Long-term follow-up of e-antigen (HBeAg)-positive acute viral hepatitis. Eighteen consecutive patients with HBeAg in serum and histologically verified acute viral hepatitis were included in a follow-up study of the natural course of the disease. Five patients were followed up for from 2 to 6 months. Two of these healed clinically and cleared both HBeAg and HBsAg, while three were positive for HBeAg and HBsAg at the last control. Thirteen patients with a follow-up of from 27 to 102 months became HBeAg-negative during the time of observation. In all but one, progression of the liver disease stopped when HBeAg was cleared. The results further indicate a close association between the duration of HBe antigenemia and the severity of the liver disease.


Acquired, transient factor X (Stuart factor) deficiency in patient with mycoplasma pneumonial infection. A case of severe haemorrhagic diathesis due to acquired deficiency of factor X (both immunologically and in procoagulant activity) is presented. The clinical and serological features of this case indicated mycoplasma pneumonial infection. Factor X in the peripheral blood did not appear to be influenced by administration of vitamin K, prothrombin-complex concentrate, fresh plasma or fresh whole blood. Circulating inhibitors of blood coagulation were absent and systemic amyloidosis could not be demonstrated. After 20 d, factor X spontaneously returned to normal. In view of the absence of other known causes of factor X deficiency, a possible relationship with mycoplasma pneumonial infection is suggested.


Massive platelet transfusion after splenectomy in a case of myelofibrosis. A patient with myelofibrosis complicated by massive splenomegaly underwent splenectomy to alleviate the increasing transfusion requirements and iron overload. The platelets exhibited qualitative defects pre-operatively. Following splenectomy the patient bled profusely and required massive blood and platelet transfusions. The postoperative haemorrhage was controlled by giving sufficient platelets to normalize the platelet aggregation.


Red cell changes in hyperthyroidism.

Red cell changes in hyperthyroidism. The Coulter 'S' red cell profile was studied prospectively in 100 untreated non-anaemic hyperthyroid patients and followed up in 52 of them until they had become euthyroid with radio-iodine or carbimazole treatment. Serial haematological data were also obtained in 23 hyperthyroid patients during treatment with beta-adrenoreceptor blocking drug alone. The most significant finding was a low mean corpuscular volume (MCV) which was invariably present throughout the hyperthyroid state. Treatment with beta-adrenoreceptor blocking drugs did not significantly alter any of the red cell parameters. On the other hand, the MCV increased and was restored to normal with radio-iodine or carbimazole treatment although there was a lag period of about 6--8 weeks between achieving the euthyroid state and the normalisation of this red cell index. While none of the patients were aneaemic, the haemoglobin level rose significantly following effective anti-thyroid treatment. It is suggested that measurement of the MCV may have a useful role in the diagnosis of hyperthyroidism. 2 possible mechanisms leading to the observed red cell changes in hyperthyroidism are postulated.


Influence of age on bronchial mucociliary transport. Mucociliary clearance was measured in 19 healthy non-smoking male subjects, aged between 21 and 69, by analysing the decrease in bronchial radioactivity of an aerosol of resin particles (mean diameter 7.4 +/- 1.5 micrometers) labelled with 99mTc. The mucociliary clearance was expressed as the percentage of radioactivity eliminated after 1 h. The measurements were made on two occasions with an average time lapse of 5 weeks. The intra- and inter-individual coefficients of variation were 15.6% and 41.5% respectively. The mucociliary clearance was significantly lower (P less than 0.05) (mean 21.8 +/- s.d. 7.8%) in the older subjects (greater than 54 years) than that observed (mean 34.1 +/- s.d. 14.1%) in the younger subjects (21 to 37 years). A significant negative correlation (r=-0.472, P less than 0.05) was obtained between the ages of the healthy subjects and their mucociliary clearance. However, the fact that the results varied considerably within each age group suggests that factors other than age may have an effect on the mucociliary clearance.


Pulmonary function in Bechçet's syndrome. Pulmonary function in Behçet's syndrome has not received much attention, although sporadic cases of airways obstruction have been described. In this series of five cases one had abnormal results with reversible airways obstruction and emphysema. These findings were likely to have been associated with asthma, previous smoking habits and pulmonary tuberculosis, and not another manifestation of Behçet's syndrome.


Immunoprofile studies in patients with pulmonary tuberculosis. IV. Tuberculin skin reaction and test of inhibition of blood leukcoyte migration. Study of the relationship existing between in vivo and in vitro correlates of cell immunity has revealed that there is no marked correlation between the magnitude of skin induration of the tuberculin skin test and the degree of inhibition of migration of blood leukocytes stimulated by PPD in patients with newly detected, bacteriologically confirmed pulmonary tuberculosis.


Tolerance of guaiacolic ester of acetylsalicylic acid by patients with aspirin-asthma. The effects of oral administration of the guaiacolic ester of acetylsalicylic acid (ASA-G) on the ventilatory function were studied by means of a body plethysmograph, in a group of nine ASA-asthmatic patients. No differences in specific airway resistance were observed between ASA-G and placebo. It is concluded that ASA-G is tolerated by patients with ASA-induced asthma.


Clinical and pharmacological observations on a new microcrystalline theophylline preparation. Tablets containing 250 mg of microcrystalline theophylline were given at 6-hourly intervals for 6 days. Minimum plasma theophylline concentrations in eight patients averaged 36.6 +/- 5.4 mumol/l (1 mumol = 0.18 mg), and the corresponding maximum concentration were 81.8 +/- 10.6 mumol/l. In 11 patients, studied after a single 250 mg dose, significant improvements in PEF and FEV1 were observed, in spite of maximum concentrations averaging only 38.8 +/- 2.2 mumol/l, which is below the commonly regarded lower limits of the therapeutic range. Nine of the 11 patients complained of side effects and in three patients a reduction in dose was necessary. In four volunteers given a single dose of 250 mg the plasma concentration of theophylline were not particularly affected by whether the tablets were taken fasting or postprandial.


Mediastinal parathyroid adenoma detected on a routine chest X-ray. A case is described in which a large tumour was detected in the posterior mediastinum on a routine chest X-ray. Although the parathormone level was very high, no clinical nor radiographic signs of hyperparathyroidism were present. The tumour was removed by lateral thoracotomy and proved to be a parathyroid adenoma. Postoperatively the serum calcium returned to a normal level.


Congenital defects and occupational factors. A comparison of different methodological approaches. In a previous study of children with congenital CNS (central nervous system) defects (N = 120), it was shown that exposure had occurred more often among the study mothers than among their referents. In the present study this population, extended with a one-year material of parents of children with oral clefts (N = 102) and their referents, was analyzed in a conventional way concerning occupational factors. This procedure was carried out in order to determine whether information on occupational factors only would provide enough hints to confirm known information concerning exposure, which had been acquired with the more-detailed but laborious interview method. No significant differences were observed in a comparison between the study groups and their referents when work of the mothers outside the home during pregnancy was considered. According to the social class grouping, classes 3 and 4 appeared more often among parents of children with congenital CNS defects than among their referents. With respect to industrial classification, manufacturing and different community services occurred more often among mothers of children with congenital CNS defects and oral clefts than among their referents. Some clustering could be observed with regard to the occupations of the parents in the two study groups as compared to their referents. When the material was methodologically processed in the conventional way described, no obvious conclusions could be drawn about exposure.


Increased frequency of chromosome aberrations in workers exposed to styrene. Chromosomal aberrations in lymphocytes from peripheral blood were significantly more frequent in six workers from a plant manufacturing polyester resin boats (average 10.8 per 100 cells) than in six age-and sex-matched referents (5.2 per 100 cells). The contamination of the workroom air with styrene, as measured on three occasions within three years in different areas of the plant, was 50--400 mg/m3.


The battle against occupational lead poisoning in Finland. Experiences during the 15-year period 1964--1978. Occupational lead poisoning has been greatly reduced as a problem in Finland during the 1970s. Case-finding efforts and increased awareness of plant physicians first caused an increase of the incidence with a peak of 89 reported cases in 1974. A sharp decline followed, and, although about 30 mild cases are still reported annually, classical clinical poisoning hardly exists anymore. An extensive regular monitoring program covering 8,000--10,000 blood lead (PbB) analyses a year also shows that exposure levels have been reduced. In 1977 only 70 PbB values, or 1%, were in excess of 70 micrograms/100 ml, and 243 values (4%) exceeded 60 micrograms/100 ml. All such values came from workers employed by less than 30 workplaces, and several of them belonged to workers monitored more than once a year. It is proposed that the general development of occupational health in Finland is to a great extent reflected in this favorable development; however, since special research, educational and informative efforts have been devoted to the lead problem, it may well be that these measures have also influenced the outcome. The results show that, on a nationwide scale, the lead problem can be coped with much more effectively than one has been apt to think. Hence the nonfeasibility of lowering maximum permissible exposure levels has been put in serious doubt. There is no reason to allow unnecessarily high exposure in the vast majority of workplaces only because a small minority has technical difficulties.


Comparative percutaneous toxicity of ten industrial solvents in the guinea pig. This report is part of a study on skin pathology, blood levels and percutaneous toxicity after the epicutaneous administration of solvents. The method used for the study of percutaneous toxicity differentiated between different types of solvents, and between different applied volumes of the same solvent. Five solvents caused some mortalities (in declining order: 2-chloroethanol, 1,1,2-trichloroethane, ethyleneglycolmonobutylether, carbontetrachloride, and dimethylformamide). Four solvents--benzene, toluene, 1,1,1-trichloroethane, and trichloroethylene--did not cause mortality, but a statisically significant effect on weight gain was observed. For n-hexane the weight gain did not differ (P greater than 0.2) from that of the control animals exposed to distilled water. For comparison, the same amounts of the solvents were injected intraperitoneally. There was a fairly good agreement between intraperitoneal and percutaneous toxicity, but slight deviations were observed for carbontetrachloride and dimethylformamide.


The effects of moderate heat stress on mental performance. Moderate heat stress is believed to affect mental performance by lowering levels of arousal. Conscious effort can counteract this effect. In most experiments, raised temperatures are perceived at the start by subjects and can act as a stimulus to exert conscious effort. In practice, temperatures usually rise slowly and may therefore have a more marked effect. Thirty-six male and 36 female 17-year-old subjects in standard cotton uniforms (0.7 clo) were exposed in groups of four in a climate chamber to rising air-temperature conditions typical of occupied classrooms, in the range 20--29 degrees C. The maximum rate of rise was 4 degrees C/h. Each group performed mental work during three successive periods of 50 min with 10-min breaks between. During each break the air temperature was reduced by 3 degrees C. Sentence comprehension was significantly reduced by intermediate levels of heat stress in the third hour. A multiplication task was performed significantly more slowly in the heat by male subjects, showing a minimum at 28 degrees C. Recognition memory showed a maximum at 26 degrees C, decreasing significantly at temperatures below and above, and an independent measure of degree of certainty in recall showed a maximum at 27 degrees C. These findings are in accordance with the hypothesis of reduced arousal in moderate heat stress in the absence of conscious effort.


Serum and urinary vanadium of vanadium-exposed workers. In this investigation the environment of vanadium workers was studied. It was found that low concentrations of vanadium (0.01--0.04 mg/m3) in the air do not correlate with vanadium serum levels or its urinary excretion. The results, however, suggest that values of vanadium in serum and urine samples reflect absorption of vanadium because vanadium could not be detected in the urine of referents. In higher vanadium exposure (0.2--0.5 mg/m3), the concentration in the air inhaled remaining unknown due to the use of dust masks, urinary vanadium excretion and serum vanadium level decreased significantly with exposure-free time.


Blood flow in the contralateral hand during vibration and hand grip contractions of lumberjacks. Pulse wave changes were examined among 63 professional lumberjacks. The tests were carried out in connection with an annual health examination. A photoelectric plethysmographic method was used to measure pulse wave changes during contralateral muscle work and vibration exposure from a dynamic shaker with a strain-gauge dynamometer. The relative changes in pulse wave amplitude were counted, and the changes were classified as dilatations, constrictions, or constant pulse wave amplitude. Contralateral muscle work caused vasodilatation, but vibration exposure could cause vasoconstrictions in the right hand. Most of the vasospasms were recorded at 60 and 100 Hz. The strongest vasospasms were seen at 200 Hz. The occurrence of vasospasms in the contralateral hand correlated with the severity of white finger symptoms rated according to an index for traumatic vasospastic disease.


Analysis of some older Scandinavian formulations of 2,4-dichlorophenoxy acetic acid and 2,4,5-trichlorophenoxy acetic acid for contents of chlorinated dibenzo-p-dioxins and dibenzofurans. Ten samples of older formulations of 2,4,5-trichlorophenoxy acetic acid and 2,4-dichlorophenoxy acetic acid used in Sweden were analyzed for chlorinated dibenzo-p-dioxins and dibenzofurans. The analyses were performed with gas chromatography/mass spectrometry with a high resolution glass capillary column for maximum isomeric separation and sensitivity. The detection limit was 0.01-0.05 ppm. The amounts of contaminants were of the same order of magnitude as that found earlier in European samples with later production dates (late 1960s and 1970s).


Direct determination of chromium in urine by electrothermal atomic absorption spectrometry. A simple, direct method for the determination of chromium levels in urine is described, electrothermal atomic absorption spectrometry having been used after the urine samples had been acidified. The optimal conditions at the ashing and atomization stages was determined. The detection limit of this method is 5 nmol/1, and the coefficient of variation (within day) is about 3% in the concentration range 20--400 nmol/1. Use of a low temperature asher with electrically excited oxygen before analysis gave results similar to those of the direct procedure. Good correlation was obtained from two other laboratories using different instruments and pretreatments.


[Retinoid in the treatment of psoriatic arthropathy: a pilot study]. Four patients with active seronegative psoriatic arthropathy were treated with retinoid (Ro 10-9359) in a daily dose of 30 mg for at least four months. Within the first 4--6 weeks of treatment all patients showed marked improvement of arthritis as measured by the number of swollen joints, the Ritchie joint index, morning stiffness and the pain experienced. One patient stopped taking her concomitant medication of nonsteroidal anti-inflammatory agent, while the others were able to reduce the intake of such drugs substantially. None of the patients were taking steroids. The elevated erythrocyte sedimentation rate observed in all patients studied also fell gradually in the course of treatment. With the exception of dry lips observed in two patients, other adverse effect such as extensive mucosa dryness and cheilitis, as commonly seen in patients receiving this agent, were not recorded. In view of these encouraging preliminary results we are now conducting a multicenter control study to substantiate these findings.


[First experience with retinoid acid derivative Ro 10-9359 in the treatment of viral epithelioma]. Two patients with extensive verrucae plantares have been treated successfully with the retinoic acid derivative Ro 10-9359. Both patients were practically unable to walk due to widespread involvement of the plantae pedium. In a second series of 12 patients with verrucae vulgares this form of therapy produced unsatisfactory results. In 2 further patients with verrucae plantares healing was achieved in one, and also in a patient with verrucae planae. A patient with verrucae periunguales did not react to the treatment. The dosage was gradually increased to above the normal value of 1.0 mg/kg body weight per day, according to individual tolerance. The aim was to reach a dose of over 1.5 mg/kg body weight per day. The side effects were therefore impressive and interruption or termination of therapy was often necessary. However, new side effects have not been observed with this high dosage and this new indication, apart from psoriasiform dermatitis and an intermittent vegetative disturbance, the latter without clear evidence of a causal relation to the Ro 10-9359 medication. Pathological liver values have not been observed. Treatment with retinoid appears to be appropriate in cases with verrucae plantares, especially where conventional methods do not prove satisfactory.


[Use of antibiotics in a surgical clinic. A prospective study of the Waid Community Hospital, Zurich]. A study was performed to analyse antibiotic usage in a surgical department, with the object of providing a basis for improving antibiotic policies. Patients admitted to the Department of Surgery (134 beds) of the Waid Community Hospital in Zürich (400 beds) after 1st Jan. 1979, and who received antibiotics during the period between 22 Jan. and 31 March were included in the study (n = 154). Daily chartreview provided all necessary information on clinical, diagnostic and therapeutic data of the patients included. 154 patients had 178 treatment courses which were reviewed according to guidelines proposed by the "audits of Antimicrobial Usage" (1977) and categorized as follows: I. agree with indication, appropriate choice and use of antibiotics; II. same, inappropriate choice and/or use of antibiotics; III. administration not justified. 83 of 178 treatment courses were prophylactic and 95 therapeutic. 58% of the prophylactic treatment courses were not justified (cat. III), and the remaining 42% were inappropriate in choice and/or use of antibiotics (cat. II). 41% of therapeutic treatment courses were adequate (cat. I), 43% were indicated, but these patients would have benefited from a more appropriate choice and/or use of antibiotics (cat. II), and in 16% the use of an antibiotic was not justified (cat. III). These results are compared with similar studies. On the basis of our findings, appropriate propositions for improvement of antibiotic policies are discussed.


[Sinus arrest after intravenous administration of lidocaine]. A 60-year-old patient with coronary artery disease and antecedent (1976) myocardial infarction developed sinus standstill with nodal bradycardia of 41/min while on antiarrhythmic treatment with lidocain (2 mg/min drip infusion). Severe hypotension (70/50 mm Hg) occurred concomitantly. Withdrawal of lidocain and intravenous injection of 0.5 mg atropine restored sinus rhythm within 4 min, followed by a very sluggish, gradual increase in blood pressure over the next 45 minutes. Fortunately this episode did no harm to the patient. He was allowed to leave hospital 6 days later as there was no evidence of a second myocardial infarction and anginal pain was successfully controlled.


[Fine needle biopsy guided by computed tomography]. Percutaneous fine needle biopsy guided by computed tomography is now a well established method in most university radiological departments. Positive results are obtained in some 80% of cases. With this tehcnique most abdominal and pelvic structures can be reached without danger for the patient under local anesthesia, even when the fine needle passes through the gastric or bowel walls. In some instances the technique can also be employed for biopsy of pulmonary and mediastinal lesions.


[Risk factors and psycho-social factors in myocardial infarct of the young man]. Psychosocial and standard risk factors were assessed in 21 young males aged 32--45 admitted for acute myocardial infarction. All patients underwent extensive clinical, dietary and psychosocial investigation by a team of cardiologists, psychiatrists, dieticians, social workers and physiotherapists both during hospitalization and later at home. Most standard risk factors were found infrequently and the estimated risk of coronary disease would have been low. Heavy smokers (1--4 packs of cigarettes per day) totalled 20/21 patients. In every case the patients, before myocardial infarction, had sustained severe long-term stress in their professional, social and/or familial environments. With rigid and obsessive personality patterns, they appeared to be the prisoners of their problem situations and totally unable to relax. Severe psychosocial stress and heavy smoking appear to be almost constant findings in young males admitted with acute myocardial infarction.


[Follow-up of severe adult respiratory distress syndrome]. The results are presented of the clinical, radiological and pulmonary function follow ups in 6 patients 19 to 35 months after the onset of a most severe adult respiratory distress syndrome (ARDS). The previously healthy young patients required ventilatory support for 16 to 135 days, reflecting the severity of the ARDS. In agreement with earlier studies, lung function improved rapidly in the first year but barely thereafter. Nineteen to 35 months after the ARDS a mild to moderate degree of restrictive ventilatory impairment could be detected in all our patients, associated with a significant arterial hypoxemia on exercise in five. Additionally, three patients showed signs of reversible airway obstruction. If the subacute course rather than the acute phase of the disease is taken as the criterion, there appears to be a relationship between the severity of the ARDS and the residual impairment of lung function. The fact that even most severe lung damage eventually led to a more or less significant loss of the functional reserves of the lung, but hardly ever ended in chronic respiratory failure, justifies all possible intensive care efforts in the treatment of those patients.


[Continous ambulatory peritoneal dialysis (CAPD)]. Eleven patients were treated with continuous ambulatory peritoneal dialysis (CAPD) for periods of 2-7 months (48 patient-months). Clinical and biochemical control of uremia was adequate in all patients. Control of hypertension and serum phosphate level was easier than with previous intermittent peritoneal dialysis (IPD). Mean protein loss during CAPD was 9.7 +/- 2.7 g/day. Seven episodes of peritonitis occurred in 3 patients (1 peritonitis/6.8 months). General use of CAPD cannot be recommended until the high incidence of peritonitis is reduced by urgently needed technical improvements. A potential complication of CAPD was that triglycerides were markedly elevated in 4 patients.


[Symptomless enteritis-salmonella excreters in an abbatoir]. Stool checks for Salmonella were carried out daily for several weeks in twelve men working in surroundings heavily contaminated by enteritis Salmonellae. Eleven of the workmen periodically showed salmonella in faeces. Positivity fluctuated from person to person between 2 and 37% and, depending on the day of the week, between 5 and 17%. The time taken for excretion was probably always less then seven days.


[Pharmacokinetics of a new cephalosporin, cefoperazone]. Cefoperazone is a semi-synthetic cephalosporin for parenteral use with an extended antibacterial spectrum covering Pseudomonas aeruginosa, Enterobacter cloacae and Serratia marcescens. Its pharmacokinetic properties were studied in 8 healthy subjects after 2 intravenous infusions of 2 g of the drug at a 12-hour interval. The mean peak serum concentrations were 134 +/- 16 microgram/ml and 143 microgram/ml. Cefoperazone was shown to possess a long half-life for a cephalosporin (1.7 hours). In our concentration range the drug is 90% protein bound. The apparent volume of distribution was a mean 11.4 liters and the renal clearance 18 ml/min. The cumulative urinary excretion was small, viz. 23% in 12 hours, indicating that there should be no need to modify the dosage regimen in renal failure. Comparison of in vitro studies with the pharmacokinetic properties show that 2 g cefoperazone given intravenously twice a day should inhibit most sensitive bacteria.


[Thrombosis of the internal carotid artery and damage to the intima of a renal artery after blunt trauma]. A 47 year-old man acquired intimal tears of the right internal carotid artery and the right renal artery by blunt injuries of the neck and the lumbar region in a horse riding accident. After a 10 days free period an occlusive thrombosis of the neck artery with fatal issue appeared. The clinical symptoms and diagnostic procedure are presented. Based on macroscopic, magnifying optical and histological necropsy findings these important artery injuries are discussed.


The rate of urinary excretion of phosalone residues in occupationally exposed persons. The absorption of malathion and phosalone was followed in occupationally exposed workers by determination of residues excreted in the urine. Because of the high concentrations found in the morning urine samples, the rates of excretion of phosalone metabolites in the urine of a volunteer experimentally exposed to phosalone during one and then again during three subsequent working days were investigated. The urinary excretion of phosalone metabolites was most intense 4--5 hours after exposure. At the beginning of the next day, the metabolites were still well measureable in the urine. Blood and plasma cholinesterase activities were only slightly reduced during exposure. The analyses of 24-hour urine samples, or of urine samples taken 4--5 hours after exposure, are not suitable for the routine control of occupationally exposed persons because of sampling difficulties. Instead, analyses of samples taken immediately before and after work hours have to be performed. A systematic increase in the concentrations of pesticide residues in the morning urine should initiate more efficient and well-timed protection measures.


Comparison of vector competence for West Nile virus of colonized populations of Culex tritaeniorhynchus from southern Asia and the Far East. Seven colonized stocks of Cx. tritaeniorhynchus from different geographic areas of Southern Asia and the Far East were assayed for susceptibility to WN virus infection by membrane feeding and by intrathoracic inoculation. Infected females also were tested for their ability to transmit virus to baby mice. No geographic pattern of differential susceptibility to WN virus infection was apparent from the experiments; however, the per os ID50 of one strain from Khulna, Bangladesh was over 10-fold greater than the ID50's of stocks from Karachi, Pakistan and Sendai, Japan. No difference in susceptibility was found by parenteral inoculation of virus. Likewise, greater than or equal to 90% of infected females from all the colonies were able to transmit virus.


Vectors of scrub typhus and their hosts on a mature oil palm estate. L. (L.) deliense was the predominant vector of scrub typhus in a mature oil palm estate, but a small number of L. (L.) fletcheri (0.1% from rodents) and L. (L.) vivericola (0.02% from rodents and 8.0% from black plates) was also collected. Although good correlation between L. (L.) deliense collected from rodents and from black plates was not established, either method may serve as a general indicator of population fluctuations over a period of time. For the most part, the vectors of scrub typhus were limited to litter piles, and thus, the possibility of contracting scrub typhus within this type of habitat was minimal.


Studies on susceptibility of Pila ampullacea, to the infection with the rat lungworm, Angiostrongylus cantonensis. Experimental infections of Pila ampullacea with first stage larvae of Angiostrongylus cantonensis were carried out to determine susceptibility of this molluscan host in relation to dose level and snail host size. Snails were divided into 3 size groups and exposed to A. cantonensis first stage larval suspensions of varying concentrations. The results showed that overall, about 20% of larvae ingested by the snails developed into infective third stage larvae, but the percentage was inversely related to both the number of larvae to which snails were exposed and snail weight. The infective worms were concentrated in the foot muscle and mantle of the molluscan host.


Iron supplementation studies among pregnant women. The effect of iron supplementation alone or in combination with ascorbic acid as a preventive and or corrective measure against anemia were tested using pregnant women seeking pre-natal consultation at various health centers in Greater Manila Area. One tablet containing 65 mg iron alone or in combination with ascorbic acid per day during a supplementation period which varied from 16.5 to 17.8 weeks maintained initial hemoglobin and hematocrit levels in non-anemic women. Three tablets of the same iron preparation (total of 195 mg iron) daily resulted in significant increases in hemoglobin and hematocrit in anemic women. Ascorbic acid had no apparent beneficial effect. Considering the positive response to iron treatment, it is recommended that a nationwide program of iron supplementation of pregnant Filipinos be undertaken.


Serum folate and folic acid binding proteins in iron deficiency anaemia. Serum and red cell folate and folic acid binding protein (FABP) concentrations were determined on 20 iron deficiency anaemic children of both sexes aged 6--12 years. All cases had haemoglobin level less than 12 gm% or haematocrit less than 36% with low serum iron and elevated unsaturated iron binding capacity. Serum folate levels in the anaemic group was not significantly different from that of normal subjects while red cell folate level was significantly lower in the anaemic group. However, all cases had red cell folate levels higher than 100 ng/ml. There was a direct relationship between the haemoglobin concentration and serum folate level. Serum FABP level in the anaemic group was found to be significantly higher than that of normal subjects and showed no correlation with haemoglobin, haematocrit, serum or red cell folate levels. The significance of elevated serum FABP was discussed.


Descriptions of odonate nymphs from Thailand. The descriptions of odonate nymphs from Thailand are presented. The insects of the Order Odonata both naiads and adults may serve as the second intermediate host of some intestinal parasites in Thailand.


Niemann-Pick disease in association with homozygous hemoglobin E: a case report. The first case of Niemann-Pick disease Type A in a Thai infant was reported. The patient also had abnormal hemoglobin E. The diagnosis was based on the clinical features, bone marrow findings and sphingomyelinase levels in the culture of skin fibroblasts. The autosomal recessive mode of inheritance was confirmed in this case.


Socio-economic development, environmental and health perspectives in Malaysia. With Malaysia independence in 1957, development in the country changed from system maintenance to development planning. Environmental and health perspectives are discussed in relation to current development as reflected in the Second Malaysia Plan 1971--1975 and the Third Malaysia Plan 1976--1980.


Prevalence of chronic respiratory disease in selected industries in the Philippines. A survey on the prevalence of chronic respiratory disease in selected industries were carried out. Results of the study revealed that chronic bronchitis is the most common chronic respiratory disease observed in the plants surveyed. This could be due to the inhalation of toxic dusts, fumes or gases at the place of work. Lung function tests showed that lung volumes like vital capacity and FEV1 are within normal units although a little bit reduced if compared with those free of symptoms. This would suggest that cases observed are mild in character. It is recommended that dust control be instituted in the textile, feed and cement plants. In the chemical and steel plants, SO2 is the main problem and should be prevented from affecting the workers by the use of hoods and higher smoke stack. In the chlorine plant, prevention of chlorine leakages into the workroom must be done by frequent inspection and tightening of conveyor tubes to prevent gas leakage into the surrounding environment.


Studies on the biological effects of nitrogen oxides and photochemical oxidants. The animal studies in mice resulted as follows. Long-term exposure to NO2 at or above 0.5 ppm affected primarily the respiratory organs. The pulmonary effect of NO was slighter than NO2. Nitrosylhemoglobin formation in vivo was much smaller than in vitro strong affinity of NO with hemoglobin. The components other than O3 contained in the photochemically formed oxidant mixtures enhanced the effect of O3 alone. Symptoms of the patients seriously injured by photochemical smog in Japan suggested the different type in quality from the Los Angeles-type smog.


Physical changes of the environment and health effects with special reference to water pollution and sanitation in Malaysia. Development of a human community are not without changes in its environment. Such changes result in either beneficial or adverse effects on human health. In Malaysia, in the wake of the New Economic Policy aimed at the redressing of the poor population and income distribution, development of the nation has brought about various changes in the environment. Some of these changes have elevated basic public health problems, while others, particularly new agricultural practices and industrialisation programmes with urbanisation trends, have brought a new set of problems due to water pollution and sanitation. Various measures are being taken to protect and to improve the environment so that progress can be realised with minimum adverse effects. This also calls for assistance from international sources, in terms of expertise, training and funds.


Industrial development and health in Malaysia. Industrial development in Malaysia is discussed in relation to impact on health. Trends in Malaysia are evaluated and the findings of some studies in Malaysia are reviewed.


Cutaneous irritation in the topical application of 30 antineoplastic agents to New Zealand white rabbits. Of 30 antineoplastic agents studied for their primary irritation potential in rabbits, 9 showed some potential for irritation. Five of these 9 agents produced a significant dermal irritation. None of the irritation observed was considered to be irreversible skin damage. The study further showed a strong correlation between irritation observed by the Draize method and acute inflammation evaluated histopathologically. There was a tendency toward increased epidermal thickness of irritated skin sites. None of the agents produced gross or microscopically visible lesions in the internal organs observed.


Evaluation of teratogenicity and behavioral toxicity with inhalation exposure of maternal rats to trichloroethylene. Female rats were exposed by inhalation to trichloroethylene (TCE) vapors at a concentration of 1800 +/- 200 ppm to determine whether exposure before mating and during pregnancy is more detrimental to reproductive outcome than exposure either before mating alone or during pregnancy alone. Four treatment groups were utilized in a two by two factorial design: exposure to TCE for 2 weeks before mating and during the first 20 days of pregnancy; TCE before mating and filtered air during pregnancy; filtered air before mating and TCE during pregnancy; and filtered air before and during pregnancy. Significant elevations in skeletal and soft tissue anomalies, indicative of developmental delay in maturation rather than teratogenesis, were observed in the group exposed during pregnancy alone. The mixed function oxidase enzymes, ethoxycoumarin and ethoxyresorufin, indicative of cytochrome P-450 and P-448 activities, respectively, were measured in maternal and fetal livers, as well as livers of non-pregnant females, and showed variable levels of activity not uniformly related to treatment or pregnancy. Behavioral evaluation of offspring indicated a lack of treatment effect in tests of general activity levels at 10, 20 and 100 days of age. However, a reduction in postnatal body weights was seen in offspring from mothers with pregestational exposure. No results indicative of treatment-related maternal toxicity, embryotoxicity, severe teratogenicity or significant behavioral deficits were obtained in any of the treatment groups.


Alterations in metabolism of cytidine components in rat liver after oral administration of butylated hydroxytoluene (in vivo study). The administration of the antioxidant, butylated hydroxytoluene (BHT) to rats decreased the utilization of [2-14C]orotic acid for the synthesis of cytidine nucleotides in the acid-soluble extract and RNA of the liver. The specific activity of the uridine components was slightly decreased. The depression of the specific activity of the cytidine components depended on the dose of the drug. Simultaneously preformed [U-14C]cytidine in experimental rats was to a higher degree transported to the liver and incorporated into RNA cytosine; its deamination was markedly suppressed. Both phenomena depend on the BHT dose. The concentration of both the uridine and the cytidine components of the acid-soluble extract remained unaffected by the administration of BHT. The utilization of [2-14C]orotic acid for the synthesis of DNA cytosine was depressed after the administration of BHT; by contrast, the specific activity of DNA thymine was higher. The incorporation of [1-14C]palmitic acid into microsomal phospholipids was not substantially influenced over the dose range 25--500 mg BHT/kg. The specific activity of neutral lipids in microsomes increased.


Chronic toxicity of acetone in the fresh water snail Lymnea stagnalis. With water of total hardness of 230 mg/l of CaCO3 all the tried concentrations (0.1, 0.2, 0.4 and 0.6%) of acetone induced a decrease in the growth of the young pond snails. For older snails, a 0.4% concentration was the threshold at which an inhibitory effect of the shell growth was observed. From the 0.1% concentration a decrease in the shell mineralization was recorded. In the range of 0.1--0.6% concentrations, the decrease of the fecundity varied from 3% to 31%. At lowest concentrations, only the number of egg-masses/snail was reduced. At the 0.6% level a lower number of eggs/egg-mass was added. The 0.6% concentration of acetone disturbed only the fertility of the eggs; lowest concentrations significantly increased the frequency of polyembryony.


Total synthesis of heterocyclic steroids, Part II. Synthesis of (+/-)-17-thia-3-methoxy-8 alpha, 14 beta-estra-1,3,5(10)-triene-17-dioxide. 2-Methyl-3-oxothiophane-1-dioxide (II) was prepared and was used as the D ring precursor in the total synthesis of the title compound via modified Torgov synthesis.


A comparison of the in vitro metabolism of estrone, estradiol-17 beta and estrone-3-sulfate by the livers of young virgin female, pregnant and female fetal guinea-pigs. The metabolism, in vitro, of [3H]-estrone, [3H]-estradiol-17 beta and [13H]-estrone-3-sulfate by the livers of pregnant, young virgin female and female fetus guinea-pigs has been compared using 900 g supernatants and microsomes. The ability of the guinea-pig livers to synthesize polyhydroxylated estrogens has been fo-nd to be small. The major metabolites isolated were unconjugated estrone and estradiol-17 beta or their glucuronides. The percentage of sulfates was lower after incubations with [3H]-estrone than with [3H]-estradiol-17 beta. A kinetic study with microsomes has shown a direct conversin of estrone-sulfate to estradiol sulfate. Fetal microsomes have been found to exhibit a more active hydrogenation of estrone to estradiol-17 beta than microsomes from young female or pregnant animals.


Radioimmunoassay of serum and ovarian pregnenolone in immature rats. Antiserum was generated in a rabbit against pregnenolone-16 alpha-carboxyethyl thioether conjugated to bovine serum albumin. The antibody, used for the assay of pregnenolone in extracts of serum and tissue homogenates, proved sufficiently specific to allow direct assay of extracts without chromatography. Sensitivity, defined as that point on the standard inhibition curve equal to the lower value 2 SD from the mean radioactivity bound to antibody in the buffer control (zero hormone) tubes, was 0.02 ng. The accuracy was confirmed by the recovery of known amounts of pregnenolone added to serum and aqueous buffer medium. The inter- and intra-assay coefficients of variation were respectively 10.6% and 9.1%. Specificity was confirmed by checking cross reactivity of various steroids and by finding comparable pregnenolone levels in samples before and after chromatography. The administration of aminoglutethimide to rats resulted in the reduction of ovarian and serum pregnenolone levels. Administration of isoxazole, on the other hand, caused an increase in both serum and tissue pregnenolone levels. These findings are in agreement with accepted views of the action of these two metabolic blocking agents.


18-substituted steroids. Part 4. A chemical synthesis of 3 alpha,18,21-trihydroxy-5 beta-pregnan-20-one 18--20-hemiacetal (18-hydroxy-tetrahydro-DOC). 3 alpha,18,21-Trihydroxy-5 beta-pregnan-20-one 18 leads to 20-hemiacetal (18-hydroxy-tetrahydro-DOC) has been prepared from 3 alpha-acetoxy-5 beta-pregnan-20-one by reduction to the 20 beta-alcohol, application of the 'hypoiodite' reaction [Pb(OAc)4-I2-hv] with subsequent steps leading to the 18-hydroxy-20-ketone (as hemiacetal), and C-21 acetoxylation [Pb(OAc)4] followed by hydrolysis.


Improved preparation of pregn-5-ene-3 beta,16 alpha,20-triols and 5 alpha-pregnane-3 alpha,16 alpha,20-triols. The compounds named in the title were prepared by routes which included the reduction of suitable 16 alpha,17-epoxypregnan-20-ones with aluminium amalgam to give 16 alpha-hydroxypregnan-20-ones, and reduction of the 20-oxo function either with sodium borohydride to obtain the 3,16 alpha,20 beta-triols or with lithium-liquid ammonia to obtain the 3,16 alpha,20 alpha-triols.


Alteration of biliary ursodeoxycholic acid in guinea pig during early stages of cholestyramine feeding. The effects of cholestyramine feeding on biliary ursodeoxycholic acid, fecal excretion of bile acids and neutral sterols on cholesterol 7 alpha-hydroxylase and hepatic HMG-CoA reductase were examined in the guinea pig. In the bile there was a 57% decrease in the concentration of ursodeoxycholic acid while an increase was observed in the concentration of chenodeoxycholic acid. Cholestyramine feeding for ten days resulted in a decrease in plasma cholesterol levels and an increase in both hepatic HMG-CoA reductase and cholesterol 7 alpha-hydroxylase activities. The fecal excretion of both bile acids and neutral sterols was significantly increased.


Simultaneous determination of biliary cile acids in rat: electron impact and ammonia chemical ionization mass spectrometric analyses of bile acids. Bile acids in the rat bile were fractionated into unconjugated, glycine- and taurine-conjugated fractions by employing piperidino-hydroxypropyl Sephadex LH-20 ion-exchange chromatography. Subsequently, these fractions were analyzed by gas-liquid chromatography (GLC) and GLC-mass spectrometry using a Silicone AN-600 column. Not only lithocholic acid, deoxycholic acid, chenodeoxycholic acid, hyodeoxycholic acid, ursodeoxycholic acid and cholic acid, but also alpha- and beta-muricholic acids were quantitatively and simultaneously detectable in conjugated and unconjugated fractions, respectively. In the unconjugated and conjugated fractions, varying amounts of the unidentified bile acid were detected upon GLC. The electron impact and ammonia chemical ionization mass spectrometric results and catalytic hydrogenation on the compound indicate that this bile acid seems to be a derivative of beta-muricholic acid having a double bond in the side chain. The present method is suitable to the simultaneous and quantitative determination of unconjugated and glycine- and taurine-conjugated bile acids in the rat bile.


Total synthesis of heterocyclic steroids, Part III. Synthesis of (+/-)-3,17-dithia-A-nor-14 beta-estra-1,5(10),6,8-tetraene-17-dioxide. With 4-oxo-4,5,6,7-tetrahydrobenzothiophene and 2-methyl-3-oxothiophane-1-dioxide (III) as AB and D ring precursors respectively, (+/-)-3,17-dithia-A-nor-14 beta-estra-1,5(10),6,8-tetraene-17-dioxide (I) was synthesised following the modified Torgov method.


Preparation of highly hindered steroid esters: application of some newer methods of esterification. The scope and limitation of some recent acylation methods were investigated as applied to the preparation of steroidal esters of highly hindered acids. As representative steroids, 19-nor-17 alpha-ethinyl testosterone (19-NET) and testosterone, and as representative acid, pivalic (trimethylacetic) acid were used.


Ponasterone A: a new ecdysteroid from the embryos and serum of brachyuran crustaceans. The apolar ecdysteroid present in the developing embryo of the blue crab, Callinectes sapidus Rathbun, is tentatively identified as ponasterone A (2 beta, 14 alpha, 20,22-pentahydroxy-5, beta-cholest-7-en-6-one) on the basis of chromatographic, immunological, and mass spectral evidence. The apolar ecdysteroid present in the serum of land crabs, Gecarcinus lateralis, in the late premolt stages of the intermolt cycle is also tentatively identified as ponasterone A on the basis of chromatographic and immunological evidence.


Metabolism of progesterone by chorionic cells of the early sheep conceptus in vitro. Progesterone-4-14C was extensively metabolized during incubation with dispersed trophoblast prepared from chorionic membranes of the 21-day sheep conceptus. Of the metabolites formed, 17, 20 alpha-dihydroxypregn-4-en-3-one, 20 alpha-hydroxypregn-4-en-3-one, 20 beta-hydroxypregn-4-en-3-one, 5 alpha-pregnane-3 alpha, 17,20 alpha-triol, 5 beta-pregnane-3 alpha, 17,20 alpha-triol, 5 beta-pregnane-3 alpha,20 alpha-diol, 3 beta-hydroxy-5 alpha-pregnan-20-one, 3 alpha-hydroxy-5 beta-pregnan-20-one, 20 beta-hydroxy-5 beta-pregnan-3-one, 5 alpha-pregnane-3,20-dione and 5 beta-pregnane-3,20-dione were identified. These findings indicate that the sheep conceptus acquires extensive steroid metabolizing capability very early in pregnancy.


Rural women's credit systems: a Nigerian example. The following article looks in detail at a rotating credit system used by rural women of Nigeria. This system, which women use to ensure the availability of cash to meet their family's financial needs, has analogues throughout the world. This close study of behavior--in this instance, about how women form groups to save and why--reveals rural women's roles in the family and the economic priorities created by these roles. This kind of information, rarely recorded or attended to, is an indispensable base for learning about how women are affected by and affect development policy. Further, understanding the mode of operation of this credit system and its value to the women who organized it provides guidance for the design the projects that work and are meaningful to women.


Marked preference for female sterilization in a semirural squatter settlement. The following article analyzes the reasons very poor semirural women in South India choose sterilization as a means of birth control. The women, who work for minimal wages in a narrowing job market and whose children have little hope for jobs or land marriages, are choosing to be sterilized after two or three births. Among their limited range of contraceptive choices, female sterilization in the nearby hospital where women go for deliveries and abortion is perceived by them to be the most advantageous in terms of the cost of medicines and transportation and time away from jobs. The article illustrates the centrality of economic factors in low-income women's family planning decisions.


Women in the household economy: managing multiple roles. The following article describes the strategies of a group of rural Kenyan market women for coordinating their various family responsibilities: subsistence production, income generation, child rearing, and household maintenance. By approaching the study of these women through their income-generating role, which is essential to the performance of their other roles, this analysis provides an important éntree for understanding all aspects of women's behavior.


Women's reality: critical issues for program design. The following article looks at social controls on the behavior of rural women in Bangladesh that need to be considered in project designs if women are to be able to respond to development programs. Rural women in many countries are constrained by analogous social pressures, which usually have an economic basis favoring the more powerful and therefore are resistant to change. Since these pressures on rural women often have a negative effect on the goals of rural development, they need to be understood and addressed.


The Rift Valley fever epizootic in Egypt 1977-78. 1. Description of the epizzotic and virological studies. From October to December 1977, an extensive epizootic occurred in Egypt resulting in abortions and increased mortality in domestic animals, and severe clinical disease with fatalities in man. Rift Valley Fever (RVF) virus was isolated and identified as the causative agent. In humans, acute febrile, encephalitic, ocular and fatal haemorrhagic diseases were documented as resulting from RVF virus infection. A retrospective serological survey indicated RVF was recently introduced into the area. The 1977 epizootic extensively involved five Governorates. In the summer and autumn of 1978, epizootic RVF reappeared in Egypt and spread to previously uninfected areas. Virological, serological and epidemiological studies, and factors related to the spread of RVF are discussed.


Yersinia enterocolitica infection from West Africa--a case report. A case of Yersina enterocolitica infection is described from West Africa. Intestinal function studies demonstrated an associated protein-losing enteropathy whilst the histo-pathological appearance of the rectum suggested an ischaemic colitis. Y. enterocolitica infection has been infrequently reported from the African continent and may be manifested in a variety of clinical presentations leading to difficulty in diagnosis.


Application of the enzyme linked immunosorbent assay (ELISA) for the serodiagnosis of Schistosoma mansoni infections in St. Lucia. As part of our search for a serodiagnostic assay to replace the expensive and tedious stool examination in the diagnosis of Schistosoma mansoni infection, we have studied the sensitivity, specificity and quantitative features of an enzyme linked immunoassay (ELISA) using crude S. mansoni egg antigen preparation. Results of studies carried out in both London and St. Lucia indicate that the assay can give useful serodiagnostic information ranging from 82 to 99.5% sensitivity, depending on level of infection intensity and method of blood collection and 100% specificity in St. Lucian/St. Vincent populations. The St. Lucia study also showed that the assay could be operated in a qualitative form in an endemic area.


The incidence of hepatitis B surface antigen in Nigeria. We have determined the incidence of hepatitis B surface antigen (HBsAg) in an urban (Enugu) and a rural (Okpatu) population groups in Nigeria. There were no statistically significant differences between the incidence in the two populations. Contrary to earlier reports we did not observe any significant age-related differences in the incidence rates within either population group. In general our results are similar to those reported for the urban inhabitants of Ibadan (several hundred miles west of Enugu) and its surrounding rural population. The low carrier rate recorded for schoolchildren drawn from a mainly high socio-economic group in our population has led us to suggest that socio-economic status alone or together with exposure to mosquito and other insect bites are probably the most relevant factors in the transmission of HBsAg in Nigerians.


Endomyocardial fibrosis and rheumatic heart disease in Mozambique. The first five cases of endomyocardial fibrosis to be reported from Mozambique are described in an autopsy series over the years 1975-77, together with 85 cases of rheumatic heart disease in patients who died and were autopsied during the same period. Outside the central parts of the African continent, endomyocardial fibrosis does not seem as rare as previously thought. Observations on the age and sex of the patients correspond with what is already known about both diseases. The strikingly higher frequency of rheumatic heart disease discussed in this review is at variance with the findings of SHAPER et al. in Uganda over the years 1950-65 and poses problems as to the hypothesis of a common aetiological process in both diseases, i.e. a hypersensitivity mechanism acting on cardiac connective tissue.


The anthelmintic effects of flubendazole on Brugia pahangi. The anthelmintic effects of flubendazole (methyl [5-(4-fluorobenzoyl)-1-H-benzimidazol-2-yl] carbamate) (Janssen Pharmaceutica) were evaluated in jirds (Meriones unguiculatus) and cats (Felis cattus) infected with Brugia pahangi. Flubendazole was macrofilaricidal at 5 x 2.5 mg/kg and 1 x 25 mg/kg in jirds and 1 x 100 mg/kg in cats when administered by subcutaneous injection. It also killed developing larvae in jirds. It was not microfilaricidal.


Diagnostic value of bone marrow culture in typhoid fever. The diagnostic efficacy of bone-marrow culture, serial blood cultures and agglutination tests was compared in a prospective study of 60 patients with typhoid fever, two thirds of whom had received prior antibacterial therapy. Salmonella typhi was recovered from marrow cultures in 95% of patients but blood cultures were positive in only 43.3% (P less than 0.001). Agglutination tests were eventually diagnostic in 56.7% of patients, but in only 25% at the time of admission. If procedures had been limited to blood cultures and agglutination tests, diagnosis would have been missed in 21.7% of cases. The efficacy of marrow cultures was affected not by the duration of disease but by the extent of antibacterial therapy before presentation. Bacteriological recovery was faster from marrow cultures.


Immunization with culture supernatant in experimental amoebic meningoencephalitis. Mice were immunized with 0.25 ml culture supernatant intraperitoneally and challenged with 5 x 10(4) Naegleria fowleri intranasally. Survival rate was 11% after one and 25% after three immunizing doses, compared to 0% in controls.


The quantitative effects of maternal dietary energy intake on pregnancy and lactation in rural Gambian women. The quantitative relationships between dietary energy intake and weight gain in pregnancy, birthweight and lactation performance during the first three months of infancy have been studied in such a way as to take account of major differences in the patterns of heavy manual labour at different times of the year in a subsistence farming community. Maternal weight gain and the accumulation of subcutaneous fat were significantly lower when the last trimester of pregnancy fell during the time of heaviest farm work and lowest energy intakes. The birth-weight of babies was also significantly correlated with differences in energy intake throughout the year. During early lactation breast milk yields were significantly related to concomitant alterations in the subcutaneous fat stores. Evidence has been produced which suggests that in undernourished nursing women there could be a competition for dietary energy between the repleting maternal subcutaneous fat organs and the mammary glands at the expense of milk production.


Single injection treatment of meningococcal meningitis. 1. Long-acting penicillin. A single injection of a long-acting preparation of penicillin (Triplopen) was compared with a five-day course of crystalline and procaine penicillin in the treatment of meningococcal meningitis. The clinical response of patients treated with Triplopen was very similar to that of patients treated with crystalline penicillin and much more convenient to administer. However, four patients treated with Triplopen had a positive CSF culture 48 or 72 hours after their injection. One injection of Triplopen cannot, therefore, be recommended as an entirely safe form of treatment for meningococcal meningitis unless patients can be carefully followed.


Single injection treatment of meningococcal meningitis. 2. Long-acting chloramphenicol. A single injection of a long-acting oily preparation of chloramphenicol (Tifomycine) was compared with a five-day course of crystalline and procaine penicillin in the treatment of 131 adult patients with meningococcal meningitis. The clinical response to treatment was similar in the two groups of patients. Serial lumbar punctures showed a parallel fall in CSF cell count, protein and lactate and all posttreatment cultures were sterile. Single injection chloramphenicol treatment was cheaper and much easier to administer than penicillin. Long-acting chloramphenicol is thus an effective form of treatment for meningococcal meningitis and is likely to prove of particular value in the management of epidemics in areas with limited medical resources.


Amoebic liver abscess: a retrospective clinical evaluation of twenty-seven cases. Twenty-seven patients with Amobebic Liver Abscess were observed during the last two years and were analysed retrospectively with respect to diagnostic procedures and therapeutic strategies. Seven of the 27 patients had surgery and were subsequently referred to our hospital. Those patients with surgery had a longer duration of illness and hospitalization (3.3 months) compared to the other 20 patients with chemotherapy alone (2 months). Most important diagnostic parameters for extraintestinal amoebiasis were: typical clinical findings, time spent in tropical or subtropical countries, strongly positive Latex agglutination against Entamoeba histolytica antigen, and isotope and/or ultrasound scanning to confirm abscess formation in the liver. The vast majority of abscesses were found in the right liver lobe. Response to treatment with complete cure was seen in all patients, regardless of whether Metronidazole alone or combinations of Metronidazole with Chloroquine and Metronidazole and Dehydroemetine or Chloroquine and Dehydroemetine were used. There is a need for prospective therapeutic studies to compare the different drug regimen concerning side-effects, toxicity, costs, application, and duration of hospitalization. From the retrospective data it seems that surgery is not beneficial for the patients.


Cell mediated immune (CMI) responsiveness to soluble egg antigen (SEA) and its relation to the occurrence of schistosomal hepatosplenic disease in patients with schistosomiasis mansoni. The delayed intradermal test and migration inhibition tests were used to assess the delayed hypersensitivity in patients with BHF and simple intestinal bilharziasis using SEA. All bilharzial patients gave a positive intradermal test. The specificity of the intradermal test using SEA is demonstrated clearly by the negative response in all control groups.


Influence of Trichinella spiralis infection on development of sarcoma-180 ascites tumors. Long-term infection of mice with Trichinella spiralis has been shown to stimuate increased host protection aginst transplantable solid tumors. The present investionation was initiated to determine whether parasitized mice were similarly protected from induction and progression of an ascites tumor. ICR/CD-1 mice were orally infected with 50, 100, 200, 300, or 400 T. spiralis larvae, and subsequently challenged intraperitoneally with 5 X 10(4) Sarcoma-180 (S-180) ascites cells. Animals were observed and weighed daily for development and progression of malignancy. Protection from fatal ascites neoplasia was found to be statistically significant under selected conditions of larval dose and challenge interval. Mice infected with 100 or 200 larvae were more resistant to S-180 progression than both uninfected controls or other infected groups. Protection was observed in groups challenged 2 weeks after nematode intubation but not at 6, 8 or 34 weeks. This finding is in contrast with long-term protection seen previously with B-16 melanoma tumors, and suggests that antineoplastic effects of T. spiralis infection differ for ascitic and solid murine tumors.


The multiplication of Dugbe virus in the Ixodid tick, Hyalomma rufipes Koch, after experimental infection. Nymphs and adults of H. rufipes were inoculated intracoelomically with a Dugbe virus concentration containing 1.5 LD50/0.02 ml. The virus multiplied to a peak titre of 9.3 log10 +/- 0.03 in nymphs and 4.4 log10 +/- 0.02 in the unfed adults. Virus infection persisted during metamorphosis and was passed on to the adults. A blood meal significantly increased the titre of virus in the adults at a probability less than 0.001. Also the tire in the engorged females was significantly higher than that in the fed males at a probability less than 0.05. Dugbe virus persisted for a long time in the unfed adults and a titre of 2.4 log10 +/- 0.06 was obtained in 165 day old adults.


An evaluation of the bovine -- Onchocerca gibsoni, Onchocerca gutturosa model as a tertiary screen for drugs against Onchocerca volvulus in man. In this trial suramin, diethylcarbamazine, trichlorphon, levamisole, mebendazole, melarsonyl potassiu, Hoechst 33258 and tinidazole were administered to cattle infected with O. gibsoni and O. gutturosa to determine the usefulness of this screen in predicting the effect of drugs in man against. O. volvulus except for melarsonyl potassium which was macrofilarticidal against O. gutturosa but not O. gibsoni when cattle were slaughtered 6 weeks after treatment. It was concluded that cattle infected with O. gibsoni are a satisfactory substitute for chimpanzees infected with O. volvulus, as a tertiary screen for drugs against O. volvulus, but that their use would be restricted to centres in O. gibsoni endemic areas where the necessary facilities and specialised knowledge required to use cattle as experimental animals exist.


A histological investigation of skin lesions in onchocerciasis patients from Southern Togo. Specimens from unselected populations in an area of hyperendemic onchocerciasis were used to describe and quantify histological changes in the upper layers of the dermis and the findings were compared with the macroscopical lesions observed. 553 persons, the inhabitants of two villages in Southern Togo, were examined. 502 biopsies were processed histologically. Onchocerciasis prevalence was over 75% and macroscopical skin lesions were evident in 30--40% of the population examined. Histological changes typical for the infection existed in the dermis in 68.5%. A cellular infiltration was seen in 49%, changes in the elastic or collagenous fibrils in 28.9% of the specimen. The observations are described in detail. Signs of inflammatory as well as primary degenerative changes were seen in biopsies from all age-groups. When microscopic and macroscopic findings are compared, it can be noticed that atrophy may start at an early age without preceeding dermatitis and that inflammatory reactions may occur at all ages. After submersion in saline for 24 hours not all microfilariae had emerged from the skin snips as evidenced by the histological examination. In 12.1% of those that otherwise would have been diagnosed as negative, microfilariae were identified in the sections.


A case of bilateral gynandromorphism in Simulioum soubrense Vajime and Dunbar (Diptera: Simuliidae). A bilateral gynandromorph of Simulium soubrense Vajime and Dunbar, one of the vector species of the S. damnosum Theobald complex, is described as part of a continuing study of the morphology and taxonomy of the West African vectors of onchocerciasis.


Absence of antiarrhythmic effects of helium in patients with spontaneous premature ventricular beats at rest. Six patients with spontaneously occurring arrhythmias were studied to assess the antiarrhythmic properties of helium. The patients were divided into two subgroups breathing air, helium-oxygen (heliox), and nitrogen-oxygen (nitrox) in an alternating sequence during successive 20-min periods under continuous ECG surveillance at rest. There were no significant reductions in spontaneously occurring premature ventricular beats while breathing heliox, compared to breathing air of nitrox. Alternating the breathing gases in this manner caused no change in plasma concentration of electrolytes or in activity of serum glutamic-oxaloacetic transaminase or lactic acid dehydrogenase. We conclude that helium does not affect spontaneously occurring chronic premature ventricular beats in conscious resting man when it is breathed for a period of up to 20 min.


Increased blood-brain barrier permeability to tetracycline in rabbits under dysbaric conditions. Alteration of the blood-brain barrier (BBB) by dysbaric exposure may have relevance in several areas of hyperbaric medicine. Drugs administered to persons exposed to dysbaric conditions, e.g., divers, compressed air workers, may penetrate the brain in amounts that could produce toxic or undesirable effects. Modification of the BBB may also have pathogenetic implications in decompression sickness. Furthermore, increased BBB permeability to certain potentially useful antitumor agents, antibiotics, and other compounds under dysbaric conditions may provide the basis for a new therapeutic approach. This report concerns the influence of dysbaric exposure on BBB permeability to an antibiotic. Tetracycline (5-40 mg/kg) was intravenously injected in 22 experimental rabbits (subjected to air compression-decompression) and 17 controls (kept at ambient pressure). Fluorescence microscopy and spectrometry revealed significantly greater tetracycline concentrations in 72.7% of the experimental brains. With the 5 mg/kg dose, the mean tetracycline concentrations was 0.17 micrograms/g in control brains and 0.33 micrograms/g in experimentals. These results indicate that dysbaric exposure increases BBB permeability to tetracycline. It appears that BBB alteration is related to intravascular gas bubbles but is independent of the development of decompression sickness. The conclusions of this investigation are pertinent to brain pharmacotherapy and may provide some new insight into the mechanism of decompression sickness. They also point to potential risks connected with drug administration under dysbaric conditions that can alter BBB permeability.


Ketamine and thiopental sleep responses in guinea pigs in hyperbaric helium-oxygen. One-hundred twenty three guinea pigs, randomly divided into four groups, were exposed to the following normoxic environments: Group I, 1 atmosphere absolute (ATA) air; Group II, 1 ATA helium-oxygen (heliox); Group III, 20 ATA heliox; and Group IV, 31 ATA heliox. Each group was divided into five subgroups; each subgroup received a different and graduated intravenous dose of ketamine in one of these environments. An additional 172 guinea pigs were exposed either to 1 ATA air or 31 ATA heliox and given thiopental. The duration of sleep, determined by failure of the animals to right themselves, was then used to construct dose-response curves for the two drugs in the hyperbaric environments. Results demonstrated less pressure antagonism of anesthesia with ketamine than with thiopental. For both drugs, pressure not only increased the dose required to induce sleep but also decreased the duration of sleep, when it occurred, by as much as 50% compared to effects of the same doses at surface pressure.


Influence of increased gas density and external resistance on maximum expiratory flow. The effect of external resistance on the relationship of expiratory air flow and intrathoracic and mouth pressure on subjects breathing gas of increased density was investigated. Five subjects breathing air performed multiple maximum forced expiratory maneuvers through orifices of various sizes at 1, 4, and 7 ATA in a standard double-lock compression chamber. Measurements of flow and pleural, mouthpiece, and transpulmonary pressures were made, and flow-volume and pressure-volume curves were constructed and analyzed at 75, 50, 35, and 25% of vital capacity. At each lung volume, maximum flow could be maintained until a certain orifice size was reached. This "limiting orifice" was 7.5--10 mm in diameter and did not change with lung volume or density. Under the conditions studied, this finding leads to the conclusion that the flow-limiting segment of the lungs behaved as a rigid orifice less than 10 mm in diameter. Orifices slightly larger than the limiting orifice increased pleural pressure, as expected, but transpulmonary pressure decreased while the flow remained stable, which indicates that airway compression may be lessened by increased intra-airway pressure.


Prolonged oxygen exposures in immersed exercising divers at 25 fsw (1.76 ATA). Twenty-four oxygen exposures lasting 80 to 271 min were performed by six immersed exercising subjects at 25 fsw (1.76 ATA) in both warm and cold water. Two types of exercise were performed, moderate work (50 watts) for long periods of time, and graded exercise (25-150 watts) lasting 85 min. In 21 degrees C water, moderate exercise lasted 228 +/- 39 min, with a mean VO2 of 1.72 +/- 0.11 liter/min. In 4 degree C water, the duration was 163 +/- 22 min, with a mean VO2 of 1.83 +/- 0.16 liter/min. The differences in duration of oxygen exposure in warm and cold water reflect termination at an inspired PCO2 of 7.6 mmHg, a level reached earlier in cold water because of CO2 absorbent exhaustion. In 21 degrees C water, the VO2 for graded exercise ranged from 1.51 to 3.00 liter/min and in 4 degrees C water, from 2.00 to 3.16 liter/min. Central nervous system oxygen toxicity was not observed during these exposures, although two divers had clinical and spirometric evidence of early pulmonary oxygen toxicity. The absence of CNS oxygen toxicity is attributed to low resistance and minimization of dead space, which caused a low inspired PCO2, although the divers' experience with oxygen diving and their excellent physical condition may have contributed as well.


The square-root principle in the calculation of one-stage (no-stop) decompression tables. A square-root formulation, square-root time x excursion depth = k, developed at the Royal Navy Physiologic Laboratory (RNPL) predicts the safe duration of air excursions at 1 ATA for periods up to 6 h (air) and up to 3 h (heliox atmosphere). At pressures above 1 ATA, the value of k was initially considered to be proportional to Haldanian multiples of ATA and not to the square-root ATA used in this paper. Excursions of infinite (infinity) duration can also be predicted from a square-root formula derived from the systematic heliox saturation excursions conducted at the Experimental Diving Unit in which net excursion depth = k square-root P abs. This paper presents a broad spectrum format that extends the square-root principle: 1) to values of k above 1 ATA in the RNPL formula and 2) to excursions for (infinity) time from habitat depths to 820 ft; and 3) which demonstrates a relationship between fractional time excursions and excursions for infinite periods of time. Application of the generalization that net excursion depths are proportional to square-root P abs would reduce to a minimum the number of programmed test dives and would, in addition, allow such dives to be conducted at relatively low pressures, with only occasional validating tests at deep depths.


Effect of helium/nitrogen/oxygen mixtures on HPNS convulsion threshold in euthermic rats. This study compares the effects of various so-called trimix mixtures (10, 20, and 40% N2 in He-O2) on the convulsion threshold pressure (Pc) and EEG activity in 60 adult male Wistar rats with chronically implanted electrodes with those in 20 rats in He-O2 only. Restrained animals were individually compressed with trimix mixtures at 80 or 160 atm per hour to a simulated depth  of 138 ATA; colonic temperature was maintained at normal levels. Pc was defined as the initial occurrence of overt sustained generalized tonic-clonic seizures, accompanied by typical "spike and wave" patterns in all EEG leads. As in man, in rats trimix increased the depth of the onset of HPNS tremors and myoclonic jerks in all six groups of rats. However, the Pc of the trimix groups was no different from the Pc of the helium-oxygen group (113 ATA), and at 40% N2, rats showed EEG seizures but no overt convulsions. These results are discussed in relation to those of other studies showing the extension of Pc in mice and monkeys attained by adding narcotics to heliox; the paper also considers the relevance of method of compression, addition of nitrogen, core temperature, and species differences, as well as the need for EEG measurements and direct observation of overt convulsions as indicators of an effective antagonism of HPNS.


Equivalent air depth: fact or fiction.

Equivalent air depth: fact or fiction. In mixed-gas diving theory, the equivalent air depth (EAD) concept suggests that oxygen does not contribute to the total tissue gas tension and can therefore be disregarded in calculations of the decompression process. The validity of this assumption has been experimentally tested by exposing 365 rats to various partial pressures of oxygen for various lengths of time. If the EAD assumption is correct, under a constant exposure pressure each incremental change in the oxygen partial pressure would produce a corresponding incremental change in pressure reduction tolerance. Results of this study suggest that the EAD concept does not adequately describe the decompression advantages obtained from breathing elevated oxygen partial pressures. The authors suggest that the effects of breathing oxygen vary in a nonlinear fashion across the range from anoxia to oxygen toxicity, and that a simple inert gas replacement concept is no longer tenable.


Cerebrocortical necrosis in ruminants: effect of thiaminase type 1-producing Clostridium sporogenes in lambs. Large numbers of orally inoculated thiaminase type 1-producing Clostridium sporogenes failed to establish in the alimentary tract of two conventionally born lambs. Conversely, when similar inoculations were given to two gnotobiotic lambs, large populations of Cl sporogenes established in their rumens and correspondingly high levels of thiaminase were produced. No clinical symptoms of thiamine deficiency or cerebrocortical necrosis were seen despite the presence of high levels of thiaminase in the rumen of one of the gnotobiotic lambs for a period of 86 days.


The application of new ideas on the protein requirements of the dairy cow. The intake of undegradable dietary protein in a cow's early lactation may be a major factor in determining peak yield. The natural degradability of proteins varies with different feedstuffs. Maturity of crop, use of additives, drying or grinding all affect the degradability. Time spent in the rumen is an important factor in the amount of protein degraded.


Prediction of the protein requirements of farm ruminants and implications of these predictions for diet formulation. Methods of determining protein requirements are reviewed and recent proposals of the Agricultural Research Council working party on nutrient requirements of ruminants outlined. Needs of the rumen microorganisms for degradable nitrogen to achieve optimum rumen digestion of feed are predicted. The extent to which milk production and live-weight gain can be sustained by microbial protein alone is estimated. Higher milk yields and rates of growth require dietary protein that escapes degradation in the rumen but is digested in the small intestine. Small changes in degradability of dietary protein are predicted to have a large effect on the dietary crude protein requirement. Although there is still inadequate data for precise prediction, the concepts of the metabolic approach have been valuable in understanding those physiological situations where protein is most likely to be limiting, where use of protected proteins and urea might be most appropriate, in the planning of critical experiments and in the design of new methods of feeding or management of ruminants.


Epidemiological investigations on viral hepatitis in preschool and school communities. Note III. Sources of infection for HBsAg carriers and former viral hepatitis patients. HBsAg carriers and viral hepatitis B patients detected in preschool and school communities as well as members of their families were subjected to thorough epidemiological investigations. The source of infection was represented by the community in 33.3% of the preschool children and in 26.5% of the schoolchildren and by the family in 10% of the former and 29.4% of the latter.


[Computer tomography: physico-technical basis, indications and clinical application (author's transl)]. The increasing use of whole body computerized tomography in daily radiological routine work has revolutionized the diagnosis and treatment of several diseases. The clinical importance of computerized tomography (CT) is discussed on the basis of the first 1000 examined patients. While CT of the head is an already well-established method which surpasses all other diagnostic means as regards reliability and accuracy in the detection of space-occupying lesions, this cannot be stated for other parts of body. But CT already holds a leading position in the diagnostic work up of patients with space-occupying lesions both in the retroperitoneum including pancreas, kidneys and pelvic organs, and in the proof of nodular peripheral lung metastasis and tumours of the mediastinum. Surprisingly, CT shows osteoblastic and osteolytic bone metastasis earlier than any other method, including bone scintigraphy with radio-isotopes. These first results are very encouraging, although any statement about the importance of CT in clinical routine work and comparison with other methods, holds only for a short period of time. Changes in technology, improvement in diagnostic facilities permit no statement for good.


[Mammography of non-palpable lesions (spot localisation) (author's transl)]. Modern methods of mammary investigation currently enable the detection of tiny-tumours which are not clinically palpable and referral of these patients to surgery at an early stage. This poses a challenge to the surgeon, who cannot rely on palpation as a guide to accurate extirpation of the tumour, but has to rely wholly on the radiological report. A method was, thus, worked out in this department to provide accurate evaluation of the position of the suspect area of the breast to facilitate operative measures and, furthermore, act as safety measure between the time of tumor biopsy and receipt of the histological report. Preparation radiography proves that the suspect area on mammography is identical with removed specimen. The advantages of this procedure are obvious. The surgeon can rely fully on the radiodiagnostic findings and enlist the radiologist as essential member of the therapeutic team. As a result the operative procedure can be finely gauged by the surgeon and the tumour removed with maximum sparing of healthy breast tissue. This procedure has produced excellent results in 35 patients and can be recommended for application to patients with tiny tumours.


[The involutional breast in mammography (author's transl)]. There is no uniform image of the involutional breast. Different mechanisms of involution of the breast lead to variable findings on clinical examination, mammography and thermography. A description is given of common findings since it is necessary to recognise the various physiological forms as prerequisite for their differentiation from pathological findings.


[One year's experience of a mammography unit (author's transl)]. 3035 examinations were performed at the newly-opened Mammography Unit of the Department of Radiology, Semmelweis University, Budapest in 1976 and 1977. Most of the examined persons presented themselves voluntarily and had some kind of complaints. 153 cases of breast cancer were detected and operated. 86% of the breast cancer patients had objective signs.


[Results of combined radiological and endoscopic investigation of the stomach (author's transl)]. In 817 patients who were subjected both to X-ray examination and endoscopy of the stomach, the diagnosis was verified histologically. The radiological findings were confirmed in 86% of the cases and the results of endoscopy were verified in 89% of cases. The diagnosis of gastric ulcer was confirmed by X-rays in 87% of cases, by endoscopy in 95%. 88% of the malignant tumours of the stomach were discovered on X-ray examination and 89% through endoscopy. The diagnostic results of X-ray examination to detect carcinoma of the gastric stump or of an anastomosis were somewhat poorer. With optimal technique the results of radiodiagnostic examination are hardly inferior to those of endoscopy. There are advantages and disadvantages inherent in both techniques but they are of a different nature so that the two methods are by no means competitive; indeed, they are complementary and a combination of both methods yields maximum results. X-ray examination offers considerable advantages if it is carried out before endoscopy.


[Graphic representation of normal and pathological pregnancies by means of an ultrasonic-growth curve of the amniotic sac and of the biparietal diameter (author's transl)]. A diagram is presented which enables the continuous recording of biometric values from the earliest possible time right up to the end of pregnancy. It has been tested in practice. The duration of pregnancy and fetal development and growth can be evaluated from the diagram.


[New bacteriological results with Co-trimoxazole (author's transl)]. The current situation regarding resistance to cotrimoxazole and trimethoprim as well as the selected ratio of our combination and the resulting proportions of the two components in body fluids and tissues are discussed. Special attention will be paid to the relevant synergy in the respective proportions. Data on the development of resistance towards co-trimoxazole obtained from London, Zurich, Hamburg and Austria will be presented. In general, however, in Zurich a slight increase in resistance to staphylococci, Klebsiellae and Serratia can be seen. If we take an investigation in Hamburg as an example, we can show the importance of distinguishing between infectious hospitalism and a genuine development of resistance. Reference is made to Austria, because of claims that the resistance problem would be improved by combination with another sulfonamide (sulfametrole). The situation in Austria resembles that in Zurich. In order to deal with the problem as to whether the risk of the development of resistance to co-trimoxazole is still as significant as 10 years ago, the resistance frequency towards TMP alone will be further analysed. The chromosomal as well as the plasmidic transferable resistance is on slight increase in England, France and Italy. However, susceptibility to the combination has not yet adversely influenced. Accelerated deterioration of the susceptibility could occur if TMP alone were introduced in more countries. However, 30-50% of TMP-resistant organisms are still susceptible to sulfonamides and remain therefore sensitive to a strong synergistic influence of the combination, which is shown in many instances. As a result of various chemico-physical properties different ratios of both components, SMZ and TMP occur, in body fluids and tissues which differ from that in the plasma. However, many of these ratios are comprised by the large range of potentiation of the combination against many pathogens. A more complete synergistic inhibition however, would be achieved by the development of new supplementary combinations.


[Carcinoma of the uterus in the Austrian mortality statistics. 1. Carcinoma of the uterus in Viennese autopsy reports 1976 (author's transl)]. The official mortality statistics in Austria fail to report the localization of uterine cancer in nearly two thirds of cases and, thus, the annual death rate of women with cervical versus endometrial cancer is not clear. These two diseases behave totally differently with regard to their aetiology, age distribution, early diagnosis, therapy and prognosis and, therefore, a separate analysis is necessary. This study presents an analysis of the incidence of uterine cancer in a series of 7,276 women who died in Vienna hospitals in 1976. Of the 151 cases (2% of all the women in the examined collective) 106 died of cervical carcinoma, 33 of endometrial carcinoma and 9 of unspecified uterine carcinoma. The average age of women who died of cervical carcinomas was 60 years, whilst that of patients with endometrial carcinoma was 71.7 years. In 12.6% of cases double carcinomata were found. The relation between deaths from cervical carcinoma to endometrial carcinoma is 3.3:1. If this ratio is applied to the 942 deaths from uterine carcinoma in 1976 in Austria, then one can estimate that more than 700 women must have died of cervical carcinoma and more than 200 of endometrial carcinoma. The 303 deaths from cervical carcinoma and 65 from endometrial carcinoma reported in the official mortality statistics are, therefore, totally misleading and ought not to be used as a basis for epidemiological investigations.


[Amenorrhoea and hyperprolactinaemia (author's transl)]. Prolactin was determined by radioimmunoassay in the serum of 112 patients with primary or secondary amenorrhoea. 21 cases showed hyperprolactinaemia with levels above 25 ng/ml (18.7%). 10 patients with levels between 25 and 50 ng/ml showed heterogeneous clinical features. In nine women (8%) the prolactin level was above 100 ng/ml; they all had severe amenorrhoea. As a result of treatment with bromocriptine menstrual bleeding occurred in 4 out of 7 cases and 2 of these patients became pregnant. In 3 cases prolactin did not return to normal levels and in 2 out of these patients microadenomas of the pituitary gland were diagnosed by special methods. They were removed surgically by the transsphenoidal approach.


[Hormonal and functional parameters in hyperprolactinaemia (author's transl)]. 58 women with raised serum prolactin levels and normal hypophyseal-X-ray parameters were subdivided into three groups according to the serum prolactin level (16 to 40, 41 to 80, greater than 80 ng/ml). In addition to the determination of LH, FSH, oestradiol, progesterone and testosterone in the serum and thyroid diagnostic procedures the following hormonal tests were performed: 1. response to gestagen; 2. response to clomiphene; 3. Gn-RH-test for hypophyseal function; 4. ovarian response to administered gonadotropins (only in cases with prolactin levels greater than 80 ng/ml). The grade of menstrual cycle disorders depends on the severity of the observed hyperprolactinaemia. Slight disorders like luteal phase insufficiency, anovulatory cycle and oligomenorrhoea are associated with low- or medium-grade hyperprolactinaemia. Mainly secondary, but also primary amenorrhoea is found in cases with higher serum prolactin levels (greater than 80 ng/ml). In these cases the hypophyseal response to Gn-RH is frequently found (61%) to be negative and, moreover, the ovarian response to administered gonadotropins seems to be diminished. Increasing HPRL levels often appear to be associated with a negative response to the other above-mentioned tests.


[Does myocardial damage arise as a result of administration of tocolytic drugs? (author's transl)]. Fifty pregnant women admitted consecutively on account of threatened abortion or premature labour and treated with Ritodrine and Verapamil intravenously in the usual dosage were investigated with respect to creatine kinase activity and, in the event of a raised level, its isoenzyme creatine kinase--MB. Determinations were carried out before treatment and, in accordance with expected peak values in case of myocardial necrosis, after 6 and 12 hours. Three pathological values were recorded and these are discussed individually. Furthermore, statistical evaluation of the recorded values showed no significant differences.


[Results of postoperative radiotherapy in breast cancer (author's transl)]. The results are presented of postoperative irradiation in the treatment of breast cancer at the Department of Radiotherapy and Radiobiology, University of Vienna. Our data compare well with the best results reported in the literature. Apart from the importance of high loco-regional freedom from disease for the quality of life of these patients, the related increase in survival prospects is stressed.


[Amniocentesis for antenatal diagnosis. A report on an initial series of 180 cases (author's transl)]. The results are presented of amniocentesis for diagnostic genetic purposes in 180 patients. A diagnosis was obtainable in 170 cases (94%). Genetic abnormalities were detected in 11 cases; one patient miscarried 3 days after amniocentesis. Antenatal diagnosis of certain genetic disorders can be considered a routine method nowadays and should be offered to any woman at risk. It therefore seems necessary to supply the practitioners with the relevant information on this topic.


[Hexoprenalin as a tocolytic drug (author's transl)]. Hexoprenalin, a betasympathomimetic drug, was tested with respect to tocolytic effect and cardiovascular side effects. The dosage varied according to the obstetrical situation and the resultant indication for tocolysis. "Long-term tocolysis" in the prophylaxis of premature labour was indicated when more or less rhythmical uterine contractions were present without any effect, as yet, on the cervix. The dosage was 0.075 microgram/min hexoprenalin intravenously as long-term infusion using a motor pump. In a collective of 20 patients in the last trimester of pregnancy the tocolytic effect was satisfactory, the mean rise in fetal heart rate being 2.43% and the mean rise in maternal heart rate 4.13%. Massive tocolysis to inhibit effective premature labour was indicated when rhythmical uterine contractions had already exerted an effect on the cervix. The dosage was 0.33 microgram/min hexoprenalin intravenously in form of a long-term infusion using a motor pump. In a collective of 20 patients in the last trimester of pregnancy the tocolytic effect was satisfactory, the mean rise in maternal heart rate being 33% and the mean rise in fetal heart rate 3%.


[The double-chambered right ventricle (author's transl)]. Report on two girls with an obstruction within the right ventricle beneath the infundibulum. A muscular band - probabaly the abnormally situated moderator band - emerges at right angles from the ventricular septum, crosses the lumen and ends at the anterior wall of the right ventricle, thus separating a high-pressure inflow chamber from a low-pressure out-flow chamber. The latter compartment is distinctly larger than the infundibular chamber in Fallot's tetralogy. In bt connecting the left ventricle with the hig-pressure compartment. In one patient an increase of severity of the obstruction could be documented; this child showed a subvalvular membranous aortic stenosis. The diagnosis has to be established by meticulous pressure recording between pulmonary and tricuspid valve and by dye injection into the right ventricle. Ventricular septum defect (in 80%), subvalvular aortic stenosis (in about 10%), pulmonary valvular and peripheric stenosis  and open Ductus Botalli are the most important accompanying lesions. The malformation - not diagnosed prior to surgery - causes serious trouble during operation. The investigator thus has to be aware of this condition in every pulmonary valvular ahd subvalvular stenosis especially when accompanied by a ventricular septum defect.


[Responsibility of the radiologist in gastric studies]. The radiologist's responsibility for the investigation of the stomach. The most successful results in the gastro-intestinal examination is obtained by combination of ray-examination (double contrast method) with gastroendoscopy and biopsy. It is of main importance, that the X-ray examination is performed at the beginning of all diagnostic step. The radiologist is obliged to use the best examination method. Therefore an economic standardized process of diagnosis is recommended which can take place also at the radiologist's consulting room. The high accuracy which can be reached by the recommended proceeding justifies the little additional expenditure of time and material.


Kinetic properties of the purified 3-hexulosephosphate synthase from Pseudomonas oleovorans. The kinetic characteristics of the purified 3-hexulosephosphate synthase from the facultative methylotroph Pseudomonas oleovorans were investigated. It could be demonstrated that the dependence of the reaction rate on the rib(ul)ose-5-phosphate as well as the formaldehyde concentration has a complex shape with the appearence of plateau and trough regions. The shape of the curve is changed in dependence on the fixed level of the second substrate. Multiple forms of the 3-hexulosephosphate synthase were found to be responsible for the generation of the complex kinetic characteristics. By means of ion exchange chromatography it was possible to separate four active enzyme forms with different kinetic characteristics. These forms were also found to be interconvertible. This behaviour of the 3-hexulosephosphate synthase is assumed to have the main regulatory function of the enzyme.


Substructural studies on sporulation of Saccharomycopsis lipolytica. During sporulation of diploids from crosses between different strains of the yeast Saccharomycopsis (Candida) lipolytica irregular numbers of ascospores per ascus have been observed. Using the serial section method it could be shown now by means of electron microscopy that in one-, two-, and three-spored asci unenclosed "naked" nuclei occur additionally to nuclei incorporated in mature spores. It was demonstrated that the production of less than four spores per ascus in this yeast is not the result of a lack of meiotic products but of the nonutilization of nuclei from meiosis. In 2--4 spored asci usually four products of meiosis in form of enclosed and free nuclei could be demonstrated which indicate a normal meiotic division. All ascospores derived from asci with different spore numbers are uninuclear. It is assumed that a defect in spore formation caused by structural changes of chromosomes or aneuploidy should give rise to the occurrence of non incorporated nuclei and spore irregularity. It was concluded that meiosis and spore formation in Saccharomycopsis lipolytica seem to represent parallel and coordinated processes which generally resemble those recorded for Saccharomyces cerevisiae and Hansenula species.


Urinary concentrating processes in vertebrates. Avian and mammalian kidneys can produce a urine hyperosmotic to the blood by means of a renal countercurrent system. Birds are uricotelic; mammals are ureotelic. It is proposed that the inner medulla present in mammalian, but not in avian kidneys serves specifically to accumulate urea in the inner and outer medulla. Among mammalian kidneys the degree to which urea accumulates in the inner medulla is inversely related to the complexity of the vascular bundles (in the outer medulla) and the cortical urea recycling index. A model is proposed for urea recycling via the vascular bundles. The renal pelvis varies in size among mammals. Its relative size is unrelated to the type of vascular bundles, cortical recycling index; or urea accumulation in the inner medulla. Since urine refluxes into the renal pelvis during rising urine flow only, the function of the pelvis could be that of bringing the more dilute urine into contact with the outer medulla and underlying capillaries, thereby aiding in reducing the urea concentration in outer and inner medulla during rising urine flow. The size of the renal pelvis may be related to the volume of the inner medulla. Other factors may also be involved.


The vertebrate urinary bladder: osmoregulatory and other uses. The bladder may serve more biological uses than simple storage. The importance of bladder functions can be inferred from its presence among vertebrates, its anatomy and histology. From an evolutionary perspective, bladders have evolved at least twice in the vertebrates. The variability of permeability of the urinary bladder to water and solutes among species is discussed. Finally, the urinary bladder may play an osmoregulatory role.