Leprosy--a clinico-epidemiological study in a rural population of Bundelkhand. The present study was carried out in the three villages viz. Kochha Bhanwar, Kargawan and Pichhore, situated within 3 kms radius from M.L.B. Medical College, Jhansi, U.P. About 91 per cent (91.17%) of population was surveyed. Out of the 3,362 individuals studied, 18 cases of leprosy could be detected giving a prevalence rate of 5.41/1000 population. No association between the size of village and prevalence of leprosy cases was observed. The highest prevalence rate (7.40/1000) was seen in age group 15-49 years with male to female ratio of 2.6: 1. The disease was not prevalent in preschool age-group. Poor class of people contributed comparatively to a greater extent (6.37/1000). Size of the family did also not seem to be associated with the prevalence of disease. More than one case of leprosy in a family was observed in 30.7 per cent of the families. Early cases of leprosy remained acceptable in rural society whereas advanced cases were not acceptable. The disease seemed to manifest at all ages except pre-school age group. Majority of the cases (55.56%) were of early stage with a duration of the disease of less than 2 years. Possibilities to arrest the disease by early diagnosis, and prompt and proper treatment have been emphasized.


Homogeneous antibodies directed against human cell surface antigens: I. The mouse spleen fragment culture response to T and B cell lines derived from the same individual. The use of the mouse spleen fragment culture system is extended to the production of antibodies to human lymphoblastoid cell lines. These antibodies were tested for reactivity against the immunizing cell line, and against a second cell line which had been derived from the same human blood sample. Many of the antibodies were found to discriminate between the 2 isogenic lines. These results demonstrate the potential of the mouse spleen fragment culture system to provide homogeneous reagents which detect distinguishing markers on closely related human cells.


Immunologic reactivity of lymph nodes regional to prostatic cancer: preliminary observations. Regional pelvic lymph nodes from 9 patients with prostatic carcinoma were investigated for in vitro immunologic reactivity to T and B cell mitogens. Regional lymph node lymphocytes were significantly more reactive when obtained from nodes morphologically displaying T and B lymphocyte hyperplasia than from nodes that histologically appeared normal or depleted the lymphocytes. The data suggest that a morphologic evaluation of lymph nodes regional to prostate cancer may reflect the patient's antitumor immune response.


Survival of men treated for chronic stable angina pectoris. A cooperative randomized study. During 1972 to 1974, 686 men aged 27 to 67 years, admitted to thirteen Veterans Administration Hospitals with stable angina, resting or exercise electrocardiographic abnormalities, "graftable" arteries, and abnormal left ventricular function (80 percent) were randomly assigned to surgery (332) or medical (354) treatment. There was no significant difference in clinical, angiographic, and ventriculographic characteristics. The over-all operative mortality rate (30 days) was 5.8 percent, 5 percent in the 95 percent who had saphenous vein aorta-coronary bypass alone. Eighty-nine percent of the 79 percent recatheterized at 1 year had at least one patent graft. Longevity for patients with one, two, and three vessel disease who were treated surgically was comparable to that previously described, but did not differ from that of the medically treated groups. Survival in the over-all surgical group was 86 percent at 4 years as compared to 83 percent in the medical group, which in these "operative candidates" is better than usually cited. This difference was eliminated when the 90 patients (13 percent) with left main disease, whose longevity was significantly improved (p = 0.005) by the operation, were excluded. Despite this exclusion, a slight trend in favor of surgery was still discernible in the largest subgroup, those having triple vessel disease with an abnormal left ventricle.


Effect of aorta-coronary bypass operation on factors precipitating angina. About two thirds (65 percent) of 271 male patients and one half of the 44 female patients who had angina pectoris prior to the aorta-coronary bypass operation experienced total relief of symptoms 1 year after the operation. This was especially apparent for angina associated with walking activity and the postprandial angina. In the nonoperated patients who had angina pectoris and only mild or no coronary artery obstruction, 38 percent of the 127 men and 27 percent of the 73 women were free of symptoms 1 year after the original examination.


[Role of endoscopy in diagnosis and therapy (author's transl)]. Gastroenterologic endoscopy has developed into a perfect diagnostic tool. All sections of the gastrointestinal tract are accessible to visual inspection. The early diagnosis of gastrointestinal cancer has become a reality. The sources of acute bleeding can be located by emergency endoscopy. The combination of endoscopy with other procedures (biopsy, radiology, ultrasonics) has opened up further essentially diagnosis possibilities. Where changes occur in polyps, small particles are not representative. Polypectomy has advanced to total biopsy. Along with this, the step from diagnostic to curative endoscopy was taken. Further milestones in this direction are endoscopic papillotomy and endoscopic hemostasis and the prevention of bleeding by the use of laser light.


[Emergency gastrointestinal endoscopy (author's transl)]. In upper gastrointestinal hemorrhage in nearly 100% of the cases it can be determined endoscopically whether it is bleeding from esophagus, stomach or duodenum. In more than 90% the bleeding source can be localized and diagnosed exactly. In the colon localization and diagnosis of bleeding lesions by endoscopy is possible in more than 90%. In some of these hemorrhages simultaneous endoscopic therapy is possible.


[Laser coagulation in acute gastrointestinal hemorrhage (author's transl)]. The high mortality rate of up to 64% as a result of emergency for gastrointestinal hemorrhage indicates the need for a reliable method for endoscopic bleeding control. By developing a special flexible endoscopic laser transmission system it was possible to transmit high-power Nd-Yag laser radiation, which is especially effective in massive hemorrhages. In 1 1/2 years 186 (94%) of 198 bleeding incidents in 150 unselected patients could be controlled by endoscopic laser irradiation (varices: 60; Mallory-Weiss tears: 14; ulcers: 101; multiple erosions: 11).


[Endoscopy of the resected stomach (author's transl)]. Endoscopy of the resected stomach is indicated in the presence of all types of symptoms affecting the stomach, in gastrointestinal bleeding, and within the framework of prophylactic screening and follow-up examinations for cancer detection. Frequent findings are peptic ulcers, suture granulomas, and reflux esophagitis. Carcinomas in the stump develop increasingly from the 10th to 15th postoperative years. In the resected stomach, the pylorocardial expansion type of gastritis predominates. Atrophy is not an obligatory finding. Foveolar hyperplasia is typical, predominantly in the region of the anastomosis.


Preservation of hearing in tumors of the internal auditory canal and cerebellopontine angle. One hundred thirty-nine tumor removals are reviewed with special interest in ten attempts to save hearing. Three patients with bilateral tumors had some hearing preserved. One of these individuals had a 1 cm tumor removed and his postoperative SRT and discrimination scores were the same as his preoperative ones. Overall, the authors were able to maintain some hearing in six out of ten attempts. While there is no question that patients with bilateral tumors benefit from residual hearing, this is not always true in unilateral cases. The suboccipital and middle fossa procedures are discussed as well as the relative merits of each approach in the preservation of hearing. The total series (139 tumors) is discussed in detail regarding results and complications.


Transference of cell mediated immunity in patients with head and neck cancer. A group of 67 patients with head and neck cancer has been studied of which 40 have received immunologic transfer factor from a normal donor pool. Examination of these patients revealed that lymphocyte reactivity to nonspecific mitogrens is depressed in patients who have head and neck cancer to a much greater extent than is seen in patients with other types of tumors. Furthermore, the depression is more prevalent among patients who have been treated with radiation. Patients in the head and neck group who have received transfer factor show an initial decreased response to PHA stimulation in culture. This is not seen in a control group of head and neck cancer  patients or in patients with nonsquamous cander. Thymus-derived lymphocytes are depressed in patients with head and neck cancer, irrespective of whether they have received radiation. Th T-lymphocyte levels increased in eight of 38 patients who received nonimmune transfer factor, but 7 of these were in the group who had not received radiation. The leukocyte adherence inhibition (LAI) test has been used to determine tumor immunity in the patient test group. Changes in tumor immunity did not occur in those patients who received normal nonimmune transfer factor. Studies are presently in progress which provide for treatment of patients with head and neck cancer with specific squamous carcinoma immune transfer factor.


[The Dieulafoy's ulcer (author's transl)]. In the years 1971-1976 five patients with Dieulafoy's ulcer were operated upon succfully in the Innsbruck University Surgical Clinic. A high consumption of alcohol and tobacco was an outstanding feature in the history of all these patients. Gastroscopy is the diagnostic procedure of choice in this disease; it should be done during the acute phase of hemorrhage since the rather minor morphological changes often cannot be detected when they are not bleeding. Occluding the bleeding vessel by stitches is the therapy of choice. Procedure including resections, especially a socalled "blind" resection, do not seem to be justified. If the bleeding vessel cannot be found during endoscopy a large gastrotomy ought to be done with careful inspection especially of the upper third of the stomach. Our patients were followed up to 64 months; they all are well and without complaints. Prognosis thus seems to be very good if a correct diagnosis is established quickly and if surgery is done adequately.


[Duodenal neurofibroma close to the papilla with hemorrhage and narrowing of the duct of Wirsung and the choledochus (author's transl)]. A solitary duodenal neurofibroma located very closely to the papilla and causing intestinal bleeding could be demonstrated by endoscopy and sonography in a 53 year old female. ERP showed narrowing of the proximal segment of the pancreatic main duct. The diagnosis was confirmed at surgery, in addition it was found, that the choledochus was incarcerated by the tumor as well. A duodeno-hemipancreatectomy after Whipple was performed, because of the localization of the tumor.


Macrophage dependency of T-lymphocyte mitogenesis by Nocardia rubra cell-wall skeleton. The mitogenic activity of the cell-wall skeleton (CWS) of Nocardia rubra on purified splenic T-cells (thymus-derived lymphocytes) was investigated. N. rubra CWS showed remarkable mitogenic activity on normal spleen cells of C57BL/6J mice at concentrations ranging from 10 to 100 microgram per milliliter of culture medium, while, on purified splenic T-cells, N. rubra CWS did not act as an mitogen at any concentration. However, mitogenic activity of N. rubra CWS on T-cells was restored if purified splenic T-cells was reconstituted with X-irradiated peritoneal exudate cells (macrophages). The above results suggest the necessity of macrophages for T-lymphocyte activation by N. rubra CWS as well as PHA-P or Con A.


[Study on the antihemorrhagic action of aminaphtone]. This research is the continuation of a previous published paper. The blood losses occurring during multiple dental extractions under general anesthesia in pretreated patients (not with a recent new capillary protector) have been measured. The results obtained have been processed statistically and confirm the effectiveness of the product.


Characterization of a suppressor-cell leukemia. Evidence for the requirement of an interaction of two T cells in the development of human suppressor effector cells. To characterize the suppressor activity of neoplastic T cells from a child with acute lymphoblastic leukemia and hypogammaglobulinemia, we applied an in vitro assay that determines the capacity of pokeweed-mitogen-stimulated lymphocytes to mature into immunoglobulin-secreting cells. The geometric mean synthesis by peripheral blood lymphocytes from 12 normal persons was 3200 ng for IgM, 2447 ng for IgG and 1825 for IgA (2 X 10(6) cells per 12 days in culture). The patient's leukemic cells produced no detectable immunoglobulin and depressed the immunoglobulin production of normal lymphocytes by 85 to 100 per cent in co-culture experiments. However, suppression was observed only when co-operating normal T cells were present. Prior irradiation of either the leukemic T cells or the co-operating normal T cells nullified the suppressor effect. Therefore, an interaction between at least two different T-cell subsets may be required for the generation of suppressor effector T cells in man.


[The influence of permanent cerebellar stimulation on senso-motor disorders in cerebral palsy (author's transl)]. Based on Cooper's good results implantation of a bilateral cerebellar stimulator was performed in 2 children with cerebral palsy. The patients suffered from marked hypertonia of all limbs and involuntary movements. The follow-up study of 8 months revealed a decrease of spasticity and a progressive improvement of fine motor control. Our preliminary results justify the clinical application of cerebellar stimulation for functional treatment of sensory-motor disorders.


[Long term results of electric stimulation of the conus medullaris in a case of neurogenic bladder]. The authors present long term results (19 to 45 months: Average 37 months) of electrical stimulation of the conus medullaris in neurologic bladder. In 3 cases, the result remain excellent: efficient stimulation, normal micturition, absence of residual urine. In 6 cases, after a long period of normal function, the micturition is poor with residual urine, eventhough the conus medullaris stimulation always produces a satisfactory contraction of the detrusor. In four cases the relapse is due to disease of the external sphincter region, poorly or untreated. In female patients the results are better than in male patients, with positive results in 2 of the 3 women and 1 of the 6 men. The authors find that their results can be compared with those of B. NASCHOLD, originator of the method. They emphasize the necessity of a close collaboration with the urologist to maintain excellent results.


[Treatment of chronic pain syndromes by transcutaneous stimulation. Preliminary results. A propos of 40 cases]. The study of the effect of transcutanous stimulations shows that 40% of the patients suffering of chronic pain can be relieved or greatly improved by this technic. The best results are obtained with peripheral nerves lesions. On the contrary no results are observed with malignancies or facial pain. This way of stimulation is easy to develop and does not imply any danger for the patient. It can be used as a test prior to percutanous stimulation or implantation of a direct stimulation, or can, by itself be an effective treatment.


Catecholamines in individual hypothalamic nuclei of acutely and repeatedly stressed rats. Norepinephrine (NE) and dopamine (DA) concentrations in 17 individual hypothalamic nuclei and 3 other brain regions were measured in rats, acutely or repeatedly stressed by immobilization, using a microdissection technique and a radioisotopic-enzymatic assay. Following the first 20 min immobilization (IMO) a significant NE decrease in the ventromedial (NVM) and supraoptic (NSO) nuclei and a DA decrease in the arcuate nucleus (NA) as well as NE and DA increase in the dorsomedial nucleus (NDM) were seen. Repeated IMO (40 times) produced a NE increase in the NVM, NDM, NSO paraventricular nucleus (NPV) and median eminence (ME), and a DA increase in the NDM and NPV. Changes of NE and DA concentration found in some individual hypothalamic nuclei under the influence of stress indicate that catecholamines (CAs), particularly in the medial basal hypothalamus, could be involved in the regulation of some neuroendocrine processes which are being activated during stress, especially ACTH release.


Susceptibility to motion sickness and ego closeness, ego distance as measured by the autokinetic response tendency. This paper reports results from one phase in an ongoing study of the relationship between vestibular function and various aspects of personality, cognitive style and symptom formation in mental illness. In the experiment reported here a measure of autokinesis was shown to relate to motion sickness experience as judged by actual stimulation in a rotating chair. Low and intermediate sensitive subjects showed less autokinesis than the most motion sick individuals (two-way analysis of variance F = 5.735, P = 0.006). Males in this sample showed a significantly greater autokinetic tendency than females (two-way analysis of variance F = 6.995, P = 0.011).


Theoretical and therapeutic potential of indolamine precursors in affective disorders. The strategy of loading with precursor amino acids of the monoamines postulated to be involved in the affective disorders is reviewed. Phenylalanine, tyrosine, L-dopa, L-tryptophan and L-5-hydroxytryptophan (L-5HTP) have been found to induce differential behavioral and biochemical effects in both healthy subjects and endogenous depressives. Indoleamine precursors predominantly cause mood changes. However, the efficacy of these amino acids as antidepressants has been neither clearly established nor refuted, probably due to insufficient consideration of the following criteria; sufficiently high plasma levels to be taken up into the brain, effective stimulation of serotoninergic systems, and selective increase of serotonin turnover with minimal interaction with other neurotransmitters. The use of intravenous L-5HTP as a provocative test in depressive patients, with concomitant neuroendocrinological and psychometric measurements, may be a method adequately fulfilling these requirements.


Cranial computertomography in children with tuberous sclerosis. 20 children with tuberous sclerosis were examined by computertomography (CCT). The test is useful to detect cerebral involvement with great certainty. The method is especially helpful in the early diagnosis of the disease. This offers the possibility of giving an early genetic advice. Characteristic CCT scan abnormalities in tuberous sclerosis are multiple densities in the walls and the roof of lateral ventricles. This specific finding can already be seen prior to the occurrence of calcifications in standard roentgenograms.


[Contrast ventriculography using dimer-X]. The authors report the results of 100 Dimer-X ventriculographies mainly in cases of midline tumours. The value of tomography for the diagnosis of tumours is stressed. Besides that, the contrast was used for visulization of intracerebral cavities, emptied abscesses, cavities in astrocytomas and intracerebral haematoma. Complications following the use of Dimer-X for direct filling of the ventricular system are discussed.


Pathologic aspects of chemotherapy response in the treatment of osteogenic sarcoma. An analysis of two cases. Two patients with osteogenic sarcoma of the proximal tibia were treated pre-operatively with intensive chemotherapy with high dose methotrexate (HDMTX) with citrovorum factor rescue (CFR) and adriamycin (ADR). One patient died before surgery. The other underwent en bloc resection of the primary tumor with prosthetic replacement of the involved tibia, following by adjuvant chemotherapy consisting of HDMTX with CFR and ADR, but died of metastases. Complete control of the primary or metastatic tumor was not achieved. It is emphasised that intensive multiple drug chemotherapy should be administered with extreme caution. The histologic findings are carefully analysed in relation to objective tumor response and toxic chemotherapy effects.


X chromosome and color blindness.

X chromosome and color blindness. A red-green color blindness was studied in four families. All the carriers of the gene (mothers and sisters of the color blind individuals) had normal color vision. The color blind individuals were protanomalous or deuteranomalous. No protanopia or deuteranopia was found in the subjects who have been studied.


Linear acceleration modifies the perceived velocity of a moving visual scene. In the present work, we have shown the effect of a vestibular stimulation on the velocity perception of a moving scene. The intensity of this effect is related to the amplitude of the cart acceleration, image velocity, spatial frequency of the visual stimulus, and the angle between the directions of cart and image movement. A simple model has been developed to determine whether the perception of visual movement is due to the geometric projection of the vestibular evaluation on the visual vector, or the inverse.


Effect of nerve length and temperature on the induction of action potentials in denervated slow muscle fibres of the frog. A. Pyriformis and extensor longus digiti IV muscles of Rana temporaria were denervated by cutting the sciatic or peroneal nerve at various distances from the muscles. Slow fibres were identified by their membrane time constants, and examined for their ability to produce action potentials in response to intracellularly applied current pulses. B. The slow muscle fibres acquired the ability to generate action potentials several days after denervation. The duration of this latent period depended on the length of the peripheral nerve stump, and on the temperature at which the frogs were kept after the operation. C. At 18 degrees C the latent period increased by 0.36 days per mm of sciatic nerve stump. At 11.5 degrees C the corresponding value was 0.7 days/mm. The effect of length of the peroneal nerve was smaller than that of the sciatic nerve. D. It is suggested that the peripheral nerve stump serves as a reservoir of 'trophic' material which is transported towards the slow fibres at a rate of 2.8 mm/day (at 18 degrees C) and seems to block the formation of Na channels. The Q10 value of this transport system would be 2.7.


[Mallory-Weiss syndrome. A study of 25 cases (author's transl)]. Twenty five cases of Mallory-Weiss syndrome were visualised endoscopically, representing, 4,6 p.cent of a serie of 540 consecutive upper gastro-intestinal bleedings. More frequent in men (85%) the mucosal laceration of the oesogastric junction caracteristic of the Mallory-Weiss syndrome is caused by a sudded intra-abdominal hyperpression. The lession is often associated with a prodrome of vomiting (80%). A hiatal hernia (80%), the ingestion of gastrotoxic drugs (52%) or of excessive alcohol (28%) are favorising factors. Emergency endoscopy allows an accurate diagnosis. The severity of the gastro-intestinal bleeding is generally not important and most patient can be managed non surgically.


Gastrointestinal haemorrhage from small bowel duplication. A case is reported of duplication of the small bowel presenting with gastrointestinal haemorrhage. This is the first reported case in an adult. A review of the literature has been made and the pathogenesis discussed.


Transcutaneous electrical nerve stimulation: an adjunct in the pain management of Guillain-Barré syndrome. Transcutaneous electrical nerve stimulation was applied in the pain management of a patient with Guillain-Barré Syndrome. As subjectively reported by the patient, her back and lower extremity pain was significantly decreased although her foot paresthesia was not decreased. The program was continued for an 11-day period because TENS was considered a valuable adjunct for the patient's comfort. Transcutaneous electrical nerve stimulation is a valuable addition to our repertoire of available physical therapy modalities. We hope that as clinical experience with TENS increases, fellow clinicians will volunteer the experiences of their endeavors.


[Communicating hydrocephalus due to acustic neurinoma (author's transl)]. In 3 patients with predominant symptoms of communicating hydrocephalus more investigations led to the diagnosis of neurinoma at the cerebellar-pontine angle. Possible causes of CSF circulatory disturbances will be discussed.


Computed tomography in the evaluation of subdural hematomas. Computed tomographic (CT) scans used in the diagnosis and management of subdural hematomas were analyzed with respect to their contribution to angiography and surgery. There has been a progressive increase in the use of CT in evaluating post-traumatic and postoperative subdural hematomas at the Mayo Clinic. At present, 40% of all patients undergo operation on the basis of the CT findings alone. False-positive diagnoses revealed at surgery have decreased to less than 4%. Erroneous negative interpretations have involved 10% of all patients whose diagnosis was subdural hematoma. Criteria for the interpretation of scans have been established.


Preferential enhancement of human T cell survival "in vitro" using subthreshold concentration of phytohemagglutinin. Cultures of human peripheral blood lymphocytes were maintained for 21 days in the presence of subthreshold concentration of PHA. The identification of T and B human lymphocytes by membrane markers showed that at day 21 of culture, the cell population surviving is constituted predominantly of T lymphocytes.


Auditory brain stem responses in the diagnosis of cerebellopontine angle tumours. There is a constant search for more reliable methods of diagnosing cerebellopontine angle tumours at an early stage. The auditory brain stem responses promise to be of use as such a method. In two patients with extracanalicular neurinomas we found a definitely abnormal brain stem response even though conventional tests produced a cochlear type of test pattern. In a third patient with a meningeoma we obtained a similar type of response. Here the conventional tests clearly pointed to the presence of retrocochlear disease. Characteristic findings are a broadening of the whole nerve action potential and a delay in the appearance of the Jewettv-FFP7 complex.


Human tissues as source of colony-stimulating factor in human bone marrow cultures. Human bone marrow cells were cultured by the agar method using feeder layers containing human tissue fragments of various origin. Colony stimulating factor (CSF) was shown to be released from all tissues tested (adipose tissue, skeletal muscle, peritoneum and vascular wall), and primary cultures of human fibroblasts could also stimulate colony growth. Colony growth of murine bone marrow cells was also stimulated by all feeder layers. Thus, the study demonstrates that monocytes and macrophages might not be the only source of CSF of possible importance for human granulopoiesis in vivo.


Erythropoiesis in the anaemia of chronic disease. The amount and effectiveness of erythropoiesis was measured using 59Fe in 10 patients with the anaemia of chronic disease and in 10 iron deficient patients with a comparable degree of anaemia. In both conditions the anaemia was the result of the failure of the marrow to compensate for a modest degree of peripheral haemolysis but ineffective erythropoiesis was significantly greater in iron deficiency than in chronic disease. The results suggest that although the peripheral blood picture is similar in both conditions the anaemia of chronic disease cannot be attributed simply to iron deficient erythropoiesis.


Generation of cytotoxic T lymphocytes against Ly alloantigen. Cytotoxic T lymphocytes specific for immune alloantigens controlled by alleles of the Ly system have been induced in vivo. These results were obtained either in a secondary type of response or by treating mice before immunization with a single dose of cyclophosphamide (80 mg/kg).


Poly A:U-induced secretion of T-lymphocyte helper factors. In vitro exposure of mouse thymocytes to complexes of polyadenylic:polyuridylic acid (poly A:U) effected, within 6 h, the release of soluble factor(s) capable of nonspecifically enhancing IgM and IgG plaque-forming cells (PFCs) in in vitro primary and secondary spleen cell responses to burro erythrocytes. Poly A:U stimulation was, most likely, polyclonal, since production of soluble factor(s) occurred in the absence of antigen and in serum-free culture media. Poly A:U-induced soluble factor(s) were not capable of substituting for T cells but were dependent on T cells for the expression of PFC enhancement. These data support the hypothesis that the mechanism of poly A:U's adjuvant action is polyclonal stimulation of T cells, causing early induction and release of nonspecific, soluble PFC-enhancing factor(s).


Aorto-coronary vein bypass and valvular surgery. During the period 1972--1975, 26 patients underwent valvular surgery combined with aorto-coronary saphenous vein bypass at Ullevål Hospital, Oslo. Aortic valve replacement was performed in 13 patients, mitral valve replacement in 8 and double valve replacement in 3 patients. The Björk-Shiley tilting disc valve was used in all cases. A Carpentier ring was inserted in one case and an open mitral commissurotomy was performed in another. Twenty-nine saphenous vein grafts were inserted. Three early deaths (all patients in functional class IV (NYHA)) were due to myocardial failure. There were 2 late deaths (both patients in functional class III before operation) of which one was due to myocardial infarction and the other to ventricular fibrillation. The overall mortality was 19%. At follow-up with a mean observation time of 11 months, 19 of the 21 survivors were improved at least one functional class. Only 2 patients had mild angina pectoris. No valvular dysfunction was found. Twenty-one of 22 re-examined grafts were patent (95% graft patency). Valvular surgery combined with aorto-coronary vein bypass in this material shows low mortality and good clinical and haemodynamic results in patients in functional class II and III. Patients should be operated upon before they reach functional class IV, as the mortality in that group is very high.


[The effect of diclofenac sodium on the metabolism of diabetics in qualitative diet therapy with an without tolbuamide. A clinically oriented study in aged diabetics with rheumatic disease]. The influence of diclofenac sodium (Voltaren) on glucose metabolism was investigated in a group of 13 maturity onset diabetics treated by a standard diet alone. A second group of 14 patients with maturity onset diabetes well controlled by a standard diet and tolbutamide (Rastinon) was examined for a possible drug interaction. Determinations of capillary blood glucose as well as assessments of urine sugar by Clinitest and 24-hour urine glucose determinations were regularly done before and during treatment with diclofenac sodium. The results of this study show no alteration of glucose metabolism. These laboratory data suggest that there is no clinically relevant interaction between diclofenac sodium and tolbutamide. Neither the blood glucose profiles of the individual patients nor those of the two above-mentioned groups showed any alterations of blood glucose concentration. Diclofenac sodium, a non-steroidal antirheumatic drug, may be recommended in the treatment of rheumatic diseases in diabetics. Indomethacin, naproxen, sulindac, diftalon and diclofenac are more recently developed antirheumatic drugs which have been specially tested in diabetics.


Retropharyngeal hematoma in a hemophiliac. A retropharyngeal hemorrhage, a rare but potentially fatal complication of hemophilia, is described. Its early manifestation may be a "sore throat", and the patient with this symptom must be closely observed. If there is any doubt about the clinical situation, or if hemorrhage in and around the throat occurs, appropriate replacement therapy with factor VIII should be started at once.


Combined abdominoperineal resection.

Combined abdominoperineal resection. Abdominoperineal resection has long been recognized as a procedure with formidable morbidity. Through meticulous dissection, use of proper tissue planes, attention to location of urologic and neurologic structure, careful hemostasis, and appropriate postoperative measures, most of the complications outlined in this article can be avoided. Should a complication develop, close surveillance and early recognition coupled with the appropriate management can still offer the patient a satisfactory recovery.


Hypothalamo-pituitary-adrenal function in pituitary adenoma and craniopharyngioma. Part II: insulin test and clinical features. For the assessment of hypothalamic corticotropin releasing hormone (CRH) secretory function, insulin test, lysinevasopressin test, and rapid ACTH test were performed and plasma crotisol was assayed. Disturbances of CRH secretory activities were found not to be related with the degree of suprasellar extension of tumors, contents of tumors, the degree of visual disturbances, or the duration of symptoms, and it was supposed that more complex mechanisms were responsible for CRH secretory abnormalities.


Intramural hematoma of the small bowel: a possible lethal complication of herniography. A severe and possible lethal complication of herniography is reported. A 3-year-old child who was born with an undescended testicle on the right side and a normal descended testicle on the left underwent a herniography study. Twelve hours following the procedure, he developed lower abdominal pain which progressed over the next 72 hours. A diagnosis of mesenteric hematoma was entertained and he underwent abdominal surgery. At operation a large intramural hematoma was found in a segment of nonviable bowel. This segment was resected with an end-to-end anastomosis. The postoperative course was uneventful.


Isolation of antithrombin III from normal and alpha1-antitrypsin-deficient human plasma. The plasma of individuals, hetero- or homozygous for alpha1-antitrypsin deficiency, contains greatly decreased amounts of antithrombin activity as assayed against factor Xa. However, heparin stimulation of the residual antithrombin activity is observed, which is comparable to that of normal plasma. Antithrombins isolated from both normal and alpha1-antitrypsin deficient plasma by a simplified procedure are indistinguishable in both properties and yields. The microheterogeneity observed on isoelectric focusing of both preparations can be eliminated by treatment with neuraminidase. Neither purified human antithrombin nor alpha1-antitrypsin, when assayed against bovine trypsin, is stimulated by heparin. These results clearly establish the unique natures of antithrombin and alpha1-antitrypsin and show that about 75% of the antithrombin activity measured in normal plasma is due to alpha1-antitrypsin. Estimates of antithrombin III activity in normal plasma by assays dependent on enzymatic activity can probably be obtained only in the presence of heparin.


The aspirin tolerance test in von Willebrand's disease. Opinions about the clinical value of aspirin tolerance test proposed by Quick von Willebrand's disease are conflicting. The results of the present study seem to support the view that a platelet defect, induced by aspirin, causes a significant lengthening of bleeding time only in the cases with severe von Willebrand factor deficiency.


Absence of blocking antibody in non-inhibitor haemophilic plasma. This study examined the hypothesis that non-inhibitor haemophilic plasma contains antibodies which are specific for sites other than the active procoagulatn site on factor VIII, and that some of them might be sufficiently close to the active site that pre-incubation of such plasma with factor VIII would block the subsequent binding of inhibitor antibody. Among the 26 non-inhibitor plasmas examined, none was found to contain such blocking antibody. This result does not eliminate the possibility that antibody is present in such non-inhibitor plasmas which is neither specific for the active enzyme site of factor VIII nor capable of blocking the binding of antibody which does have that specificity.


Immunoglobulins and antinuclear antibodies in aqueous humour from patients with juvenile "rheumatoid" arthritis (Still's disease). Aqueous humour and blood from twenty cataractous patients with chronic anterior uveitis and the monopauciarticular form of juvenile rheumatoid arthritis were tested for immunoglobulins G, A, and M and for autoantibodies, particularly those against nuclear antigens. The aqueous immunoglobulins were raised in the majority of patients even when the eyes were normal biomicroscopically. Raised IgG antinuclear antibodies were found in 85% of the aqueous samples. Information obtained from the study of aqueous humour from fourteen patients with senile cataract was used for statistical analysis of these data. The presence of high molecular weight immunoglobulins in the aqueous humour from patients with Still's disease suggests an abnormal blood-ocular barrier which may be responsible for the recurrence which follows an ostensibly treated primary attack of uveitis. The presence of antinuclear antibody in a few aqueous samples without a concomitant rise in the blood levels is suggestive of local antibody synthesis.


Biomicroscopical observations on corneal endothelium in pseudophakia. The principle and technique of Maurice's method of microscopy of the corneal endothelium at high magnificant is discussed. An instrument is now available for clinical use (clinical specular microscope). The experience of the authors in patients with an intraocular lens is reported. A rather high deficit of endothelial cells was found in a series of 26 children and young adults, that had suffered injury from 2 to 11 years previously. An average immediate endothelial cell loss of only 6-7% was found in extracapsular cataract extraction with simultaneous implantation of a 2-loop or 4-loop intraocular lens. A striking difference was found between the two eyes of bilateral pseudophakic patients when one eye had undergone intracapsular surgery and the other eye extracapsular surgery. It had to be concluded that barrier deprivation of the intracapsular aphakic eye leads to continuing endothelial cell loss other than through ageing. Subclinical and clinical late corneal dystrophy therefore belong to the "barrier deprivation syndrome" together with retino-vascular accidents (macular and optic disc oedema) and vitreous degeneration.


Surgical and postoperative problems with Binkhorst 2- and 4-loop lenses. The operative and postoperative complications are described in a series of 537 eyes with lens implants, with suggestions for prophylaxis and treatment. The level of complications is low, and the authors believe that the visual results in terms of patient satisfaction make lens implantation a worthwhile procedure.


Lymphocyte changes in acute malaria.

Lymphocyte changes in acute malaria. Lymphocyte sub-populations were studied in children with acute malaria. Depletion of T cells was found associated with an increased proportion of null cells. K cell activity for chicken red cells was also increased and it is likely that some of the increased number of null cells were K cells. An increase in K cell activity in acute malaria could be part of a protective immune response.


Outpatient medical records: improvements through layout engineering. Dissatisfied with some functional aspects of the problem-oriented medical records used by their medical group, a committee of member physicians redesigned their office charts. Applying techniques of systematic layout planning, employed regularly as a tool of industrial engineering, these clinicians devised what they feel to be outpatient document with unique features. The resulting product forms a cohesive unit, eliminates duplication and provides many medicolegal safeguards.


[Patient-oriented information processing in internal medicine]. The internistic accessory documentation as a partial region of the information processing referred to the patient in a hospital fulfils the demands of diagnostic and therapeutic kind from the point of view of the hospital physician to rationalise and optimize the demands of administrative work, such as identification and duration of stay, and demands of the physician performing the follow-up treatment to get a quick and sufficient information with the threefold aim of treatment (including prevention, diagnostics and after-treatment), documentation (including statistics, archivation, information) and research (any connection of data for cross-section and longitudinal section examinations you like).


[Experience and results in the evaluation of documentation-oriented medical records in the German Democratic Republic]. At the instance of the chronic liver diseases (Nr. 571 and 573 IKK) is shown in form of a model which high value of information the process of the stored data of the headline of a medical record suited for documentation. Thus informations concerning the clinical morbidity/mortality, analyses according to age and sex, residence and admitting institution, comparison of admission, treatment and post-mortem diagnoses, ascertainment of the diagnosis and finally economic data may be got. From this result the epidemiological conclusions and the statements for analyses of factors.


[The pararheumatic syndrome in thyroid diseases]. 25 patients with hypothyroidism and 100 patients with hyperthyroidism were anamnestically, clinically, serologically and radiologically examined for the presence of a para- or pseudorheumatic symptomatology. The evaluation was carried out in comparison to the control groups of the same sex and age distribution. In nearly half the cases in hypothyroidism a symptomatology with polyarthralgias, myalgias, weakness of the muscles, acroparaesthesias, rigidity, swelling of the fingers and thickenings of the synovial membrane which are to be classified as "myxoedematous pseudorheumatism" stood in the foreground, which for the largest part were concomitant with a polyarthrosis. Furthermore a syntropy with the cervicobrachial syndrome, the humeroscapular periarthritis, calcifications of bursa and insertions of the sinews, the gout and the carpal tunnel syndrome were found. In the not infrequently prevailing pararheumatic symptomatology differential-diagnostic difficulties may develop within the total clinical picture. The patients with hyperthyroidism showed a symptomatology of the joints and tissues of the upper extremities which above all had the character of trifles.


[Physical therapy in rheumatic diseases]. For the physiotherapy of rheumatic diseases principles of order are recommended. The aims of physiotherapy (allevition of pain, improvement of mobility, inhibition of inflammation), dosages of physiotherapy (intensity of treatment, time of treatment, region of treatment), quantification of pain and reaction to treatment are in the foreground in these cases. With regard to an appropriate choice of methods these principles of order are explained at the instance of the rheumatoid arthritis and the ankylosing spondylitis. Concerning the rheumatism of the soft tissues a classification of the therapy according to localisation and course of the disease (acute, recurrent, chronic) is explained.


[Indications and results of surgical therapy of rheumatic diseases]. The indication to synovialectomy is present in chronic inflammatory articular processes, which cannot be sufficiently controlled by an optimal medicamentous treatment of a duration of 6 months. It is urgent, when the synovialitis is connected with the danger of a damage of tendons and nerves. An essential restriction by the age of the patients or the activity of the process does not exist. Reconstructive-reparative and stiffening operations are indicated, when the correction of deformations or the stabilisation of joints shall be achieved. In these cases the interventions first mentioned may also contribute to the alleviation of the pain and the improvement of the function. The results of the surgery of joints in chronic rheumatic diseases are good in the majority of patients. Further improvements may be achieved by timely indications and the enlargement of the possibilities of the alloplastic substitution of the joints.


[Mechanism of the adjuvant action: effect on the stem cell and B-lymphocyte migration from the bone marrow]. The authors studied the influence of synthetic polyelectrolytes of polyacrylic acid and poly-2-methyl-5-vinylpyridine and of complete Freund's adjuvant on the migration of stem cells and B-lymphocytes from mouse bone marrow. The stem cell count was evaluated by the number of splenic colonies; as to B-cell migration--it was assessed by the accumulation of the antibody-forming cells forming from B-lymphocytes migrating in the spleen in the transfer of fixed number of T-lymphocytes. As revealed the synthetic substances under study intensified the migration of stem cells and of B-lymphocytes to a much greater extent than Freund's adjuvant. The mechanisms of the influence of the adjuvants used on cell migration processes are discussed.


Application of cubital venous graft for double coronary bypass. In experiments with cadaver hearts the cubital vein was used for aortocoronary bypass anastomosis. The indications, advantages and drawbacks of the use of a venous section of inverted Y shape are discussed. Since 20 to 30% of patients in need of an operation of this type have saphenous veins which cannot be applied as grafts, use of the cubital vein is recommended.


Effect of atenolol, a new cardioselective beta-blocker, on plasma renin activity in treatment of hypertension. Atenolol, a cardioselective beta-blocking drug, was prescribed in doses of 100 mg b.i.d. in 23 patients with essential hypertension. At the end of the first month of treatment with Atenolol we found a significant fall in blood pressure, heart rate and plasma renin activity (P.R.A.). Besides, there existed a relationship between changes in diastolic blood pressure, in mean arterial pressure and initial plasma renin activity, and a relationship between changes in blood pressure and changes in P.R.A. It results from this finding that pretreatment P.R.A. is of predictive value of short-term efficacy of the beta-blocker. This correlation was borderline in 21 patients after a mean of 7 month treatment and could no be found for 12 cases after a mean of 10 month-treatment while the fall in P.R.A. was still significant. It therefore appears that--with reserve of the representativeness of the sample--quantitative relations between the antihypertensive effect of Atenonol and P.R.A. are no longer significant on long-term treatment.


Long-term experiences with minoxidil in combination treatment of severe arterial hypertension. Thirteen patients with advanced hypertensive disease insufficiently controlled by conventional drugs were treated with minoxidil in combination with a beta-blocking agent and a thiazide in a long-term study. A reduction from 214 +/- 5/122+/3 to 166 +/- 7/95 +/- 3 mm Hg in the mean supine blood pressure was obtained. The dosage range of minoxidil was 7.5-35 mg per day (mean 18.8 mg), and in all cases beta-blockade was necessitated by the occurrence of reflex tachycardia. Only two of the patients were found to be unsatisfactorily controlled on combined therapy. In five cases, minoxidil was disontinued during the observation period, but only in three cases was the discontinuation due to side effects, v.z. sodium retention and augmented hair growth. Stable diabetes developed in one patient, and in two cases of established, dietetically treated diabetes oral antidiabetic drugs had to be administered. Five non-diabetic patients showed no significant changes in fasting plasma glucose and the K values in intravenous glucose-tolerance tests. Minoxidil seems to be a safe and potent antihypertensive drug for long-term use in severe arterial hypertension, but it cannot be recommended for routine treatment.


Relationship of various QRS indices to SGOT levels in acute anterior myocardial infarction. In 52 first myocardial infarction which were anterior in location, several QRS indices derived from measurements of precordial QRS complexes using their correlation with highest recorded value of serum glutamic oxaloacetic transaminase (SGOT). The sum of R amplitudes in V1 to V6 inclusive (3r V1-6) was preferred over indices which included measurements of Q amplitude or duration because it was simpler to calculate and most frequently showed the best significant correlation with SGOT both in the presence or absence of radiologic evidence of pulmonary congestion. Furthermore calculation of change from normal values of precordial R amplitudes did no improve the correlation. Thus 3r V1-6 perhaps as a reflection of amount of loss of myocardial muscle mass is a quantitative ECG approach which correlates with severity of myocardial infarction and should receive more attention in evaluation of infarct size in man.


[Significance of various clinical pictures falling under the general term "rheumatism" for social medicine]. Statistical reports of the "Bundesversicherungsanstalt für Angestellte" and from an affiliated rheumatological rehabilitation clinic show that within the general term of "rheumatism" inflammatory rheumatic diseases are only a few per cents. Myalgic syndromes of the vertebral column without obvious changes of the skeleton rank first. They are followed by degenerative diseases of the vertebral column and peripheral joints. While the number of treatment courses of cardiovascular disorders for men and women (male predominance) remained relatively constant from 1968-1974 and in 50% of the cases lead to pensioning-off, treatment courses of bone and joint diseases have clearly increased with a female predominance; pensioning-off is necessary only in a few cases. There is no correlation between morbidity and number of treatment courses; the importance of economical and social factors for the therapeutic regimen is pointed out. Rehabilitation clinics of the pension-paying institutions offer optimal possibilities of a long term treatment of rheumatic diseases, as single or repeat treatment. The activities of a league against rheumatism should concentrate on the clinically and sociomedically most severe joint diseases.


Right ventricular monophasic action potential during quinidine induce marked T and U waves abnormalities. An unusual case with quinidine induced marked T and U waves abnormalities of giant size and alternans occuring in sinus rhythm is reported. Right ventricular monophasic action potential recorded during bizzare T and U waves abnormalities showed a marked prolongation of its duration and regressed after the drug was withdrawn.


The crossed extensor hallucis response in neurological disorders; an electromyographic analysis. The electromyographic activity in several leg muscles during the elicitation of "the crossed up-going toe sign" (CUT) was studied in patients and compared with that obtained in connection with the Babinski sign and in normal subjects. The results indicate that the patterns of activation and the responsible pathways are different for the CUT and Babinski signs. The difference between the normal subjects and the CUT positive patient is a matter of quantitative difference of coactivation of distal leg muscles during the test procedure rather than a change of reflex patterns.


Electrophysiological membrane properties of the frog muscle fibre: effects of detergents in the triton series. The effect of the nonionic detergent Triton X-100 on the membrane properties of frog sartorius muscle fibres was studied using intracellular microelectrode technique. The effect of Triton X-100 was compared with that of Triton X-45 and Triton N-101. At 40 muM Triton X-100 had little effect on the specific membrane resistance (Rm), membrane capacitance (Cm) and the resting membrane potential (Er) while the action potential (AP) was markedly reduced. At 160 muM AP was completely abolished and Er was diminished linearily with time. The effect on the maximum rate of rise (VA) of the AP was dose-dependent and the apparent dissociation constant (KD app) and K(D) were found to be about 40 muM. The Hill coefficient was 1.6 indicating a deviation from a first order reaction. The effect of Triton X-100 on Er may be accounted for by a reduction of the Na--K pumping activity. The effect of Triton X-100 on the AP is suggested to be due to a perturbation of a protein-system either by a drug-receptor interaction involving two or more sites, or an unspecific binding of Triton X-100 to hydrophobic loci on the protein.


Effects of alcohol on ganglion cell receptive field properties and sensitivity in the frog retina. Previous results have shown that alcohol has an effect on vision and on the excitability of retinal neurons. Action potentials of single ganglion cells were recorded by microelectrodes in opened and excised eyes from frogs (Rana temporaria L.). Histologically two types of synapses have been described in the retina: conventional synapses and synapses with a ribbon or bar shaped component surrounded by a rather uniform layer of synaptic vesicles. The "ribbon synapses" are presynaptic contacts in receptor and bipolar cells while horizontal and amacrine cells have conventional synapses. Tests with ethanol doses up to 0.2% indicated stronger effects on the conventional synapses than on the ribbon synapses. Alcohol decreased or abolished the lateral inhibition ( inhibitory surround) mediated by the amacrine cells and depressed the signals from the green rods, which apparently are mediated by horizontal cells. Further alcohol decreased the sensitivity of the signals from the completely dark-adapted red rods in the retina, and increased the sensitivity of the cone-mediated responses for class 3 and deviating class 4 cells, when measured against a background light. Alcohol also increased the latency of the response up to 55 msec. depending on the size of the stimulus field.


Effect of skeletal muscle denervaton on the activity of muscular acetylcholinesterase (E.C. 3.1.) in frog. The activity of acetylcholinesterase (AChE 3.1.1.7.) was determined in skeletal muscle homogenates in frogs at various time intervals (15--24 days) after denervation. At the same time changes in AChE activity were compared with morphological changes of neuromuscular end plates in these muscles. Muscle denervation caused initially, within 30 hours, a rise in AChE activity by about 30% in relation to control muscles, followed by its fall to the control values after 4--6 days. The activity decreased further reaching lowest values 15 days after denervation, when it amounted to about 65% of the value of control muscles. After that time, when regeneration of nerves set in, the activity of AChe rose again returning to the control values after 24 hours. In the initial period of denervation no correlation was found between AChE activity and morphological changes in end plates. It was found however in the later period when degenerative changes were most pronounced as well as when reinnervation was in progress.


Acute upper-gastrointestinal hemorrhage. New observations on an old problem. In a two-year period, 289 patients with acute upper-gastrointestinal hemorrhage were evaluated. The site of hemorrhage was proven by endoscopy in more than 90% of cases. The frequency of any particular bleeding site was characterized for several subgroups and was found to correlate with: (1) the severity of the bleeding episode; (2) the iatrotropic stimulus of hemorrhage, and (3) the history of ethanol consumption. No difference was found in the frequency of ulcer and acute mucosal lesions as sites of hemorrhage between patients who consumed aspirin and those who did not. A history of symptoms of peptic ulcer correlated with the presence of an ulcer as the bleeding site. It is possible that failure to identify important patient subgroups may be partially responsible for the disagreement between previous reports.


Acute gastroduodenal lesions in head injury. An endoscopic study. Early and serial endoscopic examinations were performed in patients with head injury to determine the actual incidence and course of the acute gastroduodenal lesions. Acute gastroduodenal lesions were found in high incidence of 35 in 47 patients (75%). It was stressed that the lesions were found in 16 of 25 cases without obvious gastrointestinal bleeding. The lesions were mainly found in the stomach (78%) and of these lesions erosive gastritis was seen in the greatest frequency. Gastric ulcer was found in 11 patients. Erosive gastritis was found within one week after the trauma, while gastric ulcer usually developed after one week. Erosive gastritis was mainly located in the body of the stomach and usually healed within ten days. Gastric ulcer also had a good course. There was no case in which the erosive lesion extended to the ulcer. Among 22 patients with gastrointestinal bleeding, three had intractable bleeding. Steroid administration seemed to have little effect on the occurrence of acute gastroduodenal lesions.


Characterization of tumour cells in concomitant chronic lymphocytic leukaemia and acute monocytic leukaemia. A 68-year-old woman presented with haematological changes of chronic lymphocytic leukaemia and acute monocytic leukaemia. This diagnosis was confirmed by identification of cell surface markers for T and B lymphocytes and the identification of abnormal immunoglobulins and lysozyme in serum and urine.


Cellular immunity in squamous cell carcinoma of the uterine cervix. The thymus-dependent immunity of 42 patients with SCCC was evaluated by: delayed cutaneous reactions to ubiquitous antigens, DNCB sensitization, and lymphocyte response to PHA. In addition, T and B lymphocytes were detected in peripheral blood and in tumor sections, by adherence to E and HEAC. Depressed CMI was more intense in patients with disseminated disease, although a premature impairment of CMI was observed in some patients with initial-stage tumors. The absolute number of peripheral T lymphocytes showed association with both cutaneous reactions and PHA response. However, there appeared to be no significant correlation between the stage of the tumor and the pattern of adherence of E or HEAC to the biopsies.


Involutional diabetic retinopathy.

Involutional diabetic retinopathy. The end-stage or involutional phase of proliferative diabetic retinopathy may result in stabilization of vision for long periods of time. However, the clinical resemblance to the progressive tapetoretinal degenerations suggests that marked functional impairment of the retina is present in such eyes. We studied 19 eyes with involutional retinopathy to document the status of the retinal function. Studies included fluorescein angiography, visual field examination, dark adaptation testing, color vision testing, electro-oculography and electroretinography (ERG). The results indicated marked functional abnormalities in all eyes. The ERG tracings showed uniformly subnormal responses and delayed implicit times, similar to those of dominantly inherited retinal pigment degeneration, and indicative of a progressive retinal disorder. In two patients, color vision testing showed defects similar to those seen in inherited tritanopia; and in the remaining patients, defects were indicative of an acquired blue-yellow dyschomatopsia.


Topographic impairment of night vision related to exercise. We observed impaired night vision in the lower visual fields of long distance runners. We reduplicated our field observations by studying four vigorously exercising men, aged 26 to 52 years, under controlled laboratory conditions. Results of our observations showed impaired night vision did occur in the inferior visual fields of all four subjects.


Excretion of gentamicin in rabbit tears after subconjunctival injection. We subconjunctivally, injected gentamicin, in a dose of 10 mg, into normal and inflamed (Staphylococcus aureus endophthalmitis) rabbit eyes in which the nasolarcrimal ducts had been blocked. We retrieved approximately 10% of the dose of drug in the tears, the majority in the first 30 minutes. The difference in lacrimal excretion of the drug between normal and inflamed eyes was not significant. Higher concentrations of gentamicin found in the ocular tissues of normal eyes than inflamed eyes cannot be attributed to loss in the tears.


The locus of unique green in deuteranomalous trichromats. A method of color naming was used to determine the spectral locus for unique green (UG) as it was perceived by 20 color normals and 24 deuteranomalous trichromats. The loci for the normal group were distributed bimodally, as earlier investigators had reported, and a bimodal distribution was also found for the deuteranomalous group. In the latter group, UG was located at long wavelengths only by those who had been classified as mild deuteranomals according to several clinical criteria. Those who located UG at shorter wavelengths included individuals whose defects ranged from mild to severe. This result is discussed in the context of theories of deuteranomaly and is presented as further evidence for the existence of 2 types of deuteranomaly.


Massive upper gastrointestinal hemorrhage in the elderly. Sixty-six elderly patients with massive upper gastrointestinal bleeding were retrospectively analyzed. This study supports the concept of vigorous resuscitation, early diagnosis with fiberoptic endoscopy, and prompt surgical intervention in patients with continued bleeding. When this approach was utilized in a community hospital, operative mortality was reduced to 5 per cent.


A transthoracic devascularization procedure for control of bleeding esophageal varices: preliminary report. A procedure for control of variceal bleeding has been described which involves "devascularization" of the distal one third of the esophagus and upper one half of the stomach combined with a Nissen fundoplication performed through a left lateral thoracotomy and an incision in the left diaphragm. Transection of the truncal vagi is required to effectively de vascularize the distal esophagus and, thus, pyloromyotomy or pyloroplasty is added. Six patients who were moderately high risk candidates underwent this procedure for control for persistent hemorrhage; five of these patients were operated on within 48 hours of admission. There was one postoperative mortality. The five survivors have not rebled, and there has been no evidence of encephalopathy or progressive liver deterioration over a mean follow-up of thirteen months.


[Drainage of the radioactive lymphotropic tracers 198 Au-colloid and 99m Tc-sulfur-colloid from the orbit in rabbits (author's transl)]. In order to investigate lymph drainage from the retrobulbar space colloid solutions (198Au-colloid and 99mTc-sulfur-colloid) were injected into the right retrobulbar space of 31 rabbits. The distribution of radioactivity was measured in vitro after dissection with a sodium iodine crystal well counter and in some animals in vivo with the Gamma camera. More than 90% of the applied activity of either colloid solution was found in some animals up to the eighth day post injection in the retrobulbar space and in the liver. The remaining activity was recovered mainly from the regional lymph nodes, due to its smaller particle size higher values were registered in the experiments with 198Au than in those with 99mTc. The highest concentrations with up to 4,6% of the activity were observed in the deep cervical lymph nodes on both sides. Minor concentrations of activity were found ipsilateral in the superficial cervical and mandibular lymph nodes. Furthermore, small but significant activities were demonstrated in the optic nerves as well as in the contralateral retrobulbar space. The present data clearly substantiate the existence of lymph drainage, although a slow one, from the retrobulbar space. Moreover they indicate a reverse prelymphatic-lymphatic flow toward the optic nerves and the contralateral retrobulbar space. These results are of importance in the discussions of lymphostatic ophthalmopathy. The clinical application of this method is desirable; however, at present it is not yet practicable without further studies.


[Electron-microscopic findings in Bowen's disease of the conjunctiva (author's transl)]. The conjunctival tumors of eleven patients were histologically diagnosed as an intraepithelial squamous cell carcinoma Bowen's disease. All characteristic intraepithelial changes were manifest. Microinvasion, secondary dyskeratosia, dyskeratotic keratinisation, individual cell keratinization, and loss of intercellular desmosomes were clearly evident in the electron microscope. Virus-like organisms were not observed.


Penetration of ocular compartments by tetracyclines. I. An experimental study with tetracycline. Total antibiotic concentration of tetracycline hydrochloride was determined in the ocular structures of rabbits by radioactive tracer method. Concentration of tetracycline of 0.1 to 5 microgram/g, adequate to inhibit the growth of bacteria of high or medium susceptibility, was measured from all ocular structures with the exception of the lens. Tetracycline concentration in the aqueous humor was inferior to that in the vascularized ocular tissues and to that in the cornea. Vitreous body tetracycline level, about 0.3 microgram/g, was about half of the concentration in the aqueous humor. The disruption of the blood-aqueous barrier following paracentesis led to an immediate increase of tetracycline concentration in the anterior structures of the eye.


Penetration of ocular compartments by tetracyclines. II. An experimental study with doxycycline. Using radioactive tracer method the distribution of intravenously injected doxycycline of 7 mg/kg was studied in the rabbit eye. Long-lasting antibiotic concentration of 1 microgram/g or more was measured from all vascularized ocular structures. Vitreous body doxycycline concentration, almost equal to that of aqueous humor, was 0.3 microgram/g. Doxycycline concentration in the cornea exceeded that in the aqueous humor. In all vascularized ocular structures plasma antibiotic concentration was at least once achieved, indicating good penetrability of doxycycline into the tissues. This good penetrability is obviously related to the high lipoidsolubility of doxycycline, whereas its high protein binding is reflected in low concentrations in the aqueous humor.


A study on alkaline phosphatase in cornea of various animals with special regard to keratocytes. The distribution of alkaline phosphatase was investigated in corneas of various animals by means of histochemical and biochemical methods. Special attention was paid to keratocytes that proved to be positive when a proper substrate and technique were used even if the activity differed according to animal species. Naphthol-AS-MX-phosphatate with Variamine-Blue-RT salt in the simultaneous azocoupling method was the most sensitive substrate; less suitable were naphthol-AS-phosphate, and particularly l-naphthyl-phosphate with Fast-Blue-BB-salt in the same method. Keratocytes were completely negative with beta-glycerophosphate in the Gomori technique. Contrary to keratocytes, epithelial and endothelial cells were without substrate predilection. The results of both approaches showed a wide inter-species variability. The overall activity of alkaline phosphatase detected histochemically and its activity in the unsedimentable fraction of whole corneas determined biochemically was in good agreement. The highest activity was found in the calf cornea; enzyme levels decreased gradually in the bovine, rabbit, dog, sheep, and pig cornea.


[The D.C. response in the human electroretinogram under different degrees of wakefulness (author's transl)]. A report is given on the D.C. component of the human ERG following stimulation with red light of varying intensities and under different conditions of vigilance. The degree of the subject's wakefulness can be followed by looking at certain frequency components of the power spectrum of the occipital EEG. 1. The ERG remains uninfluenced by the degree of the subject's vigilance. 2. Red light is especially suited for eliciting separately photopic an scotopic responses in the on-effect of the ERG, possibly in the off-effect also. The D.C. potential is regarded as a component of the scotopic b-wave. The photopic x-wave can be recorded with very low stimulus intensities and stays clearly separated from the D.C. component.


Comparison of canine distemper virus strains in gnotobiotic dogs: effects on lymphoid tissues. The effects of infection on various aspects of lymphoid function in gnotobiotic dogs with 2 virulent strains of canine distemper virus (CDV), Snyder-Hill CDV and R252-CDV, were compared. Both infections resulted in a viremia-related lymphopenia which was nonselective in that the percentages of B and T cells remained unchanged throughout the observation period. Nonfatal Snyder-Hill-CDV infection resulted in a transient depression of in vitro lymphocyte responses to phytohemagglutinin-P, whereas R252-CDV produced prolonged in vitro suppression of phytohemagglutinin-P stimulation. The differences observed are of minor significance and do not explain the differences in central nervous system demyelinating potential between these 1 strains of CVD.


Responses of enriched populations of feline T and B lymphocytes to mitogen stimulation. Lymphocytes from healthy adult cats were separated into T and B cell-enriched subfractions by centrifuging rosetted cells on sodium metrizoate/Ficoll gradients. The responsiveness of unseparated lymphocytes (T + B), and T and B cell-enriched subfractions to stimulation with mitogens (phytohemagglutinin-P (PHA-P), concanavalin A (ConA), and pokeweed mitogen (PWM) was tested. Cultures of unseparated lymphocytes and those enriched in T cells showed similar responsiveness of PHA, ConA, and PWM stimulation; however, only a weak response to ConA and PWM was observed in B cell-enriched cultures. The mitogenic effects of PHA-P, ConA, and PWM on feline lymphocytes appeared to be due primarily to T-cell activation.


Primary alveolar hypoventilation treated with nocturnal electrophrenic respiration. A case of primary alveolar hypoventilation is described. Despite characteristic clinical findings, the diagnosis was delayed for 4 years. Alleviation of nocturnal hypoxemia and hypercapnia initially by a rocking bed and subsequently by phrenic nerve stimulation was accompanied by reversal of cor pulmonale and polycythemia. Electrophrenic respiration is an effective form of long-term management in primary alveolar hypoventilation.


Closing volume and flow volume abnormalities in alpha(1)-antitrypsin phenotype groups in a community population. Alpha1-antitrypsin phenotype groups, found in a community population studied in Tucson, were compared by using the maximum expiratory flow volume curve and the single-breath nitrogen test, alone and in combination. Subjects 25 to 54 years of age were used for the comparison, among whom there were 728 Pi M, 29 Pi MZ, and 62 Pi MS phenotypes. None of the flow volume parameters or closing volume parameters was able to differentiate among the phenotype groups; subjects in groups heterozygous for alpha1-antitrypsin did not differ from individuals homozygous for Pi M with regard to any or all flow volume or closing volume parameters.


A continuous flow method for the estimation of serum alpha-amylase activity. An automated assay for serum amylase is described. Using the AutoAnalyzer II the method employs, as substrate, a solution of dyed amylopectin which is commercially available (DyAmyl-L). After incubation of serum and substrate at 55 degrees C, 1.0 mol/lKOH is introduced and the coloured products of enzymic hydrolysis are separated by dialysis against phosphate buffer. Absorbance is measured at 540 nm and the enzymic activity read from a standard curve obtained using calibration sera Versatol E and EN. The system provides accurate and reproducible measurement of serum amylase. The results obtained from assaying 100 'normal' sera are compared with those using another method of alpha-amylase estimation.


Red-green colour blindness in the Isle of Man and Cumbria. The frequencies of red-green colour-blind males in the indigenous population of two regions of Britain, the Isle of Man (5.6 per cent) and Cumbria (5.0 per cent), do not readily fit into the pattern of a SW-NE gradient in the frequency of the colour-blind gene in Britain suggested by earlier studies. Frequencies of red-green colour-blind females are also given for these two populations.


Idiopathic late-onset immunoglobulin deficiency with associated defect in cell-mediated immunity. An 8-year-old boy presented with idiopathic late-onset immunoglobulin deficiency manifested principally by recurrent suppurative chest infections and chronic diarrhoea with malabsorption. Nodular lymphoid hyperplasia and giardiasis were shown on small bowel biopsy. Investigation of the immune system showed low serum levels of IgG, IgM, and IgA, negative skin tests to four recall antigens, absent mixed lymphocyte reactivity, and impared lymphocyte responses to mitogens in vitro. Serum complement and granulocyte function studies were normal. Maintenance therapy with gammaglobulin and antibiotics gave a good response.


The involvement of T1 and T2 lymphocytes in primary and secondary delayed type hypersensitivity responsiveness. The contribution of short-lived and long-lived T lymphocytes (T1 and T2 lymphocytes respectively) to primary and secondary delayed type hypersensitivity (DTH) responsiveness was studied by means of thymectomy of adult mice (ATx) with sheep red blood cells as the antigen. Within one month after ATx a fall of the primary and secondary DTH responsiveness was found of 20% and 50% respectively. This reduction can be attributed to the loss of short-lived T cells. ATx 8 months prior to the administration of the priming dose caused a decrease of the primary and the secondary DTH responsiveness of about 50% and 65% respectively. These data suggest that both the short-lived T1 and the long-lived T2 precursor cells account for the occurrence of (1) cells mediating the primary DTH response and (2) memory cells responsible for the secondary DTH response. The contribution of both populations of precursor cells in primary and secondary DTH responsiveness appeared to be only proportionally different.


Changes in lymphocyte subpopulations in mice receiving a single injection of poly-A:U. The electrophoretic mobility (EPM) of lymphoid cells from the spleen and thymus of A/Sn mice was studied after a single injection of a double-stranded synthetic polynucleotide, poly-A:U. The proportion of spleen T lymphocytes with a high EPM increased markedly and rose to 80% of the total cell population on the 3rd day. The percentage of high mobility lymphocytes began to decrease on the 4th day, but normal values were not reached until the 15th day. Important variations in electrophoretic distribution profiles of the thymic cells were also observed after poly-A:U inoculation. In the untreated athymic Nude mice, 5% of the spleen cells have a high mobility and are presumed to be T-cell precursors. After a single inoculation of poly-A:U, the percentage of these cells increased to 18%. This increase correlated well with the increase in theta-positive spleen cells.


Molar growth yields, respiration and cytochrome profiles of Beneckea natriegens when grown under carbon limitation in a chemostat. The effect of growth rate on the physiology of Beneckea natriegens was studied in chemostat culture. The molar growth yields (Y) from glucose and oxygen, the specific rates of oxygen (Qo2) and glucose (Qg1c) consumption and the specific rate of CO2 production (Qco2) were linearly dependent on the growth rate over the dilution rate 0.17 h-1 to 0.60 h-1. Further increase in the dilution rate resulted in a decrease in growth yield and respiration rate and these changes were coincident with increases in the specific rate of glucose utilisation and of acetate production. The affinity of Beneckea natriegens for glucose was similar when measured either directly in chemostat culture or in a closed oxygen electrode system using harvested bacteria. The total content of cytochromes decreased with increasing growth rate. However, the quantity of CO-binding cytochromes remained independent of growth rate and correlated with the potential respiration rate.


Lymphoma cutis of apparent B cell origin. A nodular, poorly differentiated lymphocytic lymphoma involving lymph nodes, spleen, and skin is reported in a 60-year-old man. The clinical course of this disorder strongly implied cutaneous involvement as the initial site of disease. Immunologic studies indicated that the neoplastic cells carried surface immunoglobulin (IgMgamma), thus suggesting a B lymphocyte origin for the lymphatic neoplasia.


Failure of downward gaze: the site and nature of the lesion. We report four patients with paralysis of downward gaze but with intact upward gaze, including one with detailed clinico-pathological studies and another with a focal computerized axial tomographic (CT) scan abnormality confirming the presence of bilateral lesions of the dorsomedial red nucleus, including the fasciculus retroflexus. It is suggested that sudden, permanent selective failure of downward gaze accompanied by transient disturbance of consciousness is an embolic syndrome of the posterior thalamosubthalamic or rubral artery.


Cranial computerized tomography and Marie's ataxia: a case report. Cranial computerized tomography (CT) is an aid in the diagnosis of the spinocerebellar degenerations and may be used to define and categorize individual cases based on the extent and localization of atrophy. We discuss a case of Marie's ataxia and the cranial computerized tomographic appearance.


Right coronary endarterectomy: a procedure with increased risk of perioperative infarction. Although right coronary endarterectomy extends operability on this vessel, the procedure is associated with increased risk of perioperative infarction. Forty-nine patients at St Vincent's Hospital underwent endarterectomy and saphenous vein grafting to the distal right coronary artery, with a hospital mortality of 6.1% and a perioperative infarction rate of 20.4%, compared with rates of 4.2% and 10.9% respectively in a group of patients who did not require endarterectomy. These figures show a trend toward statistical significance which suggests that careful patient selection for endarterectomy is required to obviate an increased risk of complications with this procedure.


E-rosette forming lymphocytes in acute leukemia before and after cell incubation with human serum thymic factor. The Authors studied the effect of the human serum thymic factor on the peripheral blood leukocytes from ALL patients, by testing the frequency of the E+ cells by means of the E rosette assay before and after cell incubation with this factor. In four out of twenty-four patients tested, the thymic factor incubation of peripheral blood mononuclears increased the number of E+ cells. The shift from E- to E+ cells caused by the human serum thymic factor occurred among null cells (E-, SM-Ig-). The possible value of the test in investigating whether a T0 leukemia might really exists is pointed out, as well as its prospective importance in monitoring the variations of the immature T cell counts in relationship to the patient's treatment and his disease course.


[Primary pulmonary tuberculosis in children under 2 years of age (22 cases)]. In order to stress the problems of our hospital, the experience of the Pneumology Service during August 1975 through July 1976 was reviewed. This practice was deemed necessary considering that tuberculosis disease is still important in children but specially in those under two years of age. It is necessary that every child be vaccinated during its first year of life and if this takes place there will be a wider protection against the disease, but specially, complications to the central nervous system will be avoided which are main causes of death in these children. When the parameters to reach a diagnosis of the disease are negative, but still there is a clinical suspicion, one must take advantage of experienced technicians to deliver whether or not it is convenient to initiate a therapeutic test. Finally, we consider that the solution to this problem lies chiefly on preventive procedures including good nutrition, B.C.G. vaccination, improvement of social and economic conditions of the family and hygienic measures.


[Intracranial abscesses in children].

[Intracranial abscesses in children]. An analysis of 23 consecutive cases of brain abscess is reported. The most frequent early symptoms and signs were headache, vomiting, papiledema, focal neurological abnormalities and pyrexia. Roentgenogram of skull, electroencephahologram and ecoencephalogram were abnormal in all cases in which they were obtained. Therapy was based on early diagnosis with accurate location, aspiration or excision of the abscess. Lumbar puncture is hazardous and yields only suggestive information.


[Splenectomy in histiocytosis X].

[Splenectomy in histiocytosis X]. Present concepts of histiocytosis X are reviewed and the results obtained in three patients that underwent splenectomy are described; postoperative survival is analyzed in order to evaluate the possible beneficial influence of splenectomy. One case corresponded to a female with a survival of nine years and another one a male with a survival of fifteen months; both received postoperative treatment with corticosteroids and are asymptomatic at the present time. The third case had an unfavorable evolution (he did not receive postoperative treatment). Even though present experience dose not alow to establish definitive conclusions, we must consider in the usefulness of splenectomy as a part of the treatment of histiocytosis X.


Importance of methodology in demonstrating depression of T-lymphocyte levels. A comparison has been made of 3 methods of determining E rosettes in young, healthy people, women with breast cancer and an age-matched group of healthy women, in an attempt to explain the wide variations in T-cell levels in different disease states reported by different workers. The greatest difference in levels of E-rosetting cells between the different groups was seen in incubation of 1 1/2 h at 4 degrees C. Much of the difference seen in these comparisons disappeared after overnight incubation at 4 degrees C, which was associated with an increased T-cell level in all groups. Consequently, although maximal levels of T lymphocytes as determined by E rosetting are found using overnight incubation, a short incubation period may be superior for demonstrating subtle depressions in levels of T lymphocytes as seen in elderly people and cancer patients. This depression is not considered to be cancer specific, because of the findings in the age-matched control group and similar findings in benign disease states.


[Radiologic manifestations of histiocytosis in childhood]. The radiologic changes that ocurred in 37 cases of histiocytosis are reported. According to established clinical types, they are grouped and analyzed stressing in bone lesions their aspect, characteristics and distribution, together with the evident differential diagnosis and the X-ray guideline to be followed to determine the course. The importance of plain X-ray is stressed and other less frequent changes are mentioned in those cases with diagnostic problems.


Light- and diffusion-potential-induced shift of carotenoid spectrum in reconstituted vesicles of Rhodopseudomonas sphaeroides. Proteoliposomes were reconstituted from detergent-solubilized pigment.protein complexes of chromatophores of Rhodopseudomonas sphaeroides and soybean phospholipids. The reconstituted vesicles showed a photooxidation of reaction center bacteriochlorophyll and a light-induced spectral shift of carotenoid to longer wave-lengths. The  red shift similar to that in intact cells or chromatophores, indicates the generation of local fields in the membrane of proteoliposomes. When inside-positive membrane potential was induced by adding valinomycin and potassium salt, a shift of carotenoid spectrum to shorter wavelengths was observed. Therefore, the reconstituted vesicles, at least in the major part of population, produced the light-induced local field in the same direction as in intact cells, which is inside negative. Sidedness of the membrane structure and the direction of electric field formation in reconstituted vesicles were opposite to those in chromatophores (inside-out vesicles.


The light-induced carotenoid absorbance changes in Rhodopseudomonas sphaeroides: an analysis and interpretation of the band shifts. An analysis has been made of the spectrum of the carotenoid absorption band shift generated by continuous illumination of chromatophores of the GlC-mutant of Rhodopseudomonas sphaeroides at room temperature by means of three computer programs. There appears to be at least two pools of the same carotenoid, only one of which, comprising about 20% of the total carotenoid content, is responsible for the light-induced absorbance changes. The 'remaining' pool absorbs at wavelengths which were about 5 nm lower than those at which the 'changing' pool absorbs. This difference in absorption wavelength could indicate that the two pools are influenced differently by permanent local electric fields. The electrochromic origin of the absorbance changes has been demonstrated directly; the isosbestic points of the absorption difference spectrum move to shorter wavelengths upon lowering of the light-induced electric field. Band shifts up to 1.7 nm were observed. A comparison of the light-induced absorbance changes with a KCl-valinomycin-induced diffusion potential has been used to calibrate the electrochromic shifts. The calibration value appeared to be 137 +/- 6 mV per nm shift.


Ubiquinone reduction and proton uptake by chromatophores of Rhodopseudomonas sphaeroides R-26: periodicity of two in consecutive light flashes. Chromatophores of Rhodopseudomonas sphaeroides strain R-26 were subjected to a series of brief flashes of light in the presence of diaminodurene as an electron donor. Odd-numbered flashes induced the reduction of ubiquinone to the anionic semiquinone, as indicated by absorbance changes near 450 nm. This reaction was not attended by proton binding. Even-numbered flashes caused disappearance of the semiquinone, presumably by conversion to the fully reduced form. This reaction was attended by proton uptake.


High-order fluorescence and exciton interaction in photosynthetic bacteria. We have observed fluorescence at visible wavelengths from chromatophores of photosynthetic bacteria excited with infrared radiation which we attribute to bacteriochlorophyll of the antenna system. The fluorescence is prompt (no delay greater than 5 ns). Its spectrum shows peaks at 445, 530 (broad) and 600 nm when excited with either 694 or 868 nm. Quantum yield is of the order of 10(-9). The dependence on intensity indicates generation by mainly third-order processes which could involve triplet state in combination with excited singlets. Second-order single-singlet fusion could also contribute. The high-order fluorescence can also be explained as arising from absorption of a second photon by singlet excited states.


Lymphocyte plasma membranes. VI. Plasma membrane glycoproteins of thymic and splenic lymphocytes from inbred rats. Plasma membranes of splenic and thymic lymphocytes from ACI rats were analyzed for their protein and glycoprotein components by surface radioiodination with 125I and SDS-polyacrylamide gel electrophoresis. The glycoproteins were extracted with lithium diiodosalicylate, characterized and assayed with  antisera to thymic antigen. Plasma membranes of both cell types showed more than 25 proteins of which 10--15 were glycoproteins. Both cells showed five major glycoproteins but their apparent molecular weights or intensities differed. Surface radioiodination showed a 120 000 daltons component, common to both cell types, and a 27 000 daltons thymus-specific component as the most exposed surface glycoproteins. Lithium diiodosalicylate extracts of the plasma membranes contained almost all of the glycoprotein components and comprised 5-6 percent of the total membrane protein and 40-50 percent of the total membrane carbohydrate, with sialic acid content in thymus twice that of the spleen cells. About 1 percent of the total plasma membrane protein and 7 percent of the total isolated glycoproteins from thymocytes were reactive with rabbit anti-rat thymocyte antiserum and the immune precipitates showed two components with apparent molecular weights of 72 000 and 27 000.


Comparison of the carbohydrate and amino acid composition of normal and S-variant alpha-1-antitrypsin. alpha-1-Antitrypsin has been isolated and purified from the serum of an individual with the Pi S phenotype whose serum contains only 50--60% as much alpha-1-antitrypsin as normal M-type serum. The preparation was homogeneous by the criteria of sodium dodecyl sulfate polyacrylamide gel electrophoresis and sedimentation equilibrium ultracentrigufation. When analyzed in the ultracentrifuge, the S-type alpha-1-antitrypsin exhibited a molecular weight of 47,500 which was essentially the same as that of the M-type (47,300) and the Z-type (47,500) alpha-1-antitrypsin. The S-type alpha-1-antitrypsin contains 15.2% carbohydrate consisting of 16.4 residues/mol of N-acetylglucosamine, 7.8 residues/mol of mannose. 6.7 residues/mol of galactose and 7.1 residues/mol of sialic acid which is essentially the same as the carbohydrate composition of the M-type alpha-1-antitrypsin. In addition, M- and S-type alpha-1-antitrypsin have very similar amino acid compositions.


[Formation of antibodies against the antigen-recognizing receptors of T-lymphocytes in a syngenous system]. As shown, formation of antibodies to the antigen-recognition receptors of T-lymphocytes was possible in a syngeneic system. The antiserum of CBA mice given intravenous injections of CBA lymphocytes, immune to C57BL cells, proved to specifically inhibit in a mixed culture blasttransformation of CBA T-lymphocytes only against the C57BL cells. The same antiserum failed to influence the proliferative activity of CBA T-lymphocytes reacting to the "foreign" antigen (DBA/2 cells). No antibodies against the C57BL cells were revealed in the antireceptor antiserum. It is assumed that the autoantireceptor antibodies had a regulatory effect on the immune response.


[Preparation of mouse antiserum against isologous aggregated immunoglobulins and its effect on rosette forming cells]. A method of obtaining antisera against isologous aggregated mouse immunoglobulins is described. This serum designated MAAS blocked in vitro the antigen-binding receptors of the immune rosette-forming cells. MAAS was injected to mice immunized with SRBC. In comparision with the immunized mice given normal isologous serum rosette-forming B-cells were absent in the spleen of mice given MAAS at the peak of isologous response. But the antibody-forming cell count was not decreased under the influence of MAAS.


Terminal deoxyribonucleotidyl transferase activity in B-cell acute lymphocytic leukemia. Moderately high levels of activity of the enzyme terminal deoxyribonucleotidyl transferase (TdT) were found in the leukemic cells of a patient with acute lymphyocytic leukemia. The proliferating cells were B lymphocytes bearing IgG antibody, and the disease was associated with an IgG monoclonal spike and a mediastinal mass. The observations in this case suggest that TdT is related more to the immaturity and proliferation of certain lymphoid stem cells than to their progress toward B- or T-cell differentiation.


Evidence for monoclonal proliferation in prolymphocytic leukemia of T-cell orgin. A cytogenetic and Quantitative immunoautoradiographic analysis. B- and T-cell markers were studied in a patient with prolymphocytic leukemia, a rare variant of chronic lymphocytic leukemia. Thymus-derived features were identified on the membrane of the neoplastic lymphocytes using the following cellsurface markers: Heterologous T-cell antigen, sheep erythrocyte receptor, surface immunoglobulin, complement receptor, Fc receptor and mouse erythrocyte receptor. Cytogenetic studies of leukemic cells from unstimulated and mitogen-stimulated cultures revealed a consistent karyotype characterized by marker chromosomes and a decreased chromosome number, whereas chromosomal analysis of hair root cells yielded a normal karyotype. A uniform expression of T-cell antigens measured on single leukemic cells by quantitative microphotometric immunoautoradiography correlated with the cytogenetic findings which are compatible with a descent from one progenitor cell.


The effects of replacing ester by amide on the biological properties of compounds related to acetylcholine. 1 Replacement of ester by amine in series of derivatives of diphenylacetic acid reduces the affinity for muscarine-sensitive acetylcholine receptors of the guinea-pig ileum from 40- to 100-fold. With similar series of phenylacetic acid the reduction is only 2- to 4-fold. In both series changes in the composition of the onium group produce similar changes in the affinity of amides and esters and it appears that the stiffness of the amide bond reduces the binding of the phenyl groups at the far end of the molecule from the onium atom. 2 Replacement of ester by amide in similar series of acetyl compounds reduces activity on the guinea-pig ileum over 1000-fold and on the frog rectus over 50-fold. Compounds with larger onium groups are antagonists on both preparations with log affinity constant around 3. The amides have similar affinity for electric eel acetylcholinesterase. 3 The amides are slightly bigger than the esters in solution and slightly more hydrophilic. 4 Replacement of ester by amide in acetylcholine reduces the proportion of gauche conformer about the C--C--bond from 100% to 39%. 5 The ability of acetylcholine to activate receptors is thought to depend on some degree of flexibility in the --CO--0--bond, though the hydration of the bond may also be important.


Bioproduction of rubratoxin in a glucose-mineral salts broth with nutritional supplements and metabolic inhibitors. A sterile glucose-salts broth fortified with various metabolic inhibitors and nutritional supplements was inoculated with conidia of Penicillium rubrum P3290, and incubated quiescently at 28 degrees C for 14 days. Potassium sulfite and sodium metabisulfite at all test concentrations caused moderate reduction in rubratoxin formation; at high concentrations (greater than or equal to 2.7 X 10(-2)M) accumulation of fungal tissue was also retarded. Production of rubratoxin and cell mass was inhibited by p-aminobenzoic acid; syntheses of toxin were completely blocked by 7.5 X 10(-2)M of the vitamin. Effects of sodium fluoride on P. rubrum cultures grown on inorganic nitrogen sources varied from inhibition of mold growth and (or) rubratoxin A production to reduction in formation of rubratoxin B. With organic nitrogen sources, fluoride caused a 30 and 60% reduction in synthesis of rubratoxins A and B, respectively. Sodium acetate at all test concentrations enhanced formation of rubratoxin; mold growth was enhanced when acetate concentration was larger than or equal to 6.0 X 10(-2)M. A moderate reduction in mold growth was caused by lower acetate concentrations (1.2 X 10(-2)M or 2.4 X 10(-2)M). Sodium arsenite and iodoacetate at test concentrations blocked mold growth and toxin formation; sodium azide and 2,4-dinitrophenol caused a marked reduction in mold growth but inhibited toxin formation completely. However, sodium azide permitted slight growth and toxin formation when mold cultures were incubated for 28 days.


Symposium on pancreatitis: 1. Conservative management of acute pancreatitis. Acute pancreatitis may present as the mild edematous type or the more rare and dangerous hemorrhagic form. The effects of the latter are believed to be due to the activation of pancreatic enzymes, notably trypsin. Therefore attempts are being directed towards suppression of pancreatic enzyme activation in the management of the condition. Aprotinin and glucagon are the agents for this purpose that have received most attention. Patients with acute hemorrhagic pancreatitis are subject to respiratory failure, which is not detectable early by clinical evidence, so that early monitoring of pulmonary function by the determination of arterial blood-gas pressures is desirable. This is borne out by the findings in six fatal cases.