Chronic bronchitis--measurements and observations over 10 years. A total of 111 patients with chronic bronchitis were selected for study in 1963. By 1974 only 54 patients were available for clinical examination, chest radiography, and pulmonary function measurements. There was a significantly higher mortality compared with men of the same age and in the same locality, and this was due to cardiorespiratory failure and bronchial carcinoma. Reduction of cigarette smoking, declining atmospheric pollution, and antibiotic treatment have reduced the 24-hour sputum volume of these patients. The initial one-second forced expiratory volume (FEV1) and vital capacity were significantly lower in those patients who later died from cardio-respiratory failure. The duration of antibiotic treatment and the smoking record have not significantly affected the decline of the FEV1 with advancing age. The transfer factor (diffusing capacity) for carbon monoxide (TF) has declined more in those who continued to smoke. Of the 54 patients 14 had radiological evidence of emphysema initially. This has shown little change over 10 years.


Baritosis: a benign pneumoconiosis.

Baritosis: a benign pneumoconiosis. Baritosis is one of the benign pneumoconioses in which inhaled particulate matter lies in the lungs for years without producing symptoms, abnormal physical signs, incapacity for work, interference with lung function, or liability to develop pulmonary or bronchial infections or other thoracic disease. Owing to the high radio-opacity of barium, the discrete shadows in the chest radiograph are extremely dense. Even in the most well-marked cases with extreme profusion of the opacities, massive shadows do not occur. When exposure to barium dust ceases the opacities begin slowly to disappear. Nine cases of baritosis occurring in a small factory in which barytes was crushed, graded, and milled are described. Two of the cases occurred after only 18 and 21 month's exposure, and 9 of the 10 men employed for more than one and a half years had baritosis. Five of the affected men examined at intervals since their exposure to barytes ceased in 1964 showed marked clearing of their radiological abnormalities.


Cartilage in children's lungs: a quantitative assessment using the right middle lobe. The amount and development of cartilage in the lungs of 150 children dying between 24 week's gestation and 12 years has been studied using standard sections of the right middle lobe. Both the cartilage-bearing bronchi and the cartilage fragments increase in number until approximately two months after birth, after which time a constant level is maintained. There is a progressive increase in the total area of cartilage in the child's lung during infancy and childhood, and this appears to be more directly related to the crown-rump length of the child than to its age. Percentiles of the quantity of cartilage found in the standard lung sections are presented.


Conservative surgery for bronchial adenomata. Fifteen patients with bronchial adenomata have undergone surgical treatment and have been followed up for periods of one to 25 years. Management consisted of bronchotomy with local excision in six cases, segmental resection in two, lobectomy in six, and pneumonectomy in one case. One patient who underwent lobectomy subsequently died of an unrelated cause (gastric haemorrhage) in the early postoperative period; of the remaining 14, there have been no cases of recurrence, and all patients have remained sympton-free with normal chest radiographs. These results strongly support a conservative surgical approach where the clinical and histological diagnosis of carcinoid tumour is definite.


Acute aortic dissection and medial degeneration in patients with 'floppy' mitral valves. Mitral regurgitation due to 'floppy' valves is frequently associated with areas of medical necrosis in the ascending aorta. Application of the aortic clamp to such an area during valve replacement may produce an intimal tear followed by acute dissection. This complication occurred in three patients and was treated successfully by repair of the tear in the two cases where the dissection was observed at the time of operation. Is is suggested that infrequent clamping of the aorta and careful control of the pefusion pressure may decrease the risk of intimal trauma and acute dissection.


Elective operations for post-infarction left ventricular aneurysms. During a two-year period (February 1973 to February 1975) 20 consecutive patients with post-infarction left ventricular aneurysm, seen at the Wessex Cardiac and Thoracic Centre, underwent aneurysmectomy with or without aorta-to-coronary artery saphenous vein bypass grafts, ventricular septal defect closure, or valve replacement. The diagnoses were established by clinical means, plain chest radiographs, left ventriculography, and selective coronary arteriography. The indications for surgery were uncontrollable congestive heart failure and angina, ventricular arrhythmias, or a rapidly growing aneurysm. Low cardiac indices or high left ventricular end-diastolic pressure were not considered to be contraindications to operation. Resection of the left ventricular aneurysm was performed with the use of normothermic cardiopulmonary bypass with haemodilution. In addition to the aneurysmectomy, four of these patients had concomitant closure of post-infarction ventricular septal defects; four had valve replacements; two had grafts to coronary arteries; and one had both replacement of the mitral valve and a right coronary vein graft. There were two hospital deaths (10%) and two late deaths (10%), making an overall mortality of 20%. All but one of the deaths were related to coronary artery disease. The survivors are active, and their rehabilitation was satisfactory. The longest survivor is doing well two years after left ventricular aneurysmectomy, ventricular defect closure, and tricuspid valve replacement. It is evident from our experience and from the reports of others that surgery has an established place in the management of post-infarction left ventricular aneurysm.


Dead space ventilation in normal children and children with obstructive airways diease. Anatomical dead space was measured in 72 normal children aged from 5 to 16 years, using the single breath method. There was a linear increase in this measurement with height, weight, and end-inspiratory lung volume. Physiological dead space was measured in 52 normal children using the Bohr equation and substituting a rebreathing PCO2 for alveolar PCO2. There was a parallel increase in this measurement with height, weight, and end-inspiratory lung volume. The difference between the two dead space measurements constitutes the alveolar dead space and was constant over the whole age range at 45 +/- 22 ml. The ratio of physiological dead space to tidal volume was 33-6 +/-4-6% and was unaltered by age or change in lung volume. The effect of airways obstruction on the dead space volumes was studied in 36 children with asthma and 28 with cystic fibrosis. Physiological dead space increased with increasing airways obstruction. Anatomical dead space remained constant in spite of marked increases in lung volume associated with the airways obstruction.


A PATHOLOGICAL study of the lungs and heart in fatal and non-fatal chronic airways obstruction. The lungs and hearts from 50 patients were examined using morphometric techniques to determine the size of the right ventricle, the amount, type, and distribution of emphysema, the size of the bronchial mucous glands, and the proportion of the lung occupied by small airways of less than 2 mm diameter. The patients were divided into three groups according to the clinical history: 18 died as a result of chronic airways obstruction, 17 had symptoms of chronic chest disease but died from some unrelated cause, and 15 had no symptoms related to the respiratory system. The total amount of emphysema was found to be greater in the fatal than the symptomatic group who in turn had more emphysema than the asymptomatic group. A positive correlation was found between the amount of emphysema and the right ventricular weight. The amount of panlobular emphysema in the lung was found to be greater in the fatal group than in the others but this did not apply to the amount of centrilobular emphysema. The amount of panlobular, but not centrilobular, emphysema showed a positive correlation with right ventricular weight. As the total amount of emphysema increased it was found that there was an increase in each of three zones in the lung-apical, middle, and lower. There was no relationship between the bronchial mucous gland size and either the clinical state of the patients with symptoms or the right ventricular weight. The proportion of lung occupied by the lumen of small airways was significantly reduced in the fatal group as compared to the other two groups and also showed a negative (inverse) correlation with right ventricular weight. The total amount of emphysema, the amount of panlobular emphysema, and reduction in small airways lumen in the lung are the three factors in chronic airways obstruction which are quantitatively related to death in chronic airways obstruction and to right ventricular weight.


Influence of long-term intermittent exposures to hypoxia on decompression-induced pulmonary haemorrhage. Healthy male rats were acclimatized by being placed in a decompression chamber at a simulated altitude of 18 000 feet (5486 m) for three hours daily for 84 days. The altitude acclimatized rats paired with unacclimatized rats were rapidly decompressed together. The range of decompression was performed from on atmospheric pressure to an ambient pressure of 30 mmHg in 0-2 seconds. It was found that in control rats, 14 of 20 lung (70%) exhibited pulmonary haemorrhage following rapid decompression. In altitude acclimatized rats, however, only 6 of 20 (30%) revealed decompression-induced haemorrhage. The difference was statistically significant. The present findings indicate that long-term intermittent exposures to hypoxia might increase the resistance of pulmonary tissue to rapid decompression, resulting in a decrease in frequency and severity of pulmonary haemorrhage. The possible mechanism of such a phenomenon is discussed.


[Veterinary medicine and prevention of cruelty to animals: a paradox?]. The fact that veterinary medicine is associated with the protection of the welfare of animals in intensive live-stock farming is increasingly coming to be regarded as not being an inconsistency. The veterinarian has various responsibilities in this regard, to the stock farmer who has to make money out of his animals but whose goodwill in society will also depend on the welfare of the animals, and, finally, to the other members of his profession and himself. When the housing of the animals is altered, stock farmers will require some support. However, an increase in costs and a possible decline in competetive position should not be allowed to stand in the way of essential improvements.


[Welfare or absence of welfare in farm animals (author's transl)]. A particular adjustment of the Live-Stock Act in the Netherlands is advocated in a brief comment on problems of welfare in intensive live-stock farming. The appointment of veterinary inspectors under the Veterinary Service may provide both temporary solutions and permanent supervision. The necessary knowledge and flexibility as well as a committee of arbitration will be essential in this scheme. This would also appear to be in accordance with suggestions by the Minister of Agriculture. International co-ordination and settlement of financial consequences are a prerequisite. Further studies on the veterinary criteria of animal welfare will be required in addition to an ethological approach.


[Transport of animals prior to slaughter (author's transl)]. The transport of animals prior to slaughter is discussed in broad outline. Attention is paid to the need for adjustment and harmonisation of legislation in this field. It is pointed out that veterinary advice on and interest in the transport of animals has been wanting. Methods designed to improve matters and to ensure a more efficient approach to the problem are reviewed.


[Transport of live-stock and process of slaughter (author's transl)]. The introduction on the transport of live-stock and the process of slaughter is mainly confined to transport and stunning as part of the processing of pigs as this presents a fair picture of the problems which also arise in the case of other animals. The study was promoted by problems of welfare both in the animals and in the people involved as well as by the need for modernization. The problems are due particularly to the advent of scale economies in slaughter-houses, the law failing to adjust itselt with sufficient rapidity. These problems will be solved most effectively by a good understanding between and interplay of research institutes and, for instance, the various executive veterinary services.


[Veterinarians and experimental animals - duties and rights (author's transl)]. Well over one million warm-blooded experimental animals are used in the Netherlands every year. The community is socially responsible for the purposes of research. The team of investigators is responsible for the scientific and technical merits of the experimental study, and this responsibility is based on the special knowledge and skill of those concerned. The future Laboratory Animal Act will not be able to ensure "the rights of animals" by rigid rules. The Act is effective in that it: (a) affords guarantees that experts (including veterinarians having expert knowledge of the care and management of laboratory animals, veterinary inspectors and animal technicians) will assist at experiments on animals and, (b) will make available that data of laboratory animals and types of experiment, which is essential to the proper functioning of social responsibility. The veterinarian having expert knowledge of the care and management of laboratory animals should take steps to ensure that the stress to which animals are exposed in experimental studies is not in excess of the value of the experiment. His attention should therefore be directed to the health and uniformity of the experimental animals, the methods adopted in experimental procedures, the training of animal technicians and medical or biological students, instruction of intending research workers, providing literature on experimental animals and normal values, advice on experimental designs and the choice of an animal model.


[A way to spatial irradiation planning. III. Further information on the procedure for obtaining dose homogeneity in noncoplanar ray beams and its experimental verification]. The method is based on the following principle: Single, initally unsettled parameters of irradiation are determined by explicit calculation in such a way that the dose gradient resulting from the dose gradients of the single ray beams in the point of intersection of their axes becomes zero. The separation or addition of components of the gradients is performed by use of co-ordinates for the ray beam as well as for the body. The following parameters can be determined explicitly: First, the weights of the partial doses which are to form the total dose in the point of intersection and/or second, the angles of the wedges and/or third, the rotational angles of the wedge filters, i. e. the angles of rotation of the wedge filters about an axis corresponding to the central ray. In the course of the following experimental verification of the method, maximally possible dose homogeneity results within the area of the crossing ray beams. Moreover, the advantages of field arrangements with different planes of incidence are coming into view.


[A way to spatial irradiation planning. IV. Examples of radiotherapeutic practice and conclusions]. The method described in detail in part III of this paper aims at an optimization of dose distributions with regard to homogeneity within the common area of intersection of the ray beams concerned; now, practical planning is achieved with good results. Common clinical examples are treated, but of such a kind that dose homogeneity is not to be obtained without difficulty, either because of the chosen arrangement of fields within different planes of incidence or on other grounds. Finally, the advantages, practical possibilities and limits of the method indicated are thoroughly discussed.


[Experience in peritoneography, for the prevention of the primary complications during intraperitoneal instillation of radiogold]. Prior to intraabdominal radiogold therapy of the ovarian carcinoma, at the gynecologic clinic of the university of Göttingen and at the gynecologic and obstetric center at Giessen a peritoneography is made. If the distribution of the contrast solution is homogeneous within the abdomen, a homogeneous distribution of activity can also be expected after the radiogold instillation. By means of the peritoneography it is possible to see incorrect punctures into the abdominal walls, into the intestine, into the retroperitoneal space, or into peritoneal conglutinations before the radiogold instillation. Peritoneography, therefore, contributes to a reduction of the early complications of the radiogold therapy. The method used in peritoneography at Göttingen and the method of Giessen are described. The first one (Göttingen) is more comfortable for the patient, as it necessitates less changes of position; the other (Giessen) is a little more economical. A suitable cannula for puncture is described.


[Effect of x-rays on changes in electrolytes and metabolism of the myocardium. VI. Radiation-induced changes of catecholamine content]. In the myocardium of guinea-pigs, the behaviour of the catecholamines noradrenalin and adrenalin as well as the monoamine oxidase activity was biochemically studied following a local irradiation with 250 up to 6000 R surface dose. The noradrenalin content is significantly reduced already after a surface dose of 250 R. This drop of the noradrenalin content is beginning 15 min after irradiation, and not till 72 hours later, a complete normalization of the noradrenalin content is to be shown. A fractionated irradiation with twice 250 R SD in an interval of 24 hours leads to a further reduction. The changes of the adrenalin content are uncharacteristic, the activity of the monoamine oxidase is unaffected.


Radioprotection of liver lipids of whole-body gamma-irradiated female rats by cystamine. The effect of administration of cystamine (5 mg/100 g body weight) before 1200 R whole-body gamma irradiation has been studied on irradiation-induced changes in liver and its subcellular fractions'lipids of fasted female rats. Cystamine prevented the irradiation-induced increase in liver triglycerides and liver mitochondrial total phospholipids, but it decreased microsomal total phospholipids and proteins. Cystamine prevented the radiation-induced increased 32P-radioactivity (counts/min/mumole phospholipid phosphorus) of microsomal phosphatidyl choline. Cystamine prevented the radiation-induced increased uptake of NaH232PO4 (counts/min/g liver) in liver microsomal phosphatidyl ethanolamine and supernatant phosphatidyl choline; but in microsomal phosphatidyl choline, cystamine did not do so, but on the other hand it itself increased the uptake in control rats. Cystamine did not prevent the irradiation-induced decreased incorporation of (U-14C)glucose into liver triglycerides, total phospholipids and phosphatidyl choline. Cystamine itself decreased the incorporation of (U-14C)glucose into liver triglycerides and phosphoglycerides of control rats.


Distribution and behavior of isoselenouronium salts in the body. V. Acute toxicity and metabolic fate of selenium derivatives. The acute toxicity of AESe, 2-ASe, and Se-MEG was estimated in mice after i.v., i.p. and s.c. application. In all forms of application, 2-ASe was found to have the lowest toxicity. The study of excretion showed that administered compounds are excreted practically completely within seven days, mostly by urine. The excretion by faeces is very low and by exhalation is under the threshold of demonstrability. The metabolism of 2-ASe is slow, most of it is excreted without any change; AESe is transformed into a mixture of 2-ASe and Se-MEG. Se-MEG is excreted by urine totally metabolized as trimethylselenium ion.


Distribution and behavior of isoselenouronium salts in the body. VI. Comparative study of distribution and radioprotectivity of selenium derivatives. The protective effect of AESe, 2-ASe, and Se-MEG during irradiation with a dose rate of 500 R/min was followed. The protective effect of 2-ASe is substantially lower during the dose rate of 20 R/min and even during an increased dose. AESe and Se-MEG are noneffective. The time of duration of the protective effect of 2-ASe corresponds to the period of its high concentration in the organism after the administration, i.e. ca. 45 min.


[The irradiation of air-filled cavities in a plexiglass phantom using 42 MiV bremsstrahlung]. For the investigation of dose distributions as they are produced by the existence of cavities within the irradiated volume, a nonhomogeneous plexiglass phantom has been exposed to a 42 MeV radiation due to retarding of particles. Depth dose curves as well as the ion dose of the interface being more distant from the focus have been measured using different dimensions and depths of the cavity. The modifications of the dose distribution are essentially due to the density difference producing the displacement of the depth dose curve and to multiple scattering effects. The displacement of the depth dose curve amounts to about two thirds of that dimension of the cavity which runs parallel to the radiation axis. An increase or a decrease of the ionization within the air-filled volume results from multiple scattering effects and in dependent on the shape of the cavity.


Endogenous biochemical factors affecting the efficiency of some radioprotective or radiosensitizing drugs: sulfhydryl groups and lipid peroxides. The changes in the amounts of blood and tissular sulfhydryl groups and lipid peroxides were investigated in lethally gamma-irradiated rats treated with cystamine, AET (radioprotectors) or alpha-methyl-dopa (a radiosensitizer). The results of experiments revealed the following findings: 1. The ionizing radiation generally causes increases in the levels of tissular sulfhydryl groups and lipid peroxides (excepting the hepatic levels of these compounds). 2. AET and, especially, cystamine are able to reverse the radiation-induced changes in the tissular amounts of sulfhydryl groups and lipid peroxides; there are close relationships between this effect (including its intensity and extension) and the radioprotective action of these drugs. 3. In spite of its radiosensitizing action, alpha-methyl-dopa induces approximately similar changes in the tissular amounts of sulfhydryl groups and lipid peroxides, suggesting that biochemical processes other than an excessive yield of free radicals are also involved in radiosensitivity.


[Reproductive death and population kinetics of survived hamster cells in vitro during 48 hours following x-ray doses up to 800 Rad. II]. By means of a quantitative analysis, the time dependency of the number of dead cells and the resulting statement of cell numbers are compared with colony survival curves and with the distribution of colony sizes. The obtained periodical variation of reproductively killed cells is analyzed through population kinetics and is reduced to the number of those among the irradiated cells which show radiation-induced  lethal reproductive damage. Therefrom, together with both sorts of interphase-dead cells, the dose dependency of the three lethal fractions results, taking into consideration the quantitative cellular statement. The formation of maxima of reproductively killed cells at the intervals of generation time until F3-generation is explained by an autosynchronization of partly lethally injured cell populations. From colony size distributions a linear dose dependency of the mean colony size group can be derived; this is discussed in connection with DNA double strand breaks regarded as a possible cause of reproductive lethal damages. The data obtained concerning the development of a cell population with radiation damages are evaluated by the construction of phylogenetic schedules for every 300 rd and 500 rd. By this means, the underlying population kinetics is being revised quantitatively.


[Results of treatment for laryngeal carcinoma in Würzburg]. From 1960 through 1972, altogether 418 patients with laryngeal carcinoma have been treated at Würzburg, 333 = 82% of these by primary radiation therapy with Co-60 gamma-rays. The results are reported and analyzed in dependence on prognostic factors as tumor site and extension, formation of metastases and age of the patient. Five-year survival of primarily irradiated cases from 1960 to 1967; Glottic T1 = 90%, T2 = 70%, T3 -31%. Supraglottic T2 = 51%, T3 =20%, T4 = 16%. Quota of cases with posterior surgical treatment: Glottic = 8% supraglottic = 28%. The attempt to preserve the larnyx function by means of radiation therapy as an initial measure does not bring along any risk for the patient. The incidence of recurrences with secondary surgical treatment is not smaller than with irradiation only.


[Radiation therapy of eyelid carcinomas]. Forty patients with histologically verified tumors of the eyelid, partly being pretreated surgically, were irradiated and reexamined. The irradiations were performed with an apparatus for surface therapy using soft rays. The radiation quality was between 55 and 100 kV, the dose between 3000 and 6000 rd. The single doses amounted to 300 or 400 rd. The rate of recurrences after primary irradiation of basaliomas was 5,5%, the rate of recovery 94,5%. The patients who underwent primary operation show a distinctly increased rate of recurrences. The percentage of complications was small, amounting to 8%. Primary irradiation is recommended for the treatment of stages T1 and T2 of eyelid tumors, the percentage of recovery being high and the number of complications small. Advanced stages ought to be treated according to the site and infiltration of the tumor either by the telecaesium apparatus under conditions of semi-deep therapy with use of a lead satellite for protection of the cristalline lens and with following soft-ray therapy, or by primary operation followed by radiation therapy.


Effect of field size on the radiation penumbra and integral dose for telegamma therapy units. Because of the large source size in telegamma therapy units, the boundaries of the radiation beam beyond the collimator are not well defined and a zone of falling dose and resulting penumbra are produced. In general, the collimator design is such that the geometrical penumbra is nearly equal in magnitude to the source diameter. However, the magnitude of the physical or radiation penumbra is influenced by the radiation transmitted through the edge of the collimator, the geometrical penumbra and the scatter from the source and the collimator. In the present study, the variation of radiation penumbra with field size has been investigated for two different makes of telegamma units. It is seen that the radiation penumbra can be as large as 4.8 cm for a 20 X 20 cm field. The effect of such large penumbra on the integral dose is discussed.


Effect of gamma-irradiation on cholesterol of chicken brain. Cholesterol in chicken brain has been determined after head irradiation with 60Co gamma rays. The brain of five-week-old white Leghorn chickens, irradiated with 1200 R showed appreciable decrease in its cholesterol content after two and five days, and a slight increase after seven days of irradiation. But the cholesterol content after seven days of irradiation was still less than the control values. However, an insignificant increase in brain cholesterol (than control) was observed after 14 days of irradiation. Nine to ten weeks old Rhode Island Red chickens exposed to 4000 R head gamma-irradiation exhibited a similar effect in cholesterol content of the brain.


An estimate of the 60Co gamma attenuation in the small phantom enployed in the definition of tissue air ratio. Tissue air ratio definition employs a concept of dose at the centre of a small mass of tissues that is suspended in air and is just large enough to give electronic equilibrium at its own centre. When the dose at the centre of the said small mass of tissue is to be derived from a knowledge of exposure in free air at the same point, the attenuation in the small mass of tissue should be taken into account. This attenuation for 1250 keV photons has been evaluated through a theroretical model and the attenuation factor is estimated to be 0.975.


[Critical consideration of various irradiation methods in Hodgkin's disease]. The utilization of individualized irradiation methods in Hodgkin's disease is reported.  The advantages are emphasized in comparison with a schematized mantile therapy.


[Development and utilization of the Nominal Standard Dose for the tolerance dosage to healthy tissue in radiotherapy]. The utilization of the Ellis-formula for the determination of the tolerance of normal connective tissue is described. Beyond this, the formula is adapted to so-called critical organs. The individual suppositions implicated by the Ellis-formula are commented. Because of the verifyable congruency of the Ellis-formula with data obtained in clinical practice  also by other authors, this conception is presented for the provisional determination of the limits of tolerance of normal tissue together with a computerized programme elaborated for use in different therapeutic techniques.


[Improvement of gynecologic radium therapy through the afterloading method using cesium 137]. For all centers performing gynecological contact irradiation the use of afterloading techniques is urgently required, since they eliminate any radiation exposure to the personnel. The radio-therapist may position and control the empty applicators still free from radiation withoug haste. This procedure diminishes the occurrence of overdosages and underdosages. The care for the patients is possible without radiation exposure, and the morbidity of contact therapy can be reduced by occasional mobilization of the patient, the applicator without sources remaining at its place. The fully automatic apparatus "Curietron" using cesium-137 sources (0.662 MeV gamma emission, half-life period 26.6 years) with an equivalent source activity (factor 2.6) yields the dose distribution demanded in the gynecologic field which in practice is identical to that of Ra-226 (medium gamma emission 1 MeV, half-life period 1620 years). With similar dose distribution, a biological and therapeutical effect alike to Ra-226 may be expected from Cs-137. In comparison with Ra-226, the following advantages of Cs-137 may be mentioned: Lower half-value thickness of 5.5 mm lead (low expenses for radioprotection), less danger with handling (no emanation of radioactive gases), and lower contamination risks in case of breaking. The measured dose distributions at equivalent source activity and similar geometry of the applicators revealed the possibility with regard of all techniques of gynecologic irradiation utilized in our field of arriving at similar relative and absolute dose distributions by means of the Cs-137 afterloading technique. Whilst short-term afterloading irradiation with highly active sources, their radiobiological effectiveness being not yet ascertained, has to be tested at appropriate scientific centers, it is necessary to demand afterloading techniques with dosages and duration of irradiations approved over decades for all centers of gynecological contact therapy because of radiation protection.


[Radiotherapy of 4468 uterine carcinomas]. The treatment results of 3847 carcinomas of the cervix and of 621 carcinomas of the uterine corpus during a period from 1928 to 1966 are reported in a statistical review. The constancy of the absolute recovery rate of carcinomas comprising fifty per cent within all stages and different time intervals is supposed to be due to early standardization and multiple fractionation of the radiation therapy maintained without essential modifications. The recovery rate of carcinomas of the corpus was found amounting to 61 per cent altogether, remaining also unchanged, though, between cases with carcinomas solely irradiated (43%) and woman who were surgically treated before irradiation (87%) the difference of efficiency rates was increasing with the years.


[The influencing of rat-tail tumors with and without irradiation]. In a collective of 200 Wistar rats, the influence of anticoagulants upon the rat tail tumor (Walker 256 carcinosarcoma) was checked with and without irradiation. After implantation of the tumor and development of a certain definite tumor volume, the animals were divided into four different groups of 50 rats each. The first one was the control group without any manipulation, the second received an one-stage X-irradiation with 2500 R SD directed to the tail tumor, the third was treated with an oral dose of Phenprocoumon which was added to the daily drinking quantity (0.1 mg/kg body weight), and the fourth group was given an one-stage X-irradiation together with the oral Phenprocoumon treatment. The influence of these different treatments on the growth of the primary tumor, on the incidence of metastases and on the death rate was checked up. The best therapeutical effect was observed with combined radiation and Phenprocoumon treatment. The therapy resulted in an almost complete growth rate depression of the primary tumor, in an early tendency of remission of the primary tumor, a 42 per cent decrease of the incidence of metastases to the lung, and a 42 per cent increase of the survival rate. With regard to the frequency of metastases and to the survival rate, treatment with Phenprocoumon alone showed significantly better results as sole radiation treatment.


Mechanisms underlying decreased protein and RNA synthesis in the rat spleen following whole-body X-irradiation. Whole-body exposure of rats to 1000 R X-rays resulted in decreased rates in protein and RNA syntheses in the spleen from the fourth post-irradiation hour. These changes correspond well with impaired ability of nuclei to polymerise RNA, reduction in template efficiency of chromatin, decrease in the activity of RNA polymerase and inhibition in histone phosphorylation. Protection of the spleen by lead shielding during whole-body exposure to X-rays largely eliminated the observed alterations in protein and nucleic acid synthetic machineries. This suggests that the radiation-induced inhibition in protein and RNA syntheses is mainly due to the direct action of radiation on the spleen itself.


Microspectrophotometric quantitation of nucleic acid and protein in irradiated epidermis. Nucleic acid and proteins of newborn rat tail subjected to local X-irradiation were microspectrophotometrically studied. Feulgen, gallocyanine chrom-alum and naphthol yellow S methods were performed for demonstration of DNA, total nucleic acid and proteins respectively. The amount of proteins and total nucleic acid increases concomitantly with reactional acanthosis. However, the proteins and nucleic acid decrease as from day 3 post-irradiation. A tentative interpretation of the results would point to a giantization of the epidermic cells not only caused by aqueous imbition but also by an actual increase of the cellular protoplasm.


[Initial results on the use of C11 recoil-labelled amino acids in the animal experiment]. Extracorporeal measurement of incorporated radioactive organic compounds needs labelling with gamma emitters. The elements of organic compounds have only very short-lived gamma-emitting isotopes. (Organic compounds, therefore, up to now were labelled by more or less stable chemical coupling with gamma-emitting isotopes of the halogens or of certain metals as, for instance, chromium-51). The use of the C-11 isotope with a half-life period of about 20 min, emitting gamma radiation due to the annihilation radiation of its positrons, is very problematical, because these very short-lived nuclides can be used only at the place of their production by nuclear engineering. But especially these nuclides are very interesting just because of their short half-life period, the radiation load being lessened thereby and, in addition, the organic compound remaining chemically unchanged. Utilizing the (gamma, n) reaction, we have succeeded in labelling organic molecules in solid state directly within the electron beam due to the retarding of particles from a linear electron accelerator, and the absolute as well as the specific yield was satisfying. Till now, we have tested almost exceptionally amino-acids; during experimentation with rats, an example of the practicable utilization in nuclear medicine was set by means of the amino-acid methionine. This was confirmed by results of comparative studies using C-14 and Se-75 labelled methionine (Se-methionine respectively).


[Intraerythrocytic enzyme activities in euthyroid subjects and hyperthyroid patients before treatment and following stabilization of metabolism using radioiodine therapy]. The activities of six intra-erythrocytic enzymes--glucose-6-phosphate-dehydrogenase, aldolase, pyruvate kinase, hexokinase, triosephosphate-isomerase and phosphoglucomutase--have been measured in euthyroid probands (n=18) and in hyperthyroid patients (n=13) prior to radioiodine therapy and after stabilization of the metabolic conditions. The hexokinase, triosephosphate-isomerase, pyruvate kinase, and glucose-6-phosphate-dehydrogenase did not show any significant changes. A moderate diminution of the aldolase activity and a distinct decrease of the phosphoglucomutase activity occur during hyperthyroidism. After normalization of the metabolic conditions, both the enzymatic activities increase again.


Effect of radiophosphorus on the developing endocrine glands of Swiss albino mice. I. A study on the thyroid gland. A study has been made on the effects of P-32 on the developing thyroid gland of Swiss albino mice. The series of experiments reveal that: (I) P-32 at the dose rate of 1.0 muCi/g body-weight to the seven-day pregnant mouse has almost no effect on the 18-day foetus or as late as 14-day postnatal thyroid. (II) With the same dose, when given to one-day-old mouse, signs of dead mitotic figures are noticed. The effects are more pronounced in the beginning, but after the fourth week no morphological changes are seen. (III) When a seven-day-old animal is injected with the same dose, dead cells are found in the earlier stages followed by the damage to the vascular structure of the epithelium. (IV) The 14-day injected group shows damage to the epithelium in the form of condensed nuclei and loss of colloid from the follicles. Replacement of follicles by fatty degeneration is evident. (V) A maximum susceptibility to P-32 irradiation is shown by 21-day-old injected animals, where epithelial desquamation and replacement of follicles by fatty degeneration are easily marked one week after the injection. (VI) In the last group, where P-32 is given at the 28th day after parturition, there may be a tendency of the thickening of the blood vessels. (VII) The females show a greater damage to P-32 injection than the males in the postnatal period studied.


Radioprotective effectiveness and toxicity of ATP, AET and serotonin applied individually or simultaneously to mice. II. Dose depending protection by single agents. The work reported was done as a part of a detailed study on the antiradiation effects of three chemical agents-ATP, AET and serotonin-given individually or simultaneously, the ultimate aim being the identification of an optimally effective and non-toxic dose ratio for the triple combination of protectants. Individual PD50 (protectant dose ensuring 50% survival after lethal irradiation) values were found to be 166 mg/kg and 37 mg/kg for AET and serotonin, respectively. ATP was most effective (45% of 30-day-survival) at 1200 mg/kg in face of a level of X-irradiation above the minimum lethal dose. Some sex differences were observed in protection provided by everyone of the three agents, females being more susceptible to the protective action.


Influence of trichlorfon and fractionated irradiation on hydroproteolytic activity of pancreas and intestinal tissues of rats. Investigations into the hydroproteolytic activity of pancreas and intestinal tissues (small intestine and colon) of rats after fractionated irradiation (5 X 150 R) were carried out. There was found marked postirradiation enhancement of lipase activity in pancreas and duodenal part of intestine and increase of B-glucuronidase and acid phosphatase activity in nearly all parts of the examined intestinal tissues. Fractionated irradiation resulted in an increase of pancreatic catheptic (proteolytic) activity causing simultaneous decrease of proteolytic activity in intestine and colon. Preventive administration of Trichlorfon (ten days before irradiation) in the dose of 10 mg or 30 mg/kg evoked modification of hydroproteolytic activity in intestinal tissues of healthy  and irradiated rats. Trichlorfon applied in the dose of 30 mg/kg exerted antilipolytic and anticatheptic effects in pancreas and intestinal tissues of irradiated rats.


Noninvasive diagnosis of carotid occlusion by ocular pneumoplethysmography. An ocular pneumoplethysmograph was devised to measure the systolic pressure in the ophthalmic artery and to obtain calibrated pulse volume changes from the ocular globe, with simultaneous recording from both eyes. The instrument is self-contained and portable. It can be applied by paramedical personnel, and the graphic recording is readily interpreted by the physician. It has proved to be 100% accurate in noninvasively detecting unilateral carotid occlusion or preocclusive stenosis. This technique, when combined with carotid compression, has been shown to be most valuable in assessing the tolerance of a cerebral hemisphere to proximal carotid occlusion. It was used to evaluate a wide variety of carotid arterial lesions. Elective carotid resection without graft replacement and urgent and elective carotid ligations were performed, based on the preoperative prediction that such procedures would be tolerated without neurological injury. The instrument and the technique of its application are simple, safe, and accurate.


Alterations in behavior, brain electrical activity, cerebral blood flow, and intracranial pressure produced by triethyl tin sulfate induced cerebral edema. The interrelationships between cerebral edema, intracranial pressure (ICP), and cerebral blood flow (CBF) were studied in acute and chronic triethyl tin sulfate treated rats. Prior to pentobarbital anesthesia behavioral observations were made. ICP and regional CBF were measured under steady state conditions and brain water content was determined by vacuum drying of the right cerebral hemisphere. Control and chronic animals were neurologically normal. There were two distinct acute groups: (1) acute low pressure (ALP) animals - alert but tetraperetic, and (2) acute high pressure (AHP) animals - deeply stuporous, with minimal pain response and gross EEG slowing. ICP was significantly elevated only in AHP animals. Hemispheric CBF was significantly reduced in AHP and chronic animals. The interaction of increased pressure and edema (AHP) produced the greatest decrease in CBF, although deep white flows were significantly affected in all experimental groups. Chronic animals had significantly lower flow in four of seven regions compared to ALP animals despite no significant difference in ICP. Water content was significantly increased in all experimental groups with the greatest increase in the chronic animals. In the absence of any significant increase in ICP, cerebral edema appears to cause a significant reduction in cerebral blood flow and this reduction corresponds with the magnitude and location of the edema.


Surgical treatment of primary intracerebral hemorrhage- Part 1: new angiographical classification. A new angiographical classification of primary intracerebral hemorrhage is presented. We have clarified the predilection sites of intracerebral hemorrhage and the advancing direction of the hematoma by studying autopsy cases. Furthermore, we tried to detect the presence or absence of destruction of the internal capsule and ventricular rupture by means of angiography. Our classification, introducing the idea of dynamic changes of hematoma advancement from localized to advanced type, can be applied to clinical practice. This classification, along with the patient's level of consciousness, it felt to be the most important indication for operation.


Geographic differences in mortality from stroke in North Caroline. 1. Analysis of death certificates. Analysis of death certification in North Carolina for a three-year period, 1969 through 1971, showed regional differences in mortality rates from stroke in white men, with the highest rates in the Plains (tobacco growing and farming) area and the lowest rates in the Mountain region. These geographic differences in death rates were observed in all but the youngest age decade and also in the various types of stroke, i.e., hemorrhagic and occlusive cerebrovascular diseases. This regional variation in mortality, however, was not present in white women or blacks. The prevalence at death of heart disease, hypertension and diabetes also was higher in the Plains than in the Mountain region, suggesting that the observed geographic variation of stroke mortality is related to one or more of these major risk factors. It is concluded that the geographic differences in stroke mortality, which had been reported during previous decades, are real and are not due to variations in death certification, errors in diagnosis, or other explanations that might artificially produce inaccuracies in vital statistics.


Cerebral infarction following bilateral carotid artery ligation in normotensive and spontaneously hypertensive rats: a pathological study. A pathological examination was performed on normotensive rats (NTR) and spontaneously hypertensive rats (SHR) following bilateral common carotid artery ligation. After ligation, diffuse and extensive cerebral infarcts in the carotid artery territory occurred frequently in SHR, while NTR occasionally had well-circumscribed small infarcts. The posterior communicating arteries, which are the major anastomotic channels connecting the carotid and vertebrobasilar systems, did not show any anomalies and were well developed in SHR and NTR. Vascular changes secondary to hypertension, such as fibrinoid necrosis or thickening of the wall, were not observed in SHR. Because of the paucity of structural difference of the blood vessels, the more diffuse and extensive cerebral infarcts in SHR after carotid occlusion were attributed to the hemodynamic difference rather than the morphological difference between the two groups. The results of the present experiment suggest that hypertension per se, i.e., hemodynamic factors, may be operative for the development of cerebral infarction.


Platelet survival studies in stroke-prone spontaneously hypertensive rats (SHRSP). Platelet survival was studied by using 51Cr-labeled platelets in stroke-prone spontaneously hypertensive rats (SHRSP), stroke-resistant SHR (SHRSR) and normotensive control rats of the Wistar-Kyoto (WK) strain. Relatively young animals of the same age prior to the development of cerebrovascular lesions (cerebral infarction and/or hemorrhage) were used. Platelet half-life time in SHRSP was slightly but significantly shorter than in any other groups or rats, irrespective of the type of platelet donors. Mean platelet consumption was also significantly increased in SHRSP only. Platelets of SHRSP injected into SHRSR showed normal survival. These data support the concept that the shortened platelet survival in SHRSP is brought about by some extracorpuscular abnormalities. Although the vascular changes in SHRSP could be the most likely explanation for the shortened platelet survival, its mechanism remains to be solved. This investigation suggests that studies of the platelet survival in hypertension may be useful in predicting the development of stroke before its clinical recognition.


The role of the carotid body in mediating the cerebrovascular response to altered arterial carbon dioxide tension. The role of the carotid bifurcation chemoreceptors in mediating the cerebrovascular response to altered arterial PCO2 has been suggested to be large. In the present study the cerebrovascular response to raised PCO2 was measured in a group of baboons before and after bilateral inactivation of the carotid bodies. The results suggest that these chemoreceptors do play a part in the cerebral vasodilator response to raised PCO2. The role of the carotid body, however, appears to be relatively minor as it only accounted for +/- 40% of the total response and became significant only at arterial PCO2 levels of more than 50 mm Hg. It is postulated that the peripheral chemoreceptors in the carotid bifurcation mediate part of the cerebrovascular response to altered PaCO2 but the role is quantitatively small.


Pathogenetic similarity of strokes in stroke-prone spontaneously hypertensive rats and humans. The predilection sites of cerebrovascular lesions (cerebral hemorrhage and/or softening) were studied in  1,278 stroke-prone spontaneously hypertensive rats (SHRSP). The precise supply to the main cerebral arteries was determined by trypan blue injections and microangiography. The three major territories were the anteromedial cortex, the occipital cortex, and the basal ganglia. A common angioarchitectural characteristic of these three areas was the blood supply through "recurrent branching" from the main stream. In the basal ganglia, where there is a preponderance of lesions, the arteries responsible for these lesions belonged to the lateral group of lenticulostriate arteries. The primary pre-stroke arterial lesions were further studied microangiographically in SHRSP killed at the time the initial symptoms of stroke were detected. These points were located  at the "boundary zone" of the main cerebral arteries. Our findings indicated the importance of these two angioarchitectural minor loci as the basis for functional or organic circulatory disturbances that may cause stroke. Since these local factors of stroke are common in the cortex and basal ganglia of rats and basal ganglia  of humans, these SHRSP are regarded as good pathogenetic models for studies on stroke in humans.


Cerebral manifestations of ergotism. Report of a case and review of the literature. A patient with diffuse and focal cerebral dysfunction was found to have absent peripheral pulses. Cerbral angiography revealed evidence of an arteritis with bilateral high grade carotid stenosis. When there was no laboratory confirmation of the arteritis, an iatrogenic etiology (ergotism) was suspected. This was later confirmed by the patient. The pertinent literature on ergotism is reviewed, and it is emphasized that ergotism may develop in patients on therapeutic doses of the drug.


Fate of stroke patients transferred to a long-term rehabilitation hospital. The rehabilitation outcome of 25 elderly hemiplegic patients discharged from the rehabilitation facilities of an acute general hospital and admitted to a long-term facility hospital was evaluated. Only those patients who had been on a rehabilitation program and were discharged after an average of 11 weeks because of lack of progress or severity of their functional and/or neurological disability were considered for this study. Twenty-two patients were wheelchair bound on admission and severely dependent in most self-care activities. Improvement in function and performance occurred in ten patients, while 13 patients remained unchanged. Among the improved patients, eight became ambulatory and independent in activities of daily living (ADL), eight became independent from a wheel-chair level, and eight returned home or to the community. The average stay of the patients in the chronic rehabilitation care facility was seven months, although all the patients reached their maximum level of performance within six months. It appears from this study that some hemiplegic patients require a long and intensive rehabilitation program.


Temporal profile (clinical course) of acute carotid system cerebral infarction. The records of 179 consecutive patients with acute carotid system cerebral infarction were studied to describe the temporal profile of the clinical events during the first week of the illness. Only those patients admitted to the cerebrovascular hospital service within 36 hours of the onset of the first symptom were included. The neurological status of 39% was stable (unchanged) at the end of seven days; 35% of the patients gradually improved. Nineteen percent had a progressing neurological deficit from the onset which stabilized within 48 hours of onset. Six patients (3%) had a remitting-relapsing course during the first 36 hours. Eight patients (4%) had a significant late worsening, after 48 hours of stable or improving course. Mortality was 11% for the entire group. However, a high risk of death group was identified - the mortality was 41% for those patients who had any degree of decreased level of consciousness and hemiplegia at the time of admission.


Distribution of progesterone and its effect on human blood during storage. Human blood, drawn into ACD, was stored under blood bank conditions with and without addition of tritium-labeled progesterone. At selected storage intervals, several biochemical and biophysical parameters were assayed and the distribution of the hormone between plasma and erythrocytes was determined. The retention of the radioactive material by erythrocytes was studied by repeated washes and isotonic saline. The results indicate that erythrocytes stored with addition of progesterone have higher ATP levels, less spontaneous lysis, higher osmotic resistance, and higher uptake of methylene blue throughout the time of storage than do cells stored without added progesterone. This hormone appears to be in steady-state equilibrium between plasma and red blood cells during 42 days of storage and the amount in the plasma is almost twice that present in the cells. After repeated saline washes, about 10 er cent of the progesterone remains attached to the erythrocytes. Specific association of progesterone with red blood cell populations of different density shows that high specific activity is obtained in cell populations of low density (young cells) throughout the storage time investigated.


Studies of the recovery and the cost of low-glycerol cryopreserved human red blood cells. Red blood cells were equilibrated with 28 per cent (v/v) glycerol and 3 per cent mannitol in 0.65 g/100 ml sodium chloride. The units were frozen by immersion into liquid nitrogen and stored at -160 C. After thawing, they were reconstituted and washed using the IBM 2991 Blood Cell Processor. Freeze-thaw rate curves, the effect of thawing techniques, the effect of varying postthaw washing and processing techniques, estimates of red blood cell losses because of hemolysis, and in vitro recovery were determined. In vivo recovery was determined by 51Cr techniques 24 hours after infusion and Ashby survivals and subsequent life span were measured. Metabolic, scanning electronmicroscopy, cost estimates and quality control studies were done on the reconsituted red blood cells. Recipients were evaluated before and after transfusion for metabolic erythrocyte characteristics and for evidence of hemolysis. The modified method requires less wash solution and less technician time than does the standard low-glycerol method. Two units for the same recipient could be passed through the IBM software with no alteration of cell survival or loss. Revision of the IBM 2991 processing procedure provided excellent recovery of viable previously frozen red blood cells at probably a lower cost.


Exchange transfusion in Reye's syndrome with saline-washed red blood cells. Reye's syndrome (RS) consists of encephalopathy, fatty degeneration of viscera, and elevation of ammonia, certain amino acids, and liver enzymes in the blood. It is most characteristically a disease of children and has been considered to have a poor prognosis despite the use of various treatment regimens. Exchange transfusion (ET) with fresh blood (less than 24 hours old) for the removal of toxic metabolic byproducts in TS is a relatively recent development which appears to have improved the survival rates. However, because RS may occur in epidemic proportions at any time the demand for fresh blood can place an excessive stress on blood resources. We have, therefore, utilized saline-washed (to remove potentially toxic metabolites) red blood cells (RBC's) less than six days old, and fresh frozen citrate-phosphate-dextrose (CPD) plasma in treating this disorder. Nine patients in the Milwaukee community with severe encephalopathy secondary to RS were treated with ET. These patients collectively required 151 units of washed RBC's for 21 ET. Eight of nine patients survived without sequelae. Age of blood used did not correlate with the number of exchanges required or the eventual outcome. A continual computerized EEG in five patients provided objective evidence of the effectiveness of ET. We conclude that ET with saline-washed RBC's reconstituted with fresh frozen plasma (FFP) is a fast, safe, and effective means of treating patients with RS.


Fatal pulmonary hypersensitivity reaction to HL-A incompatible blood transfusion:report of a case and review of the literature. A girl with Thalassemia major reacted to a transfusion of packed red blood cells with increasing respiratory distress until death 12 1/2 hours later. Chills and fever were followed by dry cough, dyspnea, and pulmonary edema. The recipient had lymphocytotoxic antibodies specific for donor leukocyte antigens HL-A11 and possibly W14. At autopsy, the lungs showed pulmonary edema with extensive nonspecific acute alveolar injury. Similar cases in the literature are reviewed.


Hepatitis B virus and hepatitis B surface antigen in human albumin products. A collection of 1,985 lots of normal serum albumin (NSA) and 1,361 lots of plasma protein fraction (PPF) prepared between 1958 and 1974 were tested for the presence of hepatitis B surface antigen (HBsAg). Twenty-one percent of NSA lots and 71 per cent of PPF lots were HBsAg-positive by radioimmunoassay. There was considerable variation in frequency of HBsAg-positive  lots among the 17 different manufacturers of NSA and the six manufacturers of PPF. In general, those lots prepared from volunteer donor plasma and placental material demonstrated lower rates of HBsAg-positivity than those prepared from commercial donor plasma. A striking decrease in the prevalence of HBsAg-positive lots of both NSA and PPF occurred during the period 1971 to 1973, coincident with the onset of routine screening of all plasma for HBsAg. Although NSA and PPF can be HBsAg-positive, they probably do not transmit type B hepatitis. Serologic tests for HBsAg and antibody to HBsAg revealed that albumin products prepared from infectious, icterogenic plasma were infectious prior to pasteurization, but that they no longer transmitted type B hepatitis after heat treatment at 60 C for ten hours.


Plasmapheresis-induced hemodilution and its effects on serum constituents. Samples were obtained from 23 plasmapheresis donors before, during, and after double plasmapheresis. Seventeen chemical analyses were performed on these specimens and the results were subjected to statistical analysis. Representative samples can be obtained from plasmapheresis donors before the procedure has begun, immediately after the first unit of whole blood has been removed, or 15 minutes after the completion of the entire procedure. The sample obtained after the first unit of whole blood has been removed will show dilutional lowering of the uric acid concentration and the 15-minute equilibration sample will show dilutional lowering of the inorganic phosphorus concentration. Short-term donors and long-term donors manifest a somewhat different hemodilutional response to plasmapheresis.


Optimum centrifugation conditions for the preparation of platelet and plasma products. Units of whole blood were centrifuged for various periods of times and at various speeds to prepare platelet-rich plasma. It was found that several sets of centrifugation conditions resulted in an optimum yield of platelets and plasma. This optimum was approximately 8.3 x 10(10) platelets in 245 ml of plasma. When platelet-rich plasma was centrifuged, a maximum of approximately 95 per cent of the platelets could be recovered in the concentrate. Although this maximum was also achieved by several sets of centrifugation conditions, the most efficient method was 3,800 RPM (3731 x g) for four minutes at speed.


The quality of over- and undercollected blood for transfusion. Whole blood was collected in increments varying from 100 g to 600 g into plastic containers intended for 450 ml collections. In order to determine the clinical usefulness of over and undercollected bloods, red blood cell survival studies were performed after 21 and 28 days of storage and in vitro measurements were performed weekly throughout the storage period. The red blood cell survival of 21-day-old CPD bloods was acceptable if as little as 300 g of blood were collected whereas a minimum of 400 g of blood was necessary to provide normal survival after 21 days storage in ACD solution. If as much as 600 g of whole blood were collected into a standard ACD or CPD blood pack, the red blood cell survival was within normal limits after 21 days of storage. These data demonstrate the limits to which over- and undercollected units can be utilized in transfusion therapy.


Donor and nondonor motivations.

Donor and nondonor motivations. In an attempt to gain insight into the motivations of blood donors and nondonors, two paper and pencil questionnaires were developed and mailed to approximately 7,000 individuals. In response, 1,429 nondonors and 200 donors completed and returned usable questionnaires. Among donors, awareness of the need for blood, altruism, and investment for the future (blood credit) were the chief motivating factors. Among nondonors the major deterrent was belief in medical disqualification. Of the 33 per cent who claimed medical disqualification, 40 per cent gave clearly invalid or questionable reasons. Fear, while a substantial factor among nondonors, was not as great a deterrent to blood donation as had been previously thought. A dimension focusing upon failure to confront the issue of donating was derived and found to equal or exceed fear in importance. The influence of such items as sex, age, number of donations, and number of children on reasons expressed was examined. The major results were compared with the findings of previous studies. An approach-avoidance model of blood donation was outlined, and implications for donor recruitment are discussed.


Kidney preservation: perfusion versus cold storage-1975. In order to compare the efficacy of simple hypothermic preservation of cadaver kidneys in Collins solution with preservation by pulsatile perfusion, data were gathered on over 1000 transplants between December 1973 and June 1975. In this series of new patient data, it was found that the 1-year thansplant survival rate of 59%+5% in 89 kidneys preserved in Collins solution was significantly better than the 41% + 3% rate found with 358 kidneys preserved by the Belzer machine (p = 0.005). This survival rate was better than the 47% + 3% rate in 421 kidneys preserved on the Waters machine (p = 0.05), and the 34% + 6% rate of 97 kidneys preserved by cold storage in Sacks solution (p = 0.005). The difference in centers probably did not influence the data, since 28 centers submitted data on the Collins-preserved kidneys. In addition, 43 of the 89 kidneys. In addition, 43 of the 89 kidneys stored in Collins solution had been shared between centers.


Evaluation of a fluid-controlled artificial heart. The Zurich A. H. is a pneumatic drive biventricular cardiac prosthesis with tubular silicone rubber membrane, tilting discvalves, and fluid control system. Membrane position is monitored throughout the cardiac cycle to prevent systolic membrane collapse or insufficient diastolic filling. This A. H. was implanted in 25 dogs weighing 23-50 kg. In five animals, the A. H. performed satisfactorily for more than 24 hr. At an average flow rate of 60-90 ml/min per kg, the aortic pressure ranged from 80 to 100 mm Hg, and both left and right atrial pressures were within normal range. The animals were awake, and they breathed spontaneously after 24 hr; average plasma hemoglobin  levels averaged 91 mg/100 ml, and platelet counts decreased to 65,000 cu mm. In three animals subjected to the A. H. pump for 24 hr, the A. H. was removed and replaced with a transplant. Adequate transplant function was obtained, but there were no long-term survivors. Adequate hemostasis, sepsis, and complex organ dysfunctions associated with prolonged pumping are currently the main biologic problems.


Blood bank reagents: some problems related to preservatives and dyes. Occasionally the additives used for the storage, preservation, and coloring of blood bank reagents are a source of anomalous a-glutination reactions. Discrepancies in ABO cell and serum grouping or agglutination of cells used for both antibody detection and identification may be related to the presence of these materials in blood bank reagents. These substances include acriflavin and other dyes; antibiotics, such as penicillin and neomycin; EDTA; caprylate; and occasionally saline. The literature is reviewed regarding this problem.


Studies on Theileriidae (Sporozoa) in Tanzania. I. Tick transmission of Haematoxenus veliferus. Haematoxenus veliferus was experimentally transmitted in cattle on two occasions by the tick Amblyomma variegatum; transmission was transstadial, from nymph to adult. Theileria mutans and Cowdria ruminatium were transmitted at the same time. H. veliferus infected at least 15% of red cells in a splenectomized steer and 10% in a normal steer. One experiment on transstadial transmission from larva to nymph was unsuccessful.


Salmonellosis and shigellosis in Togo (West Africa), 1971-1973. I. Carrier rates in the rural population. Carrier rates of Salmonella and Shigella in the rural population of Togo were investigated between October 1971 and January 1973. A total of 6051 stool specimens from 5075 persons living in 13 rural communities of all regions of Togo was examined. Each village was investigated twice, i.e. in the dry and rainy season, respectively. The overall carrier rate was 7.2% (Salmonella 6.6%, Shigella 0.6%). There was no significant difference in carrier rates of males and females. There was a higher prevalence of Salmonella infections in individuals over 65 years of age. Positive rates in the village varied form 2.0-19.8%. In the southern part of the country within the zone of equatorial climate positive results between 2.0% and 4.9% were observed without distinct differences between the dry and rainy season. In the central region positive rates determined in the rainy season (8.0-15.9%) were twice the rates in the dry season (4.2-7.6%). In the northern part of the country differences observed in the two investigations of each community seemed not to be related to season (2.0-19.0%). The 414 Salmonella strains belong to 133 serotypes, among them 17 new antigen combinations. Typhoid bacteria were detected in 6 subjects only; paratyphoid bacteria have not been isolated. Among Shigella strains Sh. flexneri was most frequently identified (31 of 36 strains).


Fundus lesions in the rabbit eye following inoculation of onchocerca volvulus microfilariae into the posterior segment. II. Pathology. The injection of living microfilariae of Onchocerca volvulus into the vitreous or immediately beneath the retina of rabbits gave rise to a variable degree of choroiditis. Uveal inflammation was most marked in eyes inoculated directly into the retina and subretinal tissue. The choroiditis was characterised by lymphocytic, plasma cell and eosinophil infiltration and was associated in many instances with degeneration of the overlying retina and pigment epithelium. In the eyes of animals killed more than 40 days after inoculation with microfilariae the leucocytic infiltration was usually mild or even absent, and the predominant finding was circumscribed atrophy and degeneration of the retina. It is concluded that the pathogenesis of the lesions in posterior segment onchocerciasis is basically inflammatory with, possibly, a direct toxic action of the microfilariae on the retina.


Fundus lesions in the rabbit eye following inoculation of onchocerca volvulus microfilariae into the posterior segment. I. The clinical picture. Live microfilariae of the Cameroon forest and Sudan-savanna strains of Onchocerca volvulus were inoculated into the vitreous or into the subretinal layers of the eyes of rabbits. The lesions produced are described, and are compared with those seen in control animals, which had received inocula of microfilariae-free saline supernate introduced with a similar degree of operative trauma. Control rabbits showed only minor pigment disturbance in the retina and choroid, near the healed operation scars. Infected animals showed evidence of an inflammatory process in the eye, lasting for up to 4 weeks. Fundus lesions developed following inoculation of microfilariae into the vitreous, but they were more frequent and more severe following subretinal inoculation. The lesions produced were: pallor, vascular narrowing, and flattening of the optic disc; subretinal inflammatory exudate, giving rise to a disturbance of pigment in the retinal pigment epithelium; scattered, small choroidoretinal scars, and larger circumscribed areas of choroidoretinitis, sometimes accompanied by optic atrophy. In many eyes inoculated with microfilariae the wincing reflex was lost, indicating some visual impairment. Many of the lesions were similar to those seen in human patients with onchocerciasis, but they developed much more rapidly. Microfilariae inoculated intravenously, or into the periocular tissues, were not observed to penetrate into the eye-ball.


Myiasis due to Cordylobia anthropophaga in Zambia. Dermal or subdermal myiasis due to larvae of the African tumbu fly Cordylobia anthropophaga is described from Zambia for the first time. Differential diagnosis from the closely allied C. rodhaini is considered. A patient presenting with the lesion on the penis is described. Multiple infection with different developmental stages is discussed in relation to multiple exposure or immunity. Many cases of myiasis may not reach the attention of medical personnel because of the tendency of the mature larvae to migrate out of the lesion which subsequently heals; traditional healers, to whom the condition has been known for long, also successfully extract the larvae.


[Antibodies and immunoglobulin levels in sera from patients with African paragonimiasis (author's transl)]. 96% of the P. uterobilateralis patients and 86.5% of the P. africanus patients showed a positive reaction with the homologous antigen in the passive haemagglutination test (PA). Common antigens of the two species were demonstrated by cross reactions. About 75% of the Paragonimus sera reacted also with the heterologous antigen with titres greater than or equal to 1:160. The PA test can be useful in the evaluation of the efficacy of treatment and is well suited for seroepidemiologic purposes. The complement fixation (CF) test was not suitable for serodiagnostic or seroepidemiologic studies nor for the assessment of the cure of African Paragonimiasis since antibodies persisted for at least one year after treatment. Comparative studies on levels of IgA, IgE, IgG and IgM seems to be of no diagnostic value in African paragonimiasis because no significant correlation between immunoglobulin concentration and paragonimiasis could be recognized. Very high IgE levels--up to 100 times higher than in Europeans--were found in nearly all sera. Shipment of filter papers blood specimens collected from P. africanus patient resulted in a significant decrease of antibody reactivity in all sera, the loss being about 30% in the parasitologically proven patients.


Circadian periodicity of Wuchereria bancrofti in Liberia and its effect on the results of a prevalence study. The Harmonic Wave curve of Sasa and Tanaka (1972), describing microfilarial periodicity, has been fitted to observations on 38 persons infected with W. bancrofti in Liberia, as well as to data previously obtained from the same country by other authors. The periodicity of the Liberian strain was similar to that of periodic forms of W. bancrofti in Southeast Asia and Japan. The effect of periodicity on microfilaraemia prevalence survey results has been examined, using data from a recent study in coastal Liberia. Although prevalence rates appear to be little affected the median microfilarial densities (MfD50) vary condiserably according as to whether a population is examined in the early evening or late at night.


[Mineral contents of the blood and chemical composition of the muscles of trichinella-infected piglets (author's transl)]. Three piglets of 22 kg were infected each with 10 larvae of Trichinella spiralis per g body weight. In the blood plasma the contents of several electrolytes were measured twice per week to day 45 post infection (p.i.). These electrolytes, water, dry matter, lipids, nitrogen and ash contents were assayed on samples of muscles of each animal after they were sacrificed on day 61 p.i. Three noninfected piglets served as controls. In blood plasma the contents of Na, Mg, Ca, Cu, Zn and chloride decreased, K- and Fe-contents increased. This process started at earliest on day 7 p.i. Only the Na- and the Fe-contents returned partially to preinfection values up to the end of the investigation period. In the muscles the Ca-contents were increased strongly on day 61 p.i., the Cu- and Zn-contents not the the same extent. There was a decrease in Fe, P, K, Na and Mg contents. The water contents of the muscles increased from 0.53 to 4.9%. The portion of dry matter was reduced correspondingly. Lipids contents increased 2.0 and 127.9% and ash contents 1.7 to 4.4%. Nitrogen contents were reduced by 2.5 to 5.9%.


Sylvatic echinococcosis in Argentina. II. Susceptibility of wild carnivores to Echinococcus granulosus (Batsch, 1786) and host-induced morphological variation. Domestic dogs and cats, 3 fox species, Dusicyon culpaeus (Molina,1782), D, griseus (Gray, 1837) and D. gymnocercus (Thomas, 1914), Geoffroy's cats, Felis geoffroyi (D'Orbigny and Gervais, 1843), and grisons, Galictus cuja (Molina, 1782) were fed larvae of Echinococcus granulosus (Batsch, 1786) from domestic sheep in Argentina. Dogs and the 3 species of foxes became infected. The susceptibility of D. culpaeus compared favorably to that of dogs. Most D. griseus and D. gymnocercus were less susceptible than dogs but gravid strobilae were recovered from some animals of both species. Eggs from strobilae in dogs and Dusicyon spp. were infective to CF1 mice. The mean strobilar length and the diameters of the rostellar pad and suckers of worms in foxes were significantly reduced when compared with previously reported data for strobilae from dogs. The potential significance of Dusicyon spp. as reservoir hosts of E. granulosus in Argentina is discussed as is the confusion surrounding the taxonomic identification of cestode infections previously reported from these wild carnivores. It is suggested that Echinococcus spp. reported from Argentine foxes are E. granulosus and that foxes become infected by killing and scavenging on sheep in localities where E. granulosus is endemic.


[Influence of xanthine oxidase on duration of asexual cycle of Plasmodium vinckei in the mouse (author's transl)]. Injection of 1.2 U xanthine oxidase in Plasmodium vinckei-infected mice showing high parasitemias prolonged the duration of the asexual cycle by about 10% and slightly decreased the multiplication factor of the parasites. This appears to be of theoretical interest only since the rapid and fatal course of the infection remained essentially unaltered.


Antigen-induced lymphocyte blastogenesis in a hookworm (Necator americanus) infection in man. A lymphocyte blastogenic technique was employed to examine cell-mediated immunity in a Necator americanus infection. Infective third-stage larvae of N. americanus were jsed for antigen preparation, and lymphocyte cultures were prepared from peripheral blood taken on days 3, 17, and 51 after infection with 250 third-stage larvae of N. americanus. At 3 days post-infection lymphocyte transformation was not induced; at 17 and 51 days after infection significant transformation was obtained.


Observations on a herd of beef cattle maintained in a tsetse area. II. Assessment of the development of immunity in association with trypanocidal drug treatment. Three groups of Boran cattle were maintained under different trypanocidal drug regimes for 29 months in an area of "medium" tsetse challenge. The development of immunity to trypanosmiasis in the cattle was assessed on the basis of changes in trypanocidal drug requirement, development of parasitaemia, ability to maintain normal blood values, growth and response to challenge after the withdrawal of the drugs. Observations were also made on serum antibody content by immunofluorescence and on serum immunoglobulin levels. Cattle treated with Berenil on the development of clinical disease developed a partial immunity to trypanosomiasis after two years. Cattle treated as a group with Berenil on the development of patent parasitaemia in any one animal of the group did not develop immunity. Cattle treated as a group with Samorin using the same criterion for treatment developed a degree of immunity to the disease. It was concluded that group treatment with Samorin was the most suitable of the three regimes examined for the maintenance of beef cattle is a tsetse infested area.


Serum proteins, blood and plasma volumes in experimental Trypanosoma vivax infections of sheep and goats. Measurements of blood and plasma volumes using 131I-albumin, and of red cell volume using 51Cr in goats and sheep infected with Trypanosoma vivax for 1 to 2 months (at which time the anaemia was severe) showed statistically significant increases in blood volume (29 per cent and 57 per cent) and plasma volume (44 per cent and 59 per cent), and decreases in red cell volume per kilogram body weight (49 per cent and 50 per cent) in goats and sheep respectively. Total serum proteins and gamma globulins increased, while serum albumin decreased, in T. vivax infected sheep and goats. These findings indicate that the anaemia manifested, with mean packed cell volume decreased by 60 per cent and 47 per cent in goats and sheep respectively at the time of red cell volume measurements, is attributable partly to haemodilution and partly to an actual decrease in total volume oc circulating red blood cells.


The prevalence and diagnosis of Trypanosoma evansi infection in camels in southern Ethiopia. An investigation of trypanosomiasis in camels indicated a high prevalence of infection in southern Ethiopia. Various direct and indirect laboratory methods for the diagnosis of infection with Trypanosoma evansi were compared and evaluated. At the present time inoculation of camel blood into laboratory rodents appears to be the best direct diagnostic method. The formol-gel test and the Takata test appear to be the most sensitive and accurate of the biochemical methods available. However, there still remains a need for an accurate diagnostic test for individual cases.


[Comparative studies of the properties of aldolase isoenzymes A-C in normal rabbit brain and in skeletal muscles from rabbits with E-avitaminosis dystrophy]. By means of fructose-1,6-diphosphate selective elution of aldolase isoenzymic forms from the phosphocellulose column the izoenzyme AC3 was isolated preparatively from the muscles rabbits with experimental E-avitaminosis muscular dystrophy. The specific activity of aldolase A4 and AC3 with pathology differs from that at normal state by fructose-1,6-diphosphate and fructose-1-monophosphate. As to the electrophoretic activity the isoenzymes A4 and AC3 are similar to the same isoforms at normal state. The values of the Michaelis constants and maximal rate are determined for aldolases A4, AC3 and C4 at normal state and for A4 and AC3 with E-avitaminosis. Differences in these parameters are found relative to two substrates for A4 aldolase and AC3-hybrid at normal state and with dystrophy.


[The effect of weight loss caused by tissue dehydration on changes in carbohydrate metabolism under physical load]. Moderate dehydration of rats led to a certain reduction of glycogen content in the liver and muscles. The analogous changes were observed when the animals  were subjected to physical load. The previous dehydration also causes a delay in glycogen l-vel restoration in tissue after work is over. Under usual conditions physical load which wrestlers underwent on a veloergograph caused a certain increase in the concentration of lactic and pyruvic acids in blood. Against a background of previous dehydration physical load of the same intensity caused a more considerable change in these values. Consequently, even moderate dehydration of an organism practised by some sportsmen leads to considerable change in certain values of carbohydrate metabolism. It may be one of the reasons of a negative influence produced by weight loss on working capacity.


[Anticlotting activity of fragment D from fibrinogen and fibrin and its dependence on calcium presence when fragments are obtained from fibrinogen]. The CaCl2 concentration of about 10(-4) M slightly reduces the proteolytic fibrinogen degradation and greatly increases the anticlotting activity in the arising fragments D. With a rise in the CaCl2 concentration to 10(-2) M a subsequent limitation of proteolysis occurs, but less active fragments D are formed. These facts suggest that a moderate restriction of peptide bond cleavage enhances the fragment D activity, whereas excessive restriction exhibits an adverse effect. Fragment D originating from noncross-linked fibrin inhibits clotting stronger than its counterpart--the fibrinogen derivative. The following explanation seems plausible. Certain sites of the intact molecules, essential for the inhibitory activity of the prospective fragment D, become somewhat "enzyme-proof" (due to intermolecular links characteristic of polymeric fibrin), thus, avoiding proteolytic damage. Calcium ions presented at the optimum concentration may act similarly.


[Effect of heparin on oxidative phosphorylation and ultrastructure of rabbit heart mitochondria]. The effect of heparin on isolated rabbit heart mitochondria was studied in usual clinical (0.25 u/ml) and higher doses. Hepain concentration 0.25 u/ml stimulated respiration in the state 4, decreased ADP/O ratio and phosphorylation rate and did not affect mitochondria ultrastructure. Higher concentration caused two-phase changes in respiration-short-time stimulation with the following inhibition, oxidative phosphorylation (respiratory control, ADP/O, phosphorylation rate) was progressively depressed and decoupled. The mitochondria ultrastructure is changed under the influence of 1.25 u/ml and of higher doses; the external membrane lost its two-layer character, the crista were converted into a small granular mass. Concentration of 1.25 u/ml transformed many mitochondria into empty vesicles.


[Electrophoretic characterization of hemoglobin in rats at different ages]. Under conditions of electrophoresis in polyacrylamide gel hemoglobin dissolved in 0.1% solution of NaCl is divided into two components. In old rats the amount of a "slow" component increases. When stored in vitro the whole "quick" component is converted into a "slow" one, however in the former case the process is accompanied by a simultaneous decrease in the ratio between SH- and S--S-groups, in the latter case such phenomenon is absent.


[Role of intramolecular bonds in stability of certain enzymes of the cellulolytic complex]. Stability of C1- and C2-cellulases, CX-exo- and CX-endoglucanases and beta-glucosidase of Aspergillus awamori was studied as affected by monoatomic aliphatic alcohols --methanol, ethanol, propanol and isopropanol; bi- and triatomic alcohols - ethylene glycol and glycerol, urea as well as detergents of dodecyl sulphate and sodium nonilate. The mentioned enzymes are established to manifest the highest activity in 40-60% glycerol. It is also shown that their stability is changed differently under the effect of other alcohols, urea and detergents. The latter testifies to the fact that the studied enzymes are nonidentical, in particular, they differ between themselves by a ratio of intramolecular forces which stabilize their macrostructure.


[Aminoacylation of rat liver tRNA under different experimental conditions]. The studies were performed in methionine, lysine and glycine aminoacylation of the total tRNA preparations isolated from the rat liver 3 h after total irradiation with X-rays with a dose of 800 R as well as after administration of nicotinic acid and proserine 4 h before decapitation of the animals. The tRNA preparations isolated from the irradiated animals liver are established to accept methionine, glycine and lysine to a less extent as compared with the normal state. The tRNA preparations isolated from the animal liver after administration of nicotinic acid accept methionine and glycine to a less degree and in the tRNA preparations from the liver of animals which were administered proserine the acceptance intensity lowers only with respect to lysine.


[Changes in the content of sulphydryl groups in rat tissues under the effect of muscular activity]. The muscular activity was established to affect the content of SH-groups in the tissues of skeletal muscles and myocardium. During 15-minute swimming the total content of sulphydryl groups lowers in them due to a decrease in the content of protein and nonprotein fractions. Swimming for 2-2.5 h has no effect on the content of SH-groups in the skeletal muscles and evokes its decrease in the myocardium. A more prolonged swimming (4.5-5 h) causes an increase in the amount of sulphydryl groups in the skeletal muscles due to its growth in the protein fraction. In the myocardium the total content of SH-groups and nonprotein fractions lowers. A long muscular load has no effect on the content of sulphydryl groups in the liver.


[Content of nucleic acids in the mammary gland tissues and blood plasma in goats during lactation]. The experimental data concerning changes in the content of nucleic acids in the mammary gland tissue as well as in the arterial and venous blood plasm are presented according to the months of lactation. The highest content of RNA phosphorus in the mammary gland tissue is observed the first week after lambing and then in the period of intensive lactation it is maintained at a relatively high level and only in the seventh month it decreases. The content of DNA phosphorus in the mammary gland tissue during lactation gradually lowers. In the plasm of arterial and venous blood the content of RNA phosphorus during lactation changes in the same regularity as in the mammary gland tissue. The content of DNA phosphorus remains unchanged.


[Studies on the possibility of mRNA translation for interferon in the heterologic systems]. It is established that mRNA for interoferon which is isolated from free polysomas bound with endoplasmic reticulum can translate protein in homological and heterological systems. The predominant synthesis of interoferon is observed on the bound polysomas.


[Structural peculiarities of protein typical of G-myelomas]. G-myeloma protein is shown to differ by its conformation from the donor immunoglobulin G. It is characterized by a more polar surrounding of the molecule tyrosine and tryptophane residua. Under the effect of urea the changes are less considerable.


[Effects of UV-radiation of different spectral composition on content of sterols in rat skin]. When irradiating rats with sources of UV-radiation of different spectral composition a decrease in a relative content of cholesterol is found in the animal skin. Simultaneously an increase in the content of such cholestorol biosynthesis precursors as lathosterol and 7-dehydrocholesterol is observed. The formation of cholesterol photooxidation products under the effect of UV-radiation in vivo is shown. The quantitative ratios of sterols under study depend on spectral characteristics of the applied UV-radiation sources. The cholesterol photooxidation products and antirachitic compounds formed in skin under the effect of UV-radiation are supposed to take part in inhibition of cholesterol biosynthesis.


[Study of interaction between alcohols (mono- and polhydric) and proteins in aqueous solutions]. Phosphorescence properties of protein aqueous solutions (life-time, bend-point on the plots of life-time v. s. temperature, maximum positions in spectra, intensity) were shown to depend upon the concentration in the solution of solute--additions (mono- and polyhydric alcohols, glucose, sucrose, certain amino acids). New parameter tau--average life-time of protein phosphorescence in the persence in the solution of the iodine ion constant concentration, was proposed. By the character of dependence of this parameter upon the solute-addition concentration all solutes, which were used as additions, may be devided into two classes. A rise in the solution of the first class additions (monohydric alcohols) was followed by an increase of tau, that evidences for a decrease in availability of protein tryptophanyls, which may be a result of the adsorption of solute-addition by protein. With the addition concentration about 0.5% tau passes through maximum and then decreases. An increase in the solution of the second class addition (glycol, glycerol, polyethylenglycol, glucose, surcrose) was followed by a decrease of tau, that indicates to an increase of trypophanyl availability, Such an interaction of additions with protein is typical of papain and fibrinogen. In the case of myosin the addition of the second class solutes causes a sharp increase of tau with their sufficient concentration. The obtained results make it possible to state that the solute-additions affect proteins directly besides their indirect influence by a change in the water structure.


[The neutropathic urethra: urethrogram and pathophysiologic aspects (author's transl)]. In the analysis of neurogenic urinary voiding disturbances, too much attention has been paid to the bladder, too little to the muscular tubing of the posterior urethra and to the pelvic floor. Contrast radiography of the urethra in injection and micturition, combined with urodynamic investigations, seemed suitable for comprehension of neurogenic functional disturbances of the posterior urethra and the pelvic floor. A cross section of 143 predominantly traumatic patients and 69 patients with myelomeningocele were investigated radiologically. In addition, in a number of patients urinary flow was determined by uroflowmetry and micturition studies with simultaneous recording of intravesical and intrarectal pressure, of the EMG-activity of the pelvic floor and urinary flow were performed by a special method. The radiologic section (I) shows that the urinary picture of various neurogenic bladder types are characterized by specific changes in form of the posterior urethra. With the help of systematic investigations of a number of cases it was demonstrated that in automatic bladder the roentgen contour of the urethra changes with duration of illness and that primarily secondary, morphologic changes-recognizable at the same time from the increasing number of radiologically demonstrable changes of the prostate and the seminal vesicles-are responsible. Simultaneously a typical deformation of the posterior urethra in passive urinary voiding is described, and attention directed to the fact that the urinary pictures of children with neurogenic impaired urethra sometimes cannot be distinguished from those with urethral values. Urinary flow measurements (II) show that the flow rates from a cross section of patients with lesions of the upper and lower neurons are significantly lower in comparison to normals. With the help of combined urodynamic investigations (III) it was demonstrated that a functional obstruction was present in the neurogenic bladder at the level of spastic and of paretic pelvic floors. It was proved that the roentgenologically visible deformation of the posterior urethra plays a quite decisive role in neurogenically disturbed urinary voiding. It is the main reason why, despite sufficient bladder pressure values, urinary voiding remains unsatisfactory and urinary performance low. Hence the therapeutic consequence follows: an improvement in urinary performance in neurogenic bladder is generally only possible through a decrease in the expulsion resistance. Various operative procedures for the release of bladder outlet obstruction and their uses are discussed.


[Transretcat aspiration biopsy in the diagnosis of prostatic cancer (author's transl)]. In almost three years 853 prostatic aspirates obtained from 709 patients were cytologically examined. In 313 patients we also made histological examinations. The cytologic diagnosis could be checked by histology in 288 untreated patients. The cytologic diagnosis  of prostatic cancer was confirmed by histology in 65.3% and was false negative in 28.3%. In 6.4% the cytologic material was unsatisfactory for cytologic examination. Considering cytologic findings after repeat aspiration biopsy the accuracy of the cytologic method was 71.7%. The detection rate of prostatic cancer is about 20% higher using both, cytologic and histologic methods, than using cytology or histology, only.


[The role of cells originating from seminal vesicles in aspiration biopsy smears of the prostate (author's transl)]. 328 (30.7%) of 1068 prostatic aspirates obtained from 874 patients contained cells of seminal vesicle origin. Cells originating from the seminal vesicles were recognized in aspirates obtained from 27.6% of the untreated patients and in aspirates from 60.4% of the treated patients. Patients of the latter group had received hormonal treatment or radation therapy, or both, or had been surgically treated by prostatectomy. The occurrence of cells derived from seminal vesicles was due to the site of the needled prostatic lesion in 21% of the aspirates obtained, to treatment in 21% and to incorrect biopsy technique in the remaining 58%. A false cytologic report was made in the case of 6 aspirates (1.6%).


[Nuclear medical techniques in diagnostics of urological diseases (author's transl)]. We report on the evaluation of 2170 kidney scintigrams and isotope nephrograms under the aspect of a urological radiodiagnostic of the kidney. The possibilities of a nuclear medical demonstration for kidney tumours are discussed. Furthermore we refer to the importance of the isotope nephrogram to recognize intermitting obstructions of the ureters.


[Postrenal amuria in polycystic degeneration of a residual kidney (author's transl)]. A case of a residual kidney and polycystic renal degeneration is reported in which postrenal anuria developed from a cluster of cysts filling the entire renal pelvis. The anuria was repired by removing the intrapelvic cysts and creating a temporary renal fistula. A sudden onset of anuria and the corresponding symptoms (e.g., acute abdominal pain) and also the familiar progressive polycystic degeneration of the kidney should arouse suspicion of an obstruction caused by cysts.


[The dangers of antibiotic therapy in gram-negative pathogens (author's transl)]. The increased occurrence of so-called gram-negative problem bacteria in urology compels us to use highly effective antibiotics in optimal doses. The danger of such therapy is illustrated by three cases in whom toxic damage was demonstrated following combined treatment with aminoglycosides and cephalosporins.


[The bifid ureter with a blind-ending branch -- its clinical problematic (author's transl)]. The symptoms and clinical significance of the bifid ureter with a blind-ending branch are presented. A uretero-ureteral reflux is the pathophysiologic pre-condition for the disease and its diagnosis. Complaints arise from recurrent urinary infection and/or dilatation of the blind end.


Operative and nonoperative hypertension. Recent advances in treatment. In the past five years there have been significant advances in the diagnosis and treatment of operative and nonoperative forms of hypertension. Several areas of specific interest to urologists will be discussed.


Complications of renal cyst exploration versus renal mass aspiration. This report presents a comparison of the complications of surgical exploration with unroofing and renal cyst puncture. Two hundred fifty-five patients were operated on, with a mortality rate of 1 per cent and a morbidity rate of 28 per cent. The complications in 63 patients examined by mass aspiration included a morbidity rate of 6.4 per cent and no mortality. The possibilities of over-looking carcinomas through cyst aspiration are weighed against the demonstrated morbidity of surgical exploration and found to be much less significant. The authors recommend that an asymptomatic renal mass that radiographically appears to be a cyst and is unaccompanied by urine changes or clinical stigmata of renal neoplasia be treated by cyst aspiration and not subjected to surgical exploration.


Simplified operative nephroscopy.

Simplified operative nephroscopy. Intraoperative nephroscopy is a valuable and practical adjunct to renal surgery. A simplified methodology is described using familiar cystoscopic equipment and techniques. Its particular usefulness in the definition of small radiolucent defects of the renal collecting system is illustrated.


Management of postoperative fistula of upper urinary tract. The simple procedure of passage and withdrawal of a ureteral catheter hastens the closure of a urinary fistula after surgery of the ureter or renal pelvis.