[Lung functions after single-lung homotransplantation in dogs (author's transl)]. Unilateral homotransplantation of the lung was performed in ten healthy mongrel dogs. Assessment of pulmonary function was obtained immediately after transplantation ten days and four weeks postoperatively. A conventional endotracheal tube was used for measurement of total lung function. A special tube was deviced for bronchospirometric measurements in dogs. A moderate increase of tidal volume and marked increase of respiratory rate and minute ventilation could be noted immediately after transplantation. Oxygen consumption was not changed significantly. There was a marked decrease in arterial pO2-level following transplantation, which was improved during the follow-up studies and found within normal limits at the tenth postoperative day. Bronchospirometry immediately following transplantation revealed equal ventilation values of both lungs, but oxygen consumption of the transplant was reduced 50% compared to the recipient's own lung. On the tenth postoperative day ventilatory function of the transplant was found close to that of the recipients own lung. Oxygen consumption in respiratory equivalent at this time averaged two thirds of the animal's own lung. Four weeks following transplantation no further significant change of respiratory function could be noted.


[Kinetoplast of the flagellate crithidia luciliae: a suitable substrate for the detection of antibodies to native, double-stranded DNA in the indirect immuno-fluorescence test (author's transl)]. Sera from 29 patients with systemic lupus erythematosus (SLE), 60 cases of rheumatoid arthritis, 34 of myasthenia gravis (MG), 10 of scleroderma and 20 control sera were investigated for the occurrence of antibodies to native, double-stranded (ds) deoxyribonucleic acid (DNA). An immunofluorescence procedure recently elaborated by Aarden and coworkers, which utilizes the kinetoplast of the hemoflagellate Crithidia luciliae as substrate, was employed. In this kinetoplast, native, ds-DNA is concentrated as a single large network. Antibodies reacting with kinetoplasts were restricted to the SLE group, with the exception of one MG serum which also exhibited a distinct kinetoplast fluorescence. The antibody activity of the SLE sera could be completely inhibited by small amounts of DNA and abolished by deoxyribonuclease treatment of the substrate. These findings underline the specificity of the test system for anti-ds-DNA antibodies and the high disease-specificity of these antibodies for SLE. With respect to its ease and speed of performance this highly reliable and specific flagellate test surpasses other known tests for the detection of anti-ds-DNA antibodies.


[Extracorporeal lung perfusion in experimental canine lung transplantation (author's transl)]. The present paper describes a simple method for the extracorporeal hypothermic perfusion of isolated lungs during the experimental lung transplantation in the dog. Two different solutions were used: sodium chloride-solution and Dextran-electrolyte-solution. The temperature of the perfused lung falls to 14 degrees C. The water-content is significantly increased by using the sodium chloride-solution, it is slightly increased after perfusion with Dextran-electrolyte solution. The total phospholipid-content is decreased in lungs perfused with sodium chloride-solution, it is significantly increased in lungs perfused with Dextran-electrolyte-solution.


[Bilateral abscessing coil-pneumonia with aspergillus-superinfection and unknown metastasing bronchial carcinoma (author's transl)]. A report on a 43-years old patient who fell ill with a bilateral abscessing coli-pneumonia with secondary aspergillus settlement. After a 10-week treatment with a continuous progression of the lung lesions the patient died of a respiratory insufficiency. At autopsy a multilocular metastasing squamous cell carcinoma has been found in both upper lobes of the lungs as the primary disease.


[The so-called "benign gonoccocal sepsis"]. Five female patients with benign gonococcal sepsis were seen during the second half of 1974. All cases presented the typical clinical triad of fever, arthralgias and characteristic skin lesions, the macroscopic and microscopic appearance of which could be best classified as superficial vasculitis. Skin biopsies were taken from 3 patients and the histopathological findings are discussed in detail. Genital symptoms were slight or absent, and only very few gonococci could be detected in stained smears from genital sites. However, Neisseria gonorrhoeae could be cultured without difficulty from the genitourinary tract in all cases, while cultures from blood and skin lesions were sterile. In fresh pustules gonococci could be demonstrated by immunofluorescence in 2 cases. The complement-fixation-test is regarded as a useful supplementary diagnostic procedure.


[Comparative studies on the detection of Y-chromatin in native and formalin-fixed tissue or organ material (author's transl)]. Frequency of detectable Y-bodies in interphase nuclei after mepacrin staining of paraffin embedded formalin-fixed tissue was compared with those of cryostat sections of the native material and organ smears with and without formalin fixing. In formalin fixed smears from males 42--70% of investigated cells showed the Y-body. Sections of formalin-fixed and paraffin embedded male organs demonstrated in 12--24% of their cells the typical fluorescence for the Y-chromatin. High significantly less fluorescent Y-like bodies were found in smears and sections of all proofed organs from women prepared in the same manner. Mepacrin staining in combination with investigation of Barr-bodies permits a fast determination of sex of both organ smears and sections, too.


Influence of E. COLI POLysaccharide on the interaction of E. coli K+ and K- with polymorphonuclear leukocytes in vitro. Both a K+ strain and a K- strain of E. coli withstand phagocytic killing by polymorphonuclear leukocytes and do not stimulate the respiratory burst, that accompanies phagocytosis in these cells, as compared with E. coli J 53 which are extensively and rapidly killed and stimulate the respiration of leukocytes. Both K+ and K- E. coli become readily phagocytosable after removal of their polysaccharide by heat treatment and are able to stimulate oxygen consumption by PMN. Heat treated E. coli J 53 stimulate the oxygen uptake of PMN less than live E. coli J 53. The polysaccharide extracted from either K+ or K- E. coli inhibits both phagocytosis of and the respiration stimulated by all the three heat-treated strains used. Instead the polysaccharide extracted from the phagocytosable strain J 53 stimulates the oxygen consumption of PMN exposed to the heat treated K- strain or heat treated J 53 itself.


[The fecal flora of man. IV. Communication: Comparison of the newly developed method with the old conventional method for the analysis of intestinal flora (author's transl)]. The results of 42 fecal flora analysis of healthy adult men were compared by using a newly developed method and an old conventional method. Statistical estimate indicate, that with the new method the total counts and the counts of bifidobacteria, catenabacteria (eubacteria and anaerobic lactobacilli), peptostreptococci, and clostridia (except Cl. perfringens) as well as the occurences of peptostreptococci and spirillaceae were significant higher than with the use of the old method. On the other hand the counts and occurences of bifidobacteria, veillonellae, Cl. perfringens, Megasphaerae and aerobes were similar with both method. With the new method the total counts of feces of healthy adult men nubmered 1-2 X 10(11) per g wet weight, and fastidious anaerobes, such as bacteroides, catenabacteria and peptostreptococci, were always occurred as predominant flora. The results suggest that the conventional anaerobic jar method is inadequate for the isolation of fastidiuos anaerobes and indicate that the use of modified medium 10 in combination with strict anaerobic technique is necessary for the analysis of fecal flora.


[Comparative studies on the antimicrobial activity of alpha, beta-unsaturated aldehydes (author's transl)]. A number of alpha, beta-unsaturated aldehydes were tested under standardized conditions for their antimicrobial activity against bacteria, yeast, fungi, spores and mycobacteria. It was found that the germistatic activity of the unbranched compounds is some what better than that of the branched ones. The germicidal activity is significantly depending on the structure of the aldehydes, alpha-alkyl substituted compounds showing the best results. Compounds with high activity and a broad activity spectrum are 2-ethyl-hexen-2al, 2-isopropyl-5-methyl-hexen-2-al and 2-propyl-hepten-2-al, these compounds are specially active against spores and mycobacteria.


Changes in blood coagulation due to pancreas transplantation in dogs. Blood coagulation was studied in the course of 11 pancreatectomies and 7 pancreas transplantations. Comparison of the postoperative changes in the fibrinogen level suggests the important role of the normal pancreas in fibrinogen generation. Investigation of the indices of the coagulation and fibrinolytic system revealed in the post-transplantation period a shift in the activity of the coagulation indices towards hypercoagulability. The increased fibrinogen level, the inhibited fibrinolysis and the elevated activity of the coagulation factors are assumed to be responsible for the high incidence of thrombotic complications associated with transplantation of the pancreas.


[Management of experimental heart injuries]. Treatment of 28 stabbed heart wounds in 15 dogs was done with traditional suturing or by means of an adhesive and Surgicel. The combination of Surgicel with adhesive ensured adequate closure of the wound and healing. The method is recommended for the treatment of human heart injuries in certain cases.


[Enzyme-histochemical studies of ischemic damage to the pancreaticoduodenal graft ready for transplantation in the dog]. The ischaemic lesion of the pancreaticoduodenal graft prepared for transplantation was studied by enzyme histochemical methods. Estimation of lactate dehydrogenase, non-specific acid and alkaline phosphatases and esterases and of glucose-6-phosphatase pancreas. While in the pancreas, lesions due to warm ischaemia will appear after one hour, the same can be observed in the duodenum after 30 minutes and in both organs the lesions progress rapidly. Lesions resulting from cold effects appear in the pancreas after three hours and remain unchanged for 15 to 18 hours, while in the duodenum they will appear after one hour and deteriorate considerably after three hours. Continuous perfusion for more than 30 minutes or the glucose perfusion test performed after cold ischaemia of more than two hours duration considerably affected the enzymes of the organs.


Modulation of pituitary responses to synthetic LH-RH by gonadal steroids in women with secondary amenorrhoea. LH-RH stimulation tests were performed on two successive days in 25 women with secondary amenorrhoea of probable hypothalamic origin by intravenous injection of 150 mug of synthetic LH-RH. The patients were selected by exclusion of definite pituitary or ovarian disease and in the absence of clinical or laboratory evidence of androgen excess. Five women received successive LH-RH stimulation tests only without administration of steroid hormone. Twenty women were treated with gonadal steroids in addition to the double LH-RH stimulation test by intramuscular injection of the steroid 4 h after the first LH-RH injection. Of these 20, 9 received oestradiol (Oe2), 5 received progesterone (P) and 6 received Oe2 + P. Gonadotrophin responses to LH-RH in successive tests without steroid were not significantly different. Oe2 or P alone each produced suppression of LH and FSH responses to LH-RH in the second test as compared to the first. Combined Oe2 + P produced augmentation or suppression of the second gonadotrophin responses depending on the dose of Oe2 administered. The results demonstrate a direct effect of oestrogen or progesterone alone and in combination on the pituitary responsiveness to LH-RH. The effect of the combined steroids can be modified by variation in the oestrogen: progesterone ratio.


Secretin-induced insulin response. I. Cubital insulin concentration in normal, obese and pancreatectomized patients, including portal insulin concentration in normals after secretin. Intravenous injection of the gastro-intestinal hormone secretin elicits an increase in the insulin concentration in the cubital vein. In 10 normal weight non-diabetics and 10 obese non-diabetics the latter group gave a hypernormal insulin response. By the simultaneous determination of the insulin concentration in the cubital and portal veins and also by an investigation of 2 pancreatectomized patients, it was demonstrated that an increase in the cubital insulin concentration following intravenous injection of secretin was due to an altered secretion from the pancreas and not to an altered elimination of insulin.


Secretin-induced insulin response. II. Dose-response relation. Twenty-four patients--5 normals, 5 obese subjects, 9 normal weight maturity-onset diabetics and 5 obese maturity-onset diabetics--were subjected to stimulation with the gastro-intestinal hormone secretin (GIH, Stockholm, Sweden). Secretin was administered by rapid intravenous injection 6 times every 30 min in doses increasing from 0.9-90 pmol/kg body weight. Radioimmunological insulin assay and blood glucose determination were carried out. The secretin-induced maximum insulin response rose in all groups with increasing doses. D50 (16 pmol/kg body weight) was identical in all 4 groups. Thus, the diabetic B cells exhibited the same sensitivity to secretin as the normals. Obese subjects already showed a significant insulin response after 0.9 pmol secretin/kg, whereas the response of normal weight subjects did not rise until the dose was 3.6 pmol/kg. This, combined with the normal D50, indicates an increased B cell mass in obese subjects.


Long-term effects of a low extracellular glucose concentration on glucose metabolism and insulin biosynthesis and release of mouse pancreatic islets maintained in tissue culture. In order to study the long-term effects of a low extracellular glucose concentration on the metabolism and insulin production of the pancreatic B-cells a tissue culture system was applied in which isolated mouse pancreatic islets were maintained for 1 week in vitro at a glucose concentration of 0.6 mg/ml. Short-term experiments at the end of the culture period showed that both the oxygen uptake and the glucose oxidation were depressed but could be stimulated by increasing the glucose concentration of the incubation medium. Although incorporation of [3H]leucine into proinsulin and insulin was markedly depressed it could still be enhanced by increasing the glucose concentration of the incubation medium. By contrast, the insulin release could not be stimulated with glucose alone but with glucose plus theophylline a subnormal stimulation was achieved. The insulin response to glucose was, however, maintained when the glucose concentration of the culture medium was equal to or above 0.75 mg/ml. Similarly, the glucose sensitivity of the low-glucose cultured B-cells could be restored by raising the glucose concentration of the culture medium to 1.1 or 3.0 mg/ml during the last 2 days of culture. The results suggest that the insulin biosynthesis remains sensitive to glucose even when islets have been previously exposed to a low-glucose concentration for a prolonged period of time. The observations also support the view that the impaired insulin release in response to glucose observed during fasting reflects a lack of glycaemic stimulus to the B-cell.


Toxoplasma cysts in vaginal smears.

Toxoplasma cysts in vaginal smears. Toxoplasma cysts in vaginal smears in women have been found. Exact identification of these cysts is of the greatest importance in order to avoid false positive diagnosis for cancer. From the epidemiological point of view, this finding supports the theory of transmission from cysts located in the female genital tract.


Response to pentagastrin in Man. IV. Dose-response characteristics. An analysis has been made of the gastric response of 7 individuals to a set of 5 dose rates of pentagastrin, given on different days or in sequence on the same day, in order to identify constraints on the use of secretory data in determining 'kinetic constants', such as ED50 or CMR. It has been shown that errors arise from the use of near-threshold doses of pentagastrin; too short periods of stimulation, and variant responses to pentagastrin. We conclude that values of ED50 are best considered as only qualitative, rather than quantitative, indices of sensitivity to pentagastrin.


The role of calcium in pancreatic secretion and disease. Calcium enters the pancreatic juice from two sources, one fraction associated with enzyme protein and another small fraction presumably by diffusion. The calcium concentration in pancreatic juice is lower than in plasma. It decreases with high flow rates and increases asymptotically to plasma concentration with low rates. In chronic pancreatitis calcium concentration is raised in the secretin-stimulated juice. After pancreozymin in moderate chronic pancreatitis it is low but in severe stages of the disease it is high signalling total dissociation from the entrance of enzyme protein, which is very low in these cases. Hypercalcemia stimulates enzyme secretion in the pancreas, hypocalcemia inhibits it. Calcium is essential for intracellular processes associated with secretion, the exact place in the sequence of "stimulus-secretion-coupling" still being unknown. Calcitonin as one of the hormones which regulates calcium homeostasis, inhibits secretion of enzymes but not of fluid and bicarbonate. The action of the parathyroid hormone on the exocrine pancreas is unknown. In primary hyperparathyroidism with chronic hypercalcemia acute and chronic pancreatitis occur 10 to 20 times more frequently than in the general population. In acute pancreatitis of whatever origin hypocalcemia is atypical feature of the disease indicating bad prognosis. The mechanism of its development is still unclear. In chronic pancreatitis the forming of calcified stones in the ducts is typical in cases associated with alcoholism, with protein malnutrition and with primary hyperparathyroidism. But it occurs also in cases with unknown etiology signalling a more general pathophysiological phenomenon. The calcium salts form a precipitate on protein plugs in the juice, which have been observed even in early stages of the disease in the small and larger ducts of the gland.


[Ascites in patients under chronic hemodialysis]. In this collaborative study 9 cases of intractable ascites in chronic hemodialysis patients are evaluated. Six patients died within 14, two more within 18 months after onset of ascites. Possible causes of the pathogenesis (repeated fluid overload, hydrostatic and oncotic pressure flux forces, alteration of membrane permeability) are discussed. Renal homograft transplantation seems to be the only successful treatment.


Ultrastructure of cells of Treponema pertenue obtained from experimentally infected hamsters. Cells of Treponema pertenue Gauthier obtained by elution from skin lesions and lymph nodes of experimentally infected hamsters were studied in the electron microscope by means of negative staining. The cells were also examined in thin secions of skin biopsies and lymph nodes. Fimbriae were observed on the negatively stained cells. Until now fimbriae have not been demonstrated on negatively stained cells of other species of Treponema, but at present only one straon of T. pertenue has been studied in our laboratory. Otherwise, the ultrastructure of the T. pertenue cells was found to be very similar, if not identical to, the substructural details observed in cells of T. pallidum and T. cuniculi. In thin sections of skin biopsies, treponemes were observed in the intercellular spaces between cells of the stratum basale and the stratum spinosum layers of the epidermis.


Comparison of the agglutination and the co-agglutination techniques in T-tying of Streptococcus pyogenes. A comparison of two different methods in T-typing 200 Norwegian group A strains is reported. The traditional agglutination technique was compared with the co-agglutination method of Christensen and co-workers. Fifty-five strains could not be typed by either method. The typing results for 128 of the strains were in agreement. The most common T types were the folloiwng: 1, 4, 8, 12, 13, 28, and strains belonging to the T pattern 5/11/12/27/44.


Flaming of biopsy specimens for bacteriological culture: surface sterilization and effect on bacteria in the underlying tissue. The effect of flaming (i.e. dipping biopsy specimens in alcohol and igniting them by drawing them rapidly through an open flame) on the reduction of bacterial surface contamination and on true bacterial concentrations in underlying tissue was investigated in different sizes of liver biopsy specimens in an experimental model suitable for quantitative and statistical calculations. Different degrees of surface contamination and of bacterial concentrations in underlying tissue were examined after a varying number of flaming procedures, the study comprising a total of 400 biopsy specimens. The flaming procedure repeated three times was able to eradicate a surface contamination of up to 10(4) E. coli per biopsy specimen, whereas a contamination of 10(6) E. coli per biopsy specimen was reduced to only 10(3) E. coli. Undesirable reduction in the true bacterial concentrations in tissue did not invalidate the method from a quantitative bacteriological point of view, since the median reduction in bacteria per gram tissue in biopsy specimens of 1 cm3 size did not exceed a factor of 3 after three repeated flamings. It is concluded that in regard to surface sterilization the method is unreliable as a routine in postmortem bacteriological studies.


Grouping of beta-haemolytic streptococci by using coagglutination, precipitation or bacitracin sensitivity. This study was made to compare coagglutination to precipitin test in grouping beta-haemolytic streptococci from clinical specimens and to investigate the accuracy of the bacitracin test in identification of group A streptococci. Results of grouping 126 strains with coagglutination and precipitation were identical in all except two cases. These two strains were nongroupable with precipitation but appeared as group B and C by coagglutination. When the distribution of group A, B, C and G streptococci in various clinical sources was investigated it was found that group B strains were the most frequently (41 per cent) isolated streptococci and even in isolates from pharyngeal swabs their proportion was 33 per cent. The accuracy of the bacitracin test in identification of group A streptococci was unsatisfactory as 26/62 (42 per cent) strains reported as group A by using this test were in fact group B, C or G streptococci. One of the reasons for this high number of false positives appeared to be the medium used for the preparation of the blood agar plates. In view of the frequent occurrence of non-A-streptococci in clinical specimens and high incidence of false positive in the bacitracin test it is suggested that this test should be replaced by a more efficient method of serological grouping.


Thioridazine in the treatment of depressive patients. In a double-blind study of 44 depressive in-patients, treatment with placebo appeared to give equally good results as did treatment with thioridazine. Both treatment procedures permitted the additional prescription of chlordiazepoxide when the patient's condition indicated the need for anxiety reduction. The use of chlordiazepoxide was more frequently necessary with treatment with placebo than with treatment with thioridazine.


Magnification angiography in the evaluation of transplanted kidneys. Conventional and magnification angiography were performed on 34 occasions in 31 patients with renal allografts. The differential diagnosis between acute rejection and tubular necrosis was uncertain. In chronic rejection, where vascular abnormalities dominate, the diagnosis was easier. The magnification angiography demonstrated the small intrarenal arteries to better advantage, resulting in a more accurate assessment of the condition.


In vivo and in vitro selection of mitogen responsive lymphocytes in patients with chronic lymphocytic leukemia. The in vitro mitogen response of blood lymphoid cells from patients with chronic lymphocytic leukemia was observed to be low compared to lymphocytes from healthy subjects. However, highly responsive cells could be separated from the blood of such patients by a buoyant density centrifugation technique and such reactive cells were found to be enriched by treating the patients with chemotherapy or splenic irradiation.


Excretion of metabolites of biogenic amines in patients with irradiated brain tumours. The metabolities of biogenic amines were determined in the 24-hour urine samples of patients submitted to surgical removal of a malignant brain tumour and subsequently to telecobalt therapy of the corresponding head region. A significant increase in the excretion of 5-hydroxyindoleacetic acid (5-HIAA), vanillinmandelic acid (VMA) as well as of free 3-methoxy-4-hydroxy-phenylglycol (MHPG) during the period of irradiation was found. This increase is presumably the result of radiation induced release of their parent amines from the brain; in the case of VMA the secondary response of the peripheral sympathetic system might occur.


Immunofluorescent demonstration of the presence of protein HC on the surface of human lymphocytes. Indirect immunofluorescence was used to demonstrate the presence of protein HC on the surface of a large percentage of normal human peripheral blood lymphocytes. Protein HC is a recently described charge heterogeneous, complex-forming glycoprotein normally present in human plasma, urine and cerebrospinal fluid. The synthesis of protein HC by lymphocytes was indicated by the removal of the glycoprotein from the cell surfaces on trypsinization of the cells followed by the reappearance of the protein on continued cultivation of the cells.


Effect of 16, 16-dimethyl prostaglandin E2 methyl ester on gastric secretion induced by pentagastrin and pepton meal in man. In 14 healthy male volunteers the effect of 16,16-dimethyl PGE2 methyl ester (PG/D) on gastric secretion have been studied. Gastric secretion was stimulated by an intravenous infusion of pentagastrin (2 mug/kg/h) with gastric juice collected by aspiration or by a pepton meal with acid secretion determined by intragastric titration technique. Intragastrical administration of PG(D) resulted in a strong decrease of gastric acid and pepsin secretion in tests with pentagastrin. PG(D) caused almost complete inhibition of gastric acid response to a pepton meal accompanied by a marked decline of pepsin concentration in the gastric juice as well as significant reduction in the serum level of immunoassayable gastrin. No side effects were noted during or in succeeding 24 hours after administration of PG(D).


Ceruloplasmin: the copper transport protein with essential oxidase activity. Ceruloplasmin, the blue copper-protein of vertebrate plasma, has been reviewed mainly from a functional point of view. However we have surveyed the chemistry and state copper in the molecule because of the implications of the recent data of Ryden (13,28). His observations suggest that unless special precautions are taken in the isolation of ceruloplasmin degradation, probably proteolytic, produces fragments of various sizes. When isolated, these fragments appear to be held together by noncovalent interactions. Comparison of their catalytic and spectral properties reveals no significant differences from a single homogeneous species of molecular weight of 134,000 isolated by Ryden's methods. On the other hand, the homogeneous molecule may differ in properties highly sensitive to conformation and three-dimensional parameters. Three types of copper atoms have been identified in ceruloplasmin, but their amino acid environment is still unknown. Ceruloplasmin possesses significant oxidase activity towards Fe(II) and numerous aromatic amines and phenols. Its ferroxidase activity has led to the discovery that it is a molecular link between copper and iron metabolism. Ceruloplasmin mobilizes iron into the plasma from iron storage cells in the liver. An equally important duty is that ceruloplasmin, after its rapid biosynthesis in the liver, serves as a major copper transport vehicle, comparable to transferrin. Evidence is accumulating that the copper atoms of ceruloplasmin are a prerequisite for copper utilization in the biosynthesis of cytochrome oxidase and other copper proteins. The ability of ceruloplasmin to release copper at specific cellular sites may be related to its broad substrate spectrum of biological reducing agents. A possible third role of ceruloplasmin is as a contributor to the regulation of the balance of biogenic amines through its oxidase action on the epinephrine and the hydroxyindole series. Thus ceruloplasmin is a copper-protein with several important functions, all of which are directly related to its oxidase activity.


Alcoholic hepatitis.

Alcoholic hepatitis. Alcoholic hepatitis is the precursor of cirrhosis. Susceptibility is independent of amount and duration of ethanol intake or of diet. Centrilobular hyalin, the key morphologic abnormality, sensitizes lymphocytes to secrete factors which may account (in part) for necrosis, liver cell destruction, increased collagen synthesis and development of cirrhosis. Diagnosis may be facilitated by detection of alcoholic hyalin antigen (AHAg) and antibody (AHAb) in serum of patients with alcoholic hepatitis. Treatment requires abstinence. Steroids have not reduced mortality rates. Measures to improve immunologic reactivity may be helpful. Persons unable to abstain should be enrolled in a surveillance group.


The effect of intravenous digoxin on the occurrence of ventricular tachyarrhythmias in acute myocardial infarction in man. Patients with acute myocardial infarction were allocated to two groups according to a double blind-system of radomization. The patients (n = 18) in one of the groups received digoxin intravenously as an injection of 0.01 mg. per kilogram of body weight during 10 minutes. The patients in the other group (n = 15) received saline and served as controls. A continuous ECG record was obtained from each patient during 1 hour preceding the administration of digoxin or saline and was continued for 3 hours following the injection. No antiarrhythmic treatment was given during the time of the study. Based on the continuous ECG, calculations were made of the relative incidence of patients with different types of ventricular tachyarrhythmias during the period of observation as well as the percentage of arrhythmia-containing 1 minute intervals observed during this period. There was no statistical difference between the incidence of ventricular tachyarrhythmias in the two groups in the 1 hour period preceding drug injection. The administration of digoxin and saline did not change the incidence of ventricular tachyarrhythmias and there was also no statistically significant difference between the two groups as regards the incidence of patients showing different types of ventricular tachyarrhythmias during the 3 hour period following drug administration, Considering the 1-minute intervals, those without any ventricular premature contractions were less in the digoxin group (92 per cent) than in the saline group (88 per cent; p less than 0.001). Serum levels of digoxin at the end of the observation period were well above what is considered the minimum therapeutic level and in three patients the level approached or reached the toxic range. In these three patients there was still no increased incidence of ventricular tachyarrhythmias. It is concluded that patients with acute myocardial infarction complicated by incipient left ventricular failure do not show an increased sensitivity to an ordinary dose of digoxin as measured by the occurrence of ventricular tachyarrhythmia.


[Hypersensitivity to "Candida albicans" and other fungi in patients with chronic urticaria]. Considering the high incidence of chronic urticaria among female patients and the frequent difficulty in identifying the etiologic factor of factors the author decided to investigate the possible role of Candida albicans and other yeasts usually found as contaminants in certain foods and beverages or purposely cultivated for industrial products, as the sensitizing agents leading to the clinical picture of chronic urticaria. One hundred female patients with urticaria which had persisted for more than 6 weeks were selected and investigated, disregarding those with dermographism or cholinergic and cold urticaria. Aside from a careful history and laboratory tests to complement the physical examination that could rule out chronic bacterial infectious foci, intestinal parasitic infestation and thyroid disorders, intradermal skin tests with standard doses of Candida albicans and Saccharomyces cerevisiae and other common environmental and food allergens were done. The patients' age ranged from 4 to 70 years. The skin tests sites were examined for Type I reactions at 15 and 20 minutes; for Type III reactions at 8 and 12 hours; and for Type IV reactions at 48 and 72 hours. When tested with Candida albicans antigen, 35% had Type I/III reactions and 60% presented Type IV reaction. When Saccharomyces cerevisiae antigen was used for testing, 29% had Type I/III reactions and none presented Type IV. Forty-nine of the sixty patients who presented Type IV reaction to Candida albicans had in the past significant vaginal discharge (or vaginal symptoms: burning, itching) that obliged the patients to consult a gynecologist, but only ten had stained smears and cultures from the vaginal secretions and four were told to have a monilia vaginal infection confirmed by the microbiological tests, although forty of them received Nistatin therapy at the time of the gynecological complaints. At the time the patients were seen by the allergist, complaining about urticaria, only four had symptoms and signs of monilia infection and were confirmed by culture: one presented oral moniliasis following broad-spectrum antibiotic, two had vaginal moniliasis developing right after their menstrual period; one had intestinal and cutaneous manifestations (perineal and crural) developing also after broad-spectrum antibiotic therapy. All the four patients had exacerbation of the urticaria while undergoing the monilia infection. After 1-2 weeks of elimination diet, each patient was challenged with yeasts-containing foods (bread, buns, sausages, beer, wines, grapes, cheese, vinegar, tomato catsup). Twenty-five patients (71%) of the group who positively reacted with a Type I/III reaction when tested with Candida antigen, showed a positive provocation test (reappearance of urticaria) and twenty patients (69%) of the group who reacted with Saccharomyces had a positive challenge test...


Left ventricular bypass using a cardiac allograft: hemodynamic studies. Human allograft bypass of the failing left ventricle is an efficient and practical way of effecting short-term improvement in the overall hemodynamic status of patients. It is suggested that controlled sequential pacing of the donor heart would improve the overall hemodynamic result and better preserve function of the bypassed ventricle. Simultaneous bypass of the right ventricle might prevent the acute right heart failure seen during serious ventricular arrhythmias occurring in the recipient heart. Future indications for the technique in modified form could include severe biventricular failure and acute reversible forms of heart failure.


Coronary bypass surgery after renal transplantation. Aortocoronary bypass surgery was performed in three patients with incapacitating angina pectoris who had previously had successful renal transplantation. All patients had initial symptomatic improvement. Although two have mild angina pectoris, there is objective improvement in their exercise tolerance and in ischemic ST-T changes on treadmill exercise testing. One patient, who also had resection of a left ventricular aneurysm, remains free of angina but is symptomatic from congestive heart failure. There were no postoperative complications. To our knowledge, these three cases are the first in which aortocoronary bypass surgery has been performed successfully in patients who have had renal transplantation. Anticipated problems with infection in view of the immunosuppressive therapy and renal problems postoperatively were not encountered.


Home culturing program for children with recurrent bacteriuria. One hundred forty-one children were selected from a clinic for children with recurrent bacteriuria to participate in a home culturing program. The parent was taught to employ a semiquantitative method to test the child's urine for bacteria. The degree and persistence of bacteriuria as detected by the parent strongly correlated with results obtained in the clinic, although there was a significant incidence of false-positive results as detected by the parent. Home culturing proved to be an inexpensive, reliable technique for following up children with recurrent urinary tract infections.


The incompetent pyloric sphincter. Bile and mucosal ulceration. The patient with gastric ulcer (GU) has abnormal reflux of bile-containing duodenal contents into the stomach. Antral gastritis is prominently associated with GU and is more extensive with severe reflux and with ulcer chronicity and probably when bile salts are accompanied by other constituents of duodenal fluids. Smoking is significantly associated with GU, and it produces reflux in normal subjects and in patients with duodenal ulcer, which in turn is commonly associated with GU. Reflux has not been shown to precede either the gastritis or the gastric ulcer and probably persists despite ulcer healing. The pyloric spincter in the patient with GU probably contracts subnormally to endogenous or exogenous secretin or CCK. This can be explained by associated hypergastrinemia since antral acidification improves the response. Because the pylorus may be usually open, abnormal reflux may be related as much or more to disturbances of other gastroduodenal functions known to control the movement of chyme through what may be a relatively passive pyloric zone. Speculation from animal models implicates bile reflux in aspirin-induced and shock-related gastric ulceration and assigns to bile a possible explanation, in part at least, for the apparent therapeutic efficacy of a carbenoxalone derivative and an antipepsin agent. Similar speculation warrants a search in the patient with GU for abnormalities of gastroduodenal peristalsis-related electric activity and for impaired release of secretin, possibly from antral cells of production. Possible abnormal purinergic inhibition of the gastric fundus and pylorus also warrants further study.


99mTc-tagged chicken liver as a marker of solid food in the human stomach. Past measurement of gastric emptying of solid food in man has depended on external counting of surface-absorbed isotopes without verification that isotopic labels remain attached to solid food in the stomach. In this study chicken liver was isotopically labeled with 99mTc incorporated uniformly and intracellularly throughout the liver substance. In vitro studies showed less than 10% loss of 99mTc from liver incubated with pepsin HC1. By contrast, up to 90% of 51Cr absorbed to scrambled eggs became detached under similar conditions. In feeding experiments less than 10% of 99mTc was liberated from fed 99mTc liver, while significantly more 51Cr became detached from egg under identical intragastric conditions. We conclude that 99mTc-tagged chicken liver is an adequate marker of the rate of emptying of solid food and appears to be more reliable than 51Cr-labeled scrambled eggs from which 51Cr dissociates in the stomach.


Primary upper small-intestinal lymphomal A report of 40 cases fron Iran. Primary upper small-intestinal lymphoma (PUSIL) has now been recognized as a distinct clinical entity with a distinct geographic distribution. Herewith are presented 40 cases of PUSIL seen at Pahlavi University Hospitals in Southern Iran. The investigation reveals the lymphoma to be predominantly a disease of those under 30 and males; the major complaints and physical findings point to an intraabdominal disease. An exception has been clubbing and osteoarthropathy. Special features of PUSIL include: (1) protein loss into the gastrointestinal tract leading to hypoalbuminemia and edema; (2) an antibiotic-responsive diarrhea and steatorrhea; and (3) an associated abnormal heavy-chain protein. The study further stresses the importance of peroral small-intestinal biopsy and the pathologic features of this condition.


Use of pharmacokinetic principles in drug therapy: a suggested topic outline and reading list. A suggested topic outline on pharmacokinetic principles in drug therapy, complete with a bibliography of articles demonstrating important principles and applications, is provided for practitioners interested in implementing inservice continuing education programs. The outline follows that for a course required of all B.S. and Pharm.D. students in the College of Pharmacy and Allied Health Professions, Wayne State University. The bibliography of readings is current through 1975 but is not intended to be comprehensive.


Flow diagrams for processing urine cultures. A protocol is presented for the processing of clean voided urine specimens, indwelling and nonindwelling catheter specimens, and special specimens, e.g., suprapubic aspirations, ureteral and kidney specimens, etc. Flow diagrams were developed which allow all urine cultures to be processed in a consistent and efficient manner. Criteria have been established to indicate when definitive identification and antimicrobial susceptibility testing are necessary.


Impact of cephalosporin prophylaxis on conization-vaginal hysterectomy morbidity. A prospective, randomized, double-blind evaluation of Loridine-Keflex prophylaxis in a homogeneous group of 32 patients undergoing sequential cervical conization and vaginal hysterectomy is reported. There was no infectious or febrile morbidity in the 18 oatuebts receuvubg abtubuitucs, Morbidity occurred in six of 14 patients receiving placebos (P is less than 0.05). Antibiotic prophylaxis and conization-hysterectomy morbidity are discussed.


A study of blood coagulation parameters. The object of this study was to determine the presence or absence of abnormalities in a variety of blood coagulation parameters in women on contraceptive medication. A prospective double-blind study involving a control group with a total study enrollment of 211 women during a 29 month period was established. Although research has not proved that changes in coagulation parameters will cause abnormal clotting in normal patients, a pattern appears to be developing involving antithrombin III determinations. Corresponding patterns do not appear to be developing in the other blood coagulation parameters.


A critical evaluation of the Schiller test in patients before conization. The results of the Schiller test were recorded in 87 patients before conization and in 100 healthy control women having normal cytologic examinations. Large proportions of quadrants with iodine-unstained areas were found in both the experimental and the control series. In the 87 patients, the histologic examination of the cone specimens revealed false positive Schiller tests in 32 per cent of the patients with unstained quadrants, and false negative tests in 60 per cent of the patients with iodine-stained quadrants. The Schiller test proved to be unreliable in detecting or rejecting dysplasia or carcinoma in situ at the surgical margin of the conization specimens.


The induction of ovulation.

The induction of ovulation. A treatment plan utilizing placebo, cyclical steroid therapy, clomiphene citrate, and human pituitary gonadotropin is outlined for the induction of ovulation in carefully selected potentially fertile women. Such a plan minimizes any risk with the potentially hazardous ovulatory stimulants. A total of 220 patients with secondary amenorrhea were studied and an etiologic basis for the condition was found in 98 (45 per cent). Of the 220, 190 were found suitable for the induction of ovulation, and together with 145 patients with oligomenorrhea and 17 patients with anovulation, entered the treatment plan. Ovulation was successfully induced in 351 of the 352 (99.5 per cent) and pregnancy in 218 (61.9 per cent). The success rates for the agents in the various conditions are presented and discussed.


A new corneal trephine.

A new corneal trephine. A new corneal trephine, using suction and disposable razor blades, comprised two cones, one revolving inside the other. A slide mechanism was attached to the inner cone that inclined a disposable razor blade either vertically or at 20 degrees, assuring clear view of either side of the incision and more accurate centering. The effective diameter of the cut was varied continuously from 8.5 to 2.0 mm.


Cryopreserved endothelial cell survival in vivo. We observed the endothelium of a cryopreserved penetrating corneal transplant with the clinical specular microscope at intervals from one day to two months after keratoplasty. An intact endothelial mosaic was observed at each examination, documenting the survival of cryopreserved endothelial cells after penetrating keratoplasty in humans.


In vitro astrocytic differentiation from embryoid bodies of an experimental mouse testicular teratoma. Astrocytic differentiation in monolayer cultures of ascitic embryoid bodies from the experimental teratoma OTT-6050 was studied by conventional light microscopy and by indirect immunofluorescence with antisera to glial fibrillary acidic (GFA) protein, a protein specific for astorcytes. Primitive neuroepithelial cells were identified in 24-hour cultures. Within 72 hours, two cell types diverged. One cell type, with a flattened epithelial morphology in early cultures, demonstrated delicate GFA protein-positive fibrils within 48 hours. In later cultures, this type progressively displayed more typical stellate astrocytic features, with denser, more compact GFA protein-positive  fluorescence in the perinuclear cytoplasm and cell processes. As indicated by GFA protein expression, the appearance of astrocytes of typical morphology therefore was preceded by biochemical differentiation. The second cell type, interpreted as neuroblastic, failed to demonstrate GFA protein and had a small perikaryon with slender bipolar processes that were argyrophilic with Bodian's protargol in late cultures. Divergent neuroepithelial differentiation occurred within mitotically active cell populations and proceeded without apparent tissue relationships to other germ layer derivatives.


Interstitial nephritis. A brief review.

Interstitial nephritis. A brief review. Interstitial nephritis is a common condition, which in spite of a relatively constant pathologic picture has different etiologic agents and pathogenetic mechanisms. Failure to appreciate this, particularly in the chronic group, has led to considerable confusion and has been largely responsible for the overdiagnosis of chronic pyelonephritis. Although we are still largely ignorant of the causes of interstitial nephritis, it is now possible to define many of them. While experimental studies have not made spectacular contributions to our understanding, an attempt is now being made to develop appropriate models, and we hope these will enable us to still further clarify our understanding of other entities.


Factor VIII synthesis: hepatic and renal allografts in swine with von Willebrand's disease. Transplantation experiments were utilized to study the possible sites of synthesis of von Willebrand factor (vWF) and factor VIII (F VIII) activities. Three normal kidney and two normal liver allografts were implanted into five swine with von Willebrand's disease (vWD) that survived for 1,6, and 7, and 4 and 9 days, respectively. The correction of the multiple hemostatic defects of vWD by organ transplantation was evaluated using the F VIII procoagulant activity, bleeding time, and platelet aggregating factor (PAF) levels; i.e., vWF levels. Normal kidney allografts produced no changes in the bleeding times or increases in F VIII or PAF. Transfusions for surgical hemostasis produced transient increases in F VIII and PAF. In animals receiving normal liver allografts, the levels of F VIII exceeded 100%, PAF was increased, and sustained correction of the bleeding time and maintenance of hemostasis was observed. These data suggest that the kidney is incapable of synthesizing either the vWF or the F VIII and that cells contained in the liver, possibly the endothelial cells, are one of the sites of synthesis of these factors.


Cocaine, kindling, and psychosis.

Cocaine, kindling, and psychosis. The authors review the evidence that repetitive administration of central nervous system stimulants and other compounds may be associated with progressively increasing effects on pathological behavior and seizures rather than tolerance. They suggest that the progressive effects of these compounds may be related to electrical kindling, a phenomenon in which repetitive subthreshold stimulation of the limbic system is eventually associated with major motor seizures. They review the studies supporting a pharmacological kindling mechansim and suggest a kindling model for psychological stimuli that combines neurophysiological, biochemical, and psychological perspectives.


EPSDT- one quarter million screenings in Michigan. Since the spring of 1973, Michigan's EPSDT program has screened more than 300,000 children. The Department of Social Services contracted with the Department of Public Health to design the screening and referral parts of the program; in turn the Department of Public Health contracts with local health departments to do screening with one or more teams composed of a nurse, two technicians, and a clerk. The 72 teams screen 10,000 clients each month. More than one-half of these clients are referred for diagnosis and treatment. The highest percentage (27 per cent) of referral is for dental care; the second highest (26 per cent) is for immunization. Participation in the program of state and local social services departments, local health departments, and all groups of health providers has been excellent. There continues to be a high no-show for screening and a moderate no-show rate to providers for diagnosis and treatment. Evaluation of the program elements is needed.


Bovine carotid heterograft for segmental ureteral substitution. Substitution of segments of traumatized or diseased ureter has been attempted often with little success. The ideal ureteral subsitute has yet to be found, and experiments with the newer biologically inert prosthetic materials such as the bovine carotid artery heterograft are warranted.


Urinary lysosomal enzymes for detection of acute renal allograft rejection. Six patients who received renal transplants were closely monitored to compare the sensitivity of urine levels of beta-galactosidase and N-acetyl-beta-glucosaminidase with conventional clinical and laboratory parameters in the detection of impending rejection. A rapid (60 minute), simple, accurate fluorometric assay was used to measure activities of both enzymes. Eighty per cent of ten rejection episodes were accompanied by a two- to sixfold increase in enzyme release. Parallel changes in serum creatinine levels and urinary volume occurred in six rejection episodes, but in two episodes, elevated urinary enzyme levels were observed two and four days prior to clinical evidence of rejection. It is concluded that urinary lysosomal enzyme measurements by fluorometric assay are valuable indicators of acute renal rejection, particularly when the diagnosis is not clearly established by conventional criteria that show only minimal changes. Continuing studies in a large group of renal transplant recipients are under way to evaluate the validity of this conclusion and to determine whether enzyme measurements, will, indeed, be indicative of early rejection.


The practice of surgery in the fourteenth century. Henri de Mondeville details a method of wound healing that emphasizes early debridement and primary closure. In Guy de Chauliac's advice on the treatment of groin hernias, he demonstrates an early if unsophisticated understanding of the principles of high ligation of the sac and repair of the direct defect.


Orthotopic renal homotransplantation in a patient with thrombosis of the inferior vena cava. Complete thrombosis of the infrarenal vena cava and the entire iliac venous system is a unique circumstance in a candidate for renal allotransplantation. This condition was created in a patient by the previous use of an inferior vena cava clip. The patient received a kidney transplant in the orthotopic intra-abdominal position, using his own renal vein for renovenous anastomosis. The usual method of urinary drainage was also modified. This approach to transplantation should be considered in the presence of partial clotting or occlusion in the distal vena cava or iliac venous system.


Use of the bipedicle flap in radical neck dissection for head and neck cancer. Many advantages of the bipedicle flap have become obvious in our large volume of head and neck surgery, especially in patients who have received radiation therapy. Not once has carotid blowout occurred after utilization of this type of incision.


Intermittent positive pressure ventilation in infants and children. The Long term effects in 74 survivors. Seventy-four infants and children surviving after more than 12 hours IPPV are discussed with reference to long-term physical and mental development.


Psychiatric problems in intensive care. Five patients with acute confusional states and depression. Five case histories are presented of patients with multiple trauma or severe infection, who developed psychiatric symptoms after an initially favourable response to intensive therapy. Alterations in the level of consciousness and behavioural pattern were observed, associated with the presence of acute depression, possibly primarily endogenous in origin. Following intravenous Clomipramine administration, considerable improvement was noted in all five patients, regarding both the depressive state and the clouding of consciousness. The importance of recognising psychiatric disorder in severly ill patients in an intensive therapy environment is stressed.


Continuous positive airway pressure. The collection of expired gases. A low dead space, low resistance, non-rebreathing valve is described. When used with a constant pressure source it enables the expired gases of patients being managed on CPAP to be collected for physiological analysis. It also functions as a collect valve during normal spontaneous respiration and during IPPV.


PEPP and the Bird ventilator. Application of a positive end expiratory pressure plateau to the Bird ventilator for assisted and controlled ventilation. A device is described with which the PEPP may be used with the Bird ventilator (mark 7 or 8) during assisted and/or controlled ventilation. Advantages over other currently available systems providing PEPP are discussed and these include ease of use, cheapness, versatility and safety.


[Studies on the structure of thalamo-cortical projection neurons and interneurons in the Corpus geniculatum laterale pars dorsalis of albino rats after different histological treatments]. 1. In the dorsal part of the lateral geniculate body of the albino rat (Wistar strain) the identification of relay neurons and interneurons has been carried out and the findings in Golgi and Nissl preparations were compared with those in the semithinn sections and in the electron microscopic preparations. 2. The effect of different histolical treatments (perfused by Karnovsky's fluid and embedded in micropal; immersed or perfused by Bouin's fluid, formalin or glutaraldehyde and embedded in celloidine or paraffin) in the structure of the relay neurons and the interneurons in combination with the Nissl method is described. 3. Following immersion the cytoplasm of the relay neurons is relatively broad and has a rough structure in the extreme case (glutaraldehyde) it is vacuolized due to hypoxie or anoxie. In these preparations we could not extimate dark neurons. 4. Following perfusion the cytoplasm of the relay neurons has a fine structure and is more narrow than following fixation by immersion. Furthermore the cell nucleus is enlarged. 5. The identification of interneurons is possible to a high degree of security only after fixation with one of the both aldehydes according to the well-known criteria. When Bouin's fluid is applied the chromatin particle at the nucleolus as one of the important discriminators is not represented. 6. In the single groups the relay neurons were characterized by quantitative parameters. As statistical method of calculation the paired comparison is used. The findings about the semithinn sections are regarded as the standard values because this material is expected to give the most reliable equivalent picture. 7. In 9 out of 12 cases the diameter of the cell soma is smaller and in 3 cases larger than the standard value. 3 values (perfused by Bouin's fluid and embedded in paraffin; immersed by formalin and embedded in celloidine; immersed by glutaraldehyde and embedded in celloidine) do not present remarkable deviation from the standard value. 8. Amongst the diameters of the nuclei only one value is larger than the standard value. 7 values do not significantly differ from the standard value, among them the values of meterial perfused by Bouin's fluid and embedded in paraffin and also immersed by formalin and embedded in celloidine. 9. All the quotientes from soma diameter and nucleus diameter are significantly different to the standard value. The difference between the values of immersion by Bouin's fluid and the standard value is the smallest one. 10. Although the values of soma diameter and nucleus diameter of the mateiral following perfusion by Bouin's fluid and embedding in paraffin as well as following immersion by formalin and embedding incelloidine are not significantly different to the standard value, we prefer immersion by formalin and embedding in celloidine because it is the most suitable method solving the special problems concerning the identification of relay neurons and interneurons in Nissl preparations and the metrical comparisons with findings in Golgi investigations.


Transplantation of the fetal rat pancreas: quantitative morphological analysis of islet tissue growth. When pancreases from fetal rats were transplanted beneath the kidney capsule of isologous normal adult recipients, continued growth and differentiation of the endocrine portion of the pancreas occurred. While limited amounts of acinar tissues were identifiable in the early transplant period (7 days), such cells were absent in long term transplants (14 and 21 days). In contrast, while few definitive islet beta cells were present at the time of transplantation, following 21 days at the kidney site large circumscribed islets comprised of heavily granulated beta cells in association with duct epithelial cells predominated. Mitotic figures were seen in both these cell populations. Total islet mass had increased over 20-fold during the transplantation period. Similar results were observed if fetal pancreases were grown in organ culture for ten days prior to transplantation. Continued islet and duct cell growth, as evidenced by mitotic figures and an increase in absolute islet cell mass was obtained in such cultured explants when transplanted to either isogenic or allogenic recipients. These observations support the hypothesis that fetal pancreas may be the best source of donor material for transplantation to diabetic recipients, in part due to the continued growth and differentiation of the islet tissue during the transplantation period.


Tooth attrition and the temporomandibular joint. 1. It is thought the differences shown to exist between the unworn sample and the worn sample would have been clearer if the criteria for the classification of worn had been more severe. Examination of the ranges of measurements would make one suspect some subjects suffered dental attrition to a degree that no enamel was left on the occlusal surfaces of the third molars without showing damage elsewhere. The author did not feel competent to assess third molars that had not only lost all their occlusal enamel but also one mm of dentin, so was unable to make his worn classification more stringent. Again the reader is reminded that broeken down or "worn out" dentitions were specifically excluded from the samples...


A comparative study of some dental cements used in orthodontics. It is suggested that decalcification occurring beneath orthodontic bands is, among other factors, related to the tensile bond strength of the cement to the enamel surface, its marginal leakage at the enamel-cement interface, and its solubility and and disintegration. Under the laboratory conditions described in this study the composite cement exhibited the greatest tensile bond strength to both enamel and band material. The composite cement also displayed no marginal leakage at the enamel-cement interface and showed no solubility or disintegration under the experimental conditions. It could therefore be anticipated that, of the four cements evaluated in this study, the composite cement would have the greatest potential for eliminating pathologic enamel decalcification occurring beneath orthodontic bands.


Butorphanol and morphine: a double-blind comparison of their parenteral analgesic activity. The analgesic effects of butorphanol tartrate and morphine sulfate were compared in 127 patients judged to have moderate to severe pain following major operations. The study was double-blind, and the drugs were given IM at several dosage levels. Scores for pain intensity and relief, as well as pain-intensity difference, were determined at 30, 60 and 120 minutes after medication, then were analyzed by a parallel-line assay method in a modified computer program. The analysis indicated butorphanol tartrate to be 7 times as potent as morphine sulfate. Peak analgesic effects were obtained at 60 minutes with both drugs. Side effects were minimal in degree and incidence. Neither butorphanol nor morphine induced any changes in blood pressure, pulse rate, or respiratory rate. These data, along with those from studies elsewhere, suggest that butorphanol is a safe, potent, and effective analgesic agents, with probably a low potential for inducing drug dependence.


[Statistical evaluation of biochemical data by the method of discrimination analysis. Selection of the discriminant biochemical variables. Attempted biochemical discrimination of intrahepatic cholestasis, extrahepatic obstruction and liver cancer]. An original method of statistical treatment of biological data is proposed. It permits satisfactory biochemical classification of 322 patients divided up into 3 groups : intrahepatic cholestasis (235 patients), extrahepatic obstruction (44 patients) and carcinoma of the liver (43 patients). On the basis of 32 tests, it was possible to define discriminating areas permitting satisfactory diagnosis in 95 per cent of published cases. The reduction in the number of tests necessary for diagnosis was considered. The selection technic used was original to the extent that it dose not require, like most methods used today, the determination of better individual discriminators, but the establishment of a better discriminating subunit, obtained from the initial subunit composed of a group of variables. From the 32 parameters contained in the standard liver function tests, a search for a better discriminating subunit consisting of the best four tests, permitted the authors to select a group of 10 tests : bilirubin, alkaline phosphatase, 5-nucleotidase, Thymolturbidity, Cetavlon test, serum albumin, total LDH, TGP (ALAT), OCT, GLDH, of which the discriminating value remains very satisfactory.


[Criteria and validity of continuous measurement of pO2 and pCO2 in man]. After description of a method of continuous measurement of partial pressure of blood gases, the authors describe the technical difficulties : behaviour of the electrodes, problems associated with continuous measurement, and emphasise the influence of the method on the results, e.g. heparinisation, blood flow rate, quantity of blood consumed. The results obtained under suitable physiological conditions show the difficulty of interpretation of continuous measurement of gaseous parameters and show interest in short but significant function tests.


Clinical pharmacology of oxolinic acid in young dairy calves. The in vitro sensitivity to oxolinic acid shown by pathogenic gram-negative bacterial isolates from young calves with diarrhea, pneumonia, and septicemia was investigated by the bute dilution method. Minimal bactericidal concentrations of the drug for 65.5% of the isolates were less than or equal to 1.56 mug/ml and for 90%, less than or equal to 6.25 mug/ml. Cross resistance between oxolinic acid and chloramphenicol, streptomycin, neomycin, colistin, ampicillin, gentamicin, and oxytetracycline was not observed. Oxolinic acid was orally administered to a group of calves at dose levels of 12.5 to 57.0 mg/kg, and sodium oxolinate was intramuscularly injected in another group of calves at dose levels of 12.5 and 20 mg/kg. In the 1st group, oxolinic acid was detected in blood serum 15 minutes later; peak serum concentrations averaged 25 mug/ml at 10 hours after treatment with 50 mg of the drug/kg and 3 mug/ml at 7 hours, with 12.5 mg of the drug/kg. In the 2nd group, the dose level of 20 mg of sodium oxolinate/kg resulted in mean peak serum concentration of 4 mug/ml, observed 1 hour after the drug was injected. The half-life of the drugs in serum was approximately 3.5 hours after they were orally or intramuscularly given. These investigations indicate that oxolinic acid could be used in the treatment of the common calf diseases.


Effect of lincomycin on prevalence, duration, and quantity of Salmonella typhimurium excreted by swine. Thirty-one swine (7.5 kg live wt) were fed diets which contained 0 or 110 mg of lincomycin/kg. These pigs were then inoculated with a nalidixic acid-resistant strain of Salmonella typhimurium and monitored for 56 days thereafter to determine (1) the quantity of S typhimurium shed in the feces, (2) the length of time the organism was shed, and (3) the number of swine which shed the organism for the 56-day period after exposure. Addition of lincomycin to diets did not alter these 3 criteria from those obtained in S typhimurium-exposed nontreated swine when results for nontreated and treated swine were compared. In addition, the sensitivity of the S typhimurium strain to 8 antibiotics, 1 nitrofuran, and 1 sulfonamide was not affected by in vivo exposure to lincomycin for 39 days. Lincomycin did not produce adverse effects in either inoculated or noninoculated pigs.


Sensitivity of Escherichia coli after exposure to lincomycin in vitro and in vivo. Exposure of 10 Escherichia coli isolates in vitro to a concentration of lincomycin found in the intestine of swine fed the maximun concentration recommended in feed did not significantly affect sensitivity to 8 antibiotics, 1 nitrofuran, and 1 sulfonamide when compared with sensitivity of E coli isolates not exposed to lincomycin. Changes in sensitivity, on the basis of Kirby-Bauer interpretation, did occasionally occur; however, these alterations were in zonal sizes, which were marginal for designation as sensitive, intermediate, or resistant. These same fluctuations were observed in E coli not exposed to lincomycin. Exposure of E coli to lincomycin in the intestinal tract of swine for 34 days did not alter sensitivity of E coli to tetracycline, dihydrostreptomycin, spectinomycin, lincomycin, or triple sulfa. The results indicated that addition of lincomycin to the feed did not appear to promote resistance transfer in E coli.


The multipartite genome of brome mosaic virus: aspects of in vitro translation and RNA structure. The multipartite nature of the brome mosaic virus genome is described. Particular attention is given to the translation of the RNAs in cell-free extracts, from dry wheat seed embryos and commercial wheat germ. Such studies have demonstrated that the smallest RNA is a monocistronic message for coat protein. This cistron is also carried on the intermediate sized RNA, which also codes for a larger protein, of unknown function. Translation of the larger RNAs 1 and 2 is compared, incell-free extracts of wheat embryo and wheat germ. There is evidence that these RNAs may also be monocistronic messages for large polypeptides (molecular weight 100,000), indicating that there are few non-translatable regions on these RNAs. Some recent nucleotide sequence studies are described, including the ribosome binding site of the coat protein cistron, and the 3' termini of all four RNAs, which appear to be identical, at least over a region of 150 nucleotides.


Statistical resolution of genetic heterogeneity in familial disease. If a disease can be split into two or more groups on any criterion (clinical, biochemical, physiological or statistical) then the grouping can be tested to establish if genetically independent forms of the disease have been identified. The data required are simply the frequencies of the two disease groups in relatives of probands for each of the disease groups. A systematic search for such distinct groups is proposed in searches for genetic heterogeneity in familial diseases. In disease forms with overlapping, correlated genetic liabilities, the method of Falconer (1967) can be used to estimate the genetic correlation. However, when the groupings of the disease are confounded (such as one form precluding the other as in early and late onset diabetes) Falconer's method will be biased. Special methods of analysis to estimate the genetic parameters have been developed and are presented here. However, even when the groupings are confounded the Falconer method still gives reasonable estimates of the genetic correlation, in that they are unlikely to seriously mislead the investigator in the analysis and interpretation of observed data. In practice Falconer's simple method may be preferred to the more complex methods developed here because it involves fewer assumptions and can be applied over a wider range of circumstances.


[Helminths of birds and mammals from Israel. VI. The taxonomy and ecology of Trichostrongylid Nematodes (author's transl)]. Thirteen species of trichostronglyloid nematodes have so far been recorded from wild birds and mammals in Israel and surrounding territories. Three species were found in birds: Amidostomum fulicae (Rudolphi, 1819) in Fulica atra L., 1758, A. acutum (Lundahl, 1848) in Anas crecca L., 1758 AND Amidostomum sp. in Ceryle rudis L., 1758. Ten species, 3 of which are new, were found in small mammals: Trichostrongylus colubriformis (Giles, 1892) in Hystrix indica Kerr, 1792; Tenorastrongylus josephi n. sp. in Mus musculus L., 1758; Nippostrongylus brasiliensis (Travassos, 1914) in Rattus norvegicus Berk, 1796 and Rattus rattus L., 1758; Nippostrongylus witenbergi Greenberg, 1972, in Nesokia indica Gray et Hardw., 1832; Heligmonina nevoi n. sp. in Spalax ehrenbergi, Nehring, 1898; Boreostrongylus seurati (Travassos et Darriba, 1929) in Gerbillus allenbyi Thomas, 1918, G. pyramidum Geoffrey, 1825, G. (Dipodillus) dasyurus, Meriones sacramenti Thomas, 1922 and M. tristrami Thomas, 1892; Boreostrongylus minutus (Dujardin, 1845) in Microtus guentheri Danford et Alsen, 1880; Heligmosomoides polygyrus polygyrus (Dujardin, 1845) in Apodemus mystacinus Danf. et Alst., 1877 and A. sylvaticus L., 1758; Suncinema witenbergi n. sp. in Crocidura russula Herm., 1780. Ecologic and zoogeographic relationships are discussed.


Racial variations in the incidence of congenital malformations. Racial variation in the incidence of several common congenital malformations has been studied in Atlanta, Georgia. The white-to-black incidence ratios were substantially different from unity for single defects, while approximate equality of rates was noted for multiple defects. Amongst the specific malformations for which familial data were available, affected first- and second-degree relatives were found only in the families of probands with single defects. It is postulated that these findings may indicate a more prominent function of the environment in the genesis of multiple malformations than is the case for single defects, the occurrence of which may be more strongly affected by non-sporadic genetic factors.


[Thermotolerance of the Candida. Relationships with ecology, pathology and taxonomy (author's transl)]. An investigation on the maximum temperature of growth is reported on 477 strains of Candida, 23 species and 1 variety, including species actually not identied as Candida, but well known under that generic name in medical and veterinary mycology. C. pseudotropicalis is the most thermotolerante species (49 degrees), C. albicans coming only in second position (42 degrees -48 degrees); the less thermotolerante species is C. humicola (29 degrees), but the less thermotolerante strain is a C. sake (26 degrees -32 degrees). The relationships between the maximum temperature of growth and the ecology, the pathology and the taxonomy are discuted. In the group C. krusei a linkage between the maximum temperature and the utilisation of a sugar has been established, auguring a more close relation between the thermic characteristic and the enzymologic equipment of a yeast.


[Search for antibiotic antimetabolites]. Special media have been developed during the past years, which provided detection of new antibiotics with the properties of antimetabolites produced by microorganisms. Antimetabolites of amino acids, vitamins and nucleic acids were found among the antimetabolite antibiotics. The antimetabolites of nucleic acids with an antitumor activity were most interesting. This group of the compounds included 5-asacytidin and antibiotic 1719 identical to azotomycin.


[Resistance of acylase-forming strains of E. coli to penicillin]. The role of penicillinacylase in resistance to penicillin of various strains of E. coli differing in the levels of acylase produced was investigated. All the strains produced simultaneously acylase and beta-lactamase. A preparation of pure acylase and an antiacylase immune serum were used in the experiments. The sensitivity testing was accompanied by chromatography of the culture broth with a purpose of finding penicillin inactivation products. A principle possibility of increasing the culture resistance to penicillin under the action of acylase was found. However, in testing the strain sensitivity with a method of serial dilutions the conditions for synthesis and action of acylase were unfavorable. Therefore, the main factor of the culture resistance to penicillin was beta-lactamase and not acylase.


[Tetracycline and the primary immune response]. The effect of tetracycline on proliferation of plate- and rossette-forming cells in the spleen and mesenterial lymph nodes of rats in case of the primary immune response with respect to the sheep erythrocytes was studied using the methods of Jerne, Notta and Zaalberg. It was found that tetracycline acted as an inhibitor when it was administered 48 hours before introduction of the antigen. When they were administered simultaneously its inhibiting effect decreased. When tetracycline was injected 24 hours after the antigen administration it had induced stimulation of immunogenesis. The inhibiting effect of the antibiotic was more pronounced with respect to the plate-forming cells and less pronounced with respect to the rossette-forming cells. The inhibiting effect of the antibiotic was lower in the mesenterial lymph nodes than in the spleen. The problem of independent antibody genesis in the lymph nodes is discussed.


[Random immunoglobulin. I. Use of chaotropicions and fluorescence quenching for quantitating the non-specific adsorption in the interaction of human IgG with rhodamine B]. It is shown that, when excited in the visible range, fluorescence of the dye may be either quenched or enhanced, from its initial value Fo, by addition of increasing "normal" immunoglobulin (IgGH7 S), depending if the solution is "non-chaotropic " (NaF 0,1 M) or "chaotropic" KI 1 M). Let F be the fluorescence obtained at concentration P in protein, then the plot of the quantity P.F/(FO-F)against the quantity P.F/(FO-F) gives a straight line; the zero ordinate of this is the inverse of the non-specific interaction equilibrium constant. Quenching of fluorescence by increase of temperature, and by increase of concentration of salt (KI) are also quantitatively dealed upon in order to testify that this non-specific interaction is of the "adsorption" type. Concentration of dye is 10-6M; concentration of protein is varied from 0,05 % to 0,5 %.


[Comparison of the efficacy of 3 methods of testing for the sterility of eye ointments with antibiotics]. Efficiency of 3 methods for testing sterility of antibiotic ophthalmic ointments was compared. During storage of antibiotic ophthalmic ointments infected with bacteria some "self-sterilization" takes place mainly due to death of the antibiotic sensitive bacteria. The results of determination of the ointment non-sterility depends on the level of their bacterial loading, sensitivity of the cultures to the antibiotic and time of the culture contact with the antibiotic in the ointment before its testing. The method of the ointment solution in isopropylmiristate filtration through a membrane filter followed by washing of the filter from the antibiotic and its placing into a thioglycol medium proved to be most effective for determination of bacterial admixtures in antibiotic ointments.


[Tetracycline resistance and cell-free systems of protein and polypeptide synthesis]. Acellular systems of synthesis of polyphenylalanin containing the supernatant fraction from E. coli B and ribosomes from an oxytetracycline sensitive strain of E. coli and strains resistant to that antibiotic were almost equally sensitive to oxytetracycline. The supernatant fraction from the cells of E. coli 241, a resistant strain absorbing significant amounts of oxytetracycline lowered the inhibiting effect of oxytetracycline in the acellular systems of protein synthesis (with an endogenic matrix). No fermentative inactivation of oxytetracycline by that fraction was found with both the biological and radiochromatographic methods.


[Use of media with antibiotics for isolating resistant forms of the cholera vibrios]. Higher stability of resistance to tetracycline in the polyresistant strain of V. eltor under conditions of macroorganism as compared to nutrient media was found experimentally. To increase isolation of the resistant forms of the cholera vibrio it was recommended to use agar with tetracycline or other antibiotics depending on the particular case in addition to the routine media.


[Study of the effect of rifampicin on certain immunological and protective reactions of the body]. The effect of rifampicin on formation of hemagglutinins in mice in response to administration of sheep erythrocytes was studied. The experiments showed that rifampicin administered orally in doses 10-25 times higher than the therapeutic ones did not suppress formation of the antibodies and protective mechanisms of the organism. The antibiotic did not lower the absorbing capacity of the cells by the reticuloendothelial system and the rate of phagocytosis by the leucocytes of the peritoneal exudate in mice. Rifampicin had no effect as well on adaptation of a skin homotransplant in the animals.


[Study of the growth patterns of Act. antibioticus and the biosynthesis of oleandomycin]. The study of some regularities of the oleandomycin-producing organism growth during the first stage of cultivation showed that an increase in the ammount of starch in the medium from 2 to 10 per cent promoted the growth and its specific rate. When the organism was cultivated on media with 2--6 per cent of starch, addition of ammonium sulfate in a concentration of 0.25--0.5 per cent was favourable for its growth. When the amount of starch was 8--10 per cent, ammonium sulfate in a concentration of 0.25--1.5 per cent had almost no effect on the growth and its specific rate. It was found that an increase in the amount of starch in the medium without ammonium sulfate promoted the mycelium growth and oleandomycin biosynthesis by 20 per cent, the time of cultivation being prolongated. Ammonium sulfate significantly stimulated the mycelium growth and decreased biosynthesis of oleandomycin. Additional introduction of starch solution in a concentration of 1 or 2 per cent during the first hours of the culture growth (24 hours) on the medium with 2 per cent of starch stimulated the growth, its specific rate and biosynthesis of oleandomycin by 20--30 per cent and the cultivation time increased. Simulataneous addition of starch and ammonium sulfate to the culture during the first hours of the growth (24 hours) decreased the biosynthesis of oleandomycin. The maximum respiration rate of the culture in flasks was registered in 24 hours, then it was followed by a decrease. Addition of starch and ammonium sulfate during the cultivation process, i.e. in 24, 48 and 72 hours increased every time the rate of the organism respiration.


[Effect of antimicrobial preparations on thermogenesis in yeast-like fungi and in staphylococcus]. The results of the investigation of the effect of various concentrations of levorin and decamethoxin on the curves of thermogenesis in cultures of Candida albicans 688 and Staph. aureus 209 are presented in the paper. It was found that the above drugs in the concentration ranges within 0.0001--1 gamma/ml had different inhibitory effect on thermoproduction in the microorganisms. In the presence of higher concentrations of the drugs, i.e. above 1 gamma/ml thermoproduction practically ceased. It is supposed that determination of the levels of thermoprocesses in the presence of antimicrobial drugs provided predistination of the state of the biochemical reactions in the microorganisms at various stages of their cultivation.


[Pharmacokinetic characteristics and the chemotherapeutic effectiveness of a 2% ditetracycline-erythromycin eye ointment]. The study of the antibacterial activity of ditetracycline combination with erythromycin (ratio 1 : 1) showed that the effect of the antibiotics increased with respect to most of Staphylococcus and Coli bacteria. The chemotherapeutic effect of the ointment in treatment of experimental staphylococcal conjunctivitis of rabbits was also studied. The clinical signs of the disease disappeared earlier than in the experiments with the use of ditetracycline and erythromycin ointments alone. The experiments with the rabbits revealed a prolonged effect of the ointment: ditetracycline and erythromycin in therapeutic concentrations were detected in the conjunctiva and cornea after a single application for 24--48 and 8 hours respectively.


[Study of the mechanism of action of minocycline and of certain other tetracycline group compounds]. It was shown that the mechanism of action of minocycline on intact cells of E. coli was similar to that of oxytetracycline, i.e. specific inhibition of protein synthesis. In acellular systems of synthesis of polyphenylalanine with ribosomes from tetracycline sensitive and resistant strains of E. coli, minocycline and oxytetracycline had close inhibiting activity. Therefore, the highest antimicrobic activity of minocycline was due as compred to oxytetracycline to some advantages at the stage of penetration into the microbial cell and not at the stage the protein synthesis. 4-Epi-oxytetracycline and beta-apo-oxytetracycline possessing competing properties with respect to oxytetracycline at the stage of penetration through the cell membrane did not, however, suppress the synthesis of polyphenylalanine in the acellular system isolated from the sensitive strain of E. coli.


[Antigenic properties of 1-asparaginases isolated from different species and strains of bacteria]. Immunological relation of L-aspariginase isolated from different strains of E. coli and Ervinia carotovera was investigated by the method of specific neutralization of the asparaginase effect on asparagin in the presence of immune antiasparaginase serum and the method of microprecipitation in agar. It was found that there was immunological relation between asparaginases of different strains of the same microbial species. At the same time common antigens were absent in asparaginases synthesized by different bacterial species.


[Effectiveness of capsules of the sodium salt of dicloxacillin in bronchopulmonary diseases]. Efficiency of sodium dicloxacillin in the form of capsules prepared at the All-Union Research Institute of Antibiotics was studied in treatment of 23 patients with acute pneumonia (mainly of staphylococcal etiology) and 16 patients with chronic pneumonia at the stage of exacerbation. High therapeutic effect of dicloxacillin in treatment of acute pneumonia in a daily dose of 4--5 gm was found. Satisfactory results were obtained with combined use of dicloxacillin and benzylpenicillin. In treatment of chronic pneumonia dicloxacillin was less effective. No toxic effect of dicloxacillin on the parenchymatose organs and peripheral blood was registered.


[Polyamines in microorganisms sensitive and resistant to antibiotics]. Intracellular contents of polyamine dancyl derivatives were determined by the method of thin-layer chromatography in Coli and typhoid fever bacteria sensitive to antibiotics and their variants resistant to streptomycin, levomycetin, chlortetracyline and neomycin. Increased levels of spermidine and putrescin in the antibiotic resistant cultures were found. The increased levels of the polyamines correlated with changes in the content of nucleic acids. It is supposed that the increase in the content of the polyamines in the antibiotic resistant bacteria was the result of accumulation of nucleic acids by them.


[Method for the microbiological determination of the type and concentration of antibiotics in combinations]. A microbiological procedure for determination of the group and concentration of antibiotics in combinations was developed. The method was based on the use of a collection of recombinants of test-microbes with episomal resistance (R-factor) to various antibiotics and their combinations. The collection of the test-cultures including 31 recombinant strains of E. coli obtained through conjugation provided determination of the concentration and group of any antibiotic in combination with the method of serial dilutions or agar diffusion. The antibiotics were the following: tetracyclines, levomycetin (chloramphenicol), streptomycin, aminoglycosides (kanamycin, neomycin, monomycin), penicillinase sensitive penicillins (ampicillin, carbenicillin, benzylpenicillin). The ranges of the research may be widened by including recombinants with episome resistance to other antibiotics or test-microbes with other species sensitivity to antibiotics into the collection. The procedure may be of use in experimental studies, clinical trials and screening of new antibiotics.


[Antibiotic sensitivity of the Salmonella isolated from humans ill with salmonellosis in 1967-1974]. Sensitivity to levomycetin, streptomycin, chlortetracycline, oxtetracycline, tetracycline, neomycin, monomycin and erythromycin of 548 fresh isolates of Salmonella of 32 serotypes of the main groups A, B, C, D and E was studied. The cultures were isolated from salmonellosis patients within 1967-1974. Sensitivity to neomycin, monomycin, levomycetin and streptomycin was found respectively in 96.9, 91.1, 76.5 and 74.8 per cent of the cultures. High sensitivity of the cultures was observed only to levomycetin (15.1 per cent). With respect to tetracyclines the isolates were mainly resistant (24.2-47.2 per cent) or low sensitive (25-26.5 per cent). 70.3 per cent of the strains were resistant to erythromycin and 24.1 per cent were of low sensitivity. The causative agents of typhoid fever, paratyphoid fever A and B were more sensitive to levomycetin and tetracycline as compared to other Salmonella. A polyvalent Salmonella bacteriophage lyzed from 94.2 to 100 per cent of the Salmonella cultures tested.


Salmonella in horses: a source of contamination of horsemeat in a packing plant under federal inspection. Cecal samples from 270 slaughter horses revealed that 41 samples (15.1%) contained Salmonella. Of 233 horsemeat samples tested, Salmonella was isolated from 62 samples, or 26.6%. Only 2 of 158 human stool specimens from the plant workers revealed Salmonella. Predominant serotypes isolated from the horsemeat were Salmonella enteritidis Good and Anatum, whereas the serotypes Agona and Derby predominated the horse cecal isolates. Preliminary data indicate that the high percentage of meat contamination is surface contamination due to poor slaughtering technique.


Incidence of Salmonella spp., Clostridium botulinum, and Vibrio parahaemolyticus in an estuary. A study of the incidence of Salmonella spp., Vibrio parahaemolyticus-like organisms, and clostridium botulinum in samples collected at five stations located in the Upper Chesapeake Bay, a major estuary on the Atlantic Coast of the United States, was conducted in December 1973 through December 1974. C. botulinum types B and E were detected in 12.3% of the total sediment samples examined. V. parahaemolyticus was recovered from 10.4% of a total of 86 water, sediment, and suspended sediment samples. Of 131 samples examined for the presence of Salmonella spp., approximately 3% were found to be positive for serologically confirmed Salmonella isolates. Shellfish examined during the investigation were also found to be free of enteric pathogens. The low frequency of occurrence of V. parahaemolyticus was attributed to the low salinities encountered at the sites included in the study. A low incidence of Salmonella spp. in the Upper Chesapeake Bay samples was found, whereas the distribution of C. botulinum appeared to be both random and autochthonous. A strong relationship between presence of potential pathogens and other generally accepted microbiological indicators of pollution was not observed.


Role of bacteria and protozoa in the removal of Escherichia coli from estuarine waters. The removal of Escherichia coli from estuarine water was investigated. The survival of E. coli was dependent on the presence of protozoan predators and not on the presence of lytic bacteria. When indigenous protozoa were removed from estuarine water by filtration, the destruction of coliform populations was negligible. In studies designed to prevent the growth of indigenous bacterial populations without affecting protozoan populations, coliform destruction was significant.


One-tube oxidation-fermentation methods: limitations posed by atypical fermentative reactions. Atypical fermentation in the two-tube method of Hugh and Leifson (1953), whereby acid was produced in the sealed tube but not in the open tube, was determined to be the result of a preferential metabolism of peptone over the reactant carbohydrate. These atypical fermentations are only partially detected by one-tube oxidation-fermentation methods, and as such they constitute a source of limitation to the routine use of these abbreviated techniques for oxidative-fermentation determinations.


Comparison of enrichment procedures for fluorescent antibody and cultural detection of salmonellae in raw meat and poultry. No advantage was shown in preenriching raw meat samples for detecting salmonellae by fluorescent antibodies or culture. Trypticase soy-tryptose (Edwards and Ewing, 1972) was equal to or better than selenite-cystine as a postenrichment broth.


Betamethasone dipropionate cream for the treatment of psoriasis. A collaborative evaluation. A double-blind, controlled study was performed in which eight investigators treated a total of 180 psoriasis patients with either betamethasone dipropionate cream or fluocinolone acetonide cream for four weeks. Betamethasone dipropionate cream was clearly superior to the control preparation in the degree of improvement effected and rapidity of action.


Treatment of acrodermatitis enteropathica with zinc sulfate. Control of a case of acrodermatitis enteropathica was achieved initially after three months of treatment with diiodohydroxyquin (Diodoquin). Reexacerbation of acrodermatitis enteropathica was noted two months after diiodohydroxyquin was discontinued. Treatment with zinc sulfate was substituted and resulted in dramatic and complete resolution of disease within 48 hours.


[1st experiences on the protective effect of Limulus polyphemus amebocyte lysate in the endotoxic shock in the rat]. The injection in the peritoneum of Limulus amebocyte lysate at the same time of inoculation of lethal dose of E. coli LPS is able to protect the rats against endotoxin lethality.


[Characteristics of the Salmonella and Shigella strains isolated from diarrhea patients during antibiotic therapy]. Drug resistant strains of Salmonella and Shigella were isolated from diarrhoeic children during antibiotic treatment. Two strains of Sh. flexneri serotype 2a, resistant to sulfonamides, streptomycin,chloramphenicol, and tetracyclines, were able to transfer "en bloc" their resistances to E. coli K12.


Retrospective analysis of 100 consecutive patients undergoing related living donor renal transplantation. One hundred consecutive patients receiving related donor kidneys were analyzed in regards to graft and patient survival, morbidity, mortality, histocompatibility and rehabilitation. The average followup was 3 years and 2 months with a minimum post transplant evaluation of one year. Donor morbidity was minimal and the mortality nil. Recipient mortality was 17%, all of which occurred after the first two post transplant months. The most serious life threatening complications after transplantation were due to infection. The greatest morbidity was secondary to aseptic necrosis. The overall graft survival at one year was 94%, 2 years--87%, 3 years--81% and 4 and 5 years--72%. Separation of patients according to tissue typing revealed 95% of recipients with A and B matched kidneys to be alive 5 years later compared to 55% of patients receiving C and D matched kidneys. Rehabilitation was good to excellent in 76% of the living patients and poor in only 4%. These results suggest related donor renal transplantation to be the treatment of choice for patients with chronic renal failure excluding only those individuals who are exceptionally high risks in terms of morbidity and mortality.


The treatment of hemangiomas: with special reference to the role of steroid therapy. Hemangiomas are the most common of all human birth defects. The author has reviewed a 25-year personal experience with treatment of over 1000 patients with a variety of common and rare developmental vascular anomalies. Attention is given to a more useful clinical classification of these disorders. The classification is intended to be helpful in estimating prognosis of the lesions and as a guide to the choice of therapy. Many treatment modalities are evaluated--some successful and some quite disappointing. Surgical excision, irradiation, CO2 freezing, sclerosing agents, cauterization, steroid therapy and watchful waiting are among the treatment methods evaluated. High dose--short course Prednisone therapy has proved to be a major new addition to the treatment of massive juvenile capillary hemangiomas. Numerous misconceptions have appeared in the medical literature. These are noted and a philosophic basis for present day management is suggested for each type angioma. The roles of growth, resolution, histologic picture and sense of deformity are considered in viewing the surgeon's approach to these difficult and challenging problems. Some evidence and speculations are offered as to the etiology, neurogenic influences and physiological dynamics of the various hemangiomas.


Critical analysis of treatment of stage II and stage III melanoma patients with immunotherapy. Over the past 8 years, 244 patients with Stage II or III melanoma have been treated by cutaneous injection of a crude acellular homogenate of allogeneic melanoma cells (V-I) or a more concentrated fraction (V-II), followed in most patients by exchanges of WBC between paired partners. Patients with Stage III disease exhibited an overall response rate of 24% and prolongation of survival compared with control data. Stage II patients also had prolonged survival and reduced rate of recurrence over historic peers' data. Breakdown of subgroup data revealed that V-II plus exchange of WBC is similar to V-I plus exchange or V-II alone. However, recent experience of LTF suggests a higher response rate than in either V-I or V-II groups, particularly when autochthonous tumor is used for cross-immunization. The most meaningful immunologic data resulted from analysis of DNCB and MIF data. Patients negative to DNCB rarely respond to immunotherapy. A positive pretreatment MIF or positive conversion following treatment correlates with response, whereas, conversion of positive to negative predicts poor clinical performance.


Canine lung allograft lymphatic alterations. Lymphatic obstruction has not been emphasized as a feature of lung allograft rejection. However, accumulation of fluid and cellular infiltrate, aggravated by lymph stasis, results in impaired lung function. In this study, lung specimens were recovered at varying times up to 133 days after either reimplantation (7 dogs) or allografting (29 dogs). Azathioprine and prednisone were administered to 17 allograft recipients. The presence of abnormally dilated perivascular, peribronchiolar, and subpleural lymphatic channels was a consistent histological finding, most striking in specimens recovered from untreated allograft recipient dogs. Attenuated lymphatic alterations were noted in immunosuppressed allograft recipients. In these animals the pulmonary lymphatics seemed to be ineffectual in clearing the allograft of the accumulating cellular infiltrates and fluid during rejection.