Induced motion as a function of the speed of the inducing object, measured by means of two methods. Induced motion is illustrated by the apparent motion imparted to a stationary disc by the horizontal motion of an enclosing frame. The present study examined the effect of frame speed, with a constant extent of frame motion, on the magnitude of induced motion for average frame speeds varying from 0.17 to 2.85 deg s-1. The induced motion was measured by two methods. (i) The observer adjusted the horizontal distance between comparison posts to indicate the extent of the horizontal induced motion in a physically stationary disc. (ii) The observer adjusted the slant of a comparison rod to indicate the apparent path of motion of the disc physically moving straight up and down in phase with the horizontal motion of the surrounding frame. The latter method requires the observer to integrate two apparent components of motion of the disc, one from its physical vertical motion and the other from its induced horizontal motion. The results from both methods show that substantial amounts of induction occurred at all of the frame speeds. The vector addition of apparent motions from real and from induced motion obtained from the second method, and the substantial amounts of induction found with the high frame speeds are interpreted to indicate that the processes underlying the perception of real and induced motion are essentially the same.


The effects of duration and luminance on binocular depth mixture. Two stimuli in the same binocular direction, one in front and the other an equal disparity behind a fixation point, are perceived at one depth. This depth is between that corresponding to the two stimulus disparities and varies continuously from one stimulus to the other as a function of the ratio of their luminances. When either duration or absolute luminance is increased, perceived depth changes toward the midpoint of the two disparities.


The Cheshire Cat effect.

The Cheshire Cat effect. Designing a binocular-rivalry exhibit for the Exploratorium resulted in the observation of some interesting phenomena. Under conditions of binocular rivalry, motion in the field of one eye can trigger suppression of the other visual field as a whole or in parts. This suppression sometimes occurs only in the area of motion. Subparts of a suppressed area often remain in the visual field. Conversely, moving an object into the suppressed area of a visual field can elicit dominance of that object alone, with the rest of the field remaining suppressed. The suppression of partial areas of the visual field of each eye can occur simultaneously.


The Münsterberg illusion and 'irradiation'. The Münsterberg illusion is a compelling phenomenon for which there is no generally accepted explanation. It is suggested that two different contour-shifting effects operate in this illusion, and these are named the 'symmetrical effect' and the 'corner effect' respectively. It is further suggested that both of these effects are caused by 'irradiation', and an attempt is made to cast some light upon the phenomenon of irradiation, which is itself only poorly understood.


Heritability in visual-geometric illusions: a family study. The Müller-Lyer and Ebbinghaus illusions were tested in 203 mother-father-offspring triads and 303 sibling pairs. Significant familial resemblances were found in all but the overestimated segment of the Ebbinghaus illusion. These results suggest that responses to visual-geometric illusions, mediated by optical or neural interactive mechanisms, show patterns of familial resemblance which may be based upon heritable factors.


Absolute and relative cues for the auditory perception of egocentric distance. Three experiments were performed to examine the reverberation cue to egocentric auditory distance and to determine the extent to which such a cue could provide 'absolute', as contrasted with 'relative', information about distance. In experiment 1 independent groups of blindfolded observers (200 altogether) were presented with broadband noise from a speaker at one of five different distances (0.55 to 8 m) in a normal hard-walled room. Half of each group of observers were presented with the sound at 0 deg azimuth, followed (after a delay) by the identical sound at 90 deg azimuth. The order of presentation was reversed for the remaining observers. Perceived distance varied significantly as a function of the physical distance to the speaker, even for the first presentations. The change in the binaural information between the 0 deg and 90 deg presentations did not significantly modify the results. For both orientations, near distances were overestimated and far distances were underestimated. Experiment 2 and 3 were designed to evaluate how much prior auditory exposure to the laboratory environment was necessary. A 200 Hz square-wave signal was presented from one of three distances (1, 2, or 6 m) to observers who had either minimal room information or an exposure which included talking within the room. Perceived distance varied significantly with physical distance regardless to exposure condition.


Spatial localization under conflict conditions: is there a single explanation? Visual--auditory (VA) and visual--proprioceptive (VP) localization conflict paradigms were varied to explore the comparability of the conflict situations. In experiment 1 various attempts were made to decrease the dominance of visual information over proprioceptive and auditory target information. Pairing auditory with proprioceptive information against conflicting visual information did not lessen the visual dominance, nor did dimming the visual field. A 'cognitive' manipulation, in which the subject was led to doubt the reliability of the visual information, reduced visual dominance over audition but not visual dominance over proprioception. This difference between the two conflict situations was further explored and corroborated in experiment 2. In experiment 3 no attempt was made to lead the subject to believe that paired discrepant targets were related, and the visual dominance of audition was strong while the visual dominance of proprioception did not occur. The apparent differences between the VA and VP conflict situations are discussed with regard to the feability of generating a unitary explanation of localization conflict results. Several further factors are discussed that must be explored before undertaking such a unitary formulation.


Parotid and whole-mouth secretion in response to viewing, handling, and sniffing food. There was no significant change in flow rates of parotid saliva in nineteen of twenty subjects while they viewed photographs of lemons, or in fourteen of twenty subjects while they cut lemons in a glove box. Neither parotid nor whole-mouth secretion changed from baseline when subjects viewed fresh lemons and lemonade presented in a plastic box. Further, no significant changes in whole-mouth secretion rates were observed when subjects viewed photographs of two appetizing foods, or of fresh doughnuts in a plastic box, even though subjects knew they could eat the doughnuts after the experiment. In most cases, sniffing of the lemons or of the doughnuts resulted in increased flow rates. Subjects demonstrated large differences in their patterns of affective responses to full-strength and diluted lemon juice, which were independent of salivary flow. In the absence of olfactory or tactile stimulations, few subjects altered parotid or whole-mouth secretion rates in response to viewing food or photographs of food. A reevaluation of findings on 'psychic' stimulation of saliva may be in order to ascertain the role of olfactory, tactile, and even trigeminal clues in salivary response to food stimuli.


[Treatment of ureteral obstructions due to prostatic carcinoma. Prognostic value of response to medical treatment (author's transl)]. A retrospective study concerning 146 patients with prostatic cancer showed that 30 of them (20 p.cent) presented ureteral obstacles at some time during the evolution of the disease. The majority of these cases were T3-T4 tumors. When a strickly medical approach allowed to reduce the obstruction, the 1 year survived rate was 71 p.cent. When surgery became necessary due to persistent renal insufficiency, in spite of medical treatment the 1 year survival rate was 15 p.cent.


[Biliary lithiasis in cystic fibrosis. Study of the bile salts in the serum and in the bile in one case (author's transl)]. Biliary lithiasis was discovered in a girl aged 11 suffering from Cystic Fibrosis and who underwent partial small bowel resection for meconium ileus. A cholecystectomy was performed at 15. Examination of the stones showed that they were composed of cholesterol and chemical examination of the bile showed an increase of phospholipids and a decrease in bile salts. There was also a modification of the ratio (Formula: see text) in the serum and the bile. All those factors contribute to the insolubility of cholesterol and to the formation of lithiasis. For all those reasons, the authors recommend a regular radiologic surveillance of the gallbladder in Cystic Fibrosis.


[Comparative action of L-dopa and bromocriptine on thyreostimulating hormone (T.S.H.) in primary hypothyroïdism (author's transl)]. The comparative action of fixed I-dopa (500 mg orally) and bromocriptine (2,5 mg orally) doses on T.S.H. of 20 patients (8 men and 12 women) with primary hypothyroïdism was studied. T.S.H. was significantly decreased from first hour with I-dopa (p less than 0.005) and the greater decrease was reached at the second hour. T.S.H. was the thereafter progressively increased and was like basal value at the fifth or the sixth hour of the test. T.S.H. was likewise significantly decreased from first hour with bromocriptine (p less than 0,01), but the decrease was progressive during the six hours and the greater decrease was reached at the sixth hour (p less than 0,005). The decreased T.S.H. was greater for woman than for man as much with I-dopa (p less than 0,005), as with bromocriptine (p less than 0,002). The greater decrease was the same with I-dopa or bromocriptine. These results were comparatively discussed with others. They favoured an inibiting action of dopaminergic axis on T.S.H. secretion in primary hypothyroïdism.


[Giant aneurysm of the intracavernous carotid, complicated by subarachnoid haemorrhage. Emergency treatment by occlusive balloon and thrombosis in situ (author's transl)]. A 15-year-old adolescent developed a painful ophtalmoplegia and a subarachnoid haemorrhage secondary to fissuration of a giant intracavernous aneurysm. The choice of therapeutic abstention was not retained due to the dissuration. The site excluded any direct approach and ligation of the common carotid was not adopted because of its complications. The method chosen consisted of in situ coagulation of the aneurysmal sac, induced by injection of thrombin after occlusion of the internal carotid by a double-lumen balloon catheter. In case of emergency and when direct approach is impossible, this technique may be useful on the condition of close cooperation between clinicans and radiologists.


[The role of prostaglandins in the renal regulation of blood pressure (author's transl)]. In response to ischaemic or vasoconstrictor stimuli the kidney reacts by synthesising prostaglandins (PG) which modify local vascular tone. They induce a compensatory vasodilatation and direct the blood flow towards the internal cortex. It is thus not necessary to attribute a systemic role to PG in order to understand their haemodynamic action. This explains the natriuresis following the injection of PG both in the animal and in man. Nevertheless the direct effet of PG upon the tubular reabsorption of sodium remains controversial since very different experimental models lead to contradictory conclusions. Despite these disparate data, it is probable that PG are intimately involved in the pathogenesis of hypertension. A lack of PG or a deficiency in their metabolism may be responsible in essential hypertension.


[Computer treatment of medical reports: example of the "Remède" system (author's transl)]. Physicians are mostly interested in medical text processing if they can directly interrogate the exact content of each text and not only keys leading to a more or less rough retrieval. Remede is a prototype of a medical documentary language using current medical terms and few syntactic rules. It allows to make reports directly processeable by computers. The paper presents the system runninr for one year in the Service of Cardiology-La Salpêtrière Hospital Paris.


[Nycterohemeral variations of growth hormone and prolactin in 6 Parkinson's sufferers treated with bromocriptine (author's transl)]. Secretions of GH and of PRL studied over a period of 24 hours in 6 untreated Parkinson's patients showed slight changes. The normal secretion of PRL in the female shows no nocturnal increase in the male. The secretion of GH linked to sleep is identified in the male and not in the female. These variations related to sex are interpreted as an increase in those normally found in the adult and facilitated by age. Bromocriptine given continuously at a dose of 10 to 20 mg/day for periods of 20 days to 6 months, results in suppression or a marked decrease in the 24-hour secretion of PRL. It has virtually no effect upon the secretion of GH. These results show that the dopaminergic regulation of PRL is preserved in Parkinson's disease.


[Leiomyoma of the small bowel with hypercalcaemia: presence of a substance with parathormone activity (author's transl)]. A leiomyoma of the small bowel produced laboratory features of hyperparathyroidism which disappeared promptly after tumour resection. Hypercalcaemia, hypophosphatemia, hyperchloremia, elevated chloride/phosphorus ratio, increased urinary cyclic AMP, and blood levels of immunoreactive parathormone were present. Electron microscopy showed dense round granules in the tumour cells.


[Modification of septicaemias in an intensive care unit following the suppression of prophylactic antibiotics (author's transl)]. The authors after to have suppressed the preventive antibiotic therapy in their intensive care concluded after four years of this new attitude. They ascertain that this new attitude has not changed by no means the number of septicenia in their intensive care. In the other hand, the gram negative septicemia stronghly decrease, succeeding by gram positive septicemia. This results were statistically significant in the sector of intensive care where the supress of antibiotic was quick and the most completely. Thanks to this attitude, the cost of operation of the service was divided by three.


[Embolization of the renal arteries or "medical nephrectomy" in amyloidosis nephrotic syndromes. 2 cases (author's transl)]. Some nephrotic syndroms have a very poor prognosis (life threatening) because of the protidic loss, even if the renal fonction is still normal. Only a binephrectomy can prevent this true protidic diabetes. In order, to avoid the inconvenients of surgery which can be a major problem with patients having cicatrization difficulties, a bilateral embolization of the renal arteries was done. This procedure was successfully used in two patients with nephroctic syndrom secondary to a renal amyloïdosis, who where in a cachectic state.


[Real-time cross-sectional echocardiography. Application in the measurement of the surface area of the mitral orifice in cases of stenosis or of double involvement of the valve (author's transl)]. Two-dimensional echocardiography in real time has proved in recent years to be a very valuable means of investigation in cardiology, in particular in the area of valve disease and congenital cardiac malformations. The present study concerns a group of 20 patients with essentially stenosing mitral disease, studied by two-dimensional echocardiography using mechanical sector scanner. The authors report their experience of the method in the measurement of the surface area of the mitral orifice from echotomographic sections obtained in protodiastole in a plane perpendicular to the long axis of the left ventricle and passing through the free edge of the mitral cusps. Fifteen of these patients being then treated by valve replacement, the area measured were compared with those found in the operative specimens. In 14 cases out of 15 (93%), despite the concomitant existence of appreciable mitral incompetence in 9 cases out of 15, the surface areas did not differ by more than 0.23 cm2 (coefficient of correlation = 0.990). These results confirmed that two-dimensional echocardiography in real time is a reliable method for the direct measurement of the mitral orifice area in the presence of stenotic type disease of the valve and even in the presence of associated mitral regurgitation.


[Does the hepatitis of secondary syphilis exist? Two cases (author's transl)]. Two patients are presented as new cases of secondary syphilitic hepatitis. The closely resemble descriptions in the literature with the same clinical and laboratory "profile" and the same course spectaculary influenced by anti-syphilitic penicillin therapy. The presence of treponemes in the liver, which would definitely confirm the diagnosis, was not demonstrated. This is a particularly important diagnosis, which should not be missed since it leads to treatment of fundamental importance to the patient's future.


[Treatment of recent traumatic ruptures of aortic isthmus (author's transl)]. We recommand the following procedure: --positionment of the patient allowing the simultaneous approach of left pleural cavity and left femoral vessels. --aortic liberation far away of the isthm, in a diffuse hematoma. --medullar protection by femoro-femoral extra corporeal circulation. --recovery of aortic continuity either by direct suture or by interposition of an prosthetic tube, the sutures being largely supported by mediastinal cellular tissue. We have used this technique in 5 patients, with a good result in all cases.


[Post-radiotherapy pericarditis. 5 cases (author's transl)]. These cases represented 2.8% of the patients admitted for pericarditis during the same period. The cause of irradiation was a carcinoma of the breast in three cases and a carcinoma of the oesophagus in two cases. Acute forms of pericarditis occured 8 and 13 months after irradiations, and chronic forms after 1, 8 and 13 years. Three clinical forms were observed; two patients had an acute form; the first one with a slight effusion was easily cured, the second with cardiac tamponnade recovered after surgical evacuation, two others patients had a chronic latent effusion; after surgical evacuation, one recovered but the other one developped an occult constrictive pericarditis diagnosed by rapid volume expansion. The fifth case was a constrictive pericarditis which was effectively traited by pericardectomy. The difficulty of etiological diagnosis varies with the time and the amount of effusion. When the effusion is moderate the distinction must be made with an acute idiopathic pericarditis; when effusion is large the distinction must be made with a tuberculosis and specially a tumoral recurrence; in three cases pericardial biopsy was carried out and eliminated these diagnosises; lesions were similar: pericard was sclerous and little in cells, inflammatory signs were slight or absent. The postoperative prognosis in constrictive pericarditis may be agravated by associated myocardial lesions.


[Idiopathic hypercalciuria: effects of acute phosphorus deficiency (author's transl)]. Eleven patients with kidney stone disease and idiopathic hypercalciuria (urinary calcium above 4 mg/kg/j), without phosphorus renal leak and 6 control subjects have been put for 3 days on a diet containing 1 g calcium and 1 phosphorus daily (period A), and then for 4 days on a diet containing 1 g calcium, 450 mg phosphorus and 3 g aluminium hydroxyde daily (period B). During period A, no significant difference in blood calcium, phosphorus and magnesium, not in phosphaturia, rate of phosphorus reabsorption (RPR) and ratio maximum RPR/creatinine clearance was found between the two groups. After 2 days on a low phosphate diet (period B) the blood phosphorus decreased significantly in the hypercalciuric patients but not in the control subjects, thus revealing among the forme a latent abnormality in the retention of phosphates. This abnormality could play an important role in the pathogenesis of hypercalciuria.


[Alcoholic ketoacidosis (author's transl)]. Chronic alcoholism is a frequently unrecognized cause of ketoacidosis in nondiabetic patients. Seven episodes of alcoholic ketoacidosis were observed in three patients. No consciousness disturbances were present. Semi-quantitative tests for ketones were strongly positive in urine, weakly positive in serum. The anion gap was between 25 and 41 mEq/l; serum lactate was between 0.9 and 9.0 mEq/l, and, in all cases, below the anion excess. Blood glucose ammonia was increased. Massive fatty liver was documented in all patients. All ketosis episodes followed an increase of alcohol ingestion associated with one to four week-starvation and vomiting; however, at the time of admission, alcohol was weakly increased in blood. In the four episodes where diagnosis was correct, ketoacidosis was rapidly corrected without insulin administration. In conclusion, in some nondiabetic subjects, the occurence of alcohol prolongated ingestion together with starvation and vomiting is responsible for ketoacidosis; because alcoholic ketoacidosis has often a mild clinical expression, its true prevalence is underestimated; insulin administration is not required.


[The treatment of brucellosis using rifampicine (author's transl)]. The authors discuss the present value of rifampicin in the treatment of human brucellosis on the basis of: 1) a bacteriological study of 42 strains of Brucella spp. (MIC's of rifampicin, tetracyclin, doxycyclin, minocyclin and streptomycin; results of doxycyclin-rifampicin and doxycyclin-streptomycin combinations), and 2) a clinical study of 38 cases of brucellosis treated with rifampicin, including 25 acute septicemias and 13 osteo-arthritis. Satisfactory results were observed in 92% of the cases with rifampicin alone, but one cannot state that the benefits are significant.


[Quantitative echocardiography using a minicomputer (author's transl)]. Echocardiography should not remain merely qualitative but every effort should be made to make it quantitative, providing the clinician with numerical values. Three items are necessary: a graphic table, a minicomputer and an electronic reprograph, all small in size. The tracings obtained in TM technique are digitalised using the graph table, and the computer provides the results in the form of listings and graphs. The latter are of two types: --some are used for the analysis of the respective chronology of the various phenomena: left ventricular diameter and its normalised derivative, apexocardiogram or carotid pulse, movement of the greater cusp of the mitral valve, thickness of the myocardium, heart sounds; --the others are used for study, with the aid of an X-Y representation in the form of loops, of variations in one phenomenon in relation to the other. Deformation of such loops makes it possible to detect poor synchronisation between 2 phenomena.


[Antibiotics: interactions with other drugs (author's transl)]. More and more numerous each year, and only rarely beneficial, these are responsible for unexplained therapeutic failures or complications. They may occur at different levels. In the bottle of infusion fluid, the risk is that of neutralisation of varying amounts of the antibiotic. At the physiological stages of pharmacokinetics, there may be reduction of absorption and modification of urinary excretion. The most striking iatrogenic consequences result either from competition for binding to plasma albumins or from induction (or inhibition) of hepatic enzymes responsible for biotransformation (toxic overdose). Within bacteria, these interactions explain synergisms and antagonisms. They should lead to awareness of the multiple dangers of polypharmacy.


[The oral glucose tolerance test during normal pregnancy (author's transl)]. Physiological changes in carbohydrate tolerance were studied between the beginning and end of pregnancy. Amongst 145 oral glucose tolerance tests performed between the 9th and 40th weeks, results indicated that carbohydrate tolerance evolved throughout pregnancy. The first 24 weeks were characterised by a change in the shape of the glucose tolerance curve, in the form of horizontalisation of the terminal part, but with no increase in early blood glucose figures. It was only after the 24th week that mean blood glucose levels were seen to be increased. The interpretation of glucose tolerance tests during pregnancy should take these physiological changes into account. Critical values, above which diabetes must be suspected, are different at the beginning and end of pregnancy. The critical point would appear to be around the 24th week.


[Immunoallergic acute haemolysis, thrombocytopaenia and acute renal insufficiency due to treatment with catechines (author's transl)]. The authors report the case of a 25-year-old patient who during discontinuous treatment with a venotropic agent containing catechines suffered from intravascular haemolysis, thrombocytopaenia and acute renal failure, the course of which was favourable with treatment by haemodialysis. Renal biopsy revealed lesions of acute tubulonephritis with a slight interstitial reaction but without immune deposits. The demonstration in the serum and on the red cells of the patient of anti-catechine antibodies confirmed the immunoallergic nature of the haemolysis. The existence of crossed allergy with another venotropic agent, leucocyanide, led to suspicion of the localisation of the antigenic site on the 3-4 dihydroxyphenyl portion of the catechine molecule.


[Extensive bronchial dystrophy. Physiopathology and treatment of suppurative complications (author's transl)]. Extensive bronchial dystrophy differs by its histopathology, course and treatment from chronic obstructive bronchitis. This dystrophy leads to cavities which are virtually constantly infected. The extension of infection to adjacent alveoli may be dramatic, contrasting with underlying slight chronic respiratory failure. The existence of these cavities explains the preponderant role in therapy of drainage and the fact that antibiotic therapy would appear to be indicated only in the case of extension of infection to the alveoli and the peribronchial tissues.


[Prostatic carcinoma: metabolic effect of percutaneous beta-estradiol (author's transl)]. Twenty one patients suffering from carcinoma of the prostate, confirmed histologically and previously untreated, received treatment in the form of 17 beta-estradiol administered percutaneously. At a dose of 6 mg of estradiol per day, testosterone levels fell to a mean of 1 ng/ml. No change in lipids, lipoproteins nor cholinesterase were detected.


[Ulcers of the bulb of the duodenum and duodenitis. Correlation between clinical, radiological and endoscopic findings and classification in 147 cases (author's transl)]. Three hundred and eighty three patients with epigastric pain underwent radiological and endoscopic examination of the bulb of the duodenum. Clinical, radiological and endoscopic characteristics were compared in the 79 patients with a duodenal ulcer and in the 68 with duodenitis only. Pain and a past history of ulcer disease were of no use in differentiating duodenal ulcer from duodenitis only. Radiological deformity of the bulb appeared to be a sign of duodenitis and not of duodenal ulcer, in contrast to a crater and convergence of the folds. No endoscopic sign was of value in differentiating duodenitis only from duodenitis associated with an ulcer. Active duodenal ulcers could be differentiated from scarred duodenal ulcers only on the basis of endoscopic findings. Endoscope is the best means for the study and diagnosis of duodenal disease. On the basis of these results and data already published, an analysis was undertaken of the relationship between duodenal ulcer and duodenitis only, and it is felt that many arguments are in favour of a unitary hypothesis, duodenal ulcer and duodenitis possibly being two forms of duodenal ulcer disease.


[Platelet kinetics during arterial diseases. Macro-angiopathy, cardiac valve prosthesis and prosthesis of the aortic bifurcation: 73 cases (author's transl)]. From 73 platelet kinetic studies in vascular diseases, some conclusions can be drawn: excessive platelet consumption is not as usual as previously published; abnormal platelet recovery is an usual feature in patients with vascular or valvular prosthesis; correlation between platelet kinetic abnormalities and thrombo-embolic complications needs reevaluation; constant abnormal platelet kinetics in the cases of aorto-femoral graft made these cases a valuable model for the clinical and biological evaluation of the drugs committed to a change of the platelet functions.


[Acquired chronic erythroblastopaenia followed by myelofibrosis. Remission with immunosuppressive therapy (author's transl)]. A 42-year-old patient with a regenerative erythroblastopenic anaemia (7 g % Hb), considered as Pure Red Cell Aplasia (PRCA) is submitted to an immunosuppressive treatment (cyclophosphamide + prednisone). For three times, this treatment gives a complete remission, followed by relapse when medication stopped. Hereafter the patient develops a Myelofibrosis with Myeloid Metaplasia (MMM). Between the different hypothesis, the most probable one seems to be an autoimmune PRCA secondary to MMM but appearing before the latter. This observation allows discussion about the role of immunological phenomens in MMM.


[Serum creatine kinase isoenzyme as a reflection of neonatal cerebral distress (author's transl)]. The BB fraction of serum creatine kinase was estimated in 3 groups of newborn : 30 healthy newborn at term, 20 newborn ill but without cerebral distress, 17 newborn with acute perinatal or foetal distress. In the first two groups, BB fraction was negligeable or nil, in respectively 26 and 16 cases, and between 1 and 4% in 4 cases. In the third group, it was greater than 4% in 10 cases, nil in 6 and 4% in one. The lability of this isoenzyme over periods of time, and in relation to temperature, requires the use of clearly defined techniques of sampling, storage and estimation, which may explain the false negatives seen. The determination of this isoenzyme, virtually exclusively cerebral, would thus appear to be a reliable biological indicator of neonatal cerebral distress.


[Repair of post-traumatic recto-vesical fistulae. A new technique (author's transl)]. Surgery for post-traumatic recto-vesicle fistulae involves two major risks : recurrence and residual sphincter disturbances. It would appear that a solution may be offered in the form of transanal pre-rectal colonic lowering. This technique, which is easy to perform, and which involves no suture, has been used successfully in an 11 and a half year old child.


[Necrotizing enterocolitis and milk protein intolerance. Four cases (author's transl)]. We report four cases of necrotizing enterocolitis (NEC) with colonic pneumatosis in two cases and the presence of hemorrhagic colitis, colonic stenosis and adhesive peritonitis. Surgical intervention necessary in two cases confirmed the diagnosis of NEC. Milk protein intolerance was diagnosed clinically in all cases. The evolution was satisfactory in all cases with exclusion of milk protein. The association suggests that milk protein intolerance can play a role in the occurence of necrotizing enterocolitis.


[Mixed angioplasty for the revascularisation of small calibre arteries (author's transl)]. The authors suggest a new technique of mixed angioplasty consisting of the use of a venous patch to widen the anastomosis between prosthesis and small calibre artery to be revascularised.


[Humeral lytic lesions and circulating anticoagulant in secondary syphilis (author's transl)]. A case of secondary syphilis revealed by rheumatic complaints is described. Arthralgia and myalgia were associated with lytic lesions and periostitis of both humerus. A more diffuse skeletal involvement was detected by bone scanning. A genital ulceration 4 months before, diffuse lymphadenopathy and a strongly positive serological reaction ascertain the diagnosis. The association of a circulating anticoagulant is discussed. All manifestations cleared with penicilline treatment.


Serum and synovial fluid hydroxyproline fractions in microcrystalline arthritis and osteoarthritis. Synovial fluid and serum hydroxyproline fractions were investigated in patients with osteoarthritis and microcrystalline arthritis. Synovial fluid dialysable hydroxyproline levels are higher than serum levels in both conditions. Synovial fluid total and dialysable hydroxyproline are higher in microcrystalline arthritis than in osteoarthritis, while non-dialysable hydroxyproline values are similar in both conditions. In microcrystalline arthritis, synovial fluid dialysable hydroxyproline and polymorphonuclear leukocyte counts closely parallel each other. Irrespective of the type of arthropathy, synovial fluid dialysable hydroxyproline levels correlate with urinary hydroxyproline excretion. While the data suggest overproduction of dialysable hydroxyproline by joints in both conditions, the overproduction appears to be mediated by polymorphonuclear leukocytes in microcrystalline arthritis only. The ratio of serum to synovial total hydroxyproline are further suggestive of a possible differentiation between osteoarthritis and microcrystalline arthritis. In the conditions governing the present study, urinary hydroxyproline may be used as an index of joint tissue collagen resorption. Finally the significance of synovial fluid and serum non-dialysable hydroxyproline is discussed.


Sexual difficulties and total hip replacement in rheumatoid arthritis. Fifty-three patients with rheumatoid arthritis were interviewed by questionnaire. All the patients had undergone total hip replacement and were married at the time of operation. They were asked if they had had sexual difficulties because of hip pain or stiffness and if the hip operation had in any way alleviated these problems. Forty-four of the 53 patients answered the questionnaire. Twenty-eight patients had had sexual problems which they attributed to hip symptoms. Following total hip replacement the hips of 27 patients were no longer considered to be the cause of sexual difficulties, but in 10 of those patients other problems still rendered sexual life difficult.


Proteoglycan structure of bovine articular cartilage. Variation with age and in osteoarthrosis. Proteoglycan subunits (PGS) were isolated from bovine articular cartilage of calves and from cows, 18 months and 8 years old respectively. From the latter cartilage of osteoarthrotic and of non-osteoarthrotic sites was taken. PGS were characterized by gel-chromatography on Sepharose 2B columns and subjected to digestion with chondroitinase ABC and with papain. The isolated keratan sulphate-protein cores obtained from chondroitinase digestion were characterized on Sepharose 4B and the chondroitin sulphate chains on Sephadex G-200 gels. A larger molecular size of PGS was found in calf cartilage than in the other samples. This was attributed to the larger molecular size of chondroitin, whereas no change was observed in the keratan sulphate-protein cores. No change was observed in molecular size of PGS, isolated chondroitin sulphates or keratan sulphate-protein cores in osteoarthrosis in comparison with non-osteoarthrotic cartilage from the same joint or from younger adult animals.


Eosinophilic fasciitis. Review and report of six cases. Six patients with eosinophilic fasciitis are presented. This syndrome is characterized by indurative swellings of arms and legs, with rapidly progressing difficulties in extending elbows, wrists, and fingers, and often limited motion of shoulders and ankle joints. Pain when contracting muscles, and weakness of proximal muscles and hand grip are common features. The frequent occurrence of localized skin lesions has presented differential diagnostic difficulties to systemic sclerosis and to polymyositis. Visceral involvement and Raynaud's phenomena, however, are absent or mild. Blood eosinophilia, hypergammaglobulinemia, and unspecific signs of inflammation are found. Biopsy of muscle fascia gives characteristic histopathological findings of cell infiltrations (mostly mononuclear cells, frequently eosinophils) and vascular proliferation, in the middle layer of a thickened fascia. Skin changes are prevalent, but not conclusive for the diagnosis, and myositis in some patients might be difficult to distinguish from polymyositis. The importance of the clinical recognition of eosinophilic fasciitis and the inclusion of fascia in diagnostic muscle biopsies, is underlined.


Effect of fasting and lactovegetarian diet on rheumatoid arthritis. 16 patients with classical rheumatoid arthritis (RA) selected at random underwent fasting for 7--10 days, followed by a 9-week period on a lactovegetarian diet. 10 RA patients acted as controls, taking normal diet. Pain, stiffness, medication, and clinical and biochemical findings were recorded before fasting, on the first day after the conclusion of the fasting period, and at the end of the lactovegetarian period. After fasting, 5 of 15 patients showed objective signs of improvement, compared with only one of the controls. The fasting patients showed reduced pain, stiffness, consumption of analgetics, several clinical variables, and serum concentration of orosomucoid. At the conclusion of the lactovegetarian diet period only one Diet patient showed objective improvement. No differences were found between the Diet patients and the controls concerning symptoms, drug consumption, or clinical and biochemical variables. We conclude that fasting may produce subjective and objective improvements in RA, though of short duration, but the findings of this investigation do not indicate that lactovegetarian diet has any beneficial effects.


1 alpha-Hydroxycholecalciferol and calcium deficiency osteoporosis in adult rats. An attempt was made to reverse the osteoporotic changes caused by calcium deficiency in adult male rats, partly by a daily oral administration of 1 alpha-hydroxycholecalciferol (1 alpha-OH-D3) over a period of 6 weeks, partly by additionally changing to an optimal calcium intake during the same period of treatment. The results achieved show that 1 alpha-OH-D3 combined with an optimal calcium-containing diet significantly normalized the skeleton when compared with low or optimal calcium controls. 1 alpha-OH-D3 in combination with a contiuous intake of low calcium could not significantly restore these changes during the observation time. The bone matrix composition of collagen, glycosaminoglycans and nucleic acids did not change significantly during treatment. However, new bone formation as measured by uptake of fluoretic material was noted to increase pari passu with treatment with 1 alpha-OH-D3, combined either with an optimal or with a low calcium intake. The evidence of direct and/or indirect effects of 1 alpha-OH-D3 on the new bone formation is discussed.


A radiological survey of the hips and knees in female specialist teachers of physical education. A radiological study of osteoarthrosis of the hips and knees has been performed in 364 female specialist physical education teachers, aged 46--60 years, who qualified between the years 1935 and 1950. The teachers were contacted by postal questionnaire and A.P. radiographs of the pelvis and knees were performed at a hospital in their residential locality. These were then read by two rheumatologists in consultation and graded for osteoarthrosis by comparison with the Atlas of Standard Radiographs. These gradings were compared with those of similarly aged females in the general population obtained in the Leigh and Wensleydale surveys. Moderate and severe osteoarthrosis of the knees was equally common in the teachers and the general population but minimal and mild osteoarthrosis was significantly less common in the teachers (p less than 0.001). Osteoarthrosis of the hips was more common in the teachers than in the population, though not to a statistically significant degree. An association was noted in the teachers between osteoarthrosis of the hips and ossification in the region of the greater trochanter. The results suggest that female physical education teachers are no more prone to the development of premature osteoarthrosis of the hips and knees than is the general population, but there may be a subgroup who, because of excess use of hypermobility of the hip joints, develop osteoarthrosis as a consequence.


Partial synthesis of harringtonine.

Partial synthesis of harringtonine. The partial synthesis of harringtonine from cephaltotaxine has been described. A key intermediate, 5, 5-dimethyl-2-hydroxytetrahydrofuran-2-carboxylic acid (V), prepared from 4-methyl-1, 4-valerolactone, was dehydrated smoothly to give 5, 5-dihydrofuran-2-carboxylic acid (VI), Through its sodium salt, VI was converted into the corresponding acyl chloride VIII, which reacted with cephalotaxine in the presence of pyridine to give ester IX. After being treated with hydrichloric-acetic acid, ester IX unerwent Reformatsky reaction to give a mixture (XIV) of harringtonine and its diastereoisomer (epiharringtonine) as the final product which was purified either by countercurrent distribution or column chromatography on neutral alumina. The amounts of the two epimers in the mixture shown by TLC were roughly equal.


Comparison of physiological responses to hypoxia at high altitudes between highlanders and lowlanders. This report deals with the differences and changes of physiological functions of the highlanders and the lowlanders at different altitudes during the period when the Chinese Mountaineering Team was climbing up and reached the peak of Qomolangma Feng. In a period of relaxation, there are no significant changes in ventilatory responsiveness to hypercapnia, electrocardiogram and electroencephalogram between highlanders and lowlanders with the changes at different altitudes. At 5,000 m a.s.l., however, electrocardiogram and the result of cardiac ventricular functional test show significant differences after the subjects are physically loaded. Those whose electrocardiogram readings show unusual changes, and whose cardiac ventricular functional tests show their physiological functions at low degree after physical activities at the altitude of 5,000 m, have a climbing ability hardly below 6,500 m, while those who have reached the altitudes above 8,200 m have no unusual changes in electrocardiogram, and the results of cardiac ventricular functional tests show that their physiological functions are at high degree.


[Measurement of pulmonary artery pressure at rest during volume loading for assessment of ventricular function in coronary artery disease (author's transl)]. Measurements of pulmonary artery (PA) pressure at rest with volume loading of the heart was carried out in a semirecumbent position by standardized positioning of the legs (Positioning test) in 44 patients with angiographically-proven severe coronary artery disease (CAD). The patients reacted differently and were accordingly assigned to one of the three following groups: Group I (23 patients) with normal PA pressures values showed normal results on ventriculography and accordingly, a normal ejection fraction. Group II (13 patients) showed a pathological increase in PA pressure by volume loading. Ventriculography showed hypo- or akinetic areas, with accordingly reduced ejection fraction already at rest. Group III (8 patients) showed pathological PA pressure values already at rest, in accordance with the ventriculographic existence of larger akinetic areas and a marked reduction in ejection fraction. Coronary morphology per se showed no correlation with PA pressure behaviour during volume loading at rest. Therefore, PA pressure measurement in the standardized positioning test can give a relatively accurate estimation of the functional state of the left ventricle, while statements about coronary morphology in CAD are not permissible.


[Iliac crest biopsy findings in malignant non-Hodgkin lymphoma]. Issuing from the clinico-prognostic importance of the classification after Kiel of the malignant non-Hodgkin-lymphomas the results of the attempt of a reclassification of positive bioptic findings of the iliac crest judged according to the former German nomenclature are described and discussed after the Kiel classification. In the total material of 725 biopsies 76 positive findings of the marrow were stated in malignant non-Hodgkin-lymphomas, which at 67.1% consist of such with a lower and at 32.9% of such with a high degree of malignity, in which case a strong decrease of the formerly diagnosed CLL is to be seen after reclassification, whereas the immunocytomas render the by far largest proportion. The former malignant reticuloses disappear per definitionem after reclassification and, as it was expected, are broadly distributed. In 112 biopsies which were performed on account of the suspicion of an affection of the marrow in malignant non-Hodgkin-lymphomas the 76 positive findings correspond to a frequency of 67.9%, which, however, must critically be judged, since the case in question are very selected numbers of patients.


A blood cyanide distribution study in the rabbits intoxicated by oral route and by inhalation. Blood cyanide concentration was determined in rabbits intoxicated orally or by inhalation. Experiments were carried out under urethane anaesthesia. In the inhalation experiments, rabbits inhaled a combustion product containing HCN via the tracheal cannula and in the oral studies animals were administered NaCN solution into the stomach. In addition to the carotid artery and jugular vein blood samples, postmortem samples were obtained from both sides of the heart and the descending vena cava. The arterial cyanide concentration in the inhalation group showed a close relationship with ventilation. After an initial rise, blood levels decreased a little, in some cases with transient apnea. At the last stage it again increased with gasping, reaching its maximal value. After ultimate apnea, the blood cyanide concentration declined. The blood cyanide values were higher in the oral group than in the inhalation group. The difference between the two groups became larger in the inferior order, the left heart blood--the right heart blood--blood in the descending vena cava. The left heart/right heart ratio of the inhalation group was significantly higher than that of the oral group (1.28+/- 0.28 vs. 0.95+/- 0.09). The coefficient of variation (c.v.) of the inhalation group was larger than that of the other group. Within the inhalation group, the left heart blood showed the largest c.v. values and this was probably due to redistribution of the cyanide by bloodstream after attainment of the maximal concentration.


Massive ovarian edema. A clinicopathologic study of five cases including ultrastructural observations and review of the literature. Massive ovarian edema is a tumor-like condition occurring in young women considered to be the result of torsion of the ovary to the extent that it interferes with venous and lymphatic drainage, but is insufficient to cause necrosis. Marked enlargement of the ovary occurs, and the patient usually presents with an adnexal mass. If the torsion occurs acutely abdominal pain is prominent. If it occurs gradually, the patient may be virilized and stromal luteinization is often observed microscopically within the involved ovary. Edema fluid accumulates in the stroma but the tunica albuginea and superficial cortical zone are characteristically uninvolved. In one patient, precocious puberty was the presenting finding and this regressed following excision of the mass. This unique finding suggests that the lesion can result in the production of significant quantities of estrogen, and that this is less likely to be recognized after menarche. In the case studied by electron microscopy, the principal finding was the presence of both fibroblasts and myofibroblasts in the edematous stroma. The increased number of myofibroblasts may be a response to the edema.


Melanotic schwannoma. Clinical and ultrastructural studies of three cases with evidence of intracellular melanin synthesis. Three cases of intradural extramedullary melanotic nerve sheath tumors involving spinal nerves are reported. Clinical, roentgenographic, surgical, gross, histologic, and electron-microscopic findings were remarkably similar. Electron-microscopic study of the three neoplasms showed that the individual cells contained melanin pigment in all stages of maturation; in addition, there was prominent basal lamina, micropinocytotic vesicles, and other ultrastructural features consistent with Schwann cell derivation. The total clinical, operative, and morphologic picutre in these cases suggests that the tumors are true melanotic schwannomas capable of intracellular pigment production. The potential of such tumors for recurrence and metastasis is discussed.


The optically clear nucleus. A reliable sign of papillary carcinoma of the thyroid? The clear ("Orphan Annie Eye") nucleus has been accepted as one of the important microscopic features of papillary carcinoma of the thyroid. This study undertook an examination of 100 consecutive thyroid lesions exclusive of papillary, mixed, and follicular carcinomas for the presence of these nuclei. Only two lesions (2%), a follicular adenoma and diffuse hyperplasia, had such nuclear morphology but as focal changes. Thirty-seven cases of papillary, mixed, and follicular carcinoma were also studied. Clear or empty nuclei were present in 83% of papillary carcinomas. One carcinoma of follicular type had clear nuclei in a diffuse distribution. "Pseudoclear" nuclei were noted in a variety of situations ranging from normal thyroids to diffuse hyperplasia, where they were present in 65% of cases. We conclude that clear nuclei when present as a diffuse changes in a thyroid tumor are a reliable sign of papillary carcinoma but are not pathognomonic. If the character of the clear nuclei is questionable, other histologic features of papillary carcinoma should be looked for, such as papillae with overlapping nuclei, psammoma bodies and multicocality. It was also fould that frozen sections and imprints do not demonstrate the nuclei; they appear only in fixed tissues.


The small carcinoma of the large bowel.

The small carcinoma of the large bowel. Four small carcinomas (3, 6, 10, and 15 mm) of the large intestine have been examined for residual epithelial polyp; none was found. It is felt that these carcinomas arose from colonic mucosa without a preexisting visible epithelial precursor lesion; however, occasional glands having adenomatous change were seen near the edges of the carcinomas.


Papillary-cystic neoplasm of the pancreas. A case of an unusual pancreatic tumor with a characteristic papillary-cystic microscopic morphology is presented. Review of four previously reported similar cases suggests a distinct clinical picture of a large abdominal mass occurring in a young person which apparently, after resection, does not rapidly recur. The histopathology of this tumor consists of papillary and cystic patterns, regular homogeneous cells with a few mitoses, glassy eosinophilic cytoplasm, and mucin and PAS positivity. Ultrastructural detail, including eccentric nucleoli, numerous mitochondria, sparse endoplasmic reticulum, and little evidence of secretory activity, suggests a duct cell origin for this rare tumor.


Pathology of salmonella colitis.

Pathology of salmonella colitis. Salmonella colitis was encountered in eight patients. In seven, the disorder simulated ulcerative colitis both clinically and radiologically. The salmonella infection in the eighth patient was superimposed upon hitherto unrecognized ulcerative colitis. In mild cases the histological appearances of rectal biopsies were nonspecific, consisting of edema of the mucosa with focal inflammatory cell infiltration. More severe cases were characterized by neutrophils infiltrating the walls of degenerating crypts, and in one case there were microthrombi in the mucosa. One patient who was thought to have fulminant ulcerative colitis had a hemicolectomy. The resected specimen exhibited marked hemorrhage and ulceration. There were crypt abscesses in unulcerated areas but there was also extensive necrosis of the mucosa, hemorrhage in the mucosa and submucosa, and microthrombi extending from small vessels in the mucosa into venules in the submucosa similar to the picture seen in acute ischemic colitis. In this case there was intense edema and inflammation in the submucosa as well as in the mucosa.


Histopathology of gastric dysplasias: correlations with gastric juice chemistry. Based on the experience with gastric biopsies in a rural population of Colombia with very high rates of gastric cancer, a description of the dysplasias of the gastric mucosa is given. It recognizes two main types of dysplasias: hyperplastic and adenomatous. Different degrees of atypism are recognized within each category. A comparison with other classifications of gastric dysplasias is offered. A positive correlation of dysplasia with gastric juice nitrite is found and offered as an adjuvant to the evaluation of patients with this type of condition.


Fibromatosis of the breast.

Fibromatosis of the breast. Two cases of fibromatosis of the female mammary gland treated by local excision and with a follow-up of 11 and 3 years, respectively, are described. Fibromatosis confined to the breast and not involving the underlying fibroaponeurotic fascia is a rare lesion. Among the handful of cases reported in the literature, diagnostic errors are known to have led to unnecessary mastectomy. In the breast, fibromatosis behaves in the same fashion as in the soft tissues: an aggressive infiltrative lesion with a proclivity for local recurrence following inadequate excision but without potential for distant metastasis. Clinically, it may simulate carcinoma; when suspected histologically during frozen section study, surgical resection should be limited to wide local excision and a definitive plan of therapy deferred until the lesion can be examined carefully with permanent sections.


Myofibroblasts in the stroma of invasive and metastatic carcinoma: a possible host response to neoplasia. After observing the presence of numerous stromal myofibroblasts in scirrhous mammary carcinomas, a series of invasive and metastatic carcinomas from diverse sites was examined by electron microscopy to determine whether myofibroblasts might also be present in their stroma. Myofibroblasts were identified in each instance and were most abundant in neoplasms which were hard, sclerotic, and retracted. This finding suggests that myofibroblasts represent a component of the stromal reaction to many carcinomas and contribute to the desmoplasia and retraction which characterize many of these neoplasms. The host commands several responses to neoplasia. As a result of the expression of tumor-associated antigens, the immune system contributes lymphocytes, macrophages, and antibodies, a reflection of immunologic surveillance against neoplasia. In contrast to experimental systems tumor neoantigens are poorly expressed or even lacking in many human neoplasms; thus, the immune system may be weakly stimulated or not activated at all. Tumor neovascularization induced by a tumor-angiogenesis factor represents a second host response, possibly deleterious, for it may facilitate tumor dissemination. The stromal myofibroblast reaction to many invasive and metastatic carcinomas may constitute a third, albeit more primitive response. The density of collagen produced and contractile state of such tissue may signify an attempt by the host stroma to contain the neoplasm and impede vascular invasion. If so, myofibroblast induction may complement immune surveillance or constitute a separate mechanism of response to invasive neoplasia in man.


Mediastinal meningioma.

Mediastinal meningioma. A case of meningioma appearing to arise from the stellate ganglion and associated with a unilateral Horner syndrome of long standing is presented. Clinical absence of central nervous system involvement and a normal computerized tomographic scan of the brain favor the neoplasm as being a primary extracranial meningioma. Light and electron microscopy showed characteristic structural features. A brief review of the literature is made, and theories concerning the origin of extracranial primary meningioma are presented.


High-dose barbiturate therapy in humans: a clinical review of 60 patients. Over the past three years, high-dose barbiturate therapy has been used in the treatment of 60 patients with head injury (N = 45), encephalitis (N = 8), acute focal cerebral ischemia (stroke, N = 4), and global anoxia secondary to drowning (N = 3). High-dose barbiturates appear to be useful adjuncts in the control of intracranial hypertension refractory to other methods of therapy. Administration of barbiturates to patients with this problem will often reduce the requirement for osmotic agents, thereby facilitating medical management by avoiding hyperosmolality and fluid and electrolyte depletion. In a carefully controlled intensive care setting the risk of barbiturate therapy is low, though the costs and demands on personnel are great. Survival appeared to be improved in aptients with ,head injury and encephalitis. Although the ultimate outcome was not altered in patients with stroke or near-drowning, intracranial hypertension did not occur until barbiturate therapy was withdrawn. This experience provides an ethical basis to justify further randomized studies for determining whether or not barbiturates materially improve the neurological outcome following cerebral ischemic and traumatic insults.


Precise characterization and quantification of infantile spasms. With the use of a time-synchronized video and polygraphic recording system, 5,042 infantile spasms were monitored and analyzed in 24 infants aged 1 to 43 months. Of these, 33.9% were flexor, 22.5% extensor, and 42.0% mixed flexor-extensor. Sometimes the spasms were followed by a period of akinesia and diminished responsiveness lasting up to 90 seconds, and rarely (1.0%) this "arrest" effect constituted the entire seizures. More than one type of seizure occurred in 21 of the 24 infants. In the same number, 78.3% of the seizures occurred in clusters, and the intensity and frequency of the spasms in each cluster often increased to a peak, then progressively decreased until they stopped. Predominantly, the clusters occurred soon after arousal from sleep. The number of seizures occurring at night (55.2%) was similar to the diurnal number (44.8%). The electroencephalographic seizure pattern was variable, but a marked generalized attenuation of electrical activity was a feature of 71.7% of the attacks. Attenuation episodes of similar degree and duration occurred with no evidence of a seizure.


Effects of physostigmine and lecithin on memory in Alzheimer disease. Because there is evidence that central cholinergic mechanisms are depleted in dementia, we studied the effects of central cholinergic augmentation on the memory of 5 patients with Alzheimer disease. Patients received placebo, lecithin, physostigmine, or lecithin plus physostigmine in a double-blind study using titrated doses of the acetylcholinesterase inhibitor physostigmine. Memory was evaluated with alternate forms of the selective reminding procedure. Compared with lecithin alone, the combination of physostigmine and lecithin consistently enhanced memory storage and retrieval; physostigmine without lecithin produced no memory facilitation. The strategy of combining a cholinergic agonist and precursor holds promise, although a larger clinical trial is needed.


The effect of metrizamide on the electroencephalogram: a prospective study in 61 patients. A prospective study was made of changes in the electroencephalogram after the use of metrizamide for myelography and posterior fossa cisternography in 61 patients (62 studies). The EEG changed in 21 patients (34%); 3 of these had had previously abnormal records, and the abnormalities were accentuated on the second recording. Eight developed paroxysmal activity, including spike and wave in 1. EEG changes appeared 24 to 48 hours after the use of metrizamide in 6 patients whose intervening EEGs were normal. The percentage of records that changed tended to increase as metrizamide was brought to more rostral levels. Symptoms following the use of metrizamide were reviewed in 58 patients. Although there were no seizures in the present series, seizures did occur with subsequent use of metrizamide in 3 other patients at our institution. Previous reports may have underestimated the frequency of EEG changes after metrizamide since these may require 24 to 48 hours to develop. The appearance of such activity suggests that the use of metrizamide in patients with known seizure disorders, the anatomical level to which metrizamide is brought during radiography, removal of contrast medium, and further investigation of premedication with anticonvulsants all require careful consideration when use of metrizamide is being contemplated.


Hereditary myoclonus and progressive distal muscular atrophy. Myoclonus occurs in a variety of pathological conditions, some inherited. We recently evaluated 3 members of a Louisiana-Texas family with an autosomal dominant disorder manifested by adult-onset, generalized, stimulus-sensitive myoclonus and slowly progressive distal muscle weakness and wasting. The analyses of cerebrospinal fluid homovanillic acid and 5-hydroxyindoleacetic acid before and after probenecid provided some evidence of impaired turnover of central dopamine and serotonin. Treatment with clonazepam resulted in complete and lasting improvement of the myoclonus. A postmortem examination in 1 member of the family revealed chiefly neuronal degeneration of the anterior horn cells, Clark's nucleus, and the lower cranial nerve nuclei. A similar syndrome has not previously been reported.


Adult type neuronal storage disease with neuraminidase deficiency. We describe a patient with adult-onset neuronal storage disease characterized by myoclonus, cerebellar ataxia, convulsive seizures, cherry-red spots, skeletal dysplasia, mild gargoyle features, inguinal hernia, and angiokeratoma. Cytoplasmic inclusions consistent with lysosomal storage disease were demonstrated in neurons of the autonomic nervous system. Accumulation of GM3 and GM2 gangliosides was found in sympathetic ganglia but a catabolic disturbance of these gangliosides was ruled out by normal levels of GM3 ganglioside sialidase and N-acetyl-beta-hexosaminidase A activities. beta-Galactosidase activity was decreased in leukocytes and fibroblasts, but not in serum. GM1 gangliosidosis was ruled out by lipid analyses, and mucopolysaccharidosis by normal excretion of mucopolysaccharide in urine. Sialyl oligosaccharides were increased in urine and alpha-neuraminidase was deficient in fibroblasts. This disorder is considered to be an inherited metabolic disorder of sialyl glycoproteins and oligosaccharides due to deficiency of an alpha-neuraminidase.


Mechanisms of acute carotid stroke.

Mechanisms of acute carotid stroke. In a three-year study, the clinical course and results of intracranial angiography were compared in patients having an acute stroke in the carotid artery territory combined with angiographic abnormalities indicating severe extracranial carotid stenosis or occlusion. Two major mechanisms of stroke were delineated. In one group, the angiographic intracranial abnormalities strongly suggested the presence of embolism in the cerebral vessels supplied by the stenotic or occluded carotid artery; many of these patients had no obvious transient ischemic attacks prior to their stroke and experienced a moderate to severe clinical deficit. In the other group, evidence of embolism was absent; many showed a widespread delay in cerebral arterial perfusion, experienced a greater frequency of transient ischemic attacks before their stroke, and had a milder stroke than did those with embolism.


Treatment of chronic relapsing inflammatory polyradiculoneuropathy by plasma exchange. A 58-year-old man developed recurrent episodes of symmetrical motor weakness associated with acroparesthesias and areflexia. The cerebrospinal fluid protein was elevated and nerve conduction velocities were slowed. There was no evidence of systemic disease or toxic exposure, and a diagnosis of chronic relapsing inflammatory polyradiculoneuropathy was made. The patient improved during treatment with corticosteroids, but steroid-induced complications necessitated discontinuance. A recrudescence of symptoms prompted a search for alternative therapy, and plasma exchange was tried. A marked improvement in strength was noted following each course of plasma exchange, suggesting that further similar trials are justified.


Search for viral particles and virus-specific products in idiopathic Parkinson disease brain material. Virological studies were performed on brain material from 9 patients with idiopathic Parkinson disease and 3 matched controls. Electron microscopy and indirect immunofluorescent study were carried out directly on autopsy material from substantia nigra, caudate nucleus, and hypothalamus and on primary tissue culture explants of these brain areas grown alone or in cocultivation with virus-susceptible indicator cell lines. All studies were negative for the presence of viral particles, viral inclusions, or cellular changes suggestive of virus infection. All materials were negative for antigens of herpes simplex type 1, influenza A/NWS, and measles (Edmonston strain) viruses. Within the limits of these tehcniques, there is no evidence at this time that viruses are an important etiological agent in idiopathic Parkinson disease.


Dysarthria--clumsy hand syndrome produced by capsular infarct. A 64-year-old hypertensive man presented with the dysarthria--clumsy hand syndrome, manifested by dysarthria, dysphagia, central facial weakness, deviation of the tongue on protrusion, incoordination of the affected hand, and mild imbalance on walking. A computed tomograpphic scan demonstrated a resolving acute infarction in the vicinity of the genu of the internal capsule.


Brainstem auditory evoked response in adrenoleukodystrophy. Clinical, laboratory, and electrophysiological data, including brainstem auditory evoked responses, are reported in a case of adrenoleukodystrophy. A striking asymmetry was noted in wave VI of the brainstem auditory evoked potential, followed by absence of any recognizable wave on the abnormal side. The presumed site of origin of wave VI is the medical geniculate body, a structure severely involved in adrenoleukodystrophy. It is suggested that the brainstem auditory evoked response may promise noninvasive diagnostic aid in this disorder and that absence of wave VI may emerge as a clinically useful finding in diseases of the central nervous system.


Zinc deficiency syndrome versus glucagonoma syndrome. In this paper two patients with uncommon syndromes, viz. acrodermatitis enteropathica-like eruption due to acute zinc deficiency, when on long-term intravenous hyperalimentation for Crohn's disease, and necrolytic migratory erythema as a consequence of a malignant glucagon secreting alpha-cell tumour of the pancreas (glucagonoma syndrome) are reported. Attention is paid to the many common features of the skin lesions in both syndromes. This is discussed in detail. Both patients passed through a catabolic stage. Laboratory investigations, however, failed to demonstrate a common biochemical mechanism which might be responsible for the skin lesions. Administration of zinc in the first patient and surgical treatment of the second patient results in rapid clearing of the skin lesions and other symptoms.


Results of surgical treatment for hyperthyroidism. In a 10-year period (1967-1977) 273 patients were operated upon for hyperthyroidism at the Department of Surgery of the St. Franciscus Gasthuis, Rotterdam. The evaluation of the results was carried out in 1978. A total of 205 patients appeared for investigations and drawing of blood samples. Total resection of one thyroid lobe and subtotal resection of the other lobe was the procedure of choce. 85% of the patients were euthyroid at the follow-up; 7% of the patients had a recurrent hyperthyroidism and 8% became hypothyroid. In three cases a persistent unilateral vocal cord paralysis was encountered. Surgery remains an effective and satisfactory method of treatment for appropriately selected cases, with a low rate of immediate and late complications.


Experience with bovine arteriografts for haemodialysis. Twenty-five bovine arteriografts were placed in 18 patients for maintenance of haemodialysis. Type of vascular access, complications and their management and long-term results are discussed.


Two cases of multiple gastric polyps.

Two cases of multiple gastric polyps. Two cases of multiple gastric polyps are described. In both cases a large number of hyperplastic polyps were found in the antrum and body of the stomach. A total gastrectomy was performed in these two patients. Histologically the polyps were benign; in one case gastritis with metaplasia was present. The pathological and clinical aspects of multiple gastric polyps are discussed with reference to the literature.


Case report: ischemic enteritis in a patient with Candida albicans infection. A case is reported of a 64-year old man with Candida albicans sepsis of pulmonary origin. It was complicated by a hemorrhagic ischemic enteritis that made it necessary to resect 2 1/2 m of small bowel. The specimen contained many pseudohyphae and yeast cells in the layers of the wall, especially in the necrotic areas. The superior mesenteric artery and its branches were patent and not occluded by infected thrombotic material, as has been described in another case of necrotizing enteritis accompanying Candida albicans sepsis. The pathogenesis and treatment of the ischemic enteritis in this case are discussed.


Use of Kirschner wires for percutaneous stabilization of supracondylar fractures of the humerus in children. The results of treatment of 52 supracondylar fractures of the humerus in children by means of percutaneous transfixation with two Kirschner wires are discussed and compared with the results of other methods of treatment, such as repositioning and immobilization in a plaster cast, and traction by the Baumann or Dunlop techniques. The functional results are equivalent to those of other methods of treatment. Although the number of cases studied was only small, it appears that the cosmetic results are better, while the duration of hospitalization is markedly shorter.


Blow-out of the renal collecting system and extravasation of urine due to passage of calculi. The clinical course of two patients who had peripelvic extravasation associated with passage of small calculi is reported, and clinical data of 65 similar case histories published in the literature since 1960 are reviewed for discussion of the clinical consequences of the condition. The occurrence of extravasation following sudden ureteral obstruction can be sufficiently explained by biophysical and urodynamic principles involved in the mechanism of blow-out of the elastic renal collecting system and this matter is discussed briefly. It appears that in renal pelves not obviously affected by disease, blow-out occurs oftenest in the fornix calices, but is generally an infrequent phenomenon. The condition often runs a benign clinical course provided the ureteral obstruction is relieved rapidly and the extravasated urine is sterile. Persisting ureteral obstruction and/or an infected extravasate will in general lead to serious clinical consequences requiring surgical intervention within one to several days.


Gracilis muscle transplant for delayed healing of the perineal wound. Delayed perineal wound healing frequently complicates a proctocolectomy in patients with inflammatory bowel disease. In almost half of the patients the evicerated pelvic space is not closed six months after surgery. Conventional surgery is very unsuccessful in the treatment of this persistent perineal fistula. A new technique is described using the transposition of the gracilis muscle to fill the perineal cavity. It is an easy procedure that solves a difficult problem.


Submuscular emphysema as a result of diverticulitis of the sigmoid colon without clinical implication. Diverticulitis of the colon may be the cause of the formation of subcutaneous or submuscular air in the hip or leg region. This phenomenon results mostly in an inflammation or abscess. A case is presented in which sigmoid diverticulitis caused submuscular air without any clinical discomfort.


Intraosseous ganglia.

Intraosseous ganglia. Intraosseous ganglia are benign cystic lesions of the bone; morbid-anatomically, they show no difference from the ganglia that occur in soft parts. The cases of two patients are reported. As far as we have been able to find out these are the first descriptions in the Dutch literature. The clinical aspects, morbid anatomy, pathogenesis and treatment are discussed with reference to the literature.


Kala-azar in Ethiopia: survey of south-west Ethiopia. The Leishmanin skin test and epidemiological studies. The Leishmanin skin test was performed on 1353 people in a kala-azar endemic region of south-west Ethiopia. Physical examinations were also carried out on 2723. Two of these individuals, both males, had active visceral leishmaniasis with Leishmania organisms demonstrated by spleen puncture. Two other males, including one member of the research team, had parasitologically proven cutaneous leishmaniasis. Because there was negligible migration and little movement of individuals outside of their tribal territories, the geographical distribution of skin test positivity and clinical findings could be determined and correlated with environmental parameters. The level of positive skin tests for the groups tested ranged from over 64% for the three tribes collectively inhabiting the lower regions of the Omo Valley (altitude approx. 500 m) to 6.4% for the Suri tribe, which lives at 1400 m. Skin test positivity was highest in areas of deeply fissuring montmorillonite soils and where Phlebotomus langeroni orientalis have been collected. Termite mounds of the pipe-organ type seemed to occur independently of the proportion of positive skin tests, possibly because alternative resting and breeding sites for sandflies were available in the cotton clay soil or because of the cultural patterns of the people. Almost always, males had a markedly higher prevalence of positive skin tests than did females. The degree of positivity was strongly correlated with increasing age, most positive conversions occurring in the ten to 20 year olds, the age at which males join cattle camps as part of their herding activities. Splenomegaly reached a prevalence of nearly 50% among the Hamar speaking people to the east of the Omo River, where the pattern of disease suggests malaria as the principal cause. Hepatomegaly, however, was highest in the lower Omo Basin among the Nyangatom, Dassanetch and Kerre, where hydatid disease was a major cause of liver enlargement, but seemed unrelated to the proportion of positive Leishmanin skin tests.


Morbidity in relation to the clinical forms and to intensity of infection in Schistosoma mansoni infections in the Sudan. A study of morbidity in Schistosoma mansoni infection was made in 593 Sudanese patients seen in a four-year period in Khartoum Civil Hospital. Clinical and laboratory findings were compared in three egg-count groups and in four clinical forms of the infection. Patients were divided into three levels of intensity of infection: light (up to 100 eggs/gram of stool), moderate (101--400 eggs/g) and heavy (more than 400 eggs/g). According to the presence or absence of visceral enlargement, infected subjects were divided into one of four clinical forms: intestinal, hepatic, hepatosplenic and splenic. Among the symptoms only the passage of blood in the stools was significantly related to intensity of infection, and fever was significantly related to the presence of hepatosplenic disease. Hepatomegaly and splenomegaly were significantly more frequent in the heavy infection group. Anaemia, eosinophilia, raised ESR and an increase in both serum alkaline phosphatase and serum globulins were significantly related to the intensity of infection. On the other hand, haematological and biochemical changes, as well as histopathological changes, were more marked and severe in patients with hepatosplenic disease. For comparison, the findings of 117 patients with S. haematobium infections and of 41 with dual S. mansoni/S. haematobium infections are included.


Light trap collections of ovipositing Simulium squamosum in Ghana. At a site near Boti waterfalls in southern Ghana a total of 14 644 female and two male Simulium squamosum were caught in four nights in Monks Wood light traps. The highest catch, of 6520 females, was obtained in a single night with an ultraviolet light tube that had a one-second flash rate. About 12% of the females caught were gravid and dissections of non-gravids showed that they had oviposited very recently. The traps were clearly catching females before or soon after oviposition. The same traps caught none or very few blackflies when placed in two other localities near Akosombo. Trap location appeared very important in sampling ovipositing females of S. squamosum.


Failure of carotid stump pressures. Its incidence as a predictor for a temporary shunt during carotid endarterectomy. A total of 289 carotid endarterectomies were performed in 204 patients. A decision to place a temporary shunt during carotid endarterectomy in this series was made entirely on the basis of intraoperative EEG monitoring. Retrospectively, the correlation between stump pressures and the results of intraoperative EEG monitoring in each case was determined. Evidence of ischemia developed in 6% of the total series on intraoperative EEG monitoring despite a stump pressure of greater than 50 mm Hg. The degree of disagreement between stump pressure and EEG varied according to clinical category in this series. In those endarterectomies performed for completed stroke, all cases requiring shunting had stump pressures less than 50 mm Hg. In those cases performed for symptoms of vertebral basilar insufficiency, however, 77% of the cases requiring an intraoperative shunt had stump pressures greater than 50 mm Hg. A review of the complication rate in the various study groups indicates that the use of intraoperative EEG is a safe indicator of cerebral ischemia during carotid endarterectomy regardless of stump pressure.


Popliteal vascular entrapment. Its increasing interest. In the past 20 years since the first clinical management of a patient with a congenital anomaly associated with an abnormal medial head of the gastrocnemius muscle causing external compression on the popliteal artery, approximately 100 similar lesions have been documented in the world's literature. This has been a lesion of international interest, with only approximately 25% of the cases from hospitals in the United States. This present series of 14 lesions from Walter Reed Army Medical Center, Washington, DC, during a 12 1/2-year period beginning in September 1966 emphasizes the increasing interest in this lesion. The young athletic male in whom intermittent claudication develops with strenuous exercise or the middle-aged patient with a popliteal aneurysm should be evaluated for the possibility of popliteal vascular entrapment. Medial deviation of the popliteal artery seen angiographically is a classic finding, however, there might also be segmental occlusion of the midpopliteal artery. This series outlines various types of popliteal vascular entrapment and documents successful surgical management.


Percutaneous transluminal angioplasty with the Grüntzig balloon catheter. A review of 70 cases. Percutaneous transluminal angioplasty has been used to treat lesions of the iliac, superficial femoral, and renal arterial systems in 70 patients. Overall initial success was achieved in 27/30 lesions, with 4/5 lesions documented to be patent for longer than two years. Although long-term follow-up is at present limited, the reduced cost and morbidity of this procedure are distinct advantages in appropriately selected patients. The close involvement of the vascular surgeon and a "team" approach are necessary. These preliminary results are part of a long-term study to evaluate the efficacy of transluminal angioplasty as well as to define factors that may be of predictive value in patient selection.


Nonresective treatment of abdominal aortic aneurysms. Use of acute thrombosis and axillofemoral bypass. In good-risk patients, abdominal aortic aneurysmectomy can be accomplished with a mortality of 2% to 5%. However, in poor-risk patients, ie, those with severe reduction of cardiac, respiratory, and/or renal function, the mortality of this procedure has been reported to be as high as 60%. Fifteen poor-risk patients with abdominal aortic aneurysms have been treated with acute, induced thrombosis and simultaneous axillobilateral femoral bypass. Each patient had preoperative ultrasound and radionucleide flow studies and the runoff from the aneurysm was determined angiographically. Thrombosis, induced by interruption of the iliac outflow vessels, occurred in 12 patients within 72 hours. Flow persisted in three patients, and thrombosis was induced by transaxillary catheter deposition of bucrylate in the residual outflow vessels. There were two operative deaths (less than 30 days), both due to myocardial infarctions, and four late deaths, three of which were caused by the problems that initially contraindicated direct graft replacement of the aneurysm. Preliminary experience with this approach indicates that this is a simple and potentially effective method of treatment of abdominal aortic aneurysm where direct graft replacement is contraindicated.


Renal artery aneurysm. Long-term relief of renovascular hypertension by in situ operative correction. Renal artery aneurysm is an uncommon cause of renovascular hypertension. Nephrectomy or, more recently ex vivo arterial reconstruction have been recommended as the treatment of choice. In contrast, we advocate in situ repair of the aneurysm and any associated lesions. Twenty-five hypertensive patients with 30 renal artery aneurysms were treated by tangential aneurysmectomy with primary arteriorrhaphy, saphenous vein patch angioplasty, or bypass graft. Nephrectomy was performed in two patients, one for a ruptured aneurysm. There was no operative mortality. Follow-up was obtained on all patients six months to 19 years after operation. Hypertension was relieved immediately and in the long-term in the majority of survivors. We believe these results indicate that despite the presence of severe renovascular disease, the affected kidney can be preserved and hypertension successfully relieved by a direct surgical approach without recourse to either nephrectomy or ex vivo reconstruction.


Management of lymph fistula in the groin after arterial reconstruction. Leakage of lymph from the inguinal incision is a rare but disturbing complication of arterial surgery. This article describes our experience in the management of 12 patients in whom lymphorrhea developed following arterial reconstruction. Seven patients were treated with pressure dressings, antibiotics, and immobilization. In this group, fistula healing was delayed up to four weeks, and wound infection occurred in three of seven patients. One patient eventually required removal of the prosthetic graft and below-knee amputation. Early groin reexploration and direct ligature of ruptured lymphatics was performed in the remaining five patients. Hospitalization was shortened and wound infection prevented in all patients in this group. We recommend prompt operative closure as the preferred approach in the management of lymph fistula following vascular reconstruction, especially when synthetic graft material is present.


Gastrocolic fistula as a complication of benign gastric ulcer. The symptoms, diagnosis, and management of three patients with gastrocolic fistula secondary to benign peptic ulcer disease are reviewed. To our knowledge, this brings the total of such cases reported in the literature to 50. The most frequent symptoms were abdominal pain, weight loss, diarrhea, and vomiting followed by anemia, foul eructations, and fecal vomiting. Barium meal demonstrated the fistula in about 70% of the patients, whereas barium enema examination demonstrated the fistula in nearly all of them. The diagnostic workup should rule out the possibility of a malignant cause for the fistula. The surgical management of these patients consists of the one-stage, when possible, resection of the involved portion of the antrum and the fistula of the transverse colon with appropriate reconstruction of gastrointestinal continuity. An increased awareness of the benign cause of some gastrocolic fistulas is necessary to avoid unduly extensive surgery in these cases.


The immediate care of threatening myocardial infarction in general practice. Twenty to sixty per cent of myocardial infarctions go unrecognized by patient and doctor, and there is no way to exactly predict these at the moment. But they have a much lower long-term mortality rate than do clinical infarctions. As a rule, a myocardial infarction will be preceded by pain and the sooner this is dealt with, the greater the salvage rate.


Screening for hypertension: a survey in the Hunter health region 1976-77. 15,746 people had their blood pressure measured in a hypertensive screening programme conducted in the Hunter Region of New South Wales. High blood pressure readings were found in 10.4 per cent (1,634) of the screened population. Followup information received from local general practitioners indicated that, of screened subjects attending the general practitioner following a higher screening reading, only 55.3 per cent were diagnosed as hypertensive, of whom 62 per cent had been diagnosed previously by their general practitioner. No diagnosis could be made in 20.5 per cent of the cases. A diagnosis of 'normotensive' was made for the remaining 24.2 per cent of screened subjects attending the general practitioner following a high screening reading. The value of screening programmes for hypertension is debated in view of the small number of newly detected hypertensives, the even smaller number of newly detected and successfully treated hypertensives and the morbidity associated with detection and labelling of hypertensive patients.


Some aspects of depression.

Some aspects of depression. Depressive illness remains an underdiagnosed, and often misdiagnosed entity, in all branches of medicine. Some of the factors involved are discussed: doctor, patient, environment, diagnosis, treatment. Disorders of mood, affective disorders, or simple depressive illnesses are by no means new to the human race.


Who gets an invalid pension?

Who gets an invalid pension? The major causes of incapacity in individuals accepted for the Invalid Pension (IP) are categorized, the largest groups being: ischaemic heart disease, neurosis, respiratory disease and nervous system disease. However, for years lost from work, the largest incapacity groups were: neurosis, nervous system disease, psychosis and vertebral disease. The most significant factors influencing acceptance for the IP were occupation and country of birth, with a highly significant excess of Greek born migrants.


The molecular compression of dextran.

The molecular compression of dextran. The suggestion is made that, in solution, the flexible-chain molecules of dextran can undergo an osmotic compression as concentration is increased. Approaches are developed described the molecular shrinkage (i) as arising from intra- and inter-molecular forces, (ii) based on the molecular characteristics of the dextran, and (iii) as estimated by viscosity measurements. Comparison with the macroscopic shrinkage of cross-linked dextran (Sephadex) beads [Edmond, Farquhar, Dunstone & Ogston (1968) Biochem. J. 108, 755-763] is made. In all systems studied, the experimental estimates of compression, both from gel-shrinkage and viscosity measurements were in reasonable agreement with theoretical predictions. The interpretation of the viscosity concentration-dependence was applied to compact structures (albumin and Percoll). Their behaviour was in marked contrast with that of dextran. It is noted that molecular compression may be important in considering transport processes in and thermodynamic properties of concentrated systems.


The identification of globin messenger ribonucleic acid in newt erythropoietic cells. Polyadenylated [poly(A)+]-RNA isolated from newt (Triturus cristatus) erythropoietic cells contained two main species sedimenting at 9S and 25S, and minor amounts of a 15-20S component. The 9S poly(A)+-RNA fraction induced synthesis of newt haemoglobin and globins in frog oocytes and in an mRNA-dependent rabbit reticulocyte lysate, confirming its identity as newt globin mRNA. Translation of 9S globin mRNA in reticulocyte lysate was concentration-dependent, the patterns of globin synthesis suggesting both preferential utilization and unequal amounts of the different globin mRNA subspecies. Globin mRNA activity was also evident in the 25S poly(A)+-RNA fraction whose localization in polyribosomes excluded its function as a nuclear globin mRNA precursor. Denaturation in formamide and estimation of its relative methyl content indicated that the 25S poly(A)+-RNA fraction contained equimolar amounts of 9S globin mRNA and 26S rRNA. Translation of the 25S fraction in reticulocyte lysate was less efficient than that of comparable amounts of 9S globin mRNA and induced a pattern of globin synthesis similar to that obtained with subsaturating amounts of 9S mRNA. The 25S mRNA-rRNA complex was considered to be a non-physiological aggregate generated by extraction of RNA in the presence of buffers of moderate to high ionic strength.


A lectin from the exudate of the fruit of the vegetable marrow (Cucurbita pepo) that has a specificity for beta-1,4-linked N-acetylglucosamine oligosaccharides. Lectins are present in the exudate (presumably from the phloem) of the fruits of three species of the Cucurbitaceae, namely vegetable marrow (Cucurbita pepo), melon (Cucumis melo) and cucumber (Cucumis sativus). They are all strongly inhibited in their activities by chitin oligosaccharides, but only weakly by N-acetylglucosamine. Glycopeptides from soya-bean agglutinin and fetuin are also strong inhibitors of Cucurbita pepo lectin, indicating that it interacts with internal N-acetylglucosamine residues. The lectin from Cucurbita pepo fruit was purified by affinity chromatography by using chitin oligosaccharides covalently attached to Sepharose. The lectin is not a glycoprotein, and it consists of a single polypeptide chain of about 20,000 mol.wt. It is a major protein (18% of the total) of the phloem exudate and it is postulated that it may have an anti-parasitic function.


Preparation and properties of bilirubin photoisomers. Polar photoisomers of bilirubin were formed by irradiation of bilirubin in chloroform solution in the absence of O2. Two pairs of compounds were isolated with molecular weights identical with bilirubin. One pair reverted to bilirubin in polar media and gave chemical reactions similar to bilirubin; the other pair were not reconverted into bilirubin by chemical means and gave reactions distinct from those of bilirubin. However, both groups were reconverted into bilirubin by irradiation in chloroform solution in the absence of O2. The probable role of these photoisomers in the catabolism of bilirubin during phototherapy of neonatal jaundice is discussed.


Structural characterization of ficaprenol-11 by 13C nuclear magnetic resonance. The location of the internal trans and cis isoprene units in ficaprenol-11 isolated from Ficus elastica was determined by 13C nuclear magnetic resonance. The alignment of the isoprene units was estimated to be in the order: omega-terminal unit, three trans units, six cis units and alpha-terminal cis alcohol unit.


Purification of a phosphoprotein from chromatin of rat liver. A simple and effective method to purify a phosphoprotein (B2) (Mr 68,000, pI 6.2-8) from phenol-soluble non-histone chromatin proteins of rat liver is described. The purification involved only two steps, CM-cellulose chromatography and preparative SDS/polyacrylamide (10%)-gel electrophoresis. The purified phosphoprotein B2 was shown to be homogeneous by SDS/polyacrylamide-gel electrophoresis. The yield was 2% of total non-histone chromatin proteins. The acidic to basic amino acid ratio of phosphoprotein B2 was less than 1, with high contents of glutamic acid, aspartic acid, arginine, lysine, glycine and alanine. The phosphate content of this protein is 0.3%.


Binding of radioiodinated propylthiouracil to rat liver microsomal fractions. Stimulation by substrates for iodothyronine 5'-deiodinase. Previous studies have shown that 2-thiouracil derivatives are uncompetitive inhibitors of iodothyronine 5'-deiodinase activity of rat liver microsomal fraction. Therefore the interaction of radioiodinated 6-propyl-2-thiouracil with rat liver microsomal fraction and the effect of substrate, cofactor and other inhibitors of 5'-deiodinase activity activity were investigated. It was found that micromolar concentrations of, in order of increasing potency, 3,5-diiodotyrosine, thyroxine, 3,3',5'-tri-iodothyronine and 3',5'-di-iodothyronine significantly enhanced binding of 5-[125I]iodo-6-propyl-2-thiouracil to the enzyme preparation. This stimulation was not seen in the presence of 1 mM dithiothreitol, 0.1 mM-6-propyl-2-thiouracil, 0.1 mM-6-propyl-2-thiouracil, 0.1 M-2-mercapto-1-methylimidazole or 1 mM-sodium sulphite. These results support the hypothesis that thiouracil derivatives inhibit 5'-deiodinase activity by forming a mixed disulphide with an intermediate enzyme complex, probably a sulphenyl iodide.


Hydrolysis of chylomicron triacylglycerol by endothelium-bound lipoprotein lipase. Effect of decreased apoprotein C-II/C-III ratio. Chylomicrons with a decreased ratio of C-II/C-III apoproteins on their surface produced by the addition of apoproteins C-III-0 or C-III-3 to intact rat lymph chylomicrons. These chylomicrons inhibited the activity of soluble lipoprotein lipase in vitro, but had no effect on the activity of the endothelium-bound enzyme in the perfused heart.


The incorporation of tritiated retinyl moiety into the active-site lysine residue of bacteriorhodopsin. Purple membranes were isolated from Halobacterium halobium bleached and regenerated with all-trans-[15-3H]retinal. The incorporation of label was 1.2 mol of retinal/mol of bacterio-opsin. The [3H]retinyl-bacterio-opsin obtained from regeneration was hydrolysed to give tritiated retinyl-lysine, which, on hydrogenation to N-epsilon-perhydro[3H]retinyl-lysine and reaction with 1-fluoro-2,4-dinitrobenzene, gave bis-(2,4-dinitrophenyl)-N-epsilon-perhydro[3H]retinyl-lysine. This result confirmed that the retinyl moiety of the chromophore is attached to an epsilon-amino group of lysine.


Inhibition by trioxalen (psoralen) plus near-ultraviolet light of the induction of ornithine decarboxylase in Chinese-hamster cells. Trioxalen (trimethylpsoralen) plus near-u.v. light, a potent inhibitor of DNA and RNA synthesis, inhibits the induction of ornithine decarboxylase in stationary-phase V79 fibroblasts. It does not affect the translation of pre-existing mRNA. The method, in view of its high degree of specificity and precise timing, is a better choice for inhibiting RNA synthesis than the commonly used chemical inhibitors and precursor analogues.


An improved method for the rapid isolation of brain ribonucleic acid. An improved one-step method for the extraction of RNA from rat brain is described. Fresh or frozen tissue is disrupted in the powerful protein denaturant guanidine thiocyanate, and RNA isolated by ultracentrifugation through CsCl. The procedure is advantageous in that it is relatively simple, is rapid and does not expose the sample to enzyme treatments or repeated organic extractions.


A rapid and sensitive assay for detection of nanogram quantities of castor-bean (Ricinus communis) lectins. Inhibition of lysozyme conjugated with p-aminophenyl beta-D-galactopyranoside by galactose-specific lectins from castor beans (Ricinus communis) has been utilized for assaying these lectins in the nanogram range.


Comparison of radioactive peptides obtained from specifically labelled human renal and placental alkaline phosphatases. Peptides with different chromatographic and electrophoretic properties were obtained from human placental and renal alkaline phosphatases by tryptic digestion of the enzymes labelled with radioactive orthophosphate at their active centres. These results provide structural evidence for the distinct genetic origins of the two isoenzymes that had previously been inferred from their different properties and from the observed phenotypic variation of placental phosphatase.


A comparison of methods for extracting ribonucleic acid polymerases from rat liver nuclei. Nuclei were prepared from rat liver after homogenization of the tissue in hyperosmotic sucrose and RNA polymerases (EC 2.7.7.6) extracted by two methods applied sequentially. Optimal conditions for washing loosely bound enzymes out of nuclei were determined first, and involved short (10 min) incubations at 0 degrees C in the presence of 5 mM-Mg2+ and 60 mM-(NH4)2SO4. Subsequent sonication of the residual nuclear pellet after resuspension and lysis at high ionic strength resulted in further release of RNA polymerases. The primary wash yielded about 2 x 10(4) molecules of RNA polymerases I and III (altogether) and 1 x 10(4) molecules of form-II enzymes per original nucleus, whereas subsequent sonication released 2 x 10(4)-2.5 x 10(4) form-I and -III enzyme molecules (altogether) and a further 7 x 10(3)-8 x 10(3) form-II enzyme molecules, as measured by end-labelling of nascent RNA. RNA polymerase II was partially purified from both types of extracts and shown to initiate very poorly on high-molecular-weight homologous DNA irrespective of the source of the enzyme.