Metabolic and cellular profile testing in calves under feedlot conditions: minerals, electrolytes, and biochemical components--reference values. Blood serum samples were obtained from 114 crossbred calves on a feed trial under feedlot conditions at the end of a 56-day feeding period. Average values for 19 blood components were determined. The effects of the 3 trial rations and 2 electrolyte treatments were analyzed. Except for inorganic phosphates, urea nitrogen, cholesterol, glucose, alanine aminotransferase, and alkaline phosphatase most mean values were similar to those in dairy cattle. Urea nitrogen values differed significantly (P less than 0.05) in animals fed different rations apparently reflecting the crude protein content of each ration. The mean values presented can be used as base-line data for comparison with other similar studies or with values from  diseased animals.


Metabolic and cellular profile testing in calves under feedlot conditions: minerals, electrolytes and biochemical components--changes over time in feedlot. The concentration of 19 mineral, electrolyte, and biochemical components in blood serum of 114 calves under feedlot conditions were measured or calculated over a 58-day period (2 days before and 56 days during a feed trail). The purpose was to evaluate the variability in the concentration of these components over time. The blood was collected on 7 sampling dates and analyzed on the day following sampling. Generally, the serum concentrations of the components that were measured varied considerably over the first 3 weeks of the feeding period and then had a tendency to level off during the 2nd part of that period.


Metabolic and cellular profile testing in calves uncer feedlot conditions: blood cellular components--reference values and changes over time in feedlot. The cellular components of the blood of 114 calves were measured under feedlot conditions. The results suggest that certain cellular components of the blood of a group of crossbred feedlot-type calves which are homogeneous only with regard to weight are reasonably uniform. More specifically, all red blood cell components have coefficients of variation of less than 10%. The white blood cell counts underwent drastic changes over the first 2 sampling dates, ie, before and after transport and processing of the calves. Later, in the feeding period, the cell counts readjusted to more stable levels. The results were compared with such values obtained from dairy cattle. The total erythrocyte count, total leukocyte count, and red blood cell components were found to be slightly higher in these feedlot calves than in dairy cattle. The difference might partly be due to age. The mean values reported can be used as a base for comparison with values obtained from other such studies or from studies of disease processes in cattle under feedlot conditions (or both).


Metabolic and cellular profile testing in calves under feedlot conditions: protein fractions and lactate dehydrogenase isoenzymes--reference values. Serum protein and lactate dehydrogenase (LDH) isoenzyme values were determined for frozen serum samples from crossbred yearling feedlot cattle on feed for 56 days. The mean percentage values for serum protein components from 114 samples were: albumin, 46.5; alpha-globulin, 10.4; beta-globulin, 18.7; gamma-globulin, 23.8. For LDH isoenzymes, they were: LDH1, 36.5; LDH2, 24.7; LDH3, 16.9; LDH4, 12.0; LDH5, 9.1. These values are compared with values from dairy cattle.


Efficacy of droncit against Echinococcus granulosus infection in dogs. A study was made on 120 dogs to evaluate the effectiveness of droncit against Echinococcus granulous infection. The drug was administered orally in tablet form at dose rates of 1.25, 2.5, 5.0,and 10.0 mg/kg of body weight against immature stages of the parasite and at a dose rate of 5.0 mg/kg against gravid worms. Droncit was found to be 100% effective against both immature and gravid worms at the dose rate of 5.0 mg/kg. Adverse reactions were not observed in the treated dogs, and no risk was involved in administering the drug. The use of droncit in hydatidosis control programs in discussed.


Centric fusion of autosomal chromosomes in a bitch and offspring. A fertile Golden Retriever cross had a chromosome number of 77, with 3 large metacentric chromosomes representing the 2 X chromosomes and a centric fusion of 2 autosomes. The known reproductive history of the bitch included litters of 6, 5, 13, and 10 pups during 4 consecutive estrous cycles. A total of 16 pups and their sire were located and karyotyped. The sire and 9 of the pups were of normal karyotype. Seven of the 16 pups were found to be carriers of the translocation. The translocation was determined to be a fusion of chromosomes 13 and 17, utilizing G-banding techniques. Although centric fusion has been reported in dogs with congenital disease, the dogs in the present study were not phenotypically unique or abnormal.


Haemonchus contortus infections in Targhee and Targhee-Barbados Black-Belly cross lambs. Targhee and Targhee-Barbados Black-Belly cross lambs that were raised helminth-free were experimentally infected with 10,000 or 25,000 infective larvae of Haemonchus contortus. There were no significant (P = less than 0.05) differences in results of weight gain, packed cell volumes, numbers of eggs per gram of feces, or numbers of helminths between the 2 groups of lambs.


Prevalence of Coxiella burnetii (Q fever) and Toxoplasma gondii among dairy goats in California. The prevalence of antibodies against Coxiella burnetii and Toxoplasma gondii, the causative agents of Q fever and toxoplasmosis, was examined in goats to determine the extent of the potential of goats to tansfer these infections to persons. Of 1,054 goats from 234 premises in California, 248 goats (24%) were seropositive for C burnetii and 246 (23%) were seropositive for T gondii. Of 29 dairy goats tested, 2 (7%) were found to be shedding the Q fever rickettsia in their milk; T gondii was not detected. Factors of sex, age, location, and herd size are discussed.


Plasma volume and extracellular fluid volume in horses at rest and following exercise. Plasma volume and extracellular fluid volume were determined in horses at rest and immediately after a standardized exercise test. Exercising during training demonstrated no detectable effect on plasma or extracellular fluid volume determinations when compared with resting values. An explanation of this finding and an argument for the proper analysis of plasma and extravascular fluid volumes are presented.


[Mortality by burns in children (author's transl)]. The mortality rate among 1,490 children, aged zero to fourteen years, hospitalized in the Burns Unit of Departament of Plastic Surgery in Ciudad Sanitaria de la Seguridad Social de Sevilla is studied. Analysis determined death probabilities for each case according to percentage of burned surface and age, and also LD50 in different age groups. The mortality analysis showed lethal factors related with primary care and evacuation, responsible for a decrease in survival probabilities of the children. Children with severe burns must be hospitalized in special units, which must have a high level of training in hydroelectrolitics disturbances and surgical management of this type of patients, who require homo or xenografts frequently.


[Child drawings and psychological problems in paediatrics hospitalization (author's transl)]. Consulting in child psychology in collaboration with the pediatric hospital service, gave way to a growing interest to learn and take in consideration psychological problems of children. Six drawings by children are presented about subjects of hospitalization and in which the physician takes on a familiar psychological value that goes beyond the diagnosis and somatic treatment. The affective states which children show in their drawings when they are hospitalized and the work of the physician are discussed. Some psychoprophylactic means are suggested for hospitalization, surgical operations and serious somatic illnesses that can lead to a premature death. The child's biography and what the physician can observe in his family visits, are basic elements in the psychosomatic approach. The drawing gives elements about the internal state of the child in the hospital atmosphere and preliminary indications on individual psychotherapy treatment.


[Bartter's syndrome. Pathophysiology in three cases (author's transl)]. The primary pathologic defect in Bartter's syndrome is unknown. Three patients have been studied. In two of them, with normal intra-erythrocite sodium concentration, authors prove the existence of an impaired proximal tubular sodium reabsorption. In the last case, with a high intra-erythrocite sodium concentration, this impaired sodium reabsorption was localized in the proximal and distal tubular portions.


[Modifications of insulin and growth hormone after medium chain triglycerides ingestion (author's transl)]. Authors determined the variation of glucose, ketone bodies (KB), free fatty acids (FFA), insulin and growth hormone (HGH) in blood produced by the ingestion of 1.5 g./kg. of medium chain triglycerides (MCT) in 10 healthy children between 5 and 11 years. Blood values were determined starting 30 minutes before the MCT ingestion and at 30 minutes intervals until 120 minutes post ingestion and a final determination at 180 minutes. The glucose did not change. The KB were increased (p less than 0.01) from 30 to 120 minutes and the FFA from 90 (p less than 0.01) to 120 minutes (p less than 0.001) after ingestion. Insulin secretion was elevated between 30--90 minutes with a peak value at 60 minutes (p less than 0.001). HGH began to increase at 60 minutes, remaining elevated at the last determination at 180 minutes. The HGH basal value was 0.5 +/- 0.2 ng./ml.; began to increase at 60 minutes and reached the value of 3.9 +/- 1.06 ng./ml. and 4.8 +/- 2.04 ng./ml. at 90 and 120 minutes respectively (p less than 0.001). We do not know the origin of the HGH increase. The changes may explain FFA elevation and other metabolic actions of MCT. The glucose-insulin ratio showed that the hyperinsulinemia was not caused by an increased glucose level.


[Fever of unknown origin in children (author's transl)]. A study has been made of 79 children from zero to seven years of age admitted to hospital with fever of unknown origin (F.U.O.) of more than two weeks duration. Children in whom fever was not clinically observed after one week of hospitalization are not included. In 50 cases (63.2%), it was possible to establish a definitive diagnosis within the first fornight of admission. The most frequent cause of fever was that of infection, found in 51 children (64.5%), tuberculosis and urinary infections predominating with ten cases each. In another ten children neoplastic disease was diagnosed (mostly leucosis), and there was colagenosis in seven cases (8.8%). In another seven children, the etiology was not established. Mortality rate was 7.5%. Clinical history and exploration were of main importance in the orientation of the diagnoses. The findings of this study suggest that in all children presenting F.U.O., apart from hospitalization of at least one week, a very thorough anamnesis and clinical exploration are most important in establishing the diagnosis, along with a more or less aggressive approach to the problem according to the findings.


[Acrocephalosyndactylia. Apert' syndrome. A review of literature (author's transl)]. Authors revise world bibliography up to 153 cases. As introduction, they study the different anomalies that are presented, making special mention to the frequency of this syndrome, quoting to the statistics of different authors. Familiar antecedents, parents age and the alterations that had been presented in children affected with this process, including considerations not only within race, related by blood and sex, but also those malformations that in an accessorial way were displayed with more frequency have been taken into consideration. Between all the conclusions, it's significative that syndactily appears with more frequency in fatherly antecedents and although this syndrome appears in young parents, it's increases in great proportion as the age of the progenitors advances.


[Pancreatic lipomatous hypoplasia associated with skeleton anomalies. Shwachman's syndrome (author's transl)]. A five month old girl with exocrine pancreatic insufficiency, skeletal deformities and a non constant neutropenia (Shwachman's syndrome) is presented. Infectious complications, mainly septic and pulmonary, which caused her death, were frequent. The pathologic findings showed a pancreatic lipomatous hypoplasia and absence of zymogen granulos, as well as anomalies of the growing cartilage where no radiological abnormalities could be seen.


[Long-arm deletion of chromosome 1: 46,XY, del (1) (Q42) (author's transl)]. A case of long-arm deletion of chromosome No. 1: 46,XY, del (1) (q42) is reported. From the revised bibliography only two cases are comparable cytogenetically, not so phenotypically. The usefulness of the recent banding techniques in the precise diagnosis of small structural anomalies of the chromosome is outlined and the difficulty in establishing the relationship between chromosomal alteration and phenotypical characters are commented.


[Hyperglycemia in hypertonic dehydration (author's transl)]. Fourteen patients who developed hyperglycemia with hypertonic dehydration are reviewed, and compared to a control group of twenty-four dehydrated infants without hyperglycemia. The threshold of hyperglycemia was considered at 125 mg. %. The relationship between hyperglycemia and degree of formula concentration, incidence of shock and water and solute metabolism chemistry are analysed. The different theories about hyperglycemia in the course of hypertonic dehydration are discussed. Because of the negativity of other factors, authors suggest that the most important factor in hyperglycemia may be the ionic alteration of the cell.


[Choledochal cyst (author's transl)].

[Choledochal cyst (author's transl)]. This paper reports six pediatric patients with congenital choledochal cyst. From the long-term follow-up results of the six patients authors conclude that primary excision of the choledochal cyst and Roux hepatic jejunostomy are the first choice treatment for this lesion. However, it may not be possible in all cases, and choledochocystoenterostomy would then be useful as a second choice.


[Study of calcium and magnesium in cerebrospinal fluid and its' relation to different neurological diseases (author's transl)]. Calcium and magnesium have been measured in cerebrospinal fluid by atomic absorption spectrophotometry in children. The normal values on 194 C.S.F., obtaining for the calcium x: 5.24 mg. % and s: +/- 0.378 mg. % [50--56 % lower than serum values] and for magnesium x: 2.64 mg. % and s: +/- 0.155 mg. % [19--33 % higher than serum values] are found. Higher values of calcium at birth and on the first year of life and no differences with magnesium are noted. Applying the t-test, between normal values obtained and the different pathological entities, authors find singificant differences on the level of calcium, finding higher values on the following diseases: dehydration by diarrhoea, poliomyelitis, anoxy, tumours, bacterial meningitis. Magnesium showed values significantly higher in dehydration by diarrhoea and epilepsy, and values significantly lower on febrile convulsions and virical and bacterial meningitis.


[Flat and hypoactive neonatal E.E.G. evolution in eighteen cases (author's transl)]. Eighteen new-borns were studied, four of them were pre-term with a pregnancy of 35 weeks. They had an acute neurological symptomatology and also showed a E.E.G. with flat or hypoactive aspect in the neonatal period. The evolution of these patients is analyzed clinically and electroencephalographically of flat E.E.G. and an uncertain future in those cases with hypoactive E.E.G. A review of the literature on the problem was performed in order to compare the results of other series with those obtained in the present study, attending specially etiological, clinical, electroencephalographic and evolutive aspects.


[Thymus implant in a case of DiGeorge syndrome (author's transl)]. A boy with III-IV pharingeal pouch malformative syndrome, hypocalcemia and recurrent infections is presented. The immunological work-up disclosed deficiency in the specific cellular immunity with normal serum immunoglobulin levels. An adult thymus in Millipore diffusion chambers was implanted in the rectus adominalis muscle. One week later clinical and analytical data suggesting immunological reconstitution was recorded. Two years later the patient remains in good health, T and B lymphocyte percentages are normal, being the only immunological abnormality a low serum level of IgG.


[Internal hernia through Treves' avascular field defect (author's transl)]. Authors report two cases of internal hernia through Treves avascular field defects, at the ileal level and another case in which this mesenteric mishape was incidentally found during operation for intestinal obstruction due to adhesions. In this particular case it can be speculated that the defect could have been the cause of a former neonatal obstruction for which operation did not offer an explanation. This type of internal hernia is one of the rarest in pediatric surgical practice. The clinical picture is that of an intestinal strangulation and therefore diagnosis can hardly be made preoperatively. The ileal terminal location of the strangulated loop can, in their opinion, justify a resection extending to the caecum in order to avoid vascular risks on the anastomosis in spite of the sacrifice of the ileo-cecal valve. The three patients survived. Literature on this topic is briefly reviewed.


[Mitral prolapse syndrome and hypothyroidism (author's transl)]. Authors observe a case of hypothyroidism associated with advanced development in weight and height and mitral valve prolapse syndrome (MPS), with rupture of cordae tendinae. The sudden death of a sister promotes the hypothesis of hypothyroidism with a complication of MPS not diagnosed during life and in turn gives rise to comments about this rare morbid association. Hereditary implications, evolutionary risks and necessary reserves in the classification of infantile cardiac murmurs apparently not significant are commented.


[Primary acetabular protrusion (author's transl)]. A case of primary protrusion of the acetabulum in a ten year old girl, is presented. A review of the tiology, history, clinical signs and treatment is done. Authors comment the influence of genetic factor in the mother and the father, in the clinical picture of their patient.


[Acute infantile traumatic pancreatitis (author's transl)]. Authors present a case of acute infantile traumatic pancreatitis secondary to a stenosing duodenal hematoma, exceptional etiologic mechanism. Taking into consideration this case, they review some of the diagnostic aspects and their treatment, emphazysing the need of surgical approach as a correct diagnostic treatment.


[Psychotics and their bodies].

[Psychotics and their bodies]. We observed and other persons, too, (visitors, new patients...) the strange and particular physic aspect of lunatic people who are ill long since. The autonomy everybody seaks after, psychotic people loset it. The transformations of the psychoticbody appears as a trial to singularise and differentiate theirselves from the others. The few alluring aspect of these patients would signify the derogatory imago of a destroyed body, that does not be the mediator of the relationship to the other. Psychotic does not wish to please but want to be.


[Dysperception of body image and dysmorphophobias in mental anorexia. Apropos of 115 cases involving both sexes. I. Altered mechanisms of perception in mental anorexia]. We noted frequency of body-image disturbance (BID) and dismorphophobias (DPP) in 97 girls and 8 boys among 107 girls and 8 boys with Anorexia Nervosa (AN), seen since 1973 and coming up semiologic criterions of Laboucarie and Dally & Sargant. 91,5% of the girls and 7 out of 8 boys presented a BID at one time of their evolution. The other ones did not form a characteristic group. BID prevailed in no-perception of emaciation. No-perception of overweight was exceptional. That of variations of weight was frequent, explaining to need objective elements to measure real volume. BID seems to result from an incapacity to integrate well individually perceived details into a coherent image. Its apparition signals starting of AN, and it is a fundamental criterion of evolutivity. It's not frequent it's extended to body-image disperception of the close people, but it is often associated to an increase of mental representation of ingested feed volume.


[Dysperception of body image and dysmorphophobias in mental anorexia. Apropos of 115 cases involving both sexes. II. Dysmorphophobias in mental anorexia]. Study of DPP extended over 2 groups selected as following: It was prospective in every patient seen between July 1976 and May 1977 (systematic study: SS: 35 girls and 2 boys). It was retrospective in another group before selected for importance of DPP (no systematic study: NSS: 34 girls and 6 boys). DPP were distributed into Dalpha (fear of any weight recovery), Dbeta (obsessing repercussion of a real defect, amplified in its perception) and Dgamma (delirious and obsessing conviction of a physical anomaly). We researched correlations with the type of AN (fixity or recession to childhood), premorbid weight-height ratio, overweight of the same-sex parent, important problems towards sexuality (ASC = Absolute sexual conflict = An entirely caused by a sexual difficulty, or PSC = Partial Sexual Conflict = difficulty towards sexuality when insuffisant to explain AN, or no sexual conflict), attitude towards pregnancy in cases of big-belly DPP. Every DPP were DPP of localized or generalized obesity. Dalpha is constant and pathognomonic. In females of SS, 37% presented Dbeta and 5% Dgamma before AN, 25% Dbeta and 11% Dgamma during AN. Among the 8 boys of the 2 studies, 3 presented Dgamma before AN, and everyone expressed their obsessing fear of "ugly grease". In 20% girls and 50% boys, explained aim of loss of weight was to "wipe out" the anomally DPP emphasized. We did not find any correlation between generalized DPP and studied elements, particularly with sexual conflicts (22% of our cases). The more frequent localized DPP was "big-belly"-DPP, always associated with overweight of the same sex parent, but as for other localized DPP, without any correlation with sexual conflicts, problems towards the father, neither reject of pregnancy.


[Dysperception of body image and dysmorphophobias in mental anorexia. Apropos of 115 cases involving both sexes. III. Physiopathogenic deductions and introduction of a novel definition of the disease]. Ignoring of emaciation (IE), fear of any weight recovery (Dalpha), and dismorphophobias (DPP) represent the central problem of AN, with different incidence. Fundamental need of being lean expresses, at lesss in girls, distress of personality insufficiently prepared to autonomous adult life, with its responsabilities. Obesity-DPP may correspond to projection upon the body of the obsessing conviction of being inferior, with regard to social and publicitary patterns, and get an active play in starting and management of weight loss. So AN is either an attempt to accomodate this critic situation, trying to incarnate actual female archetype, either, in the more severe cases, a renouncing with an obstinate physical and psychological recession to the state of a protected child. It seems to correspond to an attempt of negation of morbid character of this situation, so that it may be perpetuated and so that feeling of culpability can be decreased in front of familial recrimination. Constancy of these symptoms, and their relation with deep meaning of this illness, justify their introduction into a new definition of AN, diagnosed by association of at less 2 out of 3 major criterious (loss of weight superior to 10% premorbid weight, feed restrictions and Dalpha) and one out of 2 minor criterions (amenorrhea and IE).


Aphakic soft contact lens update.

Aphakic soft contact lens update. Problems with the N series were mainly due to poor or viable visual acuity that could not be rectified by correcting the residual refractive error in spectacle overrefraction. The error lay mainly in the design of the lens and the fitting rationale. The introduction of lenses (B3 and F3) with base curve and power that adequately covered a wider range of aphakic eyes has solved the fitting problems in most cases. These have been done without sacrificing the simplicity in fitting. Most eyes can be fitted using the B3 series for corneas flatter than 43.00 diopters and the F3 for steeper corneas. The clinical application of the J3 has been found in our hands to be nil. Availability and reproducibility of these lenses are reasons for our preference to fit them for noncontinuous wear in aphakia. In addition, they were found to be a very safe and efficacious correction for the aphakic eye.


Ibuprofen in the treatment of central serous chorioretinopathy. A search of the literature yielded only one other paper concerning the use of ibuprofen for ophthalmic purposes. Marsili and Conte 8 used ibuprofen on a total of 138 patients with a variety of problems, both surgical and nonsurgical. They found an excellent to good response in about three fourths of their patients. This series of patients did as well or better. Three of the 4 were significantly helped with ibuprofen, and were pleased with the results. The fourth patient quite obviously did better while taking ibuprofen than she did without medication, and her visual acuity remained about the same as during steroid therapy. However, the patient herself was not satisfied with the results. It is my conclusion that ibuprofen has merit in the treatment of central serous chorioretinopathy. The concerned ophthalmologist may find the use of ibuprofen preferable to steroids in view of the dangers when these drugs are used at high dosages or for prolonged periods.


The supranuclear disturbances of gaze in kernicterus. Five patients with kernicterus and ocular motility disturbances are reported. All of the patients showed some defect in vertical gaze but not always upgaze. The most severely affected patient exhibited slowness of horizontal saccades in addition to a total vertical gaze palsy. In general, the severity of the ocular motility disturbance paralleled the severity of hearing loss. It is suggested that damage to the periaqueductal area accounts for disturbances in vertical gaze and the infrequent horizontal saccadic disturbances results from interruption of the descending centrifugal fibers. It is emphasized that kernicterus must be included in the differential diagnosis of any supranuclear vertical gaze disturbance.


Bilateral acute anterior ischemic neuropathy in diabetes: case report. A 51-year-old white man presented with an acute bilateral anterior ischemic optic neuropathy approximately 1 month following hospitalization for a hyperosmolar nonketotic diabetic coma. One eye treated by retrobulbar corticosteroids showed marked improvement. The literature reveals that diabetic anterior ischemic optic neuropathy is often diagnosed in the absence of diabetic retinopathy.


Ketamine hydrochloride: an effective general anesthetic for use in electroretinography. Ketamine hydrochloride, a relatively safe general anesthetic agent, has been demonstrated to be effective for use in electroretinography. Pigmented rabbits were given a dose of 25 mg/kg intravenously. The oscillatory potentials in light and dark adapted states and the ERG under various light adapted states after ketamine administration were not significantly different from baseline values.


Bilateral dural arteriovenous malformations simulating dysthyroid ophthalmopathy. The clinical recognition of dural arteriovenous malformations (AVM) is a challenge to the ophthalmologist. Unilateral dural AVMs produce monocular signs which may simulate orbit disease. A patient with bilateral dural AVMs presenting with bilateral congestive exophthalmos resembling dysthyroid ophthalmopathy is reported. Spontaneous resolution of the ocular manifestations occurred.


Unusual tumor of the iris: a rare initial clinical manifestation of metastatic adenocarcinoma of the tail of the pancreas. The occurrence of an iris tumor with secondary glaucoma as the initial manifestation of an occult pancreatic carcinoma is a rare clinical entity. The subsequent appearance of a testicular mass due to metastatic pancreatic disease also is rare. The use of new advanced diagnostic techniques, such as radioisotope studies and computerized axial tomography, may reveal occult carcinoma of the tail of the pancreas before the inevitable autopsy.


Cryotherapy of herpes simplex keratitis. Twenty-one cases of epithelial herpetic keratitis were treated with cryotherapy and 14 cases were treated with Iodoxouridine (IDU). Cryotherapy was found statistically superior to IDU. The average healing time was 2.4 days for cryotherapy and 6.2 days for IDU. The advantages of cryotherapy are emphasized.


Retinoblastoma seen after surgery for traumatic cataract. A case is presented of traumatic cataract which was aspirated to reveal a retrolenticular mass. Enucleation of the eye showed this was a retinoblastoma whose cells were adjacent to the gaping surgical wound. I emphasize the facts that trauma and its sequelae do not preclude existence of previous serious lesions and that invasive surgical therapy in cases of intraocular neoplasm may lead to their extraocular spread. Diagnostic ultrasound examination of eyes with opaque media may be of great value in preventing such cases.


Fundus lesions in rheumatoid arthritis.

Fundus lesions in rheumatoid arthritis. Cotton wool exudates were found in a patient during a flare-up of seropositive rheumatoid disease with polyarthritis and pericarditis. After therapy with cortisone a concomitant improvement of the cardiac arthritic and fundal lesions was observed. It is suggested that the fundal lesions in this patient were due to the rheumatoid disease.


Effect of oral contraceptives on tear production. No significant differences were found in tear production, as measured by Schirmer tests, or in tear film break up time between women taking oral contraceptives and those not on the medication. Wide variations in these tear function tests were found in the test subjects who were all asymptomatic young women.


Vitreous touch after phacoemulsification. Three cases with touch of an intact anterior vitreous face to the cornea following phacoemulsification had moderate corneal edema. In each patient, a different method successfully removed the touch of the anterior vitreous face to the corneal endothelium with subsequent prompt clearing of the corneal edema. Although uncommon, an intact anterior vetreous face against the corneal endothelium is possible when a wide opening has been made in the posterior capsule and the underlying vitreous face remains intact. In one case the recognition of anterior vitreous face contact to the cornea was delayed by the severity of the corneal edema. Of the 3 methods of treatment used, the pars plana anterior vitrectomy approach seemed the most effective and the medical approach with 4% cocaine seemed to be the least predictable.


Goniodiathermy: experimental studies on ab interno filtration. Goniodiathermy was carried out in rabbit eyes by first performing a goniopuncture with a Barkan knife followed by the introduction of an intraocular diathermy probe into the goniopuncture tract and heating of the cut ends of the scleral fibers. Histologic sections revealed that goniodiathermy produced a gaped wound in the scleral wall of the angle. Goniopuncture alone, without diathermy, resulted in a thin, well healed scar. Goniodiathermy appears to be a safe and feasible technique for creating a tract in the scleral wall of the anterior chamber angle in adult rabbits. This procedure, with modifications, may serve as a model for creating filtering blebs in the treatment of glaucoma in humans.


[Study on the presence of "free-living" amoebae in the swimming-pools of Lyon (author's transl)]. About 90% among 44 water samples executed in 9 swimming-pools of Lyon contained amoebae. From these prelevements, 85 strains have been separated. In spite of the great diversity of the species isolated, the strains belonging to genus Acanthamoeba and Hartmannella prevail. In return, the genus Naegleria seems to be rare: it has been isolated only one time directly from water of swimming-pools.


[Investigations on the oncomiracidium of Capsalidae (Monogenea) (author's transl)]. A detailed study of the ciliated cells and chetotaxy of the larva of Benedenia monticelli (Parona y Perugia, 1895) parasite of Mugil cephalus L. is carried out. Observations on the oncomiracidium of Trochopus pini (Van Beneden and Hesse, 1863) and Entobdella soleae (Van Beneden and Hesse, 1863) reveal a common plan of these structures among those Capsalidae. The pattern is different from that observed in the Dactylogyroïdea on one hand and Polyopisthocotylea on the other hand. The chetotaxic type of Capsaloïdea is original and it could, perhaps, be more advanced ontogenetic scheme as are the haptoral sclerites and the excretory system among these Monogenea.


[Hyperandrotrema cetorhini n.g.n.sp. (Trematoda, Sanguinicolidae) parasite of the circulatory system in Cetorhinus maximus (Selachii) (author's transl)]. Description of a new genus of Sanguinicolidae, Hyperandrotrema from one Cethorhinus maximus captured on Tunisian coasts. This new genus included in the subfamily of Chimaerohemecinae is characterized by a short gullet and long digestive caeca shaped like an inverse "U". Thus, the diagnosis of the subfamily of Chimaerohemecinae is modified.


[Ovine dicrocoeliasis: incidence of climatic factors and share in the setting of a forecasting method (author's transl)]. Study of annual activity cycle of ants parasited with Dicrocoelium lanceolatum. Effect of some climatic factors (temperature, rainfall) on seasonal variations of the number of clinching parasited ants. A close analysis of the data displays a double correlation: the increase of the number of clinching ants indirectly brought about by precipitations and this with some delay; a strong decrease by high temperatures in the height of summer. Setting of a calendar including the different stages of the developing cycle of Dicrocoelium lanceolatum in Limousin and proposition of a forecasting technic established from land observations.


Medical treatment of baldness.

Medical treatment of baldness. The etiology of male-pattern alopecia is explained as an interrelationship of three factors, genetic--a single dominant sex-limited gene; endocrine--dihydrotestosterone is the specific hormone responsible; and age. Other factors previously used to explain male-pattern alopecia are debunked. Treatment today is directed in the area of endocrinology, basically using either antiandrogens that block 5-alpha-reductase, thus preventing the formation of dihydrotestosterone, or steroids that interfere with dihydrostestosterone cytosol--nuclear binding protein expression.


[Chaetotaxic variations of the cercaria Schistosoma mansoni from a human strain during successive transmissions through mice (author's transl)]. The "cercarian chaetotaxic index" from the human strain of Schistosoma mansoni from West Africa is conspicuously modified during the third transmission Biomphalaria pfeifferi-white mouse only. This might be the explanation why Planorbs collected in Guadeloupe discharge slightly different cercariae whether they come from stations where the infestation is predominantly from human origin or from stations where the infestation is predominantly from murine origin. On the contrary, the "Grand Etang" station is significatively different from all the others and seems to be exclusively murine transmitted.


Rhinoplasty in the older adult.

Rhinoplasty in the older adult. In attempting to determine the suitability of an older person for cosmetic rhinoplasty, the surgeon must keep in mind not only anatomical considerations, but also, even more important, the emotional and psychological expectations of each patient. The surgeon should make every attempt preoperatively to arrive at a meeting of the minds with the patient, so that he has a thorough understanding of that patient's desires, needs, and hopes. If the surgeon believes he is able to achieve or even come close to his patient's goals by a conservative operative approach, there is no reason why a rhinoplasty should not be undertaken. However, it is the author's experience that rhinoplasty in the older patient often fails to produce a result wholly satisfactory to the patient and the physician, and it is necessary to keep this in mind when selecting patients.


[Influence of some medium factors on the fecundity of Biomphalaria glabrata (Say, 1818) Mollusca, Pulmonata) in laboratory conditions]. In different samples of fresh waters we studied the fecundity of Biomphalaria glabrata. We tested, too, the influence of different concentrations of Na, Ca, Mg, and K-salts. The snail, B. glabrata, is not affected by very high rates of those salts but eggs laying is getting down when the amount of NaCl is between 2000 and 4000 mg/1, of MgCl2 between 410 and 763 mg/1 and KCl between 330 and 760 mg/1. The rate in Ca seems inactive in the field of fecundity but, in an other hand, high concentrations of Ca suppressed the inhibiting effect of the high rates in Mg. B. glabrata is not affected by high rates in Mg, when Mg/Ca is Low. The inhibiting effect of Mg begins when Mg/Ca is around 30. The importance of different kinds of substratum for eggs lying on fecundity was also studied.


[Three new species of Onchocerca from duikers in Gabon (author's transl)]. The duikers from Makokou (Gabon) are parasitized by many species of Onchocerca but the adults are very often occult and can only be discovered by a systematical search. Three new species are described: O. sonini n.sp. in the feet-tendons, and O. lerouxi n.sp. in the muscular aponevrosis of the trunk of C. nigrifrons; O. beaveri n.sp. in the ligaments of the atlas-occipital articulation of C. monticola. Although their external appearance differs, these three species belong to a single group, which, from an evolutionary point of view, is intermediate between the more primitive Onchocerca of Equiids and those more evolved from other animals.


Skeletal and postural relations in augmentation mammaplasty. This paper provides an in-depth analysis of the thoracic skeletal architecture. The relationship between the skeletal configuration and its implications in augmentation mammaplasty are studied. Specific explanation regarding assymetry of the breast is given and caution for a more scrupulous examination prior to augmentation is advocated.


[Validity of the two species O. lienalis and O. gutturosa from bovines (author's transl)]. A new morphological analysis of the Onchocerca from the gastrosplenic ligament reveals characteristics confirming the validity of the species O. lienalis as distinct from the cervical Onchocerca, O. gutturosa. The dermic microfilaire of the two species have completely different distributions: the microfilariae of O. gutturosa are gathered in the cephalic region of Bovines while that of O. lienalis can be found in the umbilical region. Therefore we suspect strongly that the life cycle evolving in S. ornatum in England is that of O. lienalis and not of O. gutturosa as previously postulated; and we think that O. gutturosa is more likely to evolve in Culicoides than in Simulium.


Blepharophimosis with associated cup-lop ears. Blepharophimosis is a rare congenital triad consisting of epicanthus inversus, blepharoptosis, and a wider than normal intercanthal distance. Attention has recently been drawn to abnormalities of the eyebrow and the poorly developed nasal bridge. I record 9 cases of blepharophimosis associated with cup-lop ears seen over the last 15 years. These include a father and his 4 children.


The utility of pericranial flaps.

The utility of pericranial flaps. Three cases are presented illustrating various uses of pericranial flaps. In a patient with Apert's syndrome, a large pericranial flap was folded over bone pâté harvested from the upper frontal bone to improve forehead contour. Silicone and acrylic implants had been inserted in 2 other patients, 1 of whom had previously undergone radiation therapy for the correction of cranial defects. Both were lost due to infection. Autogenous bone grafts covered by pericranial flaps healed without difficulty, emphasizing the superiority of autogenous bone grafts over foreign substances in craniofacial reconstruction. Further uses of pericranial flaps are discussed.


Nasal tip cartilage grafts.

Nasal tip cartilage grafts. Grafts of autogenous cartilage were utilized in 88 patients to augment the nasal spine, to add definition to the columella, or to support the feet of the crurae when the tip is raised. Complications were uncommon. This technique is an extremely useful adjunct when changing tip profile.


Benign fatty tumors of the peripheral nerves. Fatty tumors of the peripheral nerves, although rare, occur with sufficient frequency to pose problems in diagnosis and treatment. Moreover, the nomenclature of these tumors has suffered from controversy over their morpological description. These factors have contributed to a misunderstanding about the treatment of these localized nerve abnormalities leading, in the past, to unnecessary radical nerve excisions with resultant total motor and sensory deficit. This paper reviews the various types of fatty tumors, describes the morphology and pathophysiology of one such lesion, and provides a basis for a rational surgical approach.


Treatment of an exposed breast implant by muscle flap and by fascia graft. An exposed breast implant was salvaged on one occasion by a lateral muscle flap from the serratus anterior and a second time medially by a fascia lata graft.


Nonsurgical treatment of impotence.

Nonsurgical treatment of impotence. The most recent methods of distinguishing between organic and psychological impotence are reviewed. The old theory that 90% of impotence is psychological is disclaimed and the various nonpsychological causes are pointed out. The majority of impotent patients can be treated in a nonsurgical manner.


A microarchitectural model of regional variations in hypodermal mobility in porcine and human skin. In this paper, we focus on the hypodermal component of the integument and its functional contribution to properties of skin mobility. A specially designed mechanical apparatus was used to measure hypodermal extensibility in vivo of 6-mm "island" punches at selected anatomical sites in anesthetized pigs. Representative regional hypodermal force displacement curves were found to differ statistically in magnitude of acceleration, slope, and extensions at breaking point. A vertically oriented "lattice network" of hypodermal fibrous elements arranged in geometric subunits is consistently seen in sample specimens. Microarchitectural differences in network configuration, geometric unit size, fat infiltration, and intrinsic collagen fiber length can be correlated directly to the biomechanical data. These findings are corroborated by light microscopy, scanning electron microscopy, and quantitative hydroxyproline concentrations. A similar network is confirmed in human cadaver biopsies. Clinically, our data suggest that skin mobility is at least partially allowed by unfolding and stretching of the hypodermal vertical collagen network, and that regional variations in fibrous network architecture satisfy specific functional requisites (e.g., joint mobility, skin stabilization), as well as serving as an expansile retractile reservoir for the deposition and absorption of fat.


Orbital blowout fractures: an approach to management. Cadaver studies and clinical evidence are presented to suggest that medial wall fractures are often concomitant with orbital floor fractures. The medial wall fractures are located in the ethmoid bone midway between the medial canthus and the lesser wing of the sphenoid. These fractures may be the etiology of late enophthalmus. The discrepancy between the high frequency of occurrence of medial wall fractures in this study and the rarity of clinical diagnosis derives from the limitations of standard radiography. Computed tomography (CT scan) is useful in delineating these fractures. The operative approach is through an incision above the medial canthus. Surgical treatment includes reduction of the herniated periorbital fat and coverage of the defect with autogenous, homologous, or alloplastic materials.


Cryosurgery of the skin: an experimental and clinical study. Using three different instruments, cryolesions were made in the skin of experimental animals (pigs) and the extent of necrosis was determined after one week. The most efficient device was a probe using liquid nitrogen; the amount of tissue killed varied directly with contact time. With all the instruments, a freeze of three minutes consistently led to full-thickness necrosis of the skin. The freeze-thaw-refreeze technique did not produce as much necrosis as a single continuous freeze of the same duration. Cryosurgery was used on 65 benign skin tumors in patients. Pain was minimal and the cosmetic results were excellent. The only difficulty with the method was that it occasionally failed to kill the lesion. For that reason, at present cryosurgery is recommended only for benign lesions. If one suspects that a tumor might be cancerous, it should be biopsied before freezing. If it proves to be malignant, further treatment (excisional or x-ray) should be considered strongly.


Ankylosis of the temporalis-coronoid complex of the mandible. Ankylosis of the temporalis-coronoid complex is a clinical entity. The etiology is usually direct trauma to the temporalis muscle or coronoid process of the mandible. It is difficult to differentiate diagnostically from ankylosis of the adjacent temporomandibular joint, and should always be considered in the differential diagnosis of inability to open the mouth. The treatment is always surgical and the intraoral approach is favored. The cure rate with this modality of therapy has been gratifying.


The "disappearance" of residual basal cell carcinoma of the skin. Three patients with histological evidence of incompletely removed basal cell carcinoma underwent reexcision; no residual tumor was found. Other reports of this phenomenon are discussed and some speculative explanations are offered.


Malignant hyperthermia during repair of a cleft lip in a 6-month-old infant, with survival. The case history is given of a 6-month-old girl who survived an attack of malignant hyperthermia that occurred during the repair of a cleft lip. We believe that this is the youngest such patient reported to date. The current concepts of the mechanisms of excessive heat production and muscular rigidity are presented. The need for constant awareness, early recognition, and prompt and proper treatment on the part of both the operating surgeon and the anesthesiologist are stressed to avoid a fatal outcome. Unfortunately, as yet there is no conclusive, consistent screening test available to identify those who will experience such an episode. Because a patient has once undergone general anesthesia uneventfully does not mean that malignant hyperthermia will not occur during a subsequent procedure or even during use of some amide local anesthetics.


A filing system for transparencies.

A filing system for transparencies. A system has been developed to facilitate filing of 2 inches X 2 inches Kodachrome slides. This is coordinated with a diagnostic and therapeutic index that allows for easy retrieval. Compact metal filing cabinets are used, eliminating the need for subsequent rearrangement of slides. The system also provides a method for recall of patients. Preoperative photographs are maintained in plastic folders and checked periodically until the postoperative photographs have been taken.


A new device to assist in sizing breasts. There is a gray zone in specific communication about what size a woman's breasts will be after surgery. I have devised a clear plastic shell which accurately simulates a bra cup size of a breast in the upright position. This can be used for preoperative demonstration under clothes, intraoperatively with inflatable implants, preoperatively with gel implants, and in pexis. I have used these with great success for two years in my practice.


Herniated areolar complex.

Herniated areolar complex. A method of repair is presented for correction of both the abnormally enlarged nipple-areolar complex with herniation of breast tissue through a dilated and enlarged areola, and of enlarged areolae following pregnancy. A simultaneous augmentation mammaplasty can be performed when indicated. The deep double-layered closure reduces tension on the areolar suture line and minimizes postoperative enlargement of the reconstructed areola.


Dental rotation in cleft lip.

Dental rotation in cleft lip. In patients with untreated cleft lip and permanent dentition, the central superior incisors are usually rotated. We use a technique that we call "dental rotation" to adjust these teeth into normal position and occlusion. This technique avoids having a hard structure (a rotated tooth) press against the mucosal sutures in a lip closure. In addition, a better aesthetic appearance of the dental arch results.


Septorhinoplasty of the traumatically deformed nose. The author has reviewed the 69 patients upon whom he has performed septorhinoplasty in treatment of posttraumatic deformities. These have been followed over a 12-year period; however, only the 59 followed over one year have been studied. In analyzing the deformities, it was noted that three characteristics occur alone or in combination: excessive width, depression, and twisting. The wide nose was best treated by removal of medial tissue, full mobilization of the nasal bones, and postoperative compression exercises. The depressed nose was built forward by onlay grafts, the first choice being septal cartilage. Finally, the twisted nose was treated by freeing the nasal components, straightening the bone and cartilage, and replacing them in their anatomical positions. Not infrequently all three problems were treated in one operative session.


Immediate reconstruction of simple lacerations. A subjective description of a technique of immediate reconstruction of cutaneous defects due to laceration is presented. Extension of the use and range of the Z-plasty is emphasized and its benefits and limitations are discussed. The reconstructive surgeon is challenged to consider wider and more frequent use of these methods.


Penile disorders in two paraplegics.

Penile disorders in two paraplegics. We present two rare cases of paraplegics with remarkable sequelae of the penis due to long-term usage of a condom-catheter. One involved hypertrophy of the glans prepuce, and the other had severe constriction of the distal portion of the corpus penis with two fistulae.


Influences of different surgical procedures on growth of dentomaxillary complex in dogs with artificially created cleft palate. Possible detrimental effects of palate repair on dentomaxillary growth have been reported before. In our study, two principally different surgical techniques were compared. Dogs with artificially created clefts of the palate were subjected to either a periosteal flap (Langenbeck) or to a bone flap (Dieffenbach) closure. Skull roentgenograms and upper jaw impressions were used to study the possible effects on growth. Definite abnormalities were found following both procedures; there are strong indications that the bone flap is the more detrimental one.


Quantitative optics: the control of perspective in comparative photography. Although angle of view is only one of several factors that influence the reliability with which judgments can be made in comparing one photograph with another, application of this concept in taking photographs of patients will permit the surgeon, no matter what camera equipment is used, to achieve a high degree of standardization in preoperative and postoperative photographs.


Reduction of excessive nasal tip projection with a modified Lipsett technique. Management of the excessively projecting tip is one of the difficult problems in rhinoplasty. Several methods have been offered as solutions to this problem, but none has gained wide acceptance. The technique described by Lipsett allows reliable reduction of tip projection without sacrifice of the normal anatomical configuration of the lower lateral cartilages vital to preservation of a natural tip contour. This technique is described and several modifications that have enhanced its usefulness are discussed.


Alar hinge flap in heminasal reconstruction. Eight patients in whom heminasal reconstruction was aided by a modified septal chondromucosal flap are presented. The technique involves support of the new ala and additional lining by the hinge flap; continuity of the septum is restored by reapproximation of the ipsilateral mucosa.


Reconstruction of a large unilateral nasal defect. A modification of the nasal septal technique for reconstruction of a large unilateral defect of the nose is presented that provides cartilaginous support of the nasal defect and mucosal lining. This is accomplished by rotation of the cartilaginous nasal septum and its contralateral mucosal lining into the nasal defect. Coverage with a nasolabial flap allows complete reconstruction in one operation.


Making slides for lecture or teaching.

Making slides for lecture or teaching. Technical details are provided for making slides of several types for lecture or teaching. Advantages are simplicity, versatility, speed, high quality, and low cost.


Analysis of the adolescent growth spurt using smoothing spline functions. Height growth velocity curves between 4.5 and 17.75 years were estimated, using smoothing spline functions, for 112 boys and 110 girls from the Zurich Longitudinal Study (1955--1976). Parameters characterizing the growth process, such as peak height velocity and age at peak height velocity, were calculated directly from the estimated curves. The variability of parameters describing the adolescent growth spurt is large, both between and within sexes. Peak height, defined as increase of height velocity during the growth spurt, and age at peak height velocity both characterize the sex difference in growth in a highly significant manner. Peak height of at least 4 cm/year is found in 70% of the boys, but in only 11% of the girls. The age at peak height velocity averages 12.2 years in girls and 13.9 years in boys and has a wide range of 5.7 years and 3.8 years respectively. The sex difference in adult height of 12.6 cm is composed of the following 4 factors: +1.6 cm caused by more prepubertal growth in boys, +6.4 cm by the boys' delay in spurt, +6.0 cm by the more extensive spurt in boys and -1.4 cm by more post-spurt growth in girls. Correlations between parameters indicate that the adult height depends neither on the duration of growth, nor on the duration and height of the peak. Minimal pre-spurt height velocity and peak height velocity, but not peak height, are age- and height-dependent. Partial correlations given adult height reveal two compensating mechanisms between growth in the prepubertal and in the pubertal period. Small prepubertal height and low height velocity with respect to adult height are followed by a late adolescent spurt and vice versa. Small height at the onset of the spurt with respect to adult height is followed by a longer lasting, but not higher spurt and vice versa.


Placental enzyme polymorphism among Maharashtrians: alkaline phosphatase and lactate dehydrogenase. The distribution of placental alkaline phosphatase and lactate dehydrogenase types in 635 placentas from various endogamous groups of Maharashtra have been studied by starch gel electrophoresis. In the case of alkaline phosphatase, 6 common phenotypes and 6 rare phenotypes (F2I1, S1S2, S2S3, I1S2, F1S2, F1I2) are encountered. The highest frequency of Pls1 allele (0.7394) and lowest frequency of Pli1 allele (0.0246) have been found in the Nava-Budha. 6 cases of Cal-1 and 5 cases of Cal-2 types of LDH variants have been observed in the total samples, and Muslims possess the highest frequency of Cal-1 types (3.64%). Population groups are compared with respect to Pl alleles.


HLA antigens and IgG allotypes on the Island of Barra (Outer Hebrides). The distribution of HLA antigens and IgG allotypes in a group of nearly 200 adults on the Island of Barra, shows some unusual features. The sample tested included only people age 65 and over. Marked differences in the frequency of some HLA antigens were noted, compared to those previously determined for the northern island of Lewis and Harris, with increase in the frequency of HLA-A5 and B7. The latter antigen was present in over 40% of the group, compared with a frequency of 27% in the Northern islands. The high frequencies of HLA-A2, the Aw19 group and B12 previously noted in Scottish populations were also present. The IgG allotype, Gm (f;b4) was markedly increased, being present in 67% of the group, in comparison with frequencies of 40--45% in previous Scottish studies. These results either suggest a sampling phenomenon, or may be an indicator of selective forces related to immunological mechanisms or the age distribution of the population studied.


Anthropometry of Sherpa men.

Anthropometry of Sherpa men. On 109 male Sherpas, aged 18--85 years, 24 anthropometric measurements were performed, including weight, height, 18 bony measurements, 2 limb circumferences, and 4 skinfolds. From these data, upper and lower limb lengths, 12 indices, and total body fat were calculated. The Sherpas are of medium stature and body build, with Mongoloid cranial and facial characteristics and very little body fat. Their relatively large chests, long legs, and large calf muscles may be a racial adaptation to the high altitude at which they live and to the load-carrying, which is a feature of their life.


Skin colour of the Ainu of Hidaka, Hokkaido, Northern Japan. Quantitative data on skin colour variation are presented for Ainu of the Hidaka District, Hokkaido. Measurements of upper arm reflectance were taken using 8 filters of an EEL reflectance spectrophotometer. The results are compared with those published for the Japanese by Hulse (1976). Sexual dimorphism is well marked in both populations and among the Ainu appears to be due largely to clothing habits. There is no statistical evidence for an association between skin colour and age. Ainu reflectance values at 545 nm and antilog transforms at 685 nm lie between those reported for Eskinomos of Greenland and Brazilian whites. Although the Ainu have consistently higher reflectance values than a Japanese sample assigned to the northern part of Japan, the results give little indication of the relative contributions of genetic and environmental factors to the differences observed. However, comparison of mean reflectance for Hokkaido Ainu and 'Central' Japanese with values predicted on the basis of world trends indicates that the differences are no greater than would be expected for two populations separated by over 7 degrees latitude and differing from one another in respect of temperature and humidity. Correspondence between observed and predicted reflectance values is excellent at the longest wavelength but poor at 470 nm.


Relationship of anthropometric dimensions to lean body mass in children. This study is designed to compare the predictability of lean body mass, as measured by whole-body 40K spectrometry, from skinfolds, circumferences and skeletal widths in children 7 to 12 years of age. The specific skinfold sites were back, upper arm, side, waist, abdomen, and calf; the circumference sites were forearm, upper arm (flexed), wrist, thigh, calf, and chest (deflated); skeletal widths included wrist, knee, ankle, elbow, shoulder and hip. In a group of 163 boys, three skinfolds and body weight accounted for 89.7% of the variation in LBM, two circumferences and height and weight accounted for 87.2% of the variation in LBM, and two skeletal widths and height and weight accounted for 87.4% of the variation in LBM. Combining all measurement variables into one analysis resulted in five significant variables: weight, side skinfold, abdomen skinfold, forearm circumference and chest circumference with the coefficient of determination 90.6%, only slightly higher than with weight and three skinfolds. The significant variables from the combined analysis were then used to predict LBM in five separate age groups of boys and a sample of 44 girls. In general, weight, forearm and chest circumference contributed positively to LBM and side and abdomen skinfolds contributed negatively. The regression coefficients for each site were not significantly different among age groups. LBM in children can be estimated from skinfolds, circumferences or skeletal widths with considerable success, as has been shown to be the case in college-age adults.


ABH secretion in the population of Pembrokeshire, Wales. Saliva samples collected from 482 Pembrokeshire school-children were tested for secretor status. The Pembrokeshire gene frequencies agree closely with those available for other Welsh samples. Moreover, there are no statistical differences between the secretor-status frequencies reported in north and south Pembrokeshire.


Natural selection and birthweight.

Natural selection and birthweight. Mean birthweight, even before induced births became commonplace, is slightly lower than the birthweight at which perinatal mortality is lowest. This finding, once hard to explain by natural selection, is shown to be exactly in line with predictions from natural selection theory.


Reproductive compensation in families segregating for Cooley's anaemia in Ferrara. The reproductive performance of 100 families segregating for Cooley's anaemia was studied and compared to the performance of 127 control families. The control families were those of the sibs of the parents in the segregating families. No differences was found in the variables which might affect fertility and fecundity in control and thalassaemic families, although a different shape of the distribution of the number of births per family was found; the distribution had a higher variance in thalassaemics than in controls. The interval between the birth of a normal and an affected child is significantly longer than the interval between the birth of an affected child and a subsequent one. It was thought that these findings are indicative of reproductive compensation in families segregating for Cooley's anaemia, and of the moderate effect of the genetic counselling given to them.


The linkage relationships of marker sites on chromosomes no. 2 and 10. Two families in which aberrations involving chromosome no. 2 had been previously used for linkage studies have been re-examined using banding techniques to identify the breakage sites. In one family a (2; 10)(q21;q24) translocation was identified in individuals previously thought to have a pericentric inversion of chromosome no. 2. In the other, a fragile secondary constriction site was localized to 2q13, and it was shown by bromodeoxy uridine incorporation that the origin of the triradial chromosome no. 2 was by isochromatid breakage and non-disjunction rather than by selective endoreduplication. The three marker sites, 2q13, 2q21 and 10q24, have been analysed for their linkage relationships with 15 informative marker loci which have not yet been assigned to chromosomes other than no. 2 or no. 10. No significant evidence for linkage with any of the loci tested was found.


The seasonal variation of births of offspring from couples heterozygous for cystic fibrosis. To test whether the month of birth of patients with cystic fibrosis (CF) is seasonally distributed as reported in a Dutch survey, published Australian data were examined and no difference in the monthly variation was found between births of CF patients and their unaffected sibs. When the two groups were combined and analysed by periodic regression using successively higher Fourier terms, a significant fit to the observed frequencies was obtained with a bimodal curve. Possession of a single CF gene seems therefore sufficient for expression of the cyclic variation. In substantial agreement with the Dutch series, maximum frequencies were found to occur in March or April and in September. It is suggested that one or both parents may be subject to variable fertility mediated by a temperature-dependent mechanism. The relevance of a periodic fertility pattern in preserving the CF gene in the population by selective heterozygote advantage is discussed.


A statistical analysis of birth-order effects with application to data on pyloric stenosis. A method is presented for correcting incomplete data for birth-order analysis and variations in the ascertained incidence of affected individuals are allowed. The statistical analysis involves application of a test developed by Wilcoxon, Mann and Whitney, and Haldane and Smith. Examples are detailed for data correction, and the analysis of data for pyloric stenosis is discussed.


Choice of ascertainment model I. Discrimination between single-proband models by means of birth order data. A statistical method for choosing between ascertainment models for human family data has been constructed. The families are assumed to have been ascertained through a single proband each and the birth number of the proband among the affected children is recorded. If the proband is the eldest affected child in each family the so-called complete ascertainment model has to be used. If each affected child has the same probability of being the proband, the so-called single ascertainment model should be used. In intermediate cases a third ascertainment model should be used.


A note on the likelihood equation in the ABO blood group system. Some sufficient conditions on the data for the likelihood equation of the ABO blood-group system to have a unique solution, the maximum-likelihood estimate, are given. The simplest of these conditions is that the frequency of the blood group O in the sample shall exceed 1/8. This condition will hold for most samples.


Ancestral inference. II. The founders of Tristan da Cunha. The Tristan da Cunha data for the MN-blood types and for retinitis pigmentosa are analysed according to the methods for ancestral inference developed in the preceding paper. Joint and marginal likelihoods for the MN data show that it is possible to make inferences about the types of original founder genes, although relative values are in some cases not large. Although relative likelihoods are robust against small changes in gene frequency, they can be distorted by assuming values that differ widely from the maximum likelihood estimate. In the case of retinitis pigmentosa, under an assumed allele frequency of 0.01, we conclude, contrary to expectations, that the couple (975, 798) are substantially the most likely founders to have been responsible for the introduction of the allele. The inferences for this trait are complicated by the fact that it is recessive, and genotypes are therefore not observable. Extinction probabilities for a variety of sets of original founder genes on the Tristan da Cunha ancestral pedigree are also computed and discussed.


Papulosis atrophicans maligna (Köhlmeier-Degos disease): a disseminated occlusive vasculopathy. Malignant atrophic papulosis usually presents as pathognomonic skin lesions followed by acute abdominal pain, bowel perforation, peritonitis, and death. Rare patients who may lack gastrointestinal symptoms present with central nervous system manifestations, including headache, paresthesias, weakness, and rapid deterioration to death. The patient reported here was a 47-year-old man whose neurological symptoms apparently preceded his cutaneous lesions. His course consisted of a disseminated neurological disease and exacerbated following a herpes zoster infection. His condition rapidly deteriorated despite corticotropin, glucocorticoids, and low-molecular-weight dextran. Necropsy revealed a disseminated occlusive vasculopathy and diffuse encephalomyelomalacia of the brain and spinal cord. A review of autopsied patients with central nervous system involvement is provided.


Neoplastic angioendotheliosis: ultrastructural study and review of the literature. Neoplastic angioendotheliosis is a rare disorder characterized by progressive multifocal neurological deficit and dementia. The principal pathological findings are multiple infarcts in the brain and spinal cord and the microscopical demonstration of proliferated neoplastic cells, primarily within the lumens of arteries, arterioles, and capillaries. Vessels of the central nervous system are the most severely affected and appear to be the primary site of neoplastic proliferation. Systemic intravascular and focal extravascular proliferation can also be identified. The endothelial origin of the neoplastic cell with a gradation of changes from normal to neoplastic is demonstrated by the electron microscopical study of involved meningeal vessels. Our patient and those reported in the literature all demonstrate involvement of the central nervous system. In addition, an elevated cerebrospinal fluid protein level is present in all patients for whom that information is available, and fever and renal involvement are frequently present. Steroid therapy is generally ineffective. If the disease is suspected clinically, our studies suggest that meningeal biopsy is the diagnostic procedure of choice to help determine whether chemotherapy should be instituted.


Appraisal of the PAM cell effect as a diagnostic test for multiple sclerosis. The selective reduction of PAM cell yield reported by Carp and associates in the presence of tissue from patients with multiple sclerosis (MS) has been attributed to replication in culture of a viral agent associated with MS (MSAA). We investigated the diagnostic potential of the PAM cell effect in MS and in optic neuritis (ON). Six serum and 7 CSF samples from 7 patients with MS, 3 serum and 3 CSF samples from 4 patients with idiopathic ON, and 4 sera from 4 patients with ON induced by ethambutal toxicity were tested. Blind counting showed no reduction in PAM cell yield in the MS group nor any significant difference between the two ON groups. Disturbing inconsistencies in PAM cell growth rates over time and between control flasks were demonstrated.


A technique for the elution of cell-surface antibody from human brain tissue. An artificial system is described in which anti-dinitrophenyl (DNP) antibody attaches to hapten-conjugated human brain tissue. Treatment of this material with acetic acid at pH 2.5 to 3.0 for 90 seconds followed by immediate neutralization results in dissociation of antibody from the hapten-conjugated brain. Less than 1 ng of specific antibody can be detected, as determined by the ability of eluted material to combine with DNP in an established radioimmunoassay system. Similar methods may be applied to neurological disorders in which immunoglobulins are thought to be produced in the central nervous system.


Prolonged neonatal myasthenia gravis: electrophysiological studies. A female infant with neonatal myasthenia gravis remained weak for an excessively long period compared to the usual situation in this disease process. At 71 days of age, electrophysiological studies revealed evidence of a defect in neuromuscular transmission that improved with intravenous Tensilon therapy. Repeat study at 183 days of age was normal. This case represents an unusually long time for an affected infant to have neonatal myasthenia gravis. Electrophysiological studies are of value in the diagnosis and management of patients with neonatal myasthenia gravis.


Juvenile type of distal and segmental muscular atrophy of upper extremities. Seventy-one cases of distal and segmental muscular atrophy of the upper extremities with juvenile onset were studied. The clinical features consisted of: juvenile onset, male preponderance, unique distribution of the muscular atrophy in the hand and forearm, tendon reflexes hypoactive in most cases but hyperactive in some, no definite sensory disturbances, no involvement of the cranial nerves, and autonomic nerve disorders in the affected region. There was rapid progression during the 2 to 3 years after onset with a slowly progressive course thereafter. There were no abnormal laboratory findings except for electrophysiological and morphological findings of the affected muscles. The site of lesion was surmised to be from the C5 to T1 spinal segments with intramedullary involvement. The cause is unknown.


Papillophlebitis: benign retinopathy resembling papilledema or papillitis. Three young adult patients are described to illustrate an uncommon syndrome, papillophlebitis. This entity, characterized by mild but protracted monocular visual impairment, edema of the optic disc, retinal venous engorgement, and perivenous retinal hemorrhages, resembles atherosclerotic occlusion of the central retinal vein in older patients. In younger individuals it is benign and self limited, but may be incorrectly diagnosed as optic neuritis or papilledema. These alternatives can usually be excluded if tests of visual function do not indicate an optic nerve conduction defect and if the clinical presentation and examination of the opposite ocular fundus do not disclose evidence of increased intracranial pressure. Because resolution usually occurs spontaneously, immediate neuroroentgenographic tests may be inappropriate. Effective treatment has not been established; local instillation of corticosteroids may hasten recovery.


Hydrocephalus caused by increased intracranial venous pressure: a clinicopathological study. A child developed progressive communicating nonobstructive hydrocephalus as a result of increased intracranial venous pressure. The child had been treated for congenital heart disease at age 3 weeks by surgical creation of an anastomosis between his superior vena cava and right pulmonary artery. Although his cardiac symptoms were alleviated, intracranial venous hypertension resulted, giving rise to progressive head enlargement and other signs of hydrocephalus. Postmortem examination at age 3 years disclosed no other lesions that could have caused the hydrocephalus. Increased intracranial venous pressure can lead to either pseudotumor cerebri or hydrocephalus, the former in children 3 years or older, the latter in infants 18 months or less. Possible mechanisms accounting for these differences are discussed.


Juvenile parkinsonism: a patient with possible primary striatal dysfunction. A 15-year-old boy who initially manifested dystonic features and later developed classic parkinsonism is described. Cerebrospinal fluid homovanillic acid levels were normal or slightly elevated both before and after administration of probenecid. The patient responded favorably to treatment with levodopa and carbidopa. The normal or slightly elevated cerebrospinal fluid homovanillic acid levels contrast with the low levels usually seen in adult parkinsonian patients. The data on this patient suggest direct neostriatal involvement rather than depletion of neurons of the substantia nigra. Juvenile parkinsonism may have at least two distinct pathological forms, but they have similar clinical features and a similar response to treatment.


Hypothalamic hypothyroidism causing spastic paraplegia: recovery following thyroid medication. A 63-year-old woman with longstanding spastic paraplegia and neurological evidence of long tract disturbance was found to have hypothyroidism, partial diabetes insipidus, hyperprolactinemia, and gonadotropin deficiency of hypothalamic origin. Replacement therapy with thyroxine and prednisone induced complete remission of the neurological abnormalities. The association of spastic paraplegia with hypothalamic insufficiency  has not been reported previously. The possibility of hypothalamic disease should be considered in cases of spastic paraplegia of unknown cause.


Late components of motor unit potentials in a patient with myoglobinuria. A 45-year-old woman had severe weakness, myoglobinuria, and elevated muscle enzyme levels in the serum after a flulike illness. Electromyography some four weeks later showed motor unit potentials with late components; these remained present on subsequent electromyographic examinations performed at approximately monthly intervals for the following year. The persistence of motor unit potentials with late components is taken to imply that the late components were caused either by sprouts that failed to undergo myelination or, more likely, by ectopically innervated muscle fibers.


Blue rubber bleb nevus syndrome with CNS involvement and thrombosis of a vein of galen malformation. A patient is described with the dermatological features of blue rubber bleb nevus syndrome (BRBNS), focal seizures, and lateralized neurological signs. CAT scan demonstrated a nonenhanced density in the region of the vein of Galen. Neuropathological examination showed that this density was a clot within a vein of Galen malformation. Hemangiomas that grossly resembled the skin lesions of BRBNS were seen on the cerebral surface. Many of these hemangiomas were thrombosed and overlay patchy zones of infarction. Numerous vascular malformations of varying histological types were also found within the brain and systemic organs. Bluish, compressible, often raised hemangiomas of the skin should alert physicians to the BRBNS and the potential for vascular malformations ot occur within the brain as well as systemic organs. Diagnosis of BRBNS involving the brain may assist in interpretation of radiographic findings. The tendency of these malformations to thrombose may account for focal neurological deficits.


Deanol acetamidobenzoate inhibits the blood-brain barrier transport of choline. Competition by deanol (dimethylaminoethanol) with choline for uptake from the bloodstream into the brain was demonstrated by simultaneous intracarotid administration of carbon 14-labeled choline with deanol (plus tritiated water and indium 113m, to calculate a brain uptake index) and by measuring the brain uptake of 14C-labeled choline mixed with sera from rats pretreated with deanol (300 or 500 mg/kg 8 or 30 minutes earlier). The inhibition constant for inhibition of choline uptake by deanol (159 micrograms) was actually lower than the Michaelis constant for choline itself (442 micrograms); hence, the affinity of the carrier mechanism for deanol is at least as great as it is for choline. Deanol administration also elevated blood choline levels; thus, the effect of the drug on brain choline (and acetylcholine) levels is the result of the increase it produces in blood choline and the suppression it causes in choline uptake. These findings may explain discrepant results from laboratories seeking increases in brain acetylcholine or clinical improvement in patients with tardive dyskinesia after deanol treatment.


Saccadic system plasticity in humans.

Saccadic system plasticity in humans. A subject with a medial rectus paresis secondary to a partial third nerve palsy was forced to use the affected eye for six days while the good eye was constantly patched. Saccadic eye movements were carefully measured each day; the grain increased, with a time constant of 0.85 day. The patch was then switched to the paretic eye and the gain decreased, with a time constant of 0.85 day. The patch was then switched to the paretic eye and the gain decreased, with a time constant of 1.54 days. This demonstrated central nervous system plasticity of the pulse and step of neural activity responsible for the generation of saccades in the adult human. In addition to gain changes, postsaccadic drift velocity and saccadic velocity/amplitude relationship alterations during the patching are reported. A major conclusion that can be drawn from analysis fo these data is that the gain changing is accomplished by pulse width changes rather than pulse height (firing frequency), which was not markedly altered.


Fatal long-term sequela following radiation "cure" for ependymoma. There are no previous reports of glioblastoma occurring following central nervous system irradiation. This report describes a young girl with an ependymoma at age 13 months who was treated by radiotherapy following surgical removal. At age 6 years she presented with a new lesion in the same location. Histologically there was no evidence of recurrent ependymoma. Instead, the pathological picture suggested glioblastoma or a severe radiation-induced encephalopathy. In either case, it seems likely that the changes were radiation induced.


Measurement of regional cerebral blood volume by emission tomography. The technique of positron emission tomography was used to measure cerebral blood volume (CBV) in 10 normal right-handed human volunteers following inhalation of trace quantities of cyclotron-produced, 11C-labeled carbon monoxide. In scans obtained 4 cm above the orbitomeatal line, CBV was 4.3 ml per 100 gm of tissue, whereas in scans obtained 8 cm above the orbitomeatal line, CBV was significantly less (3.3 ml per 100 gm; p less than 0.001). This difference reflects the greater proportion of gray matter in the lower scan. Furthermore, the CBV was significantly larger (p less than 0.001) in the left cerebral hemisphere in the tomographic scans obtained 4 cm above the orbitomeatal line. These scans include the region of the superior surface of the temporal lobe (planum temporale), which is thought to be larger in individuals with left cerebral dominance for speech. This observation is the first in vivo demonstration of a structural correlate of a known functional difference in the cerebral hemispheres of man.


Changes in brain weights during the span of human life: relation of brain weights to body heights and body weights. More than 20,000 autopsy reports from several general hospitals were surveyed for the purpose of selecting brains without a pathological lesion that had been weighed in the fresh condition. From this number, 2,773 males and 1,963 females were chosen for whom body weight, body height, and cause of death had been recorded. The data were segregated into 23 age groups ranging from birth to 86+ years and subjected to statistical evaluation. Overall, the brain weights in males were greater than in females by 9.8%. The largest increases  in brain weights in both sexes occurred during the first 3 years of life, when the value quadruples over that at birth, while during the subsequent 15 years the brain weight barely quintuples over that at birth. Progressive decline in brain weight begins at about 45 to 50 years of age and reaches its lowest  values after age 86 years, by which time the mean brain weight has decreased by about 11% relative to the maximum brain weight attained in young adults (about 19 years of age). Computed regression lines for brain weights versus body heights and body weights and for ratios for brain weights to body heights and weights versus age groups show clearly differential rates of change in brain weights which are less affected by sex.


The pathophysiology of myotonia produced by aromatic carboxylic acids. A series of nine related aromatic monocarboxylic acids (ACAs) previously shown to inhibit muscle membrane chloride conductance (GCl) selectively in the rat were studied for their ability to produce myotonia. All nine induced characteristic repetitive electrical activity and delayed relaxation in isolated muscle, although the concentrations required for this action varied widely. In each case, myotonia was observed at concentrations that correlated closely with previously determined half-maximal concentrations for inhibition of GCl. Intracellular recordings from muscle made myotonic with ACA revealed prolonged latencies at rheobase, multiple driven spikes, and self-sustaining repetitive activity similar to that previously reported in hereditary goat myotonia. Phase-plane diagrams of membrane action potentials recorded after exposure to the most effective of these compounds suggested little effect on the voltage-dependent sodium system. The changes seen could be duplicated by simple removal of chloride ion. The expression of repetitive electrical activity in the presence of low membrane GCl depends on ambient temperature and on the concentration of calcium ion. Increasing temperature and decreasing Ca++ predispose toward myotonic activity; converse conditions inhibit myotonia. Myotonia induced by ACA is inhibited by concentrations of diphenylhydantoin that are clinically effective in controlling hereditary myotonia in humans.


Systemic lupus erythematosus, myasthenia gravis, and Ehlers-Danlos syndrome. Clinical, electrophysiological, and laboratory data are reported on a 21-year-old black woman with systemic lupus erythematosus, myasthenia gravis, and Ehlers-Danlos syndrome. The first two diseases are related by similar pathogenetic mechanisms. To our knowledge, this is the first patient reported with this unusual combination of rare diseases.


Multiple small cavernous angiomas of the brain with increased intracranial pressure. Small vascular malformations of the central nervous system are generally considered cryptic, or silent, because they are an incidental but frequent finding at autopsy. When they are symptomatic, these malformations have been associated with intracranial hemorrhage or seizures. The patient reported here had multiple small cavernous angiomas associated with a syndrome resembling pseudotumor cerebri. The increased intracranial pressure apparently was produced by multifocal areas of cerebral edema without associated hydrocephalus.


[Notes on Indian skulls from Venezuela and the Dominican Republic]. Ten Indian skulls from Venezuela and the Dominican Republic, respectively, have been examined anthropologically. Three of these skulls are from adolescent individuals, the remaining seven from adult ones. Four skulls were artificially deformed (tabular obliqua type). Out of the seven adult skulls five are male, two probably female. The measurements and indices are mostly within the variation range of hitherto already known values from these regions. Considering all factors one can see a population having relatively short, median wide and in general low skulls, which are also characterized by low to median cranial capacities. The face is dominated by high orbitae. The cheek bones are median wide, compared to other South American groups. The nose is often short. Its width is differing whereas, however, narrow to median wide nasal openings are prevailing. For the present it is not possible to differentiate this skull material either regionally or chronologically.


[Quantitative variations of hematological properties during growth in Spanish school children from Barcelona]. A sample of n = 836 male students between 9 and 16 years from Barcelona was analysed for quantitative variations of various hematological characters during growth. The results were compared with a sample of n = 194 adult males between 20 and 45 years. No statistically significant variations were found concerning the levels of calcium, ureic nitrogen, glutamate-oxal-acetat-transaminase (s-GOT), serum albumin and total serum protein. Against that, marked and statistically significant age variations were seen for the levels of alkaline serum phosphatase, glucose, anorganic phosphorus, cholesterol, and uric acid. These variations are without doubt associated with the metabolic processes during growth. Unexplained remain the age variations concerning the bilirubin and lactate dehydrogenase levels. Out of the serum protein fractions only the alpha1- and gamma globulins showed some age variations: The alpha1-fraction increases between 10 and 16 years, the gamma fraction decreases between 9 and 14.


[Antibiotic activity of cultures of the species of the genus Actinomadura]. Sixty five cultures of Actinomadura were isolated from samples of different soils. The study of their antibiotic activity on liquid nutrient media showed that 49 of them were active against gram-postive bacteria. The antibiotics isolated fromsome cultures of Am. carminata, Am. rubra, Am. coerulea and Am. luteofluorescens had antitumor effect in experiments on animals.


[Synthetic medium for the biosynthesis of tobramycin]. The effect of the sources of carbon and inorganic nitrogen on the biosynthesis of tobrmycin complex was studied. Maltose and ammonium chloride were shown tobe optimal. A synthetic medium for Streptomyces cremeus var. nov. 2242, to tobramyc in producing organism, was elaborated and its optimization was performed using the experiment mathematical modelling, i. e. the method of latin squares. Tobramycin production on the new medium was 6 to 7 times higher than that on the initial medium.


[Role of sterol structure in complex formation with polyene antibiotics]. The capacity of sterols of different structure being components of artificial bilayer lipid membranes for formation of complexes with polyenic antibiotics, such as amphotericin B, nistatin and levorin was studied. It was shown that sterols delat 5,7-dienic systemin ring B, ergosterol and cholesta-5,7,22-trien 3 beta-ol had the highest affinity to all the 3 antibiotics, while sterols with one double bond in ring B, i. e. cholesterol and brassicasterol had less affinity and sterol without any double bonds in the molecule i.e. 5alpha cholestan 3beta-ol had the least affinity. It was supposed that delta 5,7-sterols had the highest affinity to polyens because of the fact that atoms C-5, C-6; C-7 and C-8 in ring B were practically situated in one plane in contrast to sterols with completely saturated ring B situated in the "conformation chair". Because of this interaction between delta 5,7-sterol ring B and the same flat polyenic site of the antibiotic molecule is sterically most firm since maximum contact is possible between two planes. It was noted that affinity of sterol to the polyenic antibiotics was higher if there were a double bond at 22-23 and methyl group at C-24 in the sterol side chain.


[Phamacokinetics of methicillin, oxacillin and cephalosporin in the body of puerperae]. Features of absorption, distribution and excretion of methicillin, oxacillin and cephaloridine in 58 puerpera were studied. No complications were observed in the postnatal period of the puerpera. The results of the study of the antibiotic pharmacokinetics provided elaboration of the optimal regimen for the use of methicillin, oxacillin and cephaloridine in puerpera, i. e. I g intramuscularly every 6 hours.


Comparative in vitro activity of newer cephalosporins against anaerobic bacteria. The in vitro susceptibilities of 408 recent clinical isolates of anaerobic bacteria against cefaclor, cephalexin, cephalothin, cefazolin, cefamandole, and cefoxitin were compared by an agar dilution technique. Against gram-positive bacteria, especially peptococci, peptostreptococci, and propionibacteria, cephalexin and cefaclor were significantly less active than cephalothin (P < 0.05). Cephalexin was also less active than cephalothin against clostridia and lactobacillus (P < 0.05). Against gram-negative bacteria, major differences were observed primarily with Bacteroides fragilis, against which cephalexin, cefazolin and cefoxitin were all significantly more active than cephalothin (P < 0.001). At concentrations of 16 mug per ml, however, all cephalosporins showed high in vitro activity, except against Lactobacillus species and B. fragilis. Cephalothin, cefazolin and cefamandole were considerably more active against the former, whereas cefoxitin was distinctly more active against the latter.


Effects of binding and bactericidal action of vancomycin on Bacillus licheniformis cell wall organization as probed by 15N nuclear magnetic resonance spectroscopy. The effects of binding and the bactericidal action of vancomycin on the arrangement and mobilities of cell wall polymers in Bacillus licheniformis were investigated by (15)N nuclear magnetic resonance spectroscopy. The bactericidal action of vancomycin led to reduced mobilities of cell wall teichoic acid and teichuronic acid in surviving cells. The decrease in teichoic acid mobility was also observed upon binding of vancomycin to B. licheniformis cells and resulted from a specific interaction between the antibiotic and teichoic acid, rather than from electrostatic contraction of the cell wall. The reduction in teichuronic acid mobility appeared to be related either to the elastic contraction of the cell wall resulting from loss of cell turgor or to separation of the cell wall from the protoplast membrane. No spectral changes associated with cell wall autolysis or alterations in cell wall composition, amidation, and cross-linking were found in vancomycin-treated B. licheniformis cells. Binding of vancomycin to Micrococcus lysodeikticus cell walls led to a decrease in mobility of C-terminal d-alanine residues but was accompanied by an increase in the mobilities of other peptidoglycan residues. The possible contributions of changes in the arrangements of cell wall polymers to the lethal action of vancomycin is discussed.


Susceptibility of 40 lactobacilli to six antimicrobial agents with broad gram-positive anaerobic spectra. The minimal inhibitory concentrations (MICs) and minimal bactericidal concentrations (MBCs) of 40 lactobacillus strains were determined against six antibiotics with broad anaerobic spectra. Penicillin, ampicillin, clindamycin, and cephalothin were the most active inhibitory agents, with 95 to 100% of the strains inhibited at clinically achievable serum levels. However, despite the inhibitory efficacy of these four agents, only 5 to 22% of the isolates were killed at achievable concentrations. MBC:MIC ratios were high, ranging from 30:1 for cephalothin to 266:1 for ampicillin. Cefoxitin and metronidazole were generally ineffective against lactobacilli, with 87.5 to 100% of strains having unachievable MICs and/or MBCs. These findings may partially explain the clinical observations noting the inability to eradicate endocarditic lactobacillemias despite readily achievable MICs.


Penetration of methicillin, oxacillin, and cephalothin into bone and synovial tissues. The penetrations of methicillin, oxacillin, and cephalothin into cortical bone and synovial tissues were studied 1 h after their intravenous administration in 105 patients having arthroplasty of the hip. Although the lowest serum levels were noted with cephalothin (P < 0.01), more patients receiving cephalothin achieved osseous drug levels inhibitory to staphylococci (P < 0.01). Differences in the penetration of the three agents into synovial tissues were not statistically significant.


Reversible effects on cellular metabolism and proliferation by trisodium phosphonoformate. The antiviral compound trisodium phosphonoformate (PFA), which inhibits herpesvirus multiplication by 50% at a concentration of 10 muM, did not show any effects on macromolecular synthesis and cell proliferation in HeLa and human lung cells at this concentration. At the high concentration of 2 mM, PFA reduced DNA synthesis to 50% after 1 h of treatment, whereas no effects could be seen on RNA and protein synthesis. Treatment for 24 h with 1 mM PFA inhibited both DNA synthesis and cell proliferation to 50%. The inhibition of DNA synthesis and cell proliferation at 10 mM PFA was rapidly reversed by removing the drug from the cells.


Improved susceptibility disk assay method employing an agar overlay technique. Susceptibility disks impregnated with 35 different antibiotics were assayed by the current Code of Federal Regulations method and by a new method employing an agar overlay. The new method, a simplified analytical procedure, exhibited improvement in zone definition and an increase in dose response. Assays performed by the new method were accurate and precise. The agar overlay technique appears to be superior to the current Code of Federal Regulations method.


Effect of antibiotics on the prevention of experimental Bacteroides fragilis endocarditis. The relative efficacy of single doses of antibiotics in modifying the development of Bacteroides fragilis subsp. fragilis endocarditis was studied in an experimental model. Antibiotics were administered 0.5 h before intravenous injection of B. fragilis subsp. fragilis into rabbits prepared by insertion of a polyethylene catheter into the left side of the heart; 48 h later, intracardiac vegetations were excised and cultured anaerobically. B. fragilis was recovered from 92% of untreated animals. After a single dose of procaine penicillin G (250 mg/kg intramuscularly), 80% of the animals remained infected. Chloramphenicol (30 mg/kg), carbenicillin (50 mg/kg), and metronidazole (10 mg/kg) were also ineffective (76, 80, and 75% infected, respectively). Cefamandole (30 mg/kg), cefoxitin (30 mg/kg), and erythromycin (30 mg/kg) were significantly more active (50, 55, and 45% infected, respectively), as were higher doses of carbenicillin. Clindamycin (50 mg/kg) was the most effective regimen (11% infected). At present, the relevance of these results to the therapy of serious B. fragilis infections is not known, but this model may prove useful in the evaluation of the prevention of B. fragilis subsp. fragilis bacteremia.


In vitro activity of Sch 21420, derivative of gentamicin B, compared to that of amikacin. The minimal inhibitory concentration of Sch-21420 closely paralleled amikacin for 125 strains of aerobic gram-negative bacilli and Staphylococcus aureus primarily selected for testing because of resistance to other aminoglycoside antibiotics. Fifteen of 26 strains requiring 20 mug or more of amikacin per ml for inhibition were inhibited by two- to fourfold less Sch 21420. The majority of organisms resistant to both agents owed their resistance to mechanisms other than the carriage of aminoglycoside-modifying enzymes. Most strains carrying aminoglycoside 6'-acetyltransferase, capable of modifying amikacin, were susceptible to 10 mug or less of Sch 21420 per ml.


Activity of derivatives and analogs of dapsone against Mycobacterium leprae. Of 25 dapsone derivatives and analogs screened for activity against Mycobacterium leprae in the mouse footpad system, only 7 were active. All seven were metabolized to or contaminated with dapsone.