The hypotensive effect of fusaric acid: the results of long-term administration of fusaric acid in elderly hypertensive patients. The hypotensive effect of fusaric acid calcium salt (Calcium salt of 5-butylpicolinic acid) was examined clinically in 10 elderly hypertensive patients by the long-term administration of this agent and the following results were obtained. 1) The means of the systolic and/or diastolic blood pressures of each patient were significantly lower during the first year of the trial period than those during the one year's control period in all patients. 2) The means of the systolic and/or diastolic blood pressures of each patient were significantly lower during the second year of the trial period than those during the one year's control period in whom administration of fusaric acid calcium salt was continued throughout two years. A significant reduction of the systolic blood pressure was observed in 3 out of 6 patients and that of the diastolic blood pressure was observed in 5 out of 6 patients. 3) Comparison was made between the means of the systolic and diastolic blood pressures during the one year's control period and those during the six month's placebo period after two year's administration of fusaric acid calcium salt. During the placebo period, both systolic and diastolic blood pressures showed a tendency of returning to the levels during the control period confirming the hypotensive effect of this agent. 4) Laboratory findings after one year's administration of fusaric acid calcium salt showed no adverse effect of this agent.


The long-term hemodynamic effect of fusaric acid in elderly hypertensive patients. The hemodynamic effect of fusaric acid calcium salt (calcium salt of 5-butylpicolinic acid), an inhibitor of dopamine beta-hydroxylase, was studied in long-term administration of this agent in 10 elderly hypertensive patients. The hemodynamic items were measured by dye-dilution method before and 3 months, 6 months and one year after administration of fusaric acid calcium salt. The main hemodynamic changes observed were as follows: 1) Heart rate did not show any consistent change. 2) Systolic, diastolic and mean blood pressure decreased. The mean values of these pressures after fusaric acid calcium salt administration were significantly lower than the mean values before administration of this agent. 3) Total peripheral vascular resistance index decreased. The mean values of this index at 3 months, 6 months and one year after fusic acid calcium salt administration were significantly lower than the mean value before administration of this agent. 4) Cardiac index showed various changes throughout administration of fusaric acid calcium salt. The changes in this index might be secondary following the changes in total peripheral vascular resistance index, an inverse correlation being existed between them. 5) Stroke volume index showed almost a similar pattern of change as observed in cardiac index. An inhibitory action of fusaric acid calcium salt on the inotropism of the heart could be hardly found. 6) Plasma volume showed no tangible changes after fusaric acid calcium salt administration throughout one year. It might be concluded that fusaric acid calcium salt elicited the hypotensive response primarily through the reduction of total peripheral vascular resistance index.


Urinary norepinephrine excretion in elderly hypertensive patients during administration of fusaric acid. The urinary norepinephrine excretion during fusaric acid calcium salt administration was examined in 5 elderly hypertensive patients by double blind cross-over method. The average daily excretion of the last 5 days during fusaric acid calcium salt or placebo administration of 5 weeks' duration was compared in each patient. In 4 patients except for one, the average daily urinary excretion of norephinephrine during fusaric acid calcium salt administration showed an increase, being highly significant (p less than 0.01) statistically, when compared with that during placebo administration, the latter being essentially unchanged. In the one patient, however, the average daily urinary excretion of norepinephrine was significantly higher during placebo administration than that during fusaric acid calcium salt administration. The relationship between the changes in the average daily urinary excretion of norepinephrine and those in blood pressures seemed to be not consistent. The mechanism which brought about an increased norepinephrine excretion in the urine of the hypertensive patients is not obscure at present.


A comparative study of the coronary arterial structure in the left ventricular free wall in infarcted and non-infarcted human hearts. The structure and anastomoses of the coronary arteries were studied using coronary arteriography with barium sulfate (Micropaque) and gelatin as well as "cleared preparations" with tetralin. This was done in a total of 50 human autopsied hearts either with or without infarction and the patients had ranged from one to 84 years of age. Special emphasis was placed on the quantitative studies of the coronary anastomoses in the left ventricular free wall of 32 hearts including ten infarcted hearts. In addition histologic investigations were performed on 168 anastomotic channels selected arbitrarily from both the infarcted and non-infarcted hearts. The following results were obtained. 1. In the non-infarcted hearts, three different types of vessels, Type I, Type II and Type III respectively, were recognized in the left ventricular free wall. The number of anastomotic channels did not correlate with age, sex or weight of the heart. The number of anastomoses was closely related to the degree of coronary arterial narrowing and increased in the cases of severe narrowing. Anastomotic channels tended to be more frequent in the intracoronary and in the subendocardial layer and anastomoses of less than 150m in calibre were more numerous. 2. In the infarcted hearts the three types of vessels were changed as follows: localized increase of tree-like branching in the terminal portion of Type I vessels. Intercommunications between Type II vessels coursing parallel to the endocardial surface and between Type I and Type II vessels were found in the region of the endocardial layer up to the middle layer. Elongation of Type III vessels and an increase in their intercommunications were evident. Anastomoses in intercoronary and in the middle layer were found to have increased significantly. The percentage of anastomotic channels with large calibres, especially over 201 mu was increased, as compared with the non-infarcted hearts. 3. The wall thickness of anastomotic channels tended to be thinner in the infarcted hearts than in the non-infarcted ones. In the region adjacent to the infarction foci, attenuation of walls of the vessels was pronounced as compared with the wall thickness in anastomotic channels of similar size in the non-infarcted heats.


Antibiotics produced by Streptomyces ficellus. I. Ficellomycin. Ficellomycin is a new basic antibiotic produced by Streptomyces ficellus. Ficellomycin, C13H24N6O3, inhibits the growth of gram-positive bacteria in vitro and is effective in the treatment of experimental Staphylococcus aureus infections in mice.


Antibiotics produced by Streptomyces ficellus II. Feldamycin and nojirimycin. Feldamycin, a new antibacterial agent, and nojirimycin, a previously described antibiotic have been isolated from cultures of Streptomyces ficellus. Feldamycin, C17H25N7O5, is an amphoteric compound which inhibits a variety of bacteria in vitro but is found to be ineffective in the treatment of experimental bacterial infections in mice. Nojirimycin (5-amino-5-deoxy-D-glucose) has been isolated previously from cultures of several species of streptomycetes.


A new antibiotic XK-90 I. Taxonomy of the producing organism, fermentation, isolation and physicochemical and biological properties. A new antibiotic XK-90 is produced by Streptomyces sp. MK-90 and is active against Gram-positive and Gram-negative bacteria. The taxonomy of the organism, fermentation, isolation and physiochemical and biological properties are described.


Studies on marine microorganisms. V. A new antibiotic, aplasmomycin, produced by a streptomycete isolated from shallow sea mud. A new antibiotic, aplasmomycin, which inhibits growth of Gram-positive bacteria including myobacteria in vitro, and plasmodia in vivo was obtained from a strain of Streptomyces griseus isolated from shallow sea sediment in Sagami Bay. The antibiotic forms colorless needle-like crystals and has a molecular formula of C41H60O14Na. Based on its physical and chemical properties, aplasmomycin was concluded to be a new antibiotic. The antibiotic was produced in selected media devised to relate to a marine environment.


Chemical studies on actinoxanthin.

Chemical studies on actinoxanthin. The antitumor protein actinoxanthin exhibits high inhibitory activity against a number of gram-positive bacteria and some strains of transplantable leucoses and related tumors. Actinoxanthin was shown to consist of a single polypeptide chain crosslinked by two disulfide bonds and to contain 107 amino acid residues. Reduced and alkylated actinoxanthin was digested with chymotrypsin, thermolysin and trypsin. Based on the sequence analysis of fragments so obtained the complete amino acid sequence and the location of disulfide bonds of actinoxanthin has been proposed. The high degree homology of some regions of actinoxanthin and the antitumor protein neocarzinostatin have been revealed.


Biosynthesis of bikaverin in Fusarium oxysporum. Use of 13C nuclear magnetic resonance with homonuclear 13C decoupling to locate adjacent 13C labels. Bikaverin obtained by supplementing cultures of Fusarium oxysporum with singly and doubly 13C labeled acetate was enriched by approximately 0.5 atom percent with the 13C isotope. At this low enrichment 13C NMR spectra of samples labeled from (1-13C)- and (2-13C) acetate did not show, unequivocally, the pattern of isotopic incorporation. Small sample size, poor solubility and difficulties in the assignment of resonances also restricted the amount of information thacetate. The difficulty was overcome by using 13C homonuclear single-frequency decoupling in conjunction with 1H heteronuclear decoupling to locate bonded 13C-13C pairs. The carbon skeleton of bikaverin was shown to be biosynthesized entirely by condensation of acetate units and the pattern of assembly was established.


Ceftezole, a new cephalosporin C derivative I. In vitro and in vivo antimicrobial activity. Ceftezole, a new cephalosporin antibiotic similar to cefazolin, has the following chemical structure: (6R,7R)-8-oxo-7[2-(1H-tetrazol-1-yl)acetamido]-3-[(1,3,4-thiadiazol-2-ylthio)methyl]-5-thia-1-azabicyclo[4.2.0]oct-2-ene-carboxylic acid. Ceftezole was found to be a broad-spectrum antibiotic, active in vitro against many species of gram-positive and gram-negative bacteria except Pseudomonas aeruginosa, Serratia marcescens and Proteus vulgaris. The activity of ceftezole against clinical isolates of Escherichia coli and Klebsiella spp. appeared to be nearly equal to that of cefazolin and higher than those of cephaloridine and cephalothin. Cross-resistance was observed between ampicillin and cephaloridine, but not between ampicillin and ceftezole, in susceptibility tests on clinical isolates of P. mirabilis. The in vitro activity was little affected by the inoculum size, the presence of human serum or the test medium. Ceftezole exhibited apparent bactericidal activity at the concentrations above the minimum inhibitory concentration (MIC) against both S. aureus and E. coli. The development in vitro of resistance by S. aureus 209p and E. coli NIHJ to ceftezole after 16 transfers was similar to or somewhat slower than that to other drugs tested. Ceftezole was relatively stable in nutrient broth and minimally degraded in the serum or tissue homogenates of rats. Ceftezole, in a single subcutaneous administration, exhibited somewhat less efficacy in mice against intraperitoneal infections with Streptococcus pyogenes, S. pneumoniae, E. coli, K. pneumoniae or P. mirabilis than either cephaloridine or cefazolin. However, ceftezole exhibited efficacy similar to that of cephaloridine or cefazolin when administered in three doses. Furthermore, ceftezole was as effective as cefazolin in the treatment of experimental abscesses in mice caused by subcutaneous inoculation with S. aureus.


Ceftezole, a new cephalosporin C derivative II. Distribution and excretion in parenteral administration. The distribution of ceftezole in blood and tissues and its excretion after intramuscular or intravenous administration of single doses of 10 and 20 mg/kg were compared with those of cefazolin, cephaloridine and cephalothin. Blood levels of ceftezole in rats and rabbits were lower than those of cefazolin, and higher than those of cephaloridine and cephalothin. Retention time of ceftezole in the blood was somewhat shorter than that of cefazolin. However, blood levels of ceftezole in dogs were nearly the same as those of cefazolin and cephaloridine. The rate of urinary excretion of ceftezole in 24-hour urine after administration in rats and rabbits was found to be higher than those of the other antibiotics tested. In dogs, however, the rate of urinary excretion of ceftezole was nearly the same as that of cefazolin and higher than those of cephaloridine and cephalothin. The biliary excretion of ceftezole in rats and dogs was much higher than those of cephaloridine and cephalothin, but lower than that of cefazolin. Tissue distribution of ceftezole in rats was compared with that of the other antibiotics by intramuscular and intravenous administration. The initial level of ceftezole in the kidneys was found to be substantially higher than those of the other antibiotics. The initial level of ceftezole in the liver and lungs was also slightly higher than those of the other drugs when administered intramuscularly. Tissue levels of ceftezole were somewhat lower than those of cefazolin in rabbits after intravenous administration. Ceftezole attained a higher maximum level in rat lymph by intramuscular administration than the other antibiotics tested. The maximum concentration of ceftezole present in the exudate in the rat inflammatory pouch was higher than that of cefazolin. In rabbits with cerebrospinal meningitis induced by infection of Streptococcus pyogenes, the level of ceftezole in the cerebrospinal fluid was several times higher than that in normal rabbits. The serum level and urinary excretion of ceftezole was examined in 6 healthy male volunteers after intramuscular administration of a single dose of 500 mg. Ceftezole attained a mean maximum serum level of 22.9 mug/ml 30 minutes after administration and disappeared from the blood in about 6 hours. It was excreted rapidly in the urine. The concentration in 1-hour urine was the highest (mean level: 2,667 mug/ml) and the total excretion rate was 92.6%. No metabolites with antimicrobial activity were observed in the urine. No changes in the pattern of plasma level and urinary excretion and no accumulation in the tissues were observed after repeated intramuscular administration of 20 mg/kg of ceftezole in rabbits, 26 times, for 14 days.


Antibacterial activity of efrotomycin.

Antibacterial activity of efrotomycin. Efrotomycin is a narrow spectrum antibiotic. Among the genera tested for susceptibility in vitro it is most active against isolates of Moraxella, Pasteurella, Yersinia, Haemophilus, Streptococcus and Corynebacterium. The drug is as active by oral administration as by the subcutaneous route. Blood levels rise rapidly to high concentrations, after oral dosing, and are prolonged. Two peaks occur which may indicate biliary excretion and reabsorption. Urinary excretion is minimal. The high blood concentrations explain, in part, the in vivo activity against pathogens such as Bordetella bronchiseptica which are relatively insensitive in vitro. Oral activity of efrotomycin is an advantage over the related antibiotics. X-5108 and mocimycin.


Effect of steroid hormone on rheumatic carditis. One hundred and eleven patients with rheumatic carditis of the first attack were treated with steroid hormone. In the cases, in which the steroid hormone therapy started within 2 weeks from the onset of the disease, all except one did not reveal a residual valvular heart disease after 2 years from the treatment. It was suggested that early diagnosis and the earliest start of steroid hormone therapy with large dose on rheumatic carditis is necessary for the prevention against development of rheumatic heart disease. A therapeutic schedule for rheumatic fever is recommended.


Some problems in long-term prevention of streptococcal infection among children with rheumatic heart disease in Taiwan. In Taiwan, rheumatic fever (RF) and rheumatic heart disease (RHD) remain widespread and constituting a health problem. The long-term prevention of streptococcal infections among rheumatic children has also failed to prevail, and yet has seldom been emphasized. Therefore, recurrence of RF remained prevalent. For an appraisal of the difficulties in the administration of long-term medication prophylaxis, a prospective study was started in 1967. One hundred and five consecutive cases of RF and RHD were followed up for more than 1 year to 6 years with an average of 4.4 years. One hundred and two cases received monthly injections of benzathine penicillin G for 6 months to 6 years, of whom 10 were switched to daily sulfa drugs; 1 case had oral penicillin daily for 6 years; in 12 cases, sulfa drugs were given for 6 months to 5 years. Fifty-one cases (48.6 %) stayed well in the program; 22 (21.0 %) stayed but were not compliant; 32 (30.4 %) dropped out soon or after staying in for more than 1 year. Major risk factors leading to non-compliance are; 1) apparent recovery from the illness or resumption of the normal activity; 2) cram session at school; 3) lack of easy medical care system; and 4) shortage of active participation by the health workers and general practitioners. The present study confirmed that the long-term prevention of streptococcal infection was effective and contributed to the decline of RF recurrence rate from more than 30 % down to 6%. Our study implicates that this important preventive program can not be achieved just only by the hospital staff, but should be approached jointly by all doctors, health and social workers, school teachers and the parents.


Mitral valve replacement in children and adolescents with rheumatic heart disease. To our knowledge, no documented hemodynamic studies in larger series of young patients undergoing valve replacement for rheumatic valvular disease have been reported previously. It seems to us that the natural history of rheumatic heart disease in India often follows a rapid and fulminant course which makes an aggressive surgical approach mandatory. An operative mortality of 22 % was seen in this series. Pronounced cardiac disability together with the poor general condition and the low nutritional status contributed in no small measure to this figure. Patients have been followed for periods ranging from 6 months to 6 years following corrective surgery. A remarkable absence of thrombo-embolic phenomena was a striking feature in the follow-up. There has been no evidence of rheumatic reactivation in any of these patients. This communication reinforces the beneficial results of valve replacement even at this young age when severe mitral incompetence exists refractory to medical treatment.


Antihyaluronidase level in children with rheumatic fever and other streptococcal infection. 1) The serum ASO and AH assays were performed and compared in a series of 90 healthy children and 7 pediatric patients with rheumatic fever and other disorders related to hemolytic streptococcus infection. 2) The upper physiological limit of serum AH titer was estimated to be 256X for children. 3) In rheumatic fever, sometimes the serum AH level rises earlier than elevation of serum ASO and remains to be high over a long period even after the serum ASO has returned to normal level. 4) The results suggest importance of the serum AH determination in the serologic diagnosis of rheumatic fever and other conditions of hemolytic streptococcus infection.


Group A streptococcal infections as related to rheumatic fever. Beta-hemolytic streptococci were recovered frequently, particularly from the throats of children, and the same type of group A strains was isolated from both throats and tonsils. A significant antibody response to streptolysin O was observed in 44.8 to 43.5 % of the children whom group A streptococci were recovered. It is considered that these children had the definite evidence of acute streptococcal infections, and administration of josamycin, penicillin G, and benzyl penicillin V benzathine decreases the frequency of recovery of beta-hemolytic streptococci and prevents rheumatic fever.


Effect of diltiazem, a new anti-Ca agent, on left ventricular function in patients with and without angina pectoris. A study using ultrasonic analogue conversion system. The effect of diltiazem hydrochloride on left ventricular function has been examined in patients with and without angina pectoris. Left ventricular volume and function were measured by ultrasonic analogue conversion system. In 12 patients without angina pectoris, a fall in systemic blood pressure, a decrease in heart rate, no change in EDVI, an increase in ESVI, decreases in CI, EF, endocardial mean Vcf, normailized mean systolic ejection rate, SWI, and W/min while no change in systemic vascular resistance were observed following the intravenous injections of 40 mug/Kg of the agent. In 10 patients with angina pectoris, decreases in EDVI and ESVI, no change in CI, a tendency of increases in EF, endocardial mean Vcf, and normalized mean systolic ejection rate were observed following the administrations of the same dose. Changes in systemic blood pressure, heart rate, SWI, W/min, and systemic vascular resistance were the same as those in patients without angina pectoris. The results indicate diltiazem-induced reduction in left ventricular function in patients without angina pectoris whereas improvement in left ventricular function in patients with angina pectoris.


Detection of the site and extent of the left ventricular asynergy in myocardial infarction by echocardiography and B-scan imaging. The left ventricular wall motions in 53 patients with myocardial infarction and 14 normal subjects were studied by echocardiography and B-scan imaging (ultrosono-cardiokymography, ultrasono-cardiotomography). (1) Abnormal left ventricular wall motions corresponding to the electrocardiographic sites of infarction were seen in the echocardiograms in 80 % of total patients and 100 % of acute cases. Exaggerated wall motion in opposing noninfarcted areas was seen in 50 % of acute cases and 10 % of old cases. Quantitative analysis of asynergy could be made by comparing PWE, SE and those ratios to EDD-ESD of infarcted hearts with those of normal hearts. (2) In acute myocardial infarction, abnormal motions of left ventricular wall are marked in acute phase and diminished in extent gradually in recovery phase. But in some cases, echo-demonstrated segmental dyskinesis did not disappear in recovery phase, possibly due to the presence of irreversible myocardial damage. (3) Echographic thickness of the infarcted wall was less increased then normals or was not increased during systole and decreased when bulged out in some cases, indicating the existence of necrotized muscle. Moreover, multiple echoes sometimes seen between endocardial and epicardial echoes of infarcted myocardium were considered to display the fibrosis of the infarcted myocardium. (4) Abnormal echocardiographic motions of septum and posterior wall were observed in some cases who had no electrocardiographic abnormalities which suggest septal or posterior wall involvement. Echocardiography could detect another affected area of the left ventricle which could not be detected by electrocardiography. (5) Echocardiography in combination with B-scan imaging (UCKG, UCTG) can detect not only the location, but also the size and extent of myocardial infarction. (6) The results of this study indicate that echocardiography and B-scan imaging (UCKG, UCTG) are sensitive methods in detecting the size and location of asynergy and making a precise diagnosis of myocardial infarction. But it is necessary to distinguish abnormal septal and posterior wall motions observed in right ventricular volume overload, complete LBBB or PMD(COCM) from those of myocardial infarction.


Blood fibrinolytic activity and fibrinoid necrosis of small arteries in the rats treated with renal cortical extract. In order to determine the role of fibrinolytic system in the production of fibrinoid necrosis, blood fibrinolytic activities were measured in the rats nephrectomized and administered with the subcellular fractions (lysosomal or microsomal fraction) of the rat kidney cortical extract. Tissue plasminogen activator was present in both fractions and blood fibrinolytic activity was increased in the rats so treated. But fibrinoid necrosis in pancreatic and mesenteric small arteries was observed only in those administered lysosomal fraction. Direct relationship between the increase of blood fibrinolytic activity and the aggravation of the vascular degeneration could not be observed in this experiment.


Effects of temperature on norepinephrine-induced sinus acceleration and overdrive suppression in the isolated dog atrium. Using an isolated, blood-perfused atrium preparation, the effects of temperature on SA nodal pacemaker activity were investigated in 9 preparations. The PP interval decreased as temperature was raised. Regular sinus rhythm and atrial contraction were maintained above approximately 26 degrees C. Below 26 degrees C, sinus depolarization still showed a regular rate, although atrial contractions had ceased. At about 24 degrees C, atrial rhythm became irregular. Below 20 degrees C, atrial depolarization disappeared. Chronotropic responses to norepinephrine were suppressed at decreased temperatures, not only with respect to maximum PP shortening but also to the threshold dose for inducing sinus acceleration. Overdrive suppression was not influenced significantly by decreasing temperature. These results indicate that a temperature decrease causes suppression of SA nodal pacemaker activity, although the SA node continues to function regularly until about 25 degrees C.


Principle of adaptation of heart size to volume load. A theoretical approach. A hypothesis of a principle of the adaptation of heart size to volume load was generalized from some experimental findings in literature on hearts of a few mammalian species. The hypothesis was that the heart adapts its size and weight so that both myocardial force per unit cross sectional area and extent of shortening per unit length be kept constant. From these 2 conditions, mathematical relationships of heart weight and enddiastolic volume to stroke volume were derived by the aid of a thick wall sphere model of the left ventricle. The calculated result was in good agreement with comparative physiology data in literature on normal hearts from rats to cows. The present hypothesis was therefore suggested to be a basic principle of heart adaptation to the natrual volume load in a wide variety of mammalian species.


A case of rhabdomyoma in infancy.

A case of rhabdomyoma in infancy. A case of cardiac rhabdomyoma was presented. She was diagnosed as intraatrial tumor by cardiac catheterization and angiocardiography at 7 months of age. Two months later, she was undergone open heart surgery, which revealed larger rhabdomyoma in the left atrium obstructing the mitral valve.


Aorticopulmonary fistula. A case of successful repair with review of literature since 1943. A case of aorticopulmonary fistula secondary to thoracic aortic aneurysm of syphilitic origin has been presented. Aneurysm involved the first portion of the ascending aorta and ruptured into the main pulmonary artery a few cm above the pulmonic valve. Two weeks after onset, the patient successfully operated upon under profound hypothermia with perfusion. Thirteen cases of this disease since 1943 were reviewed and we discussed briefly profound hypothermia as a useful technic for surgical correction of this condition.


Atrial dissociation.

Atrial dissociation. Atrial dissociation was recorded in a patient with malignant hypertension and microangiopathic hemolytic anemia. Digitalis intoxication was considered the cause of atrial dissociation.


Carcinogenesis in tissue culture 26: malignant transformation of rat liver cells in vitro associated with paradoxical electrokinetic changes. Periodical examinations of the electrophoretic mobility of rat liver cells of two culture strains, RLC-10(2) and JTC-25.P3, were performed after the treatment with 3.3 X 10(-6) M 4-nitroquinoline 1-oxide (4NQO) for 30 min in culture. As early as 47th day after a single treatment with 4NQO, both control and treated cells of RLC-10(2) were found to produce tumors in animals on back-transplantation. At this stage, however, little difference was yet observed in electrokinetic patterns between the treated cells and the original antecedent cells. In contrast, a subline, JTC-25.P3, treated twice with 4NQO under the same conditions demonstrated a malignant electrokinetic pattern resembling that of rat ascites hepatocarcinoma strains, although its tumorigenicity was not verified. These discrepancies between changes of electrokinetic pattern and tumorigenicity were discussed with special references to the antigenic difference between cultured cell strains and each original host rats.


Temperate coliphage HK022. Clear plaque mutants and preliminary vegetative map. Wild type phage HK022 was mutagenized by N-methyl-N'-nitro-N-nitrosoguanidine to induce clear plaque mutants. A total of 225 clear plaque mutants were isolated and 198 of these were assignable to one or the other of two complementation groups of the corresponding cistrons which have been designated as cI and cII, respectively. Approximately 25% of the c mutants were found to be temperature-sensitive (cts); producing turbid plaques at 32 C and clear plaques at 38 C and above. From complementation tests involving cI and cII mutants, bacteria lysogenic for cII prophage were frequently obtained. Double lysogens harboring a CI and a cII prophage were infrequently found and single lysogens harboring only a cI prophage have not been recovered. Bacterial lysogens harboring a prophage carrying a cts mutation in the cI cistron were readily obtainable. However, such lysogens show a lethal phenotype at 40 C and above, although they appear to be fully viable at 32 C. It is shown that by incubation of lysogens harboring a cts mutant of the cI cistron at 42 C, it is possible to isolate cryptic lysogens which are non-immune but harbor at least one of the phage sus+ alleles. Genetic data involving cI, cII, and two complementing sus mutants of essential genes are presented. From these data the following vegetative map is deduced: sus4--cII-cI-sus3.


Multiple mating types of Mycobacterium smegmatis. Multiple mating systems were found in the strains of Mycobacterium smegmatis. Nineteen wild type strains were classified into five different groups according to their mating behavior. All crosses between substrains derived from the same wild type strain or between substrains belonging to the same group were infertile, while eight different intergroup crosses were fertile. It was suggested that in most of the fertile crosses, chromosome transfer was unidirectional. Genes controlling matings were resistant to curing by acridine dye, sodium dodecyl sulfate and higher temperature suggesting that they were chromosomal genes. However, the location of these genes could not be demonstrated because none of the chromosomal markers tested was found to be linked to these mating genes.


Viral DNA synthesis in vitro with the inclusions isolated from adenovirus 12-infected cells. A fraction defined as the inclusions was isolated by banding in CsC1 gradients from nuclei of adenovirus 12-infected KB cells. When examined by electron microscopy, the isolated inclusions were relatively homogeneous, finely granular materials of moderate electron density, possibly representing the disintegrated type II or IV inclusions. The conditions of endogenous DNA synthesis in vitro with the inclusions were determined. The product of DNA synthesis in vitro with the inclusions was mainly viral and scarcely cellular, as revealed by DNA-DNA hybridization and methylated albumin kieselgur column chromatography. However, viral DNA synthesized in vitro was smaller (18S, 22S) than viral DNA in virions (31 S, 34 S) in neutral and alkaline sucrose gradients. Effects of various treatment of the inclusions on the DNA-synthesizing activity showed that phospholipase C inhibited the activity efficiently. The in vitro DNA synthesis was stimulated by addition of the cytoplasmic extract from adenovirus 12-infected cells and not that from unifected cells. The analysis of the composition of the inclusions showed that the inclusions contained DNA, protein, phospholipid and a small amount of RNA and carbohydrate.


Inhibition of intracellular multiplication of adenovirus by interaction between infected and uninfected cells. The possibility that virus multiplication may be inhibited by interaction of infected cells with uninfected cells was tested by experiments, using human adenovirus type 12 (Ad12). Permissive human cells (human embryonic kidney-HEK,KB or HeLa) were infected and seeded on uninfected or infected "nonpermissive" cell (human embryonic lung=HEL) monolayers, and virus yields or proportions of viral antigen-synthesizing cells were compared with each other. Both the virus yields and the proportions of viral antigen-positive cells were not reduced significantly when seeded on infected HEL cells, while they seeded on uninfected HEL cells both of them were reduced remarkably, compared with the yield and the proportion of controls seeded on glass. Similar results were obtained regardless of the type of permissive cells, HEK, KB, or HeLa. Similar reduction of the yield was observed when seeded on HEL cells infected with Ad12 inactivated by heat or by antiserum, and partial reduction was observed when seeded on HEL cells infected with UV-inactivated Ad12, depending on the extent of UV dosis. These experiments showed that intracellular virus multiplication may be inhibited by interaction of infected cells with uninfected cells, and this may be due to the difference in the cell surface structure.


Anomaly of the aortic arch: a case report. A case of the anomaly of the aortic arch was presented. The case showed subclavian steal syndrome due to the hypoplastic left subclavian artery associated with the double aortic arch with the obliterated left aortic arch. The hypoplastic left subclavian artery was replaced with the Dacron tube graft and the obliterated left arch was divided. Subclavian steal disappeared and the patient is in good condition at the present time.


Application of Duhamel's operation for the surgical treatment of rectal cancer. Several sphincter-preserving procedures for surgical removal of cancer at the upper or middle part of the rectum often cause disturbances of the ano-rectal and bladder functions. To preserve these functions it is important to minimize the damage to the anal sphincter as well as to the pervic nerves and to preserve the rectal mucous membrane as much as possible. Duhamel's procedure was employed with very satisfactory results.


Resectability and regeneration of liver in postsinusoidal block. To study resectability and regeneration of cirrhotic liver, hemodynamic changes following partial hepatectomy were observed in dogs with presinusoidal block caused by ligation of the portal vein or with postsinusoidal block caused by ligation of the hepatic veins after portacaval anastomosis, since cirrhosis of the liver in man is mainly of postsinusoidal block occasionally accompanied by presinusoidal block. With a presinusoidal block, resection of 50 per cent liver was tolerated well, but with postsinusoidal block only less than 30 per cent could be resected. Thus the functional reserve of the liver with postsinusoidal block seems to be much less than that of presinusoidal block. After major hepatic resection the weight of the remnant liver with a dual blood supply increased markedly, while with a postsinusoidal block it increased slightly and with a presinusoidal block there was no change. Histometric studies showed that regeneration was prominent in the remnant liver with a dual blood supply, slight with a postsinusoidal block, and even less with a presinusoidal block. Thus, the liver with a postsinusoidal block possesses more extensive regenerative capacity but shows much lower resectability than with a presinusoidal block. Therefore, the resectability of the liver associated with cirrhosis seems to be more closely related to its functional reserve capacity than to its regenerative capacity.


Effect of diuresis and nephron dimensional heterogeneity on the distribution of nephron filtration rates. Conflicting data in studies of the effect of natriuresis on intrarenal single nephron glomerular filtration rate (SNGFR) redistribution may arise from the interplay of hitherto largely overlooked factors. In the present work, the effect of diuresis induced by saline, glucose or mannitol, as well as the effect of anatomical nephron heterogeneity, were studied. A highly significant positive correlation was found between the logarithm of the urine flow per gram of kidney weight (log V) and the mean superficial (S) to mean juxtamedullary (JM) SNGFR ratio. The rise in S/JM SNGFR with diuresis was primarily a function of decreased JM SNGFR. Total proximal tubular length (TPL) was used as a measure of nephron size. The distribution of nephron sizes was evaluated as S/JM TPL. The effects of urine flow and anatomical heterogeneity on S/JM SNGFR were spearated by means of multiple regression analysis, which yielded the following equation: S/JM SNGFR = -0.049 + 0.179 log V + 0.818 S/JM TPL. Both slopes were highly significant (P less than 0.001). These findings indicate that S/JM SNGFR increases with urine flow, independently of sodium homeostasis, and that anatomical heterogeneity has a marked effect and must, therefore, be controlled. Conflicting data in the literature are harmonized with the present data when appropriate correction can be made for the dimensional factor. There is no evidence that SNGFR redistributions play a role in sodium homeostasis.


Bicarbonate reabsorption in the dog with experimental renal disease. Renal bicarbonate reabsorption (expressed per unit of glomerular filtration rate, GFR) has been reported to be diminished in uremic man and uremic rats. Both the increases in parathyroid hormone concentrations and in natriuretic forces have been considered to play a role in this change. The increased kaliuresis per nephron observed in chronic uremia could theoretically also contribute to inhibition of bicarbonate reabsorption. Despite the common use of normal dogs in studying bicarbonate reabsorption and of uremic dogs in studying alterations of renal function in disease, few studies of bicarbonate reabsorption in uremic dogs have been performed. In the present studies we have examined bicarbonate reabsorption in normal dogs and in dogs with experimental renal disease using a conventional bicarbonate titration technique. In unanesthetized normal dogs, the threshold for bicarbonaturia was 24.8 mEq/liter of GFR. A maximal reabsorptive rate (Tm/GFR) of 34.0 mEq/liter of GFR was obtained. In a second group of dogs, GFR was decreased to one-fifth normal. FENa was increased 16.9-fold over normal values: UKV/100 GFR and FEP were increased 5.8-fold and 10.9-fold, respectively. The threshold for bicarbonaturia in these dogs was increased to 30.5 mEq/liter of GFR and the maximal reabsorptive rate was increased to 41.2 mEq/liter of GFR. Thus, the capacity to reabsorb bicarbonate was increased despite the presence of high fractional excretion rates for sodium, potassium and phosphate. This increased reabsorptive capacity could not be accounted for by the effects of other known determinants of bicarbonate reabsorption.


Dissociation of urate from sodium transport in the rat proximal tubule.=. The tubular transport of urate and sodium was examined by clearance, free-flow micropuncture, intratubular microinjection and precession techniques in control rats and in rats receiving a new uricosuric diuretic, indanyloxyacetic acid (MK-196). The i.v. infusion of MK-196 (50 mg/kg of body wt/hr) resulted in significant increases in the fractional excretion of sodium (FENa) from 0.98 +/- 0.01 to 11.86 +/- 2.88% (P less than 0.001) and in FEurate from 14.1 +/- 1.03 to 56.0 +/- 2.86% (P less than 0.001). End-proximal tubular fluid to plasma inulin (TF/Pinulin) ratios were 2.43 +/- 0.15 and 2.51 +/- 0.10 in control and drug-treated animals, respectively (P = NS). Total urinary urate recovery after MK-196 administration was higher following microinjections of [2-14C] urate into early proximal tubule sites: 70.5 +/- 2.7% in controls vs. 84.9 +/- 0.9 (P less than 0.001), and after microinjections into late proximal tubule sites: 82.8 +/- 2.9% vs. 91.3 +/- 1.9 (P less than 0.05). Urinary precession of urate from inulin was demonstrable following placement of isotopes of these compounds on the surface of the kidney in controls, but was abolished by MK-196. This agent, therefore, inhibits the reabsorption and secretion of urate in the proximal convoluted tubule, the net effect being a marked increase in urinary urate excretion. By contrast, its inhibitory effect on sodium reabsorption is exerted at a site or sites distal to the accessible portion of the proximal tubule. The demonstration of reduced urate reabsorption and normal sodium reabsorption in the proximal tubule suggests that the reabsorption of these constituents of the glomerular filtrate is not intimately linked at this nephron site.


Pathophysiological response of the blood coagulation system in acute glomerulonephritis. A new procedure, plasma fibrinogen chromatography, has been utilized, together with other blood coagulation assays, to quantify fibrin formation in 43 children with acute poststreptococcal glomerulonephritis (AGN) from the time of hospitalization until recovery. During the prediuretic phase of AGN, significant evidence for substantial increase in fibrin formation (intravascular coagulation) included gross increase in plasma high molecular weight fibrinogen complexes (HMWFC), the development of either hypo- or hyperfibrinogenemia and gross depression of coagulation factor XIII concentration and of alpha2-macroglobulin concentration. During the diuretic phase of the disease, these abnormalities regressed and evidence of enhanced plasma fibrinolytic activity, documented by an increase in fibrinogen first derivative, was detected. Concomitantly, urinary excretion of fibrin(ogen) degradation products (FDP) underwent substantial increase. With disease recovery, which occurred in all children, urinary FDP excretion ceased and all coagulation findings normalized.


[Treatment of persistent hypotony (author's transl)]. One patient with persistent hypotony after cyclodialysis and another one after contusion of the eyeball with recessed angle and traumatic cyclodialysis were successfully treated as follows: Blood plasma of the patient is injected in the anterior chamber and fibrinogen is transformed into fibrin by recalcification. Both patients attained normal intraocular pressure after this treatment and the signes of persistent hypotony disappeared. This seems to be an essential advantage compared with surgical interventions. Our method is very easy in practice and allows repeated treatment. A possible transformation of fibrinogen into fibrin in the vitreous cavity of an aphacic eye is resorbed very early without visible inflammatory signs. In contrast to the proposed surgical intervention in the literature, no pathological rise of the intraocular pressure for more than a few days was seen.


[Long-term observation of ablatio-prophylaxis with kryopexy (author's transl)]. Prophylactic cryo coagulation is especially suitable when there is cloudy media, e.g. blood in the vitreous body or a cataract which would prevent light or laser coagulation. Cryo lesions applied under ophthalmoscopic control are without complication. The paper reviews the 116 eyes collected in 1971 and augments it with 202 eyes treated by 1975. Retinal detachment occured in 1.3% and new breaks occurred in 4%.


[Examination of retinal correspondence with minimal dissociation (author's transl)]. With the phase difference haploscope the incidence of anomalous retinal correspondence in patients with convergent strabismus was examined with respect to the degree of deviation, the duration of squint and the fixation pattern of the deviated eye. Anomalous correspondence was found more often when small angles were present, in older patients and in cases with excentric fixation. Even when the deviation exceeded 19 degrees and the fixation was central, we observed harmonious anomalous correspondence in 30% of cases, The evaluation of the correspondence in children with esotropia and central fixation by means of paradoxic diplopia after correction of the deviation with prisms revealed harmonious anomalous correspondence more often than with the phase difference haploscope, although the conditions of casual seeing are changed in this test. We have attempted to ascribe these findings to simultaneous stimulation of the central retinal areas of both eyes, the nearly unlimited visual field and the short binocular exposure of the pictures in our method. Finally we described our first experiences with a modified Kongruenztest. With this simple technic it is possible to examine the state of correspondence under conditions of casual seeing.


[Convergent strabismus in the age of presbyopia (author's transl)]. Based on 15 case reports it can be shown, that the onset of a convergent squint is even possible in the age of presbyopia, independent of the patient's refraction. The clinical picture resembles that of a divergence paralysis or the convergent strabismus of the Bielschowsky type. In 13 cases the decompensation of a previous esophoria may have caused this distance-esodeviation; a divergence paralysis is not probable. In two cases change of orthophoria to esotropia could be observed. Therefore we share the opinion of v. Graefe, that an increased tonicity of the internal recti induced for compensation of weak convergence in aged individuals may cause esotropia. Treatment with prisms for distant vision is easy and effective. No case required surgery.


[Manifestation of diabetes (author's transl)]. Material of research: 350 cases of diabetes mellitus. The time between the manifestation of diabetes mellitus and the onset of retinopathy is reduced in two cases: with diabetes manifesting itself (a) at the age of puberty, (b) after the age of fifty. The retinopathy appears as "retinopathia simplex" (in all its different subvarieties) and as "retinopathia proliferans". Out investigation showed a gradual decrease in the benign forms of the retinopathia simplex with advancing years--from twenty to sixty--of diabetic manifestation, with retinopathia proliferans simultaneously gaining ground. With diabetes manifesting from sixty on, retinopathia proliferans dwindles to insignificance; there remains an indefinite form of retinopathia simplex.


[The Wyburn-Mason syndrome (author's transl)]. A patient aged 39 years with Wyburn-Mason syndrome is presented. He had an apple-sized intracranial arteriovenous angioma racemosum of the left temporo-medical region, which was inoperable, as it extended to the basal ganglia. It was diagnosed by carotid angiography and by sequential brain szintigraphy. More than 50 retinal arteriovenous anastomoses were observed in the left eye, involving all quadrants and the macular region. Some of these anastomoses were only found by fluorescence angiography. Clinical signs were hemiparesis and decreased sensibility of the right side, headaches, speech disorders and right homonymous hemianopia. Vision was decreased to 0.4. By partial embolisation via the right common carotid, it was possible to reduce the size of the intracranial hemangioma.


[Therapeutic problems in postoperative keratopathy (author's transl)]. Keratopathy following intraocular surgery is usually a neglegible transitory lesion which does not require special treatment. An intractible bullous keratopathy frequently develops in cases of endothelial dystrophy. Other causative factors leading to postoperative keratopathy are excessive operative traumatisation of the cornea, vitreocorneal adhesions, athalamia, detachment of Descemet's membrane or epithelial down-growth. For conservative treatment of postoperative keratopathies topical application of corticosteroids, acetylcholine, vitamine-A-ointments, hyperosmotic agents, soft contact lenses, and systemic application of carboanhydrase inhibitors can be used. According to our experience even in cases of severe keratopathy a significant improvement of visual acuity and discomfort may be achieved by long lasting and intensive conservative treatment. Only in rare cases one has to resort to glueing a contact lens on the cornea (Dohlman) or to perform a keratoplasty using Stocker's technique.


[Experimental investigations on the influence of environmental stimuli on the intraocular pressure (author's transl)]. The aim of this study was to demonstrate the effects of the influences of the technological world (optical, acoustical and stress) on intraocular pressure. The experiments were undertaken on rabbits for the following reasons: compliance with the laws governing experimentation, practicability, and the assumption that our premise was correct. Under normal living conditions we found that the rabbit's intraocular pressure followed a pattern of; mornings an average of 23.15 mm Hg, afternoons of 23.05 mm Hg, and evenings of 24.14 mm Hg. After subjection to intense optical and acoustical strain and after situations of stress the intraocular pressure rose on an average of 6 mm Hg (25%). It seems clear that we should make use of these results in our practice and give appropriate consultation and advice to our patients with raised intraocular pressure.


[Projects of the international agency for the prevention of blindness (author's transl)]. The International Agency for the Prevention of Blindness (IAPB) had a meeting in Bethesda, in which the author took part as the chairman of the glaucoma prevention committee. Priority was given to the 6 causes of preventable blindness. These are onchocercosis, trachoma, keratomalacia, cataract, glaucoma and injuries. Projects for prevention of blindness were discussed. In developing countries eye care can reach the population only by mobile units with an eye specialist and allied personnel. The training of such health personnel in 3 different levels and the curriculum for each level was also discussed.


[A mixed kind of glaucoma (author's transl)]. Raised intraocular tension with reduced C-value was observed with completely or nearly all round open chamber angle in 10 out of 117 eyes after acute angle-closure glaucoma. These cases represent mixed glaucoma. The simple glaucoma element could be traced back to the damage caused by the malnutrition of the trabeculae during the acute angle-closure. A "primary" mixed glaucoma was found only in 3 cases.


[Unusial oraparallel changes in the retinal periphery (author's transl)]. 6 patients (8 eyes) showed peripheral oraparallel changes, that differ ophthalmoscopically from lattice degeneration: Smaller and mostly depigmented, they have a longer circular extension without palisades. The lower temporal quadrant was mainly concerned. Probably the unusual retinal changes are a variation of the pigmentary epithelium without a tendency to form a retinal detachment.


[Disturbances of the retinal vessels as a result of Purtscher's retinopathy (author's transl)]. A 31-year-old patient was buried at canal-building. He sustained Purtscher's retinopathy on his left eye. A fluorescein-angiography displayed six years after the trauma a large neovascular frond and intraretinal neovascular network. These findings demonstrate the severe lesions of the retinal microcirculation caused by the trauma.


[Infantile hysterical amblyopia--no rare disease (author's transl)]. 11 cases of hysterical amblyopia were found in an ophthalmologist's private office (0.2% of 5128 new patients in 2 1/2 years). The incidence in children under 15 years of age (1.5%) was 4 times higher than in elder patients (0.04%). The main symptom of hysterical amblyopia is the slow and hesitating reading during examination of visual acuity accompanied by demonstrations of high concentration. In infantile hysterical amblyopia diminution of vision and defects of visual field are usually of short duration. The diagnosis should be made as soon as possible, because in children it is a symptom of psychological problems. They usually arise from conditions in the child's environment.


[A case of trichotillomania (author's transl)]. The author reports on an 8-year-old girl who pulled out eyelashes of both eyes because she was "bored". There were found no further grave neurologic signs. This was a harmless psycho-neurosis.


[Thoughts on a case of perforating flying-stone injury on a 10-year-old boy (author's transl)]. After a left-sided perforating corneal injury caused by a stone, with iris prolaps and wound cataract suffered by a 10-year-old boy, retinal detachment or shrinking of the eye (phthisis bulbi) can occur. On the other hand vision with contact lenses excludes only a few occupations, e.g. in the armed forces, railways, ships etc. The possibility of retirement neurosis (money for suffering!) must also be considered.


[Mechanical guide of the rotor trepan in keratoplasty (author's transl)]. A new system of trepanation based on a firm mechanical guide of the rotor trepan is described. Apart from the well-known advantages of the electrically driven trepan, further considerable improvements are evident. As here the rotor instrument is guided mechanically, the risky and important phase of corneal incision in keratoplasty is considerably less dangerous. With this instrument, the incision becomes much safer, the centring of the trepan becomes easier and an unintentional injury of iris and lens may be considerably avoided.


[On the aesthesiometrie of the cornea (author's transl)]. Based especially on the studies of v. Frey, the anatomical, physiological and methodical fundamentals of aesthesiometrie of the cornea are considered and an electromagnetic instrument for the quantitative reproductable aesthesiometrie of the cornea is introduced. With this instrument it is shown by using various sizes of tactile probes, that the threshold value of the corneal sensitivity does not primarily depend on the size of the tactile probe, but mainly on the applied pressure. Moreover, the threshold of corneal sensitivity was measured at seventeen different points and a topographical description of the sensitivity conditions elaborated.


[First experience with highly hydrophilic therapeutic soft contact lenses (With special reference to herpetic corneal disease) (author's transl)]. 74 therapeutic problem-cases of various corneal diseases were treated with the highly hydrophilic Weicon 72 (W 72) which proved to be a valuable therapeutic tool. Additional applications of hypertonic saline and of industrial preparations of steroids, antivirals and antibiotics were tolerated without observable side effects. Additional therapy is often inevitable to achieve an optimal therapeutic effect. Nearly all treated cases of chronic herpetic keratitis - mainly metaherpetic corneal diseases - responded well or excellently to W 72 therapy. If, however, the indication for soft lens therapy is somehow inadequate, if additional therapy is wrong or not applied at all and if the patient does not keep strictly to the therapeutic regime undesired side effects are likely to develop.


[Clinical and histological results of lyell-syndrome (author's transl)]. The Lyell-syndrome and the importance to ophthalmology is demonstrated. The nosological position - as staphylococcal disease (almost only in childhood) and as allergic extreme variant of bullous mucocutaneous disease is described. The differential diagnosis of similar (identical?) syndromes is discussed: Fuchs-syndrome, Baader-syndrome, Fiessinger-Rendu-syndrome. About 15 personal patients and 40 in the literature with LS with participation of the eyes is reported. The clinical results, development of the disease and the histological pictures of the cornea are made for the first time discussed. The therapy by lamellar or penetrating keratoplasty is reported.


[Some observations on the use of cyclocryopexy in the treatment of various forms of glaucoma (author's transl)]. Cyclocryopexy constitutes a method for the therapy of absolute or hemorrhagic painful glaucoma. The authors describe its technique, its indications and the postoperative results obtained in 38 patients, from which they make appropriate conclusions.


[Echooculometry in retinal detachment surgery without subretinal drainage (author's transl)]. Changes of the height of retinal detachments up to 0.1 mm can be visualized by A-scan-ultrasonography; such small changes cannot be ascertained by means of ophthalmoscopy. Based on echooculometric measurements of the maximal height of retinal detachments during the first hours and days after surgery without subretinal drainage, the final success (24 cases) or failure (2 cases) could be predicted 24 hours at latest. Thus in cases of retarded resorption of the subretinal fluid it can be decided by means of echography, wether a reattachment of the retina can be expected or a failure, the cause of which needs early detection.


[A contribution of the course of vitreous haemorrhage (author's transl)]. After some basic remarks about the physiological adhesions of the vitreous body to its surrounding structures in the anterior part of the eye (lens, ciliary body, pars plana) and the posterior part of the eye (macular, optic disc) the general history of bleeding in the vitreous body and the different possibilities of its resorption by haemolysis, phagocytosis and fibrotic transformation are discussed. Furthermore a case of a subhyaloideal haemorrhage around the posterior pole is described. The adherence of the vitreous body in the macula area, which is usually only visible by experiment or in cases with posterior vitreous detachment, is here directly documented with photographs.


[Butterfly-shaped dystrophy of the macula (author's transl)]. The authors report a rare form of pigment dystrophy of the macula in a 17-years-old patient, which was diagnosed on the basis of characteristic ophthalmoscopic changes. Results obtained from an analysis of all the patients relations pointed to a familial occurrence of these changes. Up till now a similar case has been described only by Deutman and co-workers (1970) as "Butterfly-shaped pigment dystrophy of the fovea".


[The treatment of keratomycosis with clotrimazole (author's transl)]. Clotrimazole (Bisphenyl-(2-chlorphenyl)-1-imidazolyl-methan) is a recently developed antimycotic with low human toxicity and a broad antifungal spectrum and is well tolerated by the skin and mucosal surfaces. 1% clotrimazole eye ointment was used by the author in the treatment of five corneal ulcers from which fungi could be isolated. Prompt improvement and complete resolution of the ulcer within 3-8 weeks, depending on the severity of the condition at the beginning of the treatment, were achieved in all cases under clotrimazole therapy. The drug in the preparation used was well tolerated and can be recommended as a first choice antimycotic for topical application in the eye.


[Motor disturbances in squint - pathogenesis and treatment (author's transl)]. Motor deviation in strabismus must be considered in the context of the different elements which determine it, that is, taking account of the nature of the deviation. Modifications in the muscle may on very rare occasions be due to a paretic origin, but they can also be of innervational origin or stem from muscular modifications secondary to the innervational deviation. To decide on operative procedure, it is absolutely essential to determine the aetiology of the deviation, for normal static and dynamic motility can only be achieved by an aetiological therapy. Since muscular disorders may be of various kinds, and given that in many cases, the deviation can be cured by functional treatment alone, the author does not feel that the precise measurement of the deviation by an instrument such as the synoptometer is indispensable, the best assurance of a post-operative oculomotor balance being the suppression of abnormal accommodation and the normalisation of the retinal correspondence before the surgical intervention. This affirmation is supported by the clinical and experimental data presented in this paper.


[Misdiagnosis of intraocular iron foreign bodies (author's transl)]. Out of 393 intraocular foreign bodies (1961-1975) 361 were magnetically removed and 32 non-magnetically (copper 7,brass,2,lead 5, glass 10, stone 3, wood 4 and plastic 1).60% of the foreign bodies were caused by hammer and chisel injuries.73 foreign bodies were diagnosed too late, in 71 cases no x-ray was made. The incidence of complications (infection, siderosis, retinal detachment was considerably increased where the foreign bodies were removed late. From the 73 foreign bodies (18.5%) the patient did not consult a doctor in 37 cases because of "insignificance". 4 times the family doctor was consulted, who treated the patient symptomatically. In 4 cases occurring in the weekend no eye-specialist could be ostensibly found. In 26 cases the ophthalmologist performed no x-ray control, and small foreign bodies were twice described as "x-ray plate artefacts" from the roentgen specialist. It must be an absolute rule in the eye-doctor's practice that every injury received while working with metals necessitates an x-ray control!


[Tonometry and tonography for open Schlemm's canal (author's transl)]. In 13 eyes tonometry was performed during trabeculotomy at the beginning, after preparation of the outer scleral lamella and after the excision of the outer wall of the canal of Schlemm. In 4 eyes this was combined with tonography. There was no significant change of the averaged i.o. pressure and the resistance to aqueous outflow. Thus in primary open angle glaucoma the resistance to aqueous outflow must be located primarily in the trabecular meshwork.


[Measurements of intraocular gentamicin concentration using hydrophilic contact lenses as drug delivery system (author's transl)]. Investigations were performed with two groups of anaesthetised rabbits to test the possibility of increasing the penetration of topically administered. Gentamicin into the eye through the use of hydrophilic contact lenses. After application of Gentamicin drops the drug concentration in the aqueous humour was biologically quantitated. In the first group one eye of the animal was fitted with a hydrophilic contact lens and the other eye was submitted to a comparative measurement. In the second group both eyes were fitted with contact lenses which had been soaked in Gentamicin solutions of two different con-entrations. The result showed an increased intraocular Gentamicin level in the eyes fitted with hydrophilic contact lenses. However, in the latter group we found low intraocular drug levels where only contact lenses soaked in Gentamicin solution were used.


[Tubular structures in the endothelia of the retina and in retinoblastoma (author's transl)]. Tubular inclusions in the capillary endothelium were observed in three retinoblastomas. The structure of these inclusions is the same as that observed in the capillary endothelium of the dog's retina.


[Research on the state of the cell membrane and the mechanism of corneal autolysis in the conservation process (author's transl)]. In this work we have thrown light on the basis of our experiments on 530 rabbits', dogs' and human eyes preserved under various conditions on the influence of antioxidation substances on corneal preservation. The development of autolysis is highly dependent on the absence of antioxident - also important for the survival of the cornea. From our results we have drawn conclusions regarding the participation of antioxidant (-tocopherol, chondroitin sulphate) on the self-regulating oxidation of structural lipids in the cell membranes of the cornea, and its effects on preservation.


[Cortison-instillation -- treatment of an orbital epidermis cyst (author's transl)]. An orbital epidermiscyst about 23 mm diameter was treated and cured with instillation of triamcinolone.


[Vascular retinal complication after long-time therapy with oral hormonal contraceptives (author's transl)]. A case report is given of a vascular disease of right retina of a 37-year-old woman during treatment with contraceptives during 9 years. The retina shows at first a clinical picture of chorioretinitis centralis serosa. After stopping the hormonal preparation and prescription of Dexium (Kalziumdobesilat) the retinal changes disappeared quickly (oedema, exsudates, hemorrhages).


[Sarcoidosis of the ocular fundus (report of a case) (author's transl)]. A report is given of an unusual case of an extensively scarred fundus following chorioditis in sarcoidosis, where depigmentation was prominent and reminding us in the differential diagnosis of possible degenerative changes.


[The persistence of the Bergmeister papilla (author's transl)]. Persisting primitive papilla epithelialis is described in a 22-year-old woman. The papilla has blurred borders, a central papilla eminence and a yellowish colour. In addition pigmentary pseudoretinopathy with perivascular pigment deposits and hypermetropia with aplasia maculae occurred. This picture can be confused classically with pappilloedema.


[Corneal lesion by vacuum extraction (author's transl)]. The case of a 6-year-old boy is reported who was delivered out of a frontal position by application of the vacuum cup to the left part of the forehead. His left eye exhibits a pronounced somewhat irregular astigmatism. There are some vertical descemet tears. Because of the application of the vacuum pump close to the left bulbus, an increase of the tissue tension and consequently a deformation of the bulbus occurred by the vacuum in the bulbar region. The described lesions parallel the vertical descement tears which occur in forceps-delivery. Owing to the greater horizontal corneal diameter, a more pronounced extension of the cornea in the horizontal meridian occurs, which would explain the vertical course of the descemet tears. The obstetric contraindication for the application of the vacuum extraction in case of a frontal or facial position of the fetus is justified also from the ophthalmological point of view because of the risk of occurrence of irreversible corneal lesions.


[Experience with magnet implantation in lagophthalmos (author's transl)]. The results of magnet implantation in the upper and lower eyelids of 29 patients suffering from Keratopathia due to lagophthalmos due to facial palsy as well as the surgical techniques involved are described. Contrary to a lateral tarsorrhaphy - still popular today - this method does not alter the form or the size of the palpebral fissure nor does it hinder the visual field. It is technically simple to perform and easily reversible should nerve function recover. The subjective results were also good.


[A simple method of restoring lidfunction in facial nerve paralysis with permanent magnets (author's transl)]. This is a report on 8 cases of lagophthalmos due to paralysis of the facial nerve. The in-ability to close the eyelid may bring about severe diseases of the eyes. By implantation of permanent magnets in the rims of the eyelids the dynamic lidfunction can be restored. We developed a very easy method implanting the magnets. The operation can now be done on out-patients. The results after 2 1/2 years' follow-up are presented.


[Amblyopia - discovered by examinations at school (author's transl)]. 50 children out of 188 examined at school showed an amblyopia. It was classified according to the age of the children, the visual acuity, the fixation and the treatment of the amblyopia. The high percentage of these amblyopic eyes discovered by examinations at school justifies the demand of an ophthalmological examination of all children before going to school.


[Intracellular localisation of urea-cycle enzymes in liver (author's transl)]. Enzymes of the Krebs-Henseleit urea-cycle were localized by means of differential centrifugation and fractional tissue extraction in rat liver and in human liver. Argininosuccinatlyase (ASAL) and Argininosuccinatsynthetase (ASAS) represent enzymes of the soluble cytoplasmic fraction. Ornithine-ketoacid-transaminase(OKT), carbamyl-phosphate-synthetase (CPS) and ornithine-carbamyl-transferase (OCT) are localized in the mitochondrial and nuclei fractions of the liver cell. Most of the arginase activity is bound to subcellular structures (probably to nuclei). A small portion of arginase-activity was found in the soluble cytoplasmatic fraction. The enzymes of the Krebs-Henseleit urea-cycle are equally distributed in rat liver and in human liver. Differences in the subcellular localisation of (mitochondrial) enzymes in human liver could be attributed to mitochondrial breakage during tissue preparation and do not represent in-vivo conditions.


[Urinary phenylalanine metabolites in hyperphenylalaninemia (author's transl)]. Urinary phenylalanine metabolites after phenylalanine load of 4 healthy controls, 15 patients with classical phenylketonuria and 8 patients with hyperphenylalaninemic variants are measured quantitatively by gas chromatography. Statistically significant differences are found for a number of metabolites, e.g. phenylpyruvate, phenyllactate, ortho-hydroxy-phenylacetate, para-hydroxy-phenylpyruvate and para-hydroxy-phenyllactate. The results are discussed with respect to discrimination of phenylketonuria patients and patients with hyperphenylalaninemic variants and in respect to pathophysiological aspects.


[Lipid A antibody titers in Crohn's disease (author's transl)]. Lipid A antibody titers and O antibody titers against E. coli were determined in 18 patients with Crohn's disease, 28 patients with ulcerative colitis, 24 patients with acute enteritis and in 68 healthy adults. The patients with Crohn's disease showed a statistically significant elevation of the lipid A antibody titers and of the O antibody titers against E. coli compared with each of the three other groups investigated. The results could be indicative of bacterial involvement in the pathogenesis of Crohn's disease. The determination of lipid A antibody titers may be useful for the differential diagnosis between Crohn's disease and ulcerative colitis.


Glomerular morphology in nephrotic heroin addicts. Renal biopsies of 23 heroin addicts who presented with the nephrotic syndrome were examined by light and electron microscopy. The majority of patients (14) showed focal segmental glomerular sclerosis on light microscopy, four patients showed "minimal change", and two were classified as "focal global sclerosis." In one case focal mesangial proliferation was the outstanding feature; one patient had diabetic glomerulosclerosis; and one had mesangiocapillary glomerulonephritis and dysproteinemia. Visceral epithelial swelling and proliferation were present in 14 patients on light on light microscopy. Electron microscopy showed distinct podocyte changes consisting of loss of foot processes, vacuolization, and cytoplasmic degeneration; focal separation of podocytes from basement membranes was found in 11 of 18 cases. In some instances a few electron-dense deposits were present in the mesangium. Membranous nephropathy was not encountered, although it occurs in 30 to 40% of unselected adult nephrotic individuals. Of 15 patients followed for 2 months to 5 years, one died of heroin overdose, eight went into renal failure, two improved, and four continued to have proteinuria. It is concluded that nephrotic syndrome of heroin addicts is most often associated with focal segmental glomerular sclerosis and occasionally with minimal change disease or focal global sclerosis. Conceivably these three conditions represent different phases of one disease process, although different reactions to heroin or its various vehicles and contaminants cannot be excluded. The morphologic resemblance to experimental aminonucleoside and N,N'-diacetylbenzidine-induced nephrosis suggests a possible toxic origin.


Golgi complex alterations induced by X537A in chief cells of rat parathyroid gland. Electron microscopic examination of chief cells of rat parathyroid glands incubated with the antibiotic ionophore X537A showed selective alterations of the Golgi complex. The changes were dependent on the duration of X537A exposure. After 50 minutes of incubation, the cisternae and vesicles of the Golgi complex appeared highly swollen and disorganized. Because of its selective action, X537A might be a useful tool in the investigation of the role of Golgi apparatus in parathormone secretion.


Hypoxic protection in paraquat poisoning. Ingestion or injection of the herbicide paraquat (1,1'-dimethyl-4,4'-dipyridylium dichloride) has caused more than 120 deaths in humans. Most have been due to respiratory failure caused by pulmonary edema, hemorrhage, and atelectasis, or subsequent pulmonary fibrosis. Paraquat is concentrated in lung tissue and is believed to cause superoxide radical formation in the presence of oxygen and suitable electron donors. Exposure to increased concentrations of oxygen has been reported to accelerate the toxicity of paraquat. The therapeutic efficacy of a reduced oxygen environment was investigated by exposing paraquat-poisoned mice to 10% oxygen after stepwise drops from 14% oxygen. Sixty-one mice were given intraperitoneal injections of 27 mg. per kg. of paraquat. The 25 mice in hypoxia for 7 days had a 32% mortality rate versus a 78% mortality rate for the remainder of the mice in room air, p less than 0.01. After a dose of 20 mg. per kg. of paraquat administered intraperitoneally, 24 mice in hypoxia had a 25% mortality rate versus 51% for 35 animals in room air. Brief exposures of the hypoxic group to "normoxia" (room air) led to pulmonary edema and death. The continuous exposure of paraquat-poisoned animals to hypoxic environments was protective. This approach may be useful in other oxidant lung injuries.


Alterations in rabbit alveolar macrophages as a result of traumatic shock. Biochemical and electron microscope studies were conducted to determine the effects of traumatic shock on rabbit alveolar macrophages. Both resting and phagocytosing macrophages from the shocked animals, in comparison to comparable control macrophages, showed increased release of acid phosphatase from the cells into medium upon incubation in vitro, but decreases in the total content of acid phosphatase and beta-glucuronidase. Studies by electron microscopy showed ultrastructural alterations in macrophages from shocked animals consisting of a reduction in the number or a complete absence of lysosomes and, in some cases, increased amounts of rough endoplasmic reticulum and free ribosomes. In vitro incubation of macrophages from shocked animals with Pseudomonas aeruginosa showed that the process of bacterial ingestion was not impaired nor were the numbers of bacteria ingested decreased as compared to control macrophages. However, the ability of macrophages from shocked animals to destroy ingested bacteria appeared to be significantly altered. Extensive degradation of Pseudomonas was observed within phagocytic vacuoles of control macrophages after 15 minutes of incubation. In contrast, the majority of ingested organisms in macrophages from shocked animals showed no evidence of degradative changes.


Stimulated growth of submandibular gland. The effects of chronic isoproterenol (IPR) administration on the growth of submandibular gland were studied. Treatment of female rats with IPR, 0.02 mg. per gm. of body weight, twice daily between 13 and 29 days of age resulted in a 3.6-fold increase in the weight of the submandibular gland, with a 4-fold increase in ribonucleic acid and 1.8-fold increase in deoxyribonucleic acid content. Incorporation of tritiated thymidine was stimulated by two injections of the drug but it was below the control level after 5 days of IPR administration. When the administration of IPR was discontinued, the weight of the gland rapidly declined and within 11 days it reached the control level. However, the average deoxyribo-nucleic acid content of the glands of IPR-treated rats remained 20 to 25% above the control level. IPR treatment altered the cellular composition of the gland and influenced the proliferation of the various cell types differently. Between 14 and 30 days of age, the frequency of acinar cells increased from 29% to 44%. Concomitantly, the frequency of terminal tubule cells declined from 30% to 15%. There were no significant changes in the relative frequencies of other cell types during this developmental period. Chronic administration of IPR led to an increase in the frequency of acinar cells. At the same time the relative proportion of terminal tubule cells declined. During the observation period, the proliferative activities (labeling indices) of all cell types, except that of the ductal cells, declined. IPR treatment ahd the most pronounced, depressing effect on the proliferation of the acinar cells. At the same time, the drug accelerated the differentiation of acinar cells and it caused their marked hypertrophy. Administration of IPR to growing rats affords a favorable system for analysis of the relationship between normal and drug-induced growth.


A comparison of the orientation of elastin fibers in the elastic laminae of the pulmonary trunk and aorta of rabbits using the scanning electron microscope. Five pulmonary trunks and two aortas from adult rabbits were fixed in formalin as close to their in vivo dimensions as possible. They were then cut open, pinned out, stripped to expose their medical elastic laminae, dehydrated, and coated with gold. A hair was placed over each specimen as a reference line for orientation purposes. The arteries were examined under a scanning electron microscope and 20 photographs were taken of each specimen. The tangential surface of an elastic lamina was seen to consist of long, parallel, anastomosing, broad elastin fibers with numerous finer fibrils interconnecting them at right angles. The angle which each elastin fiber made with the circumferential axis of the vessel was measured. Although elastin fibers within any particular level within the media were all roughly parallel, there was variation in orientation of fibers between successive elastic laminae. This variation was relatively slight in the aorta where most fibers were approximately circumferentially orientated. In the pulmonary trunk the variation in orientation was extreme and extended completely over a 180 degree range.


Tissue factor in cultured cells: pharmacologic effects. Tissue factor activity in suspension cultures of WISH amnion cells is modulated by pharmacologic doses of agents which alter membrane structure and function. Lysosomal stabilizing steroids (hydrocortisone, dexamethasone, aldosterone, prednisolone, and estradiol) suppress the change in activity which follows subculture; lytic steroids (testosterone and progesterone) are ineffective. Chloroquine both increases the specific activity and extends the time before return to the basal level. Dimethyl sulfoxide and ouabain suppress the complete expression of activity but do not inhibit the subsequent decay. The effect of cytochalasin B is complex, the drug being either suppressive or slightly stimulatory depending on the time of addition. Cyclic nucleotides (AMP or GMP) or insulin do not regulate the expression of tissue factor in these cells. A dramatic increment and prolongation of activity occurs when colchicine or vinblastine is added to the cell suspension shortly after subculture; there is much less stimulation by griseofulvin. Lumicolchicine has no effect while deuterium oxide is inhibitory. From these experiments, we conclude that increased membrane fluidity or altered secretory processes resulting from microtubule disruption stabilize tissue factor in cultured cells. Since contradictory results were obtained with agents which stabilize lysosomes or inhibit transport, the role of these cellular functions in tissue factor production or decay is unclear.


The renal sympathetic system and juxtaglomerular cells in experimental renovascular hypertension. Marked reduction of the monoaminergic nerve fluorescence and catecholamine tissue content were demonstrated in the ischemic kidney of rats made hypertensive by unilateral renal artery stenosis (two-kidney Goldblatt hypertension). The nonischemic kidney showed a normal degree of fluorescence and catecholamine content. The electron microscope failed to demonstrate recognizable nerves around most of the glomerular arterioles of the ischemic kidney, whereas a normal rich innervation was observed in the nonischemic side. The juxtaglomerular index and renal renin content were elevated in the ischemic kidney and markedly reduced in the nonischemic kidney. Juxtaglomerular cells were present in the glomerular mesangium and ultrastructurally showed changes consistent with increased renin synthesis. The extent of disruption of the sympathetic system in renal hypertension might play a role in the degree of hypersecretory response of the juxtaglomerular cells to renal artery constriction.


Cystic fibrosis: effects of serum factors on mucus secretion. The effects of serum from children with cystic fibrosis and from normal children on the mucus-secreting, ciliated epithelium have been investigated in vitro using explanted tissue from rabbit lung. By optical and scanning electron microscopy, a sequence of structural changes is observed after incubation with cystic fibrosis serum; this sequence does not occur with normal serum. The earliest changes involve swelling of the goblet cells, with subsequent discharge of mucus onto the epithelial surface. This is followed by disruption of the normally rapid and synchronized ciliary activity. Mucus gradually extends over the surface entangling cilia. Finally, some shedding of ciliated cells occurs from the epithelium. These findings suggest that factors in cystic fibrosis serum cause discharge of mucus leading to a disturbance of the normal ciliary activity in the rabbit lung. It is postulated that such changes result in dysfunction of the mucociliary clearance mechanism and that this dysfunction may be a contributory factor to the pathogenesis of lung disease.


Rhabdomyoma of the heart: ultrastructural study of three cases. The electron microscopic features of three primary cardiac rhabdomyomas were studied for the first time. Distinct striated muscle cells arranged in a disorderly fashion are described. The cases demonstrated a spectrum of possible myobibril differentiation with one case having only Z-bands and myosin filaments present while the other two had well formed thick and thin filaments with all of the bands present including Z, I, A, H, and M. Glycogen bodies, numerous mitochondria with tubular cristae, lipid deposits, and peculiar striated structures resembling zebra bodies were also seen. Desmonsomal attachments suggestive of Purkinje-type fibers were seen in all of the cases and were the only types seen in cases 2 and 3. In addition, intercalated discs characteristic of myocardial fibers were noted in case 1. This finding still leaves the exact histogenesis of the lesion uncertain although origin from two types of fibers is possible.


A new experimental approach to assessment of velopharyngeal adequacy: nasal manometric bleed testing. A new experimental method for assessment of velopharyngeal adequacy/inadequacy, using nasal manometric pressure readings for three types of speech conditions under controlled incremental bleed conditions, is described. Cleft palate speakers (N = 30) tended to have higher nasal pressure readings than non-flect palate speakers (N = 56), with or without bleed conditions. Reduction in nasal pressure under controlled incremental bleed for non-cleft palate speakers and cleft palate adequate (CPA)  speakers is compatible with an aerodynamic quadratic equation. Unlike cleft palate inadequate (CPI) speakers, non-cleft palate speakers and CPA speakers exhibit similar ability to achieve 0 cm nasal monometric pressure under a bleed bore diameter of 4 mm for a circular bleed orifice. Results for cleft palate marginal (CPM) speakers are less conclusive. Reliability of nasal manometric bleed testing was limitedly tested but not conclusively established in the present report. Further study of reliability and validity is necessary.


Word retrieval of aphasic adults.

Word retrieval of aphasic adults. This study determined (1) the types of word retrieval behaviors employed by aphasic adults in conversation and (2) the degree to which identified behaviors were successful in prompting production of intended words. Five retrieval behaviors--delay, semantic association, phonetic association, description, and generalization--were identified. It was possible to organize the retrieval behaviors of 18 aphasic subjects in a hierarchical order of efficiency. Use of a particular behavior and the success with which it facilitated production of an intended word appeared strongly related to severity of aphasia. Findings again bring to focus the significance of the associational processes to the problem of word retrieval in aphasia.


Stutterers' perceptions of therapy improvement and of posttherapy regression: effects of certain program modifications. In an attempt to improve its effectiveness, a traditional, symptomatic stuttering therapy program for school-age children was modified to (1) focus more upon self-therapy activities while reducing group work emphasis; (2) specify more precisely the target responses used to replace stuttering; (3) establish clearly the criteria for client progress; and (4) provide well-defined activities for the transfer of speech change. Participants used a questionnaire to evaluate their improvement and post-therapy regression in various dimensions of stuttering severity, and results were compared with questionnaire findings from an earlier treatment program. Significantly greater improvement in speech fluency was perceived by the participants following the modified program, and follow-up videotape samples confirmed their perceptions as revealed on the questionnaire.


Reliability of monosyllabic discrimination tests in white noise for differentiating among hearing aids. In spite of criticism, monosyllabic discrimination tests are widely employed for hearing aid selection. The current study was designed to investigate the following questions: (1) How reliable is aided speech discrimination of monosyllables in a background of white noise? (2) Can differences among hearing aids be reliably demonstrated by measuring intelligibility of monosyllables in a background of white noise? and (3) Do hearing aids interact with hearing loss? Twenty subjects with mild-moderate sensorineural hearing losses participated in two experimental sessions. Four hearing aids were evaluated using the NU-6 monosyllables in a background of white noise (s/n = +20 dB). Since the standard deviation of the test-retest differences was 6%, differences between aids were not considered significant unless they exceeded 12%. An interaction between subjects and hearing aids was found; that is, the best aid for one person was not the best for all. Measuring monosyllabic word intelligibility in a background of white noise does not reliably identify a single best aid. However, one or more inferior aids were consistently eliminated in 80% of the subjects.


The grammatic closure subtest of the ITPA: a comparative study of black and white children. This study investigated the performance of black children and white children on the grammatic closure subtest of the Illinois Test of Psycholinguistic Abilities. Ninety-six children, who were attending kindergarten, second, and fourth grades, were examined. They were equally divided for sex, race, and grade placement. Results indicated that kindergarten children, regardless of race and sex, performed similarly; however, black children of both sexes did significantly poorer than white children in higher grades. When allowances were made for some black English responses, however, all children in each age-group performed similarly. Implications for diagnostic applications are discussed.


Response patterns of pre-school-age children to the Northwestern Syntax Screening Test. This study was undertaken to describe the response patterns of 216 boys and girls between the ages of five-and-one-half and six-and-one-half years of age on grammatically matched receptive and expressive items of the NSST. The results showed no significant differences among the mean scores for three age levels or between the two sexes. However, the obtained means were substantially below those obtained on the NSST standardization sample. Item analysis suggested several inconsistencies between the ages of five-and-one-half and six-and-one-half years of age on gram-correct expressively but incorrect receptively.


The LOT test and school-age children.

The LOT test and school-age children. The LOT test was administered to 100 normal-hearing subjects ranging in age from seven years, six months to 10 years, six months. The test was conducted at 500, 1000, 2000, and 4000 Hz with 99 subjects who were able to perform the required task. The LOT test misclassified (false-positive result) only 4% of the normal-hearing children at 1000 Hz. The test misclassified 3% at 2000 Hz, 3% at 4000 Hz, and 14% at 500 Hz. A new criterion for the use of the LOT test with children is proposed which reduced the percentage of misclassification to 2% at 1000, 2000, and 4000 Hz. The frequency of 500 Hz is not recommended for the preadolescent population.


Articulation functions and test-retest performance of normal-hearing children on three speech discrimination tests: WIPI, PBK-50, and NV Auditory Test No. 6. This study investigates the performance of normal-hearing children on three types of speech discrimination tasks: (1) a multiple-choice, closed-message set test requiring no verbal response, the WIPI; (2) an open-message set test for adults, Northwestern University Aue talker were administrated to 60 normal-hearing children, divided qually between the ages three-and-one-half, five-and-one-half, seven-and-one-half, nine-and-one-half, and 11-and-one-half years. The number of tests and sensations levels administered varied by age. The WIPI test yielded the highest discrimination scores, the PBK-50 was intermediate, and the NU-6 was most difficult. A small number of items on the WIPI test accounted for a large percentage of the errors. For three-and-one-half years olds, the WIPI appears to be the instrument of choice. For children aged five-and-one-half years, both the WIPI and the PBK-50 appear to be appropriate clinical tools. Children aged seven-and-one-half scored similar to children aged nine-and-one-half on the WIPI and to children aged nine-and-one-half and 11 and-one-half on the PBK-50 and NU-6. Test-retest differences were small on all three tests.


A system for reporting tympanometric results. Available electroacoustic middle-ear measurement instruments report information concerning middle-ear function in at least six different terms. These terms are used to report middle-ear function: impedance, compliance, admittance, susceptance, conductance, and volume. A standard system for the clinical expression of middle-ear measurements, regardless of the particular measurement unit used, is proposed.


Writing in aphasia rehabilitation: cursive vs manuscript. Reading and writing performance was observed in 30 adult aphasic patients to determine whether there was a significant difference when stimuli and manual responses were varied in the written form: cursive versus manuscript. Patients were asked to read aloud 10 words written cursively and 10 words written in manuscript form. They were then asked to write on dictation 10 words responses using cursive writing and 10 words using manuscript writing. Number of words correctly read, number of words correctly written, and number of letters correctly written in the proper sequence were tallied for both cursive and manuscript writing tasks for each patient. Results indicated no significant difference in correct response between cursive and manuscript writing style for these aphasic patients as a group; however, it was noted that individual patients varied widely in their success using one writing form over the other. It appeared that since neither writing form showed better facilitation of performance, the writing style used should be determined according to the individual patient's own preference and best performance.


Visual intelligibility of consonants: a lipreading screening test with implications for aural rehabilitation. A lipreading screening test consisting of 100 consonant-vowel (CV) syllables was prepared on videotape and presented to subjected with normal hearing and vision. The results of visual consonant confusions revealed nine homophenous categories with high test-retest reliability. Based upon these categories, obtained under ideal viewing conditions, criterion levels of performance were specified in an attempt to determine the need for place of articulation instruction during lipreading training. Examples of confusion patterns from hearing-impaired observers are shown and implications for visual training are presented.


Perilymphatic fistula and its interest to audiologists. Forty-one patients who had sudden hearing loss associated with spontaneous perilymphatic fistllas were reviewed in this investigation. A history of physical exertion or an upper respiratory infection prior to the onset of hearing loss strongly suggests the presence of spontaneous perilymphatic fistula. However, absence of such a history does not necessarily preclude the possibility of membrane rupture. A great variation in audiologic and vestibular findings was observed. Tinnitus was present for most patients and vertigo or disequilibrium was reported by some. Findings support the need for surgical exploration in patients with sudden hearing loss when a perilymphatic fistula is suspected. Postoperative success in restoring hearing function in cases with perilymphatic fistula is good if the fistula is closed within two weeks after the initial insult. Delay in closure of such fistulas can cause irreversible loss of hearing.


Listeners' impressions of speakers with lateral lisps. This paper reports research conducted to determine whether the lateral lisp is a speech defect. The specific purpose of this research was to determine whether the lateral lisp calls adverse attention to the speaker. Two groups of broadcast communication students rates the concept "The Person Speaking" on a 49-scale semantic differential. One group performed the task after listening to a tape recording of a young woman reading contextual material with a simulated lateral lisp. The other group performed the task after listening to a recording of the same woman reading the material in a normal manner. Analyses of the scale values computed for the two conditions indicated that the lateral lisp called adverse attention to the speaker. A systematic replication was undertaken to assess the generality of this finding. The procedures of the original investigation were followed except that business administration students served as judges. The results replicated those of the original investigation. These data indicate that the lateral lisp is probably a speech defect and suggest that the practice of eliminating school speech services for children whose only speech difference is a lateral lisp should be reconsidered.


Hexagonal packing of lipid acyl chains and membrane plasticity. Electron microscope and electron diffraction observations on microcrystals of pure lipids (a phosphatidylethanolamine, two phosphatidylcholines, a phosphatidic acid, and a galactocerebroside) reveal an extreme flexibility of lipid layers when the acyl chains are hexagonally packed (d100 = 4.17 A). This is corroborated by similar observations on wet bilayers of a lecithin. It is shown that more "crystalline" polymethylene packings do not impart such plasticity to lipid layers and are therefore an unsuitable structural matrix for dynamic biological membranes.


Purification of plasma membranes from rat mammary gland by a density perturbation procedure. A highly purified plasma membrane fraction was obtained from a microsomal subfraction of rat mammary gland after treatment with digitonin to increase its density. The purified membranes were enriched 70-fold overall in 5'-nucleotidase with essentially no contamination from glactosyltransferase, succinate-ING reductase, or NADPH-cytochrome c reductase. The membranes were also highly enriched in sialoglycoproteins.