out to try to establish the relationship of sex of the patient, age of the patient, and the type of malocclusion to the retention of the orthodontic band. The effect of treatment time and the presence or absence of extraoral traction on band recementation were also considered. The results obtained from the study led to the following conclusions: 1) There is no significant difference in the degree of band recementation occurring during orthodontic treatment between girls and boys. 2) There appears to be a tendency for bands to be recemented less frequently in patients 17 years of age and over. A larger sample would be necessary before being more definite. 3) The Class II, Division 2 type of incisor relationship may predispose to a higher rate of band recementation. Once again a greater sample size would be essential to be more categorical. 4) The percentage of bands recemented increased as the duration of treatment increased. 5) The use of early Kloehn cervical facebow therapy leads to a higher rate of band recementation on the maxillary molars.


Premature science and immature lungs. Part III. The attack on immature lungs. In Part I, I gave an account of the discovery of surface forces by Laplace and by Young (1805-1806) and of its first application of the lung by Von Neergaard in 1929. Part II told some highlights of the rediscovery of surface forces, the discovery of pulmonary surfactant and of its unique properties, and the finding that the lungs of babies who died of respiratory distress syndrome ("hyaline membrane disease") lacked this remarkable substance; part II dealt largely with the work of Radford, Pattle, Clements, Avery, and Mead. Part III tells of the multidisciplinary attack on immature lungs; it concludes this series, but not the story, because, as is almost always true in science, many questions still need answers.


[Pregnant vaginal carriers of beta-haemolytic streptococcus group B (author's transl)]. Vaginal schwabs of 142 pregnant women in different stages of pregnancy have been studied. 45 women who weren't pregnant and had no signs of vaginal infections, were the control group of the study. A higher incidence of "Streptococcus agalactiae" in vaginal schwabs of women who weren't pregnant (15.5%), as compared to the pregnant women (7.1%) was observed. A lower incidence of "Streptococcus agalactiae" was found in the last three months of pregnancy (1.8%) which is in direct relation to the low number of neonatal sepsis caused by "Steptococcus agalactiae" found in our country.


Supraventricular tachycardia: mechanisms and management. The phrase paroxysmal supraventricular tachycardia describes a group of arrhythmias with similar electrocardiographic features but different mechanisms that have been clarified in recent years with specialized intracardiac recording and pacing techniques. Reentry accounts for most cases and has been localized to the A-V node and less frequently to the sinus node, the atria themselves, and A-V nodal bypass tracts (Wolff-Parkinson-White syndrome). These forms of supraventricular tachycardia are initiated by premature beats that dissociate conduction between two pathways and permit the establishment of circulating electrical activity that spreads to atrial and ventricular myocardium. Paroxysms cease when the conducting properties of the reentrant circuits are disturbed by changes in autonomic tone or the application of certain drugs, pacing, or cardioversion. Supraventricular tachycardia may also result from abnormal automaticity in atrial tissues. Such automatic atrial tachycardias are often associated with A-V block ("paroxysmal atrial tachycardia with block") and may be due to digitalis intoxication. This arrhythmia is treated by withdrawal of digitalis or administration of antiarrhythmic drugs that decrease automaticity.