Sacral agenesis. Analysis of 22 cases.

Sacral agenesis. Analysis of 22 cases. Sacral agenesis is a rare congenital anomaly of the spine and is usually associated with urologic abnormalities. Twenty-two patients are reviewed. Twenty-one had other congenital and developmental abnormalities in addition to sacral agenesis. Physical examination showed flattening of the buttocks, loss of the gluteal cleft, widely spaced buttock dimples, and a palpable sacral defect. Lateral views of the spine are essential when anteroposterior views suggest an absence of sacral segments. Seven patients had a significant familial history of diabetes mellitus. All patients with involvement of more than one sacral segment had neurogenic bladder dysfunction with incontinence. The degree of neurologic deficit could not be predicted from the radiologic appearance of the sacrum.


Renal cystoscopy.

Renal cystoscopy. Percutaneous endoscopy of renal cysts is described. Its purpose is to rule out the presence of tumor within a cyst.


Transverse colon conduit for supravesical urinary tract diversion. Twenty-two patients with extensive pelvic irradiation underwent supravesical urinary diversion using a transverse colon conduit. Primary diseases were most often carcinoma of the cervix and urinary bladder. Indications for diversion included original treatment planning, radiation cystitis, vesicovaginal fistula, and ureteral obstruction. Operative mortality was low (4 per cent), and most complications were managed by further surgery. Normal upper urinary tracts usually remained normal after diversion; relief of existing hydroureteronephrosis was seen in a majority of patients. Stomal problems have been minimal, and renal function has remained normal or stable. The method affords the use of nonirradiated transverse colon as well as the ureter high above the field of pelvic irradiation and is the preferred diversion in such patients.


Radical cystectomy for carcinoma of bilharzial bladder. Technique and results. One hundred and sixty-two patients with carcinoma of the bilharzial bladder were treated by radical cystectomy. The postoperative mortality was 12.9 per cent and the five-year survival rate was 38.9 per cent. Correlations of the survival figures relative to the various pathologic features of the tumor revealed that squamous and transitional tumors have essentially the same prognosis, and that the most important prognostic index was the tumor grade. In most cases treatment failures were due to local recurrences which developed within one year after operation.


Serial carcinoembryonic antigen assays in patients with metastatic carcinoma of prostate being treated with chemotherapy. Serial carcinoembryonic antigen (CEA) assays were conducted in patients with endocrine-unresponsive prostatic adenocarcinoma who were being treated with multidrug chemotherapy. Changes in CEA correlated with the clinical status of the patient in 70 per cent of the determinations and were more accurate than acid phosphatase in monitoring the response to treatment.


Hypernephroma and associated ureteral involvement. The propensity of a hypernephroma to invade the renal vein and even the inferior vena cava is widely known. However, in contrast to papillary carcinoma of the kidney, hypernephromas rarely involve the ureter. Review of the English literature reveals 42 reported cases of ureteral involvement. Most represented metastases as opposed to direct, contiguous extension which is extremely rare. C case of hypernephroma with contiguous castlike extension into the ureter without mucosal violation is presented. Mechanisms of ureteral involvement and implications regarding treatment of hypernephromas are discussed.


Asymptomatic bacteriospermia. Cause of infertility in men. The causes of male infertility are still poorly understood, and asymptomatic bacteriospermia in the male can cause infertility. A new method was evaluated for examination of bacteriologic cultures of semen specimens. Treatment of the male shows successful results with pregnancies following.


Seminoma in male aged seventy-three.

Seminoma in male aged seventy-three. This is a report of a seventy-three-year-old male found to have a seminomatous tumor of his left testicle. This may represent the oldest reported case of pure seminoma. Men of all ages should have careful palpation of the testicles as part of a physical examination.


Adrenal insufficiency after unilateral radical nephrectomy. A case of adrenal insufficiency occurring after unilateral radical nephrectomy is presented. Recommendations for identification and treatment of this condition are discussed.


Treatment of uncontrolled hypertension by therapeutic renal infarction. Certain hemodialysis patients need to be made anephric, either surgically or physiologically. Bilateral renal infarction with shredded absorbable gelatin sponge (Gelfoam) was performed on a woman with malignant hypertension being maintained on chronic center dialysis who was too great a surgical risk for bilateral nephrectomy. Peripheral embolization complicated the procedure resulting in a forefoot amputation for dry gangrene two months later. Her postinfarction peripheral plasma renins remained elevated, and she remained hypertensive but was more easily managed with fewer drugs. This technique has been successfully used by others in 1 patient with chronic renal failure and heavy proteinuria and another with hypertension and a solitary kidney. If, as in our case, postinfarction plasma renins remain elevated and hypertension persists, bilateral nephrectomy could be performed at a later date or infarction could be repeated.


Retroperitoneal cyst and congenital absence of ipsilateral kidney. The case report of a patient in whom a cystic retroperitoneal mass and the congenital absence of the ipsilateral kidney, ureter, ureteral orifice, and trigone is presented. The embryology and literature are noted. We can find only 2 similar cases in the literature.


Retroperitoneal teratoma.

Retroperitoneal teratoma. Retroperitoneal teratoma is the third most common primary retroperitoneal neoplasm of childhood ranking behind neuroblastoma and nephroblastoma. Ten per cent of these tumors are malignant. Two cases of benign retroperitoneal teratoma are reported, and the first description of the angiographic appearance of such a tumor is presented.


Parasitic lumbar arterial blood supply in renal angiomyolipoma. A young woman with azotemia was found to have an angiomyolipoma which had parasitic blood supply from a lumbar artery. Parasitic lumbar arterial blood supply from a lumbar artery. Parasitic lumbar arterial blood supply has previously been considered a strong indication of malignancy. Since this benign lesion had not invaded the adjacent retroperitoneal structures, the phenomenon tends to confirm the postulate that parasitic blood supply to a lesion may occur through hypertrophy of small anastomotic channels normally present between adjacent vessels but not normally seen in angiography.


Role of intravenous urography in clinical assessment of polycystic kidney disease. This study is a retrospective review of 30 patients with polycystic kidney disease analyzing the quantitative measurements of renomegaly reported in the literature and the correlation of radiographic findings with the clinical complications of uremia, hypertension, infection, and the need for dialysis. The only significant correlation noted was between renal size and the presence of infection. There was no significant correlation between renomegaly and the presence or development of hypertension, uremia, and the need for chronic dialysis.


[Errors in diagnosis of strangulated irreducible hernias]. In the paper, the errors in diagnosis of strangulated irreducible hernias are analysed. The attention of specialists is drawn to the fact that in some cases irreducible hernias may be the cause of different cardiovascular and pulmonary disorders (angina, bronchial asthma). It is recommended to treat patients with irreducible hernias irrespective of their age. This measure would obviate not only complications relative to the principle lesion but also the development of reflex vascular and pulmonary complications.


[Tactical and technical errors as the cause of development of external intestinal fistulas]. An analysis of causes of the development of external enteric fistulas in 71 patients, who to the moment of surgery showed no purulent-inflammatory processes in the abdomen, has demonstrated that in most patients (40 persons) the fistula development can be related with technical errors (an injury, deserosing, suturing of the intestine) during an operation. It is believed that for prophylaxis of enteric fistulas a special care should be given by a surgeon to mobilization of the intestine from adhesions, strict observation of technical recommendations and tactical purposes pertaining to treatment of acute intestinal obstruction, strangulated hernias, etc.


[Stomach and duodenal ulcer in chronic nonspecific lung diseases]. The results of observations over 61 patients suffering pneumosclerosis and chronic lung emphysema, associated with secondary gastroduodenal ulcers, are reported. These made 20.2% among 302 patients with gastroduodenal hemorrhages. The clinic of these ulcers in a third of patients having cardiopulmonary insufficiency is characterized by few or no symptoms at all, that would handicap their diagnosis. For timely prevention of grave complications the authors recommend a careful examination of the gastrointestinal tract in all patients with persistant chronic lung affections, who complain of abdominal pains and dyspepsia.


[Acute gastrectasia].

[Acute gastrectasia]. The authors report their 20 observations of acute gastrectasia. An importance of early diagnosis of this pathology is emphasized, and due attention should be given to a proper interpretation of the observed symptoms. Also, the authors stress the importance of decompensated pyloric stenosis in the development of acute gastrectasia. It is concluded that in early diagnosis of acute gastric dilation the complex conservative therapy with a mandatory gastric sounding, correction of hydroelectrolytic disorders and patients' being in Shnitzler-Diterichs posture are of primary importance. In case of failure of this therapy and for intraoperative establishing of the diagnosis of acute gastrectasia gastrostomy may be performed.


[Lamblia-induced cholecystitis].

[Lamblia-induced cholecystitis]. Case reports of 32 patients with lambliasis induced cholecystitis, treated in the surgical clinic for a 28-year period, are analysed. The clinical data allow establishing the differential diagnosis between cholecystitis attack induced by the presence of Lamblia in bile ducts and an attack induced by the presence of concretions in the gallbladder. It is the authors' opinion that the complex exploration of patients should be carried out. A carefully selected anamnesis, data of multiple duodenal sounding and coprologic studies serve as a valuable adjunct in establishing the correct diagnosis and therapeutic tactics.


[So-called "white bile" (clinico-experimental study)]. Based on clinical (37 cases of "white bile") and experimental (20 experiments) findings obtained by the authors, the characteristic of the so-called "white bile", observed in mechanic jaundice of various etiology, is given. It is pointed out that "white-bile" is the secretion of bile ducts and gallbladder mucous membrane--a colorless liquid, this secretion is permanently excreted and is a constant ingradient of colored bile while obturation of bile outflow ducts contributed only to its accumulation and detection.


[Diagnosis and treatment of intestinal obstruction caused by cholelithiasis]. Cholelithic intestinal obstruction was observed in 7 (4.7%) of 150 patients operated upon for intestinal obstruction of non-tumor origin. The patients' age ranged from 56 to 82 years. The patients were admitted within the terms from 1 to 21 days since the onset of the disease. All patients were subjected to surgical therapy. In one case a duodenal concretion was removed, and cholecystectomy was performed. In the remainder a bile stone was removed from the small intestine. In one of these patients the intestinal segment changed pathologically being resected with an end-to end anastomosis. Three patients died: two--from peritonitis and one--from pulmonary artery embolism.


[Surgical interventions in complicated forms of acute appendicitis]. Under study were the results of treatment in 10 056 patients with acute appendicitis, including 418 patients having its complicated forms. It is concluded that the extent of surgical intervention in complicated forms should be determined by the character of the complication, manifested in pathological changes of the peritoneal coat and patient's status. Appendectomy may be performed in most patients with appendicular infiltration. It is the authors' opinion that indications to peritoneal dialysis in peritonitis of appendicular origin should be largely restricted. The tactics employed by the authors enabled them to reduce the mortality in complicated forms of appendicitis up to 4.4%.


[Remote results of surgical treatment of chronic suppurative lung diseases]. The work was undertaken to study late results of surgical treatment of suppurative lung diseases during 1950-1974. Questionaries were sent to 420 operated patients. Answers were received from 328 (78%) patients, 86% of them were examined clinically, 14%--were estimated according to questionaries and their physician findings. 50 per cent of patients were followed up for 10-24 years. A positive effect was gained in 94.8%. 82 per cent of the operated patients have practically recovered well. The causes of poor issues are described, and trends for their improvement are delineated.


[Operations in concomitant diseases of the abdominal organs]. Under consideration are one-moment operations for associated lesions of abdominal organs. Based on the experience with 103 such operations, the authors subdivided patients into two groups: emergency operated patients and those in whom planned interventions were performed. It is believed by the authors, that a careful clinical preoperative examination of the latter and methodical revision of abdominal organs in urgent laparotomies make it possible to reveal an associated pathology of abdominal organs and to perform a radical one-moment operative procedure.


[Purulent infection and sepsis in surgical patients]. The problems of pathogenesis, clinic and treatment of general purulent infection and sepsis are discussed. 1045 patients with different purulent diseases were observed by the author. Sepsis was diagnosed in 18 patients, that made 1.7 per cent to a total number of observations. Among these septic patients 8 patients died.


[Complications of local use of hydrocortisone in surgery]. Complications in 12 patients having diseases of the locomotor system resulting from local application of hydrocortisone are analysed. Having studied the character of complications and causes producing them, the author made a conclusion that if definite conditions for inducing the blockade are not complied with, it results in complications, which are much more dangerous than the initial lesion and, sometimes, may lead to disability.


[Diagnosis and surgical treatment of relative valvular insufficiency of deep veins of the lower limbs]. The experimental and clinical findings obtained by the authors have evidenced the rationale of using an autovein or large femoral fascia for application of a cuff. While using synthetic materials, some cases of venous thrombosis under a cuff were observed. Late results of the operation during 2-5 years were followed up in 25 patients, 13 of them had crural ulcers. No varicosity and ulcers were noted in outpatient examination.


[Hemangioma of the synovial membrane of the knee joint]. The data on 15 patients with hemangioma of the synovial sheath of the knee joint are reported. It is the author's opinion that surgical removal of the tumor is the most radical method of treatment for hemangiomas. Among 15 patients such procedure was accomplished in 6, in the remainder biopsy or partial removal of the tumor followed by radiotherapy were performed. Late results were followed up in 9 patients.


[Surgical treatment of lung abscesses in children]. The authors report their clinical observations of 44 patients, aged from 2 months to 14 years, with acute pulmonary abscesses. As evidenced by the authors a roentgenological examination in dynamics is of great value in establishing the diagnosis of pulmonary abscess, since it makes possible to follow the destruction of lung tissues and the formation of cavities. For treatment of lung abscesses different methods were employed: toilet bronchoscopy with antibiotics perfusion, puncture and drainage of the abscess, in case of pulmonary hemorrhage a resection of the lung portion involved, the complex conservative therapy.


[Subcutaneous injuries of the duodenum in children]. In Child Surgery clinics of the Leningrad City since 1955 to 1974 eight children, aged from 3 to 15 years, were operated upon for this kind of trauma. The diagnosis of duodenal injuries intraoperatively is based on the presence of retroperitoneal hematoma, emphysema in the retroperitoneal space, yellow-green staining of the posterior peritoneal leaf.


[Intestinal obstruction in children caused by congenital adhesions and fibrous cords]. The authors present an analysis of 36 observations of congenital adhesive intestinal obstruction in children aged from 1 day to 11 years. In newborn infants and small children, aged from 1 to 3 years, the disease was mostly manifested in the clinic of acute obstruction. Therefore, all these children were operated upon on urgent indications. An importance of restoration of the bowel function as early as possible is emphasized for prophylaxis of the adhesive process. Postoperatively, physical therapy and prolonged peridural anesthesia are widely advocated. No recurrence of adhesive intestinal obstruction was noted.


[Annular pancreas in children].

[Annular pancreas in children]. In the paper, the results of examination and treatment of 19 patients with a ring-shape pancreas are presented. In children an annular pancreas is manifested in acute or recurrent high intestinal obstruction. The method of treatment consists in by-pass anastomosis constructed between the duodenum and jejunum or duodenoduodenostomy. Dissection of the ring seems to be not permissible in children. 10 children died postoperatively. The high mortality rate is conditioned by premature delivery, associated defects of development and delivery trauma.


[Evaluation of the results of intramodullary metallic osteosynthesis of diaphyseal humeral fractures]. In the paper, an analysis of the results of surgical treatment in 32 patients with fractures of brachial diaphysis is given. Thirty one patients were subjected to retrograde osteosynthesis, the end of a nail being remained under the greater tubercle of the humerus, and in one patient a nail was inserted directly just on the cubital fossa aspect. Among 32 examined patients only 11 patients showed complete restoration of the anatomical integrity and function of the extremity. Partial restriction of the motion was noted in 6 cases. It is the author's opinion that in diaphyseal brachial fractures intramedullary osteosynthesis, with an nail being inserted upwards through the upper margin of the cubital fossa, is mostly rational.


[Diagnostic value of the reaction of morphological dissociation of clotted blood (RMDCB) in nonspecific pneumonias and lung cancer]. The authors studied separate parameters of the reaction of morphological dissociation of clotted blood in 97 patients, 83 of them suffering chronic nonspecific pneumonia and 14--lung cancer. Such RMDCB tests as the amount of the third fraction of blood coagulation (TFCB), the time of TFCB sediment formation and "the prognostic index" are found to be of certain diagnostic value, and along with other laboratory tests and clinical symptoms these allowed a differentiation between chronic nonspecific pneumonia and lung cancer.


[Treatment of pseudarthroses and ununited crural bone fractures with transosseous compression-distraction osteosynthesis]. The materials of clinical observations of 103 patients with pseudarthrosis and unhealing crural fractures, in whom 104 operations of compression-distraction osteosynthesis were accomplished, are analysed. The results of the treatment in various groups of patients are described.


[Preoperative care and anesthesia in surgical treatment of thyrotoxicosis]. The authors made an analysis of clinical materials pertaining to 1234 patients with thyrotoxicosis, who were given different preoperative management and operated upon under local and general anesthesia. It is noted, that there is less number of postoperative thyrotoxic crises after mercosolyl administration in combination with reserpine and nonspecific drugs than after Plummer preoperative preparation (0.1% versus 1.2%).


[Cold-induced anesthesia under a tourniquet during amputation of the lower limbs in old patients]. The technic of cold anesthesia under a tourniquet is described, and an analysis of 26 operated patients is given. The anesthesia was always a success. A complication was observed in one case (after inadequate application of a tourniquet chill and tachycardia were noted). A conclusion is made on certain advantages of cold anesthesia under a tourniquet in high amputation of the lower extremities in patients with manifest senile changes in the respiratory and cardiovascular systems.


[Use of autohemotransfusion in lung cancer surgery]. The authors report their experience with over 100 operations, using autohemotransfusions in patients with malignant pulmonary neoplasms. Autohemotransfusion was performed after the modern technic now employed. 3-7 days before the operation exfusion of 250-450 ml of blood was made. During 10 days after exfusion patients were given hemostimulating therapy. Autohemotransfusion was employed during the operative procedure. Before the exfusion, pre- and postoperatively at the 1st-5th-10th day and before patient's discharge a parallel determination of CBV, CPV, HV, circulating protein volume and clinical analysis of blood, blood bilirubin, residual nitrogen in blood, urine analysis were made. Based on the data obtained and literature survey the use of autohemotransfusion in most planned operative interventions is believed by the authors to be rational.


[Transfusion of newly stored blood].

[Transfusion of newly stored blood]. It is shown that freshly stored stabilized blood differs in its effect on a recipient only on account of addition of stabilizors to it. The replacement effect due to transfusion of freshly preserved citrated blood is analogous to that noted in direct blood transfusion, however the response of the cardiovascular system inadequate for the transfused blood volume would restrict the rate and volume of transfusion. Freshly heparinized blood differs from donor blood by impaired coagulation factors, but it is identical in hemodynamic effect. Freshly preserved sorbent blood is mostly close in its efficacy to direct transfusions, since its content differs from native donor blood only in calcium content.


[Errors in diagnosis of abdominal tuberculosis in surgical practice]. A detailed clinical analysis has shown that abdominal tuberculosis in its clinical manifestations and course is characterized by pathognomonic signs which, if properly accounted, can provide an opportunity to avoid frequent diagnostic errors. It is the author's opinion that patients with abdominal tuberculosis should be operated upon only in surgical complications of the latter and after a careful examination, establishing the precise diagnosis and adequate preoperative management.


[Functional changes after segmental and lobar resections of the lungs at remote periods of observation]. Clinico-roentgenological and functional studies were carried out in 78 patients 2--12 years following segmental (42 patients) and lobar (3) pneumonectomies for tuberculosis. An analysis of the data obtained indicated that partial pneumonectomies within the boundaries of 1-5 segments per se fail to produce significant disorders in the ventilatory and gas metabolism function of the lung. 2-12 years after the operation the patients show considerable ventilatory reserves. Significant respiratory disorders are observed only in patients with postoperative complications and pathological changes in the lung, pleura and bronchi conditioned by tuberculosis and non-specific lung pathology.


[Lumbar retroperitoneal novocaine block, antibiotics and enzyme inhibitors in acute pancreatitis]. The possibility of infusing medical drugs in fascial sheaths of the pancreas was grounded anatomically. The blockade was used in 119 patients with acute pancreatitis. The authors recommend this blockade in complex with other therapeutic measures.


[Selection of a drainage operation in obstruction of the common bile duct]. Drainage operations were accomplished on extrahepatic bile ducts in 194 patients. It is the authors' opinion that in emergency surgery the operative procedure may be terminated by external drainage only in relative blockade of bile outflow in the duodenal lumen, while in unrelieved complete blockade of bile outflow such drainage seems to be permissible only in patients with an extremely high operative risk. Biliodigestive anastomoses were constructed in 96 patients. In persistant cholemia, cholangitis, signs of hepatic insufficiency the authors construct biliodigestive anastomoses and simultaneously accomplish provisional external drainage of bile ducts.


[Closed liver injuries].

[Closed liver injuries]. An experience with treatment of 50 patients having closed hepatic injuries is analysed. The use of instrumental methods of exploration (laparoscopy and laparocentesis) facilitates to establish the diagnosis and shortens considerably the time of preoperative examination of patients. Suturing of the hepatic wound with its pedicled omentum tamponade is the principal type surgery. The postoperative mortality was 29.6 per cent.


[Injuries of the heart and pericardium]. The authors experience with surgical treatment of heart and pericardium injuries is summarized. A total of 38 patients were operated upon. The surgical aid consisted in simultaneous performance of the complex of reanimation measures, urgent thoracotomy and suturing of the heart wound. Thirty six patients have recovered, two died. One patient died due to mediastinitis, the other -- due to progressive cardiovascular insufficiency.


[Characteristics of collateral circulation after ligation of the femoral artery under conditions of cold injury]. Studies on 52 dogs have shown that ligation of the femoral artery 12-14 hours following ice cooling of the extremity is accompanied with a great number of severe acute pneumonias frequently resulting in death. The leading mechanism of local disorders is spasm of the collaterals, the development of circulatory hypoxia of the tissues and congestive alterations in the venous system.


[Role of drugs with disaggregative effect in the prevention of thrombosis in reconstructive operations on the veins of the limbs]. With the aim of prophylaxis of early postoperative thrombosis in reparative operations on veins of the lower extremities acetyl salicylic acid (aspirin) was used. Diminishing of adhesion and aggregation of thrombocytes, a reduced fibrinase activity and lessening of clot density were noted.


[Effect of peridural block on the adrenal cortex function after operations on the biliary tract]. In patients operated upon with the use of peridural blockade the concentration of 11-OCS in blood plasma does not exceed the normal values both during surgery and in the immediate postoperative period. In patients operated upon under conditions of the routine combined narcosis an increased secretion of corticosteroids was observed.


[Postural reactions of the circulatory system in patients with extrapulmonary tuberculosis]. The main cause of occurrence of postural reactions in patients with extrapulmonary tuberculosis is a deficit of blood circulatory volume as well as cerebrospinal disturbances and "harmful" peculiarities of the operative posture. An increase of the circulatory volume by infusion of 0.5-1.0 litres of plasma substituting substances prior to patient's being rendered the operative posture liquidates, to a great extent, postural reactions of the circulatory system.


[Ileus of the small intestine in the postoperative period]. It is shown that there are difficulties in establishing the diagnosis of intestinal ileus postoperatively, since therapeutic measures, residual phenomena of the principal lesion and operative trauma alter the clinical picture of intestinal ileus. An experience with treatment of 14 patients, subjected to relaparotomy for intestinal ileus, is reported.


Fracture-dislocation of the tibio-tarsal joint in a dog. A case of tibio-tarsal dislocation in a dog with fracture of both malleoli is described. An unusual feature was the absence of lateral instability in the hock despite fracture of the lateral malleolus.


The shape of the free end of the bovine penis during erection and protrusion. Illustrations in some anatomy textbooks purporting to be left lateral views of the organ are in fact right lateral views. The origin of this error is discussed. The variability in normal shape is described in 55 living bulls and 20 excised specimens from bulls of different breeds. The importance of a correct understanding of normal anatomy in clinical examination and surgery of the bovine penis is emphasised.


The control of inbreeding in closed herds with limited numbers of sires. The application, in the calculation of inbreeding coefficients, of the formulae described by Wright and Cruden and a computer program based on Wright's formula, was examined. All three methods, used without rounding up, gave similar inbreeding coefficient figures.


Bovine leptospirosis: infection by the Hebdomadis serogroup and mastitis. An outbreak of mastitis involving approximately 70 out of 140 cows over a two-month period is described. Common mastitis pathogens were not incriminated. Leptospires belonging to the Hebdomadis serogroup were isolated from the milk of three out of five cows and the blood of two of those cows.


Pharmacokinetic investigations on diminazene and rolitetracycline in comparison to a combination of both. Serum level tests were carried out on healthy cows with a combination drug of one part Berenil and two parts Reverin. When compared with the commercial preparations Berenil (Diminazene) and Reverin (Rolitetracycline), the kinetic behaviour of Reverin in the combination preparation was identical. In the case of Berenil, administered in the form of the combination drug, the second slow elimination phase with a 63 hour half-life, as found after the administration of Berenil only, could not be observed. Eight hours after administration of the combination only minimal Berenil serum levels were detectable, after 24 hours the levels were lower than the limit of detection. This has a practical bearing on the question of residues.


Bovine leptospirosis: a serological and clinical study. Antibodies to serotypes representing one or more of 10 Leptospira serogroups were detected in the sera of 1766 (49-1 per cent) cows and heifers out of a total of 3600 sera tested. Infection by the Hebdomadis serogroup was the predominant infection; antibodies to serotype sejroe were found in 1503 (41-8 per cent) sera. Antibodies to the Icterohaemorrhagiae (7-7 per cent) and Balllm (7-3 per cent) serogroups were the next most common, while antibodies to the Australis, Javanica, Canicola, Panama, Cynopteri, Pyrogenes and Autumnalis serogroups were detected in a small number of animals. Only the Hebdomadis and Icterohaemorrhagiae serogroups were associated with clinical disease.


Lameness and leg weakness in rapidly growing turkeys associated with hip lesions. A form of epidemic lameness affecting rapidly growing broadbreasted turkeys of different breeds was investigated in 16 flocks. The condition commenced when birds were between eight and 14 weeks old and was consistenly associated with the development of lesions in the hip. Affected birds first showed leg weakness and ataxia and later chronic postural changes involving the hip. The post mortem lesions were those of inflammation, oedema, ulceration, fibrosis and complensatory hypertrophy of localised areas associated with the hip articulation. The cause was not established but the anatomical features of affected birds, their nutritional status and their apparent freedom from recognised infectious diseased are discussed.


Modulation of plasma copper and zinc concentrations by disease states in ruminants. Alterations in plasma copper and zinc concentrations were associated with the onset and course of several diseases in sheep and cattle. Plasma Cu concentration rose as plasma Zn declined. The pattern of these changes was similar to those reported in non-ruminant animals and man.


Bovine leptospirosis: demonstration of leptospires of the Hebdomadis serogroup in aborted fetuses and a premature calf. Leptospires were demonstrated in five aborted fetuses and in a premature calf. Evidence is presented to indicate that a member of the Hebdomadis serogroup was the causative agent.


The pathogenesis, diagnosis and control of Johne's disease. Since 1962, when the control of Johne's disease was last reviewed by the BVA technical development committee there have been no dramatic advances in diagnostic methods for Johne's disease or in methods of control. However, there has been a slow, but steady increase in knowledge of the various aspects of the disease. This article attempts to set out what is known and, more important, not known about the subject.


Identification of Ehrlichia canis in East Africa. Ehrlichia canis, the causative agent of canine ehrlichiosis or tropical canine pancytopaenia (TCP) has been identified in Kenya. Transmission studies to two dogs resulted in signs of ehrlichiosis including marked thrombocytopaenia, pyrexia, reduction in the packed cell volume and the presence of E canis in peripheral blood mononuclear cells.


Chronic bronchitis and alveolar emphysema in the horse. Broken wind is a syndrome characterised by chronic bronchitis and alveolar emphysema. Clinical signs include nasal catarrh, persistent coughing, dyspnoea and poor exercise tolerance. In racehorses, lung haemorrhages may result in epistaxis. Broken wind is a disease of domestication ascribed to pollution of the stable air with fungal spores from hay and straw. Treatment and prevention are based on the provision of fresh air and, if housing is unavoidable, the adoption of a permanent regime of dust-free stable management. If an early diagnosis is made and appropriate treatment instituted, the prognosis is considered to be reasonably good. The disease exemplifies the validity of the Royal Veterinary College motto Venienti occurrite morbo (treat the disease at its first appearance).


Priorities for pig research.

Priorities for pig research. A postal survey was carried out by the Pig Veterinary Society to establish the opinions of its members on priorities for pig research: 153 members, 64 per cent of the total--returned analysable questionnaires. The survey shows that problems of highest priority for members are atrophic rhinitis, non-infectious infertility, neonatal enteritis, economics of disease, preventive medicine programmes and swine dysentery. The membership was classified by the nature of their work into five groups and the six subjects listed above cover the top three priorities of all groups. A classification of the papers listed in the Index of Current Research on Pigs XXII 1976 suggests that some of the six subjects are under researched.


Ronidazole in the treatment and prophylaxis of experimental swine dysentery. Experimental swine dysentery was produced in groups of susceptible pigs by feeding pure cultures of two isolates of T hyodysenteriae. These infected groups of pigs were then used to assess the efficacy of ronidazole medication of the drinking water and of the feed in the treatment and prophylaxis of the experimental disease. Ronidazole was found to be effective in the treatment of swine dysentery and appeared to eliminate the causal agent, T hyodysenteriae, from treated affected pigs when given in the drinking water at 30 and 60 ppm for three days and in the feed at 120 ppm for four days. The inclusion of ronidazole in the feed for 14 days at 30, 60 and 90 ppm was found to suppress the development of the disease but 90 ppm was the only level found to prevent the development of infection.


Acute impaction of the rumen in a herd of Friesian cows. An outbreak of acute impaction of the rumen in a herd of Friesian cows associated with the over eating of young grass and exposure to severe weather conditions, is described. The morbidity rate was 100 per cent and the mortality rate 6-5 per cent.


[Non-specific immunologic reactivity among patients with primary multiple malignant neoplasms]. Under examination were seventy four patients with different combinations of primary multiple malignant tumors. In patients with 2 skin tumor nodes a high percent of delayed allergic reactions was found in response to the use of 2,4-dinitrochlorobenzene (DNCB) and a correlated with the former high coefficient of the percutaneous test with tripan blue (QD). The mentioned indices are diminished as the third or more skin tumor nodes appear. In polyneoplasia involving internal organs delayed allergic reactions were found to be absent and QD markedly reduced.


[Blast-transformation reaction in patients with bone tumors]. The authors have studied phytohemagglutinin stimulation of DNA synthesis in leucocytes cultures of the peripheral blood in patients with some malignant osteoplasms and benign tumors, and the influence of plasma factors on this process, as well. In most cases, lymphocytes of patients with malignant tumors were shown to have a considerably decreased, as compared with the control, level of blasttransformation. No such difference was found for leucocytes cultures of patients with benign tumors.


[Polyamine excretion in patients with tumors]. Polyamines excretion with the urine in patients with cancer of the stomach, lung, mammary gland and cervical cancer is considerably increased, as compared with patients having nontumor lesions and healthy individuals. Following a surgical removal of the tumor as well as after chemotherapy the level of polyamines in the diurnal urine is diminished up to normal values. The determination of polyamines excretion may serve as a test for laboratory diagnosis of malignant tumors and also as a criterion of the efficacy of treatment.


[Respiratory phosphorylation in the liver mitochondria of rats with transplantable sarcomas]. The method of polarography was used to study respiration and phosphorylation capacity of the hepatic mitochondria in rats with transplantable sarcoma 45 and Walker carcinosarcoma in different terms after transplantation, and in spontaneous regression of the tumors involved, as well. In the hepatic mitochondria of tumor-bearing animals a marked dissociation of respiration and phosphorylation is observed, being mostly manifested in oxidation of glutamate and endogenic NAD-dependent substrates. Non-phosphorylating oxidation suffers to a less extent. Experiments with the use of rhothenon indicated that an impaired rate of the coupling of oxidation and phosphorylation was also related with a destroyed succinate site in the respiratory chain. In the presence of serum albumin an up to normal  values restoration of the rate of respiration and phosphorylation coupling is observed in the hepatic mitochondria of tumor-bearing animals. The degree of interference in the respiratory phosphorylation process is mostly significant at late stages of tumors development and sharply declines in their spontaneous regression.


[Effect of a fractionated dose of fast electrons on mitotic activity and the number of DNA-synthesizing cells of tumor NK/Ly]. The mitotic activity and DNA synthesis in cells of NK/LY tumors in mice were studied after irradiation with fast electrons in fractionation of the dosage in 3 regimens having similar total dosage (1000 rad) and the total time of irradiation (5 days) but different single doses, the number of fractions and an interval between them. A marked decrease in mitotic indices values (MI) was observed with all three regimens during the first hours after irradiation. 3--6 hours after irradiation the period of their restoration started, which was mostly intensive in daily irradiation with 200 rad. A dependence between the time of MI restoration and the dosage per fraction and number of fractions is described as an exponential function with an index 1.47. The kinetics of variations in the number of labelled cells showed a similar character, but it was less pronounced, whereas peaks of rising of the label index in all regimens did not exceed the control level.


[Activity of lymphocytes from patients with malignant melanoma in a culture with phytohemagglutinin]. In the present work, the authors have employed a test for blasttransformation and mitotic activity of lymphocytes in the culture with phytohemagglutinin (PHA-Difeo) to estimate the state of cell immunity in patients having malignant melanoma (95). A correlation was made between these tests and the number of lymphoid cells in patients blood prior to and 10--14 days after surgery, radio- and combined therapy. The most informative index of the cell immunity state in patients with malignant melanoma before application of special therapeutic measures was the absolute number of lymphocytes in blood, while following the treatment- the kinetics of the complex of tests under study.


[Method quantitative assessment of the danger of chemical carcinogen exposure]. A formula of quantitative estimation of the degree of blastomogenic activity of chemical substances is suggested, in which blastomogenic activity of the substance (C) is directly proportional to a total number of the names of tumor involved organs in experimental animals (T), a relative frequency of carcinogenesis 100 (See Article), and is inversely proportional to the logarythm of an effective carcinogen dosage mg/Kg/lg ED50), a latent perioe of tumor development (l) in days, a total number of the names of tumor involved organs in control animals (T). (See Article), wheren-the number of experimental tumor-bearing animals, n1 -- the number of control animals with tumors, N -- the number of experimental animals surviving the first tumor appearance, N1 -- the number of control animals surviving the first tumor appearance. Numerical values are given for four classes of the blastomogenic activity of chemical compounds according to "C" criterion. The first class -- extremely high greater than 0.5, II class -- high 0.499 -- 0.1, III class -- moderately high 0.099 -- 0,05, IV class -- low less than 0.05.


[Effect of overheating products of wood hydrolysis on 3,4-benzpyrene output]. Under study was the effect of overheating of wood pyrolysis products at 600 degrees C on the content of 3,4-benzpyrene in them. Overheating only of the water portion of pyrolysis products would increase considerably its BP content, on account of it the total output of the carcinogen is increased. While overheating of total pyrolysis products results in still greater increase of total BP output on account of its concentration rise both in the water portion and resin. Overheating of resin separately would result in a 7 times increase of BP concentration in it.


[Plastic repair of the urinary bladder]. Clinical observations of 76 patients in whom an artifical urinary bladder was constructed from the rectum are presented. 52 patients were operated upon for cancer of the urinary bladder, total papillomatosis, a metastasis of uterine cancer in the bladder, cancer of the sigmoid with the urinary bladder involvement, sarcoma and cancer of the prostate with the bladder involvement. 17 patients were operated upon for extrophy, 7 -- for cancer of the urethra. An isolation of the rectum is followed by ligation of the upper rectal and vein. Fifteen patients died postoperatively due to peritonitis (6), ascending infection of the urinary tract (4), postoperative shock (I), phlegmon of the minor pelvis (I). In late postoperative period an artificial urinary bladder provides for reservoir and excretory functions.


[Blood levels of testosterone and dihydrotestosterone in breast cancer]. In concentration of testosterone and dihydrotestosterone in blood plasma was determined in 21 healthy females and in 37 patients with breast cancer. The method of competitive binding of tritium labelled testosterone and dihydrotestosterone by specifically binding beta-globulin was employed. It was found that healthy females fail to show any age variations in the concentration of the hormones under investigation in blood. In menopausal patients testosterone concentration tends to decrease in cancer dissemination.


[Mutational-metabolic model of carcinogenesis and the progression of the neoplastic process]. The given data indicate the presence of a negative correlation between metabolic indices (a decrease of the tolerance to glucose, increase of the blood level of free fatty acids, insulin, cholesterol triglycerides, cortisol, stc) and the indices of cellular immunity, which is determined by the number of rosette-forming cells and blasttransformation reaction to PHA and skin tests. Accordingly, the administration of an antidiabetic drug-phenformin (phenetylbiguanide)--apart from the improvement of metabolic pattern, results in the restoration of the cell-mediated immunity indices. These findings provide a basis for stating the phenomenon of metabolic immunodepression. The metabolic immunodepression may be supposed to prevent immunological surveillance activation, which normally is realized through the signals, provided by cells subjected to somatic mutation. It is noteworthy that the given metabolic conditions (hypercholesterinemia, hyperinsulinemia, the enhanced utilization of free fatty acids) promote the division of somatic cells. Thus, the same metabolic shifts which increase the pull of proliferating cells and, accordingly, increase the possibility of mutation development, also cause the metabolic immunodepression at the same time. These opposite metabolic influences on somatic cells and T-dependent lymphocytes cause the development of the syndrome of cancrophilia. The syndrome of cancrophilia normally arises at pregnancy, in intensive growth of the organism in childhood, accelerated development, stress and during normal ageing. Many carcinogens cause the decrease of tolerance to glucose, the increase in blood-insulin level and elevation of the threshold of sensitivity of the hypothalamus to feedback suppression. This phenomenon is based on the decrease of catecholamine level in thehypothalamus in ageing, stress and the action of some carcinogens. Thus, the syndrome of cacrophilia provides the conditions for cancer development and tumor progression, besides, the tumor itself produces the metabolic shifts typical of cancrophilia. In the light of mutation-metabolic model of cancer development, it is possible to consider the fundamental factors which increase of hinder carcinogenesis.


[Angioscanning in the diagnosis of breast neoplasms]. Angioscanning with macroalbumin J131 was performed in 30 patients with different mammary gland diseases (breast cancer--in 22, breast sarcoma--in 1, cystic fibroadenomatosis--in 6 and one patients without any breast pathology). Twenty eight of thirty patients were subjected to surgery, and the diagnosis was supported histologically. Injection of macroalbumin J131 in the subclavian artery enabled the authors to visualize malignant neoplasms, located mainly in the external quadrants of the mammary gland. The least size of the tumor, revealed by angioscanning, was 1.5 cm in diameter. The method of isotope injection directly in the subclavian artery, employed by the authors, may be recommended for patients, whose primary tumor is localized in the external half of the gland and in the axillary process.


[Monolayer culture study of colony-forming bone marrow cells from patients with lymphogranulomatosis]. Measurements of colonies diameter in monolayer cultures of bone marrow in 21 patients with lymphogranulomatosis (an active process and the state of clinical remission) and in 5 healthy donors with subsequent mathematical processing of the results indicated that in most patients with active lymphogranulomatosis and in some patients being in the state of clinical remission, in contrast to healthy donors, the distribution of colonies in diameter is not in accord with the normal law of the distribution. The reliability of the phenomenon observed and its significance for recognition of active lymphogranulomatous process are supported by an additional mathematical analysis.


[Information-retrieval system for pathomorphological studies of neoplastic diseases]. The information retrieval system of studying the operative oncological material, realized on manual punch cards, is suggested. Coding and decoding of signs is accomplished by means of a descriptive dictionary. The latter comprises 18 coded signs. The method of making a list of descriptors is given. A brief technic of handling a code card is presented.


[Treatment of skin cancer (based on data from Moscow Region cancer institutes)]. Observations over 3308 patients with skin cancer were conducted, 77.5% of them were in stage I, 19.7%--in stage II, 2.6%--in stage III and 0.2%--in stage IV. The incidence in males was twice as rare as in females. The dependence of skin cancer on sex was studied in 1645 patients. The majority of patients aged from 51 to 70 years. According to histological findings basalioma was observed in 75.9% and squamous-cell cancer--in 24.1%. Short-focal roentgenotherapy at voltage of 40--60 kw was employed in 94,3%, the combined therapy--in 4.5% and the associated one--in 1.2%. Doses from 5000 to 7000 r (79.5% of patients) were routinely used. The clinical cure was gained in 97.7%, the duration of radiation effect realization was 3--4 weeks in 60 percent of cases. The clinical cure was seldom observed in dosage under 4000 r. The results of 10-year observations indicated that among 2616 patients recurrences were noted in 63 (2.4%). Short-focal roentgenotherapy and the combined treatment seem to be the methods of choice intreatment for skin cancer.


[Role of the polyclinic examination room in detecting breast cancer and precancer]. The authors review their 5-year experience with the work of the women's diagnostic department for recognition of cancer and precancer of the mammary gland. The efficacy of the activities of this diagnostic department is believed to be determined by two main factors: 1) proper organization of its activity and 2) its close contacts with an oncologist of the polyclinic.


[Prostaglandins compared with oxytocin for induction of labour at term (author's transl)]. 12 cases of induction of labour with prostaglandin F2 alpha and 8 with prostaglandin E2 were compared with 14 cases in which induction was undertaken with oxytocin. All inductions were successful, the induction--delivery intervals being slightly shorter in the prostaglandin groups than in the oxytocin group. Both with prostaglandin F2 alpha and with prostaglandin E2 the cardiotocogram showed uterine hyperactivity in most of the cases with an unexpected, episodically-occurring increase in basal uterine tone and remarkable tachysystoly. Uterine hyper-activity led to fetal heart rate alterations of the "dip 2" type in about 50% of the cases. According to these results prostaglandins cannot be considered superior to oxytocin for the induction of labour at term.


[Connexions between instrumental delivery and cerebral damage in the infant (author's transl)]. An interdepartmental investigation was carried out on the incidence of brain injury, especially so-called minimal brain injury, after instrumental delivery of infants by means of forceps or vacuum extractor. There is no statistically-significant difference in the incidence of brain injury in infants delivered by means of forceps as compared with the vacuum extractor; there is, however, a significant increase in incidence of brain injury in infants following instrument-aided delivery as opposed to spontaneous delivery. A thorough explanation of the methods is given and the results are discussed.


[A prospective study on the occurrence of postoperative thrombosis of leg-veins and the possible influence of aescin in its prevention (author's transl)]. Based on the frequency of subclinical, postoperative thrombosis which we detected using radio-iodine-tagged fibrinogen (125I-fibrinogen) in 2 comparable test groups of 100 female patients each, we were able to compare the effectiveness of Aescin (Reparil) to the untreated group. Whereas only 16 patients in the Reparil group were thrombose-positive we found 27 such cases in the control group. The analysis of these data shows Reparil to be of distinct advantage when compared to the untreated group.


[Effect of long-term treatment with synthetic oestrogens on plasma lipids and arterial vessels in male rabbits (author's transl)]. The effects of long-term treatment with synthetic oestrogens (Retalon retard, Sanabo Ltd., Wien, 5 mg/kg i.m. at weekly intervals) were investigated in 12 male rabbits and compared with the data obtained in 9 saline-treated control animals. After 6 months of treatment the oestrogen group showed significantly higher plasma phospholipid (p less than 0.005) and cholesterol (p less than 0.01) concentrations than the control group. However, histological examination of various important arterial vessels (the aorta and the coronary, cerebral, limb and renal arteries) revealed no pathological changes indicative of premature atherosclerosis in either the oestrogen group or in the control group. It is concluded that long-term treatment with synthetic oestrogens does not result in a higher incidence of atherosclerosis in rabbits.


[The fate of corneal infiltrations in cases of epidemic keratoconjunctivitis. A follow-up study over two and a half years (author's transl)]. 34 out of 72 patients (47.2%) with epidemic keratoconjunctivitis due to an infection with the adeno-virus type 8 still showed, on average, corneal opacities after 2.3 years. The gamma2-test proved the statistical significance of the correlation between the prevention of persistent corneal changes and the abstention from topical treatment with corticosteroids in the acute phase of the disease. Yet, steroids mitigate the subjective discomfort, delay the development of keratitis by several days, or even prevent its manifestation as long as corticosteroids are applied. However, in one third of the cases, the keratitis recurs as soon as topical treatment with corticosteroids is stopped. Recurrent attacks of keratitis may flare up over years and the visual acuity may decrease to 6/12 causing transient incapability of working.


[Methods and results of immunological investigations of the aqueous humour (author's transl)]. It is possible by means of various immunological methods to identify more than 15 proteins in the human aqueous humour. Quantitative methods permit the determination of the concentrations of these proteins in the aqueous humour. The absence of high molecular weight proteins shows that the aqueous humour mainly consists of an ultrafiltrate of serum.


[Prophylactic effect of isosorbide dinitrate on postoperative cardiac complications (author's transl)]. Isosorbide dinitrate (ISD) was administered before, during and after 178 operations performed on 127 patients with arterial occlusive disease. Its influence on postoperative myocardial infarction, heart failure and mortality was tested by comparison with 188 operations performed on 140 patients with hypertension and/or old myocardial infarction receiving no ISD prophylaxis. Risk of cardiac complications was similar in both groups. Mortality in the ISD-treated group was significantly lowered as compared with the control group and was about half of the overall mortality in patients with arterial occlusive disease operated on at our hospital over the past 10 years. This difference depended partly on the influence of ISD on cardiac complications. Post-operative myocardial infarction during ISD prophylaxis occurred in 0.6% of cases as compared with 3.7% in the control group (p less than 0.05), whilst the respective values for postoperative heart failure were 5.7% and 18.2% (p less than 0.001). Both complications are related to absolute or relative hypoxia during the post-operative stress period. ISD is effective by lowering cardiac preload and afterload and thereby diminishing myocardial oxygen demand. ISD is the drug of choice for surgical patients since it provides a steady and long-lasting effect after sublingual absorption. ISD prophylaxis during the perioperative period is indicated in cases with coronary artery disease and with increased cardiac preload or afterload.


[The therapeutic management of consumption coagulopathy in progressive liver cirrhosis: low-dosage heparin therapy (author's transl)]. The high incidence of consumption coagulopathy in active liver cirrhosis prompted us to introduce low-dosage heparin therapy (LDHT) in the management of this condition. An investigation was carried out on 109 patients with clinical and biochemical evidence of progressive liver cirrhosis, which was designed to evaluate whether in addition to basic LDHT, the administration of either vitamin K1, human fibrinogen or partial prothrombin complex (Prothromplex 500) enhanced the results obtained with LDHT alone. The normotest, PTT, thrombin coagulase activity, fibrinogen and platelet count were determined at regular intervals. A significant increase in fibrinogen and platelet count was obtained within 14 days of LDHT in about 75% of the patients and the consumption coagulopathy was halted. Additional treatment with vitamin K1 did not bring about any further increase in the prothrombin complex. Substitution therapy with factors II, IX, X and fibrinogen combined with LDHT brought the expected results. The results reported in the literature and the aims of, and indications for LDHT are discussed.


[Studies on the immune status of patients with operated and irradiated cervical and breast cancer. III. Comparative investigation of the immune status of patients with breast cancer treated by operation and irradiation and of patients with cervical cancer treated either by operation or irradiation (author's transl)]. The immunological reactivity of 19 operated cases of breast cancer (14 T1 2, 5T3) was investigated before and at 3-weekly intervals up to 12 weeks after radiotherapy by means of a large panel of techniques. The results were compared with two groups of identically-investigated patients, one consisting of 11 cases of cervical cancer (stage III), treated solely by irradiation and the other of 12 cases of cervical cancer (Stages I a and II b), treated by operation only. Before irradiation and in the non-irradiated group cellular immunity appeared to be more disturbed in cases of breast cancer than in cases of cervical carcinoma, as shown by the lowest number of lymphocytes, the lowest number of spontaneously-rosetting lymphocytes, the lowest percentage of DNCB sensitization in patients and the lowest percentage of Tuberculin-positive skin tests. In both types of carcinoma the humoral immunity appeared to be impaired, as apparent from the lowered immune response to tetanus vaccination. Other parameters of humoral immunity such as the immune globulin concentration, iso- and heteroagglutinine, the titre of measles antibodies or membrane fluorescence of lymphocytes showed no dinstinct trends during the investigation period. After irradiation a) inhibiting and b) stimulating influences were observed: a) The incidence and extent of the immune response to tetanus vaccination was further reduced and a distinct lymphopenic effect was observed. b) The incidence of positive skin tests with varidase, as well as the number of spontaneously-rosetting lymphocytes increased after the commencement of irradiation. Apart from the known sensitization with DNCB and skin tests with tuberculin, determination of the antitoxin titre before and after tetanus vaccination provided the most reliable results in regard to immunological reactivity in the investigated tumour patients.


[The effect of anti-inflammatory substances on free muscle transplants in the experimental animal (author's transl)]. The effect of repeated subcutaneous injections of hydrocortisone and phenylbutazone on connective tissue formation was investigated in free rat muscle transplants. The follow-up investigation took place 4 weeks after transplantation of the long extensor muscles of the digits to the vastus lateralis group of the rectus femoris muscle. Connective tissue measurements were performed on the basis of hydroxyproline determinations. It was observed that in the untreated transplant there is twice as much connective tissue (expressed as a percentage) as in the same muscle remaining in situ. Hydrocortisone did not reduce the amount of connective tissue in the transplant. Phenylbutazone reduced the amount of connective tissue by 27%. At the same time the total weight of the transplants treated with hydrocortisone and phynylbutazone was reduced by 15% and 33% respectively. Attention is drawn to the myotoxic properties of hydrocortisone and phenylbutazone. Hence, in spite of the inhibited connective tissue formation there is no improvement in muscle fibre regeneration and their use cannot be recommended.


[Field trial with a new type of influenza subunit vaccine (author's transl)]. In a field trial a new influenza subunit vaccine was tested in parallel with a vaccine prepared from the whole virus. The subunit vaccine essentially contained only the proteins of the viral envelope, haemagglutinin and neuraminidase, which had been selectively solubilized by treatment with cetyl trimethylammonium bromide. Both vaccines contained 700 IU of strain A/Port Chalmers/73 in 0.5 ml. They were given to volunteers by the subcutaneous route with and without the addition of Al (OH)3 as adjuvant. Blood samples were taken on days 0, 28 and 90. Development of antibodies was assayed in the haemagglutination-inhibition (HI) and neuraminidase-inhibition (NI) test. All vaccines exhibited a very good immunogenic effect as judged from the number of volunteers with at least a four-fold rise in antibodies in the HI-test and those reaching titres that are considered to be sufficiently high for protection against disease. The best results were obtained with the aqueous subunit vaccine. All four vaccines also stimulated the formation of neuraminidase-inhibiting antibodies. The vaccines were well tolerated by the volunteers. The incidence of minor local reactions such as redness, swelling and pain varied according to the vaccine used, as shown on statistical evaluation. The aqueous subunit vaccine clearly proved to be superior in this respect.


[Paraneoplastic syndromes affecting the nervous system and the musculature associated with malignant tumours of the thyroid gland (author's transl)]. Two cases are presented of the paraneoplastic syndrome in patients with a malignant tumour of the thyroid gland. The first case presented with a pseudomyasthenic syndrome (in conjunction with a haemangio endothelioma) and the second case with a form of neuromyopathy (in conjunction with a partly solid and partly hormone-producing thyroid carcinoma). The pathogenesis and classification of the so-called carcinomatous neuropathies is briefly outlined and the initially atypical course taken by the first case is discussed.


[Incidence and presentation of myocardial infarction in Tyrol, Austria; (WHO ischaemic heart disease register Innsbruck 1971/72) (author's transl)]. In 1971 a population-based Ischaemic Heart Disease (IHD) Register was established in the Innsbruck area as part of the WHO international collaborative study. Demographic and geographic data covering the area, as well as the locally-applied methods are described. One hundred and seventy four cases (133 males and 41 females) of acute myocardial infarction (AMI) were registered in the age group 20-64 years. This corresponds to an annual incidence rate of 1.9(0/00) in men and 0.6(0/00) in women. These results confirm indications from the national mortality statistics that Innsbruck belongs to the group of areas in Europe with a relatively low incidence of AMI. The epidemiology of AMI in Europe is discussed. The frequency distribution of AMI according to month of the year, day of the week and hour of the day is reported for this area.


[Pulmonary artery end-diastolic pressure recordings after myocardial infarction (author's transl)]. 29 patients with acute myocardial infarction were subdivided into 3 groups using the information gained by continuous measurement of the pulmonary artery end-diastolic pressure (PAEDP) during a stay of 3 to 5 days in the coronary care unit of this hospital. Group I comprised patients with a PAEDP of below 12 mm Hg (without treatment), group II those with a PAEDP of between 12 and 20 mm Hg and group III those patients with a PAEDP of above 20 mm Hg. 3 to 6 months after rehabilitation and ambulant ""coronary training'' a follow-up control PAEDP measurement was performed at rest and during ergometric stress with the bicycle exercise test. 2 out of the 15 patients in group I had a pathological PAEDP at rest, whilst exercise of 50 watts raised the PAEDP to pathological values in 40% of this group of patients. Group II: 58% of the patients with an initially-raised PAEDP showed a normal value at follow-up examination 3 months subsequently. Exercise of 50 watts raised the PAEDP to pathological values in 66% of the patients in this group. Group III. The pathologically high PAEDP recordings at rest made it impossible to subject these patients to stress with the bicycle ergometer. The prognostic value of the classification of patients with myocardial infarction into pressure groups and the importance of PAEDP follow-up measurements on patients after myocardial infarction at rest and after ergometric stress are discussed.


[On-line analysis of anaerobic power and oxygen debt in rectangular-triangular stress testing (author's transl)]. The rectangular-triangular bicycle exercise test with on-line analysis of respiratory function and gas exchange is used in the evaluation of physical performance. A programme has been developed for on-line computation of an index of anaerobic power and of oxygen debt. The index of anaerobic power is calculated by subtracting the oxygen uptake exceeding the resting values from the energy demand to sustain a given work load. The oxygen uptake exceeding the resting level during a period of five minutes after the exercise test is added up and the result is taken to represent the index of the oxygen debt. In this presentation of preliminary results it is concluded that the index of anaerobic power and the parameter of anaerobic power (maximal oxygen uptake in symptom-limited stress testing) provide valuable additional information in regard to the physical performance of untrained people, athletes and patients with impaired cardio-pulmonary function in quantitative terms.


[Epidemiological investigations on measles in unvaccinated and vaccinated children (author's transl)]. A national study, with participation of 82 paediatricians, was carried out on 9472 children over medium observation periods of between 3.13 and 5.46 years with evaluation of the history of measles, incidence of complications and details of vaccination procedure performed. The protection rate of primary vaccination with live vaccine was 0.89, with split vaccine (3 times) 0.67 and after a combination of split vaccine (3 times) with live vaccine (9 to 12 months later) 0.94. Complications due to measles in unvaccinated children were found in 5.9% of cases. Measles complications after failure of vaccination were found in 2.9% and 2.8% of children vaccinated with live or split vaccine, respectively. No such complications were observed in children vaccinated with a combination of split and live vaccines.


[Familial nephrotic syndrome with focal glomerular sclerosis (author's transl)]. This is a report about three siblings (one boy and two girls) suffering from a clinically- and morphologically-identical form of renal disease. The disease began in each case with symptomless proteinuria at the age of 3 years and proceeded after several years to the full-blown picture of idiopathic nephrotic syndrome with the rapid development of renal insufficiency. Histologically, minimal proliferative intercapillary glomerulonephritis with focal sclerosis was found in all 3 cases. This condition was resistant to steroid and immunosuppressive therapy. The incidence and the morphological, clinical and therapeutic peculiarities and the prognosis of familial nephrotic syndrome are discussed on the basis of these case reports.


[Long-term use of medium chain triglycerides in cystic fibrosis (author's transl)]. Conventional treatment of 15 children (aged 4 to 17 years) with cystic fibrosis and persistent failure to thrive was supplemented on an out-patient basis by a daily oral intake of 35 g of medium chain triglycerides (MCT) fat. Follow-up investigations were pursued for a longer period than described in the literature, namely up to 6 months after initiation of the MCT diet. While frequency of the bowel movements was reduced and abdominal discomfort disappeared no weight gain was observed. Clinically, steatorrhoea was clearly diminished. Pre-treatment serum cholesterol levels were lower (121 mg/dl, n=25) than in healthy subjects (182.2 mg/dl, n=56). No significant changes in either serum cholesterol or serum triglycerides were detected over the 6-month period. There were no clinical signs of an essential fatty acid deficiency in 4 patients followed up for 2 years so far. MCT fat should be included in the standard dietary regimen used in the management of any child with cystic fibrosis and failure to thrive. Its use is fully justified by the clinical improvement and alleviation of the steatorrhoea.


[The development of infants subjected to aided respiration in the newborn period (author's transl)]. 22 children who required respiratory aid (LPPV, CPAP) in the newborn period were followed up to the age of 12 to 36 months. The birth weight ranged between 1050 and 4100 g and the duration of artificial ventilation ranged between 36 and 698 hours. Neurological development of 17 children was completely normal, whilst four showed noticeable hyperkinesis or slight dystonia and one child developed spastic diplegia of a moderate degree, which was almost completely overcome by physiotherapy. The mean developmental quotient (Eggers-Wagner) ranged between 76 and 127.


[Hereditary symphalangism: observations on this syndrome in a newborn infant and his mother (author's transl)]. Symphalangism is the partial or complete bony fusion of phalanges in the fingers and toes due to an autosomal dominant gene, with inherited failure of development of one or more interphalangeal joints. Two patients--a newborn baby and his mother--both revealing this rare malformation, are presented in this paper and the clinical and radiological features are described and discussed.


[The umbilical cord blood lead concentration: a comparison between an urban and rural population (author's transl)]. The cord blood lead level was determined to 40 newborn infants. The values were significantly higher in the infants born to mothers resident in Vienna than in the infants born to the group of mothers from the rural surroundings of Eisenstadt. The overall mean blood level was 17.7+/-7.4 mug/100 g. Increasing pollution requires investigations concerning possible effects on the growing fetus and would serve as foundation for future trend assessment studies.


[Pseudoatresia of the oesophagus in the newborn infant (author's transl)]. Pseudoatresia of the oesophagus seems to occur more frequently than assumed from the cases actually diagnosed. With reference to an appropriate case its traumatic origin is discussed and is considered to be closely connected with anatomical facts and special circumstances arising in newborn infants. Clinical symptoms, therapy and prophylaxis are pointed out. Common oesophageal atresia is the most important condition to be ruled out in the differential diagnosis.


[18 q deletion in mother and daughter (author's transl)]. Transmission of 18 q deletion from a mother to her daughter is described in this report. By means of diverse banding techniques the same deletion was proven in both cases. Partial deletion on the long arm of chromosome 18 produces typical malformations and clinical characteristics which are compatible with life. In case of propagation it can be transmitted as a dominant characteristic.


[Results of repeated IgE titre determinations for the early diagnosis of tumour recurrence in the otolaryngological area (author's transl)]. Repeated serum IgE determinations in 292 tumour patients, in parallel with clinical check-ups, show the great diagnostic significance of the serum IgE level. The IgE titre variations give an insight into the tumour-host relationship and, in particular, into the current state of activity of the tumour patients who were found to be tumour-free after specific therapy have constant serum IgE values on repeated examination. The serum IgE level declines significantly during radiotherapy and after operative therapy. Tumour recurrence or metastases cause a sharp increase in the serum IgE level already before clinical manifestations can be ascertained. Hence, this method contributes through continued immunological checks towards an early diagnosis of tumour activity.


[A case of reversible deafness in cystic arachnoiditis (author's transl)]. A patient studied preoperatively by a neuro-otological test battery showed signs of an extensive cerebellopontine angle tumour. During the operation dense fibrotic tissue was found extending from the choroid plexus to the right acoustic nerve, which was freed and thus decompressed. Postoperatively, low frequency hearing improved markedly in the right ear. In contrast to the well-known documented cases of successful decompression of the optic nerve it has not been possible up to now to achieve a successful outcome in similar procedures on the acoustic nerve. In the described case the fibrotic lesion had obviously just caused reversible damage to the myelin sheaths of the eighth nerve, which can be interpreted as "neurapraxia" (Seddon, 1943). Further investigations in regard to the systematic elucidation of possibly reversible damage to the acoustic nerve are currently being performed at the IInd ENT department of Vienna University.


[A six-year review of patients attending the sterility clinic (author's transl)]. The paper  reports the therapeutic results achieved in patients attending the sterility clinic over the period 1969-1974. Altogether 540 couples were examined and treated. The average age of the female patients in this series was 29,6 years; the length of time over which pregnancy had been attempted averaged 3.9 years. Sterility was attributable to the female partner in 54.3% of the cases, to the male partner in 32.4% and to both spoused in 3%. No apparent cause for the sterility was detected in 10.3% of the cases. 209 pregnancies occurred following treatment, corresponding to an overall success rate of 38.7%, or 40.6% when due allowance is made for the 27 cases in whom the outlook was certainly hopeless. 107 husbands were treated and in 22 cases (20.5%) their spouses became pregnant during the period of treatment. The following therapeutic measures proved successful in the females: clomiphene: 34 pregnancies in 82 patients; gonadotrophins (HMG), HCG): 13 pregnancies in 35 patients; 22 out of 66 patients becamse pregnant had been discontinued; treatment of luteal insufficiency with Duphaston resulted in 13 pregnancies among 43 women; tubal surgery led to eight pregnancies in 32 patients and uterine surgery to one pregnancy among five patients. The greatest number of pregnancies was achieved by simple therapeutic measures such as consultation, determination of the optimum time for conception, local treatment, and cervical dilatation.


[Psychological aspects of hysterectomy (author's transl)]. The effects of hysterectomy on social and psychological behavioural changes were evaluated in 88 patients who were examined psychologically and somatically preoperatively and for a period of 5 to 6 months postoperatively. All patients were aware of the surgical consequences and were investigated in regard to social history and by means of psychological tests (HAWIE, MMPI, Rorschach). The personality profiles of these patients fell within the normal range, although showing a tendency towards psychosomatic alteration, which, however, decreased significantly after the operation. Hysterectomy does not appear to produce any clear-cut changes in the attitude toward sexuality according to the findings of this study. Neither the age at which sexual maturity was reached, nor the intelligence level, number of children, age nor social class appeared to show any significant influence on the capacity to achieve orgasm or the frequency of intercourse. Only three patients showed transient postoperative depression, although this is frequently described in the literature; its aetiology is discussed. The therapeutic approach, especially in the field of surgical gynaecology, must encompass every aspect of medicine and appropriate explanations of the surgical consequences should be given to the patients to prevent postoperative psychological complications.


[The value of liquid crystal thermography in the detection of breast cancer by the gynaecologist (author's transl)]. A report is present of 1300 unselected patients investigated for breast cancer by liquid crystal thermography. The value of this method is comparable to the value of mammography, since the number of carcinomas which remained undetected by each diagnostic procedure was equal. The high degree of diagnostic accuracy achieved by the use of liquid crystal thermography indicates that this simple dignostic procedure is recommendable as a screening method for the detection of breast cancer in gynaecological practice.


[Creatinine during pregnancy (author's transl)]. Determination of the creatinine concentration of the amniotic fluid was undertaken between the 25th and 40th week of gestation in 114 patients. The normal serum creatinine level was simultaneously determined in 43 of these patients. The aim of this study was to examine whether this parameter of fetal renal function allows a conclusion to be drawn with respect to fetal maturity and the length of gestation. With increasing length of gestation a marked increase in the amniotic fluid and the maternal serum creatinine concentration was observed (p less than 0.01). The large scatter of the values made it impossible to relate any particular creatinine concentration to a certain week of gestation. However, if the concentration of creatinine in the amniotic fluid has reached a value of 2 mg% or more, a mature baby can be predicted in most cases. A tendency to raised levels of creatinine was seen in cases of EPH gestosis and latent diabetes mellitus. The determination of creatinine in the amniotic fluid can be recommended with certain reservations as an additional method to assess fetal maturity.


[Endogenous oestrogen state in women with postmenopausal bleeding (author's transl)]. The endogenous oestrogen state in 52 women (33 with endometrial carcinoma and 19 with benign conditions of the endometrium) was assessed ny means of histological examinations of vaginal swabs and of radio-immunological determinations of 17 beta-oestradiol. Considering their age, these women displayed an oestrogen activity far exceeding that found in previous studies. There was no difference between the oestrogen levels in women with carcinoma and the other patients. Furthermore, it was stiking that in the same group of women the examined parameters frequently showed different results. Consequently, a diagnosis based solely on the investigation of one parameter must frequently be misleading.


[Surgical therapy of varicose veins of the lower limb (author's transl)]. Between 1969 and 1975 302 patients were surgically treated for varicose veins of the lower limbs (bilaterally in 61 cases) in the 2nd Department of Surgery, University of Vienna. 151 patients (including 30 cases operated on bilaterally) were followed up. The "classic" technique of vein stripping introduced by Babcock [1], modified in regard to certain details, was employed. The results of the follow-up examinations are presented and discussed.


[Intraoperative Histological Investigations in Gynaecology (author's transl)]. This study corroborates the great value of pathologist consultation in cases of diagnostic difficulty arising during the course of gynaecological operations. Joint discussion of the macroscopic appearance and/or interpretation of the frozen section appearance proved indispensable in the decision as to the appropriate operative procedure and the extent of the surgical measures in 147 cases submitted to intr-operative frozen section investigation. The highly satisfactory results are discussed and attributed largely to the efficient cooperation between pathologist and surgeon.


[Biotransformation of 10-(3-quinuclidinylmethyl)phenothiazine (LM 209), a new anti-allergy agent and the distribution and excretion of its metabolites]. 1. Metabolism of 10-(3-quinuclidinylmethyl)phenothiazine and the distribution and excretion of the metabolites, especially the sulphoxides, were studied in rat and dog after oral and intravenous administration. 2. Urine and bile contained relatively little unchanged drug. The sulphoxide, sulphone, N-oxide and N-oxide sulphoxide derivatives were identified as well as glucuronide and sulphate conjugates, suggesting the formation of hydroxylated products. Faeces contained mainly unchanged drug but also some sulphoxide and N-oxide. In the lung, brain and cerebro spinal fluid only unchanged drug and traces of sulphoxide were found, whereas in liver sulphone and N-oxide were also present. 3. After administration of the 35S-labelled sulphoxide, the distribution of radio-activity was very different from that observed with LM 209. The biological half-life (t0-5) of SM 209 was 3 to 4 times higher than that of the sulphoxide. LM 209 is better absorbed and its diffusion in the organism is superior. 4. Metabolism of LM 209 by liver microsome preparation was more rapid than metabolism of the sulphoxide. 5. These findings indicate that the activity of LM 209 is due more to the molecule itself than to its major metabolite.


The biodegradation of the surfactant undecyl sulphate. 1. The metabolism of the odd-numbered carbon chain surfactant, potassium undecyl [35S]sulphate in the rat was investigated. 2. The major route for elimination of radioactivity was the urine, regardless of the route of administration. 3. The surfactant was extensively degraded in vivo to yield propionic acid 3-[35S]sulphate, the major radioactive component in urine. A second urinary metabolite was identified tentatively as pentanoic acid 5-[35S]sulphate. 4. Whole-body autoradiography revealed the liver as the major site of metabolism. 5. The nature of the metabolic products of undecyl sulphate suggest that it is bio-degraded by initial omega-oxidation followed by beta-oxidation.


Metabolism of metoprolol in the rat in vitro and in vivo. 1. Metoprolol was metabolized in rat liver microsomes in vitro by O-demethylation with subsequent oxidation and by aliphatic hydroxylation of the methoxy-ethyl substituent and by oxidative deamination of the propanolisopropylamine side-chain. The same routes of metabolism in the rat in vivo were revealed from urinary metabolites. Eight metabolites were identified by g.l.c.-mass  spectrometry by comparison with synthetized reference compounds. 2. Metoprolol binds to cytochrome-P-450 eliciting a type I difference spectrum with KS = 23 +/- 2-0 muM. The apparent Michaelis-Menten constant Km = 39 +/- 4-0 muM and Vmax = 1-28 +/- 0-22 nmol/mg protein X min were not significantly affected by pre-treatment of the rats with metoprolol or phenobarbital. Metoprolol pre-treatment had no effect on the cytochrome-P-450 level in the microsomes nor on the rate of metabolism of four standard substrates. Phenobarbital increased the cytochrome P-450 as expected. 3. Four metabolites representing the three main routes of metabolism were quantitatively determined after metabolism with rat liver microsomes and compared with the urinary levels of the same compounds. The same major metabolites were found in vitro and in vivo. The total amount of metabolites was not influenced by pre-treatment with metoprolol or phenobarbital. The relative amounts of the three main metabolites were slightly affected by pre-treatment.


Taurine conjugation of 2,4-dichlorophenoxyacetic acid and phenylacetic acid in two marine species. 1. At least 50% of a dose of 14C-labelled 2,4-dichlorophenoxyacetic acid or phenylacetic acid was excreted in urine in 48 hours after administration to dogfish shark or flounder. 2. For both compounds, more than 90% of the urinary 14C was present as a single metabolite. 3. Each metabolite was the taurine conjugate of the administered compound.


Metabolism of debrisoquine sulphate in rat, dog and man. 1. The metabolism of debrisoquine sulphate in the dog has been studied and is similar to that in rat and man. 2. Two acidic urinary metabolites, shown to be present in rat, dog and man, have been isolated from rat urine. After derivatization they were characterized by n.m.r. and mass spectroscopy as methyl 2-[2-(4,6-dimethylpyrimidylamino)-methyl]-phenylacetate and 2-[2-(4,6-dimethylpyrimidylamino)-ethyl]benzoate.


The metabolism of zingerone, a pungent principle of ginger. 1. The metabolism of 4-(4-hydroxy-3-methoxyphenyl)butan-2-one (zingerone), a pungent principle of ginger, has been investigated in rats. 2. Oral or intraperitoneal dosage (100mg/kg) of zingerone resulted in the urinary excretion of most metabolites within 24 h, mainly as glucuronide and/or sulphate conjugates. While zingerone itself accounted for roughly 50-55% of the dose, reduction to the corresponding carbinol (11-13%) also occurred. Side chain oxidation took place at all three available sites and oxidation at the 3-position, giving rise to C6-C2 metabolites, predominated. About 95-97% of the dose was accounted for. 3. Appreciable (40% in 12 h) biliary excretion occurred. Biliary studies and studies in vitro using caecal micro-organisms indicated that several O-demethylated metabolites found in the urine are of bacterial origin.


The metabolic fate of the coronary vasodilator 4-(3,4,5-Trimethoxycinnamoyl)-1-(N-pyrrolidinocarbonylmethyl)piperazine (cinepazide) in the rat, dog and man. 1. An oral dose of the coronary vasodilator 4-(3,4,5-trimethoxy[14C]cinnamoyl)-1-(N-pyrrolidinocarbonylmethyl)piperazine was well absorbed and more than 60% of the dose was excreted within 24 h. In 5 days, rats, dogs, and man excreted in the urine and faeces respectively 36.7% and 58.3%, 33.4% and 68.6%, and 61.3% and 38.1% dose. Faecal radioactivity was probably excreted via the bile. 2. Plasma concentrations of radioactivity reached a maximum within about 1 h in all three species and declined fairly rapidly (t0.5 less than 3 h). For several hours, more than 50% of the plasma radioactivity was due to unchanged drug. After correction for dose and body weight (normalization), peak plasma concentrations of unchanged drug in man, rat and dog were in the approximate ratio 100 :30:1. 3. Similar metabolites were excreted by the three species, but the relative proportions differed. Rats and man excreted 17.2% and 15.9% respectively as unchanged drug in the urine whereas dogs excreted only 3.6%. Rat bile and urine contained 4.3% and 9.8% dose respectively as glucuronides of the mono-O-demethylated compounds and dog and human urine contained 9.0% and 2.6% respectively of these metabolites. The corresponding pyrrolidone accounted for 2.5%, 5.5% and 5.1% respectively in rat, dog and human urine. Complete O-demethylation also occurred since 4-(3,4,5-trihydroxycinnamoyl)-1-(N-pyrrolidinocarbonylmethyl)piperazine was present in rat faeces (22.1% dose).


Interaction between bronchoconstrictor stimuli on human airway smooth muscle. In healthy human subjects, the simultaneous aerosol administration of histamine and methacholine results in a pronounced decrease in maximum flow rates on partial expiratory flow-volume (PEFV) curves. When given alone in the same concentrations, these drugs produced no or minimal decreases in flow rates. The results suggest an interaction of histamine and cholinergic stimuli on airway smooth muscle (ASM). This mechanism might explain many experiments where vagal blockade diminished or abolished ASM response to histamine and other stimuli, simply by interfering with histamine-cholinergic interaction at the ASM level. These findings confirm similar findings of animal in vitro experiments. The experiments clearly confirm the sensitivity and value of assessing drug effects prior to a deep breath. Flow-rate changes after a full inspiration, taken from the maximum expiratory flow-volume (MEFV) curve, show either no relationship to the concentration of inhaled methacholine or significantly less effect than that seen on the PEFV curve.


Viability assessment of allograft valves by autoradiography. Autoradiography using [(3)H]thymidine is a quantitative method to assess tissue viability. It has been found to be very useful in the organization of fresh aortic valve allograft banks. A brief description of the technique, as well as the marked difference in the active metabolism of fibro-blasts of valves placed in two storing solutions, is outlined.


Nuclear nonhistone proteins in murine melanoma cells. I. Quantitative isolation and fractionation. Nuclear nonhistone proteins (NHP's) have been implicated as regulatory agents involved in controlling genetic expression. Utilizing murine melanoma cells, we describe a method for isolating and fractionating NHP's which greatly increases the yield of these proteins as well as the level of resolution required for detecting small differences in particular NHP's. Mouse melanoma cells were grown in medium labeled with [(3)H]leucine. Following 48 hr of incubation, the cells were harvested and nuclei isolated. The NHP's were extracted from the nuclei in a series of steps which yielded four major fractions: NHP(1), NHP(2), NHP(3), NHP(4). This method solubilized 80-90% of the protein from the nuclear homogenate. The NHP fractions were then separated on DEAE-cellulose columns in a series of salt steps increasing in concentration from 0.05 to 0.50 M NaCl, followed by steps of 2 M NaCl and 4 and 7 M guanidine-hydrochloride. The 40 NHP fractions eluted from these columns were further separated on polyacrylamide-SDS gels and ranged in molecular weight from 9000 to 110,000 daltons. Differences were observed in the electrophoretic pattern of each of these 40 fractions. The high resolution of these fractionation procedures greatly enhances the possibility of observing small changes in proteins which may play a role in gene regulation.


Neutropenia during high dose intravenous oxacillin therapy. Five patients who developed neutropenia following intravenous administration of high dose oxacillin for serious Staphylococcus aureus infection are described. Neutropenia was reversible with cessation of intravenous oxacillin therapy. Two patients were continued on oral oxacillin without untoward effects.


A statistical analysis of reviewer agreement and bias in evaluating medical abstracts. Observer variability affects virtually all aspects of clinical medicine and investigation. One important aspect, not previously examined, is the selection of abstracts for presentation at national medical meetings. In the present study, 109 abstracts, submitted to the American Association for the Study of Liver Disease, were evaluated by three "blind" reviewers for originality, design-execution, importance, and overall scientific merit. Of the 77 abstracts rated for all parameters by all observers, interobserver agreement ranged between 81 and 88%. However, corresponding intraclass correlations varied between 0.16 (approaching statistical significance) and 0.37 (p < 0.01). Specific tests of systematic differences in scoring revealed statistically significant levels of observer bias on most of the abstract components. Moreover, the mean differences in interobserver ratings were quite small compared to the standard deviations of these differences. These results emphasize the importance of evaluating the simple percentage of rater agreement within the broader context of observer variability and systematic bias.


[Behavior of heparinocytes and fibrinolytic degradation products under sulfobromophthalein or indocyanine green in patients with liver diseases or persons with healthy liver]. Due to a slight haemooysis after the application of bromsulphalein an intravasal coagulation with reduction of the number of heparinocytes and an increase of fibrinolytic split products develops. These changes are to be observed in the vast majority of tests, also in such cases where no clinical signs of an incompatibility appear. Indocyanine-green does not cause these severe disturbances of coagulation. Slight changes are traced back to the examination technique. Patients with chronic liver disease already show increased values of fibrinolytic split products. In increased initial values of fibrinolytic split products bromsulphalein does not cause a further increase.


[Aspects of the risk-free use of micro-catheterization in 3342 examinations]. The microcatheterization for purpose of sounding of the right heart has proved itself in the prediagnostics of vitia cordis, for verification of the latent cor pulmonale, especially in combination with the bicycle ergometer load, and in the intensive medicine in the permanent measurement of the pressure of the pulmonary artery. The method gives the advantage of the frequent reproducibility and at the same time uncomplicated usability. In 3,342 microcatheter investigations only eight complications appeared (0.24% of the cases). Practical methodical references are given and possibilities of error in registering the pressure are indicated.


[Importance of ECG in the monitoring of patients with pacemakers]. As treatment method of choice in permanent bradycardic disturbances of cardiac rhythm the control of pacemaker patients increasingly obtained importance. The knowledge of the normal as well as the disturbed pacemaker ECG is one condition for the optimal care of pacemaker patients, since more and more practicing physicians are involved into this responsible activity. After description of the ECG in intact pacemaker function (including the possibilities of errors) the disturbances most frequently observed in practice (change of the pacemaker frequency, deficits of synchronisation and stimulation) are dealt with and explained.


[Qualitative demands on a anti-N blood group test reagent from Vicia graminea (anti N vg)]. Qualitative demands made on anti-NVg are enunciated. Apart from a short description of the production and directions for the use indications for testing the specific effect, the purity and the titre are given. Furthermore, serological peculiarities of the anti-NVg for special questions are reported. Anti-NVg shall enlarge the series of the out superseding the usual anti-N-serum of the blood-group-serological diagnostic remedies with-rabbit.


[Diagnostic strategy in rheumatology].

[Diagnostic strategy in rheumatology]. Nowadays, rheumatology is primarily understood as arthrology. In special diagnostics at first an articular process is to be ascertained or excluded, the arthralgia is to be separated from the objectifyable arthritic syndrome and this must be more enclosed by simple findings of the anamnesis and the physical examination. The tentative diagnosis which is present after this already in the vast majority of cases must be confirmed by aimed laboratory and X-ray diagnostics. Some guiding principles concerning the X-ray examination, state and perspectives of articular scintigraphy, arthroscopy, thermography and relevant genetic research are reported.


[Possibilities and limits of the morphological diagnosis of rheumatoid arthritis]. For the morphological diagnostics of rheumatoid arthritis only the judgment of the synovial membrane is of practical importance. Based on the experience gleaned on more than 2,000 synovectomy preparations the following evidence concerning the possibilities and the limits of the morphological diagnostics and the judgment of activity can be enunciated. 1. A certain histological diagnosis of the rheumatoid arthritis is possible only when rheumatoid granulomas or their equivalents are proved. 2. A probability diagnosis results from a definite combination of symptoms of proliferative and exsudative reactions of the synovial membrane. Especially the absence of proliferative signs decreases the degree of probability of the diagnostic evidence. 3. Seropositive and seronegative cases do not reveal any differences in histological respect. The possibility of the class-specific determination of rheumatoid factors by means of an immunofluorescence test and the fact the seronegative cases showed IgM and IgM rheumatoid factors, when this test was used, demands an examination of this evidence. 4. As to the synovial membranes of large joints in the same membrane so distinctive local differences of the findings may exist that thus the value of the needle biopsy is restricted. Only positive findings may be evaluated diagnostically. 5. Apart from a diagnosis the histological findings of the synovial membrane also allow a judgment of the local activity. The basis activity and the actual activity are differentiated. The basis activity is regarded as an expression of the immunological activity, the actual activity as an expression of the inflammatory activity. There are no unambiguous relations to the total clinical activity. Differences in the behaviour of the activity between seropositive and seronegative cases are not to be proved. A revision of this evidence under the aspect of the class-specific proof of the rheumatoid factor is necessary.