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[Study of histamine in asthma].

Histamine is generally considered as the principal chemical mediator in experimental allergy of type I and anaphylaxis. However, its part in human bronchial asthma remains discussed, because neither the dosage of histamine in blood, nor the use of antihistaminics have furnished any real evidence. This study is dealing with two elements: the importance of local bronchopulmonary phenomena, and the associated mediators also liberated in asthma, such as SRSA. ECFA, kinines, prostaglandins and disorders of balance between, on one hand, alpha and beta-actions of the catecholamines, and on the other hand, between the two main types of cyclic nucleotides. These considerations should allow a better approach of the asthma etiopathology and perhaps an improvement of its treatment.

Repetitive extrasystole as an index of vulnerability to ventricular fibrillation.

The assessment of ventricular vulnerability by inducing ventricular fibrillation (VF) presents limitations when neural activity is being investigated, especially in the unanesthetized animal. As repetitive extrasystoles (RE) have been observed to precede the occurrence of VF, it was relevant to determine whether the RE threshold provides a reliable index of cardiac susceptivility to fibrillation. The RE and VF threshold relationships were studied in 32 chloralose-anesthetized dogs during left stellate ganglion stimulation, vagus nerve stimulation, and beta-adrenergic blockage with practolol. The vulnerable period was scanned at 1-ms intervals and at 2-mA increments with a single, 2-ms, constant-current cathodal stimulus; RE and multiple RE were induced reproducibly when 66% and 82%, respectively, of the fibrillatory current was administered. The nadirs for RE and multiple RE were coincident in the cardiac cycle with the vulnerable-period threshold for VF. Stellate and vagal stimulation and beta-adrenergic blockade resulted in comparable changes in RE and VF thresholds and produced equivalent shifts in the cardiac cycle of the RE and VF vulnerable-period nadirs. These observations suggest that RE and VF phenomena share a common electrophysiologic basis and that the RE threshold can be used as an end point for measuring ventricular vulnerability to VF.

Palliative surgical treatment of gastric carcinoma, duration of survival in 217 cases.

During the period 1958 to 1972 inclusive, 217 patients were subjected to a palliative operation because of carcinoma of the stomach. Subtotal gastric resection was performed in 33 and a total resection in 42 cases. The postoperative mortality in the resected group amounted to 8%. The average duration of survival with exclusion of the postoperative mortality amounted to 17 months with a median duration of 12 months. Five patients in this group (7%) survived for 5 years, and two patients are still alive without recurrence 9 and 6 years, respectively, after the operation. Among the 142 remaining patients, the postoperative mortality was 23%. The average survival with exclusion of the postoperative mortality was 5 months; the median duration of survival amounted to 4 months. The average duration of survival among the patients subjected to a gastro- or jejunostomy was shorter: 3 months, with a median of 2 months. Of the various palliative measures, resection is to be preferred. If it is not feasible, gastro-enterostomy and intubation may be considered. In a limited number of cases, the alimentary fistula may still be indicated, even though it is an unsatisfactory type of palliation. Hoerr's classification is satisfactory as a clinical subdivision. The dividing line between operations with curative and with palliative intent as a rule is put at B III. Of the patients treated palliatively, 92% had died after 2 years; 79% of those subjected to resection and 100% of those subjected to some other intervention.

Changes in the cells of the adenohypophysis associated with the diadromous migration of the threespine stickleback, Gasterosteus aculeatus L.

The adenohypophysis of the threespine stickleback, Gasterosteus aculeatus, was studied light-microscopically to determine and estimate the cell types and their function. For these purposes, the adult specimens obtained during the period from migration to spawning were examined. Further, the juveniles caught in the spawning bed were subjected artificially to sea water. The rostral pars distalis (RPD) consists mainly of two types of cells: dorsally shifted lead hematoxylin (PbH)-positive cells bordering the neurohypophysis correspond to corticotrophs, and antero-ventrally shifted acidophil cells are identified as prolactin cells. The latter undergo marked hypertrophy and active state just at the time of entering the river (February), while no detectable change was seen in the former throughout anadromous migration. The role of prolactin on the osmoregulation in freshwater environment is thus suggested. The proximal pars distalis (PPD) consists mainly of two cell types: the basophil cells in round shape are regarded as the gonadotrophs and the acidophil cells in ellipsoid shape are considered to be somatotrophs. The size of the gonadotrophs reaches the maximum at the time of spawning. A few AF-positive cells of elongate shape occur in the dorsal region and are identified as thyrotrophs. In the pars intermedia (PI), two types of cells are discernible: PAS-positive and PAS-negative cells. The latter attained their maximal size in the earliest time of anadromous migration.

[Adams-Stokes syndrome in a case of Mobitz type II AV-block triggered by premature atrial contractions].

The case of a patient with Mobitz type II AV-block is presented who suffered from recurrent dizzy spells and syncopal attacks. These episodes were due to intermittent asystoles lasting for 3-17 seconds, and it could be shown that they were triggered by two or more successive premature atrial contractions. The observation that there were no subsidiary escape beats or rhythms during the asystolic intervals and the ECG pattern for the conducted beats (RBBB and LAH) suggest an intraventricular (trifascicular) level of AV-block. The exact analysis of the asystolic pauses makes it likely that these were initiated by the penetration of the premature atrial impulses into the left posterior subdivision of the left bundle (concealed conduction). The present case demonstrates the fact that premature atrial contractions may produce prolonged asystolic attacks in patients with advanced intraventricular conduction disturbances.

Rheumatoid factor (antigammaglobulin) in women: effects of oral contraceptives use of its prevalence.

A total of 14,856 women, including 921 pregnant subjects, were tested for rheumatoid factor; 4,562 were using oral contraceptives at the time of testing. The prevalence of rheumatoid factor increased directly with age. The age-adjusted prevalence of rheumatoid factor was lower in oral contraceptive users than in nonusers but this difference was not statistically significant. Rheumatoid factor remained positive in 39% of subjects undergoing retesting after an average interval of 16 months. Those women with higher titers of rheumatoid factor were more likely to remain positive (81%). Of the women having positive tests, 5.4% were identified as having rheumatoid disease.

Acute nonlymphocytic leukemia in adults: correlations with Q-banded chromosomes.

Chromosome banding patterns were obtained for 50 of 55 consecutive adult patients with acute nonlymphocytic leukemia during a 5-yr period. Twenty-two of the 50 cases were diagnosed as acute myelocytic leukemia (AML), 24 as acute myelomonocytic leukemia (AMMol), 2 as acute promyelocytic leukemia (APL), and 2 as erythroleukemia. Twenty-five patients had initial chromosome abnormalities during the course of the disease. The median survival of patients with normal chromosomes initially (group I) was 10 mo, whereas that of patients with abnormal chromosomes initially (group II) was 2 mo. Similar times were obtained for treated patients with AML and AMMol. However, when the AML patients were separated into those with and those without a chromosome abnormality, the median survival times were markedly different (2 mo versus 18 mo, respectively). Patients with AMMol demonstrated no difference in median survival times when subgrouped according to the presence or absence of chromosome abnormalities. The treated group II patients whose marrow samples had only abnormal metaphases had a poorer response (10% complete remission) and median survival (2 mo) than the group II patients who had at least one normal metaphase (42% complete remission with a median survival of 9 mo). The two cases of APL demonstrated a deletion of the long arm of No. 17 which occurred in the same region of the chromosome in each case. Both patients had similar clinical histories, with disseminated intravascular coagulation, and neither responded to therapy.

Message and non-message sequences adjacent to poly(A) in steady state heterogeneous nuclear RNA of HeLa cells.

Highly purified steady state heterogeneous nuclear RNA from HeLa cells has been prepared by a new procedure. Detergent-washed nuclei are disrupted in 0.4 M ammonium sulfate, which also disociated contamination polysomes. The hnRNA remains bound to chromatin, which can be pelleted by gentle centrifugation. Ribonuclease inhibitors permit the preparation of very high molecular weight nuclear RNA. The hnRNA was cleaved with alkali. The poly(A)-containing fragments were separated from those containing oligo(A), and a cDNA copy was prepared. Hybridization of this nuclear cDNA to cytoplasmic mRNA showed that the scarce (complex) message sequences make up a larger proportion of nuclear RNA than of cytoplasmic RNA. In addition, at least 30% of the poly(A)-adjacent sequences in nuclear RNA have no apparent counterparts in the cytoplasm. cDNA prepared from hnRNA sedimenting faster than 45S under denaturing conditions gives similar results, showing the presence of both message and non-message sequences in very large transcripts. cDNA complementary to mRNA was separated into the abundant and scarce sequences, and hybridized separately to the poly(A)-adjacent sequences in nuclear RNA. The hybridization of the abundant sequence cDNA was used to set an upper limit on possible cytoplasmic contamination. Hybridization of the scarce cytoplasmic sequences are represented in nuclear RNA approximately once per cell.

Determinant competition during the immune response to N-acyl derivatives of ox insulin in the Hartley guinea-pig.

Subgroups of female Hartley guinea-pigs were immunized with N-carbamylated ox insulin, N-maleylated ox insulin, N-phthaloylated ox insulin, or with the crystalline ox insulin from which the N-acylated insulins had been prepared. The immunogens were administered in water-in-oil emulsions containing pertussis vaccine as adjuvant. Sera obtained 20 days after secondary immunization were assayed for their antibody titres to iodo-ox insulin and their insulin-binding capacities. The data were log transformed for statistical comparison. N-carbamylated ox insulin seemed to be as immunogenic as crystalline ox insulin and no specific carbamyl hapten antibody could be found. N-maleylated and N-phthaloylated ox insulins yelded significantly less antibody cross-reactingwith iodo-ox insulin, but produced a complementary quantity of specific maleyl and phthaloyl hapten antibody respectively. Thus it was shown that in the system used the immune response was partitioned between different determinants, ox insulin and its N-acylated derivatives being equipotent immunogens.

[Comparative studies on the teaching of oral pathology].

This is a self-assessment of teaching effectiveness for teacher, students and teaching-material as well. A curriculum of oral patholology was created and prepared as syllabus, lectures and audiovisual aids. In order to estimate and compare the eductional achievements of different systems, a series of written multiple choice questions were prepared. Only items with an index of discrimination of more than 0,25 were used. The average index was 0,5. The results of a short-term experimetn (1 hour) shows that a teaching sequence in the conventional lecture style was most effective in transmitting knowledge (72% of maximum), audiovisual aids rating second (63%), followed by individual homework study using printed material (48%). The differences were statistically significant in most experiments. In the second type of experiment (long-term-experiment) we registered the time the students spent with lectures over a period of six months. When permitted to chose between the different systems the students preferred the audiovisual method to the lectures. Individual testing of these students shows a positive correlation between knowledge acquired and time spent with the audiovisual machines.

CT banding of human chromosomes. The role of cations in the alkaline pretreatment.

This paper describes a study of the role of certain cations in the alkaline pretreatment step used in the CT technique for chromosome band formation. Treatment of human chromosomes with ammonium bases or with the hydroxides of the monovalent alkali metals Na, K, or Li resulted in their rapid disintegration, unless very short treatment periods or diluted solutions were used. In the latter cases a subsequent staining produced a weak G-banding pattern. The chromosomes appeared to be much less sensitive to treatment with the hydroxides of the divalent alkaline earth metals Ba, Sr, Ca, and Mg. Staining after exposure to these hydroxides yielded R-banding patterns. The reduced alkali sensitivity of the chromosomes and the reverse banding pattern formation observed are probably the result of a chromatin stabilization by the divalent cations of the alkaline earth metals. It is proposed that not only in the R-band formation with the hydroxides of the alkaline earth metals but also in that obtained by other techniques, chromosome stabilization plays an important role.

Tube leukocyte (monocyte) adherence inhibition assay for the detection of anti-tumour immunity. III. "Blockade" of monocyte reactivity by excess free antigen and immune complexes in advanced cancer patients.

Leukocytes from patients with limited cancer display LAI reactivity whereas leukocytes from patients with metastatic cancer frequently demonstrate no reactivity in the tube LAI assay. The leukocytes (monocytes) of reactive patients react with tumour antigen through specific cytophilic anti-tumour IgG antibody bound to the monocyte's Fc cell surface receptors. The non-reactive monocytes from patients with advanced cancer lacked the ability to bind free cytophilic anti-tumour antibody. Moreover, the serum of the non-reactive patient contained no free cytophilic anti-tumour antibody capable of "arming" normal leukocytes. The serum of patients with large tumour burdens contained free tumour antigenic determinants capable of absorbing free cytophilic anti-tumour antibody from the serum of reactive patients or when preincubated with reactive leukocytes abrogating their LAI responsiveness immunologically specifically. Blocking was immunologically specific; therefore, the specificity must reside in the tumour antigenic determinant since immune complexes are bound nonspecifically. The tumour antigen coat was removed by gentle trypsinization of the monocyte's surface. This restored the monocyte's capacity to react with the sensitizing tumour antigen and to bind free cytophilic antibody from the microenvironment. Nonreactivity in the tube LAI assay of patients with metastatic cancer was not the result of a numerical deficit of circulating monocytes but was mediated by an excess of tumour antigen in the microenvironment of the sensitized monocyte.

[Ultrastructural identification and immunocytochemical study of somatostatin cells in antral mucosa of the rabbit and the mouse (author's transl)].

In normal and L-Dopa treated rabbits and mice, combined immunochemical methods, photonic histological methods for endocrine cells and ultrastructural methods were used to elucidate ultrastructure and properties of somatostatin cells of the antral mucosa. In normal rabbits, immunoreactive cells giving no fluorescence with Falck's technic, they corresponded neither to serotonin cells nor gastrin cells; they were unreactive with Fontana, Hellerström-Hellmann, Sevier-Munger and Mac Conaill methods but very slightly stained with Grimelius methods. In L-Dopa treated animals somatostatin cells gave formaldehyde induced fluorescence (they were included in GIC cells, thus in Apud group), exhibited a good reaction with Grimelius and Sevier-Munger methods. In order to carry out the alternate semi-thin/thin section procedure (semi-thin sections for immunofluorescence or immunoenzymatic detection and serial thin sections counter-stained for conventional ultrastructure studies), immunological treatment were performed on M.F.F.--glutaraldehyde fixed small fragments of mucosa before inclusion in Epon 812 or, after inclusion, on semi-thin sections. We succeeded in identifying ultrastructurally somatostatin cells. They displayed round or ovoïd shaped secretory granules, and three constant typical structures: numerous microfilaments--light and homogenous granules, often seeming like lipids---granules made up by coarsely filamentous cores surrounded by a large empty halo. Somatostatin cells seemed different of X cells because of their predominant localisation in the antral mucosa (in the rabbit X cells were predominantly in the fundus) and because of the lack of nuclear microfilaments; they also seemed ultrastructuraly different of D1 cells.

Influence of purified plasma proteins on testosterone uptake and metabolism by normal and hyperplastic human prostate in "constant-flow organ culture".

Surgical samples of human prostate were explanted and submitted to constant-flow organ culture. The medium contained 3H-testosterone 50 nM, and except for controls, increasing concentrations of human serum albumin (HSA) or human sex-steroid-binding plasma protein (SBP). At steady state, the explants were washed and homogenized, and the total radioactivity, radioactive testosterone, androstanolone (17 beta-hydroxyandrostan-3-one), androstane-3 alpha, 17 beta-diol, and androstane-3 beta, 17 beta-diol were determined after the addition of the corresponding internal 14C standards. From these data, testosterone uptake and metabolism were quantitated. The concentration of unbound testosterone in protein-supplemented culture media was measured separately by equilibrium dialysis. In control superfusions without protein, the tissue concentration of total radioactive steroids was equivalent to 182 +/- 18 (mean +/- SEM) pmoles/g of prostate. Androstanolone represented about 2/3, testosterone 1/10, and the two androstanediols together 1/10 of the total radioactivity. No difference was found between "normal" and hyperplastic prostate explants. In experiments with HSA (15-176 muM), is was observed that the uptake of radioactive testosterone in the prostate explants was decreased in direct proportion to the unbound testosterone fraction of the superfusion medium, but the proportions of testosterone metabolities in the superfused explants remained the same. In experiments with SBP (6-135 nM), the concentrations of unbound testosterone in the superfusion medium were reduced to the same levels as in the experiments with HSA. The reduction of tissue radioactivity was somewhat larger than that expected from the reduction of unbound testosterone in the superfusion medium for the concentrations of SBP less than 50 nM, and then remained approximately constant. In addition, SBP altered the metabolism of testosterone: the androstanolone/testosterone ratio in the prostate explants was critically dependent upon the SBP concentration in the superfusion medium. It is therefore suggested that, independent of its effect on the binding of testosterone, SBP has a direct effect on testosterone uptake and metabolism by the human prostate. The underlying mechanism is unknown.

Rosette formation between human lymphocytes and sheep erythrocytes. Inhibition of rosette formation by specific glycopeptides.

Rosette formation with unsensitized sheep erythrocytes is a characteristic of human thymus dependent lymphocytes. Release of glycopeptides from the sheep erythrocyte by trypsin reduces rosette formation. These tryptic glycopeptides inhibit rosette formation by untrypsinized sheep erythrocytes; this suggests that rosetting is mediated by erythrocyte surface glycopeptides. To investigate the molecular nature of this interaction, we examined the abilities of various model compounds to act as haptenic inhibitors of rosette formation. Inhibition is given by glycopeptides bearing oligosaccharide units rich in sialic acid, galactose, N-acetylglucosamine, and mannose linked to asparagine residues through glycosylamine bonds. Among compounds tested, fetuin glycopeptide is most effective, but human transferrin glycopeptide and human erythrocyte glycopeptide I also inhibit rosette formation. Other compounds including human erythrocyte glycopeptide II, human IgG glycopeptide, lacto-N-neotetraose, 3'- and 6'-sialyllactose show no significant inhibition. Neither sialic acid, galactose, manose, nor N-acetyl-glucosamine alone inhibits rosette formation. Stepwise degradation of fetuin glycopeptide established the galactose residues as important determinants of inhibitory activity. Fetuin glycopeptide blocks rosette formation when added to a suspension of human lymphocytes and sheep erythrocytes or when preincubated with human lymphocytes, but not when preincubated with sheep erythrocytes. Studies of the binding of [3H] fetuin glycopeptide to normal lymphocytes demonstrate 7.5 x 10(6) saturable binding sites per cell. No saturable binding of this compound to sheep erythrocyte membranes is observed. Compared to normals, lymphocytes from patients with chronic lymphatic leukemia demonstrate decreased fetuin glycopeptide binding with a mean of 0.9 x 10(6) sites per cell. This decreased binding correlates with the impaired ability of these cells to form rosettes. The data suggest that fetuin glycopeptide inhibits rosette formation by binding to the thymus-dependent cell where competition occurs with sheep erythrocytes for specific lymphocyte surface receptors.

Cold activation of complement i. presence of coagulation-related activator.

Determination of the complement titer in the serum and plasm of 120 patients with chronic liver diseases showed that in eight (7%) patients with cirrhosis of the liver, chronic active or chronic inactive hepatitis complement in the serum was less than half in the plasma. The dissociation of complement serum and plasma was due to cold activation of the classical pathway of complement in vitro since serum drawn from these patients at 37 degrees C lost hemolytic activity in 4 hours when transferred to a cold environment. Neither HB antigen nor cryoglobulin participated in this phenomenon. The activation of complement in the cold could be prevented by increasing the ionic strength, or by adding vitamin E or, to a lesser extent its vehicle HCO-60, while heparin, Trasylol, soybean trypsin inhibitor, or hirudin had no effect. Trans-AMCHA prevented activation in one case. It is speculated that a factor appearing as a result of blood clotting is able to activate the classical pathway of complement in the cold; it is probably not related to Hageman factor (factor XII), factor VII, thrombin, kallikrein.

Influenza virus subunit vaccines. II. Immunogenicity and original antigenic sin in humans.

Subunit vaccines containing hemagglutinin, neuraminidase, and nucleocapsids of A/Port Chalmers/1/73 (H3N2) influenza virus were prepared after treatment of purified virus with ammonium deoxycholate. The immunogenicity of these subunits and the response to the common and specific antigenic determinants on the hemagglutinin subunits were studied in man. The subunits were as immunogenic in man as intact inactivated influenza virus vaccine at an equivalent concentration. Booster doses of antigen did not increase the antibody responses. Intact influenza B virus vaccine did not potentiate the immune response to the type A subunits in man. Volunteers responded differently to the common and specific determinants on the hemagglutinin subunits. The predominant antibody response was to the common or cross-reacting determinants present on hemagglutinins of both A/Hong Kong/1/68 (H3N2) and Port Chalmers/73 virus. Some men who failed to produce specific antibodies to the hemagglutinin of Port Chalmers/73 virus responded to the specific determinants on the Hong Kong/68 hemagglutinin. Higher doses of the subunit vaccines (1,400 chick cell-agglutinating units) did induce antibodies to the specific determinants on the Port Chalmers/73 virus hemagglutinin as well as to the common and specific determinants on Hong Kong/68 influenza virus.

Histamine release by exocytosis from rat mast cells on reduction of extracellular sodium: a secretory response inhibited by calcium, strontium, barium or magnesium.

1. Histamine release from peritoneal mast cells of the rat was stimulated when the cells were exposed for 10 min to sodium-deficient media where all NaCl had been replaced by KC1, RbC1, glucose, sucrose, mannitol, or Tris, provided calcium was less than about 0-5 mM. 2. Light and electron microscopy showed the response to be exocytosis. 3. The chelating agents, EDTA and EGTA, abolished the response to sodium lack and their inhibitory effects were reversed by re-incubating cells with calcium but not magnesium. 4. The response was inhibited by dinitrophenol combined with glucose-deprivation. 5. The response was inversely related to the concentrations of sodium and calcium below 137-5 and 0-5 mM respectively. 6. The related alkaline earth metals, barium, strontium, and magnesium, resembled calcium in inhibiting the response to sodium lack. 7. No secretory response was seen when the cells were exposed for 10 min to calcium-free medium in which lithium replaced sodium. Exposure to this medium for 60 min, however, elicited secretion. 8. It is concluded that when extracellular calcium is low, a reduction in extracellular sodium induces a conventional exocytotic secretory response dependent on energy and cellular calcium. It is suggested that sodium lack may mobilize calcium from a cellular site possibly the inner aspect of the plasma membrane.

Sequence homology between Moloney murine sarcoma virus and Moloney leukemia virus RNA.

The Moloney murine sarcoma-leukemia virus [M-MSV (MuLV)], propagated at high multiplicity of infection (MOI), was demonstrated previously to contain a native genome mass of 4 X 10(6) daltons as contrasted to a mass of 7 X 10(6) daltons for Moloney murine leukemia virus (M-MuLV). The 4 X 10(6)-dalton classof RNA from M-MSV (MuLV) was examined for base sequence homology with DNA complementary to the 7 X 10(6)-dalton M-MuLV RNA genome. Approximately 86% of the M-MSV (MuLV) was protected from RNase digestion by hybridization, whereas 95% of M-MuLV was protected under identical conditions. These results indicate that the small RNA class of high-MOI M-MSV (MuLV) contains little (perhaps 10%) genetic information not present in M-MuLV. Virtually all of the 1.8 X 10(6)-dalton subunits of M-MSV (MuLV) RNA contained regions of poly(A) since 94% of the RNA bound to oligo(dT) cellulose in 0.5 M KCl. This suggests that the formation of the 1.8 X 10(6)-dalton subunits occurs before their packaging into virions and does not result from hydrolysis of intact 3.5 X 10(6)-dalton subunits by a virion-associated nuclease.

[Diagnostic importance of visken -- an adrenergic beta receptor blocking agent].

Among the newest beta-blocking agents visken is the one that either produces no or very little adverse inotropic effect. In some groups of patients with organic and neurotic cardiac disorders, screened as a result of a careful clinical examination, changes that occurred on the ECG with 12 leads following an intake of a single visken tablet (5 mg) were studied. Ingestion of visken was not seen to bring any improvement in the ECG findings in 88 per cent of 50 patients with organic disorders, most of whom had sclerosis of the coronary arteries and hypertensive disease attended by a high diastolic pressure. A thorough clinical examination of 70 patients presenting neurotic conditions helped to rule out any organic cardiac lesions, and in them the diastolic pressure did not exceed 95 mm Hg. The visken test showed that in 91 per cent of these cases the ECG returned back to normal and only in 1.5 per cent of them no changes could be observed. In both of the above groups the effect of visken was statistically significant (p less than 0.001). Repolarization derangements in the I and II leads among patients with organic lesions was observed 4 times as often as in the II and III leads. Among neurotic patients changes recorded in the II and III leads were twice as frequent as in the I and II leads.

A double-blind trial of ethamsylate in the treatment of primary and intrauterine-device menorrhagia.

22 patients complaining of primary menorrhagia or menorrhagia associated with an intrauterine device (I.U.C.D.) were studied in a double blind trial with crossover of ethamsylate and placebo. Acutal menstrual blood-losses were calculated from the iron content of used sanitary material during one pre-trail menstrual period and four trial menstrual periods, during which patients received ethamsylate ("Dicynene") treatment during two menstrual cycles and placebo during two cycles. During ethamsylate treatment the mean menstrual blood-loss was reduced by 50% in patients with primary menorrhagia and by 19% in patients with an I.U.C.D. This difference between the two groups is probably accounted for by the differing values of initial blood-loss which was significantly higher in the group with primary menorrhagia. Tampon usage and the duration of bleeding were not significantly altered by ethamsylate treatment. Reported side-effects, which were not serious, were equally common during ethamsylate and placebo treatment.

[Recent advances and prospects in periodic hemodialytic treatment for patients with uremia].

Following a brief outline of the history of haemodialytic technique, the most relevant recent progress is illustrated. Advances include the success of the internal artero-venous fistula for access to the vessels, of "less than" single "greater than" haemodialytic units, of three-times-a-week dialysis, and the creation of new disposable dialyzers of high efficiency and low priming volume. Some of the problems posed by the patient in periodic haemodialysis are then examined (the problem involved in the risk of hepatitis, that of persistent severe anemia even after haemodialysis has been begun and that of osteopathy) and the most suitable measures for preventing or limiting these situations are presented. Finally, survival indices of patients undergoing periodic haemodialysis are examined and it is concluded that, although various clinical problems have as yet failed to find a complete solution, the patient under haemodialysis can enjoy a satisfactory state of rehabilitation to family and working life and survive even for more than ten years after the terminal phase of uraemia.

[Studies on human alpha-2 macroglobulin structure and its complexes with proteases, using polyacrylamide gel electrophoresis].

Pure alpha2M is prepared with fresh plasma as starting material, to prevent the interaction of alpha2M from proteolytic enzymes of plasma such as thrombin, plasmin and kallikrein. During the purification steps, polybrene and aprotin are used as inhibitors and plasminogen is absorbed onto bentonite. When alpha 2M is submitted to polyacrylamide gel electrophoresis (PAA) containing 0.1% SDS, a complete dissociation in two half-molecules of MW 380,000 occurs. When alpha2M is incubated in 1% SDS and 1% beta-mercaptoethanol as reducing agent, only one component of MW 190,000 is observed in PAA-SDS. This experiments show that the alpha2M molecule consist of two symetric halves of same MW (380,000) linked by non covalent bonds. Each two-half-molecules is made of two polypeptides chains MW 190,000 linked by disulfide bonds. Thus alpha2M molecule contains four polypeptides chains having a same MW. The same techniques were applied to the study of alaph2M proteinases complexes. Three different proteinases (plasmin, trypsin and papain) were used in these experiments. Trypsin and papain are commercialy available. Plasminogen was obtained by affinity chromatography and activated into plasmin by insoluble streptokinase fixed on PAB cellulose.

B-cell antibodies, Ia-like determinants, and their relation to MLC determinants in man.

The HLA supergene is located in the 6th chromosome. Its position to the centromere and the position of a number of polymorphic isoenzymes has been elucidated. The HLA supergene codes not only for determinants present on all nucleated cells, but also for determinants present on B cells and absent from T cells and platelets. These determinants can be recognized by serology, and evidence is presented that some of them are coded for by a hither to unrecognized locus Ag, which is very closely linked to the MLC determinants of the D locus can be recognized with the help of the MLC test using unprimed cells, homozygous for the MLC determinants, so-called typing cells primed against one MLC determinant in the PLT test. So far, 8 MLC determinants have been recognized. Significant disease-association studies in different racial groups appear to be especially informative. They already indicate that the association found so far must rest on different mechanisms. Whether some of them could be caused by partial deficiency for one or more of the complement factors remains to be proven.

[FAB immunoglobulin fragments. I. The comparative characteristics of the serological and virus-neutralizing properties of a gamma globulin against tick-borne encephalitis and of the FAB fragments isolated from it].

A comparative study was made of the serological properties and virus-neutralizing activity of antiencephalitis gamma-globulin and Fab-fragments isolated from it by gel-filtration. Horse immunoglobulins against the autumno-summer tick-borne encephalitis virus could be disintegrated with the aid of papaine to monovalent Fab-fragments which (according to the complement fixation reaction, the test of suppression of the complement fixation, and the HAIT) retained the serological activity whose level was compared with that of the serological activity of gamma-globulin. Fab-fragments possessed a marked virus-neutralizing activity. The mean value of a logarithm of the neutralization index was 2.65 +/- 0.2 for Fab-fragments and 3.74 +/- 0.38 for gamma-globulin (P less than 0.01).

5-Fluoro-uracil cream in the successful treatment of therapeutically refractory condylomata acuminata of the urinary meatus.

A therapeutic trial of 5% 5-Fluoro-uracil in cream form was conducted in 40 men with condylomata acuminata unresponsive to other therapeutic measures. Sixty per cent of the condylomata on the genital and/or anal mucosa showed complete regression. The most promising results were recorded in the cases of condylomata affecting the urinary meatus. These lesions disappeared in 13 of 14 cases after an average of 3 weeks' treatment with subjectively few side effects. With regard to this type of condylomata it may be said that a great therapeutical advance has been achieved. The treatment of other condylomata involving the genital or anal mucosa often causes intolerable discomfort to the patients. The method should in these cases therefore be attempted only when the lesions prove to be refractory to other methods of treatment. In its present form the application of 5-FU cream is difficult to confine solely to the condylomata itself. The cream appears to have little or no effect on condylomata at sites other than the mucosa.

Clostridium difficile.

Seventy-five meconium samples were examined for the presence of Cl. difficile; 3 strains were isolated. Additionally 45 laboratory animal faeces specimens were tested for the same purpose, a further 2 cases were isolated. These five suspicious strains were identified as Cl. difficle according to the tests mentioned in the previous paragraphs. The organisms isolated here showed the same characteristics as five of the strains received and also as the organisms isolated from the inoculated animals with the crude cultures of Cl. difficile. These organisms were variable in size, roughly 2-9 XO.3-0. 8u, Gram positive rods, motile, capsulated, flagellated, most probably peritrichous, possessing non-bulging spores located terminally or subterminally, free spores were rarely detectable. Cell arrangements: singly or in pairs and occasionally in short chains. On longer incubation the organisms slightly shifted to become Gram variable and longer in size. Colonies on ordinary agar and solid blood agar appeared to be punctiform and rough. On the other hand the colony appearance on the rest of the solid media which are mentioned previously are as follows: 1-3 mm in diameter, greenish, smooth, non-haemolytic, entire some showing slight irregularities of their edges. Colonies slightly raised, butyrous and semi opaque to opaque. This organism does not liquify the serum of Loeffler medium and also does not cause any changes of this medium. The metachromatic granules are readily seen by Albert's staining. Neither proteolytic nor lipolytic activities are possessed by this organism. Sensitivity to antibiotics showed the same pattern as mentioned about the strains received.

Quantitation of antibodies to Herpes simplex virus types 1 and 2 by complement-dependent antibody lysis of infected cells.

The release of 51Cr from cells infected with herpes simplex virus type 1 or type 2 by antibody and complement was examined as a method of quantitating antibodies to the viruses. With decreasing concentration of antibody, a typical dose-response curve was observed; a region of antibody excess in which dilution did not affect percentage of specific 51Cr release followed by a region in which a linear relation existed between dilution and percentage of specific 51Cr release. Therefore, a quantitative expression of antibody titer was defined as that dilution of serum which yielded 50% specific 51Cr release. The slopes of the linear portion of the dose-response curves were characteristic of the type of virus used to infect the cells and not upon the source of antiserum, thus, the slopes could be used to estimate antibody titers. The multiplicity of infection influenced the antibody titers; reproducible results were obtained when cultures were infected with 3 to 5 plaque-forming units per cell; the antibody titers decreased when less virus was used. The antibody titers obtained by the 51Cr release test were similar to those obtained by a microneutralization test. The 51Cr release test was found to be reproducible and to be useful in estimating the percentages of antibody activity attributable to antibodies to cross-reacting and type-specific antigens.

5-Azacytidine. A new anticancer drug with effectiveness in acute myelogenous leukemia.

Clinical studies involving 5-azacytidine, a ring analogue of cytidine, began in Europe in 1967 and the United States in 1970, and we review available preclinical and clinical studies here. The drug possesses cytotoxic, antimicrobial, antineoplastic, abortive, and mutagenic activity in various biological systems. 5-Azacytidine is thought to exert its antineoplastic effect through interference with nucleic acid metabolism. The dose-limiting toxicities are nausea, vomiting, and leukopenia, while the incidence of thrombocytopenia is low. Hepatic toxicity ranges from abnormal findings in liver function tests to hepatic coma. Clinical results in solid tumors are not encouraging, but 5-azacytidine shows consistent antitumor activity in patients with acute myelogenous leukemia resistant to previous treatment. An overall response rate of 36%, with 20% complete remissions, was achieved in 200 previously treated patients with acute myelogenous leukemia. Further studies must define the role of 5-azacytidine alone and in combination for the first-line treatment of acute myelogenous leukemia.

Cross-sensitivity of common aminoglycoside antibiotics.

Guinea pigs were sensitized to neomycin (A, B, or C), paromomycin, gentamicin, kanamycin, streptomycin, and dihydrostreptomycin via intradermal or foot-pad injection with an adjuvant containing killed Mycobacterium butyricum or M tuberculosis H37Ra (Ra). These antibiotics produced greater cross-sensitization with an increase in the number of immunizations and chemical structural similarities. After repeated intradermal injections (adjuvant Ra) of neomycin, guinea pigs showed cross-sensitization to paromomycin, kanamycin, and streptomycin. A single intradermal injection of one of these antibiotics produced stronger reactions to the most closely related antibiotics, with no meaningful sensitization to the least-related allergens. Streptomycin-sensitized guinea pigs seldom showed a meaningful cross-sensitization to dihydrostreptomycin or the other antibiotics (except neomycin C); however, guinea pigs sensitized to dihydrostreptomycin or the other antibiotics often showed strong cross-sensitization to streptomycin.

Responses of cancer patients in the MEM test: not just a function of charge on basic proteins.

It has been reported that lymphocytes from cancer patients give positive responses to PPD, myelin basic protein, tumour basic protein, and certain histone fractions in the MEM test. The underlying mechanisms of the MEM test are poorly understood, but it is widely assumed that it detects immunological sensitization to specific antigenic determinants. The cross-reactivity experienced is interpreted as indicating shared antigenicity. Since all the stimulatory proteins are strongly basic we investigated an alternative explanation that responsiveness is a function of electrical charge by comparing the known stimulatory proteins in the MEM test with two others of similar basicity: lysozyme and cytochrome-C. We obtained highly significant stimulation with PPD, tryptophane peptide of myelin, and tumour basic protein using Mantoux + cancer patients, but found no response to other basic proteins. We failed to confirm the reported activity of histone F2a. Our results indicate that basicity alone is insufficient to elicit response, and strengthens the concept that the MEM test is measuring sensitization to the determinants shared by myelin and tumour basic protein.

Cholinergic sites in skeletal muscle. I. Denervation effects.

Cholinergic interactions in systems derived from rat skeletal mixed muscle are detailed. The isotherms of the binding of [125I]diiodo-alpha-bungarotoxin over the range of 10(-10)-10(-5) M toxin have been separated into a "nonspecific" component exclusive to the toxin and a "specific" component that binds both the toxin and d-tubocurarine. The "specific" component appears to reflect two independent sets of binding sites. One of the sets has an affinity constant on the order of 10(9) M-1. Following denervation, the number of sites in this high-affinity set begins to increase after 3 days, reaches a peak (28-fold higher than normal) on the 8th day, and begins to decline. Similar results are obtained when sensitivity of this set to an antibody derived from patients with myasthenia gravis is examined. This sensitivity is reflected by the inhibition of the alpha-bungarotoxin binding by the myasthenic IgG fraction. Following denervation, sensitivity first appears on day 3 progresses coincidentally with the increase in new sites in the set. The charcteristics of this set suggest that it represents the acetylcholine receptor and that the new sites appearing during the course of denervation are extrajunctional receptor sites. The interaction with the myasthenic IgG indicates an antigenic difference between junctional and extrajunctional receptors. The second set of specific binding sites has an affinity constant on the order of 10(5) M-1. The number of sites in this set increases only fivefold as a result of denervation. The increase also begins between days 2 and 3. The definition of this low affinity set of sites is not presently clear.

Preparation and characterization of two isozymes of choline acetyltransferase from squid head ganglia. II. Self-association, molecular weight determinations, and studies with inactivating antisera.

The two isozymes of choline acetyltransferase (Acetyl-CoA:choline O-acetyltransferase, EC 2.3.1.6) from head ganglia of Loligo pealei have been examined by polyacrylamide gel electrophoresis, gel chromatography, and equilibrium sedimentation in the ultracentrifuge. Inactivating antisera, prepared to both native and dithiothreitol-treated isozymes 1 and 2 of squid choline acetyltransferase, were used to demonstrate the immunologic identity of isozymes 1 and 2. Each isozyme appeared to contain two non-identical catalytically active subunits, with molecular weights of approx. 37 000 and 56 000. A staining method was developed to visualize choline acetyltransferase activity in acrylamide gels. The method is based on the formation of a precipitate of manganese ferrocyanide at sites where free coenzyme A is released. By this method, and by analysis of gel slices, it was found that each of the isozymes can form aggregates of several different sizes. The formation of immune precipitates with the aggregates showed the identity of the multiple bands of enzyme protein resolved on disc gel electrophoresis. Isozyme 1 was most active as a small aggregate, whereas isozyme 2 was most active as a large aggregate. Both chromatography on Sephadex G-200 and isoelectric focusing yielded a number of active species with molecular weights ranging from 35 000 to 300 000. In addition, we demonstrated the dissociation of enzyme protein in the presence of 1.0 - 10(-2) M dithiothreitol, the formation of multiple precipitin bands by aged enzyme, and the identity of the different isoelectric fractions of each of the isozymes.

[Changes in the chromatin structure of hepatocyte nuclei of rats trained to hypoxia].

Structure of chromatin in the nuclei of the isolated surviving hepatocytes and in the isolated nuclei of hepatocytes were studied by fluorochroming with acridine orange and by microfluorimetry of fluorescenc connected with the stain chromatin at 530 and 590 nm in intact rats and in the animals trained to hypoxia in a pressure chamber for 60 days. The nuclei of hepatocytes of intact rats were distributed by fluorescence at 530 nm into three classes with the intensity ratio of 1:2:4; as to the nuclei of hepatocytes of the rats trained to hypoxia - they formed a single class corresponding to the second class of control. In intact rats the ratio of the fluorescence intensity at 590 nm to such at 530 nm (alpha coefficient) formed normal distribution; in trained rats - a bimodal distribution with a shift of the maximum in the direction of reduction and increase of alpha in comparison with control. It is supposed that in hypoxia there is a repression of one and depression of other genes in the chromatine of the nuclei of the liver.

Comparison of in vivo translation rates and messenger RNA levels of alpha2U-globulin in rat liver and Morris hepatoma 5123D.

The synthesis of the male rat hepatic protein alpha2U-globulin has been examined in Morris hepatoma 5123D and male host liver using pulse incorporation of labeled amino acids in vivo, followed by immunoprecipitation of the newly synthesized alpha2U-globulin from the soluble protein fraction of liver and hepatoma tissue. It was found that no alpha2U-globulin synthesizes alpha2U-globulin at a normal level (0.9 to 1.0% of total hepatic protein synthesis). A variety of liver-derived cell culture lines also did not have alpha2U-globulin synthesis. The level of the specific mRNA coding for alpha2U-globulin can be quantitated using in vitro translation of polyadenylate-containing RNA in a Krebs II ascites cell-free translational system, followed by immunoprecipitation of the alpha2U-globulin synthesized in vitro. Using this technique, it was found that host liver contained alpha2U-globulin mRNA at normal levels, whereas hepatoma tissue contained no detectable mRNA coding for this protein. Thus, alpha2U-globulin synthesis is deleted in the minimal-deviation hepatoma 5123D as a consequence of the inability of that tissue to produce functional mRNA coding for alpha2U-globulin. The implications for the regulation of gene expression in malignant cells are discussed.

Hepatitis-B: a review.

The recent literature on various aspects of hepatitis-B is reviewed with emphasis on the interrelationships of viral structure, antigenic components, and host immune response in acute, chronic, and asymptomatic carrier states of the infection. The mode of replication and mechanisms of transmission are discussed. Special attention is paid to potential non-parenteral routes of spread. The role of hepatitis-B in associated immune complex diseases and in hepatoma is outlined. A guide to the interpretation of serologic tests for hepatitis-B associated antigen and antibody patterns is presented in relation to the clinical stage and prognosis of the infection. Therapy, except in conceptual terms, is not covered but a summary of the current status of active and passive immunization is given. The unresolved question of the infectivity of carrier medical staff for their patient contacts, and the reverse, is discussed.

Functions of primary afferents and responses of extracellular K+ during spinal epileptiform seizures.

Paroxysmal activity in ventral roots induced by penicillin in decapitate cat spinal cords is associated with waves of depolarization of primary afferent fiber terminals. These paroxysmal depolarizations can be detected as spontaneously occurring negative dorsal root potentials (DRPs) and are associated with antidromic discharge of nerve impulses in dorsal root fibers; they can also be detected by testing the excitability of afferent nerve terminals by focal stimulation. Negative DRPs evoked by afferent nerve volleys are altered in waveform but not in amplitude during seizures induced by penicillin, although they are blocked by the administration of picrotoxin. While blocking afferent-evoked DRPs, picrotoxin does not interfere with paroxysmal DRP'S, INDICATING DIFFERENCES IN THE GENERATION OF THE Two phenomena, which nevertheless have some link in common, for the paroxysmal waves occlude the evoked DRP. Such occlusion would appear as blockade, if DRPs were recorded by condenser-coupled amplifiers. In the presence of pentobarbital penicillin suppresses evoked DRPs, but under such circumstances seizure activity is not observed. Extracellular potassium activity within spinal gray matter transiently increases during seizure activity. Such increments of potassium activity are maximal in the ventral horns. This and several other observations suggest that in decapitate spinal cords systemically administered penicillin induces seizures which originate in the ventral gray matter. Accumulation of excess potassium may be the cause of paroxysmal depolarization of afferent nerve terminals. Excess potassium while not playing a principal role in initiating seizures, may influence the course of seizures by depolarizing afferent terminals. Such depolarization probably enhances tonic background release of transmitter substance, may modify the effect of synaptic input, and may favor synchronization of waves of neural excitability through extrasynaptic mechanisms.

Dependence of reward contingent positive variation (RCPV) and cortical synchronization on visual input in the cat.

Cats trained to press a lever for milk reward display high amplitude low frequency electrocorticographic post-reinforcement synchronization (PRS) associated with epicortical steady potential shift, termed Reward Contingent Positive Variation (RCPV), over the parieto-occipital cortex. Previously, it was found that the PRS-RCPV phenomenon depends on unpatterned light input devoid of any conceivable information or conditional property. Although training in the dark most likely eliminated the "novelty" factor and the resulting orienting reaction to "light off" as a cause of PRS-RCPV suppression, a possibility could not be excluded that the absence of light had a negatively reinforcing property preventing the emergence of PRS-RCPV. Hence, in the present study an experimental paradigm was used in which "light off" and/or "tone on" cues signalled the availability of reward, the "light off" periods extending through the consummatory response. Seven out of 9 cats, despite 2-4 months of daily training, and 85% correct timing of bar press performance, never showed a PRS-RCPV response (one animal showed only sporadic and poorly developed patterns.) However, when the light was turned on during consumption, in 85% of such tests a fully developed PRS-RCPV emerged in a stimulus-bound manner. One animal was an exception and showed PRS-RCPV both in the absence and presence of light. It was concluded that light input plays a crucial role in the emergence of the PRS-RCPV phenomenon and therefore also participates in the integration of gustatory input.

Quantification of computer analyzed serial EEGs from stroke patients.

While considerable studies have been conducted by others in automation of the EEG, this method does appear to hold promise for quantitative evaluation and automation of the EEG in the CVA patients or those with similar neurologic deficits. Patients were followed up to 1 year post-ictus. The computerized evaluation of serial records in the CVA patients showed trends which were similar to the percent disability of the patients who were graded neurologically. The patients included in the study were those with middle cerebral artery, carotid and vertebro-basilar defects. A substantial increase in the low frequency activity with a concomitant decrease in high frequency activity was observed in the CVA patients. The results observed in these patient examples demonstrate the utility and efficacy of one method of automated analysis of serial EEGs. The parameters defined by this study have proven to be consistent and effective measures. Since these parameters are objective, they are not affected by patient histories and hence, can be utilized to track the ongoing EEG activity and the accompanying clinical state regardless of the disease entity or the course of therapy pursued. The addition of automated objective quantitative measures to EEG analysis provides a dimension not currently available to the clinician.

Seizure moitoring: a new tool in electroencephalography.

A seizure monitoring system, based on telemetry and computer techniques, has been developed to provide a reliable means of recording the patient's spontaneous seizures. It allows a patient's EEG to be monitored for hours or days with 16 channels of EEG from surface, sphenoidal or stereotaxically implanted depth electrodes, from any ward or room within the hospital. The EGG is delayed in time by up to 4 min by a mini-computer so that either the patient can push a button when he experiences his aura or others can push the button when they observe his seizure. Since the delayed EEG is written out, the preictal, ictal and postictal are recorded on paper, without many pages of uneventful interictal information. During the past 16 months, the seizure monitoring system has been used as a clinical service to examine patients with surface electrodes (42), sphenoidal wires (25) and depth electrodes (7) during 146 recording sessions for over 3200 h of monitoring time while over 200 seizures have been recorded.

Localization of bovine pancreatic polypeptide (BPP)-like immunoreactivity in rat pancreatic monolayer culture.

Antiserum to bovine pancreatic polypeptide (BPP) has been used for immunofluorescent staining in the light microscope. With this technique it is possible to detect the presence of specific cells in monolayer culture from neonatal rat pancreas which contain BPP or a closely related peptide.

CT banding of human chromosomes: description of the banding technique and some of its modifications.

A technique is described for staining centromeric areas and reverse, mainly telomeric bands in human chromosomes. With this "CT" technique karyotyping of C-banded metaphases is possible without previous or subsequent use of other banding methods. The method consists of an alkaline pretreatment at 60 degrees C with Ba(OH)2, followed by salt incubation in 2 X SSC at 60 degrees C and staining with the cationic dye "Stains-all". In a series of experiments the influence of the variables in the procedure was studied, with the following main results: 1) Ba(OH)2 treatment alone and subsequent staining produces a distinct reverse banding pattern in which the secondary constriction of chromosome 9 is positive. 2) The 2 X SSC incubation in the CT procedure causes the Ba(OH)2 induced reverse bands to become weaker; the centromeric regions, however, become very prominent. 3) If the temperature of the 2 X SSC treatment is raised to 85 degrees C, the CT technique results in a specific staining of the short arm regions of some probably variant acrocentric chromosomes. The interphase nuclei of individuals possessing such acrocentrics usually show very distinct chromocentres after this treatment; in the polymorphs these chromocentres are often situated along the nuclear membrane. The mechanisms which may form the basis of the staining results obtained, and the possible significance in human cytogenetics of the techniques described, are discussed briefly.

Dissociation and denaturation behaviour of sesame alpha-globulin in sodium dodecyl sulphate solution.

The effect of anionic detergent, sodium dodecyl sulphate, on the major protein, alpha-globulin of sesame seed (Sesamum indicum L.) has been investigated by gel filtration, sedimentation velocity, viscosity, optical rotation, difference spectra and fluorescence measurements. The detergent causes dissociation of the protein first and then denaturation. In the detergent concentration range of .175-4.0 X 10(-"3) M four components are observed in the ultracentrifuge. The specific rotation of the protein increases with the detergent concentration above 2.5 x 10 (-3) M detergent suggesting conformational change; above 8 X 10(-"3) M detergent the value of -[alpha] does not change. The reduced viscosity etared however, increases above .25 X 10(-3) M detergent and does not attain a plateau value. The difference spectrum of the protein indicates that both tryptophan and tyrosine groups have been affected by the detergent. The fluorescence intensity decreases and the maxima shifts towards red in the detergent solution resulting in an "isoemissive point" at 355 nm. The double difference spectra in sucrose-detergent protein system show that below 5-0 X 10(-3) M detergent, the difference absorption and fluorescence spectrum result from the binding of the detergent near the chromophoric groups and are not due to conformational change. Binding studies by equilibrium dialysis indicate the presence of 50 binding sites in the protein and binding constant of 3-0 X 10(3).

Distribution and properties of an adenosine triphosphatase in the tanycyte ependyma of the IIIrd ventricle of the rat.

The distribution, histochemical properties and ultrastructural localization of adenosine triphosphate (ATP) hydrolyzing enzymes in the tanycyte ependyma of the third ventricle have been studied in female Wistar rats. Using a calcium-cobalt procedure and a lead capture technique, splitting of ATP could be demonstrated in perikarya and processes of tanycytes in the region of the ventromedial nucleus. The reaction showed no dependence on magnesium or sodium ions, did not occur with other monodi-, and tri-phosphates as substrates, and was inhibited by p-chlormercuribenzoate (PCMB) and sodium fluoride, but not by ouabain. With the calcium-cobalt method the highest intensity of reaction was found at pH 9.4, whereas the lead method gave optimal results at pH 6--8. At the ultrastructural level, the reaction product was found at the outer surface of the plasma membranes of tanycytes and reached its highest concentrations in the region of the region of the apical microvilli; From the findings it is concluded that splitting of ATP in tanycytes is due to a true ATPase. The enzyme might be involved in an active transport of substances by tanycytes.

Cytochemical evaluation of the Guard procedure a regressive staining method for demonstrating chromosomal basic proteins. I. Effects of fixation, blocking reactions, selective extractions, and polyacid "differentiation".

Appropriately fixed preparations stained by a modification of the Guard (1959) reaction for "sex chromatin" display selective staining of interphase chromatin and mitotic or meiotic chromosomes. This is a regressive staining method which seems to depend on the selective displacement of an acidic dye from less basic structures, and retention of the dye at more basic sites. The results obtained with the reaction can be controlled by the length of time that the preparations are "differentiated" in solutions containing phosphomolybdic and phosphotungstic acids (polyacids). After three- or four-hour exposures to polyacid solutions, all chromatin is stained. However, with longer differentiation, "condensed" chromatin can be stained preferentially. Of a number of fixatives investigated, only 10% formalin, ethanol-acetic acid (3:1), and Bouin's solution proved useful. Others resulted in diminished specificity or a total loss of selectivity. The most intense staining was obtained after formalin fixation. Less intense dyebinding was observed after fixation in 3:1 - probably due to extraction of some histone fractions-and the least amount of dye was bound in Bouin's-fixed chromatin - probably due to blockage of arginine residues by picric acid. The reaction was not affected by enzymatic removal of nucleic acids or the extraction of lipids. It was diminished by treatment with trypsin or weak acetylation, and it was completely prevented by strong acetylation, deamination, or extraction of basic proteins with HCl. The results presented suggest that the modified Guard (1959) procedure selectively demonstrates basic nucleoproteins. Further, by the use of regressive differentiation in polyacid solutions, the retention of dye in more condensed chromatin can be favored.

Purification and properties of two deoxyribonucleases of Pseudomonas aeruginosa.

A survey of the major deoxyribonucleases in Pseudomonas aeruginosa strain PAO was undertaken. Two activities predominated in Brij-58 lysates of this organism. These have been purified from contaminating nuclease activities, and some of their properties have been elucidated. The first was a nuclease that degraded heat-denatured deoxyribonucleic acid (DNA) to mono- and dinucleotides. The activity of this enzyme was confined to single-stranded DNA, and 100% of the substrate was hydrolyzed to acid-soluble material. The Mg2+ optimum is low (1 to 3mM), and the molecular weight is 6 X 10(4). The second predominant activity was an adenosine 5'-triphosphate (ATP)-dependent deoxyribonuclease. This enzyme had an absolute dependence on the presence of ATP Mg2+ concentrations of approximately 10 mM. Five moles of ATP was consumed for each mole of phosphodiester bonds cleaved. The acid-soluble products of the reaction consisted of short oligonucleotides from one to six bases in length. Only 50% of the double-stranded DNA was rendered acid soluble in a limit digest. The molecular weight of this enzyme is 3 X 10(5). The observation of these enzymes in P. aeruginosa is consistent with the possibility that recombinational pathways similar to those of Escherichia coli are operating in this organism.

Mobility restriction in vivo of the heavy ribosomal subunit in a secretory cell.

Analysis in insect (Chironomus tentans) salivary gland cells of labeled RNA as a function of time after precursor injection and its distance to the nuclear membrane, cytoplasmic zone analysis, could previously be used to demonstrate the presence of short-lasting gradients in newly labeled ribosomal RNA. Since the gradients were sensitive to puromycin, they are likely to be a result of diffusion restriction due to an engagement of the subunits into polysomes. In the present paper the possibility was explored of recording gradients that were caused by labeled subunits in puromycin-resistant associations, which, in all probability, involve the endoplasmic reticulum. It was found that labeled 28 S and 5 S RNA but not 18 S RNA were present in radioactivity gradients lasting for at least 2 days but less than 6 days. The gradients also remained during inhibition of RNA synthesis by actinomycin, and they were completely resistant to puromycin whether given in vivo or in vitro. The semipermanent gradients formed fhere offer a unique parameter for the in vivo study of conditions for formation and maintenance of heavy subunits in puromycin-resistant bonds. An explanation for these and previous results is that the light subunit, although restricted in movement by engagement to polysomes, is nevertheless free to exchange and spread between rounds of translation, whereas at least part of the heavy subunit population is bound to the endoplasmic reticulum and less free to spread. These results offer a good in vivo correlate to previous results on in vitro exchangeability of subunits.

Ultrastructural studies on the localization of neurohypophysial hormones and their carrier proteins.

Neurophysin, vasopressin and oxytocin were localized in different portions of the supraopticohypophysial tract (SHT) using the unlabeled antibody enzyme technique at the ultrastructural level. In vasopressin-positive supraoptic perikarya, vasopressin and neurophysin were present in all neurosecretory granules. Within the zona interna of the median eminence, vasopressin and neurophysin were present in two populations of axons, one with granules of 1300-1500 A and one with granules of 900-1300 A. Following exposure of thin sections of median eminence to antiserum to neurophysin, reaction products were present in granules and in the extragranular cytoplasm in the axons with larger granules; in all other cases reaction product was confined to the granules. Vasopressin-positive fibers were also presented in large numbers of the zona externa of the median eminence and many terminated on the pituitary primary portal plexus. A few oxytocin fibers were present on the portal capillaries in the infundibular stalk. In the posterior pituitary all axon profiles were neurophysin positive. Neurophysin was present as both a granular and cytoplasmic pool. Vasopressin-containing axons account for 90% of the neuronal elements in the posterior pituitary and oxytocin for the remaining 10%. Findings on the subcellular distribution of these peptides are related to current theories on transport and release of neurohormones.

Modulation of cyclic AMP in purified rat mast cells. III. Studies on the effects of concanavalin A and anti-IgE on cyclic AMP concentrations during histamine release.

Changes in rat mast cell cyclic adenosine 3',5' monophosphate (cAMP) concentrations during stimulation of histamine release by concanavalin A (con A) and anti-IgE were studied. Con A caused an increase in cAMP with a mean peak level at 20 sec of 232% of control (range 164% to 365%). Con A-stimulated cells demonstrated falls toward control levels after 20 sec, but generally remained above control for at least 5 min. By 10 min cAMP had returned to control values. The con A effect on cAMP occurred in the absence of phosphatidyl serine but was markedly inhibited by 5 mM alpha-methyl-D-mannose. Anti-IgE induced a less marked increase in cAMP (157% of control, range 110% to 540% of control) which reached a peak at 20 sec. Two monospecific goat anti-rat myeloma IgE antisera induced similar changes in cAMP whereas normal goat IgG had no effect. These peak values were followed by a rapid decrease in cAMP. Within 2 min the cAMP content of anti-IgE stimulated cells had fallen to levels well below control and remained below control levels from 45 sec to over 15 min. Histamine release in both systems began after the peak cAMP levels, during the period of rapid destruction of cAMP.

Suppression of reaging antibody formation. IV. Suppression of reaginic antibodies to penicillin in the mouse.

Reaginic antibodies to the benzylpenicilloyl determinant (BPO) and ovalbumin (OA) were induced readily in B6D2F1 mice by a single i.p. injection of either 1 or 10 mug of BPO4-OA suspended with 1 mg of Al(OH)3 in 0.5 ml of saline. Administration of conjugates consisting of the hapten coupled to the isologous, nonimmunogenic murine gamma-globulins (MgammaG), i.e., BPO9-MgammaG, BPO11-MgammaG, or BPO12-MgammaG, resulted in complete and specific suppression of the induction of the anti-BPO reaginic antibody response without affecting, however, the level of reaginic antibodies to OA. Further study of the effect of epitope density on the immunologic properties of BPOX-MgammaG revealed that a) the lightly haptenated conjugated, BPO1-MgammaG and BPO2.9-MgammaG, were not immunosuppressive, b) the conjugates, BPO4.3-MgammaG and BPO19-MgammaG, were partially tolerogenic, and c) the heavily haptenated conjugate, BPO31-MgammaG, was nontolerogenic. Moreover, most importantly, the ongoing anti-BPO response in sensitized mice was readily abrogated by either four daily or four weekly injections of BPO9-MgammaG. The immunosuppressive effect of BPO12-MgammaG conjugates was dose dependent, complete suppression being achieved with 200 mug of the tolerogen. The unresponsiveness to BPO of spleen cells from immunosuppressed donors was also maintained in adoptive cell transfer experiments in spite of the additional administration of the immunizing antigen under conditions expected to yield a secondary IgE response. Hence, it is suggested that, with special precautions to prevent unleashing an anaphylactic shock, treatment of penicillin-sensitive individuals with polyvalent conjugates of an appropriate number of BPO groups per human gamma-globulin molecule would constitute a rational immunotherapeutic procedure for the abrogation of the allergic response to BPO.

2,7-Fluorenediamine and 2,5-fluorenediamine as peroxidase reagents for blood smears.

Our new histochemical methods for peroxidase activity, which do not require benzidine as a hydrogen donor, have been modified for hematological use. Diamine derivatives of fluorene (2,7-fluorenediamine and 2,5-fluorenediamine) were employed in place of benzidine and the result obtained was satisfactory. Two staining techniques were developed. (1) Smears of peripheral blood or bone marrow aspirates were fixed in 2.5 per cent glutaraldehyde solution for 1 minute. Smears were then washed in tap water and covered either by a saturated solution of 2,7-bluorenediamine or by a 0.05 per cent solution of 2,5-fluorenediamine in the presence of hydrogen peroxide for 5 minutes. After being washed in running tap water they were counterstained with Carazzi's hematoxylin solution for 10 minutes. (2) The second technique employs pretreatment of blood smears with 5 per cent CuSO4 solution and aldehyde fixation was omitted. Smears were counterstained by Giemsa stain. The nuclear chromatin structures were well preserved and nucleoli were easily distinguished in the immature cells. In the first method, clear brown granules were recognized in the cytoplasms. In the second method, peroxidase-positive granules were stained black and the staining of nucleus and cytoplasm resembled that of McJunkin's method.

Temperature-dependence of rapid axonal transport in sympathetic nerves of the rabbit.

Stop-flow techniques were used to determine how temperature affected the axonal transport of dopamine-beta-hydroxylase (DBH) activity in rabbit sciatic nerves in vitro. These nerves were cooled locally to 2 degrees C for 1.5 hr, which caused a sharp peak of DBH activity to accumulate above the cooled region. Accumulated DBH was then allowed to resume migration at various temperatures. From direct measurements of the rate of migration, we found that the axonal transport velocity of DBH was a simple exponential function of temperature between 13 degrees C and 42 degrees C. Over this range of temperatures, the results were well described by the equation: V=0.546(1.09)T, where V is velocity in mm/hr, and T is temperature in degrees centigrade. The Q10 between 13 degrees and 42 degrees C was 2.33, and an Arrhenius plot of the natural logarithm of velocity versus the reciprocal of absolute temperature yielded an apparent activation energy of 14.8 kcal. Transport virtually halted when temperature was raised to 47 degrees C, although only about half of the DBH activity disappeared during incubation at this temperature. Another transition occurred at 13 degrees C; below this temperature, velocity fell precipitously. This was not an artifact peculiar to the stop-flow system since the rate of accumulation of DBH activity proximal to a cold-block also decreased abruptly when the temperature above the block was reduced below 13 degrees C.

Some chemical principles applicable to some silver and gold staining methods for neuropathological studies.

Some of the chemical principles involved in some silver and gold staining procedures for neuropathological studies are analyzed in the light of experience with methods for astrocytes, microglia, axons and reticulin fibers. The role of formalin fixation, and of treatment with ammonium bromide or oxidizing agents prior to staining for glial cells or reticulin fibers respectively, is described. The silver staining methods are divided into two fundamentally different groups. One is based on the use of silver diammine solutions with or without other substances such as carbonates or pyridine, and at varying times, gold toning. This group encompasses a great variety of techniques for staining glial cells, reticulin fibers and axons. The second group is based on the use of weak solutions of silver ions, reduction in a photographic developer, treatment with gold chloride, and a second reduction in oxalic acid. This group is represented by methods for staining axons and reticulin fibers. A brief analysis of the gold and mercuric chloride methods for astrocytes is also given.

Lung damage caused by phospholipase C and the changes in phospholipids in the rat lung.

The lipid and protein fractions of the endobronchial lavage fluid from the normal rats which contained the lung surfactant were analysed. Lecithin, the main main component of the lung surfactant, was exclusively combined with a dextran precipitable protein. This protein then behaved as beta-globulin on cellulose acetate electrophoresis or low density lipoprotein on agarose gel filtration. After administration of phospholipase C (from Clostridium Welchii), the protein content of the lavage fluid increased markedly. The amount of dextran precipitable protein also increased markedly and its properties remained the same on gel filtration after treatment with phospholipase C. The phospholipids in the lavage fluid were not affected, although the total phospholipids in the lung tissue, especially lecithin, did decrease during the 10 days after treatment. Histopathologically, an eosinophilic dense exudative fluid appeared in both the interstitium and the broncho-alveolar spaces. A large number of the alveolar lining cells disappeared and a few of them were desquamated into the alveolar spaces. Thus, the immediate destruction of the alveolar lining cells after the administration of phospholipase C resulted in interstitial pneumonia in 10 days. The significance of phospholipase in pulmonary inflammation is discussed.

Clinical syndromes of mastalgia.

232 patients attending a breast clinic with breast pain as the primary presenting symptom were studied prospectively to define clinical syndromes and to attempt to elucidate aetiological factors. Those women in whom mastalgia was a minor aspect of their complaint, or who were primarily seeking reassurance that they did not have cancer, were excluded. Most mastalgia patients could be placed into well-defined subgroups on the basis of clinical, radiological, and pathological features. After excluding causes of pain arising outside the breast, six specific groups with widely differing aetiological bases were defined, leaving only 7% unclassified lithout known aetiology. The six defined groups were cyclical pronounced mastalgia, (believed to be hormonally based), duct ectasia. Tietze syndrome, trauma, sclerosing adenosis, and cancer. Psychological factors were found to be less important than has been previously suggested. Classification of patients with mastalgia into homogeneous subgroups is a prerequisite of any therapeutic study.

Cotrimoxazole and folate metabolism.

Cotrimoxazole 4 tablets daily (1 tablet = trimethoprim 80 mg and sulphamethoxzole 400 mg) was given for a period of six to fourteen days to 13 inpatients, and serum-folate levels were measured before and one day after the course of treatment. The results were compared with those from 8 patients not receiving antibacterial therapy, tested on admission and one week later. Two assay techniques were used, one employing Lactobacillus casei and the other 125I-labelled folate isotope dilution. The microbiological technique showed a significant decline in folic-acid levels in the serum after cotrimoxazole, and this decline was not seen in controls. By contrast, the radioisotope technique showed no significant alteration in serum-folate levels compared with controls. This suggests that cotrimoxazole does not depress true serum-folate and that many low microbiological results obtained during cotrimoxazole therapy reflect interference with the assay organism. There is insufficient evidence to incriminate cotrimoxazole as a significant cause of blood dyscrasias in excess of those which might occur on sulphonamide alone or even with other antibacterials.

Correction of abnormal coagulation in chronic liver disease by combined use of fresh-frozen plasma and prothrombin complex concentrates.

The effect on abnormal coagulation tests of infusions of fresh-frozen plasma (F.F.P), prothrombin complex concentrates, and a combination of these treatments was compared in 30 patients with chronic liver disease undergoing needle biopsy. A single dose of F.F.P. (12 ml/kg body-weight) was found to be the least effective therapeutic regimen. The concentrate containing factors II, IX, and X was also not adequate, but the additional administration of factor-VII concentrate corrected the prothrombin-time (P.T.) and "Normotest" (N.T.) in most patients. However, this regimen did not correct the prolonged kaolin activated partial thromboplastin-time (K.P.T.T.). The results of tests for exploring both the extrinsic (P.T. and N.T.) and intrinsic (K.P.T.T.) coagulation systems only became normal after the combined administration of a lower dose of F.F.P. (8 ml/kg body-weight) and of both concentrates (12 units/ml). There was no clinical or laboratory evidence of thrombotic complications. No patient developed acute hepatitis or hepatitis-B surface antigen in the twelve months after biopsy. These results indicate that prothrombin-complex concentrates in combination with F.F.P. may therefore be used to allow liver biopsy to be performed safely in patients presenting with severe coagulation defects.

[Experimental studies on the reaction of the immunological system during chronic otitis media and about the course of this disease (author's transl)].

During chronic otitis media intact immunoglobulins are split due to the proteolytic activity of extracellular bacterial proteinases into fragments of different molecular weight. The most malignant bacterial proteinases are the proteinases of pseudomonas aeruginosa (pyrocyanea). These proteinases can only be inhibited by alpha-2-macroblobulin of human blood serum. Because of its high molecular weight we find this inhibitor only in a very low concentration in the middle ear secretion. The destruction of the immunoglobulins is certainly one of the factors of weakening the immunological system in the middle ear. The inhibitory system with alpha-1-antitrypsin, inter-alpha-trypsin inhibitor and alpha-1-antichymotrypsin is unable to inhibit these bacterial proteinases of pseudomonas aeruginosa. The only possibility to get a high concentration of alpha-2-macroglobulin in the middle ear secretion is the liberation of this inhibitory by injuring blood vessels during a tympanoplasty. By this procedure the proteinases of pseudomonas aeruginosa with maximum activity at pH 7.8 and with a high proteolytic activity are almost completely inhibited. By blocking these proteinases combined with an appropriate antibiotic therapy and with the reconstruction of the destroyed parts of the middle ear by a tympanoplasty we can produce a preponderance of the immunological system as compared with the proteolytic activity of the proteinases. This high proteolytic activity can be a cause of the destruction of the small processes of the ossicular bones, especially of the lenticular process of incus. In order to demonstrate that there are proteolytic splitting processes of intact immunoglobulins, a quantitative analysis of the immunoglbulins IgG, IgA and IgM was done pre- and postoperatively. By these studies we found postoperatively a much higher level of intact immunoglobulins, particulary in cases of chronic otitis media associated with cholesteatoma. The blocking of the proteinases and the increase of the level of intact immunoglobulins combined with the reconstruction of physiological conditions in the chronically inflamed middle ear by a tympanoplasty lead to a stabilsation of the immunological and inhibitory system and create the prerequisites for a healing process in chronic otitis media. It is the purpose of further studies to learn about the capability of the split-products of the immunoglobulines to attach and to absorb antigens and toxins during a chronic inflammation in the middle ear.

gag Gene of mammalian type-C RNA tumour viruses.

The translation product of the gag gene of mammalian type-c- RNA viruses is a 65,000-68,000 molecular weight precursor polypeptide (Pr65) whose cleavage leads to the formation of four virion proteins, p30, p15, p12 and p10. An immunological approach has been used to establish the arrangement of the sequences coding for these proteins within the viral genome as (5') p15-p12-p30-p10 (3').

An evaluation of a procedure for the isolation of myelin basic protein (BP).

A detailed description and stepwise evaluation of a procedure that can be used to obtain myelin basic protein (BP) from whole brain is presented. The procedure involved the 0.001 MHC1 extraction of whole brain pre-treated in a sequential manner with chloroform-methanol (2:1 v/v), acetone, and deionized water. This is followed by a precipitation of the extract at pH 9.0, and gel filtration of the supernatant in 0.01 M HC1. Yields of canine and porcine BP and their disc gel evaluations are presented at several key points in the procedure. The final products possessed a high degree of homogeneity when examined on SDS gels stained with commonly used protein stains. When compared with six SDS-gel marker-protein standards, the canine and porcine final products had mobilities that correspond to an apparent molecular weight of 18,5000 +/- 5%. Quantitative binding of 125I-labeled canine and porcine BPs with standardized rabbit anti-BP antisera gave comparable results. Immunoelectrophoretic and immunodiffusion examinations demonstrated single components and complete identity. The canine and porcine BP's also reacted fully with syngeneic anti-BP antisera raised in Lewis-strain rats. The canine BP was tested for encephalitogenicity in Lewis-strain rats and found to be comparable to rat BP in producing experimental allergic encephalomyelitis.

Evidence for a gonadotropin from nonpregnant subjects that has physical, immunological, and biological similarities to human chorionic gonadotropin.

Substances from urinary extracts of normal, nonpregnant subjects and human pituitary gonadotropin preparations were found to react similarly to human chorionic gonadotropin (hCG) in a radioimmunoassay system that is highly specific for hCG and without crossreactivity to human luteinizing hormone (hLH). The antiserum was produced in a rabbit immunized with a bovine albumin conjugate of the unique carboxyl-terminal peptide (residues 123-145) isolated from a tryptic digest of the reduced, S-carboxymethylated hCGbeta subunit. The antibody recognition site on the peptide was found to reside on the last 15 amino acid residues of the carboxyl-terminal peptide, as evidenced by the competitive binding activities against 125I-labeled hCG of a series of peptides chemically synthesized according to the carboxyl-terminal sequence of HCGbeta. In order to elucidate the nature of the crossreacting substance in urinary extracts, a human postmenopausal urinary preparation (Pergonal) and a kaolin-acetone extract of urine from a patient with Klinefelter's syndrome were subjected to gel chromatography on Sephadex G-100. The results indicate that fractions showing immunocrossreactivity with the antiserum to hCGbeta-carboxyl-terminal peptide coeluted with 125I-labeled hCG which was separated distinctly from hLH. The same fractions from this postmenopausal urinary gonadotropin preparation exhibited in vitro biological activity proportional to the immunocrossreactivity of the hCG-specific antiserum. Concentration of postmenopausal women's urine by acetone precipitation retained approximately five times more immunoreactivity per unit volume than kaolin-acetone extraction, when assayed with the antiserum to hCGbeta-carboxyl-terminal peptide.

Specificity of antisera to human fibrinopeptide A used in clinical fibrinopeptide A assays.

Distinction between fibrinopeptide A (FPA) and larger polypeptides containing the FPA sequence is critical for the interpretation of clinical results with FPA immunoassay methods. Therefore, the immunochemical reactivity of 14 rabbit anti-FPA sera with six different FPA containing antigens was studied in detail. Antigens tested included: fibrinogen; fragment E of fibrinogen; the amino-terminal disulfide knot of fibrinogen; Aalpha 1(Ala)-51(Met); Aalpha 1(Ala)-23(Arg); and, FPA. Synthetic partial sequences of FPA were also tested. The 14 FPA-specific antisera were divided into 3 distinct categories with: I, FPA immunoreactivity of larger polypeptides containing FPA approximately 1/100 of FPA on a molar basis, II, FPA immunoreactivity of the larger polypeptides intermediate between I and III; and III, FPA immunoreactivity of the larger polypeptides approximately equal to that of FPA on a molar basis. The antigenic determinants of a category I antiserum (R 2) are included in Aalpha 7(Asp)-16(Arg) with Asp(7), Phe(8) and Arg(16) being essential. When attached to FPA, the sequence Gly(17)-Arg(23) decreases the immunoreactivity of FPA with category I antisera 100-fold. The practical consequence of these findings is that, when category III antisera are employed, both FPA and larger FPA-containing polypeptides are equally immunoreactive. Since thrombin treatment of the larger polypeptides does not alter their immunoreactivity, category III antisera cannot discriminate between FPA and the larger polypeptides. On the other hand, with category I antisera, although the immunoreactivity of FPA itself is unaltered by thrombin treatment, larger polypeptides [e.g., Aalpha 1(Ala)-23tArg)] show a 100-fold increase in immunoreactivity following thrombin treatment and thus can readily be identified and separately quantitated. It is concluded that antisera with the specificity of category I are essential for the specific and accurate measurement of FPA, and for its distinction from larger FPA-containing polypeptides, in clinical plasma samples.

Long-term anticoagulant therapy for TIAs and minor strokes with minimum residuum.

One hundred seventy-eight patients with transient ischemic attacks (TIAs) or small strokes with slight symptoms persisting for more than 24 hours (incomplete recovery = IR) (TIA-IR) from both the carotid and the vertebrobasilar systems were treated with anticoagulants. Ten patients stopped the treatment because of severe side effects. Only one patient had a lethal cerebral infarction when the thrombotest values were above the therapeutic level; no other infarction happened during the treatment period. Moreover, the frequency of TIA decreased during the treatment, compared with descriptions of the natural course of TIA. One hundred four patients were observed for a mean of 21 months after the anticoagulant treatment ended. During the observation period, six patients had cerebral infarctions. This was a sixfold increase compared with the stroke incidence during treatment, and was almost identical with the incidence of strokes seen during the natural course of TIA. All the cerebral infarctions were in patients who had their initial TIA/TIA-IR from the carotid territory (within the same carotid artery which earlier had given symptoms). The investigation shows that long-term anticoagulant treatment is useful, especially in patients with carotid TIA/TIA-IR, and that this treatment should continue as long as the patients can manage it. In patients with vertebrobasilar symptoms of malignant character, it seems feasible to terminate the treatment after about one year. The mechanism of the anticoagulant treatment is obscure, but it does not appear to influence the progress of the atherosclerotic process.

Passive immunization against exposure to hepatitis B virus in the military: potential and possibilities.

The value of standard γ-globulin with a low titer of antibody to hepatitis B surface antigen (anti-HB(s)) vs hepatitis B immune globulin (HBIG) in prevention of icteric hepatitis B in the military is unclear. Although recent studies have shown a decrease in icteric hepatitis after administration of both types of γ-globulin in populations where acquisition of hepatitis B virus (HBV) is most likely the result of nonparenteral transmission, the data pertaining to parenteral exposure suggest that HBIG delays the incubation period of HBV and decreases the development of passive-active immunity. Since no studies have demonstrated efficacy of standard γ-globulin or HBIG in a drug-using population where multiple HBV exposures are likely, the results observed in most trials are not comparable to hepatitis B associated with drug abuse in the military. Therefore, before a recommendation for use of routine γ-globulin or HBIG can be made for drug-related hepatitis in the military, efficacy of standard γ-globulin and/or HBIG should be demonstrated in this population.

Cell-mediated cytotoxicity against Sendai-virus-infected cells.

After injection of Sendai virus, a parainfluenza virus type I, mice generate cytotoxic lymphocytes which lyse specifically Sendai-virus-infected target cells in vitro. Their action is not inhibited by specific antibody in vitro. Killer cell activity appears 4 days after infection, reaches a maximum on the 7th day and disappears on the 14th to 16th day. Decrease of cytotoxic cell activity is correlated with an increase of haemagglutinating antibodies. The cytotoxic effector cell could be characterized as a thymus-derived cell, there is no specific activity in antibody-dependent cell-mediated cytolysis (ADCC). The degree of cytotoxic effector cell activity is only slightly influenced by the dose of injected infective virus. Using different syngeneic Sendai-virus-infected cells as targets for cell-mediated cytotoxicity, a tumor line was not lysed by cytotoxic lymphocytes in spite of viral surface antigens. Preliminary experiments were performed to demonstrate the H-2 gene restriction of the cytotoxic interaction. Using macrophages and tumor cells as targets only syngeneic infected target cells were lysed.

Inhibition of electron transport on the oxygen-evolving side of photosystem II by an antiserum to a polypeptide isolated from the thylakoid membrane.

A polypeptide fraction with the apparent molecular weight 11 000 was isolated from stroma-freed chloroplasts from Anthirrhinum majus. An antiserum to this polypeptide fraction inhibits photosynthetic electron transport in chloroplasts from Nicotiana tabacum. The relative degree of inhibition is pH dependent and has its maximum at pH 7.4. The maximal inhibition observed was 93%. The dependence of the inhibition on the amount of antiserum yields a sigmoidal curve which hints at a cooperative effect. A calculation of the Hill interaction coefficient gave the value of 10. The inhibition occurs on the water splitting side of photosystem II between the sites of electron donation of tetramethyl benzidine and diphenylcarbazide. Tetramethyl benzidine donates its electrons before the site where diphenylcarbazide feeds in its electrons. Analysis of the steady state level of the variable fluorescence also indicates that the inhibition site is on the water splitting side of photosystem II. Tris-washed chloroplasts are equally inhibited by the antiserum and the inhibition is also observed in the presence of an inhibitor of photophosphorylation like dicyclohexyl carbodiimide and in the presence of the uncoupler carbonylcyanide m-chlorophenyl hydrazone (CCCP) which means that the inhibitory action is directed towards the electron transport chain. Valinomycin which is supposed to affect the cation permeability of the thylakoid membrane has no influence on the inhibitory action of the antiserum. The same is valid for gramicidin. Methylamine on the other hand can induce a state in the thylakoids in which the antiserum is not effective. If the antibodies are already adsorbed prior to the methylamine addition then the high inhibitory effect by the antiserum remains unchanged upon addition of methylamine. From the experiments it follows that a component from the vicinity of photosystem II is accessible to antibodies that is, the component is located in the outer surface of the thylakoid membrane. It appears that the inhibitory effect is produced in the course of the light reaction.

Serum alpha-fetoprotein levels in extrahepatic biliary atresia, idiopathic neonatal hepatitis and alpha-1-antitrypsin deficiency (PiZ).

Serum alpha-fetoprotein levels were measured using a sensitive radioimmunoassay in 77 infants presenting with persistent conjugated hyperbilirubinaemia. A breed range of alpha-fetoprotein concentrations occurred in both the 23 infants with extrahepatic biliary atresia and the 35 with idiopathic neonatal hepatitis but the 13 with alpha-1-antitrypsin deficiency had uniformly low levels. High alpha-fetoprotein concentrations (above 10 000 mug/1) favoured the diagnosis of neonatal hepatitis especially in the first ten weeks of life, but the overlap between neonatal hepatitis and extrahepatic biliary atresia was large and alpha-fetoprotein determination cannot be recommended as a reliable method for distinguishing the two conditions. Serial alpha-fetoprotein values showed no consistent relationship with standard liver function tests and gave no guide to prognosis. There was an association between alpha-fetoprotein production and needle biopsy evidence of hepatic giant cell transformation. The uniformly low alpha-fetoprotein levels in alpha-1-antitrypsin deficient infants with neonatal hepatitis is a new observation and possible mechanisms for disordered glycoprotein release are discussed.

Immune complex receptors on cell surfaces. II. Cytochemical evaluation of their abundance on different immune cells: distribution, uptake, and regeneration.

A recently developed method for ultrastructural demonstration of cell surface receptors for immune complexes is applied to evaluation of these receptors on various cell types. The method entailing incubation with a complex of horesradish peroxidase (HRP) and antibody to HRP (anti-HRP) disclosed dense foci indicative of immune complex receptors distributed at 30- to 120-mmu intervals over macrophage surfaces. Invaginations, loop-like evaginations, and pinocytotic vasicles stained prominently. The number of stained immune complex receptors averaged 200,000 per oil-induced macrophage and 120,000 per noninduced macrophage, as determined from counts of focal deposits in electron micrographs. Receptor periodicity on giant cells present in oil-induced exudates resembled that on macrophages, but the larger giant cells contained an estimated 1.5 million sites. Although receptor periodicity on eosinophils and neutrophils equaled that on macrophages, the staining was lighter and was interrupted by intervals of unstained membrane. Neutrophils averaged 28,000 and eosinophils 35,000 receptors per cell, whereas those lymphocytes with receptors averaged 3,500 per cell. Viable cells incubated with anti-HRP sequentially exhibited about half as many reactive sites as did cells incubated with immune complex. When warmed to 37 C, viable macrophages and eosinophils pinocytosed soluble immune complexes almost completely within 30 minutes and phagocytosed insoluble complexes more slowly. The endocytosed soluble immune complexes were sequestered within tubulovesicular structures in addition to the expected phagocytic vacuoles. Receptors appeared fully active on macrophages that were restained with soluble, cold immune complex after they had endocytosed immune complex in the course of a 30-minute warming interval.

The relationship between hypervariable regions, antigen-binding specificity and the three-dimensional structure of antibodies.

The amino acid sequences of the V domains (VL + VH regions) of 3 antibodies raised to type III pneumococcal polysaccharide in individual outbred rabbits are reported. With the exception of the second hypervariable section of the L chains, these antibodies have very different sequences in the hypervariable segments of the V domains. Within the third hypervariable region of the H chain, each antibody has a different length. On the sole basis of the amino acid sequences of these three anti-pneumococcal antibodies, the results do not support the concept of a simple correlation between primary structure in the hypervariable sections (known to determine the shape of the combining site) and antigen-binding specificity. In view of the large number of amino acid interchanges in the hypervariable positions and because of the size difference between the rabbit H chains, it is likely that each anti-SIII H chain studied here represents the product of a different structural germ line gene. In contrast to such a complex immune response to a relatively simple polysaccharide antigen, an extensive structural uniformity has been observed in the heavy chains of mouse myeloma proteins with phosphorylcholine activity and a mu chain from a human Waldenström IgM endowed with the same activity. The finding of a very similar heavy chain variable region in two different species which are separated by about 75 million years in evolution favours the concept of stable transmission of variable region genes throughout evolution.

Allotypes of the a series and their variants in rabbit immunoglobulins.

Six allotypic specificities of the a series are found on rabbit immunoglobulins: a1, a2 and a3 are found both in domestic and wild rabbits Oryctolagus cuniculus; a100, a101 and a102 seem to be present only in wild rabbits. Each of these specificities is a family of variants always present together in a given serum. These variants can be studied through the cross-reactivities detected between the patterns of the a series. The results of studies of cross-reactivities between a1, a3 and the two specificities a100, and a102 and also the cross-reactivity between a2 and a minor variant of the a1 specificity suggested a hypothetical scheme. This hypothesis attempts to take into account the evolution of the specificities of the a series and their variants. This hypothesis also postulates the existence of a set of closely linked genes which control the synthesis of the variants of a given specificity. One could suppose that primordial allelic genes might have appeared from an ancestor gene. By duplication each allele would have led to the appearance of a set of genes coding for a given specificity. These genes might have evolved through mutations and recombinations. In wild rabbits, the observation of an allotype which seems to result from a recombination between the group of genes coding for the a2 variants and the group of genes coding for a3 variants argues in favors of the genetic recombination mechanism.

Protease inhibitors in plasma of patients with chronic urticaria.

The hypothesis that deficiencies of plasma protease inhibitors might play a role in the pathogenesis of chronic urticaria was evaluated. Plasma levels were measured in patients with urticaria and a matched control group for alpha1-antitrypsin, alpha2-macroglobulin, total trypsin-inhibiting capacity, kallikrein-inhibiting capacity, and the complement factors C1 esterase inhibitor, C3, and C4. A total of 92 patients with chronic urticaria or more than three months' duration was studied. Patients with acquired cold urticaria had significantly decreased levels of alpha1-antitrypsin and total antitrypsin activity. In patients with acquired angioneurotic edema, alpha1-antitrypsin levels and antichymotrypsin activities were lowered, with less significant decreases in anti-trypsin and antikallikrein activities. Levels of C1 esterase inhibitor , C3, and C4 were normal in all groups. There was no correlation between the increased sensitivity to intracutaneously administered kallikrein injection and deficiencies of of protease inhibitors.

Post-tetanic changes of depressor responses evoked by stimulation of the aortic nerve.

The effect of changes in duration of the conditioning tetanus on the size of the testing depressor response was studied in rabbits anaesthetized with urethane. Depressor responses were evoked by stimulation of the aortic nerve. The interval between the conditioning and testing stimulation was fixed at 40 and 120 sec. Two frequencies of conditioning tetanus were employed. Brief conditioning tetani facilitate the testing response. With lengthening of the conditioning stimulation the size of the testing response is decreased and when duration of the conditioning amounts to 20-60 sec depression of the testing fall of blood pressure reaches a steady level. Further increase in duration of the conditioning tetanus to 180 sec does not affect the plateau of depression of the testing response. The longest duration of conditioning affecting the size of the testing response is considered to determine the range of control of the testing response exerted by preceding conditioning tetanus. Since the levels of plateau of depression are different for two used frequencies of conditioning, it is suggested that this factor may control the size of the testing response beyond the range of control executed by the duration of the conditioning tetanus.

The detection by immunodiffusion of tumour associated antigenic components in extracts of human bronchongenic carcinoma.

Antisera to extracts of a variety of bronchogenic carcinoma were raised in rabbits and extensively absorbed with immunoadsorbents prepared with normal lung extracts cyanogen bromide linked to Sepharose 4B, and glutaraldehyde insolubilized normal lung extracts. The antisera were tested by immunodiffusion against a panel of extracts from a variety of bronchogenic carcinoma, foetal lung extracts and pools of normal lung extracts. The results indicate that two distinct antigenic components are associated with bronchogenic carcinoma; one which is present in a high percentage of the tumour extracts tested and appears to have partial identity with a foetal lung component, and one (or more) which is not foetal and appears to have higher cross-reactivity (but not exclusively) with tumours of the same pathological type. Attempts to detect either antibody or antigens relating to these components in the serum of patients with bronchogenic carcinoma by these techniques were unsuccessful. The foetal cross-reacting component was neither carcinoembryonic antigen and alpha1-foetoprotein.

Glycine transport by hemolysed and restored pigeon red cells. Effects of a Donnan-induced electrical potential on entry and exit kinetics.

The influence of a Donnan effect on the transport of glycine by hemolysed and restored pigeon red cells was examined. The Donnan effect was produced by replacing Cl- with 2,4-toluenedisulfonate or glutamate. The effects of the associated membrane potential and inside-outside pH difference on glycine entry and exit rates were examined. The effects of pH on entry and exit rates in the absence of a Donnan effect were also examined. In the absence of a Donnan effect, Na+-dependent glycine entry requires the protonated form of a group with a pKapp of 7.9 and the deprotonated form of another group with a pKapp of 6.8. Neither of these are required for exit but the deprotonated form of a group(s) with a pKapp of 6.2 is required. The pK 7.9 group and pK 6.2 group probably react with H+ at the inner face of the membrane and the pK 6.8 group probably reacts at the outer face. The V for glycine entry was determined for cells with their Cl- largely replaced by toluenedisulfonate and without such replacement. Between pH 6.1 and 7, the ratio of the respective V values, VT/VC1, was 1.5-1.7. VT/VC1 rose above pH 7 to near 4 at pH 8.3. At pH 6.9, with glutamate replacing cell Cl-, the analogous ratio (VGlu/VC1) was 1.7. The increase of VT/VC1 above pH 7 could be quantitatively accounted for by the increase in cell [H+]/medium [H+] caused by the Donnan effect together with the assumption that the pK 7.9 group reacts with H+ at the inner face of the membrane. When cell Cl- was replaced by toluenedisulfonate or glutamate there was a drop in the term in the glycine Km describing Na+ dependence of glycine entry. When cell Cl- was replaced by toluenedisulfonate therewas a rise in the Na+-independent term in the glycine entry Km. By replacing varying amounts of cell Cl- with either toluenedisulfonate or glutamate, plots were obtained of entry rates vs. the cell [Cl-]/ medium [Cl-] ratio consistent with the assumption that the Donnan-induced membrane potential acts on a "moving" charge. Glycine exit was only slightly accelerated by trans-toluenedisulfonate. The ratio, exit rate into toluenedisulfonate medium/exit rate into Cl- medium rose with decreasing pH. This rise could be accounted for by a Donnan-induced inside-outside pH difference which affects a pKapp 6.2 group reacting with internal H+. The observed influences of the Donnan effect on V (glycine entry), on both components of Km (glycine entry), on the shape of the plot of glycine entry rate vs. the cell [Cl-]/medium [Cl-] ratio and on glycine exit all fit the assumptions that when the empty porter reorients, one unit of negative charge accompanies it "across" the membrane and that no other steps involve charge movement. The properties of the system seem inconsistent with a translational ("ferry boat") mobile carrier.

Comparison of normal and chronic lymphocytic leukemia lymphocyte surface Ig determinants using peroxidase-labeled antibodies. II. quantification of light chain determinants in atypical lymphocytic leukemia.

Five cases of atypical lymphocytic leukemia were investigated with regard to their membrane-associated light chains. Detection and quantitation of antigenic determinants were performed by means of peroxidase-labeled antibodies according to Avrameas et al. The cases studied had clinical and cytologic features in common: an active clinical course, marked splenomegaly, severe anemia and thrombocytopenia, little or no lymph node enlargement, and very high white blood counts with small mature lymphocytes and poorly differentiated lymphoid cells. Blood lymphocytes of all patients carried a single type of light chain, and 90%-100% of the cells were stained. The average number of antigenic sites per cell was 72,500 (range 40,000-97,500). These results differed from those previously found in typical CLL (mean value 9000) and approached the values of normal peripheral blood lymphocytes (90,000). The criteria investigated in this study could be of value for the diagnosis and prognosis of some atypical forms of lymphocytic leukemia.

Selective uptake and retrograde axonal transport of dopamine-beta-hydroxylase antibodies in peripheral adrenergic neurons.

In the present experiments the uptake and retrograde axonal transport of antibodies to dopamine beta-hydroxylase (DBH) in adrenergic neurons was studied. When partially purified labelled antibodies to DBH were injected unilaterally into the vicinity of the adrenergic nerve terminals in the iris, radioactive substances accumulated preferentially in the superior cervical ganglia of the injected. By SDS (sodium dodecyl sulfate) gel electrophoresis and immunoprecipitation it could be shown that the accumulated radioactivity in the superior cervical ganglion represented antibodies to DBH. This retrograde accumulation was greatly reduced by colchicine, axotomy or destruction of the adrenergic nerve terminals by 6-hydroxydopamine. The rate of retrograde transport was the same as that of nerve growth factor (NGF) and tetanus toxin in sympathetic neurons. The retrograde transport of antibodies was confined to sympathetic neurons and could not be detect in either sensory or motor neurons.

Macrophage plasminogen activator: modulation of enzyme production by anti-inflammatory steroids, mitotic inhibitors, and cyclic nucleotides.

Plasminogen activator production by cultured mouse peritoneal macrophages can be modulated in vitro by low concentrations of various pharmacologically active molecules. Glucocorticoid hormones and their synthetic derivatives, as well as cholera toxin, colchicine, and vinblastine markedly inhibit production of this enzyme without affecting other important macrophage functions. The effect of glucocorticoids is of particular interest, both because their relative in vivo anti-inflammatory potencies correlate exactly with their effect on plasminogen activator production in culture and because this effect occurs at near physiological concentrations. In view of the correlations established in other systems between plasminogen activator production and cell migration, we have also examined the age of the macrophages in thioglycollate-induced exudates. Confirming the results of Van Furth and Cohn (1968), we have found that the majority of these cells are young, having recently replicated and arrived in the peritoneal cavity. Using a fibrinagar overlay technique which allowed us to determine the production of plasminogen activator by individual cells. we have found that the majority of these cells produce the enzyme. The potential roles of plasminogen activator in monocyte migration and the relationship of this enzyme to the anti-inflammatory effect of gluccorticoids are correlated and emphasized.

The avascular nephrotomy.

A simple and innocuous method for colouring the renal cortex is proposed. It makes visible, during the operation, the line of demarcation between different arterial areas and allows the performance of nephrotomies with minimal trauma to the renal parenchyma and a minimum of subsequent renal destruction by ischaemia. It is indicated as a complement to renal hypothermia, for the removal of complicated and extensive lithiasis; it can also be helpful in easier cases when hypothermia in not required.

[Necroses in the granular cell layer of the cerebellum due to methylchloride intoxication in guinea pigs (author's transl)].

Neurotoxic action of methylchloride was reported by various authors. As this solvent is widely used in chemical industry the morphological changes in the CNS of guinea pigs due to methylchloride intoxication were comparatively studied by light- and electron-microscopy.

Direct effects of glucagon on protein and amino acid metabolism in the isolated perfused rat liver. Interactions with insulin and dexamethasone in net synthesis of albumin and acute-phase proteins.

The isolated rat liver perfused for 12 hours at pH 7.10 with a suspension of bovine erythrocytes in Krebs-Ringer bicarbonate buffer containing 3 per cent bovine serum albumin has been used as a test system to study effects of glucagon and of dexamethasone in the presence and absence of insulin on net biosynthesis of rat serum albumin, fibrinogen, alpah1-acid glycoprotein, alpha2-(acute phase) globulin, and haptoglobin. Quantitative measurement of perfusate glucose, amino acid nitrogen, and urea affords a basis for determining net glucose and nitrogen balance in the perfusion system. Although the dose of dexamethasone (total 1.0 mug.) used was insufficient to induce synthesis of alpha2-acute phase globulin, net syntheses of albumin, fibrogen, alpha1-acid glycoprotein, and haptoglobin were increased. Glucagon given with dexamethasone depressed albumin and haptoglobin synthesis markedly, but not that of fibrinogen and alpha1-acid glycoprotein. Glucagon with dexamethasone markedly enhanced ureogenesis and glycogenolysis and elicited an exaggerated negative nitrogen balance. The unfavorable effects of glucagon on albumin and haptoglobin synthesis and on nitrogen balance were reversed by giving insulin simultaneously. It is emphasized that insulin is essential for positive nitrogen balance.

Detection of e antigen and antibody: correlations with hapatitis B surface and hepatitis B core antigens, liver disease, and outcome in hepatitis B infections.

Testing for e antigen and antibody (anti-e) was performed by immunodiffusion and counterelectrophoresis in patients with polyarteritis nodosa fulminant hepatitis, and chronic active hepatitis (CAH), in 59 asymptomatic carriers of hepatitis B surface antigen (HBsAg) who underwent liver biopsy, and in 150 carriers followed with sequential SGPT determinations. Counterelectrophoresis was more sensitive that immunodiffusion. Neither e antigen nor anti-e was found in the absence of HBsAg. Among HCsAg-positive patients with polyarteritis nodosa and CAH, e antigen was found in 16 of 18 and 13 of 22, respectively. It was not found in any of 43 patients with fulminant hepatitis, of whom 24 were HBsAg-positive. The e antigen was detected in none of 13 biopsied carriers with normal histology, 4 of 28 with nonspecific changes of 11 of 18 with CAH or chronic persistent hepatitis. Conversely, anti-e was present in 9 of 13 with normal biopsy, 7 of 28 with nonspecific changes, and none of 18 with CAH or chronic persistent hepatitis. The e antigen was found more commonly in nonbiopsied carriers with elevated SGPT, and anti-e in those with normal SGPT. Six carriers whose antigenemia terminated spontaneously had anti-e. The presence of e antigen correlated with a high titer of HBsAg, and with immunofluorescent detection of hepatitis B core antigen in the nuclei of hepatocytes. Conversely, anti-e was associated with significantly lower titers of serum HBsAg (P less than 0.001) and lack of detectable hepatitis B core antigen in the liver.

Fc receptors and Ia antigens.

Antibody against Ia antigens inhibits the ability of B lymphocytes to bind aggregated immunoglobulin and to form EA rosettes. The explanation suggested for this phenomenon has been that Ia antigens are identical to or closely associated with Fc receptors. But a variety of observations preclude acceptance of this explanation since inhibition is also demonstrable with antibody against a wide variety of B cell surface components, including H-2K, H-2D, beta2 microglobulin, immunoglobulin, Ly 4.2. Furthermore, Fc receptor function can be separated from Ia antigens by capping or by isolation of membrane components. It seems likely that the mechanism of inhibition of Fc receptors by antibody against Ia antigens is part of a broader spectrum of effects induced when antibody binds to cell membrane antigens.

The histamine release process and concomitant structural changes in rat peritoneal mast cells. In vitro study on effects of compound 48/80 and the dependence of the process on cell preparation, temperature and calcium.

Two morphologically different populations of rat peritoneal mast cells were observed in response to incubation with compound 48/80. Type 2 mast cells: cells with distinct contours exhibiting intracellular vacuoles containing altered granules and without signs of granule liberation; Type 3 mast cells: cells with indistinct countours and with varying number of granules liberated. The absence of calcium in the medium, high temperature (37 degrees C) in the presence as well as in the absence of calcium favoured type 2 versus the type 3 cells. The isolated mast cell population was less morphologically heterogeneous than the mixed cell population in response to the addition of compound 48/80. It is concluded that mast cells might release a great part of their histamine content without a concomitant liberation of the granule matrixes. The varying morphological pictures observed after incubating of mast cells with compound 48/80 is due to variable factors inherent to the experimental procedures.

The effect of EDTA and metal cations on the 5-bromoindoxyl acetate esterase activity in the thyroid of the guinea pig.

Miscellaneous metal cations and EDTA have been used as activators and inhibitors of esterase activity in the thyroid of the guinea-pig. The results indicate that the 5-bromoiondoxyl acetate esterase in the epithelial cells probably consists of two different A-esterase isoenzymes, one present in group I cells (the para-, intra-, and inter-follicular cells) and the other in group II cells (the follicular cells proper). The first isoenzyme seems to be calcium-dependent whereas the other is activated by various metal ions. Ca2+ + Mn2+ and Ca2+ + Co2+ were found to activate the esterase activity in group I cells. EDTA and Mn2+, on the other hand, activated the esterase activity in group II cells.

Plasticity in the developing visual system: the effects of retinal lesions made in young rats.

The central visual pathways of the rat have been used as a model for investigating the significance of axonal interactions in mammalian neural development. Attention is restricted largely to the aberrant distribution of optic axons to the ipsilateral side of the brain and their distribution in the superior colliculus after early unilateral eye damage. The normal ipsilateral retinotectal pathway in pigmented rats appears as a series of patches located anteriorly and laterally in the stratum opticum, whereas in albino animals it is a small area lying anteromedially. In both, a few axons are often found at the extreme posterior border of the superior colliculus. After unilateral eye enucleation at birth, an aberrant ipsilateral pathway from the remaining eye arises at the optic chiasm. It originates from all parts of the retina and terminates in the ipsilateral superior colliculus in a topographic fashion such that the upper retina projects laterally and the lower retina, medially. The pathway is heaviest anteromedially (from lower temporal retina) and lightest posterolaterally (from upper nasal retina). There is always a heavy projection to the extreme posterior border of the superior colliculus. In only two animals of a large series was direct intertectal sprouting found. After partial retinal lesions, there is again an ipsilateral pathway from the unlesioned eye which fills the projection area of the lesion. As after total enucleation, the pathway arises from most of the ipsilateral retina, not just that region homotypic to the lesion site, being heaviest from the lower temporal and lightest (or deficient) from the upper retina. There is suggestion of ordering of the projection into the deafferented region in that the ipsilateral degeneration after lesions in the intact eye is compact but does not fill the gap in the crossed projection completely. There is also indication that some intact parts of the retina lesioned at birth may also project in an inappropriate retinotopic fashion to the deafferented region. The corticotectal pathway shows a normal map. Study of the ipsilateral retinotectal pathway indicates that the axons terminating at the extreme posterior border of the superior colliculus arise from the lower temporal retina. The results are interpreted as indicating that the aberrant uncrossed pathways after complete or local retinal lesions, compare very closely in most features. Both distribute to the deafferented area of the superior colliculus -- in one, this is the whole surface, while in the other it is a small area. The fact that in the latter case axons are ending in quite inappropriate parts of the tectal map, may be explained more simply in terms of interactions between adjacent axons in the optic pathway rather than by an hypothesis involving a change in the cell labels across the tectal map.

Four-phase study of computer-assisted and slide-tape methods of stimulating clinical endodontic problems.

1. Computer-assisted instruction of stimulated clinical endodontic problems is superior to a slide-tape presentation for test selection but not for diagnosis and treatment planning. 2. The lack of a difference in diagnosis is likely due to the already superior performance of students in diagnosis at the University of Kentucky without computer assistance. A study with students of less background might reveal a difference in presentation methods. 3. Students with high GPSs score higher on a written test of endodontic clinical judgment. 4. Reliable results on the effects of a human tutor's supplementing machine instruction were not obtained. 5. Students felt that the problems presented in this study were useful in preparing for clinical treatment of patients. 6. After some exposure to machine methods of instruction, students divided into three sizable groups, one preferring a human teacher, another preferring a machine, and the third having no preference. The decision to use only machine or human instruction cannot then be made from student attitudes. 7. Students liked the active participation and immediate responses of the computer but not the time necessary to complete the problems. 8. Students liked the self-pacing, speed, and convenience of the slide-tape method but not the incompleteness of the problems presented by this method. 9. It appears that there is some justification from this study for offering both slide-tape and computer-assisted presentations to students.

Results of virological and serological studies of three influenza A Hong-Kong epidemics in Leningrad.

An analysis of morbidity of the population in the course of 3 influenza A/Hong-Kong epidemics showed a pronounced decrease in influenza affection of adult population in the last epidemic in 1971--1972. Comparative studies of the diagnostic value of CFR and HIT demonstrated identical sensitivity of CFR as a method of influenza diagnostics in both the epidemic and interepidemic periods. HIT was suitable for the detection of influenza only in the epidemic period. In the interepidemic period, the percentage of influenza infection diagnosed by means of HIT amounted to only 23--24 of all serologically confirmed cases of influenza. The highest percentage of virus isolation was observed when material from patients with serologically confirmed influenza was used. All strains of influenza A virus isolated in 1969 and 1970 were similar in their sensitivity to inhibitors of animal sera. Suring the last influenza epidemic, 2 of the 136 isolated strains were found to be resistant to gamma inhibitors and highly sensitive to the inhibitors showed their close relationship to gamma inhibitors. Antigenic analysis of the influenza A strains isolated during the 3 influenza epidemics revealed changes in the antigenic structure of the agents of the influenza epidemic in Leningrad in comparison with the standard strain A/Hong-Kong/I/68 (H3N2).

Hypotheses and recent findings concerning aetiology and pathogenesis of the muscular dystrophies.

The survey reports recent findings and current hypotheses on the aetiology and pathogenesis of the muscular dystrophies. Briefly presented are (1) biochemical anomalies of structure and metabolism, (2) membrane defects, (3) the neural hypothesis, (4) the vascular hypothesis, and (5) the connective tissue hypothesis. At present, research interest is focused primarily on membrane structure and biochemistry, on neural muscle trophism, and on the genetic aspects of abnormalities in molecular biology. Whether the progressive muscular dystrophies are primary disorders of voluntary muscle or whether the primary alteration is located outside of the muscle still remains unknown.

Spastic paraplegia associated with Addison's disease: adult variant of adreno-leukodystrophy.

Clinical and pathological features of an adult variant of adreno-leukodystrophy (ALD) are presented. A male with clinical and laboratory signs of Addison's disease (AD) developed at age 22 a slowly progressing paraplegia with slight sensory deficits in both legs and bladder and sphincter dysfunctions; he died at age 24 in an AD crisis. Autopsy revealed hyperplasia of lymphatic tissues, lymphocytic infiltrates in various organs including the CNS and adrenocortical atrophy with prominence of large ballooned, sometimes bizarre and occassionally striated cortical cells. CNS lesions consisted in incomplete demyelination of long tracts of brain stem and spinal cord with accentuation in the pyramical tracts; in these areas, perivascular cuffs of "epitheloid" histiocytic cells contained a strongly PAS-positive non-sudanophilic material. Electron microscopy demonstrated massive stroge of leaflet structures in perivascular histiocytes identical to the lamellar profiles previously described as specific for ALD. Some leaflets were found in close contact with compact lamellar arrays and with an electron-dense fingerprint material within astrocytes. In our case, the spastic paraplegia-AD syndrome which has been described previously in several clinical observations could be neuropathologically classified as an adult variant of ALD. Several differences to "classical" ALD occurring in young boys are stressed: the predominance of the endocrine disorder probably accounting for some of the perivascular lymphocyte infiltrates within the CNS; the absence of both clinical and pathological signs of diffuse cerebral involvement and the peculiar topistic pattern of CNS lesions and the very slow evolution of neurological signs paralleled by the absence of active sudanophilic demyelinating lesions. The possible mechanism of demyelination and the nature of the suggested metabolic defect in ALD are discussed. The ultrastructurally prominent leaflet structures may originate from myelin remnants, thus relating ALD to pathological storage of a myelin degradation product.

Interactions of vesicular stomatitis virus with murine cell surface antigens.

The process of maturation of vesicular stomatitis virus (VSV) results in the loss of 70% of the H-2k antigenic activity from L-cell plasma membranes. This phenomenon is also demonstrated during VSV infection of cells of the H-2d haplotype. Using the method of inhibition of immune cytolysis, VSV-infected L5178Y tissue culture cells and VSV-infected METH A fibrosarcoma cells grown in vivo show a loss of H-2d activity of 73 and 76%, respectively. Using monospecific antisera, it is seen that VSV infection results in a significant loss of antigenic activity of the gene products of both the H-2D and H-2K regions in cells of the H-2d and H-2k haplotypes. In hybrid cells expressing H-2k as well as H-2b, VSV infection results in the decrease of both H-2 antigenic activities to the same extent. VSV purified from L cells shows considerable H-2k activity, but the reaction of this virus with anti-H-2k serum does not prevent a normal subsequent infection with this virus. VSV may associate with H-2 antigen in the culture medium, but the results of mixing VSV with uninfected H-2-containing homogenates suggest that this association occurs only when the host cell and the cell homogenate share the same H-2 haplotype. Velocity sedimentation of VSV, which would remove contaminating cellular membrane fragments, does not separate H-2 activity from VSV. H-2 activity is also stably associated with VSV throughout sequential sucrose gradient centrifugation steps. It is possible that H-2 antigen is a structural component of VSV grown in murine cells.

Rational choice of penicillins and cephalosporins based on parallel in-vitro and in-vivo tests.

Because of the unavailability of strictly comparable data, seven representative penicillins and the five cephalosporins currently used in Britain were evaluated in parallel, both in vitro and in vivo. Penicillin sensitive and resistant strains of Staphylococcus aureus and Proteus mirabilis were the main test organisms. Minimum bacteriocidal concentrations of cloxacillin, flucloxacillin, cephalothin, and cephazolin in serum were much higher than conventional minimum inhibitory concentrations in the absence of serum. Cephalexin and cephradine showed the smallest divergence in these values. Staph, aureus beta-lactamase caused least damage to methicillin and cephradine, whereas enzymes from Escherichia, Klebsiella, and Bacillus cereus had least effect against cephradine followed by cephalexin. In mouse protection experiments, highly protein-bound antibiotics had relatively low efficacy. Cephradine had the highest mean activity followed closely by cephaloridine and cephalexin. From the data, cephradine was the cephalosporin of choice, and firm decisions were also made about the choice of penicillins.

Acute leukaemia after immunosuppressive therapy.

Three cases of acute myeloid leukaemia developing after treatment of renal disease with cyclophosphamide have been studied. None of the cases was complicated by additional treatment with irradiation or other cytotoxic agents, or by a pre-existing malignancy. Marrow aplasia as a cause of the leukaemia was ruled out. It is suggested that the immunosuppressive action of cyclophosphamide could predispose to the development of malignancy in two ways: malignant clones of cells could emerge and multiply or oncogenic viruses could invade the cells or escape from immunological control and cause induction and development of malignancy.

Pregnancy hepatitis in Libya.

The death-rate from hepatitis in pregnant women in Libya is high. Of 922 hepatitis patients treated during 1975, 377 were males and 545 were females. The case fatality-rate was 0.53% for males and 7-67% for females. In 293 pregnant women it was 12-97% compared with 1-6% in 252 non-pregnant women. In pregnant women deaths occurred mainly in the last trimester. Although 18-4% of the male patients and 15-2% of the women were hepatitis B surface antigen (HBsAg) positive, no patient shown to be antigen-positive died. The frequency of hepatitis in the second half of the year fell both in pregnant women and in the general population, suggesting a warning hepatitis-A epidemic. The exact cause of the high mortality in pregnant women is not clear, but it may have a nutritional basis.

Characterization of the reverse transcriptase of a type C RNA virus produced by a human lymphoma cell line.

The reverse transcriptase (RNA-dependent DNA nucleotidyltransferase) of the type C RNA virus produced by the human lymphoma cell line SU-DHL-1 was purified by ion-exchange chromatography of SU-DHL-1 culture fluids and repetitive affinity chromatography on poly(rC).agarose, as were the polymerases of several other type C viruses. The DHL-1 enzyme used template-primers at levels expected of a viral reverse transcriptase, and sodium dodecyl sulfate gel electrophoretic analysis of radioiodinated DHL-1 enzyme revealed a peak at a position corresponding to those of several other type C viral reverse transcriptases (namely, at 72,000-78,000 daltons). The purified enzyme was partially neutralized by antibodies specific for the reverse transcriptase of simian sarcoma virus. Two-dimensional analysis on thin-layer cellulose plates of tryptic hydrolysates of the radioiodinated enzymes of several viruses revealed that six peptides are common to the polymerases of simian sarcoma virus, gibbon ape leukemia virus, baboon endogenous virus, and the DHL-1 virus, and that two to four peptides are unique to each of these enzymes. The DHL-1 viral reverse transcriptase appears to be most closely related structurally to the enzymes of simian sarcoma virus, gibbon ape leukemia virus, and baboon endogenous virus. However, the DHL-1 viral enzyme differed from any one or combination of the other subhuman primate viral enzymes by virtue of its unique peptides. The implications of these findings with respect to the probable origin of the DHL-1 virus are discussed.

The flow properties of axoplasm in a defined chemical environment: influence of anions and calcium.

The flow properties of axoplasm have been studied in a defined chemical environment. Axoplasm extruded from squid giant axons was introduced into porous cellulose acetate tubes of diameter roughly equal to that of the original axon. Passage of axoplasm along the tube rapidly coated the tube walls with a layer of protein. By measuring the rate of low back and forth along the tube, the rheological properties of the axoplasm plug were investigated at a range of pressures and in a variety of media. Axoplasm behaves as a classical Bingham body the motion of which can be characterized by a yield stress (theta) and a plastic viscosity (eta p). In a potassium methanesulphonate medium containing 65 nM free Ca2+, theta averaged 109 +/- 46 dyn/cm2 and eta p1 146 +/- 83 P. These values were little affected by ATP, COLCHICINE, CYTOCHOLASIN B or by replacing K by Na but were sensitive to the anion composition of the medium. The effectiveness of different anions at reducing theta and eta p1 was in the order SCN greater than I greater then Br greater than Cl greater than methanesulphonate. Theta and eta p1 were also drastically reduced by increasing the ionized Ca. This effect required millimolar amounts of Ca, was unaffected by the presence of ATP and was irreversible. It could be blocked by the protease inhibitor TLCK. E.p.r. measurements showed that within the matrix of the axoplasm gel there is a watery space that is largely unaffected by anions or calcium.

Effect of megestrol acetate on uroflow rates in patients with benign prostatic hypertrophy: double-blind study.

Sixty-one patients with benign prostatic hypertrophy (BPH) and decreased maximum and mean urine flow rates were randomly assigned to megestrol (Megace, 120 mg./day) or placebo therapy. The patients were studied over a five-month period with maximal and mean urine flow rates every two weeks. The patients on megestrol demonstrated significant increases in maximum and mean urine flow rates from the sixth through the twentieth weeks compared with their own control baseline values; the placebo-treated patients showed no significant changes in mean flow rates at any time point over the twenty weeks in comparison with their own baseline control values; maximum flow rates in placebo-treated patients did demonstrate statistically significant increases above their own control baseline values at eight, twelve, eighteen, and twenty weeks. Megestrol-treated patients, in comparison with the placebo group, showed statistically significant increases in maximum flow rate at fourteen, sixteen, and twenty weeks after therapy, and statistically significant increases in mean flow rate over the placebo patients at ten, twelve, fourteen, and twenty weeks. Clinical symptoms improved in 78 per cent of the megestrol-treated patients and 57 per cent of the placebo-treated patients. The side effects of megestrol were minimal except for loss of libido in 70 per cent of patients.

A quantitative method for the assessment of the microtopography of human skin.

The skin relief influences the exterior aspect of the skin which is very sensitive to aging. It could also be related to the mechanical properties and structure of both dermis and stratum corneum. Consequently, quantitative measurement of the skin surface roughness would seem most useful, as it would permit a quantification of skin aging, an in vivo analysis of mechanical forces acting on the skin structure, and the detection of abnormalities otherwise not visible. The method described comprises three steps: (1) making a silicone rubber negative replica, (2) making an Araldite positive cast, (3) roughness measurement of the cast with a device commonly used in engineering, which provides quantitative parameters: Ra, Rp, Rt, Rmax and others. The reliability of each of these steps was checked, and also the absolute need to locate precisely the site of sampling and to know the angle of the scanning direction with the main axis of the limb or the body. The method seems useful for studying aging, either normal or affected by UV rays and other physiopathological events influencing the skin surface.

Procainamide-induced lupus erythematosus-like syndrome in relation to acetylator phenotype and plasma levels of procainamide.

To investigate the relationship between acetylator phenotype and the development of procainamide (PA)-induced systemic lupus erythematosus (SLE-like syndrome, 28 patients with chronic ventricular arrhythmias treated with PA were followed for one year. The therapy was guided by plasma monitoring in all patients in order to obtain the proposed therapeutic plasma level of PA. Nine patients (30%), both slow and rapid acetylators, developed the SLE-like syndrome within one year. PA plasma levels were similar in both slow and rapid acetylators and there was no difference in total dose or duration of therapy before development of the syndrome. Thus, the acetylator phenotype is probably of no or minor predictive importance when PA therapy is guided by plasma monitoring. On the other hand, the antinuclear antibodies appeared significantly more rapidly in patients developing the syndrome and could possible be used as an indicator of the risk. The results support the hypothesis that the primary amino group structure of PA may be of importance in the induction of the SLE-like syndrome.

[Effect of Soviet bleomycin-bleomycetin on the body of animals in multiple parenteral administration].

Toxicity of bleomycetin was studied on 3 animal species (rats, rabbits and dogs). The antibiotic was administered intramuscularly and intravenously in various doses for a prolonged period of time. The death of the rats, rabbits and dogs treated with repeated lethal doses of bleomycetin was due to its toxic effect on the kidneys and probably lungs. The level of urea in the blood of the animals before death increased up to 300--400 mg %. Histological examination of the kidneys revealed the picture of glomerulonephritis. The lungs were highly plethoric and showed areas of alveolar collapse and consolidation consisting mainly of the collapsed alveolar epithelium. The liver was not affected by bleomycetin according to both the results of some functional tests and histological examination. tthe blood sugar level after bleomycetin administration was not altered significantly. The changes in the peripheral blood were not pronounced. An increased P wave, decreased R wave and deep S wave were seen on the ECG. Such deviitions may be due not only to the changes in the myocardium but also to the lung affection. When bleomycetiin was used repeatedly in nonlethal doses (1 mg/kg for rats, 1--2 mg/kg for rabbits and 0.25--0.5 mg/kg for dogs), the above changes were less pronounced or not manifested at all. No inhibitory effect on hemopoiesis is an important positive characteristics of bleomycetin, so that it compares very favourably with most other antitumor drugs.

Human adenohypophyseal quantitative histochemical cell classification. I. Morphologic criteria and cell type distribution.

Recent advances in immunocytochemistry and histochemical staining have made it possible to identify pituitary cells that contain specific hormones by their appearance under light microscopy. Criteria for identification of functional cell classes were formulated from these studies. Fourteen hypophyses were obtained at the time of autopsy (four to 22 hours postmortem), embedded in paraffin, sectioned, and differentially stained. Cell counts on areas in the acidophil wing and basophil wedge were performed using the formulated criteria. Chromophilic thyrotrophic hormone cells and melanocorticotrophic hormone cells occurred significantly more frequently in glands from men, whereas the numbers of other cell types were statistically comparable in glands from both sexes. We were able to functionally classify 72.1% of 53,167 pituitary cells. Only 0.1% of presumptive secretory cells were completely chromophobic. Cell distribution patterns were similar to those previously described, with the exceptions that gonadotrophic cells were more prominent in the lateral wings and that prolactin cells had a more even distribution.