Absence of vesicoureteral reflux after stone basket manipulation. Reflections on iatrogenic reflux. Twenty-four patients were studied after cystoscopic basket manipulation for distal ureteral calculi. Voiding cystourethrograms or cystograms were obtained at varying intervals post-operatively to detect evidence of vesicoureteral reflux. Reflux did not develop in any of the patients. In comparison with other known causes of iatrogenic reflux, stone basket manipulation does not appear to interfere with anatomic factors which normally prevent incompetence of the ureterovesical valvular mechanism.


Reflux in opposite ureter after successful correction of unilateral vesicoureteral reflux. Reflux developed in the contralateral ureter in 20 per cent of our patients undergoing unilateral ureteral reimplantation for reflux. This occurrence was not predictable from the preoperative evaluation. Bilateral reimplantation may be indicated in some patients requiring surgical correction for demonstrated reflux.


Effect of furosemide on postprostatectomy blood loss. The value of induced diuresis, employing furosemide, on blood loss during and after prostatectomy is evaluated. Two series of 100 patients (consecutive) undergoing prostatectomy, one series with furosemide and one without, are compared. The conclusion drawn from critical analysis is that induced diuresis with furosemide is beneficial in reducing blood loss.


Changes in testis of guinea pig after vasectomy. Thirty adult guinea pigs were bilaterally vasectomized and subsequently sacrificed at one, three, and six months after operation. Cell counts were performed on five seminiferous tubules from each animal to identify and quantitate changes in spermatogenesis. Forty-three per cent of the animals had alterations in spermatogenesis that were characterized by generalized hypospermatogenesis and presence of multinucleated spermatids. There was a high incidence (93 per cent) of sperm-agglutinating antibodies in the vasectomized group. Sperm antibodies were not detected in the normal and sham-operated animals. Mean testicular weights and seminiferous tubule diameters were significantly reduced in the hypospermatogenic animals. The intersitial tissue of the vasectomized and sham-operated animals was morphologically indistinguishable from that of unoperated animals.


Prevention of infection during transrectal biopsy of prostate through double-glove technique. Eighty male patients, most of whom had suspicious prostatic nodules on digital examination, were subjected to transrectal needle biopsy of the prostate. The biopsy needle was held between the gloved hand and an overlying sterile finger cot on the index finger. When the lesion was palpated, the needle was pushed through the finger cot and a tissue specimen obtained. All patients were treated orally with minocycline hydrochloride 100 mg. twice a day starting eight to twelve hours before biopsy and continuing at this dosage for five days after biopsy. Except for one episode of transitory hematuria, there were no reports of infection or complication, as manifested by fever, chills, or transrectal or transurethral bleeding.


Regression of pulmonary metastases from renal carcinoma. This article describes a patient who had a nephrectomy and hormone therapy for renal carcinoma. There was roentgenographic evidence of pulmonary metastases at the time of surgery. He was alive and showed no clinical or roentgenographic evidence of pulmonary metastases six and one-half years after treatment.


Testis tumor metastatic to lung: twenty-two-year survivor. A case is presented of a twenty-two-year survivor following pulmonary resection of a solitary embryonal cell carcinoma metastasis from a primary teratocarcinoma of the testis. The literature is reviewed with regard to this problem, and the criteria for pulmonary resection of metastic lesions are presented.


Arteriovenous aneurysm of kidney after open renal biopsy. Renal arteriovenous fistula following percutaneous renal biopsy is being reported frequently in the literature. For this reason, open renal biopsy has gained popularity as a safer alternative procedure. We present a case of a large arteriovenous fistula seen two years after open renal biopsy. The presentation was highly atypical, mimicking an acute gastrointestinal event, rather than sudden hemorrhage in a previously asymptomatic fistula.


Characterization of renal stone models with Gray Scale echography. In vitro studies with clinical correlation. Solid, matrix, and urate stone models were studied in an idealized laboratory setting by gray scale echography. The stone models could be both identified and characterized by ultrasound. Preliminary studies indicate that ultrasound may be useful in determining the nature of foreign matter in the collecting systems of patients with renal calculous disease.


Postoperative nephrogenic adenoma of bladder. Nephrogenic adenoma of the bladder, which has been associated with either a chronic infection or severe trauma to the bladder, occurred in a six-year-old girl apparently secondary to urologic surgery. It was also a possible cause of enuresis.


Paraquat poisoning in a dog and cat.

Paraquat poisoning in a dog and cat. Paraquat (1,1'-dimethyl-4,4'-bipyridylium dichloride) has in the last decade gained popularity as an effective weedicide. It is marketed for commercial use as a liquid concentrate Gramoxone ICI (20% paraquat). Accidental or intentional ingestion of Gramoxone has caused 232 human deaths between 1964 and 1973 (Anon 1974). Most human patients suffer transient renal and hepatic insufficiency and pulmonary oedema followed after a latent period by progressive pulmonary fibrosis leading to death from respiratory failure (Harrison 1972). The clinical features of non-fatal paraquet poisoning in a cat and the clinical and pathological findings in fatal poisoning in a dog are reported.


Porcine atrophic rhinitis: snout radiography as an aid to diagnosis and detection of the disease. Snout radiography is a useful and practicable aid to the diagnosis of atrophic rhinitis. It is also a fairly reliable means of detecting and measuring turbinate atrophy and distortion of the septum nasi in the live pig. Suitable physical and pharmacological methods of restraining pigs for snout radiography are described and guide lines for producing satisfactory, standard snout radiographs are given. Parameters and criteria are recommended for qualitative and quantitative methods of interpreting snout radiographs. The quantitative scoring system approximates the macroscopic post mortem snout scoring system generally employed in Britain and provides data which might be used in genetic or other control programmes. Radiographic standards are tentatively suggested for certifying pigs free from gross lesions of atrophic rhinitis for sale or export purposes.


An assessment of the practical impact of insecticide resistance. In spite of widespread resistance of the sheep blowfly to organophosphorus insecticides, they are still widely relied upon in Austrialia. Hybrid-resistant blowfly larvae do not produce fly-strike as readily as pure-resistant larvae so more attention should be paid to the use of biological, rather than chemical, control, wherever possible.


Studies in dogs and cats dosed with trimethoprim and sulphadiazine. Serum level studies in cats and dogs dosed with 30 mg per kg per day of either oral or injectable formulations of a 1:5 trimethoprim/sulphadiazine combination showed good absorption by both routes of administration. Toxicity tests with the products demonstrated a high margin of safety in dogs given this dose level; the margin of safety in cats was lower but still adequate. The high success rate in clinical trials against a wide range of bacterial infections confirmed the predictions from the serum level results that a dose rate of 30 mg per kg per day orally or parentally, would be therapeutically efficacious in both species.


Copper metabolism in experimental Border disease. The proposal that hypocupraemia and hypocuprosis are characteristic manifestations of Border disease and of aetiological significance has been investigated. Mean plasma copper concentrations in 65 affected and 47 unaffected lambs were similar and in a controlled experiment, plasma and tissue copper concentrations tended to be higher in affected lambs than in controls. It is concluded that hypocupraemia and hypocuprosis are not consistent features of Border disease and thus have no aetiological significance.


Bos taurus Y chromosome of Africander cattle and the development of improved breeds for the tropics. The Africander has anatomical and other characteristics of an animal of approximately 3/4 Bos indicus heredity. The fact that these cattle carry the Bos taurus Y chromosome supports this view and indicates that the local cattle in South Africa would have been crossed with one or more Bos taurus bulls. Droughtmaster and Braford cattle retain the Bos indicus Y chromosome because Bos indicus instead of Bos taurus bulls were used to establish these taurindicus breeds. Contrary to some assumptions, an approximate tenfold increase in productivity of cattle was made during the 18th and 19th centuries due to improvements in disease control, nutrition and genetic improvement. What is now needed is the development of taurindicus breeds combining to the maximum possible extent the disease resistance and hardiness of Bos indicus with the early maturity and productivity of Bos taurus cattle. In addition, the ravages of disease and the seasonal variations of food supply need to be overcome in tropical areas.


Salmonellosis in apparently healthy dogs. When rectal swabs were examined from 672 dogs in Tehran, Iran, 52 (7-7 per cent) yielded Salmonellae of 20 different serotypes. The 672 dogs examined comprised 472 household pets, 181 kennel dogs and 19 strays. Tehy showed an incidence of 4-4 per cent, 15-5 per cent and 15-8 per cent respectively.


Intestinal malformations in calves and their surgical correction. A clinical study was made on 45 cases of intestinal malformations found in calves during a four year period. Fifteen calves were euthanised for different reasons. Surgical correction was made in 30 calves; 15 of them recovered. The recovery depended on the extent and the localisation of the defect and on the general condition of the animal.


An investigation into the prevalence of S aureus on avian feet. The feet of 63 domestic poultry and 37 birds of prey were swabbed and cultured. Staphylococcus aureus was isolated from 4 X 7 per cent of the former and 10 X 8 per cent of the latter. The recovery of S epidermidis was considerably higher, the organism being cultured from 80 X 9 per cent of poultry and 62 X 1 per cent of birds of prey. The significance of the low S aureus isolation rates is discussed in relation to avian staphylococcal infections and attention is drawn to the importance of the choice of plasma for the coagulase test when identifying S aureus from non-human sources.


[Some physicochemical changes in poultry meat caused by Pseudomonas ssp. II]. Studies showed that the reproductive capacity and the biochemical activity of the experimental Pseudomonas ssp. II are manifested to a various extent in the white and red poultry meat. No changes in the meat set in until the microbial count reach 10(8)-10(9) per gram of meat. This critical value is reached on the fifth day for the red meat, and the 7th day for the white meat. Later on the changes in PH, the aminoammonia nitrogen, the volatile fatty acids, the ammonia gas reaction, and the CuSO4 reaction show such values that give grounds to discard the meat. The reaction for the demonstration of H2S is consistently negative, which is referred to as an individual feature of the monoculture used.


[Effect of ionizing radiation on the activity of liver acid phosphatase in chick embryos and chickens]. The treatment of chick embryos and chickens at 1000 rad leads to the decrease of the total activity and the increase of the free activity of the acid phosphatase in the liver. These changes are mostly manifested at the 72nd hour following irradiation. The electron-microscopic studies reveal secondary lysozomes (cytolyzomes) full of round or elongated structures of varying density. All changes are most strongly manifested in 12-day-old embryos, and are most weakly manifested in 20-day-old ones.


[Effect of subtoxic doses of dipterex on guinea pigs]. Chronic experiments were carried out with 62 guinea pigs (31 test and 31 control animals) which were given dipterex orally for 60 days at the rate of 100 mg/kg each. The effect was followed up of dipterex on the bactericidal properties of the blood, the phagocytic activity of some organs of the reticulo-endothelial system, the serum cholinesterase, the alkaline phosphatase, the hemoglobin and hematocrit values of the blood, and the proteinogram of the blood serum. A neglible drop of the gamma-globin fraction of the serum and the phagocytic activity of the immobile cells of the RES of the spleen and liver was found. The hemoglobin content decreased by 13.5 per cent, while the hematocrit value remained unchanged. At the amount given above dipterex suppressed by 50 per cent the activity of the serum cholinesterase, and increased by 36 per cent that of the alkaline phosphatase.


[Experiments to determine the immunizing dosages in a single vaccinal dose of dried, lapinized K vaccine against swine plague]. Investigated was the amount of the immunizing doses per one vaccinal pig dose of five operative numbers of the lapinized K vaccine against swine fever. For this purpose pigs were immunized with 100, 200, 300, 400, and 500 fold dilutions of the vaccinal dose. A couple of weeks later the pigs were infected with 10(6)LD50 each of a pathogenic swine fever virus. It was found that the immunizing doses for the individual operative numbers of the vaccine vary in number from 100 to 400 in one vaccinal dose.


[Study of disorders in calcium and phosphorus metabolism in the intensive fattening of young cattle]. Studied were mass disease outbreaks on eight farms in calves intensively fed concentrate mixtures that were rich in phosphorus compounds. Clinically, there were selling and deformations of the joints with pains. The tarsal and carpal joints were chiefly involved. Kyphosis of the backbone, spastic paresis of the posterior part of the body as well as tetaniform spasms in the initial stage of the disease were also observed. Morphologically, the diseased animals manifested erosions and thinning of the joint cartilage, tearing of the Achilles tendon, and increased amounts of the joint fluid. The histologic study revealed edema of the cartilage cells, disorders in the structure of the hyalin cartilage, formation of cavities, and broadening of the lumen of the Haversian canals. In most cases the blood serum presented hyperphosphatemia (up to 15.67 mg% inorganic P) and relative or absolute hypocalcemia (up to 4.47 mg% Ca). On the farm both hypocalcemia and hypophosphatemia were observed. Good prophylactic results were obtained through correct Ca:P ratios in the diet that contained calcium additives as well as by the injection of vitamin D solutions, etc. It is believed that these cases should be referred to a distinctive form of rickets of a characteristic clinical course' the inadequate Ca:P ratios in the rations playing the main etiologic role. Subsidiary causes are probably vitamin D deficiency, restricted movement of the animals, and mechanical traumata caused by the animal's own bodyweight.


[Distribution and seasonal dynamics of Hyalomma plumbeum (Panzer) species ticks in Pazsrdzhik District]. Determined were specifially a total of 12,580 Ixodes ticks taken from various farm animals. The seasonal dynamics of the parasites were followed up studying the infection in the farm animals in four communities of the Pazardjik district. It was established that from 50.7 to 60.02 per cent of the ticks belong to the Hyalomma plumbeum species. These parasites were found in 45 communities on the territory of the district excluding its southern high mountainous parts. The H. plumbeum infection in farm animals was found from April to November. Most active and numerous were the parasites in June. In the regions of highest altitudes they were prevailing in July.


[A comparative assessment of the results of plastic surgery on the facial nerve following total removal of neurinomas of the acoustic nerve]. The study was conducted in 3 patients following the application of intracranial facial nerve anastomoses, in 25 patients with the facial nerve anastomosed with the accessory nerve, and in 17 patients with facial-hypoglossal nerve anastomoses. Apart from the clinical observations of the facial muscle contractions, the comparative evaluation of the plastic operations was conducted with the aid of electromyography, electrogustometry and salivary glands secretion studies. The authors concluded that the intracranial anastomosis results in better restoration of the motor function of the facial muscles, the gustation being also partially restored on the side on the intervention. Among the anastomoses of the VII nerve with the XII and XI that with the XII is preferred.


[Electroencephalographic reflection of arterial spasm following surgery for saccular cerebral aneurysms]. The purpose of the investigation was to study the electrophysiological manifestations of arterial spasm developing following surgical interventions for cerebral arterial aneurysms. Repeated EEG-recording was undertaken for this purpose in 40 patients with aneurysms of different localization. The EEG data were compared with the results of a neurological examination and angiography performed pre- and postoperatively. It was found that with an uneventful postoperative course no focal changes develop in the bioelectrical activity, and EEG returns to the initial (preoperative) state or to the normal pattern as soon as by the 15th-20th day. In the presence of postoperative arterial spasm, verified clinically and angiographically, the latter is reflected in EEG tracings as peculiar focal changes in the biopotentials. These changes have a nature of a periodically occurring delta-activity recorded predominantly in the zone of ischaemia. Along with a regress of the spasm its EEG manifestations were found to decrease as well. The focal EEG changes observed in postoperative spasm differ from the localization of those EGG changes that are caused by other factors (haematoma, cicatrical processes, etc.).


[Treatment of aneurysms of the cerebral arteries using stereotaxically oriented external uniform magnetic fields]. The paper presents a theoretical substantiation of the magnet-haemodynamic method of induced thrombosis of arterial aneurysms. The method is based on an "induced" bioelectrical phenomenon that develops in the circulating blood after the vessel in question is placed in a constant magnetic field, the field lines of which are perpendicular to the blood flow direction. Animal and in vitro experiments with induced thrombosis of 100 experimental aneurysms are described. For extrapolating the experiments into clinical conditions a special magnetic device was created that is provided with appliances for external stereotaxis and angiographic control. Nine clinical observations with induced thrombosis of aneurysms were conducted, the follow-up reaching 2 years.


[Age and changes in the mechanical properties of the cerebral arteries (experimental findings)]. Experimental investigations into mechanical properties of cerebral arterial vessels of different localization and changes in these properties with age were effected. An analysis of the data obtained showed that the anatomic localization, the biochemical composition and age-specific changes affect the mechanical properties of the walls in these vessels. The available information is of importance in solving some tissues concerned with the pathogenesis of the cerebral circulation disorders and in vasal neurosurgery.


[Several parameters of the kinetics of cellular proliferation in human macroglial tumors]. The thymidine labelling index was studied by autoradiography in 95 human macroglial tumours. In 75 supratentorial tumours the values of the labelling index ranged from 0.05% to 20.10%, while in 20 cerebellar tumours it comprised 0.05% to 1.49%. Macroglial tumours of the large hemispheres could be subdivided with statistical significance into two discrete groups according to their labelling index: the group of slowly growing tumours with the labelling index below 2.5%, and the group of faster growing tumours with the labelling index above 2.5%. Gradual spontaneous malignization of the Group 1 tumours turning into Group 2 tumours is hardly probable. The duration of the DNA synthesis phase in 4 macroglial tumours of the large hemispheres in man varied from 5.7 to 7.5 hours.


[Experience with the use of intravascular interventions using a balloon catheter for several types of cerebral pathology]. Detachable balloon catheters were used during 38 intravascular procedures in 25 patients with vascular lesions and tumours of the brain. Permanent balloon occlusion of the cavernous part of the internal corotid artery or a reconstruction of this portion of the carotid artery, with its function preserved, was performed in patients with carotid-cavernous fistulas. In arterio-venous aneurysms one or two afferent vessels were occluded, while in cases of arterial aneurysm the latter was blocked itself. In cerebral neoplasms balloon catheters were used to precise the blood supply sources of the tumor, to occlude the vessels supplying meningiomas, and to perform intravital staining of the glial tumors. Positive results were obtained in 24 of the 25 patients. One patient died of middle cerebral artery thrombosis. The method of catheterization and occlusion of cerebral vessels with the aid of balloon catheters proved effective in the examination and treatment of patients with some vascular lesions and tumors of the brain.


[Improved hemagglutination and hemagglutination inhibition tests for arboviruses]. The capacity of formalinized goose erythrocytes to be agglutinated in interactions with arboviruses was studied. Formalinized goose erythrocytes were found to be as sensitive as native erythrocytes, and were used successfully for diagnosis of arbovirus infections and study of the immune structure of the human population and animals. The superiority of formalinized erythrocytes is determined by the duration of storage (2 years of the observation period) withoug any change in the capacity for agglutination.


[Development of a method for preparing adeno-associated virus type 4 antigen]. A method for preparation of adeno-associated type 4 virus (AAV-4) purified from group-specific adenovirus antigen by adsorption on formalinized sheep erythrocytes and elution into hypertonic NaCl solution was developed. In 1 M naCl solution the purified AAV-4 retained its infectivity and the complement-fixing and hemagglutinating activities. Separation of AAV-4 and adenovirus group-specific complement-fixing antigen was based on differences in conditions of their adsorption and elution. AAV-4 was inactivated by treatment with both formalin and hydrogen peroxide but retained its complement-fixing antigen and hemagglutinating properties. The purified antigen or virus is recommended for serologic tests and other purposes.


[Preparation of monospecific sera against oncornaviruses and oncornavirus-associated antigens of human cultured cells]. A method for preparation of monospecific sera against oncornaviruses and oncornavirus-associated antigens of continouus human cells has been developed on the basis of the results of comparative studies of the properties of viral and virus-associated antigens of the cell. Utilization of an adsorbent from cells free of virus antigen for adsorption of immune sera against oncornaviruses with polyspecific properties resulted in preparation of specific antiviral serum free of antibody to virus-associated antigen of the cell. Sera against virus-associated antigens of the cell containing no antibody to virus were prepared by adsorption with concentrated purified virus isolated from the cell culture.


[Cerebral complications of cervical angiography (frequency, clinical manifestations, preventive measures and treatment)]. The authors carried out angiographic examinations in 327 patients with tumours in the cervical region and 11 of these (3.36%) demonstrated complications, toxico-allergic ones in 10 and thromboembolism of the cerebral vessels--in one case. Toxico-allergic reactions and dynamic disturbances of the cerebral circulation developed more often in contrasting 2 or more brachycephalic vessels, with a two-fold introduction of the contrast medium into one and the same vascular basin and also in cases of a quick injection of a relatively large amount of the compound into the vertebral artery. Thromboembolism of the cerebral vessels was, apparently, caused by a small clot of blood which occluded an atherosclerotically altered internal carotid artery at the site of its bifurcation. Clinical manifestations of the said complications and a number of preventive and curative measures in case of cerebral complications arising during cervical angiography are considered in detail.


[Sedimentation properties of virion RNA of Newcastle disease virus after annealing under different conditions]. After annealing at high temperatures 50S RNA of Newcastle disease virus was partially degraded. The resulting fragments had the sedimentation coefficient of 23--32S. Solution of dimethylsulfoxide and formamide were used to decrease the temperature of annealing. However, annealing with denaturating agents caused agglomeration of 50S RNA molecules. This phenomenon is discussed.


[Analysis of the long-term results of contact of human cell cultures with influenza virus]. Influenza A/Hong Kong/1/68 and A/Victoria/35/72 viruses may produce in primarily trypsinized human embryo kidney (HEK) cell culture a chronic form of persistence accompanied by periodic emergence of cytopathic changes arrested by additional medium change. This persistence causes morphological changes in HEK culture manifested in the substitution of epithelial elements by fibroblasts and prolongs the "life" of culture by over 100 days as compared to the controls. The chronic form of persistence of these viruses in human embryo lung diploid cell culture (HELDC) was accompanied by a cytoproliferogenic effect but did not lead to histomorphological changes and did not exert "oncogenic-lide" changes in cell membranes. Inapparent infection with A/Hong Kong/1/68 virus in HELDC did not cause any histomorphological and cytokaryological abnormalities and was accompanied by complete elimination of the virus from the culture. No oncornavirus contamination was found in HELDC cluture either in intact state or after inoculation with influenza virus.


[Serological study of the specificity of leukocyte hepatitis virus]. For investigation of the specificity of leukocyte hepatitis virus (LHV) in Botkin's disease, 369 patients with virus hepatitis, 96 donors and 61 patients with acute respiratory diseases were examined. The occurrence of specific antibody to LHV was determined by a micromodification of the conventional CFT. LHV was passaged in leukocyte culture stimulated with phytohemagglutinin. A control antigen was a leukocyte culture from the same donor not infected with LHV. An additional control was Epstein-Barr virus passaged in continuous leukocyte suspension cultures. The complement-fixing antibody to LHV was detected in sera from children and adults with virus hepatitis. The number of sera with antibody to LHV was significantly higher than that in the control groups. A rise of antibody titers in the course of the disease in the experimental groups in contrast to the controls attested to certain specificity of LHV in Botkin's disease. No antigenic relationship between LHV and HB antigen was found in serologic tests. The lack of differences in detection of the complement-fixing antibody to Epstein-Barr virus in the experimental and control groups suggests no role of this virus in the etiopathogenesis of Botkin's virus hepatitis.


[Properties of an infectious agent isolated from the blood of patients with type B hepatitis and donor-antigencarriers]. An infectious agent different from HB-Ag was detected in sera from patients with hepatitis B and donors-carriers of HB-Ag. This agent can be passaged for a long time in the human tissue-chick embryo system and has a density of 1.38--1.40 g/ml in cesium chloride gradient.


Barbiturate intoxication. Morbidity and mortality. The complications encountered in caring for 185 patients intoxicated with barbiturates were reviewed. The population consisted of 142 patients with long-acting barbiturate concentrations of 8 mg per 100 ml or greater, 20 patients with short-acting barbiturate concentrations of 3 mg per 100 ml or greater and 23 consecutive patients with short-acting barbiturate intoxication referred for monitoring. Pneumonia was the major cause of morbidity and mortality and correlated best with the initial depth of coma and the use of an endotracheal tube in treatment. Cardiovascular instability manifested by pulmonary edema was the next leading cause of morbidity and mortality and correlated best with the initial depth of coma and the quantity of intravenous fluid administered. In retrospect, use of eliminative measures such as dialysis would probably not have altered the outcome in most of the patients who died and attempts at forced diuresis may have contributed to several deaths. Particular emphasis should be placed on the problems of sepsis and fluid therapy in the management of these patients.


An evaluation of bilateral breast carcinoma. Simultaneous and sequential lesions. The detection of bilateral breast carcinoma, simultaneous or nonsimultaneous, appears to be increasing. Undoubtedly a major factor in this is the increased use of mammography and xeromammography. In a 21-year period at Saint John's Hospital and Health Center, 1,189 cases of primary breast carcinoma were treated, of which 34 (2.9 percent) were bilateral. However, from 1972 to 1974 the incidence has risen from 1.9 to 10.8 percent, with a simultaneous rise in numbers of xeromammograms made. Xeromammography should be done routinely in patients in whom carcinoma of the breast is suspected. Its use should also be an integral part of the follow-up in patients in whom mastectomy has been carried out previously.


[Activity of DNA-dependent RNA polymerases A and B in spleen nuclei of mice infected with Rauscher leukemia virus]. The activity of DNA-dependent RNA polymerase A and B in isolated nuclei of spleens of mice infected with Rauscher leukemia virus was studied. A 3-fold increase in the activity of both RNA-polymerases in leukemic spleens was established. Study of the properties of RNA-polymerase B from nuclei of spleens of mice infected with Rauscher virus in comparison with the enzyme from normal tissue revealed the existence of some specific features in the enzyme from leukemic cells. The nature of the increased activity of RNA-polymerase B in leukemic cells is discussed.


Microsurgical treatment of hermifacial spasm. Five cases of idiopathic hemifacial spasm have been successfully treated by operative manipulation of arterial branches compressing the VIIth nerve in the posterior fossa. Terminology, clinical presentation, pathology and therapeutic approaches to hemifacial spasm are discussed. Hearing loss due to operatively induced vascular impairment of the inner ear, a complication in our first case, should be avoidable. Our experience indicates that hemifacial spasm reflects mild chronic compression of the facial nerve. The proposed mechanism is transaxonal excitation between afferent and efferent fibers.


[Role of phagocytes and antibodies in freeing the body from influenza virus]. Persistence of influenza virus in normal and immune mice was studied by determinations of the virus infectivity and by the immunofluorescence procedures. After intraperitoneal inoculation the virus could be found in macrophages of the peritoneal exudate in both normal and immune animals. However, in macrophages of normal mice synthesis of V- and S-antigens of influenza virus occurred indicating the possibility of virus reproduction in them, whereas in macrophages of immune animals there was practically no synthesis of S-antigen despite a greater number of cells with V-antigen of influenza virus in their cytoplasma. The assumption that elimination of influenza virus from the body is due to specific antibody and immunologically changed macrophage elements is substantiated.


[Diabetes mellitus: puberty and angiopathy (author's transl)]. It is inferred from a study of 140 cases of diabetes mellitus commencing between the ages of 10 and 17 that puberty causes the premative and accelorated appearance of angiopathy. The characteristic course of the angiopathy is not affected by puberty and does not necessarily persue an absolutely malignant form. It is genetically pre-determined and undergoes only insignificant enviornmental modifications subsequently.


[Insulin and adipose tissue (author's transl)]. The effect of insulin and glucose on lipolysis, on the re-esterification rate of free fatty acids and on glucose oxidation was investigated in isolated fat cells of the greater omentum. Insulin alone inhibited increased lipolysis only, but had no effect on normal basal lipolysis. The insulin effect on lipolysis was not altered by glucose. The re-esterification rate of free fatty acids was stimulated by glucose in a dose-dependent way. Insulin had no effect on the re-esterification rate of free fatty acids in the presence or absence of glucose. Basal glucose oxidation was slightly, but significantly increased by insulin. It is concluded that the prinicipal action of insulin in human adipose tissue is the inhibition of increased lipolysis, whereas glucose metabolism remains largely unaffected by insulin.


[The effect of Glipizide on the blood glucose and insulin in non-ketotic diabetes mellitus (author's transl)]. 9 patients suffering from non-ketotic diabetes were treated for 7 days with glipizide, a sulphonylurea derivative. A decrease in blood glucose level was observed in 6 patients during the course of the day, accompanied by an increase in immunoreactive insulin during the first half of the day and an increase in the insulinogenic index. In one patient with insulinopenic diabetes glipizide had only a very small effect on the blood glucose and insulin concentration. 2 patients suffering from insulin resistance caused by type IV hyperlipoproteinanemia and obesity showed an increase in insulin, but no decrease in blood glucose concentration. These results are a further indication that sulphonylurea agents should be administered only in the case of certain specific types of diabetes, because no therapeutic response can be expected in diabetes caused by insulinopenia and insulin resistance.


[Is there a feed-back mechanism between serum gastrin concentration and gastrin release (author's transl)]. The dialysability of gastrin heptadecapeptide was investigated in a model arrangement. The amounts of gastrin passing through the dialysis membrane during a 6-hour dialysis procedure are very small. Furthermore, the serum gastrin concentrations were measured during a 6-hour haemodialysis session with and without simultaneous pentagastrin infusion (0.003 mug/kg/h) in 8 patients on intermittent haemodialysis. There is a continuous decrease in the serum gastrin concentration during the 6-hour dialysis period with simultaneous pentagastrin infusion, while in the investigation without pentagastrin infusion phases of increase in serum gastrin levels are observed. In view of this different response of the serum gastrin curve it is suggested that a direct feed-back mechanism exists between the serum gastrin concentration and gastrin release, a mechanism which was interrupted by the pentagastrin infusion in the present investigation.


[The effect of oxyphenbutazone and flufenamic acid in vitro on the purine salvage pathway of human lymphocytes (author's transl)]. The effect of oxyphenbutazone and flufenamic acid was investigated on the enzymes of the purine salvage pathway of human lymphocytes in vitro. A distinct decrease in adenine-phosphoribosyltransferase activity and in guanine-hypoxanthine-phosphoribosyltransferase activity was observed following the administration of either pharmacological preparation. The loss of enzyme activity was 23 to 39%. The pharmaceuticals were used at a concentration of 50 mug%.


[Clinical results with dopamine in acute renal failure (author's transl)]. Dopamine possesses specific pharmacological actions which distinguish it from the other catecholamines. Apart from its positive inotropic effect, dopamine exerts a favourable influence on renal function with an increase in renal blood flow and alterations in intrarenal haemodynamics. The use of dopamine in the early stages of acute oliguric failure is recommended on the basis of the good therapeutic response achieved in a series of cases.


[Transfemoral coronary angiography. I. Report on the decreasing complication rate in the increasing number of cases]. 4950 coronary arteriographies performed by the percutaneous transfemoral technique (Judkins) are reviewed with respect to mortality, morbidity of myocardial infarctions and cerebral emboli, incidence of femoral thrombectomies and incidence of threatening events like arrhythmias and contrast reactions. With increasing number of coronary arteriographies that were performed yearly the incidence of all complications could be reduced by more than 90%.


[Transfemoral coronary angiography. II. Technical aspects of risk lowering]. Based on an experience of 4950 coronary arteriographies and a review of the literature common complications of transfemoral coronary arteriography are named, their mechanisms are analyzed and technical modifications of the procedure are suggested that we found useful to decrease the risk associated with this diagnostic test. Since throboembolic complications are a central problem of the transfemoral technique, various mechanisms producing myocardial and cerebral emboli are carefully analyzed. The significance of routine systemic heparinization has been emphasized repeatedly, but the contribution to safety of mechanical catheter tip debridement that can be reliably achieved by a meticulous ritual of appropriate steps is not universally recognized. These steps include a careful guidewire technique, insisting on spontaneous free back-dripping of blood from newly introduced catheters after removal of the guidewire, aspiration of blood with a syringe and flushing with saline and contrast. Careful observation of the blood pressure contour is mandatory whenever the catheter is advanced. In view of the time-thrombogenicity relation of catheter material, the procedure has to be performed expeditiously. After apparent solution of the problem of thromboembolic accidents, the only major complications occurred in patients with severe left main coronary artery lesions. Whenever disease of the left main coronary artery can be anticipated by a suggestive history, by highly abnormal ECG changes with exercise or by calcifications of the coronary arteries, the number of contrast injections should be reduced to a minimum necessary to adequately demonstrate the severity of the stenosis and the anatomy of the peripheral vessels for possible bypass surgery.


[Heart function in patients with and without wall dyskinesia. Echocardiographic-cineangiographic comparative study]. The mean velocity of circumferential fibre shortening determined by echo and angiography is a good parameter for the assessment of the basal left ventricular contractility. It remains relatively constant in acute and chronic changes in preload i.e. compensated volume overload, though the inverse relation to afterload is still maintained. For the calculation of mean VCF we assumed the heart to be a rotational ellipsoid. Models and extrapolation of curve are not necessary for the calculation of this parameter. On the basis of these considerations we investigated with the echographic and angiographic technique 5 patient groups having normal cardiac function (group I, IV) and abnormal function (group II, III and V).


[Arrhythmia analysis--arrhythmia control (comparative studies of 4 small computers for automatic electrocardiography control)]. Four arrhythmia computers presently available on the market were tested with respect to their efficiency in identifying abnormal QRS-complexes. A considerable variation for the calculated sensitivity and specificity has been found with a highest value for sensitivity (92.9%) combined with a low specificity (72.4%), and a highest value for specificity (100%) combined with a very low sensitivity (36.6%). The best results were obtained by a computer with a sensitivity of 90.9% and a specificity of 98.5%. For the routine use of these computers in the CCU common artifacts (e.g. muscle potentials) must influence their performance in a practical way: neither should minor artifacts stop the function completely nor should the computer continue to measure with a high level of "noise". Based upon the results of these test series suggestions for the concept of arrhythmia computers for CCU are presented.


[Cardiofacial syndrome].

[Cardiofacial syndrome]. A case of cardiofacial syndrome is reported, consisting in congenital heart disease combined with unilateral lower facial paresis. The whole cases of the literature and the pathogenetic mechanisms are discussed.


[Transumbilical heart diagnosis and ballon atrioseptostomy]. The way of catheter insertion through the umbilical vein is presented. We attempted the transumbilical heart catheterization in 63 patients, in 14 we failed to make an exact diagnosis. Furthermore, in 17 out of 26 patients we could perform the balloon atrial septostomy transumbilically. The possible complications are discussed and this access is recommended as an elegant and time-saving method.


[Postoperative endocardial fibrosis following mitral valve prosthesis]. Uncommon observation of endocardial fibroelastosis of the left auricle and ventricle found at autopsy. The 46-year-old female patient had her mitral valve replaced 15 months ago because of mitral stenosis (and slight incompetence). The left auricle with certainty did not show endocardial fibrosis at the time of operation. The therefore acquired postoperative fibroelastosis of the left auricle is probably caused mechanically resp. by hypoxia since postoperatively valvular incompetence and restenosis with severe thrombosis of the artificial valve developed. There are no reasons to assume an inflammatory etiology. It must remain open if the fibroelastosis of the left ventricle was congenital. Its possible etiology - if it was also acquired - is discussed.


[Familial preductal aortic coarctation. Report on a sibling observation]. The cases of two siblings, who died of preductal coarctation of the aorta, are reported. The rare familiar congenital cardiopathies are of special importance for the etiological questions and for judgement of the prognosis of inheritance.


[Left ventricular function in mitral valve stenosis]. In 12 patients with mitral stenosis left ventricular performance was assessed by pharmacologically (Methoxamine) induced increased afterload. At rest ventricular enddiastolic pressure (6.2 +/- 3.1 mm Hg), left ventricular enddiastolic volume (68 +/- 20 ml/m2), endsystolic volume (26 +/- 11 ml/m2) and left ventricular ejection fraction (0.63 +/- 0.06) were normal in each subject. Methoxamine induced a mean increment  in peak systolic atrial pressure of 65 mm Hg. Left ventricular stroke volume, stroke work, stroke power, enddiastolic pressure and volume increased with Methoxamine in each patient. The mean left ventricular ejection fraction remained unchanged for the group and remained within the normal range for all patients. No difference was observed between the response of the mitral stenosis group and a control group of 10 normal subjects with the exception of the account of mitral regurgitation during the pressure load in 9 mitral stenosis patients. This study indicates the left ventricle in mitral stenosis is capable of a normal response to a pressure load. No evidence of impaired left ventricular function was detected in this group of patients.


[Influence of propafenon on hemodynamics of the left ventricle and atrioventricular conduction with special reference to the WPW syndrome]. 15 patients were injected 2 mg/kg Propafenon intravenously in 3 minutes. In 10 patients the changes of the atrio-ventricular conduction and the sinus-node recovery time were measured. In 5 out of these 10 patients the influence on the left ventricular systolic pressure, the left ventricular enddiastolic pressure and the dp/dtmax was also measured. 4 patients had a WPW-syndrom and one patient an AV nodal tachycardia. There was a significant increase of the PQ-time (16,7%), the AH interval (9%), HV interval (33%) and the width of the QRS complex (13.8%). The intratrial conduction (PA-time), the heart rate and the sinus-node recovery time were not influenced. In 6 out of 7 patients the effective refractory period of the AV node was prolonged and in one it remained unchanged. There was a statistically significant decrease of the dp/dt, the heart rate staying the same. The systolic pressure decreased slightly and the enddiastolic pressure increased insignificantly. In 3 out of 4 patients with WPW syndrome the accessory pathway was blocked and in the 4th the effective refractory period of the pathway prolonged. In 3 out of these 4 patients a tachycardia could be initiated by the extra-stimulus method which was not possible after administration of the drug.


[Regional myocardial perfusion on distribution through coronary drugs. I. Method of myocardial double radionuclide scintigraphy]. A methodical introduction of the measurement of regional myocardial microperfusion is given. Based on the results of selective coronary perfusion scintigraphy in this technique two isotopes are injected into the same coronary artery with a characteristic time interval between the two injections. The influence of the coronary active drug on regional myocardial microperfusion can be measured, when the second isotope is injected after a time interval corresponding to the maximum drug effect. The second isotope then marks the actual regional microperfusion under the influence of the drug. The two isotopes can be discriminated by their characteristic energy spectra and then quantitatively be compared. The scans are taken in different positions and then compared with the corresponding coronarograms and left ventriculograms.


[Regional myocardial perfusion redistribution through coronary drugs. II. Influence of dipyridamole and oxyfedrin on regional perfusion distribution]. The influence of Dipyridamol and Oxyfedrin on regional myocardial precapillary microperfusion patterns was investigated in groups of 15 and 13 patients by means of selective double lable perfusion scintigraphy. Automatic impulse rate integration allows the comparison of different perfusion areas in the same scintigram as well as the comparison of different identical regions in different scintigrams. The scans were taken in two positions (frontal and l.a.o.). Microperfusion patterns were measured before and after the intravenous application of the drug. We found a typical shift of the microperfusion patterns with both medicaments. Under the influence of Oxyfedrin and Dipyridamol there was an increase of the relative microperfusion intensity in the vicinity of the major arteries but there were great differences as to the degree of their reaction maximum. Besides the results of the groups some typical cases are demonstrated. The method allows a satisfactory measurement of differences in the regional precapillary myocardial perfusion under the influence of coronary active drugs. We believe that statements on physiologic and pathologic functions are possible.


[Alternating and intermittent bilateral bundle-branch block in acute myocardial infarct with development of total atrioventricular block]. The development of bilateral bundle branch block of various degree in the course of an acute myocardial infarction was demonstrated in a 74-year-old man during continuous ecg-monitoring. Initially there was a tachycardia- and bradycardia-dependent left bundle branch block, followed by a right bundle branch block with second degree type II AV block (Mobitz), and finally complete bilateral bundle branch block with asystole. Different combinations of incomplete block were shown and the presence of type I and type II second degree block within the bundle branches could be demonstrated; Wenckebach periods became indirectly visualized through changes in the AV conduction. This case illustrates the prognostic importance of progressive intraventricular conduction disturbance and reveals the multiplicity and possible mechanisms of conduction defects within the bundle branches.


[The - wave of apexcardiography in total AV block]. The apex cardiogram (acg) in three patients with total heart block showed also during closure of the a.v. valves a-waves, which modified the shape of the systolic wave of the acg. This means that in these cases the a-wave is not caused by impingement of the blood inflow from the atrium on the ventricular wall by contraction of the atrium itself.


[Serum potassium and urine potassium concentrations following single and repeated potassium load]. Levels of potassium concentration have been determined after single and repeated oral application of potassium. The maximum level of serumpotassium concentration was found about 2 hours after intake of 120 mval potassium. The concentration of potassium did not return to basic values within 24 hours. The concentration of potassium in urine increased during the first 4 hours. 6 to 12 hours later the maximum  level is achieved. This leads to the conclusion that enterally applicated potassium is shifted into the intracellular space and is later released into the extracellular space. Repeated application of potassium in diminished dosages leads to reduced increased of serum and urin potassium concentration. The increase in concentration remains relatively constant during the whole period of application. For longterm therapy with oral potassium an application of a minimum dosage of 40 mval potassium in an 8 to 12 hours rhythm is reasonable.


[Ergometric determination of cardiac output in 1500 Swiss children and adults of both sexes, aged 5 to 65 years. Relation to body constitution, sex, age and work capacity in the step test (Part 2)]. The stroke volume of the heart during exercise in upright position (steptest) was determined in 1500 Swiss children and adults of either sex, aged 5 to 65 years. The use of the simplified ergometric method (Strehler) allowed to carry out these determinations mainly in series and without any difficulty. Average absolute values are presented for each year during childhood and adolescence and for each decade in the period of adult life. The stroke volume is lower in the female than in the male group; this refers to absolute values as well as to values relative to body size. The absolute values are approximately proportional to body weight, to the cube of body height and to a standard volume calculated from body height and body weight. There is a typical age-depending course of the relationship between stroke volume and body size (standard volume), the development of the stroke volume showing a minimum before and a maximum during puberty. Provided work load in per cent of the maximal working capacity is the same the stroke volume of the heart during exercise in upright position remains unchanged until the age of about 55 to 60 years. The practical scope of the investigation was to collect data for the setting up of a new stroke volume standard.


Excystation of Isospora arctopitheci Rodhain, 1933 with notes on a similiar process in Isospora begemina (Stiles, 1891) Lühe, 1906. The in vitro excystation process of sporozoites of Isospora arctophitheci Rodhain, 1933 from the titi marmoset Saguinus geoffroyi and of Isospora bigemina (Stiles, 1891) Lühe, 1906 from the bobcat, Lynx rufus is presented. Sporocysts of both species lack a Stieda body and when exposed to a trypsin-sodium taurocholate (pH 7.4) excysting fluid the walls of both collapse in a similar fashion, along apparently predetermined lines. Similarities and differences on excystation between. I. arctopitheci, I. bigemina, and other Isospora, Eimeria, and Sarcocytis species are summarized. Such studies show that 2 distinct patterns of sporozoite excystation have been described to date, and both appear to be related to the structure of the sporocyst.


Cytochemical detection of carbohydrates in the Golgi complex of Leptomonas pessoai. Using the periodic acid-thiosemicarbazide-silver proteinate technique, a positive reaction was observed on the membranes of the Golgi complex of Leptomonas pessoai. A positive reaction was also observed in other cytoplasmic membranes located near the Golgi complex. Structures which could represent reserve polysaccharides were not observed in the cytoplasm of Leptomonas pessoai.


Comparative cytological studies of mitotic and male meiotic karyotype of Ascaridia dissimilis (Vigueras, 1931) and Ascaridia galli (Schrank, 1788). Gametogony and spermatogenesis of A. dissimilis and A. galli were studied. It was found that the chromosome number of A. dissimilis is 2n = 10 for female specimens and 2n = 9 for male ones. The chromosome number of A. galli is also 2n = 10 for female specimens and 2n = 9 for males ones. Comparison of the relative length of chromosomes in the chromosome set, expressed in percentages, shows nearly equal magnitudes for both species. Spermatogenesis processes were studied. It was found that they run a similar course in both species. In the following stages of gametogony and spermatogenesis differences between the two species are not discovered.


On the karyotype of a laboratory Trichinella strain from Bulgaria. The karyotype of male and female individuals of the species Trichinella nelsoni was studied. It was found that the number of chromosomes in females individuals is 2n = 6 and in males 2n = 5. Each pair of chromosomes differs from one another as to dimensions and location of the centromere. The univalent chromosome that was found in the chromosome set containing five chromosomes is the second largest submetacentric chromosome. It is suggested that this chromosome is the sex chromome of the studied Trichinellae.


Ultrastructural studies of the cysticercoid of moniezia expansa (Anoplocephalidae) with special reference to the development of the cyst. Cysticercoids of the sheep tapeworm Moniezia expansa have been grown in oribatid mites in the laboratory. Three species of mite became infected: Xenillus tegeocranus, Platynothrus peltifer and Euzetes globulus, the latter not previously recorded as a host of anoplocephalines. Cysticercoids aged 15 and 28 weeks were examined with the electron microscope. Four distinct types of cells were found in the 15-week cysticercoid. Subsequent cyst development involves a transformation from a cellular to a mainly fibrous structure. The fibres, arranged in three layers, resemble collagen fibres described elsewhere. The outer epidermis of the cyst is replaced by an amorphous, electron-dense outer coat whose nature is unknown. The inner part of the cyst becomes condensed to a myelin-like structure. The scolex develops features characteristic of the adult tapeworm.


Trace elements in Isoparorchis hypselobagri. The trace elements contents of the tissue of Isoparorchis hypselobagri were ascertained by quantitative analyses. The iron content was found to be particularly high in comparison of copper and zinc.


The effects of low temperature on Lymnaea truncatula. A group of 20 young and another of 20 adult Lymnaea truncatula were abundantly supplied with food and kept continuously under cold conditions (5 degrees C) in the laboratory for 3 months and the effects  of low temperature on their behavior, growth and reproduction were studied. The results indicate that at low temperature the activity of L. truncatula was markedly reduced but complete hibernation did not occur. The snails seem to be unaffected by the low temperature itself since none (both young and adult) died during the 3 months that they were kept at 5 degrees C. Reduced feeding, even in the presence of abundant food, during the cold conditions caused an almost total inhibiton of growth. Of even more significance was the suppression of reproduction which was connected with the metabolic rate of adult snails kept at low temperature. Young snails seem to profit by exposure to low temperature. On the return to normal laboratory temperature (16-22 degrees C) the young snails became very active, fed voraciously, grew rapidly, tended to live longer and produced more offspring than the controls. Low temperature, however, appears to have an adverse after-effect on the growth and reproduction of mature snails. Relatively, fewer eggs were deposited in this case. The results indicate that under natural field conditions in England, where temperature fluctuations during the usually mild winter months are common, the greater burden of increasing the population in overwintered snails must rest on the younger members of the community.


[Cytophotometric DNA measurements in mononuclear round cells of synovial fluid]. Cytophotometric investigations were performed on synovial fluid mononuclear round cells in patients with various joint diseases. In nearly all instances only round cells with a diploid DNA-content were found. No increased proliferation could be observed neither in patients with rheumatoid arthritis nor in patients with a high relative number of neutrophilic granulocytes in the synovial fluid.


[Isoelectric focusing studies of synovial fluid in rheumatoid arthritis]. Synovial fluids obtained at operation in several different diseases were studied by means of isoelectrical focussing. All the punctates of patients with rheumatoid arthritis showed bands which migrated towards the cathode and which were not found in synovial fluid from other diseases, except in 2 meniscus lesions. In the range of pH 6.81-7.30, typical synovial proteins were demonostrated.


[The course of adjuvant disease in rats of the strain AF/Han-EMD-SPF]. The development of articular and osseous lesions in AF/Han-EMD-SPF breed rats with adjuvant disease was studied by morphological methods. At the noninjected side arthritic lesions with eventual progressive joint destruction appeared about the tenth day after adjuvant injection. Nearly simultaneously an incipient tumorous osteomyelitis in the bones both of injected and non-injected side was observed. Since epitheloid granuloma were also seen in the periarticular tissue of some animals the authors believe that all lesions in adjuvant arthritis are caused by a widespread dissemination of the injected complete adjuvant.


[Abnormality in the behaviour of mice after an experimental encephalitis by yellow fever virus 17 D. Experiment model(author's transl)]. Viral encephalitides in infants are very often followed by serious mental manifestations. To be able experimentally to investigate this pathological phenomenon, we established the following model. Mice having recovered from an intracerebral infection with yellow fever virus 17 D (routine test for the potency of yellow fever vaccine) and giving the impression of normal and healthy animals were examined for their psychical behaviour. As unit of measurement we took the time for running through a labyrith (fig. 1). At the entrance of the labyrith in a box there was placed the population of animals of one cage (6 animals in maximum) and at the opposite side there was deposited the food. The animals going to be examined had been without food for 24 hours. The time was taken having passed from the moment of placing the animals up to the moment of their nibbing at the food. We examined 11 groups of mice having past routine tests for the potency of the yellow fever vaccine. One of them had been tested twice at an interval of 54 days (table 1). The 791 mice which had passed the encephalitic infection showed an average running time of 8.90 min. The 164 controls, however, had an average running time of 4.37 min (table 2). This difference is significant (p=greater than 1/1000). The average running time is proportional to the injected virus quantity (table 3). The significance of each single virus dilution to the group of normal animals is always greater than 1/1000. The significance is more than 1/100 for each single virus dilution between 10(-1) and 10(-3) compared with the virus dilution of 10(-5). Immediately after the clinical period (21 days), no difference could be observed between the single virus dilutions. After 76 days only, the test showed the above mentioned differences (table 4). Therefore, the mice having found their food after a long running time had more serious postencephalitic lesions than those having had a shorter running time. To prove this statement, we examined histologically brains of 14 mice which had found their food after 20 min on an average and those of 16 mice having had an average running time of 6.58 min. The histological evaluation was performed in regard to eight pathological characteristica. The results were recorded on tables for each slide with a histological preparation. For this we used squared paper (fig. 2, 3). For each brain of mice, the so-called "index of lesions" was calculated by the proportion of labelled and all squares. .....


[Newer antimycotics. II. Arylhydrazones of derivatives of mesoxalic acid (author's transl)]. The author produced a number of aryl-hydrazone-derivatives of the esters and amides of mesoxalic-acid-seminitril and of mesoxalic-acid-diethylester, investigated their fungistatic efficiency in vitro, and discussed the association of chemical structure with the fungistatic effect in the series of these compounds. From the author's results it can be concluded that some compounds from the series of the aryl-hydrazones of mesoxalic-acid-seminitril-esters exert a strong fungistatic effect on Trichophyton gyps. (Tabl. 1); namely those, whose ester-alkyl-group is relatively short and in that there are the substituents of benzolring Cl-atom, CH3- or NO2- groups. On the other hand the majority of the compounds of this series is totally ineffective (Tab. 2). Each aryl-hydrazones of the amides of mesoxalic-acid-seminitril ant that ones of the mesoxalic-acid-diethylester are ineffective on Trichophyton gyps. (Tab. 2, 4, 5). Not a compound of the investigated series exerts any fungistatic effect on fungi-strains other then Trichophyton gyps. Those aryl-hydrazones of the mesoxalic-acid-seminitrilesters, which proved to be most effective on Trichophyton gyps. are on the mouse only negligible toxic and they do not irritate the skin and mucous membranes of the experimental animals; their fungistatic effect is not influenced by cystein, cysteamin or thioglycolic-acid. On the basis of the intensive fungistatic efficiency and small toxicity of some aryl-hydrazones of the mesoxalic-acid-seminitril-esters, it seems that a number of representatives of these types of chemical compounds could be given a role in the chemotherapy of superficial human and animal dermatomycoses.


[Possible relationship between bacterial surface structures, immune-adherence, chemotaxis and phagocytosis (author's transl)]. In the present study we attempted to determine the relationship between bacterial surface structures, immune adherence, chemotaxis and phagocytosis. As shown in table 1 encapsulated bacteria (Klebsiella ozanae, K. pneumoniae, Pasteurella multocida, Streptococcus pneumoniae), Mycoplasma pneumoniae and M. fermentans had a much lower immune adherence-activity than non-encapsulated bacteria (Bacillus cereus, Brucella abortus, Erysipelothrix insidiosa, Escherichia coli, Listeria monocytogenes, Pseudomonas aeruginosa, Salmonella typhimurium, S. typhi). Consequently, the former bacteria, in the absece of specific antibodies, activated complement via the C-3-bypass to a smaller extent than the latter. In modified Boyden chambers the encapsulated bacteria and the mycoplasmas were much less cytotaxigenic than the non-encapsulated bacteria (table 3). Corresponding to this was the chemotactic response in vivo. Finally the rates of phagocytosis were considerably lower with the encapsulated bacteria than with the non-encapsulated ones (fig. 1).


[Field studies with a new tick-borne encephalitis (TBE) vaccine]. The vaccine used contained formalin-inactivated TBE virus that was grown in chick embryo cells and adsorbed to Alhydrogel. In a first study, conducted in 1973, a total of 81 volunteers were given subcutaneously two doses of vaccine 4 weeks apart, and a third dose 7-9 months later. After each vaccination, the rates of seroconversion were assayed in the hemagglutination inhibition test. The values obtained were 76%, 96% and 98%, respectively. The geometric mean titers found were 1:26, 1:36 and 1:44. The vaccine was well tolerated locally and systematic reactions such as fever headache and fatigue were only recorded after the first dose of vaccine. In 1974 and 1975 a total of 30,000 persons were vaccinated in areas where the disease is endemic. Most of the vaccinees work in forests and are, therefore, at high risk of infection. Circumstantial evidence indicates that the vaccine is protective.


[Clinical and histopathological findings in mycoplasmal polyarthritis of rats. III. Course of infection during the weeks 7-30 and 54-61 (author's transl)]. Clinical, microbiological and histological findings of the late phase of experimentally induced Mycoplasma-polyarthritis in rats are described. Investigations were carried out between the 7.-30. week and between the 54-61. week p.i. M. arthritidis could be reisolated from affected joints regularly up to the 7th week p.i. Thereafter until 12th week only occasional recovery was possible. The healing process of affected joints dominated signs of arthritis which could be confirmed histologically as a purulent process.  The alterations of carpal and tarsal joints were divided into purulent, chronic deforming and chronic minor lesions. The findings derived from investigation of joints and parenchymatous organs during the course of the disease are discussed.


[Distant metastases in carcinomas of the upper airways and digestive tract (author's transl)]. 144 patients with a carcinoma of the upper airways and digestive tract were examined at necropsy in the Institut Bordet, between January 1, 1960 and December 31, 1973. The study shows that 43% of these patients had distant metastases and that among these 2/3 were in local recurrence. Only 1/4 of the metastases had been recognized before death: most of them appearing in the first year following the diagnosis of the primary tumor. Survival of patients with metastases is short, most of them dying within 3 months after metastatic discovery. There seems to be no evident relationship between the initial degree of extension of the tumor and the risk of later metastatic dissemination. In the search for the most frequent metastases, located in the lungs, liver and skeleton, one should use pulmonary laminography and liver tests combined to scanning and laparoscopy.


[Colon occlusion due to safety belt (authors transl)]. The author describes a delayed occlusion of the colon, consecutive to an ischemic constriction, occurring after a car accident in a patient wearing his safety belt. The patient, 49 years old, had undergone urgent laparotomy just after the accident: intraabdominal hemorrhage from hepatic and mesocolic lacerations were discovered and treated. Six weeks after that operation the patient developed an occlusion of the transverse colon necessitating segmental resection and end-to-end anastomosis. Pathology disclosed typical signs of ischemia with constriction. This was considered due to the horizontal part of the safety belt. This should be placed low and tight enough so that the pelvis, rather than the abdominal viscera, receives the shock. After accidents with safety belts the possibility of such complications should be present at mind.


Iron deposits in chronic alcoholics. Special studies in relation to the iron contained in red wine. The iron deposits in 52 persons with marked chronic alcoholism, almost all from wine, have been studied. No relationship was found between the level of the deposits and the quantity of iron ingested by the alcoholic with the beverage. We point out the influence that alcohol may have on iron deposits. A critical examination was also made of the methods for determining organic reserves of iron.


Serum levels of C3 and cholinesterase in various diseases of the liver. The levels of C3, cholinesterase, albumin and prothrombin were determined in 46 patients (27 males and 19 females) - 26 with cirrhosis of the liver, 9 with acute hepatitis, 6 with chronic aggressive hepatitis, 1 with chronic persistent hepatitis and 4 with fatty liver. In all patients and, particularly in those with cirrhotic liver, it was shown that the normal or pathological level of serum C 3 is related both qualitatively and quantitatively to the normal or pathological levels of cholinesterase, albumin, and prothrombin. The percentage in which the levels of these four parameters were pathological was considerably higher in the cases with hepatic coma than in the cases without hepatic coma. The determination of the range of confidence for the 4 parameters showed that, in the patients with hepatic coma, cholinesterase reacted most sensitively to liver damage (0.5 - 0.94) followed by C3 and prothrombin (0.33 - 0.81). Also in the cases without hepatic coma, cholinesterase was the most sensitive indicator (0.05 - 0.29), followed by prothrombin (0.03 - 0.24), albumin and C3 (0.00-0.16).


Effects of fructose infusions in patients suffering from acute viral hepatitis. Two groups of patients suffering from uncomplicated viral hepatitis were treated for seven consecutive days with intravenous infusions of fructose and glucose, respectively (1 gram per kilogram body weight per diem). Serum transaminases were determined daily as were total bilirubin and uric acid levels. No statistically significant variations in the values of these tests were observed between the two groups of patients. Serum lactic and pyruvic acid concentrations were also determined both before and after infusion during the first three days of treatment. Blood lactic and pyruvic acid levels were found to rise significantly after fructose infusion, but not after glucose infusion. These changes, however, were limited and did not affect the lactate/pyruvate ratio.


Influence of d-galactosamine hydrochloride on lipids and their fatty acid composition in plasma and liver of guinea pigs. 48 hrs after i.v. applications of 1 g/kg b.w. galactosamine hydrochloride to guinea pigs the total lipids of plasma, liver homogenate and isolated liver microsomes were extracted and separated by dialysis and thin-layer chromatography. The fatty acid fractions of total lipids (plasma), neutral lipids and total phospholipids (liver homogenate) as well as phosphatidylcholines and remaining phospholipids (liver microsomes) were analyzed by gaschromatography. In plasma the concentration of total lipids was unchanged in the galactosamine group. A slight decrease of the C16- and an increase of the C161- fatty acids were observed. In total liver homogenate neutral lipids increased 9-fold, and phospholipids 2.5 fold after galactosamine application. Specially there was a relative and absolute increase of the C16-, C16(1)-, C18(1)-, and C18(3)-fatty acids in the neutral lipids, whereas the C18- and C18(2)-Fatty acids were relatively diminished. Similar changes within the fatty acid fractions could be found to a minor degree in the phospholipids. 48 hours after application of galactosamine the phospholipid content in isolated liver microsomes increased about 2-fold. Likewise there was an absolute increase of nearly all fatty acid fractions as well in phosphatidylcholines as in the other phospholipids. In both phospholipid fractions the percentage of the C18-fatty acids decreased and a relative increase in C16-fatty acids was observed. Contrary to the findings in total liver, in the isolated microsomes predominantly saturated fatty acids (C16, C18) were found.


Esophageal function in progressive systemic sclerosis. A prospective study was performed in 13 consecutive patients with systemic progressive sclerosis (PSS). For the diagnosis of impaired esophageal peristalsis cineradiography and manometry are equally useful. Esophageal suction biopsy allows the diagnosis of esophagitis but not of scleroderma. Mild to severe esophageal involvement was observed in 12 patients. In only one patient the esophagus was virtually normal. Dysfunction of the esophageal body may occur early in the course of the disease while incompetence of the lower esophageal sphincter is observed on an average after 7 to 8 years. Both impairment of peristalsis and pressure of the lower esophageal sphincter may lead to delayed esophageal clearance. Relaxation of LES is normal even in the absence of primary peristalsis. Extensive esophageal damage including severe gastroesophageal reflux may be present in the absence of esophageal symptoms.


The entity of non occlusive mesenteric ischemia: strophanthin effect on mesenteric blood flow in experimental animals. Digitalis glycosides have the well known positive inotropic effect on the heart. Their effect on extracardiac vascular smooth muscle receives increasing attention. In experimental animals a significant decrease in mesenteric blood flow and an increase in mesenteric vascular resistance could be shown. Angiography of main mesenteric arteries, smaller arteries, and arterioles reveal typical vasoconstriction. Angiomorphometric measurements show good correlation between the decrease in vascular diameter and the increase in vascular resistance.


Multiple dermal perifollicular fibromas with polyps of the colon -- report of a peculiar clinical syndrome. In the present study, a peculiar fibromatosis cutis in two siblings has been reported, the dermatosis being characterized by innumerable perifollicular fibromas on face, neck and trunk as well as multiple fibromata pendulantia. Since the father allegedly had skin lesions resembling those of his two affected children, an inherited condition is assumed for the disease which manifests itself rather late in age. In the female patient, several adenomatous colon polyps were found, one transformed into an incipient carcinoma. Since the clinical and dermatohistological features are anything but typical of Gardner's syndrome and, in particular, hamartomalike fibromas of the perifollicular hair sheath are not constituents of its well-known skin tumour complex, we have discussed in detail the possibility of a peculiar cutaneo-intestinal syndrome hitherto unknown.


Evidence for the involvement of vasoactive constitutents of mast cells in axon reflex vasodilatation in the skin of the rat. Axon reflex vasodilation following injury to the skin of the pinna of the ear was studied in rats by a thermometric method. Post-traumatic vaso-dilatation did not occur in animals treated with tyrosine ethyl ester, an inhibitor of chymotrypsin. Vasodilatation was not affected by treatment of the rats with chlorpheniramine (antihistamine) or cyproheptadine (antihistamine and anti-serotinin) or with aprotinin, soybean trypsin inhibitor, epsilon-aminocaproic acid or tosyl arginine methyl ester (inhibitors of trypsin and of some other proteinases). Taken in conjunction with the results of other investigations, these findings indicate that in the skin of the rat: (a) histamine and serotinin are not essential for the initiation of axon reflexes, and (b) the chymotrypsin-like proteinase of mast cell granules, released as the result of antidromic activity in sensory axons, may act as a kininogenase and be responsible for causing dilatation of arterioles at the efferent limb of the axon reflex.


Neuropathological considerations in cerebro-hepato-renal syndrome (Zellweger's syndrome). The nervous system in patients with cerebro-hepato-renal syndrome appeared to be affected at various tissue levels. There was evidence of a migrational disorder manifested by polymicrogyria and lack of normal neuronal maturation. There was dysmyelination of the white matter associated with accumulation of neutral fat in astrocytes. Within the peripheral nerves, masses of tangled neurofilaments producing dystrophic axons were demonstrated by electron microscopy. These findings could be explained on the basis of a genetic metabolic defect, one that involved particularly the amino acids. The defect may have interfered with the normal intercellular reaction during embryogenesis resulting in the malformation of multiple organs. The same metabolic abnormality could have caused the hepatic damage and disturbance in normal myelination during the neonatal period.


Extravasation, spread and cellular uptake of Evans blue-labelled albumin around a reproducible small stab-wound in the rat brain. A small stab wound was made in the frontal lobe of the rat brain in order to study both the acute damage and the restitution of the blood-brain barrier to macromolecules under well-defined experimental conditions. Intravenously administered Evans blue-labelled albumin (EBA) was used as a tracer and the brain sections were observed in a fluorescence microscope. EBA leaked into the neuropil only during the first 3 days after the trauma. The maximal leakage occurred during the first day after the injury. The tracer spread from the area surrounding the stab wound in a reproducible way, initially roughly centrifugally. Nerve and glial cells close to the wound displayed a diffuse fluorescence of their cell bodies 1 to 6 h after the injury, i.e. at times with maximal extravasation of the tracer. A more granular distribution of the tracer was seen in neurons and glial cells at both very short and long times after EBA injection. Thus, the blood-brain barrier lesion induced was reproducible and reversible as judged by the pattern of EBA leakage. Some cells immediately adjacent to the injury had a diffuse cytoplasmic distribution of the tracer complex, in contrast to cells more distant from the injury, having a more granular distribution of the tracer in their cytoplasm. However, the appearance of the fluorescence in neurons and glia was to a large extent dependent upon the time after the injury, at which the cells were exposed to the tracer complex and on the time that had elapsed from the time of injection of the tracer complex to the sacrifice of the animal. Thus, it seems likely that two factors contribute to the appearance of the neuronal EBA distribution: on one hand the location and possibly extent of cellular damage of the cell, and, on the other hand, the time and amount of EBA to which the cells were exposed.


Autoradiographic localisation of 3H-uridine in spinal ganglion neurones of the rat and the effects of methyl mercury poisoning. The uptake of 3H-uridine into rat spinal ganglion neurones has been followed by autoradiography for up to 48 h after its intravenous injection. Labelling of nucleoli and of nuclei reached a peak within 1 h and then declined. Nuclear labelling returned to background levels by 24 h, but nucleolar labelling was still significant after 48 h. Animals dosed with methyl mercury chloride (7.5 mg/kg daily) showed no change in labelling rate in nucleolus or nucleus after 1, 2, or 4 doses. After 8 doses there was severe reduction in labelling in both nucleolus and nucleus; this amount causes extensive loss of axons, loss of some cell bodies and a marked reduction in amino acid incorporation into proteins. On recovery after a further 8 days, labelling levels returned to normal. It is concluded that at the time when loss of ribosomes occurs from the cytoplasm methyl mercury is more likely to be directly disturbing ribosomal structure than RNA synthesis, for methyl mercury causes marked changes in ribosomal organisation after 4 doses, but disturbances to RNA synthesis do not occur until the 8th dose.


Murine influenza virus encephalomyelitis. III. Effect of defective interfering virus particles. Defective interfering influenza virus particles lessened the yield of infective virus recovered from brain after intracerebral challange of 3-week old mice, but failed to affect the appearance of disease or lethality. In 7-week old mice, the presence of defective interfering influenza virus particles reduced both lethality and virus yield. Viral inocula containing significant numbers of defective particles appeared to diminish later inflammatory changes, nerve cell degeneration and the appearance of viral antigen in deeper cerebral regions. The protective effect exerted by defective virus particles does not appear related to interferon production in brain.


The effects of measles virus and various strains of SSPE virus on organotypic cultures of nervous tissue. The neurotropic effects, virologic behaviors and morphologic appearances of 4 strains of subacute sclerosing panencephalitis (SSPE) virus have been examined in organotypic cultures of hamster cerebellar tissue and have been compared with the Edmonston strain of measles virus in the same system. While measles virus caused extensive damage to nervous tissue, the SSPE strains, in general, exerted a less deleterious effect. All of the SSPE viruses replicated in this tissue. The SSPE strains showed morphologic variation ranging from normal measles-type virions to apparently nucleocapsid deficient forms. It is speculated that some of these differences between measles and SSPE virus may account for the differences in the in vivo conditions with which they are associated.


Neuro-Behcet's disease showing severe atrophy of the cerebrum. A 38-year-old female died 6 years after the onset of what was, clinically and histopathologically, consistent with neuro-Behcet's disease. Pathologically the cerebrum showed severe atrophy. The main changes were observed in the grey and white matter, the diencephalon and the basal ganglia by light microscopy. All these changes originated in softenings around blood vessels, especially small vessels or capillaries. These foci fused together to form large regions of softening. Glial or mesenchymal reactions were minimal. In the white matter there was slight perivascular-infiltration, mainly consisting of lymphocytes. In view of these findings, it is suggested that these changes were caused by an allergic vasculitis. The present case of Neuro-Behcet's disease is the first one showing general atrophy of the cerebrum. It is very important in relation to demyelinating encephalitis.


Distribution of blood flow in myomatous uteri as measured by locally injected 133Xenon. Regional blood flow in the myometrium and myomata has been measured during laparotomy in 11 patients using locally injected 133Xenon. Blood flow was calculated from the wash-out curves using both initial slope technique and compartment analysis. Assuming equal partition coefficients in myometrium and myomata the following values in ml-min-1-100 g-1 are seen: initial slope technique-myometrium 15.6 +/- 2.29, myomata 5.1 +/- 0.95, compartment analysis-myometrium 20.01 +/- 3.21, myomata 5.5 +/- 1.16. The blood flow was always lower in myomata than in myometrium of the same uterus. The main reason for the reduction of blood flow per unit weight of uterus in patients with myomata previously reported thus seems to be low blood flow in the myomata. A slight reduction of blood flow in the surrounding myometrium, however, also seems probable.


The intravenous infusion of prostaglandin F2alpha in the management of intrauterine death of the fetus. Prostaglandin F2alpha (PGF2alpha) was given intravenously in the treatment of 16 cases of intrauterine death. Delivery was achieved without complications or side effects in 15 out of the 16 patients. A posterior cervical rupture occurred in one patient treated with cervical dilatation and PGF2alpha-infusion.


A new technique for the localization of the cervix at 113mIn placental scintigraphy. Sixty women in the third trimester of pregnancy were examined with 113mIn placental scintigraphy because of bleeding. In 24 of the cases, the scintigraphic procedure was initiated by application of a Meyers ring containing 113mIn round cervix. In the other cases, the fundus and the symphysis pubis were marked by means of a small radioactive source. Complete placenta praevia was correctly detected in 8 cases and marginal placenta in 4 cases. The scintigraphic localization of the placenta was correct in all the women where the ring was used, whereas when the external marked was used, seven errors occurred. The authors therefore recommend this new technique in order to facilitate the evaluation of the scintigrams.


Influence of aging upon the urinary hormone excretion in the male. The urinary excretion of LH, low polar oestrogens, neutral C19 and C21 steroids was measured in normal healthy males aged 20-79 years. No significant changes could be noted for the excretion of LH, pregnanediol and 17-ketogenic steroids between 50 and 79 years. The excretion of androsterone and aeticholanolone was significantly lower in the oldest group (70-79 years). A significant drop in the excretion of DHA was noted at approx. 60 years. The excretion of low polar oestrogens remained constant from 20 to 55-59 years, but showed a highly significant (P less than 0.001) decrease at about 60 years. This drop might reflect a sudden decrease in the plasma levels of oestrone sulphate due to a decreased sulphurylating activity in the liver.


Lumbar epidural analgesia in labour. A clinical analysis. Lumbar epidural block was given for pain relief to 296 women in labour. Bupivacaine was used as the analgesic agent and the technique is described in detail. Satisfactory analgesia was obtained in 92% of the cases during the first stage of labour and in 84% during the second stage of labour. The frequency of instrumental deliveries and of occipitio-posterior position increased but the clinical condition of the newborn seemed to be unaffected.


Fetal movements diagnosed by ultrasound in early pregnancy. The purpose of this work was to ascertain whether ultrasonic techniques based on fetal movements were suitable for examinations in early pregnancy. The series consisted of 124 patients who came to be examined because of bleeding on the 6th-20th gestational week. The rapid B-scan method detected the fetal movements from the 8th week onwards, and the results were 100% reliable from the 10th week onwards. The combined A-B-scan method detected the fetal movements from the 12th week. Techniques based on the detection of fetal heart function were used as control methods. According to our results, the methods based on the indication of fetal movements constitute a practical alternative for elucidating the problems of early pregnancy.


Changes in the cervical blood flow during labour. The cervical blood flow changes during labour in pregnant women (15 cases) have been studied by local injection of 133Xe into the cervix. The blood flow changes were compared with the external uterine pressure which was measured with a tocograph. During contractions the radioactivity decreased temporarily, but increased again between contractions. The overall decrease was greater in the control group (4 cases) than during spontaneous contractions. The conclusion is, that relative cervical blood circulation is rapidly changed during labour.


Unchanged total body calcium in normal human pregnancy. The total body calcium--estimated from bone mineral content in the distal part of the forearm measured by use of photon absorptiometry--was determined during pregnancy in 13 women. The results indicate that total body calcium is constant during pregnancy.


Vaginal repair in the radical operation for cervical carcinoma. An attempt was made to preserve postoperative sexual function and the recovery of bladder function by a simple modification of technique in 22 cases of radical operations for invasive carcinoma of the cervix. The procedures consisted of two parts. After removal of the specimen, the bladder peritoneal flap is sutured to the anterior vaginal wall leaving a 2 to 3 cm margin between the line of suture and the edge of the peritoneum. Similarly, the posterior peritoneal flap is sutured to posterior vaginal wall leaving a margin. Both edges of the peritoneum are then closed forming a pouch as an extension of vaginal canal. The length of the vagina was successfully elongated by this procedure, thus adding to better postoperative sexual function.


The effect of a copper IUD and various "inert" Iuds on the histological picture of the rabbit endometrium during early pseudopregnancy and pregnancy. The influence of a copper IUD and two "inert" IUDs on the histological picture of the rabbit endometrium during early pseudopregnancy and early pregnancy was studied. The copper IUD markedly inhibited the endometrial maturation during the first five days of both pseudopregnancy and pregnancy. The "inert" IUDs had no such effect. The copper IUD prevented the normal response of the rabbit uterus to 17-beta-estradiol in castrated animals. The observed effects of the copper IUD might seriously interfere with the normal process of implantation.


Plasma renin activity in abortion.

Plasma renin activity in abortion. Healthy women (N = 96) were investigated for changes in plasma renin activity (PRA) in abortion. In spontaneous abortion PRA levels were significantly lower than in induced abortion although higher than in healthy women. These findings may be explained by differences in corpus luteum function and renin production of the feto-placental unit. Alternatively, prostaglandins, released by the contracting uterus in spontaneous abortion may cause PRA suppression, as observed in 9 pregnant women with abortion induced by the intra-amniotic use of prostaglandin F2alpha.


Congenital annular constrictions due to amniotic bands. Amniotic bands which become involved with fetal parts, especially the extremities, are produced by rupture of the amnion during pregnancy with the consequent union of the extra-embryonic mesoderm in fibrous strings. An infant with the amniotic band syndrome, in whom an annular constriction of the left leg and right hand was found, is described. He was treated successfully by multiple Z-plasties and a plaster cast to correct the clubfoot. The oedema of the leg persisted for 5 weeks and then subsided completely. The role of amniotic abnormalities in the production of congenital malformations is reappraised. The microscopic and histological investigation of the placenta and membranes should accompany every case of fetal malformation in abortuses, stillbirths, and affected newborn.


Vaginal surgical intervention for a sacro-coccygeal teratoma obstructing labor. Congenital sacro-coccygeal teratomas are rare tumors and may cause dystocia. The case presented was managed unusually by incisional drainage of the tumor through the vagina in a course of an obstructed labor, though the vaginal delivery resulted in the birth of a live, healthy infant.


Haemophilia prophylaxis in Sweden.

Haemophilia prophylaxis in Sweden. 29 boys (4-18 years old) with severe haemophilia A were given prophylactic infusions of AHF concentrate (human fraction I-0) for 2 to 13 years in an attempt to change the haemophilia from a severe to a moderate form and thereby prevent arthropathy and severe bleeding episodes. The sizes of the doses and the intervals at which the doses were given were titrated by AHF survival studies. As a rule, the patients received AHF in amounts sufficient to raise the AHF level to 30-45% at 5-12 day intervals. In about 50% of the infusions the AHF content was not below 1% before the next infusion. During such prophylaxis all patients except one have been in a good general condition. They have had bleeding episodes, which have, however, been much less severe and less frequent. The children have been able to live an almost normal life. The number and duration of stays in hospital have been markedly reduced. 17 of the patients had only minor or no joint defects before the start of the treatment. In this group the joint function was identical with that found in moderate haemophilia in the same age groups. Two patients developed anticoagulants. No other side effects were seen. The prophylactic regimen in Sweden thus reduced severe haemophilia to moderate.


Influence of fat and carbohydrate content of diet on food intake and growth of male infants. Two groups of normal fullterm infants were studied from 8 to 112 days of age while receiving formulas of the same caloric density and prepared from the same ingredients. A limited selection of strained foods were permitted. From the combination of formula and strained foods, one group received 29% of calories from fat and 62% from carbohydrate whereas the other received 57% from fat and 34% from carbohydrate. Fifteen infants in each group completed the study as planned. Energy intakes per kilogram and rates of gain in length and weight were similar in the two feeding groups.


Serum isoamylases in cystic fibrosis.

Serum isoamylases in cystic fibrosis. Salivary and pancreatic isoamylases were determined in the sera of 33 patients with cystic fibrosis (CF) and in 34 CF-parents. Pancreatic serum isoamylase activities were greatly decreased in patients with CF, and only two values from this group fell within the normal range. Salvary isoamylases, however, were markedly increased so that the total serum amylase activities were normal. We interpret the low pancreatic isoamylase levels in serum to reflect reduced exocrine masses in the pancreas of CF-children. In heterozygotes, the mean activity of the pancreatic isoamylase was significantly higher than in the reference group, while salivary isoamylases were within the normal range. Due to a genetic polymorphism pancreatic isoamylase may occur in two main fractions. This variant type of pancreatic isoamylase appeared more frequently in CF-heterozygotes than was expected from a reference group of blood donors.


The Vater association: malformations of the male external genitalia. Eight cases with the VATER association of malformations are presented. Maliformations of the external genitalia were found in 3 out of 7 male patients. Two of them presented with a bifid scrotum and a caudally displaced, dysplastic penis. Two patients had been exposed to progestin in early pregnancy and one of them had hyposadias and testicular atrophy. It is suggested that malformations of the male external genitalia might be part of malformations found in the VATER association.


Congenitally corrected transposition of the great arteries. A clinical study of 101 cases. The anatomy, natural history, clinical features and symptomatology of 101 cases of congenitally corrected transposition of the great arteries (C-TGA) diagnosed over a 20-year period at Hospital for Sick Children, Toronto, Ontario, is reported. Only 1 patient had no association lesion and only 14 an intact ventricular septum. Pulmonary stenosis was present in a little more than half of the patients. Left A-V value involvement existed in 21 patients. In spite of the hich incidence of associated lesions with prognosis was better than expected. Seventy-six patients were alive at the end of the study, no one being critically ill. No death occurred among the patients with intact ventricular septum. Patients with pulmonary stenosis as a group developed symptoms later, were less handicapped and had a better prognosis than those without a pulmonary stenosis. One third of the patients had dysrhythmias. Eight patients having a 3rd degree AV-block. Auscultatory findings were not of too great a help when diagnosing C-TGA. Forty-seven patients had a single second sound, of these 37 had pulmonary stenosis. In 60% of the patients, where information was available, the second sound was reported to be of normal intensity. Our surgical experience is documented and discussed. Palliative procedures were done with successful results and low mortality. Totally corrective procedures were performed in 9 patients with 4 deaths.


Measles vaccination. VIII. The occurrence of antibodies against virus envelope components after immunization with inactivated vaccine. Effects of revaccination with live measles vaccine. Children immunized with 4 doses of formalin-inactivated vaccine and/or purified hemagglutinin prepared from Tween 80-ether (TE) treated material were subjected to a follow-up 8-9 years after the last dose of vaccine. 11 out of 27 children had clinical and/or serological signs of infections with wild measles virus during the 8 to 9 years post-booster period. 10 out of the 11 children with infections had non-hemagglutinating-inhibiting (HI) hemolysis-inhibiting (HLI) antibodies demonstrable in their sera after removal of HI antibodies by absorption with TE antigen. In contrast 13 out of 16 vaccinees without detectable signs of infection lacked non-HI HLI antibodies. 10 out of these 13 children were vaccinated with further attenuated live measles virus. There were no clinical reactions to faccination. 4 vaccinees with low pre-vaccination HI antibody titers showed significant rises of antibody titers including non-HI HLI antibodies. In the remaining children no take of the live vaccine could be demonstrated. Thus HI antibodies of a certain minimal concentration can block the replication of vaccine virus even in the absence of non-HI HLI antibodies. However, since it will be difficult to establish these conditions by sue of available inactivated vaccines it is recommended that future vaccine products should include both major virus envelope surface components, the hemagglutinin and the hemolysin.