Effects of rapeseed oil on fatty acid oxidation and lipid levels in rat heart and liver. The comparative rates of oxidation of erucic and oleic acids and of their CoA esters were studied in heart and liver mitochondria of rats fed a standard diet or semisynthetic diets containing 25% of the calories as either rapeseed oil (46.6% erucic and 10.4% eicosenoic acid) or olive oil, for a period of 5 months. The long exposure to the diet containing 25% rapeseed oil did not alter the oxidative activity of mitochondria and did not induce morphological changes in the heart. It is confirmed that erucic acid is oxidized in mitochondria at lower rates than other long chain fatty acids and that its activation as CoA derivative may be one of the rate limiting steps of the overall oxidationprocess. Total lipids and triglycerides do not significantly change in the heart whereas they increase in the liver of rats fed the diet containing rapeseed oil.


Double bond position affects metabolism of cis-Octadecenoates. The metabolic fate of cis-positional isomers of octadecenoates has been compared to that of naturally occurring oleic acid (cis-delta9). Radioactive mixtures of tritium-labeled positional octadecenoate isomer and oleic acid-10(-14)C were administered to laying hens, and their eggs were analyzed for the isotopic ratios (3H/14C) incorporated into total egg lipid, triglycerides, and phospholipids. Variations in the isotopic ratios indicated the comparative metabolic utilization of cis-positional isomers delta8 through delta12. Incorporation into egg lipid fractions is as follows: triglycerides: delta9 greater than delta8, delta9 greater than delta10, delta9 greater than delta11, delta9 greater than 12; phospholipid: delta9 greater than delta8, delta9 greater than delta10, delta9 less than delta11, delta9 less than delta12.


Monoacyl-sn-glycerol 3-phosphate acyltransferase specificity in bovine mammary microsomes. The acyl-CoA:acyl-sn-glycerol 3-phosphate acyltransferases located in the microsomal fraction of lactating bovine mammary tissue show a preference for palmityl-CoA particularly above the apparent Km values of the acyl acceptors. Using saturating levels of monopalmityl-sn-glycerol 3-phosphate, the order of acylation was palmityl- greater than myristyl- greater than oleyl- greater than stearyl- greater than linoleyl-CoA. Apparent Km values for monopalmityl- and mono-oleyl-sn-glycerol 3-phosphate with palmityl-CoA as donor were 16 and 13muM, respectively while the Km values for palmityl-CoA with these two acyl acceptors were 5 and 5.2muM, RESPECTIVELY. The apparent Vmax values for the palmityl acceptor and donor were 25 and 30 nmol/min/mg protein. Phosphatidic acid was the principal product. The inclusion of magnesium in the assay depressed activity while the addition of ethylenediaminetetraacetate doubled the rate of acylation.


Occurrence of 2- and 3-hydroxy fatty acids in high concentrations in the extractable and bound lipids of Flavobacterium meningosepticum and Flavobacterium IIb. The major hydroxy fatty acids of cellular lipids in Flavobacterium meningosepticum and Flavobacterium sp. King's group UUb were identified as 2-hydroxy 13-methyltetradecanoic, 3-hydroxy 13-methyltetradecanoic, 3-hydroxy palmitic, and 3-hydroxy 15-methylhexadecanoic acids using gas chromatography-mass spectrometry and GC-mass fragmentography. The concentration of these hydroxy fatty acids comprised up to 30-40% of the total extractable and 20-30% of the bound lipid fatty acids, respectively. From the stability for mild alkaline hydrolysis, 2-hydroxy fatty acids seemed to be attached with ester linkage, and 3-hydroxy fatty acids with amide linkage.


Biosynthesis of polyunsaturated fatty acids in the developing brain: II. Metabolic transformations of intracranially administered [3-(14)C] Eicosatrienoic acid, evidence for lack of delta8 desaturase. [3-(14)C] Eicosatrienoic acid (delta11,14,17) chemically synthesized from [-(14)C] linolenic acid was injected intracranially into 14-day old rats and sacrificed 8 hr later. The analysis of brain fatty acids by radio-gas liquid chromatography before and after ozonolysis showed that the tetraene fraction consisted of a desaturated product, delta5,11,17-20:4, and its elongated product, delta7,13,16,19-22:4. Both of these products, with a combined total of 61% of the total radioactivity recovered in the tetraene fraction, contain a nonmethylene interrupted double bond system and, therefore, are unsuitable for further desaturation. The other two components, delta6,9,12,15-18:4 and delta8,11,14,14-20:4, must have been formed from delta9,12,15-18:3, formed by retroconversion of the starting material 20:3, followed by desaturation and elongation. These results suggest a lack of delta8 desaturase in the developing brain, leading to formation of delta5,11,14,17-20:4 rather than delta8,11,14,17-20:4. However, the nonmethylene interrupted doulbe bond isomer does not restrict chain elongation.


In vitro biosynthesis of prostaglandin E2 by kidney medulla of essential fatty acid deficient rats. Weanling rats were fed either a semisynthetic diet with no fat, with 28% by wt partially hydrogenated fish oil, or with 28% by wt arachis oil(control diet) for 6 or 7 1/2 months. The in vitro conversion of arachidonic acid to prostaglandin E2 by homogenates of the rat kidney medulla was measured by gaschromatography with electron capture detection. The kidney medulla of essential fatty acid deficient animals showed increased activity for the in vitro conversion of exogenous arachidonic acid to prostaglandin E2 when compared to the controls. The change of the enzymatic activity in the essential fatty acid deficient animals was reversible, as shown by refeeding. Inhibition of the prostaglandin synthetase was found at exogenous substrate concentrations higher than 50-100 muM.


Phospholipid composition of Culex quinquefasciatus and Culex tritaeniorhynchus cells in logarithmic and stationary growth phases. Culex quinquefasciatus and Culex tritaeniorhynchus cells were grown in spinner culture and harvested in logarithmic and stationary phases of growth. The phospholipids were extracted from the cells, and the fatty acid profiles of the phospholipid classes were determined and compared. The major components were phosphatidylcholine and phosphatidylethanolamine, constituting greater than or equal to 80% of the phospholipid. The fatty acid profiles of lysophosphatidylcholine, phosphatidylinositol, and cardiolipin showed changes with aging of the Culex cells and between the species. In the lysophosphatidylcholine fraction, there was an increase in saturation of the fatty acids of the C. quinquefasciatus cells, and chain lengthening occurred in both species from the logarithmic to stationary phases of growth. In the phosphatidylinositiol fraction, both Culex species showed a decrease in monoenes and an increase in polyenes, while only the C. tritaeniorhynchus cells showed an increase in fatty acid chain length with aging. The C. quinquefasciatus cells had an increase in polyenes with aging in the cardiolipin fraction. Differences in the percentage composition of the fatty acids were shown in all the phospholipid fractions between the Culex species in the logarithmic phase of growth and all except the phosphatidylinositiol and cardiolipin fractions in the stationary phase.


Effects of protected cyclopropene fatty acids on the composition of ruminant milk fat. Unsaturated fatty acids can be protected from ruminal hydrogenation, and when fed to lactating ruminants, the constituent acids are incorporated into milk triacylglycerols. By this means, it has been possible to reduce the melting point of milk triglycerides and to make softer butter fat. This report shows that, by feeding small amounts of protected cyclopropene fatty acids, one is also able to make harder butter fat. Sterculia foetida seed oil, a rich source of cyclopropene fatty acids, was emulsified with casein and spray dried to yield a free flowing dry powder. When this material was treated with formaldehyde and fed to lactating goats(ca. 1 g cyclopropene fatty acids per day), there were substantial increases in the proportions of stearic acid and decreases in the proportions of oleic acid in milk fat. Similar results were obtained when the formaldehyde-treated supplements were fed to lactating cows (ca. 3 g cyclopropene fatty acids per day). The effect was considerably less apparent when the S. foetida seed oil-casein supplement was not treated with formaldehyde, suggesting that cyclopropene fatty acids are hydrogenated in the rumen as are other unsaturated fatty acids. The effect of feeding protected cyclopropene fatty acids on the stearic:oleic ratio in milk fat is probably due to cyclopropene-mediated inhibition of the mammary desaturase enzymes.


On a non linear describing function for bio-data. The behaviour and handling of a flexible three variable--parameter function is presented, which is suitable for unbiased regression analysis. The function is defined by an intercept, a slope or coefficient and an exponent on the independent variable. Analog and digital problems and solutions are defined. Handling is simple and the program is run without operator intervention. The range of curves include linear, convex, concave and asymptotic forms and can be extended to include sigmoid and parabolic forms. Some application results are presented for different situations.


Reception of microwaves by the brain.

Reception of microwaves by the brain. The question of how pulsed microwaves induce auditory effects in animals and man leads to an examination of the parameters which determine the frequencies of maximum reception by the skull, and the positions of maximum energy deposition within the brain. The interaction of microwaves with a nerve membrane model and with live nerve cells is also discussed, as well as planned experiments to determine the microwave properties of membranes.


Sex hormones and metabolism of glycosaminoglycans. I. Effect of orchidectomy and administration of testosterone in rabbits. The effect of orchidectomy in male rabbits and administration of testosterone to orchidectomized animals on the metabolism of glycosaminoglycans (GAG) has been studied. The response of the different GAG fractions in the aorta varies with the nature of the GAG, and in some cases is different in different segments of the aorta. Orchidectomy produced an increase in hyaluronic acid fraction, decrease in heparin sulphate fraction, and no response in the chondroitin sulphate A fraction in the aortic arch, thoracic aorta, and abdominal aorta. Chondroitin sulphate C and chondroitin sulphate B fractions decreased only in the abdominal aorta and were not significantly altered in the other two segments, while heparin fraction decreased only in the thoracic aorta and was not affected in the other segments. Administration of testosterone to the orchidectomized animals counteracted these changes in the aortic GAG fractures. The enzymes concerned with the synthesis of precursors of GAG--L-glutamine:D-fructose-6-phosphate aminotransferase, UDPG dehydrogenase, and UDPG pyrophosphorylase-- all decreased in the orchidectomized animals; testosterone administration increased their activity in the orchidectomized animals. Enzymes concerned with degradation of GAG--beta-glucuronidase, beta-hexosaminidase, aryl sulphatase, cathepsin, and hyaluronidase--increased in the orchidectomized and decreased on administration of testosterone. Concentration of PAPS and activity of sulphate-activating system and sulphotransferase also decreased in the orchidectomized animals, and testosterone administration tended to restore this decrease to normal levels.


The development of obesity, hyperinsulinemia, and hyperglycemia in ob/ob mice. The development of obesity, hyperglycemia, and hyperinsulinemia, was examined in obese-hyperglycemic (ob/ob) mice, their lean littermates, and homozygous lean mice (+/+) between 17 days and 8 wk of age. By 4 wk of age ob/ob mice displayed many of the metabolic characteristics that are typical of the syndrome in adult animals, including elevated systemic insulin and glucose levels, increased body weight, obesity, reduced skeletal growth, and in vivo evidence of insulin resistance. In addition, 4-wk-old lean littermates of obese mice had greater body weights, increased per cent carcass lipid, and higher insulin levels than did +/+ mice of the same age that were raised under identical conditions. At 17 or 21 days of age ob/ob mice, defined by either (1) elevated carcass fat content when compared to littermates at time of killing or (2) by phenotypic expression of obesity at 6 wk of age, exhibited moderate hyperinsulinemia, hypoglycemia, reduced skeletal growth, and "obesity", as expressed by the Lee index. The present results indicate that altered pancreatic beta-cell function, obesity, and abnormalities of somatic growth all precede the onset of hyperglycemia and insulin "resistance" in ob/ob mice. Furthermore, the occurrence of these characteristics before 17 days of age suggests that the transition to laboratory diet is not essential for the expression of the ob mutation. The present data also support recent studies that have described a small but reliable effect of the ob gene on the metabolism of heterozygous lean mice.


Quantitative evaluation of the oxidation of an exogenous glucose load using naturally labeled 13C-glucose. Maize glucose was used as a natural tracer for studies of metabolism. It is richer in 13C than common vegetables and foods derived from these, and the C02 formed from it is consequently richer in 13C than the CO2 expired by man fed on a diet of common vegetables. The quantitative results, obtained by measurement of delta 13C of the expired CO2 and of VCO2 during the oxidation of an exogenous glucose load (about 100 g) in eight normal subjects over 7 hr, have shown a consumption of 28.64 +/- 1.44 g of glucose (mean +/- SEM), which represents about 30% of the load given. A comparison is made with the results obtained from other methods and the originality and usefulness of this new quantitative procedure is outlined.


Stress-induced inhibition of triglyceride secretion in vivo sand rats (Psammomys obesus). The effects of acute stress upon circulating triglyceride, glucose, insulin, free fatty acids, and glycerol were investigated in obese desert sand rats. Three groups of animals, designated "nonstress", "non-exertional stress", and "exertional stress", were studied. Acute stress, with or without accompanying exercise, was associated with significant decreases in circulating triglyceride; significant increases in circulating glucose, free fatty acids, and glycerol; and variable changes in circulating insulin. Since these data indicated that substrate availability and hepatic insulization were adequate and therefore could not explain the observed fall in circulating triglyceride, endogenous triglyceride secretion rates were examined by the Triton method. Compared to predicted rates based upon earlier studies, both nonexertional and exertional stress were associated with significantly decreased endogenous triglyceride secretion. Thus, acute stress in the sand rat, with or without accompanying exercise, appears to induce an immediate decrease in endogenous triglyceride secretion and circulating triglyceride.


Metabolic adaptation with physical training: 14C-acetate incorporation into tissue lipids. Forty-eight rats were fed ad libitum, fasted 24 hr, rested 48 hr,and injected i.p. with 40 muCi of 14C-acetate/100 g body weight. Twenty-four rats had followed a progressive physical training program for 12 wk and 24 rats acted as their controls. Following this injection, the rats were sequentially sacrificed at 5-, 10-, 15-, and 20-min intervals and total cholesterol (TC), free cholesterol (FC), and triglyceride (TG) specific activity and concentrations were measured from serum, liver, triceps, and heart tissue. Curves relating specific activity to the time point data were fitted by the method of least squares. Comparison of these curves revealed that serum, liver, and triceps TC and FC specific activity were significantly higher in the trained rats. In contrast, corresponding TC and FC concentrations for these three tissues varied. Liver TC level was significantly less for the trained group, probably due to a reduction in the esterified moiety, since liver FC measures were unchanged. Training resulted in significantly lower TC concentrations in the selected tissues studied even though specific activity curves appeared similar for both groups. Our conclusions are that lipid metabolic adaptation; studied in vivo, occurs in tissues with training, but that these adaptations are not uniform across tissues, lipid moieties, or measurement parameters.


Diabetic neuropathy: clinical aspects.

Diabetic neuropathy: clinical aspects. The importance of diabetic neuropathy derives from its remarkable frequency and its clinical impact. In view of the varying underlying pathogenetic mechanisms and the resulting diversity of clinical representations, it becomes apparent that there are diabetic neuropathies, rather than a single entity of diabetic neuropathy. The scope of involvement is widespread with virtually every system at risk. Although peripheral neuropathy is by far the most common expression, visceral neuropathy is also highly significant. It may affect every part of the gastrointestinal tract, the genitourinary tract, and sexual function, as well as direct autonomic nerve pathology. Clearly, neuropathy in diabetes offers a specific and important diagnostic challenge to the clinician and plays a definitive role in differential diagnosis. The problem is heightened by the fact that any and all of the diabetic neuropathic syndromes may be the initial clinical manifestation of diabetes in the absence of covert manifestations of carbohydrate metabolic disorder. It is to be stressed that the diagnosis is more than an academic exercise, since each diabetic neuropathic syndrome carries with it some beneficial therapeutic modality to aid the patient.


Replication of mycoplasmavirus MVL51. III. Identification of a progeny viral DNA-protein intermediate. Intracellular replication of the non-lytic single stranded circular DNA mycoplasmavirus MVL51 has been shown to involve three DNA intermediates: RFI, RFII and SSI. Growth in Eagle's basal medium, rather than richer tryptose medium, has allowed the identification of an intermediate between nascent progeny chromosomes (SSI) and mature virus. This intermediate is a protein associated form of SSI.


Ultrastructural studies of influenza C. II. von Magnus phenomenon. Influenza C was propagated by serial undiluted passage; conditions known to produce non-infectious (von Magnus) particles with influenza A and B. Following each passage infectious material was assayed for infectivity and haemagglutinating activity and the values related by calculating the log difference between infectivity and haemagglutinating titre (I:A ratio). Infectious material from each pass was examined for ultrastruct aberrations by negative strain electron microscopy. Influenza C exhibited a significantly smaller decrease in I:A ratio than exhibiyed by similarly propagated influenza A and B. Ultrastructural examination of the serially passed influenza C revealed no production of morphologically aberrant forms, whereas serially passed influenza B produced a strikingly altered morphology.


Long-term study of large-bowel cancer.

Long-term study of large-bowel cancer. A personal series of 2,314 patients with large bowel cancer has been reviewed. This series has been treated over a 25-year period and all patients have been followed up. Although patients appear to be presenting earlier, there has been only a marginal improvement in the 5-year survivals. The recognized precancerous conditions of the large bowel account for a very small percentage of carcinomas.


The chiropractic patient: psychosocial aspects. A study of 84 patients attending for the first time an Australian-trained chiropractor is reported. The patients could not be distinguished from the general population on several demographic and trait psychological measures. Before treatment the patients regarded chiropractors as technically competent as general practitioners, but somewhat superior in interpersonal skills. Eighty-two per cent had received and failed to respond to previous treatment, nearly 60% gave a desire for pain relief as their sole reason for attendance, and two-thirds affirmed that they visited the chiropractor as a last resort. At a 10-week follow-up, all but 11% reported some improvement and 74% were sufficiently satisfied with their treatment to affirm that they would return to a chiropractor if their condition recurred. Factors that might have influenced outcome were studied and are discussed.


Sodium bicarbonate treatment for tricyclic antidepressant arrhythmias in children. Sodium bicarbonate has modified or reversed arrhythmias due to tricyclic antidepressants in 11 children. It has proved to be the most clinically effective method of treatment of these arrhythmias in children, and reference is made to experimental studies which support this view.


Rheumatoid arthritis improved by treatment with levamisole and L-histidine. A case of classical rheumatoid arthritis of 12 years' duration, was treated during an exacerbation with levamisole and remission was induced. The findings support the postulate that depressed cell-mediated immunity to an unknown antigen is the primary immunity defect in rheumatoid arthritis, and that the defence mechanism stimulant levamisole is an effective treatment, at least in some cases. The lack of toxicity of the drug is noted, but in this case the blood aspirin level rose while the patient was taking levamisole with an unaltered dose of aspirin. There was some depression of the neutrophil count after five months which responded to a reduced dosage.


Stercoraceous perforation of the pelvic colon--an unusual complication of pica. A case of stercoraceous perforation of the bowel in a 31-year-old woman, an habitual paper eater, is reported. Treatment was by evacuation of the faecal mass through the enlarged perforation and direct closure of the perforation without proximal colostomy.


Renal physiology.

Renal physiology. The kidney is composed of one million nephrons that function as a series of integrated units. The excretion of a wide range of natural and artificial compounds results from unselective filtration and specific reclamation of wanted substances. Active transport of weak acids and weak bases supplements this mechanism. In addition to its excretory function, the kidney has important endocrine and metabolic functions and influences the function and metabolism of most body systems. An understanding of renal function affords an explanation for many of the phenomena observed in renal disease.


Herpes simplex virus-an obstetric hospital problem. The incidence of morbidity from herpes simplex virus among nurses of an obstetric teaching hospital is reported. The absence of local epidemiological data regarding this important infection is noted in an analysis of the influence on rostering and sick leave of the nurses.


The investigation of dementia: the results in 100 consecutive admissions. One hundred patients admitted consecutively to the Neuropsychiatric Institute, each with the provisional diagnosis of dementia, were investigated. The diagnosis was confirmed in 81 patients. Amongst these, a potentially reversible cause was found in eight patients. Eleven patients were found to have potentially treatable pseudodementing illnesses and eight patients were found to have a chronic organic brain syndrome not characterized by intellectual deterioration. It is recommended that all patients with provisional diagnoses of dementia be investigated early in the course of their illnesses, in the anticipation of finding a reversible dementia or a treatable pseudodementing illness. The investigations can be conducted more efficiently in specialist units, staffed with neurologists and psychiatrists, and having easy access to pathology, neuroradiology, nuclear medicine and computerized axial tomography facilities.


Infant death rates in Queensland, 1962 to 1972. Published statistical material has been used to analyse the infant death rate in Queensland. The neonatal death rates, which tend to reflect the level of obstetric care, were approximately twice as high in the Peninsula Division as in Brisbane, and the late infant mortality rate was almost eight times as high in the Peninsula Division as in Brisbane. In the Peninsula there has been no fall in infant death rate over the 11 years studied. One small area had an infant mortality rate of 100 deaths per 1,000 live births. The areas with the highest infant death rates were those with a significant Aboriginal population. The data show that proximity to major health facilities does not ensure low infant death rates and in the Brisbane Metropolitan Division there were threefold differences in late infant death rates. It seems likely that infant death rates are influenced by the economic status and education of parents and by the priority they place on infant care. The study has shown that published statistical data can detect areas within Queensland with high infant death rates, and could therfore be used to direct resources to improve the well-being of infants in these areas.


Renal failure after snake bite.

Renal failure after snake bite. Three cases of acute renal failure after snake bite are presented. All required dialysis and the recovery phase was prolonged in each case. Investigations show that microangiopathic haemolytic anaemia was associated with the acute renal failure.


Spines and seat belts: mechanisms of spinal injury in motor vehicle crashes. A case of spinal injury associated with the use of a lap/sash seat belt is presented. A review of the literature is made and a mechanism of injury related specifically to lap/sash seat belts is proposed. The danger of unrestrained rear seat occupants is emphasized.


Obstruction due to prepyloric mucosal diaphragm. Antral mucosal diaphragm is uncommon, and presents with manifestations of obstruction to the pyloric outlet. The diagnosis is usually established only by gastrotomy. Excision of the diaphragm or pylorophasty affords permanent cure and unnecessary partial gastrectomy should be avoided.


Paediatric communications with the post-partum patient. Discussions with mothers during their puerperium allows the introduction of thoughts on child care and management to a captive audience at a highly receptive stage. Many mothers lack an understanding of the problems they are likely to face in the first months after delivery and are desperately afraid of "spoiling" their child. They are generally quite ignorant of the problems of feeding, "colic" and others. Discussion group counselling of the parents of babies treated in an intensive care nursery is of value for the parents and for the hospital staff. The mothers have problems of guilt and anxiety over their possible aetiological role, doubts about their ability to cope with an "abnormal" baby, and problems due to lack of contact with their baby.


Mediastinoscopy.

Mediastinoscopy. A series of 150 mediastinoscopic examinations, performed at The Prince Charles Hospital, Brisbane, is reported. The procedure was employed as a diagnostic aid in the care of patients known to be suffering from disease processes involving the superior mediastinum, and as a preoperative assessment in a group of patients known to have, or suspected of having, bronchogenic carcinoma, There was no mortality. The morbidity rate was 2%.


Murray Valley encephalitis, 1974: clinical features. Of the 58 patients who developed Murray Valley encephalitis (MVE) during 1974, 22 were admitted to Fairfield Hospital, Melbourne. The patients were of all ages, but the disease was most common in children. Calculations suggest that the incubation period of MVE is from one to four weeks. The severity of brain damage varies considerably; 11 patients recovered almost completely, seven had severe residual damage and four patients died. There are no special features which distinguish MVE from any other form of encephalitis. The survival of five of eight patients who required artificial respiration suggests that patients with suspected MVE should be transported at an early stage to a hospital where artificial respiration is available if necessary. There is no evidence that infection with the MVE virus can cause clinical manifestations of a disease other than acute encephalitis.


Isolation of Murray Valley encephalitis virus from the brains of three patients with encephalitis. Murray Valley encephalitis virus was isolated from the brains of three patients who died from encephalitis during the 1974 epidemic. Isolation of the virus from autopsy material was successful when death occurred within two weeks of the onset of illness; however, no isolations were made from specimens collected before death or from autopsy material obtained from patients who died more than two weeks after the onset of symptoms. The virus was recovered most frequently in embryonated eggs, but two strains were isolated in cell culture.


Treatment of calcinosis circumscripta and Raynaud's phenomenon. The case is presented of a patient with severe sclerodactyly, subcutaneous digital and palmar calcification, and Raynaud's phenomenon. Treatment with probenecid and intra-arterial injection of reserpine resulted in considerable improvement.


Some notes on prescriptions.

Some notes on prescriptions. Two separate surveys of prescriptions and prescription habits have been performed. In a survey in one pharmacy in Tamworth, 16 out of 750 prescriptions had to be returned to the doctor for correction. The most common problem was illegible handwriting. Another survey to determine the competence of script writing amongst 12 interns at Tamworth Base Hospital revealed a certain lack in their basic training.


The facts on the legibility of doctors' handwriting. A large number of people, both doctors and others, were tested. The handwriting of each participant was graded and four different statistical tests were performed on the results. In all of these tests the doctors' handwriting came out significantly worse. Thus the only conclusion which could be established from these results was that doctors' handwriting is indeed less legible than others.


Liver scanning in patients with suspected metastatic malignant disease. Liver scans of 72 patients with suspected malignant disease were evaluated to determine the accuracy of the investigation in detecting disease, including metastases and also its use to the referring surgeon. A comparison between the liver scan result and clinical and biochemical findings was also made. The liver scan had an overall accuracy of 83% in diagnosing metastases, compared with 64% for the serum alkaline phosphatase (SAP) level and was more useful clinically than the SAP level. Careful classification of the liver scan patterns allowed more consistent interpretation and improved the specificity of the diagnostic information obtained. Clinical assessment of liver and spleen size by abdominal palpation was unreliable and occasionally misleading.


The incidence of glucose-6-phosphate dehydrogenase deficiency in a population of Greek, Italian and Yugoslav origin in Australia. Cord blood from 2,220 male babies of Greek, Italian and Yugoslav origin, born consecutively over a four-year period at The Royal Women's Hospital, Melbourne, were screened by enzyme electrophoresis for glucose-6-phosphate dehydrogenase (G6PD) deficiency. The group comprised 1,220 babies of Greek, 600 of Italian and 400 of Yugoslav origin. G6PD deficiency occurred most commonly in the group of Greek babies, and 4-6% of these babies were deficient, while G6PD deficiency was detected in 1-2% of Italian and 0-3% of Yugoslav babies. These percentages are similar to those reported in Greece, Italy and Yugoslavia, and give some indication of the incidence of G6PD deficiency in people of Mediterranean origin in Australia.


Dermatology in hospital practice.

Dermatology in hospital practice. Modern hospital facilities have proved of great value in the management of the more difficult problems presenting to dermatologists. In a series of 100 consecutive patients admitted to hospital, four died, at least one out of every three was found to have undiagnosed internal disease and the average time to gain a remission was three weeks after outpatient treatment had proved unsuccessful over an average of six months.


Retrograde gastric mucosal prolapse as a cause of haematemesis. Three cases of haematemesis associated with alcohol abuse are described. Early fibreoptic endoscopical examination in each showed a focal, well demarcated area of gastric mucosal haemorrhage, close to the oesophagogastric junction. Two patients showed prolapse of the lesion into the lower part of the oesophagus, and the third had coexistent Mallory-Weiss tears. Our observations suggest that forceful vomiting is responsible for this lesion, by causing abrupt retrograde gastrooesophageal prolapse. The prognosis of the lesion appears good.


Renal and cardiac complications of drug abuse. The case is presented of a young man who, after prolonged intravenous narcotic administration, developed subacute bacterial endocarditis involving the aortic valve, and rapidly progressive glomerulonephritis. After treatment of and recovery from renal failure, persistent proteinuria was shown to be caused by focal glomerulosclerosis. The association of these lesions with "mainlining" is reviewed.


Routine use of low-dose intravenous insulin infusion in severe hyperglycaemia. A review if presented of the use of low-dose insulin infusion in the management of 58 episodes of severe diabetic hyperglycaemia. Neutral insulin in a dosage of 2-4 units per hour is infused via a paediatric giving set to achieve a sustained physiological elevation of insulin levels. This method is safe, simple and rapidly effective in lowering the blood glucose level, the mean rate of fall (62 mg/100 ml/hr, or 11% per hour) being unaffected by prior insulin therapy, acidosis or ketonuria. Classification of the hyperglycaemia as ketoacidotic or hyperosmolar is unnecessary before insulin therapy is instituted, as the relative decline in glucose level is the same in the hyperosmolar non-ketotic group as in the others. Proven infection significantly lowers the rate of fall of glucose level. Hypoglycaemia and hypokalaemia are rare during low-dose infusion. Early and adequate replacement with potassium phosphate is recommended, oral potassium supplements being continued for several days. Bicarbonate therapy is rarely indicated in the management of acidosis. No patient had cerebral oedema during treatment, and one elderly patient with extensive pneumonia and empyema died during the infusion. It is suggested that continuation of low-dose insulin infusion, together with 5% dextrose solution, after the plasma glucose level reaches 200 mg/100 ml, may hasten the clearance of ketones, preventing relapse.


Minor analgesic use among high-school students:  indications for renal morbidity and mortality. Reported patterns of minor analgesic use by adolescents were taken from a baseline 1973 survey, and a follow-up 1974 survey. The differences between the sexes within each year were shown to be highly significant. Trend analysis in minor analgesic use included the year-to-year comparisons, the degree of minor analgesic use, and the rate of change in this use. The trends show the long-term process of minor analgesic use, and support the cause for concern about analgesic nephropathy.


Analgesics and the kidney: a community-based study. The adult population of a small Victorian town was interviewed for current analgesic consumption and the replies were validated by urine testing. One thousand four hundred and fifty-six subjects were ranked by stated analgesic consumption, and the 50 highest consumers matched for age and sex with non-consumers. Early morning urine specimens were collected and no significant difference in osmolality or white cell excretion rates was found between the two groups. It was concluded that the absolute risk of renal impairment on chronic analgesic consumers is low, and that patients on therapeutic regimens, including analgesics, may be reassured that any risk is minimal.


Total body water content in normal and grossly obese women. Total body water content was estimated for 27 normal and 27 obese women by an isotope dilution technique using tritiated water. The mean total body water content expressed in absolute amounts was significantly raised in the obese group (P less than 0-001), but was significantly lower (P less than 0-001) when the values were expressed as a percentage of body weight. Significant correlations were found between weight and total body water content (P less than 0-001 and P less than 0-05) for the normal and obese subjects respectively. Separate regression equations based on height and weight were calculated for the normal and obese subjects, and good agreement was found in most instances between the measured and calculated total body water contents. The overweight women, with two exceptions, had total body water values in the expected range, which indicated that they were accumulating fat, not water. Although excess water was found in 2 women, this contributed only about 50% to their overweight.


Analgesic nephropathy: a major or minor problem? Habitual analgesic takers run approximately three times the risk of developing chronic renal disease as nontakers or occasional takers. Over 200 deaths may occur each year in Australia from analgesic-induced renal disease, but this must be balanced against the benefit to society of simple, effective pain relief. This can be placed in perspective by contrast with the cost to society of cigarette smoking.


Serum IgE levels in patients with liver disease. IgE (reaginic antibody) levels have been estimated on 160 occasions in 120 patients with liver disease. IgE levels were significantly raised in patients with untreated active chronic hepatitis, and returned towards normal with steroid or immunosuppressive therapy. They were also increased in patients with liver disease associated with alcoholism. There were no significant alterations in IgE levels in other types of acute or chronic liver disease. There were no significant correlations between IgE levels and the age or sex of the patients and the results of other laboratory tests carried out.


The use of methadone as a treatment tool for opiate addicts: A two-year follow-up study. Eighty-three per cent of a sample of 116 drug addicts in a Sydney methadone treatment programme were successfully followed up. Methadone was not found to be "the quick cure" for opiate addiction. More than two-thirds were still taking methadone, only 3% had not taken any opiates for six months or longer, and a further 5% had not taken any opiates for less than six months. The remainder (22%) were using illegal opiates either regularly or intermittently, or were in gaol. However, from the employment, crime and social-emotional stability data, it may be concluded that the methadone programme, particularly if adhered to continuously, is "successful". These findings generally support the findings of overseas studies. The clients, especially those who were still adhering to the programme, felt that methadone was helpful, although there was concern about still being drug-dependent and about side effects.


Longitudinal growth study of Tasmanian children. 2. The seven-year-olds. A longitudinal growth study of Tasmanian children, involving 1,114 infants born between September 1, 1967, and August 31, 1968, has continued into the seventh year during 1974-1975, when measurements of height and weight were recorded on the 898 remaining children that could be traced. A portion of the results is presented here. The main findings is that a high percentage of children who are overweight at the age of three years is likely to be overweight at seven years. Birth weight is not an important factor in determining the weight of a seven-year-old. Children over the 90th percentile at age three years are, on the average, more than 5 kg heavier at seven years than children between the 10th and 90th percentiles at three years. The seven-year-old weights themselves do not appear to have altered in the past two decades, being virtually identical to those in the 1957 Standard Tables for Australian Children.


Amanita preissii "mushroom" poisoning.

Amanita preissii "mushroom" poisoning. "Mushroom" poisoning has rarely been reported in Australia. We present six cases of Amanita preissii poisoning successfully treated with atropine sulphate. The symptoms and signs were typical of muscarinic poisoning, which suggests that this alkaloid is the principal toxic component. A short time interval between the ingestion of poisonous fungi and the onset of symptoms, in our cases within one hour, indicates a good prognosis. The dangers of mistaking poisonous for edible varieties of fungi are emphasized, particularly in relation to immigrants not conversant with Australian fungi. Public education and control of marketing are advised.


Terminal exacerbation of chronic melioidosis in New South Wales. A fatal case of melioidosis, thought to be the third recorded from New South Wales, is presented. Infection probably occurred in Queensland. The patients presented with a subcutaneous abscess complicated by pyaemia, extensive lung involvement and septicaemic shock. The diagnosis was bacteriologically confirmed shortly before death, by isolation of Pseudomonas pseudomallei from blood, pus swabs and tracheal aspirates. There is a need for greater awareness of this disease in persons who have resided in South-East Asia and in North-Eastern Australia.


The effect of an anorectic agent (Mazindol) on control of obese diabetics. The use of an anorectic drug (mazindol) did not significantly interfere with the therapy needed to maintain control in obese diabetics. In two of four insulin-requiring patients, a reduction of the insulin requirement occurred when weight was lost. No change was needed in oral hypoglycaemic therapy in the six weeks of the trial.


A family with neurogenic atrophy of the distal muscles of the upper limbs: clinical and electrophysiological studies. A Chinese family manifested mild neurogenic atrophy of the distal muscles of the upper limbs. None of the affected members had sensory abnormalities, or pyramidal tract or bulbar involvement. The onset of the illness was in the middle of the second decade of life. The muscle atrophy was more severe in the female members. Electromyographic examination of the atrophic muscles showed evidence denervation. One female patient demonstrated slow motor conduction velocity in the right median nerve.


A technique of sexual counselling.

A technique of sexual counselling. A method of sexual counselling based on the technique originally proposed by Masters and Johnson but modified to suit local conditions is described. The method is basically "client-centred" and depends on interviewing both partners of a sexually inadequate relationship so that the clients themselves set the level of desired sexual achievement. Factors which may inhibit a sexual relationship are explored, particularly those involving cultural, moral, religious, education or financial matters. Ejaculatory problems and orgasmic dysfunction are treated in the manner described by Masters and Johnson, whilst other interpersonal and communicative problems are handled by making use of Kagan's Interpersonal Recall snselling clinics are discussed.


Pericarditis during infection with Mycoplasma pneumoniae. A 37-year-old woman was found to have pericarditis during the course of a Mycoplasma pneumoniae infection which also produced primary atypical pneumonia. Intrafamily spread of the infection was observed, with varying clinical manifestations. The case is described because there appears to be little information on mycoplasma pericarditis.


Theatre utilization analysis.

Theatre utilization analysis. A method of analysing operating theatre utilization is presented as a management information system applicable to medical administration.The operating theatre plant represents an item of considerable expenditure in a hospital budget. This aspect of hospital activity requires maximized utilization to ensure an appropriate cost benefit. Extraction of information in such a form provides a basis for exact comparisons of performance of the personnel involved and determining needs for additional resources.


Tinidazole (Fasigyn)--single-dose therapy for trichomonas vaginalis. In this open evaluation trial, tinidazole in a single dose of 2 g proved highly effective in the treatment of trichomonal vaginitis in 25 women. There were minimal side effects and patient acceptance was good.


Diagnosis of gastric malignancy by fibreoptic endoscopy and gastric biopsy: Comparison with radiology. Of 473 patients examined with the fibregastroscope, 27 were found to have evidence of gastric malignant disease on the endoscopic and biopsy results. Of these 27 patients, 20 were initially examined by barium-meal (single-contrast) radiography then by endoscopy and biopsy. The barium-meal study was reported as showing definite malignant disease in two cases (10%), appearances suggestive of malignant disease in 11 cases (55%), and other lesions in eight cases (35%). Endoscopic examination enabled a diagnosis of advanced gastric cancer to be made in 13 cases (65%), of appearances suggestive of malignant disease in two cases (10%), and of other lesions in five cases (25%). Gastric biopsies gave a histological diagnosis of gastric malignant disease in 19 cases (95%), and of appearances suggestive of malignant disease in one case (5%). Furthermore, the histological types of gastric malignant disease were shown by the gastric biopsies. In seven cases without initial screening by barium-meal radiography, endoscopy and biopsy confirmed the diagnosis of gastric cancer in all. It is concluded that endoscopy is superior to radiology in the diagnosis of gastric malignant disease. The study also shows that gastric biopsy further increases the diagnostic ability of endoscopy and should be done in all cases in which gastroscopy is performed.


Histoplasmosis: an outbreak occurring among young men who visited one cave. Sixteen cases of acute benign inhalational histoplasmosis were investigated after an outbreak of the disease in a group visiting a cave. The diagnosis was confirmed in 13 patients by chest X-ray examination, histoplasmin skin testing and serological examination. An attempt to isolate the organism Histoplasma capsulatum was unsuccessful. The epidemiology and relationship of the disease to bat ecology is discussed.


Allergy testing, psychological assessment and dietary treatment of the hyperactive child syndrome. Thirty-one children with behavioural problems and learning difficulties were allergy tested for sensitivity to salicylates, artificial colours and flavours, eighteen children had a positive response, and 15 of these were given the Australian Version of the Feingold K.P. diet. Ninety-three per cent responded with improved behaviour in the areas of overactivity, distractability, impulsiveness and excitability. Sleep and enuresis problems were resolved partially or completely. This study demonstrates that the aforementioned elimination diet significantly affects behaviour.


Social and psychological changes after tubal sterilization: A reevaluation study on 425 women. Four hundred and twenty-five women replied to a questionnaire designed to assess social and psychological changes occurring after tubal sterilization. Dissatisfaction with the outcome of the operation was unrelated to patient age at the time of the operation, parity, religious affiliation and history of emotional instability. While the incidence of negative social and psychological changes was low, a substantial proportion of the sample reported positive effects, particularly in emotional and sexual adjustment.


Hodgkin's disease presenting as pericarditis. Two patients presented with initial symptoms of pericarditis. Palpable lymph nodes developed a few weeks later and a diagnosis of Hodgkin's disease was made. Although rare, this mode of presentation of Hodgkin's disease has been reported previously, and it should be considered in the differential diagnosis of any patient with pericarditis with severe general symptoms or a prolonged course.


Petit mal status in a patient with chronic renal failure. A 39-year-old woman with traumatic spinal paraplegia and chronic renal failure had peritoneal dialysis for acute renal failure precipitated by a bout of urinary tract infection. Two weeks after the dialysis she lapsed into coma for a few days. An electroencephalogram indicated petit mal stupor as it showed generalized epileptic discharges during the initial period of her coma.


On the uses of intracranial pressure monitoring. Intracranial pressure monitoring with an intra-ventricular catheter, an external transducer and a continuous chart recorder was undertaken in 15 patients with acute brain damage and in six patients suspected of suffering from long-standing raised intracranial pressure. In the acute cases, monitoring was useful in the diagnosis of raised intracranial pressure and in the assessing of the efficacy of its treatment. In the chronic cases, the clinical suspicion of raised pressure was confirmed or refuted without doubt. Complications were minimal, and the method was judged to be of considerable value in selected cases.


The influence of smoking on pancreatic function in man. A combination secretin-Lundh test was performed on 14 healthy established smokers to determine if smoking inhibited pancreatic secretion and therefore might contribute to the production of a duodenal ulcer. Seven of the patients studied smoked more than 20 cigarettes per day and were classified "heavy smokers". The remaining seven patients smoked less than 20 cigarettes per day and were classified "light to moderate smokers". The volume and bicarbonate output of the pancreas were lowered in both groups of patients after smoking one cigarette. This apparent side effect of nicotine may possibly play an important role in the production of duodenal ulcers in smokers by producing an acid milieu in the duodenum. Tryptic activity was unaffected by smoking.


Laryngeal cancer and smoking.

Laryngeal cancer and smoking. The smoking habits of 109 male patients with laryngeal cancer were analysed. Two-thirds were heavy smokers. There was one non-smoker. In 12 cases, stopping smoking did not prevent the onset of cancer. Alcohol appears to be a contributing factor. Recent studies have suggested that lowered patient immunity and the herpes virus may be important aetiological factors.


Four years' experience with the gravigard in nulliparous women. A study of the Gravigard in nulliparous patients is presented. Experience with the use of the device in 348 other patients is drawn upon for the discussion. The Gravigard is shown to be an acceptable form of contraception for nulliparous females who cannot take oral contraceptives. The failure rate was 2-6 per hundred woman-years (HWY) (corrected 1-3/HWY).


A three-year trial of the Gravigard (Cu-7) intrauterine device. The Gravigard (Cu-7) intrauterine device was evaluated in 201 patients (106 nulligravid, 20 nulliparous and 75 multiparous) for a period totalling 4,794 menstrual cycles. Only 4-9% of all insertions of the device proved difficult. Nine involuntary pregnancies occurred at a life-table rate of 3-0 +/- 1-3 per 100 women during the first year. Both pregnancies and expulsion of the device occurred more frequently in nulliparous than in multiparous women. Most expulsions of the device occurred during the first six months of use. A continuation rate of 72-6 per 100 women was achieved during the first year, of 58-2 per 100 women during the intial two years, and of 36-0 per 100 women during the three years of the trial. One of the most noteworthy features of this new IUCD is the extreme ease of its insertion in both nulliparous and multiparous patients.


Smoking, transient ischaemic attacks and stroke: A temporal association. Two patients are described, both of whom demonstrate a temporal association between the clinical manifestations of cerebral ischaemia and smoking. A number of mechanisms through which smoking may influence cerebral blood flow and platelet function are discussed, and their relevance to the present cases is considered.


Posterior fossa extradural haematoma.

Posterior fossa extradural haematoma. A case of extradural haematoma of the posterior cranial fossa is presented and some of the pertinent literature reviewed. Suggestions are made which may enable the general surgeon and his staff looking after the patient in the acute phase to detect the presence of this lesion.


Naturally acquired immunity to influenza type A: a clinical and laboratory study. After type A influenza virus had undergone major antigenic change in mid 1968, it was noted that individuals previously infected by strains of the old subtype (Asian), especially late strains, appeared to be unexpectedly resistant to clinical attack by the new subtype (Hong Kong). Prospective studies have since shown that, during the A/England/42/72 influenza epidemic of 1972, in which the incidence was approximately 7% in the community, clinical influenza due to this virus was not found in 229 subjects previously confirmed as having had A/Hong Kong/1/68 influenza, even though vaccine which had been effective against A/Hong Kong/1/68 was ineffective against A/England/42/72. During the A/Port Chalmers/1/73 influenza epidemic of 1974, clinical influenza resulting from Port Chalmers virus was not found in a closely monitored group of 176 unvaccinated subjects previously infected by A/Hong Kong/1/68 or A/England/42/72, although laboratory studies demonstrated Port Chalmers infection in five of these (2-8%). By contrast, among 99 subjects who had no such history of earlier infection, 22 developed laboratory-proven Port Chalmers influenza and most of them had typical illness.


Three cases of granulomatous arachnoiditis after myelography. Arachnoiditis occurring after myelography is well recognized and the mechanism is understood. Three cases of arachnoiditis caused by oily myelographic contrast media are presented. This complication of myelography may occur even if recognized precautions are observed. The general problem of encystment of dye with a chronic inflammatory process, fibrosis and granuloma formation is described.


Women's attitudes to mastectomy for breast cancer. One hundred patients who had been subjected to mastectomy for carcinoma were interviewed retrospectively to gauge their attitudes to any physical and/or emotional disabilities relating to their operation or disease. It was found that 40% of the patients had delayed for longer than a month after the onset of symptoms before seeking medical advice, but the reasons for this were not readily forthcoming. However, fear of mastectomy was not a common cause. Anxiety and embarassment due to an absent breast occurred in about one-third of patients, and did not diminish with time. Knowledge and the use of mammary prostheses was far from universal, and disturbingly only two-thirds were counselled in these matters by their medical advisers. Physical complications were common, particularly lymphoedema of the arm, and as expected this was closely related to the type and extent of treatment undertaken.


Intraventricular haemorrhage in the newborn. Coagulation studies were performed on 128 babies who were premature or who had respiratory distress syndrome (RDS). Forty-four babies were found to have abnormal coagulation parameters. Twenty-one were treated with plasma coagulation factors II, VII, IX and X (PPSB), and of these six died from intraventricular haemorrhage (IVH). Twenty-two did not have PPSB treatment and four died from IVH. In 84 babies in whom coagulation studies gave normal results only one baby died from IVH. The combination of RDS and abnormal coagulation produced a high-risk group to IVH and treatment with PPSB did not reduce the incidence of IVH. It is postulated that prevention of IVH lies in early and effective treatment of RDS.


Fluoride content of prepackaged fruit juices and carbonated soft drinks. Epidemiological studies have established the beneficial effects of water fluoridation. Present dietary trends, however, indicate that many Australian children may consume more prepackaged fluids than actual tap water. The fluoride concentrations of a selection of carbonated soft drinks and prepackaged fruit juices were investigated. The results indicate that, in an optimal fluoride area such as Sydney, children who consume a consistent and large proportion of their fluids as carbonated soft drinks in cans, fruit juices and fruit drinks may not be receiving the full benefit of the water fluoridation.


Giant intracavernous aneurysm: rare cause of isolated sixth cranial nerve palsy in a child. A boy, aged 7 1/2 years, developed a sixth cranial nerve palsy for which no cause was found until 8 1/2 years later, when he developed a rapidly progressive ophthalmoplegia. A giant intracavernous aneurysm was then demonstrated on carotid angiography and successfully treated by carotid ligation. Radioisotope techniques were of value in diagnosis and follow-up.


Pseudohypoparathyroidism associated with cri du chat syndrome. A case is reported in which features of pseudohypoparathyroidism were found in association with the cri du chat syndrome. This association may throw some light on the localization of the chromosomal abberration which underlies pseudohypoparathyroidism, since deletion of the short arm of chromosome 5 has been clearly established in the cri du chat syndrome.


The diagnosis of giardiasis.

The diagnosis of giardiasis. Four methods of diagnosing giardiasis are compared. Examination of smear preparations made from the jeunal biopsy specimen showed positive results in all of the 20 consecutive cases of giardiasis reported. The test was more reliable than examination of histological sections of the jejunal biopsy, wet preparations of jejunal aspirate, or faecal smears.


[Frequency, diagnosis, and course of hepatotoxic side effects of Rifampicin (author's transl)]. In a retrospective study the following was found: Out of 111 patients suffering from tuberculosis and receiving a combined INH-therapy without Rifampicin 23% showed an increase of serum-transmainase activities, on the other hand out of 105 patients, treated with a combination including Rifampicin 74% did so. A pathological De Ritis ratio GOT/GPT was found in 31 among 59 comparable cases of Rifampicin-treated patients, and a pathological ratio GOT + GPT/AP in 22 among 37 cases before the transaminase-activities rose above normal. Development of a distinct toxic hepatic damage has to be anticipated in those cases, which show a De Ritis ratio below 0,5 or a GOT + GPT/AP ratio above 1,0 while transaminase-activity still is only slightly elevated. Liver biopsies taken from 10 patients showed no regular relation to the biochemical data.


[Endoscopic-radiologic cholangio-pancreaticography (author's transl)]. Results of 408 own endoscropic-radiologic cholangio-pancreatico-graphies are presented, indications and diagnostic relevance of the method are discussed. Low rate of complications and its high diagnostic value are reasons for ERCP's clinical importance even as a routine procedure at gastro-enterological centers. In the future, cytological, immunological and biochemical analysis of juices and aspirates as well as endoscopic surgery will contribute to an even wider clinical use of the method. In 337 patients (82.6%) cannulation of the papilla of Vater and visualization of one or both duct systems were successful. In 198 cases with visualization of ducts (58.8%) pathological lesions were found. Thus observation of indications and contra-indications of ERCP is documented, of a method, which is not too risky, but relatively expensive and difficult to employ.


[Dissolution of a radiolucent stone in the common bile duct by sodium cholate infusions through the T-tube (author's transl)]. A case of a retained gallstone in the common bile duct after cholecystectomy (in a 38-year old man) is reported in which infusions with saline and spasmolytics failed to flush out the retained stone into the duodenum. An infusion with sodium cholate over nine days through the T-tube was successful in dissolution of the radiolucent stone.


[Acute intermittent porphyria: report on 17 patients with 49 attacks (author's transl)]. In 17 patients (15 women, 2 men) with acute intermittent porphyria in the incidence of 23 clinical symptoms during 49 attacks was calculated. The most frequent symptoms in percentage of attacks were: Red colour of the urine 100%, abdominal pain 92%, tachycardia 88%, hypertension 75%, vomiting 54%, peripheral neuropathy 50%. In 35% of acute attacks a transient normochromic, normocytic anemia developed which is probably due to a disturbance of heme synthesis. Oliguria was found in 25%, azotemia in 12.5% of attacks. 4 patients with an average of 5 preceding acute attacks showed a persistent reduction of renal function during the symptom-free interval, in contrast to 12 patients with an average of 1.7 previous attacks and normal renal function. During the observation period from 1960-1974 3 (= 18%) of the 17 patients died.


[Experiences with cephradine (Sefril) in septical-surgery (author's transl)]. 100 patients with septic-surgical diseases were treated with the cephalosporine-derivate Cephradine (Sefril). 79 patients were treated by surgical intervention in advance of the antibiotic therapy, 21 by Sefril in combination with conservative therapy only. The continuance of medication amounted to two weeks in 94%. A complete healing of the pyogenic infection was obtained in 86 patients. Complications occured in 6%.


[Compression of the ulnar nerve at the wrist (author's transl)]. Compressions of the ulnar nerve at the wrist in or beyond the canal de Guyon are comparative rare. Those originating from compression in the sulcus ulnaris at the elbow are much more common. The clinical symptoms are typical: Weakness of the small muscles of the hand, loss of sensibility and pain. The diagnosis can be made on the clinical picture. It has to be confirmed by electromyography. Surgery should be performed as early as possible to avoid permanent damage to the nerve. Any delay can cause irreversible loss of function of the ulnar nerve. As causes of the compression of the ulnar nerve tumours, inflammation of the sourrounding tissue or trauma have been described. In this paper we report about compression of the ulnar nerve in the canal de Guyon due to a thrombosed aneurysme of the ulnar artery. This condition is quite rare. It is characterized through sudden onset of pain in the hand. Immediate surgery with decompression of the nerve, as we did in our case, will result in complete recovery.


[Lumboscopic renal biopsy (author's transl)]. Renal biopsies with a new "lumboscopic" (half-open) technique were performed in 109 patients. Access to the kidney was gained by a small flank incision and biopsies from the renal cortex were taken under vision through the lumboscope. The biopsies were successful in all cases. The advantages of the new technique are convincing and lumboscopy suited to replace the regular open biopsy procedure.


[Plasma hydroxyproline in chronic renal failure (author's transl)]. The plasma concentration of hydroxyproline fractions were determined in 50 adult patients with renal insufficiency and 19 patients receiving maintenance hemodialysis treatment. Free and peptide bound hydroxyproline fractions (total hydroxyproline) were elevated, the protein bound hydroxyproline (hypro-protein) was only slightly increased without significant correlation to the degree of renal insufficiency. The total hydroxyproline correlated only with the level of the alkaline phosphatase. The validity of the single fractions of hydroxyproline in plasma as parameter of the renal osteodystrophy is discussed.


[Nonsymmetrical communication in clinical visits (author's transl)]. The article tries to demonstrate on an empirical basis how physicians in hospitals react to threatening situations, namely the demand of information about illness by severely ill patients. Four types of reaction relating to physicians' verbal communications are distinguished and illustrated by tape-recordings on clinical visits:1. Disregard, 2. Shift of the topic or the addressee, 3. Communication of "reference-information", 4. Communication of "functional uncertainty". The results demonstrate that nonsymmetrical communications are significantly more usual in regard to severely ill than regard to non severe patients and significantly more usual among traditionally trained physicians than among physicians with psychosomatic or psychotherapeutic training or orientation. Some practical consequences are mentioned, especially in the field of medical education.


[Constitution and obesity in adolescents (author's transl)]. Obesity was found in 18% of 475 adolescents of both sexes by subtraction of lean body weight from whole body weight. Severe obesity is more frequent in male while lower degrees are more often seen in female adolescents. Obese youths are not only fatter than lean ones: their lean body weight is also higher, shoulders, chest and hips are broader. Their weight at birth was higher than that of none-obese subjects. Their mothers more often classify themselves as "well developed", "stout" or "fat"; the same is true for the fathers of obese girls but not for the obese boys' fathers. The results are discussed in context with the new findings of adipose tissue hyperplasia. It is felt that hereditary constitution of an individuum is of great importance in the development of obesity.


[Comparative trial on the effects of diet, mazindol, and placebo in the treatment of exogenous obesity (author's transl)]. In a single blind study 25 out patients with exogenous obesity were treated for 6 weeks with Mazindol (2 mg one hour before lunch). The active treatment period was followed by a placebo period of 4 weeks. 9 out of 25 patients (group I) were asked to stick to a diet of 1000 cal daily for 14 days before entering the active treatment period. The rest of the patients (group II) were asked to start with this diet when entering the treatment period. There was practically no weight reduction during the initial 2 weeks on diet alone in group I. In both groups on Mazindol there was a significant weight reduction beginning after one week with a maximum weight loss of 4,1 and 5,1 kg respectively at the end of the active treatment period (2p less than 0,001). After the first week of the following placebo period there was an increase in weight in both groups (2p less than 0,01). During both treatment periods no changes in clinical (including) ergometric investigations) and laboratory findings were observed. However from these results no conclusions can be drawn regarding cardiopulmonary tolerance and abuse potential. In a few cases mild side effects related to the CNS have been found.


[Diagnostics of lactose-malabsorption: value of tolerance tests and 14CO2 exhalation test in patients with and without lactase deficiency (author's transl)]. Lactose-tolerance-test (LTT), ethanol-lactose-tolerance-test (ELTT), 14CO2 breath test and 14C-glucose determination were simultaneously performed in 27 healthy subjects, 16 patients with a Billroth II gastrectomy and 6 patients with a malabsorption syndrome. Intestinal mucosal lactase was absent or significant diminished in 5 of the B II cases and in all patients with malabsorption. In the lactase deficient patients a diminished serum glucose rise after ingestion of 50 g lactose was observed in LTT as well as in ELTT. False positive results in LTT could not be prevented by performing the ELTT. Furthermore the ELTT is not suitable for ambulant investigations because of the required high ethanol load of 0.5 g/kg. Most reliable results were obtained by determination of 14C-serum-glucose after oral application of about 15 muCi of 14C lactose. In respect to lactase level neither false positive nor false negative results were observed. For clinical investigations the procedure of isolation and measurement of 14C-glucose is too laborious however. 14CO2-exhalation test cannot be recommended because of many false positive and false negative results. Moreover 14CO2-exhalation seemed to be insensible and predominant depending on factors other than lactose absorption.


[Diabetic nephropathy, hypothyroidism and colfibrate-induced myopathy (author's transl)]. A case of a pluriglandular-insufficiency syndrome (Diabetes mellitus and primary hypothyroidism) is described. The history and symptomatology of the patient is presented and prevously published references are briefly discussed. The case reported was complicated by renal insufficiency and by a "muscle-syndrome" after clofibrate therapy for hyperlipidemia--two complications, which were possibly intensified by the hypothyroid state of the patient.


[Hyperoxaluriaas a complication of intestinal diseases (author's transl)]. Urinary oxalate excretion was measured in healthy persons and patients with Crohn's disease, colitis ulcerosa, sprue and other diseases accompanied with malabsorption, and patients with insufficiency of the exocrine pancreas gland. Further measurements were made in patients after resection of parts of the small intestine or the colon. We found a clear increase of urinary oxalate excretion in patients with resected parts of the small intestine, sprue or other malabsorption syndromes. In 4 patients with resected parts of small intestine or pancreas we even found urolithiasis. Urinary oxalate excretion correlated significantly with steatorrhoea and increased if larger parts of small intestine were resected. Increased resorption of oxalate from food causes increased urinary excretion. Details about the patho-mechanism of this increased excretion are not known yet; an important factor seems to be the reduced absorption of fat in the small intestine.


Electrical ventricular defibrillation.

Electrical ventricular defibrillation. Ventricular fibrillation is the condition in which all of the muscle fibers in the ventricles of the heart contract and relax randomly and do not propel blood from the heart. This condition, which is the major cause of sudden death from a heart attack, can be reversed by passage of a single pulse of current through the heart using electrodes applied to the chest wall; this technique is known as ventricular defibrillation. World-wide clinical experience has shown that with existing defibrillators, successful defibrillation of subjects weighing over 100 kg is infrequent. It should not be concluded, however, that defibrillation cannot be achieved in such subjects. To illustrate this point, data will be presented to show that it is possible to establish a dose concept in which the output required from a defibrillator can be specified in terms of the weight of the subject. This dose concept evolved slowly from studies reported by investigators in various countries. For example, the present-day techniques of ventricular defibrillation are due to the investigations of researchers all over the world. Prevost and Battelli (1898) in Switzerland first showed that electric current can both induce ventricular fibrillation and achieve defibrillation. The studies of Kouwenhoven in the 1930's in the USA showed that 60 Hz alternating current can be used for defibrillation. The first human defibrillations in 1947 and 1952 used this type of current; these studies were reported by Beck and Zoll in the USA. The present-day technique for defibrillation derives from the animal studies reported by Gurvich and Yuniev 1946 in Russia. Finally, Lown et al. in the early 1960's applied the technique to man. Exciting new developments are underway in ventricular defibrillation. Not only are higher output defibrillators beginning to appear, but automatic and fully implantable defibrillators are being involved. In this paper, the present state of the art of defibrillation will be reported and future trends will be described.


Ultrasound in the assessment of vascular function. The study of circulatory function is fundamental to the understanding of many physiological processes and pathological conditions, and has been greatly advanced by developments in the use of ultrasound. Transcutaneous measurement of blood velocity has been made possible by the use of Doppler shift methods, and many methods of spectral analysis have been developed. Blood volumetric and flow profiles can be achieved through the use of range-gated pulsed Doppler systems. A combination of Doppler velocimetry, pressure measurements and volumetric visualisations provide a powerful alternative to more conventional investigations like arteriography. Current developments indicate that the use of ultrasound in investigating vascular function is cost effective.


Signal processing: from mathematical theory to clinical acceptance or vice-versa? Signal processing in physiology and medicine hasn't developed as well as one could have hoped in spite of important efforts in research. The bases for present techniques in signal processing are evaluated for the two types of signals encountered in physiology, namely, continuous signals and point processes. It seems that morphological analysis ought to be adapted to the study of continuous physiological signals and that point processes constitute an important form of signals. The principal areas where industrial development can be expected are explored.


Biomedical engineering for "The Age of Health". A systems approach to health care inevitably emphasizes shifting present emphasis from curative to preventive orientations. However, problems arise through the inertia and resistance of our politico-cultural system. The present highly-developed curative-oriented system depends heavily on technological and biomedial engineering expertise, as indeed will a preventive-oriented system. They must serve however within the priorities defined by the systems objectives in health care. This paper reviews, in terms of technological content and socio-political issues, some major developments including; multiphasic health testing and disease screening, health appraisals, clinical labs and other test procedures, protocols, computerized information systems, data bases and systems modelling.


The measurement of pressure and flow in the microcirculation: application to physiological and clinical problems. The analysis of hemodynamic phenomena at the level of microscopic blood vessels of diameters ranging from 10(-2)-10(-3) cm is currently based on direct measurements of plasma pressure and red blood cell velocity in in-vivo conditions. Pressure measurements are performed with active pressure measurement systems via cannulae with 1 mum tip openings. Flow measurements are deduced from optical transit time methods from data recorded by television. The technique provides both average and dynamic data. The latter is derived from signal processing of the direct measurements by means of active filters. These techniques yield data on low level signals related to the periodic action of the heart. This analysis provides information on the transit time of pressure and flow pulses through the microcirculation. These  methods are currently utilized in routine physiologic investigations and as a means for studying the human skin microcirculation of normal subjects.


The artificial heart - progress, problems, and further development. The state of the art in the development of artificial heart research based on more than 100 own animal experiments and information from the other groups working in the same field is laid out. Consideration is given to a variety of special problems. The use of biomaterials (blood compatibility and mechanical strength and durability), the flow pattern in the pumps (clot formation), and special hemodynamical effects are discussed as well as different driving systems and percutane energy transmission (avoidance of infection). Respective measurements show the hemodynamics in the systemic and pulmonary circulation, especially the difficulties of the venous inflow and the regulation of the pumps. The effect of an active artificial atrium and new ways of computerized regulation using noninvasively measured parameters are described. Other pathophysiologic findings (lung, kidney, acid-base metabolism, gastrointestinal tract, blood) are dealt with according to their importance. The miniaturization of the driving system and new methods of energy supply necessary for a totally implantable artificial heart system, envisaged for the future, are also pointed out.


The concept of intensive medicine. A systems approach of importance to medical engineers. The paper demonstrates how planning, organizing, equipping, and running all Intensive Care Unit (ICU) should be carried out, using a systems approach, and by keeping in mind that quality and degree of overall performance is a function of effectiveness and efficiency. The interactions of the ICU with its "environment" are discussed; a method of estimating the size of the ICU is mentioned. Then, the elements determining performance are analyzed: personnel, pathophysiologic states of the patients, financial and material resources. Furthermore, the problem of goal-oriented systems synthesis is outlined and suggestions for more detailed studies on the structure of some of the "subsystems" are put forward. The paper summarizes some important consequences for medical engineering as applied to intensive medicine.


Regulation of carotene synthesis in Phycomyces. Three independent mutations of Phycomyces blakesleeanus resulting in overaccumulation of beta-carotene are recessive and belong to the same complementation group. The corresponding gene has been named carS. Evidence is presented that gene carS is not the same as gene carA, previously defined by mutations blocking carotene production. Vitamin A increases carotenogenesis in wild types and in carS mutants to about the same extent. Intersexual heterokaryosis increases carotenogenesis most prominently in carS genetic backgrounds (up to 300 times the production of the wild type in the same conditions). Vitamin A, intersexual heterokaryosis and carS mutations are thought to stimulate carotenogenesis through different mechanisms. It is suggested that the carS gene product participates in end-product regulation of the pathway.


[The normal neonatal EEG (author's transl)]. Polygraphic examinations (EEG, EKG, electrooculogram and recording of respiration) were carried out on 120 full term healthy newborns. EEG recordings taken in wakefulness states showed a low-voltage background activity with a noticeable share of 8 c/sec. waves. The latter occurred in 12.5% of the examined newborn infants in more regular groups, lasting from 3--6 seconds, and reached an amplitude of up to 20--25 muV. The EEG sleep recordings differed from case to case. Certain identical EEG-patterns could be observed during active as well as during quiet sleep. Typical "tracés alternants" occurred in 63.4% of the recordings, as a rule in the quiet sleep phase. In nearly 1/3 of these cases they contained isolated fine spikes or sharp waves of variable localisation. In 70% of the sleep recordings bilateral fronto-central paroxysmal steeper transients and in 6.7% spindly about 14 c/sec. wave groups were observed, mainly during active sleep phases. In nearly 20% of the 52 newborns where the centro-temporal electrodes were connected transversally, single sharp and slow waves were recorded. They were localized resp. more pronounced in the right hemisphere. They did not appear in any of the 68 cases in which the electrodes were connected longitudinally only.


[Childhood sarcoidosis (author's transl)]. Between 1972--1974 26 children (15 boys and 11 girls) aged 11--14, with sarcoidosis were observed in county Szabolcs-Szatmár, Hungary. The number of cases varied between 1--6 per year, so the incidence of sarcoidosis is about 2--11/100000 for the age group 10--14 years of this county. Sarcoidosis was detected because of complaints in 4 cases, and by mass radiographic surveys in 22 cases. In each of the patients the thoracic form of sarcoidosis was in the foreground (in 6 cases mild bilateral hilar adenopathy, in 2 cases only unilateral hilar adenopathy, in 18 cases typical BHL-syndrome sometimes with "tumorous" adenopathy and in 7 cases out of the 18, hilar adenopathy and mottling in the lungs). The laboratory data were an unsatisfactory basis for the diagnosis. The tuberculin test was negative in 65 per cent. There was no proof for infection with atypical mycobacteria by intradermal tests. The most important basis of diagnosis was the biopsy (mediastinoscopy), especially in cases of simultaneous infection with tuberculosis. Prednisone treatment was carried out in the first place in cases of adenopathy and mottling, and in the cases of elevated serum calcium. Prednisone resistance was observed in two cases; in one of the patients it was secondary since it manifested itself only at the relapse of the BHL-syndrome; in the other patient the drug resistance was primary.


[Hypermethioninemia in the differential diagnosis of infantile obstructive jaundice (author's transl)]. In 7 infants suffering from obstructive jaundice we found transient high levels of methionine in serum. All cases had only intrahepatic cholestasis, especially with intrahepatic biliary hypoplasia, whereas other patients with extrahepatic biliary atresia and/or combination of extra- and intrahepatic obstructive jaundice always showed normal levels of methionine. Therefore hypermethioninemia seems to be helpful in differentiating the various causes of infantile obstructive jaundice.


[Are products of the Maillard-reaction in babyfood toxic for the newborn? (AUTHOR'S TRANSL)]. It was investigated, whether during the whole course of pregnancy in guinea pigs there is a materno-fetal transfer of epilon-fructoselysin, the most important product of the so-called Maillard-reaction. Several authors accused Maillard-products in terminal sterilized babyfood as a dangerous agent, which has been shown, to hamper fetal development in rats. Experimentally, C14-labelled epsilon-fructose-lysin appears in the fetal blood, 15 min after injection to the narcotized mother, reaches maternal blood concentration after 30 min, and later stays at higher levels as in the maternal blood until the end of the experiment after 120 min. Thereby the transfer of Maillard-products to the fetus is proven. From the fact, that man since using fire for cooking takes up an important amount of Maillard-reaction-products, it can safely be concluded that these products most likely are not dangerous to the human fetus or new-born.


[Cranial axial computerized tomography in children (author's transl)]. This report on computerized tomography in 400 children confirms the high diagnostic value of the new method in neuropediatrics. 31 brain tumours were diagnosed in children. Tumors present themselves as lesions of latered density compared to that of brain matter. Intravenous injection of contrast media increases the density of various lesions as tumors, angiomas, acute infarctions and abscess. Infarctions are low density lesions whereas hemorrhage is a high density lesion and both are thus safely differentiated. Edema may be visualized in the vicinity of tumours in brain injuries and in encephalitis. The normal ventricular system, hydrocephalus, cerebral malformations and subdural hygroma are easily demonstrated. Diseases of the orbits may also be detected.


Prenatal diagnosis of hemoglobinopathies. A review of 15 cases. We attempted prenatal diagnosis of hemoglobinopathies in 15 cases--11 for beta-thalassemia and four for sickle-cell disease. Fetoscopy was used in seven cases, and placental aspiration in eight. One premature labor, with fetal loss, followed placental aspiration. Globin synthesis was assessed by incubation of samples with 3H-leucine and chain separation on carboxymethylcellulose columns. Homozygous disease was predicted in two pregnancies, which were interrupted, and the diagnosis confirmed. In one case homozygosity was suspected. A repeat test was advised but not accepted. The fetus had thalassemia trait. One pregnancy was interrupted despite our prediction of thalassemia trait. Eight pregnancies went to term. Seven predictions that the infants would not have homozygous disease were confirmed. One prediction of sickle trait proved to be sickle-cell disease. Although prenatal diagnosis of hemoglobinopathies is feasible, the present frequency of fetal loss and diagnostic error indicates need for improvement.


Radioimmunoassay of myelin basic protein in spinal fluid. An index of active demyelination. With a sensitive radioimmunoassay that can measure as little as 2 ng of basic protein in cerebrospinal fluid we studied 303 patients with a variety of neurologic diseases. Patients with active demyelinating diseases had high levels (17 to 100 ng per milliliter) of basic protein. Moreover, patients with multiple sclerosis in acute exacerbation had these high levels, those with slowly progressive multiple sclerosis had lower levels (6 to 16 ng per milliliter), and those in remission had less than 4 ng per milliliter, comparable to the control population. Thus, the assay appears to be a useful index of active demyelination.


Autoimmune panleukopenia.

Autoimmune panleukopenia. A patient with episodic panleukopenia involving neutrophilic granulocytes, monocytes and lymphocytes had recurrent bacterial infections and a circulating cytotoxin that injured primitive myeloid cells as well as differentiated granulocytes and mononuclear cells. The cytotoxin was an immunoglobulin with activity against mouse, as well as human, myeloid stem cells. Clinical remission during cyclophosphamide therapy was associated with disappearance of the circulating leukocytotoxin. Serum from a period of active disease was cytotoxic for the patient's own lymphocytes obtained during clinical remission. Absorption of cytotoxic serum with granulocytes removed activity against both granulocytes and lymphocytes. These studies suggest an autoimmune disease in man characterized by episodic granulocytopenia, monocytopenia and lymphocytopenia due to humoral antibody against non-HLA antigens shared by several hematopoietic cell lines.


Usefulness of chromosome examination in the diagnosis of malignant pleural effusions. To determine whether chromosome analysis could facilitate the diagnosis of malignant pleural effusions, we examined chromosomes in effusions from 104 unselected patients. An effusion was regarded as malignant if at least three of 30 metaphase cells were hyperdiploid or contained a marker chromosome. Results were compared with standard cytologic diagnoses. All 22 benign effusions were diagnosed correctly by cytologic examination, but one nosed correctly by cytologic examination, but one (acute rheumatoid lung disease) was misclassified as positive by chromosome criteria. Of the 82 malignant effusions, 53 (65 per cent) were diagnosed correctly by cytologic tests, as compared with 58 (71 per cent) by chromosome analysis (P greater than 0.2). Among patients with malignant neoplasms, 13 had leukemia or lymphoma; only four of these (31 per cent) were diagnosed by cytologic tests as compared with 11 (85 per cent) by chromosome analysis (P less than 0.01). The combination of standard cytologic and chromosome analyses correctly identified 83 per cent of the neoplasms, a result significantly better than that with either technic alone (P less than 0.01).


Circulating immune complexes in infective endocarditis. To examine further the role of immune-complex deposition in infective endocarditis, we studied 29 patients with infective endocarditis for presence of complement-containing circulating immune complexes. Ninety-seven per cent (28 of 29) had serum levels of immune complexes greater than 12 mug per milliliter. Mean levels in these patients were significantly higher than in patients with sepsis without endocarditis or in normal controls (P less than 0.05). Circulating immune-complex levels were correlated with longer duration of illness (P less than 0.025), extravalvular manifestations of endocarditis (P less than 0.025) and hypocomplementemia (P less than 0.05). Patients with right-sided endocarditis had significantly higher circulating immune-complex levels than patients with left-sided involvement (P less than 0.025). In general, levels fell to zero with successful antimicrobial or surgical therapy. This drop was concurrent with disappearance of extravalvular signs, blood cultures becoming sterile, and rise in serum complement levels. These findings support the concept that immune complexes may be important in the pathogenesis of infective endocarditis.


Trichophyton mentagrophytes infection in laboratory white mice. Trichophyton mentagrophytes infection was studied in a breeding colony of 42 white mice. Symptoms were observed in only 3 out of the 12 animals shown to carry dermatophyte on their coats. Literature on Trichophyton mentagrophytes infection mice is reviewed. The use of the technique developed by Mariat & Tapia (16) to isolate dermatophytes on cultures, specially for epidemiological surveys, is postulated. Attention is called to the importance of healthy animals, directly or indirectly, as carriers of fungi and sources of infection to other animals and human beings.


Studies on perithecium of Ceratocystis stenoceras by a scanning electron microscope. The surface and cavity of the perithecium of Ceratocystic stenoceras were studied with a scanning electron microscope. The body was spherical, 96-231 u in diameter, and the surface was covered with hyphae. The neck was a lanky hollow cylinder and the wall consisted of a bundle of tubular hyphae encircling a central canal. A whorl of hyaline hyphae was found at the tip of the neck. The surface of the neck from the body to a distance of about 1/6 was rough and warty. But the surface of the neck above that place was smooth, on which a regular design could be seen. The wall of the neck the body consisted of 5-6 layers of cells. However, the wall at the tip was of 1-2 layers of cells. The cavity was filled with ascospores. They were like segments of an orange of 1 X 2 u with smooth surface.


[Paracoccidioidomycosis: an epidemic in the Republic of Paraguay, the center of South America]. The investigation done on the frequency or incidence of Paracoccidioidomycosis in the Republic of Paraguay, with the cases appeared and registered in the Institute of Pathology of Asuncion, presents an incidence rate of 0.46 per 100,000 in the total population; 0.52 per 100,000 in the population at risk. Considering the exposed masculine population the rate is 1.03 per 100,000 and for the feminine 0.02 per 100,000. The age group most affected is within the 50-54 year range with 3.54 per 100,000, the highest rate of all the groups studied. These are the incidence in a strongly exposed population which is controlled and well known. The period of 10 years (1960/69) which has been chosen for this investigation, shows a frequency of the mixed type (lymphatic-visceral or lymphoma-type) which reaches 25% of the total, and a low frequency for the pulmonary form which reaches a mere 12.5%. The mucocutaneous lesion with the involvement of the regional lymph nodes is the dominating form. Considering three consecutive 5 year periods between 1960 to 1974, no cases with proved pulmonary involvement were found until 1964; from 1965 to 1969 the percentage of pulmonary lesions in all the cases considered was 23.0% and from 1970 to 1974 reached to 38.4%. However, mucocutaneous and the lymphatic-visceral or mixed forms do not show significant variations. The rats are small and represent the incidence of this mycosis. It is suggested that a failure of the immunologic system would be found in those affected by the disease and there would be a strong resistence in the majority of the population exposed or within the endemic area of the infection.


Simple technique of epicutaneous inoculation of guinea-pigs with dermatophytes. A simple technique of epicutaneous inoculation of guinea-pigs making use of a polyethylene chamber stuck to the animal's skin with the Duracryl resin is described. In this way, inoculation with a defined number of fungal elements is made possible.


The effect of amitrole (3-amino-1H-1,2-4-triazole) on cytokinin activity and sexual reproduction in the yeast Schizosaccharomyces octosporus. Cytokinin activity in extracts from actively growing cultures of Schizosaccharomyces octosporus was greatly reduced by exposure to amitrole (5 X 10--3M). Amitrole treatment, at the same concentration, stimulated cell enlargment and ascus production in this organism. These data suggest that a relationship may exist between low levels of endogenous cytokinins, cell expansion in preference to cell division, and ascus formation.


Determination of the growth curves of the mycelial and yeast forms of Paracoccidiodes brasiliensis. The growth curves of 2 different strains of P. brasiliensis were determined. Cultures were made in a dialyzed trypticase soy broth and the growth assesed at selected intervals by means of viable cell counts. In the yeast form, both strains exhibited un uniform pattern of growth; the mycelial forms were also similar although one of the strains survived for a longer period of time. When the 2 yeast curves were compared with the mycelial ones, large differences were noticed. Thus, the mean survival time for the yeasts was 13.5 days while it was 50.25 days for the mycelia. During the exponential phase, the mean rate of growth was accelerated for the yeasts (0.110) in comparison with the one exhibited by the mycelia (0.0265). Irrespective of the form of growth and for both strains, death occurred abruptly, a few hours after a period when colony counts were high, indicating that the fugus was viable at the preceeding interval.


Microsporum racemosum: first isolation in the United States. What is believed to be the first isolation in the United States of the dermatophyte Microsporum racemosum (2) was obtained from a 79 year old white male. The patient had numerous excoriations on the forehead, scalp, and nape of the neck. (Fig. 1) A culture of scrapings from the forehead grew out a flat, granular, cream-colored colony with a red cherry-colored pigment on the reverse. (Fig. 2). The growth was exceedingly rapid, reaching a thallus of 40 mm. in diameter within 15 days. On microscopic examination the organism was found to produce numerous echinulated macroaleuriospores, (Fig. 3,5) as well as numerous microaleuriospores which are striking in appearance, occurring in wand-like clusters and being frequently stalked. (Fig. 4,5) The macroaleuriospores are quite large, achieving over 60 microns in length and 15-16 microns in diameter. The colony and microscopic appearance was consistent with Borelli's description, with the exception of the wall of the macroaleuriospore. Borelli described the wall as being thin and very similar to M. gypsum, while in the isolation from Illinois, the wall was moderately thick. Drs. Ajello and Padhye of the U.S. Public Health Service, Center for Disease Control, Atlanta, Georgia confirmed the identification.


[Behavior of Ethephon residues on stone fruits and berries. 1. Ethephon residues on sweet and sour cherries]. The authors describe a gas chromatographic method for determing Ethephone residues. Studies on the residual behaviour of Ethephon on sweet cherries showed that the fruits contained 0.88, 1.45 and 1.83 p.p.m. of Ethephon after applications of 0.05, 0.075 and 0.1% Flordimex mixture, respectively. When the same doses were applied to sour cherries, the fruits contained 0.54, 1.12 and 1.44 p.p.m. of Ethephon; and the juices, 0.81, 1.36 and 1.77 p.p.m.


Inactivation and excretion of dopamine by the cat kidney in vivo. 14C-Dopamine at a dose between 0.16 and 400 nmol per kg body weight was injected locally into the renal artery and urinary excretion of the label was followed for a period of up to 75 min. During the first renal passage the injected kidney excreted 28.2+/-8.3% (n = 8) of the activity applied. As shown by column chromatography the 14C-activity in urine was mainly present as 3,4-dihydroxyphenyl acetic acid (40%), homovanillic acid (15%) and dopamine (app. 20%). Excretion rate and the pattern of dopamine metabolites in urine was independent of the administered dose. Thus, the excretion of dopamine by the cat kidney is linked to an inactivation by the kidney enzymes MAO and COMT. From the literature it is known that in dog and chicken kidney catecholamines are not metabolized to such a large extent during renal excretion.


Uptake, distribution and metabolism of isoprenaline in the dog saphenous vein. Dog saphenous vein strips were incubated with 2 muM 3H-isoprenaline. After 2 and 8 min of incubation small cross sections were cut and prepared for light and ultrastructural autoradiography. In addition, the accumulation of 3H-isoprenaline (3H-ISO) in the tissue as well as the formation of 3-O-methylisoprenaline (3H-OMI) were determined by liquid scintillation counting. The density of silver grains was 6.5 times higher on smooth muscle than on connective tissue. It decreased from the intima to adventitia when determined in the 2 min specimens, suggesting the existence of a selective transport of isoprenaline through the endothelium of the vein. The preferential distribution into the juxta-intimal part of the media which was observed after the 2 min incubation period was abolished by cortexone. Silver grain density, especially over the smooth muscle, was markedly increased by U-0521 and decreased by cortexone. Simultaneous treatment with cortexone and U-0521 led to a marked accumulation of silver grains over neuronal tissue; this accumulation was prevented by cocaine. Strips incubated at 0 degrees C and without oxygen showed almost no grains. In control conditions the saphenous vein strips removed 1968 +/- 19 pmoles-g-1 during 8 min of incubation. 86.3% of that value corresponded to 3H-OMI formation. O-methylation of 3H-ISO was strongly inhibited by U-0521 and, in a lesser degree, by cortexone. The influence of U-0521 on inhibition of O-methylation of 3H-ISO was not modified by cortexone. We found a linear correlation between silver grain densities per unit area of the vein strips and the 3H-isoprenaline accumulation determined by liquid scintillation counting, indicating a clear correspondence between silver grains and 3H-isoprenaline.