In vitro production of sterioid cataract in bovine lens. Part I: measurement of optical changes. Fresh calf lenses were incubated in nutritive media, to which was added ouabain and dexamethasone phosphate at concentrations of 1 X 10(-4) M. At the end of a three day incubation period, cortical opacification developed in the control series of lenses as well as those lenses incubated in both ouabain and dexamethasone phosphate. Using a light transmission device which quantitates lens opacification, it was noted that dexamethasone produced a level of cortical opacification significantly greater than that of the control series. Ouabain produced a level of cortical opacification statistically identical to that produced by the dexamethasone. It is suggested that the aforementioned light transmission device is an accurate and reproducible method of quantitating cataractous opacification.


Sliding of epithelium in experimental corneal wounds. A scanning electron microscopic study. The morphological changes in the rabbit cornea due to a linear wound and a central keratectomy and its reepithelization were examined under the scanning electron microscopy. After the rounding off and retraction of the edges of the wound, during the first 6 h, the stroma was infiltrated by leucocytes. First of all the superficial epithelial cells migrated over the edges of the wound to protect the exposed cleft in the tissue. After 15 h the basal epitheliel cells sent pseudopodia-like processes of varying lengths into the wound area. The migrating cells were mainly flat. During this phase the primary migration of the basal epithelial cells was followed by subsequent cell layers. In the migration, three types of cells can be distinguished: 1. very flat cells with smooth edges without microprojections, which adapt their shape to the clefts in the damaged stroma, 2. flat cells with considerably folded plasma membrane on the cell surface giving a coral-like appearance, 3. cells with voluminous cytoplasmic processes. The rapidly sliding epithelium covered the defect with star shaped growths so that after only 48 h a nearly complete closure of the wound was achieved. After 96 h the deep wound was completely covered by epithelium. The epithelial cells did not yet possess their original surface structure in that they had demonstrably fewer microvilli and microplicae than normal. Only after five days at the earliest could the normal surface relief be seen. The surface cells were predominant in the first stage of the healing process and the basal cells only in the second stage.


Immunoelectrophoretic determination of tear fluid proteins collected by the Schirmer I test. Using reservoirs containing 50 microliters of antigen solution in combination with a micro-modification of the electroimmunoassay a detection limit of 0.05 ng applied in 400 microliters corresponding to 0.125 ng/ml has been achieved. Tear fluid eluate from Schirmer paper strips has been tested in the assay. The eluation procedure failed to extract all tear proteins as 32 ng were left in the paper. Despite the loss, experiments have shown the method to be suitable for immunological determination of tear proteins collected by the Shirmer I test.


Non-contact specular microscopy of human corneal endothelium. The non-contact specular microscope enables a large area of the corneal endothelium to be examined and photographed without any risk of traumatizing the anterior surface of cornea. This non-contact technique is described in detail. Standard deviation of the relative difference between two independent estimates of central endothelial density from 24 eyes was 3.7%. Standard deviation of the relative difference between counts from left and right eyes from 57 subjects was 4.7%. A significant negative correlation between age and endothelial cell density was found (r = -0.59, P less than 0.001, n = 76). The interindividual variation in cell densities was found to be larger in the old age group, indicating that cell loss during aging varies among different individuals.


Ultrasonic estimation of gestational age and fetal weight. Ultrasonic fast-scanning analysis was carried out during the 2nd and 3rd trimesters of pregnancy. In 1690 cases biparietal diameter, in 784 chest transverse diameter measurements were done and suitable growth charts constructed for the estimation of gestational time. Both the biparietal and chest transverse diameter values were taken into consideration in 582 cases and the results analysed by mathematical methods. A method has been worked out for the estimation of fetal weight with an absolute standard error of 261 g. On the basis of comparative studies it is suggested that obstetrical teams working with ultrasonic devices should establish their own set of parameters and methods.


Development and organization of the personality as a system of regulation. Personality is not only the totality of conscious and unconscious characteristics but the unity of somato-organic and psychic characteristics. The somatic organism is a specific morphological and physiological system of the individual. The psyche is a functional structure developing individually in the course of ontogeny, under the effect of internal processing influenced by the environment. A concept is detailed concerning the structure of the human psyche, the system and nature of the conscious and unconscious functions. The personality is a manifestation of the connections and the formation into a system of the somatic organism and the psyche. This interconnection brings about the socialized humanization of the vital processes in man living in society. A concept concerning the essence of personality is discussed, emphasizing the "actual personality" and describing its structure. Clinical examples are given concerning the interconnection of somatic organism and psyche and of the somato-psychic and psycho-somatic processes. Direction and key of the codes as well as the importance of the meaning of life within the cybernetic system is explained, and conclusions are drawn for the purposes of education.


Urinary osmolarity in late stage nephritis and nephrosis. Urinary osmolarity was studied with the DDAVP test in 30 children in the late stage of glomerulonephritis or nephrosis syndrome, and in 12 control children. A restriction of the concentrating ability of the kidney was demonstrated in the cases accompanied by residual symptoms, in comparison to the healthy children and to the patients in lasting remission. In the cases examined histologically, tubular damage corresponding to the functional change could be demonstrated.


The competence of the infant.

The competence of the infant. In our residential nursery we succeeded in realizing a developmental pattern, in the course of which infants, beginning from the first days of their life, could initiate and accomplish increasingly effective interactions with the adults caring for them, and with the physical environment. Development, preliminary conditions and the importance of competence are discussed.


Urinary excretion of prostaglandin E and F 2 alpha in healthy newborn infants and in infants with hyaline membrane disease. Urinary PGE and PGF 2 alpha excretion was estimated in 11 healthy full-term (mean birth weight, 3327 g; mean gestational age, 39.2 weeks). 15 healthy preterm (mean birth weight, 1722 g; mean gestational age, 32.1 weeks) and in 9 preterm infants suffering from hyaline membrane disease (HMD) (mean birth weight: 1454 g, mean gestational age: 31 weeks). Measurements were carried out on the 1st, 3rd and 5th days of life by radioimmunoassay, using Clinical Assays Inc. RIA kits. Urinary PGE excretion on the first day of life was 3.76 +/- 0.41 ng/day, 2.43 +/- 0.65 ng/day and 1.19 +/- 0.27 ng/day for healthy full-term, healthy premature and premature infants with HMD, respectively. The differences were significant at the level of p less than 0.05. With advancing postnatal age urinary PGE excretion markedly increased in each group (p less than 0.05). Urinary PGF 2 alpha excretion on the first day was 10.8 +/- 2.0 ng/day in full-term, 6.6 +/- 2.2 ng/day in healthy premature and 4.35 +/- 1.9 ng/day in premature infants with HMD. Then an inconsistent rise could be observed without statistically significant difference between the individual groups of various postnatal age and between the different groups of the same postnatal age. The decreased renal PGE production is suggested to be involved in the pathomechanism of HMD.


Successful treatment of perinatal intraventricular haemorrhage. In 18 cases of perinatal intraventricular haemorrhage, continuous ventricular drainage was applied. As a result, ICP hypertension was inhibited and thus brain damage prevented. The early intervention prevented the formation of hydrocephalus (evoidence of shunt dependence) and aspiration of the bleeding prevented DIC and maintained coagulation factors.


The role of the hypophysis in the regulation of the daily rhythm of aldosterone secretion. In 12 patients treated with prednisone for more than two months, the daily rhythm of aldosterone secretion was disturbed during treatment as well as in the first week after discontinuing the therapy. The secretion of aldosterone was at the lower limit of the normal range. The daily rhythm of aldosterone secretion became normal earlier than the rhythm of 17-hydrocorticosteroids, approximately at a time when ACTH secretion became normal. A shift in maximum aldosterone secretion from morning to the afternoon or evening hours was observed in eight patients as early as on the third day of dexamethasone administration. A similar disturbance in the daily rhythm of aldosterone secretion was found in five of six patients with pituitary dwarfism.


Cellular esterase activity: estimation by fluorescein diacetate hydrolysis. Quantitative estimation of cellular esterase activity makes it possible to differentiate cells and cell subpopulations. The fluorescence of fluorescein obtained by hydrolysis from fluorescein diacetate is detected and used for measuring the esterase activity. The method described is suitable for the quantitative determination of esterase activity in human lymphocytes.


Epilepsy and brain abscess.

Epilepsy and brain abscess. Among 22 children who had recovered from brain abscess, 9 later developed epilepsy. Epilepsy developing as a consequence of brain abscess depends on the length of the catamnestic period and the localization of the abscess. The appearance of epilepsy is more frequent after frontal and temporal abscesses and in cases presenting symptoms in the acute phase of the abscess. Since epilepsy may develop years or even decades after recovery from the brain abscess, it is recommended to keep the patient under control for years.


Activation of the bactericidal capacity of blood granulocytes. Evaluation of a new method and the effect of levamisole. In most polymorphonuclear (PMN) bactericidal assays each PMN is given appr. 0.5-4 bacteria to kill but it has not been sufficiently shown that this ratio is optimal for the detection of changes in PMN killing functions. One PMN, incubated with increasing amounts of Staph. aureus, can kill between 45 and 90 colony forming units (CFU). Therefore a new assay, giving each PMN a submaximal bacterial amount (i.e. using 2-4 CFU/PMN) concerning the effects on PMNs of thermal inactivation and of levamisole. Exposure to 46 degrees C for 3-5 minutes decreased the killing capacity, easiest descernable with the standard assay. Incubation with levamisole in concentrations ranging between 10(-6) and 10(-7) mol/l increased the PMN killing capacity, and this was most evident with the modified assay. Thus, enhancements of PMN killing functions might be detected better with the present modified PMN bacterial assay, whereas impairments are disclosed more readily with the standard assay.


Effect of renal vasodilatation on intrarenal blood flow distribution. Total renal blood flow (TRBF) and its intrarenal and intracortical distribution were measured before and during renal vasodilatation induced by acetylcholine infusion using the 133Xe washout, 86Rb uptake and radioactive microspheres distribution techniques. A good agreement was observed between TRBF calculated from 133Xe washout and measured with the electromagnetic flowmeter (FM). 86Rb-TRBF was lower than FM-TRBF and, due to the progressive reduction of renal 86Rb uptake, the difference increased with the increase of flow. With the alteration of TRBF the intrarenal distribution of 86Rb uptake did, however, not change significantly and, accordingly there was no redistribution of RBF either between the cortex and medulla, or among the individual cortical zones. The intracortical distribution of labelled microspheres showed, however, moderate flow dependent changes: with the rise of TRBF, due probably to the reduction of the steric hindrance, the estimated fractional perfusion of the inner cortical zones increased. The sum of the per cent 86Rb content of the innermost cortical zone (C4) and of the medulla exceeded the per cent microsphere content of zone C4. It is concluded that the medulla is perfused not exclusively with blood flowing from the juxtamedullar glomeruli. The regional flow values obtained from the 133Xe curves are not comparable with the results obtained by other methods and cannot be attributed to well defined areas of the kidney.


Intrarenal haemodynamics in postobstructive diuresis in the dog. Intrarenal haemodynamics were investigated in the dog prior to and after relief of 24 hr bilateral ureteral ligation (BUL), by the radioactive microsphere technique. Prior to release of 24 hr BUL there was an about 50% reduction in total blood flow (RBR), with a nearly proprotional decrease in the perfusion of the four cortical layers. Following release of the obstruction, total renal and outer cortical (zones 1 and 2) blood flow remained diminished, while perfusion of the inner (juxtamedullary) layers (zones 3 and 4) increased as compared to its prerelease values and equalled controls. Glomerular filtration rate (GFR) amounted to about 27% of controls in the postrelease phase. A marked increase in absolute and fractional sodium water excretion was observed after release of 24 hr BUL, as contrasted to normal controls and dogs after 24 hr unilateral ureteral ligation (UUL). This state, designated as postopstructive diuresis, might be explained by redistribution of intrarenal blood flow towards the juxtamedullary zones, and by a powerful natriuretic substance accumulated during complete obstruction.


Effect of ethanol on certain metabolic pathways in young R/Amsterdam rats. R/Amsterdam rats were offered a 15% aqueous ethanol solution as drinking fluid from delivery via the milk (Group A) or from the weanling (Group B). Ethanol treatment resulted in a significant retardation of growth in both Groups A and B compared to controls (Group C); the changes were more marked in Group A. Female rats responded to ethanol with higher increase of microsomal G6P-ase and mixed function oxygenase activities than males subjected to the same treatment. Hepatic triglyceride, glycogen and protein contents remained unaffected by ethanol. There was no difference in the changes of liver metabolism between Groups A and B either receiving ethanol already from birth via the milk or only after weanling.


The effect of high mesencephalic transection (cerveau isolé) and pentobarbital on basal forebrain mechanisms of EEG synchronization. A study was made of the effects of high mesencephalic transection (cerveau isolé) and low doses of pentobarbital on the cortical synchronizations elicited in acute immobilized cats by (a) low frequency stimulation of the lateral hypothalamus (HL) and nucleus ventralis anterior thalami (VA) and (b) by low and high frequency stimulation of the laterobasal preoptic region (RPO) and olfactory tubercle (TbOf). The results obtained were as follows: (1) The synchronizations induced by basal forebrain stimulations were found to survive in acute cerveau isolé cats, moreover, even a facilitation of the synchronizing effect were observed. (2) A gradual facilitation was observed upon TbOf and RPO stimulation, while in the case of VA and HL stimulations, the facilitation appeared immediately after the transection. (3) Low doses of pentobarbital depressed the cortical effects of TbOf stimulation, while an increase of the synchronizing effect of low frequency VA and HL stimulation was found. The observations suggested that (i) the synchronizing mechanism in the ventral part of the basal forebrain (RPO and TbOf) differs from that of the thalamus and HL; (ii) the basal forebrain synchronizing mechanism is effective without the contribution of the brain stem; (iii) the mechanism responsible for the synchronizing effect of low frequency HL stimulation is similar as that described for the thalamus.


Plasma corticosterone level of rats after bilateral lesion of the globus pallidus and elimination of the sex-dependence of the body weight loss following pallidal lesion by bilateral adrenalectomy. Plasma corticosterone (CST) level and body weight were studied in male and female rats after bilateral pallidal lesion (GPL). The effect of high dose of glycocorticoids on body weight of food and water deprived, non-lesioned rats was also studied since high CST levels due to the stress caused by the aphagia and adipsia could be anticipated. Weight changes in lesioned-adrenalectomized animals were in investigated as well. A weight loss, higher in males than females, developed after the pallidal lesion and the CST level was higher in lesioned females than in lesioned males. This sex-difference was present in non-lesioned, food and water deprived animals as well. The weight loss was higher in lesioned males than in food and water deprived male/female controls. Adrenalectomy eliminated weight loss differences between the sexes after lesion, by reducing the weight loss in males. CST administration reduced body weight loss in food and water deprived males but not in familes, and cortisol facilitated it in both sexes.


Oxygen uptake capacity of the amphibious fish - Amphipnous cuchia (Ham) (Symbranchiformes, Amphipnoidae). The O2 uptake capacity of Amphipnous cuchia has been determined in relation to standard temperature of 25 degrees C. The measurement of O2 uptake indicates nearly 75% of the oxygen demand to be met through the air breathing organs and 25% by the skin and vestigeal gill through water in a normal habitat. The total VO2 during aerial-aquatic gas exchange is 60.5 ml/kg/hr. The prevention of surfacing resulted in a lower O2 uptake rate (38.29 ml/kg/hr). During submergence, the utilisation of air sacs for extracting O2 by regular pumping of water in and out is peculiar to the fish. Under normal respiratory conditions (air + water), the slope for O2 uptake through air is 0.72, 0.23 for water and 0.57 for both air + water. The average ratio borne by the fish for aquatic/air breathing (ml/kg/min) is higher in fishes below 60 g body weight, and aquatic respiration predominates in fishes weighing less than 6.0 g.


Effect of acute ischaemia on active and passive large deformation mechanics of canine carotid arteries. Large deformation mechanical properties of dog carotid arteries excised following 1 hour of ischaemia and 1 hour of reperfusion were compared to those of contralaterial normal arteries in vitro. Vascular smooth muscle was invariably activated by 0.5 microgram/ml noradrenaline. Relative reduction in the diameter of postischaemia arteries following noradrenaline administration was twice as large (max.: 13.2 +/- 2.0%) as that of normal controls (max.: 5.7 +/- 1.5%) in the pressure range of 0--220 mmHg. If the smooth muscle was totally relaxed there were no differences between the geometrical (wall-thickness, radius) and mechanical properties (stress, incremental elastic modulus, incremental distensibility, strain-energy density) of the arteries in the two series. It is concluded that the increased reactivity of postischaemic arteries is not caused by changes in geometric or mechanical properties of their passive wall elements.


Intrarenal haemodynamics in uranyl nitrate-induced acute renal failure. Intrarenal haemodynamics were investigated in the dog at various intervals after the iv. injection of 10 mg/kg uranyl nitrate (UN). Renal blood flow (RBF), as determined by measuring the renal venous effluent and by radioactive microspheres, decreased by about 23% at 6 hr after UN administration, as compared to normal controls, then rose and reached controls at 24 to 48 hr; subsequently, RBF increased and surpassed controls by about 36% at 96 hr. Thus, the early phase (6 hr) and the late phase (96 hr) of uranyl nitrate-induced acute renal failure (UNARF) were characterized by an increase and by a decrease, respectively, in overall renal vascular resistance. Glomerular filtration rate (GFR) diminished to about 37% of controls at 6 hr, with no change in urinary output (V). In the following hours, however, GFR and V fell quickly and reached practically zero at 12 to 24 hr. Approximate calculations revealed a predominantly preglomerular vasoconstriction in the early phase and post-glomerular vasodilatation in the late phase. Radioactive microspheres showed a nearly proportionate decrease in perfusion of all cortical layers in the early phase (6 hr); in the late phase (96 hr), however, blood flow to the outermost layer remained unaltered, while perfusion of the inner cortical and juxtamedullary layers increased significantly.


Hepatic storage and biliary excretion of rose bengal in the rat. The distribution of intravenously administered rose bengal (RB) depends on its dose. At a low dose (10 mg/kg), RB can be found almost solely in the liver and plasma. However, at higher doses (from 25 up to 200 mg/kg) the amount of RB found in extra-hepatic tissues gradually increases. In this experiment the hepatic transfer maximum of RB amounted to 146 micrograms/kg/min. By increasing the dose from 10 to 200 mg/kg, the hepatic concentration of RB also approached a maximum (1250 micrograms/g). The storage capacity of the liver, however, did not limit the transfer maximum of RB.


[Training of personnel for mental health teams]. The mental disorder is a biopsychosocial phenomenon. Starting from this idea, this paper suggests the active participation of every psychiatric professional with the organizated help of community groups, specially trained in mental health matters. A double social function is obtained by this: 1) programmed public training, and 2) practical performance in the assistence field of the same community. In Chile, in general, two social stratus are distinguished; the european culture (middle and upper class) and the popular aboriginal culture (working and rural class). Both have their own pattern about medicine: the european culture, based on the scientific concept, and the popular one based on the magic-religious thoughts. Between them, there exists a barrier. On the one hand, there is not sufficient scientific medical assistence on a national level; on the other hand, the popular medicine is precarious, but more effective in its social function (low cost, availability, absence of bureaucracy, human contact, comprehensible language of medicasters, etc.). The Integral Mental Health Programme objective, in this point, is to join a minimum of the popular medicine sociological structure with the actions of the scientific medicine. Interaction between these will be produced according to the transculturation principles. Patterns for training the 5 levels of the functions delegation are given.


[Readmissions in a pilot psychiatric ward]. We did this work because the observation shows us a high percentage of readmissions in Psychiatric Services. Alejandro Korn Hospital has 2,306 beds, 98% of them occupied. Of these beds, 104 belong to neurology and 63 to clinic and surgery. In this hospital are the 89.50% of the whole beds of Buenos Aires Province. During the observation women area (where we work) was divided in three admission areas. Evaluation took us the last three months of 1975, and March, April and May of 1976. With Statistics Area's agree, the whole of admissions was proportionally divided in three areas. One of them was our Legal Psychiatric Ward. At the moment of the admission patient's family had to answer some questions we had prepared about causes we were looking for. During this time, 62 persons were admitted and of these, 47 were re-admitted (75.81%). To give up the treatment when the patient left the hospital was the main reason for the high re-admission percentage (76.59%): 61.11% of them gave up the treatment because they had no medical control; 25% because of bad economic conditions, and 13.89% because the patient sometimes interrupted his everyday medication.


[Towards a programmed psychotherapy: narcissistic depression]. The paper discusses the importance of developing specific psychotherapeutic approaches for the different psychopathological syndromes. It is stated that whether Psychotherapy deserves to be considered a science and not as a mere art will depend upon the formulation of goals and strategies in more definitive way, setting aside the general formulas we have up to now. Narcisistic Depression is taken as an example of the possibility of a planned psychotherapy. The psychopathology of depression is reviewed, and it is stated that the syndrome occurs when the following four conditions are present simultaneously: a) Discordance between the Self-representation and the Ideal Ego. b) A pattern of thinking in which the logic of all or nothing is at work. c) Certain traits are taken as if they were the whole Self-representation. d) A mood of hopelessness and helplessness. Several strategies for dealing with these four conditions are presented.


Computer tomography as the primary radiologic procedure in acute subarachnoid hemorrhage. CT was performed in 149 patients with acute subarachnoid hemorrhage and clinical findings consistent with an aneurysm rupture, and was found informative in most cases when performed within one week after the hemorrhage. CT disclosed in 29 per cent of cases other causes for the hemorrhage than a ruptured aneurysm (intracerebral hemorrhage, tumor, trauma, infarct) and an extensive angiographic evaluation could be omitted. In those patients where the hemorrhage was caused by an aneurysm rupture, the distribution of extravasated blood in the subarachnoid space and the brain parenchyma usually indicated the aneurysm location--angiography could thus be restricted to the proper vessel. These capabilities of CT are sufficient to economically motivate its routine use as the primary investigation in cases with an acute subarachnoid hemorrhage.


Porto-systemic collaterals in cirrhosis of the liver. Selective percutaneous transhepatic catheterization of the portal venous system in portal hypertension. In 93 patients with cirrhosis of the liver and portal venous hypertension the main tributaries of the portal vein were examined by percutaneous transhepatic catheterization. The appearance and degree of porto-systemic collaterals were analysed. Esophageal varices were demonstrated in 82 patients. No correlation was found between the portal venous pressure and the extent of porto-systemic communications.


Unilateral renal artery stenosis and hypertension. I. Angiography. The preoperative angiographic findings in 43 patients with unilateral renal artery stenosis or occlusion were reviewed in order to record abnormalities such as diameter of stenosis, collateral circulation, poststenotic dilatation and reduction of kidney size. The significance of the various lesions is discussed.


Unilateral renal artery stenosis and hypertension. II. Angiographic findings correlated with blood pressure response after surgery. The findings at preoperative nephroangiography of 42 hypertensive patients with unilateral renal artery stenosis or occlusion were correlated with the blood pressure response following surgery and also with the preoperative renal vein renin activity ratio. A stenosis reducing luminal area by at least 90 per cent (or occlusion) and the presence of collateral circulation are considered to be highly suggestive of renovascular hypertension.


Percutaneous production of renal artery lesions. Experiments in the pig. Percutaneous, intraarterial traumatization of both renal arteries in 4 pigs using the stiff end of a guide-wire resulted in intimal lesions in 7 arteries. At repeat angiography healing was demonstrated in 4 of these arteries, suggesting that spontaneous restitution may be more common than usually believed. Balloon catheter dilatation of 2 stenotic segments initially increased the diameter of the stenoses but at repeat angiography both arteries were found to be occluded. Over-distension of the balloon in the renal artery resulted in pseudoaneurysm in one case and rupture in the other.


Arterial anatomy in the normal larynx and in laryngeal carcinoma. Radiography of specimens. For a correct selection of patients with laryngeal carcinoma for surgery, especially when partial surgery is contemplated, it is important to ascertain the extent of deep tumour invasion. The usual radiologic methods and microlaryngoscopy have shortcomings in this respect. Angiography of normal specimens demonstrated that the arterial anatomy is fairly constant and characteristic. Specimens from carcinoma patients displayed vascular abnormalities related to deep invasion, as demonstrated at microscopic examination.


Calcified periarthritis at multiple sites including lumbar intervertebral discs. Report of a case. A case with calcified periarthritis at peripheral sites and calcification in intervertebral discs gives support to the perception of a distinct disease entity as proposed by SANDSTROM. The possible significance of genetic factors is discussed.


Radiographic appearances in Crohn's disease. II. The course as reflected at repeat radiography. The course and distribution of the lesions in 174 patients with Crohn's disease were evaluated from preoperative films. In the small intestine the course was locally progressive. Colonic disease involved either the right hemicolon or the entire colon. Fluctuations of mucosal lesions were common and could explain the radiographic finding of segmental and left-sided colitis. Variations in the anatomy of the lymphatic system could explain the varying distribution of the lesions.


Excretion of sodium iothalamate at compression urography after furosemide dehydration in the rabbit. Pre-treatment with an optimum dose of diuretic administered in appropriate time relation to the injection of contrast medium can improve urographic quality by increasing urinary iodine concentration as well as diuresis. The doses of contrast medium can probably be reduced.


Bone mineral content in the proximal tibia measured by computer tomography. With a slight modification of the EMI MK1 scanner a sensitive method for examination of the bone mineral content in the proximal tibia was achieved. The method allows an estimation of the amount of trabecular and cortical bone as well as their mineral content. The anatomic structure of the bone substance is demonstrated, differing in osteoporosis and osteomalacia. The reproducibility is acceptable.


Radiography in joint reconstruction with perichondrial grafts. The radiographic findings in 13 joints successfully reconstructed with free perichondrial grafts from the rib are reported. Radiography was performed during a period of 13 to 40 months postoperatively. Definite cortical demarcation occurred after 8 to 11 months and had increased 11 to 16 months following surgery. In 3 cases the final examination of 2 metacarpophalangeal joints and one proximal interphalangeal joint was completed with arthrography which demonstrated that the articular surfaces appeared even although the cortical bone contours were somewhat irregular. The extent of the joint spaces largely resembled that in healthy controls.


Choice of screens in high-speed angiography. In phantom experiments a number of intensifying screens were tested as regards their usefulness for angiography. Film speed was adjusted so as to make possible a constant radiographic exposure despite screen speeds varying by a factor of 3. Thus, screen unsharpness varied considerably. However, it was of no practical importance as long as the radiographic exposure was kept constant. This observation indicates that the modulation transfer function is of limited value in differentiating between screens for high-speed angiography. Likewise, film contrast was of little significance for image quality, as compared with radiographic exposure to the intensifying screens.


Natural antibodies in Pseudomonas aeruginosa infections. Studying 347 sera of 49 patients suffering from Pseudomonas aeruginosa infection the mean titre value (MTV) calculated from the exponent of the binary logarithm of natural antibody (NA) titres, was found suitable to characterize the humoral immune status. As long as the organism is in equilibrium with the infection, the NA level rises. In septic shock, before death or at the development of a massive infection, the NA titre decreases rapidly. The decrease may be due partly to the permeability increasing effect of endotoxin and antigen-antibody reactions exerted on the capillaries. Consequently, in the most severe phase of sepsis, when bacteria enter the circulation less NA is available to fight against them. This might be a cause of the still very high lethality of septic shock due to Gram-negative bacteria. Finally, when applying the MTV one always has to consider that despite its advantages it gives less information than the Backhausz immunogram.


Quantitative determination of staphylococcal B-type enterotoxin with Laurell's electroimmune diffusion method. The quantitative determination of B-type enterotoxin produced by Staphylococcus aureus is described. Pretreating the toxin with formaldehyde, the B-type enterotoxin could be demonstrated rapidly with appropriate sensitivity by Laurell's electroimmune diffusion method. Four to eight hours were required for the examination and 0.25 microgram/ml was the smallest demonstrable quantity of the toxin.


Protective effect of PSK, a protein-bound polysaccharide preparation against candidiasis in tumor-bearing mice. In an experimental Candidiasis of tumor-bearing mice, the administration of PSK resulted in a prolongation of lifespan when mice were treated with PSK before infection or before and after infection. The viable fungal counts in kidneys 3 weeks after infection was found to be less in PSK-treated mice than the control mice without PSK administration. The delayed-type hypersensitivity reaction in infected tumor-bearing mice against Candida dead cells were stimulated to some extent by PSK administration. The fungal proliferation in kidneys of tumor-bearing mice at the early stage of infection was prevented by PSK administration. The experimental results involving chemotaxis and phagocytosis suggest that PSK administration restores or enhances the depressed protection of tumor-bearing mice against Candida infection, mostly due to potentiating the phagocytic activity of macrophages.


Alveolar macrophage dysfunction associated with viral pneumonitis. Viral infections are known to predispose to bacterial infections of the lung. Studies on the virus-induced suppression of pulmonary bactericidal mechanisms have identified the defect with abnormalities in the alveolar macrophage phagocytic system. In the investigation presented herein, we have dissected some of the subcomponents of the phagocytic process and found virus-induced defects in phagocytic ingestion, phagosome-lysosome fusion, and intracellular killing.


Purine metabolism in rat skeletal muscle. 1. Rat skeletal muscle can synthesize purine nucleotides de novo. 2. Nucleotide synthesis de novo was inhibited by approximately 90% in the presence of 1 mM azaserine. 3. Purine nucleotides can be synthesized via "salvage" pathways from purine bases and nucleosides. Under the conditions employed incorporation rates were adenosine adenine inosine/hypoxanthine guanosine guanine. 4. Xanthine was not utilized for nucleotide synthesis.


Comparative metabolism of a new antileishmanial agent, allopurinol riboside, in the parasite and the host cell. HPP-Rib is a potent antileishmanial agent, which has been useful in defining new and unusual purine metabolizing pathways in leishmaniae, in comparison with those in the host. The ribosyl linkage both in the parasite and in the host is resistant to cleavage. In the parasite there is a selective and marked conversion of HPP-Rib to HPP-Rib-5'-P and 4-APP ribonucleotides as well as incorporation into RNA, which does not occur in the host. These findings with HPP-Rib suggest a new chemotherapeutic approach which may be exploited in the treatment of leishmaniasis.


Non-specific stimulant activity of tyramine on isolated intestinal preparations. The effect of tyramine on isolated organ preparations from several animal species has been studied. Contraction of the guinea-pig ileum by tyramine is due to a direct effect on histamine receptors whereas the contractile effect on the rat fundus and rabbit jejunum by tyramine is mediated through 5-hydroxytryptamine receptors. These studies indicate the variability and non-specificity of isolated organ responses and that the effects of tyramine are not limited to adrenergic systems.


Suppressor effects of histamine on SK/SD delayed hypersensitivity reactions in man and on E-rosette-forming cells. The effects of histamine on delayed hypersensitivity cutaneous reactions and on the formation of E-rosettes has been evaluated. In vivo, concentrations of 10(-3.6)M of histamine HCL significantly suppresses the cell-mediated reaction to antigen SK/SD at 24 and at 48 h. In vitro, amine significantly inhibits the formation of E-rosettes in normal subjects. The inhibitory effect is significant at concentrations of 10(-4)M for an incubation period at 37 degrees C of 2 h with lymphocytes. The suppressor effect of histamine in vivo may be mediated by an histamine-induced suppressor factor, while the one in vitro by an increase of intracellular cAMP. No anti-H1 and anti-H2 drugs have been employed but the effects of histamine probably depend on H2-receptors.


Aspirin, salicylate and prostaglandins.

Aspirin, salicylate and prostaglandins. The effects of aspirin, salicylic acid and gentisic acid on the paw swellings in the arachidonic acid-potentiated and in the conventional carrageenan-induced oedema tests as well as on the content of prostaglandin-like activity and leucocyte migration in the exudate of inert implanted sponges in the rat have been studied. It is concluded that aspirin exerts two separate inhibitory effects on prostaglandin formation in vivo, a rapid action of the intact molecule on easily accessible tissues and a later action due to its metabolic conversion to salicylic acid. Salicylic acid inhibits prostaglandin biosynthesis in vivo as the salicylate ion itself and there is no formation of a subsequent 'active' metabolite.


Release of cartilage proteoglycan degrading enzyme activity by thioglycollate stimulated mouse peritoneal macrophages in culture. Media from cultured mouse peritoneal macrophages were tested for cartilage proteoglycan degrading activity using S35-labelled rabbit ear cartilage. Media samples collected at 2-day intervals contained increasing amounts of activity between days two and six. This activity was activated by trypsin and antagonized by chelating agents. The macrophage products induced release of the proteoglycan component of cartilage as determined by biochemical and histological methods without affecting the collagen component. Media from cells incubated with hydrocortisone were devoid of proteoglycan degrading activity.


Influence of prednisolone and L-thyroxine on the changes in collagen metabolism in rats with adjuvant-induced arthritis. In rats with adjuvant-induced arthritis the effects of prednisolone and L-thyroxine on the changes in collagen metabolism were investigated both in the skin and tendon during the acute and chronic phase of the arthritis. In untreated animals with adjuvant-induced arthritis, a decrease in the collagen synthesis accompanied by an increase in the catabolism of collagen and a retardation in the conversion of soluble to insoluble collagen were noted both in the skin and tendon during the course of the disease. Prednisolone was found to accelerate the conversion of soluble to insoluble collagen and to inhibit the enhanced catabolism of collagen in rats with adjuvant-induced arthritis. L-Thyroxine accelerated the conversion of soluble to insoluble collagen in adjuvant-induced arthritic rats more effectively than prednisolone but was less effective with regard to the inhibition of enhanced catabolism of collagen. However, the synthesis of collagen in adjuvant-induced arthritis was improved by both prednisolone and L-thyroxine.


Development of enhanced blood flow responses to prostaglandin E1 in carrageenan-induced granulation tissue. The distribution of cardiac output (c.o.) was measured by the radioactive microsphere method in rats at different time intervals after the implantation of carrageenan-impregnated sponges. The amount of blood distributed to the developing granulomata increased from day 5 after sponge implantation to day 7, but showed no further increase at day 10. A similar pattern in blood flow was observed in the skin covering the granulomata. Injection of PGE1 (100 Ng) into the sponges led to an increase in blood flow, the magnitude of which became gradually larger between days 5 and 10. A similar, though less marked increase in sensitivity to PGE1 was observed in the skin covering the granulomata, PGE1 causing a significant increase in blood flow to the skin on day 10. These changes in sensitivity to exogenous PGE1 may be due to decreasing levels of endogenous PGE and/or maturation of the newly formed blood vessels in the granulation tissue.


Beta-[1-Phenyl-5-bis(beta-chloroethyl)-amino-benzimidazolyl-(2)]-DL-alanine (ZIMET 3164): an immunosuppressant without marked anti-cancer effect. ZIMET 3164 inhibited the growth of sarcoma 180 P, sarcoma 180 G, and Walker 256 carcinosarcoma, but was unable to prolong the survival time of mice bearing Ehrlich ascites carcinoma or the leukaemias L 1210 and LAJ I to a worthwhile extent. The primary and secondarantly suppressed in mice. The drug exerted maximum effect when given on days--2 to +2 relative to antigenic stimulus. Administration exclusively prior to immunization induced only moderate immunosuppression while injection afterwards failed to affect the primary response at all, suggesting that the drug interfers with the afferent limb of immune response. In general, ZIMET 3164 proved to be half as effective as cyclophosphamide, but more effective than chlorambucil.


Inflammatory response linked to oxazolone-indued cutaneous basophil hypersensitivity: effect of different immunomodulator and anti-inflammatory drugs. The potency of cytostatic and anti-inflammatory drugs was tested on the oxazolone-induced cutaneous basophil hypersensitivity (CBH) in mice. The challenge reaction was performed early after sensitization in order to minimize B-cell expression; exudative and cellular infiltration was estimated 6 h, 24 h and 48 h after challenge. The potency of drugs was tested at three different periods of immunization: 2 days before or after sensitization or before challenge. Cytostatics act mainly when cells are being committed, a corticoid acts on inflammation linked to committed cells, NSAIDs show inconstant anti-inflammatory effects on this test. D-Penicillamine and levamisole act in the same depressive profile in normal animals. Thus the CBH model appears to be relevant in studying drug activities on inflammation linked to T-cell expression.


The effect of clotrimazole on human lymphocyte responsiveness to plant mitogens. The effect of clotrimazole, an imidazole derivative with anti-rheumatic properties, on lymphocyte stimulation by phytohaemagglutinin, concanavalin-A and pokeweed mitogen was investigated in an in vitro culture system. Evidence was obtained to show that the drug could either enhance or inhibit lymphocyte stimulation, the response depending on the concentration of the drug in the culture system and the mitogen used, as well as on individual variability. At a concentration of the drug corresponding to therapeutic serum levels, clotrimazole inhibited lymphocyte response to the three mitogens in all the normal volunteers studied. In addition, the effect of clotrimazole on in vitro mitogenic responsiveness of lymphocytes of a group of patients with rheumatoid arthritis taking this drug was compared to that of the proprionic acid derivative, ketoprofen. Patients taking clotrimazole showed a significant reduction in lymphocyte responsiveness, when compared to pre- and post-treatment levels, whereas there was no significant difference in those patients taking ketoprofen. Although cortisol levels tended to be higher in the groups of patients taking clotrimazole there was no correlation between lymphocyte responsiveness and cortisol concentration.


Protection of mice against endotoxin-induced liver damage by anti-inflammatory drugs. Mice were injected with Corynebacterium parvum, which induces multiple granulomas in liver and renders animals hyper-reactive to the lethal effect of bacterial lipopolysaccharide (LPS). Such animals when challenged with LPS developed also extensive liver parenchymal cell damage as estimated by elevated blood asparate transaminase levels and a hypoglycaemia. Treatment with indomethacin, hydrocortisone, dexamethasone, promethazine, metiazinic acid and (+)-catechin ameliorated the liver damage. Hydrocortisone, dexamethasone, promethazine and metiazinic acid also reduced the mortality rate in mice challenged with LPS. Diarrhoea, accompanying the LPS-induced shock, was prevented by the drugs used. Possible agents mediating the hepatotoxic and shock effects of LPS are discussed.


Copper distribution and reactivity in serum following administration of cuprous oxide to rats and guinea pigs. Total serum copper levels produced by the administration of a single dose of cuprous oxide (500 mg/kg) both s.c. and orally to rats and guinea pigs are reported 1, 5, 7 and 24 h after administration, together with caeruloplasmin oxidase activities and changes in the sulphydryl group concentrations. The highest serum copper levels were obtained one hour after oral administration to the guinea pig. Both animal species exhibited increased serum copper levels after s.c. administration and this increase persisted for a longer time than after oral administration. Caeruloplasmin oxidase activity varied in a complex manner and sulphydryl group activity was significantly depressed in all cases except after s.c. administration to the guinea pig. The latter results must be treated cautiously since they may indicate interactions between copper and the test procedures. Analysis of serum fractions separated by electrophoresis indicated that the absorbed copper is mainly transported on albumin. The dissolution of cuprous oxide by amino acids and hydrochloric acid and the absorption of cuprous oxidcations of the results are discussed in terms of their relevance to pharmacological and clinical studies.


Concerning the role of endogenous copper in the acute inflammatory process. The development of two models of acute inflammation (carrageenan-induced foot oedema and pleurisy) was studied in rats after 1 month of a 0.2 p.p.m. copper-deficient diet and after 5 months of a 0.6-0.8 p.p.m. copper-deficient diet. A 'pro-inflammatory' effect of copper deficiency was observed with the 0.2 p.p.m. diet, whilst no effect was evident following the 0.6-0.8 p.p.m. copper deficient diet. These results are briefly commented upon.


Hereditary deficiency of erythrocyte acetylcholinesterase. A 36-year-old white man was found to have low erythrocyte acetylcholinesterase activity. Plasma cholinesterase activity was normal. The propositus had mild anemia and moderate elliptocytosis, but was asymptomatic. A sister, brother, father, and nephew were hematologically normal, but had slightly subnormal red cell acetylcholinesterase activities. There was no exposure to organophosphates, and paroxysmal nocturnal hemoglobinuria was excluded. Mixing experiments failed to demonstrate the absence of an activator or the presence of an inhibitor. The propositus enzyme showed normal kinetics for the substrate and various inhibitors, normal thermostability, and electophoretic migration. Major protein bands of the red cell membrane were normal by electrophoresis. Membrane cholesterol and phospholipid content were also normal. The mild anemia is presumably secondary to the presence of moderate elliptocytosis. The pattern of inheritance of the variant gene is unclear, but the propositus may be homozygous for the abnormal allele, and other family members may be heterozygous.


Effect of zinc on hyperammonemia in sickle cell anemia subjects. An increase in plasma ammonia level in human volunteers on restricted zinc intake, and in zinc-deficient rats, has recently been reported. Inasmuch as zinc deficiency has been observed in sickle cell anemia patients, we measured plasma ammonia levels in such subjects. In this report we document hyperammonemia in sickle cell anemia patients that was corrected with zinc therapy.


Microcapillary agglutination assay for detection of specific antileukocyte reactivity in neutropenic patients. Serum leukoagglutinating activity against the leukocytes of four patients with neutropenia was demonstrated using a modified microcapillary agglutination test. Cells from a panel of donors proved useful in attempting to define the identity of the antigens involved. In one instance anti-HLA-A9 activity could be demonstrated in a patient possessing HLA-A9. In the other three individuals no definite antigen assessment to HLA Series A and B antigens or the Lalezari series of neutrophil antigens could be made. Two of the patients' sera showed cross-reactivity and may be reactive with the same antigen or antigenic group. The microcapillary agglutination test appears to be useful in the evaluation of possible cases of autoimmune neutropenia.


The Chediak-Higashi syndrome: microtubules in monocytes and lymphocytes. Recent investigations of Chediak-Higashi syndrome (CHS) leukocytes have suggested that defective cell function and formation of giant granules may be due to an inability of the cells to assemble microtubules because of an abnormality in synthesis of cyclic 3',5'-guanosine monophosphate (cGMP). In the present study we have examined normal and CHS lymphocytes and monocytes for the presence and frequency of centriole-associated microtubules. No statistically significant differences between the mean numbers of centriole associated microtubules in normal and CHS mononuclear cells could be detected. Results of the study fail to support the hypothesis that microtubule assembly is a fundamental defect in all CHS leukocytes.


The perceptual effects of low-power plus lenses: studies of emmetropic observers. Two studies of the perceptual effects of low-power plus lenses were done on groups of young-adult binocular emmetropic observers. The first study used visual masking to induce short-term perceptual stress in two groups of 10 observers: one group wore plano lenses and the other wore +0.50 D lenses. No significant differences in visual perceptual performance were found between these groups. The second study used a more natural letter-search task and rotated 18 observers through nine lens powers from plano to +1.0 D in +0.12D steps, to form a test of the hypothesis that "critical" lens power benefits individual observers. Other conditions in the study were arranged to maximize the positive effect of short-term wear of plus lenses, if one was found. Results showed neither an overall group benefit from a particular power of plus lens nor an individual lens power that benefited each individual observer. These data showed a strong practice effect over the nine experimental sessions, regardless of lens power, that could account for earlier reports in the literature of positive results from using these lenses.


Disparity between circulating and marginated neutrophils: evidence from studies on the granulocyte alkaline phosphatase, a marker of cell maturity. Since circulating and marginated human granulocytes are in rapid kinetic equilibrium, cells of these two compartments have been considered to be a homogeneous population. Our studies on the relationship between neutrophil maturity and the granulocyte alkaline phosphatase (GAP) activity cast doubt on this assumption. After iv administration of hydrocortisone, 12 male volunteers showed an augmentation in circulating granulocytes of 5730 cells/mm3, accompanied by an increase of band neutrophils from 18% to 33% (p less than 0.001). During this influx phase, the GAP activity decreased by 73% when measured cytochemically and by 28% when assayed biochemically (p less than 0.001 and less than 0.01, respectively). When granulocytes were demarginated by epinephrine, the mean count increased by 38%, accompanied by a rise in the portion of segmented forms from 74% to 79% (p less than 0.005) and by an increase of the cytochemical GAP activity by 24% (p less than 0.01). Exact complementary results were obtained during an excessive transient margination, the hemodialysis neutropenia: bands increased from 24% to 54% (p less than 0.02), while the cytochemical GAP dropped by 40% (p less than 0.005). Thus, our analysis of three situations with an acute transient shift of granulocytes indicates that functionally or chronologially "older" cells have a higher GAP activity, and that the transfer of granulocyte from the circulating to the marginal pool is selective.


Clinical study of corneal response to the wear of low water content soft lenses. The changes in central and peripheral corneal thickness and topography during initial (1st-day) wear, adaptation to, and long-term wear of the DuraSoft lens were monitored in a group of 10 patients. Monitoring was by means of the electronic digital pachometer and the photoelectronic keratoscope (PEK). A variety of physiological responses to lens wear was noted in individual patients, but generally the changes occurring were comparable to those reported for other soft lenses. These changes consisted of an average increase of 5-6% in central and peripheral corneal thickness during the initial phase of wear and 4-5% during adaptation; this was followed by a reduction with long-term wear to 2-3%. Corneal topography was relatively stable throughout the period of the study.


Suprathreshold binocular interactions: the effects of prolonged monocular occlusion. A simple reaction time paradigm was used to study binocular interactions for suprathreshold grating patterns before and after 8 days of constant monocular occlusion. Prior to patching, subjects demonstrated binocular summation for near threshold contrast stimuli and binocular summation and facilitation for high contrast stimuli. After the period of occlusion, the subjects showed binocular inhibition for high contrast stimuli but still demonstrated binocular summation for low contrast stimuli. The effects of occlusion were reversible and appear to be related to an oculomotor imbalance.


Refractive state of the eye of a small diurnal mammal: the ground squirrel. Previous work dealing with the question of whether or not the eyes of small mammals are hyperopic has been restricted largely to the study of nocturnal animals such as the rat. In this study, refractive state of the eye of a small diurnal mammal, the ground squirrel, was measured by retinoscopy and from the electrophysiological response of retinal ganglion cells to grating targets. Both measurements show the squirrel to be emmetropic. We conclude that the refractive state of the eye is not a function of eye size per se, but rather a function of whether the animal is nocturnal or diurnal.


Variation of image vergence with change in object distance for telescopes: the general case. Three formulas are given and derived which can be used to evaluate the relationship between image vergence and object position for any two-lens system and will be very useful in the special case of telescopes. A corresponding formula for afocal telescopes has been published previously. The formulas presented here are applicable to all non-afocal (focal) telescopes, including particular types such as near point telescopes. All that is required for their evaluation is the positions of one pair of conjugate planes, the corresponding magnification, and the lens separation. The formulas can be used to estimate such quantities as a working or useful depth of field and accommodation demand, particularly when the optical system is not used at its design conjugates. A numerical example is presented.


Prevalence of monocular amblyopia among anisometropes. Some 167 subjects showing anisometropia of at least 2 D, were selected from the records of the eye clinic of the Ramathibodi hospital in Bangkok, Thailand and 472 subjects showing anisometropia of at least 1 D were selected from the clinic records of the Indiana University, School of Optometry. The incidence of amblyopia (20/30 or less) was found to be 100% among least meridional hyperopic anisometropes of 3.5 D and greater, and among myopic anisometropes of 6.5 D and greater. Lower levels of anisometropia showed a smaller proportion of amblyopia. Comparable results were obtained for anisometropes computed in terms of mean spherical refractive error. Significant difference was not apparent for the Thai and American groups.


Management of the aphakic patient.

Management of the aphakic patient. Because there are psychological and emotional problems, as well as optical ones, when patients are adapting to aphakic corrections, it is necessary for the optometrist to establish rapport and provide suitable explanations. Suggestions are made concerning discussions about the optical changes associated with use of spectacles, implants, and contact lenses. The author advises the use of a cataract lens package in which a series of lenses is designed prior to cataract surgery.


Antigens and allergens in birch pollen extract. More than 70% of the total allergenic activity of a birch pollen (BP) extract was detected within the first 30 min of extraction. Fractionation of the BP extract by gel filtration and analysis of the eluted antigens by a fused rocket immunoelectrophoresis revealed at least three antigens with molecular weights of about 29 000, and 17 000-10 000, corresponding to antigens Nos. 7-8 and No. 2, respectively, in crossed-immunoelectrophoresis (CIE) and in crossed-radioimmuno-electrophoresis (CRIE). Gel isoelectrofocusing of the pooled allergenic fractions revealed two major protein bands with pI's around 5.6 and 5.7, probably corresponding to antigens Nos.7-8 and No. 2, respectively. Antigens Nos. 7-8 were thermoresistant, while antigen No. 2 was thermolabile. The allergenic activity was determined by prick skin testing and by the RAST inhibition method. More than 90% of the allergenic activity in the fractions was located in the protein peak C (mol. wt. 10 000-17 000) containing antigens 7-8. About 30% of the total allergenic activity of the extract (1:10 w/v) was recovered in the peak C fractions, and only less than 0.5% outside these fractions. Higher allergenic activity was obtained for the peak B fractions (mol. wt. 29 000) by skin prick testing than by the RAST. Peak B contained allergens (antigen 2) distinct from those of peak C by the CRIE and by the RAST. The allergenic material in the low molecular weight fractions of peak D (mol. wt. 2000-5000) was allergenically similar to that of peak C in the RAST. Only weak and even negative skin reactions were observed with the peak D fractions in allergic subjects.


Inhibition experiments with solid phase mite or epithelia in house dust hypersensitivity. The present study was undertaken to verify that mites are not the only allergens in house dust extracts and that other allergens such as cat epithelia can also be responsible for house dust hypersensitivities detected both by house dust skin tests and house dust RAST studies. In order to determine whether mite or epithelia fixed on a solid phase could remove not only the IgE antibodies reactive with the homologous allergens, but also the IgE antibodies reactive with house dust allergens, the authors have absorbed 10 sera of house dust allergic patients with solid phase mite or epithelia. The absorption procedure removed a large part of the IgE antibodies reactive with specific immunosorbent (Dermatophagoides pteronyssinus or cat epithelia) and in the same way the IgE antibodies reactive with house dust immunosorbent. The percentage of RAST inhibition varied from 65% to 92% for Dermatophagoides pteronyssinus and from 65% to 94% for house dust in patients allergic to house dust and mite; the percentage of RAST inhibition varied from 67% to 92% for cat epithelia and from 73% to 90% for house dust in patients allergic to house dust and cat epithelia. This is in accordance with the hypothesis that house dust is not an allergen per se, but rather a complex mosaic of several allergens including mite, animal epithelia, etc.


Allergy to coriander. A case report.

Allergy to coriander. A case report. After 3 years of occupational exposure to powdered coriander - a spice - a woman developed respiratory symptoms of immediate hypersensitivity. Skin tests, nasal and bronchial challenge tests and the RAST were positive to coriander. Column chromatography, enzymatic digestion of the fractions and skin testing suggested that the allergen is a protein.


Nasal smear as a screening test for immediate-type nasal allergy. From a previous sample of 634 students and school children, 115 subjects were selected for a thorough rhinological examination and allergy work-up in order to assess the value of nasal secretion eosinophilia in screening for immediate-type nasal allergy. Part of the subjects had, in the previous study, been found to have secretion eosinophilia and a history of chronic/allergic rhinitis, part of the subjects had either a secretion eosinophilia or a rhinitis history, and part of them had neither a secretion eosinophilia nor a rhinitis history. A significant correlation was obtained between secretion eosinophilia and allergy. Nasal provocation tests correlated with skin tests in 87%, whereas the correlation between nasal provocation tests and Ige determinations in the serum was poorer. Thickening of the maxillary sinus was, when present, usually attributable to infection and not to allergy. Reasons for "false positive or false negative" smears for eosinophils are discussed.


Rates of release of subcutaneously injected antigens in the rat. Comparison of an aqueous preparation with two alum-precipated preparations. Release of antigen E-125 I from the site of subcutaneous injection in male rats was delayed significantly when either of two alum-precipitated preparations containing 1.0-1.2 mg of Al/ml was administered rather than an aqueous preparation. The rates of 125I excretion were similarly influenced being statistically slower through the first week after single doses of the alum-precipitated preparations. The results of these studies strongly support the view that alum-precipitated vaccines offer more protection from system reactions than aqueous vaccines.


Immunotherapy in bee sting hypersensitivity. Bee venom versus wholebody extract. Fifty-six patients with serologically confirmed bee sting hypersensitivity were treated for 1-3 years with either bee venom (BV) (31 patients) or wholebody extract (WBE) (25 per cent of re-exposed patients on BV-therapy showed a diminished reaction and 75% no reaction. Thirty-three per cent of re-exposed patients on WBE-therapy developed an unchanged or worse reaction, 42% a diminished reaction and 25% no reaction at all. An initial rise in BV-specific IgE was observed in BV-treated patients, whereas IgE levels after 1 year of treatment lay significantly below pretreatment values in both treatment groups. BV-specific IgG increased markedly in patients on BV-therapy and decreased slightly in those on WBE-therapy. The initial IgE increase induced by BV-therapy was insignificant in patients with high pretreatment levels of specific IgG-antibodies. Similarly, re-exposed patients with high BV-specific IgG showed no IgE increase, whereas a substantial rise in specific IgE was observed in those with low IgG. On the basis of clinical and serological results immunotherapy with BV is considered to be clearly superior to immunotherpy with WBE.


Mite fauna and fungal flora in house dust from homes of asthmatic children. Mite fauna and fungal flora in the house dust from homes of asthmatic children with positive and negative skin test to house dust allergen and non-asthmatic controls were examined. There was no conspicuous difference in mite species distribution among the three groups. Pyroglyphid mites dominate the mite fauna in house dust more than half of which being Dermatophagoides: D. pteronyssinus and D. farinae. There was no statistically significant difference in numbers between the two species and either species could dominate depending on the conditions of the individual houses. The average number of acarina in 0.5 g of fine dust did not differ statistically among the three groups; however, mite number per square meter floor differed between patients with positive skin test and negative skin test. The results suggest that house-cleaning might influence the possible sensitization of children. The genetic distribution of mould fungi in house dust was largely similar to that of airborne fungi. The average number of fungal colonies detected in 0.5 g of dust did not differ statistically among the three groups. Wallemia with its minute spores may cause sensitization but has so far been insufficiently investigated.


Symptoms of chronic and allergic rhinitis and occurrence of nasal secretion granulocytes in university students, school children and infants. The prevalence of chronic and allergic rhinitis was studied in an unselected population sample consisting of 315 university students and 319 school children. History was taken by questionnaire, nasal appearance was examined by rhinoscopy, and a nasal smear was studied in all subjects. For comparison, nasal smears were also collected from 60 normal infants. Allergic rhinitis complaints were reported by 28% of the students and by 13% of the school children, with no significant difference in sex distribution. The cytological examination revealed secretion eosinophilia in 20% of the students, 28% of the school children, and 22% of the infants. Secretion eosinophilia correlated significantly with allergic rhinitis history, and with nasal mucosal swelling and nasal secretion seen on rhinoscopy. Nasal secretion neutrophilia, which occurred in 47% of the students, 79% of the school children and 97% of the infants, seemed to have an adverse effect on the reliability of secretion eosinophilia as an indicator of active nasal allergy. Possible reasons for the rising prevalence rates of allergic rhinitis are discussed.


Studies on histamine metabolism in intrinsic bronchial asthma. Histamine metabolism was investigated in patients with intrinsic asthma, during the acute phase and in remission, by determination of the urinary excretion of histamine metabolites. During acute attacks the excretion of methylhistamine (MeHi) and 1-methyl-4-imidazoleacetic acid (MeImAA) was significantly increased compared with healthy subjects. The excretion of MeHi was significantly increased during acute attacks compared with remission. The excretion of MeImAA was also increased, but the difference was not significant. The correlation between the excretion of MeHi and MeImAA was highly significant. Corticosteroids, given to some patients during remission, did not affect the excretion of histamine and its metabolites. Smoking and respiratory infection during the acute attacks were both accompanied by increased excretion of MeHi. The results indicate that there is an increased histamine turnover in acute attacks of intrinsic bronchial asthma.


Determinations of penicilloyl specific IgE antibodies for the evaluation of hypersensitivity against penicillin. Results from skin tests and radioallergosorbent test (penicilloyl G and penicilloyl V) were compared in 76 patients with suspected penicillin hypersensitivity and in 22 control subjects without such clinical symptoms. The test results were also correlated to the clinical history of adverse reactions and to the levels of total serum IgE. The overall agreement between skin test and RAST results was 89% in the patient group. Two of the control subjects without symptoms were professionally employed with penicillin production; one of them had circulating IgE-antibodies and the other exhibited positive skin tests. The skin tests were more frequently positive than the RAST test. By means of skin titration some of the skin tests were demonstrated to be false positive. The discrepancy can also be explained by the fact that skin reactions also occur in other situations than IgE-mediated adverse reactions. Circulating IgE-antibodies were not found in any of 23 cases where adverse reactions appeared later than 24 h after the latest penicillin administration. It is concluded that the measurement of circulating IgE-antibodies is a valuable aid in the diagnosis of penicillin allergy.


Asthma and allergy in Finnish conscripts. We studied the occurrence of asthma, bronchial wheezing, allergic rhinitis and atopic dermatitis in 295 young men aged 18-19 years. The relationship of these symptoms to the immediate skin test reactivity was also determined. Symptoms indicating past or current allergy and bronchial wheezing were observed in 36%. The cumulative prevalence of asthma was 2.7%, bronchial wheezing 9% in addition, allergic rhinitis (including allergic conjunctivitis) 20%, and atopic dermatitis (including allergic urticaria) 20%. Positive immediate skin prick test reactions were observed in 50% of the population. Allergic rhinitis was most clearly connected with a positive skin test. This study shows that the respiratory disorders, generally considered to be allergic in origin, and atopic dermatitis are more common in Finland than has been assumed. The results are, however, in accordance with the observations made in other industrialized countries. Susceptibility to asthmatic reactions and allergic symptoms should be taken into account, more so than at present, when mudging the capability of a young man to manage compulsory military service.


[The distribution of material density and mechanical stress in the human radius during bending (author's transl)]. In a hypothetical mechanical system generated by computer, various kinds of loads are applied to 78 human Radii. The torque and bending stresses occuring at the surfaces of 390 cross-sections of the bone, taken from sites spaced at regular intervals along the bone shaft, are calculated and plotted. In this system, a load is rotated around the point of gravity of a cross-section. For each possible position of the load during the rotation, the total stresses occuring at the surfaces of the cross-sections are calculated and the position of the load causing minimal stress is determined. This position will be called "the most advantageous bending-plane". Furthermore, the variation of the cross-sectional surfaces and the moments of inertia are analysed.


A three-dimensional measurement of the human parietal curvature. The three-dimensional measurement of the parietal curvature in Japanese was accomplished with the use of moiré contourography and the sexual dimorphism was observed in it. Principal component analysis was also carried out and 4 important features of the shape of this bone were abstracted. Those were the degree of the curvature as a whole, lateral swellings, bilateral difference and posterior swelling.


Variations in calcanean facets in Indian Tali. The various patterns in calcanean articular facets of 500 Indian tali have been observed and classified accordingly. Type I tali have one flat facet on plantar surface of its head (16%); Type II tali, the calcanean facet were divided into 2 parts by a indistinct or prominent ridge (78%); Type III tali, the calcanean articular facet was partly separated by nonarticular groove and partly by ridge (1%); Type IV tali have 2 articular facets on the plantar surface of head separated by nonarticular groove (3%); and Type V tali have a single facet on the plantar surface of head and this facet was continuous with the posterior calcanean facet (2%).


[An example of gaining a growth function by its increase values (author's transl)]. In continuation of recent investigations of the author into mathematical presentations of organic growth an analytical expression for an increase function is postulated. Based on observations of growth processes by many authors as accumulated by HOEPPE (1959) a 2 term product of higher degree parabolas has a chance as being representative of a more frequent increase behaviour allowing direct integration to the growth function proper. An example is added for means of comparison with formerly developed growth functions.


The transverse head of adductor hallucis. 91 human cadaver feet were dissected to reveal the transverse head of adductor hallucis and measurements of the weights, angles of pull, width of origin and insertions were recorded. The origins and insertions of this muscle were found to differ from standard textbook descriptions. The origin usually includes the deep transverse metatarsal ligaments of the foot, the plantar ligaments of the lateral metatarsophalangeal joints, the intermuscular septa of the third and fourth muscle layers and the fibular syndesmosis of HENKEL (1913). The insertion was found to be usually by fleshy attachment to the lateral border of the oblique head of adductor hallucia. The angle of pull and the adjusted weights (% of intrinsic muscle mass) were found to be highly variable. In addition the transverse head was absent in 6% of the specimens. The function of this muscle is in question and it is likely that it is of little importance in normal foot functions.


[The effect of repeated applications of carbutamide on the embryonic development of the rat (author's transl)]. The present paper will check the effects of repeated applications of the oral "antidiabeticum" Carbutamide (substitute of the "sulfonylurea") on the embryonic development of wistar rats. The agent was given the pregnant animal by the means of a throat sonde at the 5th, 6th and 7th day post coitum suspended in Tween 80 in a dosage of 800 mg/kg bodyweight. In order to value the intrauterine development the following parameters were used: mean implantation rate, resorptions rate, bodyweight of fetuses, statemend of animalies by an accurate inspection of the body surface shape, of the skeleton and the inner organs. The rates of implantation do not differ from that of the control group. The rate of resorption increases dependend on the beginning of the treatment. The later the treatment begins the higher the resorptions rate. The body weight of surviving fetuses is diminished strongly. Damage of the skeleton appears as the presence of 14th ribs at one or each side or as ossifications at the 7th neck vertebra (neck rib). Also this results depend on the beginn of the treatment.


Bursa of Fabricius--mitotic index in the follicles of immunized and non-immunized chicks (Gallus domesticus). The mitotic index in the cortical compartment of the follicles of the bursa of Fabricius from chicks immunized with sheep red blood cells (SRBC) is always higher when compaired with non-immunized ones. This mitotic index reachs its maximum 6 days after the SRBC injection, coincident with the highest serum antibody titer. The mitotic activity in the cortex of the follicles of the bursa of Fabricius is always higher than that of the medulla during the postembryonic development of chickens (PROCHAZKA, RODAK, KREJCI 1967). Otherwise it is almost established that the cortex is a zone of continuous lymphocyte proliferation, not occuring the same with the medulla. In addition these bursal histological structures are considered as 2 distinct compartments (GROSSI et al. 1974). The purpose of this paper is to study the response in the mitotic index of the cortical and medullary compartments of the follicles of the bursa of immunized and non-immunized chicks. To correlate possible changes in the mitotic index with circulating antibody levels, the serum antibody titer from the same birds was also recorded.


[Light-microscopical researches on the olfactory mucosa of the sheep (Ovis aries L.) (author's transl)]. The functional olfactory epithelium of the sheep measures 183.62 cm2 with 302.41 . 10(6) olfactory cells. Their thickness varies between 4 and 9/1,000 micron 2 on an average and achieves in the Ethmoturbinale a unique maximum of 67/1,000 micron 2. In thinly crowded parts of the turbinalia the olfactory cells are mostly differentiated in pericaryon, dendrit, neck and capitulum, whereas in the densely crowded ethmoturbinale there are 4 zones of pericaryons one above the other, there is no neck, the capitula are longishly formed and mostly lie in the epithelium. Plasma conjugations at the basis of the capitula could also be observed. The olfactory ability is promoted by the widespread distribution of the olfactory cells. The certain recognition of mother and youngster should be effected by means of the olfactory sense, like ovis musimon, the primitive form of the sheep, does.


[A macroscopical study of the nervus glossopharyngeus of shark (Mustelus manazo) (author's transl)]. Branches of the Nervus glossopharyngeus of shark Mustelus manazo, one of the most typically retained branchial nerves, is studied macroscopically with a hope of comprehension of its original morphological meanings. There were found some anastomosis among the terminal branches of the Ramus pharyngeus dorsalis of this nerve and those of the Nervus facialis, which, though in the fine caliber of branches, probably could be considered as prototype of the JACOBSON's anastomosis encountered in other vertebrates. In addition to the hitherto reported different content of their nerve components Ramus pretrematicus and posttrematicus of the N. glossopharyngeus of the shark take essentially different courses from each other, especially in relation to the Arteria efferentis branchialis:the former courses always medial to this artery, while the latter is situated laterally to this artery in the branchial arch. The Ramus pretrematicus, in this regard, seemed rather to be equivalent to the Ramus comitans internus a. branchialis of the intermediate branches of the N. glossopharyngeus. Filamentous branches were observed to be emitted from the Ramus externus comitans a. branchialis and distributed to the gill lamellae.


The anatomical relationship of the middle ear and the jugular bulb. The authors have studied the relationship of the superior jugular bulb with the cavity of the middle ear through the examination of 200 temporal bones. It was observed that the jugular fossa presents a prominence in the tympanic cavity in 54 (27%) cases, and was also found dehiscenses on the osseous wall which protects the bulb (in 2 cases) and absolute absence of this wall in one case. It was verified the variability of the degree of exposure of both, the hypotympanum and the fossula of the cochlear fenestra by the prominence of the jugular fossa.


Os penis of the rat. II. Morphology of the mature bone. A morphological description of the mature os penis and its related structures in the rat is presented. The description aims at being a natural introduction to studies of histomorphological and histochemical events during the development of the bone. The causal interest of this topic is due to a recently published observation of a rare reaction for presence of alkaline phosphatase in the proximally positioned growth cartilage of os penis. The study, thus, presents a systematical description of the position of os penis in relation to the soft tissue structures of glans penis, of gross morphology of the bone, of its periosteal covering and of the distribution of the bone types, which together form the mature bone. The observations result in an introduction of a systematical terminology, based on the Latin language. Furthermore, certain phenomena concerning a distally positioned cartilagenous process, and the distribution of bone tissue types in os penis are observed and discussed. Together with the phenomenon earlier mentioned these phenomena need further attention in future studies of the bone.


Musculus levator glandulae thyroideae: an observation. An occurance of M. levator glandulae thyroideae is reported and its frequency of appearance is established at one in 203 cases (0.49%). The importance of this and similar observations of anomalous gross morphological structures are discussed.


Use of the positive difference transform for RBC elimination in bone marrow smear images. The use of an algorithm with a broad range of utility in digital image processing (the positive difference transform) is illustrated. Its effectiveness as a procedure for selective elimination of hemoglobin-containing images is demonstrated. A set of heuristics, employing information concerning nuclear hemoglobin content, is shown to discriminate nucleated erythrocytic cells from those of the leukocyte series.


A comparative cytopathologic study of noninvasive and invasive squamous cell carcinoma of the lung. Atypical cells and tissue fragments from the sputum of patients with early and advanced stages of squamous cell carcinoma of the bronchus are objectively characterized and quantitatively compared in this paper. Four classes of single-cell features of cytoplasm, nucleus, nucleolus and nuclear-cytoplasmic ratio are analyzed as a function of cell size and tumor development stage. Distinct differences in the cellular patterns are observed which may enhance cytologic discrimination between noninvasive and invasive stages of squamous cell carcinoma of the bronchus. Initial results justify the application of more sensitive measurement techniques (i.e., automated cytology) to an enlarged data base.


The value of preoperative thermography in patients undergoing reduction mammaplasty and mastopexy. The authors present telethermography as a complementary preoperative test. The procedure helps us choose the technique to be used, eliminating cases in which cutaneous glandular dissection is not advisable because of anomalous irrigation (deficient internal mammary artery). It also offers us a guide to the safe level of dissection and extirpation of the inferior internal sector of the breast, depending on the point of exit of the internal mammary vascular pedicles. Finally, it tells us which breast must be reconstructed first (the one with the least vascularization in its internal hemiglandula). Postoperative comparative telethermography may also be used to detect any pathological process that appears later.


Unilateral cleft lip repair.

Unilateral cleft lip repair. An accounting is made of twenty years' experience with a triangular flap method of cleft lip repair using a 60 degree tip angle. The inherent difficulty in standardizing the method to ensure a perfect length has been overcome by reducing the problem to a mathematical one--with a mathematical solution. A cleft lip pattern has been designed to facilitate and ensure an accurate end result.


Abbe flap on mucosal pedicle.

Abbe flap on mucosal pedicle. A difficult secondary bilateral cleft lip deformity with nasal distortion was treated with eight local flaps specifically designed for this case. One of these was an Abbe flap in which the coronary vessel in the pedicle was inadvertently divided. The judgment in handling this flap and its fate as a composite lip flap based on a narrow mucosal pedicle is reported.


Long-term survival in basal cell carcinoma metastatic to bone: a case report. A total of 97 cases of metastatic basal cell carcinoma have been reported in the literature, 22 of which were metastatic to bone. To date there has been no survival following bone metastasis. A case report of significant long-term survival--over three times the expected--is presented. The treatment described is perhaps a guideline for management of basal cell carcinoma metastatic to bone, though it is presumed the basic biological nature of the tumor determines length and quality of survival.


Familial velopharyngeal incompetence caused by myasthenia gravis. This report describes 2 cases of familial myasthenia gravis presenting as velopharyngeal incompetence. The diagnosis was made only after pharyngoplasty had been done. Symptoms suggesting possible myasthenia gravis are seen in speech therapy and cleft palate clinics, and often labeled "palatal insufficiency" without a more specific diagnosis. In spite of the fact that myasthenia gravis is usually mentioned in the differential diagnosis of velopharyngeal incompetence, it is rarely ruled out by specific studies. We urge that myasthenia gravis be ruled out by definitive tests when the cause of neuromuscular dysfunction cannot be definitely established.


"Blow-in" fracture of the orbit.

"Blow-in" fracture of the orbit. A blow-out fracture is a relatively common injury in which the orbital floor and its contents are displaced downward toward the maxillary sinus. The reverse blow-out fracture has been identified as a "blow-in" fracture. It is a rare injury in which the fractured floor of the orbit is elevated into the orbit. The second known case of a "blow-in" fracture is reported and a mechanism of injury suggested. The fracture should be looked for in trauma cases in which the anterior wall of the maxillary sinus is depressed. Treatment of this unusual fracture is outlined in a case report.


Operating room mirror for mammaplasty evaluation. Patients undergoing augmentation mammaplasty are draped so that they can sit up during the operative procedure. With the help of a mirror, both patient and surgeon can view the new contours with trial prostheses before final closure is made. A more accurate evaluation of the result is gained, and changes can be made immediately.


Low exercise R wave amplitude after myocardial infarction predicting subsequent non-sudden death. R wave amplitude was measured before, during and after exercise test in 68 men 6--8 weeks after acute myocardial infarction. During 6-years follow-up 21 patients died suddenly (within one hour) and 25 non-suddenly. The highest mean R wave amplitude in lead CH5 during exercise test was lower in patients with subsequent non-sudden death (1.93 mV) than in patients with sudden death (2.70 mV) (p less than 0.01). Survivors (22) had the highest mean value (2.91 mV). R wave amplitude values in lead V5 at rest in the supine position before and after exercise did not differ significantly in these patient groups.


The Putti-Platt operation in the treatment of recurrent anterior dislocation of the glenohumeral joint. In this prospective follow-up investigation the results in 65 patients treated by the Putti-Platt operation for recurrent dislocation of the glenohumeral joint were analysed. The data was collected at follow-up examinations performed one year after operation and from the replies to a questionnaire distributed to the patients 2--6 years postoperatively. Analysis of the data showed that 95% of the patients considered the condition of the shoulder joint as good or at least as better than preoperatively. During the period of follow-up 23 redislocations occurred and 25% of the patients experienced postoperative pain in the operated shoulder joint. Postoperative limitation of movement of the joint was in general slight and did not hinder normal activities. Owing to the high frequency of redislocation the Putti-Platt operation is not recommended in any event for active sportsmen, since redislocation occurred to a statistically significant extent more often in this group than in other patients.


In vitro measurement of phosphorus in small bone biopsies using 14 MeV neutron activation analysis. In studying diseases of bone such as osteoporosis and renal osteodystrophy it is important to have an index of change in bone mineral content. For this purpose we describe a method for measuring the phosphorus content of 100--150 mg bone biopsies. Femoral and iliac crest biopsies from 6 cadavers were each paired with a standard bone of similar size and irradiated with 14 MeV neutrons for 10 minutes. A special rotor ensured the same activating flux across both sample and standard bone which were both wrapped in aluminium foil. The 28Al generated from bone phosphorus (31P(n,alpha)28Al) and the 27Mg generated from the aluminium foils (27Al(n,p)27Mg), which undergo beta-decay have useful gamma rays at 1779 keV and 844 keV respectively. These gamma rays were counted using a 110 cm3 Ge(Li) detector and a rotating frame permitting four 30 s counts of sample and standard alternately (interval for rotation 10 seconds) in identical geometries. Using this system the phosphorus content of the biopsies could be determined with a coefficient of variation of 4.6% using the standard bone as reference and 6% using aluminium foil as reference. In dense bone the P/dry weight ratio was 30--50% greater than in spongy bone. The clinical value of the method is discussed.


The results of surgery and radiotherapy in the treatment of small carcinomas of the thoracic oesophagus. The clinical features and results of treatment of 100 patients with small thoracic oesophageal carcinoma first seen in surgery and then in radiotherapy were analyzed. The difference in mean ages between operated and irradiated series was sixteen years. The resectability rate of surgical series was 86%. It was possible to complete radical radiotherapy in 96% of cases. The 5-year crude survival rate was 14% in the whole material. The 5-year relative survival rates in operated and irradiated series were 26 and 5%, respectively. Both surgery and radiotherapy had a little better prognosis in the lower third of the thoracic oesophagus. The comparison of our results with these of other oesophageal carcinoma series was very difficult, because the series differ in many respects. We believe that surgery followed by radiotherapy when resection is palliative, and radiotherapy when surgery is not possible produce comparable results with any other method in the treatment of thoracic oesophageal carcinoma.


Left ventricular response to dynamic and static exercise: evaluation by radiocardiography in healthy men. The effects of dynamic and static exercise on left ventricular haemodynamics were compared in 13 healthy male volunteers using single detector radiocardiography. Static hand grip effort was performed for four minutes at 30% of the maximum contraction. During dynamic exercise the subjects bicycled on an ergometer to 85% of the predicted heart rate for their age. Static exercise increased the heart rate, systolic and diastolic blood pressure and cardiac output (p less than 0.001 for all), but there were no significant changes in the stroke volume, left ventricular end-diastolic volume or ejection fraction from the resting values. Dynamic exercise in a supine position clearly increased the heart rate, systolic blood pressure and cardiac output (p less than 0.001 for all) to a greater extent than the hand grip, together with a significant augmentation of the stroke volume (p less than 0.001) and the ejection fraction (p less than 0.01). The dynamic exercise produced only an insignificant increase in left ventricular end-diastolic volume. Thus, the normal left ventricular volume response to the increase in preload during dynamic exercise was a significant augmentation of stroke volume and ejection fraction. On the other hand, the static exercise in the same subjects mainly increased the left ventricular afterload while the left ventricular volume changes remained minimal.


[Demonstration of a cytotoxic activity in the dog due to "K" cells]. Among the mononudear cells which participate in the different immunological mechanisms of cell destruction, the "K-cells" can induce in man, rat and mouse a cytotoxicity cell mediated depending on IgG type antibodies. Utilizing methods based on research works in man we were able to detect the presence of this K-cell in the peripheral blood of dogs.


[Studies of Acanthodactyla in Tunisia. II. Biometrical relations]. The four species of the g. Acanthodactylus Wieg., 1834 occuring in Tunisia are quite individualized by their biometrical relations which, moreover, allow to bring out their relationships. The size of the upper quarter in our sampling oppose two groups of two species each one. The distribution of the ratio between the length of the body and that of the tail place apart A. boskianus from the three other species in a more marked way for adults of both sexes than for juveniles.


[Notes on reptiles of Tunesia. VII. Observations on a double-headed snake Natrix (Reptilia: Colubridae)]. A case of a double-headed Viperine Snake Natrix maura (Linné, 1758) hatching is reported. Its two heads are side by side, about equally and perfectly developed and the neck is dual for the 8 first vertebras. Two post-pharyngeal fistulas and dissymetries in the cephalic markings and scales are noted. The origin of such an anterior dichtomy is discussed.


[Notes on reptiles of Tunesia. VI. Morphological and ecological differences between the members of the genera Tropiocolotes Peters, 1880 and Stenodactylus Fitzinger, 1826]. The distribution area, the nature of the biotopes and the morphological and biometrical features of three species of Gekkonidae without adhesive pads: Tropiocolotes t. tripolitanus Peters, 1880; Stenodactylus stenodactylus Guichenot, 1850 et Stenodactylus petriei Anderson, 1896 are reported. Their differences are analysed together with their ecological specialization.


[Percutaneous cholangiography: Chiba method, a diagnostic advance]. Employing percutaneous transhepatic cholangiography by CHIBA method in 15 patients, it was possible to visualize biliary system in 93.3% of the cases. The radiologic diagnostic of KLATSKIN tumor was observed in 2 cases, 4 cases of carcinoma of the papila of VATER, 1 case of carcinoma of the terminal choledochus, 1 case of intrahepatic neoplasia, 1 case of stenosis secondary to choledocal, trauma, and in another it was damaged by subcapsular hepatic leakage of contrast. The complications were minor. In 5 cases the patients had biliary colic at the time of the exam. In 2 cases, signals of baeteremia occurred in the day following the exam, and in 4 cases there was a small subcapsular hepatic leakage of contrast. In one case it was encountered hematoma under the capsule of the liver, during surgery. The diagnosis was confirmed at surgery in 12 cases. We concluded that the simplicity of the technic, its low cost and its diagnostic, accuracy have made it extremely useful.


Uses and limitations of the Crohn's disease activity index. The Crohn's Disease Activity Index (CDAI) proposed by a US Working Party was used in 39 Crohn's patients attending a combined medical and surgical gastrointestinal unit as out and inpatients. It proved easy to use and a range of values from 0 to 294 was obtained. Analysis of the contribution of its 8 components suggested a very considerable emphasis on well-being and haematocrit. No correlation with location of disease was found but there was a correlation with hospital admission and subjective assessment. Low values were found in several patients who, although known to have extensive disease were well on medical therapy. Therefore the Index measured the activity not the extent or presence of Crohn's disease. It is a very useful measure for clinical trials but in no way could replace full clinical assessment.


Infection by the hepatitis B virus in patients of a general hospital. The prevalence of HBsAg and anti HBs was studied in 1062 inpatients in the city of Rio de Janeiro. HBsAg positivity rates were as follows: a) acute viral hepatitis: 37.8% b) chronic hepatitis 46.67% c) chronic liver disease without hepatitis: 7.69% d)  diabetes 3.08% e) lepromatous leprosy 2.35% f) others 2.01%. The carrier state is  emphasized. Anti HBs was less frequent in patients with acute viral hepatitis than in patients with other diseases (hepatic or not). The highest levels were: a) lepromatous leprosy: 57.65% b) drug addicts: 46.15% e) diabetes: 43.3%. The high anti HBs positivity is discussed.


[Primary malignant tumors of the vermiform appendix: clinico-pathologic study of 8 cases]. In Botucatu, São Paulo, Brazil, 8 cases of primary tumors were encountered among 895 operated vermiform appendices: Five were colonic type adenocarcinomata and occurred above 40 years of age and three were carcinoids all in persons aged 25 or less. The diagnosis of appendical adenocarcinoma is almost never realized preoperatively. The importance of frozen sections in all suspicious cases is stressed since right hemicolectomy is the treatment of choice in cases of adenocarcinoma of the appendix. When malignant lesion goes unrecognized at initial operation, secondary hemicolectomy may be justified if histology shows invasion beyond the submucosa, at the line of ressection, or in lymph nodes. However, since the tumors is restricted to the mucosa, the patient must be followed with periodical radiology and endoscopy. In carcinoids limited to the appendix appendectomy is the treatment of choice.


[Dysphagia and cervical exostoses].

[Dysphagia and cervical exostoses]. Three cases of highly situated (cervical) dysphagia are presented. Compression of the oesophagus and/or its reflex contraction caused by cervical exostoses is the advanced etiopathogenic mechanism. Diagnosis should be essentially based on lateral radiographic views and endoscopic studies. Initial treatment should be conservative. In case this proves unsatisfactory, surgical excison of the exostoses is indicated.


Studies of the pathogenic avian Haemophili. The biochemical and physiological characteristics of 35 strains of avian haemophili from 7 countries were examined. All strains required V-factor but not X-factor for growth on artificial media. They produced acid in phenol-red broth containing fructose, glucose, and mannose. Acid production from other carbohydrates was variable or did not occur. Thirty-two strains were pathogenic to chickens. Pathogenicity varied with method of exposure. Hyaluronic acid was found in 9 strains. Hemagglutination of human or chicken erythrocytes was inhibited by its presence. Antimicrobial sensitivity patterns showed all strains to be sensitive to chloromycetin, erythromycin, furoxone, gentamicin, nalidixic acid, neomycin, novobiocin, spectinomycin, and tetracycline.